When Mom and Dad Grow Old
The prospect of talking to increasingly fragile parents about their future can be "one of the most difficult challenges children will ever face," says Clarissa Green, a Vancouver therapist. "People often tell me they don’t want to raise sensitive issues with their parents about bringing in caregivers or moving," she says. "They’ll say, ’I don’t want to see dad cry.’" But Green usually responds, "What’s wrong with that" children, she says, need to try to join their parents in grieving their decline, acknowledge their living arrangements may no longer work and, if necessary, help them say goodbye to their beloved home. "It’s sad. And it’s supposed to be. It’s about death itself."
There are almost four million men and women over age 65 in Canad

• a. Nearly two thirds of them manage to patch together enough support — from family, friends, private and government services — to live independently until virtually the day they die, according to Statistics Canada.
  Of the Canadian seniors who live to 85 and over, almost one in three end up being moved — sometimes kicking — to group living for the last years of their lives. Even in the best-case scenarios (可能出现的情况), such dislocations can bring sorrow. "Often the family feels guilty, and the senior feels abandoned," says Charmaine Spencer, a professor in the gerontology department of Simon Fraser University. Harassed with their own careers and children, children may push their parents too fast to make a major transition.
  Val MacDonald, executive director of theB.C. Seniors Services Society, cautions children against imposing their views on aging parents. "Many baby boomers can be quite patronizing (高人一等的)," she says. Like many who work with seniors, MacDonald suggests children devote many conversations over a long period of time to collaborating on their parents’ future, raising feelings, questions and options — gently, but frankly. However, many middle-aged s, according to the specialists, just muddle (应付) through with their aging parents.
  When the parents of Nancy Woods of Mulmur Hills, Ont., were in their mid-80s, they made the decision to downsize from their large family home to an apartment in Toronto. As Woods’ parents, George and Bemice, became frailer, she believed they knew she had their best interests at heart. They agreed to her suggestion to have Meals on Wheels start delivering lunches and dinners. However, years later, after a cr, Woods discovered her parents had taken to throwing out the prepared meals. Her dad had appreciated them, but Bernice had come to believe they were poisoned. "My father was so loyal," says Woods, "he had hid that my mother was overwhelmed by paranoia (偏执狂)." To her horror, Woods discovered her dad and mom were "living on crackers and oatmeal porridge" and were weakening from the impoverished diet. Her dad was also falling apart with the stress of providing for Bernice — a common problem when one spouse tries to do everything for an ailing partner. "The spouse who’s being cared for might be doing well at home," says Spencer, "but often the other spouse is burned out and ends up being hospitalized."
  Fortunately, outside help is often available to people struggling through the often-distressing process of helping their parents explore an important shift. Sons and daughters can bring in brochures or books on seniors issues, as well as introduce government health-care workers or staff at various agencies, to help raise issues and open up discussions, says Val MacDonald, whose nonprofit organization responds to thousands of calls a year from British Columbians desperate for information about how to weave through the dizzying array of seniors services and housing options. The long list of things to do, says MacDonald, includes assessing their ability to live independently; determining your comfort level with such things as bathing a parent; discussing with all household members whether it would be healthy for an elderly relative to move in; monitoring whether, out of pure duty, you’re over committing yourself to providing a level of care that could threaten your own well-being.
  The shock phone call that flung Nancy Woods and her parents into action came from her desperate dad. "I got this call from my father that he couldn’t cope anymore. My mother was setting fires in the apartment," she says. "He didn’t want to see it for what it was. Up to then he’d been in denial."
  Without knowing she was following the advice of experts who recommend using outside sources to stimulate frank discussion with parents, Woods grabbed a copy of The 36 Hour Day: A Family Guide to Caring for Persons With Alzheimer Disease, Related Dementing Illness, and Memory Loss in Later Life. She read sections of the book to her dad and asked him, "Who does that sound like" Her father replied, "It’s mother. It’s dementia (痴呆)." At that point, Woods said, her dad finally recognized their tragic plight (困境). She told her father she would help them move out of their apartment. "He nodded. He didn’t yell or roar. "
  Woods regrets that she "had not noticed small details signaling mom’s dementia." But she’s satisfied her dad accepted his passage into a group residence, where he and his wife could stay together in a secure unit where staff were trained to deal with patients with dementia. "From the moment they moved into the Toronto nursing home, their physical health improved. On the other hand, it was the beginning of the end in terms of their mental abilities. Perhaps they couldn’t get enough stimulation. Perhaps it was inevitable."
  After my father died in 2002, the grim reality of my mother’s sharply declining memory set in starkly. With her expanding dementia, room insisted on staying in her large North Shore house, even though she was confused about how to cook, organize her day or take care of herself. For the next three years we effectively imposed decisions on her, most of them involving bringing in caregivers, including family members. In 2005 mom finally agreed, although she barely knew what was happening, to move to a nearby nursing home, where, despite great confusion, she is happier.
  As Spencer says, the sense of dislocation that comes with an important passage can be "a very hard adjustment for a senior at the best of times. But it’s worse if it’s not planned out."

Val MacDonald’s organization helps children with their aging parent issues through ______.