GRAND FORKS, N.D. – Helping your parents deal with the challenges of aging can be stressful and requires an understanding of personal values and needs.
And there’s no one way to do it.
“There are all kinds of stress that people go through,” said David Bialik, licensed independent clinical social worker with the Center for Psychiatric Care in Grand Forks, N.D. “Everyone is different.”
People may need to consider hiring aides to help with tasks in the home or moving their parents to an assisted-living facility or a nursing home.
Determining the best course of action “depends on what the parents would want,” he said. A parent might want to stay out of a higher-care environment.
“When do you say, ‘Mom and Dad, you need to go’ ” somewhere that is a better fit for your needs?
Bialik moved his parents from Florida into his Grand Forks home. The experience of looking after them and addressing their needs has provided insight that he draws from when counseling others who are dealing with similar concerns, he said.
In therapy sessions, he has seen baby boomers who – at the point when they thought they’d have more time and freedom to do what they want – are finding that their parents need more help.
“It builds up,” he said. “You notice they don’t drive so well anymore. They’re kind of confused, but still doing pretty well. It takes a while.”
Other people he counsels are still busy with their own children at home, trying to be present for them and their activities, while also handling their parents’ increasing needs.
“Suddenly, you’re left with the pressures of your job and other obligations and interests,” he said. “There’s a ton of stress that goes along with it.”
“People think, ‘(My parents) need help. What do I do? They raised me. I’m supposed to do this for them. I should be doing these things selflessly.’ ”
If outside help is needed, elderly parents may ask, “Why do I have to have a stranger come into my house?” when they may prefer a family member.
Taking on the task of helping aging parents adjust to changing needs opens a Pandora’s box of emotions, Bialik said.
It’s normal to feel “all kinds of emotions” as parents lose capabilities, he said.
“For any feeling you have, there’s usually an opposite feeling,” he added.
Anger may be fueled by feelings of being cheated; you’ve lost what you once had.
“The frustration is with your own losses,” he said. “Independence is lost, the parent is changing. (Their aging) makes you more aware of your own aging.”
If your parent has become very ill, he or she “may not be the same person,” he said. “There’s a personality change. We get shocked. You don’t recognize them and they don’t recognize you.
“Try to not get angry at them for getting old. It’s our own disappointment about aging that can be hard. The question is how to turn it into something meaningful.”
Signs of mental and physical decline can spark a deeper realization in children of aging parents.
“There’s the existential loss,” he said. “You’re watching as they lose abilities. We’re losing the parent we knew.”
It’s the finiteness of life “that gives us perspective,” he said. “It’s not easy (but) it’s real, it’s complicated. And we need to find ways to give ourselves time to think about what it means to our existence.”
Bialik encourages people to “recognize and have empathy” for elders who are themselves coping with changes.
“With older people who have a fair amount of their own mental facilities left, they’re trying to maintain a sense of dignity. They’re going through losses, too.
“It’s not that they’re stubborn. Certain parts of life are going away.”
Be supportive, he said. “Let them know you’re going to help them through it.”
Living in their current home may have become unsafe, he said. “They may be using a ladder when they shouldn’t.”
Avoiding these issues may lead to “decisions that are not in their best interests,” he said. “Like with a child, we say ‘no’ because it’s better (for them).
“They may get angry at you, but we can’t facilitate what’s no longer safe.”
Deciding when change is needed “is never a simple question,” he said. “There’s a fine line.”
Bialik recommends that people first take time to think about their concerns, he said. Then gather input.
He encourages people to “recognize and have empathy” for elders who are themselves coping with changes.
“It’s not that they’re stubborn. Certain parts of life are going away.”
Be supportive, he said. “Let them know you’re going to help them through it.
“Get your siblings involved and ask, ‘What are we all going to contribute to this – physically, financially or intellectually? What are your ideas?’ ”
Sometimes siblings of the aging parent or other family members can get involved, he said. “People who have been part of the family – but not blood relatives – such as other community members or clergy,” may be helpful.
“Don’t do this alone,” he advised. “Find out what other people are doing.”
Once you’ve gathered resources, get the support of others, as well as the support of your parents, he said. “Sometimes, parents don’t offer it; sometimes they do.”
Decision making can be complicated.
“Very often, we can’t make a unilateral decision,” he said, “especially if the parent still has the right to make their own decisions.”
Siblings, including those who live at a distance, don’t always agree on what steps, if any, should be taken. In such cases, those who disagree could be invited to come for a visit to assess matters firsthand, he said.
“Give the responsibility to the person who seems to want it. Most of the time, people will support” the sibling who’s most involved, he said. “Don’t be afraid to ask for help.”
In matters involving legal documents, advance health care directives, power of attorney and financial questions, people should turn to professionals in the field, Bialik said.
“I don’t give legal or medical advice, but I’ll discuss anything because people need to process.”
He’ll usually ask, “What do you think about this?” he said. “Maybe you should talk to a lawyer or a nurse who knows about advance directives?”
These professionals can explain, for example, the results of medical actions meant to extend life.
Other people “shouldn’t take on my values,” he said, “but (focus on) their values and their parents’ values.”
Weighing the benefits of various options for the care of aging parents is no easy task.
“There are so many challenges that people have to deal with – nursing homes, assisted living, what to do about health care directives,” he said.
“Get feedback, get support, and do what fits with your personal values. There’s no one way.”
People who are trying to meet all their parents’ needs end up spending less time with their kids, he said. Being pulled in different directions takes a toll on individuals and families.
“We get so busy taking care of other people we don’t think about taking care of ourselves. Kids, parents, the job – you come last. There’s a temporary wearing-out. It costs us our health.
“How do you be there for (parents) while still taking care of yourself?”
He emphasized the importance of self-care and achieving a balance in life to preserve and maintain your own health.
“Sometimes, you’ve got to go on vacation. You have to live, too.”
More people will face questions about caring for elderly loved ones as medical advances have extended, and will continue to extend, life spans.
“Now people can live longer,” he said. “What used to be a deadly disease is now a chronic disease. You can live a very long time with congestive heart failure (for example), and live quite well.”
In recent years, Bialik’s father died at age 88. Declining health required his mother, now in her 90s, to move into a nursing home.
“It’s harder to maintain a major discussion on current issues” with her, he said. “Mom used to like to discuss politics. Now I take out my iPad and we look at photos” of past events and family celebrations.
“Older people have better long-term memories. Seeing images from the past, they make connections. It grounds them.”
In the past, he would sometimes correct her when she talked of returning to his home to live until a colleague suggested a different approach.
Now Bialik tells her, “This is your home, Mom. You’re home now,” he said.
“It gives them a sense of calmness. They think, ‘Oh, I am home.’ It helps to reassert a sense of safety and calmness.”
She will hold his hand, he said. “My kids will hug her.
“Finding the right words is harder for older people, but touch is a kind of basic communication. No words are needed.”