Turning 50 may be the most important milestone birthday in adult life.  It can be experienced foolishly or with delight.  I strongly recommend the latter. 

My youngest sibling, Pamela, turned 50 on December 30 .  Two days ago we had a rip-roaring, loud CELEBRATION of the event.  It was perfect, but not an accident.

I ignored my 35^th birthday milestone, and it bit me hard within a few months.  The unconscious can be lethal.  It is much healthier to push uncomfortable feelings to the surface.  Then you have a chance to use your conscious intelligence to meet the psychological demons that are lurking.

I could barely allow my mind to rest on the thought of “50 Years Old”.  The fears it triggered!  Loss of youth, energy, and attractiveness, having fewer choices of mates, ending my days alone, being unemployable, pending frailty, potential chronic diseases such as Parkinson Disease, dementia, diabetes, heart failure, cancer, blindness, deafness, arthritis, and loss of independence were just of few of the monsters that haunted me.  I had a lot of work to do.

I started by reading Betty Friedan’s, The Fountain of Age.  Friedan used her talent as a journalist to research and understand the realities of aging for herself as well as others.  Reading her book helped me stop panicking and start thinking. 

• Friedan observed that only about 5% of the population ends up in a nursing home.  Most people potter along pretty well on their own until they are close to the end of life. 
• Men who have defined themselves by what they do are more likely to die early if they retire and don’t find new work.  Friedan’s book was published in 1993.  I imagine there are many women who also define themselves by their work today.  Older age is a time for reinvention.
• Older people have jobs.  They may be different from the jobs they held earlier in life, but they can be satisfying and offer the income needed for a comfortable life.  Many times people retire from their jobs and start new careers that are meaningful.  Good work gives us structure, independence, mental stimulation, and a reason for living.  Work in later life gives us a chance to use our own sweat and souls to fill in the blanks that leave our lives incomplete. 

I came up with a number of reasons why turning 50 is a good thing:

• Hormones slow down.  It is possible to make a rational decision without hormones getting in the way. What a relief!
• We stop wasting time on stupid things.  It is much easier to make decisions. 
• We have gone up an incredibly steep learning curve in the first half of life.  Think of all the things we don’t have to learn.  We already made the mistakes and learned the lessons from them.  We don’t have to waste time in the next fifty years learning them again. 
• My skin is aging.  Clint Eastwood looks fabulous with wrinkles.  That is the look I am shooting for.  I will miss the smooth skin and radiance of youth, but have no need for a face that does not show how wise and really cool (kewl? kuhl?) I am now.  I have earned being 50 plus and am proud to show it.
• After 50 it is a waste of time and energy to give a darn what other people think about you.  You are free.  Make your decisions, and live with them.  No one else really cares.

Advice for Those Turning 50

1. Never retire.  Make plans to start doing things you never had time to do.  The list will only get longer.  You will never run out of things to start doing.  Your mind will keep working, and you will have a lot more fun.

2. Don’t worry about Social Security and Medicare funds running out of money.  Just assume that there will be less public money to spread around.  We are all going to have to learn to take care of each other. That’s OK.  It is a better way to age.    Forget about retiring.  It will kill you.  (See #1 above).  Keeping working, making money, and taking care of yourself. 

3. Buy a Long Term Care insurance policy.  I bought mine when I was 45 years old because I have no children and worried about how I would manage physically and financially if I needed full-time care.  Age 50 is the perfect time to take out a policy.

4. Draft your own Eldercare Plan now.  Plan ahead to give yourself the greatest amount of choice.  When you experience a crisis of aging you won’t  be able to do research and make good choices easily.  Think through various scenarios for your next 50 years.  What might happen?  What kind of legal documents, housing, financial planning, transportation, care, and community might you need?  Start checking out what is available now.  If you don’t see something you like, start planning for something that you would like.  Make it up.  Cause it to be possible.  Write down what you like.  Tell your nearest and dearest your preferences now.

5. Take care of yourself.  Understand why exercise and nutrition are important.   I practice yoga because I want my hips to work when I am eighty years old.  I am (finally) learning to eat right because I want to do a lot more things than I have time to do.  If I get a chronic disease, I will have fewer options.  My darling husband and I will have less ability to play together.  I am a physical coward and don’t want to be in pain.  It is worth getting off the sofa and going for a walk now to make my own luck for a stronger body in the future.

6. Let go of the drama.  At age 50 you realize that time is finite.  The next 50 years are going to fly by.  Do not waste a second on nonsense.  Walk away from people who sap your joy and energy.  Find people to love.  Surround yourself with people who are capable of loving.  Do work that matters. 

7. Get a pet.  I discovered pets just before I turned 50.  They offer us such generous, easy love.  Do not miss the gift critters offer.  You will never be lonely.

 8. I found my life partner and wonderful, healthy, nurturing love after we both turned 50.  You can too.  You have finally learned to make good choices.

9. We may not make to it 51.  Let go of worrying about tomorrow.  PLAN, but don’t worry.  Live for today.  It is so sweet.

10. Those of us who get old have a chance to rectify wrongs, cancel out our bad deeds with good ones, give back to the world, work through old hurts,  and come to terms with the meaning of our lives.  We need time to wrestle with all this before we let go.  If we are lucky enough to get really old, we can  complete the cycle and rest in peace.

For my 50^th birthday I took 18 of my best friends to dinner at my favorite French restaurant.  I looked and felt fabulous.  At age 56 I continue to be delighted with how I launched myself into my 50′s.  For Pamela’s 50^th birthday, the family had a wonderful fiesta for her at our house.  She gave me a list of her friends, and we invited them.  Fifty to sixty people came to celebrate.  We had Pam’s favorite foods, drinks, Latin music, and three cakes.  We even had a piñata.  A grand time was had by all, and Pamela leaped into Age 50 with roar!  We were very loud. 

DO NOT sneak into 50.  Make a Joyful Noise!

Happy 50^th Birthday dear sweet, brilliant, delightful, beautiful Pamela.  Welcome to the second half of your wonderful life.

Yesterday, I met my friend, Braden, for brunch.  We had not seen each other since 2004; but, like all truly solid friendships, we picked up the conversation as if we had just seen each other.  I have known Braden since he was a freshman, and I was a sophomore at Oberlin College in 1973.  Thirty –six years ago?? Is that possible?

I am struck by how little he has aged.  He is the bright, creative, fun, talented, energetic and unique fellow he always was.  In addition, he has integrated a layer of wisdom into his personality (the big prize in aging well).  Braden is conducting and playing in the orchestra for the national tour of a Tony winning Broadway musical.  He works out at gyms in whatever city he is in and has superb upper body fitness due to the workout he gets as a conductor.  He is writing two novels and read the entire Count of Monte Cristo in French last year.  He is also in a long-term-committed relationship.  Wahoo!

I am hoarse from talking so much.  We both howled with laughter and basked in our friendship. We are both happy in a way we never were years ago. I know many people my age and Braden’s age who are already old.  They have lost the inner life force that must stay alive.  How are you keeping it alive?

Braden is living his life well. It helps to have good, optimistic genes, but it is also possible to think your way into a happier place for living the rest of your life. Love and be loved, work, laugh, stretch your brain, exercise your body, and always, always stay curious.  Having Braden as a friend keeps me young (along with exercising, being curious, loving, laughing, doing work that matters, and always finding new things to learn and explore).  Get off the sofa and stretch forward into your long and happy life.

Yesterday, I attended the monthly meeting of the Caregiver Forum at the Texas Voice Project for Parkinson Disease. The Texas Voice Project recognizes that victims of Parkinson Disease experience voice loss due to the gradual reduction of muscle control in the throat and esophagus.  Even more importantly, voice loss in Parkinson patients can lead to death. 

Executive Director, Samantha Elandary, started The Texas Voice Project in her living room when she recognized that people with Parkinson Disease did not die of the disease itself, but most likely died from aspiration pneumonia.  Because of weak esophagus muscles, food and bacteria can get caught in the lungs and cause a person with Parkinson’s to develop infections that do kill. 

The speaker at yesterday’s meeting was Richard L. Fulbright, Ph.D., who spoke on “The Cognitive Aspects of Parkinson Disease”.  One attendee spoke about how difficult it was to reason with her spouse as his dementia symptoms increase.  No one came up with a good solution to this person’s dilemma.

Please, please develop eldercare plans for you and your parents while everyone is healthy.  It makes a huge difference.  When families discuss hypothetical situtations before the onset of frailty, fear is less, and rational adults can understand why the discussion is valuable.  Write down potential plans based upon hypothetical situations.  Then, years later, when changes are needed for the elder’s wellbeing, decisions are made based upon something real.  If an adult child pulls out a plan developed by a parent years ago, it provides some sort of starting point for discussions today.   For example: Take a child who lives in California with parents who live in New York. They discuss and develop a plan in which the parent will move closer to the child if or when physical or mental changes require more support.  Years later, when one parent dies and the other is having fender benders and leaving the stove burning, the family will have to discuss the parent’s need for help.  Having a plan gives everyone an orientation point. Choices and preferences may change.  Any clues are better than trying to persuade an elder to make a change that frightens them during a time of crisis. 

Preparing an Eldercare Plan is an act of love and courage by both parents and children.

In Senior Housing: CCRC’S–When One Parent Must Move Without the Other, I wrote about wishing I had known what I know now when I faced the situation in which my father moved before my mother did.

My father was a very difficult person his entire life. By the time he needed to move to assisted living I had made my peace with myself and our relationship. I could show up, be respectful, have compassion, and give some of my time and resources to satisfy his needs. I was very clear that he did not rule my life or my decisions. Being in his presence drained me, so I limited the amount of time I would spend with him. It always took away from the quality of work I could give in my career and the ease with which I managed my other relationships.

Even as Dad became frail he could make unreasonable, selfish demands. He would be verbally punitive when he did not get his way. My mother received most of the impact of his bullying because she was always there. I chose to do my “duty”, but stay out of the room where he was as much as possible. I would do everything I could to creatively problem solve each situation as it came up, but I made most of my contributions from a distance.

Each of my siblings had a different relationship with Dad. I cannot speak for each one’s innermost feelings, only my own. I do know that none of us made a habit if spending a lot of personal time with him.

I regret that when Dad fell on Mom and injured her I did not have the generosity or wisdom to give more of myself in person. The siblings discussed the situation with each other and decided that it was time for him to move to assisted living. Next, we told Mom. After much persuasion she agreed to the move, and we pleadingly told Dad that he had to move.

There were other options such as:

• Move both parents to a two-bedroom apartment and hire a full-time, live-in caregiver at the cost of about $100,000 per year.

• Move both parents to assisted living. Mom would wither away, but Dad would be happier. The cost would be about $6000 per month for the two of them.

• Move both parents into one of the children’s houses and enslave that child into full-time caregiving. There were no volunteers.

I am sure there were a number of other ideas we could have pursued. My parents had lived frugally and had enough savings to choose one of the expensive solutions for five to ten years, depending on what else came up. We just wanted to make the decision and compartmentalize our individual emotions as quickly as possible.

In retrospect, I wish that I had sat face to face with both Mom and Dad and discussed the problem with them as adults facing a mutual problem. I would have had to have been very focused and be able to list all the reasons why the status quo was no good. Then I would have needed to list the options there were for us as a family–physically, emotionally, and financially. It would have been great if other siblings could have been at the hypothetical meeting, but I should have had it on my own out of respect for Dad as a human being. The biggest challenge for me would be managing my anxiety. Perhaps, Mom and Dad could have come up with some better ideas. Dad was never given the choice.

Perhaps the result would have been the same decision to move Dad to assisted living. The process of having the discussion, giving him the respect anyone deserves of discussing the pros and cons of each solution would have been better. I do not believe he would have clung to his rage for the rest of his life. Over time, he would have processed the pros and cons on his own and felt he was with treated fairly. In truth, we did not like or respect him enough to have a discussion. Also, I think we were too afraid of our own emotions to take on the ordeal of the discussion, the accusations, and the anger that would have been directed at each of us.

BETTER IDEA FOR AGING: Always, always, always treat an aging elder, parent, friend, or enemy as an adult. They (we) are adults, not children in aging bodies. That means present the options, discuss other possibilities, and argue the pros and cons. Discuss the impact of each solution upon each member of the family. Write down the choices. When a decision is made ask everyone, especially the elder, for ways to make the new situation more comfortable and pleasant. Keep looking for ways to improve the situation.

The elder may be totally demented and irrational. It doesn’t matter. Include them anyway. You never know what is getting through. Ultimately, you may have to make the decision they least prefer, but it will be done respectfully and as a decision between adults with conflicting needs and agendas. That may be the best you can do, but it will always be better than deciding and carting the voiceless elder away to a new situation.

EVEN BETTER IDEA FOR AGING: Have this discussion as part of an overall Eldercare Plan while both parents are sharp and have good decision-making abilities. Write down options, preferences, and decisions. It will help when the real decision must be put into action years later.

The goal of The New Elder’s Blog is to build a community that will wrestle with difficult issues related to aging and develop better ways of dealing with the challenges that may arise. Each person’s experience is different, so there is no cookie cutter manual for any of us. It is my wish that we build a repository of ideas and experiences available for access by anyone in a time of need.

I envision being able to search the catalog with key words and pull up 10-20 examples about how others have addressed a related problem. If we are lucky we may discover an option that is a perfect solution to the situation we face at the moment. It is more likely that we will read someone else’s story and take part of her solution to apply it to our own situation. Maybe we can embellish on the idea to make it work even better for our unique problem. The new solution can then be added back to the Repository of Better Ideas for others to access.

There has never been a better time for constructive criticism.  Let’s hear about a BETTER IDEA of yours.

I just finished reading an interesting discussion about CCRC’s (continuing care retirement communities), on my favorite other blog, The New Old Age .  I did comment on that blog, but think I need to write an entire post on the subject.

CCRC’s allow people to move from independent living to assisted living, to skilled nursing within the same complex.  In my experience there are two big advantages to CCRC’s. 

1. You will know where you want to move when you need more help.  By the time it happens you may be less mobile, less alert, and less able to decide.  Deciding for yourself while you are still sharp is a good thing. 

2. Geographically, you are closer to your friends who may live in other parts of the complex.  Spouses visit every day.  As transportation becomes more of a challenge, being able to walk (or roll) to see your friends or spouse becomes very attractive.

The reality is not so easy or clear.

Several years ago I went to see my folks in their independent living apartment.  Mom shocked me when she answered the door.  She had broken glasses, a black eye, several cuts and scrapes on her face and hands, and a lump on her head.  Mom is pretty deaf and also has Parkinson’s Disease.  Her Parkinson’s seemed particularly bad that day.  She tried to fake “perky”, but it was obvious she felt awful.

My father used a walker or a wheel chair to move about the complex.  It turns out that when he moved about the apartment he just asked Mom to help him transfer.  On this occasion she was helping him to the toilet.  He lost his balance sitting down, grabbed for her, and fell on top of her to the hard bathroom floor.  My father was fine.  He had my mother for a cushion.  Not only was Mom hurt, but NEITHER of them had called to tell me or my siblings.  The fall had taken place two days earlier!

Many people who are aging will hide their diminishing capacity from themselves, their friends, their children, and even their doctors.  It is natural.  None of us want to admit to increasing frailty; but that is not the biggest problem.  The BIGGY is that we are all terrified of losing independence. 

My father was perfectly happy to have my mother as his full-time caregiver.  He was like a big, greedy baby.  My mother had no ability to say “No” to him.  The five children were perfectly happy to allow Mom and Dad to take care of each other.  Boy! Was that convenient, or what?  My wakeup call came the day of that visit.

After much discussion between the siblings and with the parents, the children insisted that Dad move to the assisted living wing.  Mom told us privately that she could not support Dad physically any more.  She could not tell him this to his face.  The children became the tough guys and insisted on the move.  Mom cried with sadness, guilt, and relief.  Dad was furious with all of us, but truly enraged at Mom. I am sure he was also frightened.  Getting old is very complex.

After the move Dad was quite disoriented for a while.  The family learned, in time, that any move  was disorienting for both.  Mom spent all day, every day with him in the assisted living wing.  She hated it.  The residents were not good conversationalists and it was a very depressing place. She also ate her meals in the assisted living wing because residents were not allowed to eat in the dining rooms of the other wings. There were good reasons for that, but it meant that Mom, too, was separated from her friends in the independent living wing. In time, Mom did eat breakfast with her friends.

Things calmed down, eventually, but Dad never forgave us. 

There is also a myth about being able to CHOOSE when you need to move to the next level of care in a CCRC.  About a year after Dad moved to assisted living, the administrator for the complex informed me that the assisted living caregivers could not cope with Dad any more.  He either had to move to the Alzheimer’s/Memory Impairment Wing or move away to a skilled nursing facility.  This particular complex did not give skilled nursing.  He moved to the Alzheimer’s wing for a while but required skilled nursing 24/7 within the year.  He refused to speak to my mother after the move to the Alzheimer’s wing.  She continued to spend her days and most meals with him there.  She remained in her independent living apartment after he moved away for skilled nursing.  She visited him daily for at least half of each day until he died. 

My father received the best care and attention we could offer at each stage.  My mother went way beyond the call of duty.  She was the role model of a loving spouse.  I am sure she experienced many emotions besides love during this time, but she never showed it. 

Knowing what I know about aging now, I would have provided different and better support for both my parents during this time.  I did the best I could then.  I wish I had understood more…sooner.

I digress.  This posting is about CCRC’s.  Logically, they make sense.  I might choose that route for myself or someone I care about.  CCRC’s solve the problem of the continuum of physical care.  They rarely address the emotional issues families face as an elder moves from one stage of need to the next.

One of my pathways into the elder care business was through real estate.  I purchased a five-unit apartment complex next to my house as an investment.  As I began to advertise for tenants it occurred to me that it was an ideal habitat for older people.  All the apartments were at ground floor level, they all had patios, and they had ramps leading to the patios.  It was possible to enter the complex through the three shared and secured garages without using steps.  The complex had lots of light and good security.  It was within walking distance of great grocery stores, the library, parks, medical services, and entertainment.  The rent was moderate, as the complex was old and not particularly glamorous.

I started thinking about the housing options for all of us as we get older.  Most people say they want to age in their own homes.  In reality, if one becomes very frail or demented this might not be a good idea .  I will write a number of blog posts on this subject, but today I want to describe one of my favorite personal choices. 

I see myself buying or renting a multi-bedroom, single story house with several of my friends or relatives.  I do not have children, so moving in with them will never be an option.  I will do practical renovations based upon universal design  addressing options such as steps, counter heights, door widths, door handles, security, bathroom safety, and support bars.  It is actually pretty easy to change an existing house for universal design if you are OK with middle range amenities.  

If I lived with friends, we would notice if any of us was not looking well.  We could share out community tasks based upon who could still do what.  If we needed care, we could share the costs of someone who either lived with us or who made regular visits.   We could consult with each other if we needed advice.  We could enjoy each others company knowing that there was a good chance we would get along given that we had remained friends into old age.  We would not feel alone.  Sharing a house and caregiver is more affordable than assisted living or skilled nursing.

A supersized version of this would be like a Senior Commune—not in the hippy, dippy way, just in terms of shared resources and common needs.  Another version might involve friends living in several houses on the same block.  My five-plex could hold up to eight friends comfortably.

A theme I will return to again and again is the recognition that there will not be enough affordable services to meet all the upcoming needs of geriatric Baby Boomers.  We are gong to have to help ourselves and each other.  I don’t have a lot of friends, but the ones I do have are gems. Most of them live very far away from me.  I can think of few things more wonderful that living close to them as I slow down physically. 

I know that I can actually make this happen.  If I bought a property, renovated it appropriately, and chose an attractive environment, some of my friends or siblings would move in with me.  I am not ready to do it yet, but blogging about it makes me realize that I should plan for it now if I want it to happen.  I am the Queen of Project Management.  I can start putting together a list of everything I need to do to make that wish a reality.  When it is time to put the plan into action, I will be ready.

There are a zillion senior living ideas out there.  Let’s start sharing them, so that more of us can build on the ideas of others.  We need to have a number of senior housing models from which we can select our preferred futures. 

TALK TO ME: the more ideas we have, the more choices there will be.

I married my lovely husband, David, about four months ago.  I had only met my in-laws once before the wedding, but I knew I was marrying into a good family.  On our first date David had told me about his parents and spoke in detail about why he was a contented son.  At that time, I don’t think I had dated anyone who liked and loved BOTH parents.  I thought, “Wow!”

David’s brother, sister-in-law, and nephew came to visit last month.  We didn’t do much, just sat around, ate, and talked.  As they left for the airport to go home, I was conscious of a lovely, achy, happy feeling someplace between my sternum and stomach–the feeling I get when I feel love.  I was so grateful that I had three new human beings to love and to love me, and there are more relatives to come.

We spend much energy on current and anticipated losses while we care for aging parents–losses of senses, capabilities, independence, friends, family, and life.  It is hard to remember that, in life, there is a constant flow of losses and gains. 

 Older people I know have lost hearing, eyesight, mobility, memory, reasoning ability, control of bodily functions, relationships, and endless other things.  I lost one parent to heart disease, diabetes, dementia, and finally death.  My other parent is becoming frail and has her own set of  chronic illnesses.  Reflecting on all the losses can get me down. It is a good to keep track of the gains too.

When I take time to remind myself of gains, I am able to remember that life is a flow. The trick is to not be unbalanced by the losses or gains.  I married a man who tells me he loves me several times a day.  Everything is more fun because he is in my life.  He has an unmarried, grown son who is now my son.  I never thought I would be a mother.  Someday we may have grandchildren.  My brother-in-law is a quiet, talented, soulful man who gets a quiver of laughter at the corner of his mouth when he has seen the humor and wisdom in a situation long before the rest of us.  My sister-in-law is a rock of goodness.  She speaks her mind, thinks clearly, and made my dog fall in love with her within the first greeting.  My nephew is a grown man who can make a chocolate cheesecake to die for, who causes me double over with laughter, works as a Nurse Practitioner, and is innately kind.  I get to keep these people and hold them close.

When you feel yourself being dragged into the doldrums, take stock of your gains.  Recently I have gained a wonderful husband and a new branch to my extended family tree.  I have gained some freedom from a lifetime of sugar addiction, progressed in a new direction professionally, live in a renovated- 96-year-old house, and have lost six pounds (all off my stomach).  Wow, indeed!

There will be losses, but our gains will help us get through them.

This post is a sort of apology to my readers. I use some words in the vocabulary of aging inconsistently. I know I am inconsistent and should just choose one version, but I can’t make up my mind yet. I use care giver and caregiver, eldercare and elder care, aging-in-place and aging in place. Is it Elder Co-housing or Elder Cohousing? I do not know which is correct. These are pretty neutral terms, but they give me trouble every time I write anything.

What about the controversial terms or synonyms?

Senior=oldster=elder=old fart=Young Man/Young Lady=Grandpa/Granny=geezer
Retirement=Golden Years=Independent Living=Third Age=Aging in Place
Or does Retirement=Years of Decline=Loss of Independence=The Beginning of the End?

I worked in various aspects of the computer industry for twenty years. I remember going through the same struggles. Is it E-mail, email, or e-mail? Is it the Web, The Internet, or the Net? What about Intranets? When did personal computer become PC? When did interface and bandwidth start being applied to people rather than machines? I remember trying to set company standards for lots of new tech words. Eventually we reached some consensus within the organization, but there is still inconsistency between entities and expert sources.

Someone who has done an excellent job of creating new useful vocabulary about aging is William H. Thomas, M.D. He uses words like elder, elderhood, and care partner. A discussion of Dr. Thomas’ work to revolutionize the concept of the nursing home will take a number of posts. If you want to learn more about his innovative ideas, take a look at his website at www.edenalterntive.com.

I like the terms elder and care partner and use them often in my writing. I like the way caregiver looks in print more than care giver, but that seems like thin justification for choosing it as my standard. I actually see care giver in print more than caregiver.

Baby Boomers may again take the lead in defining new vocabulary. There are so many of us. When the volume of use for anything reaches a saturation point with Boomers, suddenly there is a new concept or word or phrase in the mainstream.

Taking this one step further, I think we must create new vocabulary. There are not enough useful and varied terms available to describe the aging experience in all its dimensions. I am quite sure that we self-empowered boomers will not shuffle off to geezerdom without putting up a good fight to change all the things that do not suit us. We always have. Why would we stop now? So, if we can define our own vocabulary of aging, let’s do a good job. Looking at Bill Thomas’s work is a good place to start. Each of us has our own experience. We will not allow others to define it for us. While we are defining it, let’s try to also struggle with phrases, terms, and words that better, more helpfully, and more honestly describe our experience.

I really hope to get some discussion on this. We need to define more clearly a whole world that is quite unclear for most of us. Let’s hear some good new vocabulary words. If we don’t define our own aging, someone else will do it for us.

In Health Maintenance for Seniors: A Visit to the Dentist, I wrote about my mother’s increasing inattention to her dental hygiene. It was a very clinical and factual posting. This one is not. This posting addresses the least clinical and least fact-based aspect of care giving–unmanageable emotions.  This post is all about ME, ME, ME and my emotions as a care giver. (eeew-how messy!)

In August, I had major surgery on one of my internal organs. (It is actually related to caregiving. Someday I will blog about it, but I am not in the mood to talk about it yet.) Recovery was and is difficult. I cannot lift heavy things and my physical and mental energy is still about 80% of what it was pre surgery. I had always done all Mom’s transferring support before the surgery. As of today, I still cannot do it.

For the day of Mom’s visit to the dentist, three months after a root canal and crown, I called my colleague, Anna Carlton, who is the President of Home Helpers of Dallas and requested help from someone who could do all the heaving lifting. She sent me a lovely woman who did everything I could not do. I did the driving and interaction with Mom and the dentist.

Note: One of the most important things a lead caregiver/project manager ( see Who Becomes the Family Eldercare Project Manager? ) can do is make sure that one person attends all doctor appointments. That is so that all medical practitioners are kept in synch with each other.  The Eldercare Project Manager coordinates all medical treatment. In my family, I have that job, so I go to every single healthcare appointment.

The dentist appointment was my first outing with Mom since the surgery. I was nervous for myself and was also physically and mentally weak. I performed all the appropriate, responsible tasks competently.  The surprise was my emotional reaction when the dentist told me Mom had three new cavities.

All my thoughts were for me, I am ashamed to report.  I felt a surge of rage, the likes of which I had not experienced in years. My first thought was fury that I would have to take her back to the dentist in just two weeks. I simply did not want to do it. My next thought was rage that Mom did not brush her teeth well enough even after all of our discussions about brushing her teeth better and using the best toothbrush on the market. Then I was angry at her caregivers for not supervising her when she brushed her teeth.

Fortunately, I was able to contain my emotions and not explode at anyone. But my body felt it for days afterward. I did all the rational steps to make new appointments, train Mom, and talk with her caregivers; but, in reality, I wanted to scream and throw things. I wanted to yell out loud and tell my family that I was done with caregiving. It was someone else’s turn. One of the most frightening things about the rage is that it seemed to come out of nowhere. I think my mother’s caregivers do a great job in general, and I know my mother does the best she can. But rage is not rational.

Fortunately, my mental health is pretty sound, and I am generally pretty self-aware. I recognized what was happening even as I felt my stomach cramp. I could hold my tongue and carry on like a civilized person. Truly, feeling emotions and acting on those emotions are two very different things. I behaved like an adult, thank goodness, but I felt like a baby.

The fact is Mom’s dementia is increasing rapidly. She cannot do what she could do six months ago. Sometimes we have totally wacky conversions. I generally keep a sense of humor and accept what I cannot change. I know I experience grief every time I see another sign of her degeneration. I feel frustration that I cannot do more that I already do for her. Some days, I just DO NOT WANT to go see Mom. I want to keep my attention on my work, take a nap, channel psychic energy to develop ideas, have a date with my new husband, and just do what I want to do when I want to do it.

I know all of my feelings, good and bad, are valid. I feel terrible when I do not have perfect, loving reactions to some of Mom’s situations (the dentist, incontinence, dementia, time drains). But, I do love her and the bad feelings do wane. I am able to visit her again with renewed patience and love. I know the bad feelings will return—and leave again. It is just a piece of the caregiver reality.