Caring for Aging Parents
Sooner or later, many in recovery will find themselves providing care to an aging parent or parents. They may volunteer to do so, or it may be thrust upon them. The assistance may come out of great family planning, or emerge suddenly and unplanned for in the face of a crisis. The parents may be parents who loved and cared for you, or parents who never cared for you. And, your assistance may be welcomed, resisted, and/or resented.
Regardless of which of the above descriptors fit the situation in which you find yourself (or may find yourself), caregiving is never easy and often stressful, but can also be very rewarding. Like many things in life, it tends to work more smoothly when knowledge and planning accompany the task.
The purpose of this article is to provide a small overview of a huge topic in hopes of decreasing the overwhelming stress of caring for an aging parent. This, in turn, will hopefully allow readers to provide such care with less threat to their physical sobriety, emotional sobriety, serenity, and sanity.
Shocking Statistics and Facts
- In 2009, over 65 million people in the United States spent an average of 20 hours per week providing free care for an aging family member, with an estimated value of $375 billion.
- Approximately 13% of family caregivers find themselves providing more than 40 hours per week of care for an aging parent.
- Women provide about twice as much of the care as men (2/3 vs. 1/3), and caregivers of aging parents typically are employed, have their own families (over one-third have children under 18 in the home), and live apart from the person for whom they provide care.
- There is great stress associated with caring for an aging parent, and that stress impacts the immune system (allowing more illness in the caregiver). Caregiving often creates depression, alters family dynamics within the caregivers own family, leads to reduced performance on the job, swallows discretionary income, reduces self-care, steals leisure time, and often leads to irritability, anger, and reactivity.
One can easily see the threat such caregiving demands pose to the maintenance of an ongoing program of sobriety and recovery.
As I stated earlier, knowledge and planning make this a smoother endeavor. So, how do we commence a conversation with an aging parent that will allow us to better plan and serve?
It’s not a bad idea to remember the flight attendant’s advice to put our own oxygen mask on before attempting to help others. Life is fragile and unpredictable, and accidents, violence, or illness can occur to anyone, of any age, at any time. Therefore, creating our own plans and advance directives are a great idea. Once we have, sharing them with aging parents can be an easy segue to having them do the same.
Saying something like, “I heard about a college student who was jogging and was hit by a car, and is now in a persistent vegetative state. Now I don’t think anything like that will happen to me, but if it does, I’ve made some decisions about my care, and want to share those with you.”
Then you could share information about your doctors and the friends you’d want notified, whether you value quality of life over quantity of life (or vice versa), who you’ve appointed to make medical decisions for you if you’re unable to make or communicate them, as well as what treatments and/or life sustaining interventions (breathing tubes, feeding tubes, artificial nutrition and hydration, etc.) you would or would not want, and under what circumstances you might want or not want them.
Finally, you could share with them the location of all of your important papers (bank accounts, insurance, will, etc.), and how you would want your “stuff” distributed if – God forbid – you actually died.
This is not an easy conversation to have. However, having had it, the door to now having the conversation about their values, preferences, desires, fears, location of paperwork, and key people becomes far easier than just walking into their home and saying, “We need to talk about…”
Issues to Address
The three most important issues to discuss, in a non-prioritized order, are:
- Having them complete a Durable Power of Attorney for HealthCare form (just like you did, hopefully), to identify the person they want to communicate and make medical decisions for them, if they are unable. These forms are available online, if you just search the term and your state. They must be either notarized or witnessed to be valid. Once completed, they should be shared with the family physician.
- Federal privacy regulations prevent physicians from discussing a patient, even with family members, without that patient’s permission. Having aging parents sign a HIPAA Release (available from your doctor), authorizing their doctor to speak with you about their case allows the physician to discuss the patient with whomever is identified on the form. This is so valuable, and should be done in advance of having a need for it. This form does not need to be notarized or witnessed, just returned to the doctor.
- Simply knowing whether they value quantity of life over quality of life, or quality of life over quantity of life, will help with so many decisions down the road. And the only way to know is to ask. Then you can ask about specific interventions, like ventilators (mechanical breathing), feeding tubes, artificial nutrition and hydration, and whether they would want these or not, and in what situation.
There are simply too many varied issues to address here, but certainly speaking about the three biggies (immediately above) will make everyone’s life easier if there is a crisis.
Another issue that comes up is housing – if they can no longer care for a big house, would they want to try to stay there anyway (with home modification and assistance)? Or would they prefer to go to an Assisted Living setting, with fewer responsibilities and more opportunity for socialization?
It is not uncommon for people who are aging to have thought about some of these issues, and to have developed opinions and preferences. Your job is to gently ask if they have, and if so, whether they’re willing to share them.-Jay Westbrook
- Don’t make promises you may not be able to keep. You can affirm your intention to do all you can to honor a specific request, but do not promise to do or not do something that may turn out to be impossible for you. This will help you avoid tremendous guilt.
- The cardinal rule in caregiving, for any caregiver, is balance, balance, balance. If you give more than you can afford – be it money, time, effort, or energy – you will burn out, and ultimately be less able to help as the need for help increases. On page 164 in the Big Book, it says, “But obviously, you cannot transmit something you haven’t got.” Self care and balance must guide your level of caregiving.
- Seek out caregiving support groups. Most local hospitals have and/or know about such groups, or see the “Resources” section below. People who have been doing this longer than you, have learned amazing “tricks” from which you can benefit.
- Let your 12-Step (or other recovery program) home group know what you are dealing with. There is always someone “in the rooms” who has already gone through what you’re dealing with. Allow them to share their experience, strength, and hope, so that you don’t have to reinvent the wheel.
- As with everything else, recovery comes first. If you are unable to stay clean & sober, you are unlikely to be able to offer help to anyone else.
- Ask for help. Ask your siblings, your parents’ friends, community organizations, and local hospitals, “Where can I get help with x or with y?” You do not need to do this alone.
These six links will connect you to websites that can provide invaluable information on and assistance in caregiving for an aging parent. Take a look at them; keep what works and leave the rest.
I hope this article has taken away any sense of you being alone in providing care to an aging parent, and provided a few useful first steps in preparing, or continuing, to care for an aging parent. I’d love to see your feedback in the Comments section below.
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