Care of an Aging Parent: Enhancing the Psychological Journey
Whatever else 79 million baby boomers are doing, one in eight are caring for an aging parent. Some are checking in on an elderly parent who is living alone, some are caring for a parent in their own home, some are visiting parents in assisted living or nursing facilities, and others are doing long distance caring.
Whether well planned or unfolding as emergency, this a challenging task. It is one that necessitates changes, parent/child communication, family support, community services, shared information, financial resources, legal expertise, and medical care.
Underscoring this task and coloring most of these factors is the emotional reality that caring for an aging parent is a psychological journey. Metaphorically, it is one that demands a “return home” in a different role to become the “holding environment” – the psychologically attuned parent– whether that is something you have had or still yearn for.
Although the journey seems daunting and is certainly strewn with obstacles, it can also be an opportunity for mutual and positive connection.
Adapted and expanded from the literature on the risks of caregiving, clinical practice and my own journey, here are Four Basic Steps that may reduce the stress and enhance the privilege of caring for both you and your parent. They include: Acceptance, Balance, Connection and Personal Definition.
Understanding the situation and normalizing the responses of both you and your parent reduces anxiety and facilitates acceptance and functioning.
Unlike the care of children which, despite its challenges, is linear and moves forward, care of an elderly parent is more like time travel. It involves being transported backwards and forwards between different points of time.
- Within hours, even minutes you are making decisions as a parent for a parent, while worrying as a child about their reactions.
- You are busy thinking ahead in terms of resources, finances and legal needs while at the same time hearing about your parent’s childhood, reminders of your own or questions about who is still living.
- You are worrying about how safe a living arrangement could be or how appropriate a resource might be while your parent is insisting there is no need for help on one day and clearly in need of considerable assistance on another.
- You are faced with the reality that no one gets younger and no one keeps a parent or lives forever.
Recognize Your Strengths and Limitations
One of the greatest traps in the care of an elderly parent is a failure to recognize your own strengths and limitations. Understanding what you can and cannot do depends not only on the level of care of the parent, the support of siblings, financial resources, etc. but on your own personality, needs and situation.
If you can move beyond the guilt of not doing it exactly as your parent insists or not doing it “the right way”(whatever that is) you will be more open to creative solutions that may pull from family, friends, church, community and medical resources. Ultimately, you will be better able to sustain connection, be less resentful and be more caring.
- The fact that you are doing the finances while your brother does the visits does not mean you are not caring for a parent. It may mean you are covering care in the most efficient way.
- The fact that you have hired home health aides to help care for your parent does not mean you are not caring for a parent. It may mean that someone with more patience is spending time or that someone who has never heard the stories is eager to listen.
- The fact that you insure proper care and demonstrate a wish to stay connected in some way that your parent sees, knows or even only feels (holding hands with a parent with Alzheimer’s Disease), you establish constancy – you are there.
Recognize Your Parent’s Strengths and Limitations
Recognizing and understanding an elderly parent’s limitations while at the same time remaining open-minded about their strengths is key to enhancing caregiving.
- There is for many aging parents evidence of memory problems, particularly short term or working memory, which is more vulnerable to aging than long-term memories.
- Often as a caregiver you can be worn down by the fact that your parent has asked you ten times who just called but can give a detailed description of their childhood home.
- Sometimes it seems as if there has been a change in mood and memory function in a day – a reality perhaps explained by a recent study that suggests that “ silent strokes” may explain the memory loss in up to 25 percent of older adults who experience memory problems.
- Essentially, the decline that we see or the strengths that we glimpse in an aging parent unfold day to day. It is our understanding of this and reaction that makes a difference.
A dear friend confided that he had come to realize that his frustration with his mother’s memory lapses had to do with his upset about losing her as she once was. His frustration, he realized, was becoming more of a problem for her than her memory.
A women who was worried about placing her Dad in a rehab facility, as he seemed unable to communicate much with her or remember much, was shocked to find him singing all the words to Sinatra songs with the other residents. She hadn’t accounted for the stimulation of the other residents or the power of music to arouse dormant memories.
A man reported arguing with but waiting too long to take the car keys from his Mom who insisted she could still drive. Thankfully, no one was hurt, but when she left the car running at the bank drive-up window and walked away – the limitation was loud and clear.
Aware of her short-term memory problem, my mother’s denial is something I have come to appreciate. I recently asked her who the president was. Her response, “Who cares?”
Levels of Happiness
In our attempt to understand what our elderly parents need – we often overstep and project our needs. A new Pew Research survey reveals that our projected expectations are not accurate for our parents. Research suggests that until you reach their age you really can’t know how it feels.
I have heard many say “I don’t want to live that long – how can they be happy?” The reality is that most are.
- Research revealing the U-bend of happiness tells us that past middle age there seems to be growing happiness into the later years that occurs regardless of money, employment status or children.
- Maurice Sendak, renowned children’s author shares in an interview at age 83 that he has lost many beloved friends and can no longer walk, “But, you know, there’s something I’m finding out as I’m aging that I am in love with the world. And I look right now, as we speak together, out my window in my studio and I see my trees and my beautiful, beautiful maples that are hundreds of years old, they’re beautiful.”
- “Don’t Mess with The Bingo” – It is a surprise to many of us to watch elderly parents, whose prior life work has ranged from homemaker to court judge, play bingo with such enjoyment and interest. Why are we surprised?
- Consider what happens when you invite a group of people to compete in a task they can master with the possibility of a financial reward? Isn’t that a version of what most of us are doing?
One of the most important aspects of caregiver self-care is a balance of work, family, play and caregiving.
- While there is concern for many Baby Boomers who are sandwiched between care of children and care of parents, it is important to consider that the real issue may be balance and time and not multiple roles.
- A recent study on woman caregivers of elderly parents, found that while the overload was greatest with women caregivers who had careers and partners, this group had the lest resentment about caregiving and the greatest reported life satisfaction.
- This suggests that multiple roles, much like diversity of caseload with professionals, may actually serve as a protective factor to burnout.
- What becomes important is for the caregiver to recognize what he/she needs in the different domains of their life and to feel entitled to create that balance.
- It makes sense in reducing the sense of competitive needs to invite family members and partners to join in on some of the caregiving – Children and grandparents are a wonderful and mutual resource and connection for each other when time together is special and planned.
- Caregivers benefit from talking to their partner about their caregiving role, including them and asking for help and ideas. Given that most adult caregiver children have a history with their elderly parent that may make them reactive to a comment, expression or parent personality trait – it is often the daughter-in-law or son-in–law who can handle a situation or make a suggestion with a better outcome!
- Caring for an elderly parent is something most partners understand and support – particularly when love and mutual concern for the marriage remains apparent and time to just be together remains important.
- Central to any balancing act is the caregiver’s need to feel entitled to play i.e. to pursue his/her stress reducing activities – be it gardening, exercise, music, a poker game or choir practice on a regular basis.
Both caregivers and aging parents need connections. Research informs us that networks of support are crucial in reducing caregiver stress and burnout as well as providing social outlets to reduce loneliness and hopelessness in aging parents.
- Siblings are often a primary source of support for care of aging parents. Some siblings do this seamlessly in a way that buffers stress, validates reality, provides levity and meets different needs of the parent.
- Some families are drawn together for the first time by the critical needs of an aging parent such that the common purpose offsets old hostilities and offers a new appreciation of the distinct contribution each can make.
- “ Not the Brady Bunch” – For many caregivers, the source of support is not a sibling or family member because the family is not one that can step up together. People are different and their histories bear on their capabilities as well as their sense of responsibility.
- Some caregivers are not only the only one to step up in a family but they face the added stress of hearing the parent’s concern for others who are simply not doing their share. This is a very difficult situation best buffered by partners, supportive friends, groups dealing with caregiving and outside resources.
In this culture, the needs of an aging population are mounting and adult children are playing a major role in their care. More than a task, caregiving for an aging parent is a psychological journey that involves challenges and complex feelings on personal and interpersonal levels. How you define this journey very much bears on how you will cope and what feelings you will carry.
- For some, it will be the opportunity to give back to someone who has shown great love and care to them.
- For others, it will offer the promise of parent-child closeness unknown before, one that can lighten old pain and add new memories.
- For a few, it will reflect giving that continues to be without appreciation but validates the essential goodness and hope of a child’ love.
- For a significant group, it will be a journey of care and heartache with a parent who no longer remembers but is nonetheless remembered and loved.
- For all it will be a journey of pain and privilege.
Phillips, S. (2012). Care of an Aging Parent: Enhancing the Psychological Journey. Psych Central. Retrieved on August 3, 2015, from http://blogs.psychcentral.com/healing-together/2012/01/care-of-an-aging-parent-enhancing-the-psychological-journey/