It may seem strange to become a caregiver to the person who once changed your own diapers. But caring for aging parents is simply part of the life cycle for many of us. While the role reversal can be emotionally challenging for both sides, it’s sometimes the only way to ensure that aging parents can enjoy the remainder of their lives comfortably and safely. Some families work hard to prepare for the time when the child will become the caregiver, but the shift can be more difficult for others.
“Our parents are used to being the ones in charge, making it likely that you’ll have disagreements when the roles flip,” says Kumar Dharmarajan, a geriatric cardiologist at Yale New Haven Hospital.
When those disagreements do arise, he recommends: “If there is a concern over the safety of your parent, it might be time to override their feelings and make the best decision for them. If the disagreement is over something less urgent, see if there is a way to compromise.”
Feelings of pride and concerns about intruding on their children’s lives can hold aging parents back from asking for help. At the same time, adult children may feel uncomfortable taking the reins and tackling topics that were previously taboo (like finances and parents’ private habits). Wherever you are in your caretaking journey, keep these tips in mind to smooth the transition from child to caregiver.
1. Start talking now.
Many families avoid the topic of aging and parents’ future plans, and understandably so — it’s a tough thing to talk about. But Dharmarajan recommends starting the conversation as soon as possible.
“It’s much easier to have these difficult conversations before a major health event, rather than when you’re in the thick of a crisis with your loved one,” he says. “Make a plan now to ensure that everyone is aligned when you and your parents are both in a relaxed mental state, so you aren’t forced to make rash decisions in the moment.”
Some topics you may want to discuss include finances, where they would like to live (with a family member or in an assisted living facility?) and priorities for future care.
2. Be aware of warning signs.
Aging parents may not be comfortable admitting that they need help, which is why their adult children must keep an eye out for warning signs.
“Generally speaking, if your parent is struggling with daily activities, such as bathing, cooking, shopping, paying bills or driving, it may be time to enlist extra help,” Dharmarajan says.
He also says to watch out for evidence of cognitive impairment (wandering or leaving the stove or faucet on, for instance).
“These are unique to each individual,” he says. “You know your parent — stay in touch, and if you notice major changes in physical activity or behavior, it might be time [to enlist extra help].”
3. Follow their lead.
Some adult children may think it’s up to them to decide how to approach their parents’ care, but as long as they’re cognitively sound, the decision should still be left to the parents, according to Ronald M. Caplan, editor of “The Care of the Older Person.” Respecting their wishes, he adds, is key.
“Older people may be somewhat frail, or even have some cognitive difficulties, but they have a vast store of knowledge and experience, and their opinions should be valued and respected,” Caplan says.
4. Create a safe and accessible home.
The majority of people would like to stay in the comfort of their homes as long as possible, and luckily there are many simple ways to make that happen. By helping your parents make their home safer, they can stay independent longer.
“The home should be made as user-friendly and accident-free as possible,” Caplan says. “Bathrooms should have hand holds that are properly installed so that they don’t give way with weight. A walk-in tub may be considered. Toilet heights should be comfortable. A stairwell lift to the second floor may become necessary. Hazards such as loose rugs should be removed. An alarm system should be installed.”
Dharmarajan also recommends considering newer innovations, such as digital pill dispensers, smart lighting and home assistants and emergency medical alert systems.
5. Ask for their advance directives.
It’s important to make sure that your parents have important legal documents in order while they’re still fairly healthy. Stacey Gordon, the founder and director of New York-based geriatric care management firm ElderOptions, lists three key documents.
“Getting a living will, health care proxy, power of attorney — those three documents will explain to their health care practice what the person wants medically,” Gordon says.
Talking about these plans early on will help your family avoid any misunderstandings or disagreements in the future.
6. Create a social support system.
“Loneliness is a big issue for older adults,” says Gordon, whether they’re moving somewhere new or dealing with the loss of aging friends and family members. “It’s really important to think about social needs.”
Enlist fellow family members or neighbors to ensure that your loved one is leaving the house and having healthy social interactions on a regular basis. Help them find a community center or group to feed their interests. And whether you live nearby or far away, don’t forget to check in periodically.
7. Be open about budget concerns.
Money is a touchy topic for some families, but there’s never a more critical time to speak openly about it.
“It’s important to be very frank about exactly how much money your parents have and where it is saved, as well as how they would like these funds to be distributed,” Dharmarajan says. “If they aren’t comfortable sharing in conversation, have them write it down, similar to a living will.”
8. Keep an open mind and heart.
It’s not unexpected for your family’s plans to evolve and change as your parents age. Be sure to keep the lines of communication open for everyone involved.
“Your parents are still adults and will want to maintain their independence,” Dharmarajan says. “Don’t take that away from them by forcing a decision they don’t want.”