Posts Tagged ‘Communication’

Our aging parents are negotiating a dense web of personal transitions in the last phase of life. As Nancy Gordon points out in her article, Spiritual Care in Times of Transitions(http://www.spiritualityandaging.org/pdfs/CSASPIRSep08final.pdf), it is helpful for family members and senior services professionals to view these turbulent passages using William Bridges’ three-phase transition model: letting go, traversing the in-between zone, and integrating the change. (The Way of Transition: Embracing Life’s Most Difficult Moments) . As Bridges points out, people in transition generally move through these phases in fits and starts, across varying periods of time, rather than progressing smoothly from one phase to the next. In addition, our aging parents experience multiple transitions at the same time making managing any one of them even more difficult.

Underlying this dense web of personal transitions is loss. While loss is traumatic at any age, it becomes especially painful and overwhelming in old age. As our aging parents struggle to maintain some semblance of control in world where all control is being lost, new losses destabilize and demoralize their outlook. What can be done to help our aging parents regain their emotional and spiritual balance after having experienced a difficult transition such as a setback in their health, the loss of a spouse, or moving into new living accommodations?

1. Make the reestablishment of their control system your number one priority. Our aging parents are dependent on family members, friends, and senior services professionals to be their “control facilitators” amid the upheaval of these difficult transitions. Control facilitators are advocates that protect and enforce our aging parent’s choices in the face of losses.

Control facilitators help aging parents “reframe” their thinking about both the meaning and the opportunity that is part of a loss. As important, they provide the energy, organization, and creativity to reestablish control systems that preserve a new form of independence and dignity.

Reestablished control systems are essential for aging parents to successfully navigate a major loss without giving up hope. While it may take a wheelchair to get mom around following a hip fracture, it doesn’t mean she has to stop going to places she loves. With the right planning, transportation and support system, diminished ambulation does not have to equate with diminish options.

2. Make the offering of tangible choices your number two priority. Our aging parents need to experience first hand that their reestablished control system is operational and effective. They may be initially overwhelmed by their new circumstances and be understandably skeptical that things will get better. Taking the time to stop and provide concrete choices, even ones that may seem unnecessary, can have a reassuring and positive affect. They offer our aging parents the comfort of being in charge as well as a reason for hope as they struggle to come to terms with major changes in their lives.

The drama of our aging parents takes place in an emotional landscape, an environment that can overwhelm us without warning or apparent logic. We seem to be bobbing corks on an angry ocean of feelings that ambush us time and again. No matter how composed we appear to be to the world, most of us wind up with what I term “emotional habits.”

Emotional habits are habits that follow the emotional upheaval of our interactions with our aging parents. We tell ourselves we are going to be calm, objective, and detached only to abandon these habits within the first few minutes of struggling with them over even the most trivial matters. Why?

Part of the answer lies in the magnitude and source of the emotional energy that punctuates every aspect of the drama of our aging parents. It is helpful to step back and consider two these sources:

1. Childhood Adult children are not neutral players in the aging parents drama; they are forever the children of aging parents. They carry with them a wide range of emotions about their parents, all of them intense and complex. This is why it is so easy for them to feel panicked, angry and guilty at the same time. They are not just trying to care for their aging parents; they are tying to fulfill unspoken obligations that are unique to their childhood experiences and, even more painfully, ones only they truly understand.

2. Family Adult children are not isolated players in the aging parents drama; they are forever part of an extend family system that includes brothers, sisters, aunts, uncles, grandparents, cousins, and all the people they married. Adult children have many sets of eyes watching their caregiving efforts and all having opinions about it. So they wind up, consciously or unconsciously, frantically seeking layers of approval for contradictory and biased points of view that only escalates their emotional insecurities to unbearable levels.

Now what?

The first step is the gain an accurate perspective on the big picture. Most adult children are at an emotional disadvantage in working with their aging parents. This limits their objectivity, exaggerates their responsibilities, and increases the emotional vulnerability. Understandably, it makes them the primary target of their parent’s anger about in the “slings and arrows” of being old.

The second step is to gain an accurate perspective on the small picture. While adult children can not recast or ignore the emotional landscape the drama of aging parents, they can cut it down to size. While the complexity of the issues all beg a thousand things to worry about and to solve, the allocation unit of the journey is one day at a time. This should be the dominating insight that all adult children ask remember when they feel the pull of emotional habits. Here is the question they should ask themselves, over and over again: What is possible today?

Within this context, a number of important insights begin to surface:

1. I am in this for the long run and I need to make sure I am doing the things I need to do for myself that support the long run. Maybe this is just thirty minutes for a cup of coffee and the paper. Maybe this is a phone call to a “nutritious friend” who just listens. Maybe this is a surprising “no” when everyone expects you to say yes. Maybe this is a heart felt prayer that makes it clear you cannot do this alone. Within the day, you need long run moments that help you stay in the game.

2. I am doing the best I can do today with what I have. Tomorrow, next week, next month, next year will all arrive on schedule. But the allocation unit is one day. Only a few things will get done. Only a few calls will be made. Only a few needs will be met. Everything else will float into the future. No one can or should do more. Give it your best, engage in some long run moments, and see what tomorrow brings.

The goal is not to eradicate emotional habits; they are part and parcel of the drama of aging parents. The goal is to recognize them, resize them, and with patience and practice attenuate their impact.

I receive a steady stream of emails from adult children who are trying to work with angry older parents. In most cases, these caregivers are trying to find the best solution to a difficult situation(little or no planning, last minute complications, minimal resources, limited choices, no support system, etc.). Below is a response I recently sent to caregiver who stated “my mom hates me.”

Unfortunately, our aging parents may reject our attempts to be of help. In most cases it represents profound anger at their situation as well as their caregivers. Their outward displeasure and verbal affronts are the few tools they have left to exert control on their environment. When all else fails, control the caregiver with anger. It creates a miserable environment for everyone. You are hoping she will find some “happiness” and she is letting you know this is not going to happen and, more importantly, how angry she is at her situation and especially you. Now what?

You need to consider the boundaries of what you are trying to accomplish. Aging is a messy process and sometimes, despite our best efforts, things turn our poorly. It might help to tell your mother that you are doing “the best you can do” given the situation. She can choose to be angry, mean, and hateful. But it won’t change the situation or the opportunity you two have to work together. You don’t have the power to turn back the clock, make money appear, or correct all of the wrongs in her life. Your just trying to do the best you can to give her dignity and choices. No matter how angry she gets at her situation, the problems of being older won’t disappear. In fact, they get more complicated. The only thing that helps is working together to find the best choices.

Don’t expect your mother to jump up and hug you, apologize for her spiteful comments, and be a different person. But stay on script in a gentle and firm voice. Think of it as a campaign that you need to orchestrate over the next three months. Be compassionate, but stay on message and keep your words consistent.

Maybe you mother will not change her mind. If not, you at least are giving her a clear signal about what you can and cannot do. It returns a modicum of sanity to your world. Maybe she will tone down the anger part of the time, a small but significant reprieve. And maybe, just maybe, she may see the occasion to talk about her feelings and “test” how it feels to work together.