Jane Gross's memoir, A Bittersweet Season: Caring for Our Aging Parents and Ourselves (Knopf), is a smart and highly detailed book about navigating the complex eldercare system as it relates to healthcare, insurance and end of life--as those things relate to one's parent. It's also about learning not to be perfect or, rather, to accept one's imperfections. In this case the caregiver is Jane Gross, and the parent is her elderly mother
Many of you may know Jane Gross as the creative pioneer of The New York Times New Old Age Blog, which she began in 2008. In a recent telephone conversation with her, I had the opportunity to ask about her writing of the book, which, like the Times blog, came after her mother died in 2003.
It was then, once her own caregiving journey was complete, she circled back and figured out Medicare, assisted living, long-term care insurance--as a journalist--all of which and more she covers meticulously. "I found the detail of it both interesting and certainly not painful when I was writing about it," she told me.
A Bittersweet Season is the kind of book social workers might suggest to the family who craves more perspective about the logistical issues mentioned above. Though the subject of eldercare may seem to many dry on the surface, readers will find they are engaged by how much they learn in reading Gross's account.
One of the biggest surprises, she said, was about Medicare. "I didn't know and neither did my friends, despite being competent people, that Medicare does not cover many things." For instance, she said she, "had no idea what it meant that Medicare covered acute but not chronic care...[and] I had no idea that my mother's long-term care policy would work here and not here," meaning in one type of care facility, but not another.
"The insanity of how the institutions worked are an utter mystery until you come face to face with it," she said. In the process her mother spent $500,000 for the care she required, and before she passed away ended up on Medicaid. Indeed, this catches families by surprise, despite all their preparation and diligence.
While reading A Bittersweet Season, I kept thinking about the difference between trying to cope through busy-ness of caregiving and how that can easily be confused with trying to cope and respond through action. In other words, busy-ness versus intentional action. The latter is based in the present moment while the former, a seductive slope for many many people, is reactionary, a response that creates more anxiety and fear because it stems from--what else? Anxiety and fear.
One cannot outrun a parent's aging--or outsmart it--no matter how bright and capable the person is. I asked Gross to look back, and tell me if there were ways she thought she could "get ahead" of her mom's decline.
"There's this false belief," she said, "and it goes something like this: If doing it well is good, doing it perfectly is better."
In the book, Gross writes: My brother and I, while never close, collaborated more effectively.... and goes on to write about showing up at crucial appointments with pads and extra pens, taking copious notes, and how the two of them "seemed like a formidable pair, acting like we knew what we were doing even when we didn't."
"Thinking you could get ahead, at least in my family, my brother and I were equally of the belief that this was like a work "to do" list and we're two smart people, we'll figure out the 25 things that need to be done, and we'll do them the best that we possibly can, and life will go back to normal." She went on. "People who are used to being able to whip through a to-do list likely whip through the list faster than they possibly should, make mistakes, and it never goes back to normal as you think and hope it will."
Finally, I asked her this: What would you tell an angry caregiver? How about a "doormat" caregiver?
"You're wasting energy at a time you don't have energy to waste. Get help, off load onto a professional, and possibly offload more than you think you can afford to the extent possible.
"Ask themselves: how much are they doing/angry about the quantity and quality of the tasks, and how much of the angry/doormat stuff isn't reverting to old family roles?"
Finally, keep this in mind: "The notion that a parent beyond a certain age is going to be fine Monday, dead Wednesday...it doesn't happen this way. The trajectory is very long, slow and winding."