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Monday December 29, 2008

Middle-Age, um, Moment

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At a recent holiday party, I was chatting with some friends about movies, and the conversation went something like this:

"You know who I mean, she played the mother in the recent version of -- what was the name of that movie?"

"She has blondish hair, right? And she used to be married to Kenneth somebody -- the guy who does all the Shakespeare movies? I can't remember his name, either."

"-- based on a book by Evelyn Waugh, I think. Or was it Henry James?"

"Emily something, I think. I know it'll come to me in the middle of the night!"

If you're middle-aged, this interchange is likely to sound familiar: Most of us find ourselves fumbling for the names of books, political figures, even old friends that suddenly aren't there when we try to retrieve them. It's also common to walk with great purpose from one part of the house to another -- and completely forget what we came looking for...  Read more


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Friday December 12, 2008

The Secret Life of Parents

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When you're a parent, it's hard to know how much to tell your children about the hard realities of the adult world. Like any parent, I want to shield my children from news that will worry or frighten them. I furtively hid a magazine that featured lurid photos of prisoners at Abu Ghraib prison, for example, and I haven't told them the full story about a friend who committed suicide. At the same time, I know that when I was a kid I could always sense when my parents weren't telling me something important, and not-knowing made me worry more than the truth ever could have.

I was thinking about this recently because I have a number of friends and acquaintances whose parents concealed serious health concerns, or economic difficulties, because they didn't want their children to worry. One friend's mother was very ill, for example, and her father down-played the seriousness of her condition because, as her mother later told her, "There was nothing you could do, so what was the point of bothering you about it...  Read more


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Friday December 05, 2008

Stepfamily Issues Make Caregiving Even More Complicated

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It's never easy to care for elderly relatives, but unresolved stepfamily issues can make caregiving even more difficult. It's a problem that will become increasingly common over the next few decades, as more divorced parents age and require care.

My friend, Lily, is currently experiencing a stepfamily tsunami. Almost 50 years ago, Lily's stepfather left his first wife and married her mother, and to this day, his two daughters blame Lily's mother for the break-up of their family. As Lily and her stepsisters grew up and built lives of their own, the members of this not-so-blended family kept their resentments to themselves, for the most part, and were superficially civil when they met at occasional family gatherings.

But now that Lily's mother and stepfather are growing increasingly infirm, all the unresolved resentments have come roaring to the surface. In the last few years, Lily's mother has...  Read more


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Friday November 28, 2008

National Day of Listening

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For the last few weeks I've written here about taking time to record your older relatives' stories over the holidays. It turns out it's the season: National Public Radio (NPR) has designated today, November 28, the day after Thanksgiving, a "National Day of Listening," and is encouraging people to "sit down with a loved one...and record a meaningful conversation."

According to "Morning Edition" host, Steve Inskeep, who kicked off the project with an interview of his mother, NPR is hoping that recording loved ones' stories will become a new holiday tradition. Check out NPR's website to find interviews by Inskeep and other NPR hosts and commentators.

I've been conducting an informal poll, and it's remarkable how many people wish they'd interviewed their relatives before they died. They speak with longing about having missed an opportunity that's now lost forever. My mother, for example, wishes she'd asked her father more about her own mom, who died when my mother was a young child...  Read more


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Friday November 21, 2008

Creating a Family Oral History: Asking the Right Questions

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In my last post, I wrote about capturing your relatives' stories when you're together over the holidays. I'm going to follow-up this week with some more suggestions:

Getting started. As I mentioned earlier, your oral history project will be more fun for everyone involved if you keep your approach casual and low-key. You'll get the best and most memorable results if your relative's memories unfold in the course of relaxed conversation rather than a staged and formal interview. That said, it's important to take a little time to think about your list of questions.

Asking the right questions. You'll probably need to ask your relative some basic questions as you go, to situate her chronologically and geographically -- questions like, "Where did you go to high school?" and "When did you move into the Grove Street house?" But don't get bogged down in where and when questions, or you'll end up with a very limited -- and boring -- oral history...  Read more


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Wednesday November 12, 2008

Oral Histories: Preserving Your Family's Stories

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I wish I'd interviewed my grandparents, and recorded some of their stories, before they died. One grandfather worked in the Roosevelt administration and entered Germany with the first Allied troops right after World War II ended. My grandmother graduated from college at a time when few women received more than a high school education. I can still clearly remember the sound of my grandparents' voices, but I've forgotten many of the stories they told me.I wish I'd asked more questions before it was too late.

Many friends and acquaintances I talk to have the same regret. "There are so many things I'd ask her now, if I had the chance," a friend told me wistfully after her mother died. "And I'd give anything to have a recording of her voice." Like many people, my friend intended to interview her mother and create an oral history, but never got around to it.

If you've ever thought about interviewing...  Read more


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Friday November 07, 2008

Final Messages

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Last week, when I interviewed Michele Mason about caring for her neighbor, Andy, during his final days, she told me that the experience made her less afraid of her own death.

"It was incredible to watch Andy let go and accept his death." Michele said. "It made me feel less afraid to die."

When we watch a close friend or relative pass away, most of us can't help but reflect on the eventual conclusion to our own story. And many caregivers, like Michele, find that helping a dying patient makes the prospect of their own death a little less frightening. Particularly if the loved one dies peacefully, without a lot of pain, helping someone at the end of his life can be a humbling and awe-inspiring experience. This is the thesis of Final Gifts, by hospice nurses Maggie Callanan and Patricia Kelley, a book I recommend to anyone who has a dying relative or friend.

Callanan and Kelley talk about the special...  Read more


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Friday October 31, 2008

It Takes a Neighborhood: Epilogue

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Last spring I wrote about two San Francisco women, Randi Myrseth and Michele Mason, who were taking care of Herbert Anderson (Andy), their elderly neighbor. Randi and Michele began helping Andy eight years ago, after a mugger attacked Andy's wife, knocking her to the ground and fracturing her hip. Andy's wife died of cancer a year later, leaving him alone and in shaky health. Randi and Michele promised Andy they would take care of him until he died, so he wouldn't have to go into a nursing home.

They kept their promise. Andy died last June in his own bed, in the home where he'd grown up. He was 89-years-old.

I caught up with Michele recently to talk about what it was like caring for Andy during his last months of life, and what she'd learned from her caregiving experience.

According to Michele, Andy never regained mobility after he fell and broke his own hip last fall. During that time, his dementia grew worse, and so did his general health...  Read more


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Thursday October 23, 2008

Scenes From (Caregiving) Marriages

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How is caring for a spouse different from caring for an elderly parent or other relative?

One obvious -- and enormous -- difference is that becoming a caretaker for your spouse creates a fundamental change in your primary relationship. If you have a good marriage, your spouse is your romantic partner, your soulmate, your constant companion, and your best friend. All this can be wiped out -- or dramatically altered -- by accident or serious illness. In recently published memoirs, two women describe what it means to "lose" the husband they loved, and the steps they took to rebuild their lives and their relationships.

In her book, To Love What Is: A Marriage Transformed, Alix Kates Shulman writes about her husband, who was a vital 75-year-old until four years ago, when a fall left him with a disabling brain injury. The two first fell in love as teenagers, when they attended summer school at the same college, then reunited years later after both had weathered marriages, childrearing, and divorce...  Read more


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Thursday October 16, 2008

Gone But Not Forgotten: Rituals That Honor the Dead

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In a recent radio interview, author Francine Prose observed that no matter how prepared you are for a parent's death, you're never really ready, and the loss is far more painful than you ever imagine.

In modern society, the death of a parent, close relative or friend can be particularly searing because its often such a lonely experience. When the memorial service is over and the casserole dishes have been washed, mourners are left to their own private grief, and the dead drift into the realm of fading photos and stale reminisces. We have few rituals that help us remember our loved ones, or celebrate their lives and contributions in an ongoing way.

This occurs to me now because in San Francisco's predominantly Latino Mission district, near where I live, preparations are beginning for the "Day of the Dead" (Día de los Muertos). This Mexican holiday combines both indigenous and Catholic traditions and is celebrated on the 1st and 2nd of November...  Read more


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Thursday October 09, 2008

Silence Not Golden -- Or Helpful -- For Dying Patients And Their Families

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Should physicians talk frankly to terminal patients about end-of-life issues?

For years, this has been a matter of debate in the medical community: Many physicians worry that discussing death will distress patient and family alike, and cause the patient to give up hope.

But an important new study by researchers at the Dana-Farber Cancer Institute, published in the October 8th issue of the Journal of the American Medical Association, found that such conversations actually improve the quality of life for patients -- and their families.

Researchers found that patients who had end-of-life discussions with their doctors were no more depressed or hopeless than other patients. In fact, these patients also made decisions that eased their final days, choosing comfort care over more aggressive treatments, and calling in hospice services earlier than patients who didn't have such conversations.

What's most remarkable about these findings is the benefit for the patients' families...  Read more


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Thursday October 02, 2008

Understanding What It Means to Be Old

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When my children were very young, the parenting books I valued most were those that helped me understand what the world looked like from a child's point of view (books by Penelope Leach, and The Magic Years by Selma Fraiberg come to mind.) Now that I'm the parent of two teenagers and a teen wannabe, I reach in moments of distress for Get Out of My Life, by Anthony Wolf, which helps me comprehend the often-baffling workings of the teenage brain.

So far, I've found two (nonfiction) books that provide an empathetic and illuminating perspective on aging. I've already discussed one of these books here: How to Say it to Seniors by Caring.com expert David Solie.

The other book I return to again and again is Another Country: Navigating the Emotional Terrain of Our Elders, by psychologist Mary Pipher. In her book, Pipher shows how our mobile, fast-paced, and fragmented modern culture has failed to create a productive, meaningful role for older people, and instead shoves them aside and ignores, infantilizes, or isolates them...  Read more


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Thursday September 25, 2008

A Grandchild Steps in to Help Her Family: The Sequel

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A few weeks ago, I wrote here about my niece, Casey, who traveled from Florida to Connecticut to help my parents after my mother broke her hip.

As I wrote then, my sisters and brother and I all wondered how it would work out. My parents live in a serene little New England town that shuts down by 9 p.m. every night. Most people don't color their hair unless they're over 60, and then the preferred color is a gentle blue.

My niece Casey, on the other hand, loves loud music, Salvador Dali, and partying all night. She has tattoos and piercings, and her hair is commonly a shade not found in nature. Would she miss her boyfriend, her waitressing job, and her busy social life in Florida? Would my parents, who like doing things for themselves, allow her to help them? It's been a few weeks now, so I decided to check in and see how it's going.

Casey arrived the day after my mother got home from the hospital...  Read more


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Thursday September 18, 2008

Hospice: Comfort for Patient and Caregivers Alike

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If Caring.com expert Laura Juel has one regret about her own recent caregiving experience, it's that she and her family didn't contact hospice sooner.

As I wrote in last week's post, Juel's mother, who had terminal cancer, suffered a stroke last summer, just weeks after her oncologist concluded there was no point in continuing treatment. But Juel's family had reservations about calling hospice. "To my sisters, hospice meant giving up on my mother and turning on the morphine drip. We just weren't ready for that," Juel recalls.

It's common for families to resist calling in hospice when a loved one is gravely ill. In many cases, the family has been joined in battle for months, even years, to keep the patient alive. Turning to hospice can feel like giving up -- not only on the patient, but also on our own fantasies about cheating death and defying the odds -- at least this time. In many ways, calling hospice represents the first step in letting go...  Read more


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Wednesday September 10, 2008

Fighting for Breath: A Mother's Last Weeks of Life

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Laura Juel isn't intimidated by the world of medicine. As an occupational therapist at the Duke Medical Center in Durham, North Carolina, she deals with doctors all the time, and she's used to navigating the often-bewildering ins and outs of the medical bureaucracy. Her familiarity with medicine isn't just professional, either: Her husband is a physician as well.

Nevertheless, Juel, who is also an expert at Caring.com, didn't realize how daunting it can be to oppose "doctors orders" until this past August, when her own mother was dying. Her mother, who had been diagnosed the year before with esophageal cancer, suffered a stroke in early August and was rushed to the hospital. As soon as Juel heard about the stroke, she left her husband and three young children in North Carolina and traveled to New York to help with her mother's care.

Not long before the stroke, the oncologist told Juel's mother that there was nothing more he could do, and the family knew she didn't have long to live...  Read more


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