Archive for April, 2008

Here is a question I was asked from a caregiver who is feeling overwhelmed:

How do I respond to my 89 year old father who demands much of my attention and doesn’t understand that I have other responsibilities besides him? He lives in a senior residence five minutes away from us, where he is safe, gets meals, has nursing staff available, and other residents with friendly faces. I am his only living child. Guilt guilt guilt!

Here is what I said:

When older adults give up their primary living environment, they feel out of control. Even if the new facilities and support staff are ideal, they can not eliminate the psychological discomfort of being in a new space creates. For most elderly adults, their primary living environment represents the last area of control they have in a world of mounting losses. It sounds like your father is trying to assert some control as he comes to terms with his new living environment and you have become his primary focus.

While this is a natural response, it can be very taxing on the PRIMARY CARE COORDINATOR (PCC) of the family. Unless you find a way to “balance” his expectations, you will exhaust yourself trying to ameliorate his discomfort. For his transition to be successful, you both need “breathing room.”

One way to do this is to offer your father what I call “PREFERRED CHOICES.”? Preferred choices is a way to say to aging parents “you matter” but that you are not at liberty to ignore or renege on the other responsibilities in your life. Even though your resources are limited, you will insure that your aging parents retain a priority status in how they are allocated.

The set up for this strategy is straight forward. Despite the day to day demands of trying to get everything done, you are giving him first choice whenever you can regarding visits, appointments, and outings. If you can only come for a single visit on a given day, what time would he prefer? If you only have time Monday and Thursday this week for his next doctor’s appointment, which day would he prefer? This sends a clear signal that he is of central importance in your life and is not being left out. But it also sends a signal that there will be times when you can’t drop everything and take care of his needs.

This is not say that your father will the thrilled with the “preferred choice”? system. But it will reset his expectations and give him clear choices as to when he gets your attention. Without these boundaries, he will not be motivated to seek out other sources of support and attention in his new environment. Like you, he needs a new structure to rebalance his over dependency on one person to meet his needs.