Illustrations by David M. Brinl
|
The Care Dividend
By Hugh Delehanty, May & June 2005
As the balance of duty shifts from parent to child, both generations reap unexpected rewards
|
It was the moment I had been dreading for years, the one that had haunted me
a thousand times ever since I'd learned that my father had Parkinson's
disease. It was the moment of the death talk.
A few weeks earlier he had fallen and hit his head late at night in his room
at the assisted living facility and nearly died en route to the hospital. Dad
was so malnourished the doctors inserted a feeding tube and within a week he
was shuffling around again, charming everyone in sight. But it didn't last.
Shortly after he left the hospital and moved to a nursing home, he started
ripping out the feeding tube whenever the nurses were looking the other way.
The head nurse called and told me that we either had to reinsert the tube
surgically or remove it. Without the feeding tube, he would die in a matter of
weeks.
After conferring with my two brothers, I called Joan, a social worker I knew
who specialized in end-of-life care, to help me talk the situation over with my
dad. Even though he had made it clear in his living will that he didn't
want to be kept alive artificially, I wasn't certain how he wanted to
die.
My father, a puckish, white-haired man in his 80s with the mischievous charm
of a leprechaun, was not particularly religious. The son of Irish immigrants,
he had been raised as a Roman Catholic in Fair Haven, Connecticut, and attended
parochial school, which made him skeptical about religious dogma for the rest
of his life. He went to Mass on Sundays when my brothers and I were kids, but
he often fell asleep in the pew and I never once saw him go to confession or
take Communion. For him, going to Mass was a familial duty, not an act of
spiritual discovery.
Dad was not philosophical either. He had seen a lot of death in World War II
as an artillery officer in North Africa and Italy, but he never talked about
it.
Nor did he have much to say about his brother, James, who fell off a bridge
at age five and drowned. This tragedy, which had caused his mother to have a
nervous breakdown, must have had an enormous impact on my father, who was three
then. Yet when I asked him once what it felt like to lose his brother at such a
young age, he stared at me blankly and said he had been too little at the time
to remember. Nobody in his family ever talked about the drowning. Death was not
a subject for polite conversation.
Online Guide to Caregiving
This article is just one part of AARP The Magazine's online guide to
caregiving. Dive into this special section of content for worksheets and other
practical resources, message boards with which to interact with fellow
caregivers, and much more.
Joan ran into a wall of silence at first. Dad wasn't about to get into a
serious discussion about such a personal matter with a stranger. When she asked
him whether he believed in an afterlife, he recited something he had memorized
in catechism class. I figured he was toying with her. As the conversation
developed, however, he became more relaxed and matter-of-fact.
At heart, Dad was a pragmatist. He knew his time had come; he just wanted to
do it his own way.
"Your son tells me that you want us to take out your feeding
tube," said Joan.
"Yes, that's right," he said.
"And if they take out that tube, you're probably going to die. Not
today, not tomorrow, but soon."
He nodded.
"You may get to a point in the next few weeks or so when you're not
going to be able to make decisions for yourself. Important decisions.
Life-and-death decisions. You're going to have to rely on your son. Are you
ready for that?"
Another nod.
"I need to hear you say it. Do you trust your son to make those
decisions for you?"
"Yes, of course."
At that moment I realized a profound shift had occurred between my father
and me.
The generational divide between us used to seem unbridgeable. He was a
product of the Depression; I was a wide-eyed baby boomer. I had spent a good
part of my life creating as much distance as I could from him because he was
stubborn, autocratic, and wanted us to fit into his conventional 1950s vision
for the family. I needed the freedom to shape my own identity. So after
college, I put 3,000 miles between us by moving to northern California. Sure we
talked, but not about anything real. He wasn't interested in the demons I
was wrestling with ("all that therapy stuff," as he called it); he
just wanted to know how "the Job" was going. Most of our phone calls
didn't last very long.
Years later, after I moved with my family to New York, Dad's illness got
worse, and my brothers and I decided to split the caregiving duties. My older
brother, John, took over the finances and legal matters; my younger brother,
Dennis, coordinated the supporting cast of friends and neighbors; and I became
my father's health advocate.
A therapist I knew suggested that I spend time hanging out with
Dad—nothing special, just sitting around the kitchen table gabbing, as he
called it. We talked about my mother, who was his childhood sweetheart, and the
830 letters she wrote him during the war, one for every day that he was away.
We talked about his father, a trolley man and a union leader in New Haven, and
the lessons he taught Dad about his favorite subject: Irish history. In the
course of those conversations we both changed. Dad allowed himself to become
more open and vulnerable, and I became less of a smart-ass and began to allow
myself to feel the depth of his love for me.
Caring for Your Parents: The Complete AARP
Guide
The new book
Caring for Your Parents: The Complete AARP Guide offers a practical
road map through the complex emotional terrain of caregiving. Drawing on
AARP's wellspring of expertise, the book lays out proven methods for
helping your aging parents live their lives to the fullest.
Order it online today.
When Joan, the social worker, asked her question and my father answered, I
knew there was no going back. Yes, my father was going to die and I was going
to have to give the order to pull the plug. All my life I had been the
renegade, the one who tested the rules. That was my role. But with three
words—"Yes, of course"—my father liberated me from my
past. He trusted me with his life—and death.
The World's Greatest Gift
For most of human history, our elders could expect to spend their final
years as respected members of multigenerational households. American Indians
speak with reverence for older people, who, they say, "are the link with
our past, our present, and our future." Fijians advise each other to
"listen to the wisdom of the toothless ones." Arabs often consult
their elders on major decisions and view their care as a religious duty
because, as one saying goes, "Heaven would be found under the feet of
one's mother." And the Chinese consider parental fealty a key to
social harmony.
Of course, this is the 21st century, and recent trends in the United States
and elsewhere have put a strain on this time-honored tradition. In an
increasingly mobile world, adult children often live hundreds, even thousands
of miles from their parents, while women—who provide more than half of
unpaid caregiving—have entered the workforce in large numbers. The
challenge of working outside the home while caring for an elderly
parent—and often children as well—adds considerable stress to the
lives of women and men alike. Almost half of the so-called sandwich
generation—the cohort of Americans between 45 and 55—have children
under 21 as well as aging parents or aging in-laws. It's a tight
squeeze.
But the rewards of caregiving are many and profound. Not only does it give
you an opportunity to repay someone who gave you life and nurtured you when you
were a child, it can also bring you closer to estranged loved ones and resolve
long-standing emotional conflicts. As author Beth Witrogen McLeod writes,
caregiving "has the potential to alter us at the core of our being,
opening our heart's capacity to live fully even in the midst of loss."
In a recent survey researchers asked caregivers to describe their feelings.
"Worry," "sadness," and "frustration" came up a
lot, but the words they used most frequently were "loving,"
"appreciated," and "proud."
|
