Parents who have reached an age and capacity where they can no longer live alone grieve the loss of personal control and familiar surroundings. They fear dying alone, forgotten, or living lives that are a burden to those they love. Older parents grieve the loss of physical and mental abilities and their change of status in society. They fear being shunned by others.

Adult children grieve the relationships they once had with their parents and the loss of parental care. They fear that their parents will suffer or that there will not be enough money to care for them. They grieve changes in the family and the loss of family traditions such as Thanksgiving Day at mother's house. And they fear growing old themselves, facing the same problems as their parents.

Often adult children carry a huge burden of guilt when it is necessary for parents to leave independent-living situations. Making the emotional transition is as important as finding the right care options. Older parents may react with depression, anger, frustration, aggression, hostility, and fear when they must leave their home. Some become withdrawn and even self-destructive. Adult children may take negative social behavior as personal attacks, while the parents feel as though they are fighting for survival. These fights often take place within the family, but many older adults fully realize that they are not fighting just their children but an entire social structure and the way it views aging. ...

Many young men and women promise themselves and their parents that there will be no nursing home for the parents. Over and over again this promise has to be broken by the practical demands of life. There is also the commandment that children learn at an early age: "Honor your father and your mother, so that your days may be long in the land that the Lord your God is giving you" (Exodus 20:12). What does it mean to honor one's mother and father in the face of debilitating illness?

Convenience or quality of care. There exists a stereotype of the modern family in which Grandma and Grandpa are tucked away in a nursing home so that the family is free to have a carefree social life and travel without the worry of care for aging parents. This is seldom true. This stereotype has led some older parents to fail to consider the real reason most families feel forced to consider nursing home facilities - the quality of care. Many diseases require a carefully monitored balance of medication, and the inability to walk or take care of personal hygiene often means a full-time presence is needed to be sure older parents are cared for safely.

Honoring one's parents certainly means seeing that they are physically safe when they are no longer able to ensure their own safety. It also means allowing them to decide for themselves, as much as possible, the kind of care they receive and from whom. The tension becomes almost unbearable when the older parents do not want to accept the care their adult children think they need.

There are some elements of faith life that are important at any level of tension, compromise, and change.

Honesty honors both children and parents. As hard as it is to say clearly things that one knows will cause pain, it is the honorable action.

I finally said to Mother, "There are no more choices that will allow you to live at home, because you cannot walk alone and we cannot afford 24-hour nursing care except as part of a larger group setting. We love you, and we wish you could be young forever. But you can't, and we can't change what is happening to you. You can choose the facility you want to live in, you can choose what to do with your home and possessions, but you can't choose to live alone." - John, 54, son of Laurie, 86

Laurie had already broken one hip. She was mentally alert and her usual bright self, but her physical abilities were beyond living alone. It would be cruel to pretend otherwise.

I know that I have to make this adjustment, and that I have to be here. I hate that I can't do what I used to do. I hate it! I hate it! But my son said that he had no other choice and that I had no other choice. Pretending I was still 60 years old wouldn't help. I've been through a lot in my life, but this is the worst." -- Laurie, 86, homemaker

Another element of all conversations between adult children and elderly parents is appreciation. Whatever feelings adult children might have about their upbringing and shortcomings they perceive in their parents' lives, this is not the time for those issues to be the central focus. Most children, unless they are survivors of abuse of some kind, can be sincerely thankful for the contribution their parents have made to their lives. Genuine thanksgiving helps ease painful moments and is always a part of honoring one's parents.

A third element of honoring one's parents is respect of personal privacy and integrity of their bodies. Because adult children have developed paternal and maternal instincts toward their own children, it is easy to slip into treating their parents like children-in helping them dress and undress, telling them when to eat and what to eat, and so on. Elderly parents are often embarrassed by their children's attempts to help them with dressing and bathroom needs and prefer help from strangers instead.

Excerpted by permission from As We Grow Old: How Adult Children and Their Parents Can Face Aging with Candor and Grace by Ruth Fowler, copyright 1998 by Judson Press, Valley Forge, Pa., www.judsonpress.com, 1-800-4-JUDSON. All rights reserved.

Ruth Fowler is pastor of Community Baptist Church of Port Dickinson, New York. She has written several other books.

What challenges do you face when caring for your aging parents? What encouragement and advice can you pass along to others caring for aging parents? Visit Live It's forum to respond, or read what others have to say. Just click on the link below.