It was 1991, at least two years before the Internet was introduced to the public, when an award-winning healthcare writer in Connecticut saw “an enormous need.” Virginia Morris hadn’t yet begun to care for her own parents, but she realized there were no books for people who cared for theirs.
This February, 23 years later, her How to Care for Aging Parents (Workman, $18.95) was published in its revised and expanded third edition. After winning a Books for a Better Life award and being dubbed “the bible of eldercare,” the best-selling book in its field has helped make Morris a go-to authority, with appearances on ABC World News With Diane Sawyer and several network morning shows. She also testified before Congress about eldercare issues.
City & Shore PRIME interviewed Morris in conjunction with her recent appearance at Books & Books in Coral Gables.
Now that caregivers have the Internet, what made you choose to write a third edition?
At first I thought, who needs it? Everybody just gets on the Internet. But I realized there’s actually a ton of awful stuff on the Internet, so I wrote the third edition feeling that even though people have all this information at their fingertips, they don’t know which to trust. Corporations put out what look like not-for-profit foundation websites and there’s no way for the average person to link that website to the group that’s behind it – and they’re really trying to sell something. Even now when you think – wow, do people even use books? – I have found my readers like having one place they can trust.
Did your subsequent caregiving for your parents inform the later editions?
Oh, that’s a very interesting question. I think it has been very healthy for me and the book that I hadn’t gone through that when I first got involved. I’ve interviewed hundreds of caregivers and there’s common themes, for sure, but every story is different. And I was glad to be open-minded when I heard all that.
But later, during the first edition, I took care of my father and he died. My mother died while I was writing this third edition. So I have been through it. I don’t think it changed [the book] particularly. I think I was very empathetic already. I think what surprised me about caring for my mother for about 20 years was that even when you’re not living with your parent and you are the primary caregiver, there is a 24/7 aspect to it, a feeling that you are on-call. I was surprised how exhausting that was and how it defines you for many years. I’m not sure I realized how it was stressing me until it was over. I would say this is the No. 1 issue I try to address throughout the book.
Do you think that part of that caregiver stress comes from witnessing one’s own possible future so intimately?
It definitely is one factor. The question looms: Am I next? And that’s terrifying. There are so many aspects of this people don’t talk about openly. For caregivers, there’s a feeling of helplessness – for women, in particular. “I should be doing more.” There’s resentment – “Why do I have to do so much? I feel guilty about not doing enough but I feel resentful that I have to do any of it.” There’s a feeling of grief, and as you say, your own mortality. There’s feelings of wishing that someone would die sooner and then feeling really awful wishing that. There’s feelings of disgust, because you’re cleaning throw-up or changing a diaper, and then caregivers feel really bad because this is their parents and they love them.
For some caregivers, who had maybe unkind or abusive or drunken parents, there can be a lot of ambivalence about even wanting to care but knowing you have to do something. The sibling fights and rivalries are intense. I would say the emotional aspect of this is probably one of the hardest things, and it’s the thing I most intensely try to help with – to just recognize the limits of what they can do, learn to get help and delegate jobs and really get away from it occasionally. And to recognize that if you don’t take care of yourself, you can’t take care of your parent.
And if you’re feeling – “What’s my old age going to look like?” – maybe act on that, making some plans in that direction would relieve some of that stress. “I’m going to buy long-term-care insurance and move to this place because I know I can live in this house long-term.” I do think people don’t want to plan for their old age, but the people I meet who [do] actually feel very empowered and it relieves a lot of fears.
The aging of the Baby Boomer generation has been termed ‘the silver tsunami.’ How will it change caregiving?
First of all, it’s pretty much changed everything in its path. It’s a generation that generates change. The bad news will be that our many social and financial systems, housing and medical systems will be stressed. We don’t have enough geriatricians, for example. But I think the good news is there will be more options and that is already happening – the types of housing, the imagination and creativity of how people set up communities so people can age. There are aging-in-place technologies that allow you to stay in your home more independently and longer. There’s more movement toward patient-directed care. I think we’re going to learn to respect elderly people more and recognize that just warehousing people in nursing homes does not really work very well. I talk to people routinely who have parents that are 102, 105. We are living a long time so we are going to have to have some better plans because nobody wants to sit around in an assisted living facility for 40 years.
Do you think South Florida’s large elderly population is advantageous for caregivers and their parents?
Yes, places like South Florida that have a broad menu of services, programs, facilities are definitely much better places for the elderly person and makes life easier for the younger person. I testified before Congress that if more effort was put into providing services, then caregivers won’t burn out as easily. They need support. Somewhere between 75 percent and 90 percent of all care to the elderly comes from unpaid family members. They’re providing hundreds of billions of dollars in care that we’re not paying for and we want them to do that.
Our region is infamous for bad older drivers. What’s the best way to deal with a parent whose driving days should be over?
It’s so important to start talking about this early on, so that it becomes an easy theoretical question: ‘Dad, what if one day you couldn’t drive, what would we do?’ And you’re sort of planting a seed: ‘Oh, maybe moving closer to the shops or to me would be helpful, because one day you probably won’t be able to drive.’ My No. 1 thing would be talk about it early so it’s not: “OK, now he’s had three fender-benders…,” which is a much more threatening conversation. If you talk about it first, then you can say, “Remember how we talked about this?” That’s a much easier conversation to have.