At the end of October, I traveled to Tucson, Arizona to visit my ailing 76-year-old father. The trip had significant lessons for both patients and caregivers. Since I am both, it had a profound impact on me that I am still trying to organize in my mind.

Dad has both terminal cancer and very late-stage multiple sclerosis, a disease he has battled since he was 25 years old. Due to his cancer diag­nosis in August of 2015, he was not expected to live beyond Christmas 2016. Due to his amazing durability and positive outlook on the world, we celebrated his second annual “last” Christmas in 2016.

My mother is his primary caregiver and has been helping and coping with his steady deterioration for over 50 years. For at least the last five years, she has had to do almost every­thing for him. To say that she under­stands what it means to be a caregiver is the Mount Everest of under­state­ments. She has been there for my Dad from his young athletic out­door days all the way to his cur­rent state of total dependency. He can no longer do almost anything on his own other than to speak and smile.

Mom has always been an emotional being. She is the type of person who experiences the highest of highs from the good things in life, but can also be brought to the lowest of lows without too much provocation. Sometimes it’s in the same day!

As I mentioned earlier, she has dealt with my father’s multiple sclerosis for over five decades. She has done whatever is necessary to keep our family going during my dad’s slow, steady physical decline. I’m not sure how much she has left in the emotional tank.

Mom used to be a pretty happy person. Throughout her life, she was outgoing and made friends easily. She always loved to entertain and would go to great lengths to be sure her guests were taken care of. I felt that she truly cared for most people.

Over the last few years, though, her attitude has changed. I think it is the strain of constant and increasingly difficult care­giving that has changed her.

Mom is rarely happy anymore. She is easily upset by the most trivial of things and these days usually seems to see the glass as half empty. Over the past couple of years, my family and my parents’ friends have told me they’ve noticed a big change, and sadly, many have stopped visiting.

Mom is creating a smaller and smaller world filled by little other than care­giving, bad television, and physical problems. I hate seeing my mom like this.

I have done everything in my power to help, but nobody can change unless they really want to.

I have tried to explain what I think is going on and how I think it can be resolved, but without any success. We even had a family inter­vention meeting last year with all of us confronting her about her behavior and offering up many solutions. While our point was made, changes weren’t.

My mother’s shift in attitude is obviously due to caregiver burnout.

The solution to a caregiver burning out is to lessen the caregiver’s responsibilities. The question that I don’t have the answer to is what to do when the caregiver won’t relinquish some of these responsibilities.

One of mom’s multiple reasons for not getting caregiving help is that they can’t afford it.

My parents are not wealthy, but they have scrimped and saved enough over their lives to own their own home and have a small nest egg in the bank. While in-home assistance isn’t cheap, I calculated that they could bring a care assistant for eight hours every day for the next two years and it would only lower my mother’s savings a small amount. In fact, the best conservative estimate is that she would only run out of money at the age of 103 instead of 123.

While it seems obvious to me that they could afford this care, trying to convince some­one who has lived on next to nothing for 73 years to part with even a bit of their savings is a tough sell.

In reality, most of us will never reach our imagined retirement dreams, whatever those dreams may be. In many cases, as in my parents’, poor health will eventually keep us at home. So why not make the most of a bad situation? We worked hard for this money so let’s spend it while we are still alive.

In my parents’ case, spending money on home health aides or assistance beginning a couple years ago may have allowed my mom to not become so over­whelmed. I think that she would have kept her original positive attitude and may have been leading a happier life today.

While money can’t buy us happiness, maybe in the case of an overwhelmed caregiver it can help to stave off some un­happi­ness.

Of course there are those that simply choose happiness no matter what – like my father.

Dad has seen his physical abilities slip away from him most of his life. As of today, he is unable to go to the bathroom on his own, get out of bed without a mechanical lift (or a son with a strong back), feed himself, wash himself, or remember what happened yesterday or will happen tomorrow. He has skin cancer, lymphatic cancer, and multiple sclerosis. He was supposed to die over a year ago.

What he does do is wake up, smile, and ask how you are when you enter the room!

Some folks who have everything from health to wealth wake up and see another difficult day. My father, who has nothing, wakes up and is happy just to see you smile.

May we all be so blessed.

Aloha and all the best for 2017!