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55 VVVVVVVVVVV Caregiving Beulah A Relentless Challenge SUSAN PERLSTEIN Ihave spent my entire working life dedicated to improving the quality of life for older people; however, nothing prepared me for my mother’s final journey . I have sat by the side of the dying, sharing their last wishes and stories. I have worked in long-term care, hospice, and assisted-living facilities and in many capacities—as a teaching artist, program developer, social worker, educator , and administrator. I have developed programs for caregivers and trained staff to run creative programs for caregivers and their loved ones. So I expected to be prepared when my mother—in her nineties—began to fail. As a social worker, I had practiced the discipline of listening to what people need and want. For my mother and me, this meant that, as long as she had her mental wits about her, I would respect her decisions and help to negotiate her choices with the health-care system—doctors, nurses, social workers, hospitals, hospice, and home health-care workers. As the oldest daughter and the one living closest to her, I would be the primary caregiver, although I would always inform and engage our immediate family in caregiving decisions. Together we would wend our way through my mom’s last years. My mother, Beulah Hoskwith Warshall-Cohn, was a second-generation daughter of poor Eastern European Jewish immigrants escaping persecution to find a better life in America. Success meant that Beulah married a doctor, a dream come true. Beulah birthed three children: first me, then my brother, and last my sister. Beulah, the matriarch of the large extended family, would do anything for her children and her sister’s children. All my cousins loved her. She was the family social worker who, without a degree, listened to and encouraged them. She deeply wanted to be a successful American, to assimilate into the American way of life. Her children had to do it for her; they had to be the best and that meant that nothing her children did was good enough. As her oldest daughter, I was held responsible for everything and anything. My younger brother and sister left New York City in part to avoid her constant advice. Somehow she could always get under your skin. For example, when I was just about to get married, she informed me that I could do better. I should be marrying a doctor. I said, “But Mom, he is a PhD.” She replied, “You know what I mean, a real doctor.” Although we fought, I knew she loved her children and she meant well—as she would often remind me. If she decided she wanted something, there was no stopping her. Her endless energy, strong opinions, fierce determination, and intelligence contributed to her many successes. When my father was dying, she notified the U.S. government in Puerto Rico and had my brother flown back to the United States from his research project. Following my sister’s bitter divorce, her husband kidnapped their daughter to his country, India. All efforts to return her failed. Consequently, Beulah took the extreme step of selling her house to raise required funds and hired an international detective to rescue her granddaughter. The rescue was successful and, again, Beulah succeeded—on an international scale. Beulah married my father, Hyman Beryl Warshall, a pediatrician. Hyman dedicated his life to providing good medicine for working people in New York City and was one of the founders of the Health Insurance Plan of New York. He was an idealistic workaholic and one of the last of the doctors who would do home visits to sick children in the middle of the night and on weekends. Beulah enabled my father’s progressive politics by working as his nurse and secretary, preparing dinners for his friends and colleagues , and running the family affairs while he worked. She joined Women Strike for Peace and worked on the board of a local community center for youth at risk. Because she loved gardening, all her children belonged to the Brooklyn Botanic Gardens Children’s Garden, where we planted vegetables. After my father passed away, Beulah became an active volunteer for the garden, teaching young students about plants. I am not sure where she developed her love of classical music, especially opera. When we were young, she took my brother and me to the opera. She often listened to La Traviata, La Bohème, and Rigoletto. She especially loved Pavarotti’s...

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