The first jolt of recognition that my aging parents were possibly experiencing some struggles maintaining their independence came one summer when I was visiting with them for a couple of weeks. As the daughter who was living long-distance, the changes in my father’s health from eight months previously, may have been more evident to me than to the siblings living nearby. My father was unable to differentiate between his driver’s license and his health insurance card (which in Canada has one’s picture on it, much like a driver’s license) and no matter my patience, I could not explain the difference clearly enough for him to understand. He was unable to comprehend what normally he would never have questioned. As my visit progressed, so too did the indicators that my father was being challenged cognitively
Hindsight is always 20/20 but looking back, I recalled it had only been two months earlier that in a phone conversation with my parents they announced that they had gone for a drive that day and ended up at a car dealership and had purchased a new used car. I had already been concerned about my father still driving so this was not welcome news to me. I inquired as to what car they had purchased and details such as the color of the car. Neither one of them could answer with any real conviction but seemed comfortable with the fact that the mystery would be resolved in a few days when they would pick up the car. They would let me know then. I asked my father how the car drove. “The salesman asked me if I wanted to take it for a test drive but I told him that I knew how to drive so it wasn’t necessary.” I swallowed my urge to sound alarmed. After all, they were thrilled with their decision.
Certainly two months later with things becoming more apparent, I realized that my father may not have been able to drive an unfamiliar car without guidance and he was not about to be “found out” by a car salesman. My mother’s role in this would have been the force behind the decision to purchase a car. Due to macular degeneration, she had been unable to drive for many years and she was not going to willingly have their lives shrink by my father no longer driving.
Mom admitted to me that, “Your dad doesn’t know the route home sometimes. I have to tell him where to turn.” “Mom, I think that is a problem considering you are mostly blind. I’m not sure you should have the responsibility of the navigator.” With every ounce of confidence my mother declared, “Well, you know I think in an emergency I could drive.” “What would be an emergency mom?” After a brief moment she replied, “Getting to church.” I always admired my mother’s resourcefulness and determination but I needed to emphasize to her that her driving anywhere at any time was not an option. “Mom, I think God will let you off the hook on getting to Sunday Mass until you can make other arrangements.”
During that summer visit I suggested to my father to give up driving. Fortunately he offered no resistance and agreed it was best. That new used car was sold shortly thereafter. Within days of my visit, my father had a fall that not only hospitalized him but never allowed him to move back to his own home.
These scenes play out in many homes as adult children are faced with the reality of their aging parents no longer being able to manage their lives as before. Many times it is easier to look the other way and pretend nothing has changed. However, a care crisis will most likely occur and then people can be thrust into making decisions without being armed with all the information.
At North Shore Elder Services (NSES), our Family Caregiver Specialists are frequently consulted by concerned adult children as to whether or not aging parents need extra help to keep them living independently at home. “When do I know my aging parents may need extra help? They claim they are able to manage independently, refusing any outside help, but what do I do when I feel it is unsafe for them? Do I have to wait till there is a crisis to intervene?”
Kathy Perrella, Family Caregiver Support Program Manager, reassures caregivers that they do not need to have ALL the answers. “The important thing is that you are able to ask certain questions – not know all the answers. That’s where support groups and the Caregiver Specialists come in to play. Caregivers can use them as a resource and avoid feeling so overwhelmed. When you are feeling alone is the time to speak to us.”
Pat McMahan, Options Advisor, thinks it can be particularly challenging for adult children to be in a role reversal with their parent. “You have to sometimes learn to be more assertive in your relationship with a parent when you are acting as a caregiver. Your parent may not always like or accept that.”
The parent in need of some assistance may not agree to outside services because they feel they can do it all themselves. The adult children may not feel comfortable questioning that independence. “We had a family with two daughters who could see their parents needed assistance but they were unable to convince their parents of such. They asked NSES to meet with the family and explain what services could be provided. The advice coming from an outside source was more readily accepted.”
A quick checklist of warning signs that a parent needs help can be found at the following agingcare.com website. https://www.agingcare.com/Articles/signs-your-parent-needs-help-143228.htm. For guidance to starting “the conversation” check out the following webpage, http://www.caregiverstress.com/family-communication/40-70/. North Shore Elder Services webpage at http://nselder.org/resources/options-advising-family-caregiver-support-programs/ will provide you with support group times and other services; and don’t forget to ‘like’ our Facebook page at https://www.facebook.com/NorthShoreElderServices/ where we post articles of caregiver interest.
As caregivers, the best we can do is not look the other way and open the dialogue with our loved ones about aging issues. It’s never too soon to start that conversation but it can be too late. A proactive approach may help prevent a crisis down the road.