Illustration by Daniel Downey.
During the holidays, my dad likes to wear Pendleton red plaid. But on this particular Christmas, in 2011, my 84-year-old parent isn’t at his best. Usually clean-shaven, his face sprouts stubble. He’s decked out in the customary wool blazer, but his white shirt is spotted, the shirttail hem hanging out. And no obligatory red necktie.
“I’m just not myself,” he says when asked if everything’s OK.
More worrisome, the ordinarily indomitable driver tells me he’s anxious when he gets behind the wheel at night. When I arrive at my dad and stepmother’s condo to take them to our family holiday festivities, I’m shocked to see the disordered state of their home. The kitchen alone – leftover meals sit uncovered on the counter and in the fridge – is cause for concern. My stepmother has Alzheimer’s, but up to this point, I’d thought my dad was keeping things together.
They both wave off my housekeeping concerns. But a few months pass and conditions are anything but improving. Dad starts calling me daily to ask how to make coffee and use the TV remote. Family members pitch in, but it quickly becomes clear my dad and stepmom need to hire in-home care or move to a place that meets their growing needs.
The obstacle is convincing my dad to accept help. Because, back then, I didn’t have an activated health care power of attorney for my dad. He had the right to make his own medical decisions.
Family members aren’t the only ones who notice something’s not right. My dad’s primary-care doctor orders a neurologist’s workup. The specialist’s diagnosis is dementia. She takes a stern, matriarchal tone with my disheveled father, warning him he can’t continue “as you’ve been living.” I study his face for a reaction. His expression is as blank as if he were riding an elevator.
Noticing that she isn’t making an obvious impression, the doctor shifts her sobering gaze to me.
“This is at the point of being dangerous,” she says, and asks if I’d be interested in talking to a social worker from the local Alzheimer’s Association.
Once the doc slips out of the room, my pop whispers to me, “What is she talking about?”
On the drive home, I work the bad cop angle, listing reasons the current living arrangement isn’t working. “We’ll think about it,” is all he says.
More exchanges like this take place. I face off against his tenacious fight to dodge any changes to his life. My rebuking approach is ineffective and insolent, but it’s fueled by my fear for their safety. I know these talks should have taken place long before it became a crisis. My dad is not,
For the short term, my family corrals to meet the elders’ primary needs, while planning their entry into assisted living. Only by badgering can we convince them to move. We appear to make headway, but after a night’s sleep, these seniors are more resistant than ever. They may be cognitively impaired, but they know that accepting help means losing their independence.
What’s crucial in the conversation is showing the elders respect and dignity. It’s a key piece of advice I pocket – a few years later – from Interfaith’s Pat Bruce. I had gotten useful guidance from friends who’d been through the elder care process with their parents, but what I needed and didn’t seek out was caregiver support. The process of transitioning my dad to assisted living was daunting.
Hoping to “save” my dad from self-neglect, I lectured more than I should have. When addressing older adults, beware of the accusatory pronoun “you,” says Interfaith’s Bruce. Start with “we,” as in, “We know it’s hard to manage prescriptions. What can I do to help?”
Although the roles are reversed, “we have to be careful to avoid treating the parent as a child,” Bruce warns. Frighteningly easily, I turned into the censuring adult child, guilty of telling my pop, “You need to clean your dentures every day. You have to remember to eat breakfast.” All things his brain couldn’t keep track of anymore.
I recall the last night the elders spent in their condo. My dad didn’t talk about the move, but I could read his face. He changed into his flannel pajamas and slippers and climbed the steps of the condo to head to bed. As he gripped the railing, he turned to me, standing at the foot of the stairs. Anxiety and fear looked down at me, but trust did, too.