I am having a hard time accepting getting old. Also I am dealing with my adult daughter not showing any love nor care for me. She also mentioned that I need to take care of my health because if I become disabled she is going to put me in a nursing home where I will be taken care of. She said it would be selfish of me to expect her to care for me. I am not sure if she knows that by telling me that has ruined the rest of my days. So, how can I age gracefully and happy when I know i am going to end in a nursing home?
I thought about how scary it can feel to imagine a future of illness, disability and pending death -- something all of us will experience though in somewhat different ways. Some fear losing their independence while others fear independence, how they will cope when or if they lose a spouse, hoping to move in with one of their adult children.
Sometimes our hopes and their dreams are in harmony. Sometimes there is distinct dissonance.
And it made me wonder: just how much is reasonable to expect from our adult children as we age? How much is too much to ask?
Also, if there is a clash of expectations, does that have to ruin the rest of one's days?
Our expectations, of course, are very individual, seasoned by our own experiences and by cultural considerations.
I once dated a Jewish man from Iraq who, at the age of 25, had promised his dying father that he would take care of his then 45-year-old mother for the rest of her life. He took this oath very seriously. He loved his mother dearly, though, with her demanding nature and prickly personality, he often found her a trial. Worse, her aggressive rudeness toward every girlfriend he ever had posed a real challenge to his romantic life. His married sister offered many times to take the mother in but the mother always insisted "My place is with my son because he promised." That promise cost him any chance of marrying. He was 83 -- and his mother was 103 -- when she died.
When we were dating, more than 40 years before that, I would ask him why he was letting his mother determine the course of his life and he would reply "I made a promise. I know better than anyone how impossible she is. She is, without a doubt, the most selfish woman alive. But in my culture, we don't dispose of our older people just because they are inconvenient or hard to live with even if caring for them makes our own lives worse."
He is now 85, in poor health, and alone, never having been married or having the children he once dreamed of raising with love from babyhood to gloriously independent adulthood.
There was Ana Maria, an injured factory worker who was a patient of mine when I was on the staff of a Worker's Comp clinic. She had been starting medical school in her home country when her mother, who lived in the United States, had a minor stroke and sent for her, contending that it was her duty to care for her. Ana came immediately to care for her mother, whose disability was slight, whose general health was quite robust but whose emotional neediness was overwhelming.
Every time Ana would mention going back to medical school, her mother would protest "But I need you!!" So Ana gave up that dream and stayed, eventually marrying a man who was initially charming and eventually abusive. Finding herself a single mother of two after he left her for another woman and, with no work history in the U.S., Ana felt lucky to get a factory job. After she suffered a work-related arm injury requiring surgery, I began to see her for supportive counseling.
Her feelings were a mix of angry regrets and loving commitments. "I am angry that my mother demanded I give up a life I had worked so hard to achieve and I'm mad at me for relinquishing it all," she said. "On the other hand, my kids mean the world to me. If I had stayed in Mexico, I wouldn't have had them. And if I had stayed in school though my mother needed me, I would have felt bad about myself. I chose to come here and care for her. But overall? I think my mother expected too much even though caring for family is a big part of our culture."
Even keeping cultural considerations in mind, these are scenarios I'm sure many of us would not want for our adult children, believing that there are ways to show love and support without sacrificing one's own life and dreams.
How does one begin to envision an unknown future?
To envision the future, look to the past: What is your family history? Is there a pattern of early-onset dementia? Or have one or more generations suffered from Alzheimers? Has cancer taken a toll on your family? While it's impossible to predict your own health future, if there are certain trends in your family, it can help to imagine yourself in such a scenario and devise a plan for the future that assures good care while demanding as little as possible of your adult children. In the past, especially when women did not work outside the home, full-time caregiving by an adult daughter or daughter-in-law was more common. That may no longer be a realistic expectation.
Begin planning as if you were single and childless: What insurance do you need? What can you afford? Meet with an independent financial advisor (one with nothing to sell!). Check out long-term care insurance before you're old enough that the cost would be prohibitive or you might have medical conditions that would preclude coverage altogether. What are your possible resources for help if you become ill or disabled? If you build a safety net for yourself as if it were all up to you -- and, for the most part, it is -- you will not only build a future the way you would prefer, but also will be asking less of your adult children. Asking less of them may bring more rewards than you ever imagined when they are able to choose how they will offer you their love and emotional support.
Create a sense of comfort with the unknown. None of us can know the challenges older age can bring. We can get some clues by looking at the generations before us, but those are their stories, not necessarily ours. We may die suddenly tomorrow or live long lives with a gradual decline. We may never see the inside of an assisted living facility or a nursing home. It's impossible to know unless one already has a degenerative health condition. While it's prudent to plan for the future, it's also important to live fully in today, enjoying each happy, independent day as it comes to us, seeing this as a blessing denied to so many. Knowing that good health and life itself are finite can make today even sweeter.
Talk about future scenarios with your adult children, collaboratively, not in terms of your expectations. Ask them what they imagine and what they fear. Talk about your own parents, their grandparents. How would you like the future to be different? What is their vision for your future together? Talk about what you would like, not what you expect.
Know that love takes many forms and that you can have a good life and good relationships with your adult children whether or not any step up with an offer of full-time care. Living fully and joyfully is a choice -- whether or not you're close to your grown children and whatever your adult children do or don't do. You can build a life of friends, extended family, and neighbors. You can find companionship with a beloved dog or cat. You can find fun and engagement in interests and activities with friends and other extended family members.
And as you live fully, joyfully and independently, your adult children may love you more.
My brother, sister and I always agreed that Aunt Molly, our father's childless, never married sister, was our third and best parent when we were growing up. She brought fun, laughter and poetry into our lives and also loved us enough to teach us some tough lessons in becoming kinder, more tolerant, resilient and self-motivated adults. In fact, she was central to our lives for many years longer than our mother and father, who both died of heart attacks within four months of each other, when we were still young adults.
Aunt Molly was delightful, highly intelligent, pivotal to our lives but she also had her own life filled with friends, interests and her continued career as a writer well into her eighties. By the time she passed her 85th birthday, we began to worry about how it might be for her and how we could help should a stroke or other medical misfortune take away her independence. She worried, too, and had given the matter much thought and action.
"Whoever said old age is not for sissies was surely right," she told me one day. "You really need a sense of humor in these so-called golden years. Besides the fact that I love you, I will tell you three things and then make a request. The three things are: first, my will, birth certificate and wishes for my funeral are in the first folder in my file cabinet; second, I have every kind of insurance possible, including long-term care that provides for in-home care; finally, my greatest wish would be to be cared for by professional caregivers, if needed, and to die at home."
I nodded, not wanting to imagine such a future, but marveling at her careful planning.
"And now what I want to ask of you," she said, her eyes filling with tears. "All I ask is your emotional support as I go into this phase of my life. It's a little scary..."
"I know it is," I said, my own eyes filling with tears. She suddenly looked so frail and vulnerable.
We embraced and I felt a wave of love and a touch of relief. Emotional support was something I could give -- and my brother and sister could give, each of us in our own ways -- freely and willingly.
As it turned out, Aunt Molly never needed caregivers or long term care. She died suddenly a little more than a year after our conversation. A few days after New Year's in 2004, she was sitting in her favorite chair, doing the New York Times crossword puzzle while waiting for her dear friend Magda to pick her up for a post-holiday lunch when her tired heart simply stopped. She was 86 and still independent. It was the best possible way for her to depart this life, dependent on no one, looking forward to an excellent lunch with a good friend.
Not everyone is as fortunate. But her careful planning that took into account what was possible for those who loved her left a legacy of love that will live forever in our hearts.