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Observations and commentary on aging, caregiving, and the complex journey through the second half of life.

Magical Thinking and Aging Parents

Aging creates complexity and emotional burden. Aging parents find themselves facing situations and decisions that are hard to figure out and even more challenging to manage. They feel overwhelmed and understandably look for ways to simplify complexities and ease burdens. One of the quickest and most effect techniques is magical thinking.

Magical thinking is the respectable cousin of denial. It doesn’t pretend there isn’t a problem. Instead, it offers an unrealistic solution. Problem solved. Here’s an example.

Ann’s parents are finding it more difficult to keep up their home. Ann has tried to introduce the idea of “other” living alternatives but her parents cut her off with the statement, “we will stay here until something happens and we have to move.”

While offered as a reasonable solution, it is pure magical thinking. Ann’s parents want to stay in their own home as long as possible, but any discussion about alternative living arrangements that involves leaving their home is emotionally overwhelming for them. The quickest way to get rid of this discomfort is to find a simple, magical solution. In the case of Ann’s parents, it is “stay put until the bottom falls out.”

The good news is that magical thinking works, if only momentarily. It allows Ann’s parents to defer the unbearable complexity and emotional burden of sorting out living accommodations to an undefined future event. Unfortunately, this strategy comes with a severe surcharge: the unnecessary loss of long-term control.

By refusing to admit that a conversation about future living accommodations, though uncomfortable and complex, is necessary to maintain optimal long-term control, Ann’s parents are betting their quality of life on a hope that things will simply fall into place when a major medical set back invades their lives. Now what?

Despite their persistent refusal to discuss the “what if” housing issue with Ann, she needs to find a way to break through this communication gridlock. One effective way is to create a “When The Bottom Falls Out (TM)” mind-map that visually represents their current “magical thinking” marching orders on a single sheet of paper. This diagram will help her show her parents the impact of “we don’t want to talk about and will wait until things change before we plan” approach to long-term control. It will give Ann the opportunity to diagram the myriad of complex and unanswered questions that will surface when the “bottom” does fall out.

The “When The Bottom Falls Out (TM)” mind-map is a simple and effective reality check that affords Ann?s parents a global overview of their choices and an opportunity to reconsider other options. If they hold firm to their magical thinking strategy, then Ann has less guilt about their decision. She did her best to reframe their choices in an effort to discuss other strategies, but was ultimately rebuffed.

But the good news is that in some cases a simple one-page diagram can be a change agent. It puts magical thinking solutions in a logical, non-judgmental context and exposes their limitations and untoward consequences. It also draws an important line in the caregiving sand for adult children. It says, “Here are my marching orders as I understand them” until further notice. Many times this is all that is needed for new conversations about non-magical options.

12 Comments

  1. Interesting information. Where do you go to find out more about the “When The Bottom Falls Out (TM)? mind-map”?

  2. I’m curious about the mind map too…do you have a link to a product or template. Thanks – JK

  3. I plan to post an example of the “When The Bottom Falls Out (TM)” mind in my next blog…

  4. I just finished reading a new book “MEMORY LESSONS” – by Jerald Winakur, a geriatrician. He eloquently and poetically describes the challenges faced not only taking care of the elderly, but also in taking care of his own seriously failing parents.
    It explores both at home and institutional care, but does it in a very personal empathic way. As a psychologist who deals with the elderly and their families, I found this beautifully written and very helpful.
    Dr. Charles Merrill

  5. I’m glad I found your site. I am completely stressed out by my situation. The bottom HAS fallen out for my dad (age 74). My mom recently passed away from cancer. They’d been married almost 50 years. She had always taken care of him because he is a brittle type 1 diabetic, very prone to insulin shock. Now he is alone, refuses help, and refuses to even discuss future living arrangements. He really can NOT live alone. I’m trying to prepare myself for what I might find when I go to his house someday.

    I understand the importance of elders’ keeping control of their lives by staying in their homes as long as possible. But because of his health, my dad isn’t just another elderly person whose lost his spouse. Living alone is life-threatening for him. What do I do??

  6. If the situation is life-threatening, then you need to take action. The first step is to contact an elderlaw attorney in your area and discuss your legal options for protecting your father from self-harm. This is the link to the National Academy of Elderlaw Attorneys (NAELA) http://www.naela.org/. On the home page is a “Locate an Elderlaw Attorney button. This will help you identify elderlaw attorneys in where you live. Each state has different laws regarding elders living in unsafe situations.

  7. I have been worrying about these same issues lately, but have started to wonder why it is so wrong to allow people to continue making their own decisions even when those decisions are bad. When our loved ones are endangering their own lives by refusing to move, maybe it is because they want to? They would rather stay at home and pass away by neglecting themselves than pass away in a place other than their homes, maybe? That is very hard for us caregivers to understand (and harder to appreciate), but maybe it is more peaceful for them? I don’t know — still working these musings out myself. Thinking out loud!

  8. From someone who has experienced both a negative and a very positive experience in caregiving for his parents, I would strongly suggest that anyone having concerns or issues with their aging parents consider hiring a Geriatric Care Manager (GCM). A GCM can provide expert advise and a sense of objectivity that is very difficult for family members to have.

    There is a national organization of professional GCMs. I’d encourage you to check out its website. http://www.caremanager.org/.

    A couple of great articles about the use and benefits of GCMs are “Worry-Free Care for Faraway Parents” http://www.bottomlinesecrets.com/article.html?article_id=47887 and “Why Hire a Geriatric Care Manager?” http://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

    Almost 19 years ago, my two sisters and I were forced to make quick decisions on the care for my dad who suffered from Alzheimers. He was living at home with my mom who had a major medical emergency and we were faced with finding a safe place for him. With limited knowledge and time, the only option we could find was an institutionalized nursing home. Although the care he received there the last 7 months of his life was adequate, I often regret we didn’t have better options.

    Fast forward to 6 years ago, my mom (now age 83) needed some place to live due to financial constraints. We were able to move her into our home where she lived for 5 years until passing away in April of 2008. We have a friend who is a Geriatric Care Manager and her guidance through that 5 years, including the last 4 months with Hospice, allowed me to bury my mom with absolutely no regrets.

  9. Glad I googled just the right words to find this site. I am constantly frustrated by getting rebuffed by my folks who are aging in place, unwilling to spend enough money for decent home maintenance, let alone improvements. Only medical crises have led to talk, but never action. Dad’s in a wheelchair in a split level home that has no bathroom on the main level–talk about “magical thinking.” Add his depression to the mix, and Mom engaging in various avoidance behaviors. I worry outsiders wonder ‘why don’t their kids take better care of them?’ ARGH. My latest idea is to stop helping them at all and force their hand. Does that ever work?

  10. While stopping all support seems like it would force their hand, it usually makes things worse. You are in a dilemma, not a problem. If it was a problem, there would be a direct answer. But it is a dilemma, which means it is messy with no clear win-win and no way to really stay out of the game. Keep focusing on the control issue and consider using “When the Bottom Falls Out” mind map. They will either give you so room to partner with them or simply hold “pat” until a medical crisis forces their hand. Like I said, it is a dilemma with no Hollywood ending…

  11. Thank you for pointing out ‘dilemma-not-problem.’ That helps with my expecatations. Now that I ponder more, I think we’re dealing with decades-old dysfunctions which confound things. It’s not just being ‘rebuffed’–it’s being rebuffed with a hateful attitude by Mom. This is why I consider pulling away. She and Dad have issues to resolve between them, and they’ve spent years leaning on us kids instead of each other. Magical thinking as a team would be an improvement 🙂 Regardless, I will look around your site more. There is so much helpful stuff here!

  12. My wifes mother is in great health and is a very intergral and active part of my wifes life, and as a result mine and our son’s. She is also quite elderly.

    Although my B and her mother have on the surface a close relationship, my wife has made it clear that as soon as her mother becomes a burden, through illness or age, she will send her back to China, either to her sister or to a nursing home.

    This is a very pragmatic approach, and oddly, her mother is in complete agreement with this.

    Now my wife claims to have been raised in a very close family, and this is borne out of the ongoing contact she maintains with the rest of her family, but something about the pragmatism of these relationships doesn’t sit well with me.

    They tend to represent relationships of convenience, which in my ‘Western’ world is the anti-thesis of the foundation for family. In any case, it has worked well for their whole family so far, and given that there has never been any family inheritence to fight over, the relationships have remained symbiotic and mutually beneficial.

    Of course, this is the easy part. If or when her mother ages to a point where she herself needs ongoing help, the pressures on the whole family will be compounded. Although I have some work colleagues who have easily transitioned their parent’s into a nursing home facility, the emphasis on family within the Chinese culture, I expect, would make this a more difficult proposition.

    Only time will tell, and although my mother-in-law is in great shape for her age, both mentaly and physically, she does have a worriesome tremor and increasing rigidity in her body, which is looking more and more like Parkinson’s disease.

    For those who know about this disease, it is progressive and insidious, and takes a terrible toll on the whole family in terms of the level of care that is required. For my mother-in-law’s sake, I hope that this care, no matter how difficult, is provided by us, and not a nursing home. It just wouldn’t be right.