Uneven Aging: The MacDonald Sibs

The situation of uneven aging can hit siblings like a sneaker wave. Suddenly, one of the kids falters, while the rest are cycling around Quebec and volunteering with Habitat for Humanity.

I know Marie's sister, Beverly MacDonald (names changed for privacy) only slightly, but feel much closer because I've heard forty years of Bev stories. Bev's jobs always paid modestly; she seemed to live on air in her small house. She  has long been a single parent, and is close to her family, most of whom live in the area.

This year, at almost 58, she was diagnosed with early-stage Alzheimer's, which is progressing noticeably. The siblings are planning her move to supported living, trying to prepare her rickety but valuable house for sale, and sorting out neglected financial matters. At family meetings, Bev insists she is still fine, but she can't figure out how to accept an electronic money transfer. (A list of passwords is in the house, but where?)

When one sibling is suddenly in distress, family dynamics carom like a pinball game. Old alliances, slights, and stories are suddenly active again. They want to involve Bev in decisions as long as possible, so there is a sense of urgency, which heightens the pressure.

Should the handiest be tasked with the house repairs? Should the sister across the country come for a visit soon, despite the expense and her own health issues? How much should be spent to fluff the house, and where will that money come from? Meanwhile Bev calls Marie, in tears because a brother invited her to visit, but not if she drives the thirty kilometres herself. (She will be required to surrender her license any day now.)

Marie approaches the situation like the project manager she once was, with a plan that lists steps, milestones and contingencies. Bev agrees, but when it's time to act, has forgotten her assent and challenges why anything has to happen now.

The family system is the unseen elephant; no, make that herd of elephants. A crew of highly individual characters, the MacDonalds have supported one another through job loss, divorce, and a forest fire. But now an entire MacDonald Museum of Old Stuff is open. Sometimes they laugh: why are we talking about who got a bike in 1958, now?

There is an entirely different tone to a sibling falling ill, than when it happens to a parent. The MacDonald sibs have faced infirmities—cancers, a motorcycle accident—but this one is not going to resolve in recovery. You do not want to see the person you grew up with grow down.

The MacDonalds are familiar with sibling rivalry; theirs was a genial competitiveness that never spilled into lasting resentment. Now, no one wants the distinction of being first to lose the memory of belonging to a quirky, warm family.

I'm doing what I can. Every Christmas, Marie and I donate in one another's name to a charity. This year we started our own, the Bev Fund. I wonder why I've given to many good causes, but sometimes miss what's right under my nose. I feared that Bev would feel like "a charity case", be embarrassed.

We found a work-around: Marie and I are keeping the Fund secret. There are bills to be paid and Bev need not know how that happens. In our youth, we were partners in crime (if you count a little bit of pot, which is now legal here), and now we can be partners in kind.


Jane M. said…
Such a timely article for me and my family. I had a 'silent' stroke earlier this year. Thankfully w/o complications. I've not shared this information with anyone except my husband and daughter. I'm the first one to experience a serious health incident and for some reason feel ashamed. Your articles on uneven aging make me feel less alone. Thank you.
Venasque said…
I have had this experience myself and found that there are capable people in a family who step up, and those who do what they can while hiding under a big pile of coats. It doesn't matter who does what as long as the person is loved and cared for. If someone is feeling put upon, they need to remember it's not about them, and chances are this is not the first time they are the general (these patterns in families tend to be life-long), and the situation is going end, sooner or later.

Most of these problems here can be dealt with easily in my view. The real estate agent will fluff the house (granted there may be some charge for this but usually where I live it's part of the service, as the house sells at a higher price and he/she gets a bigger commission). If the brother wants her to come and visit then for goodness sake drive the 30 km and come and get her (or find someone who can). The one who lives far away needs to live with herself afterwards. If she will regret not coming to see her sister then the money is well spent. If it all feels OK in her heart to remain where she is, then that's fine too. In my view it is always better to act than live with regrets.

A loss changes the family dynamic for sure. In my case I felt the circle had been broken but it makes you realize life is short and fragile and you need to hold those precious to you close to your heart.

Jane M. I'm sorry you feel like this. You have nothing to be ashamed of, and if you share, they may surprise you.
LauraH said…
A very difficult topic, brings up a lot of fear and anxiety. But these things must be thought of now rather than later when it will be too late. Being on my own, I've taken a few baby steps to make sure things can run smoothly if I have a health crisis. More steps need to be taken but timing is the big question. I have older fiends who are also facing this situation. There is no easy answer.
LauraH said…
"friends'...not "fiends"
This is an impending loss of self and intellect, no most of this cannot be dealt with smoothly. One aspect that is both shocking and a relief is how quickly early-onset dementia usually proceeds. The only solution for the sufferer is death. Tragic but true.

I worked in such a centre, for elderly people of Italian descent. I was working on a history project on migration life histories, but there is no way one can escape hands-on involvement in such situations. I only with the legislator could accept a right to prior consent to assisted death, as is already the case in some countries. Yes, we need safeguards to protect vulnerable people from greedy heirs, but that doesn't mean forcing people who are no longer really alive as sentient beings to suffer indignity because of the religious beliefs of others.

A therapist I knew at that centre, an extremely gentle man who was devoted to his patients, admitted that if he were to get such a diagnosis, he'd blow his brains out.

Not suggesting that, and it must always be a choice, not murder for an inheritance, but I agree with the sentiment.

Hugs to the MacDo clan.
sensitive poet said…
I've seen both sides of the equation - I was paralyzed in 1 leg for a year after hip surgery. My wonderful husband and sons pushed me everywhere in a wheelchair during that long period, but my sister (who is an MD, and who lives about 100 km away) never visited me. Thank goodness for the wonderful rehab specialist and physiotherapists who helped me recover about 85% of my function. Lesson learned - you never know who will step up to the plate and who will crap out. But it is important to count your blessings, and the blessed people who help you rather than be bitter about those who didn't.
The tables turned when my husband later needed hip surgery, and I was the one to drive him around, and get wheelchairs for him when he needed it. I did this gladly, it is part of the give and take of marriage.
We used "Senior Moves" to help us move from our 4 storey house to a 1 storey condominium - at one point in time we were both incapacitated, and they packed up for us in a very sensitive but efficient way. They took charge of every detail, it was wonderful.
PS I did go to Thanksgiving dinner at my sister's, having forgiven her - we go back over 60 years after all- but when it came to my turn to share at the dinner table what I was thankful for, I said "my husband" and "being able to walk again".'Nuff said.
Lynn said…
My husband and I are only children so we have seen the dynamics of siblings only through his cousins (I have none). We have seen supportive sibs and ones who tear each other apart. Like sensitive poet we have used senior professionals to help us with moves and health care issues -- very capable each time, but lacking the personal touch that a caring sister or brother might have. I think we both wish we have more family, but it is what it is.
emma said…
It's a timely post for me. I've recently realized that my elder sister (single, childless) will probably need a lot of practical assistance in the next few years. There's just the two of us. I live in another city...so I am making plans and imagining scenarios. And yes, the old baggage is there.
Duchesse said…
Jane M: Thank you for your candour and also for handing me the next topic in the Uneven Aging series, Hiding Out. My POV is that your health is nothing to be ashamed of, and at the same time, it is your business until you decide to share what has happened. Thank you for being here.

Venasque: Some are easier than others, that house is way beyond the "fluffing" solution. The distant sister has her own serious illness (but not one that affects her cognition.)

LaurarH: Dang, I thought the song was "you Gotta Have Fiends".

lagatta: Protecting vulnerable people from greedy heirs or (more likely given our low savings rate) persons who are worn out caring for them can certainly be done. I too would like that provision having seen up close persons who were clear about their wishes for MAID and then lost competence before they could implement that.

sensitive poet: Thanks for your wise comment and for introducing me to "Senior Moves".

Lynne L: I am relieved that you found help. The MacDonald siblings jump into any family situation, which is both the joy and curse of a close family.

emma: Yes, they will, and sometimes the person who needs it first is not the oldest one.
LauraH said…
sensitive poet...looking online I found several companies called Senior Moves. Since it sounds like your experience was positive, can you share a link to the company you used? Thanks.
VeraL said…
Protecting the vulnerable from "greedy heirs." I've seen more of the reverse, worn out caregivers and selfish seniors who do zero planning and have high expectations. We dump on low-status women who work in LTC or home care. It smacks of 1940 to me with the black women working en masse as domestics. I suggest everyone read Gillian Bennett's take on the wastefulness and futility of dementia "care". We really are too squeamish.

"Understand that I am giving up nothing that I want by committing suicide. All I lose is an indefinite number of years of being a vegetable in a hospital setting, eating up the country's money but having not the faintest idea of who I am." "I can live or vegetate for perhaps ten years in hospital at Canada's expense, costing anywhere from $50,000 to $75,000 per year. That is only the beginning of the damage. Nurses, who thought they were embarked on a career that had great meaning, find themselves perpetually changing my diapers and reporting on the physical changes of an empty husk. It is ludicrous, wasteful and unfair."

Duchesse said…
VeraL: In some cultures' pasts, the old or infirm were killed, an approach that today has fallen out of practice because in much of the world we accept a social responsibility for what were once contributing citizens. In other parts of the world, "the country" does not bear the expense; the family or community do that as best they can.

"I am using up the country's resources" seems, in the quote you provided, tone-deaf in terms of moral perspective and taken to logical conclusions is an opening argument for euthanasia of persons with permanently limited function, what the eugenics movement and Nazism termed "useless eaters".

At the same time, I support an expanded definition of intractable suffering that would allow MAID (Medical Assistance in Dying), what lagatta mentioned: •the patient's• prior consent for MAID at a point when life becomes a terror (not just an inconvenience for caregivers or family.)

re nurses "who thought they embarked on a career that had great meaning": I disagree. I managed and worked closely with nurses for five years, and as they said, "You don't spend long in nursing school before you realize the job means cleaning up (human) waste." On the floor, nursing entails moments of life-saving contribution with daily scut work.

Some nurses are made for palliative or long-term care. For others, it's just a job. I agree that the lower-level health care positions—the aides and attendants— are often filled by persons who need work, period.

For a different perspective on care of Alzheimer's patients, see the recent, nuanced article, "The Comforting Fictions of Dementia Care": https://www.newyorker.com/magazine/2018/10/08/the-comforting-fictions-of-dementia-care

re taking advantage of the vulnerable old, I've seen it more at an earlier stage, where persons are targeted for a marriage or a "love" relationship, or "investment opportunity" while they are fairly healthy, but lonely.
sensitive poet said…
I just received a spam talking about casting a spell and magically the errant husband will come back. I can't believe it is a bona fide subscriber to your blog. Anybody else get a spam from a Dr. Azra? (I think that's the spelling, I immediately deleted it).
Duchesse said…
sensitive poet: This is not a subscription only blog and anyone can comment ( except anonymous commenters.) I remove the spam that makes it through Blogspot filters as soon as I can, but sometimes I do not catch it for a day. I also report it as spam.

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