Aging Happens…

Aging Happens…

…and will involve our parents, ourselves, and our children. In this new millennium and with the tide of Baby Boomers surging forward, it is time to see past the cultural invisibility of Aging and engage in conversation about values, needs and positive, family inclusive solutions for Elder Care. The sentiment “Failing to plan is planning to fail” more acutely accurate when we neglect to anticipate the predictably changing needs of our parents. In “Holding Hands: Journeying with the Aging Family” you will learn:

• How the “nuclear family” model made our Elders invisible, and how to we must begin seeing them again

• The Co-Generational model: assessing each generation’s strengths and developmental tasks to help you envision an integrated network of support for all the family members in a maturing family system

• Strategies for initiating conversations between three generations to promote balance through planning

• Addressing the six core human needs (Thank you Tony Robbins!): certainty, uncertainty, significance, love, contribution, spiritual and personal growth and why we must help our Elders reconnect and stay connected with them

• Identifying resources so you know where to turn for support on a moment’s notice

• Creating “life plans” for the most common “unexpected” life events so small curves in the road don’t become critical collisions!

When uncertainty is the rule (and it becomes moreso as we age) Love is what remains at the core. Here’s to all the things that let peace and dignity blossom at such a challenging and transitional time: Validation. Respect. Empathy. Kindness. Thinking outside the box. Holding Hands: The Art of Parent Care provides an integrated approach to navigating the Journey of the Aging Family.

 

To reserve your copy of Holding Hands: The Art of Parent Care, please fill out the contact form below, and keep an eye on the blog for more exerpts of the book to be posted in the upcoming weeks!

 

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Have distanced from your Elders? Why do you think that happened?

I was listening to Brene Brown on Oprah’s Super Soul Sunday recently.  She made a statement that struck me to the core. Initially, I thought of it in terms of my own life parenting adult children, working on building a new relationship. Musing on it for a couple days, though, I realized that this contributes to why — as a culture of middle aged adults — we distance from our family Elders. Brene stated “When we lose our capacity for vulnerability, joy becomes foreboding.”

“What makes us vulnerable?” Risking the pain of losing a parent you love and adore and know really well is being REALLY vulnerable to loss, pain, self doubt and regret. As our parents and other Elders age, we know that we will, ultimately, have to say goodbye. We will experience loss (statistically speaking). To fully engage with our parents as they age, as their abilities change or decline, as they need us more as advocates and companions and not just as children, is to open ourselves up to the pain of letting them go after becoming very engaged and attached. That is something, perhaps, worth defending your heart against (or not, more on that to follow).

The second part of that quote is that “Joy becomes foreboding”. When we are afraid of being vulnerable and truly open to the moment without fear of what may or may not happen down the road, even happy moments generate tension. When I had a great day with my mother, I often felt pre-emptive grief, realizing that these were special days and numbered. How much better it would have been for both of us if I could have just experienced the joy without the foreboding. Would I have shown up for her better? More often? It is something I contemplate in other relationships now.

There are many reasons why people distance from aging relatives and friends.  Their changing or dissolving abilities challenge us.  It isn’t easy to be with some people — communication is difficult due to physical changes (loss of hearing for example); cognitive changes (from mild to advanced dementia, depression and ensuing negativity), to powerlessness which makes people feel hopeless for any positive change in their situations.  Hopelessness is hard to cope with in someone we love, someone we want to help out.  Too often it seems that our Elders don’t want help, they just want to complain.  This may actually be more a symptom of depression (which is a common and treatable disease among Elders), than an overall personality change.

We may distance because WE feel powerless and hopeless.  “There’s nothing I can do, anyway.”  (A self-fulfilling prophesy if ever there was one).  “They don’t want my help” (No, but they might want your attention, to know that they aren’t alone in this last walk around the block).  “They live too far away” (how can you mitigate that through phone calls or setting them up with social media?).

This is what I have learned about distancing and avoidance.  Our parents will likely precede us in death (mine already have).  In the case of my father’s death, he was young and it was unexpected.  There was no planning for, preparing for, working out old issues.  It just happened, and there we all were, carrying around the things left unsaid and undone.  That is the stuff regrets are made of.  Regret, like disappointment, is an emotional experience I go out of my way to avoid.

My mother’s last years were quite different.  Yes, I often woke up in the middle of the night with a start and wondered if she had just fallen.  Yes, we lived from crisis to crisis because there was a lack of communication and planning for quite predictable events.  Yes, some days I thought a week-long rest in the local behavioral health inpatient unit would be just the ticket for me (thankfully I never had to use that extreme back up plan).  In the long run though, I have powerful memories of my mother.  Her grandchildren, who engaged with her often showering her with love and attention and likewise being recipients of the same — have great stories to share.  In her last years, my mother imparted her values, her humor, her resiliency on that next generation.  That didn’t happen all at once but over time, over ice cream and Scrabble boards, card games and coloring books, Sunday dinners held at her house even if the best she did was Shake and Bake chicken strips, mashies and salad.  We watched together as her abilities diminished.

My mother’s passing came as a completion of several years of work in which we loved on her, were devoted to her comfort and quality experiences.  With our help, she remained in her home until just shy of her 88th birthday, moving to an adult foster home the week before.  I sat with her daily.  We knew her favorite music, and it played in the background.  We knew the stories she liked to hear re-told, and we shared them.  We placed phone calls to people she needed to hear loved her, one more time.  Our pastor came and sorted out some last issues around shame.  When my mother passed, it was quiet, gentle, complete.  I have never looked back and thought “I wish I had only….”, because we chose to be present with her.  Choices were made that were temporary sacrifices for a lifetime of peace (mine and my children’s).  When we think of my mom and the void her absence sometimes creates for us, it is with a sense of love and acceptance.  There is no guilt.  No regret.  We allowed ourselves to be vulnerable to the pain, and in the process, allowed ourselves to experience the love and  joy that spending time with her gave.

 

I challenge you to look at current patterns with  Elder family members. What stands in the way of regular communication: Geographical distance? Technological deficits? Unresolved relationship issues? The belief that parents are the responsibility of another besides you? Time constraints?  Upon further examination, are any of those things possibly excuses to help you maintain a safe emotional distance from the reality of aging or end of life issues, for yourself or your parents? Feel free to comment below, and as always, feel free to share this blog with others walking this middle of life walk.

The Art of Parent Care: Help me know what you need.

Thank you for filling out my poll.  I hope to use this information to guide me in my blogging, so I am addressing the issues most pressing to my readers.  Remember, we’re all in this together!

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Happy Memorial Day (weekend)

Tribute to a family of participants:  The Ledford Loughead clan (my father is the baby), Oliver P. Ledford with Sea Bees on Tinian, WWII, and with support staff in Viet Nam; Eva Heineck and Katherine Heineck, USCG Spars.
Tribute to a family of participants: The Ledford Loughead clan (my father is the baby), Oliver P. Ledford with Sea Bees on Tinian, WWII, and with support staff in Viet Nam; Eva Heineck and Katherine Heineck, USCG Spars.

Holidays are a time for establishing and maintaining rituals. This last weekend in May is generally harkened as the first weekend of “summer”, play time, fun time, get-outside-in-the-sun time. We think of beaches and blankets, the smell of sunscreen and water and how there really is sand in sandwiches. The boat goes in the water, the tent gets popped up, someone gets too drunk and spoils the whole affair. Memorial Day!

Holiday rituals connect us to family gone before us. Some rituals we keep, some we let go, some adapt in collaboration with a lover or mate who brings their own with them. My father kept holidays well, though I didn’t always appreciate that. With Christmas, of course, the better kept the happier the children are, and my dad could keep Christmas very, very well! Memorial Day was harder for me as a child.  While friends would be camping or playing and enjoying the three day weekend, and he loaded us up and drove to a town I was unfamiliar with, spent time talking to people 5 decades my senior (oh how I wish I had that time back now!) and took flowers to his parents’ gravesites. I recognize now that like Christmas traditions, my father also kept Memorial Day… very well.

My father passed away 36 years ago. He’d be 99 this year (so if he’d survived the heart attack at 63, he’d still be gone by now). Memories don’t do “time” though. He is as alive for me this Memorial Sunday as he ever was, and I get to go visit him today. My 21 year old daughter will be with me to hear the stories, see the place, walk through old neighborhoods, clean the headstone, admire the cherry tree and with love and attention, place flowers and a flag. It took thinking I couldn’t go this year (and I’ve  missed 25 due to relocating far from my home town and his resting place) for me to realize how imperative it was that I go. Through all the automotive travails we have had in the last three days I thought it impractical to make the 3 hour trip “home”. I tried to console myself with setting up a small Memorial Day alter for my parents, but the thought of this man — who voluntarily served in two wars — having an empty headstone struck my heart and I realized that…. I had to go.  I had to make my love and respect for him made visible on this Memorial Day.

Through the ritual my father taught me all those uncomfortable childhood Memorial Day weekends ago, I have a cellular imperative to honor him the same way, to take my own daughter, who never knew this wonderful man, and make him real to her. My mother, whose ashes remain above ground as yet, will one day rest with him, and a more complete family reunion will take place, at least this one day a year. Hopefully, there will always be a child there to hear the stories, for it is in our rituals of remembering that we share our oral histories with our offspring. Through ritual, we teach those that come after us the values we cherish.

I never knew my grandparents, both died before I was born. I understand better the love and respect my father had for them, demonstrated by honoring them, publicly, at least this one weekend a year. They made him the man he became and through him, helped craft me into the woman that I am today and the man I see my own son becoming.

We are not disconnected from our family histories. They live in us and through us, are passed to our children whether we attend to their memories or not. Similarly, while our families are living, whether we ignore their needs, put off the phone calls, imagine that everything is “alright, or they’d call me”, we are not disconnected from them and their influence upon us.

The Post War (that would be WWII) cultural shift away from extended family and to the ‘burbs has been an interesting social experiment in fracturing the family, and it hasn’t worked out so well. When denied the comfort and company of multiple generations, aging has become isolating and demeaning, where too often Elders feel they are “less than” if they require assistance from others.  By ignoring rituals and connectedness (my mother made Sunday dinner for us for years, that became “our time”), we forget to teach our own children the importance of family connection, those generational bonds that sustain us when the world shakes beneath our feet.  Cooperation and collaboration support multiple generations of family so knowledge is saved and wealth is condensed.  I hope that as a unique American culture, we will come again to defy the idea that we are all independent, autonomous islands, sustainable on our own. This Memorial Day, I call you to remember, and then to share.

Blessings to you and yours,
Katherine

Be seen! Be heard!

When I was a child, I was often reminded “children should be seen and not heard.”  I believe that profound piece of social correction came from my great-grandmother’s Victorian era, passed on to my father.   Though he was kind, he was much older than most of my peers’ parents, and perhaps less tolerant of excessive noise and fidgeting.  His message was clear:  “Be invisible.  Don’t speak for your needs, don’t contradict your parents, don’t whine, don’t interrupt.  What adults are talking about is important.”

It troubles me that this same correction seems to be the social standard for Elders, as well, to be “Seen and not heard” and fosters myths about their plight.  “Don’t ask for help, no one will come.” “Don’t complain, there’s nothing you can do about your situation anyway.”  “Don’t contradict your doctor, because s/he knows best.”  “Don’t talk of pain, or loss, or fears, because you don’t want to be a burden and no one wants to hear it.” 

My work with seniors suffering from depression and anxiety, validates my awareness that unspoken concerns create the foundation for emotional health problems, even in those who never suffered them in younger years.  Some Elders, when they feel they have lost their voice, become withdrawn and isolate from family and friends.  They don’t feel good, and don’t want anyone to know about it.  Others react out of anger, a last ditch effort to show they still have power.  They take pain and make it mean something, not always in a proactive or productive manner.  Many hopeless or powerless Elders use “no” or refusal as a way to show they still have some of what makes them “them” left. 

Somewhere in our cultural dialogue, honestly sharing fears, hurts and losses translates to becoming a burden, and it is time to write a new story.  Rarely do I hear adult children speak of their parent’s ills as burdensome.  They voice concern, they want their parents to be comfortable, content and relaxed as they move through their days.  It is the Elder generation that walls up against sharing, as if through some externally imposed sense of shame, do not have cultural permission to reveal what is really happening with them.  Denial and minimizing are dangerously common issues, and one I faced with my own mother even though I had the therapeutic communication and nursing education to try and draw her out.  Her lack of sharing brought many trips to the local emergency department for crisis management, when had we gotten more honest information earlier, might have been resolved with a simple office call and medication adjustment. 

Our situation was in no means unique.  I have the benefit of working with a dozen or so highly functional, independently living albeit clinically depressed Elders every day.  The denial and avoidance of shame for becoming a recipient of care and attention instead of the provider is the daily norm. Emotional health dictates that we speak our truth and our needs, at every age, because unspoken feelings fester, resentments develop and once strong and capable adults begin to see themselves as victims of aging.  Too often I have people tell me they wonder why they must still wake up in the morning (which is passive suicidal ideation).  Sharing one’s fears, limitations or needs is often confused with relinquishing autonomy, but can be vitally important for safety and comfort. 

Don’t let Life happen “unexpectedly”!

IMG_1487_2We have choices about the story we tell as our families age. When I was doing some research on the literature available to support the aging, multi-generational family, I found the material woefully (and I do mean W-O-E fully!) inadequate. I kept coming across first-person stories that in describing their synopses began with “suddenly, my aging mother who lived across the country, needed assistance” or “unexpectedly, Dad wasn’t able to take care of himself anymore”. REALLY?

As a culture we seem to have a peculiar denial that allows us to ignore the changes that are typical across the lifespan? For example, we know that new parents need support and time to adapt to the demands of their infants, that teenagers will go through particular behavioral changes as they assert their independence, that college freshmen often gain 10 pounds their first semester.

We have analyzed and quantified and reported on changes across the lifespan — until we reach a “certain” age. I guess after the “empty nest” the Golden Years are supposed to manifest and the rest is all an easy listening, waves-crashing-on-shore-at-sunset relaxing life to be enjoyed. You know, where your greatest challenge is Erectile Dysfunction (and they have several pills available for that now!)

Parents don’t “suddenly” or “unexpectedly” age anymore than babies grow “suddenly” into toddlers or school-aged children “unexpectedly” become teenagers, yet we ignore these changes until the need arises.

I strongly believe that “failing to plan” – especially in the case of our parents – “is planning to fail.” Unless you are a fan of crisis and drama, you really want to start thinking this through now – while your children are little, you are still talking to your siblings and your parents can start making “back up plans” for when one or the other becomes temporarily indisposed. These conversations are so much easier to have and are much more empowering all the way around when had before someone is in the hospital.

The first step to that planning process is to get through the fear that your parents are aging, and that this means you and your lover will eventually age too. Teach your children how to communicate with you later by modeling good communication with your family now. I pray that this New Year brings open hearts and health and safety for you all!

Happy Family-ing!
Katherine

The Art of Parent Care: Help me know what you need.

Thank you for filling out my poll.  I hope to use this information to guide me in my blogging, so I am addressing the issues most pressing to my readers.  Remember, we’re all in this together!

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Plan for some self care in 2013!

I am sitting this holiday morning in the house that I grew my children in.  Here we raised lambs and goats and chickens and colts and a couple steers; where any given Saturday or Sunday morning could find unexpected teenaged bodies flopped sound asleep across my living room, arms and legs dangling over the edge of the sofa or arms of chairs as though some explosion had thrown them there.

A lot of memories were made in this house. It was a place of activity, growth and creativity, laughter and teenaged angst.  Felt tip marker identifies where pictures were colored; a bent heater vent displays someone’s foot expressing impulsive anger.  Here is the wall I papered while my then husband took our children away for two weeks (that was what I thought a vacation was in those years – everyone gone from home except me).

My mother spent a lot of time at my house.  Often, it was spent cleaning up after us, as I was not a stay-at-home mom, I was a doing-everything-but! Mom.  Besides working full time, we had 4H, FFA and Equestrian Team and later High School Rodeo, which took us out on the road 10 weeks a year.  I was a “lets tidy the barn” mom, while the living room could rock on it’s own with co-mingled clean and dirty laundry, dogs, books and toys laying about, waiting for the Saturday morning fit of cleaning.

Less clutter of both stuff and time makes everything simpler, and in simplicity, planning is easier.  I know I brought some of my own issues to the organized chaos that was our lives – afraid to say “no” to work or activities, trying to prove I was worthy of love, trying to prove as an educated, middle income woman, I could do and have it all.  (Not!)

As a family we rarely planned our activities to include my mother – in part because she didn’t want us to arrange our lives to meet her needs – but that was exactly how life was arranged.  Without intention it was often chaotic, haphazard and crisis-oriented.  Planning things together would have enabled us to utilize her energy and outside resources better so our time together wasn’t just spent doing errands. We could have done more of what I’m remembering this morning: Skip Bo and Scrabble at this dining table, 8 years of Christmas mornings in this living room, her grandchildren in jammies tucked under her arm as presents were doled out; Sunday dinners that brought everyone together.

We had love, we had animals, we had stuff, we had fun.  We had each other.  What we lacked was a plan – a vision for serenity in the midst of the jumble of activities and overlapping needs of three generations.  A plan for abrupt change in needs.  A plan for my spouse and I to get some rest and respite from juggling all that we did.

As a New Year shines on the horizon, I pose this challenge to you:  in the midst of organizing around your family needs, make a plan for self care so that you can more ably care for those you love, more intentionally spend loving time (not just busy-ness) with them. Time misspent is time lost to us…

I will post more on planning schemes and those things that should be considered in the multi-generational family during the coming weeks.  Let’s make 2013 the year that brings organized harmony, identification of family resources and confidence to your maturing family!

Image
Holiday Jolly, 2007

Love to you and Blessed Family-ing!

Katherine

Making Ends Meet

My mother was a strong woman, resiliant and fiercely independent. She lived on her own until 2 weeks before her death, and it’s not unthinkable that she waited at home until she knew her time was at hand, and then asked for help in getting her moved to a situation where she wouldn’t have to fret about us or the activities of her daily life. She reminded me of a woman in labor — knowing the birth is coming but backing away from that last transition even as she leans into the contractions. It was a tumultuous time.

In my mother’s case, we found her a wonderful adult foster home (a system of care in Oregon). I knew of the home because it was one I had some oversight in as a Community Health Nurse for the State Seniors and People with Disabilities Office. I loved the home, the caregivers, the ambiance. It was primarily a hospice home, though I really did not anticipate that was the service my mother needed. Even I, her RN daughter, thought that what she needed was time to rest, heal, let someone else take care of her. She was walking on her own with stand by assistance the day we arrived at the house, her bedroom already set up, furniture and pictures from her own bedroom adding familiarity and comfort. By the end of the week she could not stand without assistance, was irregularly communicating with us verbally, beginning to exhibit repetitive neurological motions referred to as “terminal agitation”, and sleeping frequently. (It was that weekend that I saw my father, deceased some 35 years before, standing by her bedside. It was a brief vision, but brought intense comfort to me).

On her 88th birthday, only days later, we were able to get her dressed and into a chair in the living room, where we shared an apple pie, her choice of birthday desert. Amanda her caregiver, my husband and I shared her birthday, untold friends called and sent cards.

It was clear this story was coming to an end.

My mother passed away very peacefully on a Sunday morning, with my sister, my husband, my brother in law all at her bedside. I was telling some silly story an uncle had told me the week before, about her father and a couple brothers and truck in a ditch. A “Golden Oldies” CD was playing, and I became aware simultaneously of her lack of respirations, and the words from one of her favorite songs, “Walk on the Sunny Side of the Street” — “like Rover, I crossed over….”. I asked Amanda, a tender hearted and very mature young woman, for a stethoscope, and I listened to her chest — her very silent chest. Stethoscopes are built to pick up sounds, and so are my ears, accustomed to focusing in on the earliest of fetal heart beats, the sometimes complicated extra sounds of the adult heart beat. I had never before heard just a hollow “nothing”.

The years leading up to my mother’s passing were busy, crazy busy with teenager activities, and her increasingly frequent medical trips or emergency room visits. For years I waited for “the other shoe to drop”, and after it did, after I bid her a tender and gracious goodbye, I did not grieve much. There was work to do, a memorial to attend to, a house to empty and sell, a marriage that dissolved rapidly after my mother’s demise and still… children to raise. My siblings and I went our own ways, I think each in our sorrow and orphan-ness to adapt.

I was unprepared for my first trip to visit my sister, some 18 months later, and in her guest room, find a chair. My mother’s chair.

The following is a description of the grief that finally found it’s expression. Grief comes in it’s own time, in it’s own way. There are no rules, except that there are no rules. I hope you don’t mind my sharing the rawness of that morning.

There was such a deep sadness… loss… confusion

curled up like a child in my mother’s chair, my head resting tiny against the wing of the back, where her head would loll as she’d fall asleep in front of the television.

There was a hug for me in the pillow she’d made, as I clutched it to my chest

and it became a depositor for my tears, my sobbing, my racking breath.

Mom!

All the anger and love and resentment and loss, isolation and tenderness rolled all up in a ball in my chest —

fragile —

like a Christmas ornament dropped on a cold tile floor, shattered into a million shards of glass; prismatic, sharp, painful,

liquified me into brutal tears pouring forth, each sharp piece piercing my heart and the shell of detachment worn thin in spots

thin enough to be rent apart.

Flashflood. The torrent of emotion burst from me unexpectedly, profoundly, leaving me spent and more contemplative. I had not anticipated such a powerful response, having been so accepting of her passing and my circumstances as they unfolded. I didn’t know I held such pain, or that the pain held so much power until it’s critical mass was unleashed by a familiar, winged back chair in the wrong house, sitting empty save for the throw pillow that would rest her head.

Perseveration

perseverate |pərˈsevəˌrāt|
verb [ intrans. ] Psychology
repeat or prolong an action, thought, or utterance after the stimulus that prompted it has ceased.

I would add to this definition: confusing to those subjected to it.

Perseveration is something we expect of young children. We’ve all seen a child hold on to an idea or thought long after the thing that triggered it is past. The idea is often often predicated by “I want…”. They can hold on tenaciously and be difficult to redirect. When this behavior occurs in public and the only right answer is “no”, it can lead to further escalation – sometimes hysterics — especially if one’s child is tired. We’ve all been there. It’s a challenge with our children. Small wonder when we stumble into aged parents exhibiting this same behavior, we don’t know what to do!

With perseveration, the repetitive phrase almost becomes a mantra, and perhaps this is where the brain becomes wired to separate “want” from “have”; power over our desires to relinquishing them. It is where we learn “wait”, “not now”, or “you are safe”. Rarely can a young child be reasoned with logically, distraction tends to be a parent’s best friend in this situation. With children, it may take us by surprise, but it isn’t frightening (frustrating maybe!), or dangerous (usually). As their ability to understand time, patience, limitations increases with maturation, perseverating happens less frequently.

It feels very different when Elders, perhaps due to subclinical dementia, demonstrate perseveration. I heard a story recently about an elderly father who showed up to a Memorial with an agenda. He wanted something. He had apparently wanted this item for some time, and felt entitled to it. He spoke about it to family for several days before the memorial, where he would see the people he needed to talk to about it. His immediate family didn’t know what to do about his pit bull like tenacity, and when he did engage with the family who owned the object – loudly, publicly and at the gathering after the memorial – they were mortified. He wanted what he wanted, and that was all. Perseveration. “I wish I could have been this big” (demonstrated his daughter, closing her index finger and thumb together). “I wish I could have become invisible. We didn’t know what to do.”

In the end, this daughter left her father at the gathering. He could still drive. He lived independently and could engage in intelligent conversation but his behavior around his object of desire baffled and deeply embarrassed his family. Listening to the story and empathizing with the adult child, I thought again about how a lack of understanding regarding behavioral changes left everyone powerless to help him. Arguments ensued (with the inheritor of the belonging denying anyone else had any rights to it), upsets happened. No one had insight to de-escalate or re-direct his behavior, in part, out of respect for his position as a family Elder. No one wanted to appear patronizing.

Bad behavior is bad behavior and it doesn’t matter what the age. With our children, we know it is lack of understanding, patience, experience. But when our parents exhibit that same behavior, we expect more. They have demonstrated (and taught us!) appropriate boundaries, social skills, understanding and higher functioning emotions like empathy.

Perseveration is different from bad behavior, though. It suggests that a pathway in the brain is not working correctly, a thought becomes a compulsion. In the extreme, it can be a symptom of serious mental illness or an abrupt cognitive decline, but can also just be a more benign indication of changed cognition in that one instance. The individual likely won’t recognize they are doing this; and they aren’t engaging that way on purpose. Some automated thought loop in their head has been triggered. The challenge is for family or caregivers to find a way through it.

As a mother, I used to say “distraction and bribery” were my two best friends. This can be just as true with Elders who are stuck in a thought loop like this. I offer the following as tools for coping:
1. Validate their experience, whether it be something they want, they lost, they fear losing. Validate it, let them know they are heard. NOTE: if an Elder seems to be perseverating on a bad caregiver, living situation or expresses the same story of exploitation, abuse or neglect, this MUST be investigated thoroughly. Just because they repeat the story doesn’t mean it isn’t real. In the case of abusive care, the abuser is counting on the fact that people discount the Elder’s story because they have dementia or a history of perseverating.
2. Examine how you can relieve the anxiety. What can be changed to make the Elder more comfortable? How can they feel more powerful in this situation?
3. How can you redirect the thought process? One option would be to tell Dad “I hear that this is very important to you. You know that everyone is going to be sad and upset at the Memorial. Let’s talk to Bill and ask him not to do anything with what you want until after you and he have had a chance to talk about it, and we’ll make a time to do that together.” This probably would have had to be restated in many ways, several times, right up to the point of seeing Bill. (“Remember Dad, we’re going to make a special time to talk to Bill about this later. Please be patient.”)
4. Follow through. Trust-building and integrity is as important with Elders as it is with children. When they perceive a lack of trust and integrity, anxiety escalates. Elders have little to depend on. Make sure that you can be counted on to watch their back.
5. Don’t quit. If your child was screaming an “I want” statement in the grocery, you wouldn’t stop trying to find a way to redirect or de-escalate the situation. Treat the Elders in your life the same — with calm, patience and understanding. Your anxiety will magnify theirs. Perseveration means that something is beyond their self-control, and Elder or no, they need a kind intervention to break the thought cycle loose and see beyond it’s immediacy.

We don’t want to “Parent our parents”, but we can use our parenting skills to be better children, better advocates and better friends to them as their ability to “roll with the tide” becomes less flexible. They need us, as we needed them when we were young. Breathe deeply. You can do this!