At the window with Dementia - Episode 22 "The look of the new family unit"

A reflection of how families tend to grow apart and the resulting implications.

Transcript

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I've been thinking a lot about the family unit. How do you define a family unit?
I know most people several decades ago, used to define it as multi-generational you had grandparents with parents with children and maybe even grandchildren or great-grandchildren. And now it's different. My family has been pretty similar in terms of structure for about the last eight years. Why eight years why not ten? Well, eight years ago, my husband and I bought a home, and we had two of our five children still living with us. And there was room in the basement to go ahead and build it out to make an apartment. And we decided, along with my mom, that she would live there, that my husband would finish it out and she would live with us. A couple of months before then, my stepfather actually passed from Alzheimer's, and although we lived in the same town with my mom and my stepfather, she just wasn't comfortable living alone. She certainly what was able, it wasn't that she was having any issues. And if you have followed any of my previous podcasts you know that unfortunately, that is not still the case, she is actually struggling from some memory impairment, but back then she wasn't, so it was more about just feeling secure and not feeling alone, which is how she felt after my stepfather died.

So, eight years ago, we all moved in, and everything was great, it was my mother, who had her own entrance, really her own residence within the same four walls as ours. And my husband and two of our five children (we are a blended family), his children are older so they were already out of the house, married with children, and then a few years later, my oldest daughter got married, and she still lives in our town but as I said she's now married, and she has her own child. So now it's just my husband and me, Our youngest and my mom. But that still is pretty unique because most people, don't live with their parents. Not at my age, at least. It's rare that you have someone who's middle-aged. Certainly, a term I never really imagined myself to identify with, but nonetheless, here I am with my mom living with us and my daughter too. So we've got three distinct generations under one roof. And that might have been the norm several decades ago, but it's not anymore. Now we use the term family so loosely, you have people referring to friends with the title of "He's like my brother," "He's my family," when in fact, really what they are is just very very close.

So has that really diluted the term family? Has that changed how we look at family and the value we place on our actual family? Now I know not everyone is so fortunate to have people that they are actually blood-related to that they enjoy being around. Some people, then, were a curse for whatever the reason, maybe it's mental health issues, or substance abuse issues, or they just don't get along, and there's a lot of tension.

I'm lucky, that's not the case with me. I love my family. But again, what do we define family as these days. We're also spread out across the country, sometimes across the globe. And we rarely get to see each other, and that's so so sad. And I would say that one of the few blessings of COVID because really, there's not many and believe me I see all the destruction and horrifying things about this current pandemic. But there are a few blessings, and one of the blessings, I think, is that we're all hunkering down. And that is bringing us back into that family unit.
And so with this time that we've spent together, maybe we're getting reacquainted. And maybe we're in some way, going back to that multi-generational existence.

Because think back what it used to be like, whether you know firsthand or you've seen, families that were experiencing this or maybe the closest connection you have to it is through a movie where this existed. But when you have multiple generations gathering you have exchanges, you have exchanges of experiences and thought, and you have some really dynamic conversations because the people have such different perspectives about the same topic.

We have a gathering area. Ours happens to be in the kitchen, but sometimes, some people, they have it around the dining room table.
Now, we have, as I said, adult children as well, who have been married and have children and live in our town as well. And even though, from a geographic standpoint, we live so close to one another, life has gotten in the way, and weeks go by, and we don't see each other, and yes we talk on the phone but let's be real, that's not the same thing.

So, pre COVID back early this year, my husband and I talked, and we decided you know what we need to go back to the way it used to be, we need to bring everyone together and have a time that is carved out is our time, our family time, our extended family time, where we leave the rest of the world behind closed doors, and we gather around a table, and we break bread. And we laugh, and we share stories. We connect.

So we went ahead, and we asked our family, is this something you're interested in? Because again, everyone has very busy schedules, and everyone said, "Absolutely!" So we got to do it for a few months. We got to do it in January. We got to do it in February; In March, my mother-in-law was unable to join us because she lives in a senior community, in an assisted living facility, and by the end of March, (we always gathered on the third Sunday of the month) they had already gone ahead and locked down their facility because they recognize that seniors were a vulnerable population with COVID, and so, she couldn't join us, and we missed her a lot. There was some guilt I had having this gathering without her there. We needed to get together. Maybe that month, more than any of the previous months, because the world was starting to change, and we needed to pull together and have some emotional support, and just that true raw connection of being together. And then in April, we couldn't get together, because, at that point, they were saying everyone needed to stay isolated. So we postponed it. And then in May, my granddaughter was born, and again, we could not get together, same in June, but in July, when things loosened up a little bit, we decided to do it again. This time the weather was nice, we met outside we had a barbecue, it was a lot of fun! And the way I can only speak for myself, but the way that I felt, having everyone together was as if I was renewed. I was being fed both literally and spiritually; emotionally, there was a connection. And I didn't realize how much I needed that connection. But I did, and I still do.
It's something that I think that we need to really look at as a society, how we've pulled away from the family unit, and now we're just somewhat coexisting.

In my clinic practice a few years ago, I met a gentleman.
He was referred to me for memory evaluation. And he did not want to be there, and he made it very clear to me that he did not want to be there. His wife and a couple of his children attended my support group for several months, and they kept telling me how they wanted to get him into my clinic for evaluation because they knew something wasn't right. But every time he went to his primary care doctor. She just dismissed it as normal age-related memory loss, which is, of course, what he wanted to hear, so he had no interest in coming to me.

And I don't know what finally got him to the point where he was willing to come to me. Maybe it was just to make his family quiet. Maybe he was tired of being harassed, to come and see me. And I'll never forget the first time that we spoke. He came with his wife and his oldest son. And they sat in the exam room with him and I and didn't utter a word. They were there. I don't know if it was for moral support or for whatever reason, maybe to hear what I had to say. But they didn't say anything. It was just he and I speaking. If I hadn't looked to the left, I wouldn't have even known they were sitting there really. And as we started talking, he said to me. Don't ever say that I'm old. Because if I recall correctly, part of the conversation was about normal age-related forgetfulness. He was up in years, he was in his late 80s. And we joked about it over the next several years. because we became friends, not outside the clinic, but it got to the point where his visits into the clinic, really fed both of us from an intellectual standpoint and from an emotional standpoint. See, he had worked his whole life to support his very large family he had seven children, and still married to his beautiful bride, that he married when he was in his 20s. And again, by the time I got to meet him, he was in his late 80s. And our friendship evolved over the next several years from one of clinician and patient to friends; we would talk we would have really good conversations. And he would tell me how he felt so useless because when he was younger, his family in his mind needed him in a way that they no longer needed him.

They needed him to provide for the family, which he did so so brilliantly. He was a salesman and definitely had a golden tongue; he could tell a story like you would imagine a salesman could. Back in the days before texting and emails, where you really had to have a skillset of the gift of gab, and he had it. And so, we would talk. And he would open up to me, and yes, in fact, he did have early Alzheimer's, it never advanced beyond that. So he was aware that he had memory problems, but we could have true raw conversations, meaningful conversations, and we did about so many different topics, but again, he would tell me how he felt like he was no longer needed by his family. Because his children were grown and his children had children who had children. And now he felt like a burden. Now he felt like the only time they wanted to come over, was an obligation which couldn't be further from the truth because when I tell you this family adored him. They put him on a pedestal. They absolutely adored him. And he would share with me that he missed his youth. More than anything else, he missed it because he missed having that sense of being needed, he wanted to be productive. And we talked about different ways that he could be productive in his older years because now he wasn't as mobile as he used to be. And his thought process was a bit slower. So we talked about volunteering. And I don't know how many months it had been into our relationship of friendship and patient-provider, maybe six. But he started going out, and he volunteered in his church, which was a very important part of his life. He was very faithful. And he would come back, and he would tell me how he was volunteering and how he went back and became an active member of the men's group that he was part of, and it was so sweet because one point he even came to me and he said, I went, and I talked about you. And I told them that everyone needed to go, and they needed to not be afraid to have their memory evaluated. And that everyone should go and make an appointment. And it was the sweetest thing we've come so far we laughed, because again reflecting on that first visit, how he really didn't want to be there. And again, he didn't mix words about that; he made sure that I knew that he didn't want to be there.

But our visits became almost a social visit; we would talk about what was going on, the struggles that he had, yeah, we talked about medication and some medical issues as well. But we would talk about how important he still was, and how much he still had to offer. And one of the things that I suggested to him was that he has one of his grandchildren start recording him and have him tell stories of the past, so that they would be forever memorialized, and that they wouldn't disappear when he someday passed, and he decided to do it. And they had a lot of fun making these recordings, and he would come back to the clinic, we would talk about it. And then he became sick. And it started to ravage his body; he had cancer. And instead of coming in all dressed up with a top hat like he used to, He started coming in in a wheelchair, and in his pajamas. And I didn't care. I was just glad to see my friend. And the last time, he came in I'll never forget because we had a conversation about his death. And I asked him how he felt, and he told me he was ready to go. He said he was ready. He was ready; he had lived a long life. He knew that he mattered. He knew that he had a family that loved him and appreciated him. And he was also kind enough to tell me that our friendship mattered to him. I never saw him again. I kept in touch with his family. I got the phone call when he passed. I cried. But I was happy for him because he was no longer in pain, and his wife, who had passed, just a few months before he did, I knew that they were reunited. And I share this story about my friend because it was all about the family unit. And again, as I had mentioned, he had a very large family and it was so important to him when they were together. And as they all moved out and started their own families and lead their own busy lives. He felt like he wasn't important. Even though I know, he was. And I think that this is something that a lot of our seniors feel. Because as they slow down, they just feel that they're not needed, because they don't get asked to help fix something or what is their opinion about this, or how should they go about that. And I think that's something we need to think about. I think it's something that we need to really remember that even as our bodies, age, and our mind slow down. We all want to feel important. We all want to feel needed, and we all want to feel like we contribute. And I think back when that family unit, used to live under one roof; we probably did a much better job of letting people know how much we needed them. I know that my friendship with him will never be forgotten, and I don't ever want to forget the lessons he taught me because as much as I took care of him from a provider standpoint. He took care of me, too, from a human standpoint. Don't forget about the value of family in every aspect of the word. Think about what you've done in your life and the lessons you've learned, and that you could pass on. And then think about the lessons that previous generations have had that they've shared with you and how they've enriched your life.

So yes, we are all blessed with a family; some are a little more fortunate than others, for reasons that I mentioned earlier, but don't take it for granted, don't think there's always tomorrow because someday, tomorrow's gone, we're robbed of that tomorrow. And in the meantime, I encourage you all to look at your family, to look at what you define is your family unit, and remember that everyone needs human connection, everyone needs to feel important, and regardless of what is going on in any of our lives, family can make that burden a little bit easier, that joy, a bit greater, And certainly make life much richer.

Anyway, I hope you enjoy my podcast, I'm Laura banner.
I am a nurse practitioner who specializes in dementia. Check out my website, CompassionateEducation.com you can find a lot of information there about memory issues. You can also find me on Instagram. 
I hope you decide to subscribe, check back every Tuesday, I release new episodes then. 
Take care and again thanks for listening.