A Friend Stopped By | 08/02/2009 11:00 pm

We Are Not the Boss of Them, by Paula Span

The veteran journalist and author of When the Time Comes tackles the realities of caring for an aging parent.

By Paula Span

Editor’s note: Paula Span is the author of When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions, just published by Grand Central Publishing. Click here to read an excerpt. For more on Paula, visit paulaspan.com.

Your parents become your kids – or do they?

I can see why people turn to this analogy when their aging parents grow frail or sick. The balance has shifted, often irrevocably. The grown-ups, the people who always seemed so strong, become less capable, more dependent. More and more, we who relied on them for guidance and support (or who fought regular battles for our independence) are the ones they rely on.

Unlike with kids, we have only a limited ability to get our parents to shift course.

So you hear this refrain all the time: It’s like they’re the children now, and I’m the parent.

It’s shorthand for certain realities of eldercare, which remains largely a family responsibility. It means: I have re-shouldered the duties I thought I was done with. I have to be sure she takes her medicine. I have to drive him everywhere. I’m taking on more of the financial burden. And in some cases, the ultimate sense of déjà vu: I’m buying diapers again.

More than these specific tasks, I think the parents-as-children theme refers to a state of mind. When you’re a caregiver, your time is not your own. You can spend many hours at this work, and even when you’re not on the scene you’re expecting the phone to ring with a question, a problem, a need. Shirley Grill, the daughter in the excerpt posted here on wOw from my book When the Time Comes, keeps her cell phone and her BlackBerry clipped to her waistband; even when she’s in Europe on business, she gets calls about her mother in the Bronx. As when your children were young, you feel always on duty.

For all that, however, it’s a faulty analogy, one parents understandably find insulting. Their bodies may be failing, or their minds, or both — but they are still adults with a lifetime’s experience and an undiminished need to feel autonomous. They require help, but they aren’t children.

It’s also a less-than-helpful approach. Unless a parent has such serious dementia that she cannot make her preferences known and or reach even basic decisions, parents may well insist on their own choices, in everything from what they eat (even if it contains too much salt) to where they live (even, as in Shirley Grill’s case, if you cringe every time they climb the stairs). I think my dad, doing pretty well on his own at 86, ought to ask his cleaning person to come more often. He shrugs, and does what he wants.

Unlike with kids, we have only a limited ability to get our parents to shift course.

This doesn’t mean we are without influence. We also have needs and preferences, and trying to care for parents without rendering ourselves exhausted and useless can require extended negotiations. Sometimes, a professional with initials after his or her name — a family doctor or attorney, a social worker, a geriatric care manager — can be more persuasive than we can. Sometimes we can provide options or find compromises. Sometimes a crisis hits and events decide for us.

In extreme situations, there are legal remedies, but short of that, it’s hard to ground our elders or revoke their allowances. Sometimes – and this is like child rearing – we have to make peace with our limitations.

We Are Not the Boss of Them.

53 Reader Comments (so far…) Sign In or Register to comment

Dear E.C. thank you so much for responding to my comment. I can feel your comfort.

I’m glad you filled in a little more on your MIL as I have dealt with mine and her health conditions - cholesterol & blood pressure. At this stage in her life - 83 years- we have talked about quality of life vs. a year or two of longer life with nasty side effects. It’s a challenge to have the discussion, but well worth it. I also attend many doctor appointments with her and we have the same excellent physician - a very important relationship to develop.

If I may offer an idea for you to try - have this discussion with her and then the other siblings. Ask her why she has chosen to ignore dietary advice and why she won’t wear her shoes and talk about the repurcussions if she doesn’t. She should talk to her children directly and with you there, so they know she is making decisions on her own behalf.

As to the siblings, I have received nothing but supportive praise from them - they don’t want to have their mother living with them. She visits her son and his family in Vancouver once in a while (now) and I make sure her son nearby spends time with her. I keep them informed of any changes to her medically and make sure she talks to them as well.

After you have had a talk with your MIL and your husband, talk with each of her children as well about the choices she makes and has a right to make for herself. "we are not their parents"

Xena

By xena princess warrior on 08/04/2009 11:36 am

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Thanks Xena for the advise. We have already began to do some of the intervention type process. Some of the siblings are being stubborn (like their mother) but we have already made a little progress. I’m praying that things will come together and life will began to get a little better in he near future instead of worse. It has been really nice talking to someone else what knows how I feel, and I thank you for that.

By Eldebbo C on 08/06/2009 7:06 pm

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My sister and I take care of Mom, who is 92, suffers from senile dementia (not Alz, though they try to tack that label on without testing sometimes). We have managed her affairs, found her places to live and be cared for, taken her out several times a week, managed everything from bills to clothes to hairdresser to crisis intervention and ER-accompanying for 20 years. That is when she began to outlive her reasoning abilities. She is spry and zippier than we are most of the time. We just do what we do. Sometimes I get depressed—I left my life in DC behind…Phoenix is not "me." But life just happens…you gut out the parts that don’t suit ya. I am thankful Dad left her funds—although B of A seems determined to lose them.

By Star Lawrence on 08/04/2009 2:42 pm

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Chris, the positive experiences that you write about with regard to your father-in-law and the VA and the Veterans Home are a good example of government healthcare. My heart goes out to all of you. You and your family seem to show exemplary courage, patience and respect in dealing with an extremely difficult, heart-wrenching situation, and I commend you for it. I say this because my husband has Multiple Sclerosis, and I can understand some of what you are dealing with. Hold your head high, for it sounds as if you are doing the best for all with not only your head but your heart.

By judith riggs on 08/06/2009 2:51 am

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It sounds as though there are quite a few women living up to a responsibility they didn’t ask for and but have taken on beautifully even though the going gets tough. There are no right or wrong answers. Caring for another human being,no matter how much you love them can be emotionally and physically exhausting, that fatigue is only heightened if they are moving into dementia. More and more families are having to face these situations as long term care facility costs become more and more unaffordable and our family members live longer. So bravo to the families who have taken on the challenge and here’s prayers that you are able to take it a day at a time and can get through each day. We are all going to get old…and we may be needing the same care we are giving today from our loved ones in the furture!

By Victoria J on 08/06/2009 6:36 pm

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I watched my mother take care of her mother until she could no longer live at home, at which time my parents still visited with her and cared for her every single day until the end. Never once did they consider my grandmother to be a child - even when Alzheimer’s took her personality from us, she was always treated with respect and dignity.

Many people fail to afford the elderly the respect they deserve. I have two stories that seem to apply here. First, I have volunteered at nursing homes and have seen wonderful caring people attend to the aging… I’ve also seen busy employees who were neglectful or dismissive of residents. I remember one woman - Bessie - 101 years old. I tried to chat with her a time or two, but she’d usually just glance at me and then stare over my shoulder. A nurse’s aid came up to me and said, "Don’t waste your time - Bessie can’t hear you. She doesn’t hear or talk so don’t waste your time." Being compassionate to any person could never be "waste of time", but regardless, I somehow thought Bessie was hearing more than she let on - something in her eyes. One day in the dining room, about a week later, after that same nurse’s aid had given everyone their food, Bessie’s drink went flying. I didn’t see what happened, but it had gone all over the floor, even getting the nurse’s shoes wet. The aide cleaned it up, complaining loudly the entire time and then left the room. I was behind Bessie, but I watched Bessie’s head turn toward the door and then distinctly heard the word, "bitch". I simply smiled…

I’ve always loved speaking with those older than me - the knowledge, the experience, the stories… A few years ago at work I met a wonderful couple. He was unsteady on his feet and looked like he could fall down at any moment, but he was funny and a strong businessman. She’d always sit quietly while her husband talked business, always wearing pastel, floral and lace dresses she’d sewn herself. One day when the husband was talking to someone else at my office, I stayed behind to chat with this lovely woman. My preconceived notion was that this woman, at nearly 90 years old, was a kind, gentle woman who sewed her own clothes, canned her own food, raised lots of kids, went to church every Sunday, and rarely offered her own opinion. A few minutes in conversation and I received my lesson in judging a book by its cover. I found out she was a world traveler who lived a life I could only imagine and to top it off, she was sure that she and her husband had been reincarnated many times - as she put it, she’d been "chasing him through the ages"!

By KatyDid Wells on 08/06/2009 7:19 pm

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My mom died in 2003 of COPD. It took a long time and my sister lived with her in a duplex. My sister wouldn’t have had a home had my mom not taken her and her youngest child in after her divorce, but that never stopped my sister from calling me and moaning, "When will this be over?" I teach and went to my mom every day after school and stayed with her until 11, when I went home to my family. My sons tried to visit after school when they could and my husband when he could. I brought my mom dinner because she was never a big eater and when she wanted to eat, it was a real occasion. I was thrilled when she would actually eat. She was wonderful. Hated to make work for anyone. I am only sorry that she could not have stayed with me. My sister is a screamer, and my mom did not have to hear that at the end of her life. When she was gone, my sister lost the will, kept the house, and told me to get lost. I was glad to go. I have what really matters, the hours I spent with my mom, the photos she told me to take with me, the love she gave me. My sister never knew that at the end, my mom would ask me, "Why is she such a bitch?"

By emmy wunn on 08/08/2009 9:05 pm

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A recent post on the National Center for Policy Analysis’s (NCPA) web site by Dr. Scott Atlas of the Hoover Institute and Stanford University expounded on 10 "surprising facts" about our health care system. After an opening statement that U. S. health care has been denigrated compared to other developed countries around the world, Atlas proceeds to present ten under-recognized "facts" that we should consider before turning to a larger role of government in health care.

http://www.guaranteedhealthcare.org/blog/john-geyman-md-pnhp/2009/08/06/…

The National Center for Policy Analysis (NCPA) is an American non-profit conservative think tank partially financed by the insurance industry.

http://en.wikipedia.org/wiki/National_Center_for_Policy_Analysis

http://johnharding.com/2009/08/15/corporate-america-incites-town-hall-me…

By judith riggs on 09/07/2009 10:49 pm