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Tipping point: how to cope with caring for ageing parents

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Tipping point: how to cope with caring for ageing parents

CARROL BAKER looks into changing relationships within the family as Australia’s population is living longer.

Sixty-two-year-old Carrie is locked in a battle of wills with her 87-year-old mum May to accept home help,  after discovering she hadn’t showered  for two weeks and was living on  banana sandwiches.

Carrie is emotionally exhausted and can’t seem to find a way to help her mum.

She’s not alone.

It’s a tough call, as a child of ageing parents, to navigate how to look after your mum or dad when they need it.

You want to honour their independence and autonomy, while giving them the care they need.

Added to that, there could be different opinions among siblings or partners about what that care should look like and who should shoulder the load.

There’s no denying our ageing population is set to live well beyond the realms of previous generations.

The UN Convention states that in 2050, for the first time in human history, there will be more people over 60 than there are children.

Caring for older people is set to become a global issue.

In the 1950s, the Australian Institute of Health and Welfare reports, the average lifespan for males was 66.5 and for females it was 71.5.

Fast forward 70 years and the average lifespan of males has jumped to 81.3 and for females it’s 85.4.

We have technological advancements in preventative health outcomes, medicines and more information geared towards positive and healthy ageing at our fingertips. Even though the government expects us to toil longer at our jobs before retirement, many of us can now expect to live into our 90s.

Professor Ruth Hubbard, Masonic chair of geriatric medicine at the Centre for Health Services Research, University of Queensland, is an expert in frail ageing. She says living longer and ageing is a privilege.

“It’s important to look at ageing as a consequence of societal success and a cause for celebration,” she says.

As we get older, studies show life satisfaction and contentment increase.

Older parents have accumulated a lifetime of wisdom and stories to share.

And, there’s more time to spend with grandchildren and pursuing hobbies they love.

But there comes a time when our parents might need help.

There are signs to look for that your parent might be struggling. Geriatrician Dr Catherine Yelland says some things aren’t always immediately obvious.

“You might find a few unpaid bills stacked up or open the fridge to discover food beyond its use-by date,” she says.

As they age, encourage your parents to develop a good relationship with their GP, as they can be an invaluable support and gateway for information.

As a natural progression of ageing, some people can have difficulty concentrating. Memory lapses are  more commonplace.

Older people can also struggle with loneliness and grief at losing not only a life partner, but also their independence.

Living well for longer means taking care of yourself through exercise, nutrition and social connections. But eventually there is a tipping point, when being older becomes frail elderly.

At this point, parents need extra care.

Prof Hubbard says many parents might express that they simply don’t want any help.

“Many older people are fierce about their independence, but I tell them if you have assistance now, it will help you stay independent for longer,” she says.

As your parents get older, make sure those ducks are in a row.

Early on, well before your parent reaches their twilight years, it’s helpful to get informed about legal and support services available, including an Enduring Power of Attorney. This is a legal document that gives someone your parent trusts the authority to make personal, health and financial decisions on their behalf, if they can’t, based on what they’d have wanted.

Another is an Aged Care Assessment Plan (ACAP): a comprehensive assessment of the care needs of  your parent, which offers links to  support services.

Geriatrician Dr Andrew Granger  says getting in early with an ACAP is a good idea.

“Don’t wait until a crisis happens to put these things in motion, as it can take up to a year to get an ACAP assessment,” he says.

For parents who might be reluctant to get the ball rolling, Dr Granger has this advice: “It doesn’t compel the parent to do anything, but means if they need assistance down the track, it shows what that could look like.”

Honouring your parents’ independence is important.

Have a heart-to-heart with your ageing parents, well before they need it, about what their future might look like.

This means asking if they explicitly want to stay in their own home or be supported in an environment where they have more care.

Jenny, 68, cares for her elderly mum Betty, 94, at home. Jenny put her hand up for the job five years ago, relocating from Far North Queensland.

It’s an arrangement that’s given Jenny an opportunity to reconnect with her mum, as they share a love of op shopping and cafe hopping.

Of course, not all children will live with their parents as official or unofficial carers, but many will need to pop in more often and spend more time with them.

If you notice a cognitive decline in your elderly parent, Prof Hubbard suggests finding out whether it’s transitioning to a dementing illness.

“Seek a holistic assessment by a geriatrician about this. It needs to be diagnosed because there are treatments available that will slow the progression of that cognitive decline,” she says.

A geriatrician can also rule out other causes. It may be linked to a secondary or reversible cause, such as a vitamin deficiency, lack of sleep or depression.

A softly, softly approach is called for when supporting elderly parents.

When approaching the topic  of accepting help, there’s a very  good chance you’ll strike reluctance  or resistance.

It’s about being assertive, but also compassionate and caring.

Dr Yelland says there’s no denying navigating this is tough.

“You need to strike a balance  between pointing out that they need some assistance and not being critical,” she says.

Work out various roles family members can take onboard to be a united support network. Dr Yelland says doing the best for your parent also means throwing stereotypes out the window.

“It’s not always the oldest child that has the best rapport with the parent, and it’s not always the daughter,” she says.

“It’s a delicate dance. Share the roles, without looking like you are ganging up on the parent.”

Kate, 61, is carer for her mum May, 90, who has advanced dementia, and her father Jack, 91, who has mobility issues and is in constant pain. Relatives  have gently suggested May should be  in a nursing home.

“Over my dead body,” says Kate’s dad.

Caring for her high-needs mum and dad has stripped Kate of her youth and her vitality. A decade on, she loves her parents, but sees life passing her by, and she feels guilty about that.

Caring for someone in their later years is a huge responsibility. There is much joy in caring for a loved one, but it’s hard work.

Dr Yelland says it’s not the same as raising children, but it’s an analogy she often hears.

“Children are developing and growing; with ageing parents, they are usually deteriorating or declining. So, there is a lot of sadness in the caring role,” she says.

There’s also the risk of carer burnout, so it’s important to tap into support networks of your own and take respite breaks when you need them.

Dr Granger says carers need  support, too – whether that’s psychosocial or physical.

“Even a few hours a week where the carer has time out is important, but sometimes getting the carers and the parents to accept that is hard,” he says.

There may come a time when a parent needs to access more support than the family can give. Some might happily move into care, but for the majority of parents, it’s something they don’t want.

Dr Yelland says it’s challenging for everyone: “Adult children say the hardest thing they’ve ever had to do is put the older person in a nursing home.”

Dr Yelland advocates that more education is needed across the board, but particularly for the elderly.

“We see messages in the wider community about healthy ageing, but not about how to manage when healthy ageing comes to an end, and frail ageing begins,” she says.

 

Help to optimise your parent’s ageing trajectory, through the four pillars of healthy ageing:

  • High-intensity resistance training. Prof Ruth Hubbard says this reduces age-related decline in muscle mass to reduce the risk of falls. “Exercise is the strongest evidence-based intervention when it comes to optimising ageing,” she says.
  • Check medications. “Sometimes medicines prescribed when middle aged aren’t needed when people are older and vice versa,” Prof Hubbard says.
  • Good nutrition. Get them to eat a high-protein diet, with small, frequent meals. “I’ve admitted people to hospital who’ve been on a tea-and-toast diet. Their cognition is impacted, but with the right nutrients, they significantly improve,” Prof Hubbard says.
  • Social engagement. We are social creatures, and the brain doesn’t like to be lonely. “I’d be very resistant to a gardening club but love a choir. Find something your parent enjoys,” Prof Hubbard says.

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