Molly Ivins November 21

AUSTIN, Texas — For a couple of months, I've been carrying around a newspaper clipping headlined: "Study Finds Shortcomings in Care for Chronically Ill."

What I've been looking for is a way to make the story "sexy," as we say in my trade. It would be easier if the headline said: "Crisis in Long-Term Care."

A crisis is sexy, whereas "shortcomings" are so ... perennial.

Shortcomings will always be with us. You can't cure shortcomings by throwing money at them. A policy on shortcomings will not make it into candidate debates.

You can't even get a good fight going over shortcomings: "President Opposes Shortcomings: Congress Is in Favor"; "Democrats Demand Action on Shortcomings, Republicans See Shortcomings as Personal Responsibility."

Meanwhile, I keep hearing the stories — the stories that middle-aged women tell one another.

Hope's father has had both legs amputated now because of the diabetes, and of course he's never really recovered from that first bad heart attack. Hope goes to see him at the home every day. She's a single mother with five children, one of whom has spina bifida, and she supports her family by cleaning other people's houses. Hope is not given to complaining, nor is her father, who supported his own four children by mowing other people's lawns.

"As long as he gets his breakfast tacos, he's OK," she says. He doesn't like Americano food, and the home is a tuna casserole sort of place, so every day she brings him tacos for breakfast.

Courtenay is famous among her friends for telling funny stories about her mother's Alzheimer's. The latest bulletins on Mom's dotty doings are always good for a laugh. Because you have to laugh. That's the really, really important thing — you absolutely have to laugh. The crying requires no effort at all. You're going to cry — it's the laughing you have to work at.

"I was out there last night for Thanksgiving dinner," said Courtenay, "which they have several days early so the families can go somewhere else on Thanksgiving and think about things that make them thankful. Suddenly Mom needed to go to the bathroom, and as we were walking down the hall, I heard a woman telling her mother a sort of bedtime story. 'We moved here and then we moved there, and you remember Daddy got so sick ...'

"Telling her mother about her life — it was so awkward and dear and patient.

And I thought, she's doing better than I did the last time. Because my mother keeps wanting to phone her parents. She doesn't understand why she can't get them on the phone, and I just snapped and said: `Because they're dead! They are dead!'

"But it's like water flowing through your fingers; five minutes later, whether you do it right or wrong, she asks again why she can't reach them. And then I tell her again: 'Remember when Poppy got so sick, and remember you and Mun took such good care of him and after he died, remember how Mun came to live with you and then when she died you took her back to Honey Grove, and remember how you made her casket so pretty with all those flowers and you said how much Mun would like it because it was just like a lady's bonnet. Remember? Remember?'

"If they could figure out how to keep our brains alive as long as our bodies," said Courtenay, "they should get the Nobel Prize for that. It's such a big mystery, living in suspended animation like this. But there is a kind of grace involved.

"At AA, there's a saying that you should try to do something good for someone every day without getting caught. And that's easy with Alzheimer's because they forget it as soon as it's done, so you know you're not doing it for credit. It's a kind of sacrament. You do it because of all the things that have been done for you, maybe not even by the parent you are caring for.

"Another thing that has sustained me: It helps to find somebody else going through the same thing and sit down and groan together about it. You can unburden yourself, and they won't think you're a crazy or cruel person for having these thoughts, fantasies about euthanasia. It's a real test of what you are, and you wind up thinking about what you are and how you can hang in there when you haven't got anything to hang in there with. That's a lot to be thankful for.

"The place she is in now is so much better than the first place she was in, and the first place was better than 90 percent of them — this horrible, pitiful thing that masquerades under the name of care. There was a woman with me last night who teaches at the university; she looked like death between her mother and her husband, who was misdiagnosed as having an infection rather than the cancer he actually had. So they think it's not a crisis?"

And they all have stories like that, all the women taking care of the parents with heart disease and lung disease and diabetes. Sometimes the parents have good days, sometimes bad days, but they are sick for so long, and the women who take care of them are so exhausted.

But it's not a crisis yet.

There are only shortcomings in the system.

Molly Ivins is a columnist for the Fort Worth Star-Telegram. To find out more about Molly Ivins and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate web page at www.creators.com.

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