Sunday, August 21, 2016

Aging & Involuntary Childlessness: Does It Affect Men?

I think it is important that the myth that men don't feel sad is busted. It is so damaging for everyone and society as a whole. - Robin Hadley, PhD


Articles and research on the effects of involuntary childlessness often focus on women. Interestingly, we seldom read or hear about childless older men's experiences and whether they feel sadness in not having children. As a Master's student, Dr. Robin Hadley sought to investigate the experiences of childless men as there was little information available. The research culminated in Dr. Hadley's PhD dissertation, Life Without Fatherhood: A Qualitative Study of Older Involuntarily Childless Men. Recently, I had the opportunity to ask Dr. Hadley some questions in his area of expertise to which he provided insightful responses:


Dr. Robin Hadley (© Paul Tonge)
How did you develop an interest on the subject of involuntary childlessness in older men?
I was looking for a subject for my Masters dissertation in Counseling and in discussion with my supervisor, Liz, I just said, "I was really broody in my 30's". She replied she'd not heard anything about that subject and so that is how it started. I then found there was very little about the male experience of childlessness and that has spurred me on. I think it is important that the myth that men don't feel sad is busted. It is so damaging for everyone and society as a whole.

Do you think there is a stigma around older men without children? 
Yes I believe there is a stigma about older men without children. In fact it is a double taboo as both older people generally are subject to ageism and the childless are seen as 'different' and suspect. The men in my recent study all reported a fear of being seen a paedophile and the view of men as a threat is reported widely in the media.

Are older men without children at a greater disadvantage as they grow older? If so, in what ways? 
It rather depends on their circumstances. However, men tend to have smaller social networks than women and when men exit work, their social network also tends to reduce. If they have a partner, they may come to rely on their partners’ social network. If the men's partner dies, their social network can again reduce. European research shows that there is no difference between the older childless and similar people with children. The difference occurs if something negative happens to the childless person. For example, if they fall ill, formal care is accessed earlier and they are more likely to be taken in to a care facility earlier and for longer compared to people with adult children. Adult children are often advocates in their parents’ dealings with health and care service providers. In the UK, there have been a number of high profile cases of poor care/abuse of older people in health and care facilities. The majority of these cases were highlighted by adult children.   

Was there anything that you found in your research that surprised you?
There are three things that surprised me: firstly, that the men very easily talked about their thoughts and feelings to a complete stranger. Many of them said this was the first time they had spoken about their feelings and thoughts about childlessness. Secondly, the fear that they all expressed about being viewed a paedophile - it is such a shame that all men are portrayed as a threat whatever their age. Thirdly, four of the men I spoke to had a role of 'grandfather'. The benefit they showed in those relationships was a joy to see.

What advice would you give to men who wished to be fathers but are childless and having regrets? 
Do something! Either talk with someone you trust or with a counselor. All the men I have spoken to considered becoming a father as natural. Not achieving it was a loss that was not possible to talk about - as men aren't 'supposed' to care! Therefore, the impact of non-fatherhood is not recognised in society and that loss does need to be acknowledged. Keeping it in and not being able to appreciate your feelings may adversely affect thoughts, feelings and behaviour. I would also consider looking at what connections you have that may give you the chance to have a role as an active uncle, grandfather, mentor or advisor. For example, in the UK many schools encourage older people to become involved in reading to children who would benefit from person-to-person learning.

Prior to learning about Dr. Hadley's studies, I had not considered how involuntary childlessness affects older men and appreciate learning about this issue. An important takeaway from this interview is that men experience sadness and regret as women do in these circumstances. Despite assumptions that men do not like to talk, they are, in fact, open to sharing their experiences. Therefore, it's vital to create opportunities for honest conversations and to truly listen. Thank you for this interview, Dr. Hadley. Additional details on Dr. Hadley's research: www.wantedtobeadad.com

Left: Graduating from Keele University, 2015. Right: Final Thesis


Sunday, August 14, 2016

Enough of Shaming, Let's Create Community

The number one thing caregivers can do for other caregivers is to say 'you are not alone.' -- Alexandra Drane


Earlier this week, I read an article on nextavenue.com titled, When You Are Shamed for Moving a Parent into a Care Center. Author and gerontologist Rachael Wonderlin wrote of caregivers being harshly criticized for placing loved ones into long-term care communities. This article resonated with me because I was a caregiver for my late father and also made the difficult choice of moving him into a care home. I had hoped relatives and friends would be supportive of my decision. Instead, they were outraged and accused me of being an unfilial daughter. 
Together with the staff, we wished Dad a happy birthday.

At first, I tried to care for Dad at home, but his dementia worsened and he became debilitated due to multiple strokes. As Dad's care needs increased, many challenges arose including these examples:
  • Dad lost mobility in his legs yet he would often jump out of bed and land on the floor at night. Incidentally, putting rails on the side of the bed did not work.
  • We then placed a mattress on the floor, but he would wiggle off and bang his head on the wall or furniture as he attempted to maneuver his body. 
  • Dad developed difficulties with swallowing but would refuse to eat soft, pureed foods and often threw plates on the floor in anger while blaming Mom for his situation. 
  • Dad became agitated every night and would yell and bang on the walls until daylight. Me, Mom and Phu, my husband, took turns through the night to stay with Dad to soothe him.
I developed chronic insomnia, Mom had fainting spells due to blood-pressure spikes, and Phu sometimes fell asleep at the wheel during his 40-minute commute to work. We hired caregivers to assist Dad, but we could not afford round-the-clock care. Needless to say, I opted to find a long-term care home as Dad's safety became the biggest concern.

As we moved Dad into a care home, we were shunned by family friends. Even so, I continued to do my best to ensure that Dad's quality of life would not be compromised. It was by no means a perfect situation, but Dad's condition stabilized as he ate balanced meals and received the support he needed from a warm, caring staff. In addition, my parents' relationship improved as Dad began to express appreciation for Mom for the first time in over 40 years of marriage. I had also become closer to Dad, as I visited him daily to keep him company.


Say Cheese!
Since Dad's passing in 2010, I've earned a Master's in gerontology and learned about resources and information available for family caregivers. As I reflect on my experience, I firmly believe that caregivers need understanding, encouragement, and a caring community of friends and family. Guilt and worry come second-nature to many of us, so please stop the shaming and offer a helping hand or a shoulder to lean on!

On the subject of long-term care facilities, I recently had an opportunity to share my tip for family caregivers on the Association for Long Term Care Planning (ALTCP) website. ALTCP is a nonprofit organization providing free information, resources and expert advice on planning for long-term care -- what a great service! Here is the blog post: 20 Experts Talk: DOs and DONTs When Visiting Mom and Dad at the Long Term Care Facility. It was an honor to be included among caregiving experts I trust and respect. Together, we are all part of a wider community supporting caregivers who unselfishly look after their loved ones everyday.

Sunday, July 31, 2016

On Internalized Ageism and Turning 50

"In fact, looking back, it seems to me that I was clueless until I was about 50-years-old." -- Nora Ephron


Hello, it's been a very long time since my last post. This year has been difficult as I have been going through painful personal challenges and trying to resolve deep-seated conflicts with my aging mother. Even so, I've had some incredibly wonderful experiences, including reconnecting with old friends and being asked to be on the board for the Legacy Film Festival on Aging (LFFoA) in San Francisco. 

Adding to the positive, I celebrated my 50th birthday last week in Norway, which is an amazingly beautiful country. Reaching this milestone makes me hopeful towards new possibilities. Ironically, even with a master's degree in gerontology, trying to accept aging had not been easy as I agonized over age-related changes in midlife. I often wondered whether I had ageist attitudes towards myself, and if so, where did this come from?

Celebrating my birthday in Oslo. Right: Bergen waterfront (Photos: P. Trang / K. Kawasaki 2016)



Thoughts about ageism resurfaced as I began promoting LFFoA to friends and colleagues. Some people thought the word "aging" should be removed from the festival title as it might turn people off. I asked for clarification, and one person said that aging represents loss, decrepitude, and going downhill. Witnessing ageist attitudes made it clear, however, that including "aging" in the title is important as there is nothing wrong with aging. Furthermore, omitting the word does not change the fact that aging happens. Dr. Becca Levy, a Yale researcher on aging, states that while we think of ageism as "...attitudes and actions directed toward older individuals by younger individuals..," we are exposed to culture's ageist attitudes throughout our lives and in turn, direct such attitudes towards ourselves in old age. (From Dr. Levy's article: Eradication of Ageism Requires Addressing the Enemy Within.)

Suffice to say, being part of LFFoA gives me a sense of mission in helping to confront ageist attitudes (mine included) which are commonplace. LFFoA executive director Sheila Malkind, age 78, stated that she began the film festival on aging to ...motivate younger people to see the potential of their later years.”  In Your Call, a show on KALW public radio, Sheila and a few filmmakers from LFFoA discussed the topic, "What does it mean to be an elder today?" In growing older, Sheila stated that she was surprised when her body began to manifest aging-related changes (i.e., cataracts, hearing loss). Nevertheless, she emphasized the importance of making life meaningful amidst the various challenges that are part of growing older. (Listen to the full discussion HERE.)

While aging may invariably bring challenges, Sheila believes there are many positives to growing older and that we should be proud of our age. She says she is more excited about life today than when she was a teenager! Likewise, Dr. Laura Carstensen, director for the Stanford Center on Longevity, states that contrary to negative assumptions, older people are generally happier than younger people. As people age, they are better able to manage emotions and become compassionate towards others. Listening to Sheila and Dr. Carstensen's favorable views makes me look forward to my next 50 years! 


Save the Date: The 6th Annual Legacy Film Festival on Aging is coming to San Francisco in September. 

Legacy Film Festival on Aging
September 16-18, 2016
New People Cinema, Japantown
1746 Post Street, San Francisco

Monday, December 28, 2015

In the Blink of an Eye

"Don’t cry because it’s over, smile because it happened."  -- Dr. Seuss

A little over a year ago, my mom's best friend Mrs. Y unexpectedly passed away. It was a sad loss for all of us as Mrs. Y had been an important part of Mom's life (and mine) for over four decades. Mom and Mrs. Y saw each other every week, spending countless hours talking, eating, laughing and going for walks. When they weren't together, they talked on the phone and even had plans for traveling together in the near future.

Me (with chocolate on my face) and my childhood BFF.
Knowing her dear friend was no longer here, Mom was lonely. She was also saddened by not having had the chance to say goodbye. Though I was concerned, Mom impressed me with her inner strength as she kept up with her daily walks, her cooking and sewing, and socializing with others. Still, there were times when Mom spent most of the day alone, and my heart ached for her as she was clearly missing Mrs. Y. As the year progressed, Mom started going for lunches and walks with her other friends who began calling and visiting more often. Thanks to her friendships, Mom seems much brighter and jollier these days.

At age 87, Mom has lost many people including Dad, six out of eight siblings, relatives, and countless friends. Her resilience is admirable. In an article written by Paula Span in the New York Times titled, Tougher Than They Look, scientists suggest that resilience is learned through adversities in early life and people scoring high on the resilience scale are better able to bounce back from difficulties. The article states that even in late life, resilience can be acquired. This is hopeful news!

Mom's experience made me reflect on the finitude of life, and has given me greater awareness that every single day matters. Taking this to heart, I feel gratitude for life, including its challenging aspects, and all the people contained within it. Would love to learn about your thoughts and experiences. Has adversity made you more resilient? Thank you for taking the time to read this post. 

Monday, December 14, 2015

Is Independence Overrated?

Mom as a young lady.
Have realistic expectations for the kind of help you are seeking
Express your needs simply and clearly
Let others know you are there to help them as well
Praise your pals for their assistance and pat yourself for asking for help
-- Acronym for HELP by Dr. Deborah Serani

Recently, my husband and I returned from a short vacation and found Mom to be in a very grumpy mood. She stated that she pressed the wrong button on her remote so she could not get the television to work. In addition, the heater wasn't strong enough to keep her living room warm so she was freezing. All in all, Mom said she had a miserable week.

I asked her why she didn't call her friends, many of whom live within walking distance, to help figure out her television and heating dilemmas? Many of her friends also have children who live close by, within 5-10 minutes, who could resolve her issues in a pinch. Mom quietly uttered that she didn't want to be a burden to anyone. Though I wasn't entirely surprised by her comment, it made me wonder why Mom might choose to be miserable when her friends would be happy to help her.

This episode made me recall an earlier experience of Mom's friend who refused to accept help from friends and family as she faced cancer. Struggling physically and financially, she didn't want to be a burden and thought she could manage on her own. Sadly, the situation did not end well. Both Mom and her friend's experiences made me ponder why it's so hard to ask for help. There seems to be an element of shame involved in admitting we need help, but why?

Psychologist Dr. Deborah Serani discusses various myths that keep people from asking for help, and one particular myth that stood out is that asking for help makes us look vulnerable. There is also the stereotype of the frail elder that exists in society, which combined with the myths of needing help, that might make some older adults hesitant in asking for assistance. Mom's situation might also include some cultural expectations she has for me as her daughter (but we'll save this topic for another time).

In light of this situation, I try not to be too harsh with Mom. Having been raised to not be a burden to others, I may also face similar dilemmas in the not-so-far future. Rather than wondering why other people don't ask for help, however, I think I will muster up the courage to start asking for help more often. Knowing that most people enjoy supporting others, I resolve to be open to receiving help when I need it. I welcome your views on this topic. Do you think independence is overrated?

Saturday, October 17, 2015

Why Gerontology?

"I learned a long time ago the wisest thing I can do is be on my own side, be an advocate for myself and others like me." - Maya Angelou

At 4 years old in a kimono, posing with my neighbors.
There are many reasons that led to the decision to study gerontology including my experience as a caregiver and that I've always enjoyed the company of elders. Another reason became more clear recently and it has to do with my experiences with prejudice from childhood. Growing up as a minority, there were times I was excluded from activities because some children and their parents did not want to associate with Asian immigrants. While most were kind, some people held assumptions about me based on misleading stereotypes of Asians. As a child, I remember being teased about my physical appearance, especially my almond eyes, and other times when people imitated Asian mannerisms (very much like the Mr. Yunioshi character from the movie Breakfast at Tiffany's) as I walked by. Alternatively, some people were impressed with my ability to speak with no tell-tale "Asian" accent. Though well meaning, peoples' compliments on my English intensified feelings of being a perpetual foreigner

You may wonder how my experience relates to my interest in working with older adults? I believe being treated differently because of what I am has made me sensitive to the way we treat older adults. Ageism is ingrained from childhood and we're not always aware of the prejudicial attitudes we harbor and how it affects people on the receiving end. In the past, I have asked older friends whether they had ageist views in their younger years, and many said they did. One friend who is in her early 70's admitted that as a youth, she disliked older drivers as she often thought, "Get off the road! Get out of my way!" Today, she realizes the irony as younger persons say similar things to her on the road. 

It may seem that older adults are separate from us, but in a sense, they are our future selves. Most of us will eventually become old. The inclusion of older adults in all aspects of society, therefore, would benefit all of us as we learn to create new possibilities within intergenerational environments.

Monday, September 28, 2015

For the Sake of Love

As always, The Legacy Film Festival on Aging gives great food for thought on the multi-faceted nature of aging. This past festival was certainly no exception! Of the many thoughtful offerings, the documentary Mimi and Dona was the most unforgettable. The story is about Mimi, a devoted mother and lifelong caregiver to her 64-year old daughter Dona who had been born with an intellectual disability. At 92, caregiving was becoming too exhausting for Mimi and she had to make difficult choices to protect both herself and Dona. Filled with both heart-warming and heartbreaking moments, there were many teary-eyed viewers in the audience (myself included) who were deeply moved by the unshakable mother-daughter bond.

I continued to think about this story for days afterward, and it brought back many different memories of my dad, including the period before his physical and cognitive decline. Deeply worried about his unmarried daughter, Dad would give me money whenever I visited. I refused the handouts most of the time, but would eventually give in due to his insistence. When I found out that my parents had financial struggles, I scolded Dad for being irresponsible in giving me money. As I recall the hurt look on his face, I now realize Dad wanted to protect me even though he needed protection himself. 

In seeing Mimi's willingness to sacrifice her own wellbeing to care for Dona, I have greater appreciation for my dad's deep, genuine love. This recognition has been a powerful experience, and perhaps the reason why my eyes were flooded with tears during the viewing. I'm grateful to director Sophie Sartain for sharing the beautiful, personal story of her family, which is a universal love story transcending cultural barriers. Kudos to the Legacy Film Festival on Aging for hosting yet another unique, socially relevant event!

NOTE: Mimi and Dona is scheduled to air on public television in November, please check for listings!


Left: Me and my dad on my wedding day. Right: Chatting with Sophie after the viewing. (Photo: Phu Trang)