The struggle between freedom and safety is front and center in our nation right now. Navigating this dilemma of independence versus safety has been at the heart of our work as Aging Life Care Professionals™ long before COVID-19 and wearing masks.
I believe this struggle is also at the core of most family feuds related to aging parents. When families find themselves battling it out amongst siblings about how or whether to step in to help, it is often because the siblings have different values around freedom and safety.
I find it helpful to view independence and safety on a continuum — at one end is safety and keeping Mom as safe as possible. My business partner Jullie Gray likes to say she’d wrap all of our clients in bubble wrap to keep them protected from all the risks of aging if we could.
At the other end of the continuum is independence, a desire to honor our aging parents’ freedom and fierce desire to be independent. This often means minimizing their falls, ignoring the dents in their car, and allowing them to slowly slip into self-neglect.
Yet neither of these options are viable. We cannot wrap our parents in bubble wrap to keep them perfectly safe nor can we sit by idly allowing dad to break bones from falls or put his neighbors at risk by driving beyond the point of doing it safely.
Finding balance between honoring independence and inserting safety is not always easy. It takes creativity and experience. Having clarity on the issues of disagreement between family members can be a starting place. Five of the most common challenges that families navigate along this continuum are:
#1 Driving
Worrying about whether a parent should be driving is often a top concern for adult children. Navigating this dilemma is not easy since driving does represent our freedom and independence. Driving is often essential to getting our life tasks completed. Yet the topic of driving cannot be taken lightly or ignored. The risk is far too great. As we age, our reaction time slows and our vision declines — both can have a significant impact on driving. If a parent has cognitive changes, decision making, insight (the ability to see these changes in themselves), and judgment are also impacted.
If you have concerns about your parents driving, this is the time to engage a professional such as an Aging Life Care Professional, neurologist, or primary care physician to help your family determine whether your parent can continue to drive safely and to explore other transportation options. You may find this fact sheet helpful: The Toughest Conversation: Retiring the Car Keys.
#2 Not taking medications properly, consistently, or at all
An early sign of cognitive changes is skipping medications or struggling to follow doctor’s orders. Engaging your parent’s doctor to determine if medications can be streamlined or even eliminated can be a place to start. Simplifying medications, finding a medication reminder system, or adding a professional paid caregiver can improve medication compliance. This can also be a time to consider a retirement community.
#3 Poor nutrition
Good nutrition supports healthy aging. Organizing meals can be a daunting task and is far more complex than we give credit. The skills of planning, organizing, and being able to follow multi-stepped processes are part of our executive functioning skills which are impacted with brain changes. Transportation to a grocery store and shopping for ingredients can also present a challenge. There are creative ways to assist parents with meals from utilizing a paid professional caregiver, home delivered meals, pre-packaged meals from the grocery store, or considering a move to a retirement community.
#4 Managing mail and paying bills
If mail is piling up on your parent’s dining room table, it is likely that they are also missing paying important bills, double paying charities, and could be vulnerable to scammers. There are creative ways to assist with bill paying and life management such as engaging a Daily Money Manager, organizing online bill paying, or having bills sent to a family member for payment.
#5 Falls
As we age, mobility and balance can start to decline and there is a heightened risk for falls. According to the National Council on Aging, falls are the leading cause of fatal and non-fatal injuries for older Americans. The U.S. Centers for Disease Control and Prevention report:
- 1 in 4 Americans age 65 or older falls each year
- Every 11 seconds, an older adult is treated in the emergency room for a fall
- Every 19 minutes, an older adult dies from a fall
Next Steps
If your parent has experienced a major fall or a series of smaller falls, this is a time to engage more help. An Aging Life Care Professional can help you evaluate their risk and assist you in exploring options. Physical therapists and occupational therapists can also be engaged to help your loved one build strength and to further assess home safety.
If you and your siblings are struggling with how to help your parents, it can be helpful to realize that you each come with different perspectives and different values. This can be an ideal time to pull in a professional to look at the situation and provide an unbiased assessment of your parent’s situation. This neutral party, whose role is to advocate on behalf of your parent, can be the key to finding common ground. Aging Life Care Professionals are experts on navigating this continuum of independence vs. safety and how to creatively insert help while honoring independence. You can find an Aging Life Care Professional near you at www.aginglifecare.org
Lisa Mayfield is the founder and co-Principal of Aging Wisdom®, an Aging Life Care™ practice in Seattle. Trained and licensed as a Mental Health Counselor, Geriatric Mental Health Specialist, and a Certified Care Manager, Lisa brings over two decades of experience working with older adults and their families. She is currently serving as the Past-President of the Aging Life Care Association board of directors.
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