Caring for Aging Parents

Nobody told us, but caring for elderly relatives is one of the harder tasks of aging

In the past few weeks, several clients have spent a significant part of their sessions talking about being caregivers of aging parents. Some, who have good relationships with their parents, are talking about painful feelings like sadness, grief, and fear about a future without a beloved parent or other relative. Others, who have had difficult relationships with the parent they’re caring for, are feeling angry, frustrated, and often guilty about having those feelings. Several are also taking care of their own children at the same time. And every one of them, no matter what they feel about the situation or the person, is feeling some degree of exhaustion.

“I’ve always felt like I could handle anything life threw my way,” said one woman with an elderly mother in a rehabilitation center after breaking her hip, one child having difficulties in college, and two teens still at home. “But I think I’ve hit my limit.”

And a man who has been driving seven hours every other weekend to visit his father in a nursing home memory unit in another state told me, “It seemed like a minor thing when I took it on. I like to drive, and I wanted to spell my sister, who lives nearby him. But I’m exhausted all the time.”

Like many of my other clients, both expressed guilt about not doing enough. The man visiting his father said, “He was a good father, and I want to ease his life in these last years. I should do more, but I can’t pick up and move. My wife and I have jobs and responsibilities to other people where we live. We can’t let them down. I just feel bad about it all the time.”

What can you do when you’re feeling responsible for aging parents, but can’t give them everything they need – or want?

It’s a difficult question, and there’s no one right answer. We each have to find a solution that works for us and our families, that might not work for someone else. It helps to talk to other people, to find out what they have done, and to get support from them. But remember, even if a friend, loved one, or casual acquaintance doesn’t approve of the choice you make, that doesn’t make it the wrong one.

In honor of Father’s Day, I thought I’d share something I wrote some years ago when my brothers and I made the difficult decision to move our dad into assisted living.

I’m also going to open up the chat to subscribers who would like to share some of what you might be going through right now with your own parents. I’m hoping that being able to share with others will bring you some comfort, as well as some advice from others who have been through it in the past.

“I Promised My Dad I’d Never Send Him to a Nursing Home”

My dad and I were not particularly close while I was growing up. I loved him, and I knew he loved me, but he worked long hours and was famous in our family for not being a particularly demonstrative person. At some point when I was complaining in therapy (once again) about his withdrawn behavior, my psychoanalyst asked me about my own role in this relationship. Had I ever shown my dad how important he was to me? “Of course,” I replied indignantly. But as we continued to explore this sticky issue, my analyst pointed out that Dad and I were a lot alike – we both tended to withdraw when we felt rejected. Maybe, he suggested, my father had withdrawn because he felt rejected by me.

It was a powerful insight that had a tremendous impact on my life. I began to reach out to him–and to my amazement, he responded immediately. Phone calls to my “parents” had previously been really conversations with my mother. Now Dad began to get on the phone and stay on—sometimes after Mom hung up!

As time passed, our relationship became stronger. When my mother became ill, we were able, with the help of hospice, to have her spend her final days at home. Dad, having watched good friends fade away in nursing homes, said he wanted the same for himself when his time came. He told us he’d rather shoot himself than go to a nursing home. We, like many of our peers, promised him that it would never happen. After all, we reminded him and one another, he had long term care insurance for someone to care for him at home. What would be the problem?

The problem soon became apparent. Dad, an independent 90-year old who lived alone in a second floor walk-up apartment, grew increasingly frail. As we researched the possibility of using his long term care insurance, we found first that he was not sick enough for it; and then, when a stroke made him eligible, the amount that the coverage, which had been for 24-hour care when our parents bought the policy, was now only enough for a few hours a day. Dad could not live at home.

According to an article in the NY Times shortly before COVID hit, “the burden of care for aging relatives is reshaping the lives of millions of others.” In 2019 the Labor Department reported reported that one in five Americans between the ages of 55 and 64 care for an older relative. About 15 percent of women and 13 percent of men 25 to 54 years old spend time caring for an older relative, according to the Labor Department. Among those 55 to 64, the share rises to one in five Americans. And 20 percent of these caregivers also have children at home. Many of these caregivers are women, and a large number are “sandwiched” between taking care of a younger person, such as a child, grandchild, or niece or nephew, and their older relative.

My colleague Linda Beeler wrote a touching post describing her mother’s new life in Linda’s home. Unlike Linda, none of us children had homes that could be made over to provide a safe space for Dad. I lived in a one-bedroom New York City apartment, where enlarging a bathroom and making space for wheelchair and walker was impossible.

It was clear that our promise was really a pipedream. 

The process of finding and moving Dad into an assisted living facility, where he could be close to one of us and accessible to the others, was accomplished speedily and surprisingly easily, even though we all felt overwhelmed and inadequate throughout. We even found surprising financial assistance–as a WWII vet with very little money, he was eligible for some financial aid for assisted living, if we could get through the complicated red tape.

Dad did not settle in easily. Angry, confused and frightened, he lashed out at all of us. The fear that we had made a mistake shook each of his children. We learned something important–amazing support was available from a wide range of sometimes surprising sources. Our mother’s best friend, the medical professionals involved, colleagues, our own friends, family, websites, Dad’s cleaning lady, and the woman who had driven him around (when he would allow it) all told us their own stories and stood strongly by us as we made this decision for the man who used to tell us what to do. I found that simply mentioning what was happening to almost anyone over 50 immediately elicited tremendous sympathy and stories of their own experiences–current and past–with elderly and ailing parents, and sometimes spouses, siblings, and friends.

A woman in the grocery store overheard me talking on the phone to my brother about how badly I felt about breaking the promise to have him live with me. When I hung up, she tapped me on the shoulder and said, “We all make that promise. But we can’t all keep it.” She told me her story: her husband had suddenly become quite ill. She promised him that she would let him die at home, but the nursing care became too much for her to do herself, and she could not afford the 24-hour staff he needed. “I had to put him in a home,” she said. “I agonized about it until I finally told myself that I was doing the best I could, and that he would understand. And I expect our kids will do the same with me, and I’ll understand that, too.”

These stories made our life much more tolerable. So did the fact that the place we found was beautiful, and the staff were caring, gentle, kind, and efficient. Still, I worried. I had nightmares that my mother was yelling at me for what I had done. I was clearly not being a good daughter. I was afraid of withdrawing once again, or of my Dad's withdrawing from me. But I didn't, in large part because of the backing from my brothers, their partners and spouses, and my own husband. Irritation was often present, of course. But the knowledge that we were in this together made it all bearable.

Dad gradually began to acknowledge that we had found a nice place, but still spoke of planning his escape. My husband and I took him out for lunch and smiled at one another when he said, as he made his slow and painful way back inside the facility, “Ah, home.”

After a beat he added, “One thing that’s nice about it. I didn’t realize when you moved me here that I’d get to see you so much more often.” I knew that he wouldn’t remember saying that by later that afternoon. I knew that he would be angry, hostile, and confused again by nighttime. But I treasured the words and the sentiment. And I realized that it was nice for me, too. 

Sites that I found helpful for coping with this process:

http://www.oprah.com/health/Caring-for-Aging-Parents-Martha-Beck-Advice/1

http://www.agingcare.com/Articles/I-promised-my-parents-I-d-never-put-them-in-a-nursing-home-133904.htm  

http://www.dailyom.com/articles/2012/34837.html

http://www.agingcare.com/Articles/coping-with-elderly-parent-dying-138574.htm

Photo credit: 123RF image #78146915   Photographer: dglimages