Caregiving, Loneliness, and Sacrifice

I read with alarm the story of 98-year old architect I.M. Pei who was victimized by a hired home health aide on December 13, 2015. The health aide, a woman with a Georgian surname, apparently twisted Pei’s forearm, causing bruising and bleeding. She was arrested after a two-week investigation.

I.M. Pei is a Chinese elder, and as a Chinese daughter, this story hits home. It is frightening to imagine that this could happen to our elders or ourselves if we hired in-home caretakers.

We also have Georgian family, whom we adopted as “hanai” family fifteen years ago when we helped them normalize their immigration status. They have since become U.S. citizens. The wife, who was a cardiologist in Georgia, is now a Family Nurse Practitioner (FNP) working in an urgent care center, after painstakingly learning English, taking courses while working fulltime and raising two small boys, and becoming certified. [“Hanai” is Hawaiian describing a chosen family of one’s own making.]

In many Asian cultures, the norm is to care for elders in our homes, with multiple generations of family members pitching in to provide care and companionship. As we out-marry into other cultures, our familial practices evolve to incorporate the tolerances of those other cultures. Still, many Asians of my generation have elder in-laws living in their ethnically blended homes and wouldn’t consider outsourcing elder care.

My husband Herb and I met and married in Hawaii, where Asian and Pacific Islander cultural influences are strong. We used daycare when our daughter was young and we both worked fulltime, but we didn’t use babysitters for the non-work times. Like my parents’ generation, our daughter was with us all the other times. Family is precious. Our children and elders, the most vulnerable among us, are the most precious, and we hold them close.

My retired, widowed mother joined our household in 2000, when it became clear that loneliness was her daily companion. It was a gift for our daughter, finishing her final years of high school, to have the advocacy and pampering of her last living grandparent to guide her teenage years. For my mother it was an affirmation of all that she had invested and sacrificed to become who she is and to feel needed and useful in the household of her daughter, son-in-law, and granddaughter, with a married grandson and great-grandsons nearby.

One of the great poverties of the single family detached residences that is the USAmerican dream is that families are detached, geographically distant, and unfortunately, often emotionally distant, too. Loneliness becomes one’s daily cup of tea, and the phone calls and photographs that serve as talismans against loneliness simply aren’t sufficient to overcome boredom and undiagnosed depression.

Living with one’s aging mother is challenging, especially for me, less so for my husband. My mother and I have engaged a kabuki dance as to who controls the kitchen and who is the grandmother to my grandsons, while my husband has enjoyed the favored cultural position of revered son-in-law who is kowtowed to by the mother-in-law. For me it has been a welcome respite from the challenges on the home front to engage the challenges on the work and volunteer fronts. Yet, duty remains and trumps all challenges, borne out of love and gratitude for prior sacrifices.

I am keenly aware of the ravages of loneliness. I have seen it in the faces and voices of elders who live alone, especially those who live in cities far from their children and are moved into managed care facilities when they are unable to live alone safely. I also see it in the lives of young people who have been discarded like an unwanted leftover by parents who disapprove of their sexuality or life choices.

Loneliness is so simple to truncate with the gift of our presence, but we have to choose to make that gift. Giving our presence involves sacrificing some immediate pleasures and sometimes making permanent sacrifices we’d prefer not to give up. Giving our presence involves choosing to sacrifice portions of our own lives to enhance portions of someone else’s life. Most healthy people have it within themselves to make those kinds of sacrifices for their progeny, but find it difficult to make those sacrifices for anyone else. True sacrifices are those that come with no payback and no recovery of any losses, real or perceived.

Caretaking does not stand in isolation to the whole of how we maintain our relationships. Loving, giving, and sacrificing are woven into the lives we create. Whether we choose to sacrifice or not, and how we weave sacrifice into our life stories – these are the fibers of our humanity that strengthen or weaken the connections that continue a community or end it prematurely.