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UCLA

Golden Rules

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By Dan Gordon '85

Published Apr 1, 2013 8:00 AM


Millions of Americans are caring for elderly parents, and the number is growing as the baby boomers enter retirement. The stress can be, and often is, enormous on the caregiver. Here are some tips on how to take care of your aging loved ones and still take care of yourself.

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Your day at the office was stressful enough, and the stop at your aging mother's house on the way home isn't helping. You arrive bearing groceries and offering to do laundry, but Mom would rather talk about her ailments. Only later in the visit do you learn she'd been in another minor car accident earlier in the day. Thankfully everyone was OK, but you know the time has come to ask her to surrender the keys.

In 2011, nearly 40 million Americans provided unpaid care to a declining elder—most often a parent—according to the U.S. Bureau of Labor Statistics. As the first baby boomers begin cashing their social security checks, no one has any doubt about where that number is headed. While the experience of caring for a loved one can be rewarding, it can also be physically and emotionally exhausting. Between assistance with feeding, bathing and dressing; driving to doctor's appointments; picking up meds and groceries; and assisting with financial matters, the experience is often so all-consuming as to affect other relationships—and the caregiver's own mental health. A survey by the website Caring.com found that one in four caregivers of ill or elderly relatives say they suffer from depression, nearly triple the rate of the general population.

"It's hard to watch a parent decline," says Nan Levine-Mann, co-director and eldercare counselor at the UCLA Staff and Faculty Counseling Center, which offers services to assist UCLA faculty and staff who are experiencing difficulties in their lives that affect job performance. "Often, you want to do more, but you have other obligations. A lot of people feel guilty that they can't do it all."

It's never going to be easy and every situation is unique, but Levine-Mann offers some general advice for making the best of a difficult situation.

Plan Ahead

While the tendency may be to postpone talk about sensitive topics such as finances, health-care directives and wills, these are far more easily discussed earlier than later. Beyond that, Levine-Mann urges caregivers to anticipate the road ahead, surveying what resources are out there ahead of time rather than waiting until they're needed. Consider what you will do when various levels of care are required and when your parent can no longer live independently.

Expect the Unexpected

Yes, planning is important, but also brace for the unexpected and be willing to reassess your approach when surprises inevitably occur. "You can think you're on top of things, and then your parent has a stroke or breaks a hip and you need a whole new game plan," Levine-Mann says. "Sometimes we become comfortable with the stage we're in, and fail to see when we should make alterations."

Set Realistic Goals

This goes for both you and your parent. Accept the reality that you can only do your best. As for your parent, if Mom has always been independent, it might not be worth insisting on taking over certain chores. If Dad has never shown a social side, don't expect him to agree to start playing bingo at the senior center.

Take Care of Yourself

It's easy to become so physically and emotionally spent from the caregiving experience that we ourselves become vulnerable to illness, mental or physical. The admonition that caregivers should take care of themselves is easier said than done, but setting personal limits and tending to nutrition, exercise and sleep habits will do both you and your parent a favor. "One thing we always have control over is our attitude," Levine- Mann adds. "Taking a self-soothing rather than self-aggravating approach when you're facing what seem like impossible tasks can make a huge difference."

Accept Help

Be willing to ask for and accept offers of help from family, friends, neighbors and coworkers. "There are typically people willing to do things, but we don't ask, or we think we can do it better," Levine-Mann notes. Many communities also have ample consultative and other resources—often at little or no cost—including taxi coupons and Meals on Wheels to family therapists who specialize in the geriatric population. Families can find out what they're eligible for at www.benefitscheckup.org.

Accumulate Wisdom

The UCLA Longevity Center has many links to resources for seniors and their caregivers. Visit www.semel.ucla.edu/ longevity/reference.

Practice Empathy

Some of the most wrenching decisions involve relinquishing of responsibilities—such as the need to talk to Mom or Dad about giving up the car keys because driving is no longer safe. These important discussions should be made in a way that honors the importance of independence to the parent and the difficulty in giving up control. When a declining parent expresses sadness, fear or anger over these and other changes, don't try to dismiss the concerns. "It can be hard to hear, but we need to listen and commiserate," Levine-Mann says. If clinical depression arises in the elderly, it can be treated.

Focus on the Soul, Not Just Tasks

It's easy to become so focused on chores, transportation, safety issues and other practical outcomes that we lose sight of the bigger picture—the experience of the parent in decline, and the relationship. "Try to be relaxed: Don't just go over there and feel like you have to do the shopping, cleaning and raking, but spend time with the parent," advises Levine-Mann. "Maybe it doesn't matter so much if the house is dirty. Talk about old memories and listen to what your parent is going through." By focusing on the process rather than the tasks, the experience will be more meaningful. "Caregiving can be extremely difficult, both physically and emotionally, but it can also be a great joy," Levine-Mann says. "It's an opportunity to get to know each other better, reflect, and tap into a rich history."

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