Thursday, January 10, 2008

Conclusions

Whether our seniors require eldercare in the home or in long-term care, there are many issues that create barriers to success. If we keep our seniors at home, they are happier, and often healthier, but more at risk psychologically, socially, physically, and emotionally. Caregivers themselves run the risk of burnout, with its attendant physical and psychological effects. Some profit and non-profit agencies provide respite or day-away programs for senior care. This alleviates the burden of providing the quality of care that our seniors deserve. In many cases, however, if outside agencies are accessed to recruit home care, we run the risk of hiring people who are untrained and unlicensed in caring for those with complex morbidities, exacerbated by complications of complex prescriptions, physiotherapies, emotional complications of dementia, or other biopsychosocial issues.

The difficulty with parenting has been that many parents have passed through a laissez-faire phase in which the child was allowed to flourish and thrive. I remember in Grade 7 we were to self-select learning activities, with little direct guidance from the classroom teacher. I learned very little in that class and became frustrated. This philosophy of parenting had to be changed; many books were published to teach us how to say no to our children. Rabbi Shmuley Boteach offers a show called Shalom in the Home. He is re-educating parents in how to be fair and firm. He is teaching parents to give unconditional love with the right hand and discipline with the left. Both are necessary.

In my experiences with family and friends, I have heard endless stories of adult children who are unable to say no to frail and ailing parents. It is a reversal. Adult children have to lie and deny in an attempt to protect themselves from their parents’ wrath.

Frail adults refuse the help of outside agencies, whether or not money is an issue. It is the less frail spouse who suffers. One fifty-year-old daughter, whose mother had survived breast cancer in her seventies, is trying to persuade her father to allow people to come in to help them. When he falls, the mother cannot pick him up. The mother is now fighting high blood pressure with the stress of caring for this ill man. Tough love is a concept that must be applied to adults as well as children. In this situation, it should not be up to one spouse to refuse care if family members determine that there is a need.

One family, whose father lived in the family farmhouse as he had as a boy, promised their father that his stay in the long-term care home would only last a month. They are now using more excuses to keep him in. He doesn’t like his roommate, who turns up the TV too loud, and is fighting to keep his old life. Frail and ailing adults deny that they are unable to stay in their homes; they experience falls and break limbs, which land them in an LTC home. As seniors, we must make adult choices or we will not be treated as adults.

Our favourite librarian, Mari, who kindly delivered books to my mother, told me that she tried to persuade my mother to get some help with ADL. She offered to put my parents on the Meals on Wheels program, which my father and my husband delivered. Mom would not buy into any of this. Only old, sick people needed home support!

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