Role Reversal


Role Reversal

How to Take Care of Yourself and Your

Aging Parents

By


Iris Waichler, MSW, LCSW


The phone rang at 11:00 P.M. and immediately jolted me awake. Those of us with elderly parents know the uneasy feeling when an unexpected call awakens us late at night. I jumped up and hurried to the phone. 

It was a nurse at my father’s assisted-living facility. Dad had fallen. “I think you should come over right away,” she told me. 

I was out the door and in my car in five minutes, going as fast as I could on the ten-minute drive to Dad’s place. I was thinking about him and how he had done all he could

to take care of himself and be independent. He had been

so strong and capable when my siblings and I were grow- ing up. Over the years, he’d faced-and overcome-many challenges. He continued to amaze us with his humor and ability to rebound. 

I got to his apartment. I could hear a woman laughing on the other side of the door. When I walked in, Dad was sitting on the couch in his underwear and bathrobe. His right arm and leg were covered in blood. And he was hold- ing the nurse’s hand, shamelessly flirting with her. 

“Listen, doll,” he said, “I think I’m gonna make it, don’t you?” She smiled at us both, and assured me that he was okay. 

Dad had fallen in his bathroom, grabbing the towel bar on the way down. He’d banged his leg and arm against the tub. Luckily he’d been aware enough to pull the emergency cord in his bathroom to get help. 

“What about his injuries?” I asked her. “And his vital signs?” She told me he was fine. 

His vital signs were just slightly elevated but neither she nor my dad could explain exactly why he fell.

“Your dad is quite a joker,” she told me cheerfully. 

I spent the night sleeping on the floor at Dad’s apartment, having been unable to get comfortable on his little couch. I knew he’d get up around 4:00 A.M. This had been his routine for over seventy years, and I wanted to make sure there were no more falls. It took me a long time to fall asleep. Lying there, I thought about how lucky my siblings and I were that Dad had been doing so well for such a long time. But I also began considering what additional safeguards we would need to put into place. Our goal was to keep Dad as safe and as healthy as possible.

When I began writing this book, my dad was ninety-six 

years old. My sister and brother and I were betting that he would reach the century mark. Dad continued to work out three times a week. His only complaint then was that his legs were feeling weaker and he couldn’t walk as far as he used to. All in all, he was in remarkably good health. 

Every year when we’d celebrate his birthday, I thanked him for doing such a great job of taking care of himself. “Keep up the good work, Dad” I’d say playfully. 

He always smiled and replied, “I keep doing the best I can.” And he did. We were all so grateful for him. We all loved him. He was such a large presence in my life that I couldn’t imagine him ever not being a part of it. 

That night, after Dad’s fall, as I lay on the floor, toss- ing and turning, I thought about my daughter, Grace,

who was seven at the time. Many of us have parents who, as they grow older, need more and more help from their adult children. Grace will probably take on that role one day for my husband and me. This is the way it goes for every new generation. 

Every day each of us grows older. As our bodies age, our physical and mental abilities change. Sometimes this process moves slowly. It can also shift in dramatic and unwelcome ways.

There are no magic cures or means to stop the aging process. Cosmetic surgery changes what’s on the outside

but not what’s on the inside. Medical interventions at key times can offer some relief and stabilization. And along the way, family, friends, and/or health-care professionals may need to step in to offer assistance. Sometimes seniors

treasure this assistance. At other times, they are less receptive. 

Some seniors may stubbornly object to any type of intervention. This can happen despite the obvious necessity that those close to them can see. 

As we live our lives, we collect stories about what we experience. Each of us has our own unique collection of stories that make us who we are. Our history influences the choices we make later in our lives. We all have a need to be heard; we all want to live our lives as we see fit regardless of our age. We want people to take the time to listen, respect, and understand these decisions. 

It is a blessing for all concerned when those involved in the caretaking process agree on a course of action to support their loved ones as they grow older. Many of us will later look back at these critical junctures in the lives of our seniors, and reflect upon what happened. Ideally, we will believe that the right decisions were made to keep them as healthy, independent, and safe as possible. But in the here and now, many caretakers are focusing on helping their aging parents maintain as rich a day-to-day existence as can be managed. Sometimes, taking the time to think about their past can give us important clues as to how best to tackle the challenges in the present. 

If it’s possible and you haven’t done so already, I encourage you to listen to your parents’ rendering of their own living history, and to ask them about what they want, both now and in the future. Hearing their stories can take us to places we have never been. It brings that history alive. These stories can inspire us and teach us about how we came to

be who we are. 

Often, seniors will repeat anecdotes and tales; they might forget or confuse the details. We can still learn much from what they tell us. Even if your parent tells you a story you’ve heard many times before, perhaps asking a new question will divulge a new perspective or detail that captures both your attention and your imagination. And this additional understanding can offer fresh insight that helps us to be better caretakers. 

All families have a unique history. If we’re lucky, stories of our ancestors have been shared from generation to generation. One of the favorite parts of my work as a medical social worker was taking the time to hear the life

histories of my elderly patients. I tried to incorporate that in my work with them and in their discharge planning. Often, they were eager to talk with me because few others took the time to listen. In many instances they had repeated these stories so many times to family or friends that they were

not interested in hearing them. 

As I came to see over the years, these life biographies share common themes. Seniors will frequently describe ancestors coming to this country to create a new life,

striving to create families and fulfill dreams. Their themes as they talk are similar. They talk about work, falling in love, sickness, money, family, fears, triumphs, failures, and relationships that shaped their lives. Another theme from these stories is wars. Veterans from World War II still can be eager to tell their tales. Sadly, we are losing these veterans at a rate of three hundred per day. 

As you read this book, I encourage you to think about how the themes of these stories relate to your aging loved ones. At the same time, what do you see happening with them in their day-to-day lives? Who are they now; and

who were they? How does the past affect their relationships today? 

As I was writing this section, I couldn’t help but think about how relevant these questions are for our brave soldiers of today. Coming home, many of them are wounded

both physically and emotionally-just as veterans have always been. 

Soldier or not, as we move through our adulthood, all of us experience the themes I describe above. We must face our own individual aging process and make choices about how to engage in our daily lives. Inevitably, we bring our histories into our current lives and our relationships; having an awareness of this can shape us for the better. 

The numbers on aging are changing. We are living longer than ever before. According to the 2010 census, “There are 53,364 centenarians living in the United States and these numbers continue to increase.” The term “silver tsunami” has been used to describe the growing population of people who are now living well into their nineties and beyond. In fact, according to a study by the Gerontology Research group, there are sixty-eight people-whom

they call “supercentenarians” -whose ages the Group has validated to be 110 or more, and “they estimate the real number is closer to three hundred to four hundred and

fifty persons.” 

The Pew Research Center reports that in response to our parents living longer, there’s been a proportionate increase in the number of adults assuming caregiver roles. They reported that this “is especially prevalent among

adults ages thirty to sixty-four, a group traditionally still in

the workforce.” Their “statistics show an increase in caregivers rising from 30 percent in 2010 to 39 percent in 2013.” 

Unfortunately, this role reversal doesn’t come easily for all concerned. As adult children, there’s a lot to think about when we become our parents’ caretakers and must confront this radical shifting of responsibilities. 

Reactions vary. Sometimes we talk awkwardly with our parents. We struggle to create new boundaries. Sometimes there are raging battles among siblings about who is going

to do what-battles which can end up destroying lifelong relationships. 

Identifying and assessing your parent’s needs and who will fulfill the necessary caregiver responsibilities takes determination, patience, knowledge, and-all too often- money. It includes a wide-ranging set of skills that few of us initially have. 

At the heart of the personal narrative in this book is the story of my father and the evolution of our family. His need for assistance as he grew older is reflected in so many families today. I realized that there are literally thousands of people just like me who struggle to understand and get a handle on the reversal of roles that takes place as we begin to be caretakers for our parents. 

I’ve been a licensed clinical social worker for over thirty- five years. Much of my career was as a medical social worker, working with elderly people who’d been admitted to the hospital. A big part of my job was advocacy. I made sure that my patients and their families understood their medical condition and treatment goals. I encouraged them to talk with health-care professionals when they had questions or concerns. My work also included helping manage the discharge planning for these patients and their families. 

Along with sharing my dad’s story I’ve included useful information to help guide you through the challenges of assuming this new caregiver role. Most chapters in Part One feature a personal narrative followed by key caregiver guidelines, expert insights, and resource material. 

Part Two is devoted exclusively to the major challenges that caregivers face, such as how to manage hospital bills and insurance questions, dividing up caretaker responsibilities, choosing a nursing home, and estate planning. It contains a wide array of information, including links to additional governmental, nonprofit, and private resources. 

Writing this book has been truly a labor of love. It’s taken me in directions I would not have imagined when I began it. I did a lot of research, which offered new revelations. I was surprised by the number of people who found themselves in

this position. I was also struck by the fact that often they don’t know how to access information and resources that could help.

And their sense of isolation and helplessness could be immobilizing. 

In my role as author there may be names or specific details I chose not to include in order to protect and respect the privacy of certain individuals or events. But everything you’ll read about my dad’s family history is the truth as far as I know it. It’s based on my own observations over the years as well as the stories and anecdotes shared by my parents, other relatives, and friends. 

In my family, Dad was famous for the sayings he would have ready for all occasions. He had a wonderful sense of humor, which only grew sharper as he aged. When he would make an outrageous comment or observation, my siblings and I would often tease him about it. Inevitably Dad would smile, and he’d reply firmly, his eyes twinkling, “I only say it because it’s true.” That was his mantra and it will be mine to you, the reader, throughout this book. 

Although my family’s story is unique, I am certain that

along the way there will be situations that will be familiar to you

and your loved ones. My hope is that by writing about my experiences and what I’ve learned, you’ll find valuable clarity and support. If you’re feeling overwhelmed by the challenges of helping your elderly loved one, I hope that this book will enable you to face them with new insight and energy. Remember, you are not alone.