There’s a good article in the April Atlantic by Jonathan Rauch about the struggles of caring for an aging parent (i.e., what Rauch went through with his father, who died this past December). Having been involved since 2001 in a somewhat similar situation (my mother, who died this past October), I wanted to make note of Mr. Rauch’s reflections. He concludes that senior caregivers are still mostly a “silent, invisible army” amidst millions of Americans in their fourties and fifties, most of whom are trying to get by in their own working lives while simultaneously working hard to raise their own children.
Given the experience he had over the past 12 months with his father, Mr. Rauch, a successful political affairs writer from the Washington DC area, now understands something of the sacrifices that a whole lot of unseen, uncelebrated people “out there” in the cities, towns and villages of America are making in order to comfort their parents in their decline. Now that he’s had a taste of what all these good folk silently bear, Mr. Rauch wants to put them “on the radar” of the movers and shakers of our political, cultural and economic institutions. He wants the news and entertainment media to give them more recognition, wants the government and other do-good establishments to give them more information and support, and wants employers to give them a break when their commitments call them away from the daily grind.
Well OK, Mr. Rauch, thanks. Having been a member of this silent army, knowing how it can twist your life into both emotional and financial knots, I appreciate some recognition from the intelligentsia. I could contribute some of my own practical suggestions on how government policy (and resources – which are in very short supply these days, I realize) could help create a better system of home care support, for those families who choose not to download their parent problems to an institution, as Mr. Rauch eventually did.
Should Mr. Rauch have considered letting his father move in with him, as opposed to the assisted living facility solution that he chose? I realize that such a solution would not work in many situations; but given what my brother went through in keeping my mother at home with him until the end, I can testify that the home care support network available in our country is rather weak, that you really have to be willing to suffer to to that route. With a stronger, more organized and professionalized home-care network, the “home-with-family-until-the-end” option would be more do-able.
Nursing homes and assisted living facilities can be humane options for many seniors; but I still believe that the most desirable situation is for seniors to live with children or siblings or other relatives until the end. Blood relationships are still key, even if American society has de-emphasized family bonds in the past few decades. Unfortunately, I can say from personal experience that our nation’s home support system for the aging unspeakingly asserts that at a certain point of decline and need, home care should be aborted in favor of institutionalization. That is the unspoken, default assumption. With better management and training for home care workers and more organized support from nursing managers and doctors, perhaps it wouldn’t have to be.
But nonetheless, it’s still good to see some acknowledgment from the liberal intelligentsia media that an old-fashioned notion like taking care of your weakening parents is still a good thing; and that there are millions out there who are still doing it despite the fact that our policy makers and culture makers have pretty much ignored it. I suppose that it’s all just too old-fashioned, too close to Republican values or religious sentiments, for the brains in Washington and New York to applaud.
Mr. Rauch said that after 6 months or so of trying to help his father, he was near breakdown; he wanted to go back to being his father’s son, and not be his nurse. Yea, my brother went through that phase too. But he gritted his teeth and kept going another 8 years with my mother. Mr. Rauch more or less did what Barack Obama did with his mother when she got sick; i.e., expressed his concern, maybe chipped in some money, but then got back to his world of political involvement. Sorry mom, I want to be your high-achieving son, not your nurse.
Well, Mr. Rauch, thanks for the tip of the hat, even if you didn’t go the distance quite like my brother did. I’m glad that your father was able to teach you some lessons about humankind, some lessons that your fellow thinkers and writers and policy-makers might do well to ponder.
Jim,
I too can speak with some authority about this type of situation. I had a sick husband at home for 10 years; then a few years later I assisted my sisters in caring for my mother in her last several years. Then a few years after that I was responsible for my husband’s brother who had lived with us for 20 years.
My husband was at home until his death at home; I was holding his hand as he breathed his last breath. My mother, however, was a different case. In the end, when she was in a coma in her last several weeks, we were obliged to resort to a nursing home situation as none of us was able to physically do the work she required. As to my brother-in-law: again, I simply could not do the physical work involved in caring for him alone.
What I did learn from these three situations about the responsibility for caring for loved ones in their last days is that it is one of the most physically, emotionally, and psychologically demanding situations that is ever required of a person.
I also learned that having a loved one in a nursing home is in a lot of ways even more difficult than having the person at home. While one might not have to do the physical labor involved (which in some cases is simply impossible for some people to do even if they wanted to do it), one is NOT relieved of any responsibility for the care of the person. One must constantly be on alert in visiting and watching over the person in a nursing home to be sure that all is well with the individual. This watchfulness and care requires constant visiting at various hours and times (visiting hours or not) to make sure that the person is well cared for. I made it a point of showing up at various times throughout each day (early morning, midday, night time) so that the staff never knew when I might show up. I learned that staff will tell other staff: “Make sure Mary or Joe is taken care of as the family may show up.”) One must keep a constant watch over the person; the responsibility for the care of the person is not relieved in any way when a person is in a nursing home. One can NEVER forget the person is there and is one’s responsibility to care for in his/her last period of life.
These are most difficult times in a person’s life, but they are times that one simply must “go through” if one is to care for one’s loved ones “properly.” AND one simply does it for love of the other person. No big “thank yous” are ever really offered—and, frankly, none should be expected. The loving person simply cares for those who have loved one and who one loves because of love.
And yes, in some ways when the person dies, there are mixed emotions. On the one hand there is the deep loss; on the other hand there is a kind of relief. But that “relief” comes with a “hitch” connected to both the loss and the relief of the burden: One must remake one’s life and that is an adjustment period that is difficult in its own way. In the end, death is part of life. One learns that from these situations. But one also learns that although often one thinks that the world must surely stop for the loss of the loved one; one wonders just how to remark one’s life. But eventually, one learns to adjust, one learns to remake one’s life, and life goes on, whether we like it or not.
MCS
Comment by MCS — March 23, 2010 @ 5:16 am