Your Parent Isn’t Your Toddler

One of the most difficult issues I faced while caring for my parents was becoming aware of how much I did not know about how to care for them, and how much my relationship with them changed. It is very disorienting to realize you have become the parent to YOUR parent. We had traveled to new dimensions, and I wasn’t prepared!

I think I had an idea that my parents would never really change and that they would always be the lively, fun, witty parents from my childhood. My father had a stroke around age 60 before I was married and had children. He lost his sharp wit and some of his confidence after that. He also lost his job earlier than expected. This diminished him in ways many older people face – typically men from this “Silent Generation.”  But he persevered and moved with my Mom from Ohio to California to live in an active senior area to golf and travel and have fun. They did have fun, too. Very active. Very happy. And then they aged – slowly at first and then quickly at the end. To see them change so much – to have lost so much of what I was used to, and what I know they were used to – was heartbreaking. And recognizing changes in our relationship was difficult, also. I didn’t want to “parent” my own parents.

The challenge for me became taking on the role of helping them, maintaining healthy boundaries, and finding a way to treat them with the regard and respect they deserved from me. In other words, I had to learn how to care for them without treating them like toddlers.

What is the difference between parenting children and supporting parents?

Are we “parenting” our parents, or is it another dimension in the relationship?  There isn’t a great deal of literature along this line. Most articles identify this conundrum as particularly difficult, but it hasn’t really been identified as a space on the continuum of human development.

I recall a family friend whose father was in late stages of Alzheimer’s disease told me she was frustrated when people tried to console her by suggesting, “He’s not your father anymore.”  While the comment was likely offered with best intentions, she bristled. “He is still my father!”

While we hear about that spry 95-year-old who is as alert now as when he or she was 30, in general, all humans will experience some level of diminished capacity in terms of mobility, control of bodily functions, mental alertness, and judgment. It really does appear that as we age, we go from dependent to independent to dependent again. We start life wearing diapers and we seem to end life wearing them too. For those of us caring for aging parents, from an emotional standpoint, it’s just damn difficult to buy adult diapers alongside your toddler’s pull-ups.

Feelings of anger, disgust, sadness, despair, confusion, and even humor can enter the picture for the caregiver. This is normal. We are human and our reactions – whatever they may be – are normal. It is irrational to expect that we can witness this tremendous shift in our parents’ abilities and not experience strong emotions. This is a time when we need to be gentle with ourselves. We are socially conditioned to recognize the changes in our children. There are countless parenting books, endless tomes on child development to alert us to our children’s changing needs in body, mind, and spirit. There are books on the aging process, but we don’t tend to devour those with quite the same speed. Perhaps it is too hard emotionally to explore – so again – we must be gentle with ourselves.

Perhaps we need to check our mindset. When we can rationally acknowledge that this is in fact, normal and expected, and something we, too will likely experience, we can start to shift from a position of feeling overwhelmed, sad, disgusted or angry to acceptance

I recall the first time I had to buy diapers for my dad. I had such mixed feelings. I experienced shame at the register, hoping the checker didn’t think they were for me. I think I probably made a comment about getting these for my dad – ha, ha! It’s quite likely the checker at Costco didn’t look closely at any item in my stash. But I felt so strange buying them. Then I thought about my dad. How hard must it have been for him to ask me to pick them up for him?  I recall a time my mother had me pick up some Poise panty protectors for her. She was so sheepish in asking for them. She made a pretty big deal about indicating they were “not diapers, but panty protectors”.  When I stopped to think about how that must be for her, I found my compassion.

So what do we call this time period and how do we monitor our actions?  It’s caregiving, but it’s not parenting.  I think it is important to think through how we treat our parents during this time, too.  Talking to them like we talk to our children is not great role modeling for our kids, either.  But often thinking and judgment is impaired, especially for parents with any form of dementia.  There is a way to be direct, concrete and get the message across without sounding like we are talking to a toddler. It will take some practice, this directness.  But it is well worth it.

Mostly it’s important to remember that our parents likely don’t want it to be this way either. 

Go gently with yourself, and go gently with your parent!

Signs Your Parent Needs More Help

There are some great articles on the web that can give you information about what signs to look for to tell you if your parent needs more help.  Next Avenue and A Place for Mom are two that have good information.  Common items are:

  • Difficulty with Activities of Daily Living (often referred to as ADLs)
    • Cooking
    • Bathing
    • Home maintenance and cleaning
    • Running errands
  • Frequent Falls
  • Driving difficulty
    • Look for dings on the car
    • Traffic violations
    • Limiting driving – if this is unusual
  • Social Isolation
  • Forgetfulness
    • Missed appointments
    • Getting lost
    • Trouble recalling routines
  • Not taking medications properly
  • Emergency room visits or increase in frequency
  • Money management issues – if this is out of the ordinary
    • Missed bills
    • Missing money

The Changes are the Key!

We can all be forgetful, or go through periods of withdrawal, or fall or any of the above things.  But it is the change in behavior, change in patterns that is the key. And as we age, it is normal and natural that some things take more time or effort.  My grandfather who lived to be 99 once told me, “My decades are starting to blend together.” 

I get that!  I’m only in my fifties, and when someone says the 1980’s are old or retro, I think, “that was last week!”

So pay attention and start noticing.  Look for patterns, and look for changes in patterns or behavior.  Be aware that new patterns or behaviors are not in and of themselves harmful or suspicious, however.  Change is also a good thing.  Learning new things is great for our brains, after all.  But consider if the change is enhancing everyday life, or limiting it.  Is the change to avoid a necessary or vital activity, such as socializing, or is it detracting from it.

You May Not Be the First to Notice

Also – you may not be the best person to notice.  Sorry to tell you this, but you may be biased and make excuses for your parent.  You aren’t biased because you are stupid or unable to make good judgments.  You may be a bit biased due to confirmation bias.

What’s confirmation bias?  That’s when we are directly influenced by the desire of our beliefs.  We want something to be true, or we don’t want it to be true.  So when we have a lot at stake emotionally – like with our kids or with our parents or other loved ones – we don’t always see what others see.  We see what our desires want us to see, and we don’t see what doesn’t match our desires.  We may actually be in denial because we don’t want to see it.

Again – not because we are stupid.  It’s because we are human.

So what can we do?

Seek Feedback.

I suggest talking to others.  Talk to siblings, if this is productive.  But also talk to others who are not as emotionally attached.  Talk to neighbors.  Not gossiping, but check in with them.  Get to know friends of your parents, and maybe ask if they notice anything out of the ordinary.  Let them know you are willing to hear from them.  People want to help others.  More than we think, really.  But a lot of people stand on ceremony, and consider talking to an adult child of a neighbor as being unfaithful to their friend. They might feel it is “not their place.” Let them know you care about your parent, and that they can call you if they are aware of emergencies and other concerns.

Do your parents have regular cleaners or hired help?  If it is a service and different people come each time, then these are the people to ask.  But if your parent has a weekly or monthly cleaner, this person will likely notice changes in needs.

My parents’ neighbors and friends were so helpful to me in this way.  I definitely did not want to see how impaired my parents were becoming.  When a neighbor called to tell me that the garbage cans were forgotten now and then, I listened.  When I took my Mom to her friend’s 75th birthday, she pulled me aside at one point and shared concerns about my mother’s memory and how she had stopped coming to their book club.  My aunt called to tell me she was concerned about my mother’s memory.  All of these people helped me to see what I didn’t want to see, even though I visited my parents a couple of times a week.

It is also helpful to get a professional evaluation from a geriatric case management team.  If your parent has a long-term health insurance plan this may be paid for under the plan.  Check with your parent’s doctor – a physician may be able to give you some information about services within the medical plan, or direct you to who might know more.  You can also hire a Geriatric Case Manager.  There are more and more people heading to this profession.  Also search for Healthcare Advocate – these professionals can also lend support and guidance.

When To Start?

            Probably now.  Sorry!  But if you are going to take on supporting your parent or parents in some capacity, it is never too late to start taking notice of patterns of behavior.  If you get a sense of what is happening when things seem normal and healthy, then it is likely you will notice changes later.  In Case Management, we call this getting a baseline.  You don’t have to take data like a researcher.  But start to notice daily routines.  What are your parents hobbies, social habits, basic home care routines? 

            Take some time to reach out to neighbors, if possible.  Do you know your parents’ friends?  If you are comfortable – trade phone numbers.  Like I said – most people want to help, but they often don’t know how to help or who to contact.

            Our goal in all of this is to be able to best support our parents.  Their habits will naturally change over time.  Most of those changes will makes sense in some way.  But if something seems, well, weird, then it probably is.  But check it out with someone else.  Look for changes in routines and patterns.  It may be strange, but when we are closest to someone, we don’t always notice what’s under our noses.

            Do you recall that old adage about raising children, “It takes a village?” I think it takes a village to care for each other, as well.  Start building your village!

Was this helpful? Are you noticing changes in your parents’ needs and routines? What is working for you?

Terrible Choices

Mom wakes, again, after nearly 30 minutes of sleep. She is groggy. She scowls, and looks at me, almost with a look of annoyance. “Where am I?’ she asks.

“Mom, you’re in the hospital,” I tell her with as much gentleness as I can manage after answering the question multiple times.

“What?! Why am I in the hospital?”

I tell her she has been having trouble breathing and that is why she has the oxygen tube in her nose. She is cranky. She jerks her head from side to side and scratches her head. “Where’s Charlie?”

There it is. Where is Charlie. The love of her life.  My Dad.  My Dad who died not 3 weeks ago.  She doesn’t remember.  I’ve had to tell her now too many times.  How do I keep breaking her heart? Am I doing the right thing in telling her?  I’ve been asking myself that one too many times, as well.

“Mom…” She can tell by my voice, I think because she looks at me with sad eyes. “He’s dead?” She asks in a whisper. “He’s dead,” she says again with knowing despair. She weeps silently; hangs her head.

We are in the hospital because she has pleural effusion. Fluid has built up in the space between the lung tissue and the chest cavity. It functions a lot like pneumonia, which we all thought she had developed somehow because that would have been easier. That could have been solved, cured. She is easily out of breath. She can’t do those things she loves the most like taking a nice walk, going to church with my family.

Continue reading “Terrible Choices”