Saturday, September 12, 2015

Envisioning the Future with Your Adult Child

The email was poignant. I could empathize with the pain and fear the mother who wrote this was feeling.

I am having a hard time accepting getting old. Also I am dealing with my adult daughter not showing any love nor care for me. She also mentioned that I need to take care of my health because if I become disabled she is going to put me in a nursing home where I will be taken care of. She said it would be selfish of me to expect her to care for me. I am not sure if she knows that by telling me that has ruined the rest of my days. So, how can I age gracefully and happy when I know i am going to end in a nursing home?

I thought about how scary it can feel to imagine a future of illness, disability and pending death -- something all of us will experience though in somewhat different ways. Some fear losing their independence while others fear independence, how they will cope when or if they lose a spouse, hoping to move in with one of their adult children.

Sometimes our hopes and their dreams are in harmony. Sometimes there is distinct dissonance. 

And it made me wonder: just how much is reasonable to expect from our adult children as we age? How much is too much to ask?

Also, if there is a clash of expectations, does that have to ruin the rest of one's days?

Our expectations, of course, are very individual, seasoned by our own experiences and by cultural considerations.

I once dated a Jewish man from Iraq who, at the age of 25, had promised his dying father that he would take care of his then 45-year-old mother for the rest of her life. He took this oath very seriously. He loved his mother dearly, though, with her demanding nature and prickly personality, he often found her a trial. Worse, her aggressive rudeness toward every girlfriend he ever had posed a real challenge to his romantic life. His married sister offered many times to take the mother in but the mother  always insisted "My place is with my son because he promised." That promise cost him any chance of marrying. He was 83 -- and his mother was 103 -- when she died. 

When we were dating, more than 40 years before that, I would ask him why he was letting his mother determine the course of his life and he would reply "I made a promise. I know better than anyone how impossible she is. She is, without a doubt, the most selfish woman alive. But in my culture, we don't dispose of our older people just because they are inconvenient or hard to live with even if caring for them makes our own lives worse." 

He is now 85, in poor health, and alone, never having been married or having the children he once dreamed of raising with love from babyhood to gloriously independent adulthood.

There was Ana Maria, an injured factory worker who was a patient of mine when I was on the staff of a Worker's Comp clinic. She had been starting medical school in her home country when her mother, who lived in the United States, had a minor stroke and sent for her, contending that it was her duty to care for her. Ana came immediately to care for her mother, whose disability was slight,  whose general health was quite robust but whose emotional neediness was overwhelming. 

Every time Ana would mention going back to medical school, her mother would protest "But I need you!!" So Ana gave up that dream and stayed, eventually marrying a man who was initially charming and eventually abusive. Finding herself a single mother of two after he left her for another woman and, with no work history in the U.S., Ana felt lucky to get a factory job. After she suffered a work-related arm injury requiring surgery, I began to see her for supportive counseling. 

Her feelings were a mix of angry regrets and loving commitments. "I am angry that my mother demanded I give up a life I had worked so hard to achieve and I'm mad at me for relinquishing it all," she said. "On the other hand, my kids mean the world to me. If I had stayed in Mexico, I wouldn't have had them. And if I had stayed in school though my mother needed me, I would have felt bad about myself. I chose to come here and care for her. But overall? I think my mother expected too much even though caring for family is a big part of our culture."

Even keeping cultural considerations in mind, these are scenarios I'm sure many of us would not want for our adult children, believing that there are ways to show love and support without sacrificing one's own life and dreams.

How does one begin to envision an unknown future?

To envision the future, look to the past: What is your family history? Is there a pattern of early-onset dementia? Or have one or more generations suffered from Alzheimers? Has cancer taken a toll on your family? While it's impossible to predict your own health future, if there are certain trends in your family, it can help to imagine yourself in such a scenario and devise a plan for the future that assures good care while demanding as little as possible of your adult children. In the past, especially when women did not work outside the home, full-time caregiving by an adult daughter or daughter-in-law was more common. That may no longer be a realistic expectation.

Begin planning as if you were single and childless: What insurance do you need? What can you afford? Meet with an independent financial advisor (one with nothing to sell!). Check out long-term care insurance before you're old enough that the cost would be prohibitive or you might have medical conditions that would preclude coverage altogether. What are your possible resources for help if you become ill or disabled? If you build a safety net for yourself as if it were all up to you -- and, for the most part, it is -- you will not only build a future the way you would prefer, but also will be asking less of your adult children. Asking less of them may bring more rewards than you ever imagined when they are able to choose how they will offer you their love and emotional support.

Create a sense of comfort with the unknown.  None of us can know the challenges older age can bring. We can get some clues by looking at the generations before us, but those are their stories, not necessarily ours. We may die suddenly tomorrow or live long lives with a gradual decline. We may never see the inside of an assisted living facility or a nursing home. It's impossible to know unless one already has a degenerative health condition. While it's prudent to plan for the future, it's also important to live fully in today, enjoying each happy, independent day as it comes to us, seeing this as a blessing denied to so many. Knowing that good health and life itself are finite can make today even sweeter.

Talk about future scenarios with your adult children, collaboratively, not in terms of your expectations. Ask them what they imagine and what they fear. Talk about your own parents, their grandparents. How would you like the future to be different? What is their vision for your future together? Talk about what you would like, not what you expect.

Know that love takes many forms and that you can have a good life and good relationships with your adult children whether or not any step up with an offer of full-time care. Living fully and joyfully is a choice --  whether or not you're close to your grown children and whatever your adult children do or don't do. You can build a life of friends, extended family, and neighbors. You can find companionship with a beloved dog or cat. You can find fun and engagement in interests and activities with friends and other extended family members. 

And as you live fully, joyfully and independently, your adult children may love you more.

My brother, sister and I always agreed that Aunt Molly, our father's childless, never married sister, was our third and best parent when we were growing up. She brought fun, laughter and poetry into our lives and also loved us enough to teach us some tough lessons in becoming kinder, more tolerant, resilient and self-motivated adults. In fact, she was central to our lives for many years longer than our mother and father, who both died of heart attacks within four months of each other, when we were still young adults.

Aunt Molly was delightful, highly intelligent, pivotal to our lives but she also had her own life filled with friends, interests and her continued career as a writer well into her eighties. By the time she passed her 85th birthday, we began to worry about how it might be for her and how we could help should a stroke or other medical misfortune take away her independence. She worried, too, and had given the matter much thought and action.

"Whoever said old age is not for sissies was surely right," she told me one day. "You really need a sense of humor in these so-called golden years. Besides the fact that I love you, I will tell you three things and then make a request. The three things are: first, my will, birth certificate and wishes for my funeral are in the first folder in my file cabinet; second, I have every kind of insurance possible, including long-term care that provides for in-home care; finally, my greatest wish would be to be cared for by professional caregivers, if needed, and to die at home."

I nodded, not wanting to imagine such a future, but marveling at her careful planning.

"And now what I want to ask of you," she said, her eyes filling with tears. "All I ask is your emotional support as I go into this phase of my life. It's a little scary..."

"I know it is," I said, my own eyes filling with tears. She suddenly looked so frail and vulnerable.

We embraced and I felt a wave of love and a touch of relief. Emotional support was something I could give -- and my brother and sister could give, each of us in our own ways -- freely and willingly. 

As it turned out, Aunt Molly never needed caregivers or long term care. She died suddenly a little more than a year after our conversation. A few days after New Year's in 2004, she was sitting in her favorite chair, doing the New York Times crossword puzzle while waiting for her dear friend Magda to pick her up for a post-holiday lunch when her tired heart simply stopped. She was 86 and still independent. It was the best possible way for her to depart this life, dependent on no one, looking forward to an excellent lunch with a good friend.

Not everyone is as fortunate. But her careful planning that took into account what was possible for those who loved her left a legacy of love that will live forever in our hearts. 






15 comments:

  1. Two other possibilities for elderly people is to garner help from good neighbors but the one I like the best is having conversations with friends who are in the same situation who might consider partnering with you in old age to care for one another.

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    1. Excellent idea! Aunt Molly and her friend Magda had such an arrangement in place. In fact, they called each other every night at 6 p.m. to make sure all was well. (This after a neighbor had a stroke and wasn't discovered for two days and then died soon thereafter.) It just happened that she and Magda were due to have lunch the day she died. Magda had a key to her house and used it to get in after Molly didn't answer the door. She also had a list Molly had made of phone numbers to call -- relatives, her terminally ill cat's vet, funeral home,etc. So everything went very smoothly.

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  2. The new ACA/Obama care makes provisions for people to remain as long as possible in their own homes. I serve on a county health board, and their directions are to become comprehensive health providers, assuring that your needs are met. If you can remain at home, the local health authority can assign whatever end of life assistance you need, before hospice takes over. Your primary doctor will need to know that you have no help at home, so he/she can contact the proper agencies to provide assistance.

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    1. Wow, Rosaria! That's incredibly valuable information. Thank you so much!

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  3. That was really heart-breaking - the story about your Jewish boyfriend and his mother. I wish we could all go as easily as your crossword friend.

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    1. Yes, my aunt was fortunate. If she could have chosen, that would have been her choice. And she was getting everything right in the crossword puzzle. She was super sharp until the very end!

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  4. Being single and childless, I found rosaria's solution comforting. That is as long as they don't repeal Obama care. I think we all hope we just blink out while still self sufficient.

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    1. Amen to that! I hope the Obamacare option stays around, too, and really appreciate Rosaria making us all away of it!

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  5. Great thoughts, Kathy---and lots of wonderful information... This is an area which most of us don't even think about until we HAVE to. I made a huge mistake by not getting long-term care insurance when I was younger... SO--that's one thing I know that may come back to bite me!

    I do NOT want to be a burden on my children --and really don't understand why some parents 'expect' that from their children. I am willing to do the nursing home thing (as bad as they are) to keep from being a burden on my children.

    But I love your idea of partnering with friends in the same situation and helping each other. IF I end up alone (without my hubby), I will get involved anywhere I can to be with others and make lots of friends... It's all about people helping people...

    I also liked your idea of communicating with your kids/families --so that they will have an idea of what you want or what can happen.. Communication is good ---as long as the parent doesn't 'demand' the kids to do such-and-such... I raised 3 sons --and have no immediate family much left --including cousins, etc... I'm just in a small family... My sons will all do what they can to help I'm sure ---but the one who lives the closest to me has a wife who feels the need to care for her elderly parents in their home someday... Who knows how or when that will happen?

    Wouldn't it be wonderful if we could all stay relatively healthy like Aunt Molly ---and then die calmly without serious illness or problems? I pray that is the way I did...

    Hugs,
    Betsy

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    1. Thanks so much, Betsy! I think most of us would like to go like Aunt Molly. The idea of friends partnering actually came from someone making a comment as did Rosaria's Obamacare information. I truly appreciate all the ideas you all have been sharing!

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  6. When I first got out of the hospital I couldn't even get up and walk to the bathroom by myself. My adult son had to help me. I felt I was asking too much from him and I felt bad. I am so thankful to being better and more independent again.

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  7. We have made plans as far as plans can be made. They don’t include children.Not one of the six has offered any assistance during our recent scare; we didn’t ask either.

    Friends are a better bet, but friends too may get ill and need help themselves. I feel totally free to spend every penny of our joint assets on professional care, in fact I have already started on paying professional carers for small bits of personal care for my husband. It makes my life easier.

    The best attitude, as far as I’m concerned, is not to have any illusions about old age: it can be wonderful but it can also be beastly difficult. Be prepared for whatever happens.

    I think I will never allow myself to be quite as overwhelmed as I was during the past summer months, I now know where to go for help.

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  8. My grandmother was kind, graceful, optimistic and joyful so it was a joy to visit her and include her in our lives.

    We included her because we wanted too and she made it easy!!

    She was an avid reader and contributed to conversations. She appreciated any token brought to her and often share pleasant stories of her youth.

    Another great-aunt was quick to criticize, passive-aggressive, resentful and spent much of her free time gossiping and promoting rivalries in the family so that she felt powerful and in control.

    The result was we loved her from afar but we had to put some distance because her children and nieces felt depleted after visits.

    The great aunt's need for attention was exhausting! She demanded to be entertained and gifts were cast aside. "After everything I have done for so-and-so" began most of her talks. She was draining but we fulfilled our obligation to visit her as best as we could and no more.

    Naturally the great-aunt speaks of feeling rejected and abandoned by her adult children. She fails to realize her controlling and manipulative ways pushes her children away. Or perhaps she likely knows but enjoys wallowing in self-pity and counting the sins of others.

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  9. Hi , Dr Mccoy and viewers,
    I have a story to tell and want all the insight I can get from you guys... yes I am already in therapy but I know it will take a loong time to help me... I will start back about 2 yrs ago my youngest daughter and her husband asked me to buy a mother/ daughter home together, after house hunting we realized it wasn't gonna work, daughter would disagree about everything we discussed, didn't wanna share a kitchen,
    Laundry room etc... renovations were unaffordable, all the closing costs and down payment were coming from me....we decided to forego that idea and move on... I than considered a move with my sister about an hrs away, into a 55 t community....a few months later daughter is pregnant.. no big deal, I can still move, her and her husband can take care of baby and work, everybody does it.. than we find out it's twins...omg...I had twins 36 yrs ago... So much work...nothing more said about moving changes...2 months pass and she now tells me her husband has lost his mind and doesn't want to raise Twins, so will I consider buying a house with her, all sharing issues no longer a concern...we find out there is a binge drinking issue with the husband. He goes into rehab and comes out feeling positive, we think... Babies born 3 months later and he is in the pic, I stay with them and help raise the girls through the first few months with my daughter, he works most of the time, diff shifts, he helps when it's convenient for him...we go ahead and get a house, I have downstairs, and they have upstairs, share kitchen, I cook and am suppose to be the helping hand with the babies.. things are smooth for awhile, he is no longer working the midnights, so that helps... Than bang, he is staying out after work, drinking and very seldom available to help, he goes away on golf tournament.. drinking tournaments and thinks nothing of being gone for days, it becomes unbelievably stressful, working, going away, drinking, binge drinking, never incapable of watching the babies..twice feel asleep watching them, daughtervworks 3 days a week sometimes, daycare, me and him, but because life throws curve balls, him incapacitated, babies sick, it all falls on me ...I have them more than anyone, and yes I am a caretakers and worry about everything, so bad, I am a wreck and cry at the drop of a hat.. I believe my daughter's life will be insane, if I leave, I keep all the balls in the air, but I can't do it anymore.. a few times she said she was leaving him, saw the lawyer, I paid for, they kinda live paycheck to paycheck, more bad news... I keep that part afloat too... she says she doesn't want to start all over with someone new, I get that... and she says he use to adore her...blah, blah, blah... they have a therapy appt...they did that before...he has also taken out some more loans while binging, so now they have more bills.... I love my granddaughters like crazy but because I'm such a nervous wreck every time something happens, I am beyond stressed, I don't think I can do this anymore the uncertainty is killing me and I absolutely despise him for the position he has put me in...and he doesn't talk to me...cause he thinks I don't like him and this is his house....lol. I still worry that I will be sicker if I leave and know my daughter's will be alone in this mess...I also have a gut feeling he just applied for the midnight detail again so he is gone all nite and sleeps all day...my daughter keeps asking about the new position and hrs but he is being very vague and I feel like as usual he is lying.. please help me tell me what you think...thank u so much

    ReplyDelete

  10. Dr Mccoy and viewers,
    I have a story to tell and want all the insight I can get from you guys... yes I am already in therapy but I know it will take a loong time to help me... I will start back about 2 yrs ago my youngest daughter and her husband asked me to buy a mother/ daughter home together, after house hunting we realized it wasn't gonna work, daughter would disagree about everything we discussed, didn't wanna share a kitchen,
    Laundry room etc... renovations were unaffordable, all the closing costs and down payment were coming from me....we decided to forego that idea and move on... I than considered a move with my sister about an hrs away, into a 55 t community....a few months later daughter is pregnant.. no big deal, I can still move, her and her husband can take care of baby and work, everybody does it.. than we find out it's twins...omg...I had twins 36 yrs ago... So much work...nothing more said about moving changes...2 months pass and she now tells me her husband has lost his mind and doesn't want to raise Twins, so will I consider buying a house with her, all sharing issues no longer a concern...we find out there is a binge drinking issue with the husband. He goes into rehab and comes out feeling positive, we think... Babies born 3 months later and he is in the pic, I stay with them and help raise the girls through the first few months with my daughter, he works most of the time, diff shifts, he helps when it's convenient for him...we go ahead and get a house, I have downstairs, and they have upstairs, share kitchen, I cook and am suppose to be the helping hand with the babies.. things are smooth for awhile, he is no longer working the midnights, so that helps... Than bang, he is staying out after work, drinking and very seldom available to help, he goes away on golf tournament.. drinking tournaments and thinks nothing of being gone for days, it becomes unbelievably stressful, working, going away, drinking, binge drinking, never incapable of watching the babies..twice feel asleep watching them, daughtervworks 3 days a week sometimes, daycare, me and him, but because life throws curve balls, him incapacitated, babies sick, it all falls on me ...I have them more than anyone, and yes I am a caretakers and worry about everything, so bad, I am a wreck and cry at the drop of a hat.. I believe my daughter's life will be insane, if I leave, I keep all the balls in the air, but I can't do it anymore.. a few times she said she was leaving him, saw the lawyer, I paid for, they kinda live paycheck to paycheck, more bad news... I keep that part afloat too... she says she doesn't want to start all over with someone new, I get that... and she says he use to adore her...blah, blah, blah... they have a therapy appt...they did that before...he has also taken out some more loans while binging, so now they have more bills.... I love my granddaughters like crazy but because I'm such a nervous wreck every time something happens, I am beyond stressed, I don't think I can do this anymore the uncertainty is killing me and I absolutely despise him for the position he has put me in...and he doesn't talk to me...cause he thinks I don't like him and this is his house....lol. I still worry that I will be sicker if I leave and know my daughter's will be alone in this mess...I also have a gut feeling he just applied for the midnight detail again so he is gone all nite and sleeps all day...my daughter keeps asking about the new position and hrs but he is being very vague and I feel like as usual he is lying.. please help me tell me what you think...thank u so much
    Reply








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