Relating

Relating

 
When Roles Reverse
By Nancy Jakubic

In 2004, Statistics Canada reported that nearly two million Canadian baby boomers were caring for 2.3 million seniors with long-term disabilities.  Approximately 70 per cent of Canadians were caring for one or both of their elderly parents.  Of that number, 70 per cent were women and 30 per cent of those primary caregivers were employed full time.  By 2031, over 750,000 Canadians will develop some form of dementia.  The Manitoba Alzheimer’s Society estimates that 18,640 Manitobans already have dementia.

We are living longer and the largest generation in history is advancing into old age.  As the divorce rate rises so does the number of blended families with adult children and toddlers in the same family unit.  Women are having children later in life.  While a 20-something mother could call on her middle-aged parent, the sandwich generation mothers’ parents are in their 70s or 80s.  They need more care than they can give.  Today’s mother may also have her own grandchildren and thereby be pressed between three generational layers a.k.a. a ‘triple-decker’. 

Karen’s full-time job as a university nursing instructor has provided her with resources and a schedule that makes it somewhat easier for her to care for her parents.  The younger generation pitches in and her mother still cares for her father as best she can.  That’s due to change.

“In one year, Mom’s gone from being hard to keep up to being almost housebound with a walker,” says Karen.  “She can’t go up and down the stairs and if we go shopping, she has to be in a wheelchair.  It’s been difficult because she’s a very active lady.  This has really slowed her down and aged her a lot.”
Karen’s father struggles with tasks like getting dressed and shaving.  He did have daily home care but resisted so much that Bertie cancelled it.  Karen finally managed to convince them to accept home care three times a week.  She also arranged for respite for Bertie every Thursday afternoon but Karen’s mom is frustrated by her limited mobility.  Karen often comes home to find Mom waiting for her in the driveway.  

“I don’t usually say ‘no’ but I will often say, “It doesn’t suit me right now, Mom,” says Karen.  “I think that’s been the hardest thing.”  Bertie and Otto were planning to move into an apartment this fall but now Otto is moving into a personal care home.  Bertie will have her hip surgery this winter and has her name in at several senior community complexes. 

“It’s a big change all around,” says Karen.  “Dad won’t be coming home.  Now I’m feeling guilty that maybe we didn’t provide enough for my Mom so my Dad could stay home longer.”

It’s common to feel extreme guilt over the decision to move a person with Alzheimer’s into a personal care home.

“The spouse may have promised that that would never happen but that isn’t a realistic promise to make,” says Janice Hebb, Client Services, Alzheimer’s Society of Manitoba.  “When this disease happens, nobody has their loved one in their home until the end.  Everybody is eventually in a personal care home.” Hebb says caring for a person with severe dementia literally doubles the stress load.

“The person loses all their cognitive ability and with that they lose their ability to do any activities of daily living,” says Hebb.  “The caregiver has to be watching constantly.  They rarely get a break and there are many safety issues.  Also, caring for someone with dementia can mean anywhere from two to ten years or longer.”

Caregivers often feel guilty about losing patience with their loved one and resenting the intense burden of care.  In turn, people with Alzheimer’s can be nasty and accusatory.  Hebb reminds caregivers to separate the person from the disease.

All seniors face numerous challenges in today’s society including affordable housing, costs of medication and transportation.
“There’s a lack of transportation options for seniors,” says Kimberly Weihs, executive director, Manitoba Society of Seniors.  “Public transport is no help if they have to climb over a five-foot snow bank.  A lot of them have mobility issues and need a door-to-door type of service.” 

This means the caregiver has to take time off work to accommodate their parents.  If they don’t, the senior may miss the appointment or not purchase the food and medications they need.

Isolation is another issue for seniors, especially those with mobility or cognitive limitations.  Weihs says more seniors are opting for the growing number of retirement communities to benefit from the social aspects.

Karen’s parents are fortunate that they have  family who love and care for them.  Karen’s daughter has a special relationship with her grandmother and Karen’s grandson has brought unbound joy to her father. 

“My dad is so connected to him,” says Karen.  “He can’t always remember his name but he calls him, ‘That little guy who knows more than all of you.’   They go for walks and Dad follows him around.  You look at the pictures of them and they’re gazing into each other’s eyes.”

Relationships like that make some families consider having the senior move in with them.   Weihs advises careful consideration before proceeding with this option.  Depending on the physical and mental health of the senior parent, the caregiver may be quickly overwhelmed.

“We’ve seen a lot of people, especially women, who are quitting jobs to look after a parent,” says Weihs.  “Especially in the sandwich generation where they also have to take their children to appointments and activities.” 

Dawn Rennie is president of Transitions, a moving service that specializes in seniors who are downsizing.  Rennie says our trend for global living often necessitates the need for caregivers to rely on the services of strangers.

“I had a woman call from California whose mother-in-law in Winnipeg needed to be moved within 24 hours,” says Rennie.  “The daughter-in-law’s husband just had chemotherapy and she couldn’t leave him.

”Another client had just undergone triple bypass surgery and needed to move their parent immediately.

This leads to a universal piece of advice:  Plan ahead.  Talk to your parents about their wishes before the situation reaches a crisis point.  In Karen’s case, Otto’s aneurysm was a wake-up call for her parents.  They made and paid for their funeral arrangements and gave Karen power of attorney.  Rennie also urges caregivers to educate themselves on the healthcare, social service, and legal systems they will inevitably encounter down the road.

Something else sandwich generation caregivers may discover are the enriching experiences that   day-to-day contact can bring.

 “I really feel that I get to do things with my grandson that most grandparents don’t,” says Karen.  “I have gotten to know my parents in a much closer way, too.  I’ve seen the amazing strength in my Mom as she has made very difficult decisions.  I’ve also seen my dad in a much different light than I would have if I wasn’t involved the way I am.”

 Losing a parent is one of life’s most traumatic experiences, no matter how old we are.

 “It’s a difficult time,” says Rennie.  “The more we address that our parents are declining the more we realize that we’re going to follow suit.”

 As Rennie reminds us, “If it happens that we    have to take care of our parents, it’s only going to happen once.” 

Photo by Ruth Bonneville