By Gail Sheehy
Did you meet the Heath family in my journal, "Handling the Boomerang"? If so, you know what an amazing accomplishment it was to get all of them—two parents, six siblings, and the spouses of the siblings—in the same room at the same time for a family meeting. And don't forget the social workers at the Motion Picture Television Fund, who arranged the meeting.
The Heath family members are all their own bosses: Among them are a film producer, a lawyer, an insurance manager, a school principal, a substitute teacher, and an administrator. They were encouraged by their loving parents, Raylene and Larry, to express themselves while growing up.
Son-in-law Bud, who's been part of the family for 41 years, qualified it: "You can tell they're all very intelligent people. They're all professional. So when they get together, they will tend to work things out in a polite and professional manner."
For a large, outspoken family, a family meeting could be tricky, but it was crucial that the Heaths have one. Mom and Dad's situation had deteriorated. Larry had been proud and happy to take over as his wife's caregiver after a fall kept her in a wheelchair, but after four years, his own health took a dive. It was son David and his wife Bonnie who picked up the full responsibility for taking care of both parents.
"What about all your siblings?" Bonnie pressed her husband after months of fitting the caregiving of his parents between driving two of her own children to school and squeezing in time for her job as a substitute teacher. She finally said, "I can't do it all."
Democracy in Action
The family meeting turned out to be highly productive. It was voted and agreed upon that each of the siblings could and would take a day to drive the parents to appointments or for an entertaining outing.
Practice sessions were set up where all the siblings learned how to pull up to the curb in front of their parents' house with their different-sized cars and transfer Raylene from her wheelchair to a low car or high SUV for appointments. She began to accept the fact that she could feel safe with other family members helping out—not just Bonnie.
Brother Larry brought up the problem of coordination: "How does everybody get to know what's going on with Mom and Dad, and all of the information that Bonnie carries with her each time she takes Dad to one of his six or seven doctors?"
The solution? An e-mail calendar to keep everybody in the loop—everyone voted and accepted.
Since Mom and Dad were included in the meeting, Mary, the oldest daughter, was able to air an unexpected concern—her mom's depression.
Over the years, Raylene's pat answer had been, "I'm fine." Her friends bought her alibis and insisted, "Raylene's not depressed." But Mary had always been extremely close to her mom and noticed her mounting anxiety and withdrawal. Raylene didn't want to leave her bedroom and talked only when she had to. With the family alerted to these signs of depression, and affirmation by the social workers, she was persuaded to consider a mental health evaluation.
Four months after the family meeting, I called David Heath to follow up on the family and to see how things were going. It was a busy morning at Universal Studios, and David was scrolling through a blur of e-mails, but he was eager to tell me the good news about his mom. "Her spirits are up," he reported. "You can hear it in her voice and feel it when you walk into their house now."
I asked if she had received treatment for her depression. "She wouldn't go to a therapist. But something better happened," he said. "I e-mailed my mother's own sister, Dorothy, and let her know Mom was not getting out. She came to visit Raylene and saw her need for someone to talk to."
Raylene has just turned 80. Her sister Dorothy is 63 and divorced, lives alone, and has just retired. She offered to stay with David's mother and father on weekends. "She seems happy to reconnect with her sister and eager to spend time with her while she is still here," David said. "She has become Raylene's soul sister, a confidant she can talk to, and that has relieved Raylene's depression."
The benefits of this expanded Circle of Care are already enormous for David and Bonnie, the sandwich-generation couple. "It's taken the pressure off Bonnie, because Dorothy now drives my father to his medical appointments and does errands for him, all the while keeping up a lively conversation," said David. "His health, too, is getting better!" Bonnie is back to teaching and spending after-school time with her own children.
The Secret of Support
Studies have confirmed what many of us know instinctively, and what made all the difference for Raylene and Larry Heath. To be truly effective, a Circle of Care that surrounds an aging couple with deteriorating health must include medical professionals, a social worker or care manager, the whole family, close friends, and neighbors. But there is one member of the circle who can offer the greatest support and pull a dependent elder back from the precipice of depression. This one "super member" of the Circle of Care is someone the older person can talk to honestly, confide in, and who she feels will not judge her.
The pillar of support in the Circle of Care may be a loving spouse, or a rabbi, priest, minister, or pastoral counselor, or a friend who has faced similar obstacles. The person could even be a care manager who has become almost as close as family. But what could be better than the reconnection with a younger, once-estranged sibling?
Sisters are sisters until the day they both die. And even then, as one brother once told me, he keeps the ashes of his two sisters in urns side by side in his solarium where they look out at the yard where they once played and fought over the one swing. He swears he can still hear them arguing over who can swing the highest.