No Easy Way Out

In working with our aging parents, we encounter predictable dilemmas with no easy way out. Here is a personal story that echoes a common theme I hear about from adult children.

As my mother approached 90 and despite increasing frailty and responsibilities for my special needs brother, she simply refused any assistance. Every approach was rejected. The best we could do was build support scaffolding around both of them for when the bottom fell out.

This went on for years. Airline flights, phone conversations, involvement of other family members, protracted conversations with our family lawyer, meetings with my brother’s caseworker, and endless strategy sessions with my wife all ended with the same outcome. It was my mother’s way or the highway.

So we shored up the situation the best we could. Despite my mother’s objections, we purchased long term care insurance when she was in her late seventies. We petitioned the court so she and I could have co-guardianship of my brother. We got her to sign a Medical Power of Attorney. Then we waited.

In 2006, she suffered a major stroke. She survived the stroke but had to be placed in nursing care due to a severe disability. My brother was moved to a foster care home for special needs adults.

Slowly we all dug our way out. Her house, my brother’s living arrangements, her long-term care benefits, and her medical care were just the tip of the transaction iceberg that needed ongoing attention. After making a heroic comeback from a devastating stroke, she passed away in April 2007.

The take away message for adult children is this:

1. Advance as far as you can go based on the personality and the nature of your relationship with the aging parent.

2. Retest the boundaries of that advance periodically even if they appear initially absolute. You never know when there is some give in the system.

3. Build the best scaffolding you can with what you have.

4. Keep asking yourself this question: What am I responsible for?

5. Draft a “When The Bottom Falls Out” list of the items that will require your management. Print it out and then start making weekly annotations. Your brain works better with a starter document. Pre-thinking about the house, the Medicare forms, the Power of Attorney steps, and so on will give you greater stability in the midst of the actual chaos.

6. Rethink what you know about the final mission of life. Most of what we are seeing in our aging parents is a need to maintain control in a world where all control is being taken away. Nothing is going to change that. It is not a rational need; it is simply a developmental task. We have all lived them in our own lives. The problem with the last one is how deeply it is connected to our family systems. However, knowing its true magnitude reduces the guilt over trying to craft a perfect ending or trying to control things that beyond anyone’s capabilities.