It is something I explain frequently to families when discussing long term care and a conversation I had last week with Dad’s three children who flew in from different parts of the country to meet with me regarding his placement in an assisted living facility.
The discussion centered on what Dad wants versus what is in his best interest. Son, Joe was uncomfortable about moving Dad to a facility against his wish to remain at home. We discussed bringing in home aides which they had tried without success. Dad wouldn’t let anyone in the home. And since none of the children lives nearby, managing a rebellious parent long distance becomes an impossible task.
I told Joe that he and his brothers need to take on more of a parental role at this point. Similar to a 5 year old child who insists he can cross the street without holding the parent’s hand, Dad’s insistence that he is OK to live alone is no longer enough to insure his safety. It is clear that he can’t appreciate his limitations and the danger to his health that his refusal to accept help poses.
Many children are understandably uncomfortable in this role, especially if the parent expresses anger and pushes back. Independence is something we value greatly as Americans, as individuals. But just as we step in when our young children assert independence before they are mature enough to handle it, we must also step in when our parents no longer have the capacity to maintain their independence.
It’s hard enough to do that when, for so long, our parents were the one guiding and protecting us. But the task is made more difficult because, so often, the decline is gradual. It might begin with poor financial decisions or bounced checks or perhaps the clutter of a once immaculately kept home. When is the right time to step in?
I told Joe that no one is going to tap him on the shoulder and tell him that “tomorrow your dad will fall down the stairs so you better put safety measures in place today”. He and his brothers need to be proactive. If they wait for Dad to tell them he is ready, that day will probably never come. I told him that they need a plan in place now that will provide for adequate supervision, even if Dad initially resists. I recommended a geriatric care manager to assist the family in determining the best placement for Dad. The GCM can also be essential to families who don’t live “around the corner” from their aging loved one, acting as the “eyes and ears” and reporting back to the children.
Joe understood what I was saying. He still wasn’t comfortable in the role of parent to his dad but with our help and the support services available he felt better about he and his brothers’ decision to step into an active role in caring for Dad.