A Geriatric Psychologist’s Perspective on Aging Parents:
5 Steps to Take During a Visit
Spending quality time with loved ones is usually something you look forward to. But when you have aging parents or loved ones, going home to see them can sometimes signify a rather different, and at times, stressful experience.
You may already have an inkling that Mom, Dad or a favorite aunt or uncle is having trouble with everyday life, but sometimes seeing changes in family members after months - or maybe years - of not seeing them can be disquieting. People change in their later years, and sometimes they can decline in health and spirit faster than you expect.
A Place for Mom expert and geriatric psychologist Dr. Melissa Henston provides some guidance on how to not only spot common problems, but tips on how to deal with any issues to get your elderly loved one the help they need.
1. Notice When Something is “Off”
You can spot problems the minute you drive up to your loved one’s house, Henston says.
“There are a whole bunch of warning signs that are easy to spot. For example, the exterior of the house has peeling paint, or the driveway isn’t shoveled or the walkway isn’t treated. Once you enter the home, newspapers are still in plastic wrap and mail is piled up. Maybe the house isn’t as clean as normal or has an odor. You can usually tell when something is 'off'."
Having a grandmother who suffered from Alzheimer’s in tandem with working in the nursing home practice in her ‘previous life’ (during college), Dr. Henston has a personal connection to the elderly. She decided from a young age that her primary focus in psychology would be issues in aging, and she has devoted her practice to improving the lives of the elderly, informing families about the signs that their loved ones need help, and helping find the right care options for each unique situation.
Since a health crisis in the elderly can escalate quickly and catch everyone involved off guard, it’s important to not ignore signs that something may be wrong. Ideally, families will have conversations with their children or loved ones about getting their affairs in order and end of life care well in advance of having any issues, but here are some signs to be cognizant of when visiting aging loved ones:
- House and yard need care / maintenance
- Disheveled clothing
- Broken appliances
- Spoiled / expired groceries
- Poor personal hygiene
- Cluttered / disorganized house
- Depressed or low energy temperament
Henston emphasizes the importance to noting anything out of character or outside of normal behavior. She remembers personally having the discussion of green eggs and ham with her own father. “I told my dad, ‘Dad, you can’t eat this stuff. Ham isn’t supposed to be green.'"
If health or happiness seems to be compromised, it’s time to have a conversation and address problems.
2. Approach the “Tough Conversation” with Care
Tread delicately when it comes to discussing retirement plans or end-of-life care. Henston comments, “Typically you need to look for the opening and opportunity, rather than just jumping in. Don’t try to take control. Try to get a natural conversation going.”
Remember that parents still consider you their child. You need to respect this relationship. Here are a few tips for setting the right ambiance for a positive and effective talk:
- Sit in a comfortable location, such as over coffee.
- Start with a normal, conversational tone.
- Ask open-ended questions, such as “How is it around the house?" or “How is driving going?” or "What have you and Dad been doing for fun lately?” to get the conversation flowing.
3. Don’t Feel Guilty
Henston relays that guilt is one of the biggest problems for family members. Many families make promises to their loved ones that they will care for them, but sometimes this just isn’t feasible. Senior living is often the best option for expert care, socializing and good quality of life. She notes:
“Mom, Dad, aunts and uncles — even spouses — feel a tremendous amount of guilt about putting their loved ones in senior living. But the most important thing is to overcome the guilt and assess the situation. Look at the logistics and whether caring for your loved one is accommodating to everyone’s life. If there is a single parent, finances may be a problem. But the biggest problem is often that caring for them can be a huge disruption to your life and their life. In reality it doesn’t work out well.”
It’s important to also remember that the role of caregiver may fall solely on the elderly partner — who may have physical limitations. In many cases, caregiving is passed to family members who may or may not have the time, finances or necessary skills to provide the best care for their aging loved one. Families need to re-evaluate their initial promise and determine what is truly the best choice for their loved one.
So much goes into the decision of caring for an older relative. Here are some questions Henston notes are important to consider:
- Can I take time off from work?
- Can I afford to stop work for an extended period of time?
- Can my children and older relative co-exist in harmony?
- Will my children be able to tolerate not always coming first?
- How will this impact my relationship?
- How will this impact my relationship with my older relative?
- How will my siblings and I manage this as a team?
- How will any of this be paid for?
This line of questioning is totally realistic and an important part of the process of making informed decisions. It’s important to consider these questions before having the ‘tough conversation’ with your loved one. Henston comments,
“The ‘promise’ is often made during an emotional time in which we do not feel we have many options. There are common emotional roadblocks when making difficult choices about caregiving, and families might want to consider seeking practical guidance to help all parties feel more confident during the transition.”
4. Have an Honest Conversation
Elderly loved ones usually appreciate an honest conversation. If you discuss that it’s important to communicate their wishes for retirement and end-of-life care, you’ll go farther than if you are condescending or dishonest.
Include them in the decision-making as it helps them feel as though they’re not being “put out to pasture.”
Talk to them about their options; whether they include staying in their family home and what that entails, or if they want to explore and tour senior living and retirement communities to see if any seem to be the right ‘fit.’ Many people still have a stereotypical image of what assisted living and nursing homes look like. Today communities offer anything from comfortable and intimate settings to large, almost resort-like communities that offer social activities and amenities. Does your loved one like fancy, intimate, or down-home and cozy? If they help you find one that is appealing, they may be able to get over the stigma and stereotypical view.
5. Consider the Risks
Henston discusses that it’s important to think of the risks involved if seniors live alone if they’re no longer capable. “There are many risks to consider if someone is truly living alone and shouldn’t be,” she relays. “For example, if there’s a physical issue where the senior has trouble getting around and they fall or get hurt it can be very scary. There was an elderly lady sitting on her bathroom floor who had fallen and couldn’t get up for 18 hours. Finally a neighbor noticed she hadn’t picked up the paper and checked on her to discover the problem.”
Here are some other issues to consider:
- Elder Fraud
- Physical Constraints
- Mental Constraints
If your loved one suffers from any of the above, there could be many consequences. From economical problems to depression and health problems; there are many things to think about. “If an elderly person can’t drive and get out easily, they can become depressed - it can become a situation of being imprisoned,” Henston candidly notes.
Above all else, approach the conversation as though it is a gift. You are concerned about their well-being and welfare. Henston reminds us, “Treat your aging loved one with love, respect, kindness and compassion. Consider what is truly the best decision for everyone involved.”
About Dr. Melissa Henston, Geriatric Psychologist
Dr. Melissa Henston is a geriatric psychologist in private practice with Colorado NeuroBehavioral Health, where she helps seniors and caregivers understand and navigate physical, cognitive and mental health changes. Additionally, Dr. Henston is a professor at the University at Denver, Graduate School of Psychology, where she teaches “Aging and Geriatric Psychology” to doctoral students.
Dr. Henston’s philosophy is that getting older is a unique process that requires self-acceptance and awareness to life values in order to achieve successful aging. She has worked with the Alzheimer’s Association, presented at conferences on aging, and lectured at the University of Colorado Health Sciences Center. She diligently works with families who are facing problems that may develop as parents transition into needing more care and performs neuropsychological evaluations on older clients to help them understand cognitive issues that can arise with aging.
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