• Thanksgiving is, for many of us, the beginning of a string of holidays. Sometime between now and the New Year, many adult children will make an attempt to visit with their aging parents.


    Adult children carry with them memoires of holidays past. The sights and smells of the familiar home with Mom and Dad there to present a warm family gathering. So, when we go back to visit, even if we consciously know our parents are aging, we subconsciously expect things to stay the same. This expectation can really throw us when we are presented with reality.


    CNN.com ran an article addressing this issue titled, "What to do when mom or dad doesn't recognize you." The article is specifically about Alzheimer's, which can present some of the most dramatic changes, but I believe the issue spans all degenerative issues with aging parents.

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    The CNN article has some good tips to help people who aren't used to being around an elder with Alzheimer's disease, such as slow down and simplify your speaking, don't yell (they aren't forgetting because they didn't hear you), and watch your body language.


    Body language is something I often remind people to watch. Even when people don't seem to understand a thing you are saying, if you are acting impatient or frustrated by their behavior, they will know it. That only makes them more agitated and anxious and the cycle continues to worsen. So, yes, remember the body language.


    I would add that if you know the parent has Alzheimer's you should go online or call your local Alzheimer's group for information. Read up on things such as distracting them from something they keep repeating, and validating their observations, which are as real to them as yours are to you. Constantly correcting someone, especially in the more advanced stages, only causes anger and humiliation. If you are prepared with tools to handle the issues you'll face, you'll have an easier time adjusting to the changes.


    An aspect of going home for the holidays that wasn't addressed in this CNN article is what I call the miracle transformation. Often, there is one sibling near the parent who has been the primary caregiver. I was that person in our family. I would watch the decline of our parents and worry about how this shock would affect my brother, when he made his yearly visit.


    So, I would prepare him, via phone conversations and emails. I'd tell him, "You have to expect that they (our parents) are thinner and paler. Remember that they may not be able to carry on much of a conversation. In other words, they may seem shockingly worse to you."


    I'd also actively prepare our parents for the impending visit of their son, creating excitement and giving them something to look forward to. They'd ask every day, "When is David coming?" I'd tell them when he and his wife would arrive. We'd make plans for the time they were here.


    Yet I'd worry about what my brother would see. He knew I was taking good care of our parents so I didn't have the problem some people face with siblings, which is blame for the parents' seemingly unexplained decline. When an adult child only sees a parent every few months or once a year, no matter what you do, they may not be ready for the shock of decline. I didn't worry about blame, but I did worry that my  brother didn't fully understand the frailty he would encounter.


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    The day would arrive. Dave would walk in and Mom would be sitting in her lift chair, with makeup on and a huge smile on her face. She and Dad would have more energy than I'd seen for months. Even in his demented state, Dad understood it was David. The visitor was his son. Dad was so thrilled he glowed.


    I felt I looked, to my brother and his wife, like Chicken Little screaming about the sky falling. Basically, my parents' instant regeneration made me look, at best like a complainer and an exaggerator.


    However - and this is very, very common - as soon as my brother would leave, my parents would crash. They'd been so pumped up to see him that they made a nearly super human recovery. Then he'd go home, and bam! They'd be worn out. They'd be depressed. In other words, they'd be back to where they'd been before all of the excitement. 


    The last year of  my parents' lives (they died five months apart) is one I'll never forget for many reasons. However, one of my saddest chores was having to be honest with Mom about the fact that she'd forgotten Dave's visit as soon as he was out the door.

    She had been so excited to see him, and when he came, the time went fast. The day after he left, Mom asked me, "When is David coming?" There was no memory of his real visit. And this, my friends, was not a situation where distraction or validation would work. There was nothing to do but tell her the painful truth. Her son had come and gone and she had no memory of it.


    So, the pain of the holiday visit to aging parents, especially those with dementia of any type, goes both ways. The adult children who are visiting need to prepare for changes in their elders, physically and mentally. They need to get some education and they need to communicate with the primary caregiver.


    The pain of the primary caregiver and the aging parent may come after the visit when the sad reality of a forgotten last visit must be explained. These issues can make for some tough times during the holidays.


    All we can do is our best. Expectations need to be thrown to the wind, because every holiday from now on will be different. Tuck away your childhood memories. You don't want to lose them, as they should remain precious to you. But don't expect a re-run anymore. The elders are changing, and you, the caregiver, will have to go with the flow.


    For more information about Carol go to www.mindingourelders.com or www.mindingoureldersblogs.com

Published On: November 26, 2008