Mocha Moms: What's on the Table?

The Mocha Moms tackle the challenges of elder care in their weekly discussion. They explore the special preparations sometimes needed when adults find themselves caring for elderly parents.

MICHEL MARTIN, host:

I'm Michel Martin, and you're listening to TELL ME MORE from NPR News.

Just ahead: Our moneyman Alvin Hall is going to help us with some of the financial issues connected to caring for seniors.

But we're going to start the conversation about elder care with the Mocha Moms. We turn to them every week for their common sense and savvy parenting advice.

Recently, we spent some time talking about child care options. And that led us to thinking about another equally challenging issue: elder care.

According to the Federal Administration on Aging, the number of Americans over 65 years old is expected to double by the year 2050 to 79 million. The over 84 population is expected to quadruple to 18 million. So this is an issue that's going to touch most of us in the future. And if you're dealing with this now, you know what a tough issue it can be.

So that's why we decided to get the Mochas to help us sort it all out. Our regular Mochas, Jolene Ivey, Cheli English-Figaro and Asra Nomani are here in the studio. We're also joined by a guest today, Dr. Marion Somers. She's a geriatric specialist and author of "Elder Care Made Easier." Welcome ladies, moms, all.

Ms. JOLENE IVEY (Co-Founder and President, Mocha Moms): Hey, Michel.

Ms. CHELI ENGLISH-FIGARO (Co-Founder and President Emerita, Mocha Moms): Hi, Michel.

Ms. ASRA NOMANI (Member, Mocha Moms): Hi, Michel.

Dr. MARION SOMERS (Geriatric Specialist; Author, "Elder Care Made Easier"): Hi.

MARTIN: Jolene, I'm going to start with you. I think everybody at this table has at least one elderly parent. What's the biggest challenge you face in helping your dad right now?

Ms. IVEY: Well, my dad moved in with us almost exactly a year ago. And it's been hard in that I'm used to seeing my father a certain way. My father has always been the most competent person I've known. And he's just always taking care of us. And now, it's just gotten to the point - he's 89 years old now. He lives with us because he really, really needs to, because I can't worry about him living someplace else.

And he's just not the most competent person I know anymore. He can't remember things. If I don't pay attention, he won't take his medicine. He won't eat his breakfast - I mean, all those little things. And it's been hard for me to change my mindset about him to be able to accept him as he is and not get angry with him for not being very competent anymore.

MARTIN: And it also has to be said, you have five children who are…

Ms. IVEY: Yes, we do.

MARTIN: …you're still raising.

Ms. IVEY: Yep.

MARTIN: So you're part of that…

Ms. IVEY: I'm…

MARTIN: …famous squeeze generation, doing both at the same time.

Ms. IVEY: I think it's more like of a Dagwood sandwich, as supposed to just a sandwich generation. It definitely is the squeeze. We've had a lot of challenges.

MARTIN: Asra, what about you?

Ms. NOMANI: Well, we've talked about how my parents have been helping me so much, and I watched my mom go up and down the stairs, the house that we're renting right now. And her knees are feeling a little bit tired. And, you know, my dad is - I can relate to forgetting to have his breakfast. He sort of ends up in retirement at about noon, you know, on the computer, and hasn't had the routine.

MARTIN: And it's Ramadan now. I know you were telling me…

Ms. NOMANI: Oh.

MARTIN: …you're concerned about - he wants to do all the things he used to do before, including fast for Ramadan…

Ms. NOMANI: Yeah.

MARTIN: …and you're worried about him.

Ms. NOMANI: Oh, we had a lovely conversation a couple of days ago. My dad's in his 70s, and he is just had this tradition all his life to fast for 30 days. And so now, I could hear in his voice the effect of a fast that he did a couple of days ago. And I just said, dad, you can't do it anymore. You're excused anyway, because you don't have to fast when you're really young or really old. And he said, but it's spiritual. It's so important to me. And I said, Dad, I don't want to be standing at your grave, remembering how spiritual you were. And I think it was a little cruel. I'm thinking that I wasn't adult enough about it, which I think is the greatest challenge growing up as an adult with your adult parent. But - yeah, it's a tricky one.

MARTIN: Mm-hmm. And, Cheli?

Ms. ENGLISH-FIGARO: Well, my father is legally blind. He had some back surgery, so he is also disabled. So he can't really get around right now. My parents are living 300 miles away from me, and I'm an only child. And it's been challenging. They're both in their 70s.

My mom has had the full brunt of responsibility of dragging my father back and forth to his different medical appointments and the surgeries, and in and out of rehab, and that kind of thing. And I feel horrible because I'm 300 miles away, raising my three children, who are…

MARTIN: The youngest of which is two.

Ms. ENGLISH-FIGARO: …who think - thank you. I have a two year old and a seven year old and a 14 year old. So I'll be hands-on parenting for the next 16 years. And I just - I feel that we're a crisis waiting to happen.

MARTIN: Dr. Marion, why don't you take it from here? How common are the things that you're hearing from the ladies here?

Dr. SOMERS: Well, unfortunately, this is what I hear all the time. Until something happens, most of us don't become involved. We're so busy with our own lives. You talked about the sandwich generation. Well, I keep saying the sandwich generation is getting eaten alive. It's very important to be proactive where and when you can. And it sounds like you are all incredibly involved. But it's the small steps that very often can make a difference, simple things like putting bars in the toilet and near the bathroom area.

MARTIN: Grab bars.

Dr. SOMERS: Grab bars.

MARTIN: For someone you might be afraid might fall.

Dr. SOMERS: Right. You know, to do the simple things like having night-lights on all the time. And I think that is - one of the most important things is keeping the lines of communication open and continuing to honor them, even though they are changing before our eyes.

MARTIN: If you're just joining us, we're talking about elder care issues with the regular Mocha Moms. And we're joined by guest mom, Dr. Marion Somers, elder care expert and author of the book, "Elder Care Made Easier."

Dr. Somers, this is a good place to bring in a question we had from one of our listeners. We mentioned on our blog that you would be coming, and asked people if they had questions to send them to us.

And we got a question from Rachel. And she says: How do we start a conversation with our seniors as they start facing this next phase of life? We're used to them taking care of us, not the other way around. How do you start that conversation?

Dr. SOMERS: You start it quietly and honestly and at a time when you're not emotionally on a high, such as when an event just happened - they fall and they're now in the hospital. You try to do it before an incident happens. And you just say - talk about the things that you can observe.

I see that it's harder for you to read, or whatever the issue happens to be. And open the door for them. The elderly are so afraid that you're going to take away their independence and put them in an institution that they don't tell you all the things that they know are happening to their bodies.

MARTIN: Just so, what if you're in Cheli's case and also in my case? You know, I have to say, I'm not going to go into my situation because I just find it so painful. I won't be able to get through the conversation. But you are far away, and by the time - well, oftentimes, you hear about something, you see something. I find often the parents put the best face forward when you're visiting. They're on they're, you know, they're on their A-game. And then by the time you do find out how bad the situation is, something's already occurred.

Dr. SOMERS: Well, I call it the acting stage. They are trying to preserve their dignity. They don't want to burden you. They don't want to have you worry. So they put on this act. They pick up the phone, and when they're on the phone, they are, you know, everything's fine. You know, they don't talk about the dead cat or the plants and dying or any of those things or the other issues that they are dealing with on a day-in and day-out basis.

MARTIN: Or they had gastroenteritis because they ate spoiled food.

Dr. SOMERS: Oh, the list just goes on and on. And I say, you have to be there occasionally. Or get in touch with a neighbor who knows them or people at church who knows them or who can see some of the changes if you're in a situation where you can't personally go.

MARTIN: Asra, I wanted to ask some of the Mochas if they feel that there are some cultural issues that might make this even more challenging for people of color. I was going to point out just the economics of it. I find that a lot of people of color who are newly middle class, you know, their parents have too many assets to receive public assistance, but not enough assets to really ensure a comfortable existence.

And a lot of the guidebooks you see out there have to do with managing their assets and spending them. They don't have any assets. So just putting the economics out there, are there any cultural things that you guys see that you want to flag?

Ms. IVEY: I can say, culturally, that my father - he grew up in the Depression, and he's very private about his finances. And I had a feeling he didn't qualify for anything. I thought that he was well-off enough that he would not be able to qualify or he and my mom would not be able to qualify for Medicaid, but he wouldn't tell me. And it was driving me crazy. So I had to take him down to the Social Services Department.

He brought all of these great big books of his finances. And when he opened them to show it to the other woman, I saw the man had way too much money in the bank to qualify for anything. And then the way, you know, the laws work, where you have to have spent down before this three-year mark because they look at your finances for the last three years. And, you know, we're just not savvy enough for that.

MARTIN: Cheli?

Ms. ENGLISH-FIGARO: I'm not sure if this is a broad generalization for all African-Americans or people of color, but even within my own family, I think the expectations are different.

I know my husband is West Indian. And so his expectation is that he will take care - or his sister will take care of the older parent. So my mother-in-law and my sister-in-law moved from New York all the way out to Arizona seven years ago, and she was in her 70s. She moved with them, and that was the expectation. And that was good, because they believed in the cultural closeness, and I think that's a good thing.

MARTIN: Dr. Somers, I wanted to ask, do you find that - again, perhaps this is a generalization - are some groups more resistant to asking for help than others because there's a stigma attached to getting help outside the family in caring for a senior?

Dr. SOMERS: Absolutely. There are definitely cultural differences. There are some cultures where the female is going to be the caregiver no matter what her job is or no matter how many responsibilities she has. In other cultures, it might be the oldest child, male or female.

MARTIN: Asra, do you have a question?

Ms. NOMANI: Well, I came from India, and as an immigrant family, you know, this is the culture that we grew up with - this intergenerational homes. And I was a typical American attitude of nuclear families until I went back to India last fall and saw all of my elderly uncles and aunts living in this intergenerational scene. I thought that this idea that you write about, doctor, about being a martyr was really an interesting one, because so many of us sometimes want to prove that we can do it. And we…

MARTIN: And what she says is don't be one. Don't be a martyr.

Ms. NOMANI: Yeah. Yeah.

MARTIN: Because you're not helping anybody if you're at the end of your rope. So…

Dr. SOMERS: Being a martyr does not help. Being angry doesn't help.

Ms. NOMANI: Right.

Dr. SOMERS: Being frustrated or feeling guilty - none of these emotions are helpful. We need to be honest with the situation at hand.

MARTIN: Jolene Ivey, Cheli English-Figaro and Asra Nomani joined us from our studios here in Washington - the Mocha Moms. Dr. Marion Somers, elder care expert, author of the book, "Elder Care Made Easier," joined us from our bureau in New York.

You can find links to the Mocha Moms and Dr. Somers' book at our Web site: npr.org/tellmemore.

Thank you all so much, ladies.

Ms. IVEY: Thanks, Michel.

Ms. NOMANI: Thank you.

Dr. SOMERS: Thank you.

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