CARING FOR AN ELDERLY PARENT AT HOME

Mary’s 79-year-old father has been showing signs of memory loss and confusion.  Concerned about what she believes are early symptoms of Alzheimer’s, Mary asks husband Joe, “What shall we do about Dad? He can’t live alone anymore.”  Without hesitation, Joe replies: “Dad can come live with us.” 

The next day, when Mary invites her father to live with them, tears well in his eyes - “Thanks, Mary, I’d like that.”  Many elderly parents who, like Mary’s father, have health problems and need help with daily activities, move in with their children to be cared for in a nurturing family environment. 

For the millions of people who assume the role of looking after an elderly parent, in-law, or other senior relative at home, this can pose tremendous challenges.  Research indicates that these caregivers are prone to stress.  Amy, who cares for her mother, recalls, “I wasn’t emotionally or financially prepared to ‘parent’ my Mom.”  Another caregiver explains, “I felt overwhelmed by the lifestyle adjustments, role changes, and responsibilities that long-term elder care requires."

Taking a parent into one’s home impacts the whole family.  If you’re about to embrace this task and are raising a family, it’s important to prepare your children to deal with this life change and have an age-appropriate talk with them about the health problems that caused their grandparent to come live with you.

Caring for an aging parent can be stressful.  But once caregivers learn some basic skills, this undertaking can be so rewarding.  Although each elder care situation is unique, whatever the circumstances, the following tips can help caregivers manage responsibilities with confidence and guide their children to adapt to the changing relationship with their grandparent. 

1.  Reach Out.  After you realize that your parent can no longer cope independently, and you decide to invite him or her to live with you, consider seeking help to prepare for the responsibilities associated with caregiving.  You may find that you need information on how to proceed with your parent’s care, and also a shoulder to cry on as you come to terms with your loved one’s condition.  There are many resources available - the challenge is finding the ones that are right for you.     

            a.  Gather Information.  Some people start by asking their parent’s physician for names of professionals to contact about elder care.  There are also agencies which provide resources for caregivers.  Mary called the National Eldercare Locator, a service of the Administration on Aging, at 800-677-1116.  By reaching out, Mary received support and gathered information on what do to and what to expect in the months ahead.

            b.  Acknowledge Your Feelings.  Don’t be surprised if you experience a range of emotions as you step in to help a parent who is showing signs of impairment. 

It’s important to express your feelings.  Otherwise they tend to bottle up inside, only to later resurface, sometimes in seemingly unrelated ways.  Suppressed grief, for example, may re-emerge as anger.  That’s what Mary experienced when she choked back her grief about her father’s weakening health.  As she put it, “I’m not one to cry.”  Although this meant that Mary escaped her emotional pain, the reprieve was temporary.  Mary soon found herself being impatient with her father and quick to snap at him.  The grief she had suppressed now resurfaced as anger.   

            c.  Seek Counseling.  Feeling bad about being short-tempered, Mary sought counseling.  There she learned to manage her anger.  Counseling also helped her grieve the loss of the relationship she used to have with her father, and resolve the betrayal she’d been feeling - “I resented Dad for no longer being that person I could count on and I felt abandoned by him.” 

Had Mary not reached out for help, her pent-up feelings could have interfered with her goal of being a compassionate caregiver. 

2.  Be Realistic, Supportive, and Patient.  Consider adopting the following approaches to bypass the frustrations that caregivers often experience:

            a.  Set Realistic Expectations.  Many elderly parents have limitations due to health conditions such as arthritis or dementia. So don’t place unreasonable expectations on your parent; otherwise you’ll be frustrated by the mismatch between what you expect and how your parent behaves.  When Gary’s 80-year-old mother didn’t use her cane despite having been told to do so, Gary shouted “Mom, you know better than to get up from your chair without your cane!  Why are you being so difficult?”

When parents don’t behave as expected, this can frustrate caregivers and cause them to lose their tempers and even become abusive.  Hoping to get a handle on his outbursts, Gary joined a caregiver support group.  There he met others who had overcome similar feelings of frustration.  These caregivers offered suggestions on how Gary could manage his aggravation.  He was then able to more understanding of his mother’s limitations. 

            b.  Be Supportive.  When parents don’t follow instructions, some caregivers interpret this as intentional, and they become critical.  “I told you to keep the heating pad on low!” yells Dee at her 78-year-old father.  “You turned it up on purpose, can’t you get anything right!”  Such disapproval can cause parents to become apathetic and unmotivated.  “No matter how hard I try, I can’t please,” thinks Dee’s father, pushing the heating pad off the bed and letting it fall to the floor.

Care should be unconditional.  “I’ve learned not to judge Mom, and instead to accept her limitations,” explains Julie.  This approach enables Julie to be encouraging to her mother, 70, who recently had a stroke.  “Good job, soon you’ll be sitting up by yourself,” she says, while providing passive exercise.  “I like helping Mom exercise, but it takes patience.  Sometimes there’s no progress for weeks, then suddenly a breakthrough.  Free of expectations, Julie savors these positive moments.

            c.  Be Patient.  Doctors invariably give the elderly many instructions, from medication to exercise regimes.  Implement these directives with patience and kindness.  Keep in mind that to gain compliance, you may need to repeat the instructions frequently. 

At times, caregivers need to be firm in order to get a parent’s cooperation.  When Julie’s mom resisted exercising, Julie responded emphatically, “Mom, you must exercise to keep your muscles strong.”  Some caregivers get so frustrated with this type of resistance that they resort to angry threats.  This is inappropriate.  Instead, these caregivers should consult their parent’s physician right away about how to deal with the non-compliance. 

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© 2009 Suzanne J.  Gelb, Ph.D., J.D.