When my father was in his eighties, he experienced ongoing numbness in his feet due to neuropathy. His legs stopped working well and he had difficulty getting around even with a walker. Simply trying left him exhausted. But he believed there was a cure. So when his cardiologist recommended heart valve surgery, he convinced himself the surgery would improve his legs, too.
His trusted, long-time dermatologist told him, “Your life will not be the same if you go through with this surgery.” My sister, a nurse, and I also explained the risks. To all of our dismay, dad went ahead with the operation.
No surgery is minor or routine for a patient in their eighties. After my father’s surgery, he was never as strong mentally or physically again. In what is known as the “flat affect” that can result from medications and anesthesia, he seemed to lose a lot of his spark and developed a lingering vacant look. Sadly, none of his mobility or stamina problems improved.
Yet, aside from making our cases about the surgery’s risks, those of us who were close to him did not try to control his actions or impose our will.
From my 40 years of experience as a care manager to older adults, I know all too well that most efforts to control aging parents’ behavior are met by resistance. Time and again I’ve seen my clients try to protect their parents from countless potential dangers: driving when their eyesight and reflexes are not what they used to be, climbing ladders to clean out the gutter of their home, keeping—and eating—expired food in the fridge. These things happen. All the time.
So do lifestyle changes affecting older loved ones’ health and fitness that younger generations wish they could fix. Refrains like “stand up straight, mom,” “let’s go to the gym together,” “try walking three times a day,” and “what if you got meals delivered?” are all too common. But adults in their Fragile Years resist attempts by their children to help them stay healthy and safe because they fear help is a sign that the end of life is approaching and that they’re no longer in control.
Watching a parent who was once strong, upright, and clear-thinking diminish is painful and sad. And trying to get the parent to not decline, and to stay clear of dangers, is a normal response. But when is—or isn’t—it the right thing to do?
I’m a firm believer that it’s best for adult children to give up any thought of “controlling” their aging parents, even if this means allowing them to make bad decisions. Trying to control them will ultimately prove as futile as telling kids what to do over and over again. Instead, my advice is to work with them to help them feel more comfortable with assistance and advice.
Navigating this process takes patience and skill. Here are a few steps I recommend, from my experience as both a professional caregiver and a daughter:
Get involved early in the game. For years I made trips once or twice a year from my home in Florida to visit and stay with my dad in Michigan. He would also come visit me in Florida each winter. This ongoing involvement helped him trust me and open up more about his condition as he grew older. In contrast, I was once assessing an older woman on her daughter’s request, and the woman said to me “my daughter thinks I am dying, doesn’t she?” The daughter hadn’t visited in three years. Her sudden involvement was a red flag. If you are involved on a regular basis over the years, your presence and support will not be alarming, and your parent will be more inclined to cooperate with your initiatives rather than resist.
Spend some extended periods of time with your parent. During one of his trips to Florida, my dad did not want to play golf—one of his all-me favorite activities. Because I had spent extended stretches of time with him, I knew this was unusual. In his book My Mother, Your Mother, Dr. Dennis McCullough lays out a 72-hour visit concept encouraging adult children to spend time with their parents over extended periods of time. No judgment, no convincing them to do anything; just be there. You can observe, get a better sense of your parent’s capacities, and build trust.
Just listen—and don’t try to fix anything. When my dad said he didn’t want to play golf, I simply listened, refraining from trying to troubleshoot or offer solutions. This helped me gain valuable information about his condition, and reinforced for him the notion that my presence was a safe place for him to talk about the changes he was experiencing – laying the groundwork for me to better assess new situations as they arose.
Proceed slowly. When it came to talking about touchy subjects such as money or my father’s medications, I found it best to start by testing the waters. I’d make a comment in passing and see how he reacted. If a conversation started, I would not push to take it further than my father was ready for. Ratcheting down and going slowly can allow you to seek solutions that are small in size and build from there.
Pick your battles: Looking back, there is only one battle I would have fought if needed: the decision to move my father into a nursing home. Fortunately for us, it wasn’t necessary: my father took that initiative on his own.
I’m certain that letting my father make his own decisions—no matter how bad they seemed—was the best choice I could have made for our relationship and quality of life. Our relationship remained steady and affectionate throughout his fragile years, and my family and I had the gift of accompanying him lovingly to a peaceful end-of-life.
Amy Cameron O’Rourke is a nationally-known pioneer and advocate for senior care in the U.S. A professional care manager with over 40 years of experience, she is founder and president of The Cameron Group: Aging Life Care Services in Orlando, Florida and author of The Fragile Years.