THE SLIPPERY SLOPE ...Caring for the Very Old...

by Julia Sneden

Having welcomed the Baby Boomers to the other side of the hill in my last column, and having noted that life after fifty isn't necessarily a swift down-slope, I am feeling more than a little guilty. Who was I kidding? While it's true that the Boomers probably have a good, long plateau ahead of them, eventually every mortal on this earth hits that down-slope, and no matter how hard you dig in your heels and grab for the handholds, downhill is downhill. Sometimes the journey is fast and slippery and sometimes it's slow and sticky - but it's definitely one-directional, and there's a dropping off point at the end of it. Some people hit that point and simply slip gracefully over the edge. Some have to lever slowly down the last cliff, and sometimes it's a long way to the bottom.

There's a popular bit of bravado that claims: "Old age ain't for sissies." Sorry, but old age is for anyone who manages to keep breathing long enough, sissy or not. I know plenty of sissies who are really, really old. They're the ones who focus on their own miseries to the exclusion of everything else, and lose interest in anything but themselves.

I also know more than a few folks who are heroic. There's no other word for people who, despite aches and pains and problems with vision and bones and bowels, steadfastly maintain an outward focus, refusing to let old age push them into self-absorption and selfishness. My heroes are people who work to maintain mental vigilance, through proactive measures like taking classes, or reading books, or keeping up with world affairs, or doing puzzles, or interacting with grandchildren to keep up with the times. They are people who enrich their spirits by setting aside their own problems to volunteer time and talents to help others in many ways: working in hospitals and hospices, perhaps, or reading to the blind, or teaching a craft or subject they love to younger persons. They are people who work hard to remain independent, even if that means taking on small jobs long after retirement age. They are people who remain physically active for as long as they can. They are people who manage somehow to retain a sense of humor despite the indignities that old age heaps on them.

God knows, the down-slope isn't pretty, as anyone who is caring for a truly elderly parent or friend is well aware. The cost to the caregiver is considerable in every way. Monetary expense, although formidable, is often the least of it. What's really hard is the time you must invest; the physical energy you must expend; and more than any of these, the drain on the heart as you shepherd your friend or parent through the struggle. Watching their capabilities dwindle is frustrating and depressing for them, but also for you, because their small victories and defeats soon begin to feel like your own.

No matter how willing one is, no matter how devoted, being a caregiver is never easy. Just knowing when to step in and assume responsibility is difficult and often traumatic for both sides of the equation. If you wait too long, you may have a huge mess to clean up, such as life savings that have disappeared through foolish investments, or gone to con men.

I remember when a local branch bank manager talked my mother into taking out a "personal loan" to pay for hearing aids, despite the fact that she had enough in her savings account to pay for them twice over. When I pointed out that she was paying 18% interest, she said: "Oh, no, darling, there's no interest because I'm borrowing from myself!" It may be that she misunderstood what the teller told her (the loan was, after all, for hearing aids), or it may be that the banker didn't think to ask her about her savings account, but either way, he certainly wasn't the person who should have been offering her advice in the matter.

If, on the other hand, you move to take control of your elderly friend or relative's finances too soon, you may be suspected of having ulterior motives. For that matter, you may be suspected of having ulterior motives anyway. If you're very lucky (and very careful), having the dreaded talk about finances and the future may be met with relief and cooperation. Those who know they're in a mess are usually grateful for help.

Whenever you assume responsibility for the well being of a very old person, there may be resentments and angers from time to time, both on their part and on yours. You may also find yourself feeling that you aren't really competent to do this, or at the very least aren't doing it well. Be prepared for some serious self-examination and doubts.

If you do take on the responsibility, it's incumbent on you to do so in as positive a way as possible. If it helps, keep in mind the euphemism that "afterwards, you'll be glad you did." God knows you'll hear it said often enough by those who are delighted that you're the one doing the work, not them.

The sad times will far outweigh the moments of joy. And somewhere lurking in the back of your mind will be the haunting thought that in just another twenty or thirty years, someone may have to do the same thing for you. It helps if you really love the person you're taking care of.

It's a big help if you can keep your sense of humor. If there are siblings or cousins or close friends who are willing to share the burden, by all means let them. If they don't offer, don't be too shy to ask for help. Being the sole caregiver is a heavy, heavy chore. Spreading out the responsibilities is preferable, even though it requires some careful diplomacy. It is really important to have ONE person in financial control, and it's usually necessary to spell out the kinds of assistance that each person will give. Sharing such small chores as cutting fingernails or washing hair or driving to appointments can make an enormous difference to the primary caregiver.

It also helps if you can find someone else who is experiencing the same kinds of problems. Support groups that are organized by Senior Services, or organizations that are linked to specific diseases such as Alzheimer's or ALS can be lifesavers for the caregiver. Services like Respite Care, and books like "The 36-Hour Day" by Mace & Rabins can also help. So can simple friendships.

My friend Angela often calls to talk about the problems of being a caregiver. My mother is 94; her father is 92. Angela and I are each other's support group. We have developed our own methods of dealing with the stresses and puzzles and frustrations of eldercare.

In the next column, I'll share some of our observations, discoveries, and even a few funny moments, in the hopes that they will be useful to our readers. As medical science finds new ways to prolong life, more and more members of our generation will be faced with very old parents. I remember once asking my 75-year-old father if he would come east for a visit at Christmas. "That depends on how Mother is doing," he said. It struck me then that not many men his age still had to order their lives around their mothers' well being, but now I find myself in the same situation - and I'm hardly alone.

There is great strength in community. Our Senior Women Web Forum is a good place to share all manner of subjects that concern those of us over 50, and in conjunction with the publication of this column, you'll find a new section devoted to Caregivers. Let's make use of it to give each other a helping hand as we continue our task.