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Spring 2004

Caregiver Role for Aging Parents Presents Challenges

VS-Spring04-ParentCaringOne of the most wrenching dilemmas faced by family members of an aging parent who begins to show signs of significant mental or physical impairment is when, and how, to intervene in ways that will ensure the safety and well being of everyone concerned, while preserving the independence of the parent to the best extent possible.

“As people lose their cognitive skills, it becomes more difficult for them to manage their daily affairs—everything from paying bills to driving. And for older persons who have had a stroke or severe mobility problems because of arthritis, the question also becomes how to create a safe living environment,” says Brandon Koretz, M.D., UCLA geriatrician.

Distinguishing benign symptoms of aging from more ominous signs can be difficult.

“An isolated problem is not necessarily a cause for concern, but when memory and functional problems persist, it’s wise to seek an initial review by a primary care provider,” says Randall Espinoza, M.D., M.P.H., UCLA geriatric psychiatrist.

Strategies to maintain the parent’s independent function include the use of adaptive equipment such as grab bars and shower chairs in the bathroom, or a walker or cane for steady movement. Caregivers—a relative or someone hired by the family—may need to assist with daily activities.

Any suggestion of change can be emotionally difficult. “For the elderly parent, the reaction can be denial,” says Dr. Espinoza. The role reversal in which the adult child begins to take on the tasks of the parent in the relationship can be uncomfortable for both parties. He suggests family members explain to the parent that they wish to accompany him or her to the physician visit to make sure that instructions are clear and nothing is overlooked.

Family members need assistance, too. “We need to help them with the day-today practical issues as well as pointing them toward support programs for caregivers,” says Dr. Koretz.





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