Thursday, January 21, 2016

The Lie of "One and Done" Caregiving

Photo by RCC.
Aging is a gradual and dynamic process.

Many people do not realize this.

I say this because I have seen a lot of adult children hold onto an unrealistic view of aging.

Many adult children expect their parents to have full health until the week their parents move into a nursing home.

The adult child expects a "One and Done" type of intervention.

They expect that they will take one week off work to help transfer their parent from an independent home to a dependent nursing care environment.

One major change in health. One move. One intervention. One week. One and Done.

"One and Done" is NOT the norm.

For most older adults, aging is a dynamic experience.  The person's needs change frequently over time.


I have seen older adults experience temporary disability (such as surgery for a knee replacement), which has them moving from home to hospital to rehab back to home. And this can happen more than once.

Even when their health needs become permanent, it takes time to find the right fit.

Will they go through several home health aids until they find a good fit?

Will they have family care? Paid in-home care? Or a combination of the two?

Will they move to assisted living?  Can they find an assisted living facility that is affordable and close to doctors and to relatives?

A person's age and diagnosis don't accurately predict the timing and trajectory of their care needs.   You can take 10 people who have the same age and same chronic or terminal disease, and their lived experiences and the types of support they need can differ dramatically.

The older adult with support of their spouse and adult children often have to reevaluate the needs and adjust every couple of years. Or every year. Or every few months.   

Aging is very dynamic.  Trying to superimpose a template on the experience leads to frustration, anger, and depression.  It's better to let go of expectations.

This is easier said than done, but it's really the best way to achieve peace during a dynamic life event such as aging.

Related:

Non-Medical Home Care
Adding Care to Senior Housing
ADLs and IADLS

30 comments:

  1. I have experienced this with both sets of parents in my life and you have hit the nail on the head. We think, well that is taken care or well, they are now back to normal. But there is no normal and things change again and again. Sometime often and other times not.

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  2. I can absolutely attest to this. My husband and I are a living test tube for how the boomers will live out their life. We are the future of the aging process.

    My husband will turn 78 in a couple of weeks. He still walks 18 holes of golf, does all of our home repairs and updates and is very active socially.

    However, we have had to make changes. Medications,hearing loss, control of high blood pressure and need to a warm climate in winter are controlling much of what we do.

    It is not a "one and done" kind of thing at all. It is evolving and in many ways coming full circle.

    Thank you for this post. I will beam it up in the cyber world. :)

    b+ (Retire In Style Blog)

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    1. B, it sounds as though you are being intentional about the aging process and responsive. From what I can tell from my view at midlife, that's all people can do--roll with it. All my best to you both.

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  3. I'm just entering these times with my parents and I will confess it's very tempting to plunge my head in the sand. I'm grateful for such as yours which inspire me and remind me the importance of paying attention.

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    1. All my best to you and your parents, Carla. You will find a path. Hugs.

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  4. I've seen this too! A lot of people my age think that my caregiver is just an exception to the "one and done" rule. In reality we know that it just doesn't work like that. It's one and one and three and one and two and four. No rhyme or reason!

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    1. I love order and patterns, but with aging I'm learning to throw all that out the window (well maybe not ALL) and take things one day at a time. You crack me up with your non-pattern sentence!

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  5. I think your advice is excellent. As all my parents have died, and I will never be a geriatric social worker again I want to stick my head in the sand, but can't!

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    1. Hugs to you, dear Pia. It's a wild ride for us and our friends now! We'll have some fun for sure and manage our challenges as best as we can.

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  6. Great Post! Aging is a chronic condition.Just because so and so just up and died at age 90 healthy until dead does not happen often. Would be great but reality is really so and so most likely had care, adjusted life practices etc.! Reality just doesn't make such a great story.

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    1. Before I turned 40, I thought people ran pretty much full tilt until 3 months before passing away. I had no idea how many adjustments people make over 5, 10, 20 years of late life. I'm starting to "tweak" a few things in order to function, and I'm in my mid 50s. More tweaking ahead!

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  7. Great article and will tweet it for you so others can see!

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  8. This has been my life experience for the last 25 years as a caregiver to 7 different family members and friends. The caregivers life can change yearly, monthly, weekly, hourly even minute by minute and that's when your elder is in a facility! So yes....do yourself a favor and don't think your job is done with one move, one phone call or one insurance choice. Prepare for the long haul by telling yourself this is what love is and hopefully someone will be able to love me when I need the most! Great post, Karen.

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    1. Every minute? Well, that's a reality check. Thanks for all the great support you offer caregivers through your blog and book.

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  9. Preach it, girl! There are as many different ways to age as there are people. But assisting a relative or friend with those issues teaches so much about love. It did for me.

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    1. I'm glad that you can articulate the silver lining, Carol! That gives others hope and encouragement.

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  10. My mom is 90 and just starting to slow down. I am fortunate to have her healthy. I love the insight your post has given me.

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    1. 90 and still doing really well. Kudos to her.

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  11. Yes, I wrote about this for Salon last year. It is a gradual process, but makes it essential for them to have community.
    Estelle

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    1. I'm glad that you are getting the word out via Salon and other venues I am sure. All my best to you, Estelle.

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  12. I was the caregiver for both my parent and my MIL and know exactly how difficult a time it is. I honestly don't even like thinking about that time anymore.

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    1. Bless you for all the support you offered. I hope that over time the positive memories of your relationships burn brighter than the challenging aspects of caregiving. Hugs and hugs.

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  13. Great post and so true. I thought it was "one & done" even though I wouldn't have known to call it that. Cared for both parents last year before they passed away. Shared this post on the MySideof50 Facebook page this evening. Thank you.

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    1. Hugs to you, Cathy, for all you did as a caregiver. Comfort to you on the passing of your parents. May you cherish their memory.

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  14. I've learned alot caring for my grandmother as she has lost 2 husbands and all of her children. We definitely have seen after moving her to assisted living that this may not be the last move...she's still pretty fiesty and I expect has several more years left. I really don't like to think about how this might play out with my mom.

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  15. Replies
    1. Thanks for stopping by the blog, Liz. Happy holidays.

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