In her latest book, “ Can’t We Talk About Something More Pleasant?, ” New Yorker cartoonist Roz Chast writes about an experience many of us face: suddenly becoming caregivers for aging parents and then watching them deteriorate and die. It’s not, as her title suggests, a pleasant subject for conversation. But with her signature wit and frankness, Chast renders it both moving and darkly funny.
Her memoir, told mostly through cartoons — and a lot of ALL CAPS and exclamation points! — offers a bittersweet look at the realities of the last years of her parents’ lives. By 2002, she writes, “I could see that they were slowly leaving the sphere of TV commercial old age . . . and moving into the part of old age that was scarier, harder to talk about, and not part of this culture. . .SOMETHING WAS COMING DOWN THE PIKE.”
By 2007 it became apparent that this “something” was coming closer, and Chast moved her parents from their Brooklyn apartment, where they had lived since 1959, to an assisted living facility near Chast’s home in Connecticut.
Chast’s father, George, then 95, died later that year. Her mother, Elizabeth, died two years after that, at 97. (Chast keeps their cremains in special boxes in her closet, near her shoes, an iron, old photo albums and other miscellany.)
In a telephone interview, Chast talked about what she learned about old age and caring for those who reach it.
What were some of the first signs that your parents needed help? In your book you talk about a lack of cleanliness you noticed in their apartment during a 2001 visit. Can you elaborate?
After we moved to Connecticut in 1990, my parents would come up to see me. By 2001, when I went to visit them, I hadn’t seen them in their natural habitat in a long time.
My mother was in charge of housecleaning and was never a great housekeeper. But this was not just untidy but grimy. Grime is not like messiness or some fingerprints on a cabinet; it takes a long time to accumulate. It was evidence that their ability to take care of themselves was going in a certain direction that was a little disturbing.
They couldn’t throw stuff away; there were plastic bags full of empty cans they didn’t know what to do with, drawers filled with newspapers. There were piles of mail, piles on the bed, piles they didn’t seem to notice. Everything looked really old, even in the fridge. And I sort of understand — as I’ve gotten older myself, I’m sympathetic to it. At a certain age you say, “Yeah, my plates don’t look perfectly shiny, but who cares?” This was past that.
But it wasn’t right away that we talked [about this]. Sometime between then and when my mom fell, in 2006, I asked them if they thought they should get help. But these topics are just so hard to bring up. We were all complicit in sticking our heads in the sand. Occasionally I would say, “Maybe you could have groceries delivered.” They didn’t want that. As a friend said, “Things are okay till they’re not.”
What should people look for in their own aging parents?
It’s so individual, and my parents still did have each other. Still, two things that I would say to people: (a) An elder lawyer can be really, really helpful. [In meeting with an elder lawyer] my parents had to talk about two subjects they were most anxious about: their personal finances and their death. He got all the official papers signed. He was able to work with them about what bank they had squirreled away $900 and gotten a toaster oven. I got power of attorney so I could get these things organized. (b) Once you have all the information, try to keep all this in one notebook. I cannot tell you the number of times I had to know my parents’ Social Security number, their medications, doctors, who was their landlord. It is so boring and so anxiety-provoking to have to look all over [for the information].
Can you describe your parents’ relationship and why this made it so difficult to provide assistance?
My parents were very, very close; they pretty much grew up together. They were born in 1912. They were each other’s only boyfriend and girlfriend. They were — to use a contemporary term I hate — co-dependent, and they had me very late. So they had their way of doing things and they reinforced each other. My mother knew best all the time, and my father agreed. My mother was very, very strong person — very smart, forceful, just about the most willful person I’ve met in my life. And my father adored her.
They both didn’t want to talk about help. [After a previous hospitalization for acute diverticulitis, my mother] never got her strength back really. She was sleeping a lot; it had just taken its toll. They didn’t leave the apartment much. My mother didn’t want to use the Life Alert because she didn’t want to go to the hospital. She kept falling. Finally she fell into the bathtub and my father couldn’t get her out. He went to the hall to get help, and he got turned around.
How did you deal with their reluctance to let you help them?
I think after that last fall, my mother actually herself said that maybe they could come to Connecticut. I just jumped on it. I talked to people at this place not too far from me. My parents agreed miraculously on what would be a trial visit. I think they knew that when they walked down the hallway [of their Brooklyn apartment] that it was unlikely they would return.
How did it feel to suddenly be thrust into the role of caretaker?
If I could have given the job to someone else, I would have done it. It was not what I wanted to do. I just — ech — everything. It’s the day-to-day sort of having to deal with the paperwork of it — and the psychological aspect of it. I was suddenly becoming enmeshed in their lives when I had spent the early part of my adulthood getting unmeshed. The less meshed I got, the more happy I felt. Suddenly I had to deal.
How did your own family — your husband and teenage kids — respond to what was going on?
With kids, you can’t say, “Can you call the cable company in Brooklyn and stay on hold for 45 minutes to get it canceled or find out if you have to mail back the box?”
I’m sure I was not always easy to live with, especially when they do start to really, really go downhill, and every time the phone rings you just want to pass out. That’s how I felt for a while.
My mother’s decline was long and drawn-out. There were several calls where they said, “Your mother’s breathing is not good.” No matter what relationship you have with your mother, you hear that and you go [to her]. It’s really hard and really impossibly sad — you see them suffering and you can’t do anything about it.
At one point, while your mother was in the hospital, your father moved in with your family. Can you briefly describe that experience?
He was with us for two weeks. He didn’t always remember what had happened to my mother or why he was suddenly living in our house. [He had dementia], so to just to have to hit him with this terrible news over and over, was awful. Then he would remember.
There were funny aspects, too. I took him clothes shopping to get new underwear. He hadn’t seen those ads for male underwear where the men have pecs. He did this double take [in the store] and said, “I don’t understand it — it looks like those men have breasts.”
What do you think of the popular idea of “aging in place”?
As long as you have a son or a daughter or some relative nearby, [it could work]. Up to a certain point — then there’s a point where they’re not really well. I didn’t live close enough to them to handle that.
[With them in assisted living], at least I knew there was a generator if there was an emergency. There was a nurse on premises. There was a level of constant care.
At this point I’m not talking about the spry part of old age, but the last chapter — the whole constellation of the body and mind falling part, of incontinence, falling, dementia. The last stages of aging are so awful — and I think in the past people would get sick and die before that last stage happened.
What was the most challenging part of your parents’ transition and why?
It was complicated. I felt bad taking them out of their apartment. There was something so sad about that. And then having to deal with everything in their apartment. On the other hand, they saved up for this and so it could have been so much more of a disaster.
I think they had been hoping that probably not all of their scrimping would go for this. But that’s sort of what happened.
Tell us a bit about your parents’ experience in assisted living.
It must have been really hard for them to adjust after living independently for their whole lives and then move into a dormlike setting with lots of people — some of whom were really not nice. Some were okay, but some were mean.
Slightly tacky question: About how much money did this cost you and your parents?
I never totaled everything, but I know at some point it was $14,000 a month for everything. You go through the scrimping mighty fast.
You seem to have conflicted feelings about your parents — your mother especially. How do you help a person when you have mixed emotions, when a person is difficult?
You do the best you can. You have all these feelings — intense sympathy and gratitude that at least they saved up for this. And resentment. I think it’s a lot of mixed feelings.
What were some of the most surprising things you discovered about elder care?
Did you know that you can live on Ensure for a year? A person can live for a really long time just lying in bed and drinking Ensure — way longer than you think. And that was kind of a surprise.
In the book you have a cartoon called “SOMETHING YOU SHOULD KNOW,” in which you say, “When I hear people trying to figure out how to live till they’re 120, I want to ask them: ARE YOU OUT OF YOUR MIND?” Can you elaborate on your thoughts on our obsession with longevity?
I think some people have never been actively involved in the physical care of somebody who is really old and really in not good health. They think of an old person as some spry 86-year-old who is still playing tennis and having a gin and tonic and is fine. They’re not thinking of someone who is 99 or 101 and can no longer see or hear and is incontinent. They are not thinking about what it really means to be really old. Maybe they have only seen them one day — like on a good day when they had their aide around to help. But not on a day-to-day-to-day basis for extended periods of time and seen what it’s like — and it’s not good.
What, if anything, would have made all this easier — for you and your parents?
Maybe there’s just no easier way. It could be argued I had it as easy as could be: My parents had the resources to be in a place that was 10 minutes from me, and I think they got pretty good care.
Knowing what you know now, what would you have done differently?
I wish that I had been more patient — especially with my dad. You try to do the best you can.
Which parent was the one who used the refrain that is the title of your book?
My father. That’s what he would say. It wasn’t limited to the nursing home talk. My mother loved to talk about who had a tumor or someone who closed the car door on her foot and got a hematoma. My father had his own share of disaster stories, too, but he would say, “Can’t we talk about something more pleasant?”