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Musings: Swimming Solo shows amazing strength

By Robert W. Duffy, The St. Louis Beacon

Susan Rava's account of her and her husband John's parents' serial affliction with Alzheimer's disease strikes a reader with affecting and occasionally numbing force.

Swimming Solo: A Daughter's Memoir of Her Parents, His Parents, and Alzheimer's Disease, published by Plateau Books, traces the mental and physical disintegration of four men and women, active, responsible members of the community, beloved of their children and grandchildren. Each was gifted. Each in his or her own way contributed vigor and substance to the life of the community. Simultaneously, they stood solidly as pillars of the richly textured, metaphorical architecture of the lives of their similarly gifted offspring and their families.

The struggle a reader—this reader anyhow—has with the book is when he or she finds evident strains of similarity with any of the lives and conditions presented in such high relief. When such a discovery happens, the result may be a despairing, "Shoot me now." There is little in the way of redemption or even relief. Memories are golden but serve as contrast with the darkness inevitably to be. While various members of the book's population behave with inspiring patience, stoicism and goodness, the narrative's unmistakable portents of doom race down the tracks of all their lives like an out of control locomotive.

The story begins at Susan and John Rava's summer place on Lake Michigan. From the house, Susan Rava sees her father-in-law violating a fundamental house rule: no swimming alone. The swim he is taking is not leisurely but instead is what appears to be a beeline across the lake in the direction of Sheboygan. He is lured back to shore, but his arrival is the genesis of a regard for him completely different than what had been before.

(Note: The author chose not to give surnames to the men and women of this book, and some have been given pseudonyms to provide, as Susan Rava said, "a modicum of privacy.")

Before this excursion, Venetian-born Paul had been, like the symbol of the city of his birth and lineage, a lion of a man—brilliant, possessed of a ferocious intellect, movie-star handsome, graceful. He grew up and matured beside the Adriatic and left when it became evident his homeland would become a bulwark of fascism and no place for Jews. Both he and his wife, Silvia, were reared in palazzos on the Grand Canal, his being next door to the Ca' d'Oro. He brought with him to America, to St. Louis, his worldly leonine presence, and she, "intelligenza"—knowingness—swathed in luxurious folds of silk.

Then there were her parents, also St. Louisans. They were bred-in-the-bone affluent Americans from way back. Before Alzheimer's gripped them, Dorothy and George were similarly entrenched in cultural affairs and community activities. Some of their political postures, reproductive health issues, for example, were guaranteed to rub many people the wrong way. They traveled widely and fearlessly. Individually they were impressive; together, they were formidable.

And, as a quartet, both couples appear to this reader (who was acquainted with three of the four) to be estimable citizens and enviable parents and grandparents. As described by Susan Rava, the ritual lunches at home in University City on Sundays, and life in Michigan on family holidays, seem washed with the golden light of Titian. Before Alzheimer's, that is.

Dementia levels all who suffer from it. It gradually grinds away at the personality of the affected individual. It afflicts family members who try to deal with the relative stricken with it in reasonable or logical and caringly sympathetic ways.

Often, no good effort goes unpunished. Alzheimer's is pathologically unpredictable in its manifestations and mind-bogglingly expensive, too, as many a family's financial resources have been leveled by it. There is no predicting what will happen next. A ringing telephone becomes a claxon, rattling nerves, evoking consternation and fear, pushing the button labeled anger. There is no cure.

Fortunately, both sets of parents of the Ravas were covered financially and could afford good care. But the draining off of emotional energy and affection is perhaps more punishing than the specter of going broke. As you discover, reading this book, the abrading force of the disease can and often does affect the emotional and physical health of caregivers.

Silently at first, then out loud, the question, "When will this end?" is asked. The answer, of course, is when someone dies.

Susan and John Rava were as brave as any people I know.

When I finished this magnificently constructed, gracefully, intelligently written account—which I commend without reservation—I wrote Susan Rava. I told her that as I read her book I felt a chilling draft of recognition and began to feel as if her story were my story. So many particulars obtained: the sadness, the confusion and frustration, the difficulty of getting answers to questions, the gyre diminishing a carefully invested nest egg, the anger and fury and consequent guilt.

Then I decided: No, I had no claim to ownership of this book. I once again was being selfish and narcissistic. Just because our experiences were similar, hers belonged to her and to her husband John.

And yet, when I replay the book in my mind, it evokes memories that careen along a continuum where the poles are labeled bad and worse. Furthermore, with every groping for the mot juste; every misplacing of the car keys; every forgetting of a birthday; every peering into a kitchen cabinet and wondering, "What the hell am I doing here?"—because of all of that, I have to say, in all honesty and humility, "Swimming Solo" is I. So, one is left looking for an antidote, not a guarantee dementia won't happen but a reason to resume not just enduring but also being open to a sense of possibility, which is to say, hope. I asked Susan Rava how she and John remained on their feet, given the intensity and serial quality of their being hammered almost constantly, parent after parent, year after year. She e-mailed me a story as an answer:

"Today we were faced with a demanding situation. John's ailing sister has just placed her elderly partner in a nursing home. We knew we had to face the situation squarely, to help out—long distance and right away.

"How did we do it? We read the paper, drank our coffee, and tested ourselves with Will Shortz's NPR puzzle. It was too early to get on the phone to Boston.

"I cut up onions, leeks, carrots, and celery. I lost myself in the chop-chop of fine dicing. I set a pot of lentil soup to simmer.

"We got on the speaker phone.

"John took notes and made an eye-on-the-ball action list. We agreed to tackle the items after a walk.

"First, we walked our old basset hound. Then John and I walked the neighborhood's dog. A friend's house is just on the market. We agreed about our sadness over their transfer. We heard a bird call we didn't recognize. Our oldest and best friends pulled up to chat from their van window. They commented on the bright colors of our jackets.

“‘We're heralding spring,’” John said.

"Back at home we tackled the long-distance issues. It's our duty, responsibility. The buck stops with us; John's sister has no other family."

I'd asked Susan how she came by her resilience, her ability not just to roll with the punches but also to spring back.

"My resilience," she wrote, "comes from my husband and family; my friends; ordinary, daily things like walking, cooking, talking. Like a kaleidoscope, multi-colored and ever-shifting, but always carefully patterned, myriad supports held us up: nursing home and medical professionals; housekeepers; several family social workers; old friends; children; the Michigan beach and the University City sidewalks; eight grandchildren who appeared beginning in 1999.

"By nature, I have a positive outlook. I may have narrowed my horizon of hope, yet John and I remain forward-looking in our lives.

"That sometimes means dinner on our patio or a phone call to a grandchild.

"These everyday pieces," she concluded, "compose our hope."

Isabel Anders on

Swimming Solo is a fascinating personal story, painstakingly told, with no unflattering or awkward details spared in the interest of wholeness—and that is its triumph.

Reading this book was not a "downer" (though this saga of eldercare has its excruciating moments). Rather, this is a lovingly recounted, intertwined story of the decline of four beloved elderly parents. Each chapter draws from the deep background of their actual lives, in order to communicate best the drama of irredeemable loss, as each is abruptly or slowly ravaged by mental and physical disabilities.

Susan Rava has a gift for relating carefully chosen details that illumine rather than clutter the flowing narrative, with insights along the way that will not be forgotten.

At the end, the reader feels as though—if you didn't actually know these people, you wish you had.

Parenting Our Parents

by David Bowman March 1, 2011, The Pulaski Citizen

A friend touted Susan Rava’s Swimming Solo (Plateau Books, $14.95, 299 pages) two weeks ago, mainly because of the astonishing plot line. The author tells about her family’s tale of grappling with four old folks suffering from Alzheimer’s disease—her parents and her husband’s parents—a rocky downhill road of 14 years with an onset starting in 1996.

Rava’s book, known in the publishing trade as creative nonfiction, weaves together some remarkably different materials.

There is, first and foremost, the sudden role-reversal routine: we must become parents to our parents. Once upon a time, they may have handed us a set of car keys. Now, suddenly, we realize that those car keys have to be handed back to us, willingly or otherwise.

There’s the monstrous matter known as “medical economics.” Can our family afford the amenities of a good nursing home or attractive independent living center, sometimes an oxymoronic label, particularly with folks suffering severe dementia of the Alzheimer’s type? If we hope to keep our loved one at home, can we afford the skilled caregivers to come at the right time or be there at bedside round the clock?

Danger lurks around every corner, not just with a fall down steps but with the psychological toll inflicted on family caregivers.

And there are the legal complexities involved in abiding by the patient’s wishes:

“Dad’s advanced medical directives instructed Mom, Missy, George and me—yes, ‘instructed’ us because that was how Dad talked about end-of-life matters—that no one should do anything extraordinary to prolong his life. Tubes and feeding lines, heroic resuscitation and respirators were all rejected in his legal documents. He would be in charge of his dying, for he was accustomed to controlling his and his clients’ issues of life and death: finances, wills, investments, burial plans, and plots” (p. 110).

The book’s title—with a beautiful watercolor cover done by Martha Keeble—takes readers on a metaphorical plunge into Lake Michigan. In the opening chapter, “Swimming to Milwaukee 1993,” Rava tells of suddenly discovering her father-in-law (Paul) has gone out way too far from shore, all by himself, putting his old soul in mortal danger. He shrugs off her concern about him and says he’s going for a walk along the beach.

Solo, no doubt, we enter this world and solo we must leave it. Yet even in our sometimes-absurd worship of individualism, we shrug off the obvious cry of our cultural roots to be at one with our family, our friends and our neighbors.

Swimming Solo also offers readers a yummy cultural buffet that begins with Paul and Silvia growing up in Venice, then emigrating to the United States, with occasional trips back to that exotic city; the St. Louis metropolitan area, where the author teaches French (at Washington University) and raises with her husband (John) their three children; then returns each summer to their lakeside summer cottage on the dunes at the south end of Lake Michigan.

Only the sudden realization that Paul is out swimming towards Milwaukee shatters this idyllic scene:

“A year or so later, Paul was afloat in his own inner world. Doctors tested him and diagnosed probable Alzheimer’s disease. No voices, no waving arms penetrated those waters. Yet, if he tuned in, he might on occasion be the polite, accommodating gentleman of long habit—only to dive back into his own private swim, aimed at a faraway shore from which no one could summon him” (p. 5).

This just-published book is recommended for all kinds of readers—all of us who can see our old age rushing towards us in a forward-projecting mirror; anyone (like me) who has already been through the scary tunnel of parenting our parents; those who need reminding that we can reach out and comfort our aged neighbors; young adults who can learn the facts of life from grandparents or other elders; and every taxpayer or government official who needs to bite down on the reality-sandwich of eldercare that Susan Rava cooks up so well.


Swimming Solo

by Lyn Sedmina, Christian Literature Editor

The unenviable decision to place a loved one into nursing care often solely falls upon the shoulders of one person—the caretaker relative. Logistics often prevent family members from being a part of the day-to-day care of the sick relative. Short visits home often do not provide sufficient time for family members to observe the declining health of their loved one. Additionally, because they are not present to see the decline, mindsets are often not willing to admit there is a problem.

In Swimming Solo: A Daughter’s Memoir of Her Parents, His Parents, and Alzheimer’s Disease, Susan Rava paints a detailed picture of the toll that the ensuing emotional roller coaster takes on a family who is caring for a sick loved one. Beginning with what they thought were simply senile moments in her father-in-law's life, Rava chronicles the ensuing fourteen-year period that followed his being diagnosed with Alzheimer's disease.

Full of raw passion—often expressed in colorful language—Rava journals the decline of her husband's father as he progresses through each stage of Alzheimer’s until his death. Shortly after, the disease hits her mother-in-law and then both of her parents.

It's easy to sit in judgement of another's situation. We may think we could have done it better. Perhaps we judge and are quick to disdain a caretaker's angry attitude toward our loved one. Rava's book, Swimming Solo, will open your eyes to the reality of a caretaker's life.

I would highly recommend this book for anyone who has, or who ever will, be faced with the decision to care for a loved one or to place them into a nursing facility.

“A Word's Worth”

Diane Moore


Swimming Solo: A Daughter’s Memoir Of Her Parents, His Parents, andAlzheimer’s Disease

Over five million people in the U.S. have been diagnosed with Alzheimer’s disease, and the costs for treating the disease exceed $6 million, according to David Perimutter, M.D. These figures alone are daunting to seniors approaching their last decades of life, but the emotional costs to family members of Alzheimer’s patients are incalculable.

Our good friends, Henry and Kathy Hamman, who own an independent press called Plateau Books in Sewanee, Tennessee, have just published a book about the costs of Alzheimer’s to family members entitled Swimming Solo, by Susan Rava. It’s a memoir written by a woman who endured fourteen years as a caregiver for both her and her husband’s parents when they succumbed to Alzheimer’s. Rava’s memoir records all the complexities of caregiving for parents with dementia, and the writing conveys her journey in a poignant style that combines the memories of better times within the family constellation and the challenges of deteriorating life quality for the four parents.

One of the glimpses into the life of the author’s father is a humorous passage centering on a beach scene:

“…I pictured a long-ago evening toward sunset. We had gathered on the beach, instructions having traveled along the boardwalk to bring marshmallows and long forks for the beach fire after the parade. Will had found an old flag in the closet under the front stairs of our cottage. Dad rolled up the cuffs of his khakis, pulled his white tennis hat down against the low sun, and called us together…Except for Dad, we were a barefooted, ragtag group that never stayed long in formation, Dad would compose the chant as we walked: ʻHere we are, all together, all our family, marching along, marching along, marching along on the beach in Pentwater…’”

This scene attracted unwanted attention to a family parade, but it continued as a family activity for many years, much to the older children’s chagrin. It was a powerful passage about the close-knit relationships among family members, which makes the retelling of the family’s former life even more poignant.

Another scene that emphasizes the depression that often afflicts victims of Alzheimer’s takes place after the author has begun receiving bizarre phone calls from her father:

“I’m old and you need to help me by letting me go home.Can’t you organize it so I can go home?” “Uh-huh,” I said. “About one hundred people in the USA tell me I’m home,” my dad said. “But everyone else knows that I’m not. Why don’t you understand? You’re not very humane or kind.”“Where do you mean by home?” I asked. “With my mother in heaven.” “You mean your mother who is dead and in heaven?” “Yes, I want to go home to my mother and father and sister in heaven, with all the nice people from Westminster Church, like the Hanfords. Don’t you want to go home to your parents?”

Rava describes her own doubts about taking on the role of primary caregiver in moments of self questioning, yet she and her husband push on with loyalty and resolve to take care of their aging parents. She shares her insights into the downhill world of Alzheimer’s, reinforcing the idea that there is no magic pill for the disease. She also includes valuable information about support systems, nursing homes, assisted living places, finances, and hospice care.

I was impressed with the filial devotion of the author and her tremendous strength in dealing with a devastating disease that strikes vital, intelligent humans and calls for transitions that take less sturdy families under, along with theAlzheimer’s victims. She writes:

“Once in awhile, when called on another ʻmercy mission,’ I found myself crying as I drove to Villa Manor or Silvia’s nursing home. I hated my self-pity. Even though I had chosen a caregiving role for our four parents, I didn’t realize that the process might launch me on the path to old age myself. Along the way, I had missed the grace period – the period of grace when John and I would have been at full capacity mentally, physically, and emotionally,and comfortable in our resources and our children and their futures… Why doesn’t God liberate me for time with my kids and grandkids, whisk me away for hugs and stories from Pooh and diaper genies and soy formula in strange cities where no one knows me and I can bring pure, singleminded, attentive love to these young families?...”

For me, that Job-like cry from Susan Rava is the most powerful passage in Swimming Solo.

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