Caretaking Declining or Aging Parents

0:06
Hi everyone, I'm Kelly O'Horo and this
0:09
is Adaptable Behavior Explained. Hi
0:12
everybody. Thank you so much for tuning
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in today. I'm Kelly O'Horo, your host of
0:16
Adaptable and today I'm going to talk
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about a topic that is really personal.
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Um, it's what I'm currently going
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through. And, uh, interestingly, I seem
0:28
to attract clients that have a lot of
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parallel processing in their lives.
0:33
Maybe that's all therapists, but
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currently, I've just noticed a few
0:38
clients on my case load struggling with
0:40
the care of a declining parent or a sick
0:43
parent. And so I thought I would do
0:44
another episode on this because it's a
0:47
really really challenging season in our
0:49
lives and not everybody goes through the
0:53
loss or the decline of a parent in a in
0:56
rapid fashion. Sometimes it takes a long
0:58
time and it's gradual and and so there's
1:01
kind of a constant looking at yourself
1:03
and re-evaluating what is it that we
1:06
need to be doing right now based on my
1:08
current capacity, my parents c current
1:12
needs and it really requires a lot of
1:16
digging in deep. So, if you're wrestling
1:18
with decisions about a parent's care or
1:22
wondering, you know, when you're
1:23
supposed to step in and of course
1:25
feeling the weight of oftentimes grief
1:28
or guilt or sometimes even resentment,
1:31
then this episode is going to be for
1:33
you. So, like I said, I'm currently
1:35
going through this right now. My mom has
1:38
been ill for about 10 months. She
1:41
started declining a little bit before
1:43
that, but um she was going into liver
1:45
failure and we've been through a variety
1:47
of surgeries, a transplant, and then
1:50
several complications following her
1:52
surgery. And so it's really given me
1:55
pause and how to address and deal with
1:58
this topic because it's just really
2:00
hard. Um but ultimately, caretaking a
2:03
parent is is really a profound act of
2:05
love and sometimes it's heartbreaking.
2:08
you know, you're called to make choices
2:10
about their care and their lives. Um,
2:13
often with little guidance and of course
2:15
with a lot of emotion. And so you're
2:18
you're asking yourself things like, am I
2:20
enabling them or am I helping them? And
2:22
and when is something too much? And when
2:25
is stepping in necessary? And then when
2:28
is it that it's time to let go and let
2:31
nature take its natural course or or let
2:34
the person take their own agency? And so
2:36
if you're struggling with any of those
2:37
things, you're you're not alone. So like
2:40
imagine that your mom insists on living
2:42
alone after a a fall. And even though
2:45
she's struggling with memory or
2:47
cognition is starting to decline, you
2:49
want to honor her independence, but
2:51
you're also terrified that she'll get
2:53
hurt again. And uh you're, you know, you
2:56
kind of don't know. Do I step in? Do I
2:58
let them try? Is it potentially
3:00
life-threatening if something happens
3:02
again? and would your um you know
3:05
interruption have prevented something
3:07
that could be avoidable? These are these
3:10
crossroads that so many of us in a
3:12
caretaking role face and it's it's
3:14
really hard and it's it's hard every day
3:17
and so um you know please know that that
3:20
there's resources but mostly it's it's
3:23
about finding connection and supports
3:24
when this is going on. So let's talk
3:27
about the practicality of things. You
3:29
know, we all have only so many minutes
3:31
in our lives. And let's face it, when
3:33
our when our parents start to decline in
3:36
age, our lives don't just stop. We still
3:38
have our jobs and our responsibilities
3:40
and our commitments and our other family
3:43
members that we, you know, have time
3:46
that we spend with them and and things
3:47
like that. And so we we first look at
3:50
the limitations on time. So we've got to
3:52
look at them and say, "What do they
3:55
need?" And honestly assess those needs
3:57
honestly. What can they do safely by
3:59
themselves? What things are slipping?
4:02
And what areas do we need to offer
4:04
potential modifications in their
4:05
activities of daily living? What do we
4:07
need to do? I know that as my mom
4:10
started decline, you know, one of the
4:11
first things we did was installed uh
4:13
safety rails in her bathroom for the
4:15
shower and for the for the bathroom when
4:17
she got out so that she, you know, would
4:19
have less of a chance to slip and more
4:20
safe things to hold on to, you know. And
4:22
that was a small intervention, but
4:24
something that we needed to be proactive
4:26
about. But you want to ask yourself, am
4:28
I helping them maintain independence or
4:31
am I taking over out of our own fear or
4:34
of our own guilt? So this is where we
4:37
have to look at that line of enabling
4:39
versus helping. Helping means supporting
4:42
their autonomy and their dignity.
4:45
Enabling means shielding them from their
4:48
own consequences that might actually
4:50
prompt needed change or care. And it's a
4:54
tricky dance, especially if you have a
4:56
propensity to be of an overfunctioner. I
4:58
know that's my adaptation is
5:00
overfunction and step in before anyone
5:02
even asks because I'm very um I want to
5:06
help people avoid their discomfort and
5:07
ultimately my own discomfort of watching
5:09
people suffer. And so they're my
5:12
personal work that I've had to unpack.
5:14
And so if that resonates with you, check
5:16
out the episodes on codependency and
5:18
boundaries because those are going to be
5:19
good ones for you to watch. But let me
5:21
give you an example of of this kind of
5:23
toiling the line between enabling and
5:25
helping. Uh let's say your dad keeps
5:28
forgetting to take his medication and
5:30
you start calling him every morning to
5:32
remind him, but then he still misses
5:33
doses and eventually you realize it's
5:35
time to set up like a pill organizer or
5:38
arrange for a visiting nurse to come
5:40
make sure it happens. So helping is
5:42
about finding solutions that empower and
5:46
help one remain autonomous, not just
5:49
patching over problems. I will say on
5:52
the topic of medication, there's an
5:53
outstanding um resource called the hero
5:57
and it is a machine that houses the
5:59
medications and it's monitored by an app
6:01
that you can have on your phone as the
6:03
caretaker as can the the patient
6:05
themselves and you can see and monitor
6:08
medications from afar. You can also load
6:10
up to like 10 pills in this um machine.
6:13
It's so awesome and Medicare covers it.
6:16
So, it's not even something you have to
6:17
pay out of pocket. It's like 36 bucks a
6:19
month for Medicare, this little machine.
6:21
So, anyways, highly um recommend
6:23
checking out the hero. We'll put the
6:24
link in um to that app in the
6:27
description below. But back to the thing
6:29
about when is it that time to take over
6:32
and when is it, you know, enabling. Do
6:34
you have a medical power of attorney and
6:36
when do you start to exercise that?
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Well, the answer is when they can no
6:40
longer make safe decisions about their
6:42
health or about their finances, this is
6:44
when you're going to need to step in.
6:47
So, when their judgment is impaired by
6:49
their illness or dementia or their
6:51
confusion is too profound and they keep
6:53
mixing things up that are really
6:55
potentially dangerous, you have to kind
6:56
of step in. And this is when
6:59
professionals will advise that it's time
7:01
for you to take over. So, let me give
7:03
you another example. Um, let's say a
7:05
friend shared how her mother after
7:08
having a stroke began making really
7:10
risky financial decisions and the family
7:13
really struggled with guilt, but
7:15
ultimately stepping in as medical power
7:17
of attorney protected her from harming
7:20
herself and ultimately ensuring that her
7:23
wishes were respected. And so we have to
7:26
figure out what's the difference and
7:28
when should we really step in. So, I
7:31
recently saw a reel with Hassan Minaj
7:34
and uh Mel Robbins and they were talking
7:37
about the let them theory and I loved
7:39
the example that they gave because um
7:43
you know he's talking about like when do
7:45
you step in or when do you let go or
7:48
when is letting go not safe? Um and I
7:50
just it really resonated with me. So
7:52
with the let them theory, it says that
7:54
we should let people make their own
7:56
choices even if we disagree with how
7:58
they're handling something. But when it
8:00
comes to a declining parent, letting
8:02
them can mean worse illness or
8:05
potentially even death. And so again,
8:07
how do we find the line there? So let's
8:09
say your parent refuses to use a walker.
8:11
They insist that they're fine and you
8:13
want to respect their autonomy, but
8:16
after a second fall and a broken hip and
8:18
and a surgery that follows, you realize
8:21
that letting them isn't loving. So
8:24
sometimes you have to step in and insist
8:26
that this is necessary even when it's
8:28
uncomfortable. And that's where we have
8:31
to recognize what are they currently
8:33
capable of and what are the the
8:34
potential outcomes of not stepping in.
8:36
You know, as as a therapist, we're
8:38
mandatory reporters and we're listening
8:40
for things like is someone letting an
8:42
adult, an elderly adult, be neglected or
8:46
are they being harmed? And this is where
8:47
you have to kind of ask yourself, if I
8:49
don't step in, is this potentially
8:51
neglect? And this is really where grief
8:54
and guilt and resentment can creep in
8:56
because you're feel you feel like maybe
8:58
you're betraying them or you know you're
9:01
losing the parent that you knew because
9:02
that relationship has changed so
9:04
drastically and you might even resent
9:07
the burden because you're overwhelmed in
9:09
your own priorities and your own
9:10
stressors in your own life. And then
9:12
when you prioritize your own life then
9:15
you feel guilty that you want your own
9:17
life back. And so it's a really
9:19
complicated factor. And of course, you
9:20
don't want them gone, right? None of us
9:22
ever want them gone. And so, it's really
9:24
tricky. It's a it's a hard time. And so,
9:27
you've got to figure out how to navigate
9:28
the grief and the resentment and the
9:30
potential guilt. And caretaking really
9:33
brings up a storm of emotions. And so,
9:35
you know, a natural emotion that comes
9:38
when our parent declines is the grief,
9:40
right? We're losing the parent that we
9:42
had. We're losing the relationship that
9:44
we once had and and the help and support
9:47
that perhaps they offered. that changes
9:49
too because the roles, you know, flip
9:52
and you're dealing with caretaking and
9:54
ultimately the life that you're putting
9:56
on hold because of the pause in your own
9:58
life that you need to step in and help
10:00
them. And so sometimes we end up also
10:03
dealing with resentment maybe towards
10:05
other siblings who aren't helping and
10:07
it's putting all the burden on your
10:08
shoulders or toward the parent for
10:11
needing so much or you know what a
10:13
friend of ours says and actually I did a
10:15
show on this on like the avoidable
10:17
crisis, right? So let's say a parent had
10:20
made choices along their life about
10:22
maybe how they ate and so they had
10:24
mismanaged diabetes and which caused
10:27
further health implications. And so you
10:29
have to really clean up the resentment
10:31
around, you know, sort of they did this
10:33
to themselves because the long-term
10:35
effect of their previous choices created
10:38
problems and then you're there having to
10:41
clean up the mess unless you want to
10:42
abandon them. It's just tricky. So
10:44
you're resentful towards maybe their
10:46
choices or towards the situation in it
10:48
of itself. And so these are these are
10:51
hard. And then you know maybe we feel
10:53
guilty for feeling resentful. I know I
10:55
went through that. I had to do a lot of
10:56
work on that. Like I you know wanting a
10:59
break or wanting things to have been
11:00
different in the past so that we
11:02
wouldn't be in the situation that we're
11:03
in. And the guilt for having to make
11:05
hard choices that maybe they're mad at
11:07
you for. And so it's just really
11:09
challenging. And so sometimes, you know,
11:10
you might find yourself snapping at a
11:13
parent or being really irritable after a
11:15
long day. And then you feel really bad
11:16
about the guilt because you weren't
11:18
compassionate and that's maybe not in
11:19
line with your values or how you want to
11:21
show up. Or maybe, like I said, you
11:23
resent siblings for not stepping up or
11:25
helping. Or maybe part of the issue is
11:27
you you don't have the courage to ask
11:30
for help and you struggle with your own
11:32
sense of not wanting to burden others.
11:34
So all of these feelings are really
11:36
normal. You're you're not a normal. Make
11:38
sure you're not alone and that these
11:40
feelings are normal. Make sure you
11:42
acknowledge these feelings. You name
11:44
what you're feeling. Talk about it with
11:46
someone you love or someone that you
11:48
trust. And and try to have moments of
11:51
normalizing these experiences because,
11:54
you know, maybe this goes on for a long
11:55
time. And so part of it is recognizing
11:59
you can't do it by yourself. That's
12:01
really hard, especially if you were
12:02
formerly a really independent person.
12:04
The other thing is sharing the load is
12:06
necessary. You want to delegate when
12:08
possible. Ask for help from family, from
12:11
friends, from other professionals. This
12:13
can be a marathon. And so, you've got to
12:15
divide and conquer when it comes to this
12:17
because our lives don't just stop when
12:20
we're called to help with a with an
12:22
aging parent. And then, of course, like
12:24
in all relationships, we have to set
12:26
boundaries, internal boundaries,
12:28
external boundaries. We can't do it all.
12:31
And it's okay to say no. It's okay to
12:33
ask for help. It's okay to continue your
12:35
own life and balancing your own life's
12:38
priorities and delegating to others when
12:42
you need to because I think a lot of
12:44
times what we forget when we're in this
12:46
role is that we matter too. you know,
12:49
we're we're we're prioritizing the needs
12:52
of the of the person who needs our care.
12:54
And because it's more dire or it's more
12:58
um stressful or maybe even
12:59
life-threatening, we kind of table our
13:01
own priorities and our own life because
13:04
it seems like it's okay. But if we do
13:06
that for too long, we end up pouring
13:08
from an empty cup. And that is only uh
13:12
something that we can sustain for so
13:13
long. We can't pour from an empty cup.
13:15
We have to rejuvenate our own cup. we
13:17
have to have our own self-care. And so,
13:20
again, back to the delegation, it's
13:22
really going to be necessary at times.
13:24
Um, use health home health aids. There's
13:27
some adult day programs that might be
13:29
useful. Uh, there's respit care. Um,
13:33
there's there's all kinds of ways that
13:35
we can in um enlist resources to help us
13:38
balance this. And then, of course, at
13:41
the crux of all of it is communication.
13:43
You've got to be honest with your family
13:45
about what you can do, what you can't
13:47
do, what you need help with, what
13:48
support looks like, and you've got to
13:50
communicate that. If you don't
13:51
communicate, people don't know what
13:53
you're going through. They can't be
13:55
there for you to be supportive if you
13:57
don't express what it is that you need.
13:59
And so, communication is key as in all
14:02
relationships. Um, that is the truth.
14:04
And then we have to look at planning
14:06
ahead. You want to talk about medical
14:08
power of attorney. We want to talk about
14:09
living wills and get those things in
14:11
order. uh care preferences before
14:14
there's a crisis. What do people want
14:16
done when they do pass? What are their
14:18
after um life wishes and how do we make
14:21
sure we can get those things set up so
14:23
that we're not dealing with that at the
14:25
same time as the loss. So, uh I had a
14:29
client that talked to me about hiring a
14:31
part-time caregiver so that she could
14:33
keep her job and still care for her dad.
14:36
And she felt really guilty at first, but
14:38
as soon as she realized that delegating
14:41
allowed her to just show up with more
14:42
patience and more love and more kindness
14:45
rather than the frustration and the
14:47
resentment over having to be not just
14:49
the um caretaker but also the daughter,
14:52
um she was actually able to be more kind
14:55
when she was, you know, with with her
14:57
parent. So, um, it's important to
15:00
remember that you're doing the best you
15:02
can in an impossibly hard situation. And
15:05
perfection can't be the goal because
15:07
there's no such thing as the perfection.
15:10
Presence is really the goal. Being
15:11
present, maintaining the relationship,
15:14
protecting the relationship, protecting
15:16
the love and the compassion is really
15:19
the priority during this hard season.
15:21
And giving yourself some grace when you
15:23
get it wrong. And again, circle back and
15:25
and repair when you when you do. So,
15:29
when this is part of your life, we've
15:31
got to look at balance. We've got to
15:33
look at kind of reclaiming our joy and
15:36
and becoming uh adaptable in these
15:39
moments. And caretaking can really feel
15:41
like it just swallows your life. But
15:44
adaptability means finding moments of
15:46
joy even when they're really short, even
15:48
when they're small. Looking for
15:50
gratitude everywhere that you can. Um
15:52
because these seasons can be long to
15:54
endure. Maybe you know you and your
15:57
parents share a laugh over old photos or
15:59
you reminisce and talk about things that
16:01
you used to do. But finding quiet
16:03
moments for yourself with you know a cup
16:06
of coffee and a sunset uh or a cup of
16:09
coffee and a sunrise or or just taking
16:11
in a sunset. Really, those quiet moments
16:14
of gratitude are are so important and
16:16
and they help you to remind yourself
16:18
that you're still you and your parent is
16:20
still more than their illness. And
16:22
that's hard to remember when you're
16:24
really consumed with the caretaking
16:26
responsibilities.
16:28
Remember to celebrate small wins. Every
16:30
time that you advocate, every time that
16:32
you ask for help, every time that you
16:34
set a boundary, you're growing. You're
16:36
putting yourself first. You're you're
16:38
navigating a hard time. And it gives you
16:40
an opportunity to reconnect with
16:42
yourself and again finding moments that
16:44
are just yours even if they're brief.
16:46
Remember even when it's hard that you're
16:48
not failing. You are loving. This is a
16:50
tremendous act of love and compassion
16:53
and kindness and oftentimes sacrifice.
16:56
And so again, please be kind to
16:57
yourself. Um this isn't about fixing
17:00
everything. It's about bending without
17:02
breaking. It's about doing the best you
17:04
can, honoring your limits along the way,
17:06
and realizing that every day is going to
17:09
present you with new challenges and and
17:11
and try to just look at what you can
17:14
accomplish that day and what you can
17:16
honor and then what you need to delegate
17:17
and pass off. So hopefully this is not
17:21
your um long long-term situation in your
17:24
life. Uh this is a it's a challenging
17:26
season and caretaking a sick or
17:28
declining parent uh declining parent
17:30
really is an act of love, but it's also
17:33
an act of courage. You've got to dig
17:34
deep. So facing your grief, facing your
17:37
guilt, facing resentments can be
17:39
challenging, but when you do, you're
17:41
going to find your strength, the
17:43
compassion, and ultimately connection
17:45
with this person. So, um thank you so
17:47
much for tuning in. Please know that
17:49
you're not alone with this. Uh, and if
17:52
this episode resonated for you, please
17:54
make sure to subscribe and leave us a
17:56
comment. Um, share it with someone who
17:58
might be going through this and of
18:00
course drop a line and connect with me.
18:02
I read all of my comments from the show
18:04
and I will respond. So, thank you again
18:07
for tuning in. Until next time, remember
18:09
that you're doing your best and don't
18:12
forget to lead with love. It'll never
18:14
steer you wrong.

Caretaking Declining or Aging Parents

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Caretaking Declining or Aging Parents

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