I would venture that many of us have aged parents who perhaps are a bit frail, perhaps not totally with it, and who have lived for decades in the same community.  That community is their security. Letting go of it is hugely scary on several fronts.  For one thing, moving to any sort of assisted living residence is the aging process made visible.  That’s because, unlike other moves earlier in life, this one speaks only of diminishment and loss.  It’s so final.  People don’t leave an assisted living residence to go back to their formerly full lives at home.  If they leave it’s for nursing care or when their life is over.   There’s no secret about this, so the move we’re talking about here is a pulling up of roots of the most excruciating kind.

When my mother was a sprightly 81, my sister and I helped her move from her home near New York City to an independent living residence in San Diego.  Eleven years later she was diagnosed with dementia.   Knowing that things would only get worse for her, we decided she would have a safer, healthier life in an assisted living residence where her daily medications could be monitored.  I call this The Big Move.  Reaching the point of “Making the Big Move” is an especially fraught time in our relationship with our parents, layered with overtones of conflict, guilt and profound sadness.

I can say from experience that, while the move from home life to an independent living community is wrenching, if it’s done at the right time, our elderly parent(s) can and do build a new community of support. Though the independent living community may not be as fulfilling as their old neighborhood, there’s still a sense of possibilities.  I felt heartened to see my mother make new friends and find new pleasures. It alleviated what otherwise seemed like a slow, relentless vanishing of capabilities, interests and social contact. Though I could see my mother’s decline, it was reassuring to see her still manage the rudiments of a full life on her own.  Any sign of continued independence, no matter how tattered and frayed, told me that the point at which my sister and I would need to involve ourselves more intimately in managing the details of her life was postponed.  And that was a relief.

However, when the move in question is from independent to assisted living, it’s a whole ‘nother story.  Many people I’ve talked to have said that the move to assisted living brought up the stiffest resistance and harshest arguments they’d ever had with their parent.  Going through this with my own mother, I picked out a host of conflicting emotions that tormented her, causing swings from gratitude to rage.  Just for starters, there was:

  • Relief that she would have more assistance for the tasks of daily living.
  • Dismay at the further visible loss of the ability to manage independently.
  • Fear of the unknown.
  • Sadness at leaving her few remaining friends behind, again.
  • Recognition from having seen others make the move, that this was the end.

For my sister and me, it was equally wrenching.  Our mother was peripherally aware that she wasn’t handling all aspects of her daily life well, but could no longer remember the details of those failings.  As our mother’s caregivers, we had to initiate the move to assisted living and make it all happen. Some parents understand the need for the move and go along with it.  If you’re one of the lucky ones in that situation, you’ll be able to make the choice of where to live a team effort in which you and your parent can work together.  Most parents, though, resist, or simply are no longer able to understand the compelling reasons for the move. That makes it hard. Why? Apart from the guilt trips and such that we’ve all read about, I think there’s more going on.

Basically, as caregivers we are acting (or reacting) either to a medical emergency or to a chronic mental or physical issue which can no longer be managed at home.   In our case, it was both. The move to a place with more care implies we know in what direction, at what speed and in what ways our parents will next deteriorate. But we don’t know this.

All we can say for certain is that we know what they need (and what we need for them to have) right now.  The rest is conjecture. So here we are, being firm, projecting determination and confidence about a solution (The Big Move) that we can’t control and which we can’t even say with certainty is going to be appropriate a few months down the road.

Talk about a toxic mix!! So how does one get through this?

  1. First and foremost, give yourself and your siblings a huge pat on the back for the tremendous job you’ve accomplished thus far. Do this often. Your parents, who in the past would have blessed you with their approval may not be able to do so now. You must acknowledge for yourself that you’re doing a terrific job, the best that anyone in your situation could do.
  2. Try to put yourself in your parents’ shoes:  They feel frail and often ache all over, they know they can’t remember things, but can’t do anything about it, they secretly realize that their efforts to convey independence haven’t fooled you, they’re scared, unsure, even sometimes ashamed.
  3. Remind yourself that your parents are not angry at you, they’re upset at their situation. You just happen to be the physical representation of that. Let them get it all out and while they’re doing so, try not to engage in explanations and rationalizations that lead to hotter tempers.
  4. Keep your objective firmly in focus. Remind yourself that your decision to move your parents is well-reasoned. While you might not be able to accomplish it in the timeframe you initially imagined, it will happen and your parents will adjust.

What’s your take on this? Has your experience been the same as mine? I’d love to hear from you and start the conversation.

copyright 2012

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