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RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne.

In personal health today, we focus on elderly caregivers. About 80 percent of the care for older people is done at home by family and friends. Older Americans themselves do a large share of that caregiving--they do it for love, and they do it for free. NPR's Joseph Shapiro has the story of one surprising caregiver.

JOSEPH SHAPIRO reporting:

In a small tidy living room, photographs of family crowd the walls, tables, and shelves. Clarice Morant coaxes her elderly brother to get up off the couch.

Ms. CLARICE MORANT: Ready to eat, honey? Ready to eat lunch? Come on, let's eat.

SHAPIRO: Her brother, Ira Barber, can't speak, the result of a stroke. He's a handsome man, sharply dressed in gray pants and matching shirt. There's an old movie on TV. Carmen Miranda is doing a mambo. Just a few steps away is the dining room table. At the head of the table, there is a plate of chicken, collard greens, and macaroni and cheese.

Ms. MORANT: You're not hungry?

SHAPIRO: Clarice Morant can't get her brother to pull himself up on his walker and take those few steps to the dining room.

Ms. MORANT: Your dinner will get cold if you don't eat now. Come on, honey. Come on, eat something.

SHAPIRO: Morant lives in this brick row house in Washington with her brother and her sister, who is in the next room in a hospital bed. Her sister is 89. Her brother is 95. And Clarice Morant, who cares for them, she's 101.

Ms. MORANT: I'll be 102 the 29th of August, this year, 2006. The 29th of August, I'll be a 102, if I'm here, thank the Lord.

SHAPIRO: But can a 101-year-old woman give good care and do it without putting her own health in danger? Morant cooks for her brother and sister. She does their laundry, bathes them--she gets up in the night to turn and change them. She's a small woman, but she stands up straight. Her friends and family don't call her by her given name.

Ms. MORANT: My name is Clarice, but they call me Classy.

SHAPIRO: Older Americans do a lot of caregiving, rarely someone over 100. But one in five Americans age 75 or older say they take care of a family member. That's according to a recent study by the Urban Institute. People 75 and older provide more hours of caregiving than people in any other age group. After her husband died, Morant moved into this house, her sister's house.

Ms. MORANT: I've been taking care of my sister for 20 years--my brother about six now.

SHAPIRO: Her sister, Rosy Laney, is blind and in the terminal phase of Alzheimer's disease. Clarice Morant says there's a simple reason why she does the hard work of caregiving.

Ms. MORANT: I made promise to the Lord.

SHAPIRO: She starts to explain that promise, then shuts her eyes tight, and holds her fist to her mouth.

Ms. MORANT: If he gives me the health, the strength, the life to do for them, take care of them, keep them from going in a home, I will do it. And as long as he gives it to me, I'm going to give it to them.

SHAPIRO: The lifting, pulling, and all-through-the-night work of caregiving can take a physical toll on anyone. Last fall, Clarice Morant got sick.

Ms. MONICA THOMAS (Social Worker): She was getting short of breath.

SHAPIRO: Monica Thomas is a social worker for a medical program that cares for Morant's brother and sister.

Ms. THOMAS: She was having congestive heart failure, exacerbation of her congestive heart failure, and then she was hospitalized.

SHAPIRO: Other family stepped in to take over the caregiving--a goddaughter from Baltimore--her brother's son and wife, in town from California. When Morant got out of the hospital four days later, it wasn't clear whether she'd regain the strength to ever again care for her brother and sister.

Ms. THOMAS: She still maintains a schedule of getting up, you know, several times, three or four times a night. I didn't think there was any way she could do that.

SHAPIRO: So, Thomas arranged for an aide to come in on the overnight shift. After six weeks, Morant bounced back.

Ms. THOMAS: She got better, she did, miraculously. She improved, she really did.

SHAPIRO: Today, the social worker worries how long Morant can continue to provide that good care to her brother and sister.

Ms. THOMAS: It would be difficult for any person to do it, much less when you are 101 years old and have some medical conditions of your own. But it's also hard to tell whether or not the fact that she has this purpose isn't part of what's keeping her alive at 101, and part of what motivates her to get better and stay as strong as she possibly can.

SHAPIRO: In the back room of her house, Clarice Morant leans her face close to her younger sister in her hospital bed.

Ms. MORANT: Is the baby sleepy?

SHAPIRO: Rosy Laney spends her days in bed. She wears a white nightgown; she's covered by a white sheet. She's a large woman, with close-cropped hair.

Ms. MORANT: Want me to leave you alone so you can go to sleep? Hm? Ready to go to sleepy house? Huh? Yeah? You ready to go to sleepy house? The baby ready to go to sleepy house?

SHAPIRO: Clarice Morant and her siblings all sleep just steps away from each other. Morant's foldout couch is an arm's length from her sister's hospital bed. Their brother is steps away, on the other side of a thin glass door.

Ms. MORANT: Well, I don't get too much, I don't get too much sleep, not too much.

(Soundbite of laughter)

Ms. MORANT: I get a little some nights. Some nights I sleep more than others. Some nights I don't think she feels too good. I feel restless so, you know, she's making noise, she'll call me. Either one of them make a noise, I hear it.

SHAPIRO: Government programs, family, and friends help them get by. On weekdays, Morant gets assistance from in-home aides. One comes three hours on Monday, Wednesday, and Friday to care for her sister. Another aide cares for the brother 12 hours a day Monday through Friday. There's also a neighbor who comes and helps with feeding and cleaning. But at night, and on Saturdays and Sundays, Clarice Morant is on her own, the lone caregiver for her sister and brother.

Dr. GEORGE TOLLER (Ira Barber and Rosy Laney's Physician): I think they're getting superb care at home.

SHAPIRO: George Taler is the doctor for Morant's brother and sister. He says his patients who go to nursing homes tend to die in about two years. Morant's brother and sister have lived much longer.

Dr. TALER: Miss Laney is really at the end stages of Alzheimer's disease, and has been maintained at home now for many years. Miss Laney is totally dependent, needs to be fed. She's been bed-bound for over 10 years. And Mr. Barber has had progressive strokes, and he's not deteriorating as fast as one would expect, given his age and his illnesses.

SHAPIRO: Taler says the difference is Morant's close attention--the way, during the day, she pulls her sister to a sitting position. Just sitting up keeps muscles strong. The way Morant gets up at night to clean her brother and sister and help them move their bodies in bed. As a result, neither has gotten a bed sore. That's a painful and sometimes even deadly breakdown of the skin that can be common for such frail, elderly people. Taler says it's not uncommon for family members, old or young, to do even the most medical of care.

Dr. TALER: This happens with families. They couldn't conceive of themselves picking up things like wound care, or even managing people on vents, and feeding tubes, and yet, when the need is there, they step up and somehow find the ability to do that.

SHAPIRO: Clarice Morant's brother and sister can no longer speak. They can't say how they feel about their sister's continued devotion. And Clarice Morant, at 101, says she isn't sure what they'd say if they could.

Ms. MORANT: I really don't know, don't have no idea what they would say. Probably say thank you.

SHAPIRO: Joseph Shapiro, NPR News, Washington.

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