Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, November 6, 1994 TAG: 9411040063
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: LIZ DOUP KNIGHT-RIDDER NEWSPAPER
DATELINE: LENGTH: Long
She took her 88-year-old mother to an Atlanta doctor. Headache complaints. She fixed Mom's favorite lunch, cream of broccoli soup (thickened with potatoes, not vein-clogging cream). And though Mom lives only a few blocks away, her daughter asked her to sleep over every night.
Now, as the ever-traveling Carter packs for another trip - and another separation from her mother - she feels guilty.
``I'm her oldest child, the oldest daughter and she would rather I be here,'' says Carter, her soft voice barely audible over a crackling phone line. ``I can't ...''
Even a full schedule of good deeds can't free Carter from the emotional tug-of-war that emerges as parents grow older, more frail, more dependent. But her just-published ``Helping Yourself Help Others: A Book for Caregivers'' (Random House; $20) offers insight and advice. The book is part practical tips, part poignant biography.
``It's a subject whose time has come,'' says Carter. ``At some point, just about everyone will be giving care or needing it.''
Carter's most telling stories come from unidentified caregivers interviewed for the book.
There's ``Frances,'' so exhausted from caring for her invalid mother that when she finally gets a vacation, she says: ``Don't contact me under any circumstances while I'm gone. Not even if Mother dies.''
There's ``Faye,'' who felt overwhelmed by her father's constant demands and criticism. One day, she packed her bags and checked into a motel, leaving the wheelchair-bound man on his own. Feeling guilty, she returned a few hours later, telling him she got tied up in town. Still, she came back ``only because I had to.''
Caregivers number anywhere from a few million to a tenth of the population, depending on whose study is cited.
Who's a caregiver? Definitions range from 'round-the-clock, live-in help for the ill or elderly, to adult kids who occasionally take Dad to the doctor.
In many ways, Carter is typical. Most caregivers are older women, whose personal calendars already are filled with work and family obligations. At 67, Carter - like her mother - is a senior citizen. Whether giving speeches on life as a first lady or hand-delivering pharmaceuticals in Africa, she's traveling more than she's home.
Ironically, her mother's stoic, selfless life of caregiving - to her children, her terminally ill husband, her aged father - makes it easier for Carter to pack up and go, even with the guilt pangs.
``My mother was really tied down,'' Carter says. ``She couldn't go anywhere or do anything. She was 70 years old before she had a life of her own, and I saw how what my mother did affected the whole family.''
At the time, young Rosalynn knew only that she wanted out. Out of Plains, population 600, and maybe out of the endless responsibilities at home. One month before her 19th birthday, she married Jimmy Carter and became the mobile Navy wife.
He teased her that she married to escape. Says Rosalynn Carter: ``I remember, I wanted to get away.''
It was a hardscrabble life, made harder by her father's leukemia, diagnosed when she was 12. Her father had cared for his wife and four kids by working as a school-bus driver, a car-garage operator and a farmer. Now he was tired, listless.
She remembers combing his hair and reading detective stories to entertain him. More vividly, she remembers feeling guilty. She believed had she been a better person, this wouldn't have happened. She recalls ``being afraid all the time - afraid of what was going to happen.''
And the desperation. To vent pressure, she ran to her secret crying place, the outdoor privy.
To buy hope, the family purchased a goat because someone told them the milk might help. The kids fed it; the mother milked it. ``When a loved one is desperately ill, one is willing to try anything,'' she writes.
Edgar Smith died at 44 in 1940. He left Carter's 34-year-old mother, Allie, with few resources and four children, ages 4 to 13. About a year later, Allie Smith's mother died, and her 70-year-old father, ``Papa Murray,'' moved in. Carter's mother cared for him for 25 years until he died in 1966. He was 95.
Carter's mother was both consummate caregiver and sole financial support of her extended family. She worked at the post office, arriving early and staying late so she could check on ``Papa'' midday. She had no vacations. No days off except legal holidays.
At home, she found no respite from responsibilities. When she asked her father's advice, he'd say, ``You can decide.'' On occasion, when he tried to be helpful, he created havoc. Like the day he walked into the kitchen and said, ``Allie, I sold your cow. I just couldn't stand to see you working so hard.'' Carter says the family needed the money the cow brought.
Carter's mother wept over the incident but not in front of her father. She told her children, ``Don't let him see me upset.'' ``Papa'' meant well. She didn't want to hurt his feelings.
As ``Papa'' grew older and sicker, he needed help with personal maintenance, such as reaching the toilet. It was an embarrassment to both father and daughter.
Yet, when Carter researched her book and asked her mother if she had wearied of the work, her mother said, no. ``Papa was easy to get along with,'' she answered.
Then she paused, thinking back over two decades of tending her father. Maybe one thing. In the last few years ``Papa'' was bedridden. He kept her up half the night with his cries.
``That was really hard on me,'' Carter's mother acknowledged. ``I still had to be at the post office at 7 o'clock every morning to work.''
Carter's personal stories only gently hint at the pressure-cooker atmosphere of caregiving. But with her longtime interest in mental health, she knows caregiving carries a price. The ill and the old get the attention, not the person who gives it.
As a result, compared to the general population, caregivers are three times more likely to be depressed, two to three times more likely to take psychotropic drugs such as tranquilizers and 12 percent more likely to use alcohol to cope, according to a 1987 study by the Select Committee on Aging.
Carter's book, co-written with Los Angeles author Susan Golant, emerged through a survey done by the Rosalynn Carter Institute at Georgia Southwestern College in Americus, her alma mater. The goal: to determine the needs of local caregivers.
Not surprisingly, those who coped best had outside interests and support, which they found in unique places. One woman said she managed fine because friends, her sisters and a daughter offered encouragement. Also: ``...I have four cats who are a big help.''
Despite the pressures, 88 percent of those surveyed said their caregiving experience was beneficial. Dealing with illness and the elderly, they learned patience; they gained perspective.
At home in Plains, Carter values time spent with her mother. In the past, she has helped nurse her through carotid artery surgery and congestive heart failure. Today, she wants to know what's causing her mother's headaches, but the diagnosis isn't certain.
Through it all, Carter's mother professes independence. She lives on her own and still drives around town, including the half-dozen blocks to her church. (``We worry about the driving,'' Carter admits.)
Like a conscientious caregiver, Carter has a safety net. Relatives in Plains keep watch, and a standby nurse knows how to reach Carter in an emergency. On the road, she tries to call her mother daily.
But saying goodbye for a trip, Carter doesn't make a fuss. She doesn't kiss her mother and tell her how much she loves her, just in case this hug is their last.
``I don't want her to feel it will be the last time,'' Carter says. ``I want her to think, everything is fine. I'll be back.''
by CNB