Role reversal: if you have to care for your aging parents

ARNOLD is a successful lawyer and the only child of his widowed mother, Stella. She has been ``difficult'' her whole life, arguing with her husband and others. Now that Arnold has the responsibility of watching out for her welfare, he's overwhelmed. Although he loves his mother, the situation is beginning to wear on him - he's waking up in the middle of the night worrying. One day Arnold finds his mother is eating all the wrong foods. When he mentions it to her, she yells, ``Don't you tell me what to do!''

Arnold then hires a companion to prepare and monitor Stella's meals. After arguing with the companion constantly, Stella fires the woman. Arnold hires another one. Stella fires that one. And so it goes from there, with stress building between the two, breaking down the family harmony.

It's for people like Arnold that Bernard H. Shulman and Raeann Berman have written How to Survive Your Aging Parents - So You and They Can Enjoy Life (Surrey Books, Chicago, 178 pp. $10.95, paper).

This is a how-to book that provides valuable insight into both the struggles and joys of the relationship between middle-aged ``kids'' and their elderly parents. The authors have had many years of experience in social issues such as these. Dr. Shulman is a professor of psychiatry, while Ms. Berman writes about social problems and family relationships.

So how could Arnold have better handled the situation?

One choice suggested by the authors might be: ``Mom, with a little help you can still be independent, still be in charge of your life. So please allow me to do this for you. You took care of me and supported me when I needed you. Now it's my turn to help you out a little. So humor me, please!''

The book uses real-life stories such as this one to illustrate the various problems older people and their children, as care-givers, face. When the adult children begin to understand the reasons behind the elderly adult's behavior, they can learn to express the care and compassion the older generation may desperately need. Shulman and Berman show how to move beyond guilt and anxiety toward the loving cooperation that can and should strengthen our family ties.

There are 2 million Americans over the age of 85. By 2020 there will be 20 million. About 6 million of those needing care now live in their children's or someone else's home - as compared to the approximately 1.5 million cared for in nursing homes. The implications of the growing numbers of elderly adults is profound - especially for the middle-aged adults who may be responsible for their care. These care-givers - ranging in age from 40 to 69 (and most are women) - need guidance as they learn to communicate with and help their elderly relatives.

The problems of older people seem many and varied: They may not hold as meaningful a place in society as they used to. Their sexual, occupational, and social status may be eroding. They just may not seem to make a difference anymore. Their sense of usefulness may be gone.

Elderly adults sometimes attempt to compensate for these problems by behaving in ways that may confuse or anger their care-givers. One of the strong points the book makes is that we need to look beyond frustrating behavior to the reasons behind the behavior.

Here are some of the ideas that Shulman and Berman recommend to help the younger and older generations move toward better relationships:

-Don't deny the fact that older people are growing old. Most want to be accepted and respected as they are. They have changed. Don't necessarily expect them to be the same strong parents they always were.

-Free yourselves of needless guilt. ``While we can and should mourn our parents' losses, blaming ourselves for the fact that they are aging only weakens our ability to help and love them.''

-Listen closely to what they're saying. Don't just try to smooth things over. By focusing on the good, while at the same time expressing care and concern about any bad feelings they may have, we're not minimizing their problems. ``It's vital that we accept without reinforcing our parent's bad feelings.''

-Make them feel important. ``We fail to appreciate the accumulated wisdom, the graciousness acquired in an earlier, kinder time.''

-Reassure them with physical contact.

-Don't reinforce excessive dependence. Don't baby them.

-Look for signs that they are short of funds. They may not want to tell you. Most parents want to remain independent. They don't want to be a burden.

-Don't give much advice unless asked, but ask their advice. One of the true joys of old age is passing along accumulated wisdom!

-Use positive support rather than quick fixes. ``This strong need for encouragement, for positive, loving words that sustain and buoy us as we flounder in rough waters, doesn't leave as we age.''

-Don't try to win every disagreement. ``When we insist on the last word, we lose our parents' respect and rob them of some of their dignity.''

-Involve them in decisions, even seemingly small ones, thus letting them keep a sense of control over their own lives.

-Make the transition between their having complete power and giving over some of their power by seeing how you can work cooperatively. ``When we help them with the little details of life, it allows them to stay in control. That's the best gift we can give them.''