The Foxwoods Dilemma
Back in early April, I had a few days of freedom before starting my new job. Yes, I admit that I took one of those days to sit on the couch and re-watch the Usual Suspects for the eight hundredth time. For another of those days, I put together what I thought had been a masterful plan to get my father out of his Framingham apartment and take him to Foxwoods.
My parents were once minor-league VIPs at Atlantic City mainstays Hilton and Caesar’s. On a Friday afternoon, their friendly “host” would call them, invite them to a show, offer them a free room and vouchers for expensive restaurants (where of course no one actually paid, thereby making the price a fiction), and plan to meet them for dinner. These 2 people became like surrogate children to them while my brother and I were off living our lives far away. Looking back on it now, I wonder if having this on-demand contact with someone who doted on them wasn’t a big part of what they were buying. Because, trust me, they were buying it. I finally saw their tax returns after my mother died and I know how much money disappeared into the slot machines along Atlantic Avenue.
In the summer of 2012, a year after I’d seen those 1040s and realized why my father’s savings weren’t what they might otherwise have been, I went to visit him in Lawrenceville. I had just sold off a business that had really been struggling after sticking with it longer than any reasonable person would (although remember, I am an entrepreneur). Which is to say, I was relieved, exhausted, proud, sad, and hopeful all at the same time. Even though I had railed against the casinos many times, my father suggested, and I agreed, that we should visit Revel, which had just opened up. Into the car we climbed and off we went.
Watching my otherwise frugal father stuff $100 bills into slot machines was quite a shock to the system. So was seeing his incontinence on such stark display; the less said about that, the better. On the other hand, something about the lure of the gaming floor re-energized him and set back the clock 20 years, especially for his walking. We had a great dinner together that was a prelude to some of the meals we have now. He was proud: in his element, still living in the house he was convinced he could take care of, and educating his son over french fries about the systems for how to beat the slot machines. Revel is gone now, as are many of Atlantic City’s casinos, victims in part of the demographic shift as my parents’ generation stopped visiting and younger gamblers never came to take their place.
So six months ago, sitting on the couch watching Kaiser Soze emerge from the police station and climb into Kobayashi’s BMW, I looked forward to our Foxwoods trip as an adventure and a chance for my father to reclaim how he felt that day. I also used it as a prop to get him to walk more and, most importantly, be ready for a long day where bathrooms would be inaccessible.
However, when I showed up to his place, he was totally unprepared. And when I say unprepared, I mean he’d had an accident and nothing to protect his jeans from the result of it. For some reason, when I suggested he change his pants, he refused, and did so as if the situation we now found ourselves in was my fault. Trying to deflect blame back to me, he blurted out “You didn’t send me an email telling me when you were coming.” HIs suggesting that I am irresponsible is a classic manuever I remember well from childhood, so when I showed him on his iPad exactly when I had sent it, I was overcome by a wave of fury unique to adults whose parents to try undercut them in the same way they did decades ago.
I demanded he put on clean pants. He refused and dug in. I calmed down somewhat and reasoned that the problem might be that it was too much work to change his pants, so I offered to help him. He still refused. So, rather than spend my day trying to argue with him further, I called off the trip, and left.
So here I am six months later. Things have improved to the point where now when I show up, he is never, ever unprepared. He makes a point of wearing not just underwear, but adult diapers that prevent the kind of unfortunate accidents that I saw that morning back in April. This might seem like a needlessly intimate detail to share on a blog, and maybe it is. My point is that this is his small way of showing respect, and I appreciate it so much. I know that getting older inevitably comes with the body’s decline, and acknowledging this is probably accompanied by a loss of dignity. I am not going through this to the level he is, although middle age is where it starts to kick in (see: nighttime bathroom trips). So for him to do that, week after week, is a small gesture that I think speaks volumes.
In recent days, I have started to think that maybe another try at Foxwoods would be a fun adventure for him, and a nice gesture from me. But then part of me feels like I don’t want to mess with a good thing. Maybe the pressure of such a long excursion was too much for him. Maybe visiting a casino in Connecticut is just not the same as weekend getaways to Atlantic City with his wife, and that changes the equation.
Mostly, maybe sometimes the anticipation of something can remain better than the actual something itself. This is my Foxwoods Dilemma.
View from the Bread: Guest Post from Sophie
The following guest post is from my daughter Sophie – here’s how having a sandwiched parent looks from the vantage point of an 11 year old. What she doesn’t know (yet) is that she too is sandwiched between 2 phases and perched precariously between being a kid and adolesence. This is why she is old and wise enough to write a coherent post, and young and naive enough to write it about liking her parents. I am savoring it while I can. So here goes…
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SOPHIE BIRO THE SUPERHERO HERE!!
Don’t worry, I didn’t hack into the blog. I had nothing to do during our writing time, so this was the best I could think of doing and my dad said I might as well. Thanks dad. Anyways, as much I like to go off and chit-chat about my life (I really do) I have to get down to business. So here it is: I like my parents. If I made a list of why it would be too long, so I’m just going to write about some of the key things.
1. They are good role models-
Though most parents try to set a good example for their kids, my parents don’t. They don’t have to try to (of at least I think they don’t). They just do their thing, but it always manages to get us inspired. From my mom working hard but always coming home and having a lot of energy to my dad being athletic, or even to the fact that they love to cook and stay healthy.
2. They do a good a job giving equal attention to everyone
Yes, they always give us the same amount of attention, but when we are with my Grandpa (or Apu, as I call him) sometimes my dad needs to pay attention to him, but right as that’s happening, my mom finds a cool game and we don’t even have a second to think about even getting jealous. It’s like they can read each other’s minds!!!
3. They are interested in the same things we are
Me and my dad could sit down and write for hours, or everyone could play cards, or we could all make a meal together, or we could all go to the gym or… (the list is endless). Though my parents have to work a lot, they always seem to find room for one of those things every single day (the list was cut short) no matter whether it takes hours or it’s just for ten minutes.
The last thing I have to say here (sorry, but my post has to end, I have a bedtime) is that below is a picture of me and my family. I’m the blonde one, that my sister is the one that looks like me, and if you can’t tell my mom and my dad apart… sorry. Bye… FOR NOW!
I’m Back and Still Sandwiched
How’s that for a long break?
I haven’t written a post in almost 5 months, so maybe some explanation is necessary before just jumping back in. Really, 2 big things happened, and my guess is that these are the ones that usually confound previously dedicated bloggers. First, the main source of angst that was driving my blog — which was trying to juggle helping out my father with everything else I was juggling — really petered out. That is, my father is doing great and continues to do great. His C Diff is gone. He is settling well into his new place. The crush of trying to sell his house, figure out where the doctors are and whether or not we could trust them, deciphering the Kafka-esque mystery that is Medicare – all of that is done.
Part of what caused this is that I helped start a support group and the feedback I got from members who had been at the caregiver game longer than I had was “Give yourself a break.” Good advice unless you are trying to stay motivated to write a blog about how you can’t give yourself a break.
So, writing as self-therapy didn’t have the same pull.
The bigger issue, really, is that I started a job. I haven’t had a “real” job in a long time where I manage people, commute to an office, have a real manager, and have direct deposit. Direct deposit is sort of a shocking and wonderful concept actually. Anyway, I became CFO of a software company called ObserveIT back in April and it was quite an adjustment. More on that in other blog posts. Put simply: full-time employment is the enemy of hobbies.
I finally feel more settled at work, as defined by being highly committed and busy, but no longer scrambling. To clear out space for writing, I made a pact with one of my favorite scribes, my daughter Sophie. She and I have carved out a dedicated time slot weekly where we both write. In the realm of multitasking and great parenting, I also plan to use this time to indoctrinate her away from dance music into what I am going to call “writing music”. This is code for music to which it is my solemn responsibility to introduce her. Tonight we are listening to Dire Straits. Someone has to do it.
Which brings us back to the question of topic. I have felt less angst-ridden about my father recently so I am pretty sure I can’t sustain a blog about that. (Note: I hope I’m right!).
That said, I am still as sandwiched as ever. Meaning, I have plenty that to explore related to work/career, raising children, marriage, being neither young nor old, and to being in a weird place called “middle age”. Facebook recently has been just as much about friends who are fighting and beating cancer as it once was for baby or wedding pictures.
A friend mentioned to me that writing twice per week seemed an unsustainable pace. Maybe — although I loved it while I was doing it. So, I’ll start with my weekly time with Sophie and take it from there. I’m glad to be back.
Bookmark This: A Big (Helpful) Medicare change
Bookmark This: A Big (Helpful) Medicare change
Short blurb on a change for Medicare reimbursing for services to maintain a patient’s level that would otherwise deteriorate. So, if my father (for example) is receiving doctor-prescribed services to keep him ambulatory, those are now covered; before, you had to have to lost something you were trying to regain. This is big and is going to save a ton of money in the long run since it’s going to keep people healthier, however you define that, longer, and therefore out of the hospital.
If Medicare should have one overarching strategic initiative, it should be to keep the elderly out of hospitals no matter what. Love it.
Plus, for the Sandwich Generation that is often the taxi of last resort, it’s going to give us additional months of time without the chauffeur’s hat. I wear it well — but maybe this will help some of the rest of you.
No Time for Selfies
A quick note on what “the real world” is.
It’s been noticed and commented on by many that everyone is taller, faster, funnier and cooler on social media than in real life. As the number of channels grows (Facebook, Twitter, Instagram, Google Plus, Pinterest for starters), it must be getting harder to build a #personalbrand. But that doesn’t mean that people aren’t trying.
And if you think this seems silly on an average day, you can imagine how I react to it on days when I am locked in sandwich generation or caregiver mode. Food porn selfies, videos of the great concert, car lust commentary, political rants to the echo chamber, absurd Top 10 lists, or nearly anything from the Huffington Post – it seems like another world entirely. For some reason, it makes me feel even more isolated than I do already. On the bad days (and yes, there are bad days), it’s almost insulting that people are taking time out to advertise themselves.
Do I know that this is irrational and ridiculous? Yes. But it’s how I feel sometimes, and if you can’t recognize and honor your own feelings on occasion, you will not last long emotionally in the caregiver game. Or the Sandwich Generation one.
I think this is especially true as a man, where you are often expected to advertise, publicly, that you are above feelings.
Not sure that’s going to make a worthy tweet. #ohwell
Invite the Cow In
Moo
As a sandwich generation man, I juggle competing priorities and events constantly. Usually, I am cognizant that this is actually a sign of good fortune. Sometimes it is easy to forget this, however. Then you forget for a couple of weeks in a row and start to long for a simpler existence. What if I could plan less? What if I could just work as long as I wanted and finally conquer my to-do lists? What if I could go away for the weekend with my wife and not have one eye on my cellphone?
There is a story in Judaism of a man who lives in a small house with his wife and many children. He is losing his mind with the noise and the crowded conditions. He consults his Rabbi to ask what he should do, and is told to invite his cow into the house. Not understanding why, he takes the advice anyway; such is the power of Rabbis in Jewish folklore. He does so, and now, of course, it is worse. Much worse (and don’t get him started on the smell). So then the Rabbi advises him to banish the cow. Suddenly, his previously unbearable cottage seems spacious, quiet, and more than enough home for everyone.
The emergency room is my cow.
Now that my father has emerged from his first Massachusetts hospital experience, I am looking forward to moving back into my cozy little cottage. We’ll resume our usual Thursday frozen pizza dinners. I’ll go back to being tech support on his iPad, and to reaching the light bulbs he can’t get to, and to expecting him late for everything. I’ll have my next Saturday morning spent in front of our weekly-meal-planning-whiteboard with Nova, figuring out how to squeeze in one more meal with her and our kids.
True, I didn’t really invite the cow into my home; it sort of barged in. But the same emotion applies: gratitude for the people I have inside the house and the hope I get to live here with them just a little while longer.
Sandwich Generation Irony alert – Part 2
You know how most blog posts from caregivers are about their elderly parents? Well, right now, the list of my family members from healthiest to sickest looks something like:
1. My daughter Sophie
2. My dad
3. Me (distant 3rd – I don’t recommend going for a weekend of skiiing and drinking with your friends when you actually have the flu, nor do I recommend flying home from said weekend on a red-eye into a flu-filled house. I’m just saying.)
4. My daughter Lily, who I took to the doctor earlier today fearing pneumonia. She doesn’t have pneumonia, but when your kid is too flu-ridden to sleep, you have to get it checked out.)
5. Nova. She is out cold for the 3rd day in a row.
My dad just commented over email that he wishes he could help. He better not offer that again, because I’ll find something. In the sandwich generation, it usually works the other way. But sometimes….
Yes – It’s a Waiting Room Selfie with my daughter Lily
How To Get Your Parent to Move (or, Learn from the Universe)
People my age (44, thanks for asking) commonly look for ways to have their parents do something that they are simply not wired to do. Move out of their home of 30+ years. Hand over the keys to the checkbook. Give up driving. Eat less salt. Luckily, the Sandwiched Man has been through many of these and has the magic antidote to get your elderly parent to do all of the above, and then thank you for the privilege.
The answer is: it’s not possible.
Here’s what I mean. My father lived in his split-level in Lawrenceville for more than 2 years after my mother died. He drove to the supermarket, to CVS, to the library, occasionally to the train station to pick me up, and even up to Boston. He was determined to mow his own lawn, manage his own medication, pay his own bills and deal with the house’s aches and pains on his own. At first, he let me assume my mother’s prior role managing the checkbook. This lasted until my brother and I decided that keeping the house clean was a priority worth spending money on occasionally. Then he suddenly decided to change his checking account online password, and move all of his assets out of Fidelity (where I had parked them) and instead invest them with a broker at Wells Fargo. He also decided that not speaking to me for 2 months would be a good idea.
Now, of course, I manage almost all of this and he moved to be near me. How did this happen?
Gradually.
First, the money. He noticed that his investment account didn’t pay enough interest. He’d had experience with my approach and results (index funds, boring stuff) and realized perhaps that he’d made a mistake. I suggested that if he wanted to move things back, I’d be happy to help, but no pressure. So about 6 months later, he reversed course and let me back in. He even told me his banking online password.
Next, moving. It is amazing to me that he lasted as long in that house as he did, because the margin for error was zero. Once he got sick, he absolutely could not manage being there anymore. But I started the conversation way before then, and not by asking for a date by which he was going to move. Instead, I asked him that when he moved, where would he like to go? Massachusetts (me) or California (my brother)? We needed to make plans, I told him. Then he told me that he was not moving. “I know,” I said. “But someday you probably will. Those are just the odds. Think about where you’d rather be.” Using that line of conversation is some of the best advice I ever got.
Six months later, on a drive back from Legal Seafoods during one of his aforementioned visits to Boston, he again mentioned that he did not want to move right away, and that things were fine. “Sure,” I replied. “Until you get sick with something that puts you in the hospital. Then we have a whole world of problems because there’s no one near you, and neither Rob nor I can move down there.” The next day at the kitchen table he told me that after thinking about it, he’d want to come to Boston, and probably within a year. I paused. “OK. No rush.”
Then he got sick. And immediately, he declared that it was time to sell the house and move. It was definitely not ideal, but realistically, it was the best we could have done. He simply was not going to budge earlier.
Preserving his dignity is paramount for my brother and me, and not just because some day we hope our children remember our example and do the same for us. If he’s not bought in, it is simply not going to work, whatever it is. If he doesn’t have the will to make it work, it’s not going to work.
(Parenthetically, we didn’t just how little margin for error he had until he lived in the house for 2 weeks between my breaking him out of rehab and my brother moving him up to Boston. The roof was falling apart. The air conditioning had been broken all summer and, it turns out, the summer before. He could no longer open childproof pill bottles or punch his lifesaving antibiotics through the plastic. Every time he scaled the stairs, we risked disaster. Then once we moved all of the furniture, the extent of the carpet’s mildew infestation became evident. It was a horror show.)
My point is that in the end he moved “suddenly”, but the buildup took time. I had to lay a foundation. That takes time, patience, persistence, a sense of humor, and a respect for the dignity of the proud human being you are dealing with and whose pride is going to come in handy for you someday. Trust me on this.
Think of it this way: most meteors cross half the universe before they shoot across the sky for a few seconds. Your job as a caregiver (and a parent, really) is to keep it moving across the universe so that you are ready for when it hits the atmosphere.
Top 10 tech tips for the Sandwich Generation
Let’s face it. When you are helping manage an elderly parent’s life, you face the toxic combination of accountability without responsibility. That is, you are sort of in charge, but not really, because this is your parent we are talking about. As you remember from your childhood, this person has an opinion.
Anyway, I am here today to tell you the good news. You live in an era which has technology that can make your parent’s life better, and your life a little easier.
Here are my top 10 devices/gadgets/tricks to help you accomplish a lot to take care of your elderly parent and save you a lot of worry and time. This post is also cut-and-paste friendly so that you and your parent can look at it together and decide which of these make sense. Here goes, in no particular order:
1. Dropcam – do you wish you knew when your parents’ delivery or repair guy showed up (or didn’t)? This $149 web camera is easy to install anywhere there’s a decent wireless signal, and then broadcasts the picture privately to an app on your smartphone. Point it at the door to your parent’s place, sign up for the $10/month logging service and now you have a record of everything, including when (and IF) your parent came and left. Many is the time my father has been late to meet me, but it’s not a big deal, because thanks to Dropcam, his departure time is easy to figure out. And it’s not invasive because, trust me: you will not be watching this all the time.
2. iPad – admit it: you are tech support for your parents and it makes you crazy. Rather than recommending how to manage this bad situation, I instead advocate that you help your parents ditch their computer entirely. Use a tablet instead. Fewer viruses, fewer moving parts to break, easier to transport around their house/apartment, and the ideal platform for checking out pictures and videos of the grandkids. Makes Skype accessible, and great for reading (Kindle app with big print = success). Plus it has a camera. Bonus tip: definitely get a Zagg keyboard with it too.
3. Amazon – whether you know it or not, you are the shopper of last resort for your parents. Why not make it easy to pick up the 1 or 2 things they never have time to go buy? If you have an Amazon account, add your parent’s address and preferably their Visa or Amex card. Then sign up for Amazon Prime if you haven’t already. Now you can shop for them for just about anything in minutes. Note: you will also need an Amazon account for your parent if they don’t have one already so that they can buy or borrow books on Kindle.
Now, for a word about telecommunications (a.k.a., the phone):
4. Google Voice – old telephone technology makes it nearly impossible for you to serve as a backup for your parents. Enter Google Voice, which gives you a virtual phone number that you can forward to any phone, or connect via a little adapter (we use OBI, but there are many others for this) to a regular telephone base. This is a lifesaver. His voicemails get sent to him as emailed voice recordings, so they are easy to listen to. And, I forward a copy to myself. Again, I don’t listen to these 99.9% of the time, but I know when the calls came in, and if he misses anything, I am a pretty good backup. Then on his cellphone (coming up next), I recorded a voicemail greeting that says “I don’t listen to this voicemail — call me on my home phone instead, which is 508-xxx-xxxx.”
5. Panasonic KX-TG4745B home phone – big buttons, easy to program and add handsets and LOUD, LOUD, LOUD. Which is great for him. He has an 800 square foot apartment and 5 handsets because his mobility is terrible. But now he is reachable. My father’s hearing is so bad that he uses the speaker phone next to his ear to hear the phone. I don’t judge – it means I can actually call him now.
6. Snapfon, with ported home phone number – now that you have a new home number, keep the old home number by porting it to a mobile phone (your current provider won’t be happy, but that’s life!). We use Snapfon for my dad, a cheap big-buttoned cellphone that is not smart and is therefore very, very easy to use. We moved his old home phone number to it when he moved. He almost never remembers to have it on (not a big deal – remember the Google Voice trick above), and has forgotten how to use almost all of the features. But he has a cellphone if he really needs one, and at $15/month, it’s a bargain.
And, now back into the apartment.
7. Apple TV – my dad is hooked on Apple TV, especially since he can stream YouTube to it from his iPad. When you give your parent the gift of seeing any content they want on the television set they love, you will change his life. I promise. And, because the iPad talks to it, your parent will soon be watching anything and everything on their TV set.
8. Powered recliner – my sister-in-law suggested this, and I scoffed at first, but I was wrong. My father’s chair will recline so that he can nap and read in extreme comfort, and also will electrically move him into nearly a standing position so that he can escape. The La-Z-Boys will run you over $1500, but we bought a much less expensive one from Spinlife and it looks great. Even a cheap one of these is about I went with the faux leather rather than cloth because it’s easier to keep clean (if your parent has incontinence problems, fabric… well, you know). Another tip: although you can file for a Medicare reimbursement for part of the expense, don’t do it if you can forgo the money. The process hurts, and can suck up a ton of time that will then delay your loved one falling asleep in comfort.
9. TV headphones – rather than blast the TV, my dad has headphones with a remote wireless transmitter that plugs into the audio out jack of his TV. I gave the link for the Sony headphones, which are $80, but really any pair will do if your parent, like mine, is nearly hard of hearing.
And last but not certainly least…
10. Google Calendar / Gmail: your problem is this: you want to be able to micromanage things, but not do all of the work yourself. And you can’t always call to remind your loved one about events. It turns that you have kids who you are shuttling to dance/swim/soccer/Bar Mitzvah/football/violin practice.
So if you can possibly move to a model where email is the central communication channel, do it.
I remind my father about calendar appointments by putting them into Google Calendar and having a reminder email sent at least a few hours before to his gmail account. My dad has recurring appointments that he now gets email reminders for and never forgets. Once you get used to this system with email as the glue, you will never go back.
I subscribe to his Google Calendar. Then I can add appointments on his calendar and mine at the same time and set up alerts for him.
I also know his gmail password — again, I NEVER read his email, but if for some reason he needs me to doublecheck things for him, I can do it. He uses the native iPad mail program as his mail “client” (the program with which he reads email). It’s not perfect but works well enough.
I realize that not everyone has parents who can handle email. My advice is that if you can possibly make the up-front investment to make this work, find the time. Travel down to your parents’ home if they live far away and implement as many of these as you can. It is going to improve your life radically caring for a remote relative for whom, in the end, you are both accountable and responsible.
Irony Alert!
I organized a great support group for some fellow members of my Temple also taking care of elderly parents. But… then I couldn’t attend because I actually was in the hospital with my father.
He has some severe hip pain, and the good news is that nothing is broken. Probably a pulled muscle. We were trying to figure out where he was going to end up tonight (the hospital, it turned out) and going forward (hopefully back in his same community, which part is TBD).
And in true sandwich generation fashion, my kids’ swim team annual postseason ‘banquet’ was also tonight.
So, now I am really glad I enjoyed the smooth days when I did. And to my fellow support group members who were there tonight… I was thinking about you. Ironic, right?
The Sandwiched Man 
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