Help for Elderly Parent Can Fray Family Ties

By Ellyn Spragins

NY Times, November 3, 2002

There is no light touch to bring to the topic of elderly parents. No humor in failing bodies, except the kind used in the birthday cards of younger people. You can read all you want about active seniors and "zoomers," the new term for aging baby boomers, but most elderly parents are not rappelling off mountains or running marathons.

They're often engaged in a slow-motion surrender of body functions and self-determination. Guess who seems to be making them surrender? Their kids. When adult children step in, they often unknowingly brandish a most potent weapon: money. Parents may hear, "Dad, I've arranged for someone to come lend a hand with the cooking and cleaning." Or, "Mom, let us help you with your doctor bills."

Money signifies more control and power in your older years than at any other time of life. You have only a fixed amount of it left. You're unlikely to have a new job or a big bonus to enlarge it. So when your own formerly dependent children suddenly tell you not only how to live your life, but also that they will foot the bill, it may feel like a power play at your most vulnerable moment.

"After losing power over so many domains of your life, this is a message that you've gone beyond the age of maturity and we're going to have to take over," said Donna Wagner, a gerontologist and director of the Center for Productive Aging at Towson University in Maryland. "It's insulting."

Between the stresses of poor health and the hidden messages that parents and children read into discussions about money, strong bonds can fray easily. For one woman in her 70's, who lives in suburban Philadelphia, the turning point came after her husband, who suffers from Alzheimer's disease, fell and required hospitalization in September, according to Barry Jacobs, a psychologist at the Crozer-Keystone Center for Family Health in Springfield, Pa. Her daughter, one of Mr. Jacobs's clients, was able and eager to pay the hospital and subsequent nursing home bills. But this loving gesture may have backfired.

"Now the mother feels tremendous embarrassment that she had to accept help from her daughter," Mr. Jacobs said. "She feels she can't talk to her daughter in the same way because her daughter, who had been more deferential, talks to her in a more aggressive way."

This is how some parents, formerly congenial grandfathers and cheerful grandmothers, inch their way toward becoming what health care workers call "noncompliant elders." Older adults may not have the health, mental competence or the finances to run their lives the way they want anymore. But they can still exert their will by saying no: "I don't want any strangers in the house," they might say, "and I don't need physical therapy."

For most children of increasingly frail parents, offering to pay for home health aides, wheelchairs, assisted-living homes and other expenses is an expression of love, a small way to give back to the folks. But spending money on a parent's needs is palliative, too, experts say. Cash is concrete. It's a visible sign of action in the face of the alarming process of aging and dying. Paying for expenses, Ms. Wagner, the gerontologist, says, often gives sons and daughters the feeling that "they can make their parent's aging stop."

When their financial assistance is rejected, adult children are sometimes bewildered, frustrated and impatient with their parents' surprising intransigence. "What people struggle with is, `When am I being neglectful?' " by allowing parents to stay independent, said Sheila Greuel, a care adviser at Mid-Illinois Senior Services in Sullivan, Ill.

Of course, some children do neglect their elderly parents or fight with their siblings over spending prospective inheritances. But for the most part, this final stage of a relationship with a parent is marked by adult children's devotion, however complicated the emotions around it.

Nearly one in four households contains an employed adult who also has provided care for an elderly person, according to a 1999 national study by the National Alliance for Caregiving in Bethesda, Md., and the National Center on Women and Aging at Brandeis University in Waltham, Mass.

FOR many of these people, the financial penalty goes far beyond paying for some of a relative's expenses. If they manage to function in a job while providing care, they often pass up career-enhancing training, assignments and promotions. Many shift from full-time to part-time work or quit altogether. For those reasons, 43 percent of families who care for adults have incomes below $30,000 a year, versus 35 percent for families who don't provide such care, according to Suzanne Mintz, the president and a co-founder of the National Family Caregivers Association in Kensington, Md.

Providing for a parent is probably the least discretionary expenditure you'll ever have, after providing for your children. But sometimes the financial pressure, combined with the emotional pressure of giving physical care, can generate enough resentment to fill a bubbling cauldron. Sometimes, money funneled to parental care causes marital spats and sibling squabbles.