The Challenge Of Caregiving During 2021

"If you look deeply into the palm of your hand, you will see your parents and all

generations of your ancestors. All of them are alive in the moment. Each is present in your body. You are the continuation of each of these people." - Thich Nhat Hanh

It is no longer uncommon for four generations of a family to be alive at the same time. The population of 65-year-olds and over is expected to double in size within the next 25 years in the United States, and the age group 85 and older is now the fastest growing segment of the U.S. population. As the Baby Boomers approach old age, they are facing one of the most complicated and multifaceted issues they have faced in their lives: caregiving and care receiving.

Increasing longevity raises the prospect that two generations within a single family may need caregiving, placing increasing and potentially impossible burdens on those who may find themselves caring for both parents and grandparents. As more and more of us find ourselves in the role of caregiver or a care receiver, we need to take a fresh look at the challenges inherent in such relationships. But we also need a new vision of caregiving: one that emphasizes the potential rewards -- emotional and spiritual -- that can accompany this most demanding of life’s challenges.

A New Paradigm of Caregiving

Along with opening a discussion, the social expectation that we should respond to one another in kind is the foundation of the new caregiving paradigm that is based on a mutual exchange of recognition and understanding. The care-receiver gives up his or her independence until the crisis has passed, and the caregiver understands the paradoxes and the helplessness that occurs with an illness. This reciprocity can heal broken relationships because, in our culture, there is no common ritual for caretaking, and reciprocity can clear the way to promote a new kind of relationship between the generations. This reciprocity in caregiving emanates from a sense of shared responsibility, mutuality, and intimacy, not from a guilty conscience or role-reversal strategy where parents become like children.

Throughout my 28-year career as a social worker at the Lahey Clinic in Burlington, Massachusetts, I saw more and more people caught ill-prepared and ill-equipped, physically and psychologically, to care for an elderly parent. Why were people so discouraged and overwhelmed? What were their fears? What were the fears of their parents? Why did so many reach the crisis point having given little thought to the caregiving challenge? Why did some families show compassion and concern, while other families remained indifferent? Why did some loving caregivers feel they were never doing enough? Why were they so drained and exhausted? Why did they feel so isolated? I addressed these questions during my practice and research at the Lahey Clinic and then, 20 years later, confronted those same questions as I cared for my own aging parents and husband.

We needed a new paradigm then and more so today. A paradigm that is based on a mutual exchange of recognition and understanding. The care receiver gives up his or her independence until the crisis has passed and the caregiver Try to understand the paradoxes and helplessness that occurs with an illness. This reciprocity I thought could promote a new kind of relationship between generations. With this new paradigm the dynamic within a family have an opportunity to shift and strengthen.

In this year of the Greatest Pandemic, we are witnessing a force that has shattered our lives: no family should ever again face the issue of not seeing their loved ones or be with them at their time of death. In the Tibetan Book of Living and Dying, Sogynal Rinpoche tells us there is no greater gift of charity you can give than help in a person to die well. It is the unalienable right of all of us to have or share in a good death called benemortasia. How grateful we should all be that hospital workers, nursing home workers and caregivers who probably were not related or knew the person dying gave the greatest gift of all: the minister of support and love.

I can only offer a thought. A life review of the patient, written in the patient’s chart that goes with him/her wherever he/she goes, may help in the future to at least reveal the person as the way he/she lived. It is not a solution. It is up to our grandchildren to find a way. After all we will reach Mars in the future.

I am attaching this letter from my research, sent to me from a granddaughter.

Dear Gloria.

I am attaching this letter to my questionnaire you sent. In writing it I discovered something very precious to me. My grandmother was short and chubby with a soft cuddly face and she always had a mournful expression. I am much taller than her and I loved standing over her as she cooked steak and onions for her seven sons. I saw my grandmother before she died. During her life she introduced me to many stories in her life. Stories with unforgettable maxims on love, respect, and also suffering. I am not sure you will quite understand what I am trying to say. But when I come to turning points in my life, I think of my grandmother first and then her stories. Her life does not serve as a model for my life only her stories do that. What is precious to me is that in many ways, I am like my grandmother and I know I will always have a part of her soul in mine.

Good luck on your research.

Yours truly,

[granddaughter's name]

By reevaluating the assumptions, myths, crises, and consequences of modern-day caregiving, a new generation can redefine caregiving and transform it from an experience approached with anxiety and dread to one of opportunity and reward.