Tag Archive | eldercare

The Song for Another Time

At the risk of alienating more than a few readers, I have a disclosure to make: I am a  huge country music fan.  It’s true.  It’s been almost 25 years now since someone played Mary Chapin Carpenter (who went to my high school, actually) for me and I was hooked.

One of my recent “songs on repeat” is from a band called Old Dominion.  It’s called “A Song for Another Time”.  It’s about a relationship which is great, but is going to end, and soon.  The idea is that we should enjoy it now, and feel the sadness later.  This is a common country music theme, I know.  To make the cliche worse, as if it could get worse, the descriptions of how amazing things are, and how sad they will be, are just the titles of songs strung together.  Brown-Eyed Girl.  Sweet Caroline.  Always on My Mind.  I’m So Lonesome I Could Cry.  You get the idea.  Trust me: no one will be writing articles about this tune 50 years from now about how it changed music.

But I am hooked on this song anyway.  It captures something in the way that only music can.  Like many of you, I have lived almost this exact scenario in a relationship before.  (As an aside — I could do a whole other blog on those moments in relationships, of all types, when you know it’s all going to change, either one way or the other.  Comes down to only a few and they always stick with you.)  And as a Sandwich Generation father, there are moments when I feel like I am living it now.

My daughters just turned 13 in June.  I’ve been told by countless parents that the journey from here to 16 is fraught with peril.  Occasionally I can see that future, but not today.  Today my kids still think I am funny and smart, and mostly like being around me.  We have fun together.  They make just about anything I’m doing more fun.  They still have some innocence and at the same time show flashes of wisdom that make me shake my head at how amazing they are going to be as women.

After the first day of school, I took Sophie to Five Guys and we just hung out and ate dinner together and talked about our days.  It was simple, and sweet, and lovely.

My father too is in one of these phases where I recognize that things are about as good as they are going to get.  There are more bad days than there used to be and some things that I do for him make me a die a little every time.  I wish I didn’t feel that way, but I do.  And yet I know the glass is still half full.  Many blogs about caregiving are written by women, mostly older than I am, who are caring for very sick parents who need help with the basics, who can’t remember who they are, or are fighting terrible diseases.   Much of my time as a Sandwich Generation son is spent just talking, or fixing modest technical issues with his iPad.  Last Sunday afternoon we hung out and watched the US Open final, like we have for almost 40 years now.  It makes me feel like a kid again and so happy that I still have my father.  It was simple, and sweet, and lovely.

In the back of my mind, I know different days are ahead.  The moments will come in those relationships when I know they are going to change.  As the lyrics go, though – that’s a song for another time.

The Scooter (Part 1)

I moved to New England in 2003, trading the mild Bay Area climate for April snow.  Needless to say, I felt some bitterness about this as I’d fled the Northeast years before to avoid this kind of unnatural condition.  In response, I did what many adult males do: deluded myself.  Specifically, I pretended that having no solution for removing snow magically would prevent snow from appearing.  That didn’t work.  I passed a couple of winters shoveling Massachusetts snow the old-fashioned way, which did not put me in a better mood about the situation.

Then Nova turned me onto the idea of a gas-powered snow thrower.  Her logic was pretty simple: I couldn’t change the weather by pretending it wasn’t bad, so I needed better equipment.  I relented, and I admit it: it was probably the best $800 I ever spent.  Firing up its engine requires flicking enough switches and pulling hard enough on a starter cord that I feel like I’ve gotten physical.  I get to use a choke switch.  Who doesn’t love a good choke switch?  And it is marvelously loud.  Sure it is effective at throwing snow a long distance, but after the other benefits, I almost don’t care.  It has changed the way I look at snow.  And since we’ve had some winters where the snow hasn’t stopped, I deserve something that can do that for me.

Here’s what this has to do with being a Sandwich Generation father.

Over the past year, my father’s mobility has declined.  It’s a fact.  It’s to the point now where he shuffles his feet and not much happens.  He has trouble turning.  With a walker he can get himself down a hallway, but the clock is ticking on that as well.  So about 3 months ago, he asked me to help him buy a motorized scooter to help him get around.  Which I resisted.  My logic was that once he started using a scooter, he wouldn’t be walking again, which itself would have downstream consequences that couldn’t be good.

I held onto this logic for some time.  Like my pre snow-thrower delusion, I felt that I could hold back time a little longer.  It’s like trying to wish away blizzards in Massachusetts; you might get lucky for a while, but eventually, the snow emergency is coming.  And like that decision, it took someone else to point out that my logic was, in fact, delusional.  Actually, this time it took 2 people.

But, in my defense (which is the opening phrase of most indefensible defenses), this is my father we’re talking about.  We used to play tennis on the street where I grew up.  He helped teach me to swim.  He would lift heavy equipment onto his car’s roof as a core part of the way he made his living as a consulting cable TV engineer.  I didn’t worship him for these things – we just didn’t have that kind of relationship – but I always knew he was especially strong.

When my mother passed away 5 years ago and I saw her laying there in the hospital, he was the one who kept me from falling over.  He was 87.  I’ve held onto that as proof that he can defy time, and maybe by extension, that I can too.

Then I thought about what the scooter what mean for him.  Right now, he is trapped inside most of the time.  With one, he’ll be able to spend a few days outside instead.  He deserves to spend more time outside.  He gave up his car more than a year ago, and a scooter will be a machine he can control.  He deserves more things he can control.  And most importantly, he appears to have found a potential girlfriend who lives far away (that is, in a different section of the community where he lives).  For all his faults — more on this next time — he deserves to be happy, and I suppose this also means that he deserves a girlfriend.

These are all things that once pointed out to me were so obvious that I wondered what kind of daze I must have been in not to have seen them in the first place.

Do I do this with my children?  I like to think I don’t.  I don’t pretend that a lack of feminine hygiene products in the house is going to prevent my daughters’ bodies from changing.  But then, as with the blind spot I wrote about before, I’m sure I have one here.  I look forward to my next discussion on my back porch to discover what it is, and the particular Sandwich Generation delusion about my children that it is hiding.

The Observation

download 2

Because it’s mid-Yom Kippur and I am in the part of the Sandwich Generation with only one parent, I am thinking about my mother today.  Last night at services I looked to my right at my children and flashed briefly to just how much they’ve grown in the 4 years since she passed away.  If she could observe them, she’d be proud of them.  Maybe she would be a little proud of how I’ve done as a father with, let’s face it, no formal training whatsoever.

Over the choir’s chanting, I flashed to a recurring dream I’ve had over the past couple of years.  I am a recurring anxiety dream kind of person.  My usual standards are (a) I’m trying to make a plane but every step just seems to take a lot longer than usual, like I’m running in molasses, (b) I somehow didn’t study all semester and the test is in 24 hours or, another variation on this topic, (c) I’m back in business school and skipped most of last semester, so this semester I am really in trouble if I want to graduate.  Oddly, I recently conquered (c); somehow mid-dream I’ve been remembering that Stanford was a zillion years ago and that this can’t be reality.

In this particular dream, I’m standing in the a dream-altered version of the kitchen of my childhood home.  It is smaller, more cluttered (which you would not think possible if you ever visited my mom’s kitchen), the light a little more slanted and muted.  My mother is alive.  Her death turns out to have been a big medical mistake and she’s back.  In the dream this is reality, not realization; as I walk into the house, I accept that this new version is just how things have been for some time now.

“Reality” also means that my father has moved back in with her into my childhood home and they have fallen back into the pattern where as a unit, she is caring for him.

I think I flashed to this because having pondered how proud my mother would be of her grandchildren, I know she would be amazed at my father.  It’s hard to remember the days before he became a widower and in his late 80’s managed not only to survive but to carve out a life.  But in the dream and last night in the synagogue, I realize that if she were still alive and could see it, it of course wouldn’t have happened.  By observing it, she would change it.  It’s the human application of the Heisenberg principle from physics: observing momentum at the atomic level alters it.

In the case of my parents, this maxim holds.  My father told me a story a few weeks ago about a planned Alaskan cruise that they canceled abruptly the morning of their flight to Seattle because she suddenly didn’t feel well.  Around and observing her constantly he didn’t divine what I surmised not long after she passed away: she spent the last several years of life struggling with illnesses, with anxiety, suffering in near silence.  It was just like her to make you worry more about her more by telling you not to worry about her.  Now, with distance, he recognizes that she must have spent weeks fearing having to let on to him that she wasn’t well enough to make that trip.  Which then altered what happened.

As a caregiver, observation frequently leads to corrective action.  It has to.  As a parent, there is a balance is between observing our children’s reality and stepping in, no matter how good the intentions, to change it.  Knowing when to do which is something for which, as previously mentioned, I did not receive formal training.  I must have skipped that semester at Sandwich Generation dad class.  Now as in my dream, I suppose I am in some trouble now as my daughters edge closer to adolesence.  At least now I know to watch out for doing both at the same time.

Bookmark This: A Big (Helpful) Medicare change

Bookmark This: A Big (Helpful) Medicare change

Short blurb on a change for Medicare reimbursing for services to maintain a patient’s level that would otherwise deteriorate.  So, if my father (for example) is receiving doctor-prescribed services to keep him ambulatory, those are now covered; before, you had to have to lost something you were trying to regain.  This is big and is going to save a ton of money in the long run since it’s going to keep people healthier, however you define that, longer, and therefore out of the hospital.  

If Medicare should have one overarching strategic initiative, it should be to keep the elderly out of hospitals no matter what.  Love it.

Plus, for the Sandwich Generation that is often the taxi of last resort, it’s going to give us additional months of time without the chauffeur’s hat.  I wear it well — but maybe this will help some of the rest of you.

No Time for Selfies

A quick note on what “the real world” is.

It’s been noticed and commented on by many that everyone is taller, faster, funnier and cooler on social media than in real life.  As the number of channels grows (Facebook, Twitter, Instagram, Google Plus, Pinterest for starters), it must be getting harder to build a #personalbrand.  But that doesn’t mean that people aren’t trying.

And if you think this seems silly on an average day, you can imagine how I react to it on days when I am locked in sandwich generation or caregiver mode.  Food porn selfies, videos of the great concert, car lust commentary, political rants to the echo chamber, absurd Top 10 lists, or nearly anything from the Huffington Post – it seems like another world entirely.  For some reason, it makes me feel  even more isolated than I do already.  On the bad days (and yes, there are bad days), it’s almost insulting that people are taking time out to advertise themselves.

Do I know that this is irrational and ridiculous?  Yes.  But it’s how I feel sometimes, and if you can’t recognize and honor your own feelings on occasion, you will not last long emotionally in the caregiver game.  Or the Sandwich Generation one.

I think this is especially true as a man, where you are often expected to advertise, publicly, that you are above feelings.

Not sure that’s going to make a worthy tweet.  #ohwell

Invite the Cow In

Image

Moo

As a sandwich generation man, I juggle competing priorities and events constantly.  Usually, I am cognizant that this is actually a sign of good fortune.  Sometimes it is easy to forget this, however.  Then you forget for a couple of weeks in a row and start to long for a simpler existence.  What if I could plan less?  What if I could just work as long as I wanted and finally conquer my to-do lists? What if I could go away for the weekend with my wife and not have one eye on my cellphone?

There is a story in Judaism of a man who lives in a small house with his wife and many children.  He is losing his mind with the noise and the crowded conditions.   He consults his Rabbi to ask what he should do, and is told to invite his cow into the house.  Not understanding why, he takes the advice anyway; such is the power of Rabbis in Jewish folklore.  He does so, and now, of course, it is worse.  Much worse (and don’t get him started on the smell).  So then the Rabbi advises him to banish the cow.  Suddenly, his previously unbearable cottage seems spacious, quiet, and more than enough home for everyone.

The emergency room is my cow.

Now that my father has emerged from his first Massachusetts hospital experience, I am looking forward to moving back into my cozy little cottage.  We’ll resume our usual Thursday frozen pizza dinners.  I’ll go back to being tech support on his iPad, and to reaching the light bulbs he can’t get to, and to expecting him late for everything.  I’ll have my next Saturday morning spent in front of our weekly-meal-planning-whiteboard with Nova, figuring out how to squeeze in one more meal with her and our kids.

True, I didn’t really invite the cow into my home; it sort of barged in.  But the same emotion applies: gratitude for the people I have inside the house and the hope I get to live here with them just a little while longer.

How To Get Your Parent to Move (or, Learn from the Universe)

People my age (44, thanks for asking) commonly look for ways to have their parents do something that they are simply not wired to do.  Move out of their home of 30+ years.  Hand over the keys to the checkbook.  Give up driving.  Eat less salt.  Luckily, the Sandwiched Man has been through many of these and has the magic antidote to get your elderly parent to do all of the above, and then thank you for the privilege.

The answer is: it’s not possible.

Here’s what I mean.  My father lived in his split-level in Lawrenceville for more than 2 years after my mother died.  He drove to the supermarket, to CVS, to the library, occasionally to the train station to pick me up, and even up to Boston.  He was determined to mow his own lawn, manage his own medication, pay his own bills and deal with the house’s aches and pains on his own.  At first, he let me assume my mother’s prior role managing the checkbook.  This lasted until my brother and I decided that keeping the house clean was a priority worth spending money on occasionally.  Then he suddenly decided to change his checking account online password, and move all of his assets out of Fidelity (where I had parked them) and instead invest them with a broker at Wells Fargo.  He also decided that not speaking to me for 2 months would be a good idea.

Now, of course, I manage almost all of this and he moved to be near me.  How did this happen?

Gradually.

First, the money.  He noticed that his investment account didn’t pay enough interest.  He’d had experience with my approach and results (index funds, boring stuff) and realized perhaps that he’d made a mistake.  I suggested that if he wanted to move things back, I’d be happy to help, but no pressure.  So about 6 months later, he reversed course and let me back in.  He even told me his banking online password.

Next, moving.  It is amazing to me that he lasted as long in that house as he did, because the margin for error was zero.  Once he got sick, he absolutely could not manage being there anymore.  But I started the conversation way before then, and not by asking for a date by which he was going to move.  Instead, I asked him that when he moved, where would he like to go?  Massachusetts (me) or California (my brother)?  We needed to make plans, I told him.  Then he told me that he was not moving.  “I know,” I said.  “But someday you probably will.  Those are just the odds.  Think about where you’d rather be.”  Using that line of conversation is some of the best advice I ever got.

Six months later, on a drive back from Legal Seafoods during one of his aforementioned visits to Boston, he again mentioned that he did not want to move right away, and that things were fine.  “Sure,” I replied.  “Until you get sick with something that puts you in the hospital.  Then we have a whole world of problems because there’s no one near you, and neither Rob nor I can move down there.”  The next day at the kitchen table he told me that after thinking about it, he’d want to come to Boston, and probably within a year.  I paused.  “OK.  No rush.”

Then he got sick.  And immediately, he declared that it was time to sell the house and move.  It was definitely not ideal, but realistically, it was the best we could have done.  He simply was not going to budge earlier.

Preserving his dignity is paramount for my brother and me, and not just because some day we hope our children remember our example and do the same for us.  If he’s not bought in, it is simply not going to work, whatever it is.  If he doesn’t have the will to make it work, it’s not going to work.

(Parenthetically, we didn’t just how little margin for error he had until he lived in the house for 2 weeks between my breaking him out of rehab and my brother moving him up to Boston.  The roof was falling apart.  The air conditioning had been broken all summer and, it turns out, the summer before.  He could no longer open childproof pill bottles or punch his lifesaving antibiotics through the plastic.  Every time he scaled the stairs, we risked disaster.  Then once we moved all of the furniture, the extent of the carpet’s mildew infestation became evident.  It was a horror show.)

My point is that in the end he moved “suddenly”, but the buildup took time.  I had to lay a foundation.  That takes time, patience, persistence, a sense of humor, and a respect for the dignity of the proud human being you are dealing with and whose pride is going to come in handy for you someday.  Trust me on this.

Think of it this way:  most meteors cross half the universe before they shoot across the sky for a few seconds.  Your job as a caregiver (and a parent, really) is to keep it moving across the universe so that you are ready for when it hits the atmosphere.

Irony Alert!

I organized a great support group for some fellow members of my Temple also taking care of elderly parents.  But… then I couldn’t attend because I actually was in the hospital with my father.

He has some severe hip pain, and the good news is that nothing is broken.  Probably a pulled muscle.  We were trying to figure out where he was going to end up tonight (the hospital, it turned out) and going forward (hopefully back in his same community, which part is TBD).

And in true sandwich generation fashion, my kids’ swim team annual postseason ‘banquet’ was also tonight.

So, now I am really glad I enjoyed the smooth days when I did.  And to my fellow support group members who were there tonight… I was thinking about you.  Ironic, right?

Classical Music, and the Reason and Will to Live

Is “caregivee” a word?  Well, if not, it should be!

As I’ve mentioned before, my father presents a classical music demonstration in his community every other week.  He does so by creating a YouTube playlist of performances around a certain theme, then writing up a short blurb that is edited by my brother or me and printed/copied by the community’s Activities Director (the soon to be world-famous Andrea), and then streaming them over wireless to an AppleTV box attached to the flat screen in the common activities room.  Very 18th century meets 21st century.

Anyway, this is his favorite project and the thing that he lives for.  If you are a caregiver, you know how important it is that your loved one have an organizing principle in their lives beyond taking medication and watching old movies.  This is his.

The “reason to live” is the slightly younger twin brother of the “will to live”, which is something we all pray for regularly, whether consciously or not.  They are inseparable.  In Judaism, I believe that this is what “Refuah Shlema” refers to.

Below is an excerpt of my dad’s latest presentation, done Wednesday.  It is his 2nd pass at Mozart, whose Eine Kleine Nachtmusik was the soundtrack to many of my childhood family road trips in my dad’s faux-wood station wagon(s).  If you don’t like classical music, enjoy instead the depth of the curating effort of a man armed with an iPad, a YouTube search bar, and a reason to live.

The Classical Music Hour

with

Andrea and Steve

Wednesday, March 5, 2 PM

MOZART REVISITED

WOLFGANG AMADEUS MOZART is perhaps the most popular classical music composer. He produced over 600 works, including 6 major operas, 41 symphonies, 28 piano and 5 violin concertos, many of them acknowledged as masterpieces in their categories.

Although a few samples of his work were introduced during the past classical music hours, a more detailed, more comprehensive examination seems to be justified.

The next 45 minutes, you will watch a great variety of Mozart’s masterworks, such as:

OVERTURE of the ABDUCTION FROM THE SERAGLIO, Vienna Symphony Orch. – Fabio Luisi

http://www.youtube.com/watch?v=GrFbiw77_90

MADAMINA Arie from DON GIOVANNI, sang by F. Furlanetto

http://www.youtube.com/watch?v=INF9r5jju0A

CHAMPAGNE Arie from DON GIOVANNI, performed by I. Kovacs

http://www.youtube.com/watch?v=wW_L6Fo7Fjk

THE QUEEN OF THE NIGHT Arie from the MAGIC FLUTE performed by E. Miklosa

http://www.youtube.com/watch?v=H_xfC9RXicU

OZMIN’S Arie, THE ABDUCTION FROM THE SERAGLIO, sang  by  Jozsef Gregor

http://www.youtube.com/watch?v=rvDZ9Ikvc7U

THE FAMOUS PIANO PIECE, TURKISH MARCH, played by pianist R. Brautigam

http://www.youtube.com/watch?v=HMjQygwPI1c

PIANO CONCERTO #20 – Romanze, played and conducted by Mitsuko Uchida

http://www.youtube.com/watch?v=qhNITXBguSs

VIOLIN CONCERTO #4, performed by Julia Fischer

http://www.youtube.com/watch?v=9Hqyxy9u4W8

SYMPHONY #40, first movement, Berlin Philharmonic, conducted  by T. Pinnock

http://www.youtube.com/watch?v=pIsMmuf9Q3Y

SYMPHONY #41 “JUPITER” – Chamber Orchestra of Europe, conducted by T. Harmoncourt

http://www.youtube.com/watch?v=zK5295yEQMQ

TURKISH FINALE from the ABDUCTION FROM THE SERAGLIO

http://www.youtube.com/watch?v=Tw84smtNE1Q

Caregiving Success: It’s Not Entirely Luck

I consider myself pretty self-aware; given how much introspection it takes to keep myself on the rails, I better be.  Every once in a while, I allow myself to take some credit for my father’s improved situation and my kids turning into warm, emphathic, smart and kind people (credit shared with my brother and wife respectively, of course).  So many things are out of our control in both situations that when a chapter ends well, you take a small victory lap even if you know already that the book itself is going to be a tragedy.

Brief side note: I have a good friend down the street who convinced me to buy an outdoor gas grill that I could connect directly to the line in my house.  Best thing I’ve bought in ages.  His logic was simple: as a father of daughters, you control so little in life that you need something that you actually do control.

Anyway, I am also keenly aware that much success in life and caregiving stems from luck.