My father turns seventy this year, and my mother has survived breast cancer. While they are both still vigorous enough to chase grandkids around for an entire day, their aging is becoming a more frequent topic of discussion among our family. During one conversation about their eventual plans to move to a retirement home and possible need for nursing care, I must have looked bewildered. "What's wrong?" my father asked. "Oh, Valerie still doesn't think you and Ruth are going to die," my husband chimed in—not unkindly, but (my apologies) dead right. Youth's parents are, apparently, as immortal as youth itself.

For thirtysomethings like me, not yet the meat of the sandwich generation but no longer the bottom slice of bread either, Virginia Stem Owens' new book, Caring for Mother: A Daughter's Long Goodbye, is a possibly unwelcome but valuable portent of things to come. An unflinching account of Owens' seven years spent caring for her mother, who suffered from Parkinson's and Alzheimer's, Caring for Mother reads like a map of the territory we may be about to enter. If aging is indeed "Another Country," as the title of psychologist Mary Pipher's book on aging suggests, then caregiving for the elderly is like hiking alongside our loved ones in a foreign land. Death is certain, Owens writes, but the process of dying is an "open, anxious space where we set up camp, uncertain how long we'll be there."

Owens' story begins when her mother is suffering from Parkinson's but is still mostly lucid and living at home. Gradually, however, her hallucinations increase in frequency, and Owens grapples with how to respond to her mother's conviction that men have broken into their attic and that tar is seeping through the floor. Recognizing the gravity of the situation, Owens moves into a house down the street from her parents and spends the next seven years taking her parents to doctors' appointments and helping her mother move into a nursing home, where she lives for five more years. Accompanying her mother as she slowly drifts into a semi-dream state, Owens ponders topics such as the medical establishment, caregiver fatigue, nursing home culture, brain chemistry, and Eastern and Western understandings of the self.

Caring for Mother is, in a word, relentless. Owens is unfailingly honest about the agony of watching her mother lose her faculties, her own frequent sense of failure and guilt, and her floundering faith in a gracious God. She does not shield herself or her readers from the anguish of a parent's decline with Christian platitudes about heaven or the virtue of a life well-lived; indeed, she quashes the notion that spiritual fortitude or lifelong practices of faith will necessarily carry a person into tranquil twilight years. At the end of her life, Owens' mother found no comfort in the faith that once sustained her, and she became displeased by any mention of religion. Owens tries repeatedly to help her mother recover her belief, to "find the switch that can flip on that steadfast faith she had always relied on." In a heartrending scene toward the end of the book, Owens' mother has a panic attack at the imminence of her death. Gripping her daughter's hand, she says, "I don't want to go away from you." Owens is speechless and can only stroke her mother's arm, "abashed to discover she loves me more than God."

Before reading Caring for Mother, I assumed that the serenity that characterizes my own grandmother, who will turn 100 later this year, was bought with the countless hours she has spent throughout life in prayer, Scripture reading, and spiritual attentiveness. She's the archetypal "prayer warrior," that most cherished of Christian images of aging: the grandmother who spends hours praying for the struggling great-grandson, the overworked pastor, the granddaughter with three small children who lives an hour's drive from family (that would be me). It seems that for some people, a lifetime's stockpile of spiritual resources can be cashed in for peace at the end of life. But Alzheimer's, which has been called "the theological disease" because it ravages memory and identity, can deplete even the most saintly Christian's spiritual capital.

Indeed, end-stage dementia threatens the popular Christian narrative of "prayer warrior" aging to its core. That narrative can accomodate some humorous lapses in memory and judgment: the old woman can forget her children's names, confuse a nurse for a granddaughter, even hobble into the dining room in her slip. What this narrative has not managed to hold, however, is an aging Christian's agnosticism, what Owens calls, in her mother's case, "the amputation of her spiritual sensibility." In his study of Alzheimer's and the love of God, Forgetting Whose We Are (Abingdon, 1996), historian David Keck writes that Alzheimer's "subverts our narratives" and "challenges and relativizes all of our assumptions about language, meaning, and humanity itself." He then develops what he calls an "Alzheimer's hermeneutic," which "learns through the humiliation of disease, dissolution, and death that we approach the Bible's narrative as creatures in need, creatures whose own selfhood is dependent on the support of the family, the church, and God." Owens' memoir would have been strengthened by reference to Keck's thorough exploration of dementia and Christian faith. Still, her account ends with a parallel move to Keck's analysis, with a measure of confidence that her mother's loss of volition, faith, and identity actually returns her to the arms of God.

While Owens gives her readers few distractions from the ache of her story, there are snatches of beauty and grace here. Owens labors throughout the book to figure out what remains of her mother's essential self, with decreasing success as time goes on. But she does discover an "underlying signification system" beneath her mother's garbled words and actions, one that she slowly learns to decipher. "The day before my brother or my daughters arrive for visits, she spends the afternoon cooking in her nursing home bed, propped up on pillows, handing me finished dishes to store away," Owens recounts. "'Is there enough?' she asks me with a worried look. 'Are the beds made?' These are her metaphors for love."

Just as she increasingly relies on her mother's gestures as glimpses of her true self, Owens herself more frequently turns to metaphor as the book goes on. Her lovely penultimate paragraphs, in which she reflects on her own grandchildren, move her story from past and present into the future:

Through our three generations of bodies runs a literal string of messages, etched in that most elegant of scripts, deoxyribonucleic acid. This chain, ladder, stream of life—call it by whatever metaphor you like—carries the letters of the dead to the yet-unborn. What are they saying? What do I want my note, tacked to the string, to say?
Only this: Loving people is such a burden. If love, in and of itself, weren't the center from which life flows, if it didn't, as Dante says, move the stars, how could we bear such weight?

Owens' book widens the ribbon of recent narratives by caregivers for aged parents that began with Changing Places: A Journey with My Parents into Their Old Age by journalist Judy Kramer and No More Words: A Journal of My Mother, Anne Morrow Lindbergh by Reeve Lindbergh. These autobiographical accounts are especially relevant now: one in four families is caring for an aging relative, and the number of elderly people in the United States is expected to double by 2030.

Caring for Mother does not make policy suggestions for the resulting roster of gerontological questions facing our society, nor does it offer pat solutions for how caregivers can retain sanity as they watch loved ones lose theirs. It does, however, shine a light on the alien land that spreads out before many adult children. And it does offer some modest, makeshift advice—which, in this case, is really the only appropriate kind—if readers find themselves caring for elders with dementia. Relying on her extended metaphor of dementia as the rubble under which her mother is trapped, Owens suggests, "Do what you can to comfort with your presence when there is nothing else to be done. Like earthquake survivors waiting near those trapped in debris, simply stay."

Valerie Weaver-Zercher is a writer and editor in Mechanicsburg, Pennsylvania.

Copyright © 2007 by the author or Christianity Today/Books & Culture magazine.
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