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A Friend Stopped By | 08/02/2009 11:00 pm

We Are Not the Boss of Them, by Paula Span

The veteran journalist and author of When the Time Comes tackles the realities of caring for an aging parent.
By Paula Span

Editor’s note: Paula Span is the author of When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions, just published by Grand Central Publishing. Click here to read an excerpt. For more on Paula, visit paulaspan.com.

Your parents become your kids – or do they?

I can see why people turn to this analogy when their aging parents grow frail or sick. The balance has shifted, often irrevocably. The grown-ups, the people who always seemed so strong, become less capable, more dependent. More and more, we who relied on them for guidance and support (or who fought regular battles for our independence) are the ones they rely on.

Unlike with kids, we have only a limited ability to get our parents to shift course.

So you hear this refrain all the time: It’s like they’re the children now, and I’m the parent.

It’s shorthand for certain realities of eldercare, which remains largely a family responsibility. It means: I have re-shouldered the duties I thought I was done with. I have to be sure she takes her medicine. I have to drive him everywhere. I’m taking on more of the financial burden. And in some cases, the ultimate sense of déjà vu: I’m buying diapers again.

More than these specific tasks, I think the parents-as-children theme refers to a state of mind. When you’re a caregiver, your time is not your own. You can spend many hours at this work, and even when you’re not on the scene you’re expecting the phone to ring with a question, a problem, a need. Shirley Grill, the daughter in the excerpt posted here on wOw from my book When the Time Comes, keeps her cell phone and her BlackBerry clipped to her waistband; even when she’s in Europe on business, she gets calls about her mother in the Bronx. As when your children were young, you feel always on duty.

For all that, however, it’s a faulty analogy, one parents understandably find insulting. Their bodies may be failing, or their minds, or both — but they are still adults with a lifetime’s experience and an undiminished need to feel autonomous. They require help, but they aren’t children.

It’s also a less-than-helpful approach. Unless a parent has such serious dementia that she cannot make her preferences known and or reach even basic decisions, parents may well insist on their own choices, in everything from what they eat (even if it contains too much salt) to where they live (even, as in Shirley Grill’s case, if you cringe every time they climb the stairs). I think my dad, doing pretty well on his own at 86, ought to ask his cleaning person to come more often. He shrugs, and does what he wants.

Unlike with kids, we have only a limited ability to get our parents to shift course.

This doesn’t mean we are without influence. We also have needs and preferences, and trying to care for parents without rendering ourselves exhausted and useless can require extended negotiations. Sometimes, a professional with initials after his or her name — a family doctor or attorney, a social worker, a geriatric care manager — can be more persuasive than we can. Sometimes we can provide options or find compromises. Sometimes a crisis hits and events decide for us.

In extreme situations, there are legal remedies, but short of that, it’s hard to ground our elders or revoke their allowances. Sometimes – and this is like child rearing – we have to make peace with our limitations.

We Are Not the Boss of Them.

53 Reader Comments (so far…) Sign In or Register to comment

Kim Horton
I need my mother to read this because she is caring for my grandma/ her mother.  God love them both, they are just a pair the two of them.  I have said the exact words to her, she’s dealing not with a child but an adult who is being forced to depend on her child and she doesn’t like the feeling.  Thank you for the validation!
By Kim Horton on 08/02/2009 11:27 pm
Mary Utrup
I just happened to catch your post and I hope you will let your mother know that someone in the great WOW network e’d to congratulate and BLESS her for the work she is doing with your grandmother. In this day of "the best resthome" mentality it is comforting to know that there are families who still "take care of their own." My own mother was an insulin dependent diabetic with a very imbalanced profile. When my father was in his last weeks he asked my youngest sister to please "take care of mom". She was "chosen" because she had the most experience with our mom when she would have her low sugar attacks. It was not an easy time for either of them. Nothing was "more certain" than that dad would out live mom, afterall she was "chronically" ill and dad had been in the best of health most of their 59 years of marriage. Not only did my dad "go" first, my mom lived another five years without him. It takes a great deal of courage, determination, and love to take on the "job" your mom has now. The more love and support you can give to the two of them the happier the memories will be in the years ahead. The comfort the two of you are giving to mom/grandma, whether it is acknowledged or not, means a more than you can imagine. Thanks again for keeping her "at home".
By Mary Utrup on 08/08/2009 11:24 am
joan larsen

The stories are so familiar to me.  My own living room has served as a confessional - with tears - as friends, already 60 or 70, have told stories that were so similar to what I have just read.  I have found that it is far better if a professional is the intermediary to talk to the aging parent.  I have seen the parent turn on the daughter, hate the daughter for suggesting help may be needed. 

But in my large city, the most well-known agencies are those that send out Polish women for long stays with the parent.  And then I have seen something not talked about:  the parent lying, slapping the caregiver, treating her so terribly, that now I have the Polish woman coming over in tears to tell of her treatment … as well as the isolation as time goes on.  Normally, they will stay as their families in Poland rely on the considerable money made here.  But the situations - the aging parent and her feelings and then the treatment more often than we may know given to the Polish women tears at my heartstrings. 

What does one do?  There is no easy answer … but stress and heartbreak often go hand in hand with each member of the group.

The book sounds very worth reading as these situations will become more prevalent as all of us live longer. 

By joan larsen on 08/03/2009 12:21 am
Kelly In Texas

What to do? LOVE THEM AND CARE FOR THEM just as they did for you when you were an infant. Pay if forward people. Deal with it people.

It is not easy, but it is a part of life. Notice that I said "it is a part of life". Not death. It is still a part of "life" for them.

Beware this Obamacare that is putting our elderly out to pasture. WE have the duty and honor of giving our aging parents the rights and advantages of the very best of care. NOT THE GOVERNMENT. No one else has the right to tell my parents or my family what they deserve, or how they will be treated.

It is our honor to care for the elderly.

By Kelly In Texas on 08/03/2009 12:36 pm
Andrea Brandon
What I wouldn’t have given to have had this opportunity. My mother died much before her time.
By Andrea Brandon on 08/03/2009 8:07 pm
Washington  Cube
I was my mother’s caregiver, and she died way too young, plus I had the added horror of her losing her personality so in effect losing her twice.  There are no easy answers.  You send them out to caregivers, it can go both ways.  You have a caregiver in and they can abuse and steal or keep the television switched to Spanish tv blaring away.  It’s an individual decision.  With hindsight, I have no regrets over my choices, but I wish I hadn’t had to face them so soon.
By Washington Cube on 08/03/2009 10:32 pm
Andrea Brandon

Cubie,

Where have you been? I’ve missed you.

I agree - there’s no hard and fast answer for any family in this situation.

I was Durable Power of Attorney for an elderly firend who was bipolar and had the beginning stages of dementia. She had no family and it was hard  making her leave her home and go into a residential facility. But in the end, I think she enjoyed the move because she had people to talk to whereas before all she had was the tv set.

 

By Andrea Brandon on 08/03/2009 10:58 pm
Washington  Cube
I’ve got four other blogs to contend with, Andrea, plus….stuff.  Yeah, I’ve done POA and executor and probate queen.  I wish I could say "never again," but who knows.  Nice to be missed.  I’ll try to be more regular.
By Washington Cube on 08/04/2009 1:38 am
Kelly In Texas

Hey Cubie! I’m with Andrea…you’ve been gone toooooooo long….

It is so hard to deal with the illness and death of a parent. No easy way to deal with any of it. But after all of the tears and trials and harsh words….I did the best that I could for my parent.

That is something that we can know, Cubie…we did our level best out of love and respect.

By Kelly In Texas on 08/04/2009 9:01 am
Washington  Cube
I agree, Kelly.  I’m not going to spell out here what I went through, but there were other circumstances that made things so horrible.  I chose to enter the situation, because I felt it was the right thing to do, and I did NOT want regrets later over stepping away from it.  I paid a price, but in the end, I have peace in my heart.  And yes, out of love and respect, Kelly, absolutely.  And thanks for noticing I have been gone.  So many don’t. Laughing.  I’ll try to show up more.
By Washington Cube on 08/04/2009 1:48 pm
judith riggs

Kelly,

I agree with you 110% since I, too, consider it an honor to not only care for the elderly, but to be with them until the end. I not only helped contribute to the care of my Mother, I was there when she took her last breath. However, regarding your comments about the Obama Healthcare plan, I have to disagree, especially since his comments were taken out of context: http://politifact.com/truth-o-meter/statements/2009/aug/03/dan-lungren/l… . The cost of doing nothing - the conservative plan for health care - is staggering: The average family will pay $10,000 more in premiums by 2019 if nothing is done. We can not afford the conservative health care plan. We must reform health care now, for you and me and our families. Please check your facts before posting. Feel free to use the above link. Thanks.

By judith riggs on 08/06/2009 2:29 am
Kelly In Texas

Yes judith….quite an honor it is. Thank God that I was able to care for and request life preserving proceedures for both of my parents, before Obamacare was forced through our legislature under less than democratic processes.

I think that YOU judith, need to check YOUR facts before posting or sharing the opinion that Obamacare is anything less than a government take over of over 17% of our economy.

Anyone that is scared and manipulated into the Obamacare will be a part of turning our most important freedom over to a group of 15 non practicing medical professionals that will decide WHO WHAT WHEN and WHERE we get care. The fact remains that a small percentage of Americans are without health care because they can not afford it. The rest are HAPPY with the health care plans that they have. FACT.

So judith, instead of handing our most important freedom over to an inept government bureauocracy, let’s take the time and get this right. There are MANY other ways to improve what is ALREADY the best health care in the world.

There are many things hidden within this bill that take the freedoms from Americans and place our lives and our money directly in the hands of a greedy and spend happy government. Not the American way by any means.

You many want to ask yourself just WHO wrote this bill? No one seems to have read it….so, who exactly wrote it?

No judith, the fact is that this administration is pushing socialism down our throats and they are out and out lying about it. Yes, liars.

This is not about health, nor care, it is simply about control of life and death and BILLIONS upon BILLIONS of taxpayer money being handed over to a few corporations and big government.

Wake up America.

By Kelly In Texas on 08/06/2009 9:49 am
judith riggs

Kelly,

This is my last response so read carefully. There is no nice way to say this so I’ll be blunt: you are dead wrong.

1."group of 15 non practicing medical professionals that will decide WHO WHAT WHEN and WHERE we get care." 

They aready do - they’re called insurance executives.

2." instead of handing our most important freedom over to an inept government bureauocracy, let’s take the time and get this right. There are MANY other ways to improve what is ALREADY the best health care in the world."

Do you know anyone on Medicare or Medicade? Any retired servicemen or women?  Have you written your senator and asked him/her about their government healthcare? Best healthcare in the world?? http://pewresearch.org/pubs/1293/health-care-public-gives-lukewarm-ratin…. Only the conservative republicans give the highest marks to US heathcare.  Why am I not surprised? We should not waste time fighting back against ridiculous myths like "death panels," "socialism," or "government-funded abortions. People are dying Kelly. http://standupforhealthcare.org/blog/

3 "The fact remains that a small percentage of Americans are without health care because they can not afford it. The rest are HAPPY with the health care plans that they have. FACT."

FACT Kelly:16% of Americans are without health care insurance. That’s 1 in 6 adults according to a Gallop Poll: http://www.news-medical.net/news/20090722/16-percent-of-Americans-without-health-insurance.aspx  You should back up your so-called facts with links and statements from reliable sources Kelly. The problem is that the polls like this don’t capture the critical reasons why reform is necessary. Firstly and foremost, this poll doesn’t represent the voices of millions of uninsured Americans, and extending coverage to those people is one of the primary motivations for reform. Also, most  employers pay nearly all of the premiums, and they do so before tax, which leaves people with a distorted sense of how much health care actually costs.http://blog.newsweek.com/blogs/thegaggle/archive/2009/09/01/poll-finds-large-majority-of-americans-happy-with-their-health-insurance.aspx

4. "No one seems to have read it….so, who exactly wrote it?" 

Certainly not those such as Charles Grassley who have been holding the so-called town meetings. Instead of calming thoise in attendance with facts, they continue to spread the fear with innuendo and outright lies. The truth is, they have no interest in reform. http://beltwayblips.dailyradar.com/story/the_truth_about_charles_grassley_and_health_care/  And those people you see making a fuss at the town hall meetings? They’re paid by the health care industry to do so Kelly: http://personalmoneystore.com/moneyblog/2009/08/05/obamacare-town-hall-h…

5. the fact is that this administration is pushing socialism down our throats and they are out and out lying about it. Yes, liars."

Socialism Kelly? Please. Even Billy Wharton, a socialist political organizer, says that Obama is not a socialst. http://www.washingtonpost.com/wp-dyn/content/article/2009/03/13/AR2009031301899.html  In fact, in the above article he thanks Mike Huckabee and John McCain for putting the Socialist Party in the spotlight. Fact, yes, a real fact Kelly, is that John McCain stated on Larry King Live that he doesn’t think that Obama is a socialist, which, at the time he made the statement, ran counter to most of his campaign rhetoric in the past. (A nice way of saying - LIAR.)

I could go on and on, but I have a real life Kelly. I also have a husband with MS who, by the way, is no longer insured because his COBRA ran out August 31, who also got fired after working for a small company for over 14 years since he has MS (we know that was why because he got it in writing and that’s what they wrote him), who can no longer get insurance because - he has a pre-existing condition.  

Let me offer you some advice Kelly - please check your FACTS and TRUTHS before writing and making Sarah Palin look as if she is a Rhodes Scholar (www.rhodesscholar.org) and wasting time. Here are some links that might help:

FactCheck.org

PolitiFact.com

Health Care For America Now!

House Committee on Education & Labor

Also you might want to stop listening to people such as Glenn Beck and Rush Limbaugh. Glenn Beck’s sponsors are dropping him like mad because he seems to be not playing with a full deck and Rush Limbaugh "has been delivering misinformation, L I E S to a large audience to America". http://www.alternet.org/media/141547/limbaugh%27s_lies_sabotage_the_heal…

Here’s another good link regarding liars:  http://www.thenation.com/doc/20031013/corn 

Goodbye and good luck.


By judith riggs on 09/07/2009 10:27 pm
Kelly In Texas

Here you go judith….some great reading material:

Tuesday, March 24, 2009

by Scott Atlas

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world.  Economists, government officials, insurers and academics alike are beating the drum for a far larger government rôle in health care.  Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex.  However, before turning to government as the solution, some unheralded facts about America’s health care system should be considered.

Fact No. 1:  Americans have better survival rates than Europeans for common cancers.[1]  Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom.  Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway.  The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2:  Americans have lower cancer mortality rates than Canadians.[2]  Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3:  Americans have better access to treatment for chronic diseases than patients in other developed countries.[3]  Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease.  By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them. 

 Fact No. 4:  Americans have better access to preventive cancer screening than Canadians.[4]  Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

  • Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

Fact No. 5:  Lower income Americans are in better health than comparable Canadians.

Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent).  Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."[5]

Fact No. 6:  Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6]  All told, 827,429 people are waiting for some type of procedure in Canada.[7]  In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8]

Fact No. 7:  People in countries with more government control of health care are highly dissatisfied and believe reform is needed.   More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."[9]

Fact No. 8:  Americans are more satisfied with the care they receive than Canadians.  When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10]

Fact No. 9:  Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K.  Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11]  [See the table.]  The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain.  The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12] 

Fact No. 10:  Americans are responsible for the vast majority of all health care innovations.[13]  The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14]  Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15]  In only five of the past 34 years did a scientist living in America not win or share in the prize.   Most important recent medical innovations were developed in the United States.[16]  [See the table.]

Conclusion.  Despite serious challenges, such as escalating costs and the uninsured, the U.S. health care system compares favorably to those in other developed countries.

Scott W. Atlas, M.D., is a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center.  A version of this article appeared previously in the February 18, 2009, Washington Times.


 

By Kelly In Texas on 08/06/2009 2:32 pm
Victoria J

Atta girl Kelley, you  do stay on republican message don’t you…even if it hasn’t met the truth in a decade. I find it interesting how the Republican spin works so hard to defeat Obama that they don’t give a good hoot, if families listening vote against their own interest as long as they defeat the President. Maybe one day old Kelly girl with put the country ahead of her party. You got a relative or know anybody on Social Security Kelly?….that is the government…or haven’t you noticed and all your right wing republican legislators are they taking government paid health insurance? Wowowow!

By Victoria J on 08/06/2009 5:07 pm