I thought I didn't want to have children. Taking care of my grandmother with dementia has made me reconsider.

• I grew up in a big household and thought I didn't want to have kids.
• Recently, I took care of my grandmother, who has dementia, and it changed my perspective.
• I now see the value in having someone who loves you to care for you later in life.

For as long as I can remember, people have told me I'd be a great mom someday — and it would always make me cringe.

I'm the eldest of four, and my parents would often provide extra support to children from my mother's side of the family whenever they needed it, like taking them in to live with us for months (or years, occasionally), throwing birthday parties, buying them new clothing and toiletries, and providing tutoring. 

At first, I was overjoyed to have extra companions and playmates. Our home was a safe place where anyone could crash and receive a warm meal — and it didn't matter what time they showed up or how long they needed to stay. Still, as I grew older, I could not help but feel like I never had enough love or the opportunity to create and enforce healthy boundaries. It was a constant tug-of-war of putting the needs of others first and then feeling guilty for desiring a sweet escape from the chaos. It's something I struggle with to this day.

Eventually, those feelings of resentment caused me to look at raising a child as more of a burden than a gift. I resented the ups and downs and what I saw as the thanklessness of it all. I also wondered how I could ever give a child enough love to protect them from the perils of life, let alone earn enough income to provide for them and myself. Instead, I chose to create a guilt-free, child-free life with minimum responsibilities — and until recently, I thought that was all I needed. 

Something shifted for me earlier in the pandemic

My paternal grandfather died earlier in the pandemic. The last thing he asked of me was to come home, find a husband, and start having babies — and that frustrated me beyond belief. That sentiment had nothing to do with his bewilderment about my lifestyle but more so with my hesitation to articulate why I wanted to remain child-free.

I'll forever remember sadness in his eyes as he told me to "just think about it"; I'll also remember how much he loved me, which is something I took for granted in the moment. A week later, I received a call telling me he was gone. As my family made the funeral arrangements, my aunt reminded me that my grandmother's dementia was worsening. So I decided to fly home from the south of Spain — where I'd been living for three years — to a place I had avoided for over five years. 

Everything was different from how I'd remembered it. Not only that, but I was different. While I was in the many photos my grandmother displayed throughout her home, I no longer recognized that girl. My diet had drastically changed from a Southern one to a Mediterranean one. I spoke Spanish or Spanglish at home, and I dressed more conservatively. I'd also developed a phobia of becoming a victim of gun violence while in the US, something I did not have to consider while living abroad. 

To avoid dealing with these new family dynamics and the discomfort they brought about, I poured myself into my work, hoping to stay out of the way. After a few months, my aunt sat me down and expressed her disappointment in my lack of communication and how unrecognizable my personality and interests had become. She said it was as if I'd become a stranger to them all, no longer the outgoing and funny hurricane of a woman but a somber, anxious, and evasive workaholic. I was grateful that the conversation brought it all out in the open.

Caring for a grandparent with dementia

After that heart-to-heart with my aunt — I had already been feeling unfulfilled at my job — I finally gave my notice to my job and switched to freelancing while I focused on my family. It was the best decision I could have made. My aunt, her husband, and their daughter had been caring for my grandparents for so long. They deserved my support. They were there to share special times and support them in their most vulnerable moments — and for decades, I had missed almost all of those precious experiences. It was time for me to be fully present and committed.

We developed a schedule that included medication management, preparing my grandmother's meals, bathing her, doing general housecleaning, and spending quality time together. My grandmother showed signs of regression. She would become confused, temperamental, forgetful, or afraid with the slightest change in her routine. She would also demand autonomy, which can be challenging for a 90-something woman with limited mobility. 

About six or seven months into my stay, my grandmother took a tumble as she tried to climb into bed on her own. She spent five days in the hospital, refusing to eat unless my aunt fed her. She refused treatment from the doctors and nurses. The stress also caused her to forget who I was. She wouldn't speak or say goodbye, saying that I had "let those people hurt her" and expressing that she wanted to go home.

After witnessing the dedication, love, and resilience my aunt embodied as she patiently negotiated with and worried about my grandmother, something clicked. I thought back to when I asked my grandmother why she insisted on me having kids. In response, she asked, "Who is going to take care of you when you're old?" At the time, I had thought that was what nursing homes were for. 

As patient as those nurses were with my grandmother, I couldn't imagine her under anyone else's care. All she wanted was to be cared for by us. She trusted us. In the following months, my grandmother began to look at me as more of a companion. I rewatched Westerns and old Hollywood classics with her for hours each day and listened as she recounted her childhood stories and gave me advice. 

We invested in strengthening her memory, sensory, and motor skills. We created a safe space where she wasn't just living but also learning and thriving by developing a routine for her and not deviating from it, spending quality time with her, and checking in with her about how she's feeling. Along the way, we've also learned that it's important to check in with each other and communicate when we need an extended break, need a night or day off, or are simply feeling unwell. This helps us avoid feelings of resentment or becoming burned out. 

My perspective on having children changed

One day, during a vulnerable moment, my grandmother expressed embarrassment and frustration about not being able to do the simplest things anymore. I assured her that whatever she needed was no trouble, reminding her of the care she had always shown me. She replied, "You keep saying you don't want children, but I think you should think about it. Even if you don't have any, you'll make a great nurse someday."

A few months later, I was ready to resume my personal journey and move back abroad. I felt a sense of pride as my aunt, the pillar of our strength, embraced me and expressed her gratitude for all I'd done. And once I settled into my new home, my grandmother accepted my video call and exclaimed, "It's about time my nurse called. I missed you." 

I truly hope I someday get the opportunity to love and care for another person as she has cared for me and as much as I love her. What an honor that would be. I've made more mistakes than I care to admit, but my willingness to learn from them and seek out help has improved my family's dynamics and helped us create a deeper bond with and respect for one another. Throughout it all, I've learned that unconditional love isn't automatic; it's a journey — and it's an emotion I'm better prepared for now.