"What do we do with mom?"

You don't know how many times people have approached me in both my personal life and my professional role with this question or some variation of it: "What do we do with mom?"

We all age - and even if we don't (yet) consider ourselves aged, many of us love and are loved by older people. Aging is universal, but that doesn't mean it's without challenges. Aging comes with physical and mental changes. Supporting someone, say, a family member or parent, during this important phase of life can be very meaningful. Many people feel it's an opportunity to give back to someone who gave a lot to you, to make amends for past hurts, or that it's their family duty. At the same time, worries about an older family member driving, staying home alone, or becoming forgetful - can also be very stressful.

In addition, role changes can be a tricky issue to navigate. Think about the matriarch or patriarch of a family. Maybe this is the person who once hosted large family gatherings, made family decisions, and looked after multiple generations of children or grandchildren. Now this person may be forgetful or needing rides to the doctor. Transitioning from a caregiver to becoming a care recipient can trigger feelings of shame and embarrassment. It's normal for people to experience a sadness and sense of loss for the independence that they once had, and for loss of a certain role in the family as they once defined it. For adult children and grandchildren, becoming a caregiver or care-manager can feel awkward as they start to make decisions for someone who may have been completely independent previously. And, even in a perfect world where adult children get along with one another, filling this role can place real burdens on time, money, and other relationships.

It's important for individuals and families in this situation to acknowledge that this phase of life can be very challenging and stressful. While society recognizes that it's difficult to be a parent of young children, we don't do as good of a job recognizing that caring for older adults is also hard. It follows that we don't provide as much support to caregivers as they may need. As a caregiver or adult child, whatever you're feeling is ok. Exhaustion, anger, guilt, worry, sadness, love -- these are all normal.

I advise people in this situation to try to involve their older loved one in as much of the decision-making as possible. It's important for everyone to feel that they have some agency in their lives. Self-determination is critical, unless there's an issue of safety.

I also recommend advanced planning with the whole family together. Medical advanced planning (for instance, completing an Advanced Healthcare Directive or POLST) is very important - but I am also referring to non-medical planning. It's important to think ahead 6 months to a few years down the line about what kind of care will be needed and how you and your family will meet this need.

Finally, caregivers need to remember to take time for themselves. Again, caregiving and care-managing can be very stressful. Exercise, eat healthy. go to your own doctor, or take your partner out on a date. Not only do you deserve it, but it will make you a better caregiver - and family member- in the end.

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