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'Take on Today' Offers Fresh Perspectives on Caregiving

This episode talks about the challenges family caregivers face

Two women sitting together

Courtesy Isabel Tom

Isabel Tom, left, with her grandmother.

Wilma Consul:

As our loved ones get older, many have fears or uncertainty about what it means to take care of them. Whether it’s emotional and physical stress or financial strain, caregiving certainly comes with its challenges. But what if we have the wrong idea about caring for our aging friends and family?

 

Today we’ll hear from a caregiver about her experience growing up in a multigenerational household, looking after her grandparents and learning to value the older adults in her life.

 

Hi, I’m Wilma Consul with An AARP Take on Today.

 

Wilma Consul: 

 

When Isabel Tom was in her 20s, she considered her grandmother as one of her best girlfriends. She grew up in a multi-generational household with her parents and her paternal grandparents, whom she called Mama and YeYe, Cantonese for grandmother and grandfather.

 

Now in her 30s, she has written the book, The Value of Wrinkles, a kind of a manual on how to better our relationships with the older populations.

 

Wilma Consul:

 

So, Isabel, I find your book warm and full of valuable information. Why write this book?

 

Isabel Tom:

Well, when my grandma passed away, it was January 2018, and after she passed away, I was thinking back and reflecting and I realized how blessed I was to have her in my life for 35 years, she was a 102. And I-

 

Wilma Consul:

Wow.

 

Isabel Tom:

...looked back on my relationship with my grandpa and how I got to care for him, and he died at 98. And I just realized how blessed I've been by being able to have a close relationship with my grandparents growing up with them, but also having been exposed to so many older adults and just the way that they have loved on me and encouraged me and inspired me. I just felt like that was something that needed to be written and shared with the world.

 

Wilma Consul:

And I appreciate it more because I had actually a best friend who was 104 and she passed on this January. So when I read your book, I feel a lot of the things that you were feeling in the book. You also gave a lot of great pointers in this book, for example, what are the misconceptions about aging, about living with, or working with seniors?

 

Isabel Tom:

Well, so I started working with older adults when I graduated from college. That was the first job that I had, and after graduating college. And I think that in my mind, I thought I was going to transition to another job, but I soon came to realize that this was fun, being around seniors was just really meaningful. And that helped me not only appreciate older adults in that setting, in my workplace, but also at home. It helped me appreciate my grandparents and just see them less as people who are aging and who would eventually die, but to see them as treasures and people who had a lot of wisdom and could share even stories of history with me. So I look back and I realized that a lot of people have this misconception, that older people, they just lose their value as they age. And that's so far from the truth.

 

Wilma Consul:

Tell us a little bit about your grandmother and grandfather. Where did they come from?

 

Isabel Tom:

So they were born in China and they lived in China and then Hong Kong. Until, let's see, my parents were married and in the US, and they didn't come over until after my parents were married. They came over here when they were in their late 60s and 70s. So they spent most of their…

 

Wilma Consul:

And how old were you?

 

Isabel Tom:

So I was born and they were 68 and 71. So they're just entering the last season of their life, I guess.

 

Wilma Consul:

And that's a typical, at least Asian immigrant experience that... I'm from the Philippines, and I see in the community a lot of the grandparents ended up coming to this country to be the babysitters, right? So for you, you appreciate this, but you didn't start out like that. You didn't like it at some point, having to live with your grandparents.

 

Isabel Tom:

Yeah. I don't think I really appreciated it till I was in my mid-20s. And I continue to appreciate the fact that they were there more and more each day. But yeah, as a child, it's nice when you get a lot of gifts and a lot of attention, but as I started getting older, I was the youngest of three and so my grandparents, you could say I was their favorite. We won't tell anybody else. But I was the favorite. They would watch me walk home from school. They would literally be sitting at the window sill and as I walked home from school I could see the front door open from a block away. So they hovered over me, they really adored me. I was the highlight of their day. And it's fine when you're younger, but then as you get older it's not that cool.

 

Wilma Consul:

Especially when you ended up having a boyfriend taking you home late at night, right?

 

Isabel Tom:

Exactly. So my grandparents, we have a lot of funny stories with my now husband, now Kevin, of both their opinions, but also how they took part in our relationship.

 

Wilma Consul:

Oh, well, I'm glad that you ended up with him, right?

 

Isabel Tom:

Yeah, absolutely. There was one time where I remember, Kevin and I were not seeing each other anymore and my grandma definitely had some questions for me. She liked him from the start. So definitely love to put in their piece, but they loved him and were with us together as a married couple for over almost a decade.

 

Wilma Consul:

Wow, wow. That is a blessing. You've spent your career working with older population. At one point did you decide that this is what you wanted to do?

 

Isabel Tom:

I think it was the first week, to be honest. I got this job because I got a referral from a friend's parent to work at this large retirement community. And I had mentioned before that I was thinking, "After this, I will transition to another job. I just needed a job. That was all." And I didn't expect to enjoy the job as much as I did. But what happened is in that first week, my eyes were opened to how neat and how each older adult was different. And this company that I worked for, Erickson Living, they just treated older adults with such dignity. And they have designed communities really to cater to the needs of older adults and really to build community. And that really was amazing to me, how they were able to improve the quality of life of so many older adults through design and through their company culture of just caring for them in such a great way.

 

Wilma Consul:

Now that's interesting because you wrote about the thinking that went into putting your grandmother in a nursing home. For many cultures, this is the worst thing that you could do to your parents or grandparents. Talk about how you reconciled with that decision.

 

Isabel Tom:

Well, even though I had worked in a nursing home, that was the hardest decision that I had to make. And there are many days that I just cried and cried because I could not believe I had actually allowed my family and myself to put her into a nursing home. And I knew that the people who work in senior living communities, they are amazing. So for me, the number one thing that we did first was the nursing home was a block away from my house, and so that made me feel a little better at first. And obviously you have that guilt of moving somebody into a nursing home, but I think the interesting thing for us was that my grandma told us to find a place for her, because she saw that my two other sisters and I, we were trying to care for my grandma in the home. And we all had kids. We have nine kids total, and they're all young.

 

Wilma Consul:

Wow.

 

Isabel Tom:

Younger than 10. And we were sleeping with her at night, with our kids by our side. I was changing diapers and also trying to bring my grandma to go to the bathroom and she could see how much we loved her. She could see how much we were doing. And so she actually requested for us to bring her to a nursing home. And when I look back, I realized that was what we needed to do. And obviously, you want to keep your loved one in your home, but there comes a point where you need that extra help so that you can just spend those last days and last weeks with your loved one.

 

Isabel Tom:

Because we moved her to a nursing home, the staff there, they were the ones who helped to do the actual physical care. But that allowed me and my sisters and the rest of our family, just to sit with her and enjoy her and care for her as her family. And not have to be busy doing paperwork and taking care of all of the little things of just like taking her to the bathroom and changing her diaper, all of those types of things. In the end, I see it was a blessing.

 

Wilma Consul:

And that's nice of her that she understood that, because she knew that how you guys were taking care of her. And being that block away, you visited her a lot, right?

 

Isabel Tom:

Yes. Sometimes three, four times a day. And we would just pop over-

 

Wilma Consul:

She must have loved that.

 

Isabel Tom:

...just to say hello. I think the nursing home was a little shocked by how often they saw me there.

 

Wilma Consul:

Yeah. My sister did the same thing with my mother and yours is a block away. She's like a few miles away, but I see how caregiving is very hard, even that, to visit every day, and you three times a day, that's a lot of work. Caregiving is a difficult job, so bless all of the folks who are doing caregiving for anyone in their family. And this pandemic has put more stress on caregivers, right? What advice would you give to a caregiver who's struggling right now?

 

Isabel Tom:

I would say first to tell yourself that you're doing a really good job and that your loved one is so blessed to have you there. I mean, there's nothing easy about this. I think what I tell people is that the blessing of COVID is that it has helped caregivers to stretch their muscles and to become more creative in the ways that we can bless our loved ones. So before we were resorting to the ways that we're used to, just showing up and at the nursing home or at assisted living, or just showing up at our loved ones houses, making them food. The things that we're used to and now COVID has caused us to be creative in how we love them. So maybe we're finding new ways to care for our loved ones, finding new ways to relate, having different types of conversations. And I think, after all of this is over, I think it will make you a stronger caregiver.

 

Wilma Consul:

Sadly though, seniors and adults aged 65 and up, account for about 80% of deaths from COVID. In your book, you say that the caregiver's acceptance of death makes a big difference. How so?

 

Isabel Tom:

If you're not prepared for death, we all know it's going to happen, but if you're not prepared for it, then when your loved one dies it ends up being very traumatic. And I can say working in hospice care, I've seen a lot of families, understandably, they just can't accept that their loved one is going to die. And they end up having so much guilt and regret for not having said certain things. They also end up making decisions differently. So if you don't accept death, then a lot of times the decisions you make are not always the best for your loved one.

 

Wilma Consul:

Give us an example.

 

Isabel Tom:

So examples are that you want your loved one to live forever. And so the treatment that you may choose may actually end up causing more suffering, unnecessary suffering for the older person. So I would say, if you're looking at things like a ventilator, a lot of people, they say they want everything done on their advanced directive and a ventilator is one of the life-sustaining treatments listed there, but they don't really know what it entails. And they don't know that older adults don't tend to do too well on ventilators. It's a very invasive and aggressive treatment.

 

Isabel Tom:

And so if you cannot accept that your loved one is declining, then sometimes you're going to put them into situations where they are going to deal with a lot more suffering. And when they pass, you're going to be there to witness it and it will cause you a lot of grief and sorrow. But when you're able to accept someone's death, you're able to use those last days and last months that you have with them and really make the most of it, rather than just fighting against what will naturally happen.

 

Wilma Consul:

Okay. What about things like the business of dying? How can caregivers' acceptance of death, how can that be easier? As far as like arranging for funerals and for this and that, and it costs money and all that, looking for, how are they, are they going to be buried? Sometimes people don't want to deal with these things. And then when the person dies, then they end up trying to figure it out, or not prepared for it.

 

Isabel Tom:

Yeah. What makes it harder is that when that person passes, you are left planning a funeral in probably within a week. And there are so many questions that you will have that are unanswered, that you could have talked to your loved one about, and that could have honored them a lot more. The other part of it too, is that if you don't accept the death of your loved one that is going to come, then there's a lot more conflict and family drama. And for our aging parents, especially, we know that they don't want their children to be fighting. They want peace in their family.

 

Isabel Tom:

And so one of the best ways that we can honor them is by talking with them and figuring out what they want, how would they like to be honored when they pass? And there are so many conversations too, that if you actually spend the time talking to your loved one it will ease the pain of losing that person.

 

Wilma Consul:

Now, your grandfather, YeYe, is that how you say it? Am I saying it correctly? YeYe, okay. So your grandfather, YeYe, died at 98, and your grandmother, Mama, followed at 102. You honor them in this book. What are you hearing from those who've read this book?

 

Isabel Tom:

What people have told me is that they have been encouraged to continue the journey of being a caregiver, but they found a lot more purpose in it. Because they've seen that they're not just there to take care of the logistics for their loved one, but they are there to give their loved one a proper sendoff and to love them well, to the very end.

 

Wilma Consul:

Isabel Tom wrote The Value of Wrinkles: A Young Perspective on How Loving the Old Will Change Your Life. You can also read her blog at isabeltom.com. Thank you very much, Isabel, for joining us today.

 

If you liked this episode, please let us know by emailing us at newspodcast at A-A-R-P dot org.

 

Thanks to our news team.

 

Producers Colby Nelson and Danny Alarcon

Production Assistant Brigid Lowney

Engineer Julio Gonzales

Executive Producer Jason Young

And, of course, my co-hosts Bob Edwards and Mike Ellison.

Become a subscriber on Apple podcasts, Google Play, Stitcher and other apps. Be sure to rate our show as well.

For An AARP Take on Today, I’m Wilma Consul.

As our loved ones get older, many have fears or uncertainty about what it means to take care of them. Whether it’s emotional and physical stress or financial strain, caregiving certainly comes with its challenges. But what if we have the wrong idea about caring for our aging friends and family?

Today we hear from Isabel Tom, author of "The Value of Wrinkles: A Young Perspective on How Loving the Old Will Change Your Life." Learn about her experience growing up in a multigenerational household, caring for her grandparents and learning to value the older adults in her life.

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