Parental Guidance is the essential how-to guide for people who don’t live in the same town, city, country or continent as their parent, yet want to actively ensure their parent gets the help they need to maintain well-being, safety and happiness at times when health problems attack independence and longevity.
As a young nurse trainee I was assigned an 80year old woman,
admitted to hospital because she was dying.The lady had been admitted to hospital two weeks after the death of her
husband of 50+ years.Her medical file
was light on details:no sudden
illnesses, chronic diseases or obvious causes resulting in her becoming
bedridden and time-limited.
Understanding what was happening with this lady was beyond
me.As way of explanation, the charge
nurse told me that the woman wanted to die.That after her husband, who had been sick with cancer for almost a year,
died – she ran out of reasons to live and was now willing herself to die.
As I gave her a bed-bath and changed her sheets, I tried to
persuade the woman that there were many good reasons to be alive.Her eyes remained vacant and her lack of
words told me that she was unconvinced by my arguments and determined in her
own plan of action.She died on her fifth
day in the hospital.Being young and
inexperienced in most life matters rendered me incapable of understanding her
lust for death.
“Till death do us part” is part of a marriage vow
originating from the Book of Common Prayer (originally published in 1549), still
repeated in many wedding ceremonies conducted in the English speaking
world.Rising divorce figures clearly
indicate that an increasing number of couples are not taking this vow
seriously, yet there remains a significant group of older adults able to
legitimately celebrate 30, 40, 50 or even 60years of marriage.
Getting old with someone you love is a popular romantic
notion intrinsic is all societies.Generally
over time romance diminishes and is replaced by more practical considerations like
jobs, mortgages, children, vacations, aging parents etc etc.For better or worse, enduring partner
projects are the things that glue many marriages together.
Increasing age comes with an escalating probability of
illness and disability – often resulting in one partner taking on the role of
care-giver for their ailing spouse.With
most chronic illnesses, like dementia, this role can extend for years becoming
heavier as the disease progresses.Spousal
care-givers frequently conceal their exhaustion and difficulties, not wanting
to admit defeat by asking for help to look after their partners.This can cause stress that negatively impacts
on the care-giver’s health and ultimately leads to “caregiver burnout”.
Assessment of an in-home care situation with older couples
is difficult for families and professionals alike.Family members are often blind to what is
happening in their parent’s home.They
may believe that everything is okay and that their ill parent is having a rare
‘bad day’ when they visit or are unable to speak to them on the phone.Health professionals may be denied entry into
the home and distracted from the truth by cancelled appointments and assertions
that everything is fine. The threat of
separation by hospitalisation or admission to residential care is a source of
great anxiety for many older couples – as is the fear of being left alone.
The irony is that accepting the help that is available can
often extend the time a chronically sick person can be managed within the home environment.For a spouse, accepting help can mean taking
a well needed respite break – whether for a few hours or a few weeks.A good example is that of the many dementia
sufferers exhibiting nocturnal sleeping disturbances, often waking to loudly
rummage through drawers and wardrobes.Caregivers quickly become exhausted when their own night sleep patterns
are disrupted.Giving a caregiver a few
hours to sleep, relax, go to the movies, drink coffee with a friend, take a
walk, whatever the person needs to do to replenish themselves is not a luxury –
but a necessity.It helps to maintain
perspective and attachment to the world going on outside the home that holds
them, albeit willingly, inside caring for their partner.
Home care services, support groups, older adult respite care
programs (day and longer term), informal help from family and friends – are all
options available to support older adults caring or being cared for within
their own home.While little can be done
to lighten or remove the feelings of loss and sadness at seeing a life partner
suffering due to illness, we can help to ease the daily burden of care by encouraging
older couples to accept the services available to them.Most importantly, supporting the individuals,
rather than seeing the couple as a single unit, will promote an individual
acceptance of the situation from their own personal perspective - and relieve
the unreasonable expectation - “till death do us part” .