We cannot escape it. We observe changes in our parents or family members that are telltale signs of the aging process. We may be caught off guard, dismiss any concerns, or try to continue as if all is normal and undisturbed.
Witnessing physical and cognitive changes in our parents is so very difficult. Not only do we realize that they are reaching a stage in their life that warrants change and guidance, but we are also confronted with our own mortality. As our parents age, we must acknowledge that so do we. Once the new reality of our parents’ lives is accepted it is important that we try to remain open-minded and maintain a positive outlook. This is a time in life when we have the opportunity to advocate and support our parents and by doing so help them maintain their independence and sense of self worth. Encouraging our parents to remain actively involved and in control of their future may diminish any feelings of intrusion, and they may welcome our inclusion into discussions of change.
Occasional brief periods of forgetfulness may be normal signs of aging or an indicator of a serious problem. We may have to struggle to not appear alarmed. How do we approach creating change in our lives and in the lives of others? Where do we start?
It is not unusual that during visits or phone calls with family we notice behavioral changes or signs of declining health. It may be a challenge to discuss our concerns without appearing intrusive or without expressing doubts in their abilities to function independently and safely. Returning home to our own life of stress and responsibility may lead to feelings of guilt or relief to be away from our parents and our observations.
When an opportunity presents itself to speak candidly with our parents, we should try to approach the discussion in a non-threatening way by using safe topics of conversation. A discussion about current events in our life may prompt them to share their own day-to-day activities, providing us with some insight into how they are managing and adjusting to new changes that aging may have introduced.
In determining how the aging process is affecting our parents, we should ask ourselves the following questions:
- Medical appointments – Are they maintaining contact with their physicians and keeping appointments? Is doubt expressed about their physician’s care or guidance?
- Medications – Are they managing their medications independently, using a pharmacy service or pill box? Are they having difficulty with the costs of their medications or are they noncompliant and have mentioned making self- prescribed changes in order to save money or because they feel the drugs are not effective?
- Socialization – Is their level of activities with others changing? Have they stopped participating in activities that in the past were important, such as church, volunteering, seeing friends? Are they in touch with family less?
- Home maintenance – Are you concerned with changes in their environment, such as the cleanliness of the home, strong odors, collecting clutter? Are they using makeshift items for support when walking, such as holding onto furniture to move about the house, or to assist in standing or sitting? If they own a pet(s) are they able to manage their care? If they smoke do they do so safely?
- Shopping and meals – Are they having difficulty with getting groceries or appear to be eating poorly? Is food stored properly, spoiling? Are they hoarding food or displaying poor judgment with what they eat? Have they lost or gained weight, can they recall what they have had eaten lately? Are they drinking enough liquids, consuming too much alcohol, or overusing an unsafe substance?
- Personal care – Are they dressed appropriately, have their personal cleanliness habits changed? Are they unaware of the condition of their clothing; is it soiled, torn or ill fitting? Is their clothing appropriate for the season?
- Financial management – Are they still independent with managing their checkbook and investments or do they require the help of others? Have they expressed frustration over their finances? Have bills gone paid or utilities discontinued? Do they respond to sweepstakes opportunities, donate frequently to charities? Have they recently purchased an item or had work done in the home that you think was unnecessary?
- Driving – Are they driving safely? Have you noticed any new damage to their car, are they maintaining the car? Have they had any experiences with getting lost or taking too long to arrive at a destination? Do they have any vision changes that would impair their driving? Do they drive at night?
Some families are more comfortable with these discussions than others. It may be typical of ongoing contact with our parents to share this type of information. Depending on our family history of communication, broaching these topics may be difficult, if not impossible. Some talks may arise from our own disclosure of how we manage multiple tasks in our daily life.
It is important to remain open with parents about any concerns and plans to take action. The degree to which we can become involved and make decisions for them will be limited by their knowledge, their involvement in the decision-making process, and their Advanced Directives. Prepared legal documents such as a Living Will, Durable Power of Attorney, and Health Care Power of Attorney will determine the level of involvement that we may have when participating with our parents in making changes in their lifestyle and care.
Becoming aware of aging changes is just the beginning of a new journey for children and parents. Fear, anger, and feeling overwhelmed are typical reactions that we may encounter as we acknowledge change. Encouraging independence is a very important piece of this process for both generations. We want to believe that our parents are still very capable of remaining active and independent. Our parents need to maintain as much involvement and control over heir life as possible, delaying any dependency on us or others.
As children, we do not need to feel alone on this journey. There are many resources available to guide and support us in understanding and preparing for the increasing needs of our parents. Planning ahead and being aware of their future needs and wishes may make the difficult transition of introducing change a little easier.
ABOUT THE AUTHOR
LAURIE RAY, MSW, CMSW, C-ASWCM
ADVACED AGING CARE SPECIALIST
Over 20 years’ experience in the field of Social Work, Laurie’s background includes extensive work in hospice care where she provided end of life support to patients of all ages in a variety of settings. In 2004 Laurie established and was Executive Director of COPE Eldercare, the area’s only nonprofit 501(c)(3) charity providing geriatric care management services regardless of the ability to pay. In addition, the 2013 January/February issue Social Work magazine named Laurie in its annual recognition of “Ten dedicated and Deserving Social Workers”. Laurie has been teaching Pet Therapy for ten years assisting volunteers and their canine companion to become a certified team.