As children living in a bubble of love, we grow up seeing our parents as our superheroes. And when the reality of life knocks on our doors, we are forced to realise they are only human. Humans who did their very best to not only provide us with the basics of a safe home, nutritious food, and a good education, but also a carefree childhood filled with warmth, love, comfort and support. Humans, who, as age takes its toll, become frail, fallible, and need someone to hold their hand — literally and metaphorically.
It can be a bit overwhelming to witness this role reversal, to suddenly find that the loving hearts and beautiful minds you depended on to guide you are now looking to you for guidance. So today I’m going to walk you through the roller coaster ride called parenting your parents.
First things first, let’s look at the two types of caregivers. One is the caregiver who lives with the senior parent or parent-in-law, and the second is the caregiver who lives in a different home in the same city or a different city, or in a different country. Both will face a variety of challenges — some similar, some unique.
Before you embark on the journey of taking care of your parents, forgive them. Whether they couldn’t attend your school concert, were not there for your PTAs, didn’t allow trips with friends, didn’t let you study abroad, imposed their choice of career or spouse on you, or even let you down when you needed their support — forgive them their flaws and mistakes. This is not as much for them as it is for you. Letting go of these pent-up feelings will help you restart this relationship with a clean slate.
In any conversation you have with them, never point out their “dependence” or “inabilities” as personal failures, but talk about how natural it is to age and face age-related issues. Rephrase your words and emphasise how they are the one making the choices while you are there to make their life smoother. Reassure them of how by allowing you to care for them your parents are giving you a gift — a chance to say thank you for all they have done, a chance to express your love and respect for them. As proud independent individuals, most parents will appreciate this approach.
A special note for those caregiving for their parents from afar is this — let go of your guilt for not having your parents live with you. We each have a number of situations that prevent living together and you are doing your best. Sometimes, it’s the parent who doesn’t want to give up their independence of living in their own home. To deal with this, during vacations, visit them often and have them visit you too. Video call, send photos, and leave them voice notes about how your day is going or how something reminded you of them or how you’re missing them. Also maintain detailed communication with their domestic/nursing staff to make sure you get to know about small, simple needs your parents may not be sharing with you. Just because you live far away does not mean you can’t share your life with them.
Creating a care plan
What every adult taking care of an ageing parent needs is a ‘care plan’. Whether you’re an only child or have siblings, whether you’re married or single, whether you’re financially comfortable or not — a care plan is a must to meet your parents’ daily needs, prevent chaos, and retain your sanity while juggling a potpourri of responsibilities.
• Make a care planner. Based on your preference, it can be a digital or a hard copy one. Make a hard copy one for your parents.
• List the care team. From you to the household help to the medicine delivery to close friends/family who will visit regularly. Put their photos, names, contact numbers, and any other specific information.
• Create a care schedule. Make to-do lists to cover daily, weekly, monthly, quarterly and annual tasks. From taking baths to taking medicines, to regular health checks, to medical tests, to buying groceries, to paying phone/ electricity/ gas bills, to vacations — schedule everything.
• Do a safety check. Look over the house to replace sharp corners, add lights, reposition or remove objects they may trip over, and with their permission add CCTV cameras. Special focus must be placed on making the bathroom easily accessible and usable as majority elder falls happen there. Railings need to be installed on the stairs, in the bath area, on either side of the commode. An emergency bell/button should also be installed near their bedside area and bathroom — this will help them to call for help in case of falls.
• Make financial issues transparent. Add the budget, and list all income sources and expenditures here. Clarity in this department will put both your parents’ and your mind at ease.
• Legal documents checklist. Make a list of all legal documents (will, deeds, power of attorney, last rites wishes) related to your parents and note where these documents have been kept.
• Latest medical reports. The results of the latest annual check-up reports and the current medication prescribed by the doctor/s should always be easily available.
• Emergency contacts. In addition to friends and family who you know for sure will respond and their physician, add numbers of the nearest hospitals, ambulances, oxygen supply, blood banks, etc.
• List favourite and ‘unfavourite’ things. While keeping their current favourites in mind is a must, remembering what they don’t like is equally important, especially in terms of food, clothing, and yes, people. Incorporating their small favourites in everyday life, such as colour, TV soaps, things to do, preferred way of doing things will make them feel loved and cared for.
Common issues to be aware of and how to deal with them
Let’s take a look at some examples of issues you may face and the solutions. The core formula for caring for ageing parents is ‘Love + Respect + Compassion’. And the basic solution, which can be tailored to handle most issues, is this.
Tell them that you understand that they don’t want to do something particular at that time. Next, inquire about the reason to understand why they don’t want to do something. Then give them options or a time window when they would like to do the activity, so they get to exercise their choice and have a feeling of being in control.
Medication management
Whether the medication simply got over, or they’re facing some side-effects, or they’re fed up with managing the number of medicines they need to take, seniors often just stop their medication. On the other side, if they feel they have small health issues such as headaches, indigestion, or body pain, they take over-the-counter medication. We need to explain to them that both are big ‘no no’s. They should never stop old medicines or start new medicines by themselves without talking to you and their doctor because the side-effects may be drastic.
I know someone who saw their BP was low over a few days, so they just stopped their BP medication. When they began feeling weaker, the family checked and found out they had stopped the diabetes medicine instead of the BP meds. Thankfully, they caught this error in time!
To reduce chances of such situations, create a chart with the name of the medicine, its colour, and what the medicine is used for. You can also use pill boxes to segregate their medicines by doses and time of the day. If you live with them, they can just ask you regarding their medication change or if you live elsewhere, assure them that you’re just a call away. Even for small signs and symptoms, for example fevers, stomach upsets, they should always let you know and check in with their doctor. When they do inform you, treat it seriously and respectfully — don’t brush it off — because they should never feel shy or uncomfortable to call you.
Battling boredom
With age, loneliness creeping into a senior’s life is quite expected. And a lot of their loneliness have its roots in boredom. And with nothing to do, they start seeking attention from their children. And if you don’t make their wish your command, they begin to think their children are too busy. The truth is most children are busy managing their own households, careers, relationships, and don’t have as much free time as their senior parents.
Parents, however, don’t always realise this and feel like they are being neglected. This is why you must be vigilant about keeping them active. Encourage them to make new friends, new hobbies, call friends over or visit friends, play cards, Ludo, etc. If they are a couple, they can find company in each other by doing these activities together, especially if most of their friends are no more. You can also set up Netflix/Amazon Prime for them and show them how to navigate it.
However, suggest but don’t impose activities. It’s quite possible they may not feel comfortable doing what you are saying. At the end of the day, let them do what they like. You can try once or twice, but ultimately, it actually helps to let them get bored on their own. I had tried to engage my mom in several hobbies, new and old, but she just didn’t want to. But recently I heard she is choosing to go for drives again. Why? Because when my mom got too bored, she herself started doing things she enjoys. Give them the space for their positivity to resurface, for them to want to do things for themselves.
Food fiascos
They only want to eat for taste. This is one of the most common issues you will find. If meals aren’t tickling their taste buds, or the same sabzi is repeated for a few days, if a health drink comes in a flavour they don’t like, or salt/sugar/oils are regulated for medical reasons, they may flat out refuse to eat. In such cases, ensure that every day at least one meal and one snack is prepared the way they like. Show them how they benefit from eating healthy. Also ensure to have their relevant stats monitored — say blood sugar, blood pressure, sodium and potassium levels, etc. and use supplements/medicines as prescribed by their physician.
Hygiene hoopla
Habits change with age and you may find that a parent who used to bathe at the crack of dawn and after returning from office now refuses to even bathe once a day or even change their clothes. Inquire if anything in the bathroom would make their lives easier — handles, a chair, a hand-held shower. Ask them if they would prefer a sponge bath in their room.
Gently suggest if they would want someone to help with the bath — may be their spouse or you. Once, my mom kept insisting on sponge baths rather than showers, so I asked her why. She said she felt colder when taking showers — a simple solution adopted was to have someone regulate the heat according to her preference before she took her shower. Always politely enquire about the reason — after all, they are not children.
If a parent has incontinence issues and is refusing help to clean up after soiling themselves, don’t start making a huge issue. Remind yourself that these are the people who changed your dirty diapers. Parents may consider adult diapers demeaning, so while at home find alternate solutions. Also incentivise diapers by highlighting how they will be able to lead a full life outside and go to their favourite places freely.
Muddled money matters
Since financial well-being dictates our lives and our independence more than we’d like to admit, parents may have a hard time sharing or relinquishing control. When the staff salaries are handed out, ask your dad to hand over the envelopes. Highlight how expensive jewellery and a lot of cash lying around in the house threatens their safety. This is especially for those with ageing parents who live alone, only with staff. They are an easy target for break-ins and robberies so when visiting them, ensure that their valuables are kept in the bank and minimum cash is kept at home. This ensures that there is no temptation for the helping staff too and prevents them from slowly and steadily removing valuables from the home.
While some suddenly become extremely miserly, some parents begin overspending like there’s no tomorrow. Some may even refuse to settle their affairs — property, assets, cash, jewellery — by making a will. Shine a light on how they will help to take care of both themselves and you by managing their affairs. Call their trusted friend to help with this difficult conversation and have their trusted legal representative answer any and every question they may have.
Refusal to accept external caregiving
Extremely independent individuals, those who have worked all their lives, or run the household with an iron fist, may have issues with asking for help, especially from their children. Whether it’s something big or small, they may hesitate to ask, or even hide issues. Parents concerned about medical expenses or worried about their favourite food being stopped may hide stomach upsets, pains, and aches.
For example, if your parent was an excellent driver and now refuses to give up driving, find out why they insist on driving. Is it because they feel incompetent? Is it because they don’t want to burden you? Is it because they love long drives and don’t want to give that up? Take them on long drives as family quality time. Keep a chauffeur who can help them get around. Reassure that their safety will bring you peace, that they are being responsible citizens by not putting others in harm’s way, and shape stopping the driving as a request.
Timeless grief
Grieving a loved one is a very personal matter and everyone has their own process and timeline. Losing a spouse at any age is traumatic, but for seniors especially, it is extremely difficult. Not only do they feel an inexplicable loneliness, it reminds them of their own mortality. When they are grieving their spouse, please do not interfere or hurry their grief. Sometimes it may take a year, sometimes they may take their whole life to grieve. With my parents, when my father passed away, I was pushing my mom to start new hobbies and do old things she likes very early on in her grieving period — I did not understand that she needs more time to come out of her grief.
Today I understand that it was wrong on my part and we should not have tried to hurry her healing. Also, when I was coming back to Kolkata, I called my aunt to stay with her. This too didn’t give her the downtime she needed. A grieving person needs some alone time too to feel their feelings and let out their grief — they need their privacy to cry, or remember their spouse in their own way. A respectful, caring distance is also important.
Red flags for elder depression
An often overlooked aspect of elder care is their daily mental health and elder depression has such subtle signs that it is often mistaken for symptoms or side-effects of physical issues. Loneliness, fear of death, a history of depression, and hormonal issues can be some of the causes. Some of the red flags to watch out for include:
• Sudden weight-loss, loss of appetite, not wanting to eat their favourite foods.
• Becoming less social than usual, not wanting to meet their closest friends and family, not having conversations longer that two-three minutes.
• When a usually active person spends all day in bed.
• Excessive sleepiness, sleep disturbances, insomnia.
• Increased talk of death and feelings of despair, hopelessness, helplessness.
If you see any of these symptoms persist for over 21 days, please get in touch with a mental health professional.
To ensure their best care, like Mary Poppins, you have to be firm but kind. But always with respect. The priority of eldercare is to keep them healthy, comfortable, safe, and happy. And some non-negotiables you’ll need to incorporate always while navigating this new relationship are respect, empathy, compassion, kindness, and self-awareness.
While you are taking care of them in several ways, ‘parenting’ them, remember your parents are still people with a wealth of knowledge and respect. When things get challenging, and they will, remember that these are the people who have loved you unconditionally — even when you behaved in unlovable ways, and we all have. They are our Solar System. They took pride in each of our achievements. We can never repay what they have done for us. Remember the core formula is always LOVE + RESPECT + COMPASSION.
Minu Budhia is a psychotherapist, counsellor, founder of Caring Minds, ICanFlyy, Cafe ICanFlyy, and a TEDx speaker. Follow her on Facebook and Instagram @psychotherapist.minu. Email to askminubudhia@ caringminds.co.in
Caregiver burnout
THE PROBLEM
Caregiving, while something done out of love, a sense of duty, or both, can be overwhelming. Often, we do our duty at the cost of neglecting our own physical, mental, emotional, and spiritual needs, leading to caregiver fatigue and then caregiver burnout. This is a state when due to mental and physical exhaustion you cannot function effectively and your relationship with your parents starts suffering. While we do our best to care for our parents, it is essential to not put our own needs on the back burner. Here are some warning signs that you’re getting drained and need to take a pause before a caregiver burnout happens:
• You feel constantly guilty and frustrated at not being able to do more to help your parent.
• You feel a lack of control in your own life because you’ve put your personal life or career on a complete hold.
• You’re irritable and and often anxious, and panic when you are unable to reach your parents.
• You feel lonely, isolated and start withdrawing from your family and friends.
• Your physical and mental health is deteriorating.
• You are financially stressed round the clock.
• Your sleep patterns are disrupted.
THE SOLUTION
To cope with caregiver burnout, you need to do a few things.
• Let go of the wish to be the ‘perfect’ child. Just the way your parents learnt parenting while raising you, so will you learn while caregiving for them. Also, even as adult children, our craving for validation from the parents doesn’t go away. Learn to let go of the need to get a ‘pat on the head’ for everything you do right — we are flawed, imperfectly perfect humans after all.
• Be honest with yourself. Accept that you have chosen the caregiving role — out of love or duty — and the good, bad, and ugly that comes with it are part and parcel of the experience. Also, sometimes we have unrealistic expectations of ourselves and thus give in to some unreasonable demands too. Figure out what you can actually cope with and get help with the rest.
• Learn to ask for help. This doesn’t mean that you are any less good at taking care of your folks, just that you are human. Getting support is essential for not only your health but also for ensuring that you can give quality care for your parents. Whether this is in terms of hiring staff, getting siblings or family to pitch in, or having your friends take care of you, all of this is okay.
• Find your tribe. Whether online or offline, find a community of caregivers to talk to. They are the ones who you can vent to and get excellent advice from to manage everyday issues.
• Schedule regular breaks. Take 30-45 minutes of alone time every single day. Whether you laze on the sofa watching OTT soaps, go for a run, read a book with a glass of wine, meet a friend for coffee, or just take a nap — this is an act of self-care you must do for yourself. And even if it may seem impossible, along with these mini breaks, schedule fortnightly days off and short vacations too.
• Give yourself permission to feel your feelings. It is natural to get overwhelmed, to feel lost or lonely, or angry. Let these feelings out by first accepting that you feel them, acknowledging that it is not ‘wrong’ to feel these, and then journal to get them off your chest. And if things keep getting tougher, please reach out to a mental health professional.
