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My good friend is struggling with a problem most children eventually have to face: what to do when one's parents can no longer take care of themselves. Miriam and Robert (not their real names) are nearly 90. She's suffering from arthritic legs and cannot get around on her own; he's recuperating from hip replacement surgery. After much painful deliberation, the friend, with the support of the family, has decided to place Miriam in a local nursing home. Robert will undergo a month of rehabilitation at another facility; his post-rehab fate is still undecided. For the first time in a long time their house, which they've shared for over 60 years, will stand empty.
Given the hurdles and hoops my friend had to leap over and through, this could easily turn into a story about the fragmented state of health care in America. The family ran themselves ragged trying to juggle finding a suitable home, hiring affordable temporary in-house nursing care, and wrangling with government and hospital officials over paperwork, eligibility, available programs, and so on. If ever there was a need for Virgil to guide Dante through the wilderness, it was this.
It could be that story — but it isn't. Outside the official struggle, late in the evening as the family sat around the kitchen table taking a momentary rest, they could allow themselves to feel and discuss the sadness unfolding around them: two lovely people, who have lived full and honest lives, are approaching what we know we all must approach, what Hamlet called "the undiscover'd country, from whose bourn / No traveller returns." It is no longer impossible to think of their absence.
The sadness doubles in this case because the roles have been reversed: the child now becomes a parent to the parents, doing for them what they had always done for her. She must become patient as they become petulant, supply the memory they are losing, bear their anger as their bodies decline into a rickety infancy. The once-authoritative faces of her parents now carry the look of startled children.
And all this angst must be worked through while the daily necessities — cleaning up, cajoling, laundry, the special diet, setting the appointments -- make their unending demands. In the middle of the grind it becomes difficult to remember that all this effort is the right and proper thing to do. There is no noble gesture here, no saving the whales in far-off seas, nothing that brings a calm glow of satisfactory finish; instead, it is Depends and crankiness and stubborn dignity and rubber sheets and the accumulated gravity of personal history.
The situation also brings up nagging, even embarrassing questions about the calculations and costs of duty: How much of my own life do I give over to the care of those who cared for me? How much "no" do I apply to my own life to answer the "yes" of their needs? Necessary questions, but ones that leave a taste of pettiness behind. None of us wants to think we're selfish creatures, but a situation like this ratifies the fear that we will be found to be exactly that.
Add to the suspicion of ungenerosity a liberal dose of ambiguity. A situation like this can deepen our humanity; it can also broadcast unflattering self-portraits. Most likely it will do both, in that edgily ambivalent way life has of raising and lowering our expectations in the same breath. Damned if you do....
In hearing my friend speak of all this, I couldn't help but wonder what I will do when my parents require me to come to their aid. No one is ever prepared for this; it's strictly OJT, and that is what's so frightening about it, not only because of the physical toil involved but also because of the questions it will raise about my sufficiency as a human being.
For the time being, at least, the situation has stabilized. Miriam is in the home; Robert is learning how to educate his muscles to handle his new apparatus. Partial closure has come to the panic, leaving some time for reflection and long-range planning. It has been a strange journey for them all. It has taken them out of their orbits, disciplined them through discomfort, annoyed them with necessity, saddened them beyond the power of words to express. The final kicker: deepened the texture of their lives by impoverishing them with loss.
Bette Davis was right about growing old: it's not for sissies. That goes as much for the caretakers as it does for citizens turning daily senior before our eyes.
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