Archive for May, 2008

We don’t. Older adults see where they live as the Alamo and will make their last stand defending it. We advance with logic, manipulations, and threats and they use any means at their disposal to repel us. Here’s why.

1. The place they call home is usually the last spot on earth they control and for them, control is everything in a world where all control is being taken away. They know that once they lose what they call home the “endgame” begins with no going back.

2. Older adults fear the loss of independence and nursing homes more than death. This is a telling finding from a recent study called “Aging in Place in America” commissioned by Clarity® and The EAR Foundation which examines attitudes of older adults and boomers on aging and independence (you can see a summary of the study at Aging in Place).

Most of us are compelled by our concerns over real or potential safety issues to get them to move. We are hoping at some point they will finally agree with us. In most cases, they never do. They may ultimately acquiesce to our pressure, but they are more than willing to “hold position” until events “force” a change. This makes us crazy because we can see it coming and are at a loss to understand why they remain blind to threat. What happens if they fall or have a stroke? But they don’t see it that way. They look at the same facts and come up with a different interpretation of the risk. Here is what they see.

They see their home as the best place to be especially if events take a turn for the worst. They aren’t blind to what is coming. In fact many older adults admit to “wondering” what’s going to get them in the end. The question isn’t “if” or “when;” the question for most older adults is “where.” They also know that once the fall, the stroke, or the heart attack happens they will most likely lose the place they call home. Yet when they weigh all these options, they usually chose to stay put.

So where does that leave their adult children? Mostly waiting. Waiting to see what happens. Waiting for the phone to ring. Waiting for a turn of events. For a population that is accustomed to taking action, getting things done, it is a frustrating and stressful role. But it also provides an important lesson about how both parties define success at the end of life.

We define success with our aging parents in part on our management skills. Can we keep everything together? Can we avoid a predictable disaster, complication, or setback? We are determined, stressed, and deep in our heart, afraid.

Our aging parents define success in part on preserving what they know will soon be lost. Their home. Their health. Their family. Their friends. Their mobility. Their finances. Their spouse. Having any of these another day is invaluable victory in the final phase of life.

So it becomes a dance between preservers and managers who both deeply care about each other even if they can’t always show it. It is two generations with two different agendas with different needs, hopes, and fears forming an awkward but essential partnership to navigate the unthinkable.

In the end it is not about getting them to move but rather helping them to get ready to move whenever the occasion presents itself. It is about helping them preserve the final independence, control, and hope for one more “good” day until its time to move on to something else.

When a parent passes away, we take on a new kind of work. I am not referring to the necessary “estate chores” of filing papers or clearing out the house. I am referring to the psychological process of sorting out the seemingly impalpable experience of the death of a parent.

Initially, the process is emotionally draining as we are tossed back and forth in time reliving the good, the bad, and the confusing. At some point we begin to settle down, organize “what just happened” last month or over the last fifty-five years, and begin to extract new meaning from the experience. It is a cryptic process that only reveals itself in layers, flashes of information or forgotten data, like pieces of puzzle, we are asked to ponder and ultimately rearrange. Here are some of the pieces:

1. Loss. No matter what we thought, we were wrong. Losing a parent hurts more than we planned. We are humbled at the power of biology even in the face of distant and dysfunctional parent-child relationships. We are like one of Dickinson’s orphans, surprised that we wound up this way with no clear idea how to feel better.

2. Regrets. As we ruminate over our loss, we find ourselves with a laundry list of regrets, a thousand things we might have done different, better, sooner, and always with more compassion. We find ourselves longing for a “do over” and, like Lear, the chance to “get it right.”

3. Insights. Despite loss and regrets, our heats understand that the mind’s dream of perfection is fools gold. This is earth and we know that all of us suffer human endings filled with ambiguity, regrettable choices, and good intentions.

4. Stories. We are surprised to find that our lives can only be understood and explained through our stories, including the one about the loss of a parent. We are equally surprised by how important for us to tell our story even though its emphasis and meaning keep changing over time.

5. Lessons. We rediscover the real meaning of life-long learning as we come face to face with what matters the most. We know that these insights may not change our lifestyle, goals, or priorities; but they give spiritual substance and renewed meaning to our journey. It helps us feel real in a world filled of rapid and never ending transactions.

We all hope our aging parents will be robust and independent as they navigate their eighties. Some will, but the majority, nine out of ten, will not. They will become frail or suffer from dementia. They will wind up not being able to take care of themselves. We wish it were different, but the statistics on “older bodies” are blunt: rapid deceleration from eighty on is the norm. How is this information useful?

1. It helps adult children and their aging parent understand the tactical choices they will face in the “eighties zone.” All eighty-something adults are going to need help at some point. What does that help look like? Can our aging parents give up some privacy to stay put? Are they willing to change living spaces if it gives them a better level of control over their lives?

2. It helps adult children and their aging parents understand the financial choices they will face in the “eighties zone.” All forms of additional help is going to cost money. Who will pay for it? Will it come from savings, home equity, or long-term care insurance? What is the best way to manage these costs?

3. It helps adult children and their aging parents understand the emotional choices they will face in the “eighties zone.” The loss of health is going to present some tough decisions. What situations do our aging parents want to avoid? What limits do they want place on medical intervention? When is it time to say goodbye?

These are not just questions we ask our aging parents; they are questions we need to ask ourselves. They not only give us a glimpse of our own future, but they help us feel the ‘weight” of what our parents are facing.