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Role Reversal

When children have to look after their aging parents

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(Senior Citizens by LaRuth / Ruth Ellison; some rights reserved.)

Paula Span, a 20-year veteran of The Washington Post and The New York Times’s New Old Age blogger, talks with Tablet about her book When the Time Comes: Families with Aging Parents Share Their Struggles and Solutions (Springboard, Hachette, 2009), which derived from her own experience caring for her mother as she was dying and helping her father, now 87.

Your father has gotten involved only recently with the Jewish community. What made him do that?

He was a labor activist and a lefty all his life—not interested in religion; my mom was the one who sent us to Hebrew school and was involved in her synagogue’s sisterhood. After she died, Judaism became community for my dad. He volunteers at his local Jewish Federation office stuffing envelopes and he goes to shul every week. But I don’t think it’s that he found God.

What should those of us who are lucky enough to have healthy, active parents in their 60s and 70s be doing now? In the book you point out that more than a third of Americans have given no thought to end-of-life care.

Some parents say, “I’m not leaving this house except feet first!” But today we tend to stick around in increasing disability, with chronic diseases. The death rate has gone way down for strokes and heart attacks, which used to be the quick way to go. Families need to talk and plan. “Feet first” is not a plan! Children can get together to suggest bringing in a helper for a few hours a week to assist with cleaning, cooking, errands. Kids far away could hire a geriatric care manager to check on the parent every couple of weeks. Begin to modify the parent’s home to prevent falls. Call an occupational therapist to do a walk-through to say, “Put a grab bar there. Widen this doorway. Think about a stair glide.”

How could we better serve elderly parents?

Some things would be easy to make better: more follow-up after hospitalization to keep people from going back in. Educate families about resources like adult day programs that give people a place to socialize. Have activities during the day, so they can live at home longer but not be sitting alone in a dark room all day. Create a public long-term care insurance option; Senator Kennedy is pushing the CLASS Act [Community Living Assistance Services and Support], which would set up a national trust for long-term care insurance. Right now, there is no public funding of long-term care unless you’re very poor or in a nursing home.

You use the term “caregiver gain,” not a phrase I’d heard before.

I don’t want to be a Pollyanna and tell someone who is consumed with worry about their parents and their finances, “Oh isn’t this meaningful! Don’t you feel a sense of purpose and mastery!” I’d have to forgive them for punching me. But almost all religions and traditions underscore the importance of helping others. And when it’s over, most people feel satisfaction that they did a good job and discharged a responsibility. They did the best they could for the people who did the best they could for them.

Women still do the bulk of the care-giving. And a lot of Jews delay childrearing, dooming us to be a sandwich generation coping simultaneously with little kids and frail parents.

Not necessarily. Only 9 percent of current primary caregivers for the elderly also have minor children. . Many people are now sailing along independently through their 70s. Your generation delayed childrearing, but the age at which parents need serious help has moved back too.

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Role Reversal

When children have to look after their aging parents

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