When we were young children, we looked to our parents to tell us right from wrong, to make decisions for us and to protect us. As we became young adults, our relationship to our parents became different.We still turned to our parents, but more for guidance and support. Never did we imagine or expect that one day we would be the caregiver to our parent. When did it happen? When was the shift? Now we are the ones in the "worry seat."
Shifting Roles: Providing Care for Parents
As a geriatric social worker, I get calls from adult children expressing concern about their parents and looking for guidance. My clients say things to me like:
"I'm so worried about my mom living alone. She keeps falling."
"Last time I was at my dad's house, he asked me to look at some of his mail and I saw that he hasn't paid the electricity in three months."
"I've tried to talk to my parents about getting someone into the home to help them but they just won't discuss it."
Where do you start?
First, take a detailed inventory of all of the areas that you have observed to be of concern. Assessing activities of daily living will help you gain a complete understanding of your parent's situation and enable you to make a comprehensive care plan. Use the following categories to assess their functioning:
- Memory (short term, long term, immediate)
- Orientation problems (time, day, year, people, location)
- Judgment and decision making
- Safety concerns (isolation, driving, medication errors, leaving the stove on, etc.)
- Ambulation (falls, assisted devices)
- Appetite and meal preparation
- Medication issues
- Existing relationships and contact with others
- Financial management
Locate your parents' power of attorney (POA) to ensure that their assets and personal affairs are protected. If they haven't prepared a POA, consult an attorney or notary, as well as a financial advisor immediately, and encourage your parent to draft these documents.
Contact your local area agency on aging and share your "inventory" with them. Ask about the community services that are available to help meet your parents' needs. What are the processes for finding an assisted living or full nursing care environment? What are the costs? If your parent is a veteran, contact the Veteran's Affairs office to see what benefits and services your parents are entitled to. Do a search on line to access your provincial, state or federal government website. You may have government sponsored programs or funding available to assist you.
You can also hire a private geriatric social worker to conduct a complete psychosocial evaluation and assist you in accessing appropriate elder care resources. This is a really great resource to have, especially if you do not live in the same city as your parents. An online search or referral from your community agency can help you locate a geriatric social worker in your area. The local hospital social workers may also have a referral.
If your parent has a specific diagnosis (Alzheimer's, Parkinson's, etc.) contact the local support group for that disease. This group will have many resources and referrals to assist you.
In terms of supportive services, depending on if your parent is autonomous, semi-autonomous or dependent, there are different services available. You can look at home care, a retirement community, assisted living, board and care or a full care nursing facility. Again, you can find these resources with an online search, or a private, community or hospital social worker can also provide referrals.
Once you have an idea of what your parent needs and what is available, you can begin to discuss (or continue your discussions) sharing your concerns with your parent. I find that with most of my clients, this is the most difficult area.