Center for Scientific Studies

Review of "Caring for Mother: A Daughter’s Long Goodbye"

by Carol H. Weaver, Ph.D., Associate Professor of Biology

January 21, 2008 - It had been almost a year since Mother died when I spotted this book in the Union library. The title instantly caught my attention; I knew a little something about caring for a mother since my mother had been ill for six years herself. As a biologist interested in the molecular mechanisms of aging, I thought the book might shed light on those aspects of aging that cannot be scientifically measured. The book promised that it could be helpful to those who had recently become caregivers, but I found that it also appealed to quite a different audience: those who had been down the same long road and who needed someone to put into words the meanderings of that journey.

As with the author, it all started with a call from Mother. In our case, there was a combination of problems to report. Mother was not feeling well but could not go to her regular doctor in Union City; she had just been informed by a letter she felt was very impersonal that her doctor was retiring and turning his patients over to someone she did not know. My sister, who lives two states away, agreed we should find Mother a physician closer to me in Jackson so that I could be with her whenever she had an appointment without my losing any time at work. Little did we know that that arrangement would be the rule of the next six years. Ms. Owens found that she had to move back to her hometown to take care of her mother; I had anticipated this task four years earlier and had already made the move home. My sister had a different role, that of being on the road constantly. Reading into the beginning of the book, I was struck with memories that were near replicas of what Ms. Owens had experienced. For example, I instantly recognized this advice: “We need to think of this (caregiving) not just as a sacrifice or a duty. This is the work you’re doing now. It’s your calling for the present. Your vocation.” Ms. Owens juggled appointments with twelve different doctors; soon I was doing the same. And like Ms. Owens, I became “something of an expert on physician culture.” Like Ms. Owens’ mother, mine was not assertive and I had to be her advocate, evaluating comments and treatments and speaking up when she would not. Many were the times she would shush me, not wanting to be a problem. After all, aren’t physicians all always right? Godlike? In spite of her wishes, my advocacy sometimes took more of the form of being in the face of health professionals who did not treat Mother with the respect she deserved and I demanded. One nurse practitioner kept her waiting for more than an hour, only breezing in, white coat flapping, after I went to find her. According to this nurse, another more important case had taken up the time. And then she wanted my frail mother to strip all clothing off and “jump up on the table.” All this for a cursory look at her ears and throat! I did not let this sort of thing happen again, ever. Ms. Owens said it like this: “In this long, slow dance with my mother’s medicine men, I have been anxious about usurping her prerogatives. I want her doctors to speak directly to her. I want to stay in the background, supplying information when it is needed, taking note of instructions the doctors give her. I want, in other words, for her to be treated like a person and not the mere object of scientific inquiry.” But, once handed the job, I made very sure Mother received the best care and consideration possible.

Ms. Owens follows her mother’s journey to death, outlining the sadness, the guilt, the suffering of both mother and daughter. One does not know just how long the journey will be and that very unknowing makes the journey all the more arduous. The descriptions of the journey paralleled in many ways the journey my mother took. As I read, many statements popped out, letting me know that my experience was not unique but was rather common for the genre. After the fact, nearly that year in fact, I found it was time to reflect and learn that though a particular journey has its own uniqueness, it is also very similar to that of others. For me, as for Ms. Owens, the normal and natural mother-daughter relationship shifts as the journey progresses. The mother who has been strong, a steel magnolia, is no longer able to drive. The savvy businesswoman cannot sign her own checks. Housekeeping and cooking, legend at least to the family, is beyond her. The mother who remembers every birthday forgets mine.

Perhaps the most difficult passage to read, but the closest to my own experience, was Ms. Owens’ narrative of the nursing home to which her mother eventually had to go. Her mother called the other residents “inmates” and refused to become involved with them. She hated to eat in the dining room. She was fearful at night because aides would not answer her call. She did not want her daughter ever to leave. “Everyone has heard nursing home horror stories. My mother’s unhappiness no doubt made us extra vigilant about her care…We were on the alert for any sign of mistreatment or neglect. At the same time, we needed to develop a good relationship with the staff – especially the aides who had the most contact with the residents – if my mother was to get the best care there.” Anger was the predominant emotion in the nursing home that housed Ms. Owens’ mother; I think bewilderment figures even more prominently where Mother was.

Unlike Ms. Owens’ mother, my mother only briefly resided in a nursing home. Unbelievably, Mother’s myriad doctors missed the little fact of her not taking in enough oxygen. She began to fade away, was unresponsive, could not walk, and we did not know why. In a panic, we thought taking her to a nursing home would get her some help. Ironically, the ambulance attendants, coming to pick Mother up, did the usual vitals and found the oxygen problem. Given oxygen, Mother began to perk back up. After a few weeks in the nursing home, having been put on oxygen permanently and learning from her physical therapists how to walk, feed herself, and begin to function again, we brought her home. The lessons of the nursing home were many: my sister and I did not dare leave Mother alone there for long because we did not trust the aides to take care of her. The reason for going to the nursing home was to get help, and other than that provided by the physical therapists, this was a very small part of the bargain for Mother’s nursing home. Ms. Owens’ mother eventually died in the nursing home; at least Mother was in her own bedroom surrounded by people wanting to take care of her when she went into the presence of Jesus.

Like most biologists, I am completely aware of the cycle of life and know how human life ends. I know the progression of aging and illness; I understand the scientific side of life. Coping with the emotional side is entirely different and this book helps put events into perspective. Ms. Owens describes in an extremely readable story the challenges that occurred to her but that we had thought were ours alone. In some way, hearing of another’s similar journey helps make one’s own comprehensible. The author puts together “nuggets that are a bit more practical and may answer more immediate needs.” One in particular is: “The only one you can always rely on to listen to you and understand is the Spirit of God. And sometimes you’re mad at him.”

Making this book even more personal, Ms. Owens said, “Caring for my mother has, as you might expect, changed both my perception of my own aging body and the rounding off of my life... Thinking about how I want to spend my remaining life, I appreciate the literalness of that verb ‘spend’ as my capital dwindles and depreciates.”

This book is not for the faint of heart. It hurts to read some parts of it, but it helps to read other passages. For me, it helped pull the long goodbye into a logical and orderly sequence of events, events that probably everyone who becomes a caregiver can identify and define. And while the goodbye still has to be said, and maybe for many has already been said, it is indeed a part of the even longer journey of a life fully lived.