Even experts surprised by issues of elder care
By: Kim Zarzour

Don Dority was at work when he received a phone call from his mother.

“I’m at the airport. Can you come pick me up?”

Mr. Dority jumped in the car and drove to his mother, not at the airport, as she had directed, but rather, to her Don Mills home.

It was with a sense of foreboding when he pulled into her suburban driveway. There she was, in front of the house, surrounded by “all kinds of crazy things” — her kitchen plates, the drainer from the sink. Mr. Dority’s heart sank. He knew his life — and his mother’s — were forever changed.

“I called my friends, said ‘What do I do?’ I’d known she was old, and getting a little forgetful, but she’d been in relatively good condition.”

Mr. Dority brought her to the hospital’s emergency department where he learned his mother had “significant cognitive dementia”. She never returned to her family home.

“Sometimes these things just catch you by surprise,” Mr. Dority says. “Life has its challenging times.”

Today, Mr. Dority’s mother is a permanent resident in a home for the aged.

And as the only child, Mr. Dority is executor and power of attorney. He also has power of attorney for his aunt and uncle, and a consulting role in the car of his mother-in-law. He admits it can be overwhelming, but it is becoming a fact of life for an increasing number of baby boomers.

A new study points to the importance of tackling these life changes ahead of time — before there’s a crisis like the one faced by Mr. Dority. But the same study shows discussing this sensitive subject is not always that easy for parents or their ‘boomer’ kids.

According to research conducted by Home Instead Senior Care, the biggest obstacle, is the continuation of the parent-child role. Many seniors may still be dealing with their grown sons or daughters as if they are children rather than adults. And many of those seniors’ offspring may be having trouble reversing the role too.

And similar to Mr. Dority, there isn’t always advance warning.

That’s what Thornhill resident Jean Irwin discovered.

Ms Irwin’s father died suddenly two years ago. Up until that point, Ms Irwin’s mother, Frances Will, was the picture of good health. Mrs. Will, a former high school teacher, had walked miles every day, drove her own car, cooked meals for 10, never had a headache or cold. She loved to golf and kept an impeccable house. Over the years Ms Irwin’s father had tried to persuade Mrs. Will to give up their large Ottawa house, to move into a smaller home, but she was determined to hang on.

Then, Mr. Will suffered a massive heart attack and was gone. Not long afterward, Ms Irwin’s active mother was carrying milk bags from the garage into the house and her world changed. She suffered a compression fracture in her back.

The pain was excruciating, the injury debilitating. Ms Irwin was plunged into a role of caregiver for which she was unprepared.

“I never anticipated I’d be in that situation,” Ms Irwin says. “They were always the parents and I was the child.”

Her parents had talked minimally about their aging, but up until recently her mother clung to life with fierceness. Now she says she’s “ready to go,” Ms Irwin says. “Life is so totally changed.”

She thinks a big part of the problem is people don’t like talking about the end stages of life.

Studies bear that out. The Home Instead survey of 1000 United States and 500 Canadians found baby boomers have the most difficulty talking with their parents about sensitive independence issues, such as leaving home and giving up the car keys.

These hurdles may be easier to overcome when families follow what Home Instead has coined the “40-70 Rule”.

Sharon Galway, an expert on aging with Home Instead who spoke in Richmond Hill at a conference sponsored by the Ontario Community Support Association and the Ontario Network for Prevention of Elder Abuse, explains it this way: If you are 40, or your parents are 70, it’s time to start talking. Wait longer than that, she says, and serious problems can evolve.

Ms Galway, a Richmond Hill resident, found this out the hard way herself. Several years ago, when her father-in-law’s health was failing and her own young family and work as a nurse were demanding much of her time, she arranged for respite care to help him in the evenings.

He was a stalwart, self-sufficient man who kept his relationships business-like, refusing much of his family’s help. “We never had the ability to really open up the lines of communication” Ms Galway remembers.

And so when the crisis happened, they were shocked. They discovered that during a six-month period, the respite caregivers had been robbing the elderly man and Ms Galway hadn’t had a clue.

“We missed everything. The signs in the bank accounts, they took things (such as) the diamond rings, we just had no idea. If we’d been more communicative we might have discovered it sooner, but he was so independent and we didn’t see the hints until it was too late.”

Much has happened in Ms Galway’s life since then. She entered the field of elder abuse and later opened a home-care business in North York and southern York Region, but more importantly, Ms Galway has changed the way she interacts with her 84-year-old mother.

“She’s all I have left. I want to enjoy the experience, on her terms, not mine.” Rather than rush through visits, she tries to slow down, focus, turn off her cell phone, change the pace of the conversations and where they take place.

“I talk to her about protecting her independence, and about what her life has meant, and what legacy she wants to leave.”

Many people put off those delicate conversations until a crisis forces the issue, says Ms Galway. “Maybe your father’s broken a hip, ends up in emergency and you’re told dad can’t go home, that it’s not safe for him. You don’t want to wait for that, until you’re being told what to do and you’re facing 24-hour care and you can’t afford it and what do you do now. You want to look at prevention rather than crisis intervention. Seniors these days are going to live a long time.”

And there’s going to be a lot more of them.

“We’re just on the cusp of it now,” Ms Galway says. “We’re looking at a big wave coming our way.”

Statistics Canada predicts the number of seniors will double by 2026, making up 21 per cent of the population.

At the same time, family dynamics have changed, says Judy Best, operator of Home Instead Senior Care in Oshawa, and co-presenter at the Richmond Hill conference.

The job of caring for aging relatives used to fall to the women in a family, says Ms Best, but with more women in the workplace, that’s much more difficult.

And no longer do we have communal families with three generations living under one roof – or even grandma living in the same town.

Long-distance care-giving is a big challenge, she adds.

Jean Irwin understands about that challenge. Ms Irwin’s mother lives in Ottawa, and Ms Irwin, who lives in Thornhill, works at a bank. It means she must find time to make regular four-hour drives to visit with her and take her to medical appointments.

Finding out that others are facing the same challenges can be helpful, says Don Dority. “It’s hard sometimes – I never thought when I was 30, 35 years old, that I would actually be caring for my parents. Medical technology these days means they’re living longer and there’s a need for more supportive help to go on for a very long time.

“But any good responsible child takes on these responsibilities. That’s just the way life will be.”

Experts in aging offer the following suggestions:
• Approach the issue as a problem-solving discussion. Rather than say “I wouldn’t worry so much if you were in a nursing home,” try “where do you want to be down the road, and let’s figure out how we can make that possible.”
• Listen for what your parents want to talk about, and if you’re finding too much resistance, back off. If you push too hard, you may just be setting up more roadblocks because the senior is trying to protect his independence.
• If possible, arrange family meetings so that all siblings have a role, whether they are local or long-distance.
• Approach each issue as it arises, rather than barrage your parent with multiple concerns all at once.