Clift: Society's Challenges as We Age

Write what you know. That's what Gail Sheehy did when she published her best seller about life's predictable stages. A user-friendly guide to adulthood, "Passages" was recognized in a Library of Congress survey as one of the 50 most influential books of our time. But the narrative ended at the half-century mark. Sheehy was in her 30s at the time, and her attitude was, "What happens after 50 that matters?"

A great deal, she discovered, and she's chronicled much of it with her keen eye as a social observer. Lecturing this week at the Chautauqua Institution in upstate New York, Sheehy noted that a woman who reaches the age of 50 without evidence of cancer or heart disease can expect to live until 92. There was a rumble of surprised delight followed by gasps as the audience processed the information. "Who ever prepared us for the possibility we might live long enough to forget the name of our first husband?" Sheehy asked.

What happens in later life is not as predictable as the earlier stages. Society is changing, and people are taking longer to grow up, and much longer to grow old. There is enormous satisfaction as life gets extended, but there is also illness and loss of independence. Sheehy is currently researching a book on caregivers, a subject she's been living with for the last 15 years as her husband, the celebrated editor and founder of New York Magazine, Clay Felker, has battled three separate assaults by cancer. Sheehy lifts the curtain on the army of unpaid and overworked caregivers that she calls "the backbone of our broken health care system."

It's a job nobody really applies for, and it began for Sheehy with a phone call from her husband's oncologist. "It's not benign," he said. Those words plunged Sheehy and her husband into a whirlpool of fear, denial and confusion. "It dawned on me that my life had changed," she said. A literary journalist who specializes in spotting socio-cultural trends, she broke down the process she was living into stages. She called the first, "Shock and Awe," the mobilization for what lay ahead. She did meditative breathing and biofeedback to identify her anxiety trigger points. Her husband learned self-hypnosis. She asked God to direct her thinking away from self-pity and to give her inspiration and intuitive thinking to make the right decisions.

Next is "The New Normal." The surgery was successful, but her husband slumped into depression knowing his former life was unrecoverable. It took another cancer shock, a diagnosis of low-grade Hodgkin's disease, to catapult the couple into a life change they could both embrace. The doctor prescribed no treatment. He told them to go out and live, "Do something wonderful." Sheehy knew they had to tear up the world they'd constructed in New York publishing and do something radical to lift her husband from depression. Felker had nurtured a generation of journalists, and they brainstormed how to get their mentor back into action. Teaching journalism at California-Berkeley was a long way from Manhattan, and the faculty apartment was spare, but there was a running trail and a place to have coffee and oatmeal in the morning, and it was fun. "We were in love all over again," Sheehy said. "We made this our New Normal."

You can guess what's coming. She calls it "Boomerang." There's another shift, a new diagnosis, another function lost. In Felker's case, it was a recurrence of cancer requiring surgery at the base of the tongue that would silence him. "And he was a communicator," says Sheehy. A friend from New York offered to teach with him, to be his voice, and six weeks after the surgery, Felker was back in the classroom. He had to eat with a gastro-intestinal tube, but Sheehy was determined that would not keep them from seeing friends and going out to dinner. She told of traveling to France where she bought a blender and met with the chef in a fine restaurant to explain her husband's situation. "He was aghast that a person would eat his food without tasting it, but he prepared it and delivered it in a silver pitcher with a chaser," she said. Two waiters stood by to block the view so her husband could pour the meal into his tube with privacy. "After that we were fearless," she said.

Sheehy went to what some might consider extreme lengths to preserve the life she and her husband had known. She has the resources, and she was clear about where she would draw the line as a caregiver. "I didn't want to give up being a wife and turn into a nurse," she said. "I was never going to change my husband's Depends, tasks that humiliated him and changed the relationship." Most caregivers don't have that choice, a reality Sheehy illuminates in her research. She points out that baby boomers are shocked to discover Medicare pays nothing for caring for elderly parents at home. "It's called custodial care, which makes it sound like it's a clean-up job," she says.

Sheehy's last stage is a question: "How long?" Her husband is in a nursing home. The doctors say he is in the stage of slow dying, but it can take a long time. Her situation is not unique, and she ends with a plea to policymakers to design a system for how we want to grow old, and then figure out how to pay for it. It's a societal challenge on the scale of the personal transformation she described in "Passages" years ago.