•  Book Review: Another Country

I wake up in another country, there is no more north or south. Asleep we pass through one another like blowing snow, all of us, all.

-- Linda Hogan "Our Houses"

I have always loved older people. My happiest memories from childhood involve my grandmothers and my mother's father. My father's father spent most of his life in a mental hospital, but the other three grandparents held my world in place. I think of Glessie May, my father's mother, a sturdy, dark-haired woman who made her living selling Avon in Christian County, Missouri. When we planted corn in her garden, my job was to bury a little bluegill beside each seed for fertilizer. Together we hiked through woods looking for poke, wild berries, or mushrooms. Glessie never had indoor plumbing, but when our family came to visit, she fixed fried chicken, gravy, fresh biscuits, and pie -- and that was for breakfast. When we left, she'd hug me to her ample chest and beg my father to move us back to the Ozarks where we belonged.

I lost my last grandparent when I was in college almost thirty years ago. I still fall asleep with pictures of all of them in my head. They are calming pictures that help me let go of the day. Glessie was earthy and outspoken; the Page grandparents were well-educated and a little Puritanical. I know they all had faults. However, in all my time with my grandparents, none of them ever said a cross or ungenerous word to me.

Mrs. Van Cleave, a white-haired immigrant in her seventies, taught me pottery making. After school I'd stop by her house. I was a big-boned, gawky adolescent who lived in a state of continual amazement at the cruelty and stupidity of many of the kids at school. Each afternoon around three, I'd reach Mrs. Van Cleave's house, shell-shocked and so rattled that I could barley speak.

She'd greet me with hot tea in a china cup and thin lemon cookies on a hand-painted plate. We'd walk to the quiet back room that was her pottery workshop. Side by side, we'd knead clay, glaze pots, and paint figurines. We rarely spoke, but in her studio smelling of banana oil, clay, and turpentine, I could forgive. My body went slack with relief.

As I write this book, I am fifty, a baby boomer born just after World War II. If life can be divided into seasons, each approximately twenty years long and beginning with spring, I'm in the mid-autumn of my life. My next season will be winter. If my parents were alive, I'd be caring for them. Twenty years from now, most probably, my children will be caring for me.

Wallace Stegner wrote, "After sixty you are aware how vulnerable everything is, including yourself." Though I haven't yet reached that age, I feel intimations of that time. I deal with anxiety-provoking situations by gathering information, by anticipating problems and thinking them through. Partly I explore the issues of aging to calm myself down. I want to be prepared. Like the gray squirrels of eastern Colorado, I want to store up supplies for winter.

For [my book] Another Country, I interviewed and saw in therapy mostly Caucasian and African-American Midwesterners in their seventies, eighties, and nineties. Most were middle-class rural people, although some were from cities or were immigrants. Some were indigent, and a few were rich. I know that there are hundred-year-old joggers, figure skaters, and other miraculous elders. I have tremendous respect for such people, but I chose not to focus on them. Rather, I selected ordinary people who were coping with the standard amounts of loss and disability. I felt they were the ones who had lessons to teach me. I cannot claim to represent all the voices of the old in America. But I do hope that I articulate many of the issues that all the elders face.

What every person I interviewed had in common was a life that spanned the century. They were around when Henry Ford designed the first assembly lines, when sliced bread was invented, and when the first movie theaters opened. They were alive when the Titanic sank and the Lindbergh baby was kidnapped. They were the last generation in this country to be raised in a communal culture and to grow up on pre-Freudian terrain.

I wanted to learn about our community-based country that has almost vanished, and also to understand the country of old age, which most of us one day will inhabit. Old people know about loss, ill health, and diminishment. They cope with experiences that would take down a younger person. There is an old joke that goes: "But other than that, Mrs. Lincoln, how did you like the play?" We can ask of all our elders, "But other than the facts that your friends and family are dying and you are ill, how are you doing?"

I cannot imagine maintaining good mental health under the conditions that most old people eventually experience -- under conditions Aunt Betty alluded to when she wrote, "Most of the people I know are gone now." The old face physical problems, the loss of friends and family, and their own impending deaths. Many of them do so with courage and dignity, even humor. I wanted to learn how they do it.

Many of my friends and clients have sick and aging parents. They worry about their parents' doctors, their driving, their finances, and their houses. Some have put their parents in rest homes or hired live-in help. Others are worried because no one is caring for their aging relatives. Every time the phone rings, they fear catastrophe.

Adults have always worried about aging parents, but our current situation is unique. Never before have so many people lived so far away from the old people they love. And never have old people lived to be so old. Recently I called one of my aunts, who was in a hospital and scheduled for morning surgery. It took more than an hour to get through -- lots of people love my aunt, who was on the phone with her children, her siblings, and her favorite nieces around the country. When I finally spoke to her she was upset about a laxative she'd been given. It was too strong, and she hadn't been able to get herself out of bed and to the bathroom. She was stressed by her "accident" and fearful of the surgery.

From a thousand miles away, I told her I loved her. My aunt croaked out an "I love you, too," but she was distracted by her current worries. After the call, I thought realistically about her situation. She had a daughter nearby who would be by her side when she could get off work and who would do a heroic job supervising my aunt's situation. After the surgery, my aunt would have a roomful of flowers and balloons, but right this minute she didn't have anyone to get her to the bathroom. That's what she really needed, someone who was there "this minute."

Many old people are living in a world designed for young people. They can't drive, walk through shopping malls or airports, or deal with rushed doctors in managed care systems. Many can't handle stairs, small-print books, or menus in darkened restaurants. They have access to expensive and sophisticated medical care that prolongs their lives, but many must sacrifice their savings to afford it. Some must choose between medications and food. Modern technological advances, such as dialysis and organ replacement surgeries, keep people alive but create chronic problems of their own. Some people live to be more than a hundred, but they often outlive their support systems, neighborhoods, and bank accounts.

I hear stories from clients and friends about their struggles to make good decisions about aging relatives. Almost everyone wants to do the right thing, but adult children have busy, complicated lives that often include full-time jobs, long commutes, and family responsibilities. They may be a thousand miles away from the people who need their time and attention, and they may not have the financial resources to care for their loved ones.

As I write, I think of Heather, who called last night to talk about her dilemma. Just out of graduate school, Heather was lucky enough to get a tenure-track position at a large university on the East Coast. Unfortunately it's a continent away from her mother, who is dying from cancer. She mentioned her concerns to the department chair, who said, "You aren't going to be a baby about this, are you?" Heather was debating giving up this job. "It makes me nervous and sad. My career is going so great. But I can't abandon my mother. Do you know of any work in Nevada?"

I think of my friend Betsy, a working mother with two small children who has spent the winter caring for her faraway parents. In the fall she had to fire an incompetent doctor in the middle of a medical emergency. She wasn't sure at the time whether her action was heroic or lethal. Several times this winter, her parents were in hospitals in different towns, and Betsy set up phones so that her parents could at least talk to each other. When her father died, she took her mother out of a rehabilitation center and drove her across our snowy state to the funeral. "I haven't read a newspaper, seen a movie, or even had my haircut in six months," Betsy told me. She was considering going on Prozac.

I think of my friend Marilyn, whose parents live in a retirement community in Arkansas. Once a month she makes the ten-hour drive to be with them. Her father is institutionalized with Alzheimer's and no longer recognizes her. Marilyn still writes him two letters a week, which her mother reads to him. Marilyn told me, "I go for Mom. She takes care of Dad, and I take care of her."

My client Carla's mother had a heart attack in her Arizona condo. Carla took time off work and flew down to be with her during the surgery. She stayed on for the opportunistic infection and later the pneumonia. It was a difficult month. Her mother had recently married a man who drove a Lincoln Continental, gambled, and liked rare steaks and bourbon. He made fun of Carla's vegetarianism, her casual clothes, and even her Honda. The two of them stood across the room from each other in the ICU, trying, but barely able, to maintain the illusion of civility. They hardly knew each other, and yet they had to make life-and-death decisions together about a person they both loved.

I recently met a woman whose parents, when they retired, had moved to Palm Beach to play golf. This woman and her family were a thousand miles away, and her children grew up hardly knowing their grandparents. Then last year her mother died and her father insisted on moving back to be near his daughter. "He wants us to treat him like the prodigal son," she said. "But my kids don't know him. He's depressed and ill, and all of a sudden I am his daughter again. I'll try to help him and I want my children to know him, but I resent that he had nothing for us during his healthy years."

From both generations I hear stories of conflict, frustration, guilt, and anger. While the old often feel abandoned and misunderstood, their younger relatives often feel unappreciated, stressed, and guilty. Hurt feelings often come from taking personally problems that are cultural or developmental. As a nation, we are not organized in a way that makes aging easy.

Right now we are in a crisis. We lack the housing arrangements, social structures, traditions, and wisdom to make the last years of life manageable. No one wants to die surrounded by hired help. No one wants their parents to be anxious about money and in pain their last years. Yet these things happen all the time. There is an enormous gap between what we believe is right and what is practical.

When logistics can be worked out so that families are together, there are still conflicts caused by the personalities involved and by different ways of interpreting the world. The generations have very different mental landscapes, and that interferes with communication and compassion. A father is upset that his daughter wants to bring up the past and "open old wounds." She wants to process events; he wants to "let sleeping dogs lie." A son wants to know his mother's medical condition, and she "doesn't want him to worry." He says, "My main worry is that I don't know what is going on."

My goal is to map out the terra incognita between old people and their children, to help each generation understand the other. The last years of a relationship are important ones. Sadness and conflict are inevitable, but much pain can be avoided with better information, empathy, and planning.

My mother was hospitalized for eleven of the last twelve months of her life. She had diabetes, along with its cruel problems -- peritonitis, heart and liver failure, vomiting, chills, and legs that cramped and jerked from potassium deficiency. She was bedridden, bloated, and brain damaged. She had skin cancer and osteoporosis. She broke her arm when she fell out of bed, and her vertebrae when she tried to lift a small suitcase.

Sometimes she hallucinated. One night she delivered babies all night long and admonished the nurses, "Don't drop that child. Wash the floor, wash the floor." Another night she called out for a large pot, onions, and tomatoes, and she cooked spaghetti for a big crowd. Other days she saw dollar bills on the ceiling or held conversations with her long-dead parents and husband.

She had months of ups and downs, and then just downs and downs. In all those horrid months, when she never felt the breeze on her face, saw the sun, had a good meal, or slept without pain, she never complained. She appreciated a glass of ice, a back rub, or a story. She smiled when she recognized the faces of friends.

I was the oldest daughter, three hours away, but I had two teenagers, a book to write, and a full-time job. For months I drove to her hospital every other weekend, then every weekend. I took the calls from relatives and doctors and tried to handle her money, her medical care, and her house.

That year, no matter where I was, I felt guilty. If I was with my mother, I wasn't caring for my own kids or my clients. If I was working, I was ignoring my family. When I was with my children, I thought of my mother alone in a faraway hospital. I got depressed and crabby. My husband and I fought more and my children didn't get the supervision and nurturing they needed. I got a speeding ticket.

My mother never expected to die, and her affairs were not in order. Her money and her legal papers were a mess. She'd insist on leaving the hospital, go home alone, then be readmitted in crisis. She wouldn't move closer to her children, yet she hated being alone. Her unrealistic plans and her disorganization made my life complicated and stressful.

I alternated between guilt and anger. I'd be furious about a decision she made, and resolve to confront her. Then I'd find her vomiting or too weak to lift her head from her pillow, and I'd back down. I'd feel like a horrible daughter and try to be more nurturing. Then I'd hear about another bad decision.

My mother's last year was a worst-case scenario. She was nauseated and in pain, then she died alone. By the time she died, I felt a weird combination of being stressed to my limits and ashamed I hadn't done more. Mother and I had some good talks, but many things didn't happen the way I wished that they had. I had spent a year tired, anxious, and sad. Then I lost my mother.

That whole year I felt isolated and alienated. While my friends were taking ski trips and going to parties and movies, I was worried that I couldn't get to the grocery store, help my kids with their studies, or schedule an anxious client. At social gatherings I wasn't much fun. All my stories were sad ones. When I talked about the complexity of Mother's situation, it overwhelmed me and bored others. I wondered if I would ever be happy again.

One reason I am writing this book is to help others in my situation feel less alone. I want to increase our information about and interest in the plight of older people and their families. I want to explore social and psychological arrangements that allow the old and young to be connected to each other. Together we can create a culture in which it's easier to do the right thing.

Those last years can be difficult, but also redemptive. As we care for our parents, we teach our children to care for us. As we see our parents age, we learn to age with courage and dignity. If the years are handled well, the old and young can help each other grow.

This book has some very sad stories and, especially in the middle, plenty of bad news. But I hope I have captured the humor and resilience of this older generation as well as the sorrow and hardships. I hope I've shown their tendency to laugh and joke, to tough it out, and to put on their best clothes and go dancing. By the end, I hope the reader sees the possibilities for joy and wisdom that come from connecting to our parents' generation.

I encourage adults to seek out their older relatives and get reacquainted. We live in a fragmented culture, and many of us have lost contact with extended family. Indeed there is little in our culture that encourages these contacts. If you say you are going to a family reunion or having relatives visit for a week, people are likely to feel sorry for you. Extended families are often viewed as boring and bothersome, as thieves of our valuable time.

My five aunts were important to me in childhood. My Missouri aunts, Grace and Henrietta, took me fishing and helped me catch crawdads in Ozark creeks. My aunt Agnes from Colorado cooked Sunday dinners for twenty of us. My aunt Margaret talked about books and plays, and Aunt Betty helped me find huckleberries for pies. During my middle years, with work and children, I had been too busy for them, and while I was away, they all became old.

For this book I interviewed them about their lives now and when they were young. These visits were among the best experiences of my life. I learned about my family and myself. I had very different talks with them from the ones I have with my peers. I gained some perspective on the century and the life cycle. I absorbed valuable information about how to age and how to approach death. Alex Haley said, "The death of an old person is like the burning of a library." Visiting my aunts allowed me to read some of the books before they burned.

I also spent a great deal of time in rest homes and assisted-living facilities. For the most part, I found caring, if overworked, staffs and well-intentioned administrative personnel. And I found some residents who liked their rest homes. There was more interaction between the homes and the outside world than I imagined. I saw children stopping by, school groups coming to sing or read with their buddies, and friends and relatives who were loyal and devoted visitors. However, there weren't enough connections between the old and the young. Many residents went months or even years without hearing the laughter of children or holding a baby.

Many people in rest homes or even in their own homes or apartments had almost no contact with anyone but other old people and /or their caregivers. Meanwhile, all over America we have young children hungry for "lap time" and older children who need skills, nurturing, and moral instruction from their elders. We have street gangs of ten-year-olds, and old-age ghettos in which our elders are more and more cut off from the real world. Children play with cyberpets while old women stare out their windows at empty streets. Grandparents feel lonely and useless while a thousand miles away their grandchildren are not getting the love and attention they desperately need. There is a lot wrong with this picture.

Each generation has its own gifts to share with all other generations. I hope this book inspires people to work on new ways to connect the generations. I hope adults will call, write, and visit their own aunts and great-aunts. I want grandchildren and grandparents to spend summers together and maybe even figure out ways to live near each other. I hope my writing inspires people to plan family reunions and intergenerational bonding events. I want community activities organized not by age but by formed families so that people of all ages can work together. I want schools to be facilities where people of all ages work and play. In short, I hope we all can become one country.

-- Mary Pipher, Ph.D, is a practicing psychologist and author of Reviving Ophelia and The Shelter of Each Other. This essay serves as the introduction to her latest book, Another Country: Navigating the Emotional Terrain of Our Elders (Penguin Putnam, 1999). Reprinted by permission of Penguin Putnam Inc.

First published July 4, 2000
Last updated September 14, 2007
Copyright © 2000 Consumer Health Interactive

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