There’s No Substitute for Presence. So I Uprooted My Family.

I don’t necessarily believe God advertises on billboards—but I had to wonder last August.

My husband and I were sitting in a Chicago park, talking about our pressing responsibilities to our aging parents. It was the first time since the beginning of the pandemic that we had crossed the Canada–United States border to visit them: my mother in Ohio, my husband’s mother in Illinois. My mother had particularly suffered from the year of social isolation, a hardship compounded by the toll of caring for her ailing husband. For the first time since moving to Toronto a decade before, we wondered, Is it time to go home?

That question hung in the August heat, and presumably, it was answered by the billboard I then noticed on the other side of the Edens Expressway.

Tired of Illinois taxes? Move to Ohio!

In 2011, my husband accepted a Toronto-based position with his American company. We expected, as the company did, that this would be a short-term opportunity for our family. We quickly plugged into a wonderful church in Toronto and grew to love our new city. Though our initial visa was approved only for three years, we chose to extend it. Then extend it again. And again. In 2017, we finally gained permanent resident status in Canada. We bought a house. We spent two years renovating that house. We moved back into the house in October 2019 and intended to stay.

Until last summer—and the billboard and fears for our aging parents.

We spent the fall praying and involving our community in a process of discerning God’s will. And what became unavoidably clear to me, especially as I plodded through my daily Bible reading plan, was the emphasis in Scripture on honoring one’s parents. A host of proverbs, like Proverbs 23, hailed over me:

Do not despise your mother when she is old.

May she who gave you birth be joyful!

What a pleasure to have children who are wise.

Those proverbs chastened me. Though my husband and I never wanted to neglect our parents, neither had they been an important consideration in our decisions. We moved for jobs; we moved for graduate school. We moved for opportunity—and opportunity always seemed to call.

But here seemed a different invitation: to return a debt of gratitude to God and our parents. In a culture as heartily individualistic as ours, this certainly wasn’t the script I’d been handed, and it’s true I’ve wrestled with the meaning of this. I have met my own hard-edged resistance to surrendering our permanence here in Toronto and, more importantly, to abandoning the entitlement I feel to autonomy.

To be blunt, I don’t want the interruption that providing practical support to our parents will impose on our already-busy lives, even while I realize that ordinary help—advising on financial matters, attending appointments, even regularly opening the mail—is difficult to do from a distance. I’ve also begun to see that the emotional elements of caregiving as people age and face new anxieties aren’t easily met by proxy.

There’s no doubt we’re facing a global crisis of care for the aging, who are outliving previous generations. When elderly family members living in long-term care facilities died at disproportionate rates during the COVID-19 pandemic, many adult children began to reconsider the care they had planned for their aging parents. As research is now showing, multigenerational living appears to be on the rise, and this can benefit both the young and the old.

The options, however, are limited for seniors facing severe physical and cognitive decline, people who need more care than an adult child can provide. In the United States, professional home health aides are underpaid and contend with dangerous, unregulated work conditions. Their services are hard to employ and hard to retain.

And while government programs like the Program for All-Inclusive Care for the Elderly (PACE) continue to expand, accessibility is limited, and the alternative of private care remains exorbitantly expensive. Even with the generous long-term care insurance my mother and stepfather purchased years ago, the benefits are inadequate to support the monthly costs of their assisted living, especially in inflationary times.

One current response to this crisis of care is technological. In Japan, the world’s “grayest nation,” dementia has reached epidemic proportions, and cities like Itami—a suburb of Osaka—have turned to digital surveillance to monitor those who wander.

To be sure, there are life-saving benefits to tools like security cameras and tracking devices, but one can’t help but identify the irreplaceable need for human caregiving, the kind described by Arthur Kleinman in The Soul of Care. Kleinman is a professor of psychiatry and medical anthropology at Harvard, and when his wife, Joan, was diagnosed with dementia in her late 50s, he shouldered the burden of her care for many years.

As Kleinman explains in his book, caregiving is always too great a role for one person, especially in the case of dementia, and he understood early on that his wife needed a “system of care.” At the same time, he valued “presence” as a vital aspect of caregiving—and one that couldn’t simply be bought. He wanted to be with Joan and to walk with her through the valley of the shadow of death.

It was a journey that lasted more than a decade.

A secular Jew, Kleinman did not necessarily characterize his call to care for his wife as issued by God. Nevertheless, he used biblical language when expressing his willingness: “Here I am. I am ready,” he wrote.

Moving closer to care for my aging mother, that’s what I seem to be saying to God. Truth be told, I worry about my own incapacity to do this new work, but I’ve read Kleinman’s concluding words with great hope:

“You do what you can,” Kleinman writes, “and your very actions put you in the life of another with his or her needs. You cannot respond this way all the time, but that is not really the issue, is it? The genuine question is whether you can find it in yourself to respond with care some of the time, or at bottom, any time.”

Here I am, I’ve said to God, knowing my own inadequacies for the task. I don’t imagine it will be easy, and I don’t expect to do it alone. Maybe most importantly, I hang tight to God’s promise to care for me. As the prophet Isaiah wrote, God is a nursing mother—and it is impossible for him to forget his own compassion.

Jen Pollock Michel is a writer, podcast host, and speaker based in Toronto. She’s the author of four books and is working on a fifth: In Good Time: 8 Habits for Reimagining Productivity, Resisting Hurry, and Practicing Peace (Baker Books, 2022).