Saturday, August 20, 2011

Who is Walter Karabian?

I've been using rescued potholder for about a year. I retrieved it from my grandparents' kitchen when they moved into assisted living. My mother, who believes in keeping only new things, had already tossed out all the cast iron frying pans and skillets before my arrival. But, I was able to salvage two old wooden rolling pins, miscellaneous utensils and some potholders (like this one).

Today, as I was removing the lid to a pot of boiling beans, I became curious about the printing on this particular potholder as I set it down print-side up.

Who is Walter Karabian?

From a Google search, I found Mr. Karabian, listed on USC's History Alumni page. Walter Karabian was a California State Assemblyman from between 1966 and 1975 and is now a practicing lawyer in Los Angeles, CA at Karms & Karabian.

Obviously this potholder was a campaign giveaway during his 1960's election, and it was a clever choice, considering my family kept and used it in their kitchen ever since. Funny how one piece of bric-a-brac uncovered a small slice of California's history for me.

I continually implore my father to record stories about the mementos he has packed away in miscellaneous boxes in the garage. So much history exists within our elders that won't be accessible when they are are no longer with us. We aren't always lucky enough to have something printed on each item. I look forward to asking my grandfather his what he thought of Mr. Karabian's campaign and why he saved his potholder.
So if there is anything to take away from this clever little potholder, it's a reminder to record our stories today.

Ref:
http://dornsife.usc.edu/hist/alumni/

Thursday, August 18, 2011

The Golden Age of Sex

Erica Jong’s notes how speaking about sex and seniors seems to be a taboo in mainstream media. She says, “You won’t find many movies or TV shows about 70-year-olds falling in love, though they may be doing it in real life.”


So why are younger generations surprised that older adults want to have sex?

Not My Parents
My mother, a registered RN for 25 years, refuses to accept that her parents, my grandparents, still want to have a sexual relationship even though they are in assisted living.

When my grandfather asked the nurse in their facility to help him get a prescription for Viagra, she was surprised by his request. She called my mom, to ask if my grandparents were still "sexually active", my mom emphatically denied they were and said my grandfather was crazy and to just forget about his request.

I was appalled. Having just completed the book Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Catwhich discussed sex after dementia and how patients with dementia can change to become more sexually demanding, I sent her a copy of the book, hoping she would get the idea, from a geriatrician with expertise.

After she finished the book I asked her about it. She conveniently ignored (or 'blocked out' as she put it) the story about the couple and the change in sex life after dementia. She said she didn't want to think of her parents that way.

I encouraged her to allow my grandfather's request to fill the prescription. I tried to reason with her that even though my grandmother was always an innocent Golden Girls "Rose Nyland" type before dementia, perhaps she is now more of a "Blanche Deveraux". She had a laugh over it, but it wasn’t enough to sway her. My thought is that sex and seniors is a difficult topic when the seniors in question happen to be your own parents.

Grandma's Boyfriend
My husband's grandmother had an intimate relationship with a wheelchair-bound man at her assisted living home. When she found out the man was actually seeing many women in the facility at the same time, she was very upset by it. She withdrew from the relationship and hid from her neighbors for a couple months. The pain in learning her boyfriend had many girlfriends was compounded by the fact that she seemed to be the only one who didn't know it. His other girlfriends even teased her about it.

Although she wanted to break up with him because she wanted a monogamous relationship, she decided not to. She figured it was worth more to her to keep the relationship. Her boyfriend died last month after a relationship that lasted several years, and although she conducted his funeral, she never did tell his family about their intimate relationship. She did however confide to us that while she was glad to have known him, she won't be doing that again.

New Books
What is wonderful is to see books like Joan Price’s, “Naked at Our Age: Talking Out Loud About Senior Sex” bringing to light the topic of ageless sexuality in light of the physical changes that occur with aging. In the book, she not only includes readers' stories, but also information from 45 sex experts, doctors and health professionals.

New Risks: HIV/AIDS
An additional consideration for seniors having sex is the increasing number of HIV and Aids cases occurring. These generations were not raised with all the safe sex education and marketing that the younger generations take for granted. A recent article says that by 2015 the majority of HIV/Aids patients will be 50 years of age and older. The new health focus will be to help seniors protect themselves from contracting the virus and from passing on the virus. It will be important to get seniors tested for HIV with quick, discreet home test kits to hopefully stop the spread of the disease, to provide better distribution of information to older adults about safer sex, and to better advertise senior prophylactics alongside products already aimed at active seniors, like Viagra.



References:
http://www.newjerseynewsroom.com/healthquest/sex-and-seniors-get-erica-jongs-attention
http://www.pressdemocrat.com/article/20110806/LIFESTYLE/110809620?Title=-8216-Senior-sexpert-8217-shatters-a-sexual-taboo&tc=ar

Thursday, August 11, 2011

Memorial Art Therapy

Art and its Usefulness as Therapy

Art is a form of communication, traditionally a visual language or assemblage of marks, sounds, ideas or feelings, which may not be communicable as interestingly, or provocatively in written form. Art therapy is a branch of art focused on an individual’s subjective, introspective experience of creating the art. The soothing and cathartic experience for the maker of the art and its lack of expectations make it an accessible and sought after form of therapy for those seeking emotional release from a grief experience.

Art therapy assists the bereaved to gain insight about themselves through the making of art. The art therapist conducts not to critique the art produced, but to evaluate and support survivors’ needs to come to terms with an emotional trauma that is otherwise too painful to investigate through other forms of therapy. The art provides a space of projection, a filter for comfortable self-examination that can be enjoyable and approachable for all participants.

Although we all share a human experience, because of culture, social stratification, the individuality of experience requires the establishment of a baseline from which to evaluate emotional wellness, world constructs, attitudes and outlook. Art media serves as a tool of experiential control for therapy. Additionally, symbols reveal associations and metaphors. Under the guidance of an art therapy counselor, the bereaved can use various media to express feelings related to their grief that would otherwise be too difficult to confront in a safe and or approachable manner. The art allows them to separate the event and or feelings from themselves to gain insight and perspective.

Working with Bereaved Couples

“Change creates loss and grief is how we react.” When one person in the relationship is ready to move on but the other is not, one person can crush the other’s self-esteem or prevent the grieving person from working through their grief at a healthy pace. Unreasonable expectations can lead to animosity and negative or destructive behavior. Working with couples to achieve understanding is of utmost importance because an unhealthy recovery from bereavement can lead to the disintegration of the relationship. Inadequate social or psychic support in events such as SIDS (Sudden Infant Death Syndrome), conflicted feelings after a suicide, or ambiguous unresolved losses like a kidnapping or runaway, often manifest in difficulties in sustaining the relationship. These types of loss are especially traumatic on relationships due to a lack of coping skills. Results from these losses may be low self-esteem, depression, questioning of one’s own faith, sleep disorders, poor impulse control, drug abuse, and other types of chronic emotional pain.

According to Rogers, “Grief is inherent in living – a part of our human experience. It does not need to be ‘fixed,’ ‘treated,’ or ignored. Grief needs to be lived as a normal emotional response to loss. It will be unique to each of us and there is no ‘normal’ timetable to ‘complete’ the process. Emotional trauma can lead to unhealthy coping behaviors that further put strain on relationships. Signs that a loss is not fully being resolved are mummification of the deceased’s room, or intense psychological responses to the deceased’s name coming up in conversation. When a partner’s mourning process is disregarded by the other partner, their family, and or friends, the misunderstanding leads to isolation, and intense psychological pain.

According to Elizabeth Kubler-Ross’ five stages of grief theory, grievers heal at different rates, passing through the stages of grief inconsistently. Each person will process grief differently and this can lead to problems in communication, resulting in negative interactions. For example, one spouse may be in denial of a loss and unwilling to accept the truth, while bargaining with God to bring back a lost loved one. The other spouse who has accepted the loss may have fallen into a depression. Consequentially, neither is able to meet on the same level with the loss and their inner world is threatened, with feelings of helplessness and isolation. This can sometimes lead to self-destructive behavior or betrayal, with the added risk of the relationship ending.

Sometimes a spouse can be a reminder of a traumatic event or loss. He or she may physically look a lot like the lost love one or he or she may have broke a sacred confidence that will never be regained. Bereavement can also be tied to an addiction, incarceration, domestic abuse, gambling, infidelity, etc. One may not bear to see, hear or be reminded of them without flashing back to the distress. In such cases, if the relationship is to survive, couples must find a new normalcy of living and establish a mutual respect and understanding of each other’s grief surrounding the loss event.

Couples can share unresolved anger and guilt through art making. Art allows survivors to objectify pain and healing from their bereavement through discussion and symbolism. Art allows the bereaved to express issues that may never have been addressed. Therefore, the survivor recovers because the making of art gives power to the artist. The introspective nature of the art necessitates nonjudgmental discussions in a safe, and supportive environment. Although the loss event may always be lying silently under the surface, relationships can emerge stronger when grief issues are transcended.

Group Dynamics

Bereavement groups bring trauma survivors of diverse personalities together in a dynamic setting of openness and self-expression. However, to maintain a healthy healing environment for group members, art therapists must manage the various strengths and weaknesses to provide effective therapy sessions. Therapists must be cautious about dysfunctional personalities to prevent them from derailing activities and must also place a priority on keeping the calm, therapeutic atmosphere necessary for effective grief work to be accomplished. Effective therapy groups collaborate well together and support one another to achieve their individual and collective emotional growth and wellbeing.

The bereavement coordinator may not have much flexibility as to who is a part of the group. Group members will often be of varying levels of maturity in their grieving process and personalities may clash due to the dynamic material engaged in the therapy work. Thus “in the various weekly sessions with each new expressive art there may be discussion on reconstruction of meaning.” The individual personalities within the group can add to facilitating or impeding growth. One goal as an art therapy group facilitator is to recognize group members’ emotional states and personal limitations, which reactions are normal or abnormal, and how to guide group activities towards promoting growth, personal wellbeing, and a supportive environment that facilitates grief work being undertaken.
In discussing group dynamics, Rogers (2007) discusses different personality archetypes encountered in the bereavement group setting including:

• The Advice giver – Use of domineering language
• The Self Righteous Faith Moralizer – Use of guilt or supernatural unknown to manipulate behaviors.
• The Talker – A self-absorbed person who monopolizes the group’s time seeking approval.
• The Challenger – A person who looks for fault with everything.
• The Small Talk – A person who uses chitchat to avoid uncomfortable topics.
• Speaker of the group - An overpowering personality speaking out of turn and thereby taking over the group.

The therapist’s understanding of these common personality manifestations is vital to plan each session to avoid dangerous situations. As Rogers points out, “as family, friends, and caregivers, the only gift we have to offer those who are grieving is the quality of our attention.” So an art therapist must manage the personalities of their groups as well as facilitate effective therapy. “Combining the support of the group and the use of physical and creative activities offer the grievers what they need most: acceptance and nonjudgmental listening.”

As Rogers points out, “the final session is Ritual, which is designed to bring the course together and allow healing through creative expression and ritual.” A grief group session may be closed out with the making of art and or a review of the art created. This art may be related to the discussions of the day, and can be an enjoyable conclusion to each session that group members will look forward to. The repetition of the activity also allows members to collect their thoughts and investigate feelings and or ideas in a group setting and nonjudgmental collective manner.


Ref:

Rogers, E. J. (2007). The Art of Grief: The Use of Expressive Arts in a Grief Support
Group. New York, NY: Taylor & Frances Group, LLC.
Kubler-Ross, E. (1969). On Death and Dying. New York, NY: Simon & Schuster


Tuesday, August 9, 2011

Books: Making Rounds with Oscar by David Dosa, M.D.

In Making Rounds with Oscar, geriatrician Dr. David Dosa focuses on the nuances of Alzheimer’s disease and dementia. Of Dr. Dosa's patient stories, I found most intriguing the story of a woman with dementia named Ruth Rubenstein and her doting husband, Frank Rubenstein. I have focused on the details of their relationship as chronicled by Dr. Dosa, as it clearly illustrates how dementia affects relationships from diagnosis through decline.

Diagnosis
“I had to look into the eyes of the eighty-year-old woman I had just examined and ruin her life.” Dr. Dosa is examining Mrs. Rubenstein to determine if she has dementia. Couples like Ruth Rubenstein and her husband Frank have a symbiotic relationship whereby one can deflect the questions to the other. So when asked about her favorite restaurant, Ruth does just this – she has her husband answer the question. Dr. Dosa is not deterred by this attempt at covering up her memory loss, and moves on to asking her next to draw a clock from memory. Ruth does this after some coaxing. However, when asked to place the hands at 2:45, she puts the little hand at the two and the minute hand half way between the 4 and the 5.

Next Dr. Dosa asks her how many four legged animals she can list in one minute. Ruth lists only 6 and cat was listed twice. When asked to spell the word ‘world,’ Ruth is able to do so quickly and accurately but she cannot spell it backwards, and gets only two of the letters in place when she tries.

Privately, Dr. Dosa asks her husband more specific questions including if she has done anything dangerous in her everyday living, like leaving the bath running, leaving the stove on, having car accidents or fender benders, or if any other changes in her behavior have occurred. This particular section reminded me of a good friend whose mother had consistently been hitting the curbs and sometimes parked cars at her assisted living facility. My friend had the hardest time convincing her mother to give up driving. Independence is hard to part with, but the dangerous facts spoke for themselves. My friend finally scheduled a meeting with her mother’s doctor, so together she and the doctor could address her health issues in relation to her ability to drive.

Aging and Memory
During Dr. Dosa’s examination of Ruth she tries to insists her memory loss is simply because she is old, but memory does not decline due to simple aging. Here, Dr. Dosa touches on the fact that “age really has nothing to do with memory, and problems with memory are never normal aging.” In fact, many problems like arthritis, high blood pressure, high cholesterol, adult-onset diabetes, and some cancers are contributed with aging, simply because they usually occur in people’s senior or elder years. Interestingly, these are not strict aging related health issues, but rather the effects of years of build-up in the body, allowing the problems to surface in later life. For instance, if one has smoked for 50 years of their life, it makes sense that the damage would in time catch up producing perhaps emphysema or lung cancer in one’s 60’s or 70’s. In fact, my grandmother who began smoking at age 16 did not get emphysema until she was in her early to mid 70’s.

Decline Begins
Dr. Dosa chronicles the decline of Ruth’s mental health via dementia. First Ruth’s memory impairs her social graces and embarrassed by her memory loss, she withdraws from her friends. The withdrawal causes a depression, which is then treated by medication. Next Ruth becomes unable to complete household chores, meals are frequently burnt, simple recipes become too difficult to manage, and her husband Frank must resort to hiring a maid and ordering meals out.

Romance Flourishes
What is interesting is that despite this decline, the Rubenstein’s relationship remains loving and dementia even spices up their love life. Dr. Dosa said, “One day…Frank pulled me aside…like a young teen sheepishly buying condoms for the first time, he asked me if I had any samples for something that might help his impotence." Frank was having trouble meeting his wife’s sexual demands, which Dr. Dosa explains is not unusual for married couples when one has dementia.

Caregiving Becomes Too Difficult
However, as Ruth’s mental decline gets worse, it becomes apparent to Dr. Dosa that Frank can no longer care for her. Frank appears unwashed, disheveled and exhausted. Although Frank takes offense at Dr. Dosa’s suggestion that he put his wife in a skilled nursing facility, he takes the suggestion to heart and hires an in-home caregiver.

Health Declines
Not long after, Ruth contracts pneumonia and is hospitalized. Her memory impairment makes the hospital stay difficult. She wanders about in the middle of the night, gets “tangled in her IV tubing” and falls “awkwardly to the floor.” The fall leaves her with a broken hip requiring surgery. The surgery leaves Ruth with more health issues. She “suffered a pulmonary embolus and became less stable.” When her breathing becomes difficult, they intubate her. Her health does eventually improve but it leaves her too weak to walk and her husband Frank must consent to place her in the skilled nursing facility.

Appetite Declines
In the skilled nursing facility, Ruth stops eating and loses 10 pounds. Her husband insists that she is seen by a gastroenterologist, and refuses to consider hospice. She again contracts pneumonia and returns to the hospital. During this stay she is given strong medications to calm her. Eventually a one-to-one aide is then assigned to keep her from getting up from the bed and falling during the night.

She returns from the hospital, but is too confused to eat and refuses to do so. Intravenous fluids are required to sustain her. She experiences a confused delirium and agitation from hospitalization and refuses to eat. Her husband Frank insists that she must eat, and requests a feeding tube. However, Dr. Dosa kindly reminds him “When your wife was still able to speak her mind she told me she didn’t want a feeding tube to help her with her nutrition. Shouldn’t we honor her wishes?” Frank agrees with Dr. Dosa to honor his wife’s wishes, but begins to cry saying, “Doctor, I’m not ready for her to go.”.

Misconceptions About Feeding Tubes
Here, Dr. Dosa explains the misconceptions with feeding tubes and how they are the point of contention with most families. Most people believe that the feeding tubes prolong life, but Dr. Dosa points out that there is “no place for feeding tubes in terminal dementia. Objectively they have never been shown to increase a person’s length of life or reduce the number of episodes of pneumonia. Feeding tubes are not without their side effects.” Although people believe that not feeding a patient is “cruel and unusual punishment”, Dr. Dosa points out that “loss of weight at the end of life is a natural by product of the body shutting down as it prepares itself for death. People at this stage do not perceive hunger or thirst the way someone who is healthy” does.

Health, Love & Appetite Appear to Return
Some days later, Ruth’s delirium improves and she starts eating again. She and Frank are seen walking down the hallway holding hands. When their anniversary date comes up, Frank asks for privacy so he can be alone with Ruth. Dr. Dosa notes that “requests for privacy between patients and spouses are not uncommon…they’re a married couple. Just because she lives here doesn’t mean that they don’t have needs.” Interestingly, what Dr. Dosa finds out from the head nurse is that another male patient has been spending a great deal of time in Ruth’s room and that Ruth likes his attention.

Spouse Forgotten
Within a few minutes of husband Frank’s arrival, Ruth screams and rushes out of her room. “The look on her face was one of pure terror and she ran past us without stopping.” Her husband Frank calls Dr. Dosa into the room and explains their relationship and what just occurred.

Frank and Ruth had met at a concentration camp in 1943. They spent nine months together until they were sent away to different camps. Before the separation they agreed that if they survived, they would look for each other to meet at a church courtyard in Frank’s hometown. That date they met up was 63 years ago that day; this was the anniversary Frank had come to celebrate, but instead of a celebration he was met with a shock. “’For the first time since that day, Ruth does not know who I am.’” When he bent to kiss her forehead, he said “’in her eyes all I could see was terror…I was a stranger to her. She just started screaming…I put my hand up to comfort her and she slapped me in the face. Then she got up and ran out of the room.”

Existential Death

Frank then said, “Doctor, in my mind my wife died today…please just make whatever is left of her [life] comfortable and don’t let her suffer anymore.”

Somatic Death

Frank never returned to the nursing facility after this day, and within a few weeks, he died of a heart attack. Ruth outlived him by just a couple of months, and without any children, “her lawyer was the closest thing she had to next of kin.”

Although Dr. Dosa’s chronicle of the Rubenstein’s relationship is not met with a happy ending, it is an honest portrayal of how dementia takes its toll on patients and their families.

Dosa, D. (2010) Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat. New York: Hyperion

Saturday, August 6, 2011

Happy 100th Birthday Lucy!

Today Lucille Ball would have turned 100 years old. It's hard to believe she's been gone over 22 years, having died at age 77 in 1989. Lucy still seems very much 'with' us. She has remained with us throughout the years due to the success and syndication of her and husband Desi Arnaz's television series 'I Love Lucy' which originally ran from the fall of 1951 to Spring of 1957.

I grew up watching 'I Love Lucy' in re-runs, and later on purchasing the entire series on DVD. I've memorized most (if not all) of the dialogue and often (almost daily) refer to different portions of episode story lines when reflecting on things that happen in my own life. I believe the success of 'I Love Lucy' was not only due to the extraordinary talents of Lucille Ball, Desi Arnaz, Vivian Vance and William Frawley, or to the brilliant foresight of Desi Arnaz to film the episodes with 3 cameras simultaneously on durable 35mm film, but to the quality of the show to accurately depict American life.

Although the show was in actuality fictional, many of the story lines were simply an exaggeration of real life. They poked fun at the ups and downs of life in America. I've often wished I'd been alive during the run of 'I Love Lucy.' The 1950's era society of 'I Love Lucy' detracts nothing from the messages we see in the show. Society is still society, and people in it still contend with all the ups and downs portrayed so many years ago in the series, making 'I Love Lucy' a timeless piece of work. It remains the longest-running show to continually air in the Los Angeles area, for over 50 years after it ended. Thus, we can only expect that Lucille Ball 'Lucy' will continue to 'live' on through this show for many years to come.

Tuesday, August 2, 2011

Books: If You Ask Me (And of Course You Won't) by Betty White

In If You Ask Me, Ms. White explores her a variety of life experiences and favorite stories. Sections of interest specifically exploring aging and health were the sections on “Growing Older,” “Health,” “Loss,” and the last chapter titled, “I’m Eighty-Nine?”

In “Growing Older,” Ms. White opens with the idea that “if one is lucky enough to be blessed with good health, growing older shouldn’t be something to complain about. It’s not a surprise, we knew it was coming – make the most of it.” She goes on to say, “So you may, not be as fast on your feet, and the image in the mirror may be a little disappointing but if you are still functioning and not in pain, gratitude should be the name of the game.”

In “Health,” Ms. White discusses maintaining her weight: “I make it a point to never let my weight vary more than five pounds in either direction.” About vision she says, “I wear glasses to read or to drive.” For her exercise regimen, she has had the luxury of having “a two-story house and a bad memory, so all those trips up and down the stairs take care of my exercise.” Ms. White also keeps herself busy with crossword puzzles, which she subscribes to monthly. She refers to this as her “mental gymnastics.” She attributes her good health in avoiding sickness and colds to her daily vitamin C dose. She attributes her endless energy to her father, who was also very energetic and reflects on how hearing problems isolated her father in later life. “My father never enjoyed parties and avoided them whenever possible. He always said he couldn’t hear anybody in a crowd.”

In “Loss”, Ms. White says, “I think the toughest thing about loss, and the hardest challenge is the isolation you feel in its aftermath. You spent so much time sharing your life with someone, talking through issues, even disagreeing about things, and all of a sudden there’s a hole. There’s nobody there and you think, Well, who’s in charge? My God it’s me. I have to make the decisions. I can’t share the decisions any longer. And that’s tough because you don’t fully trust your own judgment.” The loss of Ms. White’s husband, Allen Ludden, left her compassionate and willing to reach out to others experiencing the loss of a partner. With regard to fan mail, she answers personally on just a few topics. “There are a few categories…to which I do respond, those who have just lost a life partner and need to share their pain with someone who has been through it.”

In her last section, “I’m Eighty-Nine?”, she says “One thing they don’t tell you about growing old – you don’t feel old, you just feel like yourself.” She goes on to say, “But I don’t get depressed as the number climbs. Perhaps because I don’t fear death. To some it is such a bete noire that it ruins some of the good time they have left.”


White, B. (2011) If You Ask Me: (And of Course You Won’t). New York: G. P. Putnam’s Sons.

Monday, August 1, 2011

Books: Not Becoming My Mother by Ruth Reichl

In Not Becoming My Mother, Ms. Reichl explores her mother’s life history as she reads through a box of her mother’s old letters and diaries. Her journey through the box uncovers important life lessons that her mother strove to share with her.

Ms. Reichl finds that her mother, Miriam, grew up in an era that was less open to women to pursuing careers other than care of the family and household. One of the first letters she finds addressed to her mother, from her grandfather tells Miriam, “She was smart but it did not really matter. She was handicapped because she was not pretty. And she would be a failure if she never married.” Miriam was discouraged by her parents to study medicine and instead was encouraged to and received a degree in music.

After receiving her music degree Miriam instead opened a bookstore. “It was a bold move for the time. The day the shop opened Miriam’s mother’s good friend…sent a note of encouragement and congratulations: ‘I admire the intelligence and courage that you are manifesting in the venture. You are showing what girls can do in this, our age.’”

Her bookstore allowed her to correspond “with some of the most interesting minds of her day. Authors thanked her for critiques of their books.” However, despite Miriam’s independent success and intellectual achievements, her parent’s wished only marriage for her. “’How we pray for you to meet Him;' “’Happy New Year and may you find the Mr. Right. It is our one prayer and hope and we think of it every moment’; ‘There was a new moon last night, and I prayed and prayed for Him. I dream that you will find a mate.’”

In time, Miriam does marry, and “she described the marriage as ‘tempestuously unhappy,’ but women of that time did not walk out merely because they were miserable. And they certainly did not walk out when there were children.”

Miriam remarries around World War II to Ms. Reichl’s father. “The war years were a good time for strong women. Dad was to old to be called up, so he moved into her small apartment…My parents pooled their resources, found an investor and created a small publishing company to produce handwritten literary books.” Fortunately, it is in this second marriage that Miriam has found someone who encourages her intellectual pursuits and entrepreneurial efforts. Together the couple produced “a twelve–volume series called ‘The Homemaker’s Encyclopedia.’”

When they sold their publishing company, Ms. Reichl’s father encouraged Miriam to find other work “but after the war jobs for women were not easy to come by. In fact, women who worked were considered unpatriotic. ‘You women and girls go home, back to being housewives as you promised to do’, trumpeted an army general in a widely televised speech in the background you can hear the men cheering wildly.” “All of those smart, competent women sat at home, twiddling their thumbs and telling their daughters how much they had enjoyed working during the war.”

Miriam “took on volunteer jobs…doing stints at the Red Cross, the Girl Scouts, UNICEF, the Silvermine Guild of Artists, the Metropolitan Museum and the New York Public Library.” Her mother was “still in search of a meaningful career.”

Through the stories of her close friends’ experiences, Ms. Reichl’s mother worked to express thoughts on marriage and the importance of career work to her daughter. One of friends, Flora took over her husband’s business upon his untimely death, and made the company more successful than it was when he ran it. “’The business is four times the size it was when Lou [her husband] was alive. The funny thing is that if Lou hadn’t passed away she would have just been another bored housewife.’” Another friend, Claudia lost her drive to live after her husband died in an accident. In time however, Claudia bounced back, returned to her earlier career, and became “very busy, traveling endlessly around the world.” Her mother said, “’Claudia has a career. She does exactly what she wants and answers to no one but herself’…That was all she said. It was enough.”

In late life and after the death of Ms. Reichl’s father, Miriam “filled her life with all the things that she had always wanted – art, music, people – and freed herself from everything that did not make her happy…For the happiest years of her life, Mom relied almost entirely on herself.”

In the last chapter, “Gifts”, Ms. Reichl sums up the important lessons her mother taught her. “In her own oblique way Mom passed on all the knowledge she had gleaned…Work was her most basic lesson: Using herself as an example, she made me see that working is as necessary as breathing. Mom’s strongest belief was that ‘it is what we are made for’ and she was convinced that those who are not useful can never be satisfied. She tried to make me see that a job was not enough; she wanted me to have the meaningful career that she herself had yearned for.” On marriage her mother taught her “it works only when it is based on mutual respect between to people who encourage each other to live up to the best in themselves.” Ms. Reichl closes with “I began to understand that in the end you are the only one who can make yourself happy. More important, Mom showed me that it is never too late to find out how to do it.”

Reichl, R. (2009) Not Becoming My Mother: And Other Things She Taught Me Along the Way. New York: The Penguin Press.