From the opening paragraph of her prologue, Lisa Ohlen Harris held my attention and didn't let go until long after I read the books' final words.
This is a book about two very different women sharing a household and a family. It's about aging and caregiving and family obligations and resentment and hurt feelings and ethical convictions. Ultimately, this book chronicles a kind of reverse midwifery in which my mother-in-law and I held hands through her physical and mental decline, hospice care and end of life.
With grace and dignity, Harris shares her many years of caregiving for her mother-in-law Jeanne. Readers first meet Jeanne in the grip of a disease that will ultimately claim her life. Harris blames the years of secretive cigarette smoking for Jeanne's COPD (Chronic Obstructive Pulmonary Disease) and all that entails. Even after her death, Harris' resentment of the behaviors that led to the disease are unflinchingly shared.
Through this slim volume, readers enter the world of day-to-day caregiving: unending physical care, seemingly endless doctor appointments, repeated emergency room trips and hospital stays, the abandonment of one's own needs and desires to meet the needs of the sick family member. Harris also gives a brutally honest portrayal of what it is like to open your home up to someone who is not related by blood but is nevertheless family just the same.
I married Todd, promising to stay with him till death separates us. I did not marry his mother. My religious commitments discourage divorce but would sanction it in grim circumstances. I have never felt my marriage was grim. But I have regretted that when she became a widow I invited and insisted she move to be with us, years ago, when she was well and strong. For now, without making holy promises, I have nonetheless entered into a covenant of care with her that will not easily be broken.
It is the dichotomy of the remembering, resenting, lamenting and loving that propels Harris forward as she shares her years as Jeanne's caregiver.
We make our marriage vows in a cloud of smiles and joy and anticipation....With a kiss, two lives are joined like an unbroken circle. Till death separates us... I suspect that I will be with my mother-in-law until death separates her from me. This, too, is a holy union. A new creation has happened here—the formation of a family tie where blood does not bind. Like our first parents, cast out of paradise, I step on thorns and thistles. I wish for a way out—anything, anything but death to release me from this. But it is too late. I remember. I lament. I resent. I love.
As if caregiving is not a daunting enough task in and of itself, Harris is doing this in her own home while trying to raise her four daughters. At times, when Jeanne is still well enough to share a meal at the family dinner table, lines are blurred as to who sets rules, who corrects childhood behaviors, and even who gets to go on outings as "nuclear family." Harris honestly delves into the feelings that arise from such situations arise. At times one can only laugh at the situation and comments. Other times, readers will want to shed a tear or two for the ways in which the author must put aside her own feelings in spite of the situation.
Please don't think this is yet one more memoir that merely chronicles the days and tasks of caregiving. It serves a far bigger purpose. It presents the subject of advanced directives and the myriad small decisions that must be made in healthcare even when a directive is in place. It points out the pitfalls that occur when certain members of the healthcare community fail to lay out all of the facts before any healthcare decision is made. Even with an advanced directive, Jeanne trusted her providers to guide her every step of the way on her journey; but the truth of the matter is that sometimes providers are not capable of admitting that there is nothing more they can do. Instead, they offer one more option—and then another and another. Harris found this to be true on more than one occasion but felt she had to allow Jeanne to make her own decisions even when she didn't know which questions to ask; or when Harris feared her own questions would make it appear that she was choosing an expedient death.
Harris also broaches the subject of timing the entrance into Hospice care. In some regions, this concept is embraced readily while in other areas, it is a last resort that is offered far too late in the disease process to be of much real benefit to patient or family and caregivers. Harris' tender handling of this subject is to be commended.
As a long-time oncology/hospice nurse and as the daughter-in-law who had the privilege of practicing "reverse midwifery" with both my mother-in-law and father-in-law as well as a current caregiver for my own aging parents, I found this book to be well written, tender-hearted, and brutally honest. It should be required reading for all who are now (or will one day) be in the business of caregiving.
Lisa Ohlen Harris lives in northwest Oregon with her husband and four daughters. She is the author of the Middle East memoir Through the Veil which was a 2011 finalist for the Oregon Book Award. You can visit her website.
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