By JUDD MATSUNAGA, Esq.
Little children will often play house pretending to be the parent. That’s perfectly fine when they’re little. But adult children playing “parent” to their elderly parent, i.e., “role reversal,” is never right and doesn’t work. When our parents age, mutual respect and honor should remain (Source: www.sageminder.com, “Role Reversal with an Aging Parent,” Jan. 14, 2024).
Adult children caregivers must never forget that there is a major difference between caring for elderly parents and children. Children are just learning, and they will grow out of their dependency. On the other hand, elderly parents are suffering enormous losses, of which they are keenly aware. They are not going to learn, adapt or “grow out of it.” Instead, they will continue to decline and gradually lose their independence.
It’s difficult enough to step in, set boundaries and help someone we love manage their lives without making them feel incompetent and devalued. While there may be similarities between parenting and elder care, there are far more stark differences. Preserving an elder’s dignity, independence and sense of control as much as safely possible should be a priority for caregivers. (Source: www.agingcare.com, “How Role Reversal Skews Your Thoughts,” Carol Bradley Bursack)
“But Judd, what about ‘parentification,’ or elderly parent-child role-reversal?” Absolutely NOT! While relationships between parents and children clearly change over time, there is no such thing as a “reversal.” Unless specific powers of attorney, etc. are granted, we do not actually have any legal responsibility for our parents in the same way that parents have legal obligations to children. (Source: www.thekeningstonsierramadre, “Parentification,” Sept. 4, 2022)
In fact, the only person that can legally declare an aging parent cognitively incapable of caring for themselves is a judge. Doctors give their “opinions” of incapacity, i.e., inability to manage one’s affairs, but without a legal proceeding called a conservatorship (guardianship in most states), aging parents have the same legal rights, responsibilities, and privileges as any other American adult — quite unlike children.
Most of the time, adult children step in out of a desire to help. But an elderly parent will stay stronger if we allow him or her to do as much as they can for themselves. When they can’t do it – we can step in or we can ask or pay others to help. Caregivers should never do something for someone that he or she can and should be doing for themselves.
That doesn’t mean that things stay the same. Ideally, by adulthood, most of us “children” have grown up enough that we are on some kind of level playing field with our parents by our early 20s! This means that parents and children should ideally honor and respect each other in the same way they would their own peers. In a healthy parent/adult-child relationship, no one feels obligated to fulfill basic adult obligations for each other.
Aging, however, comes with some declines that make this mutual “peer” relationship difficult. The reality is, our parents may need us in ways that are very new to us. The key to handling these changes is acceptance and honesty on both sides and good communication. The adult child needs to be able to speak honestly and frankly about the concerns he or she has related to the parent’s health or situation.
The elderly parent also needs to accept new limitations as they come and be able to ask honestly and clearly for help when needed. Sometimes, the best thing to do is to assess the situation together or look for warning signs to determine if more help is needed, because sometimes, both parent and child do not notice the gradual changes taking place.
An adult child’s role, therefore, is not to “parent” the parent – but rather, to help the parent deal effectively with the changes that age brings. The parent’s role is not to become dependent, but rather to take full responsibility for himself or herself by acknowledging when help is needed and being able to ask for that help.
Of course, these things are easier said than done. And no amount of understanding will make it easier to maneuver this fine line between having a good relationship with someone who is declining and becoming “parental.” Obviously, when there are extreme mental limitations, it is very difficult to not become parental – but if your parent is functioning cognitively, there is not a real reason to take on a parenting role.
While everyone begins with the best intentions, the strains of role reversal can start to cause dysfunction in the relationship — and it may come from either party. An article from The Kensington, an assisted living and memory care residence in the San Gabriel Valley, identifies parent-child relationships as either “healthy” or “unhealthy.”
Some warning signs of unhealthy role reversal include the following:
● Feeling manipulated (aka “guilt trips”) — The adult child often tries to make the elderly parent feel guilty by saying things like “After all I have done for you…..” Or, the elderly parent attempts to manipulate or make the adult child feel guilty through statements like: “After everything I’ve done for you…”
● Judgment or criticism — Frequent critical or judgmental comments can have cumulative harmful effects. For example, the adult child makes judgmental or critical comments all the time to the elderly parent like “Why can’t you move faster?”
● Patronization — Even though you are both adults, there can be an impulse to belittle or talk down to the other person. For example, the adult child makes patronizing remarks like “Now let’s eat our food, dear….”
● Secrets — You limit information that your parent has every right to know about because you think he or she cannot handle it — like her diagnosis or her financial situation. Or, the adult caregiver makes decisions for their aging parent without consulting him or her first.
● Other role reversal red flags:
– Frequent feelings of guilt, not meeting the parent’s standards
– Feeling incapable of saying “no” to your parent
– Feeling judged or controlled by them
– Not meeting the adult responsibilities for your own children, life, or finances
You are in an “unhealthy” child role if: (1) You feel guilty if you are not doing what they want you to do; (2) You feel incapable of saying no to requests; (3) You feel controlled and judged; and (4) You are not taking responsibility for your own finances or other adult responsibilities, e.g., acting as wife for your husband.
It is important to remember that if you have not established a healthy peer or same adult-level relationship with your parent thus far, it will not get better as he or she ages. Consider what you need to do to fully separate as an adult and take full responsibility for your choices and your own life.
One area many adult children get stuck in is approval. If adult children are still making decisions related to your parents to garner their approval, they have not fully separated in a healthy way. We all want to be liked and approved of — but if you find yourself making certain types of decisions only because you cannot bear the disapproval of a parent, it is time to become more independent and take full responsibility for your own affairs.
All relationships change over time. The key is to acknowledge the changes and adapt. The best attitudes to have to help with this process are acceptance, honesty, and faith in one another. If you start to feel strain about how you are relating to an aging parent, it may be wise to talk with others about it. Your siblings may be a great resource as they may have similar concerns; but sometimes, a person outside of the family — like a friend or a counselor — can help sort out where your boundaries should be.
The following are some helpful tips for establishing a “healthy” role with an aging parent from the article from www.sageminder.com.
● Have honest and respectful conversations with one another
● Meet your own needs and say “no” in order to protect priorities you each have
● Have a deep respect and realistic trust in one another
● Avoid secrets and guilt trips
● Take good care of yourselves
● Ask for help from each other and from others
The last bullet point, i.e., asking for help, is worthy of a little elaboration. Remember that you don’t have to do it alone. Your parent may need more support and one-on-one care than you can provide. They may benefit from getting to interact with another friendly face. You may not be able to find time in your schedule to be with your parents as often as you’d like.
In all of these cases and more, your loved one could benefit from the help of a professional caregiver service. Professional caregivers can assist with many different aspects of caring for your elderly loved ones, from providing transportation services, to assisting with housekeeping and meal preparation, to helping with ADLs, like grooming or bathing.
If paying for professional caregiving is a problem, look into In-Home-Supportive-Services. IHSS is the only public program that I know of that will help pay for home care. In order to qualify for IHSS, you first have to qualify for Medi-Cal. But since Medi-Cal just eliminated the Asset Test, qualifying for Medi-Cal shouldn’t be too much of a problem.
Finally, don’t let the responsibilities of caregiving get in the way of you experiencing life together, as a family. Remember to go out, share meals, watch movies, talk about old times, and have a relationship with your elderly parent beyond providing care. Trust, love, and respect are often built on these mutual experiences.
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Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.