My experiments and learnings from caring for elderly parents

In March 2019 I joined Adamas University, Kolkata, and got a chance to stay with my parents after 33 years. This continued, till March 2020, then lockdown followed, and I got stuck in Bangalore. As travel was not possible anymore I left the assignment.

In between, I made two visits, and this time I got them to Bangalore. The idea is to settle them here — in a separate place close by and see whether they are comfortable.

Luck would have had it, my mother got sick on the journey (we came by train as our pet cat and dog traveled with us) and was in CCU for two days. Now she is feeling better, though still at the hospital. And I am staying with her for her night as the attendant.

This gives me some time to put my thoughts together, on elder care, which are essentially my learnings in the last two years. Many who are my age have elderly parents, and I am sure all of them face some challenges in taking care of them. And I believe some of my learnings may be of some use to address them.

A few disclaimers — I am extremely lucky that my parents are alive while they are around eighty, that I have the option of being close to them, and some level of financial wherewithal to support them. My learnings may not apply to all, but I am sure some of them will be close.

The other thing that I want to state is I have tried to be as candid as possible — as I want this write to be of practical value, not a sermon. Also, while we all will love to believe that our parents are the best, let’s not forget that they are humans too — and have their share of frailties. This is not in any way an expression of my frustration or anger (which I sure have experienced many times), but rather an attempt at dispassionate observations. And yes, is not that I follow what I write here, but I am trying.

Now my learnings:
1. Parents as they grow old will become children in many ways — emotional, unreasonable, obdurate, impatient. They will lose physical strength, and maybe many other faculties — memory, hearing, clarity of thinking, and articulation. All of them are irreversible and need acceptance.

2. At an advanced age, the most important gift we can give to our parents is quality time. I emphasize “quality” rather than “quantity” because the difference is critical. The time we spend with them should be for them — to listen rather than hear them, to speak rather than talk to them, to care rather than sympathize with them. It need not be physical (if possible, it is good), as today we have many channels to reach. But this needs to be personal (not WhatsApp for example), and regular.

3. Come what may, and whatever had been the spousal differences through life, the biggest companion the parents have is each other. I think if they lose the other at a relatively early age (say maximum mid-sixties), they can cope with the loss. But beyond that, the dependence is very high at emotional levels. So, we need to ensure that we care for both parents equally (irrespective of whatever angst we may have against them — and believe me, we all have), and allow them to continue with their (inevitable) frictions rather than trying to control/ reduce/ eliminate them. The conjugal differences give a sense of continuity that should not be disturbed.

4. Though the body becomes weak, our mind remains young. And so though many aged people may say that they are now looking forward to hitting the bucket, deep down all of them want to live (except perhaps they are in a very unhappy situation or suffering from a debilitating disease). And so, there is a deep unstated sense of insecurity about whether the near and dear ones will be caring for them when they become older and more infirm.

This has nothing much to do with how much we care for them, this is a natural sense of uncertainty. We can’t stop it but can help reduce it through positive reinforcements. One critical way is not to initiate discussions on property they will leave (if any — I have none) unless it is initiated by them.

The uncertainty is aggravated by the fear of one of them passing away, as the other will now be left with no partner to speak to. So, some visible actions like taking health policy, a dedicated place to stay, etc. will help sustain confidence.

5. We all like specialists when we are younger it is a win-win for us– we get fast recovery and health providers can make more revenue. But as the body gets older, the challenges become interconnected. So, there will be sodium/ potassium balance issues with kidney and bowel challenges. So, specialists can help only so much.

My suggestion is as the parents start approaching 65+, we should try to identify a General Physician (GP), or a Specialist who will be ready to act as a GP and stay with that doctor. It is not easy to find one, who is competent, trustworthy, long-term, and good with the elderly. But once we find one, stay with it. As older bodies are tomes of history, we need to know the past more than the present to make any interventions.

6. Old and infirm does not mean people want to be dependent. The desire to not depend on while the body is not willing can create challenges of their own. Be ready for parents to exert themselves more than they can, go out to the local market without the mask, stop taking medication on their own, or even refuse to measure the vitals saying the instruments are missing.

What to do? I think the best way is not to show anger and work with the issue. Three things I have seen working — making each parent responsible for the other (if they are both alive), sharing the loads with the siblings (if they are there), and making a routine that needs to be followed up diligently without any expression of irritation.

7. We all have experiences and carry memories. And by nature, many of these are not good.

We move ahead by consciously filtering out the bad memories and keeping the good ones — it is a key trait that helps us remain sane. But as studies have shown, the bad memories do not die, they go deep and lurk there.

When one is old and infirm, and especially not keeping well, sometimes these memories may come back. And with less control over what one speaks, it may well blurt out.

This can be very painful, and times may appear like a betrayal. It may even make us look at our parents and think whether they deserve the pedestal that we have put them on. But this is a reality that many of us cannot escape.

What is the way out? Well in retrospect we may think of any number of solutions, but they do not work. For now, the way is possible to let it flow and try to ignore it without remorse. But if I can go back, possibly I will try two things — discuss the not-so-pleasant things even if they are painful, and try for closures. And also focus on a relationship of equals among the family members rather than the assumed hierarchies that we operate with. Hopefully, as we open up as a society, this will reduce in the coming years.

8. Old age is lonely. People see their family members, siblings, ex-colleagues, and friends passing away at regular intervals. A sense of purposelessness can easily set in.

When we are in productive years, we can dream of a career, travel, bring up kids, and acquire assets. These are hardly the goals for senior citizens. Melancholy or even frustration can easily engulf the mind. How to give them a purpose?

Well as silly as we find it, to me the soap operas dished out on TV is a great solution. We may find that our super-educated, successful parents may be hooked on these wanton family conspiracies. But curiously this gives them a reason to wait for the next episode, where the demons will be slain for a better day. Given the weakening intellectual faculties, their 2-minute stories told over 23 minutes are well suited for the senior citizens, and funnily enough, I see a value in them now.

These soap operas also give us some ideas to nurture. We all know that grandparents bond best with their grandchildren, as they see a reflection of their children from their growing up days. But the other thing that does a great trick is the pets — dogs, cats, birds.

Giving food to the pets, giving them commands, caring for them, and getting unconditional love from them is a great engagement. Our dog and cat helped tide over the COVID lockdown with Elan. Try it.

9. We all want to change ourselves and the people around us. Our children, spouse, relatives, colleagues. Sometimes it works, many times it does not.

Change is not easy, it needs effort. And we know if we change for the better, there are benefits. Hence even if painful, most reasonable people take feedback and work on it.

The logic does not work much with the elderly. They are not looking for growth in their career or accumulating resources. At best, they are looking at a peaceful existence in their final years.

Avoid trying to point out things to them, hoping they to change. It will mostly never work. It will only add to heartburn, irritation, and uncertainty.

Live with parents as they are — there is no prize in reforming them. The most important thing is peaceful cohabitation.

10. And this brings me to my last point, which I think many well-meaning and super-caring children end up doing. Mostly Inadvertently.

In their efforts to give comfort to our parents, we may take away everything from them and get it done. Like buying vegetables, cooking, cleaning, you name it.

With money, technology, and an outsourcing culture it is perfectly possible. But my thought is — don’t go full hog. Calibrate and be slow in taking up responsibilities. Otherwise, parents may feel disempowered, or even a burden.

The same applies to moving them close to you. Yes, it gives better supervision, care, and less tension. But it may well cut off the parents from their ecosystem, which they want to maintain despite many challenges.

The idea of remaining free and not being a load on someone is a strong one. Especially for the people who lived their lives independently — both financially and otherwise. We need to be respectful and caring about that, which may avoid many a misunderstanding and fault lines.

These are my learnings. Being close with my parents when they are old, while I am past middle age.

Are they applicable to you? May not be. But at least if they help you build your constructs, I will feel a sense of contributing.