She had months of ups and downs, and then just downs and downs. Yet in all those horrid months, when she never felt the breeze on her face, saw the sun, had a good meal, or slept without pain, she never complained. She appreciated a glass of ice, a back rub, or a story. She smiled when she recognized the faces of friends.

I was the oldest daughter, but I was three hours away, and I had two teenagers, a book to write, and a full-time job as a therapist. I drove to her hospital every other weekend, then every weekend. I took the calls from relatives and doctors and tried to handle her money, her house, and her medical care.

No matter where I was, I felt guilty. If I was with my mother, I wasn’t with my kids or clients. If I was working, I was ignoring my family. When I was with my children, I thought of my mother alone in a faraway hospital. I got depressed and crabby. My husband and I fought more. I got a speeding ticket.

My mother had never expected to die, and her affairs were not in order. Her money and legal papers were a mess. She’d insist on leaving the hospital, go home alone, then be readmitted in crisis. She wouldn’t move closer to her children, yet she hated being alone. Her unrealistic plans and disorganization made my life stressful and complicated.

I alternated between guilt and anger. I’d be furious about a decision she made and resolve to confront her. Then I’d find her vomiting or too weak to lift her head from her pillow, and I’d back down. I’d feel like a horrible daughter and resolve to be kinder. Then I’d hear about another bad decision.

By the time my mother died, I felt a weird combination of stressed to my limits and ashamed I hadn’t done more. Mother and I had had some good talks, but many things didn’t happen the way I had hoped. I spent a year tired, anxious, and sad. Then I lost my mother.

Despite its attendant stress and pain, helping parents through their last years is one of our best chances to grow up. No longer children, we can become truly helpful. If we say no to this challenge, a part of us stays forever young and helpless.

Families that work together through a death reap many rewards. The adult children can say thank you and repay parents for their help. The parents can receive gratitude. They also have their last chance to help their children grow, and they can feel great pride in how their children respond to the challenges of this time.

Adult children gain strength from struggling with the difficulties of this stage—strength they will need later for their own old age. They also learn by observation how to handle illness and goodbyes. Caring for my mother while she died, I observed how well she handled pain. I saw the joy that cards and letters gave her. I learned about patience in the face of frustration. I learned about the importance of small, temporary victories, wrested from the great jaws of defeat. I made notes to myself that I’ll pull out and read when my time comes.

During this process things happen in families that have never happened before. Family history is revealed. Secrets are told. Unmentionables are mentioned, even discussed. Mother talks about her miscarriage or about Uncle Arthur’s suicide. Dad hugs his sons. Parents who were nicknamed the “Bickersons” are suddenly gentle with each other. In the cauldron of loss, new aspects of character rise to the top.

Old-old age can be a time of great sorrow but also of great healing. One of my clients was raised a Catholic but had years ago broken with her faith and become a Buddhist. Her father, who had taken a second job when she was a girl to keep her in Catholic schools, couldn’t believe his oldest daughter would reject the religion that meant everything to him. He believed she wouldn’t go to heaven. He couldn’t forgive her.

My client went home to care for her father in the last weeks of his life. She read him his Bible and prayed with him, something she hadn’t been willing to do for years. He asked her questions about Buddhism. The last day of his life, he said to her, “I think Buddhists and Catholics go to the same heaven. We will be together in the end.”

Another client, Belinda, was disowned by her rural Kansas parents when they learned she was gay. She kept in touch with one of her sisters but had heard nothing from her parents or brothers for 20 years. Her letters were returned unopened. Belinda was in her 40s and living in a city far away when her sister called to report that her father had developed tongue cancer. She called her mother and offered to help.

Much to her surprise, her mother broke into tears and accepted her offer. Over the years, and especially with her husband’s illness, she and her husband had softened towards Belinda. Impending death can have a way of putting things in perspective. Partly too, her parents accepted her because all the other children were tied up with jobs and children. Belinda was a freelance writer who could work anywhere.

Within weeks, Belinda had moved her office into her old bedroom on the farm. Her brothers came by to see the folks, and while at first they were skeptical about her, when they saw how kind Belinda was to their father, they softened, too. They began joking and horsing around with Belinda the way they had done as kids. Her sister relaxed, too, when she had another sister to share the burdens of her parents’ old-old age.

Belinda’s parents felt she was their savior. It’s hard not to love and appreciate someone who is helping with driving, insurance forms, bedpans, and back rubs. At one point in his six months of dying, Belinda’s dad said, “I’m sorry about the cancer, but I am glad it brought you home.”

I don’t mean to imply that every story has a happy ending. Heroic behavior can lead to bitterness and burnout. Sometimes the caregiver is not appreciated and, in fact, is the focus of the dying person’s rage. My client Darin, for instance, handled his dad’s estate for years, only to be left out of the will because his very demented dad thought Darin was stealing from him. My client Abby’s loving care of her dying mother made her siblings jealous and angry. They never helped out but only second-guessed her, and after her mother’s death she told me, “I don’t care if I never see my sisters and brothers again.” During the last years of her parents’ lives Cheryl’s husband felt she was over-involved with them and had no time for him or the children. During this time, she was depressed and cranky. She lost perspective and control of her life. In the end, she couldn’t work things out with her husband and ended up alone.

Hard tasks like the ones Cheryl took upon herself pay off only if everyone concerned can agree to tolerate imperfection and to stay the course. This stage in the life of a family tests our skills and character. It requires courage, forebearance, stoicism, and a sense of humor and perspective. And it requires the ability to assert needs, communicate openly, and deal with pain.

But how we deal with sick and dying parents will influence the way we ourselves grow and develop for the rest of our lives. Will we be warm or distant, responsible or hedonistic? During this time we all get a chance to “grow our souls,” as psychologist Frank Pitman puts it. 

Of course, the older generation can help the process along with their own courage, humor, perspective, and forebearance. Dean and Janice, ages 75 and 71, are a case in point. They were old family friends whom I hadn’t seen in years, but when I heard Dean was homebound with emphysema, I scheduled a visit.

Trim and brisk in her movements, Janice met me at the door with a hug. I could still see the Janice I had known well—the gardener and traveler who liked a house full of kids and company—but she had worry lines around her eyes and looked as if she’d had a hard year. I asked how she was doing. “I get a little tired,” she said. “Dean is up a lot in the night. But hospice is coming now, and that helps. I’m grateful for every day we have together.”

Dean lay on a daybed in their living room, a man who hadn’t ever liked movies or church because they required him to sit too long indoors. From my childhood, I remembered people asking Dean, “Don’t you ever sit still?”
 Today he was propped up against a wall of pillows awaiting my visit. Beside him was a table with a computer, pills, tissues, and lotion. He looked like himself with his white bushy eyebrows and wild white hair, except he was thin and had supplemental oxygen.

He took my hand and smiled, but when I asked how he was feeling, he answered honestly and in some detail. Though he wasn’t in pain, he had gotten so weak he could walk only a few steps without resting. Then there were days he couldn’t get enough oxygen, and that was scary. He’d lost peripheral vision, but he still could use his computer and watch videos. He said he was learning patience, a virtue he’d never before possessed.

“I got old, but Jan stayed young,” Dean said. “We have a date every night to watch sports on television. She fixes us colas, and we cheer our favorite teams on.”

Janice had filled the room with things that gave Dean some control and connection. His telephone and personal planner were close at hand. On a table by the day bed were letters, newspapers, and bird identification books. Dean’s bed looked out on bird and squirrel feeders and a birdbath.

“Just when I slow down enough to get interested in birds, my eyes are so damn bad,” he joked, “that I can hardly see them.” We laughed, and he continued. “We’ve got it all wrong in this culture. The young should identify birds. They’ve got the eyes and ears for it. The old should go to rock concerts. We can hear music and see the light shows just fine.”

We laughed some more, but then Dean leaned back exhausted against his pillow. Janice adjusted his blankets and said, “Dean can’t keep food down. That worries me the most. Hospice said it’s time to consider a feeding tube, but he’s not sure he’ll do that. And he has one bedsore that won’t heal. The doctor is watching it.”

She sighed and looked wanly at Dean. “I make you sound like a mess.”

They laughed, and she continued in a lighter tone, “Really it’s not all bad. Dean and I have had some very good times. We’ve talked over everything and looked at all our photo albums. We have our son over one night a week and our daughter on another. We’ve had plenty of time with our grandchildren. Since Dean’s illness has slowed us down, we have time for everyone.”

Dean added, “I can still eat my favorite foods. Janice knows just how I like my eggs. And the computer is a godsend.”

We talked about Dean’s life. Many people like to review their lives as they approach the end. They want to talk about the good and bad times, the victories and great sadnesses. Dean was no exception.

While we all have lives shaped by accidents, this is especially true of Dean. During the war Dean missed a train and fell asleep on a bench at the Kansas City station. When he woke up, Janice, then a stranger, was sitting nearby. She offered him fruit and coffee. Later he got a job as an engineer because, just as he walked in the door of the plant, another engineer announced he was quitting. Dean’s daughter was born on his mother’s birthday and had her name. When we talked about these events, Dean cried a little, something I had never seen him do before. He wasn’t embarrassed, though, and merely said, “Now that I’m old, I cry more.”

Except for his parents’ early deaths—in a 1918 influenza epidemic—Dean had lived a lucky life. But his luck was running out. Even as we spoke, he began wheezing, and Janice reattached the oxygen tube. She asked if he could swallow a pill. “Later,” he said hoarsely.

We waited a few minutes while Dean concentrated on breathing. Then he wanted to talk about his children. His main regret, he said, was that they didn’t get along. Lily was a vegetarian, a Unitarian Universalist, and a liberal, Rob a Republican Christian who liked to hunt. They had always been competitive and intolerant of each other. Both had stored up hurts, and by now they barely spoke.

“Now that we’re getting old,” Dean said, “I hope they’ll pull together. When we’re gone, they’ll need each other.”
 Janice said, “Dean plans to talk to them about this soon.”

He laughed, “Yeah, they need one last lecture from their old man.”

We had tea and watched the squirrels and birds. While Dean looked up a finch in Peterson’s bird guide, Janice dug out pictures of my folks, and we looked at all of us when we were younger and mostly out of doors. I stayed until Dean fell asleep.

I next saw Janice at Dean’s funeral two months later. She was composed that day and looked less exhausted. She said Dean had died at home, the way he’d wanted to. Hospice had been wonderful. His last weeks were tough, but he’d managed to stay mentally clear. He’d e-mailed his friends goodbye.

I asked if he had managed to deliver his last lecture to the kids. Janice smiled, “The day before he died,” she said, “he had us all hold hands in a circle around his bed. He made us promise to stay together and look out for each other. Rob and Lily both promised. It wasn’t a lecture, but I think it will do the trick. The kids have helped each other through this. Their children were pallbearers. I think Dean will get his last wish.” 

Mary Pipher’s latest book, Another Country: The Emotional Terrain of Our Elders, was published by Riverhead in 1999. She is a member of the Unitarian Church in Lincoln, Nebraska.