If your children love Disney movies as much as mine do, “the circle of life” probably conjures up images of Simba on Pride Rock with Elton John singing in the background. The “circle of life” is a phrase I use frequently in my work as a geriatrician as I counsel my patients and their adult children.
Many of these adult children are still raising their own children—even as the circle of life begins to require them to “parent” their parents. If you’re in the middle of this challenging time, know that you are not alone.
Our elders often lose both physical and/or cognitive function as they succumb to the natural process of aging. This renders them in need of guidance and assistance. Sometimes, they even need their families and caregivers to completely take over decisions or activities that they can no longer perform. In this stage of life, it can be very difficult for the elder to accept from their children the very help they so desperately need.
It can also be very difficult for adult children to know how to help their parents navigate these life changes and know when and how to support them. Here are a few tips to consider when “parenting your parents.”
1. Give them space to grieve their independence
Elders mourn the loss of independence, just as they would the loss of a loved one or the loss of a limb. Grief is grief, with its ebb and flow, predictable unpredictability and sometimes crushing weight.
Give the elders in your life space to grieve the loss of their former independent selves. Know that grief is messy and understand that in their denial and bargaining, they may not be open to accepting the help you are trying to give. It’s not personal and it’s not about you.
Hold space. Be patient. Just like your teen will fight to gain independence, your aging parent will fight to keep it.
2. Pay attention to driving clues
Self-limitation of driving is sometimes the first clue to driving impairment in older adults. Statistically, most accidents happen within a 10-mile radius of home, so an elder who says “I don’t drive far” is not necessarily cutting their risk of an accident.
Driving is a complex task that requires all of the following: selective and divided attention, working and long-term memory, gross and fine motor skills, cognitive and physical function, and visual and kinesthetic awareness.
An astute driver needs to be able to react quickly and appropriately to unpredictable occurrences in high-risk situations. Cognitive overload occurs when the complexities of the task overwhelm the older driver and can lead to accidents.
As you would worry about putting an inexperienced teen driver in control of a vehicle, you should consider whether your older parents are truly safe to operate a vehicle. Ask yourself these questions:
- Do you feel safe in the passenger seat with them behind the wheel?
- Do they often need a “co-pilot” when driving?
- Have they had a few minor fender-benders?
If so, it may be time for “driving retirement”, or at the very least a comprehensive driving assessment. Seek the advice of a geriatrician or if there isn’t one available, contact your local AAA (Area Agency on Aging) for resources in your community.
3. Offer decision support only when needed
I have three daughters, all currently under the age of 16. I tell them frequently that I am not in the business of raising children—I’m in the business of raising adults. My husband and I remind them often that a big part of our job as parents is to help them become good decision-makers.
Whether we are ready for it or not, our children are programmed to reach for autonomy and self-determination. That pull towards self-governance doesn’t necessarily slack up with aging.
While a teen needs support and encouragement in making decisions about their own lives, they also come to expect the “space” to do so. Your elderly parents are no different. Like a teenager, they may not always want or feel the need to have your input.
So, offer assistance where needed, especially for big decisions, and especially if you are concerned about cognitive impairment—but do so with respect. Pick your battles and prioritize your involvement in decisions that have the biggest impact, such as major healthcare or financial decisions.
4. Don’t forget about their sexuality
I know you’d rather not think about it, let alone talk about it, but here’s the deal: your aging parents are still sexual beings! Perhaps they have been faced with relinquishing that part of themselves to the process of aging, or perhaps maybe not.
Sexuality is a part of life and those elders who can still enjoy sexual expression should be encouraged to do so. That said, with sexuality comes responsibility. As awkward as it may be, you are socially primed to have “the talk” with your teenage children, but what about your elderly parents?
If they are in a position of having been widowed or otherwise left without a partner, the time may come when they desire to explore an intimate relationship with a new partner. All the same safe sex rules apply, as do concerns about consent; however, the context is very different.
If your elderly parent has some cognitive impairment, they may or may not have the capacity to consent to a sexual relationship. By the same token, just because your mom can’t remember what she had for breakfast yesterday, that doesn’t mean that she lacks the capacity to consent to an intimate relationship.
Decision-making capacity is the ability to weigh the pros and cons of a situation, articulate values around the available options, make a choice based on those values, and have that choice be consistent over time. Remember that you are dealing with a mature adult. If you have concerns about that new companion in your parent’s life, talk to them.
5. Give them grace around the big move
They say, “home is where the heart is,” which is why it is so devastating for seniors who, because of functional or cognitive decline, can no longer safely live in their homes.
Understand that if your parents are in this situation, you need to expect resistance to any suggestion that they need to move out of their home and into another environment. Aging is fraught with changes that sometimes mean the loss of what is comfortable and familiar; and again, there is grief in that loss.
Support your parents’ aging in place by being proactive about home safety, fall prevention and additional caregiving when needed. Share with them that the willingness to accept help may be the price they pay for being able to continue to live in their home.
Likewise, accepting the need to move from home to a senior living community may be the price they pay for being able to hold on to some of their independence… which brings us full circle and back to where our discussion began!
Life is a cycle. Many of my elderly patients carry a great deal of angst about having to depend on their adult children for support. I remind them that just as they made sacrifices to care for their children, life creates opportunities for their adult children to return the favor and care for them.
With the right support and encouragement, “parenting your parents” can be a very rewarding labor of love.
If you’re concerned about your aging parent, ask if you can accompany them to their next doctor’s appointment or find a geriatrician near you.