The Rites of Life: Caregiving

By Liz Barry Audio slideshow by Kim Raff

Lisa Dibble, 51, sits on a stiff wooden chair, her eyes fixed on her father’s face. The fluorescent lamp overhead casts a jaundice gleam on his angular features.

It’s just past noon on Saturday, Sept. 20. With the beige privacy curtain drawn, no sunlight penetrates the room at the Medical Care Center, a nursing home in Lynchburg.

“I’m ready to get out of here if I have to crawl,” says her father, Earl Stinnett.

“Yeah, really,” says Lisa with a knowing chuckle.



A machine down the hall beeps at six-second intervals like a mechanical heartbeat.

Beeeep ... Beeeep ... Beeeep ...

Lisa’s father lies on his back on the twin bed, his feet inches inches from the edge. He wears a button-down shirt tucked into cotton sweatpants.

Lisa reaches into the CVS bag at her feet and pulls out a magazine, “Popular Mechanics.”

“Oh boy,” he says, with gratitude.

Beeeep ... Beeeep ... Beeeep ...

Lisa keeps the visit short. Afterwards, she will run errands for her parents and catch up on long-neglected chores at home. Before leaving, she clasps her father’s hand.

Earl speaks barely above a whisper. “You don’t know how much I need to get out of here,” he says.

“I know,” Lisa says.

Her voice is calm and steady. “I’m doing everything I can.”

Turning a corner

Before July, Lisa’s relationship with her parents, who are in their 70s, followed a comfortable pattern. She visited on birthdays and holidays, and talked to her mother every day by phone. Her parents were generous with advice; Lisa could rely on them if she had a problem.

Before July, Lisa’s life was full but manageable. As executive director of The Gateway — a small non-profit that helps homeless men struggling with alcohol and substance abuse rebuild their lives — she found her job demanding and fulfilling.

On July 27, everything changed.

A week before, her parents caught a virus, nothing out of the ordinary. Lisa called daily to check on them. After a few days, Lisa’s mother, in high spirits, reported that she and Earl had almost recovered.

Lisa called again, two days late: no answer. Concerned, she checked their house.

It was empty. Neighbors told Lisa that her parents had been taken by ambulance to the hospital.

Lisa was shocked at her parents’ condition. They were hallucinating, disoriented, confused. The doctors told her the diagnosis was dementia and failure to thrive, and that the virus weakened their bodies and sparked a sudden mental decline, she says.

“It was horrifying. I couldn’t understand it.”

Her parents were fully independent. Just a few months earlier, her mother completed their tax returns.

“It’s like you turned a corner, and you lost them,” she says

Lisa is forced to confront her parents’ decline and mortality. For the first time in her life, the parent/child roles are reversed; now Lisa is responsible for her parents’ welfare.

In 2006, there were as many as 38 million adult caregivers nationwide, and about 900,000 in Virginia, according to a 2007 report by the American Association of Retired Persons (AARP). As the baby boomer population ages, the number of caregivers is expected to rise.

During the next two months, Lisa muddles through a tangle of difficult choices. Her first big task is choosing a nursing home. She sorts through factors like cost, reputation, parents’ preferences and quality of care, and decides on the Medical Care Center, the same nursing home her grandmother stayed at years ago.

Under skilled care, Earl and Peggy rebuild their physical strength. Meanwhile, Lisa tends to their home, bills and responsibilities, and visits every weekend.

Going home

On Oct. 3 — more than two months after her parents entered the Medical Care Center — Lisa’s mother’s confusion is still pronounced. Her father, despite the initial diagnosis, bounced back and has gotten the green light from doctors to return home.

Since it’s a Wednesday, Lisa has taken the day off work. She arrives at the Medical Care Center just past 10 a.m.

In the dim room, Lisa stuffs her father’s clothes and belongings into plastic garbage bags. She works drawer by drawer, quickly and methodically. Earl, dressed in a button-down shirt and a crisp pair of blue jeans, sits quietly on the bed in his room.

Lisa signs the release forms.

“You go in and talk to her, and I’ll come back when I’ve finished loading up the car,” Lisa says to Earl, as they stand in front of Peggy’s room.

Earl hands his wife a canary yellow envelope. Peggy turns off the TV, and reads the card aloud, her voice cheerful and animated.

Earl sits on her bed, shoulders hunched. As she reads, he retrieves a crumpled tissue from his pocket and dabs his eyes.

“I wish I was taking you with me,” Earl says in a shaky voice.

“What?” Peggy says.

“I wish I was taking you with me.”

“Where?”

“To home.”

Peggy changes the topic to the weather. “Not a cloud in the sky,” she says.

Lisa enters the room, and watches for a moment. Earl, choked up, cannot speak. Lisa doesn’t want to leave her mother, but she has no choice. Her mother is not well enough to come along.

“We’ll be back over to see you when we get a chance,” Lisa says, blinking through tears.“I’ll get you some more things you need.”

With a final hug, daughter and father head home.

Reaching deep

After her parents' sudden decline, Lisa’s life hurtles forward at full speed.

Outside of work — her biggest time commitment — Lisa is an active member of Timberlake United Methodist Church, where she teaches a weekly Bible study class. She also serves as president of the Greater Lynchburg Transit Company’s board, and writes poetry in her spare time.

“All of a sudden I have a whole other couple of people’s lives to run. I went from stressed to overwhelmed.”

In the U.S., caregivers provide an average of 21 hours of care per week according to the AARP report. Studies have shown that caregiving can affect a person’s work productivity, financial situation, health and emotional well-being.

Lisa’s to-do list seems never-ending. When she crosses off one thing, she adds three more. Chores at her own home get neglected. There is little time to decompress.

“I’ve had to reach deep in my own faith and my own strength. I found that I’m a lot stronger than I ever thought I would be. I’m amazed that I’ve held up.”

Most nights, Lisa is lucky to be home by 8 p.m. She musters energy for a quick bite to eat and TV, before heading to bed, spent.

“You get to the point where you are a little bit numb, which is not a good thing because it means the pain level has gone so high that you can no longer deal with it.”

Lisa reached out for support at her church. Though some people were receptive, she wanted and needed more. Her church has groups to help a person grieve the death of a family member, but nothing for the life crisis she is experiencing.

So Lisa went on a mission. She approached church leaders about bringing the Stephen Ministries, a national program that provides one-on-one support for people going major life crises, to her church and United Methodist Churches across Lynchburg.

“For me, it’s about bringing about a positive change. If it’s happening to me, it’s happening to other people,” she says.

“I imagine there are a lot of hurting people out there that are facing this alone.”

A time of uncertainty

It’s Earl’s first day home, mid-afternoon.

Lisa sits at the kitchen table, counting pills under her breath.

“One, two, three, four. . . ”

She slides the colorful capsules along the glass tabletop into small piles, and sorts them into their proper compartments in the pillbox: Sunday. Monday. Tuesday. Wednesday . . . Morning. Noon. Evening. Bed.

Earl sits on a plush blue recliner, his favorite chair, feet propped on the footrest. Sunlight streams in from the window behind him.

He is animated as he chats with Emma Jones, a companion from Generation Solutions, a company that provides services to seniors to make staying at home easier. During his first two weeks home, an aide will stay with Earl from 9 a.m. to 5 p.m., seven days a week. Lisa hopes to scale back after that.

With the medicine sorted, Lisa devotes the afternoon to the chores remaining on her to-do list: Fill new prescriptions at the pharmacy; swing by the locksmith for a spare key; buy fresh fruit, meat and milk for Dad.

By 5:30 p.m., Lisa has loaded her father’s refrigerator with groceries.

“I’m tired,” Earl says.

“OK, your jammies are on the bed.”

With purse in hand, Lisa glances around the kitchen. Her eyes rest on a stack of papers that need to be sorted and filed away. Another day.