Healthy Helping for Family Caregivers of Senior Parents

How to build your relationship and help your super-senior parents “age well.”

Posted Aug 29, 2019

 Kane Lynch, used with permission.
Source: Kane Lynch, used with permission.

After my husband’s heart attack, his cardiologist said, “Your heart will be fine until you’re 80.” “What about after that?” my husband asked. His cardiologist replied, “You might not want it to last after that. Everything goes to shit after 80.”

He was being funny but also serious. Disability and care needs tend to grow in our 80s and 90s. The longer you live the more likely it is you’ll live with a disability and need help managing your health and daily living. 

Gerontologists and psychology of aging experts say that “aging well” in your 60s and 70s is about preventing and delaying disability. It’s also about maintaining a high level of cognitive and physical functioning and remaining socially engaged. But aging well in your 80s (octogenarian) and 90s (nonagenarian) means something else entirely. By then, the chances are pretty doggone high that you’ve aged into disability. Aging well at this stage has a new layer: How to preserve your personal freedom and decision-making (that is, your personal autonomy) in the face of your increasing disability and care needs. This is no small thing for research finds that elders’ perceptions of control are associated with better cognition (thinking), health, and longevity. 

Because age-related disability means that many “super-seniors” rely on their adult children for support and assistance, family caregivers play an important role as far as their parents aging well. I’ve been thinking about this a lot. My father is in his mid-eighties and my mother a few years younger. The ravages of age and Parkinson’s disease stalk my father and my mother has her own health concerns. Their world is getting smaller and the tasks of daily living more challenging.

As a person who spends a ridiculous amount of time thinking about healthy helping, I want to provide the kind of help that supports my parents’ aging well at this unique developmental stage of their lives. Regardless of a caregiver’s good intentions, not all help is equal as far as preserving the dignity and personal autonomy of the care receiver and increasing their subjective life quality. Thinking it’s in the best interest of their loved one, some family caregivers can be paternalistic and controlling. In a quest to be helpful, or because it’s easier or quicker, some family caregivers can be patronizing and sap their loved one’s personal autonomy by doing everything for them. 

Findings from gerontology and the psychology of aging suggest that the aim of adult children caring for super-senior parents should be “assisted autonomy.” This means that for as long as possible that parent care receivers are given:

  • As many realistic choices as possible, within their abilities and yours
  • A chance to do as many activities of daily living and personal care that they can 
  • The power to direct and participate in their caregiving
  • A voice in medical decision making, housing, and other decisions

Maintaining the care receiver’s autonomy and well-being, as well as the caregiver’s, requires interaction and negotiation between the caregiver and receiver. An added bonus of these communications is that in many cases they provide the opportunity for tender, emotionally meaningful interactions that boost the life satisfaction of super-seniors, most of whom want at the end of their lives more than anything to be close to their children. 

I was reminded of this recently when in a quest to be a good caregiver that promotes the assisted autonomy of her parents, I agreed to my father’s request to take him on a long, overnight trip to a medical facility for a fact-finding mission. However, I’m not well myself, and going wasn’t a good idea for my health. Wanting to support him in managing his health in the way he chose, I struggled with calling off the trip. After much thought, and support from others concerned about me, I finally called him to say that I didn’t think I was up to it. His response was gentle and kind. I think he found it satisfying to be able to act as a good father would, and it meant the world to me that he did. 

Developmental psychologists Lang and Schutz (2002) suggested that emotionally meaningful contact between an adult child caregiver and senior parent care receiver requires the adult child’s detachment from their parents’ parenting mistakes and how these mistakes affected them. They have to come to an emotional place where they see their parents as people with their own weaknesses, needs, and sorrows. If you’re not yet “there,” conversations with your parent about their personal biography, and about their parenting mistakes, may help. Recognizing your own life mistakes and the contexts that gave rise to them, may also fuel the empathy you need to leave the negative past, reclaim the positive past, and enter into a healthy, healing, and rewarding here-and-now relationship with your parent(s). 

Although being a family caregiver of super-senior parents is at times stressful, the long good-bye also provides opportunities for emotionally meaningful connection for all involved. For many, it provides an opportunity for growth and healing in the parent-child relationship. This is a gift to a senior parent and to an adult child—especially if these connections were previously weak or fractured.

References

Burn, S.M. 2016. Unhealthy Helping. Create Space. 

Lang, F.R., & Schutz, Y. (2002). Adult children’s supportive behaviors and older parents’ subjective well-being---A developmental perspective on intergenerational relationships. Journal of Social Issues, 58, 661-680.

Molton, I.R., & Yorkston, K.M. (2017). Growing older with a physical disability: A specific application of the successful aging paradigm. Journal of Gerontology: Social Sciences, 72, 290-299.

Robinson, S.A., & Lachman, M.C. (2018). Perceived control and cognition in adulthood: The mediating role of physical activity. Psychology of Aging, 33, 769-781.

Tesch-Romer, C., & Wahl, H. (2017). Toward a more comprehensive concept of successful aging: Disability and care needs. Journal of Gerontology: Social Sciences, 72, 310-318.