As parents get older and their health declines, it becomes increasingly difficult to ignore the proverbial elephant in the room, particularly when memory issues are involved. A shift in power occurs in which the child now has to take care of the parent. This is an enormous challenge for the entire family. Even in the best of parent-child relationships, the power shift can be problematic, but when the connection is already strained, it can become extremely hard to deal with.
Denial Is Not a River in Egypt
Denial is a psychological defense mechanism that often occurs for adult children. As a caregiver, you may refuse to make the tough decisions required for your parent’s care. However, making no decision is still a decision—and it’s usually not the best one for the elderly loved one you are responsible for.
A book that I often recommend for caregivers is A Gradual Disappearance by Elizabeth Lonseth. The eldercare resource website A Place for Mom describes it as “a warm, personal and concise guide for people who have a loved one with Alzheimer’s disease or dementia.” Lonseth cites the problems that being in denial can lead to. Included below are some of these issues and their associated consequences.
Overdoses and Accidents
Refusing to accept that a loved one has dementia or Alzheimer’s disease can lead to threats to their physical well-being, including overdoses and accidents. While you may believe a weekly pill dispenser is all that’s needed to ensure your elderly parent takes their medications, this is often not the case. A person with memory loss may end up taking too many pills at one time or throwing them all away.
In a similar vein, not accepting that your senior parent needs a walker can lead to a fall, resulting in broken bones, displaced joints, hospitalizations and pain medication. Leaving your elderly relative unsupervised can also lead to accidents in the kitchen or bathroom. They could cut or burn themselves, leave the stove on or eat food in excess because they don’t remember how much they’ve consumed.
Delaying Professional Help and Caregiver Health Decline
In many instances, a spouse or adult child may be aware their loved one has a memory issue, but they associate shame with the disease and don’t want anyone else to know about it. They may try to handle everything themselves, but as the impairment progresses, the burden will become overwhelming.
If you deny the need for help in caring for an elderly relative, you could end up putting your own health at risk. Family caregivers over the age of 66 have a 63% higher mortality rate than non-caregivers, and in many instances the caregiver ends up dying before the person they are caring for.
Competency and Capacity
Another problem that stems from denial is not getting necessary legal documents in place, including financial power of attorney, medical power of attorney (also referred to as an advance health directive) and written permission for adult children to have access to a parent’s health records.
Without such documents, it can be difficult to deal with financial issues, get proper care and authorize medical procedures. In such instances, you may have to go to court to obtain the legal right to supervise your loved one’s care. This authorization is called a conservancy or guardianship, and it is expensive and time-consuming to initiate and maintain. Obtaining a conservancy also involves having the elderly individual deemed mentally incompetent, which can be a humiliating experience for them. And once they are judged as incompetent, they will no longer be able to execute any legal documents on their own.
Financial Exploitation and “Black Sheep”
If you, as a caregiver, are in denial about a parent’s memory loss, you may be blind to the fact that your loved one has become vulnerable to financial exploitation. Assuming control of finances and taking away checkbooks is difficult, but if it isn’t done, it could allow others—including family members—to exploit the elderly person. One prime culprit for this abuse is an adult child, possibly a “black sheep” of the family who may have problems with drugs and gambling. Such a person often sees nothing wrong with taking advantage of their parent, especially since they believe the money would come to them when the parent passes on anyway. They reason that since they need the funds now, they may as well grab hold of them while they can.
Sibling Reactions and Family Conflict
Denial can lead to major family conflict. Those in denial can frustrate those in charge of caring for an elderly parent. Many adult children in denial won’t help out while their more aware siblings take on multiple burdens, often on their own. Additionally, the ones in denial may accuse their responsible siblings of overreacting. They may erroneously believe that supplementary care is unnecessary and that Mom or Dad can be retrained to dress themselves and make their own meals.
One of the best ways to prevent or overcome denial is to hold a family meeting. You should do this immediately after the initial diagnosis if possible. The sooner everyone in your family understands the ramifications of the illness, the less denial is likely to occur. Helpful guidelines for organizing a meeting are outlined in the A Place for Mom article “Guide to Elder Care Planning & Family Meetings.”
Another article, “Denial Is Dangerous,” includes tips to overcome denial among family members of elderly parents with dementia. A few examples are:
- Help family members understand that their fear is overruling logic.
- Assist them in seeing that it’s not about the inconvenience to their life and whether they will get the disease themselves. What’s important is to help someone they love get the best care possible.
- ·Be kind, gentle and calm, as anger will only cause them to dig their heels in deeper.
Knowledge and information are two of the most beneficial tools for caregivers. If you would like practical advice, words of wisdom and encouragement from someone who have been there, Elizabeth Lonseth’s short but powerful book is a must-read.