Caring for an aging parent is a responsibility few people ever expect or envision. We avoid thinking about our parents falling ill or growing weak. We don't feel equipped to handle the welfare of those who raised us. Confusion, sadness, helplessness jar us during this unsettling transition.
As baby boomers live longer, healthier lives, any assistance that is required typically becomes the children's responsibility. For many families, the discussion about who will take care of Mom and Dad comes on the heels of a crisis. As a result, most families find themselves unprepared to handle their parents' increased dependency.
Still, with the increase in number of older adults comes the increase of adult children caring for their parents. More than 20 million in the U.S. alone provide care for an aging parent or in-law. What's more, families rather than institutions provide 80 percent of long-term care.
So how can adult children, siblings and parents deal with the inevitable challenges that accompany this life transition?
Begin by openly discussing each person's role and responsibilities within the family structure. While caregiving can be extremely stressful, sharing duties is a guaranteed way to ease the tension. Whatever distance family members live from one another, devise a care plan so everyone can be involved.
Addressing the sensitive topic of finances is also a must, as is compiling important personal and financial documents. Finally, take the time to evaluate how to build unity among siblings—in spite of the high potential for tension.
There's no question that many caregivers only find frustration and exhaustion. But with solid support and communication, caring for an aging parent can bring a renewed sense of love, compassion and tenderness into any family.
Within a brief span of time, adult children can find themselves responsible for Mom and Dad. Watching a parent grow vulnerable and dependent is an uncomfortable transition. But shifting family roles are becoming increasingly common as more and more people try to meet the demands of their own children, while feeling the tug to assist their aging parents.
Providing care for parents, whether local or long-distance, lasting months or years, involves major change. With financial implications, strain among family members and difficult decisions at every turn, it's no wonder so many caregivers and potential caregivers feel overwhelmed.
But don't despair. There are practical ways to prepare for and adjust to the new roles within a family.
Talk with your aging parents early—before too many challenges arise. It's one thing to sit down as a family for an honest discussion about care preferences before a crisis develops. It's another to do so after receiving a disheartening diagnosis. Certainly, it isn't easy talking with your siblings and parents about the "what if's." But listening to your parents, involving everyone in the decision-making and working together to set up a plan will be worth it in the long run.
Assess finances—both yours and your parents. From savings accounts to medical insurance to routine tasks like paying bills and balancing the checkbook, the whole family can attain a sense of relief from having money matters in order.
Collect medical information and learn the medical history. Many parents are notorious for keeping the extent of their ailments under wraps, especially when it comes to telling their children. Who are your parents' doctors? What medications are your parents taking? What are the dates of their recent medical tests? It pays off to have this information available if and when the need arises.
Keep communication lines open among siblings. It's all too easy for turmoil to erupt when discussing "what Dad or Mom wants." Adding emotions, finances and family history to the mix can result in damaged relationships; this is a time when family members really need one another. Try to remain sensitive, work through disagreements calmly and keep in mind that these relationships will endure for years to come.
Accept these changes as a natural part of life. No one would deny that watching a parent fall ill or grow weak with age is an emotionally draining experience. Yet hiding or diminishing painful emotions may lead to withdrawal, depression or anger. Working through the stages of grief is a necessary part of facing the inescapable realities of living and dying. Though there is no right or wrong way to endure the mourning process, understanding the stages of bereavement can help when adjusting to this new season in life.
Much that is written about aging parents describes the stresses, the challenges and the headaches that come with providing care. My story shows a different side—a more positive side—of sharing those last years together.
My husband Norman and I were both raised with the model of bringing elderly family into the home. My mother cared for her parents, and Norman's grandmother lived with his family for ten years. Naturally, I figured, our parents would some day move in with us.
After my father died, my mother lived on her own for a decade, keeping up her house and yard, and trying to stay on top of her burgeoning health problems. Her decline was a slow one, but I could see subtle changes.
She would call one of us in a panic, saying she was having trouble eating, when she was really having trouble remembering directions to the grocery store. She couldn't remember which medication to take. Her vision also deteriorated, and her back problems worsened.
We lived several hours away from one another at that point and kept in touch through daily phone calls and frequent visits. During one stay, my mother noticed that the home behind ours was for sale. Her decision to purchase it was a good one; she lived there for five years. Nearly every night, Norman would bring her over for dinner, and we regularly helped with her household chores. But as her daily care became more and more difficult, she knew it was time for a change.
While we were remodeling our kitchen, my mother asked if she could come live with us. So we added to the remodel, enlarging a bedroom and bathroom to fit her needs. Since her parents had lived into their 90s, we expected the same—and we wanted her comfortable.
What a blessing it was to have her with us! That's not to say there wasn't work. She needed help with everything from bathing to dressing to going to the bathroom. For some reason, instead of helping herself to food, my mother preferred that Norman or I did this for her, quickly earning her the adoring nickname "The Queen."
Looking back, I know Norman and I could have gotten short with her, succumbed to anger or worried about the future. But we made an effort to laugh as much as possible, see the humor in things and always communicate openly.
I certainly wasn't raised with this kind of honest communication, but I knew it was necessary to sustain a healthy environment. I used to say, "Everybody do the best they can, and we'll forgive the rest." Together, we learned about setting boundaries, not holding grudges and being up front with one another.
Yes, it was difficult to watch her health decline. And yes, it was sometimes a trying experience. My mother, for example, would often ask the same questions over and over again. But I quickly learned that getting irritated and scolding her didn't do any good. When she complimented me on the "new" dress I wore every Sunday to church, I would simply respond, "I'm so glad you like it!"
I knew she wasn't choosing to forget, and I knew aging was a part of life. So I accepted her absentmindedness and made every effort to treat her gently—even when I didn't feel like it.
My mother's insurance enabled us to get help with her routine care on weekdays. This allowed my husband and me to carve out time for each other. We realized that our relationship had to be the priority.
Speaking of Norman, he was the biggest help, and I couldn't have done it without him. When we married, we agreed we would love each other's parents as our own—and that agreement stuck.
We both knew that the time with my mother was finite—just like the time we spent raising our children. Neither of us wanted those lingering "if only" thoughts when our parents passed away: If only we would've given our parents more time, more love, more attention. Caring for my mother certainly made our lives busier and more complicated. But we wouldn't have done it any other way.
After living with us for two years, mom caught a cold and her body started to wear out. The last day of her life, our family was singing to her from a hymnal, and we could see her mouth moving along with the words. She died surrounded by her loved ones, and we have all the confidence that she continued her song in heaven.
Caring for my mother wasn't always easy. But when she died, I had no regrets. Helping her was a privilege, and I'm so thankful that she was happy while she lived and at peace when she died.
If there's one issue that parents and children often find difficult to discuss, it's finances.
It was sure that way for Bruce Madson.
"It's a taboo subject that we've avoided," he says, "even though [my parents] both have health problems and are struggling to stay on top of things."
Maybe your parents have always been hush-hush about their finances. Perhaps talking about money makes everyone in the family feel uncomfortable.
Undoubtedly, though, the day will come when age or unpleasant circumstances will force parents and adult children to hash out this touchy topic. Without question, the best time to address finances as a family is when your parents are relatively healthy and independent.
If a parent becomes ill or disabled, the limitations dramatically change the decision-making process. Fewer options are available and administrative hassles quickly add up.
Speaking with your parents is a necessary first step in avoiding future financial headaches. Consider these strategies when broaching this sensitive topic with your mom and dad:
Involve appropriate family members in the discussion. Talking about a parent's potential incapacity and inability to manage independently is a conversation no family enjoys. Parents may not want to give up money matters, and children may hesitate to control it. But in the event of a crisis, it's crucial to have a plan devised to handle the onslaught of financial decisions.
That said, parents also have the right to make their own choices, including the making fiscal decisions privately. In this case, it is recommended that your parents meet with a financial planner, lawyer or an advisor who specializes in helping the ill or elderly.
Ask your parents what they feel comfortable handling. Allowing parents to have as much independence as possible is ideal. Encourage them to maintain control as opposed to taking it away—unless their decisions become harmful.
Are they confident paying the bills, making deposits and dealing with health insurance? Are they aware of frauds targeting seniors? Do they have records of their savings and spending? If necessary, delegate who will follow up with them on these responsibilities.
Make sure personal and financial documents are in order. Concern over a parent's financial well-being is front and center for many adult children.
These are some of the financial matters to consider:
Plan for an emergency. Before crisis mode hits you, sit down as a family and settle on some key answers that will give everyone involved some peace of mind.
Who will speak for your parents if they are unable to speak for themselves? Do they have a durable power of attorney to handle financial affairs if they become ill? Has an attorney drawn up a will or living trust in recent years? What about end-of-life care?
Handling these details now will help protect your parents and their assets in case of an emergency.
Listen to your parents and treat them with respect. Keep in mind that you may not agree with every financial decision your parents make. Still, there is no need to parent your parents.
Instead of telling them what to do, ask questions that clearly express your concern: "What can I do to help you?" "How do you think we should handle this?" "Do you feel overwhelmed by any aspect of your finances?"
With good intentions and a willingness to listen carefully, your family can work through this challenging topic one issue at a time. And when the hard work is done, your family will act and react more effectively.
Joan Johnson remembers when her parents started becoming dependent on their children. She remembers her brothers and sisters talking at length about their care options. A nursing home, an assisted-living facility, hiring in-home care.
Ultimately, family members chose to care for their parents themselves.
"We thought it would be easier than it was," says Joan. "My mother and father ended up needing 24-hour assistance, and while we were happy to do this, we should have been taking better care of ourselves. It was difficult, emotionally, to see them deteriorate, and the mounting responsibilities really took a toll."
Providing day-to-day and even minute-to-minute care for an aging parent can be tremendously stressful. Caregivers suffer symptoms so severe that they themselves become known as "hidden patients;" they fail to notice the signs of stress in their own lives.
When the attention is so focused on their parent, numerous and potentially harmful symptoms go unnoticed in the lives of the adult children. What's more, the warning signs of stress can attack so subtly that they're difficult to detect—and this can create a real danger.
Studies show that more than half of all caregivers suffer from depression, while the majority experience what's commonly referred to as "caregiver stress."
It's no wonder, considering many who care for a parent also juggle a multitude of responsibilities. Full-time jobs, parenting their own children and household duties all add to already high levels of stress. In the process, it's common for caregivers to put their own health, feelings and well-being aside. The results can be damaging: anxiety, sadness, guilt, and a whole host of physical ailments.
If you are in a caring for aging parents, recognize the warning signs, then deal with the stress immediately.
If you care for others, it is also imperative to make your own health a priority. Consider these suggestions:
Create lists and establish a daily routine. Keep track of tasks, then balance, prioritize and delegate responsibilities. Most importantly, modify your schedule to avoid anxiety and exhaustion.
Ask for help when you need it. Enlisting the support of friends and loved ones does not make you appear weak. It is of utmost important that you care for yourself in order to provide good care for your parent. Looking beyond immediate loved ones, many cities provide adult care and other services for the elderly, and many churches offer programs for seniors. With safe, friendly environments and plenty of activities, use outside care to give yourself and your parent a break.
Take care of your body and mind. Besides fitting exercise into your schedule and maintaining a balanced diet, it's crucial to find time to relax, pursue a hobby and connect with friends. While leaving a parent in someone else's hands is difficult, getting away at least a few hours a week is critical. Neglecting your own physical and emotional health leaves you vulnerable to disease and exhaustion.
If you feel depressed, get help. Caregivers are at tremendous risk for depression, yet many do not realize that they are depressed. These feelings can develop over time and will become progressively worse if not treated. Instead of hoping this condition will just go away, seek medical help; it'll make all the difference.
Regularly talk with a counselor, support group or close friend. Even though you may not want to discuss your feelings and frustrations, it's beneficial to find an outlet. A parent may have behavioral issues—yelling, hitting, wandering from home—that stir up unfamiliar and very painful emotions. A sympathetic listener could provide the support, comfort and perspective you need to get through the day.
It's worth noting that caring for an aging parent—while challenging—can have many positive effects on the whole family. There's an added sense of purpose, the ability to nurture an intergenerational bond and the knowledge that you're making a difference in the life of your parent.
Giving proper care and attention to yourself and your loved ones will create a healthier, happier environment sure to improve everybody's quality of life.
If you are coping with the frustrations, concerns and guilt that often accompany long-distance care giving, you are not alone. Recent estimates from the Alzheimer’s Association indicate that more than 3 million adults provide assistance remotely for ailing or vulnerable relatives, usually aging parents.
Making sure Mom and Dad are well cared for is a difficult challenge; doing so from many miles away has its own set of issues. What happens in an emergency? Are medications properly administered? Who’s there to lend a hand with the activities of daily living?
It’s no wonder common care-giving stress intensifies when involvement is from afar. Oftentimes, aging parents fear “being a burden” to their adult children, so they fail to be forthright about their declining health. Parental pride, privacy and sometimes embarrassment may also prevent adult children from really knowing the severity of a situation.
Still, taking stock of your parents’ needs—ideally before a predicament arises—will help everyone involved.
Discuss care choices as a family. Find out what your parents want assistance with now, and what kind of help is available in the future. Your parents’ needs will change, so this is the time to explore services and resources within the community.
Who can help with grocery shopping and errands? What if the house cleaning becomes too much to handle? Who can be trusted to answer any financial questions? Together, compile a list of names and numbers with important contacts, including doctors, neighbors, senior center liaisons, etc. Encourage your parents to maintain as much independence as possible, but learn as much as you can about any resources available.
Establish a circle of community support. Alert long-time friends, neighbors, family members—even the mail carrier—about your parents’ condition, so you have a network of people to call if you need someone to check in with them. Encourage those in your support system to visit regularly, or if possible, set up a schedule detailing who will stop by during the week.
You can also enlist help from local churches, civic groups and volunteer organizations. They may provide transportation, companionship or meal delivery. Make sure all of your contacts have your phone number in case they spot a problem.
Ask your parent if you can go along to a doctor’s appointment. When you’re in town, this is one visit that’s definitely worth your time. Get to know your parents’ doctors, nurses and any social workers on staff. Talk with your family beforehand about questions and concerns, and take notes on what the medical staff recommends.
Work with your parent to draw up a list of each medication being taken, and review that list with the doctor. Establishing a relationship with your parents’ doctors will make talking with them easier down the road. Also, medical staff may have inside information on valuable community resources.
Evaluate in-home safety. When you visit, walk through the house room-by-room with your parents and look for possible hazards and safety concerns. Loose rugs, furniture in a walkway or newspapers, electrical cords, plants on the floor could pose as a problem.
Check the lighting in each room, and make sure adequate lighting exists for late-night trips to the kitchen or bathroom. Evaluate the safety of the handrails and stairs, the bathtub and toilet and any potentially dangerous belongings such as weapons, tools or medications.
Making needed home improvements now will offer more peace of mind in the future.
Keep in touch often, via phone, e-mail or letters. Some families find it valuable to purchase a cell phone for their parents (Don’t forget to teach them how to use it!) in case of an emergency. Others program important numbers into the speed-dial to make the calls less of a hassle.
Most long-distance caregivers would like to spend more time with their parents, but frequently connecting by phone may be the most viable option. Stay alert for any warning signs that your parent may require additional care. Look for opportunities to communicate by mail and e-mail. Send pictures, cards and interesting articles. And above all, remind your parent of your constant love and support—no matter the distance between you and them.