Renee Duke, 82 loves to host family gatherings and enjoys cooking big meals for everyone. | Photo submitted by Renee Duke

Saint Renee

Owner, CEO and foster Mom.

By Ella Roberts and Jett Hutton-Lau

Renee Duke sits on the edge of the bed where her frail husband’s body resides, nearly lifeless, but still breathing. Her foster son, Paul, sits beside her with his head burrowed into his chest. He turns and faces her and mutters out the words, “Mom, Dad’s gonna die.”

Paul, now 52, has Down Syndrome and although he has a mental disability, he understands what death is. Ever since her husband passed away from a brain tumor, Duke says Paul has never been the same.

“He never talked much after that. He kind of just ignored the world,” she said.

Paul is just one of nine, now adults, who have been brought in by Duke’s family as babies through foster care. Although they were not brought together by blood, Duke has always felt that her foster kids were her own, and would treat them and make them feel this way amidst all the beautiful chaos, until she no longer could.

Duke grew up living with her three brothers, one sister, her grandmother, great uncle and the foster babies her mom took in who had been put up for adoption. Her mom took in multiple foster children until they were assigned a permanent home. Having the infants for several months and then having to give them up was very difficult for the whole family. When Duke was a junior in high school, a neighbor told her parents about a friend of theirs who cared for children with developmental disabilities. This person was able to keep the children she took in for many years.

“He never talked much after that. He kind of just ignored the world.” — Renee Duke, Owner & CEO of Family Concept

“My folks talked to us about taking in children that were diagnosed as retarded (the vocabulary at the time). Everyone in the family was on board,” Duke said.

Duke’s father had a brother who was severely mentally and physically handicapped so caring for children with these issues didn’t seem difficult to them. Over time, Duke’s family began specializing in care for children with Down Syndrome. Their family liked that they were able to teach them many skills and could keep them as part of the family long term. Eventually, Duke’s parents had the maximum number of children a home could be licensed for: 10.

Renee Duke reminisces on the highs and lows of being a foster parent. | Video by Jett Hutton-Lau

“We really liked being able to get out with the guys and go do things with them,” Duke said.

Before COVID-19, Duke was very adamant on getting them out of the house often whether that meant going out to dinner, bowling, seeing a movie, pontoon rides, walking around the mall or playing basketball. They have also traveled across the country in a motorhome and have been on five cruises.

Duke’s second son, Jason Axelberg, grew up knowing the kids he considered his brothers and sisters were different from him, but never less than. Axelberg remembers what it was like to attend high school with two of his parents’ foster children: Kathy and Andy.

“It was difficult, but I found myself sticking up for them,” Axelberg said. “They’re no different than you and me.”

His closest friends considered them buddies, taking them roller skating and just hanging around the house.

Jason graduated with Kathy and Andy from Wisetta High School in 19991.

After graduating, Duke was a soloist in a large church in downtown St. Paul, worked nights at a country club and worked for her mom during the day while also on a waiting list for Hennepin County for a case management position. In the meantime, she got married to her first husband.

Duke’s first years of college were spent studying music, the field her families, friends and teachers expected her to pursue. In her third year of studies, she decided she wanted to work with children with developmental disabilities, so she changed her major to psychology.

“It was difficult, but I found myself sticking up for them. They’re no different than you and me.” — Jason Axelberg, son of Renee Duke

After getting married, Duke realized she had a larger calling in life, she wanted to be a foster parent like her mom and dad. So, she convinced her husband to tackle her new dream with her by telling him it would allow more time with each other. The two started out with three of the children Duke’s parents had and gradually added six more. They also adopted two boys as infants who do not have a mental disability.

Axelberg has been working for his mom for 21 years, but has been helping out all his life. He has seen the toll the responsibilities have taken on his now 82-year-old mom.

“She’s got back issues and leg issues. We’re trying to get her to take more days off, but she’s been doing this all her life,” he said. “She doesn’t know anything else.”

On top of the physical labor, Duke has endured the emotional toil of losing four of her foster adults, three to alzhiemers in the last six years. While she is fully aware of their shorter life spans due to their lower immunity than the general public, Duke has accepted the role of a mother from the day they were taken home from the hospital. All of them refer to her as “mom”.

“It saddens everybody, for her especially because she’s known them since birth. They’re like her kids,” Axelberg said.

Renee’s brother and sister in law have taken on some of the foster kids themselves after their mom passed away and another one of her sister’s helped out as well. Her sister in law also works for school district 287 which helps schooling and finding jobs for disabled adults. Her other brother was also a big advocate for adults with Down Syndrome.

“Something that’s in the family,” Axelberg describes it.

Axelberg says he admires just how dedicated his mom is to what she does. By doing what she does, he explains, she has allowed them to have a childhood just as anyone else has gotten.

“She has a big heart,” Axelberg said.“She’s called St. Renee.”

Duke has had two back surgeries and juggles with keeping seven years of paperwork for each of the foster adults, attending each of their doctors appointments, bathing them, feeding them and keeping the house spotless in order to meet the state and county standards. The county and the state make annual and semi-annual check-ins, and the legal guardians also check in once every one to three months.

The expectations may be set high for Duke, but she is known to set her expectations for herself even higher, Jamie, Duke’s granddaughter explains.

Before the COVID-19 pandemic, the foster adults would normally leave for their day programs in the morning where they would go to work and get paid to do an assigned job, as well as go to school. Because they are at a higher risk, none of them have been able to go into their day programs, so instead they meet with the directors over zoom every morning. Losing their sense of routine has had an impact on their overall health. “They’ve gotten lazier. You can tell they’re aging a lot faster too because of it,” Jamie said. | Photo by Ella Roberts

Like her dad, Jamie has also played an important role in taking care of the foster adults. She is a part-time student at Bethel University in her fifth year so that she can continue to play softball as the starting shortstop. Jamie comes every morning to help them get ready before her classes and goes back each night after practices or games.

“I’ve been involved with the guys as long as I can remember, ” Jamie said. “They’ve even been to a few of my games.”

In 2001, at the urging of one of her brothers who worked for the county, Duke decided to go corporate, calling her company “Family Concept”, so that when she was no longer able to care for the foster adults they would be able to stay together. In order to do that, Duke was forced to divide up her foster adults into two homes. One, where Duke and her husband take care of Andy, Kathy, Peggy and Paul. The other is located in Brooklyn Park , where Axelberg, Jamie, his daughter, and two family friends switch in and out taking care of Troy and Mel.

“They can have a good productive life.” — Renee Duke, Owner & CEO of Family Concept

Although COVID-19 has had quite an impact on the overall health and wellbeing of the foster adults, especially with such a shift in their daily routine, Duke believes she has done her best to provide her foster adults a childhood just as anyone else’s and stands firm that “they can have a good productive life.”

Foster adult Peggy, then and now.

Timeline | Renee’s life

1. 1948- Family brought home babies who were put up for adoption to foster, but would eventually have to give them up
2. 1954–1958- Duke helps out with her mom all throughout high school
3. 1959- During Duke’s first year of college she begins thinking about fostering herself. She majors in music but then switches it to psych
4. 1963- Duke graduates from college with a psych degree
5. 1965- Duke marries first husband, sings at a church, waitresses at a country club, helps out mom and is on a waiting list for Hennepin County for a case management position
6. 1968- Duke takes three of her parents foster kids (Annette, Lisa & Margret)- got them right from the hospital
7. 1971- At age 31 Duke adopted her first son; at the time she had 5 foster kids
8. 1972- Dukes mom wanted to cut down in size so she took two more from her
9. 1973- Dukes Adopts her second son
10. 1985- Dukes mom passes away
11. 2001- Dukes Decides to go cooperate so that her guys could be together if she no longer could take care of them

Fact Box| Down syndrome

According to the CDC:

• Down Syndrome continues to be the most common chromosomal disorder. Each year, about 6,000 babies are born with Down Syndrome, which is about 1 in every 700 babies born
• Between 1979 and 2003, the number of babies born with Down Syndrome increased by about 30%.
• the life expectancy of people with Down Syndrome increased dramatically between 1960 and 2007. In 1960, on average, persons with Down Syndrome lived to be about 10 years old. In 2007, on average, persons with Down Syndrome lived to be about 47 years old.
• Between 1983 and 2003, about 93% of babies born with Down Syndrome survived to one year of age. In the same time period, about 88% of babies born with Down Syndrome survived to 20 years of age.

Compared to children without Down Syndrome, children with Down Syndrome are at higher risk for:

• Hearing loss (up to 75% may be affected)
• Obstructive sleep apnea, a condition where a person’s breathing temporarily stops while asleep (between 50 -75%)
• Ear infections (between 50 -70% may be affected)
• Eye diseases, like cataracts (up to 60%)
• Eye issues requiring glasses (50%)
• Heart defects present at birth (50%)
• Intestinal blockage at birth requiring surgery (12%)
• Hip dislocation (when the thigh bone slips out of the hip socket) (6%)
• Thyroid disease (a problem with metabolism) (4–18%)
• Anemia (red blood cells can’t carry enough oxygen to the body) (3%)
• Iron deficiency anemia (red blood cells don’t have enough iron to carry oxygen to the body) (10%)
• Leukemia (1%) in infancy or early childhood
• Hirschsprung disease (an illness of the gut that can cause constipation) (<1%)This article includes the American Academy of Pediatrics Health Supervision for children with Down Syndrome from 2011.

List | Healthcare needs

A study used data from the 2005–2006 National Survey of Children with Special Healthcare Needs (NSCSHN) to look at the effects of Down Syndrome on families. Responses from the NSCSHN questionnaire indicated the following:

• More than 60% of families of children with Down Syndrome provided health care at home. Health care included practices such as changing bandages, care of feeding or breathing equipment, and giving medication and therapies.
• Over 40% of families of children with Down Syndrome had a family member who stopped working because of the child’s condition.
• About 40% reported the child’s condition caused financial problems.
• Among children aged 0–4 years with private insurance, average medical care costs were 12 times higher for children with Down Syndrome compared to children of the same age without Down Syndrome.