blog-0057500001400697004Dear Michael:

My elderly parents live in Cleveland. So far, they’ve been okay, but lately my dad’s health is shaky and my mom’s mental state isn’t the greatest. I am the only child who lives nearby; my brother and sister live in Montana and Florida, so they’re not around much. I don’t know what to do. I feel I am going to get asked to have them move in with my husband and our two kids, and neither he nor I could handle that. I have suggested they consider assisted living, but they both say they want to die in their own house and that a nursing home would “kill” them. I’m driving up and back to Cleveland every weekend and they want me to come up more often. What about my own life? Help!

Dutiful Daughter in Cincinnati


Dear Dutiful:

I used to work for San Diego Hospice and learned a great deal there about caring for ailing or ill parents. Here are some things to consider:

As a caretaker, your number one priority is to take good care of yourself. Look at your family history: do you have a pattern of always being the caretaker, the one who makes sure that everyone is doing okay? What role have your siblings taken in the past? It’s helpful to know yourself and not fall into old dysfunctional family patterns. How can you balance the needs of your husband, your kids and your parents? Start by not doing it all alone. Bring your husband and siblings into this (and if your kids are old enough to understand, include them too). Let your kids and husband know just what you’re dealing with. Maybe the kids can help more around the house to decrease your stress. If you don’t tell them what’s going on, how can they pitch in and help? Even little kids can understand that “grandpa and grandma aren’t so strong and need help sometimes”.

At San Diego Hospice, I facilitated family meetings when a family member was ill or dying. Everyone in the family gets together and does specific problem solving: in this case, the focus would be how to best assist your parents with possible health/financial/quality of life concerns. The result of a family meeting is a “family plan” that is specific on who will do what for whom and when, e.g., you will visit your parents every other weekend and stay overnight one night, your siblings will call your parents twice a week and visit in person once a month, etc. If your brother and sister can’t make it in person to help create the “family plan”, include them on a conference telephone call or speakerphone.

A big part of caring for our aging parents is money. Financially, do your parents need help? If so, who is able to help them and how? Perhaps your siblings have financial resources that you and your husband do not. Perhaps they have more flexible jobs, and could come to Cleveland for a week or two at a time, to see how your Mom and Dad are doing.

Get help. Make a list of who can help your parents. Find out what’s available in their area. Do they have neighbors that they’re close to? Neighbors can often help you keep an eye on them. Do they have friends they see regularly? Do they belong to any social groups, bridge clubs, Senior Center? These are all resources that your family can tap into so you don’t end up burning yourself out.

Get information. In the family meeting, really talk with your parents and find out what they want for themselves. Talk with their doctors (with their permission). Find out how what financial resources they have (I know it can be tricky, but it’s important to see the complete picture) and get the details of their insurance and what it does and doesn’t cover. Do they have a Will? A Durable Power of Health Care? Talk with them about these important documents. Consult with an attorney if necessary.

Get respite for yourself. You can’t do this alone. Do your parents qualify for hospice or palliative services? For Meals on Wheels? For public transportation? Much of this information is available on the internet. If your kids are old enough to be computer savvy, let them help you with this. Get them involved in problem-solving (remember: they may be doing this for you and your husband some day).

Be flexible. Situations change: parents get sicker (or healthier) and your own family situation is likely to change over time too. Can you anticipate the future, discuss possible scenarios and get everyone involved in talking about what the options are and how the family will choose from among them?

Monitor your caretaker/codependent tendencies. You can’t do it all, no matter how much you (or they) think you should. Get a periodic reality check from your husband and kids. All caretakers need to increase their self-care. Get a massage now and then, talk with a therapist (or someone objective to “vent” to), get away for an occasional day or weekend with your honey (without the kids, if possible) and find a few minutes for yourself every day: read, garden, take a bubble bath, rent a funny video and watch it alone or with your man, go for a 15-minute drive in the car, buy yourself some new clothes, walk around the block…you know!

And, dear readers, don’t ignore this topic because you’re young and your parents are healthy. The best time to talk about the future with your parents is when things are going well and they are healthy and financially solid. The worst time is when something dramatic happens and no one has thought ahead or made any tentative plans for health emergencies, legal matters, Power of Attorney for Durable Health Care, Wills, Living Trusts, etc. Being pro-active now can spare you a lot of grief and panic in the future. God willing, we’ll all live long enough to age gracefully and die peacefully. Planning ahead really helps.