Elder Care: Ticklish Times

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Three years ago, the personnel director of a New York City bank began to notice that things weren't quite right at her 85-year-old mother's home in Connecticut. "The house was in total disarray," she recalls. "There were piles of unopened mail stuffed everywhere, with bills months old and unpaid. But she was writing checks to buy magazines and knickknacks to enter sweepstakes."

The woman begged her mother to clean up the house and talk about her money situation. Nothing doing--until a year later, when the older woman learned she had cancer. With some urging, she agreed to move to a supported-living condo in New York, and her family found out that she had $20,000 in credit-card debt that she couldn't explain. Helping her was a struggle. "Mom's mostly competent, but not fully," says her daughter, 47. "She's very independent and stubborn and insists on doing a lot for herself."

Families everywhere will recognize the dilemma. How can children help and protect their parents yet respect their autonomy? What if the parents resist help when the children think they are in trouble? How do the children know when to step in, when to step back? The answers involve a renegotiation of parent-child roles that's happening in almost every family, especially with today's elders living longer than the generation before them.

"Often this comes with an epiphany: 'Oh, my God, Dad's getting old,'" says University of Southern California sociologist Vern Bengtson. A small event, like superorganized Mom losing her checkbook, may be the trigger. Or the recognition of parental decline may dawn gradually. Some offspring fight off the reality until a crisis hits, while others fret and nag long before their parents need any help. Many folks, Bengston points out, enter old age relatively healthy, still helping their kids with baby-sitting and financial support, but their offspring may overreact to small, normal signs of their parents' aging.

"Studies show that the height of death anxiety occurs in people's 40s and 50s," notes Karen Fingerman, a gerontologist at Penn State. "When you begin to calculate how many years you have left, it makes your parents' aging even more evident." In a study she conducted of 2,000 middle-aged daughters and healthy, aging mothers, she found that the daughters were more worried than necessary, often to the annoyance of their mothers. To help their parents, Fingerman urges, "kids need to confront their own emotions. Recognize that you're not just worried about your parent; you're worried about losing your parent, which is your worry."

The key is whether something is objectively wrong that requires an intervention--not always an easy call. Experts suggest watching for changes in behavior, especially sudden ones. Has a formerly sociable mom become taciturn and isolated? Does Dad suddenly find paying the bills stressful? Does he have trouble seeing when he drives at night? Have there been serious lapses of memory or judgment, a pot left unattended on the stove, a large check written to a con artist?