In case you have doubts, richer people are happier than poorer people. A 10% increase in income raises happiness in every country of the world, according to global research. What has happened to the American middle class in the past three years is exactly the opposite. Median household income fell nearly 10%, to $49,909, reports Sentier Research.
Gallup-Healthways has been measuring Americans’ well-being for three years. People’s daily mood improves as their income rises, up to $75,000. While overall well-being depends on a cluster of physical, emotional and social experiences, men’s sense of well-being is strongly tied to a dollar number. The rub: The median income for a year-round, full-time employed male is little improved (in 2010 dollars) over almost 40 years ago.
The largest cohort in America today — women 45 to 55 — derive well-being from a different calculus than men, according to Healthways research. If the family income is sufficient to pay the bills, most women are able to compensate from other sources of well-being: children, friends, a sense of meaning in work or community service. But even these female strengths are being sorely tested by a moribund economy.
Overturning precedent, this generation of women 45 to 55 self-reports the lowest well-being of any age group, according to Healthways’ well-being index. Why?
People filter their expectations through their experience, and younger Boomer women have had a great ride up to now. Doors were kicked open for them by the pioneer Boomer generation. When they shot out of colleges and grad schools in record numbers, job offers were waiting.
The responsibility for caring for aging or sickly parents falls overwhelmingly on women in this age group. Money can’t buy off their guilt. Even when a midlife woman’s income reaches the enviable number of $120,000, if she still has a child at home plus an aging family member who needs caregiving, Healthways data show her well-being begins to decline. Very likely, this daughter works at a high-powered job that leaves her little time to do hands-on caregiving. At work, she feels guilty about not visiting. When visiting, she feels guilty about not working.
The greatest source of stress for most women is the emotional problems they bring into the workplace.
Wendy Li is a prime case. A hard-working Chinese-American who speaks four languages, she landed a job at Merrill-Lynch right out of college, in 1986. Overtime and bonuses brought her income up to $55,000 by age 30. Then her husband’s company transferred him to Columbus, Ohio, and Wendy was confined in the sleepy suburb of Dublin with two small children.
She found meaningful work as a medical interpreter. “At Merrill-Lynch, I thought only of money,” she says. “As an interpreter for sick immigrants, I work from the heart.” But at age 46, her income is half what it was 16 years ago; no overtime, no benefits, no health insurance. She is on call 24/7 at a hospital.
When her grandmother had a stroke, Wendy spent three years shuttling between the old woman’s sickbed, work and family. No sooner did her grandmother pass on than her husband was laid off. Unemployed since January, he helps out at home.
“I try not to let money be that important,” she says, “but my husband is ashamed of not being able to support his family.” Her son will join the Marine reserves to receive 60% of his tuition.
The danger to well-being, reports Healthways, is to believe conditions will never improve.
Women such as Wendy Li, stressed as they are, remain stubbornly optimistic. Her strongest supports are religious faith and female friends. “We don’t gossip at lunch,” she says. “We share useful information on how to survive this recession.”
Midlife women are flourishing compared with men. Despite the daily gloom of economic predictions, women in midlife are more optimistic about their lives today and five years from now than men are about theirs.
Surprisingly, 25 percent of women ages 45 to 55 give themselves a 10 out of 10 on optimism about their future, finds a Gallup-Healthways poll of Americans’ well-being. These women have a sense of meaning and engagement. They love learning new things. And they expect in five years to be at the top of a ladder of well-being.
Only 17 percent of men in this age group have the same sunny attitude about their present and future lives. What accounts for this striking disparity?
Lindsay Sears and her scientific team at Healthways Research Center found a prominent trend: Younger Boomer women fall back on the greatest booster of their optimism — strong social support and girlfriend circles. It isn’t the number of friends they have; it’s the quality and consistency. Men of the same demographic are not as likely to have a strong support network.
The most optimistic women spend about six hours a day in social interaction. Some of that time may be with a friend at work, with family, a husband or children, or with a partner, a love interest, or neighbors. But girlfriends are the bedrock. The most optimistic women have an inner circle of anywhere from four to a dozen friends who “have their back” and will drop everything to help in a crisis.
Having hundreds of “friends” on Facebook and contacts on LinkedIn is great for business and self-promotion. But coming home from a conference with a fistful of business cards is not emotionally fulfilling. “Contacts” won’t be there for you when you have a blowup with your boss and fear for your job. If you have no ready social outlet, you’ll likely start to sleep poorly and feel your energy drain. The best way to recover optimism is to walk and talk with a girlfriend or a group.
This is exactly what delivered Elizabeth Fox from a midlife funk. She was 46 and pregnant with her third child when her mother died. As the former manager of a Nashville radio station, she was used to 60-hour workweeks with no time to waste socializing.
“I just had to get off the bus,” she says, remembering the isolation and sluggishness she felt when she was still in her pajamas at 9:30 a.m. after getting her kids off to school. A girlfriend urged: “Just come and walk with me. It’ll help you.”
Fox hiked the day before she had her baby. She hasn’t stopped in the nine years since. A friend still picks her up at 5:15 a.m. to gather with their tribe and refresh their senses on a Tennessee mountain trail, followed by coffee and girl talk. By 7:20 a.m., Fox is home and ready to work.
A few years ago, she needed a new passion. But like so many mothers ready to return to work, she felt inadequate. Taking inventory of her skill set, she realized she’s a natural communicator who loves shopping and being helpful. Why not start a blog? “Just do it,” she told herself.
A technophobe, she hooked up with a female partner 15 years her junior. After a year of brainstorming, the two women, above, launched StyleBluePrint.com, a site about books, cooking, and cool boutiques. She is still astonished that they could start with a blank screen and in two years build an audience of 42,000 unique visitors and a profitable business.
But she will never again let her friendships lapse. She recently gathered in Denver with “The Hens,” eight women who shared the indelible years of their late 20s and early 30s. They time-traveled back to a weekend when they ditched a ski trip to huddle around a lovesick Fox. If there were a crisis today, they’d still huddle.
“I just turned 55,” Fox says without embarrassment. “I have a passion, and it’s working!”
(Published simultaneously with USA TODAY.)
Here at WVFC, we’ve always maintained that there are myriad ways to use one’s voice. The National Osteoporosis Foundation’s new initiative, “Generations of Strength: Mothers and Daughters” is a worthy example of how the simple act of conversation can be a powerful way to impart vital health information. On September 26th, NOF introduced the campaign at a well-attended luncheon at the elegant Pierre Hotel in Manhattan. The event kicked off with champagne and a silent auction featuring splurge-worthy goods ranging from Judith Ripka earrings to a week in Antiqua. Afterwards, attendees dined on filet mignon while two lithe and lovely members of Dance Times Square strutted, swayed, and swirled their stuff. They were young, but we have to say that watching how beautifully they moved was inspiration for keeping our own bodies strong and supple.
The goal of the Generations of Strength campaign is to encourage mothers to pass along to their daughters the information they will need to do just that. According to NOF, one in two women is at risk of an osteoporotic fracture, and one in four will actually suffer from one. By talking to their daughters about bone health, calcium, vitamin D, exercise, and other important factors related to osteoporosis, NOF maintains that mothers can help to prevent osteoporosis for generations to come.
Of course, talking the talk is most effective when one also walks the walk — or, as NOF’s Generation Award recipient Lisa Oz (wife of TV’s Dr. Oz) said, “You have to take care of yourself in order to take care of your loved ones.” We get that: If, say, you’re extolling the benefits of exercise to your daughter when you haven’t seen the inside of a gym in years, your words are likely to fall on deaf ears. But if you deliver your message from the pulpit of an exercise bike, then odds are she’ll take it to heart. Stated honorary chairperson Gail Sheehy (who will be writing regularly about osteoporosis for WVFC, starting today), “It’s important to have conversations before a health crises.”
On September 26, the National Osteoporosis Foundation launched Generations of Strength: A Mothers and Daughters Campaign, an initiative to encourage mothers and daughters to talk about how to protect their bones (I am the honorary chair). I only wish I had known enough about osteoporosis to help my mother prevent its worst consequences. In her late sixties, her sit bones became so powdery, it hurt her even to sit and read.
Given that most personal of warnings, I was vigilant during the menopausal passage, when for a span of five to seven years bone loss accelerates to 1.5% a year. In my sixties, however, I have slacked off. It certainly isn’t because my doctor lets me forget the necessity for monitoring this most stealthy of chronic illnesses. My gynecologist, Pat Allen, is more than proactive. She lovingly badgers her patients to follow up with diagnostic tests.
In the interest of full disclosure, I was a scofflaw. I thought I was home free after menopause. More than once Dr. Allen urged me to ask my internist to order an X-ray of the spine because a dark area had appeared on the bone densitometry evaluation of my spine. This could have meant a vertebral compression fracture.
I finally went for a current bone density test. This time, however, I knew enough to ask for an even more accurate test: a Vertebral Fracture Assessment (VFA), which requires an additional prescription. Richard Bockman, M.D., chief of the endocrine service at Hospital for Special Surgery (HSS) in New York, studied the printout and smiled. “Your hip has good bone density for your age,” he reported. “And look at the wrist!” He showed me on the colored graph that I am well above my age group in wrist strength.
The results confirmed the success of the three-pronged regimen I have chosen to follow for almost 20 years: Weight-bearing exercise for 30 minutes three times a week (I used to run; now I pedal on an elliptical machine with an incline, or walk briskly for 45 minutes in the park (or until my dog gets tired and flops). Once a week I grit my teeth through a full-body workout with a trainer who takes no prisoners, or I take an abs class from a brutal Navy Seal. Every day I swallow 1200 mg. of calcium with vitamin D and snack on yogurt. (A blood test can measure whether one needs additional Vitamin D.) I also use the lowest-dose estrogen patch recommended for bone loss, which has saved me from my mother’s painful osteoporosis. At this stage of my life, I have chosen to take the risks of prolonged hormone treatment to enjoy the benefits of mobility.
But what about my spine? “Your problem is not osteoporosis, it’s degenerative disc disease,” Dr. Bochman said. One of those gelatinous cushions between vertebrae has been wedged at one end and squished down to paper-thin. This can cause pain and sciatica. What to do about it?
Stretching exercises, pilates and yoga, and deep tissue massage, he recommended. The truth is, it’s after 65 that women must be the most vigilant. We continue to lose bone for the rest of our lives. So at 65, every woman — even those with no family history or other risk factors — should get a baseline bone density measurement. If a woman has experienced some months of aching back pain and had 1½ to 2 inches of height loss, she also needs a spine image to look for both osteoporosis and/or degenerative discs. Even better, get a Vertebral Fracture Assessment. But a woman has to know enough to ask for a VFA.
And that gets us back to the whole point:
Women need to talk to other women to share what we know and encourage one another to act. The Conversation is the key to prevention. Let’s talk.
Wulf H. Utian, M.D., founder of the North American Menopause Society, has recently published a small, well-organized manual for women who want information about menopause that is straightforward and easy to understand, with the fitting title, Change Your Menopause.
A decade ago, women worried less about menopause because many studies that were not rigorously designed supported the belief that hormone therapy would safely lower the risk of heart attack and osteoporosis, and would make it easier to manage the symptoms associated with the menopausal transition. That was before the Women’s Health Initiative (WHI) created a media firestorm that changed the way that doctors and women looked at their options for symptom management. Women now flock to anti-aging specialists who offer useless saliva and blood tests in order to design a special hormone cocktail for each woman that they promise will keep her sexy and youthful forever and will not cause breast or endometrial cancer, or increase the risk of blood clots, stroke, or heart attack .
In Change Your Menopause, Dr. Utian gives the reader the most basic and up-to-date information she needs to understand how the female body works before menopause, during the menopausal transition, and in the post-menopausal period. He uses the language of reason, not words that promote fear and anxiety, as he discusses the small number of symptoms that are proven to be associated with the time when ovarian function is unpredictable. He also provides a discussion of the impact of the permanent change in ovarian function that occurs after menstruation ceases.
Menopause affects many parts of a woman’s body: her cardiovascular system, fat distribution, bone health, temperature stability, sleep, and sexual function. Change Your Menopause outlines these and the steps that every woman should take as she faces menopause to determine her risk for diabetes and other chronic illnesses and to use this time to do everything that she can in order to prevent illness from becoming a part of her future.
There are easy-to-understand chapters on treatment options, including an extensive one about alternative therapies and a thorough, unbiased discussion of hormone therapy. Dr. Utian points out that each woman’s menopause is different and that each woman must choose, with information and guidance from her doctor, what is the most sensible plan for her.
This is an accessible book for women who want to know the basics of menopause and who recognize that if they are armed with information from a doctor, scientist, teacher, and leader in the field of menopause for over 40 years, they can create an individual plan for symptom management and disease prevention in the second half of their lives.
I have known Dr. Utian for 20 years and his voice is clear in this book. I worked with Gail Sheehy on the first book about menopause, the best-selling The Silent Passage, published in 1992. At that time Dr. Utian was kind enough to spend time with me so that The Silent Passage would contain the best management for menopause. He told me then and he tells readers in Change Your Menopause, “Menopause is not a disease. It is a phase of life. Use it as a wonderful opportunity to take stock, to concentrate on healthy living.”
Now he adds, “Then, get up and go. Change Your Menopause.”
On August 19, 2011, we published our 2,000th post. This was a big milestone for “the little website that could.” The site, Women’s Voices for Change, was created by a handful of women who first met for tea to discuss menopause and the ways that negative stereotypes of this word defined women over the age of 40. We committed ourselves to changing the perceptions that people have of menopausal women.
In 2005, partnering with the North American Menopause Society, Women’s Voices for Change created a happening, a big night out for women who were no strangers to coupled black tie events. But this one was different — the women were invited to come solo. The code we used was: “Black Tie, No Pants”.
|It was a gala like none other, an evening where fabulous women of style, intelligence and courage presented themselves in stunning gowns and their best jewelry to be the real face and voice of The New Menopause.|
|Liz Smith and the late Gov. Ann Richards were the hosts of the night and Bette Midler entertained.|
Gail Sheehy, our first Champion for Change, was honored for blazing the trail in The Silent Passage. She received a Steuben bowl designed by the artist Michele Oka Donor as well as Prada’s handbag of the moment.
To our numerous friends, writers and contributors, we say thank you again. We hope you will continue to take part in our conversations as we forge a new direction under the leadership of our first full-time editor, Maura Rhodes (right). Multifaceted and accomplished in the worlds of magazine and virtual journalism, Maura will be reaching out to readers to express themselves from far and wide and every corner of the nation. You’ll read more about her impressive experience and far-reaching vision in the weeks to come.
We are here for you and because of you. We march with you and are inspired by you. We need you to play a role as a reader, writer or both. We speak for you, yes, and we hope you will be inspired to speak here, too. We look forward to both being and hearing your voice in the days and years to come.
I’d like to add to Women’s Voices’ 9/11 remembrance this story of healing. All of us over 40 have experienced some natural disaster, together with personal catastrophes. It is all too easy to retreat inside and ruminate on our wounds, and to seek support or professional help to heal. That’s fine as far as it goes, but often, it does not go far enough. There is another way. That is by turning outward, and through compassion for others in the throes of loss, employing our skills and experience to help them through a dark passage.
I met Lt. Bill Keegan at Ground Zero, where I spent a good deal of time while researching and writing a book about the families, cops and firefighters who lost the greatest number of loved ones when the Towers went down: “Middletown, America: One Town’s Passage From Trauma to Hope.” He and the men and women on his team taught me a great deal about how to turn trauma into hope.
Irene has reminded us that when hurricanes, floods, earthquakes, tornadoes or fires unleash fickle fury, no man or woman is an island.
Let’s also remember what some of the bravest Americans did in the aftermath of another national trauma, on 9/11, and how it helped them heal emotionally and spiritually.
Bill Keegan is one of my heroes. A lieutenant with the Port Authority police, he stood on the vast crematorium at the World Trade Center on the night of Sept. 12, unable to think straight. He knew some of his ablest officers and best friends were lost in the voids below. How could he command men whose brothers and fathers were buried in there?
But when he saw cops running up on top of a seven-story mountain of fiery ruins to work with their hands, he knew what to do. “Awright, we’re gonna start small,” he shouted to men near him. “Clear this one little area. Get a board in here for a desk. Get bulldozers in here. Let’s just start.”
He set up a leadership tree with 300-400 volunteers, active and retired cops, women with staff jobs at Port Authority, and construction workers. His team bonded. They worked in shifts, every night, for the next nine months. I knew him as the beloved night commander of Ground Zero.
Only when it was all over did the workers begin falling apart. Money was not enough; church was not enough; drugs and drink didn’t help grief and guilt. Two years after their service on 9/11, Keegan knew he and his team all needed to get outside themselves.
“Hey, we may be the most experienced people dealing with catastrophic events. Why don’t we get together and do it again, on a voluntary basis?”
Fifty men who had worked on the pile with him jumped at the chance. They missed the camaraderie, the humor, the sense of humanity they had felt in using their skills to comfort others.
That core group trucked down to New Orleans in the immediate aftermath of Hurricane Katrina. “I have 50 people here who want to help rebuild the Ninth Ward so people can be back in their homes for Christmas,” Keegan told local authorities. Working with St. Bernard Parish, his team rebuilt 12 homes in six days.
Keegan found funding to launch a non-profit, H.E.A.R.T. 9/11 (Healing Emergency Aid Response Team). Since Katrina, H.E.A.R.T.’s 300 volunteers have responded 26 times to other disasters: the Gulf Coast, Nashville, Haiti. In the wake of Hurricane Irene, they have been all over Hoboken, Newark and Hudson County, N.J. They have learned a lesson that any one of us can follow.
We’re all now struggling against a man-made economic disaster. The longer people are unemployed, the less likely they are to continue looking for work. One way to push back against despair is to volunteer to help others in your community whose homes or businesses have been destroyed. It can be extremely empowering. You learn new skills. And we could all use some hands-on experience in drying out basements. Irene will surely have a sister.
Previously posted at USA Today.
This week the blogosphere gave us sharp portraits of family caregivers, a new power woman politico in Portland, Ore., brain-teasing art in New York and new reasons for women to dance as if no one’s watching.
- We’ve been curious about the new Talk to Me interactive exhibit at the Museum of Modern Art in New York since we learned about it. At The Blog That Ate Manhattan, Margaret Polaneczky, M.D., reports on a card game with the following premise: “If your DNA determines who you are, and defines both your strengths and limitations, then you could say we all live our lives with a pre-dealt deck of cards.” In the game, she writes, “Players send in swabs of saliva; the designers send it out to be analyzed and then generate a customized 50-card deck from each player’s specific DNA.” Click over to see the rest, and maybe you’ll be curious to experience it.
- We love it when women of substance enter electoral politics. Naomi at A Little Red Hen introduces us to Eileen Brady, a New Seasons executive now running for mayor of Portland, Ore. She notes that “earlier this month, one thousand people showed up at New Seasons to apply for positions in their new Beaverton store. A number of them were already employed but this employer is known for providing great health benefits, good wages, opportunities for growth — and a very positive work environment. That shows and, aside from the great produce and environmentally conscious food choices — we always feel it’s almost our neighborhood store. Even though we have to cross the Willamette River to reach their Seven Corners store. It’s a great place to snap photos as I did HERE in 2009 — if the very polite manager does not catch you!” Naomi adds: “It would be wonderful if Portland, Oregon, had another woman mayor in sync with the 2012 centennial of woman suffrage in Oregon. She would not be the first. Dorothy McCullough Lee, who served from 1949-53, was described by a historian as, “more qualified by experience and training to serve … than anyone in Portland’s previous history.”
- WVFC godmother Gail Sheehy and writer Susan Baida might be interested in this week’s series at Forbes Woman about the challenges of caring for an impaired family member. “Caregivers take on several unpaid jobs they never applied for — chauffeur, financial adviser, personal care attendant, nurse. They spend hours in relatives’ homes and at doctors’ offices. Caregivers often report real satisfaction in knowing that Dad is eating right or that Grandma has her medicine. But they also report high levels of stress, financial difficulties and health problems. In this special series from News21, five families describe the worries and rewards of long-term care.” The result is a mix of cogent information, video interviews and sharp writing. Go look.
- This spring and summer have featured tons of headlines about women and war, including a special summer issue of On the Issues Magazine. The latter features a trenchant media commentary from Prof. Kathleen Barry, author of the new Unmaking War, Remaking Men: How Empathy Can Reshape Our Politics, Our Soldiers and Ourselves. In looking at war crimes, she writes, “I saw the rage of blinding macho that is not unfamiliar to women who are victims of male violence. It does not matter whether or whether not a woman is ‘guilty’ of the charges he hurls, or if a woman ‘provoked’ a man to rape her, as men claim, or if a person was merely riding in a taxi. When the world of blinding macho is unleashed, devastation follows.” But, she adds, women are helping change the landscape: “Empathy for those who are at the other end of U.S. guns and for those reduced to killing machines by the US military can engage us with a new consciousness in which the old masculinity of violence against women and in war is no longer possible. That kind of empathy in all of us makes war personally intolerable and will give rise to new political action. For feminists, those kind of connections are already embedded in our politics,” Barry asserts. We can’t wait to see the book.
- Sometimes, you just gotta dance, WVFC’s Alex MacAaron reminds us at her blog Lovin’ the Alien. MacAaron’s essay pirhouettes from the preschool twirling of her daughter (the “alien” of the blog title) to her own youthful dance studies to a motherhood-induced break to her own recent discovery of Zumba and Nia dance-exercise classes. Nia’s “combination of eastern martial arts and modern dance is also a tremendous workout. But, the emphasis is on the joy of movement and on listening to and honoring your individual body,” MacAaron writes. “While I’m often one of the oldest women in my Zumba class, Nia tends to attract a more mature crowd. There are women of every shape and size and we are all there to ‘dance as if no one is watching.’” After reading her blog and looking at the video below, we’re tempted to sign up — or at least to dance around the house more.
Last year, we were thrilled to inaugurate our annual celebration of WVFC writers, which compiled all the books and authors we’d covered into an easy-to-use holiday shopping list— one for poetry and one for prose. This year, we’re doing the same. Some of the authors, like Gail Sheehy and Dominique Browning, we’ve gotten to know well in interviews and commentaries; others’ books have inspired reviews here for multiple reasons. Some are light ovelsn, some sober histories, some feminist manifestos. And this time, in honor of WVFC’s 5th anniversary, we’re also throwing in a few blasts from the past — new books by authors we featured from 2006-2008. The total would have made for lists far too long to post here, but we hope you explore our Books archives to find more writers we’ve reviewed, interviewed, and whose awards we’ve celebrated over the past five years.
|Pat Benatar, Between a Heart and a Rock Place
|Lloyd Boston, The Style Checklist|
|Dominique Browning’s Slow Love is actually dedicated to WVFC’s Dr. Pat Allen. The year we launched, Dr. Allen also tipped us off to Amy Bloom’s talent, long before Bloom’s new novel Where the God of Love Hangs Out.
| Gail Caldwell, Let’s Take the Long Way Home
Judy Collins, Over the Rainbow
| Roz Chast‘s newest book is the children’s collection Too Busy Marco.
|Edwidge Danticat opened our 2010 with news from Haiti; her new book is Create Dangerously: The Immigrant Artist at Work.|
|Fannie Flagg, I Still Dream About You
| John Fowles. The Tree
|Jaimy Gordon, Lord of Misrule|
|Nicole Hollander, The Sylvia Chronicles
|Virginia Ironside, You’re Old, I’m Old . . . Get Used to It!: Twenty Reasons Why Growing Old Is Great In 2007, we applauded Ironside’s No! I Don’t Want to Join a Book Club: Diary of a Sixtieth Year. In the new book–Ironside’s first published in the U.S.–the author “is determined to convince people that getting old is not so bad–even for a Baby Boomer who interviewed the Rolling Stones and Jimi Hendrix early in her career.|
|Judith Jones, The Pleasure of Cooking for One
|Maira Kalman, And the Pursuit of Happiness|
|Judy Richardson and Dorothy Zellner, Hands on the Freedom Plow: Personal Accounts by Women in SNCC|
| Judy Shepard, The Meaning of Matthew: My Son’s Murder in Laramie, and a World Transformed
Cathleen Schine, The Three Weissmans of Westport
Gail Sheehy, Passages in Caregiving
|Rebecca Skloot, The Immortal Life of Henrietta Lacks|
|Rebecca Traister, Big Girls Don’t Cry: The Election That Changed Everything for American Women
|Mary Walton, A Woman’s Crusade: Alice Paul and the Battle for the Ballot|
|Lis Wiehl and April Henry, Hand of Fate: A Triple Threat Novel. In 2007, we cheered attorney Wiehl’s manifesto The 51% Minority: How Women Still Are Not Equal and What You Can Do About It, Since then, Wiehl has teamed up with coauthor Henry for the best-selling Triple Threat series of legal thrillers. Publishers Weekly wrote of this latest installment in the series, out just in time for holiday sales: “Readers will identify with these very real women.”|
Let us know what books you think we should add to our lists. And check back on Friday for the Poetry Edition, to scoop up all our Voices in Verse.
Who says that it’s just one person in your immediate circle who will be needing intensive caregiving? For Felicitas Rocha, the strains of caregiving multiplied when, in addition to caring for her husband for five years, she had to start caring for her mother, who had broken her hip.
“She got to a cliff, with her mother and husband both competing for her care,” says Gail Sheehy, who interviewed Rocha for her book, Passages in Caregiving. “What was key”—to Rocha’s survival and sanity—“was that she stayed with a frustrating but ultimately productive search for a care manager.”
In Sheehy’s view, “A care manager is deliverance for the caregiver.” Rocha found one through her insurance company and through Evercare, which has a program called Solutions for Caregivers. And even though the care manager was thousands of miles from Rocha’s Southern California home, the company was able to find help for Rocha in her own community. “They also found out what she was entitled to as part of her insurance,” says Sheehy. “Forty hours a year of home-care aides for her husband, her mother, and herself. Each of them was entitled to 40 hours a year of home-care aides, of whatever kind they needed, and they could use in whichever way they wanted. Felicitas could take a week’s vacation or they could spread it out over each week.”
“Boomerang” is the term that Gail Sheehy uses to describe a phase in the caregiving process where, once you’ve figured out how to manage the new reality of caring for a loved one, things change again. That’s what happened to the Heaths.
For two years, Sheehy says, “Dad had been happy to take care of mom after she fell and became wheelchair bound. But then he fell and began showing signs of cognitive decline, so now they both needed help.”
With a demanding work schedule, the Heaths’ son David said he couldn’t possibly be the caregiver. “So it fell to Bonnie, the daughter-in-law,” says Sheehy. “But she worked as substitute teacher, and they had two teenagers at home. They were the classic sandwich-generation family.”
Within nine months, Bonnie had reached the stage of ‘I can’t do this anymore’—a quick turnaround, says Sheehy, as “most caregivers don’t get there for two or three years. They don’t allow themselves to get there.” Fortunately, the Heaths were connected to a progressive continuing-care community, where, says Sheehy, “they have people come in for a full geriatric assessment before they need to go to the nursing home. Once they did that, the geriatrician said, ‘You have to call a family meeting, and the professionals will give everybody in the family, including the two parents, the same information at the same time.’”
The staff assessment didn’t paint a pretty picture. “’Mom hasn’t been out of the house for nine months except when Bonnie takes her, and she’s fallen into depression. Dad has moderate-to-severe cognitive impairment,’” the family was told. “Once everybody heard that,” says Sheehy, “and the parents heard it and couldn’t deny their situation anymore, then everybody became activated.”
As Sheehy sees it, “the lesson of the Heath family is: When you have a family meeting with the person or people who are sick, be sure there’s a neutral moderator, a health professional, who lets everyone know what the situation is at the same time. Nobody can sit on the fence or argue, or tell you that you don’t know what you’re doing, which often happens with sisters and brothers.”
In her book Passages in Caregiving, Gail Sheehy profiles the Colberts, a family of seven siblings devoted to caring for their aging mother. As their story shows, when it comes to caregiving, it sometimes takes a few tries to find the best solution.
“Harriet, the oldest sister—unmarried, with no children—assumed the whole burden of care for their mother the year after she’d been widowed,” says Sheehy. “But she neglected to recognize that she was also working 50 to 60 hours a week.” Unfortunately, all the siblings were putting in the same kind of work hours. So she fell into what Sheehy calls “playing God”—shorthand for a caregiver making herself indispensable to the loved one and thinking that she alone can ‘save’ that person. “After a year and a half, she got sick—but the mother was failing, too. She stopped eating and wouldn’t get out of bed.”
Harriet had to take her mother to the hospital, where she was diagnosed with ‘failure to thrive’—“really the worst diagnosis to get,” notes Sheehy, “because they [the medical establishment] give up on you when you’re that way.” Once their mother was discharged, Harriet’s sister Lisa joined in the caringiving, but the strain started to tell on her, too. “She began to fall apart and neglect her children,” says Sheehy. “So they let everyone know via email that they were going to have to put mom into a nursing home.”
That galvanized the family into action. “It got the attention of the brother, Louis, who was a professional social worker in charge of an aging agency, but who had never thought of himself as being a caregiver,” says Sheehy, as well as the other brothers and sisters.
They held a family meeting and systematically asked each person: What can you contribute? “The one who’s out of work can’t contribute money but has a little more time,” says Sheehy. “The one who has a little more money can throw a little more into the pot. What I thought was a great idea was that they all decided that if they gave up potato chips they could each put $20 a week into the pot and hire a neighbor to cover the holes [in the caregiving schedule] when none of them was available.”
For Sheehy, what happened to the Colberts is “a perfect example of how the primary caregiver has to get the concept that you alone are not marked for this role. Other members of the family need to be involved, and you need to know that you can and should ask them.” From a situation where one overtaxed sister was “playing God, with mom falling into depression and ‘failure to thrive,’” Sheehy says, the family moved to a solution where responsibilities are more equally shared. “Everybody is much closer, and much happier,” she says, “including the mother, who came back completely.”
The WVFC summer-long Special Focus on Caregiving continues with Part Three of a three-part interview with Gail Sheehy, author of the new book Passages in Caregiving: Turning Chaos into Confidence. Here, Gail gives some examples of caregiving pitfalls, and how friends can help.
Let’s take a closer look at women as caregivers, and the sort of turns that the journey can take for them.
What so often happens is, the woman in the family will move in with Mom or Dad for a temporary period of time—she thought. But then it isn’t temporary. Or she’ll move Mom and Dad in with her family, which may or may not work out because her husband and children may feel quite neglected. When it really gets tough is when when a woman becomes a seasoned caregiver and is really good at it, and the person being cared for says, ‘It’s only Bonnie who can move me from my wheelchair to the car,’ or ‘I depend on Joan, she’s my eyes and ears, I couldn’t do it without her.’
It becomes a co-dependent relationship, where the cared-for person believes that their survival depends on this one person, and the caregiver often begins to believe that he or she is saving this person day by day. That’s why I call it Playing God. It’s quite—one feels extremely important and necessary. But the problem is that this is where caregivers tend to get isolated, stop taking care of themselves, stop calling friends, and friends stop calling them because they’re not available. They gradually become depressed, and depression is an illness, and when the caregiver gets ill, you’ve got two people who are going to need care.
So my main mission when I talk about this is to say: Once you get to the second crisis, The Boomerang, this is the time when you really have to reach out to the rest of the family, who may not have been involved because you took it on. Even if they’re long- distance, there are very important ways that other relatives can help.
And there are now technological devices that make it much easier, starting with Skype and different versions of an old–fashioned answering machine, where you can leave messages. Or an email machine that doesn’t need a computer. I think one of the best ways to bring other people in is to have an online calendar that actually shows the calendar of the person who needs care: when they have their doctors’ appointments, when they’re free, when their caregiver has to go away for a conference, or a business trip, or to see a new grandchild. And the accompanying email says, Here are some times when it would be really important for you to visit.
It starts with the caregiver saying, I have a right to ask for this. I deserve to get help for this very important role. That’s where it starts. You yourself—the caregiver—may not want to ask. But your best friend can ask for you. Your best friends can send out the emails and ask for you.
What are some other ways that friends can help a caregiver?
I’ll tell you about a practical thing that we did for one friend with an incurable, irreversible illness. Friends of hers on the East Coast wanted to be helpful to her and her caregiver—her husband—on West Coast. The West Coast friends found a place that makes and delivers food. We all took a week and among us provided something like three months’ delivery of dinner. So her husband wouldn’t have to do that instead of being able to sit down and watch television with her and talk with her and be with her. And that felt really good. And then when that wasn’t necessary any more, we shared the cost of one, two, or three physical therapy treatments at home. If you’re in a position to do it, you can help with expenses like that.
That means you stay in touch with the person, so there’s social stimulation there. And the caregiver is not just waking up every morning thinking, How do I get through this day, with all the things I need to get done, and all the things I need to do to keep myself working and providing for us. Because now it’s just one of you earning for the household.
That brings up the whole financial dimension.
The financial dimension is huge, absolutely huge. Very punishing. Very often I hear about caregivers who have to give up their home because they’re paying for aides to come in and they just can’t afford that, too. And then eventually move the parent in with them to an even smaller space. It becomes very difficult.
So I say, keep your job if it’s humanly possible, because you will need your financial security after this role is over. You’ll need your health insurance, you’ll need your Social Security quarters, you’ll need the social stimulation while you’re going through the caregiving role—in the sense that you have another life, with some meaning, some importance, some productivity. And actually, half of family caregivers do work full time. It’s kind of amazing, but it’s necessary.
If you could boil it down to a phrase or sentence, what’s the message you’d like readers to take away from Passages in Caregiving?
Being a caregiver for a parent or spouse is one of the most universal and least understood passages in our lives. It is also going to be one of the most memorable in coloring the way you think about yourself as a good person. You can make it a gift, or more of a challenge, or you can hide your head in the sand and be left with a residue of guilt. What I try to do in my book is walk you through the journey, so you can see how many different phases it has and prepare yourself for a marathon and learn how to develop a circle of care.
Over the next weeks, we’ll be running videos of Gail talking with caregivers and their families, with introductions prepared by Gail and the WVFC editors.
Caregiving has undoubtedly become a cultural phenomenon. With 65 million caregivers in the U.S. and an aging population expected to double in size by 2030, caring for a loved one is no longer the silent passage socially assigned to a minority of women. As seniors live into their 80s and 90s and the pool of healthcare service providers shrinks, the vast majority of us will be faced with the task of caring for a loved one.
Who better to illuminate us on this major life passage than Gail Sheehy, renowned author of best sellers including Passages and Menopause: The Silent Passage? Her new book, Passages in Caregiving, is an inspirational guide on this journey. Sheehy breaks it wide open and brilliantly sheds light on an experience that many of us anticipate as daunting, unpredictable, and stressful. Whether family caregivers are shocked into the role with “The Call” or are simply preparing for the inevitable future, they’ll find Sheehy’s book to be a valuable guide through what she calls “significant changes in the condition of our loved one that demand new coping strategies.”
Unlike childhood development with its universal developmental milestones, the aging process is incredibly diverse and unique to each individual. As co-founder of a website for caregivers, I’ve often contemplated how challenging it is to address such a wide range of needs and health issues among the elderly or chronically ill and their caregivers. Yet difficult as it may seem, Sheehy guides us through this massive landscape—a symbolic labyrinth—and defines eight critical turning points in the caregiving journey. As a caregiver for my late grandmother and father-in-law, I easily recognized each of these stages but hadn’t realized their universality. The eight turnings, Sheehy says, help caregivers “identify universal patterns in the chaos and give the journey a form that makes sense.”
Sheehy is an expert on the subject, having been for 17 years a caregiver for her husband, Clay Felker—the legendary editor and founder of New York magazine—who suffered a long battle with throat cancer. In Passages in Caregiving, Sheehy reveals each step of her personal journey, recounting how her husband underwent successful treatment, only for the two of them to be blindsided by “recurrence,” which she calls “the cruelest word in the English language.” Her story is poignantly interwoven into the book, along with stories and strategies of 30 other families and individuals, including “Today Show” host Meredith Vieira and Supreme Court Justice Sandra Day O’Connor.
For the silent caregivers out there, Sheehy does groundbreaking work in defining specific categories of caregiving—another way of showing how universal these all-too-isolating roles really are. She identifies five typical caregiver profiles, incorporating them into the stories that illustrate the different turnings.
Unlike many books that focus on the negative experiences of caregiving, with lessons learned from tragedies or mistakes, Sheehy makes a point of empowering caregivers and helping us see this journey as a potentially transformative experience. Each chapter is full of helpful lessons, advice, and a wealth of information resources. Sheehy focuses on success stories and strategies that have actually worked for families and individuals, and points out that the book is “aimed to help caregivers take charge.”
Those success stories include the Colberts, a family of seven siblings in Philadelphia, and how they came together to build a “circle of care” for their 84-year-old mother, diagnosed with Parkinson’s disease and diabetes. Another family, the Heaths, found a way to work together through crucial family meetings led by a neutral facilitator, and the guidance of a geriatrician who helped them create a “life management plan.” Other stories emphasize the importance of connecting with fellow caregivers and caring for one’s own wellbeing.
For me personally, the hardest sections to read were the last two turnings: The “In-Between Stage” and “The Long Goodbye.” Sheehy shares intimate details of her feelings through the arduous and painful stages of her husband’s last years as he suffered through chronic infections and hospitalizations. She enlightens us on the complications of our healthcare system while helping us deal with the phase between ‘no cure’ and death. She describes the challenges of Medicare not paying for home care, the system’s lack of support for palliative care, and the six-month deadline in hospice care.
If there’s anything missing from the book in terms of financial aspects of care, it’s a full discussion about long-term care insurance and the sense of denial most families experience on this topic. Long-term care insurance can cover a significant portion of expenses for an assisted living facility or home care that are not covered by Medicare.
Sheehy ends with a hopeful chapter about the future of aging in “Who Will Take Care of Us?” I was thrilled to learn about “The Village Movement,” an innovative concept that Sheehy calls “Sustainable Aging.” The idea is that these communities enter into a pact to support one other when in need, which empowers adults to remain in their own homes to the end of their lives.
While the act of caregiving is not new, the sheer number of baby boomers becoming caregivers is an unprecedented phenomenon. In that sense, the world of caregiving is a new frontier. As she has done before, Sheehy breaks new ground by revealing the once-isolated world of caregiving, equipping caregivers with information to better address their loved one’s needs as well as their own. The question, as Sheehy states, “is not if you will be called to act as a family caregiver . . . but how you will respond.”
Look Sunday for the second installment of Susan Delson’s interview with Sheehy, which explores far more deeply how this journey has affected the author and her family.
The WVFC Special Focus on Caregiving launches with Part One of a three-part interview with Gail Sheehy, author of the new book Passages in Caregiving: Turning Chaos into Confidence. Here, Gail talks about how the book came about.
We understand that the inspiration for the book was your own experience as longtime caregiver for your husband, magazine editor Clay Felker. But how and when did the book itself begin?
I always write books to understand what I’m living through, if it seems to have a universality. So it had to be in my mind in the last, oh, six months of my husband’s life. He died two years ago in July. So I outlined it for a whole summer. And then I couldn’t write one word until January of 2009.
But I had been interviewing and making videos in the year before that, because I was the AARP Caregiving Ambassador all through 2009. I’d been doing the filming in 2008. Within a month after my husband died, I had to be on the road interviewing people. That kept the pain of loss at some distance. It also was a very absorbing process. It was a good way to spend the first six months of mourning, but it didn’t start the grieving process.
The grieving process started when I started writing the book and going over my journals. I had kept journals throughout most of the journey, really just to remind myself where I’d been and to try to keep myself on track as to where I was going. A lot of people do that. It’s very helpful. It’s so easy to get lost.
Aside from your own experience, what sort of research did you do? How long did it take?
I actually started it three years ago. I had a website up, and I had an interactive video questionnaire for caregivers. All the questions were laid out, and they could just type in their answers right on my website. I got over 3,000 responses. I called and talked over the phone to probably about 150 of those people, and read the other ones. That was the basic research. In all, including the AARP research, I interviewed in person about 150 people.
When I started with AARP, I called a lot of the people who had sent in their stories. We selected four cities. First, I made a trip to each city to interview about a half a dozen people and select one or two we could film there.
Even now I have a questionnaire on my website. Because people really do like to tell their stories.
What was that like for you, connecting with other caregivers and hearing their stories?
It was very helpful. As I think it is helpful for everybody to share stories. Because the biggest enemy is feeling alone, and then being alone. Being in isolation. And that was the number one… I wouldn’t even say complaint, because people just thought that’s what they had to do. And when people connect with other caregivers, by talking to one or going to a Powerful Tools for Caregivers course, or going online and finding that there are websites, or social media out there—then it’s part of life, and it normalizes it. You’re not alone. And the most generous people and the best supporters are other experienced caregivers. They want to help, they want to pass it on. And they can take an awful lot of the fear out of the process.
Could you talk a little about women as caregivers, and why this book is particularly important for our readers?
Most women say that don’t see themselves as caregivers—that is, playing a professional-level role. They will often say to me, well that’s just what we do as daughters, just what you do as a wife. And particularly women who are past menopause, or in it, are just expected to move on to caregiving for whoever in the family gets sick first or complains the loudest. And often to take care of in-laws.
You know, there’s nothing inherently wrong with that. Because caregiving is actually quite a privilege, and many people find that it is a time when they are most intimate with a family member—even one who they might have been distant from for a while, or estranged from. But the real danger is that they believe they are the only ones to do it. That they have to take it all on.
Next: The Labyrinth, Deep Breathing, and the Eight Stages of the Caregiving Process.