Filling Aging Parents’ Needs : Social Worker Offers Advice for Adult Children

Mary Nordeem, along with her sister and three brothers, helps care for their ailing father, Paul Mason Sr., 72. He is legally blind, suffers from Parkinson’s disease and often is confined to a wheelchair.

During the past 2 1/2 years, Nordeem said, Mason has come to rely increasingly on his children for meals and transportation. He’s started wondering how much longer he can live alone in his Stanton mobile home.

To find out how to better help him, Nordeem, 45, and her brother, Mike Mason, 37, attended a lecture on caring for aging parents given last week by Judy Friesen, a licensed clinical social worker at St. Joseph Hospital in Orange.

Friesen told her audience, mostly adult children of elderly parents, that the main point they should remember is that they have options in deciding how to care for their parents, and none of them are necessarily right or wrong.

“You often hear of role reversal--the child becoming the parent and the parent becoming the child. This is an untenable solution to the problem,” Friesen said. “Children can’t use how their parents raised them as a model because they’re now both adults. Children and parents will find reversal of roles uncomfortable, and it contributes to guilt and resentment.”

Adult children are increasingly caring for their parents because people are living longer, Friesen said, adding that about 300,000 people in Orange County are 65 are older.

Studies show that about 5% of them are in nursing homes, and another 15% are receiving some kind of care from their adult children, she said. “It ranges from just calling your parents regularly to find out how they’re doing to having them move in with you.”

A myth exists that children don’t care about their older parents, Friesen said. “In my work with families I’ve found that children do care.”

The demand for information on aging parents is so great, she said later, that in the 2 1/2 years since she started giving these talks, they have doubled from four a year to eight.

Friesen told audience members that they shouldn’t feel guilty about the way they choose to care for their parents. She said they should adopt “caring strategies” they and their parents feel most comfortable with based on six factors: time, energy, dependability, pattern of helping over the years, family members’ health and rapport.

“If you’re working full time and have children of your own, you’re probably not going to have that much time or energy to care for your parents,” she said. “Some children go over (to their parents’ home) and care for their parents. Others make arrangements for help because they don’t have the time or energy; it’s not that they don’t care.”

Dependable Hands-on Care

Children shouldn’t try to provide “hands-on” care for their parents if they can’t provide dependable care because of erratic or demanding work schedules and frequent travel, she said. “In families where children have a pattern of helping their parents over the years, like telephoning parents to see if they’re OK (and) running errands, it will be normal for them to be very involved in their parents’ lives as they get older.

“But if you grew up in a family where the pattern was for family members not to be that involved in each other’s lives, as the parent gets older and needs help, the pattern will be not to personally provide help.”

Children also should evaluate their own health limitations before attempting to care for an ailing parent, Friesen said. “Children with serious health problems, like a bad back or chronic illness, probably aren’t going to be able to provide hands-on care.”

Finally, she said, care will depend on family members’ relationships with each other. “Where you’ve experienced distancing, conflict or disagreement with your parent, when he or she needs help, you may not want to be the one that provides hands-on care.”

In families with several brothers and sisters, one child tends to take on a larger share of the load, Friesen said. She cautioned that that person make sure he or she is willing to take on this responsibility--and feel free to talk with his or her brothers and sisters if they’re not.

Too often the one taking on the greatest responsibility becomes overburdened because he or she doesn’t ask brothers or sisters for help. Friesen said they think: “Why should I have to ask them to help mom? She’s as much their mother as mine.”

Willing to Provide More Help

While she understands such feelings, Friesen said, she has found that children not directly involved in caring for their parents don’t really know about their needs. When alerted to them, these children generally are willing to increase calls to parents or to provide financial help to pay for in-home care.

As parents become more dependent on their adult children, Friesen said, the children often feel guilt, anger, resentment and sadness. Adjustment is more difficult when children unthinkingly rush in “to fix and make things better” when their parents need their help, she said. “You’ve got to sit down and honestly evaluate what you reasonably can do for your parent--and what your parent can reasonably expect from you.”

In making a decision on care, children often fail to consider their parents’ neighborhood and church friends who frequently want to help, she said.

She also advised including parents in the discussions about care, “even if they’re impaired or opposed to what you’re trying to do. Your parents have the right to hear what you say and to disagree with it.

“This doesn’t mean that they have the right to have things as they want them. But unless a conservatorship has been established--a legal document saying that your parents are unable to make decisions for themselves--you can’t make them do what they don’t want to do.”

Facing Difficult Choices

When parents no longer are able to live alone, family members are confronted with difficult choices, Friesen said. The parent can live with a child, receive around-the-clock, in-home care, or move to a nursing home.

After the lecture, Mary Nordeem and her brother, Mike Mason, said Friesen’s talk was helpful, especially in ways to more effectively discuss their father’s concern about continuing to live alone.

“He said he felt he might not be able to live by himself much longer,” Nordeem said.

No decision has been made about his living arrangements, she said. “That’s something we’re going to have to talk about.”