Therapy in LA

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October 2015

COPING WITH OUR ELDERLY PARENTS?
by: Margaret L. Stoll, Ph.D., Clinical Psychology

With the growth of our aging population more people are coping with their elderly parents. Along with the good fortune of having our parents with us through much of our lives come a number of challenges. Sometimes we resist seeing our parents' diminished function and need for assistance because it is too painful to accept. We may minimize their deficits because we fear embarrassing, disrespecting or angering our parents.

One frequent challenge is the reversal in care-taking roles between parent and child. The dependency of parents on their adult children may be awkward and filled with ambivalence. Adult children with physical proximity to an aging parent may be helping with or arranging errands, appointments and household repairs, as well as visiting and giving emotional support on an ongoing basis. If the child feels they were not adequately cared for themselves, having to take care of their parent can create ambivalence or resentment. Children who felt loved and nurtured growing up are more likely ready to give back to their parents when they need assistance. Yet even then, losing the help and focus one used to enjoy from an involved parent takes some adjustment.

The more a parent’s functioning declines the greater likelihood of conflict between their wishes and what their children believe is within their parent's capacity or best interest. Continuing to drive, live in their own home, cook for themselves, or handle their financial affairs are a few of the responsibilities that elderly adults with failing physical or cognitive capacities are loath to relinquish. In an effort to respect the elderly parent’s wishes and autonomy, adult children often live with a certain level of discomfort and uncertainly about their parents’ abilities to manage their living situations. They are afraid for their parents' safety and feel a sense of responsibility to protect them and others from any ill effects of their disabilities. Overly anxious adult children can become overly controlling. Their extra advice or assistance may be given more for their peace of mind than for the true needs of the parent.

One area where this often occurs is when children urge or even force their parents to give up their home and move into some form of senior living. Even when this decision is clearly necessary or chosen by the senior, it is often experienced as a loss and takes considerable adjustment. If a senior feels rushed or forced into the move before they have accepted its necessity, their adjustment is often more difficult and prolonged. When a significant life-style change becomes necessary, such as giving up driving or independent living, it can be useful to emphasize the senior’s physician as the source of this decision. This helps to preserve the elderly parent’s sense of their child as an ally to whom they can turn for sympathy and understanding. The challenge of coping with one’s elderly parents lies at just this point, namely, offering them the amount and type of assistance that is attuned to their true needs. Just as with parenting one’s children, the aging parent’s needs for help will change over time. Modifying one’s interactions with them to coincide with this takes awareness and flexibility on the child’s part.

I believe the ideal philosophy both in childrearing and, perhaps more importantly, in dealing with our declining parents, is that of respect for the individual. With those who cannot think, move, or accomplish tasks as independently as they once did, it is easy to start treating them as objects that we direct or manage. However, being patient, taking the time to explain, and listening to their opinions and preferences, will help maintain a relationship of respect and value. This is especially important as a senior loses some of the roles and abilities that contributed to their sense of pride and self-worth throughout their life. We need to remember that our parents have the right to make the decisions about how they live their lives, and that our role is to assist them in carrying out their choices.

As with any challenge, looking at its positive aspects can be helpful. The greater involvement and responsibility of adult children with their aging parents can bring opportunities for a closer relationship. More involvement can bring spontaneous conversations, reminiscing about the past and appreciating each other’s company. The wisdom, perspective and love embodied by many elderly parents, is a gift to adult children who are fortunate enough to appreciate it. For those with unresolved feelings or conflicts this contact can be more challenging. Yet, it is also an opportunity to resolve or replace past issues with more positive experiences and memories.

The ongoing involvement of an adult child in their parent’s life can greatly improve the parent’s emotional or physical state. Emotions can influence how we perceive our physical health For example, depressed individuals have been found to report more pain with their medical conditions than non-depressed patients with the same conditions. Therefore, it is possible that an elder may feel less pain and be less troubled by their medical conditions when their adult child is involved in their life.

An involved adult child is more likely to be in a position to notice when their parent is suffering from depression, anxiety, physical pain or greater disability. Some seniors may be reluctant to complain, ask for help, or be unable to recognize that they need help with something. Being alone, feeling abandoned, losing control, or being in pain are some of the fears that many people experience with old age. Their adult child can serve as a sounding board or confidant, as well as a resource for coping with or eliminating some of these fears. Having someone who knows and cares about them and what they are experiencing can feel very supportive, secure and enjoyable to a senior.

For adult children who feel helpless to affect the losses and challenges their aging parents face, it can be very gratifying to find positive ways to help. Seeing their parent’s pleasure when they show up, hearing their appreciation, or just knowing they have made life easier for them feels good. These memories can be comforting after the parent is gone. In fact, remembering that the time together is limited can increase our patience and desire to make the most of this primary and enduring relationship.

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Dr. Stoll is a Clinical Psychologist practicing in Redondo Beach and Glendale. She is a member of the Independent Psychotherapy Network. Dr. Stoll can be reached at (310) 375-3607 or margaret.stoll@gmail.com.