Bringing the Senior Back into Senior Care: Respecting Your Loved Ones' Feelings
It happens slowly at first. Over weeks, months, or years you begin to notice that Mom and Dad aren't as sharp as they used to be. Then one day, you realize that you've started making decisions for them. It's just easier, faster. Eventually, you can see that you've become the parent, making decisions large and small. And nobody -- not you or your parent -- is particularly happy about the arrangement.
Fortunately, there is an alternative scenario.
Elder care experts say cooperative planning, with you and your loved ones making decisions together, results in happier seniors and less-stressed caretakers. "All of us want some participation and some say in what's happening in our lives," says Lisa Kidd, R.N., B.S.N., administrator for Baptist Home Health Care in Jacksonville, Fla. "You're going to get a lot more buy-in and a lot more happiness from someone who feels they made some contribution."
Cooperation doesn't have to mean a sit-down planning marathon. In fact, Kidd says small, casual questions worked into day-to-day activities is the best approach. "Aging is a fact of life. You don't want to put your loved ones on the defensive or make them feel degraded," she says. "Instead, when you're out shopping for clothes with your mom, mention that you sometimes have trouble with buttons or tight collars. Ease into a conversation. Ask if she ever has trouble getting dressed. Ask what she would like to see happen when and if she gets to the point where she can't dress herself. If you have the conversation before it becomes a real need, it's much less emotionally-charged."
Once a senior, states a preference, the topic can be revisited later, Kidd notes. For example, a parent might say "when I can't cook for myself anymore, I'm going to go to an assisted living place." When the day comes and the parent or grandparent clearly isn't safe at the stove, you can bring up that conversation. Maybe dad or granddad will want to start looking at assisted living apartments, or maybe he'll decide he'd rather have someone come to the house to prepare meals. You can help him find a home health aide or part-time cook, but the decision was his.
"One of the challenges for adult children is balancing their parents need for autonomy and control with their desire to be helpful and pragmatic," says Jody Gastfriend, Vice President of Care Management at Care.com and LICSW (Licensed Independent Clinical Social Worker).
"Avoiding an impasse can be done more effectively when you plan ahead. Expressing concerns in an empathic, rather that coercive manner is important in setting the tone for communication. Eliciting your parents' wishes and fears is particularly valuable because it can set the stage for collaborative problem solving," says Gastfriend. "An elder who is worried about losing independence may be reluctant to give up driving, but might be willing to share fears of driving on the highway or at night, which can lead to a discussion about alternative transportation. Those who communicate early and often typically have better outcomes and more options for care."
Read tips on how to talk to your parent about driving.
Of course, advance planning also allows for some revision of pie-in-the-sky dreams that may have taken hold. Many people expect they'll stay in their own homes until they die, without really thinking about whether they will be capable of maintaining a residence, or even doing simple chores, by themselves. Those who expect to move to a senior-supportive environment may have visions of buying a condo at a resort-style mature adult community that is simply cost-prohibitive. "A lot of a person's future is determined by finances," says Kidd. "You really need to ask how your loved one envisions their future and then say 'what is this going to cost?' They need to know realistically what their options are while they can understand and state preferences. You may find that your mother - who always said she wanted to go to assisted living - didn't realize she would have to sell the family home and half her possessions in order to afford the facility she likes."
Make no mistake: we all grow older and when we do, some shifting of roles is inevitable. Sometimes a capable, can-do adult will suddenly become incapable, at which point loved ones must step in.
"When my father was diagnosed with dementia, we eventually had to take the difficult step of assuming legal guardianship, when he was no longer able to make decisions on his own behalf," Gastfriend says. "This did not mean, however, that my father was incapable. It is important for caregivers to understand and elicit the strengths and capabilities that may be masked by dementia or other chronic illnesses. I don't view caregiving as a role reversal-our parents are always our parents, even when they are incapacitated. Rather, caregiving is a redefinition of roles. The caregiving journey often follows an unpredictable and circuitous path, but despite the many hurdles along the way, it can also enrich our lives and our relationships with our loved ones."
Encourage Cooperative Decision-Making:
- Engage your parent or grandparent in conversation. Learn how they see their future and how they expect to handle the challenges that come with age.
- Look at your family resources, both financial and personal. What can you present to your loved one in terms of options?
- Research external services, facilities and resources. What does the community have to offer? Discuss these options with your senior.
- Consider your parent or grandparent's temperament and personality. A social, outgoing senior needs a way to interact with other people. A very private, reserved senior may do better with in-home assistance than in an assisted living setting. Gently steer the conversation to choices that make a good fit.
- Consider your own needs. It doesn't help anyone for you to feel stressed, exhausted, broke or guilty. Don't offer more than you can do.