Already toast: caregiving and burnout in America

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Publisher
Beacon Press
Publication Date
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Language
English

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The story of one woman’s struggle to care for her seriously ill husband—and a revealing look at the role unpaid family caregivers play in a society that fails to provide them with structural support.Already Toast shows how all-consuming caregiving can be, how difficult it is to find support, and how the social and literary narratives that have long locked women into providing emotional labor also keep them in unpaid caregiving roles. When Kate Washington and her husband, Brad, learned that he had cancer, they were a young couple: professionals with ascending careers, parents to two small children. Brad’s diagnosis stripped those identities away: he became a patient and she his caregiver.Brad’s cancer quickly turned aggressive, necessitating a stem-cell transplant that triggered a massive infection, robbing him of his eyesight and nearly of his life. Kate acted as his full-time aide to keep him alive, coordinating his treatments, making doctors’ appointments, calling insurance companies, filling dozens of prescriptions, cleaning commodes, administering IV drugs. She became so burned out that, when she took an online quiz on caregiver self-care, her result cheerily declared: “You’re already toast!”Through it all, she felt profoundly alone, but, as she later learned, she was in fact one of millions: an invisible army of family caregivers working every day in America, their unpaid labor keeping our troubled healthcare system afloat. Because our culture both romanticizes and erases the realities of care work, few caregivers have shared their stories publicly.As the baby-boom generation ages, the number of family caregivers will continue to grow. Readable, relatable, timely, and often raw, Already Toast—with its clear call for paying and supporting family caregivers—is a crucial intervention in that conversation, bringing together personal experience with deep research to give voice to those tasked with the overlooked, vital work of caring for the seriously ill.

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ISBN
9780807011508
9780807011751

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Published Reviews

Booklist Review

This is an eye-opening account from a full-time caregiver. Washington and her husband were young parents and aspiring professionals when her husband was diagnosed with lymphoma. Washington embarked on an exhausting caregiving stint that drained her physically, mentally, financially, and emotionally. Whether detailing aspects of her husband's infirmities or describing herself sobbing helplessly as a physician chastises her for not taking better care of herself, Washington is brutally honest. She describes a never-ending cycle of soul-sucking experiences, from being dismissed by doctors to losing her privacy as her home turned into a care facility. She admits that she resented her ever-increasing responsibilities--and the unquestioning assumption that, as a woman, she would shoulder every task. Washington segues from her situation to the national level, warning of the widespread challenges faced by full-time, unpaid caregivers as they juggle medical care, emotional support, household management, bill-paying, parenting, and self-care tasks. In this much-more-than-a-memoir, Washington provides ample evidence and background information and comes across as a totally sympathetic individual. Her final chapter, on how to really help, calls for a massive overhauling of government, employer, medical, and insurance company policies. This is a timely and crucial appeal.

From Booklist, Copyright (c) American Library Association. Used with permission.
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Publisher's Weekly Review

Washington chronicles in her wrenching debut the devastating ordeal of her husband being diagnosed with a rare form of lymphoma and the two years she spent, from 2016 to 2018, taking care of him during treatment. Her life became a blur of doctors' appointments, battles with insurance companies, juggling dozens of prescriptions, and learning to administer IVs. The work was all-consuming and led to a strained marriage that "felt less like a ballast keeping me on an even keel and more like a weight so heavy it could sink me." After a stem-cell transplant, Washington writes, her husband saw a limited recovery but still lives with a chronically weakened immune system from chemotherapy. Her account ends with a persuasive plea for a federally funded caregiving stimulus plan, citing president-elect Joe Biden's recent statement: "We're trapped in a caregiving crisis, within an economic crisis, within a healthcare crisis." Throughout, Washington notes the gender disparity among caregivers; with three-quarters of caregivers being women, Washington writes, "There was an implication that the only point of me, as a human, and especially as a woman, was to care for another person. What about my own life? Didn't I deserve care?" Washington's tale serves as both an evocative memoir and a strident call to action. (Mar.)

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Library Journal Review

Journalist Washington's timely debut chronicles how quickly she and her husband's lifestyle shifted from married professionals and parents to caregiver and patient after her husband's diagnosis of a rare form of lymphoma. From 2016 to 2018, Washington served as a full-time aide to her husband, which had her battling insurance companies, making hospital appointments, and managing his care at home, all while trying to eke out a little extra time for herself. While working diligently as a caregiver, Washington felt alone, not realizing that there are thousands of others in similar positions all across the United States. The author highlights the necessity of providing more resources to caregivers, especially as baby boomers age. Nearly three quarters of caregivers are women, which underscores the importance of reform and the societal expectations that place women at the heart of caregiving. Washington also takes care to explore the racial dynamics of caregiving, with Black and Latinx women often serving in caregiving roles while also caring for children. VERDICT This moving, relatable story is sure to resonate with patrons who, if not already serving as a caregiver, may find themselves taking on that role soon enough. A recommended purchase for library collections.--Mattie Cook, Flat River Community Lib., MI

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Kirkus Book Review

A Gen-X writer's memoir melds a harrowing account of her efforts to help a seriously ill husband and a biting critique of how America is failing its unpaid caregivers. At the age of 42, Washington was thrust into the role of the primary caregiver for her husband, Brad, after he was diagnosed with a rare form of T-cell lymphoma. The couple's situation got worse when, after his transplant, Brad developed graft-versus-host disease and a new lymphoma and temporarily lost most of his sight, a complication that required tarsorrhaphy, which "involved sewing his eyes shut." Medication and enrollment in a clinical trial led to remission, but not before his illness had taken a physical and emotional toll, which Washington describes in unsparing detail. Too debilitated to work, Brad took a disability retirement from his job as an English professor, and the author gave up "career, travel, sex," and time with two school-age daughters while spending a fortune on necessities their health insurance didn't cover. Washington evinces a righteous anger about the indignities she faced as a caregiver--from burnout to "the clichés offered by the well-meaning: stay positive. You got this. I couldn't be as strong as you are. You have to stay strong for him. What doesn't kill you makes you stronger"--and her raw emotions can lead to rough-around-the-edges writing. Nonetheless, her experiences justify her moral outrage, and she offers a welcome Gen-X perspective on a topic that mostly focuses on boomer caregivers. Washington also acknowledges the challenges of Black, Latinx, and LGBTQ+ caregivers by citing academic studies and books like The Color Purple and Like Water for Chocolate. The result is a bracing antidote to "sentimentalized narratives" that cast unpaid caregiving as its own reward when, the author makes clear, better Family and Medical Leave Act benefits would be far more useful. A startling, hard-hitting story of a family medical disaster made worse by cultural insensitivities to caregivers. Copyright (c) Kirkus Reviews, used with permission.

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Booklist Reviews

*Starred Review* This is an eye-opening account from a full-time caregiver. Washington and her husband were young parents and aspiring professionals when her husband was diagnosed with lymphoma. Washington embarked on an exhausting caregiving stint that drained her physically, mentally, financially, and emotionally. Whether detailing aspects of her husband's infirmities or describing herself sobbing helplessly as a physician chastises her for not taking better care of herself, Washington is brutally honest. She describes a never-ending cycle of soul-sucking experiences, from being dismissed by doctors to losing her privacy as her home turned into a care facility. She admits that she resented her ever-increasing responsibilities—and the unquestioning assumption that, as a woman, she would shoulder every task. Washington segues from her situation to the national level, warning of the widespread challenges faced by full-time, unpaid caregivers as they juggle medical care, emotional support, household management, bill-paying, parenting, and self-care tasks. In this much-more-than-a-memoir, Washington provides ample evidence and background information and comes across as a totally sympathetic individual. Her final chapter, on how to really help, calls for a massive overhauling of government, employer, medical, and insurance company policies. This is a timely and crucial appeal. Copyright 2021 Booklist Reviews.

Copyright 2021 Booklist Reviews.
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Library Journal Reviews

Journalist Washington's timely debut chronicles how quickly she and her husband's lifestyle shifted from married professionals and parents to caregiver and patient after her husband's diagnosis of a rare form of lymphoma. From 2016 to 2018, Washington served as a full-time aide to her husband, which had her battling insurance companies, making hospital appointments, and managing his care at home, all while trying to eke out a little extra time for herself. While working diligently as a caregiver, Washington felt alone, not realizing that there are thousands of others in similar positions all across the United States. The author highlights the necessity of providing more resources to caregivers, especially as baby boomers age. Nearly three quarters of caregivers are women, which underscores the importance of reform and the societal expectations that place women at the heart of caregiving. Washington also takes care to explore the racial dynamics of caregiving, with Black and Latinx women often serving in caregiving roles while also caring for children. VERDICT This moving, relatable story is sure to resonate with patrons who, if not already serving as a caregiver, may find themselves taking on that role soon enough. A recommended purchase for library collections.—Mattie Cook, Flat River Community Lib., MI

Copyright 2021 Library Journal.

Copyright 2021 Library Journal.
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Publishers Weekly Reviews

Washington chronicles in her wrenching debut the devastating ordeal of her husband being diagnosed with a rare form of lymphoma and the two years she spent, from 2016 to 2018, taking care of him during treatment. Her life became a blur of doctors' appointments, battles with insurance companies, juggling dozens of prescriptions, and learning to administer IVs. The work was all-consuming and led to a strained marriage that "felt less like a ballast keeping me on an even keel and more like a weight so heavy it could sink me." After a stem-cell transplant, Washington writes, her husband saw a limited recovery but still lives with a chronically weakened immune system from chemotherapy. Her account ends with a persuasive plea for a federally funded caregiving stimulus plan, citing president-elect Joe Biden's recent statement: "We're trapped in a caregiving crisis, within an economic crisis, within a healthcare crisis." Throughout, Washington notes the gender disparity among caregivers; with three-quarters of caregivers being women, Washington writes, "There was an implication that the only point of me, as a human, and especially as a woman, was to care for another person. What about my own life? Didn't I deserve care?" Washington's tale serves as both an evocative memoir and a strident call to action. (Mar.)

Copyright 2021 Publishers Weekly.

Copyright 2021 Publishers Weekly.
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