As a child, I must have been about four or five, I had a question for my Mom. I remember her standing tall and I looked up and asked “Mom, when I grow up, do you grow down?”
I don’t remember her exact answer, but in a way, the answer is, “Yes, sweetie, sort of!”
A few years later my Grandma, my Mom’s mom, moved in with us after she suffered a stroke and I witnessed from a child’s perspective the good and the stress of a trend that’s on the rise in our culture today: dealing with aging parents. For me, this will hopefully be years away, but, the foundation of communication with my own parents is underway.
Whether you’re becoming a primary caregiver and moving your parents into your own home, moving them out of their home into an assisted care facility or nursing home or simply helping them deal with financial and logistics issues, there are many aspects that you will need to consider, especially if you have your own family.
Here are just a few tips, just the very top of the iceberg, to get you started.
EMPATHY for in-home health care for elderly parents. Get into their head and try to see things through their eyes.
1. Recognize that independence is a hard thing to give up and that your elderly parent may be reluctant to ask for help or make demands. Be empathetic, try to think about how uncomfortable it is to be sick away from “home.” That is what your elderly parent is going through.
2. Remember that they have given up their home, and are dealing with the idea that their life will never be the same. As we all age, we have an image of ourselves in our “heyday” and we have a difficult time letting that go. Physical changes: graying hair, aging faces, less mobility, slower metabolisms, a detachment from current popular culture are things we face even in our thirties and forties, when you’re even older and sick, it’s even worse because now it truly cannot be denied. Acceptance can be very difficult if not impossible for some people.
3. Also, they may have a hard time relinquishing their “role” as your parent, even though they are in your home. Be strong, but understanding if they get overbearing or judgemental: “Mom, that’s a great idea, it just won’t work here because…(and be specific, not just contradictory.) or “Mom, remember when I was that age? I did the same thing!”
There’s a huge difference between being:
--- a multigenerational family under one roof, permanently or long term, where each member has roles and responsibilities.
--- entertaining houseguests which is a temporary situation. Guests are not expected to “help” or at least, not much; and guests don’t generally make demands and readily accept the “house rules.”
--- being a caregiver. Also recognize there is a difference from being a houseguest to being cared for. Acceptance of this is an act of submission.
4. If your elderly parents are able, they should have responsibilities and chores, too. Let them help! If they are not mobile, and if they are coherent and can communicate, there are still ways for them to be involved.
5. Don’t ignore your spouse and kids, keep some time for them, too.
STRENGTH. This situation will be a test of fortitude, emotionally, physically and mentally. Do your best to prepare yourself and your family.
6. Take a break. Find time for yourself, no matter what. Don’t disconnect with your friends. Continue with exercise programs and hobbies for yourself, if even at a reduced level.
7. Ask for help. Ask your spouse, your siblings, or other dear family members or friends to “spell” you to give a break to you and your family for an evening or afternoon each week, or a weekend at least every 4 to 6 weeks. You don’t have to go away… maybe you just need that time for yardwork, errands or whatever. If you don’t have anyone to help, hire a qualified nurse or home health aide.
PLAN AHEAD. You’ll never be able to consider all issues, but there are many logistical arrangements that you can make long before it’s necessary. Communication is at the core of success in the planning department.
8. Talk with your parents BEFORE they need help. Open communication is vital. Chances are good they’ve already done some planning themselves but just haven’t figured out how to discuss it with you. Bring it up.
Conversation starters: ask! “So, Dad, have you and Mom thought about long term health care…” or … “what your thoughts are on burial vs. cremation…” or ... “do you have a will?”
9. Consider where your parents live… and the financial issues of you moving to them or vice versa.
10. Consider the legal and financial issues, too. Do you need to obtain a durable power of attorney? Health care proxy? A regular will with an assigned executor who knows they are the executor? Long term heath care insurance? Burial or cremation arrangements?
11. What are your siblings’ thoughts, abilities and expectations?
12. This will be emotional for you, too. Seek out support for yourself through friends, family, therapy or church and support groups.
BE REALISTIC. We all like to be the hero, we think we can do it all. We want to be everything to everyone… but it’s not possible unless we take care of ourselves first.
13. Make sure you stay on top of your own health with good nutrition, exercise, sleep and personal health care and hygiene. You can’t take care of anyone if you’re not in good shape yourself.
14. Get some training. Can you physically lift someone else in and out of bed? Or into a bathtub? Use a slider board? Basic first aid and CPR? There are resources for this!
15. Consider part time help, or adult day care. Or a nursing home, assisted living, etc. if it is truly something you cannot handle.
16. Include your kids in the care, maybe they can help wash Grandma’s hair with you or fetch supplies. Teenagers can take her for a wheelchair spin around the block or a short walk. Make storytime inclusive: maybe it’s in Grandma’s room, not Junior’s at bedtime.
17. Bring Grandpa out into the family, don’t keep him shut in his room, but make sure he gets a break from the hustle and bustle as well.
18. Be up front with your other responsibilities: if you have a full time job, let them know. This will be stressful… you may need to reduce some outside commitments.
HOME MODIFICATIONS for an elderly live-in. Many of these considerations can improve the value of your home, make it appealing for other buyers or yourself for future aging-in-place and living independence. Some of these suggestions don’t need to be permanent, just sturdy enough to function safely for many years.
19. Consider modifications to your bathroom: grab bars at the toilet and in the tub or shower (towel racks don’t count!), wide doorways, reduce level changes, a hand spray and seat in the shower or tub.
20. Do you need to build a ramp outside or in the garage? Consult with a contractor for the latest regulations and codes in your area.
21. Room assignments: Grandma’s room should be quiet, near the family but not in the middle of it. A main level guest room or den would be perfect if your home allows. Kids may need to double up: get their input. They may have some very creative ideas about what will be acceptable to them. Teenagers might enjoy converting the bonus room into two bedrooms with shared study space, small kids might be perfectly fine with an alcove off the hallway.
22. Do you need to add a room to your house? Consider a multi-use room that can be an office or den, or media room later on. Think about outdoor access if possible, this could be your opportunity to create a barrier-free entrance. If you need to build a bathroom, make sure it’s accessible to wheelchair users. Big roomy showers are nice for everyone!
23. Move furniture and a few accessories from their house into yours… but NOT all of it! Edit edit edit. Bring Grandpa’s favorite chair into the family room, or Grandma’s piano into the den if room allows and she plays it, maybe she can interest your kids into music.
Their dresser and a rocking chair can go into their room at your house to make it seem more familiar, but get rid of the clutter and junk.
Until next time!
Some resources for you:
The TV show “Parenthood” on NBC starts to address some of these issues of adult children accepting that their parents are no longer in the “parental” role any more: getting rid of the house the kids grew up in, having to claim their childhood “treasures,” things are no longer the way they “always were.” It’s traumatic.
Photo courtesy of The Sydney Morning Herald.