Moving from “Burden” to “Participant”, a paradigm shift in the roles the 1st generation can play in the extended family.

I hear this at least once a week – someone will state they don’t want to be a burden on their family. They don’t want to live with adult children, they don’t want to ask for help if they live alone. It hurts my heart to hear this, I learn so much from the Elders I know and enjoy sharing time and stories. I don’t want to see my role in my family change from participant — from being essential to our joyous and goal-oriented function — to feeling that I have nothing of value to contribute and would only be a draw on resources. A “burden”.


New American Dictionary defines burden thus:
burden |ˈbərdn|noun
1 a load, esp. a heavy one.
• a duty or misfortune that causes hardship, anxiety, or grief; a nuisance
• the main responsibility for achieving a specified aim or task
• a ship’s carrying capacity; tonnage:

2 (the burden) the main theme or gist of a speech, book, or argument
• the refrain or chorus of a song. (italics mine)

How did we come to believe that as we age in our family, our role evolves from essential service to a “misfortune that causes hardship, anxiety, grief”, or that we become a “nuisance”??? I have fixed ideas about how this shift from essential, valued, integrated member of the family disintegrated in our Post WWII culture, (you can find them addressed in Chapter One of “Holding Hands: Journeys with the Aging Family” to be released in 2013). More important here is refuting the myth of the invisible, devalued, aging adult and moving from “burden” to “participant” in the co-generational family.
The “burden” concept begs the question, “What do we need to change so that Elders stop defining themselves and their needs as a burden?”  How do we help them quantify the value they bring to the family?
It would be nice if Elders in a co-generational setting were more visible in our media. Portrayals in popular culture “cameo” grandparents, aunts and uncles. They are not part of the weekly story line, and are often written out of our own storylines as well.
This invisibility comes from both sides. Our aging parents, who began their families in the neo-television/post WWII era, also have no model for integrating parents. Likely, they moved away from their own families of origin to the suburbs after the war, leaving their own parents to the care of each other, their siblings or a child who stayed geographically close. To have parents live with us after WWII was interpreted as a weakness – not cutting “apron strings” or being overly involved. “You aren’t going to let your parents tell you what to do, are you?” as though taking advice from those who have been there/done that, would be shameful. Not independent. Not trendy.

Our very narrow tolerance of anything “different” bled into the way we learned to not care for our Elders. On the other end of the parenting spectrum, we were expected to cut our children loose at the earliest legal age and start planning our midlife, renewed “independent, Golden Years” with a sense of relief that all that family stuff was done, checked off the to-do list of life. I’m here to tell you, that was all a bunch of hooey.
What we gained instead were expensive and low-quality institutions to house Elders, middle-aged parents suffering from “empty nest syndrome”, new retirees suffering from a lack of purpose and sense of value. I stand firmly behind the belief, from four decades of observation and one of professional exposure, that humans are most decidedly NOT meant to be independent, autonomous islands in the stream. We hunger for connectedness, integration, participation, feeling valued and loved, and contributing to family and community. The tribal model of survival is as ancient as our earliest recorded histories, there is a reason why. This experiment of division has not promoted individual or family health as our members have aged.  It fractured family resources rather than concentrating family wealth and resources of time, and now creates a discontent in the Elder generation which too often leads to great feelings of sadness and loss. Where they may desire connection and support, they deny their own needs because somewhere along the line they bought the lie that to do so would be burdensome to the very people they gave life and love to.
This is wrong.

Recognizing how we got here is part of the solution. The other part is asking yourself how you show  you recognize the contribution your parents, aunts and uncles, Elder family friends make in your life now. Reminiscing is great, but subtly reinforces the concept that those days of value have passed.

  • Why is their presence important NOW?
  • How do they add value to your life NOW?
  • What could you not do without them for NOW?

In the early self help years, we called these “ego strokes” and they developed a reputation for being unhealthy. They aren’t. We all need to know that we matter to the people around us, and no age cohort needs that more than the one that has been rendered invisible, comical, burdensome in 40 years of televised cultural teaching.
What can your parents teach your children – essential family or cultural knowledge, survival skills, games and playfulness – that you can’t due to limited resources or time? Looking at the generations that stand on either side of you, what do they have to offer each other? Child care? Cooking lessons? Learning to budget money? Homework supervision? Being the licensed driver while a teen gets their supervised hours in? Living models of history?  Can your child learn how to express love and service to an Elder family member, just because it’s the right thing to do? (Teach them now with your parents, and they will teach your grandchildren in time).
This is how we rebuild a cultural model of family members taking care of each other across the lifespan. This model is seamless, no one gets left out. Everyone knows they are important to the quality of someone else’s life, to the security of the family and it’s members, and love and respect have ample room to grow.
Referring back to that original definition, the alternate to “nuisance” was:
2 (the burden) the main theme or gist of a speech, book, or argument
• the refrain or chorus of a song.

I choose to think this is where the descriptor as Elder family member being “a burden” first came from. As the historians of our family and culture, that is a much more tender and fitting definition of those who have come before us, shaped us, nurtured us, raised us up. May our Elder Generation come again to be revered as carrying the chorus of our family song.


Happy Father’s Day,

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. 

Getting to “yes”

There is a cycle to the life process. We start our lives dependent on others for care, nurturing, and safety, and we often conclude our lives in the same fashion. In the middle years though, we are full of ourselves, our independence, our power to make choices and effect change.

As those qualities and activities that we take for granted begin to diminish — our vision, our hearing, the stamina to shop or clean house, the reflexes to allow for safe driving — we run out of ways to show our power. Often, all that’s left is the power of “no”. This can manifest in refusing care, non-compliance with medical and medication regimens, and increased anger, depression, isolation or anxiety.

If you are encountering a frustrating situation with an Elder where the answer always seems to be “No”, if you are wanting to just “step in and and decide”, let me offer some alternatives.

1.  Examine the idea that this person’s behavior represents the only way they know right now to exert power in their lives at this moment.  For someone who has lost the ability to easily say “yes” — or who has had so many others tell them “no” … you can’t drive anymore, you can’t afford that, you can’t live by yourself, you can’t stay in your home, you can’t have ice cream, etc., being able to refuse is the last bastion of their independence. Can you look at “no” from their point of view?

2.  Help clarify values — both yours and theirs. There is nothing like fighting with someone to keep them safe and medically compliant if their first concern is how will they afford to feed the cat if they incur a budget busting medical expense or “what will the neighbors think?”  One example of this from my life involved my own mother’s refusal to use a Life Alert system.  My 87 year old mother lived alone in her home, about 2 miles from me.  Yes, we could (and did) check on her by phone and in person daily.  As a nurse, though, I understood the reality of both her night time bathroom trips, health issues that caused her to bleed rapidly when injured, as well as the life-changing impact even witnessed fall could bring.  But I couldn’t convince her to get a Life Alert button.  It turned out to be a vanity issue (as the cost was about $35.00 a month).  She didn’t want to wear “the button”, because it made her feel old.  It finally took another professional’s intervention to point out that she was torturing her children by not wearing it.  That she could understand — the power of saying “no” to this communication device was causing us emotional pain, and she didn’t want that either.  It gave her power, in that instance, to say “yes” because she was doing something proactive to nurture her children.  (She would sacrifice vanity to reduce our stress, but not for her own safety.  Hey. Whatever it takes.)

3.  Seek concensus. On what points can you agree? Build your strategies from there.  “I know you feel like you take too many medicines.  Let’s look at them together and remember what they are for.”  Review with your Elder the root condition being treated, and why that’s important.  For example, “The blue pill keeps your blood pressure down.  If your blood pressure goes up, it increases your risk for a stroke.  Taking the medication is the most sure way right now to keep your blood pressure controlled and reduce your risk of stroke.  Can we make an appointment together to talk to your doctor about what other things you can do to reduce your blood pressure, and what physical markers would make them feel safe in reducing your dosage or discontinuing the medication?” (Look for more on polypharmacy and seniors in a later post).

Together, make a plan that empowers the Elder to say “yes”.

Physical changes in taste, sight, hearing, smell can also lead to refusals, especially around institutionalized food.  If you have an Elder that is suffering from Failure to Thrive because of lost appetite or missed meals, look for environmental changes that can be made (sometimes using a bright colored plate to make the food more visible makes it more appealing).  Is the food tasteless?  Try adding fresh herbs (avoiding excessive salt), like basil, lemon or garlic to give it some zest and wake up the taste buds.  Do their teeth hurt or are dentures ill-fitting making chewing difficult? Often there is a physical cause underlying refusals that we (or caregivers) don’t take the time to tease out, and make refusals a power struggle instead of a cue about discomfort.

When we are pressed for time, it is easy to discount someone exerting their power and authority through the use of “No” as just being obstinate or difficult.  Seek to find that underlying cause, without judgement or patronizing.  This aged individual has probably forgotten more than you currently know and has seen life through many transitions.  A gentle, understanding and cooperative spirit often gives such an entrenched person a sense of significance and value, and helps bring them around to more positive decision making.  It’s certainly easier on the heart than frustration and annoyance, and lifts the Love vibe to a shining level.

Remember always that this person has seen more, dreamed more, lost more and had to be stronger than you may ever face. Don’t demand. Don’t demean. Offer dignity, respect and the time to really hear what’s on their heart. This gives us all the power to get to “Yes!”.

Blessings to you and your family this day!