The Ultimate Sibling Road Trip: honoring our deceased parents’ caregivers

The invitation came in my email from my older sister, Shirley, in late January 2020.

Hi Paul, It was great seeing you for lunch and we look forward to next month when we can celebrate your birthday. I’ll be flying into Phoenix to see Sue in mid-March for a long weekend (Thurs. March 12 – Mon. March 16) and wanted you to know that you’d be welcome to join us if you have interest/time/availability.  No pressure:  it’s something she and I like to do a couple of times each year, just to stay connected.

This time we thought we’d drive down to take “the ladies” out to lunch:  Mary, Emily, Rita, Linda, and Barb.  And then also take Danny & Joyce out to dinner.  Just a “final” thank you to everyone who made mom’s last couple of years so positive.  Sue and I both feel like this probably will be the last trip to Tucson together, so just wanted to extend the invitation to you.  If you’re unable to attend, we’ll be sure to give your love to everyone. Shirley

I quickly accepted Shirley’s invitation. Later in March, as the impact of the coronavirus was being felt in its early stages in the U.S., Shirley called me for my professional opinion about the risks for traveling. I dismissed her concerns with a quip, something that at the time I thought to be humorous. “If you had arranged for our reunion in Wuhan, China, I would have advised against it.” She was reassured, and we decided to go ahead with the plan to fly to Phoenix together.

Shirley is first in line but always deferred to others, like our late mother. Mom had a way of looking out for others at her own expense, but she would never claim sacrifice for her efforts. In fact, like her own mother, she made other lives better. As kind and unselfish a person as you would ever meet. It was a challenge to meet Shirley’s standards of accomplishment, loyalty and selfless behavior, but I tried. My high school football coach was no soft touch. A former US Marine and a model of self-discipline, he expected us to perform without any excuses. During signup for the football team, when he saw my last name, he said, “So you are Shirley Pender’s brother? In that case, I should have no problem with you.” I had learned that he had taught Shirley her high school freshman course in psychology. His message was one I knew meant I had to perform to a very high standard, indeed. Dad was an engineer obsessed with perfection, and he expected all of his children to perform at the highest level, no matter what the challenge. When Shirley had children of her own, she applied her skills derived from teaching and from her PhD in family counseling to raising her own family. She seemed to have the right answers for any issues we faced as parents. After our parents died, Shirley and her husband put aside funds in IRS sanctioned “529” accounts for higher education for their grandchildren.

Sue, my younger sibling, had followed me at high school three years later after I had left my own mark scholastically and athletically. I recall how much she prepared to try out for cheerleading, one of the few sporting activities offered to girls at the time. Sue composed a cheer routine with a degree of difficulty I would score as high as you could count. It included a C-cheer jump (with her head extended way past her shoulders as her body twisted in the shape of the letter “C”) a tumbling pass, and it ended with a progressive side-ways leg split (not the North-South variety that was easier to perform and not as risky). To me, Sue’s routine was a tour de force that would land her a spot on the cheerleading squad. However, she pulled a groin muscle in her final split maneuver, suffering an injury that would prevent her from further competition. Not being able to show her athleticism was a disappointment, but later in life she made up for it. Sue became a competitive ballroom dancer, winning in her age bracket as she competed against seasoned dancers. I was very proud of her accomplishments, especially since her dance genres required a sense of grace, rhythm and expertise that would mimic moves of athletes in major sports. She had reached the spotlight in her sport, and she came away with the joy of success and confidence in what her body could do. Sue is a very positive person, and it shows. Her generosity to her family is remarkable. She bought a timeshare in order to cover vacation expenses for her daughter, her son-in-law and for her grandson. I admire how close Sue is to her family. Her daughter has taken up ballroom dancing as well, and Sue takes 3-year-old Michael to McDonalds for food and play while her daughter attends her own dance lesson.

My sisters are my better angels. They love and support their families in a big way. My parents raised us to do our best, to respect others and to love our own children unconditionally. My sisters have set a high bar for nurturing their families. My parents would be proud of the methods my sisters chose to pass on to the next generation the same qualities they stressed in us.

Plans were already made for our final appreciation tour. Sue planned to collect us at Sky Harbor airport and drive to Tucson, a trip with which we were all too familiar. When Mom and Dad were incapacitated, each of the siblings would make separate trips to see them. By spacing out our visits, our parents got a dose of family contact every few months. The caregivers were there for Mom and Dad 24/7. As Shirley said, “They are the reason we can sleep at night in our own beds.” This road trip would be different. My sisters and I would make the drive together for a brief vacation at our destination hotel near our parents’ former home. Thanking the caregivers at special events would allow for our final goodbye.

We laughed and welled up over some of the stories we shared. We felt the love of the people who treated Mom and Dad as if they were members of their own families. We were very fortunate that such caring and loyal people provided such important daily care so that Mom and Dad could finish their lives in their home. We knew that because of the advanced age of some of the caregivers, this would be a final reunion.

Sharing our stories of bringing our respective families to Tucson for school vacations highlighted our connection with our parents and their home after retiring. Mom and Dad were very active in their late 50’s, hiking the mountains in Arizona and the trails of the Grand Canyon. Playing golf together and with their friends gave them much joy. Living on the Tucson National Golf Course and Spa was a real benefit, as my mother walked along the cart paths before dawn every morning, even after her diagnosis of Parkinson’s disease. The many memories of their good health tended to partially erase some of the bad memories of their decline.

Joyce and Danny joined us for dinner on Friday night. Joyce had styled Mom’s hair from the early 1980’s when Mom was in her 50’s and Joyce was then an 18 year-old novice in the world of hairdressing. A deep friendship developed over the years. When Mom and Dad planned their 50th wedding anniversary, Mom invited Joyce and her husband to the party. “Tell Danny he needs a suit.” Mom smiled at Joyce, knowing that Danny didn’t own a suit, but suits and evening dresses were required dress for the dinner dance at the Tucson Country Club featuring the Glen Miller orchestra. When Dad approached Danny at the party, he placed his thumbs and fingers in Danny’s new suit lapels and exclaimed, “Looking sharp!” After my parents passed, we sold Dad’s Cadillac to Danny for less than wholesale, below its auction value. Joyce commented that tips from her customers would cease if they saw what she was driving. Some of her clients were jealous that she and Danny were invited to the party when they were not.

On Saturday over lunch, the health aides, women we depended upon so completely when Mom and Dad’s condition deteriorated, offered some poignant stories of their interactions. Mom became immobile with Parkinson’s disease and Dad had developed cognitive impairment after a complicated intubation following a kidney infection. One evening, Mary moved Mom in a wheelchair from the kitchen for dinner back to the study for watching TV. She told Dad, who by then had developed balance problems and had suffered numerous falls, to remain at the table until Mom was settled. “Paul, promise me you won’t move until I get back,” Mary implored. “I promise,” Dad replied. When Mary returned to the kitchen, Dad was gone. In a panic, Mary called his name and got no answer. She turned toward the living room to see Dad sitting in a chair, smiling with his fingers crossed. “You promised!” Mary said, exasperated. “I lied!” Dad replied.

Dad was an engineer and a fastidious dresser in his days as a top executive with General Motors. His decline was felt by everyone. His pride was wounded after a visit with his neurologist. He expressed to Sue his desire to study the words to be recalled in his next mental status exam, only to sheepishly admit that the neurologist would probably change the recall words next time. He must have been embarrassed to have an aide help bathe him when he had lost 50 lbs and the strength to attend to his personal hygiene. He turned to Rita, one of the day aides, as he got out of the bath and said, “I suppose you have seen a lot of these.” Shocked, Rita responded as well as she could with, “I’ve seen a few.”

Emily shared a story how challenging some situations were as both parents developed cognitive problems. One evening Mom refused to allow Dad into her bed, saying that he was spending time with another woman. Emily convinced Dad that he had to tell Mom she was the only woman in his life, and he did just that. After a brief truce, he was allowed back in bed.

Mom had experienced bilateral knee replacements and shoulder surgery, and she welcomed Linda for a total body massage every other week. Linda reported to us that Mom had cried when a former aide had mistreated Dad. We made a change in personnel immediately, not only for that incident but also for theft of money my parents had hidden. The aide had discovered Mom’s stash of cash in the freezer and Dad’s shoebox filled with small bills.

Barbara, my parents’ accountant for over 30 years, launched her solo practice with the help of Mom and Dad’s word of mouth marketing among their friends. Cleaning up finances is a major concern after the death of a parent, and Barb has always been there for any questions about their accounts. Her own health became compromised, so she closed her accounting business. We appreciated all she had done for Mom and Dad over the years, including filing their income tax returns. It was great seeing her at our luncheon.

Because of social distancing precautions that were announced in mid-March, we avoided the hugs we so much wanted to give and to receive.

Sue, Shirley and I checked out of our hotel and drove to the airport. But before we left, I read to them some of these thoughts about our experiences with Mom and Dad and the roles we played as they aged at home. We were all on the same page about contributing to their wellbeing in the way we could be of service. Sue served as the boots on the ground, making regular visits and handling emergency interventions. Shirley acted as Trustee of the Family Trust and handled bill paying and exchanges with the agency responsible for the health aides. My job was to communicate with the physicians involved in their care, and to update the case manager for my parents on a regular basis. As a physician, I had a unique role in convincing the Chief of Medicine at a local Tucson hospital that I planned to take Dad out of the hospital AGAINST MEDICAL ADVICE so that he could attend our long-planned Thanksgiving dinner. When I committed to returning him the next day for further treatment for his chronic kidney problems, the doctor accepted my plan.

The experience of being together with my sisters for the weekend gave us memories that would last the rest of our lives.

I collected my bags at the airport, and I said goodbye to my sisters without our normal hugs. But I will always be grateful for the chance to spend the weekend with my dear sisters, my better angels. Our appreciation tour was completed, and it was time to go.