Q&A with Jo Owens, author of A Funny Kind of Paradise

Jo Owens became a nursing home aide in Canada out of a need for money, and came away with her calling. And from that experience, the pain and the human glory, came her debut novel A Funny Kind of Paradise, set in a Canadian nursing home.

The Vancouver Sun wrote “Owens…captures the skill and tenderness of caring for someone at the end of life in direct and unvarnished prose…Each [care aide] …is richly drawn and complex… [and the novel] serves to illuminate a vital profession that has been rarely documented in fiction.”

“Her writing is richly informed by her 20 years working as a care aide in Victoria, British Columbia,” said interviewer Len Fishman, head of the University of Massachusetts Gerontology Institute. And their conversation continues from there. Thanks to Taryn T. Hojlo for the interview transcription.

Author Jo Owens

LF: Let’s start by asking why you became a care aide and what’s kept you in that profession for 20 years?

JO: Actually, desperation drove me there. Much like Molly [a character in the book], an aide suggested that I take this job and that I would be good at it, and I absolutely needed money. That got me over the initial stages when it was terrifying to be doing something so new. What keeps me at it is that I have a calling for this work. I definitely ended up in the right place.

LF: The book’s narrator is Francesca, or Franny. She’s in her late sixties, and a stroke has left her unable to move, walk, talk, or eat, but Franny’s cognition is completely intact. Tell us more about her, and let’s start with you reading a passage.

JO: [reads from A Funny Kind of Paradise – youtube link]

“Franny says, ‘The stroke has left me emotionally labile, and the feelings I’ve struggled so hard to contain (or at least disguise in shrouds of anger) are naked for all the world to see. I literally lack the muscular strength to suppress them.

But here is the gift. I don’t care. I don’t care! My right hand is useless, I can’t speak and more people have seen my bare ass in the last year than if I was a streaker at the opera, because I need my diaper changed, for God’s sake. Do you think I care if you see me cry?’”

LF: Tell us a little more about her.

JO: Francesca was a strong, independent woman who ended up raising her two children on her own. She’s a home-based small business accountant, and she kind of came at life as though…if you attacked it with hammer, you’re going to get the job done. That’s not necessarily the best way to parent children, so like everyone else, she has her own baggage and things to think about. Originally, she was the kind of person who would say to herself, as you often hear people say, “If that happens to me, I would rather die.”

LF: She recalls a time when she accompanied her son’s class to a nursing home around Christmas time. When they leave, she tells him, “I’d rather be dead than have to live in a place like that.” Later she thinks, “I changed my mind when I came here.” What changed?

JO: First of all, I think that the will to live is extremely strong. We think that we can’t tolerate this, but it’s amazing what humans can get used to and even learn to embrace. Partly, that’s what’s going on, but also Franny was fortunate to end up in a good facility where she has loving care and she’s still engaged in life. She enjoys watching the care aides that work around her and gossip freely in front her because Franny can’t repeat what she’s hearing. She thinks about her children and she’s still engaged with her son who comes to see her. There’s enough in her life to make her life meaningful. This is my experience at work. When suffering becomes acute, residents do say they’d rather die. And we do hear that. But generally speaking, I find that people want to live. And they continue to want to live. Much longer than we’d think.

LF: Franny’s got issues – fear and anger are her “left and right crutches” as she puts it – and she’s really trying to work through them. Have you seen residents that you’ve cared for grow emotionally as she does?

JO: Absolutely. Absolutely I have seen people change and grow. We do. Our situations force us to. It was the famous psychologist, Karen Horney, who said, “Life itself remains a very good therapist.” Things happen. We’re forced to change, and life doesn’t stop because you’re forced into care. You’re still going to be changing. For Franny personally, I used my imagination obviously to create what’s happening to her, but as she thinks about what is meaningful in life, thinks about what she can change and what she can’t change – particularly with regard to her son, her missing daughter, and how she behaved in the past – as new residents come into her life, she is adjusting her thinking and she’s moving along in her mind, as people do. And yes, I’ve seen that in care.

LF: So, as you’ve mentioned, Franny’s brain is sharp and because she can’t talk the aides are actually more willing to speak their minds in front of her, even confide in her. What were you hoping we’d learn, through her, about the inner workings of a nursing home?

JO: One of the reasons I set this novel in a five-bed ward is because I wanted to be able to show Franny listening to people talking all the time…I wanted people to see how human your aides are…Every one of your [aides] comes with their own set of baggage. And I wanted to show some of the things that the care givers are trying to balance, some of the things that they have on their plate. The struggle that is part of life, trying to triage six to eight – or in worse scenarios, 12 to 14 – residents. Who eats what, who do you go to first? How can you give everyone good care, not just the ones that can speak up and demand it, but also the ones that are immobile and deserve just as much of your love and attention? I wanted to do that in a way that wasn’t completely preachy, and boring and I really hope that I achieved that goal because what happens in [nursing homes], in that private little world, is frequently not seen, and I wanted to show it.

LF: In Franny’s world, licensed nurses, whether it’s LPNs or RNs, are distant figures and doctors are almost entirely absent; it’s all about the aides. Is this what it looks like on the inside?

JO: I’m sure I showed quite a bit of bias there because I am a care aide, so I think it’s all about me [laughs]. But, in terms of the bulk of time caring, aides are the faces that the residents are going to see the most. I see my people every day, whereas the doctor might see you every two weeks if you have a problem, less if you don’t. The LPNs are going to see you every day also to give you your pills and if you have a dressing change, you’ll see them a little bit more. The RN, as I mentioned to you before, at my facility the RN has one hundred people. They’re going to deal with problems. So, it may be very difficult to even know their name. The care aide is the person that they see. I did an interview with a person in Toronto whose father was in care. He told me that the care aides became his father’s family. Even though I only know a small portion of my resident, the part that they are now – the whole iceberg of their previous life is unknown to me except for a little bio that might be done by a social worker or a family member – I have this tiny little part of this person, right? But they’re still mine. I have them every day. I know how they want their socks pulled up – do you want a little space at the end, or do you want them nice and snug? Do you want your tea spun like this or like that? They’re mine.

LF: I want to ask you about families of nursing home residents, especially those that visit frequently. What qualities do staff most appreciate?

JO: The first thing that’s coming to my mind, Len, is forgiveness. Maybe I’m only speaking for myself, but I want to be forgiven for my imperfections. I’m going to do the very best that I can, and sometimes it’s going to feel like it’s not enough because sometimes it’s not enough – I just run out of time. I forgot to bring your husband down for his visit, which is now going to be downstairs in the village square, or I’m not able to brush your family member’s teeth, their hair isn’t…Yeah, I want to be forgiven for the fact that I can’t do a perfect job. Maybe other care aides would speak differently.

LF: Two aides in your book are talking about the difficult daughter of one of their residents. The mother is pretty difficult, too. And one aide sums up her philosophy as follows, “If we only looked after the people who deserved kindness, it’d be a skinny job.” This is a telling commentary on the challenge of being a good caregiver, so tell us about it.

JO: This reminds me of a fridge magnet I once saw that said, “The staff are human and will react unpredictably when abused,” as opposed to being a robot. Every healthcare worker has a right to be treated like a human being. We have little signs in our elevator saying that if you don’t treat the staff with respect, you will be required to leave. But the people that I’m working with are emotionally labile and sometimes they have difficulty controlling any number of their emotions, whether it’s anger or frustration or – sometimes they yell at us, sometimes they hit us.

LF: In recognizing the time that we’re living in, in the U.S., residents account for about 40 percent of COVID deaths nationally. In Canada, the percentage is even higher. It seems to me that this hasn’t caused as much of an outcry as one might expect. What do you think?

JO: So, this is a question I was asked in the NPR interview and so I gave it a lot of thought, Len, because I had difficulty answering it. And here’s the reason I had difficulty: I do not want to contribute to our phobia of death. There is a time when it is good to die. At the same time, how we treat the more vulnerable members of our population during a pandemic is a measure of our integrity as a society. It’s really important not to get the idea that any group in our society, whether it’s their age, their ethnic background, their financial worth, their sexual orientation, that that group is in any way disposable, because that’s the kind of thinking that Hitler had. It is not acceptable.

LF: What do you want people to know about your job?

JO: Well, I was hoping that with my book I would be able to increase empathy for the people that live and work in care. But what would I want them to know? We’re here and we’re alive and just as important as anybody else – really that’s the only message.

Elder Index at Work: Helping Boston’s Age-Friendly Plan Take Aim at Economic Insecurity

This article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

Go to any city across America and you will find older adults struggling to make ends meet. Go to Boston and you will see some of the most serious elder economic insecurity problems in the nation.

This is not news at Boston’s Age Strong Commission, which first launched an ambitious age-friendly plan in 2017. The commission is now developing a Step 2 blueprint with a focus on the problem of economic security among older residents. A critical tool for that job: The Elder Index. Continue reading

New Report Ranks Elder Economic Insecurity in 100 Largest U.S. Metro Areas

Jan MutchlerOlder adults in every one of America’s large metropolitan areas face serious challenges affording their local cost of living. But the scale of economic insecurity varies dramatically, depending on what city those older adults call home.

A new report by University of Massachusetts Boston professor Jan Mutchler and graduate assistant Yang Li uses the Elder Index™ to analyze the cost of a no-frills elder budget in each of the nation’s 384 metropolitan statistical areas (MSAs), where 83 percent of older Americans live. They also tracked income levels of older adults in the 100 largest metro areas to determine what percentage of elders in those cities had insufficient income to afford their local cost of living without help.

They found a wide range of elder economic insecurity levels among both older individuals and couples living in the larger metro areas. More than 67 percent of older individuals in the Texas metro area covering McAllen, Edinburg and Mission did not have enough income to meet local expenses on their own, the highest rate among the 100 largest MSAs. Continue reading

Elder Index at Work: Helping Improve Access to Medicare Savings Programs in Massachusetts

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

The cost of health care is one of the most common economic problems facing older adults across America. In more serious cases, it can lead to a bleak choice between paying for medicine or affording other basic needs.

These are familiar facts of elder life to the Massachusetts Senior Action Council, a grass roots organization focused on public policy and community issues affecting the health and well-being of older adults.

Research on policy options to address the problem led the council to focus on Medicare Savings Programs, which help qualified beneficiaries with health costs. Though the programs are run by the federal government, states have the ability to change eligibility standards for their older adults.

The council launched a campaign to make the Medicare Savings Programs available to more Massachusetts elders. It took years but finally paid off when Gov. Charlie Baker signed the state’s 2020 budget, which included a policy that now offers an estimated 40,000 older adults access to more than $150 million in new annual benefits.

A key resource in the successful effort: The University of Massachusetts Boston’s Elder Index, a free online tool that provides realistic and detailed cost of living data for older adults living in every U.S. state and county. Continue reading

Transforming the Future of Aging

Bei Wu works toward improving health status through research and policy

If the world of academic gerontology had a rock star, it would be Bei Wu, MS ‘97, PhD ’00.

Recognized for her extensive research and pursued by top tier universities, Wu has become an international leader in the field since graduating from the University of Massachusetts Boston’s Department of Gerontology. Add the years in policy work before earning her doctorate and Wu chuckles that, having spent more than half of her life in the field of gerontology, she herself is now experiencing the aging process.

“I’ve become my own study subject,” Wu says.

Today, Wu is the Director of Global Health and Aging Research at the Rory Meyers College of Nursing, and Director for Research at the Hartford Institute for Geriatric Nursing at New York University (NYU) and the inaugural co-director of NYU’s Aging Incubator, a university-wide aging initiative.

Given her considerable success in gerontology, it’s fitting she credits her grandmother — with whom she was extremely close — for nudging her into the field. Born in Shanghai, Wu’s parents left her and her brother in their grandparents’ care when the two were young. After college, Wu accepted a research position with the Shanghai Commission on Aging only after prompting by her grandmother.

“At the time, very few people thought aging would be a challenging issue in the future,” Wu says.

But writing policy briefs and launching studies on intergenerational support with the United Nations Population Fund convinced Wu to pursue graduate studies. With no options available in China, she chose UMass Boston.

“UMass Boston has had a significant impact on my career,” Wu says. “The gerontology program has a critical mass of excellent faculty.” Continue reading

Celebrate the New Year with a Free Film Series

Programs offering community for older adults available online through the Osher Lifelong Learning Institute at UMass Boston

Watching a funny movie and discussing it with others may seem like an activity we can’t participate in given the Covid-19 pandemic. But, the Osher Lifelong Learning Institute (OLLI) at UMass Boston has a film series to keep you engaged and connected all winter. The films are free and available for anyone to download from home.

Jim Hermelbracht

This January and February, OLLI is pleased to offer prospective and current members several programs free of charge to be enjoyed in the comfort and safety of your home. Part of UMass Boston’s Gerontology Institute, OLLI provides lifelong learning, trips, and social activities for individuals over age 50.

“We are creating opportunities for all members — and future members — to stay engaged during the winter,” says Jim Hermelbracht, Director of OLLI at UMass Boston. “All programs will be held via Zoom and are free.”

Winter programs take place in January and February and are available on a first-come, first-served basis. Members are encouraged to use the OLLI online registration system to sign up for events. Non-members interested in exploring OLLI’s programs or the winter film series should contact the OLLI office (ollireg@gmail.com) to register.

This year’s winter film series, “Exploring Humor: How Funny Is It?” runs for six weeks, beginning Tuesday, January 12. The movies are all free and available on Kanopy. Attendees may choose to watch films any time and join the group on Zoom for discussion and conversation each Tuesday at 12:30 pm or watch the film with others via Zoom at 10:30 am. Instructions to download the movies will be provided. Continue reading

Elder Index at Work: Helping Advocates Address Healthcare Affordability in Washington State

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

By Taryn Hojlo

Medicare is an important resource for millions of older Americans, but that benefit isn’t free and it certainly doesn’t eliminate all other healthcare expenses elders face.

In Washington State, more than a million people were enrolled for Medicare benefits in 2018 and that number has been climbing, as it has across the country as the United States continues to grow older. Some of those people have found Medicare a particular economic challenge.

Northwest Health Law Advocates, a non-profit organization based in Seattle, is focused on older Washington residents who saw some existing healthcare-related benefits eliminated once they enrolled in Medicare. Recently, it has been using the University of Massachusetts Boston’s Elder Index to supplement research and advocacy work around the issue.

“We call it the Medicare cliff,” said Ann Vining, a staff attorney at the organization that has been advocating for affordable, quality health care for all Washington residents since 1999. “If you’re in some relatively lower income brackets, you have some access to some subsidies that you lose when you go onto Medicare.” Continue reading

Elder Index Shows Limits of Social Security to Help Older Adults Afford Basic Cost of Living

Jan MutchlerSocial Security is a critical economic resource for most older Americans but those payments don’t cover even a bare-bones budget in a single county in the United States.

The degree to which Social Security payments can help elders make ends meet depends both on individual circumstances and basic geography. An updated analysis, using the Elder Index™ developed at UMass Boston’s Gerontology Institute, recently examined Social Security’s ability to cover basic elder expenses in every U.S. county and state.

“Social Security is incredibly important to older Americans as an economic safety net but it doesn’t fully cover the cost of living anywhere,” said Professor Jan Mutchler. “The effectiveness of that safety net varies a great deal across the county and among individuals. In many cases, it falls far short.” Continue reading

Nearly Two-Thirds of Older Black Americans Can’t Afford to Live Alone Without Help – and it’s Even Tougher for Latinos

Jan MutchlerThis article originally appeared on The Conversation, a non-profit independent online news organization.

By Jan Mutchler

Older Americans who want to live independently face serious economic challenges. Half who live alone don’t have enough income to afford even a bare-bones budget in their home communities, and nearly 1 in 4 couples face the same problem.

Those numbers add up to at least 11 million older adults who are struggling to make ends meet, a new analysis shows.

The numbers are worse for older people of color. Dramatically higher percentages of Black, Latino and Asian older adults live on incomes that don’t meet their cost of living, even with Social Security. That can mean skipping needed health care, not having enough food, living in unhealthy conditions or having to move in with family.

These disparities often reflect lifelong disadvantages that add up as people of color encounter structural racism and discrimination that shape their ability to buy property and save for the future.

To calculate realistic rates of economic insecurity and estimate the disparities, my colleagues and I used the Elder Index, created by the University of Massachusetts Boston to measure the true cost of living for older adults. It tracks expenses for housing, health care, transportation, food and other basics, county by county. We paired the index with state-level income data to determine the percentage of people who don’t have enough income to cover their cost of living. Continue reading

Reach Out Massachusetts Mobilizes Communities to Combat Social Isolation

The desire to spend time alone is a natural and even healthy urge. But, seeking time alone and social isolation, are not the same.

Social isolation — defined as a lack of social connections — is considered a serious public health risk and can impair one’s physical and mental health. Older adults are at increased risk for social isolation because they are more likely to have lost a spouse and close friends, live alone, suffer from a chronic illness, or have limited mobility.

To combat this devastating public health problem, the Gerontology Institute at UMass Boston and AARP Massachusetts have created a resource guide highlighting ways in which many Massachusetts cities and towns are already addressing social isolation in their communities. The guide is the first completed project of the Massachusetts Task Force to End Loneliness & Build Community. The task force is co-led by Sandra Harris, president of AARP Massachusetts, and Caitlin Coyle, Ph.D., the lead author of the resource guide and a research fellow at the Gerontology Institute at UMass Boston. Continue reading