Having something to get up for

It is independence that the elderly will generally see as the top priority, and even when their mental health is compromised.

I have learned a great deal over the past few years in dealing with a terminal illness for my father, then working through various living options with my mother.

My challenges have been relatively minor compared to those I know others have faced.

I’ve had the opportunity to listen to the tales of others and I’ve certainly gained perspective.

I try to take complex issues and step back to identify what is most important, so that I can focus on what can be done to have the most influence on them.

It is easy, at times, to get caught up in a million details of what is out there and not be able to see what is the most critical step to be taken.

I’m not going to suggest this as a structure for everyone, as every situation is different, but if my experiences, and the experiences of others are to be helpful, then perhaps some general guidelines of priorities might be of benefit.

I believe the first priority for elder care is the element of mental health. Aging is not for the faint of heart. It is a time of loss, both in terms of personal health and social networks.  While we generally learn to cope with ups and downs all of our lives, successive downs are bound to have an impact. Add to this the possibility of significant loss of brain function, to disease or stroke damage, and the element that is truly affected by mental health is the ability to live independently.

It is independence that the elderly will generally see as the top priority, and even when their mental health is compromised, they may not wish to relinquish it.

Still, the first question every family must ask when considering how to help aging relatives is, “How capable are they to live independently and make their own decisions?”

The second priority is understanding and establishing the right connections and directions for appropriate medical care. The medical system is, to say the least, complex and overwhelmed. It is easy to be “processed,” but not truly cared for until there is a real crisis.

I’m going to suggest that many medical crises could be avoided if more time could be spent helping the elderly understand their issues, understand their treatment options and, in some cases, reduce their dependence on a cocktail of disconnected medications.

Appropriate medical care is both a family responsibility and a government responsibility.

There are support systems and alternatives within the medical system itself but few of us understand what options are available or how to access them.

What I suggest is that someone has to do the research, or access a caring individual in the system, to learn the options that are available.

If I were to pick a third priority, I would make it “purpose.” Why should someone get out of bed in the morning?

When a career ends; when a partner is lost; when health compromises the ability to do the usual daily activities; that is when a sense of purpose begins to wane and the aging process accelerates. Finding ways to create purposeful activity has to be part of the equation of elder care.

Whether it is knitting socks for a developing country, playing cards with some friends, waiting for a phone call from the grandchildren, sorting through and labeling family photos – having something, anything worth getting up for on any given day is critical to a sense of optimism and a feeling of contribution.

I was quite against my mother going into an eldercare home when she first talked about it. We had the space to take her in ourselves and felt she’d be better cared for surrounded by family. But she knew we were busy with our lives and she preferred to be around people like her, with nothing to do all day but talk about each other, about their childhoods and perhaps play a card game or two. Sitting at my house might give me a sense of purpose as a loving and caring son, but it wouldn’t give her the right sense of purpose as a “burden” to us (her words, not mine).

Mental health, physical health and a sense of purpose – those are the foundations of providing compassionate and appropriate support for the elderly.


Graham Hookey writes on education, parenting and eldercare (ghookey@yahoo.com).