Aging can challenge both the elderly and their families

New York TimesSeptember 30, 2013 


Among the many challenges of aging is knowing when to seek help and how to accept it graciously.


  • Setting expectations

    It helps to try to put yourself in your aging parent’s position and think about what you might want and need under similar circumstances. Also helpful is to have a heart-to-heart talk with your parent about expectations, deciding which you are able to meet and which might require outside assistance.

    Experts warn against promising never to place a parent in a nursing home, which may be the only reasonable and affordable source of care for someone in an advanced state of decline. And it is unreasonable to expect those who were neglected or abused as children and were never close to their parents to suddenly act like loving, caring children when parents become old and infirm.

I hear this often and said it myself: “Growing old is not for sissies.”

Among the many challenges of aging is knowing when to seek help and how to accept it graciously.

Most often, the source of help is adult children who may not be in a position to satisfy all the physical and emotional needs of an aging parent (or parents).

Recognizing that the demands of modern life have eroded the time-honored commitments to care for aging parents, China recently put in effect a law called “Protection of the Rights and Interests of Elderly People.” It requires children to meet the emotional and physical needs of their parents, and to visit them often or face fines or possible jail time.

In some former Soviet-bloc countries, aging parents can sue children for failing to provide needed financial support. Interestingly, there are similar laws still on the books in many American states, mostly unenforced relics of a bygone era.

But with or without a law, moral obligations to assist one’s aging parents are commonly felt. They can leave adult children feeling overburdened and neglectful of their own families, personal needs and goals.

If the older parent is overly demanding, hypercritical or unappreciative, his child may become angry, resentful, depressed, even abusive to the parent. If the aging adult was neglectful, abusive, emotionally distant or self-absorbed as a parent, children are more likely to turn away when physical, financial or emotional support is needed.

Adult children without siblings to help share the burden of parental care can become especially resentful.

Intensifying the challenges is the fact that people are living ever longer, often for decades, with one or more chronic ailments, including dementia. And many older people exact promises from their children that they will be kept at home indefinitely and never placed in a nursing home, even when home care becomes physically or financially overwhelming.

But an entirely different scenario can emerge if all parties involved respect the needs of others and if parents show appreciation for help rather than acting as if it was their due.

My maternal grandmother was widowed when I was an infant and lived with my family until she died of cancer 13 years later. My parents both worked long hours, and having Grandma around to help, even in a limited way, and be there when my brother and I came home from school was a definite asset. But such living arrangements have increasingly become a thing of the past.

Maud Purcell, a psychotherapist and executive director of the Life Solution Center of Darien, Conn., offers a laundry list of emotions that adult children are likely to experience when parents age and their health declines. Among them:

• Fear, when you realize that the roles have reversed and that you may now have to care for your parents.

• Grief, as a once-robust parent’s ability to function independently declines abruptly or little by little.

• Anger, frustration and impatience, when a parent’s needs interfere with your life.

• Guilt, in response to the above feelings or because you are unable to spend enough time with your parent because of distance or other life demands.

Purcell suggests that you accept these feelings as normal and not fight them. Recognize that you cannot change what your parents are going through beyond providing help and support to the best of your ability.

She wrote: “Don’t take on more than you can handle. Consider your commitments to your work and to other family members. Overextending yourself will leave you stressed and will put a strain on your other relationships. Worst of all, you may end up taking your frustration out on your parent, causing you intense guilt.”

Ken Druck, a clinical psychologist based in San Diego and author of “The Real Rules of Life: Balancing Life’s Terms With Your Own,” urges adult children to act out of love, not guilt or resentment, and to “live and give within your limits.” To avoid burnout, make an honest assessment of what you can and cannot do, then “lovingly” communicate your limits to your parent.

“Clear expectations prevent unnecessary stress, misunderstanding, disappointment, hurt and fear of abandonment,” Druck said in an email.

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