Caring for Someone? This book might help you put it in perspective

…or it might stress you out.

In Richard Russo‘s new memoir, Elsewhere, he tracks his codependent relationship with his mother from his childhood to the months following her death. Richard grew up as the only child of a can-do single mother in the aging mill town of Gloversville, NY. It was his mother who was among the first women working at GE in nearby Schenectady, NY. And years later it was his mother who rode with him across the country in a beat-up car to college in Arizona. Both were ready for a new start in life. And as Rick worked his way through his academic and fiction writing career, earning literary awards, and earning their way out of the working class, mom insisted on living near her “rock” of a son, and insinuating herself into his life. Afterall, she had nobody else.

As I read this book, I thought of my father caring for his mother (both single) at the end of her life, and of many of my friends currently caring for their parents. It is so difficult not to feel resentment or a sense of “burden” as the sole caregiver. Aside from recent work on “zen caretaking,” most of us have a hard time with dependency in a culture that values the opposite. And that’s just the tension that exists in Russo’s tale – a mother who is a die-hard stubborn independent continues this performance for some time, despite functional potential to the contrary. How does a caregiver honor that constant push for autonomy while at the same time being genuine and true?

Richard doesn’t answer these questions – it is only, perhaps, in writing the book after her death, and looking back on their parallel trajectories, that strands of understanding and forgiveness emerge. The reader benefits from starting at the beginning in Gloverville, NY, where mom fought hard for health, love, work, and family.  Learning the ins and outs of their relationship as mother and son helps one to understand how the Russos negotiate the future together, as the stubborn yet resilient Joan and Rick together confront hurdles associated with genetics, health, aging, and even dying. In some ways, Joan was unlucky when it came to health and love. A generation later, Rick was the opposite.

Many readers will probably relate to the traditional caregiving moments, especially when the story becomes a resigned “we moved mom to this place, and she didn’t like it, so we moved her again.” But under-girding the moves, the interpersonal tensions and challenges are the more interesting part of the memoir – the ways in which selves are woven into places and rituals and social mores.

I wanted this book to double as a memoir about one of my favorite authors, as well as a how-to book for caring for our parents. In many ways, it delivers on both. Most of all, it reminds us that whatever stage we find ourselves at, we all tremble constantly on the tightrope between autonomy and dependence.

A Movie Extra, at 75… thank you, Academy!

A journalist recently asked me “What are 5 reasons not to fear aging?”

I could have come up with 2,013 reasons.

Take this story about a former student’s grandmother, Evelyne Aronin, who, at age 75, lives to be a movie extra.

Yes, it is Academy Awards season.

Look closely – you may recognize her from Bourne Legacy or Extremely Loud & Incredibly Close.  Ms. Agronin has been doing this work for 34 years (298 movies!), and continues to play a fabulous “upscale matron.”

Reason not to fear aging? You can finally do what you’ve always wanted to do.

Happy 2013!… Am I living in the right place?

The happy new year message (via email) from Seymour in Florida, age 95, looked a lot like those he had sent before, in response to my birthday notes and on other occasions. (For AOW or regular blog readers, Seymour is the technogenarian who recently purchased an iphone.) By sentence two, he had launched into “our problems coping with increasing old age.” Sy wanted advice again, and I was having a hard time doling it out.

For years Sy and his partner have tried to figure out where to live. Their back-and-forth snowbird days were getting harder and harder, so the decision remained: Florida (“inside all summer with A/C”) OR (“cooped up all winter”) Upstate NY?  They wondered – are resources for elders better in either place? If so, they were prepared to choose one and stay there.

“Seymour wrote, “One thing is certain, at this point we definitely would like to continue to live at home. I have seen some of the assistive living places down here and even the good ones are simply human warehouses.”

Now let’s pause for a moment and reflect on this. Here we have a 95-year-old wanting to plan for his future, and thinking about his care. This is notable because we tend to hear about eldercare dilemmas from the children of elders or their caretakers. But many nonagenarians DO weigh and consider options, hire and fire, and accomplish self-care. And Seymour, who is on record as someone who “never buys green bananas,” is skilled at living in the moment AND thinking ahead.

My response to Seymour was a bit of a mishmash. I asked about specific needs and living environments. (How age-friendly are the two apartments?) I waxed on about the importance of proximity to family or close friends (people you wouldn’t mind asking for help), and then gave some examples of other resources. (A recent piece in the NYTimes, entitled “Staying Independent In Old Age with a Little Help,” gives similar examples of new-ish resources for meeting personal care needs; services like Home Instead, local non-profits dedicated to transportation services, Meals on Wheels, etc.) Then I took a risk (not wanting to offend a healthy friend) and asked which area hospital and doctors he and his partner preferred, pointing out that for better or for worse, as we age, we tend to spend more and more time at hospitals and doctors offices.

I think I ended on a theme of personal comfort, but I probably should have mentioned the fun of board games (on iphone!) like Scrabble (for all of those shut-in weather days).

I haven’t heard back from Seymour; I’m taking that to mean that he’s considering the options.

The thing is, it is difficult to plan ahead, at any age.  I don’t know where I want to live either!  But considering living environment, close connections, and care resources might help me figure it out someday.

What about you? What would it look like to be comfortable and cared for? And what would you do if you had to be indoors all winter in Upstate NY?

Elder Exploitation; Lessons from 2 Unscammable Elders

So far this month I have  heard of two elder women being targeted for scams. Contrary to what we might expect, these ladies proved unscammable.

Their fast reactions contradict the findings of a new research study reported in the New York Times. The study shows that as we age, our brains are less able to assess danger. However, in this case we have a 99 year old who managed to avert a scam.

That newly-unscammable elder was Ruth, who had gotten wise to this type of scam since being targeted once before in a similar way. This time she was on guard. The evening phone caller pretended to be her grandson in great need. “Gramma, it’s me, your grandson. I need your help.” This time Ruth said “Can you please hold for a moment?” and paused to gather herself. When she went back on the line, the caller had hung up.

Similarly, Carol, age 75, recounted how a woman called, and with a kind voice, started asking questions. Carol answered a few of her questions and then managed to ask her own question. “Can I ask who is soliciting this information?” she said. The caller hung up.

It seems as if a stall technique can be a valuable tactic in assessing danger.

The realization that one is being targeted and perceived as vulnerable is a powerful one. I doubt it made either of their days. But it was fine fodder for talk among their friends, and the good news is, that realization will hopefully help them (and their friends) the next time a scam outfit calls.

A friendly holiday message from Ruth and Carol: In this holiday season, when old friends and distant family members may be calling, be on guard for fakes!

 

 

 

Caring for Joseph at the Edge of Death

Frieda and Ellie knew their father Joseph was failing.  For the last week he wasn’t eating, and he was drinking very little. Thankfully, the family was together for Rosh Hashanah, the previous month, when his daughters had reserved a room in the nursing home for a private catered dinner.  The whole family, including all the grandchildren and great-grandchildren, had come locally as well as from Brooklyn, Massachusetts, and New Jersey.  They had not known this would be the last time they all would be together.

One sunny morning in the new year, unusually sunny for Oct. 20, 2012, the daughters showed up at the nursing home. They wheeled their father out into the sun. Although at this point, he was unable to speak, he still had his remarkable mind to the very end. He nodded when they asked “Does that sunshine feel good, Dad?” They massaged his bald head. He smiled. One joked about how Joseph had two wonderful daughters, and one was even more wonderful than the other. The other said thank you, and Joseph smiled. He was always the joker of the family, and now his daughters were carrying on the tradition.

When they wheeled him back into his room, he seemed so frail and tired. The daughters kissed their father and walked out of the room so the aides could put him into bed. One minute after they left, the nurses called them. “Your father has taken his last breath.”

“Dad’s last moment of life was with us, in the sunshine, right where he would have wanted it,” the daughters reported in the days after their beloved father’s service. They were still in shock. And then to me, they offered, “You talked about this in your book, how the timing is somehow under their control. It really was. It seemed like he was living for his wedding anniversary and for the holiday.”

The period after death, at the memorial and then sitting Shiva, was spent honoring Dad – his sense of humor, his amazing memory, his strong Latvian accent, how he and his wife Myra were lovebirds in the nursing home, and how his family and community loved him.

At moments, insecurities about care crept in.

“Did we spend enough time with him?” “Why didn’t the nursing home have hospice care?”

Discomfort and anger emerged.

“Mom is not taking it well. She’s upset that he has left her.”

And a vague sense of the coming emptiness in the lives of daughters hovered.

“What will I do without Daddy?” “Where will we celebrate holidays?”

Mourning a life lost is never simple.

Joseph will be missed. He was a gentle soul who later in life cried easily, a former barber who was a pillar of our community, a living memory of the horrors of the Holocaust (who wanted to tell his story only very late in life), an amazing person who regularly grocery shopped despite being legally blind, and the man who never forgot any of the birthdays of his family members, including his extended family. Joseph believed he lived a long life (to 94, almost 95) because many years ago he had kissed the Torah in the Knesset in Israel. His obituary is here.

I know one thing: Joseph’s daughters and his extended family were everything to Joseph, who lost so much in the Holocaust, including his extended family.  Just in one day, the Nazis murdered his mother, his two sisters, and his first wife, who was carrying their child.  Despite the horrors he had endured in the concentration camps, he managed to maintain such a zest for life.

To the daughters, the family, his wife Myra, and readers who loved Joseph – we must say goodbye to a dear friend. And we must work to keep his story alive.

You can read Joseph’s story here and more about his life as a nonagenarian in my book, Aging Our Way. I have never heard a Holocaust story quite like his.

Thanks to Frieda and Ellie for their blessing on this post.

Yo, Is This Ageist?

Everyone is talking about Clint Eastwood‘s performance at the RNC last week. The most common thing I hear is, “That was really crazy stuff he said up there, but he IS 82.”

There are all sorts of assumptions about senility in this chatter. I’m bothered by this. So I consult my new favorite blog: Yo, Is this Ageist? authored by the awesome Ashton Applewhite.

I guess Paula Span of the NYTimes did the same thing. She writes about Ashton’s response in her latest blog post, “On Ageism and ‘Eastwooding.’”

if you missed it, here’s Applewhite’s response:

“My take is that Clint’s primary crime was being lazy and not being prepared — you need your talking points in order,” said the expert. “Not his finest hour, for sure.”

“But to attack him as senile was ageist. I don’t think people would have leveled charges of dottiness at someone 20 years younger.”

My response:

Yo, ageism is alive and well. Check it.

And Eastwood – maybe spontaneity isn’t your strongest suit.

Peace out.

The Tofani’s: Keeping a Marriage Strong in the Face of Dementia

Frank and Angela are another dreamy couple with a bit of reality thrown in – dementia.

Frank was 18, Angela was 22, and it was a “fairy tale” romance – love at first sight. She was wearing a red dress and standing with her sisters. And he decided to pursue her, even if she was older than him.

59 years later they are still very much in love. They still enjoy “going for rides,” around Utica, NY, and beyond. They prepare and consume healthy meals together. But Angela’s dementia sometimes causes problems.

The toughest times for the Tofani’s are the mornings.  Angela awakes with fear and confusion, and Frank calms her down, but he also “gets upset.” He admits to losing patience with Angela and having his own health issues to worry about.

I met Frank and Angela in Utica. Frank wanted to show me their “saving grace;” an adult day services program at the Resource Center for Independent Living, where he drops off Angela 5 days a week 8:30-3pm. Angela looks forward to this routine. She tells me she loves sitting at the table, chatting with “the girls” and welcoming new people.

Meanwhile, Frank gets some time to decompress, pay bills, do grocery shopping, and attend to his health issues (kidney dialysis is looming). When he stops in to check on her, he gets a glass of orange juice and everyone welcomes him. In observing the workers, he is inspired by their warmth and patience, and that reinforces that what he is doing is right.

The bonus: this caregiver respite is paid for my Medicaid. Frank says he is not exaggerating when he says this place is the best thing for their health and marriage. Case in point: One day in July Frank had a stroke while he was home paying bills. Angela was at the adult day center, so he didn’t have to worry about her. He got himself to the hospital and the staff took Angela to her sister’s at the end of the day.

As a caregiver myself, I can relate to the need for breaks. I know the importance of social connections. And one thing I look for in a care institution is personalized client-centered care. Finally, keeping a loving couple together is perhaps most important.

A similar situation emerged with my grandfather, whose girlfriend was diagnosed with Alzheimer’s. Gramps tried very hard to care for her, but he finally had enough of the forgetfulness, the lost items, and the confusion. He found Linda an Alzheimer’s care facility and now visits her there.

Frank’s history and options are different. After 59 years of happiness, Frank wants to live with Angela as long as possible. “Maybe someday she’ll have to go into a care facility, but for now we’re together, and this place is our saving grace.”

Let’s face it, care networks matter tremendously when it comes to protecting autonomy. But I hadn’t considered the role adult day care may play, especially for working class Americans who qualify for Medicaid.

Thanks Frank and Angela, for helping me to see that Adult Day Services can enable autonomy and “aging in place,” and that love can persevere, despite the obstacles.