Why Elderly Parents Won’t Make Decisions
The Caring Generation® – Episode 129 March 16, 2022. On this episode, Why Elderly Parents Won’t, Can’t, or Delay Making Decisions caregiving expert Pamela D Wilson offers insights into why elderly parents struggle with aging and decision making. What can adult children caring for aging parents do to move situations forward? How might the actions of family caregivers contribute to delays in decision-making by aging parents?
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Do you ever wonder why elderly parents won’t make decisions? What can adult children caregivers do to smooth the way for planning and progress? How might the actions of family caregivers contribute to parents who delay decision-making? The answers might surprise you.
Aging & Decision-Making
Watch this month’s Livestream caregiver event. Pamela shares insights that can help family caregivers gain a better understanding of why decision-making becomes more complicated when age-related restrictions impact choices.
Watch More Helpful Videos on Pamela’s YouTube Page
Decision making at any age can be complex when you look at life-affecting choices:
- Where to live – city or state, rent or buy a home
- Who to date or marry
- Whether to have children—and how raising children might affect your life
- What to do for a job or a career – or changing a job or a career
- Decisions about education—going to vocational school or college
- How to save and plan for retirement
These are all major impact decisions that significantly affect our lives. When we are younger, we have more time to course-correct if we make mistakes. Plus, if we are healthy, we have a lot of mental and physical energy to devote to daily activities.
Aging Changes Perceptions About the Future
When a person is older, in their 60s and beyond, fewer years remain in life. In addition, poor health or physical issues can make decision-making more difficult because of limited options. The reasons elderly parents won’t make decisions can be physical and mental.
For example, older adults may find walking up or down steps more challenging, or may need wheelchair-accessible living arrangements. Let’s discuss how aging issues can result in decision-making challenges specifically in three areas:
- How poor health and physical abilities affect decision making
- Differences between decision making when young versus old
- How a lack of confidence affects aging and decision making
How Poor Health Negatively Affects Decision Making
The average person at age 60 may have a lot of physical health issues. Chronic diseases like heart disease, COPD or breathing problems, diabetes, and arthritis can make it more challenging to feel well.
We know that good health and a strong immune system are critically important to avoid or recover from COVID and other easily transmissible illnesses. Heart disease can result in circulatory issues that can translate to dementia—a term describing memory loss unrelated to a diagnosis of Alzheimer’s disease—in older adults.
A cognitive diagnosis like dementia or Alzheimer’s affects the ability to make good decisions. An individual will need a trusted person to make financial and medical decisions with this diagnosis.
If your parents are diagnosed with memory loss, or you suspect memory loss, seek a diagnosis so that you can prepare for the future. Delaying these discussions or being in situations where elderly parents won’t make decisions can make it difficult for loved ones to receive medical care and other support.
When parents have memory issues and no legal party is appointed to make decisions, a court procedure called guardianship or conservatorship may be necessary. Learn more about power of attorney, guardianship, or conservatorship here.
Exercise and Social Activity Are Protective Measures for Health
Research confirms that adults who exercise 45 to 60 minutes a day increase blood flow throughout their bodies and maintain brain and cognitive health. So daily physical activity is something to consider if you want to be physically able and mentally healthy when you are 60 and older.
There are 70-year-olds who appear to be in their fifties and 40-year-olds with severe health issues who appear to be twenty or thirty years older. Health, excellent or poor, affects the physical appearance of the body.
If you are young in age or have a youthful mindset, you might be future-oriented and enjoy setting goals. So, as a result, information seeking and investigating are enjoyable activities. You might also be outgoing, enjoy meeting new people, and be willing to learn from others.
The combination of being physically active and socially engaged impacts the ability to perform day-to-day activities. Rather than becoming physically isolated or homebound, individuals who invest in their health and remain socially connected are more likely to spend more time fulfilling their retirement dreams in their later years.
Differences in the Decision Making is a Process
When elderly parents won’t make decisions, the reason may be that they feel lost about what steps to take or what information to gather. While most people wake up, get dressed, and go to work with very little thought, making life-affecting decisions about who will care for us, where we want to live, and how to pay for care should be a more thoughtful process.
If you or elderly parents aren’t sure where to start, begin here:
- Identify the problem or issue
- Search for information and options
- Evaluate information
- Create next steps
- Implement the steps
- Review and evaluate the results
- Do I need to adjust or course-correct if the situation didn’t turn out the way I expected
By taking these steps, one by one, you may be able to identify more information that is needed or realize that what you thought was the problem to be solved may not be the problem at all. Devoting time to planning out decisions usually results in better decision making and results.
Elderly Parents May Prefer Fewer Options
When adult children research information and present it, they may realize that elderly parents find having too much information or too many choices to be confusing or overwhelming. As a result, elderly parents won’t make decisions.
Additionally, for some individuals, a negative prior experience may influence decision-making. Having a bad experience may eliminate choices to exclude previously unsatisfactory options.
For example, how many of you hear your parents say that they never want to live in a care community or a nursing home? This desire may relate to a parent visiting a nursing home 30 years earlier. A lot has changed in the design of new senior living communities over the past thirty years.
Life Examples of Decision-Making
Let me share an example of how I supported decision-making with my mother. If you follow my videos or visit my website, you may know that I was a young caregiver.
My mother smoked a pack of cigarettes a day for many years and had very severe heart disease. Finally, at the age of 60, she needed a quadruple bypass. Let me add a little context. Her bypass surgery was around 1985—40 years ago.
After the surgery, the doctor told her that she needed to lose weight. I observed her after the surgery, and it seemed she was stuck on the subject of how to lose weight.
It’s also very likely that the surgery was exhausting Heart bypass surgery is very invasive. Recovery takes time and physical effort through cardio rehab. If your parents delay decision-making, they may not have the physical energy or motivation to investigate options or may not know where to look.
So in the case of my mother, I took the initiative. I called 5 or 6 weight loss companies and requested they mail details about their programs. Within a week of receiving the packets of information, mom decided on the program she thought would work the best. As a result, she lost 20 lbs and stopped smoking.
So as an adult caregiver, this is an example of how you might take the initiative to help with aging and decision making if your parents or another family member seems stuck. First, ask permission to gather the information and then schedule a time to discuss.
A Lack of Confidence Impacts Decision-Making
How many of you have made a mistake? Then, the next time you had a decision to make, did you move full steam ahead, or did you remember the effects of the error?
When the stakes are high for a decision you are about to make do you take more time to make the decision or do you delay indefinitely? Fear of making a bad decision can result from a lack of confidence or feelings of uncertainty about the unknown.
Research by Emma Ward at the University of London confirms that when risks are high, and confidence is low older adults are less motivated to participate in any decision-making process. For this reason, some parents will stall and stall until some event happens and makes the decision for them.
I have had many clients who refused to take medications, exercise, go to a doctor’s appointment, or consider moving from home into an assisted living community while they were healthy. Even though making these decisions meant having more choices and living independently, my clients refused to make a decision.
Eventually, because these clients became sick or had an accident like a fall that resulted in leaving their home, they could not return due to an inability to care for themselves, and they had no choice but to live in a care community or a nursing home.
Rational vs. Irrational Thinking
When you think of it, the thought process of these older adults was rationally based on their life experience. They had no life experience or evidence to show them that not taking medications, exercising, or seeing the doctor to manage their health conditions was risky so they didn’t see the need to make any changes.
And they didn’t believe anyone who explained the importance of making these changes. So when looking at when elderly parents won’t make decisions, how is this different from the decision to not exercise or eat healthy? It’s no different.
Until a person has seen the effects or the risk of not doing something or is motivated to change, it’s unlikely one person can motivate another. Unfortunately, all caregivers face this aging and decision-making battle, whether caring for a spouse, aging parents, or someone else.
I don’t know a single person – myself included who hasn’t had to make a difficult decision at one point or another in life about a future unknown risk. Digging heads into the sand and hoping for the best isn’t a strategy. Being in denial or delaying important decisions can reduce the number of options or choices available.
Whether you are 20, 40, or 60, if you want to live independently when you are older, and if your parents wish to do the same, the only way to make this happen is by taking personal responsibility. Investigating changes related to aging to understand what is possible is a path forward to making the best decisions.
This means creating a plan for housing, meaning where you will live. Then saving and investing money to pay for care, managing health, and preparing for the legal aspects. Investigate what might be involved and then make the best decision knowing that you may need to consult a caregiving expert to confirm that you are on the right track.
Changes Will Happen
This uncomfortable or uncertain part of life specific to planning, aging, and decision-making is why so many people live in the past and reminisce about the good old days. Reasons elderly parents won’t make decisions is that they become comfortable in habits and routines as do many individuals.
How many of you have a goal you have wanted to achieve, but you’re still not there. Why is that?
When people think that tomorrow will be the same as today, and next week or month or year won’t be any different, there is no motivation to plan or act. Comfort is the enemy of progress.
Older adults prefer predictability, order, and structure. If you are a caregiver, you have probably noticed how a change in routine throws parents off schedule.
It’s almost as if we need a COVID or some world event to shake up our lives and make us realize that the circumstances of life can change instantly. Changes are inevitable with aging.
How to Get Elderly Parents to Make Decisions
If you are a family caregiver, it’s likely that something changed in the ability of your parents to take care of themselves. What was the change? A heart attack, hip fracture, car accident, or something else?
Based on this change, you may try to encourage your elderly parents to talk about aging and decision-making, and they may refuse. Parents may dig in their heels and refuse to talk or tell you to mind your own business.
If you are a son or daughter-in-law, you may be watching your husband or wife struggle with their elderly parents. Anything you say can be viewed as critical, so you may bite your tongue and say nothing.
Your in-laws may see you as the ill-intentioned son or daughter-in-law trying to put them away. Unfortunately, this is more common in families than you think. Elderly parents may want someone to blame for the changes they are experiencing and it’s easier to blame others than take personal responsibility.
Caring for aging parents can negatively affect marriages and all family relationships when there is a disagreement in the family with children, spouses, siblings, and grandchildren. Caregiving disagreements can divide families.
I have adult children tell me that their children struggle in school or have behavioral problems because they spend a lot of time caring for elderly parents. Other caregivers tell me they have health issues from the stress of being a caregiver. Being a caregiver, if not managed well, has many negative effects that extend beyond health and family relationships.
So what can you do when elderly parents won’t make decisions, and how do you do it?
Here are three suggestions:
- Remove the emotions and focus on the facts
- Define the problem
- Determine the help needed, why support is needed and what type of assistance will be beneficial
For example, minor tasks like occasionally picking up groceries or prescriptions are not a big deal. However, weekly visits that turn into daily visits that consume the caregivers’ time can be a significant burden
If you are a caregiver who is cooking meals, managing medications, going to doctor appointments, and helping with bathing – then these activities mean your parents can’t manage on their own. The health of your parents is not likely to improve.
Elderly parents will need more care. Are you prepared for these ongoing changes?
If you are spending more time and doing more things for your parents and less for your career, your spouse, your children your health, how is this all balancing out? It’s probably not.
Is the Caregiver the Reason Elderly Parents Won’t Make Decisions?
Who or what is delaying the decision-making? Is it the caregiver and the amount of assistance contributed?
Are your contributions to the care of elderly parents delaying decisions about in-home caregivers, moving to a care community, and other types of assistance, financial or legal planning?
Are other family members avoiding discussions about a parent’s need for care? Often, family caregivers who are in denial unintentionally cause problems with aging parent’s decision-making.
The more involved you are, the fewer decisions your parents have to make. So how do you blow the whistle and call a “time out?” Stop being so helpful.
Stop taking over your parents’ lives. While the tasks might seem easy today, a year or two or five from now, you’ll see that all the things you have done have created more work and time constraints for you.
Remember the earlier discussion about not seeing the problem with not taking medications, going to the doctor, or exercising? If you keep doing everything for your parents, that decision will eventually catch up with you one way or another.
I can share hundreds of caregiver stories even though you might not believe them – or maybe you would.
Actions to Move Decision-Making Forward
If you have come this far and are wondering what to do next, give these three suggestions a try:
- Bring up the subject of a family meeting to discuss your parent’s needs and present alternative solutions.
- Set ground rules, no complaining, no blaming, only presenting facts and solutions
- Agree upon solutions and who in the family will be responsible for making them happen
If, on the other hand, you have taken these actions and your parents still refuse, then stop helping and let your parents try to do for themselves all that you are doing. After all, you may have created this problem by being too helpful.
Until your parents experience not having assistance, they won’t appreciate all you do. While it may be difficult for aging parents to acknowledge that what they can do for themselves is less than they think – this realization can support realistic family conversations about care needs and the importance of having a family discussion.
If you are still young, healthy, and able, look objectively at your parent’s situation. This knowledge may help you realize the importance of doing everything in your power today to make sure you have unlimited choices when you are older.
Interested in Answers to Other Commonly Asked Questions by Family Caregivers?
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