Aging Parents: Conversations to Have

It's emotionally difficult to watch a parent who you always remember being capable and independent deal with declining health and advancing age. It's a contrast to parenting, where you help someone small and dependent become progressively more independent. In loving an aging parent, we witness a formerly independent person cope with losses of friends, their partner, their vitality and energy, perhaps the ability to continue living in their home alone and their challenge to gracefully accept it all.

In Erik Erikson's life tasks for different life stages, the final stage is called "Integrity vs. Despair". At this stage, people review their life, and try to come to terms with what their contributions have been, and what significance their life has had. Seniors are often coping with chronic or progressive illnesses which may slow them down and consume a great deal of their time trying to cope. Many seniors deal with some depression or anxiety as they age and deal with loss. Support from family and friends makes an incredible difference as to how well aging parents can deal with their daily life.

Many people become just more of whatever their personality was like earlier in life (think sweet, complaining, thoughtful, connected, isolated, demanding, etc.) Many older seniors key in on their daily and weekly routines and structure for feelings of security amidst the changes that are occurring.
This can make them seem rigid to younger family members, but it helps to remember that this is a part of coping for many seniors ( such as' I like to eat at this restaurant', 'I always do these chores at this time of day', set television programming, morning and evening routines that self-comfort).

When I worked years ago for the counseling department of a large, local hospital, I helped families talk through planning for aging parents. I still do in my private practice. Here are some things to consider discussing with your aging parent(s):

1. Most aging parents do better in their own home for as long as possible, with services and care being brought into the home as needed.  These might include housekeeping, a home health aide, meal delivery, a bath aide, companion care and more. What are your parents' preferences when their home is no longer the safest place for them, or their needs are more than can be supplemented at home?

2. Do they have a family-friendly family practice doctor who can be the quarterback as other specialists are needed, and is willing to talk with one family member as the point of contact? If not, help them find one. If you live at a distance, a doctor who is willing to interact by email may be very helpful.

3.Create a central storage place for important documents such as medical records, lists of medications being taken, social security numbers, health insurance policy information and contact numbers, advanced directives for healthcare, etc. Keep a hard copy in two different locations that are fire-proof and water-proof.

4. Ask your parents if they have long-term care insurance. Nursing home care is very expensive and could wipe out their savings, or yours. If your parent is healthy enough to qualify, paying that premium, even yourself, may be a smart option.

5. Discuss finances. Who is the point-of contact relative for financial matters? This individual should have financial power of attorney. They need to know the location of key accounts and policies, and the name and contact information for financial advisors.

6. If you begin to suspect your aging parent is confused, get a medical assessment as soon as possible. You can often begin with their family practice doctor who can refer on to specialists who do neurological testing and assess for memory loss and dementia.

7. Discuss what they want to happen when they die. Would they like to be cremated, or buried? Would they like a service to be held? Would they like donations to go to a favorite charity or cause? These might be difficult conversations to have, but it's essential to knowing what their wishes are.

Being sensitive to all the losses your aging parents are going through will help. Consider how you would feel if you were losing your hearing or sight, your mobility, your friends, your partner, and potentially your ability to live independently in your home. There are lots of adjustments that have to be made along the way. Get a support system for yourself. You might be an only child, but even if you have one or more siblings, the care for aging parents often falls disproportionally on one or two.

Caring for aging parents can be meaningful, and it can be hard, both physically and emotionally. Communicating with your parents about these important concerns will help you move forward to make decisions effectively and thoughtfully as changes occur. Hopefully, when we are the oldest generation, our children will be there for us as we inevitably need them more, too.