Family Therapy: Helping Aging Parents, and Staying Sane
May 22, 2009 – 11:34 pm
Examples - Helping Aging Parents
l Will and Marilyn had married late and had kids even later. With their kids
entering adolescence, they were confronted with the possibility of becoming
caregivers for Marilyn’s widowed mother after she fell, breaking her hip.
l Sarah has been a frequent volunteer for years, ever since retiring from the
school district. But her health has been failing recently and she’s not sure how
much longer she can live alone. She doesn’t want to live in a retirement home, but the last thing she wants to do is disrupt her children’s lives.
l Edward is a widower and has cancer that has spread to his liver. His children have A expressed concern over his living conditions, believing that he has not been caring for himself properly.
Definitions and Key Thoughts for Helping Aging Parents
l Aging is a natural process. The rate at which people age varies widely according
to many factors such as family history, emotional attitude, chronic medical conditions, and lifestyle.
l Although the risk of disability and illness increases with age, poor health is not an inevitable consequence of aging. Persons with healthy lifestyles that include regular exercise, balanced diet, and no tobacco use have half the risk for disability than those with less healthy lifestyles.
l Caring for aging parents can be gratifying, but that depends on a lot of complex issues, such as your own health, whether you are still raising children, financial resources, and emotional resilience. Even though being a caregiver is laudable, it is not necessarily the wisest decision if there are other options.
l The “sandwich years” is a phrase referring to middle-aged people who are
still raising children and are also caring for their parents. They are “sandwiched”
between these two generations, and it can feel like a vice grip or a well-coordinated
dance.
l As people age, their idiosyncrasies tend to become more pronounced. Easygoing
people may continue to be laid back, but those who were uptight at a
younger age may become more anxious or paranoid as they age.
l Persons entering their later years experience many transitions and endure many losses such as retirement; moving from parenthood to grandparenthood; lessened physical abilities, strength, and energy; the deaths of friends and peers; lowered social status; a tighter financial budget; and the loss of a
spouse.
Boston Therapy Assessment Interview
As you talk to the aging person or a family member, remember that aging and caregiving take many forms. Try not to project your own values. The older person may value independence far more than you would think is healthy, or the family member might be convinced that anyone older than 65 can’t be independent. Listen first, then gently respond as necessary.
Boston Therapy Assesment: Rule Outs
Medical:
Q1 If the elderly person is confused, has he or she been ill? Is there a chance of
depression, dehydration, other medical problems, or poor nutrition? (Several
medical conditions and depression can mimic the symptoms of dementia,
so always be sure that medical problems and depression have been ruled
out by professionals before making any assumptions about a person’s ability
to live independently.)
Emotional:
Q2 Is the older person lonely/depressed? (Simple loneliness can prompt a person
to reach out for help, sometimes acting needier than he or she truly is.)
General Counseling Therapy Questions
Q3 What level of care do you think you (or your loved one) need?
Q4 What are your (or your loved one’s) financial resources?
Q5 What medical issues are there? Are these terminal? Chronic? Permanent
but not debilitating? Degenerative and progressive? (Clearly, if a medical
condition is temporary, the future plans will be very different than if it is
terminal, progressive, or chronic.)
Q6 How do you feel emotionally about the possibility of needing to get more
care (give care to a loved one)?
Q7 What family members are available to help?
Q8 Is the aging person in danger?
Dangerous conditions would include:
– memory loss that leads to accidental fires, wandering, or destructive behavior;
– medical conditions that require constant supervision or that contribute to sudden loss of stability or consciousness;
– a residence that is deteriorated, unhealthy, or structurally too demanding
(e.g., too many stairs);
– an emotional state that could lead to extreme despondency or psychosis
(distorted thinking, such as paranoia).
Wise Counsel
When counseling, or providing therapy to, a caregiver, impress upon the person the complexity of issues
related to aging and the wealth of resources for caregivers and for the elderly.
Encourage the person to gather all the facts (from doctors, other family members,
neighbors, etc.). The goal is to find out how the aging person has been doing and
whether there are critical concerns.
Assess whether there is any possibility of physical or financial elder abuse or
neglect.
l Financial abuse occurs when friends or family members take financial resources
from an older person for their own benefit. This is a particular risk
when the older person is confused and no longer controlling his or her
own finances. Financial Abuse tends to increase during times of economic recession (Boston, MA is not immune to this).
l Elder neglect occurs when a spouse or live-in family member deliberately
neglects the needs of the older person for food, clothing, shelter, a clean environment,
and protection from extremes of temperature. Sometimes, this
occurs inadvertently when a previously healthy spouse becomes confused
or sick and is no longer able to provide a safe environment for a vulnerable
spouse.
l Elder abuse is physical violence directed at an older person. This could be a
form of domestic violence that has been ongoing for years but the victim is
now over 65. Or, it could be abuse of an older person by a caregiver who is
a family member or a stranger.
Action Steps –Boston, MA Therapy Tips
For older persons:
Poor health and the loss of independence are not the inevitable consequences of
growing older. To preserve health and independence, older persons should consider
the following strategies:
l Early detection of diseases. Screening to detect diseases early, when they
are most treatable, saves many lives. Older adults should be encouraged to participate in recommended screenings.
l Healthy lifestyle. A healthy lifestyle is more influential than one’s genes in
helping older people avoid the decline traditionally associated with aging.
l Immunizations. Flu shots, pneumonia vaccines, and other important immunizations
reduce a person’s risk for hospitalization and death from illness.
l Preventing injuries. Falling is the most common cause of injury with older
adults. More than one-third of adults 65 and over fall each year, and of
those, 20–30 percent suffer moderate to severe injuries that reduce mobility
and independence, says the CDC. Remove tripping hazards in the home
and install grab bars in key areas, like bathrooms. These simple measures
will significantly reduce an older person’s chance of falling.
l Programs to help adapt and self-management. Consider finding programs
to teach older Americans self-management techniques. These programs
help older adults cope with and manage the transitions of their later years.
1. Rank the Need
l Have the caregiver and the elderly person rank needs in order of importance.
Begin to brainstorm with the elderly person how those needs
can be met with minimal upheaval. Most of the time, the choice is not
between living alone or moving to a nursing home. There are dozens of
options in between, including:
– Non-medical home care for cleaning, meals, or home maintenance
– Meals on Wheels and similar programs for delivery of meals
– Help at home during key hours for things like bathing and dressing
– Adult daycare during daytime hours for those who have family members with them at other times
– Seniors housing complexes (apartment complexes with some extra supports available that are offered at a lower price for needy older persons)
– Shared housing with a younger person (who is not a family member)
– Retirement home living (that often relieves an older person of loneliness
or the need to make meals, maintain a home, and so on)
– Catered/sheltered care or assisted living (situations that provide meals,
some medication reminders, transportation to stores, and other support
services)
– Care in a private group home (where 2–6 older people might be cared for
by a couple who make caregiving their full-time job)
2. Consider the Effects
l Consider the effect of any changes in lifestyle on all family members,
not just the older one. A change in location, for example, will not just
affect the older person but also any family members who are going to
be involved.
l Attempt to keep upheaval to a minimum, especially if family life for
caregivers is already tense or demanding. (Adding a family member requiring
24-hour care to a household with teenagers or a special-needs
child, for example, might not be the best idea.)
3. Consider All Options
l Enumerate all the options and then give all of them much prayerful
consideration.
l Enlist several people—both in and outside the family—to pray about
the possibilities.
4. Give them something to live for
l Hobbies, prayers, purpose of any sort, giving and receiving love.
5. Develop Schedules
l A sense of stability and structure gives confidence to everyday life.
Thrive Boston Therapy provides help for Families dealing with difficult issues. To speak with someone from our team, call: 617-395-5806.
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