1, 2. (a) What challenges do many families face, raising what questions? (b) How can parents and children meet the challenges of changing circumstances?

IT CAN be heart-wrenching to realize that your parents, once strong and self-sufficient, are no longer able to look after themselves. Perhaps Mom or Dad has fallen and broken a hip, has become disoriented and wandered off, or has been diagnosed with a serious medical condition. Then there is the other side of the coin. The elderly may find it hard to accept that physical changes or other circumstances now limit their independence. (Job 14:1) What can be done? How can they be looked after?

² One article on care for the elderly states: “While it is difficult to discuss the issues of aging, the family who has discussed the options and agreed on plans will be better able to handle whatever happens.” The value of such a discussion is best appreciated when we acknowledge that trials that come with age cannot be avoided. Still, we can make certain preparations and advance decisions. Let us consider how families may lovingly cooperate to plan to meet some of the challenges.

3. What may families have to do when elderly parents increasingly need assistance? (See opening image.)

³ The time comes when most elderly people are no longer able to care for themselves fully; they need some assistance. (Read Ecclesiastes 12:1-7.) When aged parents can no longer manage on their own, they and their adult children should determine the best kind of help and arrange for affordable solutions. It is usually wise to have a family meeting to discuss cooperation, needs, and strategies. All involved, especially the parents, should express their feelings openly and address the facts realistically. They might discuss whether with additional help the parents can safely remain in their own home. * Or they might consider how each relative’s strengths can be used to care for the responsibilities. (Prov. 24:6) For example, some may be in a position to give day-to-day care while others may be able to provide more financial assistance. All should realize that everyone has a role; however, that role may change as time goes on and some rotation of duties may have to be considered.

4. Where can family members turn to for help?

⁴ As you begin caregiving, take time to learn as much as you can about your parent’s condition. If he or she is confronted with a degenerative illness, learn what future developments you can expect. (Prov. 1:5) Contact government agencies that provide services for the elderly. Find out what community resources are available to make your task easier and the care better. The approaching change in family circumstances may cause you to experience unsettling emotions—feelings of loss, shock, or confusion. Share your thoughts with a trusted friend. Above all, pour out your heart to Jehovah. He can give you the peace of mind you need to deal with any situation.—Ps. 55:22; Prov. 24:10; Phil. 4:6, 7.

5. Why is it wise to collect information ahead of time about care options for the elderly?

⁵ Some older ones and their families wisely collect information ahead of time about care options—such as the practicality of a parent living with a son or a daughter, making use of assisted living facilities, or taking advantage of other possibilities available locally. They have seen potential “trouble and sorrow” from afar and prepare for them. (Ps. 90:10) All too many families do not make plans, and then they are forced to make difficult decisions hurriedly when a crisis occurs. This “is almost invariably the worst possible time to make such a decision,” observes one expert. In that rushed atmosphere, family members may be tense, and conflicts may arise. Long-term planning, on the other hand, makes future adjustments less traumatic.—Prov. 20:18.

6. How can parents as well as children benefit from a discussion about living arrangements for the elderly?

⁶ You may find it awkward to talk with your parents about their living arrangements and the possible need for change. Yet, many have said how useful those conversations proved to be later. Why? Because they offered opportunities to make practical plans in an atmosphere of closeness and understanding. They found that an exchange of views in advance, handled in a spirit of love and kindness, made the decisions much easier  when they had to be made. Even when seniors want to remain by themselves and in control of their own situation as long as possible, there are definite benefits to discussing with their children what kind of care they would prefer if the need arises.

7, 8. What topics would families do well to discuss, and why?

⁷ Parents, during such a discussion, inform your family about your wishes, financial abilities, and preferred options. That will put them in a position to make appropriate decisions if you at some point are not able to do so. Likely, they will want to honor your intentions and preserve your independence as much as possible. (Eph. 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 recognize that not all may see things as you do and that it takes time for anyone—whether parent or child—to adjust his thinking.

⁸ All should realize that problems may be avoided by planning and discussions. (Prov. 15:22) That includes discussions about medical care and preferences. The points addressed on the Health Care Proxy that Jehovah’s Witnesses use are definitely topics to be covered during these discussions. Each person has the right to be informed about, and to accept or refuse, treatments that may be offered. An advance medical directive states the person’s wishes in this regard. Appointing a health-care agent (where legally possible and accepted) can ensure that someone who is trusted will make the appropriate decisions if needed. Those involved will do well to have copies of relevant documents available in case they are needed. Some have included such copies with their will and other important documents about insurance, finance, contacts with government offices, and so on.

9, 10. What changes in an elderly person’s abilities may affect the help provided?

⁹ In many cases, parents and children opt to have the elderly maintain as much independence as their abilities and limitations allow. They may be able to cook, clean, manage medication, and communicate without problems. Thus they assure their children that they do not have to be overly involved in their daily life. As time passes, however, if parents become less mobile, perhaps unable to shop, or they begin to suffer from severe memory lapses, children may need to respond to such changes.

¹⁰ Confusion, depression, incontinence, and loss of hearing, sight, and memory may be a result of aging; yet, if some of such health problems appear,  they may well be effectively treated. At the onset of any such issues, seek medical attention. Children may need to take the initiative in this regard. At a certain point, they may also have to start taking the lead in what was previously the parent’s realm of personal activities. In order to optimize the care that parents receive, children may have to become their advocates, secretaries, chauffeurs, and so on.—Prov. 3:27.

11. What can be done to minimize the unsettling effects of change?

¹¹ If your parents’ problems cannot be resolved, changes may need to be made in their care or living arrangements. The smaller the changes, the easier the adjustment will likely be. In case you live some distance from your parents, might it be sufficient for a fellow Witness or a neighbor to drop by on a regular basis and then let one of the children know how the parents are doing? Do they require help only with cooking and cleaning? Would minor modifications in the home make it easier and safer for them to get around, bathe, and so on? Perhaps all that elderly ones need to maintain the measure of independence they prefer is the help of a home-care attendant. However, if they are not going to be safe on their own, more permanent assistance would be in order. Whatever the situation, investigate what services are available locally. *—Read Proverbs 21:5.

12, 13. How have adult children who live far away from their parents continued to honor and care for them?

¹² Loving children want their parents to be comfortable. Knowing that they are cared for gives the children a measure of peace of mind. Because of other obligations, however, many grown children do not live near their parents. In such cases, some have used vacations to visit and help care for their needs, doing chores that the parents are not now able to do. Regular phone calls—even daily if possible—letters, or e-mails reassure parents that they are loved.—Prov. 23:24, 25.

¹³ Whatever the situation, the form of day-to-day care provided for your parents needs to be evaluated. If you are not near them and your parents are Witnesses, you can speak with the elders in their congregation, asking for their recommendations. And do not fail to include the matter in your prayers. (Read Proverbs 11:14.) Even if your parents are not Witnesses, you want to “honor your father and your mother.” (Ex. 20:12; Prov. 23:22) To be sure, not all families will make the same decisions. Some arrange for an elderly parent to move in with them or closer to them. However, this is not always possible. Some parents prefer not to live with adult children and their families; they value their independence and do not want to be a burden. Some may have the resources—and may prefer—to pay for care while living in their own home.—Eccl. 7:12.

14. What problems may arise for primary caregivers?

¹⁴ In many families, much of the responsibility of caregiving seems to fall on one son or daughter, the one who lives closest to the parents. Yet, primary caregivers ought to balance their parents’ needs with the needs of their own families. There is a limit to each individual’s time and energy. And the caregiver’s situation might change, making it  necessary to review the current arrangements. Is one family member perhaps taking on too many responsibilities? Could the other children do more, such as by taking turns providing care?

15. How can caregiver burnout be prevented?

¹⁵ When an elderly parent is in constant need, there is a risk of caregiver burnout. (Eccl. 4:6) Loving children want to do what they can for their parents, but unremitting demands can become overwhelming. Caregivers who find themselves in this situation need to be realistic, possibly asking for help. Periodic help may be all that is required to prevent premature recourse to the services of a nursing home.

16, 17. What challenges may children face while caring for aging parents, and how can they cope? (See also the box “Appreciative Caregiving.”)

¹⁶ It is upsetting to see the painful effects of age on beloved parents. Many caregivers experience some sadness, anxiety, frustration, anger, guilt, even resentment. At times, an aged parent may say unkind things or show a lack of gratitude. If that happens, do not be quick to take offense. One mental-health expert says: “The best way to deal with any feeling, especially one with which you are uncomfortable, is to admit it to yourself. Avoid denying the feeling or judging yourself harshly for feeling the way you do.” Talk with your spouse, another family member, or a trusted friend about how you feel. Such conversations can help you put emotional reactions in perspective.

¹⁷ There may come a time when a family has neither the resources nor the expertise to continue caring for a loved one at home. Nursing care may be deemed necessary. One Christian sister visited her mother in a nursing home nearly every day. She says of her family: “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. Of what can caregivers rest assured?

¹⁸ The responsibilities of caring for your parents as they age can be complex and emotionally trying. There is no set of right solutions when it comes to providing senior care. Yet, with wise planning, thoughtful cooperation, good communication and, above all, heartfelt prayer, you can fulfill the responsibilities of honoring your loved ones. By doing so, you can have satisfaction in knowing that they are receiving the care and attention they need. (Read 1 Corinthians 13:4-8.) Most important, you can rest assured that you will experience the peace of mind with which Jehovah blesses those who honor their parents.—Phil. 4:7.