Choices in The Sandwich Generation

Mom wakes, again, after nearly 30 minutes of sleep. She is groggy. She scowls, and looks at me, almost with a look of annoyance. “Where am I?’ she asks.

“Mom, you’re in the hospital,” I tell her with as much gentleness as I can manage after answering the question multiple times.

“What?! Why am I in the hospital?”

I tell her she has been having trouble breathing and that is why she has the oxygen tube in her nose. She is cranky. She jerks her head from side to side and scratches her head. “Where’s Charlie?”

There it is. Where is Charlie. The love of her life.  My Dad.  My Dad who died not 3 weeks ago.  She doesn’t remember.  I’ve had to tell her now too many times.  How do I keep breaking her heart? Am I doing the right thing in telling her?  I’ve been asking myself that one too many times, as well.

“Mom…” She can tell by my voice, I think because she looks at me with sad eyes. “He’s dead?” She asks in a whisper. “He’s dead,” she says again with knowing despair. She weeps silently; hangs her head.

We are in the hospital because she has pleural effusion. Fluid has built up in the space between the lung tissue and the chest cavity. It functions a lot like pneumonia, which we all thought she had developed somehow because that would have been easier. That could have been solved, cured. She is easily out of breath. She can’t do those things she loves the most like taking a nice walk, going to church with my family.

 Yesterday morning, I arrived at her home, a lovely place that provides assisted living supports, memory care and some nursing, to take her to church with my family. She wasn’t up to it. I recall going into the small room where the nurse on duty takes temps and BPs and dispenses meds. Hands on the arms of the chair for support, a quiet look on her face, she barely smiled as if that natural gesture of hers were even too much effort. She is pale and the dark circles under her eyes seem to weigh down her whole face. The nurses were concerned. She was far more lethargic than before. They pulled me aside and told me she probably needed to go to the ER. We go and she is admitted.

After hours in the ER we learn it is Pleural Effusion. They want to admit her and drain the fluid the next morning. They will insert a needle into the pleural area and draw out the fluid. They can tell from the fluid what is causing the problem. She will be sedated lightly. It isn’t supposed to hurt, but she has to be still. I don’t know if she can do it given her Alzheimer’s and grief state. When I take her to her room the nurses ask me if I will stay with her. I hadn’t thought of that. Why hadn’t I thought of that? But of course, with her Alzheimer’s and confusion, she will orient to me more readily than changing shifts of nurses no matter how compassionate they may be. I call my husband and he brings me a change of clothing and my computer. I email my work and let them know I am out again and I am not sure how long. Then the panic sets in. It is early Monday morning and we are supposed to fly out on Wednesday. My oldest child, my son, is off to college and I want desperately to go. I feel I have to go. But my mother is in the hospital, confused, frightened, anxious, grieving. This is the dilemma I have most feared. The one I have successfully avoided for 10 years.

Is this what Solomon felt like? No winning decision here.

These choices are the heart of the struggle of the Sandwich Generation. The squeeze between parent and child; YOUR parent and YOUR child. In many ways Americans have moved away from the multigenerational living situations of the past, or which are still prevalent in other societies. Certainly there are families that still live close together in the same area, but in America, children often move away and we have become a very mobile society.  In 2007, using various metrics related to population and age, the US Census Bureau estimated that typical Americans will move over 11 times in their lifetime.  Technology, low cost airfare and other factors related to ease of mobility have meant families can often see each other or talk to each other frequently, but end of life issues for aging parents presents a significant dilemma for many families.  Who gets Mom and Dad? Add to that the considerations families make about where to live to raise their children, where adults find affordable living and decent wages, and the calculus gets trickier still.

In case you are wondering – I am so grateful that I was able to call my sister, in tears, and ask for help.  She and her daughters had visited earlier in the summer to visit my parents while my husband and I took a much needed vacation.  Thankfully they were able to be there while my Dad was still alive.  But now, a month later, she was able to come out again, from Montana, and be with my Mom and my daughter while my husband and I took our son to college.  My sister-in-law also came up to stay with them to give added support to my daughter who was a sophomore in high school.  My aunt and uncle, who were very close to both my parents (my Dad’s brother and his wife) also made time to visit during this time.  Basically, I rallied people I could to come be with my Mom and my daughter.  So for less than one week, my Mom had loved ones to comfort her and care for her.  My daughter, who was extremely close to my Mom, had support while starting back to school. I am blessed to have family who could and would do this for us.  That is not always the case.  Those are the stories I hear time and again, and why I feel a passion to shine a light on this trend.

Have you experienced this? How has your family had to change to cope? How did your family make the decision?  I’d like to hear from you.  Thanks for sharing.