Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

I am worried about my parents as they are getting older. How can I convince them to get the care they need or to make plans for the future?

Answer

This question comes up often in varying ways and in varying forms. It is an important question that needs to be examined at a variety of levels. First, it would be helpful to stand back and ask yourself who is defining their needs? Are they living with greater risk than you are comfortable with? Do we, as their children want them to make decisions to ease our minds rather than allow them to live with great uncertainty, especially when that uncertainty impacts our own lives?

Unless an older person is clearly at risk and unable to make decisions on his or her own behalf and is considered incapacitated, as defined by a physician and/or the legal system, then regardless of our own anxiety about what might happen, our parents will and should make their own decisions. They are in the midst of trying to come to terms and understand what being older means to them and how they want to live the remainder of their lives. You can articulate your concerns, help them explore options, and most importantly, talk to them and try to understand what their values are.

I believe we are living in a time when dealing with growing older is still new in our society. It brings great anxieties and a series of what if questions. We can't know what might happen. Unless immediate action is necessary because a life is at serious risk, be prepared to allow older people to make their own life choices. It is not easy for them. It is not easy for you.

I suggest if you are unclear as to your parent's ability to fully comprehend their situation, and you are concerned about their mental capacity, then ask a physician for a cognitive assessment. But remember, what you consider to be a bad decision may be very similar in process to what they felt as parents as they watched their children go through difficult times where perhaps decisions were made that terrified, baffled, and frustrated them. A bad decision or poor judgment does not necessarily mean that they are no longer capable of deciding for themselves.

Make certain that you ask your parents if they have advanced directives. Make certain that you know as much about their support network as possible. Make certain that you are clear about what you can honestly do for them on a daily basis if something were to happen, so that they do not have unrealistic expectations of you.

I wish there was an easy Answer to your question. Each situation is different. Different personalities. Different needs. It is rare that someone relinquishes any independence sooner than they have to, no matter what the situation is or what our age might be.

3/12/98

Emily Carton MA, LISW, is a licensed social worker who works with Elder Options, a private care social service firm in the DC Metropolitan Area. She is also an is an intern in Bibliotherapy at St. Elizabeth's Hospital in Washington D.C.