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May 24, 2007
Long Distance Parent Care
How do we care for our dying family members when we live thousands of miles away?
As I noted in my last post, when it comes to end of life issues, Christians are quick to talk about ethics. But advances in medicine have not just turned the end of life into an ethical minefield. The Wall Street Journal has an excellent front page story today on the increasing number of children caring from afar for their elderly parents. And they're doing so for extended periods of time.
When a parent is dying, the rest of life waits. Now, it often waits longer. As medical science gets better at pulling terminally ill patients from the brink of death, a loved one's final weeks can stretch into months or years. With families often spread across the country or globe, far-flung relatives face heart-rending choices as they wait for the end.
Reporter Susan Warren writes that one woman "took eight trips to her parents' home in Columbus, Ohio, staying weeks at a time. She used up all her vacation and sick time, and then took a family leave. She ran up more than $5,000 in airfare and estimates she lost $15,000 in salary."
For the family of Valliere Wilson, her death was emotionally exhausting, and not simply because their mother died. Wilson had cancer for 15 years. During that time, her children moved, one away from Wilson's home and one back. Two children lived in California and alternated weeks caring for their mother. Their brother's marriage was in tatters after he moved back to Dallas to be with his mother. They faced job pressures and the threat of being fired for taking so much time off to be with their mom.
Then, when Wilson's cancer spread to her lungs, the travelling, caring, and grieving shifted into high gear.
On Feb. 20, Cheryl was with her mother in Dallas, missing a staff meeting in Chicago. She grew worried about rumored layoffs at work. For the first time in her 26 years at the company, she'd gotten a poor annual review, based on low productivity. She'd asked for more work, but her supervisor had noted that it was probably better that she not be stretched while she was dealing with her mom. Cheryl acknowledged, "Actually, I couldn't handle any more."
Meanwhile, Charlotte had just been told that her company's Los Angeles office was closing at the end of the year and she would be out of a job. Cracks had begun surfacing in her longtime relationship with her boyfriend. "Everything was kind of falling to pieces," she said.
15 years after she was diagnosed with colon cancer, Wilson died in her Dallas home with her daughter beside her. It was worth the stress, all of her children agreed, in order to care for their mom as she died. "I always told Mom that I would be there for her when she needs me, and I was," Cheryl said.
But the stress is enormous. And more and more Americans are feeling it. Perhaps this is a topic even greater than bioethics for Christians to pay attention to. What sort of pressures does this put on a family? In what ways can we practice faithful dying while our family is spread across the country? How does this stress affect the medical treatment we want for our parents or they chose for themselves? (Being far away can cause some people to beg their parents to do anything to hang on until they have a chance to visit. On the other hand, a major reason people chose assisted suicide is because they feel they're a burden to their caregivers.)
There is a lot here to think about and which Christians are only beginning to talk about. If you're dealing with this, I am interested in hearing from you. Write me.
Comments
I did have to care for my mother when she was dying. The worst part was that she kept the fact that she was dying a secret until the secret could no longer be kept. Because my father dies ten years before, I was prepared and hand picked a sales job that had an office in another part of the country that was constantly in need of sales people. When I had to go home, it was an easy transfer although the company was not over happy about the timing. I stayed and cared for my mother and she died at home looking at the things she held dear. Did I like it. Not particularly, but I was philosophical. My mother took care of me when I was helpless, I can help her out. Work will always be with us, and we can accomplish things far into our 70's and 80's. A couple of years out of my life were ok. I think the sight of my mother dying in front of me was worse than the process leading to it. Men always feel they have do somethng. I could do nothing. But I will say one thing...the process sure does put love into perspective; like how many other women would I do this for. Answer: one.
Posted By: Chuck | May 24, 2007 4:24 PM
Not all elderly parents want their kids taking care of them-my parents were like that. I live in IL, they lived in CT. They shared next to nothing about their health with us and we only heard about it when a health problem became so critical they were forced to seek medical care. They avoided drs. otherwise. Dad, who died in Jan. 2006 at 90, worked until just over a year prior to his death as a tool & die maker. His boss took my parents under his wing even after the company made dad retire, and at times he made my dad go to the dr.'s (and took him there too) when he noticed dad wasn't feeling well. Two months before his death, my dad collapsed in their yard. Mom called dad's boss who took him to the hospital where he was admitted in critical condition--low heartrate, grossly underweight, and severely malnourished from an impaired swallow reflex. The remainder of his time alive was spent in the hospital with a brief stint in a nursing home. I was a solo pastor and also battling illness (which eventually forced me to resign in June 2006) and was only able to get out to see him for a week, but after that I called him regularly. When dad was at home he wasn't much of a phone talker and rarely came to the phone, so those calls to him in the hospital were very precious to me. My dad had Advanced Healthcare Directives and that was helpful towards the end, because this 6' 1-1/2" man's weight had dropped to 114 lbs. In case of an irrecoverable or terminal condition he only wanted to be kept clean and comfortable--no artificial nutrition or hydration, no CPR, nothing but comfort care, and those wishes were honored. I just wish I could have spent more time with him in his final days to care for him and will always wish that I was with him when he died.
Mom had a major stroke on the 1st or 2nd of this March--it was hours before they found her lying on her floor unresponsive. The drs. said 10-12 hours, but I think it was longer because after the police broke in to her enclosed porch the main kitchen door was open. She kept her house locked up tight most of the time and only opened that door in the afternoon I believe. The neighbor boy across the street noticed that she hadn't picked up her newspaper for a day, which was unusual for her so he told his parents and they called the police. Anyway, the stroke damaged 75% of her brain plus her kidneys. Thankfully, she had Advanced Care Directives that like Dad's, stated in case of an irrecoverable health event she wanted only comfort care. Mom was kept clean and comfortable with morphine as needed for pain. We had her brought to her home 3 days before she died (on March 11 age 83) and had Hospice come in--they were wonderful and took such good care of mom. I'm glad I didn't have a job yet because when I got the call from my sister in TX that mom was taken to the hospital, I was able to fly out to CT the next day and be with mom for the remainder of her time alive. I will always hold as precious the opportunity I had to hold her hand and just sit with her, kiss her, talk to her and read Scripture to her, annoint her, brush her hair, tell her over and over "I love you," and participate in her care. Now on June 11, exactly 3 months to the day she died (and 1 year after I resigned my pastorate) I will start my new ministry position--as a Hospice Chaplain.
Rev. Carlene Appel
ladyreverend@msn.com
Posted By: Rev. Carlene | May 25, 2007 11:16 PM