PAM KERL'S 80-YEAR-OLD FATHER found it increasingly difficult to
care for her 74-year-old mother, who is in a wheelchair.
"He was trying to get her in and out
of bed, and the house was too much for him to keep up," says Kerl,
a Highland Village resident. "My brother, sister and I were worried."
Richardson resident Caren Houston
was equally worried about her 84-year-old widowed mother, who takes
painkillers for a spine fracture as well as medication for high
blood pressure and glaucoma. She skipped meals and became confused
about which medication to take at which time.
"I was over at Mother's apartment
five days a week and saw that she wasn't getting around well. I
was nervous about her falling," Houston says.
Kerl's parents and Houston's mother
were both evaluated by geriatric care professionals, who suggested
new living arrangements.
Kerl's mother moved into the nursing
home unit at The Vintage retirement community in Denton. Her father
lives nearby in an independent living apartment.
Kerl says that although her parents
are living separately after 58 years of marriage, they're happy.
"I feel better knowing that Dad isn't
left alone," she says. "The staff knows if he isn't eating because
they know if he doesn't come to the dining room. The staff also
calls residents each morning to see if they're okay."
Houston's mother has an assisted living
apartment in Presbyterian Village North in Dallas. She receives
meals and daily visits from a nurse, who keeps track of her medication.
The apartment is equipped with an alarm to summon help 24 hours
"It's a big relief because I know
that Mother is safe," Houston says.
According to the U.S. Census Bureau,
more than 25 percent of the population will be 65 or older by the
middle of the century, and the population will have as many people
85 and older as people age 65 to 69.
Geriatric case manager Kay Paggi ('68,
'90 M.Ed.) says those 100 years old and older are the fastest growing
segment of the population, while those 85 and older are the second
fastest. While medical advances have led to Americans living longer,
many of the "oldest old" —
and some younger seniors —
will become unable to live independently in their own homes, Paggi
Numerous American households, like
Houston's and Kerl's, will care for an elderly relative for an average
of 18 years, she adds.
"The Baby Boomer generation is the
first to provide long-term caregiving, but we generally don't know
how to do it," Paggi says.
Richard Lusky, chair of UNT's Department
of Applied Gerontology, says that while many adult children are
concerned about their aging parents' health problems, making sure
that their parents are meeting basic needs, such as feeding themselves,
bathing and dressing, is also
He cites a 1994-95 federal study that
showed one in five older Americans experiencing difficulty with
at least two self-care activities each day. The percentage of reported
problems rose with the age of the respondents.
"Not meeting basic needs may take
a toll on health," he says. "A person who can't drive anymore can't
grocery shop, and that will cause serious decline because of lack
of nutrition. If someone looks physically frail, you should look
for an underlying problem. Don't
assume it's just a normal part of aging."
He adds that adult children should
think in terms of "successful aging" for their parents —
helping them maintain physical functioning and remain engaged with
"Even a chronic health problem like
diabetes can be managed," Lusky says. "The most important thing
is to know who your aged parent is, and what he or she would want
to help maintain independence."
Bert Hayslip Jr., Regents Professor
of psychology, says that because many older people value their independence,
they are often reluctant to acknowledge declining skills. Adult
children may have to intervene, particularly when their parents
may cause danger to themselves or others, he adds.
"Ask them to demonstrate a skill,
such as cooking," he says. "Talk to them about things that have
become chores for them and discuss giving them some help."
This requires adult children to have
good relationships with their parents before the parents become
elderly, he says.
"When they set the house on fire because
they forgot to turn off the stove, it's not the time to discover
you can't talk to them," Hayslip says.
Paggi adds that adult children should
avoid telling their parents that they can't do something.
"Use 'I' statements so that it's your
problem. The best thing to say is, 'I'm uncomfortable with you driving.'
Saying 'You can't drive anymore' is accusatory and aggressive,"
Hayslip says adult children often
experience a mixture of dread and grief when they realize they must
confront an elderly parent.
"When you think about a parent needing
help, you may think about that person dying, and you grieve for
the loss of the person you grew up with," he says.
As recently as 20 years ago, older
people who could not care for themselves had few options other than
living with adult children or in nursing homes, Lusky says.
Today, assisted living is the most
popular option, he says. Other options include independent living,
continuing care facilities, in-home care services and adult day-care
All assisted living communities provide
meals, housekeeping services, 24-hour healthcare services, and assistance
in bathing, dressing and taking medication. Many also offer regular
transportation for shopping, daily social activities, volunteer
opportunities and field trips.
Cheryl Harding, UNT assistant professor
of applied gerontology, says assisted living communities provide
a positive alternative to nursing homes for many people.
"Only 5 percent of seniors live in
nursing homes, and the number of nursing home beds is decreasing.
The ones left are for seniors requiring very skilled medical care,"
Independent living retirement facilities
also offer housekeeping, transportation and meals, but unlike assisted
living facilities, they do not offer home healthcare services. Large
facilities have exercise and game rooms, libraries, beauty shops
and swimming pools.
Continuing care communities, like
Presbyterian Village North and The Vintage, have independent living,
assisted living and nursing home facilities in one location.
If a parent wishes to stay in his
or her home, adult children can contact their local Area Agency
on Aging for information on in-home programs such as housecleaning,
meal delivery and healthcare aides, Harding says.
Adult day care centers are another
option. These programs provide transportation to and from the centers
and offer meals, social activities and medication monitoring.
While many seniors are cared for in
their adult children's homes, UNT faculty say that this may not
be the best option for everyone. Adult children and aging parents
may have different values, Hayslip says, and friction can result
from the child taking on the parental role.
UNT faculty do suggest that adult
children work with their parents to find the best living option
or home services.
Hayslip notes that elderly people
who can't participate in deciding their living situation generally
have the most adjustment problems.
"You must involve your parents in
the process," he says. "Take them with you to tour a facility and
ask them if they would like to stay there. I would certainly not
dump elderly parents in a situation where you know they will be
uncomfortable because they will feel abandoned."
Elderly people who adjust best, he
says, maintain their identities by keeping some routines and possessions.
Kerl's mother has some of her furniture
in her Vintage nursing home room. Her father kept his cats when
he moved to his apartment.
Lusky says many retirement community
staffs are trained to help new residents adjust.
"Usually, what happens in the first
week will determine if a person stays," he says.
Regular contact with family members
through informal visits or traditional family gatherings is equally
important, Hayslip says.
them that you still love them, but that this is the best situation
for them," he says.