Caring for Our Aging Parents--and Ourselves - A Bittersweet Season

Both easy to read and informative. I'm approaching this issue in my family, so it helps to be aware of the many issues I may have to deal with before too long. Being prepared will make the journey less overwhelming.

This book is an invaluable resource for those of us grappling with the role reversal and end of life dilemma with a parent. It is candid, unsentimental, cathartic when heart breaking, and very informative.

My only criticism is where is the Canadian version?

Such a forthright, honest book about the difficulties of role reversing with aging parents. I found it helpful as a resource and as an affirmation of my emotions. It was a comfort knowing I wasn't alone with my feelings throughout this process of caregiving.

I highly recommend this book to anyone who has aging parents as well as anyone who has the foresight to begin planning for their own care. Jane Gross' insights into what is right for your aging loved one, long distance care, types of assistance available, nursing facilities, insurance and family relationships are invaluable.

I found this book to be very informative. It covered ever aspect of a caregivers concern from the beginning of dementia to the final days of a loved ones life. I especially found the information about the realities of assisted living and nursing care invaluable.

I use the library rather than purchase books, but this story was so compelling, I needed my own copy for future reference. Jane Gross' saga of caring for her elderly mother is one everyone should read. The the store site was easy to navigate and the used book arrived quickly and in pristine condition.

I'm a geropsyschologist; The Bittersweet Season is a great contribution to the field. Jane presents an open and well written narrative with an excellent and accurate source for older adults and their families.

Jane Gross writes very well - her narrative is very easy to follow. But for me, it was very detailed in the story of her mother. I feel I was just expecting a more orderly book that would help me navigate this period with my own mother. Our journey (without Ms Gross' considerable funds and a brother to help) is much too different. I am sure that she has a great deal of good advice imbedded in these pages, but it is difficult to access. I will return to reading it in time, but more as a biography. Advise everyone to get a lawyer early on - the rules are far too complicated and mistakes are irretrievable.

An excellent book with information I needed just when I needed it the most. Parts of the book are difficult to read, though not nearly as difficult as living it. I'm grateful the author shared her story.

Jane Gross has hit this monster right between the eyes. Looking at the care of our aging parents with the hind site offered my Jane Gross will make all(parents also) our future lives more livable. I purchased a number of copies and gave them to friends.

The author has a lot of useful information in this book and she uses her mother's slow decline and increasing needs to tell what one could expect to deal with.
The "but" in my title...she whines on a bit much about her angst at the state of affairs that she is having to handle. Anyone reading this book has angst over their aging parents situation...reading about hers constantly got annoying.
Am I sorry I got it? Not at all. But it's not the only one that had good information. Great for Jewish readers living in NYC.

The worst nightmare of most adult children is that their parents will die a lingering death, suffering a drawn-out and humiliating series of losses and depleting all financial reserves. Yet somehow, we think, "It won't happen to OUR family."

Wrong! In Jane Gross's important new book, she reveals that approximately 40 percent of Americans, generally past the age of 85 will follow this course - and that number will only grow with improvements and prevention and treatment of cancer, heart disease, and pulmonary disease.

Those of us who are baby boomers - used to being in control - must stand by and (as one of Jane's bloggers stated), "watch our mothers un-live." Yet we are stuck in a medical world where old age is considered a disease with a cure...when in reality, precisely the opposite is true. There ARE no heroics and there IS no cure for aging. Jane quotes Dr. Sherwin Nuland in saying, "The very old do not succumb to disease, they implode their way into eternity."

This one is PERSONAL for me. Like the author, I was thrust into an unanticipated role of moving my vibrant mother halfway across the country to a senior facility nearby. It upended my life, causing never-ending cycles of guilt, resentment, frustration, overriding terror and exhaustion - along with the days of feeling unaccountably blessed to have the chance to be a part of my mother's world again. I trusted my intelligence and management skills and believed I was making all the right choices. I wish I had read this book two years ago! Among the insights that Jane Gross reveals:

*The Medicare fee-for-service system is broken. To get paid, doctors must recommend a billable procedure; recommendations on lifestyle changes, for example, translate to no payment. Small wonder that few doctors are opting for gerontology or even internal medicine. Small wonder, too, that one-third of Medicare-age patients have difficulty in finding a new physician!

*Researching the best specialist in the field isn't always (or even usually) the answer. Sometimes, an operation can be performed and the elderly patient dies of the recovery. The question to really ask is, "Is the procedure worth it, given the waning number of years?"

*Public policy has yet to keep up with the needs of a populace, inevitably adult daughters, who put their own jobs and marriages at risk. In a study, most respondents wanted caregiver tax credits and respite services - an unlikely scenario, given today's economy.

*There comes a time when the person you viewed as parent and protector begins receding into the past. "She never stopped caring about us, per se," writes Jane Gross of her own mother, "only in our babble about a world she no longer lived in."

I could go on and on about this amazing book. I read parts of it with tears streaming down my eyes because I've been there, done that - the late night trips to the emergency room, the confrontations with a mother who initially held me responsible for her diminishing independence, the vacation guilt, the being labeled an "hysterical daughter" when I demanded certain care levels, the scramble to find quality care and a caregiver we can trust.

I was luckier than most: my mother did save up for old age and we rather quickly found a senior facility that concentrated on living, not dying, in The Hallmark (Chicago). And I have a wonderful sister who is on the same page. But the fact that I'm interjecting myself into this review is the whole point: this is shared problem that demands shared answers. Bravo to Jane Gross for a well-researched, highly personal, crucially valuable and very intelligent book.

This book is particularly pertinent to me. My Mom is 84 and has just moved to be near me and lives in an independent living facility. However the author points out, if you are in your 40s and your parents are in their 70's it may be time to have that difficult conversation on how they want to finish out their days. The story starts out, with the author Jane Gross moving her Mom from Florida to NY state to be near her after some medical issues. This book tells of her ensuing struggles and mental angst that we will all face someday.

If you are in your 30's-60's and have living parents, this book will provide you one example of what you may well face as your parents age. There are many questions and choices that have to be made. This is a combination memoir and cautionary tale of the end of life struggles in our and our parent's futures. The author writes of what she went through with her Mom very specifically, but also provides information and discussions on aging in the US.
Some things unique to the author and her Mom, that she acknowledges:
* The author's Mom knew it was time to move nearer to family, there was no resistance. This is not the most common situation.
* The author's Mom was of sound mind and quite practical.
* The author's Mom purchased long term care insurance and had assets of her own
* The author had a brother who worked with her at this time
* The author and her brother have upper middle class jobs
* The author and her brother are childless
* The author and her brother live near New York City, so prices as well as availability of services were high.

To many of us, this situation is much better than we will face. However in a broad sense the author speaks of making the choices at this stage in life over quality of life versus quantity. She also speaks of the need of a primary care physician (Geriatrician) that coordinates care between specialists to understand the broader implications of choices that a specialist may not consider. This is very helpful. However this speciality is quite unique and may be in short supply. I myself noted when my Mom was ill, that her primary care physician did not coordinate and was content to leave decisions to specialists, that might not have the full picture. Often I ended up providing this coordination and quite frankly I'm not qualified. Are you?

As I read through this book, I became more and more frustrated. As the author points out, Medicare does not provide for any level of custodial care. Medicaid does but only after the recipient has "costed down". Essentially this means, once the individual has become penniless they will qualify for this care. How ironic. The same group of people that this country has been on the backs of for their entire life, must be sucked dry before they qualify for the benefits they deserve (and in many ways paid for). The penniless that may have never worked, get this as a gimme. This truly burns...

The author recognizes that she and her brother are lucky in the sense their Mother was practical and cognizant and financially was able to handle most of the cost. She also knew she was not sandwiched between children and an elderly parent. Financially she and her brother could bear some of the burden a bit better than most.

However similarly, they were not prepared for the bureaucracy and poor structure that is out there to handle caring for an elderly parent, be it hospitals or nursing homes. They also had the balance between work and caring that we all face, as their parent must be represented during doctor's appointments by one more able to handle the transportation and paperwork. Worse yet, they also felt sandwiched between specialists that don't consider the impact their recommendations would have on an elderly person, hence the recommendation for a geriatrics coordinator or specialized doctor (Geriatrician) mentioned above.

In reading this, I was also quite floored about how many holes in quality care there was. As a matter of fact hospitals, as a model of organization, seem clearly a major hazard in an older person's health. The author talked of issues with lack of clarity on discharge orders or issues reviewing them with a patient. The author also spoke of a not too uncommon occurrence is discharging an elderly person without their eyeglasses or dentures. Often they get left behind if a family member is not helping during the discharge. This may sound like a slight oversight, but as most of you would know replacement would run in the $1000s. On a fixed income this could be devastating. I was hoping my poor experiences with hospitals and the elderly were an unusual occurrence. Now I'm disheartened.

Another point the author made was on statistics provided by Dr. Joanne Lynn which I am only partially quoting below on deaths of older Americans. There are mostly 3 main ways to die:
* Cancer deaths peak at 65 after years of good health and cause 20% of older American deaths.
* Deaths due to organ failure peak at 75 kill 25% of older Americans.
* Or a long drawn out death over 85 that bankrupts the individual and taxes the families. 40% of those over 85 will die this way.
As we approach the largest population in the US of old age, these statistics are frightening.

The end of the book has 9 pages of resources. I intend to avail myself of all that information.
The author also has a blog called the New Old Age blog. Hopefully here she will continue to provide useful information for the rest of us. This book is a must read for those of us entering this stages of care for our parents.

I opened this book, half-expecting to not like it. For some reason, the excerpts that had been printed in the New York Times had rubbed me the wrong way. I had felt that Ms. Gross had been a bit too disrespectful toward healthcare workers. But the book quickly drew me in, and I found that the excerpts I had disliked were less harsh in the context of the fuller story of Gross's mother's decline and eventual death. As someone who has gone through the stress of an elderly parent being placed in a nursing home, there were many times when I found myself nodding my head, "uh, huh".

Two chapters in particular struck me as extremely important. One was the chapter titled, "The Myth of Assisted Living". If you are considering an assisted living facility either for yourself or for a family member, you must read what Gross says about her Mom's experience in such a facility. The "Myth" is that assisted living facilities will be able to deal with seniors' medical issues as they arise, that they are more or less a step-up from a nursing home, with more privacy. In fact, ALFs, as they are known, are usually really just social/living arrangements. Thus, every time Gross's mother had a medical issue of any type, she was promptly shipped out to an emergency room, which proved very stressful. Most ALFs are simply not set up to deal with medical problems of any kind. In fact, her mother was not even permitted to have an aide stay with her, something that many seniors come to require. So if you or your parent has declining health, an ALF may not be the right facility. The beauty of the chapter is that it gives you enough information to ask intelligent questions, to minimize the "surprises" you might get in the future. Gross freely admits that she did not know what questions to ask, and so was more or less rushed into making what turned out to be the wrong decision for her mother's living situation. And the chapter reminds us that ALFs exist to sell something -- in this case, very expensive living arrangements -- and everything we are told by an administrator of an ALF should be seen in that light.

The other chapter, "The Biology, Sociology, and Psychology of Aging", should be read by every medical student, nursing student, pharmacy student, etc. Gross clearly lays out how geriatric patients have special needs and how they present differently for such illnesses as heart attacks and urinary tract infections. She notes that just as we take our children to pediatricians, so too geriatric patients should have a geriatrician. But she also explains why there are distressingly few geriatricians -- in short, these patients need a whole lot of time for their appointments and don't have a lot of "procedures". Unfortunately, Medicare is set up to pay for doing, not for listening and talking. And so these doctors earn far less than many other medical specialties. On top of that, few medical schools have departments of geriatrics. But the real beauty of this chapter occurs when Gross is permitted to shadow a geriatrician (who must be on salary, as she was only able to see 8 patients in an entire workday). As Gross gives a brief synopsis of each patient, their mental status, comorbidities, who they arrived with for the appointment, etc., it becomes clearer and clearer how complex these patients are. Of the 8 patients Gross saw that day, 5 had dementia and 2 others were borderline or early-stage. Only one patient was able to come to the appointment by herself. They all had multiple medical problems. As Gross points out about one young medical resident, you would think that being a geriatrician would require "the best and the brightest" to juggle all that medical complexity. Indeed it does, in my opinion. But these specialists get little respect from their fellow doctors. Add that to the ever-shrinking Medicare reimbursement they get for seeing patients that require far longer appointments, and you begin to get an idea of why this chapter could have also been called, "Why Mom Can't Find a Geriatrician To Treat Her".

There are ways in which Gross's account will not resonate with some of us. The biggest way is the fact that her mother was not demented. Dealing with a mother with Alzheimer's is much different than dealing with a mother (albeit a cranky one) who is cognitively intact. That is not a failing of her story or the book, because she could not help the fact that her mother was mentally with-it. Additionally, her mother, a former nurse, frequently refused tests and treatments that she thought had no purpose. And she ultimately chose the method of her own death. Many of us have parents who obediently do all that the doctor tells them, out of fear of who knows what. And many parents wind up on feeding tubes and other interventions more out of default than because of any reasoned desire to be treated that way. All of these things can lead to frustration, stress and family tension, because they just seem to more or less "happen", without any particular plan in mind. Finally, Gross was/is a single woman with no children to deal with. Adding children (of any age) to the stress of caring for an elderly parent considerably complicates matters and magnifies the stress. I say that not as a criticism of the book, because Gross's situation was what it was. But if you are a caregiver looking for advice or support in dealing with multiple family obligations, you won't find much of that in this book.

I gave the book 4 stars, because the subtitle of it is "Caring for Our Aging Parents -- and Ourselves". I did not feel that the book delivered on the "ourselves" portion of that. There is simply very little information in the book about how caregivers can take care of themselves while caring for their loved ones. I would have liked to see an entire chapter on stress relief for caregivers, or at least a discussion of how *not* taking care of ourselves can make our own medical problems, family issues, etc. worse.

Jane Gross wrote this informational memoir about the years she and her brother spent taking care of her once independent mother to share facts and figures and any gleaned wisdom with others.

After taking care of my disabled, divorced father-in-law while my husband and I were still having babies, we thought we knew enough to be prepared for the needs of our other parent(s) when the time came. Not so. Dementia affects emotions and so my mother-in-law came to hate her son (my husband). It was devastating. Still, he was asked to pay her bills (she could not see well due to macular degeneration), sell her house for her, take care of business since he was the only offspring in the state. He did not know how fierce her hatred was of him until after she died and people came forward to let him know, and her will disowning him, prepared when she had dementia, was made public record by her attorney. In our state, as long as someone is aware that they are preparing a will, it does not matter if they have dementia.

Gross shares the details about the financial burden of elder care. To be sure, my mother-in-law's assisted living began with a flat rate of $5,000 per month in 2008. Her need for care was reevaluated periodically and in 2011 her rate was $7,500 per month. This rate included someone “tucking” her into bed. After discharge from hospital, the nursing home costs (in the same facility compound) were separate and while the rate for her empty 1 bedroom condo fell while she remained in the nursing home to $5,000 per month, she could not return to her condo until she “passed” tests. She failed them. We had to hire a private duty nurse 24/7 to sit inside the condo for over a month n order for her leave the depressing nursing home with the mean nurses and return to her condo with her friends. Medicare only covered limited “gait therapy” so we were billed for rehab costs as well. We feared that she would run out of money before she passed away. Then, suddenly, she passed away. Gross details the financial decline of her once middle-class mother until she was destitute enough to be eligible for Medicaid. This is, unfortunately, many times the case.

This book is a primer for those interested in understanding elder care and the way things work with Medicaid and Medicare & secondary health insurance etc. Her memoir underscores the frustrating and painful experiences caring for an ailing parent. Still, her Mom was an emotionally distant and difficult woman - not everyone will behave in this manner. Indeed, my father-in-law was a wonderful person to be around and we enjoyed spending time with him. Then, my own father’s decline from congestive heart failure was ten years of struggle (at home) and two months of hospitalization as he dwindled away and yet his spirit never flagged and he was loving and sweet. My mother-in-law’s decline began about a year before her death - still she struggled with poor eyesight & hearing, pain in her spine etc. She was probably undiagnosed bipolar all her life so her dementia seemed to magnify the deficits in personality her untreated bipolar presented.

This book presents one story of one person aging, becoming infirm, and passing away. I think it is heart wrenching. Not everyone will encounter these problems. The greatest hurdle, in my opinion, is the acceptance of role change between parent and offspring. Next is the pain of watching a once robust parent decline in an ambivalent healthcare system. Finally, it is the enormous cost for assisted living and nursing home care. I ask myself, why should I spend my life’s savings to pay for a miserable existence in a miserable place. I’m with Jane’s mother on how I would approach that choice.

This memoir brings into focus the challenges involved in the caring of an increasingly expanding group of elderly people who are living past the age of 80, and are having to cope with varying degrees of mental and/or physical deterioration, loss of independence, and debilitating effects of chronic ailments.

Jane Gross, who has lived through the challenges of caring for one such elderly person (her mother), wrote this memoir to help others who may find themselves in a similar situation. She writes about her and her only brother's initial unpreparedness and mistakes, surprises at how complex and broken the country's health care system is and how uncoordinated doctors, nurses, and facilities can be, their steep learning curves, and how they were able to recover from their mistakes to infuse their mother's final days with some semblance of joy and comfort.

The memoir is written with a lot of heart and readers can readily sense the author's determination to not only provide readers with lots of guidance and references on how to navigate the broken health care system, but also through research and interviews with experts in various fields and other caregivers, raise awareness regarding how certain solvable shortfalls in the system can be addressed fruitfully to give better support and relief to patients and their caregivers.

An excerpt (with some paraphrasing) from the book's section on a geriatrician's presentation to healthcare policymakers:

"How many of you expect to die?"
All members of the audience eventually raised their hands.
"Would you prefer to be old when it happens?"
All hands flew up in unison.
Who would choose cancer as the way to go?
Just a few.
"What about chronic heart failure or emphysema?"
A few more.
"So all the rest of you are up for frailty and dementia?"

This outstanding book -- part memoir, part instruction manual, part expose on eldercare and financing -- is a sort of documentary about that third route. Cancer deaths come relatively early (age mid-60s) and with a rapid decline for 20% of Americans, and organ failures follow a decade later, via lengthier up-and-down declines, for another 25%. But it's frailty and dementia -- "a drawn-out and humiliating series of losses for the parent and an exhausting and potentially bankrupting ordeal for the family" -- that leads to 40% of deaths.

The topic may be heavy but the treatment is extremely readable, accessible (suspenseful and fascinating, even), and packed with useful information. New York Times writer Jane Gross uses her mother's decline as a springboard to present statistics and discuss issues, for example:
* elder housing ("assisted living is a social, rather than a medical, model of long-term care");
* elder care (home care, nursing homes, physicians, hospitalizations);
* private savings and public financing ("assume that whatever it is you need, Medicare won't pay for it");
* family relationships and responsibilities
* end of life.

Gross gathers dozens of resources into a useful appendix, and the blog she launched ("The New Old Age" at the NY Times) remains active although with new contributors. Her mother's 2001 decline prompted this book, but Gross incorporated up-to-date research when she wrote it in 2010. It was published when my 92-year-old mother was several years into her decline into frailty, and I read it in a cycle of putting it aside, then invariably being fascinated to find recognition and comfort when I picked it up again; I finished it a month before she died.

Of the many books now about caregiving and elder care, I recommend this single volume. It's one to read for your parents' aging and then again for your own.

Jane Gross 's mother was a strong independent woman, widowed in her late fifties who managed her own life well for many years. She had considerable savings and a clear sense of how to take care of herself in old age. She moved to Florida from New York when the time was right, and was managing well there. But then came the MRI diagnosis of a spinal tumor and the need for help and intervention on the part of her children. Jane Gross and her brother Michael then became much more active in the caring for their mother. The story of this process of caring is told here in a detailed and skilled way. But more it is told with a real effort on the part of the author to be of help and guidance to the vast army of those who are and will be facing a similar problem.
She and her brother met many unpleasant surprises along the way. Medicare does not cover the kind of caregiving services the chronically ill person ordinarily needs. Its system of paying doctors for the procedures they do has led instead to in many cases ignoring the patients' real needs. The time and sacrifice given by the caregiving children places great strains on their work and other family obligations. The harrowing tale of Jane Gross' sticking to her work assignment on 9/11 while she receives a call from the hospital telling her that they are immediately discharging her mother is one example of the kind of emergences caregivers face. Emergency rooms and transitions from facility to facility often are devastating to the elderly person. Nursing homes and other care- facilities do not do all the caring, and the involved relative has a host of tasks and obligations which usually require them to be there every day.
Gross in the course of writing the book speaks to many who have problems and situations not precisely like her own. As a diligent journalist she covers these also.
What I especially appreciated was her honesty in admitting faults and mistakes of her own. I know well that desire to fool oneself and think things are alright so that one personally does not have to take trouble over them, which she describes herself as guilty of. She speaks of how rushing to decision often leads to great mistakes when taking more time would have led to a better outcome for parent and caretaking child both.
She has truly written an outstanding book that I am certain will be of help to many readers.
It is of course directed to those who are now in the business or soon will be in the business of caring for elderly parents, relatives, friends. I however faced this problem some time back, and was fortunate enough to have a sister who did almost all the work. I lived abroad and she was at home devoting herself to our parents while at the same time with her husband raising four children.
I read the book rather with the thought of how I might take action to ease the burden for my family , should I come to this incapacitated state. But of course believing one can control this situation , that even the most independent person can control this situation, is delusion.
In any case I could not more highly recommend this truly caring wise and humane book.

Just as the author, Jane Gross, found herself becoming more and more the "adult" in her relationship with her mother, my husband is experiencing the same change in family dynamics. People are living longer, but through illness or old age, they become dependant on nursing facilities or family. And the transition is not easy. Jumping through the medicare and social security hoops is stressful enough, but that experience is compounded when your parent is completely dependant. Her book, A Bittersweet Season" is a personal and very well written memoir that gives the reader the strangely uplifting reassurance that they are NOT alone. With advanced medicine and better understanding of how to live a longer life, we are still in the dark ages concerning how to perservere mentally and emotionally and especially, bureaucratically.

There are some sad moments, some frustrating hair-pulling moments, as well as a few that will make you smile because you know what the author is talking about, you have or are living it right now. It is an insightful, compassionate book with a sense of humor and I highly recommend it, even if you are not at that point in your life. We all grow old, we just need to understand what to do when we and our family members get there.

This book is so helpful. It answers all the questions that children and parents will have as the parent ages towards helplessness. I am the parent of three children and I wanted to know the problems that they and I will face as I age.

The book describes the author's unsatisfactory experience with the Assisted Living option. She faced an unending series of phone calls from her mother asking her to come in and help in ways that the author thought the Assisted Living staff would take care of. Apparently, the use of a wheel chair is a No-No in Assisted Living. You must walk to the cafeteria or go hungry. You may not ride in a wheel chair. This meant that the author frequently had to bring food to her mother since the mother did not like using a walker to go to the cafeteria.

The Nursing Home turned out to be much kinder to the author's mother than the Assisted Living facility. One of the nurses became a family friend. The author discusses the Medicaid program and describes how she tried to spend down her mother's bank account so that she could enter the Medicaid program and no longer require large cash contributions from her children to the Nursing Home.

The most unexpected thing about this book was the description by the author of her mother's decision to end her life and the way that she did this, supported by her children and the Nursing Home staff. Her mother decided that day to day living was just so unpleasant, for reasons of health, that she decided to end it all. With the help and support of her daughter, her mother informed the staff that she would no longer eat or drink. The staff accepted her decision and administered morphine, when required, to keep her comfortable. On the thirteenth day her mother passed away. While the author and her brother were naturally saddened by their loss, they were also much relieved of the burden of emotionally supporting a mother who was worn out by health problems and the burden of finding the money to pay all their mother's bills. She describes the process of dying in this manner as quite painless, gradual and uneventful. Her description has given me much food for thought.

Jane Gross has rendered a public service with her book which gives a comprehensive and sensitive view of the end of life of a loved one.

This memoir relates the author's experience of how she and her brother handled the last years of their mother's care. In addition, the story serves to help other "children" navigate their way through their parents' final stage of life. I wish I had read this book 20 years ago when my brother and I shared the same experience for our mother. The information also serves to guide me as I approach my own final years. The author's "aim is to give more precise and vivid meaning to the old saying that age isn't for sissies...I want to try to make sure that adult children, our ranks growing, are not as isolated and ignorant as my brother and I were...". Ms Gross' research includes not only geriatric research, but also interviews of facilities' staffs, and blogs posted on her site created especially for this purpose. She finds that "their death certificates will say they died of heart failure or diabetic complications or respiratory failure, because the government has decreed that 'old age' is not an acceptable cause of death....I disagree. At a certain point, the wheels simply fall off the bicycle." All research areas come together to create a powerfully human picture of what it means to be aged in today's world.

Like most people who's parents are still alive, you look at them and become face-to-face with their mortality now and again. While we generally tend not to think or linger on that subject, as our parents age we know that a nebulous "something" will have to be done. While we probably initially imagine that our parents will just quietly die peacefully in their bed one day, a nagging voice in the back of our mind tells us that there are way too many cases where death is a long and time consuming process which may take years and years. I was drawn to this book because both of my parents are approaching that age where "something" will have to be done. Honestly it's a conversation I probably should have had decades ago, but as the child you always feel... odd... to ask those types of questions.

Jane Gross' "A Bittersweet Season" - while painful to read because it hit way too close to home in many instances - is probably what I would consider the catalyst to making me actually have this conversation.

No matter the level of involvement with elderly parents, it is one of the most challenging responsibilities we can face. Over the last few years I have read dozens of books related to elder care, but none comes close to the excellence of this one. Jane Gross's approach is outstanding! I was so pleased that I immediately ordered copies for family and friends--and they, in turn, ordered copies for their family and friends.
Gross provides information that is extremely useful, conveying her advice in a style that is warm and supportive. She manages to be practical, direct, but pleasurable to read--and that says quite a lot, as anyone who has been in this situation will understand. Each time I delve into the book I find myself comforted, and more confident.

Jane Gross' very personal, but universally informative memoir of caring for her aging mother is a typical 40-something's emerging nightmare. This is a candid story of the struggle to not only provide competent, caring providers for senior parents, but of an adult child's adjustment to the role reversal from offspring to caregiver. In our highly complex and shamefully inadequate health care system, Gross reveals the gaps, the shortfalls, the heartache and the frustrations associated with geriatric health care. Her aim is not just to share, but to assist readers with aging parents in better understanding the many legal and personal hurdles they'll likely encounter. As an adult child with parents in failing health, I found this book frightening, but equally compelling and helpful. Recommended.

I really enjoyed this book. This account of how one adult daughter coped with the loss of her mother was so helpful to me. I just lost my father at 90, and my 79 year old mother took care of him for one year and a half. My mother did the work of a nursing home nurse every day, especially the last 6 months. She is an inspiration, a tough ranch wife who kept her husband with her until the end when he died at home. Her home health and VA help allowed her to keep it up. This book has very good information on Medicare, our broken health care system and what you go through when you are trying to help your beloved parent when they decide they are ready to go. Jane Gross did a terrific job.

From the title, I was afraid that this book would be a touchy-feely book about the emotions of dealing with an aging parent. Actually, it is chock full of details about the various stages of aging. It is not a "how-to" manual. Instead, it is an exploration of the territory.

This book comes out of a NY Times blog, The New Old Age, and is full of detailed information, blended with anecdotes of personal experience. For example, the chapter about medicaid coverage of nursing home expenses talks first about the experience of the author's mother spending down until she was eligible for medicaid, and then talks about how little medicaid spent and how the nursing home swallowed the cost difference.

Some details are out of date, the nursing home example is from 2003. So it is hard to tell how many details apply to the present, but the general message gets across.

I am currently entering this territory with my mother, and this book is very helpful to me in terms of sensitizing me to what is to come.

I only wish that this book had been available before my brother and I were faced with our mother's last years! Every "child" of middle age needs to read this book and keep it for reference.
The most positive aspect of this book is that after reading it and saying constantly, "Yes, we faced this or that too!" we realized that we were not alone. At the time though, we felt that our circumstances were very unique. Now we know these challenges are facing EVERY middle aged child caring for their elderly parents.
Thank you, Ms. Gross, for sharing your experiences.

I only read the introduction and found myself nodding my head and wanting to annotate a library book, when I said I have to purchase my own copy. I found myself in crisis mode on June 30,2012 when my formerly ambulatory 78 year old , extremely , independent , self sufficient mother called me at 8:30 in the morning to say " I can't walk". Our lives haven't been the same since. As the Author described it "life before... And life now".
While raising three children, unable to drive, navigating the healthcare system, learning not to treat my mother as one of my kids, the realization that my sister(only sibling who died in 2009) is no longer here to help and surrendering to the fact that I CANNOT do it all... I am so glad that I found this book.

Eventually every American will be faced with difficult choices related to the care of his or her parents. This book is a wonderful way to learn how difficult these choices are, even for people who are well off and have done a good job preparing for the final days. Ms. Gross tells the story of her mother's decline and the dramatic toll it had on her mother, herself and her brother. The writing and story are so engrossing that I looked forward to reading this book everyday. I feel that I am now much better prepared for the day when I together with my elderly father will need to make the same difficult choices. Thank you Ms. Gross for sharing your story with us and for providing us with the guidance we all need.

Jane Gross, whose New York Times blog The New Old Age offers us a place we caregivers can turn to for comfort, advice and guidance, has written the definitive book on stepping into the role of taking care of an elderly parent, a role that many of us are now playing. Caregiving is immensely rewarding, extremely overwhelming, or even both depending on your personal circumstances. Once you take on the responsibility of managing your parent's life, your life will never be the same. Jane Gross guides us through her intensely personal experience with her mother in a touching, heart-felt way without sparing the frustrations, and the learning curve she and her brother shared. Read her thoroughly researched account and take comfort in knowing you are not alone in this enormous undertaking. There is help and solace along the way.

I was disappointed by this book, which I bought based on its high ratings on the store. My main problem is its hybrid quality: It's neither a true memoir (and Ms. Gross's writing is workmanly) nor a comprehensive guide. Whether you like it may depend in part on how interesting you find Ms. Gross's family. My fascination was limited.

Although Ms. Gross fully acknowledges that her family is relatively privileged, there are some very irritating lapses: She repeats another person's observation that poor people don't mind endless waits in government offices as much as middle class people because they're used to it. (Well, they have no alternative. That doesn't mean they're fine with it.) She casually says that when they were considering getting a home health aide for her mother they thought they would hire "a nice West Indian lady." (Yeah, I see the color of the health aides walking down the streets of Manhattan with their white, elderly charges, but really. Does she consider that some of her readers might possibly be of West Indian heritage?). I'm reading along, learning about Eileen the nurse, et al., when suddenly Gross remarks on the "African American women" and "Latinas" she sees on the street. I do not like books in which whites are treated as the default and everyone else must immediately be identified by their apparent ethnic heritage.

I also have to disagree with Ms. Gross's conclusion about the unfair allocation of care giving to women. She has a brother, who does decidedly less of the work, and who, frankly, sounds like a bit of an entitled jerk. The discussion of the sibling conflict is interesting, but she tends to excuse it by making broad generalizations about men and women and what they can do and tolerate. Towards the end of the book, she discusses a blog post (the book is partly based on a blog she created at The New York Times) which some women readers criticized in their comments. Essentially, they said she was wrong to counsel other women to accept the status quo. Her response was, Do these women think men and women are equal? Probably, not, and with Ms. Gross's attitude they probably won't be any time soon. Incidentally, the author assumed that the women readers who wrote in were much younger than she. I don't think that assumption was justified.

I won't deny that there are some moments of insight and humor. This, however, is not great writing. If you want hard information, start with the websites listed at the end of the book.

The title of the Prologue, "Finding Our Better Selves," is typical American New Age Optimism: If you suffer, you will get something in return. Now, if you're a lousy person, perhaps rising to the challenge of caring for an elderly relative will make you a better person, I don't know. But if you're already a reasonably decent individual, the stress, frustration, exhaustion and financial strain of this situation is simply something you have to get through as best you can. It's hardly a character-building opportunity. You should neither wallow in it nor valorize it.

An easy and fairly quick read with invaluable insights and information for those faced with planning potential caregiving strategies for aging parents.... and ultimately yourself. Not TOTALLY depressing, there is some humor and uplifting moments in it too.

Jane Gross has written a hefty book that claims to teach us how to care for our aging parents and ourselves (the children)...but it seemed more to me a lengthy monologue about what happened to Jane Gross' mother as she went down the "rabbit hole" of chronic illness and hospitalizations/ nursing home care, with Gross' varied responses to the crisis, along with her brother Michael. It is a book that was thoughtfully crafted, but unlike Gail Sheehy's "Passages In Caregiving" fails to weave accessible advice through the telling of a personal story. There would often be a long, rambling story (therapeutic for the author, but rather detailed for the reader) about a specific situation her or her mother faced (depression over chronic illness, medical miscommunication, caregiver burnout) bookended with a wallop of statistics based on huge studies about aging parents and caregivers. Statistics, however, are not a comfort when considering this battle. This is a thorough memoir, it is not a practical guide and has very little realistic take-home advice, especially with its inaccessible structuring of statistics and the personal told through an arc of chronic, multiple medical issues.

Excellent book and very well-written. As a hospice nurse for over a decade, I feel this book offers tremendous insight into the personal anguish of the decisions for care and end of life decision-making by Jane's family and undoubtedly countless others who do not have the stamina to "research" their options. Our health care system is truly a maze. I think this book should be required reading for all fourth year medical students! The VSED choice is always an option but most families cannot support it. I admire Jane and her mom for their choice.

Remember What to Expect When You're Expecting?
Baby Boomers made that an all-time bestseller and that book was preparing us for a mere 9 months.
If you're a baby boomer, and especially if you're a woman, the season of caring for, wondering about and worrying about older adults will last much longer.
This book by Jane Gross is the What to Expect for that stage.
You either will read it or regret that you didn't.

It's impossible to overstate the importance of Gross's reporting on an issue that will affect everyone in this country. But she combines great reporting (and really helpful advice) with a novelist's skill in portraying her own family's facing the inevitable. This book is a MUST READ on every level!

If your parents are in good health and enjoying their life you may want to read this well-written book to prepare you for what is to come. For me, living with and caring for my aged mother every day, it's a bit late. The chapter on resources in the back is handy, but too much of the book is about the author, her brother and what they went through with their mother. Way too much detail of their every day existense and not enough help for people going through this now. If the book were condensed by Reader's Digest that would be a big help. And then condensed again so the reader can cut to the quick and just learn the highlights of what not to do or do. Most people caring for an elderly parent simply haven't the time to search through this volume for the golden nuggets of wisdom.

It is difficult to find both reliable and practical information on end of life issues. This book does both in an honest way. I gave a copy to each of my three children and asked that they each read it prior to a family meeting which we will be having in February.

This book could not have been more timely. I literally hung on every word - her story was/is very similar to mine and gave me great comfort and critical information. As a matter of fact, I am reading it for the second time. I particularly appreciated her candid remarks about her feelings.

Rather than write a dry, book of facts, Jane Gross has written the information we need in biographical form, as she tells us the story of caring for her elderly mother. That is all well and good, the problem for me is that there is just too much detail. This biography could have been much shorter and still be interesting to read and contain all the necessary information. It was enough to know that her mother did not like her cooking, I did not need to know so much detail: "I must have forgotten a starch. Or a salad. Maybe I made lamb stew, forgetting that she hated lamb."

Because of all the detail, I am finding it hard to get through, which I do not like because I want to know the information in this book, since I am caring for my 86-year-old mother. My time is valuable and I do not like wasting it. This book should be abridged.