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Managing the role reversal when caring for elderly parents

Pete Aarssen's picture
Thu, 08/30/2018 - 09:59 -- Pete Aarssen

Many of we ‘Boomers’ find ourselves aiding our parents in our own pre-retirement and retirement years and, for the most part, these duties approach slowly and with manageable demands; well for the most part! Usually they increase over time with the increased age and reduced physical and cognitive acuity of our loved ones that normally accompanies old age. These originally modest acts of assistance eventually build toward significant care responsibilities of the parent, their home or apartment until one day we find our familial roles reversed; the child becomes the primary care giver for the parent. In larger families this responsibility can be shared and in the smaller ones, well, let’s just say that I am glad I have 4 other siblings!

This stage in life is particularly unique to each family. Some of the pit falls to succeeding at it include establishing and understanding boundaries. Let’s face it, we are dealing with mature, almost always competent people, though that competence and the confidence that those supporting them have for their independent decision-making skills, reduces over time. When elders lose control over their decision making, like any adult, resentment and frustration are sure to follow. Children of the elder would do well to remember that these outbursts, when they come, are more in frustration for their own diminished state than they are personal attacks or ingratitude.    

In an article I recently reviewed, Seattle geriatric internist Dr. Elizabeth Kiyasu said that watching our parents lose their independence is one of the most challenging realities we face as our parents age.

“We’ve witnessed our parents’ decision making our whole lives, important decisions about us, their children, and themselves,” Kiyasu explains. “Then their decision making becomes impaired and we end up making those decisions for them. Even if we rarely doubt ourselves when making decisions for our own children, making decisions while caring for elderly parents remains inherently ambiguous.
“Eating is a perfect example. If our child isn’t eating, we simply insist that they eat for nutrition alone. But our parent’s refusal to eat a complex conversation which often pits our hope to see them healthy again against their determination to let go.

“The best thing to do is to make decisions that totally respect their desires. But trying to predict those desires can be really tough.”

If you are like me, running at the speed of life, I don’t always have the patience to discover all of my aging parent’s complexities. Recurring conversations of the same nature can be wearing on one’s nerves but with adult parents, we don’t enjoy the same ability to have them conform to our best of intentions. The sooner those conversations occur, the more prepared the entire family will be. “You need to gauge whether your parents understand the consequences of the decisions they are making, regardless if those decisions involve medication, finance, or advanced directives,” Kiyasu says.

Sometimes care needs lead to enacting the power of attourney for care. Often this change is embraced as it means fewer decisions for the parent and restored peace of mind that they won’t be swindled out of significant dollars for example but sometimes, it is deeply resented; the elder believing they are yet capable.

Dr. Kiyasu stresses there are individual nuances in every parent-child relationship:

“These decisions are never clear-cut for the children. We feel guilty when we admit exhaustion, or that the demands of our parents’ care fall beyond our skill set. People don’t realize they can place their parent in a nursing home for a limited stay, or that assisted living homes come in many different forms and styles.”

Now I can’t speak to all that Dr. Kiyasu implies, some of us have greater intimacy and trust with our parents and some of us don’t. Some parents embrace help others do not. But what I do know is that we children understand them and by virtue of our love for our parents, we generally accept this burden with resignation and improve our outlook from there! We need to persevere, to visit our parents as often as we can and try to maintain a positive outlook. Group therapy as siblings really helps, it is cathartic to share our experiences and for smaller families, support group type therapy outside of the family is highly recommended!

Caring for elderly parents is not easy but it must be done. We children have the privilege and the responsibility to care for and advocate for our parents. We have good heads on our shoulders and over time, we can determine what is needed and it is entirely reasonable to balance our own needs with our parents along the way.


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