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As Parents Age
A Psychological and Practical Guide
by Joseph A. Ilardo, PhD, LCSW

Adapted from the Author's Preface

"You got me, doctor!" the elderly gentleman said. He had been stumped again by a question from the young physician. "Do you know what year it is?" . . . The pause grew embarrassingly long. The doctor was calm. None of this was extraordinary for him—clinically interesting, perhaps, and useful for purposes of diagnosis, but not extraordinary.

Sure. This wasn't his father.

As I struggled to absorb what I had just witnessed, the thought occurred to me that the same scene is undoubtedly repeated many times every day, in physicians' offices from coast to coast. An elderly family member is brought in for a check-up. An examination reveals that he or she is seriously ill, or . . . losing his grip on [reality]. The family reacts with stunned sadness. They are challenged to accept the unsettling reality that things will never again be what they once were. I learned in a very visceral way that day that aging has a profound impact not only on seniors themselves but also on their adult children.

From Chapter 2: Coming to Terms with Your Parents' Aging

In Part One of this chapter, we will first look at how adult children respond when they see a formerly vigorous parent grow increasingly frail and intellectually tentative. Next, we will turn to their concerns about their own future, for as they observe their parents deteriorate, adult children invariably project into the future and wonder about themselves and their own aging. Under specific circumstances, even the most predictable reaction can become problematic. In the second part of the chapter, you will learn how to distinguish between reactions that fall within normal limits and those that do not.

Reactions Checklist

Below is a set of criteria that can be used to assess your reactions. Each criterion is framed as a yes or no question. Any yes answer suggests a problem. Several point to the need for prompt action. In a few moments, you will learn how to cope with both typical and extreme reactions.

Do your reactions cause you to lose your sense of priorities? For example, do you find yourself giving up more and more of your life in order to care for an elderly parent? Have you moved in with them or allowed them to move in with you for no compelling reason? Have you stopped asking, "How much help am I willing and able to provide?"

Do you find yourself experiencing unexplained or atypical physical ailments? The emergence of unfamiliar symptoms is often a warning sign. So is any change in the frequency, severity, or duration of familiar ailments. Such unexplained or atypical physical ailments may be related to your involvement with your elderly parents. A competent therapist can help you make the connections and control your symptoms.

Do you find yourself experiencing more conflict at home or on the job than is typical for you? In mild forms, feelings such as anxiety, anger, depression, and resentment can make you irritable. In more extreme cases, they can affect you more profoundly and for longer periods of time.
It is not unusual for a depressed or an angry person to redirect or displace feelings. You may become increasingly intolerant of the age-appropriate behavior of your children, for example. The same is true if the predictable behavior of coworkers begins eliciting angry responses that seem uncharacteristic of you.
Unacknowledged emotional reactions to a parent's aging can cause you to overreact to things. If you find others urging you to calm down, or if people are commenting that your reactions are disproportionate to the events that trigger them, then it is likely that your responses are being colored by unacknowledged feelings inside you.

Are there changes in your personality or your ways of behaving? One usually responsible teacher began taking many days off shortly after his father became terminally ill. Examination revealed that he was in the early stages of a depression prompted by his father's looming death.
One woman who had been very outgoing became distressed by the rapidly declining health of a dearly loved father. She found herself losing interest in social activities and ignoring the company of people she enjoyed. Before long, she was unable to get out of bed in the morning. Fortunately, she had the good sense to call her family physician, who saw her promptly and made a referral to a clinician who was able to help her.

Do you find that the your feelings don't ease with time, but remain intense and unremitting, perhaps even grow? It is not at all unusual to have strong, immediate reactions to the realization that one's parent is declining dramatically and approaching death. In most people, however, these reactions subside gradually, and a quiet acceptance sets in. If this does not happen, you may be coping with reactions that are in the atypical or extreme range.
Mr. E, who had colluded with his father to isolate and exclude his mother from their close relationship, continued to feel guilt long after his father died. In fact, I saw him several years later. At that time, not only had Mr. E not forgiven himself for colluding with his father, he had still not gotten over his father's passing. Nor had he resolved the guilt he felt toward his mother.
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