Why is Helping Older Parents So Hard?

Part 2: Helping older parents comes with emotional challenges

Posted Aug 22, 2013

As we mid-lifers age, our parents or other older relatives, if we’re fortunate to still have them, may be reaching the point when they need a little help from their friends (or family members.)

In last weeks’ blog post, I wrote about some of the reasons older adults might need help and how to start getting information and connect with available services. But the basics in that earlier blog post are only part of the story. There are many emotions and uncertainties involved in the process of helping our older relatives…emotions and uncertainties for us and for them.

For our part, many of us carry considerable emotional baggage into the relationships we have with our older family members, and it may not be easy trying to become the advisor to one’s elders. For starters, it may seem disrespectful or embarrassing to start the conversation about our perceptions of their troubles. They are the older generation and we are not the experts on their lives. We might be afraid of offending or hurting the older person’s feelings.

In fact, this can be a healthy attitude to have. Unless there is an emergency, it is a good idea not to rush in and expect older parents to do everything we think needs doing. They’ve been doing their best to cope all along, they may have strong opinions, and may need time to consider our ideas or offers.

Another challenge is the natural inertia in all phases of our lives. Change takes time and energy and it’s human nature to try and maintain the status quo. And the inertia is often stronger when change means having to acknowledge a decline in oneself or a loved one. So when faced with the decline of one’s parent, acting as if things are “normal” is, well…a normal response.

I found this in a study I did with spouses and children of people with early-stage Alzheimer’s disease. Many of them hesitated to make changes like bringing in helpers or placing their relative in a day program because they wanted to keep things the same, to act as if everything is normal, even when the effort became more and more stressful (Adams, 2006).

Other emotions can sometimes get in the way of making good decisions when aging family members might need some help. One is our own grief at seeing our loved one fading, and, closely related to that, our own fears of aging and death. It is not pleasant to be faced with the vulnerability and mortality of our parents, as we are made more aware of our own.

Another situation arises when our relationship with our parents or other close relative may not have been so rosy throughout our lives, or when they can be “difficult.” We may be afraid to confront our parents because of their past moodiness, prickliness, or tendency to criticize or contradict. This type of history makes it doubly hard to approach a parent in old age and begin to discuss issues of care needs.

The lucky ones among us will have clear-cut situations, feel confident in our decisions, and have older family members who are able to participate rationally in their own care planning and adapt to new realities with grace. They will be cooperative, collaborative and mostly cheerful along with way, we will never lose our tempers and everyone will say “Thank you!” at the end.

But obviously, many of us at mid-life do not feel particularly confident in our knowledge of geriatrics or our communication skills around difficult topics. And many older adults do not adapt perfectly to aging or disabilities, nor adjust smoothly or fully. So the rest of us may need to rely on other family members for support and to consult with professionals. We will have to start the conversation slowly, gently confront our loved ones’ fears and denial, and reflect carefully on our own motives.

It helps to take a step back and regard one’s parent or other older relative with clear eyes as someone struggling to maintain independence. That’s the bottom line. Older people usually do not want to become dependent on others, do not want to become a burden, and do not want to give up their everyday small freedoms.

Late life involves fairly constant tension between independence and dependence. Some people have a harder time with these issues, so that when they are older they may have particularly strong fears of others controlling their activities or “taking over” their finances. And many older people have understandable fears of going to a nursing home or other senior living facility, for all sorts of reasons, but a major one is fear of giving up independence in the form of one’s own schedule and possessions.

It’s important for the mid-life generation to address some of these fears and concerns directly with our older family members. There are many in-home services available and ways to modify homes with bathroom bars, chair lifts, and the like, so that remaining in the home for a long time is often possible.

When aging in place does not seem to be an option, assisted living facilities and even nursing homes are less “medical” than they used to be. They may not be as bad as imagined. When they are really necessary, often for a combination of reasons (cognitive impairments, physical impairments, and the high cost of home care) the move to a structured environment with people around may be a relief, even to the older adult who is initially distressed about it.

Another tension in later life for older adults and their family members is seen by social workers time and again: independence versus security. We adult children want our older parents to be safe and to be sure all is well for them. Unfortunately, there is no such thing as 100% safety and it must be balanced with the older person’s priorities and preferences.

If an older parent with a condition such as Alzheimer’s disease or vascular dementia is becoming very forgetful and confused, or if mental illness is making that person “self neglect” to a serious degree, then it will be necessary at some point to take charge and assure that he or she gets the supervision and care needed.

However, as long as they are capable of making their own reasonable decisions, our aging parents have the right to live as they wish. In that case, it may be best to offer help, more than once, talk with them about incremental and realistic goals to help make things safer and easier for them, and seek services that seem mutually acceptable.

Adams, K.B. (2006). The transition to caregiving: Experiences of family members embarking on the dementia caregiving career. Journal of Gerontological Social Work, 47(3/4), 3-29.