November 27, 2008

Remembering Big Martha one year later

I can hardly believe that a year has gone by since the passing of my Mother and I have to tell you that I miss her a great deal. Because my Mom lived to be 93, she taught me many important lessons about aging well. Observing her opened my eyes to the importance of caregiving and it dawned on me that there just isn’t enough information about the subject. Therefore, working with the wonderful professionals at the Martha Stewart Center for Living at Mount Sinai Medical Center in New York City, which, by the way, is dedicated to my Mother, we are creating a comprehensive book, a guide to caregiving. I thought you might be interested in reading the following article, which appeared recently in the Wall Street Journal.

Martha Stewart says she likes to think of herself as a teacher, one who educates people about how to enhance their lives and homes.

Now, she hopes to provide that guidance specifically for caregivers.

Last November, Ms. Stewart's mother, Martha Kostyra, died following a stroke at age 93. Ms. Stewart is turning the lessons she learned in the last years of her mother's life -- about older adults' needs and the challenges in meeting those needs -- into a book, a guide for caregivers. This comes on the heels of the opening, in 2007, of the Martha Stewart Center for Living at Mount Sinai Medical Center in New York. Ms. Stewart pledged $5 million to the outpatient clinic, which helps older patients and their caregivers.

Ms. Stewart, 67, says she was fortunate in one sense. Her mother, she notes, was "100% independent until the day she died." Still, mother and daughter occasionally found themselves at odds over the amount of help Ms. Stewart wished to provide and the amount of help her mother was willing to accept. At the same time, Ms. Stewart found that too many caregivers had too little information about how best to help family members and themselves.

Recently Ms. Stewart sat down at Mount Sinai to discuss her role as a caregiver, her relationship with her mother and her efforts to shed more light on caregiving. Here are excerpts from that discussion:

THE WALL STREET JOURNAL: Let's talk about the difficult line that adult children walk -- the awkward transition into helping manage a parent's medical care.

MS. STEWART: They don't want the intrusion. You're always the child, and you're treated like the child. My mother didn't even have a clue [about] half the things I do. She'd say, "Ah, really, you're involved in that?" And when she [came] to a live audience on the show [she would say], "Oh my God, you have so many people here!" She just didn't focus on that because she had her own life to deal with.

WSJ: Apparently, you kept a notebook with her health records.

MS. STEWART: I tried to keep track of what she was doing. But as people age, they get a little annoyed when there's an intrusion. It was just [an effort] to keep track: Did she go to this? Did she get this kind of medication?

I also wanted her to take more vitamins. I conferred with my nutritionist. And I made all these nice little packages of nutritional supplements, herbs and things. And they were still in the drawer when she died.

WSJ: Could you talk with your mother about her health?

MS. STEWART: She was very private. She was brought up of the school that you don't talk about the will, you don't talk about the insurance, you don't talk about anything. You don't talk about it. And I'm totally the opposite of that. My daughter and I talk about it. There's nothing private.

[The Journal Report: Encore] Anders Krusberg

TWO MARTHAS Ms. Stewart with her mother in 2007

For me and my mother, it was all about preventative measures. That's all I cared about with her -- what can we do to prevent frailty, to prevent any kind of mental deterioration.

WSJ: Your experience with your mother -- has it caused you to have conversations with your daughter about your own health? Has it reached down the generations in your family?

MS. STEWART: If I have an ailment or a problem, I will mention it to my daughter. Like yesterday I said my back is still hurting, and she said, "Well, Mother, I feel sorry for you, but you have to lose weight, and you have to do maybe a different kind of exercise." She gave me seven things that I should be thinking about. And she was right about all of them. But she's really smart that way, and she really cares about physical exercise.

WSJ: So did your mother become a patient here at Mount Sinai?

MS. STEWART: Yes. She was having pain in her back and pain in her leg, and I brought her to the pain-management department here. And then I thought, maybe I could help her with her arthritis. She had a little bit of arthritis in certain parts of her body, and I took her to a doctor who was recommended to me through this hospital. So I started to bring her in for other care, care she wouldn't have access to in [her home in] Connecticut.

My mom took care of her records. But again, that gets confusing when you're 93 years old. And I think that kind of management of medical help requires the attention of me or my sister Laura, where my mother lived. And I don't think we did a good enough job with that. I don't.

WSJ: What information is out there for the adult-child caregiver?

MS. STEWART: There are lots of books on how to invest your money, and do this and do that, but very little for the caregiver. So we are working on a book, the caregiver's guide. That will take a while. I wish I could just stop everything and work on that. I've been compiling a lot of information and a lot of thoughts about that.

Just keeping prescriptions in order, or making sure that they're filled on time, is tough. The week before my mother had her final attack...somebody who works for me was helping her that day. And they went to the pharmacy, and she didn't have her prescription, so she didn't get her medicine. They gave her one pill to tide her over to the next day. But she put it in her purse, so maybe she didn't take it. I don't think so, because she was really organized, but what if she did forget?


Martha Stewart gives WSJ's Kelly Greene a tour of her latest project, a new geriatric facility at Mount Sinai Medical Center in New York. (Nov. 14)

You need somebody to oversee those scheduling problems. Scheduling gets to be difficult. And the shopping. Who's going to do the shopping, and make sure that the refrigerator's stocked, [that] there's fresh milk for the coffee? Who's going to make sure your home is clean, because it gets a little onerous to do that for yourself when you're 93? There will be a very practical aspect to [the guide], because that stuff really bothers me.

WSJ: What do you hope our country has in place for older adults by the time you're in your 90s?

MS. STEWART: I certainly hope there will be community activity that will be uplifting rather than baby play or nurseries. In everything I've ever done, it's always about talking up to people, never, never talking down to people. I find that oftentimes I get very uncomfortable in situations with elderly people where they're being treated more like babies than senior adults.

Many of these church communities and school communities [are] keeping [people] alive with stimulation and interesting activities -- going to the theater and concerts. And all of that is terribly important. It's a balancing act between how much can you really do and what should you be encouraged to do.

WSJ: It's easy to focus on everything that's hard about caregiving -- the stress, the difficulties in talking with each other. But people say there are great times, too.

MS. STEWART: What I miss the most are my Sundays. I had developed a habit of having Mom over on Sunday. So after her church, she would come to my house. We'd have this healthy garden lunch, which she devoured. She might take a nap afterward, or I would have my masseuse come over and give her a really great massage, then we'd go to the Sunday night supper at my friend's house. She'd play with the pets. I have four or five cats running around, and dogs.

There's a wonderful Sunday night dinner in our neighborhood, and I would take my mom, who was always welcome, and she sat down one night and they were teaching her a card game called Gozo rummy, which is sort of bridge-like. You play with two decks, and you play everybody's hand. My mother beat everybody the first time she sat down and played.

She got to have a lovely day. I really miss that. Replacing that is hard.\

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