Editor's Note: The following is a report on the practical applications of Julie-Allyson Ieron's new book, The Overwhelmed Woman’s Guide to Caring for Aging Parents, (Moody, 2008).
When grown children who have received their parents’ care start caring for their parents, the stress of changing roles can either damage their relationships or draw them closer together.
If you’re a caregiver for your aging parents, you’re likely facing many stressful demands. Here’s how you can give your parents the best care while still taking care of yourself:
Help your parents face the truth about their limitations. Be honest with yourself and your parents about what activities they can no longer do well – from driving and cooking, to walking and paying bills. Initiate conversations with your parents about their needs, and be willing to do what you can to help meet those needs. Ask God to empower you to serve them in calmness, comfort, and compassion. Locate Bible passages that strengthen your resolved and encourage you. Talk to friends and other caregivers, and support each other in prayer. Keep in mind that, as you honor your parents, you’re ultimately honoring God.
Foster your parents’ independence. Help your parents make the most of the time they have left, living to the fullest despite their ages. Pray for God to give you His perspective on your parents’ value, potential, and continued callings. Talk with your parents about goals they may yet want to accomplish; then see how you can help move them toward those goals. Encourage your parents to consider ministries that fit their gifts and abilities. Research programs for seniors in your community.
Encourage your parents to take good care of their health. Realize that the fact that your parents are getting older doesn’t necessarily mean they’ll face disease or disability. Help them prevent illness and injuries or improve their health, in ways such as: exercising, eating a balanced diet, maintaining contacts with family and friends, praying often, and thinking positively. Instead of focusing on what they can’t do, focus on what they can do. Help them find opportunities to serve others so they can continue to contribute. Consider volunteering to do a service project with your parents. Challenge your parents to maintain the very best health they can, spiritually, physically, mentally, and emotionally. Talk with them about what legacy they want to leave for your family.
Make the most of rehab. If one of your parents must enter a rehabilitation facility for a while, choose the place carefully and prayerfully. Visit often to let staff members know that you’re watching how they treat your parent and you’re involved in his or her care. Partner with the staff to help your parent get the most out of therapy. Try your best to be encouraging, motivating, and positive.
Cope well with grumpiness. Aging can cause your parents to go through a range of negative emotions that can make them difficult to get along with well. Understand their grief over the independence they’ve lost. Encourage them that simply experiencing signs of aging doesn’t have to lead down a slippery slope of hopelessness or despair. Help them think positively even in the face of adversity. Help them feel loved by giving them focused attention regularly. Help them feel trustworthy by giving them as many opportunities as possible to make their own decisions about their care. Help them feel valuable by dwelling on their best qualities. Instead of trying to change their behavior (which you can’t), focus on what you can do – changing your own behavior toward them. Ask God to help you see the humor in difficult situations to relieve stress, and to respond in love rather than anger whenever your parents frustrate you. Ask trusted friends to pray for you and your parents.
Prepare well for doctor’s office visits. You’ll probably spend lots of time in doctor’s office waiting rooms. Prepare well by choosing the best doctors for your parents (in terms of both their medical expertise, and your parents’ confidence in them), streamlining your schedule to make time for medical appointments, trying to get the first appointment of the day so your parents will be more likely to be seen on time, bring work with you to do while waiting, bringing your parents’ complete medical histories with you, asking doctors questions about any issues that concern you or your parents, taking notes on what the doctors say, and asking for more information when you want to further research something. Find out about the various medications that doctors prescribe for your parents and make sure that there aren’t any potentially dangerous interactions between them.
Become a patient advocate for your parents. Speak up for your parents’ best interests when dealing with the medical professionals who are treating them. Ask your parents for their permission to receive their personal medical information so you can fight side by side with them for the highest quality of care. Ask doctors, nurses, lab technicians, and others questions to be fully informed about the decisions being made for your parents’ care. Talk with your parents about their treatment options and offer your opinions when asked. Before entering the hospital, ask your parents who should make decisions for them if they become unable to make decisions for themselves. Then make sure that the designated person – yourself or someone else – will be available and clearly understands your parents’ wishes. If you need professional help to oversee your parents’ medical care, consider hiring a geriatric care manager.
Help your parents cope with losing friends and family members. The older your parents get, the more people they’ve loved will likely pass away. Pray for God’s help for your parents in their grief. Listen to your parents express their thoughts and feelings. Give them opportunities to reconnect with old friends, as well as opportunities to meet new friends. Find a grief support group for your parents to join if they’re interested. Offer your parents ways they can continue to feel productive, such as by contributing to your family or serving others in the community.
Enhance safety for parents who choose to live alone. Go through your parents’ home looking for dangers (like leaky faucets, throw rugs, and extension cords) that need to be corrected, and consider what safety products you should buy (such as grab bars in the bathrooms). Get your parents portable telephones and invest in a personal emergency response system for them. Make sure your parents are taking their medications properly every day – the right dosages at the right times. Schedule in-home visits from professionals who can provide companionship and nursing care. Look for ways to help alleviate the loneliness your parents may feel: call them daily, have your kids visit them with you, bring them meals, encourage friends to visit.
Deal well with your parents coming to live with you. If your parents come to live with you, talk openly and honestly about the issues about which you need to reach agreement, like: Who will be responsible for what expenses? How will your home need to be retrofitted to make your parents comfortable? Who will do which household chores? Let your parents choose which items to move from their previous home to yours, and which to let go. Think about how you can take advantage of your proximity to each other to build closer relationships, such as having your parents play with your kids and teach them more about faith. Integrate your parents as fully as possible into your family’s life.
Choose an assisted living or nursing facility wisely. Thoroughly research facilities your parents are considering. When you tour potential facilities, evaluate them carefully, paying attention to factors like: quality of medical attention, cleanliness and attractiveness of the environment, ratio of patients to medical staff, personal contact with staff, and opportunities residents have for practicing their faith. Also consider the results of government inspections and whether or not your family can afford to pay the cost of care at each facility. Explain to the people in charge at the facilities what type of care your parents need, and ask them to describe the specific ways their facility will meet those needs. Once you’ve found the best facility your family can afford and your parents have moved in, find ways to continue participating in their lives and allow them to participate in yours.
Find hope if you’re sandwiched between aging parents and young children. If you’re wedged between dual caregiving responsibilities – both to your parents and your young children – remember that this is just a temporary season. Pray for the strength and wisdom you need to make the right decisions about how to use your limited time and energy. Consider what responsibilities you can outsource to others: hiring a cleaning service, asking other family members to prepare meals, and even involving your young children as you care for your parents by having them keep them company or do some tasks for them. Explain your parents’ limitations to your kids and answer their questions honestly. Help your kids have fun with their grandparents in creative ways. Help your parents participate in family life as much as possible, even if they must do so from their beds. Use humor to diffuse your stress.
Ask for help and find it. Realize that if you’re trying to care for your parents completely by yourself, you’re doing both them and yourself a disservice. Get some respite. Assess and clearly communicate the kind of help you’d find most useful. Ask for help from family members, friends, and outside sources like state agencies, senior centers, and churches. Talk with your parents’ medical team about finding caregivers with proven track records. Ask God to help you locate the right helpers to come alongside you in the journey.
Work with your parents when their judgment is impaired. When your parents can’t make the best decisions for themselves (because of dementia, an inaccurate assessment of their own limitations, or some other reason), you need to protect them from harm (such as by stopping them from driving if they’re reflexes or eyesight are no longer sharp enough, or by disconnecting the gas to the stove if they start fires when trying to cook). But you should also choose your battles so you don’t engage in a major power struggle unnecessarily. Make the time to genuinely listen to what your parents have to say. Elicit their cooperation rather than issuing them edicts. Give them information about their options on decisions that affect their lives. Include them in the decision-making process as much as possible. Ask questions instead of assuming that you always know what your parents need or want. Pray for the strength you need to be patient with them.
Care for yourself. You can’t take care of your parents well if you don’t take good care of yourself. Ask God to show you which of your expectations come from Him and which come from self-imposed guilt. Pray for the strength and joy you need. Contact your local hospital or senior center to find support groups and respite services.
Raise eternal issues with your parents. Watch for clear opportunities to talk with your parents about faith in Jesus, but be careful not to evangelize in ways that are inappropriate and alienating. Make sure that you’re living out your faith in ways that inspire your parents to want to share it. Let them see Jesus’ love flowing through your life. Become familiar with Scripture passages that explain salvation, and when you do talk to your parents about it, focus on the fact that everyone who calls on Jesus and trusts Him will be saved – no matter how old they are, or what kind of life they’ve lived up until that point. Ask other believers to spend time with your parents and pray for you to get opportunities to reach them with Jesus’ love. Pray for the ability to be a credit to God through the routine tasks you take on for your parents.
Seek support from your church. Ask some people from your church to visit your parents and do anything else they can do, such as deliver meals or help with transportation. Pray for the wisdom to know the right people to ask (you may start with your pastor and his wife, or someone on the care team if your church has one), and pray for God to bless those who help you. Seek out others in your congregation who are caring for aging parents, and form a prayer chain or small group to support each other.
Deal with anger. Ask God to help you understand what’s causing your own anger, as well as the anger that your parents are experiencing. Pray for God to diffuse the anger in your caregiving situation and infuse it with His grace and understanding. Keep a log of times when your parents become agitated, and see whether it reveals a pattern that can lead you to the source of their anger. Don’t hesitate to get respite when you’re feeling overwhelmed. Set boundaries (both emotional and physical) so you’re not putting yourself or your parents in danger while you’re still fulfilling your caregiving responsibilities.
Combat depression. Get your parents involved in activities in different places, such as social, church, and exercise groups. Listen to them share their thoughts and feelings; draw them out. Read and meditate on Bible passages about hope. If your parents are having trouble functioning due to depression, encourage them to see a counselor at least once. If depression is significantly affecting your life, visit a counselor yourself.
Manage dementia. Pray for the laughter and patience you need to deal with the forgetfulness and eccentric behavior that dementia brings. Journal your thoughts and feelings; then pray about them. Talk openly with family members and friends about your challenges and solicit help in a regular rotation of caregiving duties. Enroll your parents in respite services.
Make wise financial decisions. Ask your parents to show you where they keep important information that you may need to access if they ever become unable to manage their own affairs: Social Security and Medicare information, sources of income, bank account numbers, credit card numbers, insurance policies, debts, and the location of any safe deposit boxes. Discuss issues like health insurance, long-term care insurance, prescription drug coverage, and wills and trusts. Help your parents create a list of critical financial documents and make sure everyone in the family knows where to find that list. Encourage your parents to consult a financial advisor. Discuss signing a financial/legal power of attorney to allow someone they trust to make decisions for them if they become unable to do so for themselves.
Make wise legal decisions. Make sure your parents clearly communicate their legal choices while they’re coherent and able to legally sign documents. In the absence of signed documents, state laws – not your parents’ wishes – govern the decisions. Consider drawing up documents like a power of attorney for property, a power of attorney for healthcare, and a living will. Discuss whether or not your parents would like a Do Not Resuscitate order if they should ever need CPR. Pray for God to give you all wisdom and help you carry out your parents’ wishes in a trustworthy manner. Get the estate plans for both your parents’ estate and your own estate in order.
Seek support from hospice. If one of your parents becomes terminally ill, help him or her live as fully as possible before dying. Recognize that medical technology isn’t meant to sustain a life that God is taking. Pray for the wisdom and peace you need to discern when to let go. If your parent is no longer responding to curative care, he or she can receive pain relief and symptom management through hospice. Hospice will help your parent go through the dying process with dignity, and provide you with respite, support groups, and bereavement counseling.
Deal with your grief. After one of your parents passes away, turn to God with your grief and invite Him to use it to help you grow. Search for biblical answers to your deepest questions. Openly discuss your grief with some people you trust and to whom you’re close. Appreciate the legacy your parent has left behind. Direct some of the energy from your grief in positive ways by working hard to build a good legacy of your own.
Adapted from The Overwhelmed Woman’s Guide to Caring for Aging Parents, copyright 2008 by Julie-Allyson Ieron. Published by Moody, Chicago, Il., www.moodypublishers.com.
Julie-Allyson Ieron is the author of Names of Women of the Bible, and general editor of the Believer’s Life System Compact Size. Throughout her career in public relations and management, Julie has been a speaker and instructor. Julie has authored five books and contributed to textbooks on writing. Her articles have appeared in various Christian publications, newspapers, and business magazines. Julie, who makes her home in Chicago, is a Mentor/Master Craftsman with the Jerry B. Jenkins Christian Writer’s Guild and a contributing writer for Today’s Christian Woman.