Planning for the changes to come

Graham Hookey writes about education, parenting and elder-care

To a large extent, the process of caring for others, whether it is the young or the elderly, is about learning to adapt to changing circumstances.

Parenting a child takes you through stages of infancy, toddlers, primary school, teens and young adults, while helping to care for an elderly parent takes you through stages less clearly defined but generally moving from independence to dependence and perhaps institutionalization.

If there is a difference between childcare and eldercare, at least in terms of adaptability, I think it would be the unpredictability of eldercare and, thus, issues of timeliness and complexity.

While children pass through stages in a rather predictable fashion, a parent can go from completely independent to fully institutionalized in a matter of minutes, given a major heart attack or stroke.

I have spoken previously about the importance of families having some kind of discussion around plans for the elderly in the event of sudden changes, so I won’t repeat that again other than to say a lack of planning can lead to some extremely stressful decision-making when circumstances change suddenly.

There is an infinite number of possibilities for change, but let me group them into a few major categories.

There is the catastrophic change associated with heart attacks, strokes or serious accidents.

There is the slow and steady change associated with progressive diseases such as Parkinson’s, MS, ALS, or some forms of incurable cancer.

There are temporary periods of stress and dependence caused by curable forms of disease or temporary physical setbacks (knee replacement or hip replacement) that require family support.

Perhaps one of the most challenging elements of eldercare is the onset of mental infirmities.

While a certain level of functional loss can be expected for just about everyone who lives beyond their 60s, Alzheimer’s disease can accelerate that loss and shift it from a simple absent-mindedness to a complete loss of memory and distortion of reality.

And finally, there is just the simple process of aging that wears the body out over a long period of time. While this is the most gentle process, it can also require the most lengthy support for families.

We all have a tendency to idealize our own passage from this world to the next. We want to live long and healthy lives and pass away peacefully in our sleep at a time when no one needs us to look after them and no one needs to look after us.

But that is rarely the case.

Of all the things I learned in my first phase of eldercare, during the time I cared for my father near the end of a progressive and fatal disease, perhaps the greatest was that I owed it to my own children to put in place some steps and planning for the day when they would be faced with changes in their mother and I that might require their intervention.


Graham Hookey writes about education, parenting and elder-care. Email him at

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