A Bittersweet Season: Caring for Our Aging Parents--and Ourselves

". . . affords the reader an opportunity to better know and understand their parents  . . ."

In an ideal world, everyone would live long and healthy lives in their own homes until quietly slipping into death. But in reality, aging, illness, and, in some cases, the onset of dementia, constitutes the norm.

Hoping for an easy passing once a parent surpasses the age of 85 is “magical thinking,” according to Jane Gross, author of The Bittersweet Season. Having lived the nightmare, she shares with readers the heartache, but also the joy, that can result from caring for an aging loved one.

Part memoir and part tutorial, this remarkable book tackles difficult subjects with aplomb. From role-reversal and choosing the most appropriate housing accommodations to the art of telling “therapeutic lies” and the intricacies of hospital emergency and discharge policies, Ms. Gross conveys her “hard-earned list of tips that you won’t find in the growing collection of how-to books and websites.”

Ms. Gross makes revelations, both embarrassing and brilliant, about the way in which she and her brother handled every aspect of their mother’s relocation, increasingly complex medical issues, and death. She admits to “living in a soup of fear, guilt, heartbreak, resentment, loneliness, and exhaustion from bearing the weight of so much responsibility.”

Ms. Gross also adroitly raises thorny questions regarding financial, medical and psychological status, which, in the past, were off-limit topics of discussion, but must be addressed when trying to provide the most effective care for an aging parent. In time, she realizes that to survive this journey, she must enlist a team of professionals for technical, legal, medical and practical help.

Although she eventually connects with knowledgeable individuals she trusts, Ms. Gross lobbies for an increase in geriatric specialists, who are trained to understand the illnesses and changes that affect the aging population. More of these specially trained physicians would have helped in her personal situation, but will also be much in demand as baby boomers venture into the world of assisted living facilities, adult diapers, and deteriorating mental capacity.

Ms. Gross inserts a chapter relating to the tragic events of September 11 to make the point that private and public life often intersects. As a newspaper journalist, she had the responsibility of covering the unfolding stories, while still maintaining her caregiver duties. Not only does she explain how she handles the situation—sometimes inadequately, she admits—but she also relates the way the events affected her mother.

In addition to personal experience, Ms. Gross solicits expert opinion from a range of medical professionals. She shadows a Mount Sinai Hospital geriatrician to get a “wide-angle” look at the spectrum of services that this medical specialty involves. Various other physicians, a former medical officer at the Center for Medicare and Medicaid Services (CMS), psychologists, attorneys, nursing staff and nursing home directors add their voices to the narrative.

Also, Ms. Gross reports the findings from numerous studies that delve into the psychology of the caregiving experience. Of note is Caregiving in the U.S., supported by the MetLife Foundation, the National Alliance for Caregiving, and AARP, which offers statistics as well as solace to caregivers who might think they are alone in their struggles.

Medicaid is probably one of the least understood subjects, but one with which everyone should be acquainted, at least to some small degree. Ms. Gross breaks down what she calls an “illogical, incomprehensible, unfair, and also unkind . . . system of long-term care” into manageable pieces. Using her mother’s situation as an example, she illustrates the tedious and time-consuming application process, the family’s fiscal responsibilities and the necessary interactions between the caregiver and case managers, as well as the “tangle of emotions” involved with this program. Ms. Gross does not profess to be a Medicaid expert; rather she suggests individuals seek the advice of geriatric care managers or elder law attorneys who are better equipped to answer questions in greater detail.

This book, whose underlying message could be “Be prepared,” should be required reading for anyone over the age of 21. When a reader is in need of care or is providing care, they will find that navigating this maze can be frustrating, frightening and fraught with pitfalls. The Bittersweet Season serves as a reliable handbook that offers a glimpse into the future, poses the questions caregivers should ask and offers credible answers, supplies a lengthy list of web resources, and provides reassurance based on real-life experiences.

For those currently immersed in the caregiver role, this book validates feelings, often unexpressed, and offers support and valuable advice. For those not yet involved in a caregiving situation, the book emphasizes preparation as the best defense. A tutorial wrapped in Ms. Gross’ personal memories and experiences, The Bittersweet Season aims to educate and encourage readers during a most difficult stage of life.

In one sense, The Bittersweet Season could be called a love story. While Ms. Gross freely admits the flaws in her family’s relationships, she also chronicles how a previously loosely woven connection becomes strengthened by time and trial. Reading this book and applying its lessons affords the reader an opportunity to better know and understand their parents and to prepare for the inevitable aging process.