Trying to comprehend kids as caregivers

I was emailing my colleague Paula Spencer this morning, talking about my experiences with caregiving and "Divorce, the Sequel" that has roared back onto the scene 25 years after the fact, as my two single parents head into retirement without partners. I wrote that caregiving has transformed the entire way I look at family and work. I had thought that there would be some mythical mellow period of time after my daughter was old enough to be independent, and before my parents needed elder care attention. In reality, as it turns out, there is always something going on in the family realm. Women, in particular, need to be prepared to juggle work and family our whole lives.

So there I was, feeling a little sorry for myself that I had so much responsibility before I had reached age 40, when I was confronted with today's New York Times story about children and young teens caring for their own parents.

Child caregivers. The very notion makes my head spin. While I feel strongly that children should be actively involved family members, they should not have to literally care for their parents and elders.

The Times article, In Turnabout, Children Take Caregiver Role, describes the heavy responsibility and role reversals:

Across the country, children are providing care for sick parents or grandparents — lifting frail bodies off beds or toilets, managing medication, washing, feeding, dressing, talking with doctors. Schools, social service agencies and health providers are often unaware of those responsibilities because families members may be too embarrassed, or stoic.

Some children develop maturity and self-esteem. But others grow anxious, depressed or angry, sacrifice social and extracurricular activities and miss — or quit — school.

What is it going to take to get us to wake up to caregiving in this country? I feel like we're headed toward a cliff at high speed, and we aren't even paying attention to what is right ahead of us. While sixty-something celeb-gurus like Suzanne Somers are writing books called The Sexy Years, and Slim and Sexy Forever, where do "the rest of us" turn to learn how to craft a meaningful reality with family members who are no longer young, rich, fabulous and as frisky and energetic as teenagers? There is a ton of potential but few guides to point the way.

I have resolved to take three steps. First, to explore Caring.com, where Paula Spencer is a founding editor. I am grateful to find these resources. Second, I am learning about the Divided We Fail campaign, a promising intergenerational effort to work for health care reform and long-term financial security. And finally, I am going to read Mother in the Middle, a neurobiologist's account of caring for her mother with Alzeheimer's disease while she was also caring for her own young family. I've been avoiding that kind of realistic memoir, which may be the honest guide I say I've been looking for.

This conversation will continue....

Is elder care more difficult than child care?

I am at an interesting place on my life path right now. My daughter is nine, and I feel that I am standing on a little hill that allows me to see all the way back to the day she was born, while also being able to look ahead to the day she grows up and leaves home.

My parents are in their later sixties and two of my grandparents are still living, in their nineties.

When elder care issues arise, they can come on quickly, forcefully, and unexpectedly. I have heard elder care described as "the joker in the middle-class deck of cards." I urge you to talk about elder care planning with your own parents, to lessen the impact of a crisis.

We urgently need to grapple with these issues as a society. I truly feel that as the Baby Boomers age, we'll either find a way to deal with these issues in a sustainable way, or else it has the potential to crush us economically, emotionally, and spiritually.

Here are some factors that make elder care more challenging in many ways than child care.

It can turn the child-parent relationship on its head, which feels bad.

When you are a parent raising children, it's natural to be the one in charge. When you become an adult child trying to help your parents, that dynamic can get reversed to some extent, whether you want it to or not, which feels really bad. And the generational layers really get stacked up. At age 40 you may be a mother and a daughter. At age 65 you may be a grandmother....and still also a daughter with primary caregiving responsibilities.

It's expensive.

Long-term care in the Raleigh area costs an average of $180 a day, or $65,700 a year. That's like having multiple kids in college at once (and by the way, this need might arrive just as your kids are going to college).

It can arise as a crisis.

Earlier this month I listened to a panel of adult children talk about caregiving, and they all had stories that went something like this. "My mother was living on her own, and that worked well for a while, and then one day...." Any number of crises arose and the children had to put their lives on hold to figure out what came next. I am a big proponent of planning head for these situations, but the truth is that no matter what, if your parent has a crisis, it will feel like a crisis to you, too. But the magnitude of the crisis can be lessened by having a care plan in place ahead of time--for instance, getting elders settled in a retirement community to make friends while they are healthy, and for you to have a wide and deep support network of your own.

When a crisis occurs, whether it's health related, job loss, financial meltdown, or divorce, your parents may suddenly need a lot of care, time and energy. I have come around to the point of view that women should try their best to develop a career amidst caregiving concerns, whether it's children or parents, because these issues never really go away. If you are waiting for a perfectly calm time in your life to arise before you go back to work, that time may never come.

It could last longer than raising kids.

Your kids are likely to be out of the house in about twenty years. Your parents' elder years could stretch for 30 or 40 years. That's why their life situation absolutely needs to become sustainable. Unfortunately, our current ideas about retirement don't really account for thirty years of post-employment living. So people will need to work longer and save more. Not an easy thing in this current financial crisis when retirement savings have been slashed.

It's not optional.

Neither is raising kids, in a global sense. But everyone has parents, whether they see themselves as caregivers or not. In the long run, the fact that caregiving is not optional is potentially a good thing, because it means that we'll all have to deal with family caregiving, which means it might finally get some public policy attention. The bad news: the work of caregiving still falls mainly on the women in the family.

It brings up old family issues again.

Finally, it's one of those ironic life lessons to see that old issues you thought you had come to terms with suddenly make a comeback. For me it's been my parents' divorce. They've been divorced for 25 years and I made peace with that long ago. But now that they are reaching retirement, both single again and newly trying to co-exist in the greater Triangle area, I feel like "It's baaaaaaack!" The logistical and financial issues of divorce have come to light again. For one thing, they know they're not both coming to live with me (which means that pratically speaking, neither of them is coming to live with me). A married couple can enter retirement living together for much less than two singles. So for my parents, if they needed skilled care and didn't have long-term care insurance, it could cost a total of more than $130,000 a year. Also, divorced women who were "displaced homemakers" may find that their Social Security payments are a lot less than their ex-husbands'. Women are likely to live longer yet often have less Social Security and pension benefits.

So thankfully, each of them now has them long-term care insurance. When that was accomplished recently, that I immediately felt a weight lifted slightly off my shoulders. (Did I mention that I am an only child? The buck stops here in all sorts of ways.)

I wish I could wrap up with an uplifting life lesson, but the truth is that I really have not come to terms with all of this yet. I have been pretty immune to feeling Mommy Guilt, but I feel crushing daughter guilt at times. Of course I love my parents and I am really fortunate to have them living nearby--that's a good thing. But the crises wear me down, they can't be timed or planned. The crises piled on in the last six months. Last fall my Dad needed me, my Mom needed me, I was finishing my book, and I was recovering from my unplanned appendectomy. And yes, my husband and child needed me, too, even as they took really good care of me.

I am sad that the easy time is over, and I didn't even recognize the easy time when it was happening. (It all depends on the definition of easy, too.) This new phase of my life feels like it has many off-ramps that lead to depression. I can see how people let themselves go in middle age, losing their mojo once again, preferring to be distracted and numb, and I am determined not to let that happen. I want to enjoy my life and the time my family has together, as much as possible.

This is probably the most downbeat blog post I've ever written, but I wanted to be honest with you and not sugar-coat it. I am in the midst of the maelstrom and haven't found my firm footing yet. Your thoughtful replies and perspectives are most welcome....

Hail to the Mom-in-Chief, Granny-in-Chief, Sister-in-Chief...

Barack Obama brings a refreshing image of an involved Dad of two young daughters to the White House. I cheered to see him and Michelle attending teachers' conferences days after winning the election. Their family will be a very public face for work-life integration just by their very presence in the White House--not to mention the family-friendly legislation that President Obama may champion and sign.

Their family means more to me than the Clintons did because it blows my mind to think that the President and First Lady are finally people of my generation. Here I am writing about motherhood and family, and we just elected a guy who could be another parent at my daughter's soccer game. I turned the corner to 40 just in time for the election, so yes, it is quite formidable and inspiring to know that we elected a post-Boomer (in spirit if not by birth date) President who is also in his 40's. Honestly, it makes me want to up my own game, both professionally and otherwise--when I read that he hits the gym every day it makes me think that if he has time to make that a priority, I should, too. (Hasn't happened quite yet but stay tuned!)

But it's the women behind the man who are most on my mind today. Not only Michelle, but Barack's mother, Ann Dunham, his grandmother, Madelyn Dunham, his sister Maya Soetoro-Ng, and his mother-in-law, Michelle's mother Marian Robinson.

Like most families, Barack Obama's extended clan has a whole lot of intergenerational caregiving going on. I hope that his family will raise the profile of this issue--the crucial, invisible work that women do all over the world. You have probably heard about Madelyn Dunham helping his single Mom Ann raise Barack. He lived with his grandparents for extended periods of time while Ann did her research in Indonesia. But did you know that Maya Soetoro-Ng was caring for Madelyn Dunham until her death earlier this month? Obama's break from the campaign trail for a final visit with his grandmother made headlines, but Soerto-Ng's contribution remained typically invisible. Women caring for their relatives may be the fabric of life but it's rarely news.

Time Magazine reports on a recent email written by Soetoro-Ng:

Soetoro-Ng could have accepted her brother's invitation to be by his side on election night in Chicago. But, as she had for much of the past eight years, she chose to stay in the apartment on Beretania Street where Dunham raised Obama as a boy and where Soetoro-Ng later cared for her. In the post-election e-mail, Soetoro-Ng writes of the sometimes conflicting emotions surrounding her grandmother's death and brother's success — and of the need to unplug for a while with her husband Konrad and their 4-year-old daughter Suhaila on Oahu's rural North Shore. She writes that she has been flooded with e-mail messages "of both congratulation and condolence .... There's a wide swatch of emotion cutting through me, sometimes swirling, never simple ... a briny mixture of elation, sadness, determination, regret, pride, hope, fatigue. You can imagine ..."

Now that the Obamas know they'll be moving to Washington, Michelle will leave behind her job at the University of Chicago, which paid her $316,962, to become our national (self-described) "Mom-in-Chief." I welcome the discussion about her move, because the truth is that as extraordinary as her experience is, it's typical for women to take time off for family caregiving, an average of 11.5 years over her lifetime. Should it be different? Should this work be shared more equitably, or rewarded with social recognition and benefits (perhaps Social Security credit)? Let's make sure we get to that public aspect of the conversation. In the meantime I don't see how anyone can truly criticize Michelle. Many of us have had to put family first during moves and job transitions. Sometimes it is truly a wrenching decision but still completely necessary to do so. If anything in the world would require family leave, I think it would be one's spouse becoming President. Stanley Greenspan estimates that parents can fill "Four-Thirds" of a full-time job between them before they need supplemental child care. Being President must be like Four full-time jobs in itself.

Even Barack and Michelle together needed help--especially when the long campaign demanded that they hit the trail, together or in separate directions. The woman whose role as an unsung hero is only beginning to be recognized is Marian Robinson. Our new "Granny-in-Chief" made it possible for Barack and Michelle to campaign for the past two years while Mrs. Robinson cared for the girls in Chicago. I am sure that Obama would not have run if he had not had this family care available. Marian Robinson is expected to move to Washington D. C. to continue caring for her granddaughters and giving them as much continuity and normalcy as possible.

I talked to a MomsRising group just last night and one woman talked about how she as a working Mom just could not produce exactly what a single guy could. We have to keep working to open employers' eyes, so that being a worker with family caregiving responsibilities is finally viewed as the norm rather than the exception. I don't think they really want to see that--we're going to have to insist. (I am still depressed by how easy it was for "Joe the Plumber" to hijack the national conversation when he was a completely unrepresentative worker!)

If take the time to look closely, President-elect Obama's example can remind us that while he really is a "great Dad," behind every high-powered man there is not just one woman, but often a whole crew of unsung heroines who help hold family life together.

It's time we shine a spotlight on caregiving and make it count.

A powerful coalition for caregiving

Yesterday I wrote that our best chance to get family caregiving taken seriously will be to create a coalition with Boomers facing the challenge of caring for their elderly parents.

This morning I discovered that The New York Times launched a new blog on July 1 called The New Old Age. The initial post by blog author Jane Gross clearly struck a nerve as evidenced by the fact that it has received over 550 comments so far.

In her follow-up to her first post, Gross said,

Striking to me in your responses is how desperately adult children want to do right by their parents, how desperately their parents want to spare them this burden, and how the American health care system and our government’s safety net for the elderly make this all but impossible for both generations at almost every turn.

The heartfelt sharing on The New Old Age blog sounds a lot like the caregiving conundrum that parents of young children face. I am saddened by the problems families encounter, but heartened at the possibility of creating a coalition. Let's work together on these issues. 77 million Boomers plus young parents? We could really get something done.

Mojo Grannie is doing well; thanks for your suppport

My Mom's surgery was last Friday and she's done amazingly well with her recovery. She was up and about the next day, spent most of the weekend at our house, and then went back home. I am helping her with grocery shopping for a while just so she doesn't have to lift heavy bags, but she is quite self-sufficent.

We are not out of the woods, as we await follow-up test results, but I suppose the truth is that none of us is ever really out of the woods. It's just a matter of whether or not we have the luxury of choosing to live in denial of our mortality. The good news is that every day together is a gift.

I have managed to take pretty good care of myself over the Christmas break. The day of surgery was a full day at the hospital, 7:30 am to 9:00 pm. The surgery itself was about 3 hours long, but we had to do a test at 8 am and then wait until 1 pm to get called in for the surgery itself. And afterward it took several hours to move from the recovery room to the overnight "brief stay" suite. Mom was resting comfortably the whole time so I didn't worry too much about the delay, but I was eager to see her get settled so that I could get home before my daughter's bedtime.

I mention all this so that if you are ever the supporting family member or friend in this situation, you know to be prepared to wait all day if necessary, and arrange backup for yourself at home. While waiting I read a novel cover to cover, which I almost never do!

The next day I was bone-crushingly tired, feeling like I was coming off a hangover of stress hormones and cramped from sitting all day. We'd arranged a long playdate for our daughter so that we could get Grannie settled in, and that invitation from our friends turned out to be the best Christmas gift we could have gotten from anybody. Our daughter needed to play; the rest of us needed to rest.

Now we're on the post-Christmas recovery as well, chilling out at home on a cold, rainy day. "Chillaxing," as our daughter would say, a saying she thinks she made up, but when you Google it, it's out there in slang dictionaries.

It's strange to be here, waiting for life-altering test results yet to come down the pipeline, yet I am still worried about incredibly mundane issues like, are we watching too much TV over the school break? Do I really need to clean the house again? Why bother when it will just be totally messed up again in a few hours with all of us at home?

I am feeling a mixture of a little relief, a little melancholy, and part of me that is bracing against future developments. But I am here at the blog which I think is a good sign. I hope to get a 2007 Books with Mojo list posted by the end of the week.

Hope you all had good holidays and that you're not suffering from too much cabin fever yet!

Thank you for your kind wishes

I am about to sign off for a few days, but before I do, I wanted to say thank you to everyone who has sent me messages of support in anticipation of my Mom's surgery.

Friends from the blog, near and far, have been very kind. I have a good support system in place, so we are in good shape as we prepare to face this head on.

It is interesting to see how a support system is necessarily an interconnected web. In order to support my Mom, I need my husband to take over many things I would normally do, and friends to help fill in the gaps. My Mom, over the past eight years, has provided priceless childcare for our daughter (not to mention the years she spent raising me....). We are happy to be able to help her now when she needs family to lean on. As I say in the dedication in my book, How can I ever say thank you?

So much for a Republican-style illusion of "Rugged American Individualism." None of us can do this alone.

When you see a cliff, put on the brakes

Most of the time my life is one big juggling act, always managing somehow to keep many balls in the air. As an author, my life is all about networking, outreach. My tree puts out new branches large and small.

But there are times that this just doesn't work anymore. I hate pruning back, and I have resisted it, but right now I have to face the fact that this is what I need to do. Both of my parents have had health challenges over the past couple of years. They are divorced, both live nearby, and I am their only child. Last week my mother was diagnosed with breast cancer. She went in for a routine mammogram and the next thing we knew the whole process of testing and diagnosing was underway, like a whirlwind. We went from follow-up screening to biopsy to meeting with the surgeon in the course of three days. We are grateful to have access to such speedy medical care, but it's a shock to the system even in the best of circumstances. There is so much to internalize and process, from medical information to emotional turmoil. I wandered around for a week, feeling like someone had hit me on the head with a two by four. You know those cartoon characters who have googly eyes and planets and stars floating over their heads? That was me.

I started to come out of it a couple of days ago. My Mom's prognosis is likely to be pretty good, but she does need surgery, scheduled for next week. So I am reorganizing my priorities. A couple of days ago I had a major epiphany, which is that it is actually easier to keep it together than it is to fall apart. I have too many people who are depending on me, and falling apart takes a lot of energy and explaining. So my strategy is to pare back to the absolute essentials, get them done, and let everything else go for now.

My three priorities are: 1. Family, 2. Writing, and 3. Friends, fun and self-care. Everything else has to go on the back burner.

It's going to be an interesting discipline to stick to these, because I am usually very open to doing things for other people, and I am going to have to turn down some kind and worthy requests. I am mentally checking out of my office until mid-January. I do plan to keep writing here and on (parent.thesis) but I can't predict exactly how regularly I'll be able to blog.

One more thought to rattling around my head right now: As Mojo Mom I have struggled so hard to reconcile feminist ideals with my reality and the outlook for mothers at large. I see huge structural issues with motherhood, and I know it's not all about individual choice. But at the same time, I feel like we need something beyond feminism to help us as mothers cope with our reality. I've worked hard to build up my work identity as a writer, and now I have to lay it down. I don't know HOW I would fill a 9 to 5 job right now, and yet that's exactly what the majority of women in my situation need to do.

The feminist wave that began in the 1970's gave us the right to compete on the male playing field but we have so much unfinished business to address. Adopting the male model isn't working for me, and by the way, the Third Wave of feminism is speaking to me even less than the Second. I need a Caregiving Society to help me out. We have a quadruple-decker sandwich going on in my family--my parents each have a parent living. I need a society that allows me to work and take care of my family, and one that won't put the burden of caregiving only on the daughters and wives. Is it feminism, or something else, that will make this possible?

I am glad I've been involved with MomsRising because it is the one movement that offers me hope right now.

Why is a failed executive "worth" 160 teachers' careers?

I have to hope that we are about to reach a tipping point in this country, where we wake up to what is really going on around us. Ordinary families' bread-and-butter issues don't automatically translate into sensational news segments, but we need to wake up to the fact that families aren't doing as well as they should.

Families did make headlines in the South this week, were a new study revealed that for the first time in four decades, low-income children make up a majority of public school students. The "majority" statistic is what made the news, but if you look at the national map, 49 out of 50 states have a low income student rate of more than 25%.


The national rate is 46%. Unacceptable, any way you slice it.

We also learned this week that fired Merrill Lynch CEO Stan O'Neal is receiving $161.5 million in stock options and retirement benefits. This is not a successful CEO; this is a guy whose financial bets on the subprime mortgage market resulted in an $8 billion loss and "risked the entire franchise," according to financial guru Jim Cramer, speaking on The Today Show.

How much is $161 million? A teacher making $40,000 a year, working for 25 years, would earn a million dollars in a lifetime. So we've come to the point where a losing CEO is valued at more than 160 times the LIFETIME EARNINGS of a full-time teacher.

I don't have the solutions to this conundrum but it's clear that our national/economic priorities are totally screwed up. It's time we all take a grown-up look at the future of families. Between the expensive and demanding crunch of child care, and unbelievably expensive elder care, I fear that many families are headed for worsening crisis in the near future.

I'll be writing more about this, but in the meantime I encourage you to read mothers' real-life stories posted this week at MomsRising.org. I also highly recommend the October 23 episode of The Diane Rehm Show talking about long-term health care for seniors. Her expert panel talked about alarming trends including an investment trend in health-care communities that sounded like it could do for nursing homes what subprime mortgages did for the real estate market. (Don't take my word for it; listen to the show.)

This may seem like dry policy but it is really important stuff. 78 million Baby Boomers are headed for their elder years. When the caregiving bomb explodes, the repercussions are going to end up in our laps as mothers, wives and daughters.