- DR. MARION'S METHOD
- CAREGIVER TRAINING
Camarillo Mom Part of the Sandwich Generation
Southern California Life After 50
George Burns once said, "Happiness is having a large, loving, caring, closeknit family- in another city." It may be funny, and it may be true for some, but millions of baby boomers aren't laughing.
As boomers kick and scream their way into older adult life, many are facing the unexpected and daunting responsibility of caring for their parents. Faces can be lifted, joints can be replaced, and eyeglass lenses can be strengthened, but there's no easy fix for the needs of an aging parent.
"If this trend continues, elder caregiving and its associated responsibilities, sacrifices and suffering could very well become the social and economic sinkhole of the 21st century," said psychologist and gerontologist Dr. Ken Dychtwald in his book "AgePower."
He goes on to explain that the combined trends of declining fertility and long life spans have left the average baby boomer with more parents than children. "As a result," he adds, "the average 21st century American will actually spend more years caring for parents than children."
Terri Williams is a 48-year-old widow who works for the Partners in Care Foundation. Her 80yearold mother was diagnosed with Alzheimer's disease three years ago. After Williams' husband died, she sold the family home, and she and her three children, ages 9, 15 and 16, moved into her mother's house.
Space is tight, and beds for two of the children are sleeping bags on the floor, but Williams sees it as a temporary situation. "The kids are okay with it right now," she said. "My 9-year-old son knows just how to handle my mother and is able to redirect her when necessary. The kids have learned that this is grandma's time. It kind of keeps teenage selfishness at bay."
The sandwich generation
Williams, one of 78 million baby boomers, is among the many who are referred to as the sandwich generation, squeezed between the responsibilities of caring for both children and parents, torn between the priorities of full-time jobs, managing the necessities of a functioning household and being called upon to meet the various needs of other family members. Most, like Williams, are daughters dealing with the complexities and hardships of a now-needy mother.
"Baby boomer women are faced with incredible conflicts," said Dr. Marion Somers, a geriatric care manager and author of "Elder Care Made Easier" (www.doctormarion.com). "They are struggling to be good daughters and want to do what is right and what society expects of them.
"They hold themselves up to the highest standard, but the toll it takes is often great. This is one of the most difficult challenges they will face in their lifetimes, often sacrificing their own physical and emotional needs.
"As caregivers, these women are often burdened by guilt, anxiety and depression, a growing silent health crisis among caregivers."
Studies have shown that the "typical" caregiver is a 45 to 55yearold woman who works fulltime and spends 18 hours per week caring for her 77-year-old mother. About 65 percent of sandwiched caregivers are employed, one half full-time.
Approximately 40 percent of these elder caregivers have children of their own under the age of 18 living at home. The emergence of the four-generation family will create even more complications and hardship.
Karen Stark, 52, works full time for the city of Camarillo Public Works. After her father's death, her mother began to show signs of dementia, often forgetting the names of her best friends.
"I knew that something needed to be done," said Stark, "so I moved her from Arizona to a senior community near me in Camarillo." Stark and her husband had a son and daughter at home. Her mother's condition deteriorated quickly, and she had to be moved to an assisted-living facility where she found it hard to make friends.
Her dependence on Stark increased, taking up even more of her time. "I was her only outlet," she said, "and I brought her home with me every weekend. She never asked me, but I put those demands on myself because I knew my mom had no one but me."
By 2003, Stark was close to having a nervous breakdown. Although she joined a support group for adult children of parents with Alzheimer's disease, balancing a husband, children, a full-time job and the hours spent with her mother became too much, and Stark started to exhibit all of the signs of caregiver's stress. She said, "It was hard because I was trying to be there for everyone and felt bad for my kids. I felt I was shortchanging them.
"My mother was my role model. She was supermom and sacrificed a lot. I felt that I had to do the same. My family did help, but I felt as though I had lots of part-time jobs, all at the same time."
It was just a matter of time before stress took its toll and Stark had a physical breakdown that prevented her body from eliminating any waste for two weeks. She went back to work after that, but it took her almost two months to fully recuperate.
Stark believed that she, too, had to be supermom and became the parent that her mother had been to her. "No one is trained for what I call 'role transfer'," said Los Angeles-based geriatric psychiatrist Dr. David Trader.
"It is not something that is normal for either the mother or the daughter. Even women who did not have good relationships with their mothers feel obligated to take care of them as they age. It is a very basic and natural feeling."
Asking for help
Somers stressed the need for caregivers to take care of themselves. "If you're not well, you can't help anyone else. Figure out exactly what kind of help you need," she said, "but before you hire anyone, talk with family members and friends.
"Don't be afraid to ask for help, and be clear about what you need. People are more likely to lend a hand if the role and time commitment are both clearly defined."
Susan, who chose not to give her last name, is a Chula Vista resident and the mother of three.
Two children live at home, as does her mother, 85, who moved in with her when she began to exhibit signs of dementia last year.
A stay-at-home mother, Susan was born and raised in Venezuela. She said, "I am lucky that I don't have to work. This is the way we do things in my culture, and I wouldn't have it any other way." Her husband is completely supportive of the situation, and the couple also took care of Susan's aunt until she died.
"My aunt didn't have any children, and we were her family," said Susan, "so it was up to us to care for her." Luckily, Susan has a network of support from family and friends.
What Susan does find difficult is "being strict" with her mother- telling her what to do when the need arises.
"It is very hard for me," she said, "when I need to tell her to take a shower or that she can't eat certain foods because they're bad for her. She's my mother and not my child, and she gets angry."
Setting the rules
"A woman who is parenting her parent is responsible for the well being and safety of that person," said Trader.
"She must set rules. The difficult part is knowing what control to give the parent and what control she must assume herself. The threshold is different for each person. There is no cookbook formula for it." Trader believes that, as with children, caregivers must be consistent with parents. It is also important to fight any guilt that might take over.
While Williams, Stark and Susan exemplify significant hardships and complexities of parental care, their individual plights could be worse.
Today's mobile society dictates that many women in the same situation live a great distance from their parents, necessitating last-minute trips in cases of emergency.
Others do not have siblings or other family members to help share the financial necessities or to help out in other ways.
Although many people find this difficult to do, all experts stress the importance of planning ahead.
"The Complete AARP Guide to Caring for your Parents," by Hugh Delehanty and Elinor Ginzler, offers several tips to getting the conversation started: Be open to openings; approach indirectly; ask for help; offer help; be direct and show your concern; and be ready to be found out.
The mother/daughter bond
In her book "Good Daughters: Loving Our Mothers as They Age," writer Patricia Beard explores the cultural changes that have placed so many boomer women in the middle of raising their children and caring for their parents.
"The mother/daughter relationship is like no other," she writes. "Our mothers define us before we define ourselves. Because we are like them, we look to them for models of how we should (or should not) lead our lives at every stage. Our feelings for each other are unique in quality and sometimes in intensity."
Beard provides a template for women eager to reflect on what it means to be a good daughter when a mother grows older. Her goals include:
•To help our mothers find meaning and comfort at the end of their lives
•To have relationships with them that satisfy us both and to engage with them as adults with mutual respect
•To love our mothers as uncritically as we did when we were children- or at least to be better than we have been lately at showing them that we love them.
A journey worth taking
Late middle age is a complicated time for boomers. Still healthy and active, they can, and want to, enjoy life's pleasures.
It is also a time when their parents are entering old-old age and responsibilities to family increase. It is a journey full of twists and turns, laughter and tears, joy and pain- but a journey many must take. For a daughter, in particular, it is an opportunity to look closely into the face of the woman who raised her and to perhaps see her own face reflected back.
The journey will be hard- often painful- but it can offer opportunities for reconciliation, understanding and acceptance. It can also provide the chance to finally learn just where some of those funny habits and expressions you have really came from.
Barbara Meltzer is the president of Barbara Meltzer & Associates Public Relations. She serves on the Los Angeles County Area Agency on Aging Advisory Council and is the primary caregiver for her 90-year-old mother. She can be reached at firstname.lastname@example.org.
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