Dear Dad: Hang Up the Keys

Caring for an elderly parent calls for an awkward or even painful role reversal—suddenly the person who protected you for much of your life is helpless. "No one is ever prepared for it," says Virginia Morris, author of How to Care For Aging Parents. "We don't want to think about our parents as frail or dying."

Though we realize that our aging parents will require, at the very least, an extra hand at some point, most of us do not make arrangements for the inevitable. "It's a very normal, human response. We plan for happy times, for vacations, and for babies, but it's hard to plan for a parent's sickness—even when it's already happening," Morris says.

A primary and largely unexpected aspect of caring for an elderly parent is how emotionally exhausting it can be, Morris says. "Even if you're not providing hands-on, day-to-day care, you can feel drained and very down. It's confusing, because you're experiencing a combination of grief, guilt, helplessness, and resentment."

According to the Family Caregiver Alliance, caregivers are prone to depression, stress, and frustration. Research indicates that caregiving can lead to a weakened immune system and even premature death. But a combination of strategies can ward off such dangers, whether you are in the middle of nursing a sick parent, or haven't yet faced the possibility.

Sidestepping Sibling Strife

When a parent starts to require extra assistance, a very common effect is an outbreak of sibling conflict. Adult children are suddenly thrust into their old roles—be it the bossy one, the careless one, or the spoiled one. Differences in income and ability to take time off from work and their own families further complicate sibling dynamics.

"It's good to have a family meeting," says Joy Loverde, author of The Complete Eldercare Planner. "It's a way to clear the air and get the main issues on the table." Loverde recommends that parents sit out the initial meeting, where siblings can decide on their respective roles and contributions. Mom and Dad can then assert their opinions once the plan is presented. (Remember, unless your parents are suffering from dementia or impaired decision-making, they generally should have final say over their own futures.)

More Than Coping

Another common challenge is resistance from the parent who needs help. Understandably, she may not like the idea of diminishing independence, and may refuse to alter her lifestyle, even at her own risk. If you notice Dad's driving is erratic, for example, Loverde suggests thinking carefully about who would best suggest that he start taking the bus. "When my father refused to get his hearing checked," she says, "I appealed to his best friend, who was able to get him to the clinic." The ideal instigator could be a trusted neighbor, a clergy person, or even a grandchild.

Those who have rocky relationships with their parents will of course have a particularly difficult time caring for them. The satisfaction of fulfilling one's ethical duty can lessen the pain of sacrificing yourself for an ungrateful or ornery parent.

All caregivers must remember to take care of themselves, says Loverde. Never say "no" when someone offers help. Make a list of things you need and dole out tasks, whether it's getting a teenager to mow the lawn or having a neighbor sit with Mom for an hour while you get a massage. Stay connected with your friends for emotional support and remember to eat well and exercise.

Money Matters

The biggest surprise about elder care is the price tag. "People think Medicare covers all of it, but it doesn't," says Morris. "A nursing home, for example, can be $70,000. You can easily spend $100,000 a year."

It's never too soon to start talking about your parents' financial outlook. Ask for their legal papers, and whether they have long-term care insurance. How about a health proxy or a will? Where would they like to live if they can't be alone in the house anymore? It's obviously much easier to raise these questions before a health crisis strikes.

Helping Hands

Morris suggests taking an afternoon to discover the services that are available in your mother or father's community. Especially if you live far away, compile a list of phone numbers for volunteer programs, senior citizens' clubs, and housing alternatives. "There are many excellent, free services, but people wait until they are frazzled to find them," Morris says.

Even if your parents are healthy and independent, there may be things that can enhance their lives, from books on tape to voice-activated light switches. Cutting edge products include beds that can tell you whether Mom got up and refrigerators that send you a message if they haven't been opened in a while. Such high-tech helpers are prohibitively expensive for most, but prices are bound to go down as the industry flourishes.

Silver Linings

Amidst the many stresses of caring for an elderly parent are hidden rewards. "It's hard to see them when you're in the trenches," says Morris, "but we have a need to care for each other. Many people have times of intimacy and tenderness while caring for a parent." It's a chance, after all, to give back generously to someone who nurtured you. "I can't tell you how many beautiful memories are formed from this process," adds Loverde. "You can lay your head on your pillow each night knowing that you helped someone through the end of their life. And when a parent dies, as sad as it is, it can be a gift—it puts your priorities in order rather quickly."