The Long Trip Into a Dark Season

I told myself I wasn’t going to write about any more memoirs, at least not for a while. The act of honoring thy aging father or mother has already generated so many magazine articles and op-eds and blogs and books, including Katie Hafner’s account of moving her mother into her home and Katy Butler’s story of her family’s struggle to deactivate the pacemaker that kept her father’s heart beating while his brain and the rest of his body failed.

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But here’s one more: “The Fifth Season: A Daughter-in-Law’s Memoir of Caregiving,” by Lisa Ohlen Harris. I’m passing it along for three reasons.

First, her book is eloquent and honest about the pressures of having Jeanne, the active mother-in-law who moved in to help with the kids and the mortgage, suddenly get sick and then sicker. “I married Todd, promising to stay with him till death separates us,” Ms. Harris wrote. “I did not marry his mother.” At times, she believes that being good to Jeanne has made her a less-than-good mother to her own four girls.

Second, it is forthright about the pride that accompanies the frustration. Ms. Harris is so conscientious, whatever her private misgivings, that health care types regularly mistake her for Jeanne’s daughter, not her daughter-in-law.

Caregivers so often feel guilty and inadequate that they can’t see what they have accomplished. Ms. Harris kept her mother-in-law in their shared home for seven years and knows that “there is something comforting, almost empowering, in knowing how to dress a wound, in being able to recognize symptoms of a dangerous respiratory infection even before Jeanne realizes she is short of breath. I’ve become an excellent caregiver, and along the way I’m the one who has created the illusion that she doesn’t need anyone else.”

Third, readers will get yet another lesson in the barely noticed ways sick old people slide onto the conveyor belt of contemporary medicine, even if — like Jeanne — they have always said they don’t want aggressive treatment. “The Fifth Season” shows how doctors’ evasiveness, patients’ hopefulness and their families’ hesitance to discourage them combine to keep very frail people undergoing futile treatments, and then more of them. Jeanne gets scans, infusions, drugs, a port.

This is all so much fuzzier than it seems from afar. Year after year, Jeanne gets weaker and sicker (and her daughter-in-law, infuriatingly, gets misinformed about hospice eligibility). Yet it still comes as a shock when Ms. Harris sees the doctor’s notes that say how poor Jeanne’s prognosis is.

“I finally realized that the experts, all these specialists, the ones who are supposed to be the educators of their patients, have been looking at Jeanne and seeing a dying woman,” she wrote. “But they kept sending us all over Fort Worth on wild goose chases, despite the mass of physical ailments signaling that Jeanne is at the end of her life. Why the hell didn’t anybody speak up?”

That’s why people keep writing memoirs like this one, I think, and why I keep reading them. This is one way people are speaking up. These are the stories my fellow baby boomers feel compelled to tell one another.

The plot can come to feel familiar. Often, it begins with some odd behavior nobody quite recognizes at the time, frequently a harbinger of dementia, though in this case Jeanne’s longtime “smoker’s cough” (she smoked, and mostly denied it, for 50 years) meant chronic pulmonary disease.

In Act II, the family pulls together, vowing to keep their loved ones out of nursing homes, sure they can care for them. And the older people decline, and the younger ones reel from exhaustion, and it goes on. And on.

Death comes, usually later than people wish it had. Jeanne, for instance, dies after 31 days in home hospice care, when she and her family could and should have had that support and comfort for months.

Perhaps women, especially, have always shared their elder care stories with those closest to them. Now, authors have more ways to bring these sagas to a wider audience, and they are taking advantage of them. They are creating support groups in print, safe spaces where people can share the unsayable. (I hope The New Old Age serves that purpose, too, of course.)

In the wrong hands, the stories can become maudlin or simply tiresome, but Ms. Harris’s are the right hands. “The Fifth Season” is brief, potent and gutsy.

I have seen scant evidence that anybody besides Mitch Albom (who hardly qualified as Morrie’s caregiver) has made any real money on these memoirs. That is not usually why people write them.

They are cautionary tales, full of anger and love — and warning. They are bulletins from the front, meant to guide those following behind.