This all came up on a plane trip we were taking from New York, where we now live, to Santa Barbara to visit Jill’s mom, Lora. Jill had been taking a lot of these trips recently because Lora and her second husband, Ralph, were getting on in years. Lora was eighty-seven and Ralph had just achieved ninety-one. The problem was that every time Jill came home after one of these jaunts, she was stressed and depleted and it took me days just to scrape her off the floor. Her mother always managed to put her into this state. And apparently it’s been this way since she was a child.

So we decided it would be best if I accompanied her from now on. I would act as the cruise director, sex slave, maître d’, whatever. I would support Jill so that she could support them. That was our deal.

“You’ll see,” I told her on the plane, “we’re going to have fun this time.”

“Just be nice to me,” she said. “That’ll help a lot.”

“Nice to you?”

“Sometimes you get mad at me when I’m around my mother.”

“Oh, well . . .” There was some truth in this. She drove me crazy when she was around her mother.

“I don’t care,” she said. “Just be nice.”

Her mom had recently fallen for no apparent reason and Ralph had not been able to pick her up. He had to call 911. This was a problem because they were trying to stay under the radar as far as their health issues were concerned. They thought if the front office found out that they needed assistance, they’d be thrown out of assisted care. I don’t know; it’s generational, I suppose. I don’t think I’ll mind getting assistance when I get old. Even now wouldn’t be bad.

“We’re all headed for suffering and death, baby,” I said consolingly. “But that doesn’t mean we can’t have some laughs along the way. How about we take them out for a great steak tonight?”

“They’re both on walkers.”

I shrugged. Piece of cake.

Some fifteen years before, we had moved them to Santa Barbara from Madison, Wisconsin, because the cold winters were hard on Lora’s arthritis. We were living in Los Angeles at the time and we all agreed that Santa Barbara would be a beautiful place for them to live out their days. And it would be close to us, as well. But not too close, if you know what I mean.

They eventually settled into a lovely retirement community with a beautiful view of the mountains and populated by a large number of retired college professors. This couldn’t have been better for Ralph and Lora, who put great stock in intellectual pursuits—Lora, for example, was always sending me books by Noam Chomsky. Their group of friends in Madison had primarily been professors at the University of Wisconsin, so they felt they had found the right crowd.

But then, a couple of years ago, around the time Jill and I moved back to New York, they started to show their age. Ralph had his third heart attack and also suffered from severe, chronic back pain, which could be relieved only by an operation that the doctors refused to give him because of his age. Lora was physically strong, but she was showing a little slippage in the cognizance department. This problem wasn’t helped by the fact that she had been seriously hard of hearing since she was in her thirties. She’d been faking conversations for years. A lot of the reason she talked so much was that she couldn’t hear anybody else anyway.

In the past four months, Jill had been to Santa Barbara to move them twice: first from their two-bedroom apartment to a smaller one, for financial reasons; and then from independent living to assisted care. The names say it all. Both Ralph and Lora had resisted the move to the assisted-care building, which they dreaded like the Roach Motel: the people check in, but they don’t check out. Jill cajoled them into the move by having each one blame it on the other’s disabilities. They had gotten to the point where they took great pleasure in each other’s failings. Lora virtually beamed when she had to lift things for Ralph, and he delighted in pointing out what she had just forgotten. I really hope we don’t get that way. Getting old and sick is hard enough without having to score on each other all the time.

“So, where are you about Italy?” I asked after a long pause. Jill was looking out the window at the Rocky Mountains passing by below us, thinking about her mother, no doubt. Italy was the question of the moment, although neither of us had spoken it aloud. We have a house there that we had bought five years before—a beautiful 350-year-old stone farmhouse amid olive groves in the middle of Umbria; our dream house, our paradise on earth, our new chapter, our life—and now we had a flight booked that would take us there the following week.

“We’ll see what the story is when we get to Santa Barbara. But I think maybe we should stick around. Ralph could literally go any day now. He wants to be done with the pain.”

“It’s a little weird to just sit around and wait for him to die. Like vultures. I think we should go about our lives and then when something happens, we’ll respond.”

Jill nodded, which meant she heard me but didn’t put much stock in what I said. Sometimes she just likes to hear the voice without the content.

We had been putting off going to Italy for over nine months now, which had not been the idea at all. Our original plan was to live there half the year and eventually more. But things kept getting in the way—and not just the trips to see Lora and Ralph. Moving back to New York after almost twenty years in California meant we had to jump-start our theater careers again. All the connections we had from our earlier years in the business were either retired or expired, and the new directors, producers, and casting people had all been too young to stay up and watch L.A. Law. We got a lot of blank stares. “Tell us about yourself,” they would say. Oy.

We were also busy putting the finishing touches on a documentary film that we’d been working on for almost seven years. It’s about an artist friend of ours who just turned ninety years old. He lives on the top of a mountain in Big Sur and he’s a big inspiration to us—and to anyone else who meets him. We wanted to get him down on film while he was still around and doing his work. The film kept morphing and redefining itself, and by the end it was probably the most creative thing either of us had ever been involved with.

Also, I’d just finished doing a play off Broadway, which kept us from going to Italy all through the spring. It was fun, though—dusting off the old acting chops. I played the dad.

So we promised ourselves we would spend the summer—three whole months—in Italy. We’d go in late June and stay through the end of September so that we could catch the grape harvest. Summer is a splendid time to be in Umbria. It’s when everybody’s orto is filled with tomatoes heavy on the vine, basil, arugula, eggplant, and zucchini; it’s when everybody’s cooking outside—sausages or ribs grilled over a wood fire, washed down with wine we can buy in bulk from a vineyard we know in Montefalco. We bring our jugs and fill them up with a pistola—like a gas pump—for two euros a liter.

Summer’s when every little village has a sagra, which is a festival and feast that a town puts on to raise money for the local comune; it always features whatever food the village is best known for, cooked and served by the villagers and their kids. There’s the famous onion sagra in Canarra, the sausage and celery sagra in Trevi, the wild asparagus sagra in Eggi—you get the picture.
Summer’s also when the big festivals happen. There’s the famous Spoleto Festival of Two Worlds, which is mostly classical music and dance; and there’s Umbria Jazz in Perugia, which is fast becoming one of Europe’s great jazz festivals. Our son Max, who’s a drummer, has threatened to come over and visit us this summer so that he can catch Umbria Jazz.
Summer’s also when the full cast of characters take the stage. Our wonderful crowd of expats and Italians—some of whom have kids in school or, God forbid, regular jobs, so they can’t get away during the year—are all there in the summer and ready for fun. There’s this rolling party in our corner of Umbria that opens in early June and plays right through the summer. Sometimes it’s a big group gathered around plates of ravioli at the Palazzaccio, our favorite trattoria—actually more like a roadhouse—down on the Via Flaminia. Or it’ll be the whole gang over at our place for pizza, baked at 800 degrees Fahrenheit in our wood-burning oven that dates back to the early 1600s; or it could be just Jill and me and another couple at a bar on the piazza in Trevi, talking the night away, spilling secrets like cheap wine. But the party, in whatever size, shape, or configuration, bubbles along like a good, rich soup all summer, and if you’re of a mind, all you have to do is slide back the lid and fill your bowl.

Or we could hang around Santa Barbara and wait for Ralph to die.

We know a couple who decided to table their retirement plans until her mother died. The mother was eighty-seven, with inoperable cancer. Twelve years later, when the mother finally kicked off, our friends were too old for anything more strenuous than oatmeal. The idea of this put me into a cold sweat.

And the truth is that Jill would love to go to Italy. She needs it more than I do. She wants it more than I do. Italy is her solace, her refilling station. She’s a nature girl, and she’s surrounded by it there. She takes walks up the hill to Silvignano, the tiny borgo that sits farther up on the mountain above us. Or she’ll hike to the top of Poreta—another climb that takes her to a fourteenth-century castle that overlooks the whole Spoleto valley. She loves her breakfasts under the pergola—fresh fruit with yogurt, toast with chestnut honey; maybe I’ll make her an omelet from the eggs that Vittoria, our housekeeper and neighbor, brings to us still warm from the hens. Italy is also where Jill takes the time to do her art. Sometimes she’ll sit in the shade with her watercolors and paint for hours.

She wants to go to Italy. She’s longing for it. But there’s no way in the world she can say it. Not while she’s writhing in the choke hold of mother-guilt. So she depends on me to twist her arm, because I’m a well-known hedonist who cares about nothing but pleasure. That’s our game. She says no; I cajole her into doing it, seemingly against her will; and then we both have a great time. It sounds like a lot of trouble to go through but it’s been working for us for years.

At the beginning of your journey, how did you handle Lora’s anger at what was happening to her?

Mike: When she got angry—which was often—I ran and hid in the other room.

Jill: I wanted to do the same, but instead I held her hand and talked to her for hours to convince her we had her best interests at heart.

My mother has been somewhat paranoid for years because of hearing loss in her mid-30s and the dementia made it worse.

When did you first notice that your mother was having cognitive problems?

Jill: When Mom’s second husband died several years ago, we decided to move her from California to New York—to a retirement community near us.

They had an assisted-care facility on the premises and we had someone check on her a few times a day.

It soon became clear that Mom needed full-time care.

What problems did you have with her?

Jill: She didn’t want anyone living with her. She became belligerent, partly because she doesn’t hear well and the aides didn’t know how to put her hearing aid in.

I was in the office complaining every day because there was no consistency of care and none of the aides seemed to know how to deal with dementia.

What were your next steps?

Jill: After realizing the retirement community wasn’t a viable option, we discovered that the apartment across from us was available and decided to move my mom in there.

Finding aides for my mom was a long, difficult process. It took three months of hell before I found two wonderful women through a family assistance network.

Now my mom has three fantastic caregivers. They all love her and she feels completely safe with them. She’d be lost without them—and so would I.

How is Lora now? How has her care integrated into your lives?

Mike: Lora is physically stable. Her mental state continues to decline slowly, but she still recognizes us and occasionally she speaks coherently.

The three aides cover her 24 hours a day. This gives Jill and me the time we need to go on with our lives and our careers.

You seem to have a solid marriage. Has caring for Lora strained your relationship?

Mike: No. Very early on, we realized that we had to get on the same side of this situation.

I was arguing for our life and Jill knew she was responsible for her mother’s life.

We pulled and tugged a bit until we realized we had to make sure that Lora had a good last chapter, while also ensuring our own chapters were as full and productive as possible.

Jill: After we moved my mother across the hall, I started inviting her and the aides over to our apartment daily. I soon realized that Mike felt invaded.

They now come over for special dinners or occasions, but mostly I go over there. I’ve had to learn to be grateful for Mike’s generosity and not push his limits.

Michael, in your book you mention feelings of resentment. How did you reconcile those?

Mike: My resentment in the beginning was seeing Jill’s personality change when she was with her mother. That was fine when Lora was 3,000 miles away and we saw her twice a year.

But when Lora began living across the hall − and failing mentally − I feared I would lose Jill as I knew her and that was hard to accept.

Was there a particularly frustrating or challenging moment in the transition?

Jill: The worst moment came just after we moved her to New York and into the retirement center near where we live. She told me I had taken her away from her friends and ruined her life.

I told her I would see her every day. She said, “You won’t. You’ll go away and leave me alone.”

Your two grown children—Alison, a personal chef, and Max—both moved to Manhattan to help care for Lora. What adjustments did they need to make?

Mike: I think our kids are getting a close-up look at what’s going to happen to us. They realize that they’ll have to figure out what to do when we can’t wipe the oatmeal off our chins.

Jill: Alison has a difficult time sitting with my mom and holding her hand because that’s not who she is—she’s a doer. She was always determined to help and has adjusted by cooking nurturing food, which makes her feel good and makes my mom want to eat.

In addition, Alison has a fabulous relationship with each of my mom’s aides.

Has Lora’s condition taken a toll on them?

Mike: Max and Alison share an apartment and watch out for each other. Max doesn’t visit my mother as often now that she’s less responsive. I think it’s hard for him.

He used to enjoy visiting with her and reading to her. Of course, it didn’t hurt that she lit up like a Christmas tree whenever she saw him.

Now the Christmas tree is on “dim,” and Max doesn’t know for sure that his visits are making a difference.

How do you address your own needs while taking care of Lora?

Mike: We just spent two months in Italy and Lora has been fine. We’ve found that getting away occasionally is essential.

Jill: I walk in the woods and do Pilates and yoga. I’ve also been seeing a wonderful therapist who has helped me understand a lot of my old patterns with my mother.

In many ways, this has been a tremendously exciting time of self-discovery and I’m able to discuss everything with Mike.

How has this experience changed your relationship with your mother?

Jill: I realized, with the help of my therapist, that I was still looking for my mother’s approval even after she was in a state of advanced dementia.

I have finally been able to let go of those expectations. It has helped me to really appreciate who she is now and the time I have with her.

I also realized how much I was still trying to make other people like her, which is something I’ve been doing since she lost her hearing many years ago.

As soon as I was able to let go, my stress level went way down.

Caring for a parent—particularly with Alzheimer’s—can be isolating. How did your friends respond?

Mike: It’s been a mixed bag. We have some friends who have been extraordinarily helpful—visiting Lora when we’re away, bringing her little gifts—and others who don’t want to participate at all.

Have you made any lifestyle or health changes?

Mike: My mother died of Alzheimer’s, so it’s on my mind. Brain exercises have been shown to have some effect in warding off dementia, so I do a crossword puzzle every morning. And Jill and I are learning a foreign language.

Jill: I’m taking some supplements for menopausal symptoms, which are supposed to help with memory. I also exercise and meditate every day to relieve stress.

Are there any changes you’d like to see in the treatment of Alzheimer’s patients?

Mike: We’re big supporters of preventive medicine. We think health care reform on that issue is way overdue.

Medicare and Medicaid have been working very well with Lora. Her aides are paid through Medicaid and we couldn’t have done it otherwise.

We’d love to see more government programs available to everyone.

After living part-time in Italy, have you noticed any differences in how the elderly are treated there versus in the U.S.?

Mike: The Italian system has influenced us considerably. Americans want to put their ailing and failing parents in a nursing home; Italians bring their relatives into their own homes.

The Italians often hire Eastern European women, called “badanti,” who leave their countries to come to Italy and provide 24-hour, live-in care for the elderly at a reasonable price.

In your book, you say that caring for the elderly in the U.S. has been institutionalized. Why do you think that’s happened?

Mike: It’s because Americans don’t want to have their old people where they can see them. Ours is a culture that worships youth and we don’t want to be reminded that it passes all too quickly.

The Italians − and many other cultures − revere their old people and enjoy having them around.

Many Lifescript readers are caring for parents with Alzheimer’s or dementia. Do you have any advice?

Jill: I would encourage people to find help and support. It’s so hard to manage it all on your own. The truth is, a person with eldercare experience can do it better than you can.

In caring for Lora, is there anything you wished you had done differently?

Mike: Moving Lora from California to New York was a disaster. She never recovered from that, but at the time, it seemed as if we didn’t have a choice.

I would encourage other people facing this dilemma to consider their choices carefully before they uproot a dementia patient because it can be so debilitating.

What has been the biggest surprise from this whole experience?

Mike: Seeing three generations of our family come together around this crisis. No one planned it; it just happened and we’ve never been so close.

What inspired you to write the book?

Mike: I wanted to tell Jill’s story. And I wanted people to know that, with love and empathy for each other, you can have it all—your life, along with caring for a failing parent.