The Talk

Listen to this 'Talk of the Nation' topic

When a parent gets too old to work or drive or live alone, his or her children have to think long and hard about Mom or Dad's future. There are bound to be tough questions. Does Mom need extra help? Does Dad have to move elsewhere? Have they given thought to a will? Or a living will? Have you had a conversation with your parents about their future? If so, how did it go? What worked well? What didn't? If you haven't had it, are you planning to? Are you worried about it? Amy Dickinson, who writes the "Ask Amy" column, and Joseph Coughlin, director of MIT's AgeLab, join us, to take your questions.

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I'm 65 and just retired. I have talked candidly with my children about my finances, made arrangements for my estate, etc. We have been open about these issues for years. My opinion is that it's a dereliction of parental duty to leave these decisions to anyone else. It's not fair to the children nor to ones'self. We elders need to step up to our own responsibilities!

Sent by Carol Eckhardt | 2:07 PM | 1-17-2008

I work in Long Term Care and have to say the situation in our nation is really dismal. Talking with parents about meeting their needs would be far easier if our nursing homes weren't such terrible places, and if other options were easier to research. We need more regulation for options like assisted living and continuing care retirement communities to make sure they're safe, and we need minimum staffing requirements for all long term care. That way we can all have more peace of mind.

Sent by Julie Eisenhardt | 2:10 PM | 1-17-2008

This is such an incredibly difficult task. Parents are in denial. As they age, it seems their diminished capacities contribute to their reluctance to give up some independence in exchange for safety of themselves and others

Sent by Susanna | 2:12 PM | 1-17-2008

I cared for my mom for 3 years: Driving was a huge issue. She easily gave up her home, control of her finaces..but the car?! She had pulmonary fibrosis; which affected the amount of oxygen to her brain. Yet, she still wanted to drive her car. I simply said; You know Mom, the collision insurance on your car is a LOT of money, and since you are with me..why don't we take the collision off? She readily agreed! Than, when she wanted to drive I said: You know, we don't have collision on that car anymore. Maybe you better just come with me. She agreed happily; and I never had to tell her "You can't drive". Was that manipulative? It is not how you treat someone who is thinking clearly; but she just couldn't comprehend that she could drive no longer.

Sent by Jan Ellis | 2:13 PM | 1-17-2008

When do you know its time to have 24 hour assistance - my mother has Alzheimer's Disease.

Sent by Terry | 2:20 PM | 1-17-2008

Great show! I work at Caring.com, a website dedicated to helping people care for their parents. We have a great article on this topic that I can recommend to your listeners:
http://www.caring.com/articles/talking-to-your-elderly-parents

or just go to Caring.com and search for "talk".

Sent by Chris in San Jose | 2:21 PM | 1-17-2008

What do you do when an old person is still legally competent, but continually insists on making decisions easily deemed "bad" about where and how to live. I try to shield my mother from as many of the bad consequences of her decision to continue on in her home as I can, but on the other hand I feel like it's helping her to maintain an untenable situation.

It's especially hard when the person involved is beloved but was difficult and sometimes-irrational long before she was old. Bringing up a problem with her provokes a reaction more commensurate to having created it.

Sent by Dabney Braggart | 2:21 PM | 1-17-2008

As I hear Amy answer questions I am struck with how respectfully she frames the questioning of the person in need. I have a dear friend whom I help care for along with others of her friends, neighbors and family. One of her observations has been that, in the well-intentioned effort to help, the attempt ends up being unhelpful (reorganizing rooms, making/bringing food, building/fixing things around the house). It is so important to have a lot of input from the person who needs help!

Sent by Amanda Clarke | 2:24 PM | 1-17-2008

When faced with it - not just planning, I agree with the elder who states it is the parents responsibility first and then the children.

My brother and I are now assisting our father 84 and we are now nearby after having been away years earlier.

Would like to comment online on more specifics but unable to get through.

Thanks for the discussion

Sent by Brack Jordan | 2:31 PM | 1-17-2008

There is some great help available to caregivers. Go to http://www.extension.iastate.edu/homefamily/aging/
Also at www.extension.org, there is a lot of information about Family Caregiving.

Sent by Greg Reese | 2:31 PM | 1-17-2008

Ms. Eckhardt, I congratulate you and wholeheartedly agree. After years of trying to get my father to give us (myself and my 7 siblings) information about his finances, I finally succeeded in getting him to make a will and appoint a power of attorney on the day before he received his first chemotherapy treatment for liver cancer. Even then he wanted to take the will home and "think about it" until I pointed out to him that he stood a 2% chance of dying the next day just from the treatment. After he died about six months later it took me more than 18 months to track down and liquidate his assets, and I'm still not sure that I've discovered them all. It took hundreds of hours and thousands of dollars in expenses. This all could have been avoided with a little planning.

Sent by Howard Larkin | 2:34 PM | 1-17-2008

I am 60, dealing with an aging mother who lives 6 hours away -- and I'm an only child. I live just waiting for the shoe to drop.... However, my comment is about how to make things different in the future. To that end, my husband and I are open with our two children (28 & 37) about the issues with grandma AND about what we want them to know about OUR plans, desires, end-of-life wishes, etc. I'm fortunate that my mother is open to talking about her situation and has made it clear that she does not want to leave her community, her friends, her environment to move where my family is the only one she knows. I will strive to follow her wishes -- however I/we have acknowledged that she may be left alone in some kind of care facility much of the time (she still lives independently) as I cannot move to be with her (not that she wants this or expects it). I consider myself pretty lucky in that she is not the type to manipulate my feelings or guilt-trip me.

Sent by Karen in Des Moines | 2:37 PM | 1-17-2008

Please, please remember what's most important; the parent(s) quality of life. My mother has just passed away (at the age of 87) and yes she may have lived a little longer had we, three siblings who all agreed, interfered and taken over. Instead we let her be in charge as she wished and she had her dignity. We were in very close contact with her and even though it wasn't easy all the time, we allowed her to "be in charge". What's life if you loose your independence and quality of life?

Sent by Karin | 2:37 PM | 1-17-2008

For a surefire way to get family members and friends to help use caregiver.com reverse gift list:
http://www.caregiver.com/articles/general/reverse_gift_list.htm

Sent by gary barg | 2:38 PM | 1-17-2008

Don't discount the power of grandchildren. My grandmother has twice had to be hospitalized in the past year for health related issues. Both times, after be urged to do so by her husband and daughter for weeks, it was not until my wife and I talked to her that she agreed to seek the help she needed.

Sent by Rob | 2:39 PM | 1-17-2008

I am deep in the middle of caring for my mom (94) in another state. My two sisters are in two other states, also, so distance is a big difficulty. We've tried everything they mentioned, and more. I think the speakers are missing the possibilities of illness, i.e., dementia, playing a part. That, in combination with a stubborn/controlling personality is extremely difficult. There is also the question of how much the child can do if the parent thinks they have absolutely no problems and keep you out of their business. What about the POA? That is what ultimately gained us some control, but it all had to be done behind her back. It's been really terrible, and I think the speakers need to admit that it can be just that! We have had a care manager in her town to manage from that side, and she agrees that our mom has been particularly difficult. Every situation is different and I think it is impossible to understand unless you have been there.

Sent by Karen | 2:44 PM | 1-17-2008

I tried calling but can't get through. My Mother refuses to leave her home. She is ill and cannot take care of herself. Her Home was falling apart around her. We have tried everything, social services to lawyers. I live in a different state 1200 miles away. I cannot afford to keep flying back and forth to get her to the doctor and buy her groceries. We have put a new roof on the house because it was falling down around her. I pay all of her utilities because she had everything turned off because she was unable to get her correct payments to the correct utility company. I have had people call and say"Why do you let your mother live the way she does". I have asked what can I do? I do everything suggested. She does not take her meds, she does not go to the doctor,she does not eat well. She is a brittle Diabetic,has Demetia, recently diagnosis with Altzheimers when we had her in the hospital after being hit by a car. Thanksgiving she had another urinary tract infection and a heart attack. She lives alone, refuses caregivers and any help inside the home. What now?

Sent by Rose Menger | 2:45 PM | 1-17-2008

My 62 year old mother is a chronic alcoholic and I've spent a lot of time in Al Anon working on separating myself from her and this terrible 'family disease.'She refuses treatment, has let her health deteriorate so she is more like an 85 year old, and is spending enormous amounts of money paying caregivers so she can continue to drink. If I let it, caring for my mother could completely take over my life, leaving me bitter and lonely. I caution all caregivers to learn about co-dependence and making sure they have realistic expectations of what they can and cannot control within their parents lives. This doesn't mean that you don't offer or provided help! But it can be really overwhelming if you believe you are wholly responsible for another's decisions and actions.

Sent by Miriam | 2:53 PM | 1-17-2008

We at the Community Dispute Resolution Center in Ithaca, not far from Amy's hometown, offer a program called "Wise Talk" wherein we facilitate just these kinds of conversations with elders. We are mediators as well as facilitators and we believe that talk works! But sometimes, we need help, which is what CDRC offers, and what other agencies around the country might offer as well.

Sent by Madeline Maher | 2:53 PM | 1-17-2008

Karen, you are so right. We also did everything mentioned on today's program and more with very limited success. For years before his death in 2005, my father stubbornly refused all assistance. He fired several people we arranged to help with housekeeping, nursing care after injuries and physical therapy. At one point, with assistance from his geriatrician and a representative from the local agency on aging, we succeeded in getting him to give up his drivers license after several minor accidents, including him sideswiping a care while I was a passenger, and hitting my car in front of my house as he tried to parallel park. After a lot of bargaining, he finally agreed to give up his license on the condition that he could get it back when he could pass the state drivers test. So the next week he went and passed the driving test and got his license back. Dementia was definitely at play in this case, and it only seemed to reinforce his already stubborn personality. But when we had him tested for dementia he always passed, even though he frequently displayed confusion and delusional thinking in day-to-day life, including at one point a hallucination that there was a car parked in his bedroom.

To be fair, his mental condition and his ability to drive and take care of himself varied tremendously from week to week and even day to day. But he consistently blocked every attempt to help him until he was in such bad shape that he couldn't get out of bed by himself. Even then he complained constantly that he wanted to go back to his apartment and take care of himself. Some people just never will accept help no matter what you do. This is important to understand.

Sent by Howard Larkin | 3:16 PM | 1-17-2008

My concern about this issue is for my wife and myself. We're in our late 50's and have no children; she has no siblings and I have a younger brother. I don't expect his children to help to care for us, so we have to make these decisions ourselves, just the two of us. The difficulties are several, but boil down to: how do we realize that some of these decisions must be made, to move out or stop driving, and how do we logistically take care of this ourselves? I guess putting some of this into a living will would be good, but we don't know where to start. I hope we will be strong and honest enough with ourselves and each other to do this, but it is rather frightening.

Sent by Gary Webster | 3:18 PM | 1-17-2008

I am a 53 yr old woman with a 75 yr old mother who cares for my quadriplegic brother in her home. She is past the age for doing this, but will not let go. She complains continuously to my younger sister and I, but whenever we sit down as a family to have the "talk" she denies having any problems and says she cannot stop caring for him until she is "crawling". I live 7hrs away and my sister lives in the same town. We both spend lots of time there, doing home maintenance and I stay for a week at a time to allow her to go on short vacations with her companion. My sister and her husband have offered to sell their home and move into my mother's home so she can get an apt. and live her life while she is still able to travel, etc. She refuses, but still lays guilt trips on us, attempts to manipulate us and is in complete denial of her behavior. We are at our wit's end, but continue to play this dysfunctional game in order to keep our brother's sanity. I listened to your show today and wished it were just an aging parent we are dealing with. My husband feels we will just have to let it progress to a crisis situation before we will be able to make any functional changes in the situation. I recently had to take an early retirement due to a heart condition, and fear I will not be able to take over my brother's care when I have to on a full time basis. My sister has to work FT, so we are no closer to having an alternative to this situation. If there are any experts out there who can offer advice, or other people who have dealt with anything similar, I would love to hear from them. You should know that Medicaid/medicare only provides 4hr/day of unskilled care for my brother, which is used in the morning. The people are paid very little, and it is a revolving door of healthcare workers in and out of the house, with many days of no shows. We are responsible for many aspects of his care for the remainder of the day. I appreciate the opportunity to speak about this.

Sent by Shelley Rappaport | 3:50 PM | 1-17-2008

It seems to me that this issue is one, as difficult it is to individual families, it is guaranteed to become a big problem to our society in general as the elder population explodes over the next 25 years or so. Government agencies like the DMV take no responsibility for the elderly who are unsafe on the roads. They have told me that if a person is able to get there to apply for a license, it is not their responsibility to discern who should and should not drive. If not them, who? Doctors are notoriously reluctant to restrict driving licenses, in fact, does their opinion make any enforceable difference anyway? Neuro-psych evals that are able to determine who should and who should not drive, cost $400 and are not covered by insurance. There is no law that requires them anyway, so who would volunteer to risk their driving privileges? Dementia is so easy to deny, obviously by the demented, but also by their families and even medical personnel who could be held responsible for the consequences of unsafe people on our roads. And then there is the issue of what about our own futures? If our society can really require that drivers be safe, what will happen to us when we reach that stage? It is clearly a vicious circle and denial is more than a river in Africa.

Sent by Penny Sharpe | 3:53 PM | 1-17-2008

Reading these comments make me feel better, because my sister and I (being single) moved in with my aging parents several years ago. My father had Alzheimer's, and it took my sister, me and my mother to take care of him. We also had home health come in to help him shower. He was not bad to care for, but he could not understand why he could not drive. Now my mother has times when she is confused and can not understand things. I will say though that this is how things progress if we live a long time. We have to learn how to work with a decline in mental facility the best we can, with caring and love. Fortunately, our Mother is very easy to work with in terms of her finances, etc...

Sent by Carol Latham | 6:06 PM | 1-17-2008

hi, my name is Dominick, i'm italian and i'm 26, my mom's 59 and my dad's almost 70, i often think about the things you have discussed, it scares me and i don't really feel ready, i have only one sister, she's 25, she plans to live here in Salerno but i don't, i plan to move to Canada, is that a bad thing to do? will that break my parents' hearts, what should i do?

Sent by domenico | 8:35 PM | 1-17-2008

I can very much understand Shelley, with the aging mother and disabled brother. My Mom is 78 and cares for our disabled sister who is in her 30's. Fortunately, our Mom does not complain or guilt-trip us about this at all. If anything, she doesn't complain, or take time for herself or her own needs enough. We're a large family, with some close by, and do help them. Still it's a concern - just the two of them with my Mom's needs that will soon change, and my sister's that may change also, but are less predictable.

Sent by Pat | 11:59 AM | 1-18-2008

Hi, my name is Katy and I'm 27, my mom is 60 and is moving in with us next month. She is still ok for the most part but struggles considerably at work and her job has has a terrible effect on her health having been a huge factor in cousing a stroke a couple years ago. I convinced her to quit and move in with us in order to help us out. I have two kids that I homeschool and my husband needs help with the bills. My mother had insisted on suplimenting his income so that I could continue being home to teach the kids. Now she will be teaching the kids so I can go back to work and school. The transition has been much easier for her since she is coming to our rescue instead of losing her home and feeling incompetent.

Sent by Kathleen Vining | 9:34 PM | 1-18-2008

My 66 year-old father just had a stroke, and I have moved both him and my mother in with my husband and I until he gets stronger. My father is overweight, which was, in part, led to his stroke. Unfortunately, my mother is an enabler in this regard, and it's really been hard to watch the two of them continue their old eating habits. Whenever I try to suggest food alternatives, my mom gives me a look that says, "We're just fine, thank you very much." I want to help them, but I also want them to feel comfortable here. I'm the kid, but now it's my roof we're all under. It's very frustrating.

Sent by Margarita Maldonado | 8:28 AM | 1-21-2008

Hello,

I really appreciate NPR's recent efforts to raise people's awareness about talking with their aging parents about getting older. I recently listened to January 17th's Talk of the Nation Podcast & I think it was an excellent program. I work for a small publishing business in Omaha, Nebraska and our primary business is putting out the Your Senior Resource Guide. These guides aim to give adult children and their aging parents the information they need to know when searching for care/services for themselves and/or their relatives. Our website, www.yoursrg.com also has detailed information and thousands of listings nationwide. It's a wonderful resource for any adult child or senior with concerns about aging.

Sent by Jake Scott | 4:19 PM | 1-21-2008

Wonderful program. I'm a social worker who both works with adults who are worried about their aging parents and also cares for my in-laws who are advanced in age and presenting care-giving challenges. Everyone needs resources and discussion such as the one you offer through this program.

Sent by Susan Shulman | 5:43 PM | 1-25-2008

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