I tend to write about caregiving from the perspective of parenting young children, but as many readers have pointed out to me, elder care presents its own challenges. People who’ve never run the gauntlet of combining work and child-rearing can still suddenly wind up responsible for older relatives. Indeed, particularly if a person hasn’t dealt with the work/family thing with kids, it can be quite jarring to reach a point where you feel like you can’t make plans, or commit to a particular trip, or when you start burning through the PTO. Eventually you have to get clear on what will work and what won’t.
I was thinking of this recently when I heard from a reader I’ll call Elaine.* She worked 40 hours/week at a small consulting firm. Her 90-something father had recently had a hospital stay, some time in rehab facilities, and was transitioning into a long term care facility. “His situation changes frequently, is unpredictable and requires spontaneity and flexibility to navigate it,” she told me. Her mother had been managing things, but needed a lot of support during this transition. Elaine’s firm was small enough that she didn’t have FMLA available, “so I’ve burnt through a lot of my PTO and cancelled a vacation.” Her boss was being flexible, and allowing her to make up some work, but “as the situation has worsened with my dad, I have taken even more time, finding myself even more behind. The prospect of taking the vacation later or taking the week before Christmas off as scheduled is rapidly fading.”
As she put it, “This situation is unsustainable into the future. In the short term, I’m working long days and some on weekends to make up the time, but I’m burning out.” In the long term, she was debating quitting altogether, seeing if her boss would let her buy PTO, or downshifting into part time. “In any case, it’s a financial loss, but I don’t see any way around it.”
She wanted to know my thoughts (I welcome reader suggestions too). As I noted, my parents are on the younger side, so I haven’t dealt with this, but reading Elaine’s story of unpredictability and how it was affecting her ability to work reminded me of my first winter with my oldest son. He was in daycare at the time, which had a lot going for it in terms of quality, hours, and being a quarter mile from our apartment. However, even impeccably managed daycares are going to host a lot of germs. Little kids put toys in their mouths and share them around. My son got sick frequently, and then wouldn’t be able to return until he was symptom free. It felt like I never knew if I’d be able to work on any given day. I could do some things while my son napped, since I worked from home, but I couldn’t commit to meetings or events or travel very easily.
At some point, I realized I needed to decide if I cared about that. In short, was work a priority to me? There were all sorts of things I could blame or bemoan (like why I was the parent covering all sick days). But fundamentally, I had to make a decision about whether I was going to do what it took to preserve my ability to work the way I wanted to work. I decided investing in my career was still a priority. So I wound up finding a slew of back-up sitters, and I also eventually hired a nanny because I needed more predictability.
I mentioned this to Elaine, with the caveat that of course caring for parents is different from caring for children. You have a history with your parents and you can’t automatically be in charge and make decisions for people the way you can with young children. Also, the process of aging happens at a different and less predictable pace than the milestones with kids. I can look at my baby and know the situation will be different in 4 years, which is not something you can know with eldercare. That said, some of the caregiving issues were similar. It was admirable that she wanted to be there in person to support her parents as much as she could. But she would eventually need to make a decision. Was succeeding in her current job still a priority or not?
There is no right answer. If she did want to continue moving forward, she would need to protect her ability to work at least a minimum number of hours. She could do a lot for her parents in that scenario. This is not an either/or thing of work-vs-family, but she would also have to enlist more help (some paid, and some help from neighbors or a church community, or what have you). Or she could decide that her job was not a big priority right now. In that case, she could take a leave of absence, or figure out something more low-key to do during this season of life.
She wrote back later that she’d chosen option B. “I ended up quitting my job to spend more time with dad and to help mom with the caregiving. A key point you wrote above — determining whether moving ahead in one’s career is a priority — helped solidify my decision. My career isn’t a priority at the moment, nor am I even sure what I want from my career. For now, I’m taking a ‘sabbatical’ for a few months and during that time will evaluate where I need to be in the longer term.”
I think this is great. We should all be clear on what we want with our time and our lives, and a decision made because it’s what you want to do is much more empowering than one made without considering the various options.
*I suspect I may have used this as a made-up reader name before. I’m not that creative when it comes to fake names, alas.
Photo: There are different seasons of life...
I have spent this afternoon pondering your post. There is another perspective on parenting I would like to add. Managing the care for young children and aging parents comes with complexities and decisions that are hard and unique to each family. In my situation, I have been juggling a different set of circumstances that continually have me asking the question if work is a priority or not. For the past five years, I have been managing a chronic and episodic health concern for my now teenage child. The episodes are not predictable and turn family and work life upside down life. In this instance, hospitalization is not an option at the moment. In between episodes, there are normally weekly appointments. Until the episode is over, my spouse and I must change our work schedules to provide 24/7 supervision. My job is the most important to maintain as I have the health benefits and the higher salary. I also have a little more job flexibility to work from home. (As a note, I am eligible for FMLA and my spouse is not. In the last episode, I had just come off FMLA as I recovered from injuries sustained in a motor vehicle accident.) My husband and I work together to make it work. I share this perspective not seeking solutions or sympathy. Many things can happen in a family, with or without children, to raise the question of work being a priority.
Oh gosh.
Assorted thoughts. Aging parents (and dependent adults in general) are different from children in several other ways besides those you (Laura) mention — here are two (no idea how these apply to Elaine): one, it’s entirely possible they don’t live in the same community as you (never mind the same house), and two, their future status is likely a lot less predictable (we can generally expect kids to move into school at a certain age and to become more independent/capable as time goes by, in somewhat predictable ways. Not at all true of aging adults, and of course the trend is generally in a bad direction, whereas with kids it’s mostly in a good one.). My sense is that eldercare is also noticeably more expensive than childcare, and harder to find.
Obviously, difficult choices to navigate, and certainly good to have options (such as being able to afford time out of the work force) available.
I’m so glad to see (here and elsewhere) that the need to care for aging relatives is becoming a bigger part of the national dialogue. It’s not just a “mommy problem” and while becoming a parent is a choice (in theory, anyway) being someone’s child is not. I read somewhere that if you want to stay out of a nursing home, you need three daughters or daughters-in-law who are willing to care for you. I don’t know if that’s true- although when my elderly grandfather had the flu it took three people to care for him around the clock, so maybe there’s something to that. I think elder care is harder than caring for children, too, because the elders often have very strong opinions about what they will and won’t accept for care, which can make things challenging.
@Pamela – very true on the potentially difficult dynamics. I witnessed quite a fight at the zoo last weekend between an elderly woman and her son, who was pushing her around in her wheel chair. Apparently he didn’t do it quite the way she wanted, and screaming ensued from both.
I’d chime in that another thing that makes eldercare a little more difficult to outsource than childcare is that you’re not just paying someone (or deputizing a friend/neighbour/relative) to take over the physical care and provide a little social interaction. Well, I guess it might look like that in the best-case scenario… But often it involves lots of medical appointments, interactions with health care providers, either making a decision on the loved one’s behalf or being the second set of ears to take in the information and keep everything straight. There are aspects that can be delegated to free up time, but you also deal with a lot of situations that require next-of-kin (more similar to Shannon’s description of dealing with a child’s health crisis).
I also think there’s an added level of stress and sadness in arranging elder care because you’re dealing with decline (and eventual loss) of a loved one, many elderly people suffer from depression, there tends to be a lot of guilt involved, etc.
Great topic!
My four kids line up with yours. On top of that, we’ve been through two terminal cancer battles with grandparents, with one diagnosis at 53 and one at 67. One battle ended up lasting ~7 years and one ~2 years. Spouses, rather than children, were primary caregivers.
This has meant we’ve prioritized family over career in ways other people haven’t. It confirmed my decision to take a 7 month (as long as I could get) leave of absence after my daughter’s birth in February. I would sit and nurse her and talk to my dying mom on the phone. (I’m ~2000 miles away.)
I feel a little guilty about this, but I am also relieved that the two remaining parents are likely to die relatively quickly from heart attacks in their 80’s, based on family history. Another multiyear caregiving obligation would be tough, even if it’s just doctor’s appointments and bill paying and company, vs. daily hands-on care. In the meantime, I’m trying to remember to increase contact with my Dad who is a new widower.
I will be glad when I am financially able to have a choice. Right now, I don’t. Work has to be a priority now.
My mom had to make the same choice with my grandmother in the two years leading up to her passing. She moved in with her to take care of her and did odd jobs to cover her incidentals. We are all very grateful to her for doing so. It meant the world to my Grandma and the last years of her life were well lived.