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The Care Dividend
By Hugh Delehanty, May & June 2005
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"Love Is Paying Attention"
If you're reading this, you're probably embarking on a caregiving
journey of your own. What kind of caregiver will you be? Many people when
they're starting out tend to think of caregiving as a fix-it project, says
clinical psychologist and Buddhist meditation teacher Tara Brach, the author of
Radical Acceptance: Embracing Your Life with the Heart of a Buddha, but
that perspective has serious limitations. "If you think you're just
doing a job, fixing a person who is weaker than you, there will always be a
wall between the two of you," she says. "But if you approach it with
the point of view that the person you're taking care of is going through a
natural process, a profound connection begins to grow."
Sometimes that shift happens when the stress gets unbearable, but, more
often than not, it emerges slowly, as it did with my father and me, because a
kind of intimacy develops that you've never before experienced. As soon as
you realize that your parent isn't going to be around forever, says Brach,
"the preciousness of their life becomes very immediate. You stop holding
back expressions of love because you know there's not much time."
There's also another dynamic at work. All your life you've
envisioned your parent as strong and powerful, so as he or she gets weaker and
more dependent, barriers begin to fall away. Our culture places such a high
value on self-reliance that aging parents—particularly those who survived
the Depression—often resist acknowledging weakness. But when they do, it
becomes the ground for a much deeper level of trust. "Trust occurs when
somebody's vulnerable and lets you in—and you show up," says
Brach. "It often isn't until we're sick and dying that we open up
and let that happen."
En español
Lea el articulo relacionado Con amor y sin culpa para obtener información sobre
las necesidades especiales de las personas que prestan cuidado. El artículo
está disponible tanto en español como en inglés en nuestra página bilingüe en
internet, AARP Segunda Juventud.
Read the related article With Love and Without Guilt for insights into the
special needs of caregivers themselves. The article is available in both
English and Spanish at the website of our bilingual magazine AARP Segunda
Juventud.
Caregivers who have the easiest time shifting perspective, says Brach, are
those who aren't locked into patterns of denial. "If you're in the
habit of avoiding uncomfortable situations, you will probably take the position
that something's wrong," she says. "But if you've developed a
habit of honestly recognizing your own insecurities, then you'll probably
find a place in yourself to tolerate it when someone else is experiencing pain
and suffering."
The key is self-forgiveness. Caregivers often punish themselves for not
being perfect. But what does "perfect" mean in this situation? No
matter how angelic you are, you're not going to save your parent's life
or completely ease his or her suffering. "Caregiving is painful,"
says Brach, "because you can't take away the other person's pain.
You can't make everything okay. All you can do is love that person. And the
deepest expression of love is paying attention."
That means not only paying attention to what's happening with your
parent, but also what's happening to you. When feelings of anger or fear or
guilt arise, it's important to be forgiving toward yourself; otherwise,
unacknowledged emotions will diminish your ability to be fully present.
"The more you're just being with the person, and not trying to fix him
or her," says Brach, "the more you'll be able to see them as what
Thomas Merton calls, 'the divine that comes through all life.'
"
Brach's friend, Susan Stone, had an awakening of this kind several years
ago when her mother was diagnosed with terminal non-Hodgkin's lymphoma. A
poet and an expert in Asian history and culture, Susan was training at the time
to be a Zen monk in California. When she returned to St. Louis to take care of
her mother, Blanche, she had elaborate plans. "I thought that I was going
to help teach her how to face death," says Susan. "But Mom didn't
want any part of that. So I dropped my big mission and started focusing on
little things, like folding the laundry together. I realized this was the
greatest gift I could give her. Just being with someone—and doing it
mindfully—is empowering because you're allowing that person to be who
they really are."
Three months before her death, Blanche surprised Susan by writing a poem
about the trees in the backyard. Susan said a few encouraging words, but that
didn't satisfy her mother. A few days later, Susan relates in her book
At the Eleventh Hour: Caring for My Dying Mother, Blanche announced,
"You keep saying you like my poems, but you don't say anything else. I
don't want nice words. I want real criticism. Like the kind of things you
talk about in poetry classes." So for the next few weeks, until Blanche
grew too feeble, mother and daughter talked about adjectives and line breaks
and "the fact that good poetry isn't just about pretty things, but
about real things." At one point, Blanche declared, "Where've you
been all these years? I never knew this before. And I was satisfied with just
my newspapers and my books. You're the only one who could have taught me
this, and I really need it now."
After Blanche died, Susan designed a workshop on mindful caregiving based on
her experience with her mother. "When I started out as a caregiver, I
didn't think I could do it," she says. "But I learned that I
didn't have to have all the answers. I just did things step by step, and I
found that if I made decisions based on what was needed at the moment, I
didn't have to worry. That was very liberating."
In Search of a Second Adulthood
In his groundbreaking book The Soul and Death, psychologist Carl Jung
argues that the task of midlife is to come to terms with death. "Natural
life is the nourishing soil of the soul," he writes. "Anyone who
fails to go along with life remains suspended, stiff and rigid in mid-air. That
is why so many people get wooden in old age; they look back and cling to the
past with a secret fear of death in their hearts. They withdraw from the life
process, at least psychologically, and consequently remain fixed like nostalgic
pillars of salt, with vivid recollections of youth but no living relation to
the present. From the middle of life onward, only he remains vitally alive who
is ready to die with life."
Contemporary Western culture doesn't reinforce this point of view. We
have replaced the traditional mythic rites of passage with a Peter Pan-like
obsession with youth. To cling to the past and remain stuck in the illusion of
youthfulness, writes Jung, is as absurd as not being able to outgrow
child-sized shoes. "An old man who does not know how to listen to the
secrets of the brooks as they tumble down from the peaks to the valleys makes
no sense; he is a spiritual mummy who is nothing but a rigid relic of the past.
He stands apart from life, mechanically repeating himself to the last
triviality."
Caregiving is a way to avoid that trap. The Jungian analyst James Hollis
divides life into four psychological stages, each with the power to define a
person's identity. The first stage is childhood, which is characterized by
the dependency of the ego on the parents' world. The second stage is first
adulthood, roughly from puberty to age 40 but it can last a lifetime, when the
dependency of childhood is projected onto the roles of adulthood. The third
stage is second adulthood, when those projections dissolve and one has a chance
to become a true individual, beyond the determinism of parents and cultural
conditioning. The fourth stage is mortality, which involves learning to live
with the mystery of death.
In his work as a therapist, Hollis has noticed that the elderly generally
fall into two categories: "There are those for whom the life remaining is
still a challenge, still worthy of the good fight, and those for whom life is
full of bitterness, regret and fear," he writes in his book The Middle
Passage: From Misery to Meaning in Midlife. "The former are invariably
those who have gone through some earlier struggle, experienced the death of the
first adulthood and accepted greater responsibility for their lives. They spend
their last years living more consciously. Those who avoided the first death are
haunted by the second, afraid their lives have not been meaningful."
This transition doesn't come easily. It usually requires a major loss or
disillusionment that jolts you into consciousness and liberates you from old
projections. Taking care of a dying parent can be such a catalyst if it's
done consciously. As Tara Brach puts it, "When you're close to someone
dying, you realize that you're a living-dying being yourself."
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Caregiving is a humbling experience. It forces you to move beyond narcissism
to a more inclusive identity. "We spend so much of our time thinking
'How am I going to make myself comfortable?' 'How am I going to
handle this future situation?' " says Brach. "But there's a
tremendous amount of freedom that comes when you widen the circle of what
you're paying attention to and include someone else." It's
possible, of course, to find this kind of liberation in other ways. But the
day-to-day rigors of caregiving give you direct experience of the alchemy of
selflessness. It helps you see, says Brach, that "there's more reality
in togetherness than any idea of a separate self."
Now What?
As he neared the end his life, the American novelist William Saroyan
quipped, "Everybody has got to die, but I always believed an exception
would be made in my case. Now what?"
The journey through the later years is likely to bring moments of
uncertainty and even bafflement, not just for those making the passage but also
for the caregivers helping them down that mysterious road. The specifics may
vary, but every adult child taking care of an aging parent faces some version
of Saroyan's question. What is coming next? How should I get ready for it?
How do I cope? Along the way many difficulties will arise. Caregiving can tear
you apart. After all, this is your mother or your father. And you are their
child.
I think of my friend Rosemary. She spent much of her adult life trying to
free herself from her mother, Arlene, a tough-minded, fiercely independent
woman who raised five children on her own after her husband died in a plane
crash. Then, one night when Rosemary was in her 40s, Arlene packed a suitcase
and wandered away from her house in Brooklyn, hallucinating about a helicopter
on her roof and men under her bed. She was later diagnosed with early stage
Alzheimer's, and Rosemary, who is a gerontologist, volunteered to become
Arlene's primary caregiver.
It has been a wrenching experience. Rosemary moved Arlene to an assisted
living facility a few blocks from her apartment in Manhattan and tried
desperately to communicate with her. At times Arlene would start screaming and
lash out at her for no discernible reason. But, with the help of an
Alzheimer's support group and a lot of persistence, Rosemary slowly learned
new ways to interact with her mother, and their dynamic changed. "I had to
drop what I wanted to do and step into her world," Rosemary recalls.
"When I finally did that, the opportunity for love and gentleness grew by
leaps and bounds."
Not long after things settled down, Rosemary had to cut back her time with
her mother to two days a week to care for her husband, who was diagnosed with
cancer. By then, though, Rosemary's connection with Arlene was strong
enough to withstand the strain. "When you're a caregiver, a lot of
what you do goes unrecognized," Rosemary says. "Then there are times
when the eternal mother-daughter roles dissolve. She's softened and
I've softened. She's become the loving mother I've always wanted,
and I've become the loving daughter I always wanted to be."
Tears start to well in her eyes. "I've finally learned what it
really means to love someone."
Hugh Delehanty is editor in chief of AARP Publications.
Excerpted from Caring for Your Parents: The Complete AARP Guide by
Hugh Delehanty and Elinor Ginzler, published by AARP Books/Sterling, 2005.
Order it online today.
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