Our visit to Italy included a brief overnight at Fabrizio’s family home in Velletri, a town in the Alban Hills about an hour outside of Rome. Fabrizio, Wanja and the kids come every weekend to this lovely old villa, and not just because they want to escape the heat in Rome.
You see, Fabrizio’s Dad has Alzheimer’s disease. And though he has a nurse who stays with him during the week, Fabrizio comes to stay with him most weekends, a duty he shares with his sibs who live nearby. They feed, shave and bathe their Dad, and most importantly, watch to be sure he does not wander off, as he has done on more than one occasion.
I am moved, not just by Fabrizio’s personal attention to his Dad, but by the family’s acceptance of this lovely childlike man in their midst. His dad joined us at the dinner table, and although he did not speak, he smiled a lot. Like a small child, he was taken from the table when he was finished, and sat on the nearby sofa while we finished dinner. Then off to bed early, Fabrizio holding his hand as he led him upstairs to his room. No apologies were made to us, no complaints. My children did not skip a beat. Fabrizio’s Dad was simply part of the family, just the way he was.
This sort of loving acceptance is exactly what NY Times writer Denise Grady writes about this week in an article entitled, “Zen and the art of Coping with Alzeimers“.
If Dad wants to polish off the duck sauce in a Chinese restaurant like it’s a bowl of soup, why not? If Grandma wants to help out by washing the dishes but makes a mess of it, leave her to it and just rewash them later when she’s not looking. Pull out old family pictures to give the patient something to talk about. Learn the art of fragmented, irrational conversation and follow the patient’s lead instead of trying to control the dialogue.
Basically, just tango on. And hope somebody will do the same for you when your time comes. Unless the big breakthrough happens first.
Along with acceptance, my friends express an unquestioning belief that care of their parents is just another part of life. Wanja tells me stories of friends in similar circumstances doing much the same for their parents as Fabrizio does for his dad.
“We don’t have nursing homes here,” Wanja tells me. “This is just what we do.”
She’s right. Italy has few nursing homes, and in almost all families, care of aging parents happens in the home. Acccording to a 1997 survey of nursing home care in 10 countries:
Italy has a national heath care system with universal coverage, modelled on the UK’s National Health Service [20]. There is, however, a major difference, in that no provision was made for the long-term care of elderly people. There is no uniform policy and there are literally hundreds of local solutions to meet the needs of elderly people… in Italy the care of elderly people is almost exclusively the concern of families.
The need for good home care in Italy has created a huge market for caregivers in Italy, a need that apparently is being filled in large part by Ukranian caregivers. It’s a patchwork of a solution to a growing problem, as the average life expectancy in Italy rises and families with two working parents struggle to keep their parents at home.
And it speaks of a nation that still has the family at its center.
Though our stay in Villetri was brief, it has left an indelible impression upon me. As I watch my own parents aging, I can only pray that if the need ever arises, my sibs and I can care for them with the same grace that my dear Italian friends have shown in caring for their Dad.
What do they do when there is no family (for whatever reason)?
rlbates- Good question. I have no idea…
I know there are nursing homes and ‘old-age’ homes here in France but, I think for the most part it’s the same. My neighbors are 85 & 94 and one or more of the kids (who all live near) stop by every day. It’s a part of life that, sadly, we Americans seem to want no part of.
I’m italian and I would like to comment on this post.
Ribates is right to ask “what do they do when there is no family?”.
It is all nice and good when you have a large family like it used to be for the past generations in Italy.
This is changing dramatically for my generation, now the norm in Italy is 1 or 2 children, that often have to work far form their parents due to problems finding a job close to home, or just to personal choice.
My grandmother died last week, she had a fall and broke her hip, and never recovered, going rapidly downhill and lately starting to have dementia like simptomes, probably due to a TIA or a small stroke.
My mother is alone, my father died last spring, suddendly (yes, it was a bad spring for my family). She was left alone to care for her mother, since I work abroad and have to travel more than 9 hours to reach them, and could not leave for a long time. I don’t have brothers or sisters, my mother luckily has a brother that could help her a bit.
The waiting lists for a place in a public nursing home are in the order of years, not months, and the privately run ones are horrendously expensive, and have very very long waiting lists too.
So my grandmother had to move to my mother’s flat. And it was not easy, phisically and emotionally.
It is not all nice and good as in the family you visited, often having a demented or very sick parent is simply hell for the family. What’s more, there is quite a big social stigma attached to nursing homes: you are a bad son, and especially a bad daughter, if your parents need one.
Sorry for the long post.
Francesca
Francesca:
I can only imagine the stress your family has gone through. My Mom was sick recently, and although I have 8 brothers and sisters, I was still tremendously stressed. As modern women more and more work out of the home, figuring out how to care for our parents is going to be a huge challenge, both individually and as a nation.
Although I’m painting a nice picture of my friends, I know it’s been extremely stressful for them. I just have so much admiration for their grace under pressure.
Francesca, so sorry for your families sorrows. I hope there is some sunshine in all those shadows.
These sort of things make me feel incredibly guilty and frustrated. The years I was “on the market” in my field, there were about 50 jobs nationally, and at least 200 applicants for each. After 5+ years in a PhD program, etc, I got a job halfway across the country. I’m one of the lucky ones!
Yet, I get to hear lots of guilt about what a crap daughter I am, from all sorts of people, for not “being there.”
But then I think about watching my grandmother nurse her father and mother (for years!), ruining her health, making it difficult to raise her younger children, literally spending years of her life taking care of bedridden people in her little apartment.
There have to be better answers. (I also expect to be vulnerable on the other end, since I chose not to reproduce. So I hope there’s a better answer.)
Bardiac:
I feel your angst. And hear you regarding you grandmother’s lost life. Probably what makes it work is having help come into the home, as my friends have all week long for their dad.
As for yourself, I expect you’ll be riding that bike well into your 100’s. The kids’ll have trouble keeping up with you, let alone need to take care of you.
Thanks to all for the nice words, I just come back form Italy to say goodbye to my grandmother and I found this post, it just struck me.
Sorry if my comment sounded a bit hard.
Thanks again
Francesca.
As an ombudsman and an entertainer who spends hundreds of hours in nursing facilities, it is sad to see how many families have dumped their loved one off so to speak and never visit. I think how we age and our parents age will be a direct reflection of our own personal value system. And there is a lot to be worried about when you look at what is valued in this culture. Keep up the writing. Would love to chat in the future.
Anthony Cirillo, FACHE, ABC
This post and its comments cover the waterfront for caregiving options.
Do it yourself and risk stress and exhaustion. Leave it to someone else and risk guilt and remorse. Seek a middle ground and risk always feeling you should be doing something else, whatever you’re doing at any given moment.
Caregivers understand all this. Those who are not caregivers often do not.
Pete Sampson
CaregivingBlog.com
Anthony – thanks for your comments.
Pete – Sounds exactly like what we say about raising kids, doesn’t it?
Thanks for your comments.
Wonderful post…I wish everyone had the same compassion towards their ill family members.
My parents are deceased but they took care of their parents (moved them here from India) and it was a very important thing for me to see.
Had my parents been alive, I still wouldn’t have considered a nursing home as an option as they would have gotten older.