When the Tables Have Turned...

Slowly, over time, you'll notice that your aging parents are no longer strong and vibrant. They may try to hide this or even deny it to themselves, but you see it. When the telltale signs of physical or mental decline in parents appear, you know that sooner or later you've got to step in.  Its time to talk about their options.  You predict these conversations will be loaded with emotional land mines and you want to avoid setting off hurt feelings, anger or even rage. You may put it off for as long as possible. Yet, anxiety continues to gnaw at you. Stress levels can climb off the charts as you wonder about whether your elderly parents could seriously hurt themselves or someone else.

Maybe you've noticed their tidying up and taking care of themselves have taken a slide to the worse. This doesn't have you too worried, but you take note. The first major concern that usually grabs our attention is with driving. You worry that they may not be able to have the reflexes or eyesight to drive safely anymore. We've all heard the news stories about some poor elderly person who caused a major accident.  Another big worry is their ability to live without help. If they are forgetful, will they remember to turn off the stove? Take medication?  You know that losing balance and falling can lead to serious complications. You are reminded of this each time you see them wobble or misstep.

Why these caring conversations can be so difficult.

The idea of losing independence is dreadful to many. Independence is fiercely valued in our culture. Aging parents may be relentlessly attached to being on their own. What can be especially hard is for them is to admit being needy or lacking to their children, even if their children have been fully grown adults for years. Quite typically, elderly parents have always managed their own problems and challenges without involving their children. To admit no longer having it all together, both to themselves and to others is daunting for many. Of course, we are well aware of how devastating this can be for them.  We do not want to offend our frail parents, or tear down their denial and point out their ailments. We may empathize too much due to our own emotional charge from our parents losing their independence. To make matters more complicated, family members may disagree about necessity, timing, finances or severity of the issues. This can set off emotionally charged second-guessing because this is all new territory for the entire family.

The need for having these tough conversations doesn't go away, no matter how good we are at avoiding them.  The same issues keep showing up. They may even intensify until either something is done or something happens.  The phrase stuck between a rock and a hard place comes to mind. Even when you present the most reasonable, careful and thorough argument, the topic can be distressing for everyone involved. Aging parents may assure you everything is fine. They may have an answer for anything you say or change the subject. They may get really testy or make you out to be the bad guy.

So, how do you deal with this?

The good news is... the skills you developed in dealing with your kids, nieces and nephews come in handy here. A little planning and attitude-checking can go a long way.

It is best to start these conversations sooner than later, before they are necessities. Keep in mind there is no definitive one right way to handle them. Each family is different, and each situation is different. Be aware that everyone is doing the best that they can with what they know (including you!)   If possible, discuss what is happening with other family members to see what their thoughts and suggestions are. It helps to agree to be mindful of everyone's difficulties and to try to be as understanding and compassionate as you can. Decide how it will be brought up, who will bring it up and what the possible pitfalls and solutions are.

If you test the waters with "what ifs" and "have you thought abouts" before you have to, you may be able to steer past issues before they grow into major concerns. At the very least, this will give you an idea of what you will be dealing with.

Talking to others to see how they have been handling the situation with their parents can be helpful. Besides giving you ideas, this can help you segue bringing up the topic. You can position the talk as triggered by an experience of a friend or acquaintance. This way, you can plant seeds. You can talk about initial anxiety and resulting relief and positive outcomes without talking about them directly.

You also want to prepare yourself to have patience. You will likely have to have repeat conversations. Each one can be viewed as a step closer.

If your parents react with resistance, understand that the reasons for their opposition may not be what they say.  Often, the thought of change can be overwhelming for the elderly. Change in the environment can feel foreign to them. They find it reassuring to know where things are in their present, familiar environment. If they are struggling with memory, they may not want to admit it to you, let alone themselves. Knowing these underlying fears can help you address their actual fears, not only what they reveal to you.

Taking away the keys.

Both you and your elderly parents can feel that taking away their keys is taking away their freedom, perhaps even a big chunk of their dignity. Know that you truly may be saving lives if you resist being coerced to "butt out." One way to handle this is to suggest they take the driver's test more frequently than the required 5-year intervals.  How random is 5 years - a lot can change in that amount of time!  If they pass the test, they keep the keys. If they don't pass they will relinquish them. If you brainstorm ways to help them get out and about without a car, this can be less traumatic than it seems at first. For example, some people have downloaded and set up the Uber app for their parents and then taken them for an Uber ride to show them how easy it is.

Living arrangements.

At what point do or should you insist that your elderly parents either get help, move in with a family member or move to an assisted care facility?  Of course, this will vary greatly by family, too. Know that the arrangement can be much more positive when it is anticipated by both elderly parents and their children. Early discussions will ensure that the outcome will be better than when things have to happen fast due to sudden emergencies.  No doubt, earlier planning cuts down on any likelihood of having to resort to the courts.

Our parents can be set in their ways. They've done things their way for a very long time. Their fears can make things a lot worse than they have to be. With some preparation, compassion and tough love, we can help them adopt to new necessary changes, just as they have done for us in the past.