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Coming up on "Life (Part 2)," can Baby Boomers make it cool to be a grandparent? And later, a visionary doctor reinvents medical care for Boomers and their aging parents. Plus, NPR's Juan Williams explores the mystery of the ages. Is he middle-aged or just old? All coming up on "Life (Part 2)."   

(woman) Major funding for "Life (Part 2)" was provided by The Atlantic Philanthropies-engaging many to improve the lives of and achieve health and economic security for older adults. And by MetLife Foundation-- celebrating the wisdom, talent, and experience of older adults. MetLife Foundation proudly supports "Life (Part 2)."   

[bass, & plucked strings play in playful rhythm; bright in tone]

Welcome to "Life (Part 2)," I'm Robert Lipsyte, and I'm still trying to figure out my role as a grandparent. So far it seems to be mostly grandiose parenting. You parachute in for quality time, make the little kids crazy with treats, then you slip off to let their parents, your kids, clean them up and calm them down. Cool! But the hard part is when you realize that your descendants are being raised by a different playbook than the one you used to raise their parents. There are new rules; meals are now on demand, and more elaborate explanations. You can't just say, "Because I said so." And certain words are verboten, like "no." So I gnash my teeth while biting my tongue and vent my frustration with my wife, Grandma Lois, who prefers to be called Granola. She seems more open to letting Generation X and Generation Next have it their way. But what's my role? The wise elder, dispensing advice whether invited or not? Or just shut up and lend a hand when called. I've talked to more experienced grandparents and they tell me it's like growing up. You have to just let it happen, but stay alert. I've had my moments though. When he was 4, Alfred said to me, "Gramps," that's my name for myself, the rough and ready codger, "Gramps, why are your teeth yellow?" And I said, "That's so they match my brown shirt." His parents didn't like that explanation. But Alfred and I loved it; we howled with laughter! I may be finding my role after all. And now I'm about to learn a lot more about that role. Iris Cornelius is a psychologist with years of experience helping families cope with inheritance and other thorny multigenerational issues, which must have come in handy when her mother, daughter and granddaughter, all moved into her house. What does Allan Zullo know about being a grandparent? Well, Allan and his wife wrote the book. "The Boomer's Guide to Grandparenting," which tells us, among other facts, that the average age of a first-time grandparent is 48. Joshua Coleman is a Senior Fellow with the Council on Contemporary Families and the author of... Welcome everyone, to "Life (Part 2)." The reason I have assembled you here today is to help me with my issues of being a grandparent. Josh, while I'm not having trouble with my grown children, I do feel that it's kind of a delicate dance that while physically grandparenting is easier, emotionally, it sometimes seems to take more finesse than parenting.

(Joshua Coleman) Well it's true, we have to understand that there's been a radical shift in the relationships, not only between grandparents and grandchildren, but between parents and children. So if we looked at what parents wanted from children in say the 1920's with the parenting surveys, what parents wanted from their children was that they wanted them to be respectful and not to fear them, they wanted them to be conforming, upstanding members of society. And what today's parents want from their children is that they want their love, and they don't necessarily assume that they're entitled to it, and they want them to be independent, autonomous thinkers. So the quality has radically changed and that strongly affects the way that parents relate to their adult children.

(Robert Lipsyte) I mean, the Boomers are becoming grandparents now. Some of them at an earlier age than they are probably ready to think of themselves as old. They're going to be different.

(Allan Zullo) Oh yeah, in so many ways. First of, Boomer grandparents I think are more youthful looking and acting. They're wealthier, they're more educated. But also, one of the problems that they're having is all these generations that they've got to deal with. Oftentimes, this is the first generation of grandparents, where their parents are alive in many cases. So you've got the parents, then you've got your spouse, you've got your job, most Boomer grandparents are still working. Then you've got your adult children and then the grandchildren. Where are you going to put your time and effort. This is what all grandparents, regardless of age, has to consider. What role are you going to play?

(Joshua Coleman) That is a source of potential conflict between adult children and their parents, where the adult children want the grandparents to spend sometimes much more time with the grandkids than the grandparents may actually have to spend. And there is the potential source of conflict.

(Robert Lipsyte) Well, that's my problem, doctor, exactly. [all laugh] My son is a writer and a teacher and I'm projecting, I'm projecting, but I think of him saying, “Okay, Dad, you're over, your time's gone; I'm the one who's really got to make it now. I want you to come in and take care of Alfred and Squidge.” Now this may be just my guilt, but I think it's out there.

(Joshua Coleman) Oh, it's completely out there. It's a very common tension and both generations have to be sensitive to the other. Our generation has to be sensitive to the enormous economic pressures that our kids are under, and they have to be sensitive to the fact that our children are largely raised, so this is the beginning of our having much more leisure time that we want to spend using that leisure time.

(Allan Zullo) But you've got to understand also, I think, my wife and I thought by the time we were 60, or we were in the late 50's, we would be traveling the world and enjoying all this other stuff. And we have found that all our free time that is spent traveling, involves the grandchildren. We are either going to see the grandchildren, or we're on a trip together. It's not what we thought it was going to be. And you know what, it's okay, we're having fun. Actually now, with my 12-year-old grandson and 10-year-old grandson, my jumpshot is getting better and better, and my curve ball is getting really good too!

(Robert Lipsyte) You're not going to be bigger than them for much longer!

(Allan Zullo) So it keeps us young and so much more vibrant.

(Iris Cornelius) Well and I think it's very exciting. My grandparents never played any games with me. With my grandmother, because both my grandfathers were deceased, I could help, I could help with whatever they were doing. And they would oversee what I was doing. But it was not the interactive kind of style, and I really like to be active and I like the interaction with the grandchildren as well as with the parents.

(Joshua Coleman) I think that's a really good point, and I think it brings up something that's really important, and that is that we're all probably a lot closer to our adult children than our parents may have been to us. And part of that is because of this democratic family forum that really took root in the '60's and has continued, where there isn't such a clear division between parent and child.  When I was growing up in the '60's, my parents were foreign. They listened to Bing Crosby and Lawrence Welk, the way they dressed, I would never, ever look like them. Whereas my kids dress like I do, they listen to the same thing. My grandson was in the car the other day, he says, "I want to listen to Madonna." I'm like, "Madonna!" But his mother, my daughter, grew up listening to Madonna,
we listened to it in my car.

(Robert Lipsyte) Is all of this positive?

(Allan Zullo) Oh yeah.

(Robert Lipsyte) There must be issues of competing grandparents, financially, love, all the big ones.

(Allan Zullo) One person was complaining to me that the other set of grandparents are very wealthy, and were buying the kid everything and lived nearby. They live a thousand miles away, and they said, "How do you compete against that?" And I said, "You have to find something that is special, some connection with them that only you have with them." But with the other set of grandparents that we have, we wouldn't necessarily have been friends because we didn't have anything in common. And what we did, we would go out to dinner without the adult children or the grandchildren and just get to learn, know them, understand them, and over time...

(Robert Lipsyte) And plot against them.

(Allan Zullo) [laughs] Hey, I have a strategy, yeah. And over time, we've really developed a very good rapport.

(Robert Lipsyte) Ah, a kind of last-but-not-least thought, money. Iris, what you call the transition of wealth, if there is actual wealth, that's an interesting dynamic within a family.

(Iris Cornelius) It is a very interesting dynamic. Part of the work that I do is helping families make that transition from one generation to the next, with their business and also with their wealth. And it's an area in which control can be very strong, fear can be very strong, and people can feel very manipulated.

(Robert Lipsyte) Unpack control, the idea that you're dangling the promise of this money if you do this.

(Iris Cornelius) In order to get this money...

(Robert Lipsyte) I want access to the grandkid, I want this and that.

(Iris Cornelius) Yes, and here it's usually about how you behave. I want you to behave in such and such a way. These are the kinds of things I expect. And that in order to get this, this is what you have to do. Now I think within yourself you have to acknowledge that,
and then I think it makes sense, if you have overstepped your boundaries with them, to make some sort of statement to them about it.

(Robert Lipsyte) Do you have some do's and don't's for me?

(Allan Zullo) Don't give advice unless it's asked. And I know that's really hard, and we all fail at that, because you see something, and you say, "I made that same mistake when I was a young parent," and so you have to just start, just let it go. We encourage new grandparents, read what the adult children, the new parents are reading. There is so much information. When we were raising our kids, we had Dr. Spock, one book, hooray! Now, it's just overload, you OD on this stuff. So read what they're reading or find out what they're doing so you're at least on the same page. It doesn't mean you agree with it.

(Joshua Coleman) I think the single most important thing to do is to have a strong relationship with your adult child. And that often means working on your relationship in ways that are often uncomfortable for most parents to work on. And part of that is going back and looking at the mistakes that you made with your own child and being honest about those. I was thinking, that authenticity goes a long way. It goes a huge way, particularly because I work with a lot of alienated parents, and it's often the hardest thing for parents to do is to say I really blew it with you as a kid, I really made this mistake,  I was too harsh, I was too involved in my work, I was too critical. You get a lot of respect from a kid that way and it really strengthens your bond.

(Iris Cornelius) It opens up the conversations because then they can tell you how they're making mistakes. But sometimes the children are trying to impress you with how well they're doing. So I think that to be authentic is absolutely critical. I also think it's very important to give praise when you see it, absolutely called for. Too often, appreciation is not given in our society, not just in families, in any place.

(Allan Zullo) I think that's a really good point.

(Robert Lipsyte) I think the bottom line really is that grandparents and grandchildren can bond because they have a common enemy. [all laugh]. Thank you all so very much for joining us on "Life (Part 2)."

(Robert Lipsyte) Baby Boomers want to reinvent everything, from grandparenting to their relationship with the medical profession. So it makes sense that they're exploring new and empowering ways for older patients to make enlightened and humane decisions about healthcare late in life. That's good news for Baby Boomers and their parents. One of those leading the way is Dennis McCullough. He's a Harvard-trained medical doctor and the author of "My Mother, Your Mother, Embracing Slow Medicine, the Compassionate Approach to Caring for Your Aged Loved Ones." Dr. McCullough, welcome to "Life (Part 2)." At the heart of your vision is slow medicine. What is slow medicine?

(Dennis McCullough) Slow medicine is about relationships, time, and trust. And those are 3 elements of care that have been slowly squeezed out of the healthcare system over time, and yet it's exactly what older people need to wrestle with the kinds of complexities that they face, and their families need that too. So it's not simply time in the sense of every doctor's appointment being longer, but it's having things play out over a longer period of time, whether it's discussing where your mother might need to relocate to, when the driver's license should be curtailed in some way, or the complexities of a decision around let's say, chemotherapy or treatment of Alzheimer's or treatment of pneumonia in the context of advanced dementia. It's amazing how long I felt it took for me to begin to really understand the problems of older people as a physician. I think I really had to hit my-- almost 50. And I think that is one of the issues that we're going to face in terms of getting physicians who are going to be good physicians for older people and their families. But it doesn't happen quickly. You have to acquire a certain kind of experience, I think, in complex situations before you can do it reasonably well.

(Robert Lipsyte) What I don't understand is this dichotomy. On the one hand, these younger doctors, well, the old crock is going to be going anyway. Why knock yourself out? But on the other hand, so ready to do all the tests, do everything. Are they practicing on old people, or is it the culture of medicine to use technology instead of compassionate care?

(Dennis McCullough) Well, I think it's the culture of medicine to do that and part of it is the business of medicine too. It's not just the culture. So there are two very, very strong forces. And we've moved away from more reflective practice of medicine because technologies now can elucidate things so quickly in some instances, we tend not to think that spending time listening to patients and families and understanding what the actual environment and the dynamics of somebody's life are and what they contribute to our understanding of what might best be done.

(Robert Lipsyte) How do we crack through, I mean, trapped in this system, how does a nervous, caring family kind of crack through?

(Dennis McCullough) Well, I think you have to really learn to be assertive, because the power differential in the practice of medicine is very, very large. And even doctors who write about being patients point out how disempowered you feel as a patient dealing with the healthcare system. So I think one of the things that can be very useful, is recognizing that one way to right a power differential is to have more people on your side of the table, on the more side of the desk. So one of the simple things I say for families to do is to show up with an older parent. And it doesn't just have to be one child, but another pair of ears, another pair of eyes watching what's happening in a consultation, makes the doctor, I think, a better doctor.

(Robert Lipsyte) And also more people in the hospital room as well. I think that's very true.

(Dennis McCullough) It's a message that a family gives to the healthcare system that we care and love our parent enough to show up. And you can't handle it by telephone. There's a need to be there, to sort of express that, to be a part of it, to have your feelings engaged so that doctors, nurses realize that the consequences, the ripples of the effect of an illness, and the suddenness of, what do we do now? That you can sense the emotional part of that for the family, then you respond to that, I think, as a doctor.

(Robert Lipsyte) I was fascinated the way you took me through the stations of your mother, Bertha's decline, from stability to eventually at the other end, leaving and legacy. It seemed that one of the key moments was a station you called compromise, where we begin to really get the picture of what's happening to our mother.

(Dennis McCullough) And that's the station at which there's the most rebalancing of a relationship. The first station that I talk about is stability, where you feel as if you're intruding into a parent's life by saying well, maybe I should go to a doctor's visit with you, or maybe I should be involved with understanding what your medications are. When you get to compromise, the penny drops and you say my mother isn't going to be able to do this by herself, we have to figure out how to be supportive and present for her without undermining her autonomy. But this rebalancing is happening. We are now, as adult children, having to do some very delicate work in reordering the relationship and there's a kind of interdependency also that goes on, because if you're not doing that work well, it's harder for the parent.

(Robert Lipsyte) Is it fair to say that the key in so much of this according to this wonderful book your wrote is not to be rushed, sleeping on it, taking the opportunity to think about the decision you're going to be making-- but that's tough.

(Dennis McCullough) Well, that's the way we operate though. And older people operate that way even more as time goes by, that there's some really nice research showing that older people actually make very good decisions, but they need more time to make it because they have more things to run by to relate to the decision-- what happened to their friends, what happened to their parents. You see all of this reflected in the fullness of your life.

(Robert Lipsyte) How do you balance quality of life versus quantity of life?

(Dennis McCullough) By looking very carefully and talking with and listening to a person to find out what it means for that individual. And for some people who seem to be markedly disabled when they're old, they still have things that they love so much during the day, you have to find that. Maybe it's the contact with the nursing staff, maybe it's the telephone call that comes from a daughter or a son once a day. So quality of life we can't easily define for somebody else. They have to define it for us. And what that takes is sort of probing and listening.

(Robert Lipsyte) But I mean, very often this is going to be a family choice as well as yours, I mean the ugly term of pulling the plug, it's something that the family, the stereotypical Boomer son or daughter is going to have to talk to you about.

(Dennis McCullough) And families can't do it on their own entirely, because the depth of a family's experience around aging and loss is for all of us, that's so, it's sort of so special and intense. You need to be talking with people who have been there before. What's tough for a family, I think, is to be told, well it's all your decision. Without a physician or somebody who can say we've been here before many times; we know what likely is going to evolve from this. We can't predict everything, but we can be fairly sure that we're on the way toward the end of the trajectory.

(Robert Lipsyte) Do you have any tips, any specific things that I should be thinking about right now, not only to help aged relatives, but for myself?

(Dennis McCullough) Hang around a little bit with people who are older who you spot and say there's a kind of person I'd like to get a sense of what they think about, how they're addressing the sort of complexities that are coming in their own life, the medical problems they're having. I had some just wonderful mentors who were patient friends that I hung around with and sort of listened to, and I think and much of my book comes from those stories.

(Robert Lipsyte) Again, within this insurance-driven, with all due respect, greedy doctor, demanding patient, business model, industrial medical complex, how does the individual crack through without all this help?

(Dennis McCullough) You have to join up somehow with other people. I don't think you can take this part of the journey on your own. And the simplest thing is really having some intimates, people who you trust to share the questions that you're wrestling with at a particular time. And I think that's the difficult transition for all of us, to go from being very, very independent and autonomous and learn how to be intimate and sharing as we get older, because we're going to need those advocates who understand us when we can't function on our own.

(Robert Lipsyte) Once I get to do that, I'm going to make sure I have an over-50-year-old geriatrician who has read your book. Thank you so much for joining us on "Life (Part 2)."

(Dennis McCullough) Thank you, Bob.

(Robert Lipsyte) Juan Williams is a Senior Correspondent at National Public Radio and a regular contributor to Fox News. He won an Emmy for TV documentary writing and is author of the best-selling book, "Eyes on the Prize." But he still has no clear idea of whether in his 6th decade, he's middle-aged or just plain old.

(Juan Williams) Here's the delusion from my youth. When I was say 14 and I met someone who was 20, I considered them really old. Today at 54, I can tell you that's crazy. Anybody 20 is very young! So now I have a new problem. I'm trying to figure out how old is really and truly old. As you can guess, there's a strong personal investment in this question. I want to know if I'm already old. So when I go to a Tina Turner or Paul Simon concert and notice all the graybeards in the crowd, I wonder to myself, how come all these old people are here? And are they looking at me and wondering the same thing? Sometimes, when I first meet people, I ask them, "How old are you?" Women hate this-- they think I'm saying they are old. Actually, it has nothing to do with them. I'm trying to figure this out. Is this what I look like to strangers? You know the joke, and it is a joke, about 50 being the new 30. Well yes, we have better healthcare, but at 50, a twisted ankle takes forever to heal, and you still can't find your damn reading glasses, no matter how many you buy. But what is old in an era when American men and women regularly live into their 70's and 80's? So am I middle-aged, or am I old? At 54, I know this: there are lots of hot women, even after menopause-- no joke. And here's my delusion-free conclusion about whether I'm middle-aged or just old. I am older, but I'm a young old man. Not until I'm 75 will I happily agree with any 14 year-old who says, "Hey Juan, you're old!"

(Robert Lipsyte) Actually Juan, I think 54-year-olds are still a little wet behind the ears. For now, that's it for "Life (Part 2)." Thanks for joining us. I'm Robert Lipsyte. See you next time, older and better.

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