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CARING FOR AGING PARENTS

How to have 'the talk'

Understanding and diplomacy when suggesting lifestyle changes can be vital, experts on aging say.

February 06, 2012|Melissa Healy
  • When trying to persuade a parent that life changes may be in order for his or her safety and health, it's best to start with understanding and respect.
When trying to persuade a parent that life changes may be in order for his… (Tomas Sodergren / Getty…)

David Solie thought he was being a good son and a competent manager. But his strong-willed mother was having none of it.

Carol Solie, 72, had been caring for herself, her 28-year-old son, Roger, who has Down syndrome, and the family home in Portland, Ore., since her husband died in 1989. From David Solie's vantage point in Calabasas, it was too much. So once a month, he would travel nearly 1,000 miles north to set things right.

For The Record
Los Angeles Times Tuesday, February 07, 2012 Home Edition Main News Part A Page 4 News Desk 1 inches; 37 words Type of Material: Correction
Aging parent: An article in the Feb. 6 Health section on how to talk to aging parents about their care incorrectly identified the editor in chief of Today's Caregiver as David Barg. His first name is Gary.
For The Record
Los Angeles Times Monday, February 13, 2012 Home Edition Health & Wellness Part E Page 4 Features Desk 1 inches; 37 words Type of Material: Correction
Aging parents: An article in the Feb. 6 Health section on how to talk to aging parents about their care incorrectly identified the editor in chief of Today's Caregiver as David Barg. His first name is Gary.

This son decreed that his mother should move someplace easier to navigate -- an assisted living complex, perhaps. She should relinquish her role as chief caregiver to Roger, who could be placed in a group home. David Solie insisted on looking over his mother's finances. He also had some thoughts on what kind of car she should be driving.

After fending him off for a year, the indomitable Carol Solie sent her imperious son packing and stopped talking to him for almost three years. And so David Solie, who had cared for hundreds of elderly patients as a physician's assistant, was left to ponder the mistakes that resulted in his abject failure to communicate with his own mother.

The nation's 77 million baby boomers are not the first adults to care for their aging parents. But they are the first generation to care for parents who are living longer but with more chronic medical conditions -- and often far from their grown children.

More than 43 million Americans provide care for someone older than 50 who is aging or disabled, including 15 million who care for someone with Alzheimer's disease or dementia. Nearly 1 in 10 women ages 45 to 56 is a member of the "sandwich generation," taking care of an aging parent and her own children at the same time, according to a 2006 report from the Department of Labor.

For each of these grown children, there are moments when an aging loved one's safety seems to depend on that caregiver's ability to coax, cajole, persuade or coerce Mom or Dad to make changes in the interest of his or her health and safety -- changes that almost uniformly prompt resistance.

The caregiver's aim may vary -- to persuade a parent to turn over the financial reins, see a doctor, accept help with cooking or bathing, or give up those potent symbols of adult independence, the car keys. How persuasive he or she is may well determine whether car accidents, hip fractures, house fires and destitution will be averted.

Yet there is no accepted script for how this crucial conversation should go.

"In a generation or two it will seem normal and we should have it figured out," says Elizabeth Dugan, a professor of gerontology at the University of Massachusetts in Boston and an expert on aging and driving performance. "But for now, it is challenging, rewarding, exhausting and more."

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Different agendas

David Solie was finding his way, fitfully. In his medical training, he learned about the many stages of childhood development and the physical ailments that come late in life. But his training had neglected to teach him that aging too has its developmental demands.

His elderly mother's psychological needs were certainly different from his own. In his busy life, efficiency was key, he says. But he came to recognize that "efficiency was not on my mom's agenda."

What was on Carol Solie's agenda -- as with most aging parents at the threshold of needing their children's' help -- were two things, her son says. She had a powerful need to maintain control over her life at a time when age and illness were making that increasingly complex. And she nurtured a deep desire to see and appreciate that her life had meant something -- to consolidate her legacy.

When David Solie acknowledged those needs, he naturally "softened the reins," he says. He also softened his heart, asking his mom questions about her life and listening intently to her stories. Acknowledging to his mother that there were no longer easy ways to reconcile her safety and her desire to stay put, he asked what would work for her. Then mother and son struck compromises that built a network of support around her and Roger in their home.

If David hadn't recognized the powerful forces driving his mother, he concluded, his efforts to look after her would have been doomed.

"We arrive with the best intentions," says Solie, who gathered his insights into a book called "How to Say It to Seniors: Closing the Communication Gap with Our Elders." "We think, 'They're older, they don't get it. They're wrong and I'm right.' But right's not relevant."

Of all the excruciating conversations a caregiver will ever initiate with an aging parent, the "driving talk" is perhaps the worst. A loved one who has enjoyed all the rights, privileges and responsibilities of adulthood will not cede his or her independence and autonomy happily, nor perhaps willingly.

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