I’m undertaking a 1000-day reinvention project, blogging here daily to track my progress. In Tuesday Book Club, I share an idea from a book.
Safety is a huge, common point of conflict. Don’t fall into the trap of assuming it should be your family’s top concern. Adult children (and doctors!) tend to prioritize staying safe, along with longevity. We want to prevent accidents, falls, injuries, illnesses, new medical problems, and dangers of any kind. We’d like our parents to live forever, or at least as long as possible. It might even seem wrong not to want a person to live as long as they can.
Most older adults, when faced with a trade-off between safety and independence, however, choose independence. Even when cognitive problems like dementia are present, a certain amount of risk is usually considered a worthwhile trade-off if it preserves some self-control and quality of life.
Leslie Kernisan & Paula Spencer Scott et al, When Your Aging Parent Needs Help
I’m feeling ambivalent about having taken my father’s dog into my household while he is in rehab after a fall, mainly because his partner is against it, despite her recent fall resulting in bad bruising during a dog walk when the dog lunged at other dogs. My father seems to find the dog’s temporary rehoming a relief, knowing that his dog is getting all the walks she needs, has a full grooming appointment scheduled for this week for which transportation is already arranged, and is living with a canine companion she enjoys very much. For his partner, it is a serious loss of independence, routine, and companionship of her own. It’s helpful to take her perspective into consideration and ensure that I don’t think that “safety at all costs” is the right way for them to live their life together.
I think of what will happen as I age. What if I keep skiing into my sixties, seventies, and eighties? What if I take a fall at some point and break a bone or my hip? Will my kids say, “Mom, you need to stop skiing!” I would say, “I’m ready to die on the slopes, doing what I love!”
At the same time, falls are the leading cause of injury for people aged 65 and older. I’ve witnessed more than one of my older relatives take a fall and then decline after towards death.
But are we trying to keep people alive forever? That’s not possible. In my life, I don’t reduce risk to nothing. And older people shouldn’t need to do that either, as long as they are taking on risk with awareness.
I appreciate, however, that my taking the dog into my household means we will do a zero based review of the situation if and when my father decides he would like to consider taking her back. We will ask:
- How many walks does she need each day, and who is going to do it and pay for any professional dog walks? My dad and his partner live in a fourth-floor apartment so the dog needs to be taken out at least four times a day. The expense of this has been brought up by dad’s partner, so I think it should be addressed explicitly.
- If my dad and/or his partner will be doing some of these walks, how can we reduce risk? I don’t think risk of a fall can be eliminated but there may be ways to make outings safer. Both my dad and his partner have been injured in falls when the dog lunges at a delivery person or another dog while on leash. The dog is a 50-pound standard poodle, ten years old, with plenty of vigor still left in her.
- Who will handle arranging walks, grooming appointments, vets, and other tasks? Is it helpful to my father to offload this coordination? Is it helpful to him to have someone else transport Kristy to any appointments she has? The groomer in particular is quite far away, a legacy of when Dad used to live in Denver.
- What would be the plan if suddenly Dad and Hilde couldn’t take care of the dog? Move her back in with me? Make other arrangements?
- What about when the dog may need to go out more, for example as she ages?
I look forward to having these conversations and explicitly addressing safety issues as well as whether my dad wants the burden of care responsibility for a pet at this stage in his life.
Multiple times over the years my dad has commented to me, “I shouldn’t have gotten this dog. I was too old.” And we’ve had various conversations with my sisters and him about what would happen to the dog if he and his partner could no longer care for her in his apartment. His fall and stay in rehab brought this conversation up again. One reason my sisters and I acted quickly was because it was something already on our minds.
Another issue that has arisen comes up all the time in elder care: driving. My father drives but his partner does not, as she had an epileptic seizure and accident many years ago after which she stopped. Hilde usually depends upon my father for transportation though two of her three children live close enough to help also (and often do). My sisters and I have noticed that my dad’s driving skills are not what they once were, and after suffering a fall and a blow to the head they may have deteriorated further.
Kernisan and Spencer Scott suggest the following possibilities for evaluating driving skills and deciding how to proceed:
- Invite your parent to take a self-assessment, such as that offered by AAA
- Mention your concerns to your parent’s doctor
- Arrange a driving evaluation (a driving skills evaluator or an occupational therapist driving rehabilitation specialist)
- Report your parent to the DMV yourself
- Begin to research alternate transportation
My dad has already told us he isn’t up for driving yet after his fall. This, like the situation with the dog, is the ideal time to comprehensively evaluate whether he wants to continue driving and has the skills to, and what driving tasks he might want to give up. He already has given up night driving for the most part — if we go out to dinner, I always drive.
We will have other topics besides the dog and driving to talk about as my father and his partner age, including finances and in-home caregiving help. Kernisan and Spencer Scott offer tips for communicating to “reduce conflict and enhance cooperation”:
- Stay curious about, and open to, your parent’s perspective.
- Invite your parent’s solutions.
- When talking about your own feelings or opinions, stick to “I statements.”
- Frame your ideas in positives.
- Avoid phrases with the words always or never.
- Use empathy and validation.
- No matter how frustrated you get, avoid insisting, arguing, threatening, or otherwise putting your parent on the defensive.
These are good tips for communicating with anyone, and I’ll be keeping them in mind as we go forward with my father and his partner.