'A Bittersweet Season': the all-consuming task of elder care

'A Bittersweet Season: Caring for Our Aging Parents — And Ourselves'

by Jane Gross

Knopf, 368 pp., $26.95

Nothing can fully prepare you for the overwhelming experience of caring for your elderly parents, but Jane Gross' new book, "A Bittersweet Season," comes awfully close.

From the first page, Gross, a reporter for The New York Times, provides insights that are painfully familiar to those of us in the throes of caregiving, but she also dispenses helpful advice as someone who has been there and learned important lessons.

Part memoir, part dispatch from the trenches, "Bittersweet" offers a multilayered overview of America's caregiving system, using the author's recent experience of caring for her aging mother as a vivid example and cautionary tale.

Her research includes scholarly studies, interviews and personal testimony from the popular blog she started for The New York Times called "The New Old Age." (newoldage.blogs.nytimes.com)

In the early 2000s, Gross and her brother, Michael, faced the sudden decline of their mother, a flinty and fiercely independent woman who wanted anything but to rely on others for her daily needs.

Jane and Michael were a formidable pair, both resourceful and talented writers, yet found themselves flummoxed by the labyrinthine world of elderly care. "Being clueless — utterly clueless — is the central and unavoidable part of this experience," she writes.

Among the topics Gross covers are the highly flawed Medicare and Medicaid programs, the various levels of senior care and the dysfunction of the American health-care system with its growing emphasis on specialists.

In one chapter she shares a ledger of care, a line-item budget of the enormous expenses incurred by her mother. In another she explores the phenomenon of "cruel sorting," which she defines as elderly people "shun[ning] anyone in their age group who is worse off than themselves."

Although she strikes the occasional discordant note by interjecting abrupt advice, Gross is an incisive critic of our systems and institutions. She is all the more trustworthy because she lays bare her own shortcomings as well as those of others. In one section, Gross describes the fraying of her nerves to the eventual breaking point.

This is must reading for caregivers for its information and guidance, but I found the personal saga even more compelling: moving her mother to a New York City nursing home on Sept. 12, 2001, the tension and disagreements with her brother, and the unstinting portrayal of her mother's deteriorating health.

Amid the frustration and heartache, she gives her mother's life and death a large measure of dignity, especially in her final months as she becomes paralyzed, incontinent and unable to speak.

Gross writes no truer words than these: "[Caregiving is] an all-consuming and life-altering experience that wrings you out, uses you up and then sends you back into the world with your heart full and your eyes open, if you let it."