Book Reviews

Elder Rage or Take My Father Please! How To Survive Caring For Aging Parents by Jacqueline Marcell Book review by Elliot S Eisenberg, MD

An ancient dictum states, "If you write from the heart, it will go to the heart." Author Jacqueline Marcell gives credence to this proverb with her new book, Elder Rage.

In a series of vignettes from her own life, the author paints a poignant portrait of her attempts to care for her aging and ill parents in the twilight of their lives. Her struggles with the legal system as well as with the medical system, caregivers, and nursing home institutions give the reader penetrating insight into Ms Marcell's valiant attempts to help her parents.

Early in the story, we learn that her domineering father had not only suffered a traumatic childhood but demonstrated some dysfunctional behavior even as a younger man. Outbursts of temper and alcoholism were frequent accompaniments to his personality disorder. Nonetheless, he provided for his family with consistent employment and professed real expressions of true love for his wife and for his daughter, Jacqueline. As he aged, however, his personality became further fragmented from the ravages of dementia and disease. By the time the author arrives on the caregiver scene through default (the only other sibling was estranged from the family years earlier), her father's behavior vacillates between that of a raging maniac and that of a manipulative psychopath. At the same time, her beautiful mother--who suffered years of abuse--is rendered an invalid by cerebrovascular disease. Realizing that her parents can't function by themselves, Jacqueline attempts to "pay back the parental debt." The payback becomes a wild, tortuous rollercoaster ride with existential dimensions.

In one particular heart-pounding episode, father and daughter square off in a howling feud. Insults are traded, screaming ensues, and the writer finds her once-loving dad attacking her with a vengeance. Torn between the kindness her dad once showed and the reality of his attempts to choke her to death, the author is forced to fight for her life. The reader obtains a diabolic glimpse of the irony incurred by one woman's attempts to help her aging parents.

Aside from being a riveting story, the book is punctuated by wit, humor, and an easy-to-read writing style. With an extensive background as a former Hollywood television executive, Ms Marcell constantly entertains with funny references to pertinent films, songs, and television shows. As the action unfolds, her stream-of-consciousness asides are interspersed in the serious drama. We see the skillful use of laughter as the final defense against insanity.

In addition to telling a passionate story, the book assumes a dual role as the character action ends: It becomes a valuable text, not only for the lay public but for general physicians, psychologists, neurologists, and psychiatrists. Not simply content to just tell her story, Jacqueline wants us to profit by her agony and wants to give us real solutions. She partners with a prominent dementia physician, Rodman Shankle, MD, who writes the final segment of the book from a clinical viewpoint. Drugs for treating dementia and aggression in the elderly are discussed along with psychologic techniques for evaluating these disorders. Although designed as a resource manual for physicians, this section contains much salient information to help the general public and is particularly pertinent to those "baby boomers" who currently find themselves assuming a "parental" role in relation to their aging parents.

With the graying of America, Elder Rage has ubiquitous appeal as an abbreviated textbook and reference guide for caretakers of the elderly. Even more, the book seems a good candidate for translation to the stage or to film: In addition to being an engrossing tale of split personality, aberrant behavior, and the failures of our institutions, it is a human, compassionate story of a heroine's attempt to do the right thing.

Irvine, CA: Impressive Press; 2000. 343 p ISBN: 096797030X

Dr Elliot Eisenberg is an ophthalmologist at the Vallejo Medical Center in Northern California.