Acceptance and Curiosity
Being curious about what's going on with your parent and accepting that they're doing their best will strengthen your relationship.
Many older people live for months or years in conditions that their children would probably argue are not ideal, largely because they are valuing their independence over their safety.
As the adult child of an aging parent, one of the hardest things you have to do is accept that your parent may make choices with which you disagree, and it’s still important to validate their feelings, operate from a place of love, and accept that they’re doing their best.
It took me a long time to learn that.
About six years before he died, my dad was hospitalized and a cardiologist diagnosed him with congestive heart failure.
Congestive heart failure isn’t something that just happens to you. It’s not like a heart attack. Your heart reaches a point where it isn’t pumping as well as it should and instead fills up with blood, gets backed up, and becomes, like traffic in a busy city, congested. Other organs then don’t get the blood they need, either, which can cause a host of other problems. With my dad, it caused his kidneys to fail, and he was diagnosed with stage 4 kidney disease. (There are five stages of kidney disease, and when you’re in stage 4 for a long time or reach stage 5, you likely need dialysis).
When your kidneys begin to fail, they retain water and sodium, and your body swells. When my dad entered the hospital and the nurses weighed him, the scale read 330 pounds. After a few days of a diuretic, a medication designed to get the body to release excess water, it read 250. Eighty pounds of water. Gone. He told me his sudden weight loss was an indicator of the quality of the hospital food.
My dad never seemed to fully grasp what was going wrong with his body. I think this is common. “This is just how it is when you get old,” he’d say.
Many conversations went like this:
Me: “How are you?”
Dad: “Not good.”
Me: “What’s wrong?”
Dad: “Well, I’m 75 years old, to start with.”
To an extremely unhelpful degree, he simply accepted that aging meant fatigue, sadness, and pain. I however, was determined to prove him wrong.
I bought a book about kidney disease that suggested a low-protein, low-sodium diet. With my partner at the time, I cooked him countless meals, packaged them in plastic containers, and delivered them to his fridge. We were careful to buy low-sodium chicken broth, low-sodium ketchup. I did all his grocery shopping and left many of his favorites on the shelf. I hid the salt away in the cabinet and put Mrs. Dash seasoning front and center. Life was barely worth living, he told me, if he couldn’t start his day with a salty fried egg.
Once he took over his own shopping and cooking, I struggled to hold back my judgment. “You can’t teach an old dog new tricks,” my friends told me. I wanted to shake sense into him. I thought if dietary changes would make you feel better—maybe even extend your life—how could you not make them? I’d become a vegetarian years earlier, and I’d taken up running, pilates, and yoga in the years that followed. I truly didn’t understand why he couldn’t make small changes to his food intake to save his own life.
Even now, I sometimes struggle with anger around this. If he had made these changes, would he still be here? Would he have gotten to know my children?
Give them your most generous interpretation
I read a parenting book recently that encouraged parents to find the most generous interpretation of their child’s actions. I think it’s helpful to apply the same concept to our parents, to interpret their actions generously. Maybe my dad didn’t do the dishes not because he was lazy, or because he was taking advantage of me, but because he truly did not believe he could stand at the sink for long enough, or because his depression told him he didn’t deserve to have a clean kitchen, or because his sadness made him feel it simply didn’t matter.
I think this “most generous interpretation” concept would’ve been especially helpful when dealing with my dad’s trash.
My dad lived in an apartment where you had to take the trash down the stairs to a dumpster in the trash room on the first floor. Eventually, he felt like he couldn’t safely take it down anymore, so he would drive it down in a shopping cart and ride with it on the elevator to the dumpster. After a while, that became too much, and he would bag it up by the door and wait for me to take it out. When I would stop by, there would be 2-3 bags sitting by the front door, depending on how long it had been since I was there last. After some time, he stopped even bringing it to the door. Bags of trash would sit in the kitchen. Then, he stopped being able to tie up the bags and lift them out of the can. When it got full, he would start filling the brown paper Instacart bags that he left lined up next to the trash can. If he missed, and a dirty paper plate landed on the floor near the bag, he wouldn’t bend over to pick it up. He would just leave it.
I got exasperated. I resented that my time with him wasn’t spent watching football, going out for dinner, or talking about my life and work. I resented that even when I was pregnant, and lived 25 minutes away, it was still up to me to get his trash to the dumpster. I wish I had known then about the concept of “most generous interpretation.” I would have been able to tell myself that he was doing his best, that all I could do was encourage him, that I was in charge only of my own reaction.
But if they would just do what I said
I think this sense of feeling like we know what the right decisions are—and that our parent would be better, feel better, if they just did what we said!—is common when you’re caring for someone.
But it’s a dangerous feeling.
You can’t actually know what your parent is capable of (physically, emotionally, mentally) and you can’t be sure that what you want them to do is possible. And if you make the suggestion and they don’t follow through, it can be for a variety of reasons—maybe they feel they physically can’t, maybe they actually can’t, maybe they don’t think it’s the right decision, maybe they forgot you made the suggestion at all, maybe anxiety or depression is clouding their ability to act, or maybe there are factors you aren’t considering.
I struggled coming to this conclusion. I knew my dad needed exercise, needed vitamin D, and needed to see other people. So I just knew the right decision was for him to walk down to the pool and see his friends who lived in the apartment complex. For a while, he did, but then the trip became too much. The walk became scary for him. It was hot out. What if he couldn’t handle the walk and passed out? What if it took him so long to get there that he had to pee halfway or needed to stop and take a break? Would it be embarrassing if he couldn’t make it? Even searching for his swim trunks and getting dressed could leave him winded—how was he supposed to walk to the pool and then swim in it?
I also knew my dad needed to go to dinner with his friends, but even that became impossible. He acknowledged that he shouldn’t drive, so he would need to ride along, but after chauffeuring folks for years in his big red Cadillac, having to ride with someone else felt infantilizing. I still felt disappointed each time I asked him if he’d gone out with his friends, and he told me that he hadn’t felt up to it, or that his friends had chosen a place that was too far, too expensive, Eventually, he stopped making excuses and stopped going all together. I, of course, thought he should keep going. Social contact is important for older adults, and I didn’t want to be his only source of it. But he didn’t continue to go, which meant he couldn’t have. I would just have to accept this decision.
Accepting that your parent did the best they could—given the myriad circumstances—is hard. But it is key.
Curiosity
A companion to acceptance is curiosity. I encourage you to approach your parent’s behavior with curiosity. Why is he ordering so much delivery food? Is it because he can’t stand to cook anymore? Because he has a hard time getting ingredients to cook? Because he’s afraid of using the stove and forgetting to turn it off? Because he’s depressed and needs a little mood boost from some fried chicken? Because he feels like what he eats or spends no longer matters? Because he craves the social contact, however brief, with the delivery person?
Your parent’s behaviors can tell you more about what they’re thinking or feeling, and this information can help you care for them more effectively and have that “most generous interpretation.” But you have to be curious; you have to be listening.
And it’s hard to listen when you’re focused on telling your parent what to do.
Conversations to have with your parent
“How are you doing? I heard that (friend/neighbor/parent of friend) was really struggling with her health and getting things done. It occurred to me that we haven’t talked much about things like that. How’s it going, being 70?”
“I’ve noticed that you sometimes… (something you’ve noticed, e.g.: get lost/stumble/forget appointments/pay bills late). Why do you feel like that’s happening more? What can we do to help?”
“I know that (thing you might observe, e.g.: forgetfulness/loss of coordination/fatigue) is common when you’re on certain medications or have certain diagnoses. Have you noticed any of that? Can we talk about how you’d like me to handle it if I notice those things?”
“You know I really want you to be happy and safe. What are the things that make you the happiest right now? What’s the hardest thing about being 70? How can I help?”
Things to do right now
Think of a mantra for yourself, something you can repeat when you start to feel resentful or start to blame your parent for their challenges. Maybe something like, “This is their best, and I can accept that.” Or “The only thing I can control is my reaction.” Or “It won’t help anyone for me to get angry.”
Consider asking your parent if they want your advice before you give it. If they seem to bristle at your advice, consider who they might listen to instead. A doctor? A close friend? Use their connection to that person to make the most important advice easier for them to accept.
When you encounter an annoying or problematic behavior, start with your most generous interpretation, and ask yourself questions about what could be causing it.
In Case You Missed It
I recently shared advice on how to know when you should step in and how to track your parent’s difficulties managing the activities of daily living. Hop over to that post for the list of questions you can ask to gauge your parent’s current abilities and to download the free tracker.
It sounds like you had a good and loving relationship with your dad before he started having health problems. I'm finding this is all 1000 times harder because I started with a lousy relationship with my mother. She has always been a difficult, secretive, and often mean person. I really struggle to approach her care in an open, patient, and nonjudgmental way, and then I feel like a terrible person when I fail at it. This is so hard.
It is so hard to watch your parent who used to be a "get up and go" person sit down and stay. You want to argue with it because it doesn't make any sense. They're supposed to be superheroes forever.