“Why can’t we just force her to take the pills?”
I have heard questions like this from many involved in parent care. It would be so much easier to make the decisions and have them do as you think best. Instead, there is suffering with the bad decisions that parents make.
Some of those bad decisions affect the children and their ability to support them. Not taking needed medications can lead to more hospitalizations, more serious medical conditions and more expenses. The increased stress for everyone is difficult but what if the adult child can no longer tend to the parent in their home? or the parent no longer qualifies to enter an assisted living facility nearby?
Their Autonomy
Each individual has the right to manage their affairs as they see fit within the law and as long as there isn’t harm to themselves or others. It is no simple matter to take those rights away. And when an individual is under conservatorship, it doesn’t necessarily make matters easier. Sometimes it is clear and necessary to establish a conservatorship, but it should be considered a drastic step after other efforts to maintain safety and well-being have been exhausted.
Frustrations in the Middle
Parent care often can be a journey of increasing responsibility. Each action (or inaction), like taking one’s medication, has a decision associated with it. In the beginning the parent is autonomous and self-responsible in their actions. In the end, after they pass, someone else or many someones are responsible for their affairs. In between there are many frustrations when the adult child learns they can not trust the parent to make good decisions and doesn’t seem to have any consideration of the effect the bad decisions have on those around them.
My mother never learned the limitations of her aging body, neglected to use a walker, and often impulsively reached out for whatever she wanted causing her to fall. There were upwards of a dozen ER visits and hospitalizations due to falls that I attended. Over time, she lost independence due to the physical limitations and I, and the family, learned how we needed be responsible and, at times, what we could do nothing about.
It is rare there is a single event where the papers are signed and now you are responsible and have authority. Too often, adult children feel powerless to make changes and their lives are determined by their difficult parent. The parent too often will deny there are issues, act out in their own anger, won’t take advise, or won’t delegate, and yet still has enough capacity to personally manage many aspects of their life.
Doing the Right Thing
Addressing frustration and the taxing nature of responding to issues created by your parent’s actions or general decline is important so that you can be thoughtful and reasoned in what you do. It also is important later to know you did the right thing and or the best you could. There can be regret and self -recrimination when, in reflection, we see we were driven more by our triggered emotional response than by our thoughtful intentions for their well-being.
Developing Resources
The first step I recommend is to identify and organize resources. This is important in any case but can be particularly helpful when you have frustrating actions on part of your parent. By resources I mean more than money for caregivers to watch over your parent. I mean any and all organizations, professionals, and community including medical professionals, care facilities, personal support activities and groups for your self-care, siblings and other family members, friends, neighbors, and other community of your parents. Of course, I also recommend coaching when you are overwhelmed or feel there are skills that would be beneficial for you to develop.
The appropriate resources will change over time in terms of what is needed and should be an on-going search and development. Having become educated on resources will position you to get more involved than reactively taking charge when you get those out of the blue crisis calls. You will want to participate, at least be aware of decisions about their housing, lifestyle/community, hired support services, medical procedures, hospice, memorial services, legacy, and more. If your participation brings trust, you can have a much smoother experience.
Self-Care Is a Must
The other set of actions that I advise are around self-care. Taking care of yourself is not only part of settling frustrations so you can be present, it is also part of managing the wholeness of your life. You can’t take on the extra responsibilities that involvement with your parents decline brings without added self-management and care. Self-care can be almost anything that brings a sense of calm, satisfaction, or well-being. It can be simple gratification from a guilty pleasure. And it can be more organized and go deeper. It depends on you. I recommend the basics to start: getting in your body through exercise, settling your mind through mindfulness practices, and getting beyond yourself in community. Although self-care may take precious time in an already full life, it will enable you to do more and be present to more.
Do What You Can
You can’t manage it all. Disease and dementia are just two processes that can have a long middle passage and are beyond your control. There are many. You will likely have to deal with tough situations that were otherwise avoidable. Your parent will put their own mark on how things go. It is their life after all. Regardless, your involvement can change the course of care and their well-being. They can accept care when they have someone to whom they can give responsibility. And you can have more peace when you take charge of what you can do something about and let go of the things you can’t change.
© 2019 Rob Fellows, Parent Care Consulting