When Parents Need Nurturing

By JANE E. BRODY

 

“Growing old is not for sissies.”

I hear this often and have said it myself. Among the many challenges of aging is knowing when to seek help and how to accept it graciously.

 

Most often, the source of help is an adult child (or children) who may not be in a position to satisfy all the physical and emotional needs of an aging parent (or parents). Advanced old age can create a role reversal: children who once required a nurturing parent must now nurture their parents.

 

Recognizing that the demands of modern life have eroded the time-honored commitments to care for aging parents, China recently put in effect a law called “Protection of the Rights and Interests of Elderly People.” It requires children to meet the emotional and physical needs of their parents, and to visit them often or face fines or possible jail time.

 

In some former Soviet bloc countries, aging parents can sue children for failing to provide needed financial support. Interestingly, there are similar laws still on the books in many American states, mostly unenforced relics of a bygone era.

 

But with or without a law, moral obligations to assist one’s aging parents are commonly felt. They can leave adult children feeling overburdened and neglectful of their own families, personal needs and goals. Indeed, The New York Times for several years has devoted a blog entirely to this subject, The New Old Age.

 

If the older parent is overly demanding, hypercritical or unappreciative, his child may become angry, resentful, depressed, even abusive to the parent. If the aging adult was neglectful, abusive, emotionally distant or self-absorbed as a parent, children are more likely to turn away when physical, financial or emotional support is needed.

 

Adult children without siblings to help share the burden of parental care (because they are only children, or because their siblings are unwilling or unable to help) can become especially resentful.

 

Intensifying the challenges is the fact that people are living ever longer, often for decades, with one or more chronic ailments, including dementia. And many older people exact promises from their children that they will be kept at home indefinitely and never placed in a nursing home, even when home care becomes physically or financially overwhelming.

But an entirely different scenario can emerge if all parties involved respect the needs of others and if the parental recipients of help show appreciation rather than acting as if it was their due.

 

My maternal grandmother was widowed when I was an infant and then lived with my family until cancer claimed her life 13 years later. My parents both worked long hours, and having Grandma around to help, even in a limited way, and be there when my brother and I came home from school was a definite asset. But such living arrangements have increasingly become a thing of the past.

 

Maud Purcell, a psychotherapist and executive director of the Life Solution Center of Darien in Connecticut, offers a laundry list of emotions that adult children are likely to experience when parents age and their health declines. Among them:

 

* Fear, when you realize that the roles have reversed and that you may now have to care for your parents

 

* Grief, as a once-robust parent’s ability to function independently declines abruptly or little by little

 

* Anger, frustration and impatience, when a parent’s needs interfere with your life

 

* Guilt, in response to the above feelings or because you are unable to spend enough time with your parent because of distance or other life demands

 

Ms. Purcell suggests that you accept these feelings as normal and not fight them. Rather, recognize that you cannot change what your parents are going through beyond providing help and support to the best of your ability.

 

She wrote: “Don’t take on more than you can handle. Consider your commitments to your work and to other family members. Overextending yourself will leave you stressed and will put a strain on your other relationships. Worst of all, you may end up taking your frustration out on your parent, causing you intense guilt.”

 

Ken Druck, a clinical psychologist based in San Diego and author of “The Real Rules of Life: Balancing Life’s Terms With Your Own,” urges adult children to act out of love, not guilt or resentment, and to “live and give within your limits.” To avoid burn out, make an honest assessment of what you can and cannot do, then “lovingly” communicate your limits to your parent.

 

“Clear expectations prevent unnecessary stress, misunderstanding, disappointment, hurt and fear of abandonment,” Dr. Druck said in an e-mail.

 

It often helps to try to put yourself in your aging parent’s position and think about what you might want and need under similar circumstances. Also helpful is to sit down and have a heart-to-heart talk with your parent about expectations, deciding which you are able to meet and which might require outside assistance.

 

Experts do warn, however, against promising never to place a parent in a nursing home, which may be the only reasonable and affordable source of care for someone in an advanced state of decline. And it is unreasonable to expect those who had a neglected or abusive childhood and were never close to their parents to suddenly act like loving, caring children when parents become old and infirm.

 

A version of this article appears in print on 09/17/2013, on page D6 of the NewYork edition with the headline: When Parents Need Nurturing.

 

Personal Health

Jane Brody on health and aging.

 

 

4. Internet Service as Means to Personalized, Technology Solutions for Seniors

 

The next twelve months is the year of the provider and we’re not talking about the senior care or housing provider. It’s the year of the internet service providers and no, it’s not 1995.

 

Comcast, AT&T, Verizon and Direct TV are the gatekeepers to the home, mobile phones and some senior housing communities. Each provider has a box, phone or gateway that provides connectivity to the digital world and each individual has their fair share of devices and applications that need access to the Internet through their providers interface and connectivity. As more seniors embrace more internet applications further out on the bandwidth curve, they will demand increases based upon their bandwidth needs.

 

These data providers are important as they enable the opportunity for individuals, care providers and community owners to choose their own technology solutions. However, these providers are building their own applications into the interfaces that are used daily such as the cable television interface. Some service providers will compete with independent, third party solutions, while others will choose to invest or acquire these technology solutions to incorporate into their systems.

 

The choice for technology solutions will be for operators, seniors, and their children to decide, but every solution will need to pass through the gateway of the 21st century version of the Internet service provider—which may turn out to be an electronic senior care monitoring service itself.

 

To see the complete article go to:  http://seniorhousingnews.com/2013/01/07/top-10-trends-in-senior-housing-for-2013/

Millions now manage aging parents' care from afar

 

MATT SEDENSKY

 

 

Kristy Bryner worries her 80-year-old mom might slip and fall when she picks up the newspaper, or that she'll get in an accident when she drives to the grocery store. What if she has a medical emergency and no one's there to help? What if, like her father, her mother slips into a fog of dementia?

 

Those questions would be hard enough if Bryner's aging parent lived across town in Portland, Ore., but she is in Kent, Ohio. The stress of caregiving seems magnified by each of the more than 2,000 miles that separate them.

 

"I feel like I'm being split in half between coasts," said Bryner, 54. "I wish I knew what to do, but I don't."

 

As lifespans lengthen and the number of seniors rapidly grows, more Americans find themselves in Bryner's perilous position, struggling to care for an ailing loved one from hundreds or thousands of miles away.

 

The National Institute on Aging estimates around 7 million Americans are long-distance caregivers. Aside from economic factors that often drive people far from their hometowns, shifting demographics in the country could exacerbate the issue: Over the next four decades, the share of people 65 and older is expected to rapidly expand while the number of people under 20 will roughly hold steady. That means there will be a far smaller share of people between 20 and 64, the age group that most often is faced with caregiving.

 

"You just want to be in two places at once," said Kay Branch, who lives in Anchorage, Alaska, but helps coordinate care for her parents in Lakeland, Fla., about 3,800 miles away.

 

There are no easy answers.

 

Bryner first became a long-distance caregiver when, more than a decade ago, her father began suffering from dementia, which consumed him until he died in 2010. She used to be able to count on help from her brother, who lived close to their parents, but he died of cancer a few years back. Her mother doesn't want to leave the house she's lived in for so long.

 

So Bryner talks daily with her mother via Skype, a video telephone service. She's lucky to have a job that's flexible enough that she's able to visit for a couple of weeks every few months. But she fears what may happen when her mother is not as healthy as she is now.

 

"Someone needs to check on her, someone needs to look out for her," she said. "And the only someone is me, and I don't live there."

 

Many long-distance caregivers say they insist on daily phone calls or video chats to hear or see how their loved one is doing. Oftentimes, they find another relative or a paid caregiver they can trust who is closer and able to help with some tasks.

 

Yet there always is the unexpected: Medical emergencies, problems with insurance coverage, urgent financial issues. Problems become far tougher to resolve when you need to hop on a plane or make a daylong drive.

 

"There are lots of things that you have to do that become these real exercises in futility," said Ed Rose, 49, who lives in Boston but, like his sister, travels frequently to Chicago to help care for his 106-year-old grandmother, Blanche Seelmann.

 

Rose has rushed to his grandmother's side for hospitalizations, and made unexpected trips to solve bureaucratic issues like retrieving a document from a safe-deposit box in order to open a bank account.

 

But he said he has also managed to get most of the logistics down to a routine.

 

He uses Skype to speak with his grandmother every day and tries to be there whenever she has a doctor's appointment. Aides handle many daily tasks and have access to a credit card for household expenses. They send him receipts so he can monitor spending. He has an apartment near his grandmother to make sure he's comfortable on his frequent visits.

 

Even for those who live near those they care for, travel for work can frequently make it a long-distance affair. Evelyn Castillo-Bach lives in Pembroke Pines, Fla., the same town as her 84-year-old mother, who has Alzheimer's disease. But she is on the road roughly half the year, sometimes for months at a time, both for work with her own Web company and accompanying her husband, a consultant for the United Nations.

 

Once, she was en route from Kosovo to Denmark when she received a call alerting her that her mother was having kidney failure and appeared as if she would die. She needed to communicate her mother's wishes from afar as her panicked sister tried to search their mother's home for her living will. Castillo-Bach didn't think she could make it in time to see her mother alive once more.

 

"I won't get to touch my mother again," she thought.

 

She was wrong. Her mother pulled through. But she says it illustrates what long-distance caregivers so frequently go through.

 

"This is one of the things that happens when you're thousands of miles away," Castillo-Bach said.

 

Lynn Feinberg, a caregiving expert at AARP, said the number of long-distance caregivers is likely to grow, particularly as a sagging economy has people taking whatever job they can get, wherever it is. Though caregiving is a major stress on anyone, distance can often magnify it, Feinberg said, and presents particular difficulty when it must be balanced with an inflexible job.

 

"It's a huge stress," she said. "It can have enormous implications not only for someone's quality of life, but also for someone's job."

 

It can also carry a huge financial burden. A November 2007 report by the National Alliance for Caregiving and Evercare, a division of United Health Group, found annual expenses incurred by long-distance caregivers averaged about $8,728, far more than caregivers who lived close to their loved one. Some also had to cut back on work hours, take on debt of their own and slash their personal spending.

 

Even with that in mind, though, many long-distance caregivers say they don't regret their decision. Rita Morrow, who works in accounting and lives in Louisville, Ky., about a six-hour drive from her 90-year-old mother in Memphis, Tenn., does all the juggling too.

 

She has to remind her mother to take her medicine, make sure rides are lined up for doctor's appointments, rush to her aid if there's a problem. She knows her mom wants to stay in her home, to keep going to the church she's gone to the past 60 years, to be near her friends.

 

"We do what we have to do for our parents," she said. "My mother did all kinds of things for me."