It was an unfortunate mistake. But Kim Sylvester believed at the time that she was doing the right thing.
Her 80-year-old mother, Harriet Burkel, fell at her home in Raleigh, North Carolina, fractured her pelvis and had to go to a rehabilitation center to recover. It was just days after the death of Burkel’s 82-year-old husband, who had moved into a memorial care facility three years earlier.
With growing desperation, Sylvester had watched her mother, who suffered from emphysema and peripheral artery disease, grow increasingly frail and isolated. “I would say, ‘Can I help you?’ And my mother said, ‘No, I can do it myself. I do not need anything. I can handle it,’” Sylvester told me.
Now Sylvester had the opportunity to get more information. She entered her mother’s house and went through all the paperwork she could find. “It was a mess — totally disorganized, bills everywhere,” she said. “It was clear things were out of control.”
Sylvester took action, canceling her mother’s orders for anti-aging supplements, canceling two auto warranties (Burkel stopped driving by this time), canceling a year-long contract with a chiropractor for knee injections, and turning down requests for donations from dozens of organizations. When her mother found out about this, she was furious.
“I tried to save my mother, but I became someone she couldn’t trust – an enemy. I really screwed it up,” Sylvester said.
Dealing with an elderly parent who has stubbornly resisted offers of help is not easy. But the solution isn’t to make an older person feel like they’re being rolled over and taking over their affairs. Instead, respect, empathy and appreciation for the autonomy of the elderly are required.
“It’s hard when you see an older person making bad decisions. But if that person is cognitively intact, you can’t force them to do what they think they should be doing,” said Anne Sansevero, president of the board of the Aging Life Care Association, a national organization of care managers associated with older adults and their families work. “You have the right to make your own decisions.”
This does not mean that adult children concerned about an older parent should back down or agree to all of the parent’s suggestions. Rather, other skills are required.
Cheryl Woodson, an author and retired Chicago-area doctor, learned this firsthand when her mother — who Woodson described as a “very powerful” woman — developed mild cognitive impairment. She started getting lost driving and would buy things she didn’t need and then give them away.
Punishing your mother wouldn’t work. “You can’t push people like my mom or try to take control,” Woodson told me. “You don’t tell them, ‘No, you’re wrong,’ because they changed your diapers and will always be your mother.”
Instead, Woodson learned to appeal to her mother’s pride in being the matriarch of the family. “Whenever she was upset, I would ask her, ‘Mother, what year did Aunt Terri get married?’ or “Mother, I don’t know how to make macaroni anymore. How much cheese are you putting in it?” And she forgot what she was upset about and we just kept going.”
Woodson, author of To Survive Caregiving: A Daughter’s Experience, a Doctor’s Advice, also learned to use the question, “Does it really matter for safety or health?” Standard for her mother’s behavior. It helped Woodson let go of her sometimes unreasonable expectations. One example she shared: “My mom used to pour hot sauce on pancakes. It drove my brother crazy but she ate and that was good.”
“You don’t want to rub your incompetence in their face,” said Woodson, whose mother died in 2003.
Barry Jacobs, a clinical psychologist and family therapist, expressed similar themes when describing a psychiatrist in his late 70s who disliked submitting to authority. After the death of his wife, the elderly man stopped shaving regularly and changing his clothes. Despite having diabetes, he didn’t want to see a doctor and instead prescribed medication. Even after multiple strokes affected his vision, he persisted in driving.
Jacobs’ opinion: “You don’t want to compete with someone like that as equals, otherwise you will lose. They almost dare you to tell them what to do so they can show you they’re not following you.” Advice.”
What’s the alternative? “I would use empathy and appeal to that person’s pride to deal with adversity or change,” Jacobs said. “I could say something like, ‘I know you don’t want to stop driving and it’s going to be very painful for you. But I know you’ve faced difficult, painful changes before and you will find your way.’ The.'”
“They appeal to their ideal rather than treating them as if they no longer have the right to make their own decisions,” he explained. In the case of the older psychiatrist, there were constant conflicts with his four children, but eventually he stopped driving.
Another strategy that can be useful: “Show it, but do it in a way that saves face,” Jacobs said. Instead of asking your dad if you can get in touch, “Go to his house and say, ‘The kids really wanted to see you. I hope you don’t mind.’ Or: “We made too much food. I hope you don’t mind if I bring it.” Or: “I wanted to come by. I hope you can give me some advice on this issue that is bothering me.”
This psychiatrist had no cognitive problems, although he wasn’t as perceptive as he used to be. But progressive cognitive impairment often interferes with difficult family interactions.
If you think this might be a factor in your parents, try getting them screened rather than convincing them to accept more help at home, said Leslie Kernisan, author of When Your Aging Parent Needs Help: A Geriatrician’s Step”. Step-by-step guide to memory loss, resistance, safety concerns and more.
“Decreased brain function can impair an older adult’s insight and judgment and ability to understand the risks of certain actions or situations, while also making people suspicious and defensive,” she noted.
However, that doesn’t mean you should give up talking to an elderly parent with mild cognitive impairment or early-stage dementia. “You always want to give the older adult an opportunity to speak up and talk about what’s important to them and what their feelings and concerns are,” Kernisan said.
“If you frame your suggestions in a way that helps your parents achieve a goal that they consider important, they tend to be much more receptive to it,” she said.
A turning point for Sylvester and her mother came when the elderly woman, who was diagnosed with dementia, went into a care home in late 2021. Her mother, initially unaware the move was permanent, was furious and Sylvester waited two months before visiting. When she finally entered Burkel’s room with a Valentine’s Day wreath in hand, Burkel hugged her and said, “So glad to see you,” before pulling away. “But I’m so mad at my other daughter.”
Sylvester, who has no sister, replied: “I know mum. She meant well, but she didn’t handle things right.” She learned the value of what she calls a “therapeutic primer” from Kernisan, who led a family support group that Sylvester attended between 2019 and 2021.
After this visit, Sylvester saw her mother often and everything was fine between the two women until Burkel’s death. “If something upset my mother, I would just say ‘Interesting’ or ‘That’s a thought.’ You must take the time to remember that this is not the person you used to know and create the person you need as a parent who has changed so much.
We look forward to hearing from readers what questions you answered, issues you faced with your care, and advice you need on dealing with the healthcare system. Visit kffhealthnews.org/columnists to submit your inquiries or tips.