How to get across your aging moms

This post was initially included onKFF Health News.

It was undoubtedly a mistake. At the time, Kim Sylvester thought she was being responsible.

Her mother, Harriet Burkel, had broken both hips in a fall at their home in Raleigh, North Carolina, and was now recuperating in a rehabilitation facility. Harriet was 80 years old. Burkel’s 82-year-old husband passed away just days after moving into a memory care facility three years prior to his death.

Sylvester had watched her mother, who suffered from emphysema and peripheral artery disease, grow increasingly feeble and distant, and this had caused her a great deal of anguish. “I’d ask if I might be of any help. My mother’s standard response was, “No, I can do this myself.” I have no needs whatsoever. It’s okay, Sylvester said; I’ll handle it.

Sylvester could probe farther now for information. She unlocked her mother’s door and combed through any papers she could find. She characterised the situation as “a disarray” and claimed that “total disorder prevailed” with regards to the dispersed nature of the costs. Things obviously got out of hand.

Sylvester took swift action, cancelling her mother’s anti-aging supplement prescriptions, two auto service warranty insurance policies (Burkel wasn’t driving at the time), a one-year agreement for knee injections with a chiropractor, and numerous contribution requests from various organisations. Her mother became enraged when she found out.

“I was trying to help my mom, but I became someone she couldn’t count on; the enemy. I made a huge mistake,” Sylvester admitted.

It can be challenging to cope with elderly parents who refuse to accept offers of assistance. A senior should not feel as though their life is being run over by a locomotive. Instead, it’s important to show the elderly person you value their independence by treating them with kindness and respect.

It’s tough to observe an elderly person making poor decisions. Anne Sansevero, head of the board of directors of the Ageing Life Care Association, a statewide organisation of care supervisors who work with older adults and their families, said, “You can’t require that person to do what you believe they ought to do if that person is cognitively undamaged.” “Let them make up their own minds.”

That doesn’t mean grown children who are worried about their parent(s) must step aside or agree to everything their parent(s) propose. Rather, a broader range of skills is necessary.

Chicago-area author and retired doctor Cheryl Woodson learned this the hard way when her mother, whom she called a “really effective” woman, began experiencing mild cognitive decline. She started getting lost on the road and spending money on unnecessary items that she would later donate.

It wouldn’t help to scold her mother. In his words, “you can’t press people like my mum or try to take control,” Woodson told me. Since they changed your diapers and will always be your mother, you don’t dare tell them, “No, you’re incorrect.”

Instead, Woodson learned to appreciate her mother’s sense of maternal pride. To calm her down, I’d ask, “Mother, what year was it that Aunt Terri got wed?” or “Mother, I cannot recall the steps for making macaroni.” To what extent do you utilise the cheese? And then we’d just keep going, as if nothing had happened.

Author of “To Survive Caregiving: A Daughter’s Experience, a Doctor’s Advice,” Woodson, herself a carer, learned to apply the “does it really matter to security or health?” heuristic to her mother’s routines. It helped Woodson let go of her high standards, which were holding her back. She gave the example of how her mother used to put spicy sauce on pancakes by shaking the bottle. My brother would go crazy, but at least she was drinking, right?

“You do not wish to rub their nose into their inability,” Woodson said of his late mother.

When describing a psychiatrist in his late 70s who didn’t want to budge to authority, scientific psychologist and home therapist Barry Jacobs used a similar tone. The elder man stopped shaving and rarely changed his clothes after the death of his partner. He was diabetic but refused to consult a doctor, opting instead to prescribe treatment for himself. He insisted on driving even after a series of strokes severely impaired his vision.

As Jacobs sees it, “You do not intend to go toe to toe with somebody like this, because you will lose. They dare you to tell them what to do just so they can show you they will not comply with your instructions.

Is there another choice? “I would use compassion and interest in this individual’s pride as a basis for dealing with difficulty or modification,” Jacobs said. I might say, “Look, I know you don’t want to quit driving and I know this is going to be really tough for you. You will get over this; you’ve made it through other, more difficult transitions in the past.

“You’re attracting their perfect self as opposed to treating them as if they can’t make their own choices any longer,” he said. The older psychiatrist’s constant fighting with his four children led him to give up driving.

Another useful strategy is to “show up, however do it in such a way that’s face-saving,” as Jacobs put it. If you want to check up on your dad but he won’t let you, ‘go to his house and declare, ‘The kids truly wished to see you. Please don’t mind; we made much too much food. I wanted to stop by and see if it was okay if I brought it over. I’m writing to ask for advice on a problem that’s been bothering me.

This psychiatrist did not suffer from dementia, yet he was not as sharp as he once was. Difficult domestic interactions often take on a hue of cognitive impairment.

Leslie Kernisan, author of “When Your Ageing Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, and More,” recommends getting your parents clinically assessed if you suspect this may be an issue rather than trying to encourage them to accept more help at home.

It’s important to remember that “reduced brain function can impact an older adult’s insight and judgement and ability to comprehend the threats of specific actions or scenarios,” she said.

This doesn’t mean you should stop trying to communicate with your ageing parents who are experiencing mild to moderate cognitive impairment or early-stage dementia. “You always wish to offer the older adult a chance to weigh in and speak about what’s important to them and how they feel and what their concerns are,” Kernisan said.

She explains that parents are more receptive to their children’s ideas when they are presented as a way to aid them in accomplishing a goal they have already identified as important to them.

Sylvester’s mother’s move to an assisted living facility at the end of 2021 marked a turning point in her relationship with her daughter. Sylvester delayed two months before moving out because of the fury from her mother, who didn’t realise the move was permanent at first. After what seemed like an eternity, she entered Burkel’s room, a Valentine’s Day wreath in hand. “I’m so thankful to see you,” she said to him before he embraced her and retreated. However, “I’m so angry at my other kid.”

In response, Sylvester, who is an only child, said, “I understand, Mom. She did a good job of implying, but her management skills were lacking. She learned the value of a “healing fiblet” from Kernisan, the head of a household caretaker group Sylvester visited between 2019 and 2021.

Sylvester’s relationship with Burkel improved greatly after the visit, and the two women remained close until Burkel’s passing. “When something upset my mother, I would say something like, ‘Interesting,’ or ‘That’s an idea.’ You need to give yourself some time to adjust to the fact that your parent has changed significantly from the person you grew up with.

KFF Health News is one of the foundational programmes at KFF, a non-profit organisation that provides research, polling, and journalism on health policy at the national level. Learn the inside scoop about KFF.

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