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Tuesday, July 31, 2012

Tuesday's Sciene Times July 31, 2012

Two articles in Sunday’s NY Times are of interest to us as caregivers of all ages; they each discuss the reality of growing older and of dying, albeit from differing perspectives. One is part of an ongoing series in which responses to a selected letter to the editor are published along with a response from the writer and inserted weekly into the Review section of the paper. The other is a regular column in the Styles section by Bruce Feiler. Sunday’s column was titled The Father is Child of the Man, with the subtitle “Parallels between caring upward and caring downward on the family tree,” which more accurately summarizes the article.

Mr. Feiler’s mother has a few adult children who all live in different states from her. She had been caring for her husband who has Parkinson’s disease for quite a while, including through  back surgery, without, it seems, assistance from her children, until she fell and dislocated her shoulder. The children “huddled” on the telephone and Mr. Feiler was chosen to travel to Georgia where their parents live. Feiler found that his parents benefitted from his help in reviewing their expenditures as well as in finding activities that were entertaining, especially computer or reading to help keep his father’s mind active. He also learned that the person needing care often lashes out at the caregiver and that when the loved one has a distorted view of the world it is better not to confront, but rather to agree without causing more discontent.

The letter to the editor written by Dr. Janis Abrahms Spring concerns both the medical profession and adult children’s unwillingness to discuss end-of-life issues, using the example of asking a dying man if he would like a feeding tube, without adding the sentence “Without the tube, you will die.” Dr. Spring suggests many valuable reasons for this end-of-life discussion including forgiveness and reconciliation between the generations, citing that many adult children end up caring for parents for whom they have ambivalent or negative feelings.

Both articles reveal the need for continued conversations throughout life between the life partners and between generations, switching when the children become adults to sharing concerns the parents have about their own lives instead of only listening and offering advice when their children phone to ask for help. Did Mr. Feiler’s mother need help with caring for her husband before she fell and dislocated her shoulder? Do initial discussions about feeding tubes belong at the bedside of someone who is terminally ill?

Adult children need to be aware of the parents’ needs as they age, parents need to share their concerns with their children. What keeps us from sharing? Where do we lose that trust, that intimacy that prevents these important discussions?

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