“My mom is getting older.” “My dad is losing his memory.” “My grandmother is no longer able to drive safely.” All of these statements are about one person, a mother, a father, a grandmother. This is how our society describes those who are aging around us and this is how our health care and support systems generally intervene. The semantics and practical responses to aging endorse a perception that we age in isolation.
A woman named Susan visits her family physician, Dr. Cook, with her daughter, Annie, who waits anxiously in the waiting room. After the exam with Susan, Dr. Cook calls his patient’s daughter into his office and asks to meet with her alone. Dr. Cook looks at Annie and says, “Your mother needs support at home. You need to arrange something,” and then Susan and her daughter are sent on their way. I understand. The doctor is treating his patient, not the family. But does this really work? Now Susan is left wondering what was said to her daughter and she is feeling vulnerable, scared and isolated. Annie is feeling overwhelmed and alone and she is lost as to where to start “arranging something” for her mother. This scenario doesn’t provide a solution that would allow a senior to be open to accept help from others or for an adult child to feel competent to take on the role of a caregiver. Susan is not aging in isolation with her daughter as a peripheral member of her life. They are aging together and they are aging with the doctor who provides care.
We age as a village and it takes a village to cope and to manage with the challenges (and joys) of aging. Our village consists of all of us, our parents, our children, other relatives, neighbors, each member of our health care system and our work environments. Due to the inherent strain caused by a lack of resources, lack of funds and in some regions a lack of qualified staff, our health, medical, and community care services cannot meet the demands of the aging population. Therefore, the burden of care falls on the family. (Even our semantics of aging are isolating. Take, for example, the word “burden”, which was used purposely by the author. It’s a term used to describe the result of caring for another person, and one that, in its meaning alone, creates a perception of negativity. What does this say about how we approach aging?)
We must remember that most family caregivers do not have the luxury (if you call the responsibilities of caregiving a luxury) to manage this responsibility full time. In fact, most caregivers are working at least part time while simultaneously organizing medical appointments, making meals, cleaning the home, managing medication, reviewing financial statements, and assisting their parents with personal hygiene care. All of these tasks are somehow accomplished over the weekend, after work or during work hours (to the dislike of the employer – another member of the village). Often these family caregivers have their own children – another village member – for whom they need to be available.
Yet, few people want to talk about the responsibilities of helping our families and the control of our aging process. We complain about the system and the lack of funding or efficient policies. We complain to our friends about our children neglecting us or about our parents who refuse to accept help. Instead of everyone voicing similar complaints, imagine if we all understood the continuum of aging and how each experience, transition, and crisis comes with a ricochet impact on all village members? Wouldn’t this perspective promote team aging?
If my mother falls ill and I have to fly to California to assist her for a month, will my employer give me time off? Will it be unpaid? If it is unpaid, how will I pay my expenses? Will I have my job when I return? Do I have to take money from my retirement account to cover the flight and a hotel since I cannot stay at my mother’s retirement home? How will my husband manage his job (which involves travel) and our children’s schedules while I am away? If he has to hire a babysitter, how will we pay for it since I will be losing my salary while I’m away? Will my daughter have to miss her gymnastics competition? Will her gym let her stay on the team if she misses a meet? Will my son still be able to get to his tutor after school? Will my son’s grades drop and his stress level at school increase leading to behavioral problems and an intervention by his teacher? How will my husband find the time to take his mother to do her grocery shopping as he does each week if I am not with the kids? How will my mother-in-law’s health suffer if my husband is not as available? If I need medical attention when I’m in California, how will I pay for it? How can I pay for my mother’s treatment since her husband is ill and is not able to manage the finances? Will her bank issue a check to the care provider on her behalf? Phew! Do you feel overwhelmed? I do and I haven’t even asked the questions related to my mother’s health, my relationship with my sister and my mother’s husband, their health, their finances, etc. Look at how one aging relative’s illness leads to a ricochet effect on the entire extended family. It is overwhelming; you can’t say that your parents are getting older and leave it at that.
Our villages lack insight. We have doctors making decisions independently of the impact on the family. We have hospitals that treat the presenting illness but rarely address the factors that contributed to the condition or what needs to be done with regard to the on-going management of the illness. We have individual family members who have limited and private conversations with one another but who are not creating a Family Care Plan. We have seniors who plan financially for aging but then don’t share their decisions, values, and ideas about how to use their money with any of their family members. We are each making independent decisions instead of thinking of the role each person plays and how we can work together effectively. If our village members deconstructed aging with a clear lens, they would acknowledge the painfully obvious fact that acting as if we age alone is not working. Our medical systems are overburdened. Our financial support systems are fraying at the seams. Our families are overworked, overstressed, and exhausted. We are spinning our wheels trying to evaluate and respond to one system instead of relooking at aging globally.
The population is aging and soon our seniors will outnumber those who can take care of them. According to the U.S. Census bureau projections, by 2030 one in five Americans will be a senior citizen and by 2050 they will account for approximately 25% of the population. We all know that the future of an overburdened health care system, a lack of sustainable resources and an exhausted family system will break and it is the families who will be there to try to catch the breaking pieces and find glue strong enough to hold them together.
We need to shout louder. The rooftops is not enough high enough. Each family, each health care provider, each service provider, each health care system, and each employer must revisit how we think about and approach aging.
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