Doing What You Can Do Is Enough

Do you wake up some mornings, fully primed? Where your brain is already fully in thought about something?

I’m not sure what started me this morning. I had been talking last night about all the people in my life – my sister, my sister-in-law, friends, the leader of my Toastmasters chapter, colleagues, random people I meet – who are caring for elderly parents (or, if they are older, siblings), a job they didn’t anticipate working, a p/t career with f/t stress they didn’t plan for.

I have had but a taste of their lives, spending a week moving my elderly in-laws from Orlando to Pittsburgh; flying cross-country to spend a week or two with mom to give my sister a much-needed break; sitting with my mother-in-law for an hour or two while her daughter takes an afternoon at the spa with her sister, daughter, and niece.

I must have been chewing on this thought all night while sleeping because, I awoke, fully primed, mid-thought about two memories that I think feed into the compassion I feel for all these caregivers.

When I was a 11 or 12, my friend and I used to ride our bikes a few blocks and carefully cross a busy four-lane road (children did things like that in those days), to a nursing home to visit the residents. I’m not sure how we got connected to this home. Our elementary school ballet class did perform a recital for the residents there – in full and fluffy tulle, which our rudimentary skills did not deserve – so maybe that was the start. Or maybe that was the end, maybe we arranged for the performance because of our connection there. Memory gone.

Looking back now, I can’t believe that the nursing home let two pre-teen girls wander through the halls unsupervised, poking our heads into different rooms to say hi to residents. There was an independent living wing, where residents had apartments. And there was another wing, with single rooms and dormitories of elderly people who were unable to afford apartments or unable to care for themselves. One woman sticks in my head because she had long, long, thick, straight hair that fell almost to her waist in a sheet of beautiful silver. I remember her, hunched over, her hair like a waterfall over her face, hands over her eyes, rocking and wailing how lonely she was, how her children left her there and never came to visit her. As I child, I accepted that as the truth; as an adult, I wonder whether she had short-term memory loss that robbed her for each visit as soon as it had ended.

I’d like to think that our being there helped her, that we brushed her hair for her and held the space for her to process her grief, real or imagined. In truth, that’s a lot for anyone to process, much less a pre-teen child, and I suspect we tiptoed past the open door with the scary adult who cried, and sought out residents who were happier and easier to chat with in, what I am sure was, our shallow self-centered child-like way.

This morning, almost as soon as that memory had rolled into my mind, my thoughts skipped forward to my one long-term experience with caregiving. When I was in high school, my sister’s cat had kittens. The cats stayed in our family as my sisters and I dispersed to college and years-abroad. When my mom moved to Washington DC, she brought the last kitten, Spike, now a full-grown cat with her. When mom relocated to Thailand, she brought Spike – now 10 years old – up on the train to stay with me in NYC. For the first few years, Spike and I had a ball. She loved NYC, loved taking the subway to the vet; loved meeting people, loved when they told her she was a beautiful cat; sometimes we went to Central Park. As she grew older, Spike developed older-cat diseases, notably Thyroid Disease, something older cats get especially if they’ve been around toxins, which you don’t realize your home is full of. The vet prescribed a pill, no problem.

Then the apartment flooded from above, dirty, disgusting water spilled down through several stories above and Spike and I made an emergency dash to my boyfriend’s apartment. That was stressful enough but he had recently adopted a cat of his own, who had spent very little time around me and was not pleased to find another cat in her home. Eventually we returned home and then moved to a new apartment, one that I owned, with a view not of a busy street but of the top of the trees in the interior courtyard between the north and south wings of the building. She loved waking up early to birdsong and I realized how much she might miss being an indoor/outdoor cat with trees to climb and birds to chase. Weather permitting, I used to leave the windows cracked so she could enjoy the birdsong and fresh air.

My grandmother had recently had a stroke and, mom still overseas, I had been flying down to Florida at least once a month to stay with my grandfather and try to re-engage Mimi with the will to live. When I returned from another exhausting and fruitless trip, I found a dangerously sick cat. She had clearly been ill on the rug several times, in an unhealthy color. She lay, listless and panting on the rug. The windows had been cracked open and the boiler chimney had spewed a huge plume of black smoke – as NY boiler chimneys do every fall when the heat is turned on – and a layer of black dust covered the furniture, the floor, and my poor sweet cat. I rushed her to the veterinary emergency room and they kept her for a few days. I was a wreck. If I this distraught over my cat, I wondered, what would happen when my grandmother died? I dove into therapy.

When Spike returned home, she looked so much better. One of the side effects of the thyroid medicine is high-blood pressure, which impacts the body’s ability to circulate fluids to the kidneys, and she had gotten severely dehydrated. Now, in addition to the pills, I had to administer subcutaneous fluids twice a day. When the vet released Spike to me, they showed me how to hook up the needle to the tube, the tube to the bag of fluids, how to pinch the loose skin at the nape of her neck, insert the needle and massage the fluid down her back. They advised me to soak the bag of fluids in warm water beforehand, to bring it up to blood temperature so she wouldn’t struggle against the unpleasant trickle of cold water down her back. But I was in shock and wasn’t taking it in, and struggled with it at home, wracked with guilt at every pin-prick, that I was unable to get it right. This was before the internet and I had no support, no way of finding out how to do this, other than practice. Now I’m sure there’s a How-Wiki on it and You-Tube videos; then it was nerve-wracking.

Eventually I figured it out and she came to sit happily purring on my lap while I administered the fluids. It meant changing my schedule so that I could be home by a certain time to take care of her. It meant hiring a different level of catsitter to take care of her when I went out of town, someone who could administer fluids and pills and try to get her to eat because one of her now accumulating illnesses required her to eat a low-protein diet and her appetite, always omnivorous, had grown finicky.

For almost 5 years, I was Spike’s caregiver. On her good days, my mood was up. On bad days, I worried that it was the end. When I traveled on business, I drove catsitters crazy, calling daily to check in on her. I – vegetarian since my teens – even cooked chicken for her, to try to get her to eat. (Frantic phone call to a carnivorous friend: how do I cook chicken? she passed the phone off to her husband who had talked me through marinades and side-dishes before I could interrupt long enough to say it was for my cat. Oh, just boil it, he said in disgust and hung up.) I put up with nighttime incontinence and new, loud vocalizations that I worried was catzheimers but turned out to be a kind of sonar from a side effect of the fluids: blindness.

Finally she gave up eating and I knew it was time to let go. She had outlasted my grandmother and, I think, my grandfather, too. But now it was time to let her go. I can’t even write about it now without weeping. I buried her ashes beside a rock outside my mother’s house in the forest where Spike had grown up, before she had been whisked off to the big cities and became an apartment cat. Spike was the best cat in the world – no cat since has compared – and every March I think of her, even 20+ years later.

This was my one experience caregiving. It is nothing compared to what my sister goes through every day, trying to juggle a full-time job, two kids, shopping for two households, paying two households worth of bills, dealing with the evolving cast of paid caregivers, and my mother’s elderly dog. Or what my sister in law goes through with her 90-something, cognitively challenged parents living in her home, balancing a full-time job, and two teens, dealing with my father-in-law’s failing memory, trying to help him process the grief he feels when something – anything – happens that reminds him that he doesn’t have the sharp executive skills that were his strength and pride. Or my friend, an only child, whose elderly parents divorced at a younger age and never remarried, and now he – in Covid – shuttles back and forth between two distant neighborhoods, trying to get them the treatments that they require. His mother, he told me once, goes to doctors, who tell her what to do about her problems, and she refuses to follow their instructions because they are so young, such babies, she says, and what can they know? Five years ago when he told me this, I laughed; five years later, and after a baby-faced doctor screwed up a routine surgery on me, I don’t laugh at that anymore.

My experience is nothing compared to that. But it’s real to me. And it leaves me with a greater appreciation for what it feels like to be in the sandwich generation.

If there is someone in your life who is caregiving for someone, please reach out to them today and be a listening ear. It’s okay if you don’t know what to say, what advice to give them – that’s not what they need. What they need is a safe place to talk about what they’re going through; someone to listen and to let them reflect; and to help them realize that they’re doing exactly what they need to do.

And that doing what can do is enough.

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