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Five Ways to Manage Difficult Elders
By Phyllis Staff, Ph.D.
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'You are old, Father William', the young man said, 'And your
hair has become very white; And yet you incessantly stand on
your head -- Do you think, at your age, it is right?' Lewis
Carroll (1865)
My grandmother was the original matriarch. When
she barked "frog," the only acceptable response was "how high?"
She was hard to deal with in her last days, surprising no one.
Not being the brightest penny in the family bag, I reacted
emotionally to her complaints, judgments, and demands. Rather
than leave immediately, I stood my ground, trying to defend my
relatives and myself from her relentless attacks. As a result,
we were not speaking when she died. Had I understood what I was
facing, had I tried to put myself in her shoes, our story could
have had a better ending. In hopes that your story will have a
more satisfying ending, I offer a few of the tricks for dealing
with difficult elders I've learned since then.
1) Make a plan
BEFORE a crisis The best way to deal with difficult parents is
to avoid as many problems as possible by planning how you will
handle them before they arise. Pick a time when ALL family
members can meet in person or on a conference call to discuss
what you will do when a family member needs help. Take the focus
off elderly Family members by fully including them in the
planning and making certain they have a role to play. Be sure to
take notes! Share them with all family members to verify your
family agreements. In difficult situations, you might want to
ask family members to sign and return a copy of any agreement.
Here are a few of the issues you may want to address: Physical
Location How will you help a family member when they live in
another town? Can you be an effective long-distance caregiver,
and, if so, how? If not, who will move, and when should that
move happen? Roles Who will be responsible for what? Will you
share expenses equally, or will you balance money versus time
contributions? What will happen when there are disagreements?
How will you handle changes in individual circumstances? How
will you react to threats to health and safety? Differentiate
preferences and requirements. If it's more than a preference
that family members not live together, get it out on the table
before a crisis erupts. Document Planning Where will you store
important documents such as Wills, Power of attorney, Insurance
policies, and Deeds of trust. Who will have access to these
documents? And under what circumstances?
2) Stretch your
patience muscle Remember your excitement when you crossed the
threshold of adulthood? When you first got a driver's license?
When you got your first job? When you found your first apartment
and could decorate it all on your own? Then think about how you
would feel if you had to give up adult privileges, one by one.
What you're feeling now may closely approximate the feelings of
your difficult parent. But your elder's feelings cannot be
imagined away. Your difficult parent may fear ˇBecoming
invisible; ˇSeeing themselves as useless or stupid; ˇLosing
their friends; ˇLosing physical abilities; ˇBecoming dependent.
By imagining yourself in their place, you may react more
sympathetically and suitably.
3) Forget "Parenting Your Parent"
One of the least helpful ideas in our current culture is the
notion that as your parents age, you become their parent. Stuff
and Nonsense! You are NOT your parent's parent, nor will you
ever be. Your role may be friend, confidant, caregiver, and
supporter, but when you take the role of parent, you diminish
your elder by reducing them to the position of child. No wonder
they react negatively. Wouldn't you?
4) Use behavior modification techniques Behavior modification
has gotten a bad rap of late, probably due to the many ways in
which its principles have been misused. However, used properly,
behavior modification techniques can remove unpleasant behaviors
and return sanity to your family. If you don't know the basics
of behavior modification, here is a site that can bring you up
to speed quickly:
http://chiron.valdosta.edu/whuitt/col/behsys/behmod.html A few
tips to help you begin Before you begin, you must clearly define
what outcome you want to achieve. For example, you find that you
are spending an increasing amount of time waiting for your elder
to get ready for an outing. If you want your elder to be on
time, make that the specified outcome. Identify your elder's
positive reinforcers. Clearly they do not respond to your
annoyance (or are you even allowing your irritation to show?),
but they do enjoy outings. Tie the outcome to the reinforcer in
a clear statement, for example, "If you are ready at 10:15, we
will go shopping." Shape the behavior you want. If your elder is
habitually 30 minutes late, it is unlikely that they will
suddenly be on time. So, decide in advance to shape their
behavior. For example, you may choose to wait 20 minutes. If
they are not ready, leave without them. Once that behavior has
been established, wait only 10 minutes, then only five. By using
this tactic, you will arrive at the outcome you desire with a
minimum of pain. Punishment. Punishers can work - if they are
severe and immediate. However, they increase the likelihood that
you'll get results you didn't anticipate or want! Locking
someone in a room or closet is punishment. Don't go there!
Extinction. Use extinction techniques rather than punishers to
get rid of unwanted behaviors. Extinction is simple. Offer no
reaction to bad behavior. Don't talk about it. Don't react to
it. Leave the room, leave the house if you must. But remove the
opportunity for reinforcement of such behaviors. Be aware that
it will take time for extinction techniques to carry out your
goal. Also realize that the frequency of the undesirable
behavior may actually increase while extinction is occurring. Be
patient and resolved. You'll get there if you don't weaken.
5) Identify your own contribution to difficult parents and
difficult families. Perhaps the most difficult (and perhaps the most useful)
technique is to identify your own contribution to the problem,
and stop it! ˇAre you taking the course of least resistance and
putting up with undesirable behavior because it's too difficult
to change it. ˇDo you avoid conflict at all costs? ˇCould you be
afraid to give up your position as "favorite" or "good?" ˇDo you
feel emotionally superior when you deny your own needs to attend
to those of others? Any of these may lead to more difficulties
in the future, so give them up. Decide what you can do within
reason, and do that. If you need help, ask for it. You can deal
with the problems of difficult parents and difficult families if
you are willing.
About the author:
copyright 2003 by Phyllis Staff, Ph.D. - Phyllis Staff is an
experimental psychologist and the CEO of The Best Is Yet.Net, an
internet company that helps seniors and caregivers find
trustworthy residential care. She is the author of How to Find
Great Senior Housing: A Roadmap for Elders and Those Who Love
Them. She is also the daughter of a victim of Alzheimer's
disease. Visit the author's web site at
http://www.thebestisyet.net.
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