As I get older, I hear more from friends and colleagues about their struggles with their aging parents. A close friend is headed to Colorado to meet with her siblings to discuss care arrangements for their declining 90 year old father. Her dad doesn’t want to hear about obtaining help, assisted living, or any plans for hospice. He’s an independent, strong-willed, self-reliant cowboy who likes being in control. His 10 adult children see the writing on the wall. His quality of life is going to spiral downhill in a hurry. They worry that a crisis will force his hand. They want to come up with a plan today that their Dad will go along with.
Another close family friend, age 93, was recently diagnosed with Ovarian cancer. She lives alone. One of her kids is disabled, and the other lives 3000 miles away. Her oncologist told her a few weeks ago that there was no more treatment available to her. She is philosophical and accepting. But it’s difficult for her to understand the value of signing up for hospice before she has a health crisis.
How about the 90 year old who still is driving? It is very difficult to convince an older adult that it’s time to give up their driver’s license. In most places, that is like giving up one of your legs. How will I get around? For most elders, it means a huge loss of independence and autonomy. For them, it may mean the beginning of the end.
Another close family friend, also 91, ended up in a nursing home on a ventilator (breathing tube) for several months before she died. She hadn’t made it clear to her family her wishes. It is very difficult to have a breathing tube removed once it has been put in. The hope that your loved one will get better is very powerful, even when that hope is unrealistic.
It’s very difficult for the aging mind to wrap itself around upheaval and change. It’s so much easier to keep everything the same, even as one’s quality of life slowly erodes. Elders have the tendency to be unrealistic about their capacity and to expect that their family members will pick up the slack. Frequently, they underestimate how their implicit expectations will impact their adult children. They don’t remember how difficult it may be to juggle work and family obligations with their aging parents demands.
Be persistent. Don’t give up at the first sign of resistance. Be patient with your elderly mom or dad, but be persistent too. Keep returning with your questions and concerns. Water will wear away rock.
Find a pitch that appeals to your parent’s personality. My dad gave up his driver’s license when my brother convinced him that he would save money! He made an economic argument that my father liked. He sold the car and often told me how much money he was saving on a monthly basis! And I slept much better at night.
Try a graduated approach. How about hiring someone to come in and help with the lawn? What about a cleaning person twice monthly? How about using “meals on wheels”? What about visiting the local senior center? What about getting food delivered? There are many ways of starting small. Once the door is open to getting extra help, older adults may find it easier to add support.
Focus on helping elders retain independence into the future. The ability to make decisions on your own behalf is an important aspect of independence. When adults end up in the Emergency Room or Hospital, they may lose the ability to make decisions about their living situation. Once someone has a broken hip, his or her choices shrink dramatically. An ounce of prevention is worth a pound of cure. Keeping reminding your parents of these realities.
Accept that you don’t have control, but may have to pick up the pieces. This is tough. Your parents may make choices that don’t agree with. When and if their plan falls apart, you may be expected to help out. This is just the way it is sometimes.
Tell us what you are dealing with? How are you managing?