I’ve Got a Secret
If you remember this game show from the 1950’s, you’re in the cohort that’s dealing with eldercare issues. Does your family member have a ‘secret’ that makes you hesitant to seek care for them? Let’s see how three families coped with their ‘family secrets’.
By Pat Irwin
My dad is a secret drinker
He’s a charming guy, but about once a month he and some buddies go on a bender and he becomes horrible, abusive and completely obnoxious. He needs to be looked after, but how could he ever fit into a retirement community?
Your first step is to help your dad change his life for the better. Schedule a thorough medical checkup, since alcohol often causes health problems such as vitamin deficiencies, osteoporosis, memory loss and other medical issues. Be honest with the doctor about the pattern and extent of the drinking. If the doctor has been avoiding the subject, get a new doctor to help your dad on his journey to wellness.
What is realistic for your dad to achieve? Would he be able to continue drinking, but in moderation? What support would be required? If he needs to stop completely, engage help from a professional and trusted source such as Alcoholics Anonymous. Getting a referral for a psycho-geriatrician or therapist might be a good idea as well, for your dad to explore his motivation for this behaviour.
Whether your dad plans to moderate or totally quit drinking, identify and remove his triggers and enablers such as the visits to the neighbourhood pub with pals. Help him to substitute activities that encourage more positive behaviour. If you decide to try a retirement community, begin with a trial stay. Be honest with the retirement home management and staff; they need to know in order to help. Having a drinking problem will not necessarily disqualify him from a retirement community, as long as there are controls in place.
What is common to these situations? In all cases, the family feels shame that theirs is not a picture-perfect existence. Ironically, in an age where the media shares and celebrates all variations of lifestyle, we are still judgmental and fearful when it comes to our own families.
Some families feel it is better for less-than-perfect parents to remain at home, where their ‘secrets’ can be managed by live-in care. This may be true – and yet, the parent, whose behaviour was probably caused by some form of social anxiety, may be further marginalized by being isolated with only a caregiver for company. Day programs can provide interaction with ‘normal’ society for a set period of time, minimizing the stress of being ‘in public’ while giving the person some time in the outside world – and their caregiver a break. Check your municipality’s ‘programs for seniors’ for information.
Moving to a retirement community may seem impossible, but it can work well with the proper support from management and the caregiving staff. The key is for staff to be non-judgmental, to recognize and head off triggers, to deal with slip-ups calmly and to constantly reassure residents of their unconditional support.
Smart families will realize that, while destructive behaviours rarely change in the senior years, if they can enlist an effective support network, their parent’s unique behaviour can be successfully managed.
And that’s no secret.
Difficulty getting along
My parents don’t get along well enough to live together in their house, much less a small retirement suite. I’m used to their non-stop bickering, but I can’t imagine a caregiver putting up with it.
Couples who have co-habitated for years find their relationship sorely tested when they become empty nesters and retirees, and daily habits are changed. Putting this volatile situation into a very small space can bring things to a boiling point. These behaviour patterns have developed over many years, are firmly ingrained and will be difficult to change. However, marriage therapy or mediation may help you, your parents and any potential caregivers to observe and track triggers, such as times of day, to anticipate and head off conflicts. For example, ‘sundowning’ – restless irritability in the late afternoons – is a recognized trigger and programming is often provided to minimize its effects.
Marital strife is one thing, but any sort of mental or physical abuse is unacceptable and steps must be taken to protect the vulnerable parent. That may entail creating individual space within the family home, care management by a caregiver who provides a neutral ‘buffer’, or a move to a retirement or nursing home for either or both of them.
If funds permit, each parent could be placed in separate suites within the same retirement community, one that allows a continuum of care and offers good, relevant programming. Each could pursue their separate interests but still be together for meals and even overnight. Making a new start in a new place could help break old and negative patterns, with expert support from staff and other professionals such as therapists and caregivers.
My mum the hoarder
My mom is a hoarder. She never throws things out and lives in a ‘nest’ of junk which I periodically clear out. Her personal care is terrible, she’s depressed and too embarrassed to let anyone into the house.
A hoarder will not change their behaviour without professional help. However, practical assistance is possible. Maintain an objective, non-judgmental attitude; otherwise your mom may dig in her heels and refuse all help. Find a reputable storage unit which can be visited at any time to allay fears that items removed from the home have actually disappeared. When items are organized, they often lose their appeal; after being stored for 12 months without a ‘visit’, disposal may be possible.
What is your mom’s motivation to hoard? A ‘collector’ may need to see and admire – so take detailed photos with blank pages for her to catalogue the details, while putting the actual items in storage. A Depression-era person may keep things ‘just in case’ – so gather all the items together and plan how many they will need now, and store the rest. Don’t expect logic or argue about what it all must have cost. Hoarders are unable to recognize or act on the material value of their items; their attachment is emotional, not financial or practical.
Anyone coming into the home to care for your mom must show respect and understanding of her ‘collections’. Successful helpers will take the time to talk about your mom’s life and her possessions. Professional help may be needed to ‘interrupt’ the acquiring behaviour, replace it with more healthy practices, and correct the illogical processes that led to the hoarding. Inform caregivers of your strategy to be sure everyone acts consistently in providing the help and compassion she deserves.
Most likely, we have our own version of family secrets. Lots are based on fear of being discovered or embarrassed, some are linked to pride/status and others are just plain old ‘none of your business’. Nevertheless, when secrets become problems for families and/or professional caregivers, it’s time to raise the curtain and ask for help, regardless of the situation.
Pat Irwin, BA, AICB, CPCA, is President of ElderCareCanada.