They Have It Backwards

I just got a call from a daughter who had convinced her father to talk to us about home care, saying that he has changed his mind “again” and is not ready. We have seen this before and we will see it again. One of the big franchise companies in home care thinks they have the answer, with what they call the “40/70” rule: “The idea is that if you’re 40, or your parents are 70, it’s time to start talking – at least about certain senior topics.”

We do not intend to take children of seniors “off the hook,” but, frankly, we think this is a little bit backwards. It puts the onus on the children of seniors, rather than where it belongs — with the parents. We see children of seniors, every day, willing and able to talk with their parents about aging and home care and other issues.

Too often, the parents’ response is along the lines of “I know I will need help, eventually, but not now.” The real problem is that the parents have too often not established the parameters of what “eventually” will look like.

So, here is some “Tough Love” for all of us seniors (yes, me too, I’m an AARP member!):

1. First of all, we need to remember that we are the parents, and act like it. When we are raising children, we would never think of putting them through the stress that they endure worrying about us when we do need home care, as we age. It is our responsibility to deal with our own aging, not make our children carry it around as a burden.
 2. That means we must define what the boundaries of “eventually” are, in determining when we do need — and will accept — home care. That means learning about the Activities of Daily Living (ADLs) and Instrumental ADLs (IADLs) and establishing clear lines for when we need support.  Please see the Gilbert Guide or Wikipedia for more information on this and other topics. 

 • Hygiene (bathing, grooming, shaving and oral care)
• Continence (bladder and bowel control)
• Dressing
• Eating (the ability to feed oneself)
• Toileting (the ability to use a restroom)
• Transferring (actions such as going from a seated to standing position and getting in and out of bed)


• Finding and utilizing resources (looking up phone numbers, using a telephone, making and keeping doctors appointments)
• Driving or arranging travel (either by public transportation, such as Paratransit, or private car)
• Preparing meals (opening containers, using kitchen equipment)
• Shopping (getting to stores and purchasing necessities like food or clothing)
• Doing housework (doing laundry, cleaning up spills and maintaining a clean living space)
• Managing medication (taking prescribed dosages at correct times and keeping track of medications)
• Managing finances (basic budgeting, paying bills and writing checks)

For each of these areas, we should take the time to establish a baseline (what can I do now) and an acceptable limit of competence that will tell me I need help in that area.  If I need to assign someone that I truly trust as an advisor in this, who can bring a second set of (independent) eyes, great.  Ideally, that should be someone other than my children, to help minimize their stress.

In a future blog, we will go into more discussion of how we might set those baselines and limits, with regard to our ADLs and IADLs.  Thanks for listening.


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