The Tribune

By Alicia Wallace

We spend a fair amount of time in preparation. We set goals, plan our futures and work toward becoming the versions of ourselves we imagine. We think about building homes, having children, educating those children, taking vacations and enjoying our lives. One of the things we are least prepared for is taking care of our ageing relatives. We often ignore the changes in their mobility and memory, determined to keep negative thoughts away. Mortality can be difficult for anyone to face, but even more challenging when it relates to our parents or grandparents.

While it feels better to stay on the positive side and lean on faith to see them through, the time usually comes for us to get real. Bodies and brains do not stay the same forever and, as is often said, “once a man, twice a child”.

In recent months, I have had a number of conversations with friends about elderly relatives. At first, I was surprised by the number of people in my age group who are dealing with the reality of ageing loved ones, but I remembered how many of us were raised — at least in part — by grandparents.

Many of our parents worked shifts in hotels or had nine-to-five jobs that meant we were in the care of their parents until they got off from work. We know about spending time at grandparents’ houses and being taken care of by people who seemed to always know how and could always explain why. They were the superheroes in the way family-friendly television shows now portray fathers.

One of my friends admitted that it took her a long time to realize something was a bit off about her grandmother. It was hard to notice because her grandmother continued to go about her days as she always had.

She got up early every morning to bake, have breakfast and get into the garden where she spent hours. By noon, lunch was prepared and the house was cleaned with the help of a part-time housekeeper. She would then spend time doing crossword puzzles, reading romance novels and listening to radio talk shows. On certain days of the week, she started making dinner a little early because she had to be at church for a service or meeting and she had to be there on time. This was her grandmother and it had been for a long time. What could be wrong?

There were no obvious signs, unless you saw her look at a handwritten recipe she had not referenced in years, or noticed it took her a bit longer to get in the house when she was outside alone. Everyone forgets sometimes, right?

How much could you really expect from a woman over 80?

Sometimes she is a bit short of patience. Maybe she is being a bit more daring in her language, saying more that a “doggon” or a “mess” here and there. Old age comes with a licence to be a little reckless.

It all seems normal until something happens to set off the alarm bells. The lucky among us hear those bells before something terrible happens and are able to act on it.

Our grandparents have always been strong and sharp in our eyes, and they made sure of it.

It is no easy task to reveal to them that something is wrong, or to let them know that we know the secret they have been keeping from us. It is hard to say to someone you love and respect, and whose longevity and active lifestyle is a source of pride, that they need some help. How do you tell your grandmother it is not safe for her to drive any more?

How do you tell your grandfather he needs to see a doctor and no, it is not negotiable?

Medication

For those of us who have siblings and cousins, the situation is even more complicated. Everyone has a different idea about how to take care of their loved ones. We have different opinions on medication. We do not trust the same medical care professionals. Our budgets are not the same. Our schedules do not allow us to spend the same lengths of time with our relatives, or to be at all of the family meetings. Does that mean we do not get to be a part of the decision-making process?

In my conversations with friends, I found the person taking on most of the financial responsibility tended to make the decisions, sometimes overturning decisions previously made by the group.

That person, more often than not, went head-to-head against the person with the most time to spare — the person who could be in the home the most and check-in with any in-home staff. That person, just by being present, holds power too.

Another friend of mine is living abroad and dealing with tremendous guilt because the health of an elderly relative has been on a slow but steady decline. She has a few common health issues like high blood pressure and arthritis which she has been doing her best to manage with prescribed medication over the years.

She lives in a house that is too big for her and, while there are family members who drop by to check on her, she is fiercely independent and wants to do as much as she can on her own.

If my friend still lived in Nassau, she would spend more time with this relative and be able to offer more assistance, but her circumstances do not allow it. Every now and then she asks herself if her own aspirations are selfish. She wonders if she should give up on the goals she has had for over a decade to take care of the woman who took care of her for most of her life. How do you answer a question like that?

Interestingly, in all of my conversations on this topic, most of the friends who have concerned about ageing relatives and who are actively involved in their care are women. I know a few men who have done and who are doing this work. Predictably, almost all of them are men who do not have sisters or other women in their families who are capable of taking it on. Care for the elderly, like most unpaid and underpaid labour, falls to women and girls.

In fact, I know several women who take an active role in caring for their husbands’ parents. Society has tricked us into thinking women are better suited to this work.

There is obviously quite a bit to discuss regarding care for elderly relatives. We are all getting older and we will not all age in the same ways.

Most of that can be attributed to lifestyle and genetics, but we really cannot predict the way it will go. What we do know, however, is there are only two possibilities — we continue to age, or we die. Both require planning. We do not spend enough time talking about our lives, our preferences, or our expectations.

Clash

This is a major cause of family drama. No one knows for sure what Mama would have wanted, and now she is either dead or incapable of making the decision for herself. Cue the clash of the cousins.

Do not wait for Grampy to show signs of Alzheimer’s, or for Gramma to trip on the front step. Start looking at the home.

Would it be helpful to put a rail and bench in the bathtub?

Is it time to address the living room clutter and make a nice, wide path for them to walk from the bedroom to the kitchen?

Can you introduce them to a gerontologist, or ask their trusted primary care physician to do the same? Should someone else be living in the home?

Talk about this with your elderly relatives and the people who would contribute to their care. Ask your parents how they would want to be treated in various scenarios.

The biggest point of contention is the varying ideas of what people want after the fact. It is not the most comfortable conversation, but it is better to have it now than to resort to guessing and fighting later.

More than a dozen of my friends with experience caring for ageing relatives said so.