Role Reversal: Caregiving for Aging Parents

both mental and
physical -- and long-term living situation falls to one person: her daughter --
and my mother -- Eleanor.

It's almost a full-time job. Making sure my grandmother is happy and not
feeling lonely means daily visits. Her never-ending stream of medical issues
means weekly -- if not more frequent -- trips to the doctors. Paying her rent
and her aides while keeping an eye on the bottom line means constant vigilance
if she is going to have any financial security in the long term. Finally, my
mother must deal with the endless stack of paperwork for Medicaid and health
insurance.

To make matters worse, my mother shoulders these responsibilities on her own
-- despite the fact that her two brothers and sister all live nearby.

This situation is not uncommon: When an aging parent needs care, it's often
one child out of several siblings who steps up to the plate to offer help. And
with more Americans living longer -- to 75 years and beyond -- this scenario
will only become more familiar.

WebMD talked to experts for their insights into the aging of America. What
it means for adult children, like my mother, who are put in a position to care
for their aging parents. How the one child who shoulders the responsibility of
parent-care can enlist the help of others, without starting a family war.

Aging in America

The dynamic of age in America has shifted dramatically over the last 60 to
80 years, experts agree, and its impact on the family is clear.

"There is definitely a changing age structure within families
today," says Neal Cutler, PhD. He is the executive director of the Center
on Aging for the Motion Picture and Television Fund in Woodlawn Hills, Calif.
"Its cause is simply greater longevity."

With more Americans living well beyond their 70s, more adult children are
now left in a position where they have to be caregivers for their aging
parents.

"There's a greater likelihood today that, as a 55-year-old, you will
have surviving parents, than there was say in the 1920s when both parents
passed away before you reached the age of 50," says Cutler, who is also
dean of the American Institute of Financial Gerontology. "This means that
middle-agers, who are planning for their own older years, also have to think
about their parents."

To complicate matters, one adult child of an aging parent often bears the
responsibility of the parent's care alone. What factors play a part in
determining who takes on the care of Mom or Dad?

"There is a gender bias in terms of who cares for an aging parent,"
says Lisa Hollis-Sawyer, PhD, coordinator of the Gerontology Program at
Northeastern Illinois University. "It's fairly universal that we think of
women as a caregiver, so their role in helping an elderly parent is not
uncommon."

Another factor in determining who will take on the role of caregiver to a
parent is age.

"It's also likely it's going to be the oldest," Cutler tells WebMD.
"While gender does play a big part, now -- with women in the workforce --
it's not necessarily the case anymore, and age and order of birth can come into
play."

But there's more to who is going to care for a parent than gender and age.
Instead, siblings should consider who is the best fit.

It's selective matching, explains Hollis-Sawyer, meaning that personalities,
geography -- simply who lives the closest -- and finances all play a role in
determining who might be able to provide the best care.

Caregiving for an Aging Parent: Taking Charge

If you are nominated -- willingly or not -- to be the caregiver for an aging
parent, dealing with the situation can be a challenge. It can be especially
difficult if your brothers and sisters aren't willing to recognize their
sibling responsibility.

What's the key to enlisting the help of your family to ensure the best care
for your parent? Read on for tips from the experts tha will help you wade
through not only the family issues that caring for a parent presents, but the
practical ones as well:

Open the lines of communication. As a family, with all of your
siblings and surviving parents, talk about how you will care for Mom or Dad
before the situation turns into a crisis, suggests Cutler.

"Anticipate that these are decisions and choices that are best made
before a crisis happens," says Cutler. "Sit down with everyone
together, and talk about what you want to do, whether it's a financial issue or
geographical issue. The key is conversation rather than crisis
management."

Then, when it is time for a parent to reach out to their children for help
later in life, it's clear who is responsible for what, from a financial and
support perspective, without creating a family conflict.

Pick an age. Have this conversation when your parent is still of a
"functional" age, whether it's your mother's late 60s or early 70s --
meaning she still has her mental and physical health on her side.

"A good guideline is to talk about long-term care with a parent when
issues like a health care proxy or living will come into play," says
Hollis-Sawyer. "If these are topics a person needs to think about, then how
their long-term care will be handled should also be on the table."

Support comes in many shapes. If one person is elected to be the
primary caregiver for a parent, the siblings should think about how they can
provide indirect support, whether it's by pitching in with paperwork, finance
management, or in-person help.

"A family needs to think about how to help support the sibling in charge
of a parent, either with help or compensation of some sort, to help defray the
cost that they are incurring," says Steven Stern, PhD, a professor of
economics at the University of Virginia, who specializes in aging and
disability.

Understand the finances. "Talk to a financial planner about
finances if you are caring for an aging parent on your own," says Cutler.
"You may be able to take a parent as a dependent on your tax return, if you
are paying for more than half of their well-being, such as rent, nursing home
care, or food."

The financial aspects of caring for an aging parent need to be taken into
consideration for the sake of your parent, but also for your own sake.

"Increasingly, the baby boomers will stay in the workforce longer,
primarily because they can't retire on time because of the need to care
financially or otherwise for a parent, maybe even a grandparent, and the cost
of raising children," Hollis-Sawyer tells WebMD.

When help isn't forthcoming. If the productive discussion before a
crisis strikes doesn't happen, and one child is left in charge with no support
from his or her siblings, the key is still communication.

"This situation happens a lot," says Hollis-Sawyer. "When it
does, the caregiver has to look at their options, and ask themselves questions
like, 'Would I benefit by attempting to communicate my needs to
others?'"

Reaching out to your siblings or other family members for support is a
better option than trying to take on the situation entirely on your own.

"If you do reach out, and you don't get the help you need internally
from your family, then it's time to look elsewhere," says Hollis-Sawyer.
"Turn to your community for support, like county-wide respite-care
programs, or caregiver support programs, or estate-planning consultations to
understand the financial issues at hand."

It's not all about you. Pay attention to your parent and his or her
needs, and remember that there are two people in this situation -- not just
one.

"It's so important to realize that there is a lot of stress to being the care recipient," says
Hollis-Sawyer. "There are just as many mental hurdles that need to be
overcome for the aging parent -- like accepting care and epending upon someone
else almost entirely later in life maybe when you'd like to be financially
secure -- as there are for the adult child in charge of their care."

The Upside of Caregiving for an Aging Parent

While the responsibilities of caring for an aging parent might overshadow
the benefits at times, it's important to remember the rewards of the situation
as well.

"There are definitely benefits of a positive caregiving relationship for
an elderly parent and an adult child," says Hollis-Sawyer. "The bonding
experience can create an intimacy that may not have been encountered when the
adult child was going through their own mid-adult phase. Maybe hopefully, they
are becoming closer to the parent."

Many people, she says, find that caring for an aging parent is a growth
experience, which creates an opportunity for both people to learn more about
themselves.

For the parent, having a child around to spend time with, and provide care,
may make a difference in quality of life.

"When kids provide help for the parent, it has a significant effect on
the parent," says Stern. "They have a stronger emotional connection to
their child than they would to a stranger who is an aide or a nurse in a living
facility. While it may not necessarily make them healthier, I believe it does
make them happier."

By Heather Hatfield
Reviewed by Louise Chang
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