What is Parenthood? Amy Ziettlow

03.22.2013, 1:00 PM

Amy ZiettlowAmy Ziettlow, Pastor in the Evangelical Lutheran Church in America and Co-author of the upcoming The GenX Caregiver

The Power of Loss and the Power of Adaptation

Mortality. Adaptation. Life. Beauty.

I am a pastor, writer and hospice professional. As editor of the Symposium series, I hesitated to write as part of it, but I regret that we do not have a strong voice from the integrative perspective to add increased nuance to the discussion which is evidenced in the book. And thus, I write as a novice to the organizing categories in What is Parenthood?, but I hope that my reading as a layperson who culled much from both perspectives will add to our discussion.

As I held in conversation and tension the “integrative” and “diversity” models of parenthood, I carried these words (mortality adaptation, life and beauty) with me as an interpretative lens. By the end, I appreciated the clarity and tensions of the guiding typology finding places of resonance and dissonance with my own past thought and experience, and overall, I felt like my toolbox for thinking about how best to serve real families, in real time to be greatly enhanced. Whether reading Doucet’s recommendations for family medical leave and fathers, or the ways that different scholars draw upon John Bowlby’s work on attachment theory, or the nuances of transnational parenting in an age marked by high levels of immigration, I was relieved that on-going scholarship concerning parenting and parenthood continues to be shaped by the needs of reality. A dance emerges between the practice of law, anthropological reflection, descriptive research, prescriptive suggestions, and life lived.

For me this dance in the understanding of life and relationships is shaped by mortality, adaptation, grief, and beauty, which often mixes in messy ways that demand a nuanced system of physical, emotional, financial, and spiritual support. I find that my words find a home in both the integrative and diversity models of parenthood, and thus I am reminded that both have much to offer laypeople reading.

The Diversity Model and the Power of Adaption

To show my cards, in terms of feminist theory and same-sex marriage, I resonate with the diversity model of parenthood because my practical experience in hospice care tends to revolve around compassion and adaptation within a family system. As a hospice team, our first questions for individuals and families entering end of life care focused on “who” and “how?” Who will make all the practical, financial, emotional, and spiritual adaptations to make self-fullfilling life closure possible for this individual? By necessity, the “how” trumps the “who” as I have come to focus on process over form when defining a unit of care, often the family. Caregiving crosses gender and personality: anyone can be considered the primary caregiver for a dying person we simply assess their willingness and ability to do so. Our goal as a hospice team of professionals is to empower those who are willing and able to provide care physically, emotionally, financially, and spiritually to be effective and compassionate givers of care. On a day to day basis, I have seen that care for the vulnerable happens most naturally and peacefully when a person can reside in the place they call home and be surrounded by the people they call family. The diversity approach to parenthood can be seen at the end of life in the diverse constellation of family caregiving we see in hospice care.

The Integrative Model and the Power of Loss

But here is where I begin to resonate with the integrative model of parenthood with its focus on biology and the powerful connections humanity has to our genetic family tree, the right of the vulnerable to know their biology and have access to kin, and the nuances of gender, hormonally and societally. Biology often rises to the fore when we have a physical problem—debility, illness, accident. The doctor or nurses’ first questions to a patient often involve a listing of physical symptoms and a listing of our family history—all biology. Philosophically, in hospice like in parenthood, the center of care is a vulnerable person who is facing questions concerning what is means to be human. For both the vulnerable young and for the vulnerable dying the guiding question remains the same, “What does it mean to be alive?” A question always asked under the shadow of our common fate of mortality, whether we are a newborn or ninety-five.

While I may not fully agree with all of the policy implications of the integrative model, I often find that the integrative model begins at points of potential loss and seeks to honor that experience of mortality and grief. I read a greater sensitivity to mortality as defined by human biological limits and to the grief experience that arises from loss. In life, loss of ability or function happens, loss of life and loss of relationship happens, and ultimately, a loss of a desired life narrative happens. “I can no longer hear what you are saying. I can no longer jump up and run to the restroom. I can no longer drive a car. I feel pain. I wish that Morris was here but he is in jail. I wish that Judy would come visit me but I hurt her and she cannot bear to see me and I cannot control her. I wish I knew where this cancer came from. I don’t want to die.” Hospice offers an intense window into the full menu of human experience of grief and loss in terms of physical limits, emotional limits, and financial limits. Some limits can be traced to choices that were made throughout life, but most emerge and can be mysteriously traced to the recipe of genes, environment, and accident that merely present us with undeniable limits.

And here is where I saw how the integrative and diversity models are both necessary for human relationships, be those of parenthood or caregiving at the end of life. The power of loss and the power of human adaptation are both vitally necessary to the hope of beauty. When we acknowledge the very limitedness of existence, when we trust that holding the shards of loss is necessary and possible when shared and carried communally, and when we live in hope that we can find ways to adapt who are to what we need, beauty can emerge and be embodied.

Mortality. Adaptation. Life. Beauty.

5 Responses to “What is Parenthood? Amy Ziettlow”

  1. Diane M says:

    I’ll be thinking more about this essay, but for now I’d like to suggest that a pure diversity model lacks biology/our bodies while a pure integrative model lacks flexibility.

  2. Amy Ziettlow says:

    Our tech stuff seems to be touchy right now, so this is a test comment!

  3. Teresa says:

    Sorry to take this off-topic … however,

    Amy, I’ve been meaning to comment on several of your Posts, particularly with one of your areas of expertise: hospice. I lived with an older family member for 23+ years, until she died at the age of 98, 4 years ago. I shy away from using the term caregiver, simply because I was cared for and much as I was caregiving.

    Anyway, the last months of her life, were spent in hospice in our home. Amy, I do not have fond memories of that time. I’m struggling to place hospice in a proper perspective. I own the fault was mine, Amy, in most ways. I understand that now. I was a lone caregiver, and I think my expectations for the hospice nurse/PA were way to high. I expected more than a weekly visit of just a little over an hour. That was my first big disappointment.

    Here’s the thing: there’s an old saying, that jewelers become used to fine gems. I think hospice nurses, being around death all the time, become used to death. It becomes, maybe, just a job, for them. The few times I called hospice, I felt a sense of disregard for the problem: a problem, that for me and my responsibilities was huge.

    I don’t want to think poorly of hospice. I’m willing to think that going through this has skewed my judgment, and the fault lies with me. However, could there be any truth in what I’m thinking/feeling?

    BTW, the hospice we used is one of the best in Southeast Michigan.

  4. Amy Z says:

    Hi Teresa,
    I am sorry to hear of your loss as well as your negative experience with hospice care. I often pause when I write about hospice in general since I know for so many the very word itself can cause a visceral response to so many–both positive, negative, and everything in between.
    Your point about burnout in any profession are good ones to make. And yes, hospice nurses and a hospice team in general are not immune to being burnt out and hardened to the core nature of their service. Most teams spend a great deal of time finding a balance of “compassionate distance.” As I’m sure you can imagine, new hospice team members are often TOO close to families, where every patient reminds them of THEIR dad, or THEIR spouse, or THEIR child, and for many they can’t get past that point. Some then swing, far too away from connecting to those they serve. My philosophy has been that the team helps each other find the right balance–and then watches out for each other as life goes by and presents new challenges.
    But, I will say, this type of work demands a lot of vigilance which is hard, even for the best teams.
    I will say that your frequency of visit sounds odd. In over a decade of experience, I can think of maybe 4-5 situations of folks who got one scheduled visits and that was because they specifically requested that ( due to a high level of functioning–we served people who were still working, etc.–or just because they were that private) but one visit a week is negligent at best. If the hospice is accredited, which is sounds like it would be, I would look into seeing if you could get clarification on policy (granted, you may not have any desire to do so!).
    I also want to say that hospice is FAR from perfect. Beyond being a chaplain I spent most of my time in operation management which meant I spent almost all day, every day, dealing with crises and complaints–all of them understandable since we serve stressed our people in uncontrolled settings. My role, I believe, was to help our team not to take being yelled at or complained about personally but to see that we are always in a position of power and it’s our job to try to help fix things. I think I wrote recently about how we trained staff to do that…

  5. intheagora says:

    The the natural biological family have any rights the state is bound to respect or does the state simply decide what is “best?”