1, 2. (a) What difficult challenges and questions do many families face? (b) How can parents and children be prepared for changing circumstances?

IT CAN be very painful to realize that your parents, who used to be strong and independent, can no longer take care of themselves. You may hear that Mom or Dad has fallen and broken a hip, has become confused and wandered off, or has been diagnosed with a serious illness. On the other hand, it can also be painful for older ones to accept changes in their health or circumstances, especially when this limits their independence. (Job 14:1) What can we do to help? How can they be cared for?

² An article on care for the elderly said that even though it can be difficult to talk about the problems of aging, families who plan ahead will be better prepared to make the right choices when health-care decisions have to be made. We must realize that the problems of old age cannot be avoided. That is why it is so important to prepare as a family. How can families lovingly work together to make these difficult decisions?

3. What may families have to do when elderly parents begin to need more help? (See opening picture.)

³ The time comes when most parents are no longer able to take care of themselves and need help. (Read Ecclesiastes 12:1-7.) When this happens, elderly parents and their children should decide together what care would be best and what they can afford. It is wise to have a family meeting and discuss what kind of help is needed, how this help will be given, and how everyone can cooperate. All should do their best to be realistic and communicate openly. Can the parents continue living safely on their own? * (See footnote.) Talk about what each one can do so that parents receive the care they need. (Proverbs 24:6) Some may help by providing daily care, and others may be able to help by paying for health-care expenses. Everyone should know what his role is, but as time goes on, duties may change and family members may need to take turns caring for different responsibilities.

4. As circumstances change, where can family members find help?

⁴ As you begin caregiving, take time to learn as much as you can about your parent’s illness. If he or she has an illness that will continue to get worse, learn what you can expect to happen next. (Proverbs 1:5) Contact government offices in your area that provide services for the elderly. Find out what programs can help your parents to receive better care or can make your caregiving easier. As you think about  these difficult changes, you may begin to have some unpleasant feelings, such as deep sadness, shock, or confusion. At these times, you can share your thoughts with a friend you trust. Most important, pour out your heart to Jehovah. He can give you the peace you need to accept and work through any situation.—Psalm 55:22; Proverbs 24:10; Philippians 4:6, 7.

5. Why is it a good idea to learn about health-care options ahead of time?

⁵ It is a good idea for older ones and their families to learn about health-care options ahead of time. For example, they may find out whether it would be practical for a parent to live with a son or a daughter, live in a nursing home, or use other options available. In this way, families can prepare for the “trouble and sorrow” that happens with old age. (Psalm 90:10) Families who do not make plans may be forced to make decisions in a hurry when problems eventually come. This is almost always “the worst possible time to make such a decision,” says one expert. When decisions must be made quickly, family members may be under stress and may not agree on what should be done. However, when we plan ahead of time, it will be easier to adjust to changes.—Proverbs 20:18.

6. Why is it helpful to talk about where and how elderly parents will live as they get older?

⁶ It may seem hard to talk with your parents about making changes in their home or about the need to move some day. Yet, many have said that these conversations helped them later. Why? Because it is easier to talk about difficult matters, listen respectfully, and make practical plans before problems arise. In a relaxed setting where family members can openly share their preferences, they will feel closer to one another and will remember the love they share. Older ones may want to live on their own for as long as possible. When parents talk with their children about what kind of care they would prefer, this will greatly help everyone if decisions about care have to be made.

7, 8. What should families talk about, and why?

⁷ Parents, during such a discussion, tell your family what your wishes are, how much money you are able to spend, and what options you prefer. Then, if one day you are not able to make decisions for yourself, they can make the decisions that you would have made. They will probably want to honor your wishes and do everything they can so that you can remain  independent. (Ephesians 6:2-4) For example, do you expect one of your children to invite you to move in with his family? Or are you expecting something else? Be realistic and remember that other family members may have different ideas than you do. It takes time for all to adjust their thinking.

⁸ When we plan ahead and communicate well, we can avoid many problems. (Proverbs 15:22) Talk to your family about medical care and your preferences. The information on the Health Care Proxy that Jehovah’s Witnesses have should be used when having these conversations. Each person has the right to know about treatments that are available, and he has the right to accept or refuse treatment. An Advance Medical Directive document will show what a person’s wishes are. Choosing a health-care agent will allow someone you trust to make the appropriate decisions for you if needed. Older ones, caregivers, and health-care agents should have copies of the Health Care Proxy in case it is needed. Some older ones keep their Health Care Proxy with their will and other important documents about insurance, banking, contacts with government offices, and so on.

9, 10. When may parents need more help from their children?

⁹ Many times, all in the family want the elderly to maintain their independence. As long as parents are able to cook, clean, take medication, and communicate well, children may not need to control every part of their parents’ life. However, as time passes, if it becomes difficult for parents to walk, if they are unable to shop, or if they become unusually forgetful, children may need to make adjustments.

¹⁰ Older ones may become confused or depressed. They may start to lose their hearing, sight, or memory, or they may have difficulty using the toilet. If some of these problems appear, medical treatment may help. Visit a doctor as soon as such problems begin. Children may need to take the lead in scheduling visits to the doctor and in other more personal matters. To make sure that parents receive the best possible care, children may need to speak on their behalf, help with paperwork, drive them to appointments, and so on.—Proverbs 3:27.

11. What can be done to make it easier for parents to adjust to changes?

¹¹ If your parents have health problems that are permanent, you may have to make changes to their care or to the home where they live. The smaller the change, the easier it will probably be for them to adjust. If you live far from your parents, it might be enough for a Witness or a neighbor to visit regularly and let you know how your parents are doing. Do they need  help with only cooking and cleaning? Would small changes in the home make it easier and safer for them to move around, bathe, and so on? Maybe a home-care attendant is all that elderly ones need to live on their own. However, if they will not be safe on their own, more permanent assistance will be needed. Whatever the situation, find out what services are available in their area.—Read Proverbs 21:5. * (See footnote.)

12, 13. What have some adult children done to honor and care for their parents who live far away?

¹² We want our parents to be safe and comfortable because we love them. It gives us peace of mind knowing that our parents are cared for. However, many adult children do not live near their parents. Some of these children have used vacations to visit their parents to help care for them and to do chores that they are not able to do anymore. Children can show that they love their parents by making regular or daily phone calls, writing letters, or sending e-mails.—Proverbs 23:24, 25.

¹³ Even if your family live far apart, you will have to decide what daily care is needed for your parents. If you do not live near them and your parents are Witnesses, you can speak with the elders in their congregation and ask for advice. Above all, pray to Jehovah about your parents. (Read Proverbs 11:14.) Even if your parents are not Witnesses, you must “honor your father and your mother.” (Exodus 20:12; Proverbs 23:22) Of course, not all families will make the same decisions. Some decide to have an elderly parent move in with them or move closer to them. However, this is not always possible. Some parents may not want to live with adult children and their families. They may prefer to live on their own and do not want to be a burden to their children. Some may be able to afford home care and prefer that option.—Ecclesiastes 7:12.

14. What problems may arise for those who do most of the caregiving?

¹⁴ In many families, the son or daughter who lives closest to the parents seems to do most of the caregiving. However, caregivers should be balanced as they care for the needs of their parents and the needs of their own family. There is a limit to each person’s time and energy. And if the  caregiver’s situation changes, the family may have to review the current situation. Does one member of the family have too many responsibilities? Could the other children do more, maybe taking turns to provide care?

15. What can be done to prevent a caregiver from burning out?

¹⁵ When an elderly parent needs help all the time, there is a danger that the main caregiver will burn out. (Ecclesiastes 4:6) Loving children want to do all they can, but caring for their parents may become overwhelming. Caregivers who provide this constant care need to be realistic and may need to ask for help. Some assistance from time to time may make it possible to continue providing care without using a nursing home.

16, 17. While caring for aging parents, what feelings may children have? What will help them to understand their feelings and stay balanced? (See also the box  “Appreciative Caregiving.”)

¹⁶ It is upsetting to see the painful effects of age on our dear parents. Caregivers sometimes feel sad, anxious, frustrated, angry, guilty, or even resentful. At times, an older parent may say unkind things or be unthankful. If that happens to you, try not to become offended. One mental-health expert says that when we have upsetting feelings, we must first admit that we have them and then try not to feel bad about ourselves for having those feelings. Talk with your husband or wife, another family member, or a trusted friend about these feelings. Such conversations can help you to understand your feelings and stay balanced.

¹⁷ The time may come when it is no longer possible to continue giving a loved one the kind of care he needs at home. The family may decide that a loved one needs to receive care in a nursing home. One Christian sister visited her mother in a nursing home almost every day. She says: “We just could not provide the 24-hour-a-day care that Mommy needed. Accepting nursing-home care for her was not an easy decision to make. Emotionally, it was very, very hard. However, it was the best solution for her in the last months of her life, and she accepted that.”

18. What can caregivers be sure of?

¹⁸ The responsibilities of caring for your aging parents can be complicated and emotionally difficult. When caring for the elderly, there is no set of solutions that will work for everyone. Yet, if you plan carefully, cooperate with your family, communicate well and, most of all, pray to Jehovah, you can fulfill your responsibility to honor your loved ones. When you do this, you can be proud because you are giving them the care and attention they need. (Read 1 Corinthians 13:4-8.) Most important, you will have peace of mind and Jehovah’s blessing.—Philippians 4:7.