The Yale Journal for Humanities in Medicine

Book Review

Caring for Mother: A Daughter's Long Goodbye
By Virginia Stem Owens.
Westminster John Knox Press, Louisville, 2007.
Reviewed by Howard Spiro (howard.spiro@yale.edu).

This heart-rending account of a daughter’s reaction to her mother’s growing dementia will help you share the agony of someone with mental illness. But worse, as her mother was losing her mind, the daughter-author, Virginia Owens, was threatened with losing her sight to glaucoma. Yet she allows no self-pity in her account, only the torment of trying to make sense out of a mind coming from an increasingly distorted brain. Owens finds some consolation in trying to ferret out from her mother’s increasingly garbled words some metaphors of understanding, some core of reality.

That continuing search may well have made the next six or seven years bearable, as her mother descended from forgetfulness to delusion and hallucination, paranoid some times and childish at others.

We like to hope that education and keeping the mind active prevents dementia, but certainly that was not true of her mother, once a medical assistant. The author describes a year and a half helping her 80-year-old father care for her mother with Parkinson’s disease and its associated dementia. The next five years were spent in a nursing home, during which the author kept a journal of both her mother and herself hoping to find some meeting, some narrative to bring order/sense to chaos. A woman of faith, as the phrase now is, Owens writes the journal to share what she felt during those tortuous times

She sought to cope by reading books, began to observe – and to criticize – the physicians involved in our medical world.  Twelve different doctors saw her mother, and all sent bills “like sovereign states issuing fiats.” She characterizes most of them with disdain. She describes her mother’s growing  concern at what was happening to her, but as the days turn into years and rationality turns to madness – all that concern faded out leaving behind only delusions, anxiety, and fear.

Finally the author decides to leave off her own life, her husband and her children, to fulfill her duty living close at hand and often with her parents.  The nursing home was no better. Mrs. Owens tries to make sense of what went on, sympathizes with the nursing arrangements, the patients arrayed in a semi-circle near the nurses’ desk, found some favorites to love in the nursing staff and was grateful for them. She continued to cope by trying to arrange her mother’s deficits into some kind of rational category and that helped, probably by keeping her busy

A churchgoing woman, the author left God to his affairs, and does not tell us that she prayed for relief. Still, she found spiritual comfort in knowing that “the only one you can always rely on to listen to you and understand is the Spirit of God … and sometimes you’re mad at him.”

“Having someone to yell at is only one of the advantages of being aware of God at this time. I frankly do not see how people make it through experiences like this without a sense of some sustaining grace upholding them.” She holds on because she knows, rather hopes, that her mother knows that she is not alone. And she recognizes “you’ll likewise need to know that someone, even if unseen, realizes what you’re undergoing and will stick with you.”

In her last chapter the author admonishes us “love is also all that endures … love is a choice. As for free creatures it must be. It is indistinguishable from choosing life.”

Whether it is love or duty that moved Virginia Owens I cannot say.  For many, both come from the Creator. Duty, stern daughter of the voice of God, tells us what humans must do if we truly love -- as she did.

Published: November 8, 2007