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'Doing the Right Thing' A new book provides support—and a silver
lining—for adults struggling to care for aging parents
WEB EXCLUSIVE By Peg Tyre Newsweek Updated: April 5 - Five years
ago, when her mother began slipping into Alzheimer's, Roberta Satow, a
sociology professor at Brooklyn College, was surprised to find herself
plunged into an emotional maelstrom. Her relationship with her mother had
always been difficult. Satow, who is also a practicing psychotherapist in For years, she
thrashed among waves of resentment and frustration, struggling to balance her
mother's demands with the needs of her husband and two sons—and her career.
But gradually, by working with therapists and talking to other caregivers,
Satow began to uncover a silver lining. Taking care of her mother, she
realized, wasn't going to resolve old issues. "It was, however, an
opportunity to gain a better perspective on my mother and on my own
childhood," she says.
Her journey—and the
experiences of 50 other caregivers she's interviewed—became the basis of her
new book, “Doing the Right Thing: Taking Care of Your Elderly Parents Even if
They Didn't Take Care of You,” published in March by Tarcher,
an imprint of the Penguin Group. Unlike other books in the gerontology
section of the library that are filled with how-to's,
Satow's book supplies a valuable road map for the
estimated 20 million adult Americans navigating the treacherous emotional
terrain that comes along with taking care of a difficult parent. "The emotional
and physical toll [on them] cannot be underestimated," says Suzanne Mintz, president of the National Family Caregivers
Association (NFCA), who points out that caregivers
suffer from higher rates of back problems, sleep disorder and depression.
Marriages suffer and children are affected, too. The NFCA offers
several tips and resources for caregivers on its Website (www.thefamilycaregiver.org/ed/).
But there are other new tools available online as well. CarePages,
an Internet-based service (www.carepages.com)
created by the health care company TLContact, Inc.,
helps patients and family members keep in touch during hospital stays,
convalescence or long-term care through free Web pages sponsored by
participating hospitals and other agencies. And a directory of other online
resources can be found at the Web site www.familycaregiving101.com.
In a warm, loving
family, taking care of parents can actually be an exercise in reciprocity and
promote a new level of intimacy between generations. Even when family
dynamics have been fraught with tension, caregiving
can become a learning experience. But as the blunt title of her book
suggests, Satow doesn't believe in rose-colored glasses. To survive and
thrive during what she calls the “caretaking phase of life," adult
children must first discard some of the most enduring myths surrounding our
graying society and deal with some less-than-comfortable truths head-on. Time
doesn't always heal old wounds, she points out. Emotionally limited parents
don't become more saintly as they age, either. In fact, they often become
more unreasonable and demanding as they get older. And even though it's not
easy to admit, Satow says, even the most dedicated caregivers frequently feel
a deep ambivalence about their new and often unwanted role. "You feel
angry with your parents because of the situation you're in," says Satow.
"Then you feel guilty about being angry." Satow urges caretakers
to acknowledge—privately or with a therapist—the powerful feelings that can
come along with caring for an aging parent. Then, they must begin a difficult
sorting process: figuring out which feelings are tied to the present and
which are left over from days gone by. "It's not something you can do on
a Tuesday," says Satow. "And you may need a therapist to help
you. It takes time." The benefits? Satow
says there are three. First, caregivers can begin to see their parents more
objectively. That sets the stages for caregivers to accept their parent's
limitations—and ultimately to recognize and accept their own. Seeing your
parents realistically affords caregivers another important opportunity: to
set boundaries and accept help when the burden gets overwhelming. With a
better perspective and more balance, the caregivers can reap a third, even
bigger, reward: finding a warmer, more compassionate connection. "It's
a chance at healing," she says. "A chance to feel whole
again." © 2005
Newsweek, Inc. |
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Setting
Limits to Caregiving When people confront an
ocean of need, they feel anxiety. Some run for their lives; others jump in
and drown. Both reactions are rooted in the inability to stay separate and
set limits in a healthy way that balances generosity with self-preservation. After my mother had a series
of small strokes and was increasingly unable to take care of herself, I felt
overwhelmed by her neediness. She was going to a dozen different doctors who
were not communicating with each other; she was losing weight and constantly
complaining of nausea; she had stains on her clothes; she couldn’t remember
her keys or that she had just found them; she couldn’t remember if she had
sent her rent check or not; she couldn’t remember if she had taken her
medication or not; and she couldn’t remember my husband’s name or my
birthday. She called me all the time—to ask me the same questions over and
over. My sister said it was my mother’s anxiety; she often felt angry toward
her. My sister is the oldest child and her anxiety about drowning in my
mother’s neediness made her feel so overwhelmed that she needed to withdraw
from my mother. She could hardly bear to visit her. In addition, my brother
rarely visited and never indicated when he was going to. I felt guilty and
frightened. What could I do? I felt that my only alternatives were doing
nothing at all or letting her take me over (i.e., live in my house; change my
relationship with my husband and my children; interfere with my work, my
friends, and my routines). I had to face a new phase in my own development.
For a long time I dealt with my mother by trying to keep my distance. During
high school and college I imagined whom I would go to for help if I got pregnant—my
mother was definitely out. When I was in college I had mononucleosis and I
was in the university hospital. I did not tell my mother. As a young married
woman, I never talked to her about anything personal that mattered to me. It
was easier to report on facts of my children’s lives (i.e., Jason has a cold
or Matthew got an A on his English paper) or day-to-day activities and events
in my life (i.e., I spoke to my cousin or I went to the dentist). My
withdrawal from my mother was a result of my insecure attachment to her—and
that remained inside of me, sometimes consciously and sometimes
unconsciously. The early insecure
attachment creates a wish to be comforted and a wish to run away from danger.
The problem is that the person from whom you want comfort and the person who
is dangerous is the same person—that creates an often life-long conflict. The
mother you yearn for is the mother you withdraw from; the mother you are
afraid of is the mother you cling to. Children with school phobias offer a
good example of this paradox—the inability to leave home is often a response
to a perceived threat from the parents. Thus withdrawal and clinging are two
different anxiety responses resulting from an insecure early attachment to
the mother. Ever since I returned to About two years ago I
realized that my mother could not take care of herself. She forgot to make
entries in her checkbook, although she had been a crackerjack bookkeeper when
I was a girl. She could add a long list of numbers in her head and never lose
track of the total. Now she couldn’t figure out where to enter the amount of
the check. Her clothes were dirty and she was steadily losing weight. I had
been denying it. But I couldn’t deny it any longer. I had to find some way of
helping my mother cope with living while maintaining my own life—bringing a
cup to relieve some of her feeling of helplessness, but not drowning in her
neediness. Setting limits is difficult
for most people—it’s a common problem in many areas of our life, not just caregiving. It’s hard to say “no” or “enough” without
feeling guilty. It’s difficult to tell a friend she can’t borrow money or
tell your son he can’t have another toy he can’t live without. I had a
terrible time toilet training my older son. One of my friends used to console
me by saying: “Don’t worry, by the time he gets married he’ll be toilet
trained.” The more you project your own neediness on to someone else and then
identify with the person to whom you are saying “no,” the harder it is to do
it without feeling bad about yourself. I would start off feeling like a
separate adult and saying: “Okay, now you’re going to use the toilet.” As
soon as Matthew started yelling that he didn’t want to use the toilet, I
would start identifying with him. How can I force him to do what he doesn’t
want to do? I’ll be acting like my mother. I’ll wait until he wants to use
the potty. Except he never got to that point. He was three years old and they
wouldn’t let him into nursery school in diapers so I went to a child
psychologist for help. She said: “Your son does not have a problem. You do;
you are not like your mother. You can tell him he is going to wear underpants
and throw out his diapers and he will be fine.” I followed her advice and he
never had an accident again. She made it clear to me that the problem was all
mine. I was so afraid of being like my mother that I couldn’t set limits and
stick to them. I couldn’t distinguish between being sadistic and helping my
son master a developmental task that would make him feel better about himself. If we feel needy and
deprived because we have an insecure internal attachment to our early mother
then it is hard to say “no” or “enough” to somebody else. People who have
difficulty saying “no” often get angry at people who ask them for anything.
After all, asking them for something sets off their conflict. Thus, setting
limits with needy elderly parents can be extremely difficult if we are needy
ourselves—which we usually are if we had needy parents. We vacillate back and
forth between identifying with their neediness and feeling we have to save
them; and feeling angry at them for needing so much from us and wanting to
run away so that we do not drown. Adults with a secure attachment do not feel
“needy”—or are able to work their way out of that feeling fairly quickly.
They have needs, of course, but they are not “needy.” The feeling of being
needy is a feeling of desperation for someone else to save you and to provide
sustenance. In addition, it easily gets projected on to other people so it’s
had to stay clearly separate. Caregivers who have an internal sense of secure
attachment have secure boundaries and have less difficulty saying “no” or
“enough” in a way that does not necessitate hitting the other person over the
head with it or running away from a person who is needy. They can say: “I
wish I was able to do that for you, but unfortunately I’m not.” But that does
not come naturally for many of us. We have to remind ourselves that when we
confront an ocean of need, all we need to do is bring a cup. Roberta Satow
is Chairperson of the Department of Sociology at |
