Caregiving: Shifting the narrative

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One of the most common questions I encounter in my work is some variation of “How can I make Mom/Dad/Grandma/Grandpa take better care of themselves, realize they need to move to long term care, stop driving", ... you get the picture.

It’s wrenching to watch someone make decisions that you feel are not in their best interest.  As adult children, we want to help, which can include the desire to step in and make decisions for our parents.  However, even though we may feel that making these decisions can avoid a crisis  – often our attempts to “fix” the situation, however well intentioned, may make our parents feel as though they have no control over their lives.

However valid our concerns may be – if our parent/s are competent, they have the right to make decisions about their own lives – even decisions that we disagree with.  Unless those decisions place them at imminent risk to themselves or others (at which point “capacity” would be determined by a legal professional and guardianship could be considered) they have the right to self-determination.

If you have questions about capacity, it is a good idea to have your loved one evaluated by a medical professional for cognitive changes and speak to an elder attorney about evaluating decisional capacity.

If, however, you have a pretty good idea that your parents are competent, but are making decisions you are struggling with, I have a suggestion.

Shift the narrative

It can be overwhelming to watch your parents change as they age, and you may feel anxious about the future.  It is very likely that your parents are aware that things are changing as well, and fearing the loss of their independence.  Often this fear may manifest itself as control and “pushing back”, especially when parents feel that their children are stepping in to take over.  If you can recognize that you are both feeling fear and uncertainty about the future, it can help to build a bond as you share this journey together. Sometimes it can be helpful to use “I” statements – such as,

Instead of:

“Mom, you can’t take care of yourself any more, you need to get some help in the home!”

Try:

“Mom, I have been feeling really stressed and worried for you.  It would make me feel so much better if you would let me find someone to help you around the house a bit”

Instead of:

“Dad, you have to stop driving!”

Try:

“Dad, I’m so worried that something might happen to you or someone else if you continue to drive”

Using “I” statements shifts the conversation from “there is something wrong with you” (creating a defensive response) to “I am worried about you” (hopefully creating an empathy response)  You are also describing the situation as your problem, not theirs, and asking for their help – which allows them to feel in control of their decisions.

As our roles change with our parents, try and keep in mind it is a difficult emotional journey for everyone.   In your efforts to help, it may be tempting to take control of decision making, but try to keep in mind that an important aspect of maintaining their dignity is allowing them to make decisions for themselves, as difficult as it may be.

 

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About Author

Kim Andreaus

Work Life Program Manager

Kim Andreaus is the Aging and Eldercare Program Manager for Work/Life. She has experience in geropsychiatry; both inpatient and in a community mental health setting. In addition, she has been a faculty member at NCSU, UNC-CH and Wake Tech and has taught courses in gerontology and conducted training in geriatric mental health.

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