Caregiving is a relentlessly shifting landscape, predictable only in its unpredictability. Each change requires new research and new decisions. Caregiving is rife with decisions, and at times, some might have the potential for sadness or disagreements.

You may be in a position of being required to make decisions for your loved ones, but the smoothest path may be to help your elders make their own choices. They are vulnerable, losing their sense of being in control of their lives, facing an uncertain future; at our best we, as caregivers, can try to guide and respect their choices.

Your parents or loved ones may not see the future as you do. Most of them did not grow up in a world with self-determined choices. Their lives were scripted: they served in the military, got jobs, married, and had kids. They do not function in a future of possibilities, of “what ifs.” When they start to fail they may only have desperate thoughts of nursing homes reeking of urine and disinfectants.

In my book, While They’re Still Here, I discuss my personal experiences with caring for my aging parents. Becoming their fulltime caregiver was not easy, and there were some bumps along the way, but I was able to find my way and help my parents in a way that worked successfully for all of us. Here are some tips for gentle decision-making when you know the house is on fire and your parents say they don’t mind a little smoke.

Decision making based on the teachings of our childhoods:

1. Respect your elders. Keep your mouth shut and your ears open. When decisions must be made, first listen. Then listen some more. Chat. That’s what you’ll miss the most “later.” Act as an advocate not as the decision-maker. Be as respectful as you would be of your best friend’s parent. I couldn’t begin to fix my parents’ problems until they could explain them, and they couldn’t explain them until they felt their opinions and ideas would be valued by me. Maybe I knew I was actually nodding in disbelief, but at least they felt heard and thought I was agreeing. I hoped by the next day I could come up with a reasonable, logical proposal rather than the blunt retorts running through my brain right then.

2. Patience is a virtue. Haste makes waste. Proceed as slowly as circumstances allow. Present an idea and let it soak. I often reminded myself that it took my parents eighty years to create their problems, and I wasn’t going to solve them overnight. If you’ve walked a lifetime on a rocky road together, maybe all you can do today is help take some gravel out of their shoes. But it will matter tomorrow when their feet aren’t so sore.

3. Because I said so. Time has changed their memories. Let them tell their stories the way they want to be remembered. Let them be the people they wish they’d been. Find the pearl in the bad memory. If in the worst year of your life, the only highlight was Uncle Henry’s goat eating all the laundry off the line, laugh it up. Uncle Henry bought you all new clothes; then your dad got the goat to eat the threadbare old couch . . .Let go of the past and start decision making from where they are now.

4. It’s about time you grow up. Be the grown up, even if you have to leave the room and scream in a pillow. Your roles have reversed. Be the parent everyone wished they’d had. Maybe yours weren’t the best parents way back when, but be your best now. Let time heal.

5. If you don’t have something nice to say, don’t say anything at all. Avoid potential regret. Frame every thought with as much kindness as you can muster. You can’t ever take back harsh words. If you are always doing the best you can, then later you can trust that you did the best you could. This promotes sound sleep “later.”(Do not expect to sleep well while caregiving.)

6. Hold your horses. Approach decisions as if no decision is imminent. Try not to give opinions. “Do you think you’ll still want to stay here someday when you don’t want to drive anymore?” Put it in the future, empower with “don’t want to drive,” not “can’t drive.” Try to be vague. While you’ve been up all night on your computer trying to find solutions, they’ve only been frozen in fear. You could continue the conversation with, “I kinda think I’d want to be somewhere that they had transportation, like where Aunt Hilda lives.” Then make a sandwich or open the mail; just be normal. Let your elder start to think about it. In an hour or a day or a week, they may say, “Can I afford to live somewhere else?” Be their helper, not their overseer. Just casually respond, “I’m not sure. But we can check it out just so you’ll know if it’s an option.” Your adrenaline may be shooting through you while your brain makes a to-do list, but act as if it’s a dinner choice. Italian or Thai? Anything else will build pressure.

7. We’ll cross that bridge when we come to it .Try to understand the priorities from your loved one’s frame of reference. What can they no longer do right now—Pay bills? Grocery shop? Clean the house? Get to the doctor? What are they grieving right now? Stand in your parent’s shoes and guide decisions from their perspective. There is no way to plan for the unknown anyhow, so you may as well just deal with what is in front of you.

8. Let nature take its course. You can’t stop this train called aging or prevent it from derailing no matter how hard you try. But with compassion and kindness as your engineer, you may be able to enjoy the scenery as you take this last ride with your elder. Just remember, they’ll be deciding the route, not you.

Aging and elder care can be intimidating for elders and caregivers alike. However, it can be peaceful if you keep in mind your elder’s fears, concerns and needs, and help them take as active a role as they are capable of taking in their care. By following the tips above, you can help ease your elders’ worries, foster positive conversations on their needs and care, and reduce some of your own stress and tension as their caregiver.


Patricia WilliamsPatricia Williams grew up in Elyria, Ohio surrounded by relatives and friends, then spent a few unforgettable years in Cumberland, Maryland. She is now retired from a long and satisfying career as a dental hygienist and lives in Olympia, Washington, where she has enjoyed gardening, crafting, tracing genealogy, reading, caring for pets, and entertaining visitors on the same parcel of paradise since 1977. She lives with her spouse, Katy Murray. Her new memoir, While They’re Still Here, releases in November 2017. Learn more about Williams at www.patriciawilliamsbook.com.

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