The first family had a culture of self-reliance. As they aged, the parents took great pride in maintaining their independence. To their children’s frustration, even medical emergencies were often kept secret from the family.
When managing a house became difficult, they sold their home and moved to an independent living community. Needing more help a few years later, they moved into an assisted living facility. Their children only learned of these moves after the fact.
As is often the case, the responsibility of looking after them fell to the child who lived in the same city. The around-the-clock availability of assisted living services like housekeeping, meals, transportation, medication management, and medical care made his job relatively easy. He was able to collaborate with the staff to make sure his parents were cared for and supported. The few hours a week this required was manageable and didn’t interfere greatly with his job or family activities.
When the father in this family had a stroke, he was immediately hospitalized, quickly received essential medication, and made a reasonably good recovery. When he eventually died, the family was convinced his years were extended by the good care he received from his support team and his son. His wife was able to stay in her familiar surroundings.
The second family had a culture of interdependence, spending a lot of time together and relying on each other for support in almost everything. As the parents aged, the family expectation was that the children would be there for them. They had no intention of ever leaving their two-story home. Their need for autonomy, fear of losing independence, and money scripts about unnecessary spending combined to make them refuse to even consider moving into independent living. The one local child, a daughter, became increasingly involved in their day-to-day support, working around her part-time job to manage transportation, household chores, shopping, and coordinating and attending medical appointments.
Finally, the father had a stroke in the middle of the night. No one realized this until the following day, too late to get tPA to minimize the effects of a stroke. He was hospitalized and then needed an extended stay in a rehabilitation facility. His wife could not live in the house alone, so the daughter moved in.
The father recovered enough to move back home. They still refused any in-home help and continued to rely on their daughter. Eventually, she was spending some 30 hours a week providing the services they needed. She sacrificed work, self-care, and family time until she was exhausted and burned out. The obvious solution was for the parents to move into assisted living. They still refused.
Ultimately, the father had another major stroke and had to be moved permanently to a long-term care facility. In crisis mode, the daughter grabbed the only open assisted living facility unit for her mother. Family members took vacation time and spent weeks dealing with 50 years of accumulated belongings and preparing the house for sale. Because the assisted living facility was in a neighboring town, it was difficult for the parents to visit each other. The months before the father died were needlessly isolating for them both.
The lesson from this tale? Refusing to acknowledge the limitations and needs of aging is a false form of independence. It is more self-reliant to use retirement resources to pay for appropriate assistance than to expect family members to provide care at the cost of their own wellbeing.