Postcards From the Sandwiched

Posted on January 14, 2016 by CNF • Posted in Articles Page, Featured Content • Tagged Amy Yelin, feature, sandwich generation, taking care of parents • Leave a comment

By Amy Yelin

March 28, 2015: I’m standing in the Durham, North Carolina airport, I-Phone in hand. I’m about to call my 87-year-old father to tell him that I’ve landed safely. It’s been more than a year since I’ve seen him. Usually he and his wife fly up for Thanksgiving, but this year, with both of them not feeling well, they didn’t. And while I’d thought about flying down sooner, I was either too busy or too financially strapped or perhaps simply too nervous about what I’d find when I arrived to follow through.

On our phone calls the last few months, I’d noticed my dad repeating himself much more than usual. This call from the airport would be no different. When he answers, I tell him I’ve landed. Moments later he asks, “What time is your flight taking off?”

“No, I just landed,” I repeat. “I’m about to get in a cab and come to your house.”

“Ah…” he says. “How was the flight?”

“Fine,” I say. “Real quick. Nice, big plane.”

A few minutes later, he asks, again, “So is your flight taking off soon?”

“I’m here, remember?”

“Ah, that’s right,” he says. He laughs at himself. His voice perks up. “I’ll see you soon then!”

“Are you sure you need to go?” my husband had asked when I told him about my impending trip. “I mean, is it really that bad? Or is he just forgetting a few things here and there?”

“I’m not sure,” I said “Which is why I’m going.”

My seven-year-old son overheard our conversation and reminded me of his concert on Friday. “I’m sorry buddy,” I said, “That’s when I’m flying out. I’m going to have to miss this one.”

“Don’t go mama,” he said, hugging me.

“But I need to check on grandpa.” He hugs me tighter and says, “Ok.”

That Friday, as I sit on the airplane, I imagine my son singing “If I had a hammer” with his second grade class. No doubt, if I were there, I’d be crying—children singing always make me cry—and just imagining the scene makes me teary-eyed on the plane. Then I think of my father, and my stomach clenches. Is he OK? And that’s when it dawns on me: I’m smack in the middle of the sandwich.

The Sandwich: What is it? A Brief History

What does the term Sandwich Generation even mean? It’s not a true “generation”—like Millenials, or Generation X, or Boomers. The term first emerged in the 1980’s, courtesy of a woman named Dorothy Miller, who published a paper titled, “The Sandwich Generation: Adult children of the aging.” The moniker stuck and made it into the dictionary in 2006.

A 2013 Pew Research Center study defines the ‘Sandwich Generation’ of today as those who have a living parent age 65 or older and are either raising a child under age 18, or supporting a grown child. Today, 71 percent of the sandwiched population is between the ages of 40 to 59 years old and, according to a 2012 AARP Florida study, there are a lot of us: approximately 20 million.

As the Pew report notes, we are a people “pulled in many directions.” Tugging at our financial, emotional and time-crunched strings are our children, our jobs, and our aging parents.

Curious if it’s always been this way, I contacted Stephanie Coontz, director of research and public education for the Council on Contemporary Families.

“This kind of sandwich situation has really only been around since women entered the workforce,” explained Coontz. “Before that you might have had people “sandwiched” in the sense that they were three generations living together under one roof -for example, in colonial times. But people didn’t live as long then and women didn’t work outside the home, so it’s different than today’s situation.”

After the turn of the 20^th century, the number of extended families living together went down, dropping dramatically by the 1940’s and 50’s. Coontz references a best-selling advice book during that era, penned by a psychiatrist, that posed the question are you an old fashioned mom, or a modern mother? “Old-fashioned moms were too interfering in their kids’ lives. Old-fashioned moms kept extended families in the home,” said Coontz. “So you saw more and more people putting their parents in the new modern assisted living facilities that were cropping up in the 1950’s…and they weren’t ashamed to do so. And you also saw moms staying out of their kids’ lives.”

As she talks, I know exactly what she means. In the forties and fifties, as we all know from movies, kids just picked up games in the streets. There was no societal pressure to watch your kid every second, or help them with everything

Coontz adds, “Today’s parents feel pressured not only to stay economically and educationally competitive, but also to sign their kids up for more enrichment activities and spend more quality time with them. Add to that the fact that today’s sandwiched parents are also in the prime of their work lives and may have aging parents to take care of on top everything else and it can feel like a real pressure cooker.”

Or if we’re sticking with the sandwich metaphor, she offers, “like a Pressed Panini.”

When I get off the phone with her, my older son is standing in front of me holding my car keys and a baseball glove in his hand. “We’re five minutes late for baseball practice!” he says.

I’m tempted to tell him to pick up a game of stickball in the street, but instead I smile and apologize. A minute later, we’re running out the door.

Lucy’s Pressed Panini: It Takes a Village

Forty-five year old Lucy Van Beeber remembers her father and son playing light sabers together. It was during the period her dad was first diagnosed with bladder cancer, in 2008; also the same year her second child, daughter, Bianca was born.

“My father was grouchy a lot then,” recalls Lucy. “He had had his bladder removed and he had an ostomy bag and he wasn’t adjusting well. So there we were with the kids, visiting and my four-old son Marco just wanted to play with grandpa. He wanted to play light sabers, and so I found these wrapping paper tubes that they could use. And they played together.”

It’s a memory Lucy treasures.

Tragically, Lucy’s father’s cancer would metastasize. Throughout much of 2009 she drove back and forth from her home in Somerville, Massachusetts to her parents home in New Jersey—a four-and-a-half stressful trek each way.

“My kids have known their whole lives that my attention is divided,” says Lucy. “It’s just always been that way.”

In 2010, as her father was dying, Lucy’s mother was diagnosed with breast cancer. After her mother also became ill, Lucy was hardly ever home. Her husband took on the role of the primary caregiver to the children, then ages two-and-a-half and six.

On April 21^st, 2010, Lucy’s mother had a mastectomy. Thirteen days later, on May 3^rd, her father passed away.

When talking about the experience, Lucy pauses here for a moment. “That was a really tough time,” she says. “Caring for two sick parents and being away from my husband and kids. And after my father died, it was time to do everything for my mom, who had just lost her husband and her right breast. It was really hard.”

Carol Abaya, M.A., is a sandwich generation guru. She even owns the URL sandwichgeneration.com. Her personal story about caring for her aging parents was featured in a New York Times article in 1999. For the past 25 years, she has used her personal expertise gained from caring for her aging parents to help others in the same boat. Although she’s semi-retired now, she still gets calls from people all over the country with questions about how to make decisions for their parents.

Abaya is adamant about a few things -one of them being: people in the sandwich generation cannot do this caregiving thing alone. When I spoke with her on the phone, she emphasized the importance of sharing responsibilities and asking for help.

Abaya is adamant about a few things-one of them being: people in the sandwich generation cannot do this caregiving thing alone.

“It’s just like when you’re raising young kids,” she says, “and you’re organizing play dates, and carpools and you and the other parents share chores. Well, this is what you need to do with your siblings, if you have them. Split up the chores; have meetings and communicate, even if by phone. Too many times I’ve seen one sibling try to take on everything and not ask for help. And then she ends up getting sick herself.”

Studies support this advice. In her recently published book The Age of Dignity: Preparing for the Elder Boom in a Changing America, author Ai Jen Poo cites a JAMA article showing that “family caregivers, especially those who must balance jobs with unpaid caregiving, are likely to neglect themselves to the detriment of their health. Sleep deprivation, stress, depression, immune system deficiency, diabetes and hypertension are common.”

Lucy recognizes how fortunate she is to have a good support system—despite the fact that neither she nor her husband have family nearby. During the time that she was running back and forth from Massachusetts to New Jersey to care for her parents, her neighbors stepped in to help. “They would take our kids for the day, or pick them up and take them to school and activities. Or they’d bring by meals. We’ve been able to build our own support network.”

Although her brother lives in California, he also helps out. “We have a very close relationship,” she says, adding that they talk a lot and share the responsibility of checking up on their mother who currently lives alone in New Jersey and is in the beginning stages of Alzheimer’s.

“I worry about my mom a lot,” Lucy says. “I worry how lonely is she? So I call her every day. My brother and I each call her—one of us in the morning, one of us in the afternoon.”

Despite the stress and guilt that so many in the sandwiched generation feel, Koontz notes that it’s not all negative. “What I mean is -from Generation X on down- you have a generation of kids whose parents were more democratic in their childrearing and so their children feel more of an emotional obligation to care for them . That’s a positive development! It doesn’t eliminate the time, emotional and financial pressures today’s parents are under, of having to make choices between who you are paying attention to. But it can help to look at in this light: that we’re doing much more for our families than people in the past, and that’s a good thing.”

Supporting Caregivers in the Workplace: A Growing Trend

One place Lucy finds support is at her job at Boston University. “It’s a good sort of constant,” she says. “And I can talk to people who have been in similar situations.”

Lucy’s not alone in feeling this way.

According to Jennifer Fraone, an Associate Director at Boston College’s Center for Work and Family, “more and more employers are beginning to recognize the emotional toll that caregiving and juggling both children and elderly parents takes on their employees. It’s noticeable in terms of absenteeism from the workplace. Or employees leaving.”

Unlike childcare issues, Fraone notes that it’s traditionally been much harder to find information and support around elder care, and this is where employers can step up and help.

“The good news is that there’s been a lot of growth in the last five years toward supporting employees’ whole health, and not just their physical health. Employers are recognizing that there’s a lot more that contributes to their health care costs and productivity—so they are looking at stress in their employees in a more holistic way. They are asking how do we minimize stress and help employees cope?”

Brown bag lunches and internal support groups led by geriatric social workers are becoming increasingly more common. Some organizations now employ geriatric case managers, or specialists who help families with immediate care needs, as part of their employee assistance programs.

Flexibility is also key. The Family Medical Leave Act, a federal law, allows employees to take annual leave from work to care for a spouse, child or parent with a serious health condition. But, says Fraone, “Caregivers also need to be able to take off time in small increments to take someone to an appointment and not feel like they are going to be penalized. The more flexible an employer can be, the better. It’s all about building a culture of trust. We’re trying to help employers shift the emphasis from face time (“I can see you!”), to what are the results—what is the quality of what you’ve delivered?”

The Family and Work Institute, an organization out of New York with a similar mission, annually conducts the most comprehensive and far-reaching study of the practices, policies, programs and benefits provided by U.S. employers to enhance organizational and employee success. The results of the Institute’s 2014 study show that nearly half of employers polled now offer elder care resources.

“This is a really positive trend and I hope it keeps going,” says Fraone. “We want employers to see people as a whole person, with a whole life.”

Living Arrangements: No Easy Answers

When I arrive at my father’s house I find it cluttered but clean. Together with the help of their visiting home health aide, my dad and his wife had tidied up for me.

My father is fortunate in many ways. He has no serious health issues that we know of. He doesn’t even have arthritis–a fact that impressed a geriatric doctor I met on another flight to visit my father several years ago. He is also remarried to a woman twenty years younger. I suppose one could say that all of this makes me fortunate too, as I am not his primary caregiver.

During a phone call several months ago, out of concern for his memory issues, I’d proposed the idea of an assisted living facility.

“That’s where you go to die,” he said. He also quoted the expense. I dropped the subject.

Fortunately, over the course of three days at his house, I conclude that my father is doing better than I’d thought. Yes, he repeats himself sometimes, but he is sharp and funny and, with paid help, coping quite well on his own both mentally and physically. I can stop worrying. For now, at least.

“The goal is to empower your elderly parents,” says Abaya. “As long as they are safe and their health or finances aren’t being negatively impacted, step back and let them make their own decisions. Sometimes these might be bad decisions, but you cannot make choices for them using your own values. You need to respect their values.”

One thing she strongly advises against is uprooting a parent after a spouse dies. “Unless there’s no alternative, it’s better for them to stay where they have friends and doctors and a support system in place.”

Of course, these are very personal and difficult decisions for each family. Five years after her father’s death, Lucy’s 82-year-old mom continues to live on her own in an apartment in New Jersey, despite her early Alzheimer’s.

“My brother and I have run the gamut of how we’ve approached her situation,” she says. “I have an apartment downstairs and I’ve considered having her live with me, but it’s an urban, unfamiliar area for her, and with her Alzheimer’s that could be dangerous. Plus when I’ve said to her, ‘you are moving up here,’ she responds ‘No I’m not.’ I’d love for her to be a mile down the road so I could swing by and take her to Marco’s hockey games, or for an outing. I’ve taken her to look at assisted living facilities around here but she either doesn’t remember them or resists the idea. Right now we actually have a deposit down on assisted living facility nearby but there are no openings.”

And so for now, they wait.

***

Kathy Hubbard, a 52-year-old mother of two teenage daughters in Pennsylvania, knows she is one of the lucky ones in that her father is a planner.

“My parents live about 25 minutes away,” says Kathy. “My father is 77; my mother 75. They are preparing to sell the house they’ve lived in for 15 years and move to an assisted living facility.”

She explains that her grandfather (her father’s father) started having increasing dementia when he was 75. “I think for my dad, the impending move brings him enormous peace of mind. But my mom feels like she’s too young and vital for assisted living.”

Her father’s penchant for planning means she and her sister also know what’s in his will; they know about his assets, and she says, “We have the combination to everything.”

This puts Kathy’s mind at ease. As does the fact that her parents chose to get rid of much of their stuff before moving out. “One of the greatest fears I had was that my parents would leave me and my sister with a huge house to clean up. I know that happens a lot, and they went through that with their own parents…and it was tough. I’m so very grateful to them for take the initiative to do this.”

But by no means is this whole experience easy for Kathy. Her mother is depressed and “needs a lot of emotional support,” so Kathy talks to her every day. “I’ve been spending the last two years both helping my parents move out of their house while helping my exceedingly anxious 18-year-old daughter get her brain around that she’s going to college. We went to look at schools and she had a panic attack. It’s been a tough process. And I feel like I’m constantly bouncing from one anxiety-ridden thing to another.”

For another perspective, Kathy refers me to her friend Robin Colodny, who lives in Kathy’s same town of Bala Cynwyd, PA. Robin is working mom with a 16-year-old daughter and an 11-year-old son, and her mother lives with them.

“She invited herself to come live with us three years ago after she’d had enough of my stepfather and wanted to be closer to her family,” says Robin. “Really she wanted me to move back to Florida, where I’m from and where she was living. But I wasn’t going back.”

Robin repeatedly states that she’d like to put her mom in “a time out.”

Of course, these are very personal and difficult decisions for each family. Five years after her father’s death, Lucy’s 82-year-old mom continues to live on her own in an apartment in New Jersey, despite her early Alzheimer’s.

“In her own mind, I think she thinks she’s asking for so little, but to me, it feels like she expects a lot of service. And she expects it instantly. And constantly.”

One of the bright spots of having her mom live under the same roof seems to be the relationship between the grandmother and her grandchildren

“My son gets along beautifully with my mom,” Robin notes. “When he’s interested in interacting with her. Sometimes he’ll play the saxophone and she’ll be his audience. Occasionally they’ll play a board game like monopoly. She worships my kids.”

Abaya points out that teenagers, who often need their parents attention even more than younger children, can get lost in the shuffle when parents are also caring for aging adults. Robin’s own experience highlights this when she says, “My mom takes up most of my time and energy. That’s where I really feel the sandwich…my daughter could use more of my attention right now, and I can’t really spend the time with her. I have to deal with my mother.”

She adds that to the extent her kids can help out, they do. But, she says, “They can’t do the things that exhaust me: The taxes. The financial stuff. The insurance stuff. Taking her to medical appointments.”

When I ask her if she thinks they’d be getting along better if they didn’t live together, she says, “Yes. Without question.”

The potential for tense family relations isn’t necessarily stopping generations of families from moving in together, however. According to the Census Bureau’s 2012 American Community Survey, more than 4.3 million U.S. Family households—or one in 20 nationwide—were made up of three generations living under one roof. Part of this phenomenon can be explained by looking at the large number of grown children who moved back in with their parents during the recession. While the economy has improved, members of the “boomerang generation” aren’t necessarily moving out any time soon.

Whether these families are happy or stressed—or perhaps a little bit of both—only they can say.

Caring Across Generations: An Antidote to the Sandwich?

Sarita Gupta lives in the Washington D.C. area with her husband, five-year-old daughter, and her elderly parents. Shortly after her father was diagnosed with Alzheimer’s, Gupta asked her parents to sell the house they’d lived in for forty years and move in with her.

“It was the hardest conversation I’ve ever had with my parents,” she recalls. “But they agreed.”

Gupta is happy to have her whole family under one roof, but like others who are sandwiched, she’s often overwhelmed by the responsibilities of caregiving and trying to navigate the current system to find appropriate resources for her father. “You really have to seek out information,” she says. “It’s like a second job. And it feels like everyone is struggling with these issues, and with accessibility and affordability of care.”

Gupta’s unfortunate “expertise” in this area serves her well as co-director, with Ai Jen Poo, of Caring Across Generations, a national movement to “change the way we live, age and care in America.”

Poo, a MacArthur Genius Fellow, is also Director of the Domestic Workers Alliance. Several years ago, she noticed that a large number of housekeepers and nannies were asking for training in elder care because their employers were requesting that they also take care of their elderly relatives. She and Gupta then got an idea: how could we bring both individuals and families together with the direct care workforce to craft a different future? This was the seed for Caring Across Generations, which officially launched in 2011.

The movement aims to provide a potential solution to the sandwich—or at least greatly ease some of the pressures that we sandwiched folks face. They recognize that the current long-term care system is broken. As Poo writes in Aging with Dignity: “There is no question that we are failing today’s families. Our current system is a holdover from another time, when life expectancy was around sixty years and dementia was rare…looking at the total landscape of our economy, it’s clear that the system cannot hold if so many adults between the ages of thirty-five and sixty, traditionally considered the peak of a person’s productivity, are stretched so thin.”

The movement aims to provide a potential solution to the sandwich—or at least greatly ease some of the pressures that we sandwiched folks face.

If that’s not enough, there’s another problem—what Gupta refers to as “a silver tsunami” heading our way. By 2030, due to the aging Boomer population and medical advances that help people live longer, about one in five Americans will be older than sixty. The Census Bureau projects the baby boomer population to total 61.3 million by 2029, when the youngest of that generation reaches 65.

“There will be millions needing care in the decades to come,” says Gupta. “Add to that a recent AARP study that notes 90 percent of seniors want to age in place—in their homes and communities—and there could be a real care crisis heading our way that affects all of us. We want to get in front of the problem now and build a new care system that respects people’s desire to age in place. “

The movement is tackling the issue on four fronts: cultural change work; local, state, and federal policy advocacy; online campaigning; and field activities and civic engagement—currently with a broad coalition of 200 organizations.

“Caregiving is deeply undervalued in this country,” Gupta says, ” and we want to change that. We also want people to embrace multigenerational relationships and shift how people view aging in this country.”

These are certainly no small tasks, but the organization is coming up with creative ways to bring people together around these issues, including reaching out to Hollywood screenwriters to talk about how they might think about these themes in their films. Last year they also organized a concert in Harlem in honor of Grandparents Day, inviting musicians from the millennial generation (born approximately between 1980 and 1992) to play the music of their grandparent’s generation.

“These are two huge populations: the millennials and the boomers,” says Gupta. “And we’re looking for ways they can work together to change the conversation on care…think about how powerful it would be if they were advocating together?”

On a federal and state policy level, the organization is moving the needle on some of their issues. For instance, they’ve been working with the Obama Administration on changing the home care rule to ensure that domestic workers receive at least minimum wage and have overtime protections in place. And, according to Gupta, they’ve been very successful in sparking conversations on the state level.

“States are on the front lines of this issue and we want them to take on the issue of care in meaningful ways.” She cites Medicaid expansion in Ohio and Maine’s “Keep Me Home” initiative as two examples.

“Maine is the oldest state in our nation demographically,” she says. “They’ve really taken this issue seriously. ‘Keep Me Home’ is just the beginning of how they want to address the issue of care moving forward—including building new environmentally friendly senior housing, along with providing new supports for seniors, and reassigning the reimbursement rates of the Medicare system to cover home-based care. So there’s opportunities like this, at the state level, that are moving across the country.”

There is no doubt that she is passionate about this mission. She points out that we are a nation of “doers,” and refers to a passage in Poo’s book, that reminds us how at one time in this country we didn’t have indoor plumbing:

“We made a decision to create a system to have water in our homes. Why can’t we think about care in this way? In a systematic way. How can we build a “careforce”? Homecare workers would be good preventive medicine and save costs for families. There is a lot of opportunity here—not just a crisis. Let’s look at it this way. We want something different and we’re confident that we’ll get there.”

Listening to Sarita makes me feel a bit better about the future, for my own family and for Lucy’s, and Kathy’s and Robin’s—and all my friends who are also trying to juggle childcare, elder care, and work. While we may not see many of these changes come to fruition in our own parents’ lifetimes, at least there is hope for our children, who will have to grapple with many of the same issues we are facing now if things don’t change.

“I don’t ever want to be a burden to my kids,” Lucy said in her interview with me.

I feel the same. And I bet I’m not alone.

So I’m holding out hope that Gupta and Poo’s vision of a “careforce” in this country becomes a reality. Something needs to change.

***

Amy Yelin’s essays and articles have appeared in The Boston Globe, Literary Mama, The Mid, The Manifest Station, The Gettysburg Review and other publications. Her humorous essay “Once Upon a Penis” is included in the anthology Mamas and Papas: On the Sublime Art of Parenting. She is also Managing Editor of SolLit: A Magazine of Diverse Voices and she teaches writing at Grub Street in Boston.

Click here to meet Amy and learn more about the writing of this feature story.

Top Photo: Sam Edwards | OJO Images | Getty Images | CNBC.com

Pancakes

Posted on September 13, 2015 by CNF • Posted in Articles Page, Highlights, Slider Content • Tagged alzheimers, daughter, dementia, Nancy Townsley, parents, sandwich generation, sisters • Leave a comment

By Nancy Townsley

We had pancakes at the diner down the street from dad’s house two Sundays before we put mom in the nursing home. That’s what mom had, anyway. I had oatmeal with raisins and walnuts. My sisters probably had waffles or yogurt parfaits, I can’t remember. Our dad had two eggs sunny side up, crisp bacon, wheat toast with margarine, and coffee.

Dad cut mom’s pancakes for her because she had forgotten how to do it. She used a fork to stir three packets of sugar into her first cup of decaf. Dad shook them in there himself. It was way too many, but no one said anything.

We didn’t say anything to the waitress, either, when she asked us how our morning was going and wished all the women at the table a Happy Mother’s Day. Her voice was cheery and she wore a fake pink carnation behind the pinned-on plastic badge that said Stacey. We pretended everything was OK, but I wondered whether our guilty faces gave us away. We smiled and ordered our breakfasts. When Stacey circled back around to refill our coffees, we smiled again and watched mom dump more sugar into the hot black liquid.

That’s the way my heart felt on that day. Hot. Black. Liquid.

***

We all had it written down on our calendars, the day we’d take mom to the home. Twelve days from now. Every time dad wondered out loud whether he could keep on taking care of mom by himself, we’d insist she was not going to get better. It’s not practical, my sisters and I would say. Remember how it’s hurting your back to get her in and out of the shower? How you have to wrestle her into her clothes every few days when you finally cajole her into getting out of her bathrobe? How crazy it makes you that she keeps you up half the night either laughing or crying, and you never know which it will be? How you wonder if you’ll ever get any rest ever again?

You’re almost 80, dad. This is not working. We know the two of you have lived together for more than five decades, since you were married in the Immanuel Lutheran Church in Algona, Iowa, the weekend after Thanksgiving in 1954. We know it’s hard for you to imagine yourself here in your cozy, familiar house, and her there in a sterile, silent room without you by her side. We’re so sorry it’s breaking your heart. But you really have to let go.

It was the only time I can remember, in all the years we’ve been dad’s daughters, that we were so adamant and unrelenting. All our lives we had lined up, like little tin soldiers, whenever dad exhorted us. Our family was not a democracy—we marched unflinchingly to dad’s drummer—so it surprised me when he acquiesced. But there was a sinister secret in the deal. We agreed not to tell mom we were planning to move her out of their house because her needs were too big for dad to manage. She would not have wanted to discuss it even if she could understand, dad said, which she most definitely could not. It seemed deceitful and Machiavellian and downright wrong, but still we did not tell mom she was going. Or when. Or to where. Instead, we plotted behind her back and convinced ourselves it was all right to keep her in the dark because our decision, cloaked in whispered conversations, was what was best for her.

And also for us, though we couldn’t bear to think about that.

***

The day before mom was supposed to go to the dementia care facility—a clean, well-appointed place we’d all toured and approved of—she had a heart attack. Not a serious one, the emergency room doctor said, though she’d have to stay overnight for observation. It felt like synchronicity to me, as if her body had ginned up a cardiac event in order to foil our plans. Lying there in her hospital bed, the crisp white sheets tucked up to her neck making her look so small and frail, mom blinked and her wide eyes leaked—a sure sign, I thought, that she knew something was up. That everything was going to change, and she couldn’t do anything about it. Drip, drip, drip went her IV. Beep, beep, beep went her heart monitor. Dab, dab, dab went the handkerchief I used to catch her tears.

***

It was a mistake not to bring mom to the care home in an ambulance. That would have been much more official and tidy. She went in a car sent by Cedar Crest Alzheimer’s Special Care Center. Emerging from the hospital in a wheelchair, mom complied when the orderlies started to fold her rag-doll body into the front seat of the sedan, taking care to place her fuzzy sock-covered feet just so and guide her shaking hands into her lap, one over the other. My younger sister and I scrambled into the back and told the driver to follow our dad, up ahead in the navy blue Volvo. It was funny because of course the man in the sedan knew exactly where to go, but dad was going to lead the whole sad caravan 10 miles up the road to our destination nonetheless. With dad ceremony was important, even when the mission felt impossible.

Two other cars, my older sister’s and my husband’s, followed behind.

It took us much longer than it should have to get there. Felt like it, anyway. We passed a McDonald’s, a Taco Bell and a Long John Silver’s on the way. Also a 7-Eleven, Jo-Ann Fabrics and a Shell gas station. When we finally arrived, dad looked somber, stoic, fearful and ashen, all at the same time. My sister and I popped out of the back seat just as our driver, whose name was Travis, came to a stop under the covered area leading to the care center’s foyer. Mom stayed put. She stared straight ahead. This was a bad sign.

Like an earnest hotel valet, Travis sprinted around the rear of the car and opened the passenger-side door for my mom. He smiled a nervous smile and disappeared into the building, leaving us to our private moment of transition. Like a battlefield blueprint, we had our next move figured out. We’d walk mom to the reception desk, sign her in, memorize the week’s keypad code to gain entrance to the locked common area, then find a nice alcove for the family to hunker down in. We’d get mom a cup of coffee, maybe, and reassure her everything was fine. That she’d like it here, and we’d visit as often as we could. Dad would promise to come every morning and every afternoon, which I knew he would do, because his word was his bond.

***

All of this was running through my mind as mom just sat there, eyes fixed on the windshield or the car’s hood or god knows what, maybe a robin in one of the maple trees lining the walkway, and she didn’t budge. Not an inch, not a twitch. We noticed she was crying. With mom we could always tell when the waterworks were under way because her heart-shaped face would scrunch up and get all red, just like it was right then, and she’d make low, soft, guttural noises, the kind a wounded animal might make if it were all alone and suffering. And I thought: she knows. She knows what’s happening and that she can’t control it. She knows that if she gets out of the car and walks through that door, she’s not coming out. She knows we’re betraying her.

I’d never felt more helpless. Dad took mom’s hands in his and tried to lift her from the bucket seat. “Here we go, Lucile,” he coaxed, “I’ve got you, I’ve got you.” He’d take a break, rub his aching back and try again. She cried harder and stared at him with pleading eyes. He broke down. He walked to his car, got in and drove off, “to pick up her prescriptions,” he called out the window. It was our turn to convince mom everything was all right, to convince ourselves it was. How do you do that when it isn’t? She wept hot, bitter tears. They rolled down her cheeks and dripped from her chin onto her pale blue cotton blouse, the one with two miniature Schnauzers embroidered on the pocket, just like the dog she had at home, her home, the one she was leaving for good. Her nose ran, and mucus mingled with the tears, making a mess we tried to clean up with tissues and platitudes and frantic murmured prayer. Things were that dire and intractable and confusing and dreadful—until Ann, the center administrator, came to our rescue.

***

She was wearing a long, white cardigan over a tailored red dress, and her hair was done up in a breezy French knot. As she approached our mother I thought she resembled Florence Nightingale, or even Joan of Arc. It was that important for someone, anyone, to do something to fix this. Ann crouched down beside the car door. She cupped mom’s forehead in the palm of one hand and swept a soft cloth across her soggy face with the other, chatting her up with stories about the people she’d meet inside. There was Marilyn, her roommate, who was very quiet but friendly, too. Judy, who loved to wear colorful bracelets and had taken a fancy to Marty, who clapped his hands a lot. And Joyce, who could be crotchety and sometimes swore in German, but danced gracefully around the dining hall with imaginary partners whenever they played Frank Sinatra.

Mom sniffed and stopped crying. She looked at Ann through the swollen slits of her eyes and saw the same thing we did: salvation. Ann put her arm around mom’s shoulders and mom leaned into her, enough that her body slowly rose from the car, and together they shuffled over the threshold into Cedar Crest, mom’s new and forever home. In almost a single deft motion, Ann had bound up our hearts and our spirits, not with gauze or liniment but with confidence and empathy and kindness, doses measured in magic and love. We were floored and amazed and thankful. We slumped down on a sofa in the TV room with mom until dad reappeared, a white paper bag carrying a half dozen vials of pills tucked under his arm. “You all right, ‘Cile?” he asked, brushing her sticky bangs aside. “I love you,” he soothed. “I’m here.”

And he was, morning and afternoon, for exactly three years and nine days, until mom stopped eating and drinking and the hospice nurse said she was “actively dying,” so we all gathered around her bed to kiss her cooling brow, sing to her, read to her from her bible and tell her it was all right to go.

***

Later, when we returned to dad’s house, 50 years of memories hung in the air as conspicuously as the walnut-framed wedding picture on their bedroom wall—she in her beaded tulle gown, he in his handsome white suit—and I noticed a new addition. A large calendar, with artwork by Renoir and oversize spaces for recording significant dates and appointments, sat on the kitchen table, open to the month of May.

Two squares were outlined in magenta marker.

“Lucile to Cedar Crest, 2010,” read a notation on May 21, accompanied by a sad face drawn by dad.

Under May 30, the day mom went to the peace, he’d scrawled a tribute to the span of their marriage—”58 years, 190 days”—and added a bright pink heart.

Author’s Note: Since my mother died of complications from Alzheimer’s disease in 2013, my heart has lurched every time I’m unable to conjure up a word in conversation. I wonder if succumbing to the ravages of plaques and tangles is my destiny, too. But mostly, I reflect on the meaning of her life, its serendipitous connections with mine—and I smile at the memories.

Nancy Townsley grew up as a Navy “junior” and rode horses bareback in the Puerto Rican sun. Since moving to the Pacific Northwest in 1973, she has forged a career in community journalism. Her fiction, nonfiction and essays have appeared in Brave On The Page: Oregon Writers on Craft and the Creative Life (Forest Avenue Press), NAILED Magazine, Role Reboot, runnersworld.com and BLEED, a literary blog by Jaded Ibis Productions. She lives, writes and runs in St. Helens, Oregon.

Author Interview: Amy Yelin

Posted on September 1, 2015 by CNF • Posted in General • Tagged Amy Yelin, Author Q&A, family, sandwich generation • Leave a comment

Amy Yelin is the author of this month’s feature story about raising our children while also caring for our parents. Here is what she had to say about writing this feature story.

What was the most surprising piece of research you found while writing the article?

I was blown away by the predicted number of aging baby boomers expected by the year 2029: 61.3 million people! I must also thought the phrase “silver tsunami” was kind of brilliant.

What interested you most about this topic?

I had a personal interest in this topic because I am one of the sandwiched…although I didn’t really realize it until I started writing. The opportunity to research and write this piece came to me only shortly after my visit with my father in March, and after I’d spent time writing about a local assisted living facility for a freelance client. The universe apparently wanted me to focus on the sandwich generation and elder care. I was really interested in both the history of “the sandwich,” which Stephanie Coontz kindly shared, and Carol Abaya’s advice, particularly her advice not to move your elderly parent. That was new to me, and reassuring because I’ve often felt badly that I don’t live closer to my father. Also: discovering Caring Across Generations and learning about the work they are doing, which I think is just brilliant. And hopeful.

What was the most challenging part of writing the article?

I think it was synthesizing so much information: the research, with my story, with the interviews, both the families and the experts. Connecting all the dots–which I find both challenging and, when it eventually works, satisfying.

If you were able to include more information what would you have added?

Perhaps more resources for people who are living in the sandwich. Writing the story it became clear how confusing and overwhelming navigating the current system can be. And perhaps advice on how to have “the conversation” with your elderly parent(s)– about their wishes for end of life care, and whether they have the proper documents in place. It can be a really difficult conversation to have. I admit I have yet to approach the topic with my own father.

What do you want the reader to take away after reading this feature?

I hope readers find something to connect with–something that makes them feel better about their own situation, and to know they are not alone. One piece of advice I really love came from Stephanie Coontz who said that despite how hard the situation is for those of us who are sandwiched, in reality this is a positive development because we are doing much more for our families than people did in the past. That we can take a little solace in this.

How do you balance motherhood and writing?

It’s pretty challenging. Because it’s not just just motherhood and writing–it’s motherhood, writing and making a living. I recognized before kids how much joy writing brings me, so I find ways to do it, no matter what. Sometimes I run away, to writing conferences; last summer I went to to the Vermont Studio Center for two whole weeks! This was thanks to a fellowship from the Sustainable Arts Foundation, which offers money and fellowships for writing residencies to parents who have kids under age 18. Mostly it’s a crazy juggling act. I’m most prolific when I commit to getting up early in the morning and writing. I really need the quiet. And I’ve gotten better at not beating myself up when I’m not writing much. I know i’ll get back to it.

Return to the September 2015 Issue

My Father’s Surgery

Posted on February 2, 2015 by CNF • Posted in Articles Page, Highlights, Slider Content • Tagged Allyson Shames, daughter, father, loss, parent and child, sandwich generation, surgery, waiting • Leave a comment

By Allyson Shames

The before part is easy. There is a diagnosis, a plan, steps to be followed and items to add to a to do list. Airfares and train tickets are compared, childcare found, teachers contacted, dinners to cook and notes written. The little one doesn‘t like peanut butter and jelly. Pajama Day is Friday, but don‘t send them in light colored ones. You make checklists, minutiae that keep you away from the dangers of the internet and search terms: “open heart surgery,” “valve replacement,” “bypass.”

You decide to take the train, and your father-in-law agrees to fly out to watch the kids because for your husband this is a bad week, an awful week, to be gone. He’ll be working eighty hours and he’ll need the help. It occurs to you that your father-in-law hasn’t watched a child, much less three, on his own in a quarter-century. It occurs to you that he’s never made a school lunch or managed booster seats. You email the school, teachers, friends. Items checked off the list.

By the time you arrive, your father is out of surgery and awake. He’s groggy from the anesthesia and saying things that don’t make sense. “Do you remember my friend from work whose daughter taught you how to ski?” he asks. “Yes,” you reply. “We were eight. You let us go off on our own while you sat in the lodge and drank coffee.”

“He’s dead,” he says, and you don’t know what to say to that.

In the hospital room there are many machines. You were an EMT and have spent enough time in hospitals to know what the squiggly lines mean, but here, after someone’s heart has been stopped, there are more tubes, more wires, more bags of fluid. You notice insulin, but no one will tell you why it’s there. Your father has an IV in each arm, tubes and a central line. His gown has fallen open and if you didn’t force yourself to look away, you’d be able to count his ribs.

It’s not until hours before you’re supposed to leave, your last night there, that you look at the machine and see numbers that don’t make sense. The machine beeps. You look at your uncle, a doctor, and he leaves and comes back with a nurse, who contacts your father’s doctor. They schedule a cardiology consult, but tell you they’re not concerned, that this is normal, these fluctuations in heart rate. Your mother, knitting knitting knitting in a chair next to your father, tells you she’ll drive you back to the train station. On the phone, your husband tells you maybe you should stay but your mother tells you to go and because she looks you in the eye you listen.

On the train ride home you watch your childhood course by out the window, the colonial houses of New England, small towns and white churches and parks shaped like squares. You notice that there’s a Porsche dealership and a trailer park only two minutes apart, but you can’t tease out what to think about that, so you file it away for another time. You enter New York and pull away, the invisible threads of identity pulling you back as the train pulls forward, southward, away.

You thank God for Amtrak wifi and drown in the drudgery of work for nine hours. The architecture changes as you cross the Mason-Dixon line and when you walk in the house the children are fighting, bickering over a Wendy’s Frosty that one child got but not the others, hardly looking up to see you there. One hits another, but your father-in-law, who raised four children of his own, is not bothered. You realize that he did just fine without you and that he might be the only sane, stable person in your orbit, at least until he leaves, which will be soon. You avoid him, avoid everyone, dealing only with quantifiable items like making lunch and driving to play dates, things with start times, end times, definitives.

Over the next few days, your father’s heart rate doesn’t get better. The emails fly, the doctors come and go. You wait for the phone to ring because your mother can’t ever remember to bring her phone charger to the hospital so you can’t call her, she can only call you when she decides to turn on her phone. She is the granddaughter of Russian Jews who fled the Cossacks and staidness is in her blood, but when she tells you she stayed the night in the hospital room you know she’s scared.

It’s now that’s the problem, because the surgery is over and you’ve come home and you can’t worry any more about whether your father-in-law knows how to cook a veggie burger or navigate the school dismissal line. Now all you can do is watch the clock and wait for the phone to ring.

Your father calls, finally, and you get to hear his voice, but it’s strained. He tells you to talk, to not stop talking, but then he’s silent and says, “I couldn’t hear you.” He says, “I held the phone to my left ear but I couldn’t hear anything at all.” He says this with a mix of wonder and fear. You do a Google search and find this can happen after cardiac surgery, it is rare, but it can happen. You do a lot of Google searches. It’s something you can write down on a to do list.

Each day the cardiologist visits, saying he’ll come back again, and finally they decide the cocktails of medication aren’t enough and they’ll have to do another procedure to stabilize his heart rate, which somehow keeps flying to extremes: too high, too low, a roller coaster of beats per minute. If you close your eyes, you can see the machine in the hospital room, blue lines on a black screen, and hear the beeps that call the nurses in when the wave crests too high or falls too low. You go to the fourth grade class play and for half an hour your brain is somewhere else. But then the play is over and you look around and realize you don’t know what to think about anymore.

You get in the car and the phone rings and it’s your dad’s cousin, and she asks about your father. She tells you she’s had health problems of her own, big ones, but she’s okay now, she’s finished radiation, she’s okay. She makes a joke about how if you still have boobs by seventy they’ll sag down to your stomach, and she laughs, and you say, can you call my dad? Because I think he needs to hear from you.

You hang up and there’s an email from your mother that the procedure is about to begin. You think, I should go home, I should wait by the phone because there isn’t anything on the to do list, you’ve done it all, at least all the things that matter. But the iPhone betrays you because you don’t need to go home, no one uses the home phone anyway, so instead you drive to the pool, noticing the gathering clouds and thinking you’re in a cliché, the clouds matching your mood of hovering darkness. You drive to the pool and shove the phone in a locker and swim sprints until you can feel sweat break into the water.

You swim until your legs can’t kick any more and you get out of the pool and there are mothers and babies all over, so young, and you leave, driving home as the rain starts and the wind picks up. At home, you circle the computer, drawn to the blank page and repulsed by it as well, because you know that if you give into it the words will come, and putting the fear on paper will make it real.

You pace, waiting for the phone to ring. The minutes tick by and become hours. The phone doesn’t ring. It occurs to you to eat the entire box of peanut butter Girl Scout cookies that you’ve hidden in your office so your teenager doesn’t eat them all first.

The wind gets stronger. You take the dog out, realizing no one has done that yet today, and you want to praise her for having such a strong bladder but of course she wouldn’t understand. She wags her tail and comes back inside and curls up by your feet and you think she is smarter than many people you know.

The first branches to come down are twigs, many tiny ones, and they fall in the yard like sprinkles on ice cream. You stand by the window and watch the storm, nervous about the big branches on these old trees. Each one hangs over something that can’t be easily fixed: the van, the porch, your bedroom, your daughter’s room. These are old trees with long, creaky branches. They bend too much but not enough and that makes them terrifyingly fragile.

The storm picks up as you wait for the phone to ring and you watch, paralyzed, by the window as the branches sway and bend, but they never come down.

Allyson Shames is an at-home parent and fiction writer. She lives with her husband and three children in Charlottesville, Virginia. This is her first published essay.

The Mother of the House

Posted on January 19, 2015 by CNF • Posted in Blog, Highlights • Tagged family, middle place, motherhood, mothering mothers, Rudri Bhatt Patel, sandwich generation • Leave a comment

By Rudri Bhatt Patel

While she will always be my mother, I am the mother of the house now.

My mother tells me that she doesn’t know what home is anymore. I sigh, not wanting the words to land. She sits at my dining table, while I make her fresh roti, an Indian bread that I devoured as a little girl. Her hands lay in her lap and her half-smile reflects her ambivalence. I notice her veins, the bright blue lines laying roads on her arms.

“I don’t get it, Mom. What do you mean? When you are with family it isn’t enough. You also complain that your apartment feels lonely. Which one is it?” I flip the round roti on our stove, my elbows awkward and displaced as I try to save the bread from burning.

She tries to explain. “When you lose your companion,” she says, “there is no place that fulfills you. This is my new normal after Dad’s passing.”

I feel the weight of her words and my mouth opens, but the words are stuck. Instead I watch as a piece of the bread burns at the edges.

“It is too late. There is nothing to save.” My mom interrupts my thoughts as I toy with trying to save the roti.

For a minute, I am confused. I am unclear whether she is talking about her loneliness or the bread. The conversation about her displaced home occurs, almost on repeat, every time my mother and I intersect. She confesses her pendulum of discontent. I reply in silence.

I accept that this is her new voice. The voice of a widow mourning the loss of a life she keeps referring to in the present tense.

What I didn’t expect is how much I’ve started to mother my own mom. I am a forty something raising my eight-year-old daughter and taking care of my mother too. When my daughter comes home from school, I ask her those familiar words that resonate in cars all over the country, “How was your day?” Sometimes she replies with a boisterous response, other times I plead with her to confess at least one detail. When I ask my mom the same question, she will often respond with a single word answer and like a good “parent” I keep prodding her until she reveals that her stomach hurt at night and she didn’t get much sleep.

When she visits our home, I yearn for her to take an active role in nurturing me if I am feeling down or overwhelmed, but instead, I am the one who asks if she is taking her medications that control her blood pressure and diabetes. When she leaves the room and heads to the bathroom, I peruse her room, straighten her sheets, fluff her pillows and throw out any peripheral trash that might be strewn on her nightstand.

As she bathes, I lay out her tea cup, saucer, kettle and sugar. She ambles down our stairway; her increasing weight creates an immediate panic in my gut.

“Mom, after you finish drinking your tea, please take a walk around the neighborhood. You need to exercise.”

I identify the look in her eye. It is one that looks like a teenager who dismisses the plea of her parent.

“Yes, I will go. Maybe in the evening time when it is cooler.” The tone of her voice is indignant and I know that walk will never occur.

When lunchtime hits, I ask both my daughter and my mother what they want to eat for lunch. I dump veggies and fruits into a blender and make them smoothies, knowing that both will only eat nutritious foods if I sneak them into a drink. After they are finished, I hand them a napkin to wipe the faint lime green mustache around their mouths.

I pause and glance at my mother and daughter. I am in the center, the adult, between my mom, the senior citizen, and my daughter, just a few months shy of her ninth birthday. It’s a precarious place to be, watching my daughter at the entrance of anticipation, while my mother experiences the ache of widowhood. I swing between two extremes, trying to balance the needs of both.

Despite their age and stage in life, the thread that ties them together is the same. Both look to me for approval. My daughter asks if she can have a play date with a friend, while my mother inquires whether she can go on an unplanned trip to the garden. I manage my daughter’s homework, while I reconcile my mother’s checkbook. In the morning, I drop my mother at her doctor’s appointment, and in the afternoon I chauffeur my daughter to tennis practice.

I comfort my daughter when she cries, the loudness of her angst vibrates through the walls, the catalyst from simple frustrations like not being able to string her hand through her sleeve. My mom will also dissolve into tears, remembering some specific memory about my father, like how much he enjoyed butterscotch ice cream. On nights my husband and I decide to do a date night, I make certain both my mom and my daughter have dinner before we leave, ensuring their tummies are full so they can sleep well.

As I pass by Mom’s room in our house, there is a part of me that doesn’t want her to be here. I don’t want to open the bathroom cabinet and see the medicine she has to take to push through this life. I don’t want to hear her cry in the middle of the night with pain I cannot undo.

On a recent visit, I opened our front door and observed my mom trying to make roti again. Her attempt brought a tear to my eye. As she lifted the pan to puff the bread, her arms moved slower than I remembered as a little girl when I’d sit at the dining table waiting for this buttery goodness after school.

As my daughter trailed after me, I walk over to my mom and asked her to sit down.

“It’s ok, Mom. You relax.”

In that moment, I understood that while she will always be my mother, I am the mother of the house now.

Rudri Bhatt Patel is a former lawyer turned writer. She is the Online Editor for The First Day. Rudri posts frequently to her blog, Beingrudri.com, is a contributing writer for The Huffington Post and other publications. She is currently at work on a memoir that focuses on grief and life’s ordinary graces. Rudri lives in Arizona with her husband and daughter.