Talking to Aging Parents About
Changes
Melissa
Healy, Los Angeles Times
February 6, 2012
When trying to persuade a
parent that life changes may be in order
for his or her safety and health, it's
best to start with understanding and
respect. (Tomas Sodergren / Getty Images
/ Nordic Photos /February 2, 2012)
David Solie thought he was
being a good son and a competent
manager. But his strong-willed mother
was having none of it.
Carol Solie, 72, had been
caring for herself, her 28-year-old son,
Roger, who has Down syndrome, and the
family home in Portland, Ore., since her
husband died in 1989. From David Solie's
vantage point in Calabasas, it was too
much. So once a month, he would travel
nearly 1,000 miles north to set things
right.
This son decreed that his
mother should move someplace easier to
navigate — an assisted living complex,
perhaps. She should relinquish her role
as chief caregiver to Roger, who could
be placed in a group home. David Solie
insisted on looking over his mother's
finances. He also had some thoughts on
what kind of car she should be driving.
After fending him off for a
year, the indomitable Carol Solie sent
her imperious son packing and stopped
talking to him for almost three years.
And so David Solie, who had cared for
hundreds of elderly patients as a
physician's assistant, was left to
ponder the mistakes that resulted in his
abject failure to communicate with his
own mother.
The nation's 77 million baby
boomers are not the first adults to care
for their aging parents. But they are
the first generation to care for parents
who are living longer but with more
chronic medical conditions — and often
far from their grown children.
More than 43 million Americans
provide care for someone older than 50
who is aging or disabled, including 15
million who care for someone with
Alzheimer's disease or dementia. Nearly
1 in 10 women ages 45 to 56 is a member
of the "sandwich generation," taking
care of an aging parent and her own
children at the same time, according to
a 2006 report from the Department of
Labor.
For each of these grown
children, there are moments when an
aging loved one's safety seems to depend
on that caregiver's ability to coax,
cajole, persuade or coerce Mom or Dad to
make changes in the interest of his or
her health and safety — changes that
almost uniformly prompt resistance.
The caregiver's aim may vary —
to persuade a parent to turn over the
financial reins, see a doctor, accept
help with cooking or bathing, or give up
those potent symbols of adult
independence, the car keys. How
persuasive he or she is may well
determine whether car accidents, hip
fractures, house fires and destitution
will be averted.
Yet there is no accepted script
for how this crucial conversation should
go.
"In a generation or two it will
seem normal and we should have it
figured out," says Elizabeth Dugan, a
professor of gerontology at the
University of Massachusetts in Boston
and an expert on aging and driving
performance. "But for now, it is
challenging, rewarding, exhausting and
more."
Mom's
different agenda
David Solie was finding his
way, fitfully. In his medical training,
he learned about the many stages of
childhood development and the physical
ailments that come late in life. But his
training had neglected to teach him that
aging too has its developmental demands.
His elderly mother's
psychological needs were certainly
different from his own. In his busy
life, efficiency was key, he says. But
he came to recognize that "efficiency
was not on my mom's agenda."
What was on Carol Solie's
agenda — as with most aging parents at
the threshold of needing their
children's' help — were two things, her
son says. She had a powerful need to
maintain control over her life at a time
when age and illness were making that
increasingly complex. And she nurtured a
deep desire to see and appreciate that
her life had meant something — to
consolidate her legacy.
When David Solie acknowledged
those needs, he naturally "softened the
reins," he says. He also softened his
heart, asking his mom questions about
her life and listening intently to her
stories. Acknowledging to his mother
that there were no longer easy ways to
reconcile her safety and her desire to
stay put, he asked what would work for
her. Then mother and son struck
compromises that built a network of
support around her and Roger in their
home.
If David hadn't recognized the
powerful forces driving his mother, he
concluded, his efforts to look after her
would have been doomed.
"We arrive with the best
intentions," says Solie, who gathered
his insights into a book called "How to
Say It to Seniors: Closing the
Communication Gap with Our Elders." "We
think, 'They're older, they don't get
it. They're wrong and I'm right.' But
right's not relevant."
Of all the excruciating
conversations a caregiver will ever
initiate with an aging parent, the
"driving talk" is perhaps the worst. A
loved one who has enjoyed all the
rights, privileges and responsibilities
of adulthood will not cede his or her
independence and autonomy happily, nor
perhaps willingly.
Fear silences many grown
children from having these conversations
until it is too late for negotiation,
experts say. And that may suit aging
parents: According to a 2004 study
conducted by the Hartford Financial
Services Group Inc.and MIT's AgeLab,
half of older drivers who are still
married would rather hear about driving
concerns from a spouse. In addition,
more than 4 in 10 older drivers living
alone would prefer to have these
concerns raised by their physician, as
would a third of such drivers who are
married.
Having "the talk" with a son or
daughter consistently came in last. When
they did have those talks with their
kids, older drivers tended to prefer to
hear it from children who live close by
and are more in tune with their driving
habits.
David Barg, who edits a
magazine and website devoted to
caregivers, calls the talk about car
keys "caregiver kryptonite." It can stay
the tongue of even the most assertive
child or render him powerless in the
face of a cornered, furious parent
clinging to his freedom and dignity.
That's probably just as well,
Barg says. "If you walk in cold and say,
'Give me your keys,' you're not just
saying, 'I want you off the road.'
You're saying, 'I want to infantilize
you. I want to take away your
independence. I am in control.' And that
is not the conversation you want to
have."
Ideally, says gerontologist
Dugan, the "driving talk" is not one
conversation but a series of them, begun
well before there are unexplained dings
on the car, tickets in the mail or an
accident. This can take some of the
pressure off of adult children. "It
isn't a one-shot deal," she says.
A near-miss might spark a
discussion — or even better, an
admission by the older driver of some
minor trouble on the road, like getting
lost on the way home or being honked at
by impatient drivers.
What many caregivers don't
account for is that "many times, our
loved ones already know" that they are
not as competent behind the wheel as
they used to be, Barg says. They are
uncomfortable driving on highways,
fearful of driving at night and confused
by dense traffic and have begun to scale
back their driving accordingly. That's
when an attentive caregiver can take the
first steps to easing an older driver
into the passenger seat.
The initial conversations
should acknowledge the measures that an
older adult has already taken to stay
safe, experts say. Then the caregiver
can step in with well-researched options
for alternate transport and assure an
elderly driver that his ability to see
friends, get to the doctor and continue
with other activities around town is a
priority. Later, after the car has sat
unused for several months, a caregiver
can tally the cost of keeping the
vehicle insured and registered and show
a parent how much taxi fare or bus
service that money could buy.
At the same time, Solie says,
it's appropriate to "draw a line in the
sand" that makes clear what the stakes
are.
"We tell our parents, 'None of
us can burn the house down, and we can't
kill people driving,'" he says. If
parents insist on living on their own,
they'll have to compromise for the sake
of safety: "We all have the same laws of
the universe operating over us.'"
Working
with parents
Many baby boomers make the
mistake of thinking of their new
responsibilities as a role reversal. But
that's not only wrong, Solie says, it's
a formula for failure.
"We're not parenting our
parents, we're partnering with our
parents, " he says. "You tell them, 'I
think you want to have as much
independence as possible, and my job is
to help you weigh both sides.'"
For adult children like Solie
who try to muscle their way into the
caregiver role, that sometimes means
slowing down and apologizing. "There's
nothing wrong with going back and
saying, 'I was wrong. This is your life,
and you're in control.'"
That admission can produce a
sudden thaw, he has found: "Mom or Dad
says, 'I don't have to fight this kid
for control. This kid speaks to me with
respect.' And they come alongside."
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