The harsh, cold winters are terrible for the elderly. Many attribute their painful physical conditions to that. There is also the risk of falling on the ice and in snow. The fact is, arthritis not only affects elderly people, but it can affect anyone at any age. However, since seniors believe that arthritis is handled better in warmer climates, many move away from their children to live in Florida where the heat is soothing. However, there are days when Florida's hot and humid weather can also cause pain. Another option that seniors have looked to is the desert climate of Arizona, which is quite advantageous for people with arthritis. Nonetheless, wherever they decide to go, the decision to leave will not diminish the fears or anxieties that their child may have in regards to their parent's well-being, especially when they are an only child. There is always the concern that something can happen that might uproot everyone's lives.
For example, you may have a situation like this:
The telephone rings. You answer. It's the emergency room at the hospital. It's the call you were dreading. The nurse speaks with a concerned voice, "Mrs. J., your mom was crossing the street on foot and was hit by a car. I want to let you know the nature of her injuries. She has internal bleeding; broken vertebrae in her back, a shattered pelvis and her arm and leg are broken as well. It's a wonder she survived. She is in a terrible amount of pain. Your father is very anxious and doesn't make sense when he talks. I think he is in shock. The doctor is examining him now. Can you please come soon? It is extremely urgent. Your mother is asking for you. The seriousness of her injuries requires immediate surgery. Your mother has agreed to it if it would stop the horrendous pain. Even with the surgery, the doctor is not sure if she will ever walk again. I am letting you know that she will have to stay here after her surgery until she is moved into a rehabilitation center."
You sit stunned by the complicating issues in this sudden, unanticipated mess, trying to figure out how best to break the news to your husband and children. How will they react when they find out you have to leave immediately? Who will take care of the kids when you're gone, perhaps a week or more? Taking mental notes, you wonder about the power of attorney and the living will that wasn't made at the time your parents moved, as they were both in full capacity and robust at the time so dad didn't think it was necessary. However, recently, dad has had some health issues with his heart which are causing you great concern. You are worried that dad might have a heart attack with all this stress. You say to yourself, 'I hope there is a will, because this can complicate matters. I don't even know if they both have life insurance and if so, how much? I'll have to take care of that later when I arrive in Florida, as one of my "Must Do's." You suddenly remembered what the nurse said, that your mom was going to be moved to a nursing home or a rehabilitation center after she leaves the hospital, if she leaves the hospital.
Now you are apprehensive, after considering the big "What If," what if they don't have long-term care insurance? My God, between the nursing-home residency, of which Medicare only covers a small portion, and the cost of long-term care, a mind-boggling figure of anywhere between $50,000 to a $100,000 a year may result.. Who is going to pay for that? "I can't think about that now," you say to yourself. "All of this is making me nervous." As you rush and make calls the wheels of your mind are still in motion pondering on the "What Ifs." You are starting to feel queasy and angry at the same time. You stop for a moment and say, "they'll have to sell their home and perhaps move into an assisted living facility which will be costly as well. Come to think of it, the worst could happen, they might just end up moving into my home. If mom can't walk, who will take care of her? Dad can't. Will I have to give up my job? Oh no, this can't be happening. WHY ME, I DIDN'T ASK FOR THIS! I don't mind dad living with us. He is such a sweetheart, but what about mom? It would be sheer hell. We never got along. To make matters worse, Jimmie dislikes my mom and the feeling is mutual. I am almost sure that my home will end up being a battle zone. I don't know what to do, why did she have only one child?" Your hands are shaking. "I hope my mother-in-law will watch the kids while I'm gone. What will Jimmy say? Now this will give him a good reason to leave.
Relieved that you were able to get a flight for that evening, you begin to pack. You inform your employer that you had a serious family emergency and need to leave immediately. You ask him if you could use your vacation time for this. His approval comes as a big relief.
Between the cost of airline tickets and other additional expenses added to the credit card, a hefty bill is tallied, adding more debt to your finances. Plus you lose your vacation time, time that was intended to be used at a later date. Whatever the results, the reality of the situation at hand is adding weight to your already hectic schedule. By now you know what's in store for you; the cost of flying back and forth between New York and Florida will become exorbitant. On the other hand, you could move to where they live, but that would wreak havoc for all back home. Lastly as a dreaded alternative, you could have your parents move into your home. This way you would be able to keep an eye on them even though this arrangement will also wreak havoc for all concerned. You find yourself trapped by making the choice between: "what you would rather do" and "what is required for you to do." You have officially joined the privileged ranks of the "Sandwich Generation," sandwiched between responsibility for those that raised you and choices that define your own life.
Whether the aging parent becomes confined to a nursing home, a rehabilitation center or an assisted living facility, the demands on the Sandwich Generation still exist. These caregiver's nerves are strained to the utmost. They suffer from depression, anxiety and even some may develop heart problems from all the stress. As it is, the wife-mother-daughter generally is a multi-tasked person holding down multiple jobs and responsibilities all at once.
Now let's take a look at another example. Mrs. B. is a sixty year old stay-at-home grandmother who never had to work because her husband always made decent money. Both of her children have married and maintain successful careers. Her daughter, Sue, finally was able to have two children after several unsuccessful attempts. With so much spare time on her hands, Mrs. B. can do all the things she wants to. Travel, play Mahjong with friends every other week, go to Broadway shows and participate in community activities. Since Mrs. B is a stay-at-home wife, she comes to be the lucky candidate who assumes the babysitter role at a moment's notice for her daughter. How can she refuse to take care of her sweet, innocent darlings once in a while? Happy and doing well, she feels her life is blessed. However, add to this context an aging mom with advanced dementia, the situation changes and becomes overwhelming, piling on additional responsibilities. Now Mrs. B's daughter has just received a promotion and has to put in more hours at her job. Sue is so excited, since it will raise her salary $30,000 a year. She's hoping that mom can take care of the kids full-time.
"Don't get nervous, it's only temporary until I get the hang of it, then I will put them in daycare," she says. At age sixty, Mrs. B. is not looking forward to spending 40 + hours a week taking care of a baby and a two-year-old toddler. She also has the responsibility of an aging mom with dementia. Since her father passed away over three years ago, Mrs. B. has been noticing changes in her mother's personality. Apparently she has been suffering from clinical depression with mood swings, wherein she would become enraged, unresponsive or withdrawn. She also watched her mom slowly fade into the never-ending fog of memory loss, repeating herself over and over again. Mrs. B.'s mom would become increasingly bewildered and confused, even in familiar surroundings. Lately, her appetite has been poor, and to make matters worse, she has developed a foul odor. She has been neglecting her personal hygiene as she does not realize that she has to bathe and change her clothes. Since Mrs. B. is the oldest of three sisters and as she lives the closest to mom, and supposedly had more free time on her hands than the others, she has become the designated primary caregiver, against her wishes. So as a result, Mrs. B.'s mom moves in with her daughter. Both situations have disrupted Mrs. B.'s comfort zone. It also has interfered with the quiet life that she built with her husband since the kids got married and moved out of the house.
The full-time baby-sitting issue in regards to her grandchildren is becoming a serious problem for her, going on for several months now. She cannot understand why it's taking her daughter so long to put them in daycare. Mrs. B. is too tired. She is wound tighter than a rubber band. The baby is teething and crying constantly and the toddler still in diapers is hungry, tugging at her pants. Suddenly the door bell rings. It's her next door neighbor asking if she could pick up her mail for the next four days since she won't be home. Smiling, Mrs. B. agrees and closes the door. She starts to fume, feeling envious of her neighbor, who has the freedom to take off when she wants to while Mrs. B. is trapped at home with two grandchildren, constantly changing diapers and doing the laundry.
She says, "What does she think I am, her errand girl? With all that I am doing, she has the nerve to ask!" Not even the girls at Mahjong call her anymore. They have been avoiding her like the plague. She calls her daughter constantly, complaining about the kids and her mom. The daughter, avoiding the issue, puts her on voice mail. Mrs. B. screams at her mom. She calls her sisters and vents on them for not helping out. She vents to the mailman, the supermarket cashier, whoever might lend an ear. She can't wait to vent on her husband when he comes home. There is no way for him to avoid the sound of her shrilly voice, her expression revealing her anger. He is deeply concerned that she may be having a nervous breakdown. The peaceful life of Mr. and Mrs. B. is long gone.
Meanwhile, Mrs. B. can hear her aging mom fussing because she has a terrible case of the runs, soiling her underwear and nightgown, she needs to be washed and changed just like the grandchildren she routinely babysits. Mrs. B. has found herself in a situation that is not easily solvable. She starts to freak out. She is extremely tired and cranky. She needs sleep in a desperate way. The horrible consciousness and sandwiched existence cause tears to stream from her eyes. "I can't stand it anymore. I hate what I'm doing. I don't want to do this any longer. I want it to go away," she cries. "I am only one person, how can I separate myself into so many pieces and satisfy everyone at the same time? Doesn't anyone care about me? I have needs too." She sits there stressed out, her body wracking with heart wrenching sobs. Frightened by grandma's emotional state, the baby starts to cry and her whole face turns red while the toddler starts to cry as well. Finally, she screams at the top of her lungs and says, "WHY ME? I DIDN'T ASK FOR THIS!"
Do these examples sound familiar? If so, you are not alone. Caring for aging parents is not an easy task. It saps your energy and robs you of your peace of mind. Very few people are emotionally ready to undertake this role. The comfort zone which you have created for yourself, including the freedom to come and go as you please, career fulfillment, and an active social life with your friends becomes completely disrupted. With care-giving, you feel captive to the needs of whoever you are caring for. Also, it puts you in the awkward position of parenting your own parents.
In the final part of this 3 part series, I'll address ways I have had to deal with being a member of the Sandwich Generation, and ways to help cope with the stress involved with being a caregiver.
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