How Mutual Aid Cared for My Grandmother

I was around fifteen or sixteen when my mother took me to visit my Great Aunt Netta, who had recently had to move into a nursing home. I don’t know what I was expecting, but what I saw disturbed me deeply.

The place had the feel of a hospital. The long, tiled hallway smelled of urine and disinfectant. My great aunt was in a large room, with I don’t remember how many other residents, lying in a hospital bed. She was asleep or unconscious the whole time we were there, and after a short while, we left.

Stepping out into the sunshine, I felt as if my entire system had received a nasty shock. I couldn’t speak for a while. But I knew, with a deep certainty, that what I’d just seen was wrong. Finally, I said something about it to my mother. She asked me what my solution was. Should we take Aunt Netta into our home? Or ask another relative to? I didn’t have an answer, but I was crystal clear that what I had just seen was not how things ought to be.

Many years later, family members had convinced my 94-year-old maternal grandmother to agree that it was time for her to move into “the PEO home.” Given what I had seen of elder-care homes, I was anxious for her. My mother assured me that this would be different, but until I saw it for myself, I remained skeptical.

My grandmother had been a schoolteacher both before and after she was married. Because of this, she had been able to join an organization called the PEO Sisterhood. (The actual name was semi-secret, though it appears to have stood for “Philanthropic Educational Organization.”)

The PEO was founded in 1869 by seven women students at Iowa Wesleyan University, after one of them had been rejected by the university’s sorority. The group’s purpose was to support women’s education and create a community of sisterhood. My grandmother joined when she was still a schoolteacher, and had been a member in good standing for many years.

Back in the mid-1990s, the PEO still operated at least one long-term care home for its members. What that meant was that as long as a woman was a PEO member in good standing, and as long as she could still get around and mostly take care of herself, she could come and live in a PEO home and be taken care of there until the end of her life. Should a woman come to live in a PEO home and then suffer a debilitating stroke the next day, the home would still care for her for the rest of her life.

In exchange for this care, the PEO member would sell her most valuable assets—usually her home—and donate most of the proceeds to the PEO. When my grandmother moved into the PEO home in Nebraska, she sold her house for (as I remember) less than twenty thousand dollars. This might have been enough to pay for several months at a comparable commercial care facility. She ended up living in the PEO home for eight years, until she passed away a few weeks before her hundred-and-third birthday.

This fact alone defies everything that everyone knows about elder care.

Everyone knows how expensive it is. Everyone knows that even back then, and even outside of major cities, decent care costs thousands of dollars a month. So the proposition that an organization could provide good care for an elderly woman for the last eight years of her life, out of a mere $15,000 or so ($20,000 would work out to around $208 per month), defies everything that everyone knows about this industry.

And it was far, far, more than just “good care.”

The home was a real home. The building itself was a mansion that had been donated to the organization, and nothing about it felt remotely institutional. There were spacious-but-cozy sitting rooms, a grand piano, a TV room (where residents gathered decked out in red for every Nebraska football game), a spacious dining room and kitchen, and of course, each of the residents’ own rooms.

True to its roots, the home had more of the feel of a sorority house than a retirement home. My grandmother’s room was small, but she was able to bring some of her own furniture. The ladies had all of their meals together in the dining room, a prayer was said before each meal, and residents celebrated birthdays together there. The meals were filled with conversation and reminiscences about a time long gone. My sisters and I enjoyed staying over and spending time with these women, listening to their memories of a world we could only imagine.

The quality and level of care were outstanding. The staff-to-resident ratio was higher than at most other “facilities,” and there was always someone available to help when our grandmother needed it. More than that, the staff intimately knew and deeply cared about each of the residents. I have visited multiple elder-care homes, both before and since my grandmother’s stay in the PEO home, and not one of them even came close to the environment and community that the PEO home had created for its residents. It really did feel like family.

At the time, I was astonished by what they were able to accomplish, especially given my grandmother’s lack of wealth when she moved into the home. I spoke at length with the manager back then, who told me that the primary reason they were able to provide such a high level of care was that the PEO was a private membership organization (PMA). As such, it was not subject to the—very costly—licensing requirements of most other care homes.

My grandmother passed away in 2003. Several years later, I wanted to speak with the manager of the PEO home again, because I was interested in setting up something similar, but for individuals with special needs. I wanted to learn more about how they operated. I called and was told that that manager had left, but that I could speak with the new one.

The new manager informed me that soon after my grandmother had passed away, the State of Nebraska had forced the PEO home to be treated as a public accommodation under the law, rather than a private membership association (a decision that I believe is unconstitutional). This meant that the home was no longer free from the costly licensing requirements, and the manager told me that it also meant that they could no longer finance the home in the way they had in the past. Now, residents had to pay a monthly fee to live there. The previous manager, she told me, had resigned because she felt that they were no longer able to provide the level of care that they once had.

At their peak, in the 1970s, there were twelve PEO homes across the country. Today, there are two, including the one my grandmother lived in. But my grandmother’s, at least, is not what it once was. (The second is affiliated with Cottey College, a women’s college founded and operated by the PEO Sisterhood in Missouri.)

The story of what has been lost—what has been destroyed by a state hell-bent on “protecting” people—is not simply a story of an incredibly cost-effective way of caring for people in their old age. It is not really even a story about high levels of care and impressive staff-to-resident ratios. It is a story about things that are intangible, but that matter a great deal. If anything, these things matter all the more to those who are at the end of their lives, and for whom what is most important is simple human connection. What my grandmother’s PEO home created was a genuine community with warmth and caring and love and genuine engagement built in. I doubt anything like it exists anywhere in America now.