July 2011


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So, to any philosophy student interested in some real-world experience in existentialism, may I suggest the emergency room of your local hospital. Forget the cigarettes, black berets and blacker coffee. Instead, if you want to confront all those big “why” questions and stare futility right in the face, find a way to be a fly on the wall in the ER. For added impact – the “yeah, but what does it mean for me?” effect – spend that time in the treatment cubicle of an 89-year-old who happens to be responsible for half of your own DNA.

You frequent readers may have guessed it from the lead-in – after a year of swearing he’d never be back there, Dad ended up in the ER last night, the result of a building level of confusion that began to alarm me through the course of the late afternoon and evening. An hour into his 5 p.m. scotch, the glass remained three-quarter’s full in front of him. He seemed less than enthusiastic about our planned dinner out at one of the local clamshacks, and once we arrived and sat ourselves down, he simply couldn’t engage with the paper menu in front of him. He tried to tell me of some of the conversation that had gone on at his Senior Center coffee group that afternoon, but I couldn’t make any sense of the random sentence fragments he was attempting to string together. At that point, I decided it was best for us to get back home. Walking him from the car to the front door, I realized the wobbly balance issues that had been slowly creeping up over the last couple months were suddenly much worse. It was like he had lost 75% of the strength in his legs – he took my arm and as I held onto him I could feel he was really warm.

When I reached the on-call doctor, he suggested monitoring Dad overnight and bringing him into the walk-in clinic first thing in the morning – but if his temperature hit 101, get him to the ER. Two hours later, I found Dad sitting on the edge of his bed unable to transition from sitting to laying down. I did a quick temp check – 100.8 – and I made the call to what we fondly refer to as Dad’s Big Red Taxi, which came and took away my old man.

And so, there I was, again, packing spare clothes for him and laptop, book, health-care proxy paperwork, etc., for me. Surprising how quickly routines can reestablish themselves. And, a half-hour later, there I was, at 11 p.m., attempting to appear awake and upbeat, supportive yet persistent in conversations with nurses and aides. And, yet, underneath it all, I felt, again, like Scrooge seeing the ghost of old age yet-to-come.

You see, one of the hardest things for me to deal with emotionally in this whole process is the fear that, in my father, I’m looking my future in the face. Spending as much time with him as I do – seeing the right arm barely able to lift a half-gallon milk jug (I’ve given up buying gallons because they’re just too heavy for him), the effort required to get out of the car, his inability to understand what each of his pills does or that he, in fact, has anything wrong with himself requiring the medications – I can’t help but wonder/fear what that portion of my journey will be like for me.

Sure, there are many other challenges in caregiving. The cleaning up – of bathroom floors, bed pads, spilled coffee, the half-ear’s worth of corn kernels that ends up at his feet whenever we have it on the cob – the following up with doctors and specialists and pharmacists, the desire to just give up and take a vacation where three solid nights of sleep might actually run consecutively. And, of course, there’s always the other big self-oriented worry: who will play my role when I’m 89? But the concern that really tightens my chest when I look at my father is, is he – his face, his body, his illnesses, his life – a mirror looking back at me from 38 years in the future?

Maybe it’s a middle-age crisis, but, at almost 52, the 38-year age difference between Dad and me just doesn’t seem all that substantial anymore. And I find the possibility that he could just be me, aged Hollywood-style, simply terrifying. It makes me want to run, get away to that place of simple, oblivious living that is such a luxury to those who aren’t looking mortality in the face every day. In this case, Dad got sent home six hours later with a prescription for antibiotics to treat the a)urinary tract infection, b)bronchitis or c)both that may/may not have been the root cause of the fever and confusion. But I packed him back into the car thinking that, like Sisyphus, this was a rock I’d be pushing up a hill again.

So, you student of Existentialism 101, watching fly-like from that cubicle’s wall, understand that this is what all that Sartre and Camus boils down to – at least to me. An 89-year-old man sleeping fitfully in an emergency room johnny robe, and a 52-year-old son looking on, wondering if the answer to the question “Why?” is, simply, “Because.”

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Well, it’s been some time since my last post. Mostly, I’ve been swamped with work and my new chauffeurring responsibilities since Dad has lost his license. It’s been a very difficult transition for both of us, and we are (I should say, “I am”) only now marshaling the energy to explore new options. One that I’m hoping may work out is getting Dad to agree to pay for a companion to get him out and about a couple times a week. We talk with one highly recommended possible candidate next week – fingers are crossed.

I’ve been thinking a lot about the concept of blame/fault during this whole process – I just want to shout “It’s not my fault” at him, sometimes, when he tells yet another stranger the sad tale of losing his license and how it just didn’t need to happen, with me sitting 3 feet away. It did need to happen, I want to say – and maybe, just maybe, if you’d eaten more (or, for that matter, any) vegetables and less steak, bacon and Scotch, your body wouldn’t have betrayed you in this way.

More recently, I’ve been working at stepping back and ignoring, which helps limit the explosive arguments the two of us can get into with each other. But removing myself that way and emotionally disengaging feels almost as harmful to the relationship as a go-for-the-jugular blow-up. In a way, it feels like a kind of abandonment.

So, I’ve found myself working my way through a progression of realizations – or, maybe, a realization of the realizations I need to pass through to get to a point of peace these days. It is, as the therapeutic community loves to say, “a process.” But I’m going to share these waypoints, as I see them, more as a way of talking them through for myself than as any sort of prescription for anyone else going through the process.

It’s not your fault. The person you’re caring for just got old, or got sick, or got sick and old. It’s not your fault. Getting comfortable with accepting this one has helped me a lot in the last few weeks – because, if it’s not my fault, then I’m also not responsible for making everything better. I can do my best to listen, help out and present alternatives, but I’m not on the line for making it all o.k., again.

It may be, at least partially, his/her fault. People don’t like admitting this one, I don’t think, because it can come across as blaming the victim, or hitting a guy when he’s already down. But the fact of the matter is that life choices today can affect quality of life tomorrow. People who keep smoking may well have serious issues with COPD 20 years from now. And people like my father, who refuse to change their fat-, salt- and Scotch-laden diets, despite serious kidney disease and congestive heart failure – well, they’ll probably pay a price in mobility, energy and presence of mind going forward.

In the end, it doesn’t matter. I don’t mean that you have to go back to thinking you actually can make it better – I just mean that, if you’re there, you still have to deal with the situation at hand, whatever that might be. You just can’t turn the fact that it isn’t your fault into a position of placing the blame for all current difficulties onto the person for whom you’re caring, or you’ll end up eating yourself up with anger.

Whenever possible, strive for kindness. (Note the caveat “whenever possible.”) This is much easier if you can get to the “it doesn’t matter” point in your head. But, even if you can’t, working toward a point of kindness might help you slowly ease toward that direction – sort of like how smiling when you’re unhappy can sometimes actually turn your mood around.

So, I don’t want you readers to think that I’ve gone through some zen-like transformation in the last six weeks. The anger I described in my last post is still there, I’ve just begun to realize that I can’t keep holding onto it and maintain a workable relationship with my father at the same time. This is one reason why, next week, I’m going to be seeing a therapist who has a sub-specialty in working with caregivers. As has been said in a completely different context, recognizing you have a problem is often the first step in solving it.

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