The Giving Season

Conversations with strangers can lead to unexpected connections.

Only this weekend, while I’ve been at Lake Tahoe, this happened to me. I was having a facial and in talking with the esthetician she said that she’d just moved her 83-year-old father from an assisted-living facility here in South Lake Tahoe to a nursing home in the valley about 30 miles away. The move had been less than two weeks ago, and she was clearly still in that dizzying transition period. Immediately, a connection emerged — and I shared with her about what Kay and I had experienced with Dad.

It’s so new for her that she hasn’t yet stopped reeling from moving him from one type of facility to another, clearing out and cleaning his apartment, and settling him into the new place. It’s 30 minutes away, but the difference in cost? It’s about $2000 a month cheaper there. It will mean that she has a bit farther to drive, but that cost difference is tremendous.

So many memories have been swirling ever since our conversation. It’s been two years since Dad fell and by the end of December, it will be two years since he lost mobility. January will be the two-year mark for the visits to doctors, for x-rays and CAT scans and the like. February will be two years since he had surgery to repair the spinal damage from the fall, followed by his nearly two months in a rehab unit. In April it will be two years since we brought him home from rehab, and on April 24 it will be the second anniversary of his death. It’s not that distant in time, but the pain and exhaustion have only recently really ebbed significantly.

For Carla, the esthetician, it’s only just beginning.

Her father, like mine, was basically living on his own. For Dad, though, it was different, because he was in his own home. I just spent more time there. He never had to adapt to living in an assisted-living facility. Had circumstances been different, though, that might have been an option. For us, it just wasn’t — and I’m not sure that Dad would have ever been able to make that adjustment. Others I know have made that transition with ease and grace. Fortunately, though, we could manage to have Dad stay at home.

Regardless, though, she dropped in to his apartment as I did to Egan, though perhaps more often since she was in the same town. That’s the stage where our dads were pretty independent, given everything.

Yet Carla began to take over more responsibilities, as Kay and I did, for many things. For doctors’ visits, for medical decisions, for financial discussions. Incrementally, daughters began the move to parental responsibilities. It’s that point where parents and children begin to shift roles, reversing the long-established relationship.

Because I basically lived with Dad part-time and then full-time, that he couldn’t drive anymore was a gentler adjustment, in a way. I could drive him, or get a friend to do so. He didn’t have to rely on strangers, on hired staff. It was an easier adjustment for him, though he made remarks that let me know just how much that loss of independence meant to him. We joked about my being his chauffeur, but I know that he felt the loss.

When Dad fell, that really was the beginning of his slide towards death. At 89, he just couldn’t recover quite enough. The nearly two months of rehab were a kind of hell for him, I’ve come to think — he had no privacy because he had a roommate, and not one who was one of his choosing. Dad was intensely private, and modest, and those are casualties for patients on rehab.

For much of that time, Dad was a good soldier — he didn’t complain a lot, at least to me. He read at first, but that stopped. He didn’t really watch television. My visits and visits of friends were his connection to his real life, to life itself. And even that changed as he withdrew. He became mobile, albeit with a walker and a wheelchair, but he could not recover any stability of sorts. One day I came to visit and found him pretty much unresponsive and unable to recognize me. We had a trip to the hospital emergency room where they ended up transferring him to a cardiac unit in Lafayette for a perceived heart attack. He didn’t have a heart attack. But it was a setback, regardless. Now I am convinced that had I not visited when I did, Dad would have died that night. Did I do the right thing? I don’t know; I only know that at the time, it seemed so.

After that, Dad peaked in his recovery and stalled. And with that stall he seemed to retreat more and more.

Once he was home, he had a good first week. We got him to dialysis. Now I can’t believe that we did that, but we did. Week two saw a slide, though. He fell, not once, but twice. Keeping him in the hospital bed was tricky, even though he couldn’t walk.

The second weekend, though, was when everything fell apart. On that Friday night, he bled enough that I called an ambulance. In the emergency room, they stabilized the bleeding. Then I had to get us home without an ambulance. Luckily, Kay was there and could drive us back.

He continued to bleed on Saturday, but we handled it. On Sunday morning, we consulted with the Home Health nurse and shifted to hospice. No more dialysis. We knew that it was pointless, that anything more would simply be torture for him.

He was still alert then, most of the time, and on Monday morning visited with a former neighbor who came to see him. Within an hour after she left, though, he quickly lost ground. By 1 Pm, I was using more morphine and more morphine to control the pain. By then he was talking to his mother, long dead, and thinking I was my grandmother. Early on Tuesday morning, Dad died.

These memories never really disappear, but they have (for me, anyway), moved from giving constant pain to only occasionally rising up to bite me. And even then, that bite, though sharp, no longer gouges open any kind of wound.

Listening to Carla, recognizing and remembering the path she’s now on, I once more am conscious of how loss and grief can begin long before we even recognize, simply becoming part of our daily reality– at least with prolonged illness and not sudden death.

With the scenario of prolonged illness, we lose our loved ones gradually. They change, almost imperceptibly, before our eyes, and we watch them disappear. As that happens, we grieve, often (maybe usually) without the time or energy to acknowledge that we are grieving. And even if we do recognize it, we’re too bound up in caregiving to have the time to do much about it.

Catching a 30-minute nap becomes far more important than allowing that grief to surface. If we did, it might overwhelm us. Caregivers are on their own spiraling path of change, of adapting. Somehow we have to keep going, because we must. Someone depends upon us.

As Carla left, I wished her well. My caregiving path has ended, but hers has just taken a turn.

There are so many of us out there, so many of us boomers caring for aging parents while trying to juggle our own families and jobs. If we’re single (as I am), there’s one less problem to contend with. I had no husband to help (or hinder, since not all partners are supportive). I had no children to care for. Others, though, like my sister Kay, are the sandwich generation, caught between caring for children and parents. And self. That’s always part of the equation. (And usually the part that gets ignored.)

We may not have much in common otherwise, but that caregiving role links us tightly, changing us forever.

As Carla and I agreed, we were the fortunate ones whose parents were good parents, and who have (or had) a good relationship with those parents. While some people wonder at what we gave up of our own lives in order to become caregivers, others know just how precious that experience can be, despite the exhaustion and frustration and depression that come with it.

My friend Charles and I talk about this often. We had choices — and we chose to become active caregivers. I think we had a choice — and yet had no real choice, given our families and personal experiences and values. Had I chosen otherwise, I would not have been the kind of person my parents brought up. It was not so much a sense of obligation, of giving up something.

Just the opposite. It was a sense of love, of returning the care and love that Dad and Mother lavished on me when I was a child. They never preached this. I just watched them and absorbed what I observed.

Some argue that it wasn’t my role – that I should have put Dad into the care of others earlier.
But my role as daughter is as flexible and as elastic as it needed to be.

In this season of Christmas, of gift-giving and receiving, I am reminded of the gift of love.

I gained so much more than I lost. Love is never wasted.

Carla will discover this, I hope. That’s my wish for her this Christmas season.

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