The Caregiver's Survival Handbook: How to Care for Your Aging Parent Without Losing Yourself
By Alexis Abramson with Mary Anne Dunkin
Perigee Books
Paperback 263 pp $14.95

Once upon a time, my father would dig into his pocket to fish out a dime when I wanted candy. Leaving the beach after a long walk, he'd bend down to me and carefully flick the sand from between my toes with a small brush.

Now, at 98, he lies docilely while I change his diaper. Like a baby bird, he pops open his wrinkled mouth, waiting to be fed. He shouts when he's riled, and sometimes when he's not. On those long nights when I have watched over my now blind and demented father, my exhausted mind ponders one question: How did it happen that he and I switched places?

Consider this: 78 million baby boomers are turning 50 at the rate of one every eight seconds, and 80 percent of them have at least one living parent. In the next decade, as their parents enter their 70s and 80s, these boomers will swell the ranks of the nation's caregivers. What's both comforting and sobering to me is the realization that I'm not alone.

These numbers are just a few of the reality checks in Alexis Abramson's book The Caregiver's Survival Handbook: How to Care for Your Aging Parent Without Losing Yourself.

"Does your head spin with the responsibilities of caregiving?" Abramson writes. "Does your world feel out of control? Sometimes, when you have a moment to think, do you wonder, 'Will I ever get my life back?' "

The answer, she maintains, is an emphatic no -- at least not the same life you had before you started caring for a parent or relative. But that's not as sobering as it sounds. Abramson, you see, believes that caregiving, although one of the most demanding, time-consuming, and exhausting jobs a person can have, is surprisingly rewarding and inspires resilience and an appreciation for life.

A consultant for AARP, the national advocacy group for retired people, Abramson packs her book with lots of caregiver resources and coping tips, including a list of handy household gadgets that can make life easier for seniors.

But the meat of the book lies in its lessons in survival -- from getting professional help, taking care of one's own needs, lowering expectations, and being flexible, to enlisting the aid of family, letting go of grudges, and, most of all, not feeling guilty that you can't do enough.

Abramson advises caregivers to take a break, advice that should be written in large letters. On days when my sister and I felt like we were at the end of our rope, we got a senior volunteer to stay with my dad so we could go shopping or take a ride somewhere. It reconnected us to the world and saved our sanity.

Caregivers are especially prone to thinking they are superwomen, since 72 percent of them are female. The typical caregiver, in fact, is a 46-year-old married woman with a job outside the home. There's nothing new about this gender gap. It might even suggest why the struggles of caregivers are on the nation's back burner. Granted, 28 percent of American men are now primary caregivers of their parents, but Abramson says most men still need a nudge to help out. Many male caregivers never volunteer for the job, she writes. Abramson's advice, however, on what to do about this disparity made me roll my eyes.

"If you want to ask a man for help, you need to know how to approach him -- butter him up, feed his ego," she writes. "When he has finished the job -- how matter how small -- be sure to brag on him and thank him."

Uh-huh.

Then there are unhelpful relatives. Abramson writes that you can use monetary bribes to get them to pitch in, especially if they need the dough. But the fact is, some siblings are more than willing to let you take on the whole burden if you don't ask for help.

"Many women say that dealing with unhelpful siblings is one of the most stressful aspects of caregiving," Abramson notes. In such cases, a family meeting is in order. Be businesslike and bury grievances.

"When siblings squabble over who will care for Mom or Dad or refuse to help one another with caregiving tasks, the problem often isn't about caregiving itself, but conflicts and power struggles that have existed since childhood," Abramson writes. "Maybe your sister never had to study as hard as you did, or maybe she stole your boyfriend while you were away at camp."

In my case, we were blessed that my sisters and I never quarreled over my dad's care. What was more difficult for me was dealing with feelings of guilt and even anger at times -- feelings that Abramson says are natural.

"Having negative feelings about caregiving does not make you a bad caregiver," she writes. "Mistakenly, we sometimes see these conflicted feelings as signs that we are self-centered, immature, or not up to the task of caregiving."

I suppose the guilt and anger come with the shocking realization that I am now the parent, not the child, when it comes to my father. And let's face it -- at times, we all want to run back to the warm beds of our moms and dads. Instead, when we approach them we are faced with confused or belligerent strangers.

Abramson spends an entire chapter on how to avoid "butting heads" with parents, from letting the doctor decide when to take the car keys away to setting limits in the face of unreasonable demands. Here, she wisely suggests there is a great deal of "letting go" in caregiving and of picking your battles.

To tell you the truth, it all reminds me of rearing children, a simultaneously exhausting, nerve-racking, and enriching experience.

In a few years, millions of Americans will go through this rite of passage as they become their parents' caregivers. For them, Abramson's book serves as a useful navigation tool for what's to come. And for those of us who are already caregivers, it throws us a much needed lifeline.

-- Annie Nakao is a staff writer for the San Francisco Chronicle. Her memoir of her father's illness, "Pop's Story," originally appeared in the Chronicle.

First published October 29, 2004
Last updated December 5, 2007
Copyright © 2004 Consumer Health Interactive