Several years ago my friend Lucy and her husband, who were in their 50s, left their home and jobs in Chicago and moved to Maine. Not to retire or experience a slower pace of life, but to care for Lucy’s elderly mother.
“At first she was still quite independent,” Lucy told me. “She was driving, swimming at the local pool every morning, buying her own groceries, and cooking her own meals. She also had a social life that made me tired just to look at it!”
Unfortunately, soon after they moved in, Lucy’s mother began to decline physically and mentally. She was still driving and Lucy was terrified she would hurt someone. That was the basis of some of their most difficult conversations.
“For a person who has spent all her life HELPING other people, to have the last thing you do on this Earth be that you killed someone because of your irresponsible driving — someone else’s mother or father or a young child — it would be awful,” said Lucy. “She would get angry and say, ‘Well, you just don’t understand. You don’t know what it’s like when you can’t drive anymore. Your life is over.”’
They would go round and round and not get anywhere.
How to start the conversation
Any conversation with an elderly parent is bound to be difficult if it involves losing independence. Ellen Jackson, a geriatric social worker at Maine Medical Center’s Outpatient Geriatric Center, suggested starting along these lines: “I know this isn’t an easy subject for you or for me, but there are some things we need to talk about. We are concerned about your safety, but we also want you to have a good quality of life and be happy and independent. Can we talk about ways to accomplish that?”
Lucy accomplished it by promising her mother she would find a safe and convenient way for her to get around. She couldn’t be the full-time driver because she had a job, so she found someone else through their church. “For almost a year she would show up every Thursday,” Lucy said, “and eventually Mom started to have so much fun that it began to be about having fun, not about being dependent on someone else because she couldn’t drive.”
It was a bit more challenging when it became clear that it was dangerous for my own mother to be on the road. That’s because she was in the beginning stages of dementia and couldn’t always listen to reason. My family had to enlist the help of her doctor and I finally had to hide her keys. It caused a lot of stress for all of us, but eventually, she agreed that she shouldn’t be driving.
Adjusting to change
When Lucy’s mother’s driver moved out of state, she hired someone else through a local home care agency. “As time went on Mom needed more and more help,” Lucy said. “With each staff person we added, it took a few weeks to run smoothly, but we learned that the transition time would pass and the new people would soon become old friends.”
Lucy’s mother was able to stay in her home until she passed away a few years ago. In my mother’s case, because of her dementia, eventually, she was no longer safe living in her own home — even with a lot of support from family and caregivers.
If taking her car keys away was difficult, deciding to move my mother into a memory care facility was even harder. Once again, we turned to her doctor, who agreed that she should be in a safer environment. He had a conversation with her in my presence, which I repeated to her many times. She understood the situation in the moment, but each time I told her, it was like the first time.
When the day came for her to move in, she was extremely upset. With his permission, I put the onus on her doctor and said it was a trial to see how things went. In less than two weeks, she told me she wasn’t unhappy living there and before long it was her idea.
Ellen says as hard as change is, not only for the elderly person but also the entire family, everyone usually adjusts. Trouble is, people worry about it and keep putting off talking about it, whether it’s about driving or living alone when it’s no longer safe. The bottom line is your parent’s safety, she emphasized. “It’s all about safety versus quality of life, and trying to determine the acceptable risk.”
Gaining some peace of mind
And while you may have initiated a difficult conversation because you care about your parent’s well-being and happiness, Ellen said it doesn’t hurt to say it’s also because you want some peace of mind.
In one of their difficult conversations, that’s what motivated Lucy’s mother to agree to some extra help. “I said, look, Mom, I know YOU don’t need someone to do this, but I need someone to do this. It’s for ME. ‘Well,’ she said, ‘if it makes YOU feel better, let’s try it.”’
Knowing that our mother was in a safe place made a world of difference for me and my siblings. As her dementia progressed, so did our stress levels. None of us could move in with her full-time like Lucy and her husband did with her mother. My mother was well-cared for her in her new home and often told me she was glad she made the decision to move there!
If you’ve had some difficult conversations with your parents, how did it go? Do you have any tips to share?
Another pearl; thank you, Diane. Been there done that so I recognize that there are many family members that have difficulty having the conversation. I would add my thoughts of good news that there may be affected aging persons that ‘welcome’ the intervention. It can be a relief to a parent that dearly loves him/her or a friend cares enough about that person to have the conversation.
Additionally, each of us needs to give our children or future caregiver permission to have the conversation with us when the time comes. My mom did that for me so my path as her primary caregiver was easier. I think I was 12 years old when she said, when I get to be like Grammy and Grampy, I want you to know…..
Merry Christmas!
Hi Dean. Now, it’s Happy New Year! I’ve had a few conversation with my daughters. I also recently talked to a friend who works at a memory care facility. She said she spelled everything out in detail in her advanced directive. She doesn’t have children yet but discussed it all with other family members. I’m planning to update mine with a little more detail as well.