|
On The Southern Front
AFTER FORTY-TWO YEARS IN THIS COUNTRY, my parents announced that they were returning to their native country to live. Of course, we, their four daughters, understood the verb "to live" as a euphemism. My parents were going back to the Dominican Republic because that’s where they wanted to die. But my sisters and I were all too upset to be thinking of that eventual future. Like all "children," even then in our mid-forties and early fifties, we thought of our parents’ decision as it affected us. How could they do this to us? Never mind that like many immigrants who come to the United States as adults, their native land still exerts a strong pull. And immigrants from the southern Americas in the past half-century, unlike immigrants from war-torn Europe or from far-off Asian countries in the early-to-mid-twentieth century, often act on that pull. They stay in touch with their native countries, visiting often, availing themselves of frequent, easy, and, until recently, reasonably priced flights. Many build houses back home with hard-earned savings. When the day comes that their working lives in the U.S. are over, why stay? The motor driving their immigrant lives has often been financial. Of course they want to go home. "It’s not fair," my sisters and I protested. We were still in the middle of busy professional and familial lives. Couldn’t they come live where it would be easier for us to stay connected to them? Just their astonishment was a sign of the cultural gulf between us. We were thinking in that First-World way where the young are the focus and fuel in our fast-paced, youth-obsessed U.S.A. But our parents were formed in that old-world culture where the elders hold the power and the young respect their wisdom and defer to their wishes. Even the physical layout of our houses when I was a young child in the Dominican Republic showed this different power arrangement: my grandparents lived in the central house with all their adult children’s houses built as satellites around theirs. In this country we live in our individual houses and apartments, scattered from our birth families, with our elders segregated in their residences and nursing homes, at a distance from us. No wonder my parents wanted to go back to a more simpatico, companionable way of growing old, surrounded by their young. Our clamoring self-centeredness as their children and their nostalgia and yearning for an older way of life for their older lives obscured the simple, most obvious fact: their young—now not so young—were all here now. "You’re grown up. You can take care of yourselves," my mother kept reminding us, even as she swept back hair from our eyes or brushed the lint from our winter coats. But, in fact, the issue we were soon to face was not whether we could take care of ourselves, but how we were going to take care of them as they began to decline. When they left New York in April 2002, my mother was a healthy, vigorous seventy-six, and my father, eleven years older, was also physically healthy but already showing signs of memory lapses. Not long after they had settled in their home-town of Santiago in the Dominican Republic, Papi was diagnosed with Alzheimer’s. Meanwhile, my mother seemed to go from one health crisis to another, initiating a battery of tests that resulted in a shocking diagnosis: multiple myeloma, an incurable cancer of the plasma cells. In addition, as a result of either her myeloma spreading or a series of tiny strokes—it was hard to get conclusive medical information—my mother’s own memory began to fail as well. "¿Cómo vamos a cuidar a Mami y Papi?" my sisters and I asked each other in desperate phone calls back and forth across the country. How are we going to take care of Mami and Papi? According to a 2006 study by AARP, my sisters and I had joined seven million fellow Americans who are long-distance caregivers of elderly parents. And as the fastest-growing segment of the American population, we Latinos are becoming a significant percentage of that pool of caregivers. Along with all the concerns we share with our fellow American caregivers, we face a unique set of challenges. How are we to take care of our viejitos in a way that honors their cultura (and ours) while also fulfilling our commitments to the new culture and country we find ourselves in now?
BEING MULTICULTURAL OFTEN MEANS HAVING TO INTEGRATE conflicting world views, value systems, and languages, particularly at critical life junctions. One of those critical junctions is, of course, the passage into old age. How do we straddle the pulls in different directions as our parents age and as we ourselves grow older? No wonder a recent study by the AARP Foundation Women’s Leadership Circle found that Latinas (age forty-five-plus) worry at a rate of twenty percentage points higher than the general public about our older years (a whopping 39 percent versus 19 percent of the general public; Asian-American women followed at 29 percent). We are that Borderland generation, as the Mexican-American author Gloria Anzaldúa named us, facing one of our biggest challenges to date: taking care of our elders who belong to an old-world order they will want to return to before they die, even as we are pulled by our children, grandchildren, partners, and professions on this side. That return to their native land need not be a literal one. Our parents might insist we do for them here what was done for their elders in the past there. But there, they had access to extended family, to affordable domestic help, to a stay-at-home female population. Here, we live within nuclear families, with both members of a couple working, without domestic help, often in tight quarters. Those old-world arrangements are not always possible. Many of my Dominican-American friends have had no option but to bring a parent back stateside and find an affordable caretaking situation outside their homes. "Whatever you do, just don’t call it a nursing home," my friend Dinorah told me, after relating how she had successfully transplanted her handicapped mother from the Dominican Republic to a nursing home in Queens. "Nursing home" in our culture means abandonment—cold American institutions for people who don’t have families to care for them. But Dinorah and her two brothers had no one left in the Dominican Republic to take care of their mother. Here, they and their spouses all work full time; they have young families; they live in small apartments not equipped for handicap living. So they put their mother in a nearby nursing home, explaining that this was only a temporary care facility recommended by the hospital, while they figured out something else. "What happened was she ended up really liking the place." According to Dinorah, the home was full of Latino caregivers and a sizable portion of Latino elderly. "The other day, I heard her correct someone and say, ‘It’s not really a nursing home, because it’s full of gente hispana, and we know how to take care of our ancianos.’ " Naming is important, as we who travel between two languages know. One thing I’ve learned from conversations with my parents, especially as they grow older, is to "translate" content not necessarily into Spanish (since they understand English perfectly) but into cultural terms they can accept. "A mi que no me pongan en un nursing home," my mother would often say when discussing her future old age. We were never ever to put her in "un nursing home." The term was always used in English, as if even our language wouldn’t allow for this possibility. But I wonder if Mami, like Dinorah’s mother, would feel at home in a Latino-ized, Spanish version of a nursing home with another name? I’ll never know. For my parents chose another route that can further complicate larga-distancia caretaking for Latinos of my generation. They went back to their native country, and so began a saga that continues to this day.
WHEN MY PARENTS BEGAN THEIR DECLINE and were unable to take care of themselves, we had to figure out what we were going to do about their care. Every day, there was the phone call to my parents and whichever one of my sisters was there with them, taking her turn. Our schedules were a crazed mishmash of missed work days, leaves of absence, expensive long weekends in which two days were spent traveling and forty-eight hours were spent on the ground taking them to medical appointments while trying to recruit, set up, and train helpers who could carry on when we couldn’t be there. Daily, after speaking with my parents, we’d call each other to compare notes. "All’s quiet on the southern front" became our greeting on the best of days. On the worst of days, when we were all stretched to the limit, we’d agree that things couldn’t continue the way they were going. What to do? Predictably, the four sisters had eight different opinions. I was the one pushing for bringing our parents back to the States, close to one of their daughters—I volunteered myself. We could get them excellent care at the nursing home right next door to my husband’s office. Ay! What an outcry. Didn’t I remember what Mami used to say about "un nursing home"? But this was a very nice place, where a lot of my colleagues had a parent in residence. At meal times, you’d think you were in the faculty dining room! "Those were Mami’s wishes," I heard in a chorus that included a voice from my own heart. Statements made by our parents, before their sad decline, hold a great deal of power, especially in an emotional Latino family! OK, I ceded. How about plan número dos? I’d put them in a small condo development nearby. Find them round-the-clock care. Another outcry! Didn’t I know that the worst thing for Alzheimer’s patients was to move them to a strange place? But what was the alternative? How were we going to take care of them there? Suddenly, my sisters and I had to jerry-build a system because there were no services available on the ground. No home health aides, no meals on wheels, no visiting nurses, no assisted living places, no nursing homes—all those options that my American friends who are long-distance caregivers of elders here in the United States can tap, however uneven in quality or expensive in price they sometimes are. In a developing country, the immediate problems of poverty and disease are so overwhelming that public social services earmarked for elders are years—if not generations—down the line. Meanwhile, the traditional system that has been in place for taking care of the elderly—the extended familia structure that I had known as a young child—is, in fact, eroding. It isn’t just that my parents have lost their connection to that structure by living abroad for so long, albeit with frequent visits. Most of my female cousins now work full time, a necessity in our Third-World as well as First-World countries. They, too, scramble to take care of their own parents and children in the midst of busy lives. What’s more, the domestic helpers they used to be able to hire to assist them are also in short supply. For not only are Third-World countries experiencing a brain drain, that phenomenon whereby many of the brightest and the most qualified young people emigrate to richer countries for better jobs, now they are also experiencing a "brawn drain," the loss of a caretaker workforce to First-World countries. Many of these workers are women who take jobs as domestics and caretakers, often in day care centers and nursing homes, leaving behind their own young and old. Remittances sent back by these migrant workers ($300 billion to developing nations in 2008) keep these "global care chains," as they are called, going. But money cannot make up for a lost social system, and it cannot buy services not there in the first place.
MY SISTERS AND I WERE SUDDENLY FACING not just a national phenomenon (long-distance caretaking), but a global problem. With an irony not lost on us, our own mother had predicted it. Before my parents’ departure, my mother had served for twenty-three years in the United Nations as an alternate ambassador from the Dominican Republic. Although it was an official post with a salary, my mother refused payment. She was lucky enough to have her husband’s support as well as an inheritance to fall back on. Ours was a poor country; her salary should instead be spent on program development. She paid for her own trips, her office supplies, and cleaning supplies for the cramped United Nations mission offices whose windows she also polished. (One time, in her briefcase I spotted among her folders a roll of paper towels and a bottle of Windex!) At the United Nations my mother’s chosen focus was none other than global aging, specifically in the Third World. With colleagues from a number of agencies and organizations, including the Gray Panthers, my mother marched in Central Park for the rights of the elderly. Her daughters’ jaws dropped in a gesture reminiscent of her own expression of shock. Mami championing the Gray Panthers! My, oh, my. Our mother, who had given us grief for being hippie antiwar protestors. But my mother had found her cause. An increasing portion of the world’s population would be living into old age. This "agequake," a term she coined, would especially affect countries like her own because the majority of those older people would be living in developing countries with no social welfare or health care systems in place to take care of them. And it was not as simple as asking these countries to face up to this incontrovertible shift in demographics and begin to solve the problems of an aging population, because in fact, these were precisely the countries that were overwhelmed with the challenges of poverty right now. "The reality of aging in much of our Third World is that older people are poor first, and only secondarily aged," my mother explained in one speech she read me over the phone. As the writer in the family, I was often called on to correct her English and add those little toquecitos and quotes from Shakespeare and other poets that my mother intuitively knew moved hearts more than dry facts. How to incorporate the elderly so that they could be productive members of society rather than one more burden for a poor country to bear? How to use their skills and their cumulative wisdom and expertise? How to defend their rights? It was through my mother’s efforts that the United Nations drafted a declaration of the rights of older persons (UN Principles for Older Persons) and declared October 1 to be the International Day of Older Persons and the year this declaration passed, 1999, to be the Year of Older Persons. In fact, as I found out two years ago when I attended a tribute in her honor, my mother was known informally at the United Nations as "the ambassador on aging." But my mother will not live to see or to avail herself of the elder social services she worked so hard to promote in her own country. As her daughter left with the legacy of her cause, global aging, I feel compelled to keep alive our collective concern and creative thinking on this critical world situation. Often in her speeches, my mother would point out that there was a precedent for the global community mobilizing itself to address a surge in a vulnerable segment of the world’s population. After World War II, many children were left homeless, helpless, orphaned. And so, in 1946, UNICEF (the United Nations Children’s Fund) was founded to care for the world’s children, feed them, educate them, protect their rights. Now we are facing a surge in another vulnerable population at the other end of the age spectrum: the world’s elders. They, too, need our care and our concern. How wonderful it would be to see my mother’s deepest dream come true: a UNICEF for elders. UNIFA, she dreamed of naming it, the United Nations International Fund for the Aging. Along with UNIFA, my mother came up with another futuristic creation as a way of personalizing elder issues in her speeches. She invented Elvira Vieja, a Hispanic elder who lives to see great changes brought about by the activism of an aging population. The year is 2010—which must have seemed far off in 1980 when my mother created Elvira. American society has finally realized that elders are a wonderful, vital resource—their wisdom, productivity, and energy should be used. After she retires in her late sixties, Elvira becomes one of a large pool of "board-certified health counselors," who are helping stem the flood of elders’ medical needs, freeing the universal health system (now in place) for more critical care. As much as possible, Elvira works in the Latino community, using "traditional, low-tech procedures, such as diet, herbal medicine," and other culturally appropriate and by now scientifically proven antidotes. As Elvira walks for exercise, she notices something different about the people on the street. On the average they are older. "One is almost as likely to see an older woman with a younger man as the reverse." (Go, Mami, go!) One of the more poignant moments in Elvira’s life is when her mother, Consuelo, who came to this country as a migrant worker, has to make a decision about the last years of her life. "Consuelo had always hoped to return to Mexico to live out her final years. But the more prominent role played in the United States society by older Americans led to a health care system for older people in this country that Mexico could not yet match. So she decided to stay here." In my daily phone calls to the Dominican Republic, my mother and I chat about her health, my father’s health, how she slept, how he slept, what they ate for breakfast/lunch/dinner (if she can remember). Her world is narrowing down to the immediate happenings of her day. But sometimes, in part to encourage her happy memories and creative thinking, I ask my mother how Elvira Vieja is doing. "She is still working hard. She believes elders have a lot to contribute," my mother tells me. "Good old Elvira." "She doesn’t like to be called old," my mother corrects me. I’ve lost my need to one-up my mother, and so I don’t remind her that it was she who gave Elvira the surname Vieja, which means "old" in Spanish. "She likes to be known as an elder." "What about Connie?" I ask. Last I heard in one of my mother’s speeches, Connie, Elvira’s daughter, was having a tough time as a single mother raising her daughter Marguerite while holding down a job. "Connie started a home in her home. She got a government subsidy and so she decided on a second career." Mami is on a roll now. I recall that in that gerontological utopia of Elvira Vieja’s future, home care of the elderly would be subsidized by the government as a more viable, inexpensive, and humane way of addressing elder needs. A whole home care service industry would rise up to help families do this. Nursing homes would be a disgraceful dinosaur institution of the past—like the lock-down asylums in the dark ages of mental health care. As Mami talks, I can hear my older sister in the background, coordinating the schedule with the helpers she has hired. After several frantic years of each daughter taking turns to go down and monitor their care—while worrying (upping the Latina worry charts!) in those interim weeks when none of us could be there—my older sister decided to move down to be with our parents. Her years running a mental health practice in a Latino neighborhood in the U.S. have helped her in setting up a good care system, including hiring a Dominican social worker as the ongoing "administrator." Thank goodness my parents have the funds that have allowed us to do this. Thank goodness my older sister, whether inspired by Elvira Vieja or by our mother’s example, has taken on this challenging job. For now, we have solved the problem of taking care of Mami and Papi. All is quiet on the southern front.
Julia Alvarez was raised in the Dominican Republic and emigrated to the United States with her parents in 1960. She is the author of How the García Girls Lost Their Accents (Algonquin Books, 1991), In the Time of the Butterflies (Algonquin Books, 1994), Once Upon a Quinceañera: Coming of Age in the USA (Viking, 2007), and Return to Sender (Knopf Books for Children, 2009), as well as other novels, nonfiction, children’s books, essays, and books of poetry. Alvarez is a writer-in-residence at Middlebury College. She lives in Vermont, but travels frequently to the Dominican Republic to care for her parents.
| ||||||||||||||||||||||||||
Top
When Larga Distancia Becomes...
The Dreams Of Elvira...
