Sunday, 17 February 2019

Soumya Nair

Also called as ‘Inheritance Impatience’, early inheritance syndrome is just one of the ugly faces of financial elder abuse. It is becoming a more common issue in a society where elders are living longer and living richer than at any time. Adult Children with ''early inheritance syndrome'' feel a sense of entitlement to their old parents' assets. These impatient children are not prepared to wait until their parents die. They seek ways for their parents to ''gift'' them money, or interfere in the management of their parents' assets to protect what they see as their entitlement. Here we start narrating the long story of 74 year old Ramamurthy, a typical case of early inheritance syndrome.
“I should have taken your advice, parental love blurred my 74 years of wisdom” said Mr. Ramamurthy, holding his friend’s hand, tears rolled down his eyes when despair shrouded his face.  A healthy widower past 16 years, Mr. Ramamurthy, is a classic example for “Happily Retired”. Healthy and socially well connected with a vast friend’s circle, he was able to peruse hobbies even after retirement. With sufficient savings coupled with a simple lifestyle he enjoyed  the much needed financial independence in his old age and everything that described a happy retirement was part of Mr. Ramamurthy’s life. Over a foolish decision his life became topsy-turvy. 
When everything was hunky-dory about Mr. Ramamurthy’s life, his only son puts forward a proposal which he could not resist. Ramamurthy used to live in an old Bangalore area but his son moved out to a new locality outside the city in the suburb closer to his work nudged by his wife after marriage. Ramamurthy lived in the area where he spent his entire life time, he was lucky enough that he never had to move out from his parental house neither he migrated in search of big fortunes like his other contemporaries. This has been the very reason for the strong social support systems that he had.
A typical day of Mr. Ramamurthy is enviable to many such elders. He had friends who come in groups to wake him up early in the morning to pull him out of the bed for a morning walk, a hot filter coffee at the local coffee shop, then a short walk back to home ends his socialization for the first half of the day. Second half is filled many more vibrant activities, he is part of an NGO where few of his retired friends joins him, they together help the special children  with gardening skills; his life was not just fun filled but meaningful too. Evenings he did not have a regular task but each day was different, either to the Sangeet Sabha, or calling in on a friend who is not well, visiting relatives, going to library, attending comedy shows, going to elder’s club, or just strolling around the park. Weekends were dedicated for his grandchildren, either son and family calls in on him or he calls in on them. 
Spouse loss happened immediately after retirement and few months after he had learned to cope with the loss and overcame the sorrow. It did not much affect him emotionally like it does affect many elderly when they lose their spouse at the far end of their life. He was not the typical retiree who think retirement was end of  a ‘vibrant life’ instead he masked the monotony by various activities.
Ramamurthy, at heart of the heart was a proud man and he used to boast about his son and daughter in law to his friends how loving his son, daughter-in-law and grand children were. He was sure that their weekend won’t complete without meeting grandpa. Daughter-in-law was more than a daughter, for the love and affection she showered on him. Though Ramamaurthy visits them once a week, the table would be filled with the dishes he loved to eat, he saw the efforts to pay special attention to the details of his likes and dislikes. He wished and prayed the happiness lasts forever in his life but something unusual happened. 
One morning Son and Daughter-in-law did not wait for the weekend but showed up at the door with his favorite, sweet dish made ‘specially’ by daughter-in-law. He could not recollect which special day was that he missed but his son remembered! Without a preface, son puts the proposal forward, his wife wants to start a high end boutique, he confesses that the money he had was invested in his flat and the new car yet he had to borrow some more from the bank and his purse is running dry to help his wife with her longtime dream of owning a boutique. Son puts it bluntly, “Appa can we sell this house, you can stay with us! we love to have you with us for the rest of your life, grand children love you to have you all the time with them.” 
Ramamurthy was not enthused by the proposal simply because all his life he lived in this house and lot of memories etched there. Son clarifies further, the driver can chauffer father for his activities outside, daughter-in-law will be able to cook the kind of food he loves, grandchildren will have their most beloved person telling them bed time stories, more importantly there will not be any hassle of running a house hold single handed at this age, the convincing reasons were endless. 
Upon Ramamurthy discussing it with his closest buddies, the very idea was actually shunned by them. Friends cautioned him about the trap. They walked him through scenarios that might create issues in his life later and may affect his independence. Ramamurthy is now a confused man, he had no reason to believe his friends, because he never had to experience any single bitter experience from his son and his family. He told his friends that such incidence may happen elsewhere but not in his house and zipped up his friends mouth telling how confident he is of his son’s and daughter-in-law’s love who is more than a daughter to him. 
Capitulated by a ‘reasonable demand’, Ramamurthy sold his ancestral house for a fatty sum. The purpose well served, soon daughter-in-law’s dream came true. A fancy two storied boutique came up down the lane. Ramamurthy moved into son’s four bed room luxury apartment. Initial days were exactly how he expected it to be. Those are days of just happiness in his life. Soon milieu at home took different shape.
Instead of ‘Idli’s and Dosas’, bread toast started appearing on the table for every day’s breakfast, most day’s lunch were a miss, he was asked to fix something for himself, dinners became too late as close to midnights till daughter-in-law gets back home. Ramamurthy missed most of his meals. He was expected to do errands in the house and soon he transformed to a caretaker of the house. To open the door when children gets back from school, open the door to the maid help, attend phone calls and note down the messages, guard the house, collect gas and milk, soon Ramamurthy started feeling unworthy, and felt charm of his life is wearing off. He decided to complain to his son with all authority and love he thought he had over his son, the reply from his was a rude shock. “Appa why can’t you adjust, when you get older you should learn to adjust” he added a piece of advise to his old father. 
To beat the monotony, he decided to call his friends home and they happily visited him, same evening Ramamaurthy over heard his daughter-in-law, shouting at his son and complaining how messy was the house because of his father calling people home and having a party. Grand children getting the vibes from their mom, they started complaining too. Ever since grandfather started living in “their house” they cannot invite friends to sleep over, the additional room being occupied by grandfather. They find fault with their grandfather listening to TV in loud volume and complains it disturbs their studies. The worst of all for Ramamurthy, was his son not able to comprehend his real situation but expects him to adjust, where he is not only adjusting but compromised many of his life comforts and happiness. 
Ramamurthy hit the rude reality; life in his son’s house is not what he deserves. He wanted to run out of the house packing his stuff but where to? He has no pension to fend for if he breaks free! He reminisced the good old days, living independently. He suddenly recollects his dear friend who advised him that it is suicidal to give away all the wealth to children when you are still healthy and active. He calls him over the phone and explained his plight and repent for not taking his friend’s advises earlier. 
Ramamurthy was no longer the same person; his dear friends got a rude shock to see how diminished his friend’s condition was. A person always seen in white crisp neatly pressed shirt, is no longer able to maintain the same lifestyle. Due to poor emotional health, shrunk social life, poor nutrition, mental and physical health took a downhill. He was no more interested in grooming, eating or even taking bath, no one at home took any notice of the debilitating changes happening to Ramamurthy. 
Over a period of time, son found the most convenient reason to institutionalize his father. “He doesn’t talk to people, ne needs to be reminded of bath, hair-cuts, shaving, grooming and eating” That is when he met us asking the possibilities of the institutionalized care. Upon checking, there was no psychiatric evaluation been done, reason was illogical “father doesn’t like to go to a psychiatrist he was an independent and healthy person”. 
The complicated and detailed case study discussed here, is a classic example of mismanagement of one’s wealth and independence. This is not an isolated situation in our society but many older people do not open up fearing the image of their children and family. 
As the vulnerability of older people increases, their dependence on family members also increases thus making them vulnerable and helpless. Now-a-days financial abuse is a universal menace, and fastest-growing, type of abuse of older people. It involves taking or misusing an older person's money, property or assets. It also takes different forms like persuading an older person to change their will through deception or undue influence. Sometimes greedy children are  “extorting” their parents into becoming guarantors for their home loans against their will. And it’s happening right here in our own backyard, property-related elder financial abuse is becoming the most common form of elder abuse. Often the old parents do not want to say "No" to their adult children's requests for money or asset transfers for fear of upsetting these relationships.

Those children who are eager to inherit wealth may justify their actions by saying: "Mum and Dad don't need money now, but I do" or "The money is going to be mine anyway" or “When are we going to enjoy these estates”. Our experience as social gerontologists shows that women over the age of 80 are most at risk of financial elder abuse, with adult sons being the most common perpetrators. A very common assumption in our biased society is that older people, particularly women, are unable to manage their finances. 
Past six months we compiled our findings of wealth mismanagement by adult children and immediate relatives especially on the issue of the children suffering from early inheritance syndrome. Our study shows the following. Majority have a firm sense of entitlement. They see parent’s homes as an asset that has already been paid off and think because they will eventually inherit it they deserve it now. Why wait? One woman (name withheld) came out of hospital to find her children had sold her home without her knowledge and she was homeless.

Krishnamurthi’s story is the best example for any prudent person to understand the need to preserve the financial freedom in old age. We agree that till things go wrong you will not have any valid reason to disbelieve your children. But why take chances. A small oversight can damage your own existence. Today we have hundreds of cases of neglect, abuse due to mismanagement of wealth, and these examples around us can help us draw our own life plans, not leaving it to our children. 
Ideally speaking, it is true that we love our children, no doubt they love us back in many folds, and they were our old age assurance. On the contrary, a sea change has happened in our society and in our relationships in the past few decades and it is suicidal to overindulge in children. Breaking the stereotype mindset and accepting the changes in the society and to your own families, can make us more realistic in thinking and pragmatic in action. We are used to part with our wealth to our offspring’s when our mind is intact and rest of our lives will be in the hands of our children. It was not part of our life to plan wealth for our infirm years! That’s the past.
Remember, times have changed.
Remember, more years are added to your lifespan.
Remember, there is a possibility of continued infirmity.
Remember, you may need long term care.
Remember, finally everything boils down to your financial freedom.
And finally,
Don’t be a sitting duck like Ramamurthy.


Tuesday, 5 February 2019

Are you seriously worried about your disabled sibling’s future? Here are few tips.                                                                                                                            Roshan Jacob & Soumya Nair

A child perhaps mentally or physically disabled from birth or one who might have suffered an accident earlier in life, grows into adulthood, having been cared for by very loving parents who did everything that could’ve muster is no more and the responsibility falls on the adult siblings. This is such a difficult scenario, yet happens everywhere, every time. For many, deciding who will care for a sister or brother once the parents die or become too frail, is rarely discussed. As social gerontologists we encounter more and more such care concerns in our practice. So we thought it fitting to get a conversation going. We spoke to many, all 50 plus, who will experience all of these but concerns mentioned by us are genuine. Below are some concerns of siblings and we suggest few options.

Let’s start with a letter which we received recently from Sharjah, UAE from Mr. Balagopal. His younger brother aged 54 is deaf, cognitively delayed and OCD.  (A portion is reproduced here with his permission for the purpose of this article.)

“Parents are old but ain't dying or anything, but I'm just thinking ahead. For some reason, this has been bothering me and it is making me so depressed and sad, so I will seek your advice. Also, there is no other immediate family living India other than few distant cousins. All my family in another country are as old as I am or old people.

I'm an able bodied adult, so there isn't really any real reason why I can't take care of sibling in the eyes of the law. I can't get out of it by ignoring sibling and not give him proper care because that amounts to neglect. Can't abandon my brother somewhere, either. I'll be forced to be the legal guardian, otherwise I go to jail. I'll be trapped with no way out of this. At least, that's how I'm imagining all this works, because I don't know anything about this, really.

Presently, I have the freedom to do whatever I want. At present, I am not providing care, so my life is relatively normal. But I live in constant fear that at some point of time I will be full time caregiver to my younger brother and I hate it. Is there a way to seperate myself from my family legally so that I am not obligated to be the guardian? My life won't be mine anymore. Or am I being dramatic, and there's something I can do to get out of this responsibility? I even thought about suicide”. 

Balagopal is definitely going overboard. Being the only, “next to kin”, he has the moral obligation to extend support to his younger brother. Having a sibling with disabilities certainly bring some special responsibilities towards them. No need to shy away from the obligations and he has many options to deliver it without hassling himself.As everyone grows older, eventually both parents die, leaving behind the child with disabilities, now an adult, who has outlived his or her parents is a natural thing and nothing unique to Mr. Balagopal. 

It is very natural that a sibling having concerns about the future for themselves and their brother or sister with disability. What happens when parents are no longer able to provide care? What role should the sibling play how much to get involve? What is the economical involvement and to what extent? Will the spouse adjust and able to share the responsibility of a brother or sister with disability? What about having children themselves? How can a sibling balance the responsibility to their own family and to a brother or sister with disability? These concerns are pertinent, but definitely not to the extent of Mr. Balagopal
In the past children born with disabilities didn’t always live to be adults, or at least didn’t outlive their parents. Decades ago, adult children hadn’t moved to other locations and also had joint family ‘cushioning’. Fast forward to the present times, and this scenario is not at all unusual. In today’s world order, It’s tough managing one’s own ‘core’ family, much less having to worry about sibling with disabilities joining that family, no matter how much siblings love each other, how committed they are, or how thoroughly arrangements had been made by aged parents prior to their own deaths. if living to be an adult and ageing, understand that family circumstances keep changing, medical, financial and caring arrangements should be made with the best interest for all stake holders.

The challenges of the immediate kith and kin are many when it comes to caring a disabled sibling. The challenges include fitting the many new tasks and responsibilities for their sibling into their own life routine. Will the sibling with disabilities move in with the abled one?  How do the sibling with disability’s needs fit into the routine of family life, especially when younger children, the nieces and nephews of the sibling with disabilities, are involved? Who attends the clinical appointments? Or makes medical decisions? How does it funded, especially if Mom and Dad didn’t leave any substantial corpus? Compounding the challenges, now-a-days, it’s a usual thing for the sibling with disabilities to live in one location, while the caregiver sibling lives out-of-state, thousands of miles away.
What’s the legal position?  In general, across the world, Parents are obligated by law to care for their children, and children are obligated to care for their elderly parents, but no law requires siblings to care for each other. When your parents die, a guardian will most likely be appointed for your sibling. You will not be obligated to care for them. Definitely Mr. Balagopal, can relax, because no laws to force a sibling to care for another sibling against their will.  

When the parents become old or very old, find they cannot continue to provide care. It might be time to have a discussion with your parents about long-term care for your sibling, even if he is still living with them now.  While your parents are alive is the best time to consider different options about funds, housing and care. It is better to advocate for a fool proof arrangement regarding the care and finance now than in an emergency when your parents die or are physically unable to care for him. Most of the parents might resist having this discussion, so you better should stand your ground. Emphasize that you are indeed advocating for your sibling for a better life.

As mentioned before, because of result of the medical advances, adults with severs disabilities ca expect to live longer. So it is critically essential to draw up a financial plan that will protect your parent’s retirement and your sibling’s needs after parents are gone. If the sibling is 40 plus years and could expect reach 80, that’s a long period to plan for. Every parent wants to leave behind a little something to ease their children’s way in the world. But for parents of an adult child with disabilities, the estate plan can be crucial in guaranteeing a loved one’s secure financial future.

Financial Planners can help families review their current expenses, assets and income, and make projections far into the future. If the adult child is living at home, they estimate housing costs after the parents die. These professionals may recommend that the parents invest in different portfolios, which would defray some inflation costs if they become ill, to preserve a nest egg for their child’s needs.

You can insist the parents to write a ‘letter of intent’- a road map for other siblings or trustees on how best to care for your disabled child. Ideally, the letter would describe every possible facet of your child’s life, including favorite foods, activities, the relatives and friends he should continue to see and his medical and therapy regimen. 

This is especially true after your parents die or become infirm. Your lawyer will probably set up a Trust’ (‘special needs’), which will protect beneficiary. When they die, they would leave sufficient money in the Trust instead of directly to your child. Instruct relatives or well wishers who wants to help to do the same. Unlike US and European countries, very few parents in India opt for this so called ‘trust’ arrangement. 

Here in India, majority parents forgo a trust, and leave the entire estate to their other children, expecting they will care for their sibling. Is it prudent to believe or trust the other children? Possibilities are that other children could run into financial trouble of their own or may be disinclined to help out. We suggest a scenario in which the other daughter who is providing for her sister could die and money will go into her estate for her husband and her children. This was exactly happened with one of our clients.

An essential part of the planning is to find a suitable housing for your sibling. We encourage parents to move their child out of their home before they start to decline. Moreover, It will be less traumatic for the person with disabilities. When a parent dies, the adult child will be in mourning. On top of that, they are losing their primary caregiver and their home. By finding a suitable housing early, parents can make sure the arrangement is working well and if not make necessary changes.

If this sounds familiar to you, you may be pleased to hear that there are people who can hold your hand through the cumbersome process, and who can help you keep up with all those arrangements, and transitions. In particular, if your loved one with disabilities lives any distance away, it will be imperative you find a trustworthy professional to help you dodge the pitfalls and potholes you may encounter.
With our help, Janet, a widow aged 64, set up a special needs trust for their son, Vinay, as well as zeroed in on a long term care facility. Vinay in his early thirties is quadriplegic due to a spinal injury, as result of bike accident. He’s on an intermittent catheter and needs 24- hour care. At one point of time Janet felt she was fighting a loosing battle because the other son who lives in Australia never came forward for her support. A frustrated Janet then sought professional help. ‘advantAGE told me about the urgency in the matter and I myself got convinced, and I had to find a place for him while I am still here’, says Janet. 

Monday, 4 February 2019

A Lone battle - Spousal caregivers struggle with ailing spouse

Roshan Jacob & Soumya Nair

Mrs. Arathi Mukharjee a 54- year old wife, had to wind up her carrier to care for her husband who is ailing with pseudo bulbar palsy, a crippling disorder in the highest order. Husband being diagnosed with this progressive, chronic clinical condition Mrs. Mukherjee had to dash into the role of a primary care giver. It was nothing but a bolt from the blue for the Mukherjee couple and had to shelve all their post retirement plans as they were caught unawares into a desperate situation so early in life. A shaken Arathi is not willing give in to any life challenges, is battle ready for a long tedious long term care role. She visited me to find the challenges in the new role as the spousal caregiver and to know more about the coping skills.

Caring for an elderly, ailing spouse is an unimaginably difficult task, especially when the caregivers are elderly themselves. Many studies have found to have established that wives fare worse, physically and emotionally, than husbands. Women tend to marry men older than themselves, and men generally have more health problems and shorter lives. So it’s typically the woman taking care of the man. In our social gerontology practice past 18 years, we have been able to follow hundreds of spousal pairs in which one cared for the other until he or she died, we have a fuller picture — and it’s not happy news for women.

Frequent hospital visits, difficult and oft-repeated diagnostic tests, complicated treatment procedures coupled with managing the distress is far more than just a task when managed single handedly. In the case of Mr. and Ms. Mukharjee, they are a childless couple and left with fewer filial support systems as their siblings are scattered around the world. Those distant families are not much of help due to the changed family ties and those who are close to them are equally old as they are and having to deal with their issues of health and family. Anjali had to deal with the managerial aspects associated with her husband’s illness as well as the emotional stress of seeing her husband decline day by day. 

The couples we studied weren’t very old: The women who were caregivers (as usual, a great majority of the group) were a touch past 70, on average, caring for husbands about the same age at death. The caregiving husbands were a little older – they averaged 75 and the wives they cared for, late sixties or early seventies. Cancer was the leading cause of death followed by stroke, dementia and arthritis.

Currently millions of people across the country provide free caregiving services for a chronically ill, disabled or aged spouse, family member or friend during any given year. There is a much higher likelihood of receiving care from a spouse than from an adult child because in majority of instances, children live separately. In reality, approximately one quarter or above (27percent, from our study of 800 sample) of caregivers who are currently caring for a spouse are themselves over the age of 65.

For majority of women, leaving the husband’s care to someone however professional was a bit uncomfortable. Like Arathi; she struggled with the ethical dilemma of not caring her husband enough when he needed most but delegating the responsibilities was causing internal conflict inside her. It only made Anjali’s problem bad to worse. She ended up as a full time carer to her husband and got situational house arrested. 

Many researchers have found that spousal caregivers may be likely to experience depression and anxiety at an even higher rate than those for whom they care. Such depression can be spurred by a wide variety of emotional struggles. Care recipients may no longer have the cognitive ability to relate to their spouse, or be physically incapable of engaging in traditional intimacy, leaving spousal caregivers feeling as though they have lost the husband or wife they once knew so well. Many times, caregivers may feel as though they’re adjusting to taking care of an entirely different person, especially with diagnoses like dementia, which can leave caregivers mourning the loss of their previous life with their husbands or wives. While caregivers may feel guilty for these emotions, they are completely normal. Although you may fear talking with others about the changes in your marriage, support groups of caregivers in similar situations may offer a chance to talk about your challenges with people in similar situations.

Caregiving spouses often begin to feel very isolated from friends (society) and feel tremendous guilt about their own unmet needs. Subsequently, they take on this “labor of love” and let their own positive health habits drop off to the side, putting their health at risk.  The combination of loss, prolonged stress, the physical demands of caregiving and the health vulnerabilities that simply come with age place an older spousal caregiver in a danger zone. Spousal caregivers especially need to know and recognize the symptoms of burnout and how best to cope. It is a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned. Burnout can occur when spousal caregivers don’t get the help they need or if they try to do more than they are able — either physically or financially. 
Here, I wanted to share my own personal story to prove a different aspect. Most of us assume that, when people have spent decades as husband and wife, they will take care of each other as they age. If one spouse should get a debilitating illness, wouldn't the other spouse be the natural caregiver? Mostly they are, but other times the ‘able’ spouse may be the least capable person when it comes to long-term care of an ill spouse. 
My mother was a wonderful, caring person. She used to be the default caregiver for her parents and for her mother-in-law in her younger days. When my dad was in his 70s, he had a severe stroke and bed-ridden for a quite long time. Mom had health issues of her own by then, including severe osteoarthritis. The fact that Dad needed intense rehabilitation and Mom was in no shape to take on this challenge, so I, as the adult child in town with my parents, became the person to make all of the arrangements. Spousal caregiving is not the answer. 
During the few months Dad was in the nursing home, she could, on some level, understand why he acted the way he did. However, his sometimes bizarre behaviour humiliated her. This was not the dignified man she married and spent her life with. She felt horrible for him that people would see him acting in a way that was, to her, undignified. She felt embarrassed for herself that people would see her husband in this light. Bed-ridden and helpless, her beloved husband of decades, was no longer the man she married; and Mom was worried and anxious about him started to go overboard trying to juggle between many roles on her own. I know she’s going through tough times and started to break down. 
I know many wonderful marriages where the spouse becomes a perfect caregiver.  But that’s the ideal situation. I have no statistics to give readers about how many spouses become good caregivers vs. how many do better turning the job over to a care agency or the adult children.  
Spouses are often not the best direct caregivers and this the point I want to highlight.  
I know it wasn't just Mom who had problems with this caregiving role many others also feel the same. I also know it had nothing to do with her love for him. She just couldn't be his daily, hands-on caregiver. The emotional pain was too great. I believe this happens more often with diseases such as dementia, which affect the brain, than with physical ailments. The main advice I have for people who run into this problem is to roll with it. And seek outside help. When you take action, both parents will probably be happier. 
I have seen many caregiving spouses knowingly or unknowingly resorting to neglect and abuse when the caregiving tasks are overwhelming. An ill elder is more likely to be abused by an elderly well spouse than by adult children or other caregivers. Sometimes that is because of a history of spousal abuse, but often it's not. Many a time it is out of desperation, the spousal caregiver neglect or abuse the ailing spouse. To pre-empt such untoward incidents like spousal abuse, better to hire in-home help for as long as that works. That relieves the ‘well’ spouse of some responsibility and this freedom can be a life saver, literally. Then, when that no longer works, move the parent or parents to assisted living or if needed, a nursing home. Adult children must try to understand your aged parent who can't be a primary caregiver to the ailing spouse in all the cases.
Women in our societies in India, are the traditional care givers from a tender age. When they are school going kids they guard their younger ones and then it goes on till their grand parenting and later spousal care. With nuclear families, and women in workforce, it is clearly an extremely difficult task to perform. Various factors we discussed earlier like age difference in marriages, longevity, gender difference in disease etc,. contribute to the expectations. But we can conclude that caring for an ailing or dying spouse takes a greater toll on wives, and they’re more at risk and this suggests that women are in greater need of support.

Hostility Between Aged Parents: A dilemma for adult Children
Roshan Jacob & Soumya Nair

Renjitha Reddy’s aged parents used to live harmoniously but now, in their 80s, they constantly bicker and snipe at each other. Renjitha is no more able to withstand this new development called “parental quarrelling” and she is fed up with being caught in the crossfire. 

Usually adult children come to me for care related counselling and this time Renjitha’s visit is very peculiar and she wants to find a solution for parental conflict.  An increasing number of adult children are finding themselves in similar positions because more people are living longer and becoming emotionally dependent on their adult children. Let’s listen to Renjitha’s woes, a spectre haunting her past few months. As a counsellor, I listened carefully to her without interrupting. 

“In my growing years, one of the worst things I could imagine was my parents – now in their eighties – separating. Now I think it's one of the best things they could have done. There are many authors to tell you how to handle a divorce as warring parents of a young child. But no help for such parents when those children have grown up. I'm in my late forties, but seeing my parents like this is only marginally easier than if I were still a child. To me, they're still my mum and dad.” Renjitha started her story.

My parents weren't like this. Occasionally, I saw them arguing, but It wasn’t bitter like this and they patch up within few hours. My mother used to complain about my father, but in any marriage it is a normal. Now she clearly has regrets and she speaks with the desperation of a woman looking back at a life she can not re-live. My father was different. Indeed, I have never heard my father complain about my mother but now he has started doing it too. If I am left alone in the room with one of them, the knives come out for the other and I am brought in as some sort of mediator/counsellor.

When they are alone, every exchange between them is an exercise in point scoring. What they don't realise, in this constant bickering, is how much it hurts me. Sometimes it gets uglier.  Separately, they have both admitted to me that they wish they'd never married. 

The dilemma is, if I sympathise with one is to naturally side against the other. My brothers, who stays abroad don't seem to get the same avalanche of complaints, although they understand the intensity of the bickering and the bitterness and it upsets them greatly. However, unlike me, they are not brought in because they live far away – to referee.

It is natural to seek guidance from friends and then I realize, among my friends there are three types: those whose parents, both or one, are no longer alive; those who aren't close to their parents so they don't really care if they get along or not; and those, like me, whose mum and dad no longer get on but the bickering has become part of the daily life. Everybody admit it's painful. "I try not to think about it," says one of my friend who also face the same situation. But she quipped, "Anyway, they'll be dead soon."

“Now-a-days, I hate visiting my parents because all they did was argue and complain. I used to come home exhausted because they expected me to settle their differences.” Renjitha poured out her frustration.

Elderly couples quarrel for a variety of reasons. Like in the case of Ranjitha’s parents, some who have got along well in the past, argue after a major change in their lives, such as the husband's retirement, because they may be new to this 24/7 ‘togetherness’ phase. There is all the possibility that once they are established in new routines these arguments may disappear. Again it depends on the cause; how deep rooted is the issue determines ‘healing’. Mostly couples argue over issues related to continuing problems such as finances or poor health. Still other couples argue out of habit or out of sheer monotony. 

It is very much natural that elderly parents often turn to their adult children for emotional support and help in solving their differences because they have few other support systems latch on. A robust social support system  no longer exists and most of their friends and other relatives may have moved away or died. Because of their infirmity reconnecting with the society is no longer an option.  The only solace for the aged parents at this juncture is to engage with the adult children. But conditions apply before you jump on the bandwagon. 

Essentially, your parents are ‘super’ adults having an adult problem in their relationship, and even if the drama is centered on you, it’s not actually your responsibility to arbitrate. And in all probability, as “the only sane adult in the situation” you will be  wade in to solve things, or for them to use you as a mediator, supporter, audience, or weapon. Better to stay away till it crosses the threshold level.
The sole area in which you may have responsibility is if one of your parents is abusing the other; and even then, you're not on your own to do something about it. Call support lines, family or friends and in extreme case the police who may be able to assist.

If you're going to deal with warring parents, it is better that you and your adult siblings are in this together, and having a conversation about how you're dealing with it, is a good plan. But the reality is that siblings often have different "roles" when it comes to the fighting parents at the centre of the family dynamic: the rebellious one, the mediating one, the ignoring one, the one who escalates, the one who smooths things over or pretends stuff is OK.

Five fingers are not the same. If someone backs out, that's their right. Don't let fighting parents try to pit you against one another, either. Always remember that it's their own making, not your or your siblings', and you are not metaphors or proxies for their deal. I understand your struggle If you're an only child, well, then, my sympathies that you're alone in dealing with this.

I always suggest the universal ‘wait and watch’ approach, before you partake in the ‘mediation’ process. Adult children have to ask themselves what is going on with their parents as individuals and as a couple. They have to spend some time observing their situation and examining their own feelings toward their parents so that they can come up with creative solutions. I strongly recommend that adult children should avoid the temptation to jump in and try to solve these problems because they will be taking the risk of alienating one or both parents. I mean, unknowingly you will be a victim to the ‘misplaced loyalty’ towards one parent.  

''I had always wanted to win my mother's affection, and one way to do this was to take her part against my father in their squabbles,'' Renjitha explained. ''My mother is much more aggressive than is my father, and one way she could stand up to him was by having me point out things to him that she really wanted to say.'' I quote Renjitha

Taking my cue, ‘How to handle the fighting parents’ Mrs. Renjitha and her parents got out of this unpleasant pattern by sitting down once a week and calmly discussing the parents' disagreements over household chores and finances. The mother tweaked to be more forthright about her feelings and the father to listen to the mother's views. They also learned to work out some compromises so that the mother did not feel overworked. ''The person who benefitted most from their new way of relating to each other was me,'' said Mrs. Renjitha. 

Tuesday, 26 June 2018

How Often You Visit Your Aged Parent ? SOUMYA NAIR

How Often You Visit Your Aged Parent ? 
                                                                                                 Soumya Nair                                 
Recently I and my colleague visited a Trust run old age home where they house underprivileged or may be not so privileged elderly women. In a large dormitory with beds adjacent to each other with an ample space to move around and highly ventilated well-kept with utmost cleanliness it is far fancier to be called as a charitable place. The first look may entice you with the fancy structure and facilities, however, the second look can be really heart wrenching. Each one curled up in their bed, there was a cold shivering silence in the dormitory. Sad faces facing one another but no interactions. My colleague Swetha hurried to a bed where a lady welcomed her with a sad, saggy face. The manager of the facility referred her as Lakshmamma (name changed) and surprisingly she is 90 years old. Without talking anything much Lakshmamma held Swetha by hand and seated close to her on the bed, the first thing she did was stretching her hands out to pick up a framed photo which must be ages old, in black and white, almost faded and hardly faces were recognizable, that was her husband and herself when they got married 73 years back. Handing out that photo she was curiously looking at Swetha for her reactions, somewhere she saw Lakshmamma was trying to hide her tears, she swallowed her heaviness and started talking about herself and her husband. Swetha told me, how desperate Lakshmamma was for interactions and to speak out  her stories which may means nothing to us but for her certainly it is. May be her great grand-children and grand-children has a lot to hear from their great grand mom who made it to a century. Unfortunately there was nothing of a thing called visitor to Lakshmamma and it was very evident in her desperation to speak and communicate.    

According to many social gerontology studies across the world, social isolation of the seniors has been associated with cognitive decline, decline in health, depression, increased rates of infection and ultimately even mortality. Communicating and visiting with the elders in our lives, be it a close relative or a neighbour can help ward off these detrimental effects. Periodic visits with your senior loved ones is not only rewarding, but it leads to a myriad of benefits.Spending quality time with the infirm elderly has huge benefits for their health, primarily keeping elders physically young and emotionally happy.

I can share my personal experience as a social gerontologist that many of people in residential senior care have no visitors 365 days of the year. It saddens me immensely …. particularly dementia patients, receive no visitors. I remember asking the son of a dementia patient, ‘Why you are not visiting your mother?’ The straight answer was shocking to me. “What is the point in visiting her, she cannot recognise me.” I retorted, ‘But you don’t have dementia”. 

For me, one of the most disturbing and growing trend I see in Indian ageing is the loneliness. When it comes to spend quality time with our elders, we have thousands excuses of time constraints. When you answer to your conscious: ‘Do I want to be abandoned in my later years? Is this what my elders deserve? Is this how I want to live out my old age? We must promote inclusion, and reach out to senior Indians. When I talk to my inmates in our care facility, I many who crave for a simple touch, a hug, or a soothing hand on their shoulder. We must extend our hearts and our hands in love and respect.

Despite the prevailing myth that caregiving ends with placement in a care facility, family members ideally continue their caregiving obligations after institutionalization through active involvement. But the reality is just the opposite. I recollect my friend Ms. Flipse an RD from the United States telling me how she visited her dad when he was admitted in a care facility. It sounds strange, she visited her dad in the early morning hours when daily routine chores are performed. She said, the first thing she checked was if his tooth brush was wet, which indicated her that her father was brushed for the day. Yes, it sounds immensely crazy but when you leave your loved in a professionally run care setting and not at your home it is important to get into the details of care in order to ensure your beloved parent is not hoodwinked of the right care. It is not only to make sure your parents are cheerful but also to ensure that they are extended the qualitative care. 
Some people just don’t visit because they want to avoid awkward moments. Others make brief, stiff visits. It’s important to find ways to overcome the reluctance because visits from family and friends give older adults the connection and support they need. Learn more about how to keep our senior loved ones feeling young and happy through these six benefits:

1. An opportunity to evaluate their health, safety and well-being.
The most important reason to visit loved ones is the chance to check up on their happiness and health, and make sure that nothing untoward is happening since the last time you saw them. If they suffer from chronic illness, how are they coping? Do they need extra help with care, chores, finances or medications? Do they just need a little encouragement to ensure healthy eating and physical activities? 

2. Visits can help you prevent elder abuse.
If your loved one lives alone and if they are having trouble caring for themselves a visit can clue you in to any signs of self-neglect—whether the issue is declining cognition, health or mobility. Find out the people who visit them as well as the finances. If they have home care assistance or live in a care facility, a visit is the perfect time to make sure their living situation is keeping them happy and healthy. Learn the signs of common health problems before hand as well as markers of abuse, so that you can detect any problems early.
3. Visits with family can help bring back positive memories.
Make sure each visits also serve as a time to reminisce about past happy get-togethers with family. Albums, conversation, home videos, music and photos can prompt nostalgia. These ‘memory prompts’ can be beneficial to those with dementia and memory loss. Try to avoid bringing up painful memories. But if they want to talk about something in their past, let them reminisce. Talking through it may help them put things in perspective or come to terms with what happened.

4. Be Mindful of the Length of the Visit and Number of Visitors

There is no standard “right” length of time for a visit with your older adult. It will depend on many factors like your relationship, their health condition and their energy level that day. During the visit, pay attention to signs that they’re getting tired or agitated. For some people, especially those with dementia, shorter visits may work better. Others may enjoy longer visits where you have more time to enjoy activities together. In general, it’s more meaningful and easier to handle visits from one or two people at a time. A dozen people visiting at once can be overwhelming for anyone.

5.Communicate Effectively and Respectfully

Effective and respectful communication is essential for any visit. Address and treat your older adult and other residents as adults, not children. Even if they’ve lost physical or mental abilities, they still deserve respect.
Hearing loss is very common among the seniors, so make sure they can hear you. Also, keep your faces at about the same level. Besides from being polite, many people rely on facial expressions or lip reading to understand the conversation. Overall, do your best to keep the conversation positive, and avoid arguing or upsetting them. This is especially important when visiting seniors with dementia. It’s also a good practice to make it clear that you’re glad to be there.

6. Show Affection Appropriately

As mentioned in the beginning, many elders no longer get the benefit of human touch. Show affection with hugs, holding hands or stroking their arm or back. Again it depends on person to person and your closeness which determines the physical intimacy. Pay close attention to their face and body language as you respectfully touch them to make sure they continue to be comfortable. Older adults can be sensitive and fragile, so err on the side of being extra gentle until you know what suits them.
7. Be grateful to those who care your loved ones 

You need to admire those care workers, nurses and doctors there, because they selflessly gave their time and put in the extra mile to ensure that the elderly are living comfortably there. They had to change their diapers and endure many unpleasant situations. Being in elderly healthcare sector is most challenging and difficult and we must thank them for their selfless service. 

A Few More Tips for Staying Connected to Loved Ones
When you live in a different city or country, it’s impossible to swing an in-person visit, no matter how much we might want to check on our loved ones and spend some time with them. There are other ways that we can, and should, remind our senior loved ones that we’re thinking of them, like through:
·       Cards
·       Emails
·       Letters
·       Photos
·       Phone
·       Skype

No matter where we live, we can simply pick up the phone, too — a simple phone call can do so much to bring in happiness. Long distance caregiving is a regular affair as many children live far away cities or even abroad. Also, thanks to modern technology, video chat programs like FaceTime and Skype can bridge the miles and enable us to see our loved ones face to face. So, there’s no excuse to not visit a senior loved one, in person or virtually, and the benefits are enormous. Visiting loved ones makes them happy, makes you happy, and is key to hold them in happy mood. Let them know you are there, even though they may not remember or know who you are. Everyone needs to feel loved; it the universal language.