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June 11, 2010

When a Daughter Must Parent Her Parents

A new study shows why caring for aging parents more often falls on women than on men.

A few minutes ago I got the news that my daughter’s mother-in-law has stage 4 cancer. I was still staring at the computer screen, trying to digest the information, when a friend forwarded me a report on a Canadian study with this headline: “Female Caregivers Face a Heavier Toll.”

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Yes, we do. My mother died almost exactly 15 years ago, four months after my father died. Both had Alzheimer’s disease. Both were in a nursing home about five minutes from my house. I visited them at least several times a week, sometimes daily.

“We’re so glad we had a daughter,” my mother used to tell me. “It’s only the daughters who visit.” She wasn’t entirely right: Several sons joined the many women who visited regularly. Though the study said six in ten caregivers are women, in my parents’ nursing home the number must have been closer to eight in ten.

Warning: If you are a woman with a spouse, parents, or parents-in-law, you are likely to spend a number of years as a caregiver.

"In terms of society's norms, the responsibility to care for parents tends to fall on the women," said Marina Bastawrous, the author of the study, who discovered that 40 percent of female caregivers experience high-level stress. Women, she noted, are more likely than men to quit their jobs in order to care for their parents. When my parents started needing more care than I could handle along with my demanding job, I cut my hours back to 30 a week. Eventually I quit altogether. More information on the toll that caregiving takes is available from the Family Caregiver Alliance.

Sadly, according to the Canadian study, despite — or perhaps because of — all their hard work, “adult daughters suffer more than adult sons from poor relationships with ailing and aging parents who need their care.” If we care for our parents because we want to be thanked, or because we want to be closer to them, or because we have a romantic vision of saintly elders, we are likely to be disappointed. A bookstore assistant, noticing the book I was buying on caregiving, said to me, “God bless you, dear — I remember those days. Nothing you do is ever right.”

To be sure, nothing is ever enough. Nothing will restore our parents’ youth. Nothing will keep them from eventually dying. Nothing will keep us from our own certain decline. And yet we continue to care and to hope. That is what love does. Not sentimental, stress-free, feel-good love, but tough love that does what needs doing.

My daughter’s mother-in-law has no daughters, but she has an excellent husband and three good sons who love her very much and are already doing what they can for her. She also has three fine daughters-in-law, one of whom has been taking her to her doctors’ appointments all week. Chemo begins Monday. We are all praying for their strength and her healing. Please pray with us.

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Comments

I found myself in a similar situation eight years ago, when my mother-in-law was diagnosed with stage four liver cancer. I became her primary caregiver. It was one of the hardest experiences of my life, but it was also one of the greatest blessings to care for her and get to know her before she died. My book, Penelope Ayers, is a memoir about that experience. Perhaps it would offer some comfort for your daughter as she faces the challenging and potentially grace-filled road ahead.

Amy Julia

Caregiving is mostly a women's issue--whether or not that ought to be the case, it is. It was my mom who introduced me to the challenges, heartbreak, and rewards of caring for someone at the end of their life. And many, many more women will need to take up that challenges as our leading causes of death are slow, chronic illnesses that require a great deal of personal care. I heard this NPR story about how the Equal Employment Opportunity Commission has adapted its regulations in order to address more and more workplace complaints by caregivers.
http://www.npr.org/templates/story/story.php?storyId=127531355
I think this is a topic we need to be talking about much more often.

My parents recently died within 5 years. I have a wonderful employer that allowed me to take modified family leave to help take care care of my mom who fell and broke her hip and died within 6 months of the injury. My father remarried within a year and his (much younger) wife shouldered most of the responsibilty of caring for him, although I changed a lot of weekend plans to give her time off to help take care of him. I'm single and a nurse, so, I understand that my married brothers felt like "it was my job" to care for my parents. My other two sisters (also single, one is a physician, the other a teacher) also did more than their fair share of care-giving. A lot of men can't handle the "sick room"--ok, but cutting the grass, cleaning out the garage, helping in other areas would have been helpful. I can remember being very upset when they chose to attend weekend events (weddings, picnics)instead of helping out. Both of them have daughters, and I reminded them that they need to be "good" to them, because when they're old, it will be their daughters and not their sons who will help care for them. Needless to say, I've had to work on forgiveness. It was a hard time, but a very sweet time with my parents at the end.

I'm 32; my parents are in their early 60's, and we've already discussed this situation. My parents have already planned to move into assisted living when they cannot care for their home, etc. They are making plans for what to do if there are serious illnesses, etc. Ditto with my in-laws.

Fortunately, though experiences they have had with my grandparents, they understand that them moving in, etc., would be far more than I could handle. I'm still sure that doing the daily nursing facility visit is going to be hard, though.

My heart goes out to your daughter and her mother-in-law.

I can relate to this immensely. I lost my mom to a brain stroke six years ago. During the five months that she was in rehab and back at home (with me), it was my oldest sister and I who took care of her. I have six older brothers, and they were not helpful at all. They would come see my mom on the weekends, but more out of responsibility, not because they wanted to be with her or to help. Pretty sad, but true. It was very difficult for me to care for her, especially at night when I had to get up to go to work (I'm a teacher). Nevertheless, I was blessed to have spent that time with my mom and let her know how much I loved her. I learned a lot from her faith and strength in the Lord.

Yes, it usually falls to the daughters to care for their parents. If there are only sons, they will put them into assisted living and think their job is done. Many daughters-in-law are making their husbands do the care-giving for their on parents because they know they are going to have to care for their own parents some day and see the toll it brings on the women. The sad part of all this is when the parent dies, even though the daughters did all the work and care the sons will demand equal share of the estate if any is left. So sad.

My MIL took care of her parents in their final illnesses. They'd retired to Fla., but both came back to PA to die. As a result, she decided that none of her kids should have to care similarly for her, so she and my FIL moved into a retirement community with graduated care when they were just 60! My own Mom is 76 and living alone, in good health, in my parents' house. For her final years her mother lived nearby in an assisted living facility until her death at 98. The women in my Mom's family are all similarly long-lived. My Mom understands that if she wants to move in w/ us at some point, she may, so long as she is mentally and physically capable enough to not be in danger when I go off to work each day. When that is no longer the case, she will move to assisted living as her mother did. It may seem calculated, but we all understand each other.

I had to put my Dad in assisted living after he had strokes, but I would go see him several times a week, take him treats, change CDs in his stereo, do his laundry so it "smelled right," and just spend time with him. He was a big man, and I could not physically care for him without help, plus my husband forbade bringing him into our home to live. I had to handle both medical and financial decisions for Dad. My brother never came to visit again until Dad's funeral, and my husband constantly nagged me to basically abandon Dad, telling me, "if you just don't do anything your brother will come do it," and "you are abandoning what your real job is, me and the kids." My husband had left the care of his own parents totally up to his sisters. My kids, teens and young adults, were wonderful. They visited their Grandpa, helped where they could. I'm still working on forgiving both my husband and brother for their total lack of help and support, and in my husband's case his hostility. When my Dad had first had his strokes and I returned from spending the day at a hospital an hour and a half away, and tried to tell my husband about the strokes, his words were, "So? Where the **** is my dinner?" My husband complained everytime I brought Dad over for dinner. Only went to visit my Dad once at the assisted living, and refused to help move my Dad's stuff to the assisted living or even allow me to use his truck to move Dad's easy chair. Ironically, I've actually overheard my husband bragging to people about how much help and support he was. It is hard being a caregiver, especially when you juggle a couple of kids still at home, spouse, and job, as well. God is good. Where husband and brother let me down, He brought my kids along beside me, as well as my church family, and even people I work with.

Very good information. My grandmother lived with us thru the dementia until my mom couldn't handle her anymore and it was hurting the family. My mom ended up with the same and my sister and I, having seen this happen before, knew we had to have my mom somewhere. There wasn't a great deal of money but we did find out that the state has ways to help and we did the best we could. The biggest and most important thing was that both my sister and I talked about it all the time, we were on the same wave length, although she lived closer than I did. Giving support is so important.I will pass this on to my son and daughter in the hopes that we all will sit down together and they will know how their father and I would like things handled.

Thank you for such a timely article as well as the links to the Canadian study and the Caregiver Alliance. I too was a caregiver to my precious mother who adopted me when no one wanted an abandoned child. She lived five years beyond my loving adopted father. As a young adult I was a caregiver to both. I am grateful that I could nurture them as they nurtured me.

Professionally I am a professor and academic chair of the Home Economics-Family and Consumer Sciences Department at The Master’s College. This spring I taught the Resource Management for the Aging course for the first time. Designed to cultivate a biblical perspective on the aging process and to implement the preventive skills of the Home Economics discipline into the study of aging process, I was incredibly blessed by the response of the students to the course. If you would like to participate in the survey that formed the basis for it simply click on the link that follows: http://www.surveymonkey.com/s/TFSW22X I am happy to share ongoing results with any who e-mail me at drennis@masters.edu. Thanks again for a helpful article. It will be added to the course resources.

Thank you, Pat Ennis. That was an interesting survey, especially questions at the end. I'd encourage the rest of you to click on her link above and offer your own perspectives.
And thanks to all of you who shared your experiences. Helping our parents can be simultaneously beautiful, exhausting, and infuriating (and I know lots of stories about brothers who seem to think it happens automatically, in their absence). Looking back 15-20 years when I was in the thick of it, I can say it was one of the most stressful times of my life - and I am glad I did it. Blessing on all of you who are doing it now. You are loving your parents "with actions and in truth" (1 Jn 3:18).

It is true that the work of care giving is largely left to the women of the family. Sometimes it is family politics or societal expectation, but I think that men are often discouraged from stepping up to the plate because they have a different style of relating and doing.

Caring for our sick and old parents isn't an easy thing to do. It requires a lot of time, energy, devotion and self-sacrifice, but because the love is there it becomes easier that it ought to be. And the thought that we can serve and show our love to our parents on their last few days is enough to keep us going.

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