Early communication is key when planning for the care of elderly mums and dads
As police frantically searched for his mother, Philip Verdouw and his distraught father could no longer deny that they needed help.
Despite her husband’s best efforts, Nel, who suffered from dementia, had wandered off. For several fraught hours Verdouw, friends, family and the police searched for the 83-year-old, fearing the worst.
“Whenever she disappeared she liked to head for water and we were terrified she’d gone to the creek. It was very scary,” Verdouw told The Australian.
By the time the police found Nel she was frightened, frustrated by her confusion and angry at all the fuss. She was admitted to hospital and doctors refused to discharge her until a formal at-home care regimen was established — a decision Verdouw welcomed.
One of seven brothers, Verdouw had tried for some time to convince his father and siblings that they needed professional carers to look after Nel.
Verdouw’s parents lived in Petrie, north of Brisbane, and he lived 45 minutes away in Ashgrove. He and his nearby brother Dave juggled their parents’ care, but work commitments prevented both brothers from providing daily assistance to their elderly parents.
“All my other brothers lived all around the country and overseas,” Verdouw says.
“I’m the middle child so maybe I had middle child syndrome, always trying to work things out. But it was a very hard and emotional thing, trying to look out for them but also knowing Dad was getting frail and Mum was trying to deal with something that was one day going to kill her.
“Dad did not tell us about the dementia until I started question- ing him about Mum’s actions. We think she had it for at least two years before Dad told us.
“We’d tell my brothers that we needed to get some help for Mum but they didn’t think it was needed. It was hard for them to understand what was going on because they weren’t living here and seeing it first- hand.”
Verdouw believes it’s typical of parents who are desperate to retain their independence to hide their struggles from their families.
“My dad didn’t want to admit that he needed help. He was proud and thought he could do it all on his own.
“And when my brothers visited a few times a year Mum was excited to see them so she was at her best. They’d say to me, ‘She’s fine, what are you talking about?’.”
Verdouw says the hospital’s refusal to discharge Nel forced his family to accept they needed professional support, to his relief.
“I had been trying to help out when I could but it wasn’t enough. You feel very alone when you’re trying to tell your family what’s going on and they’re not seeing it because they’re not there.”
After Nel’s admission to hospital Verdouw and his brothers organised a carer to visit their parents four hours a week to assist with household chores, provide companionship for Nel and respite for her husband, Cees.
“They would help with cooking, cleaning, and run errands. They (would) take Mum out for coffee or for a drive to give Dad a break. They were able to explain how dementia progressed, which made everything clear to us so we understood Mum’s reactions.” Caring for ill or ageing parents can create tension between even the closest siblings. Carers Australia estimates there are almost three million unpaid carers in Australia and most primary carers are family members. More than two-thirds are female and 55 per cent of primary carers provide care for at least 20 hours a week. Founder of in-home care group Home Instead Senior Care Martin Warner says it’s not uncommon that one sibling will bear the brunt of caring for ageing parents. “We were seeing instances where one sibling might be overworked and underappreciated,” he says. “They’re doing all the work and the other siblings are taking it easy, so to speak. “The starting point is to have a conversation. That isn’t always easy because siblings may not always have got on together, but they need to start looking through that.” Warner says he has encountered instances where an elderly parent requires crisis care but their offspring refuse even to talk to one another. “That’s the worst situation and it’s not typical but it does happen,” he says.
Prompted by stories of siblings falling out over the care their parents received, the company developed a guide called “The 50-50 rule”, designed to help families navigate through their internal feuds, especially during times of heightened emotional distress.
“We talk about scheduled meetings or telephone calls to have the necessary discussions, putting those issues aside and agreeing on who’s going to do what at particular times,” Warner says.
“Otherwise one person will get overloaded and it’s a very stressful situation.”
He says the role of primary carer usually falls to the eldest daughter, an untenable situation as the number of elderly Australians who require care soars.
“It’s typically the eldest daughter and that person would normally have their own family who they’re looking after while also holding down a job,’’ he says.
“Currently 14 per cent of Australians are aged above 65 but by 2050 that number will increase to 25 per cent. This isn’t a problem that’s going away.”
Warner recommends feuding siblings set up a formalised routine, allocating specific tasks at certain times to reduce the likelihood of arguments.
Whenever possible, he recommends children speak to their elderly parents while they are still well and independent and develop a plan for their future care, before there’s a crisis.
“Often there’s been an incident with a parent and they have gone to hospital and they won’t be discharged until there’s a care plan in place,’’ he says.
“We’re encountering situations where there was already dysfunction, where the family itself was encountering the need for care at a time of crisis.
“But in circumstances where there has been a conversation before the crisis occurs it’s much better. Ideally, the entire family will have made a clear decision, with mum and dad, about what they need, if they’re going to stay at home and how they’re all going to manage that.”
Verdouw’s mother Nel died in January. Her last two years were spent in a nursing home, where her husband of more than 60 years visited her twice a day.
“She was such a brave woman and we had a beautiful celebration of her life,’’ Verdouw says.
“But I’m so pleased we all talked about how to look after Mum and got outside help when we did.
“When I was really struggling and really at my lowest I could call the carers and they were wonderful,” he adds.
“It just gives you such a sense of relief and makes it less stressful when you know there’s someone you can call on.”
Philip Verdouw had to unite his far-flung siblings to make a care plan for their elderly parents after a hospital refused to discharge their mother, who had dementia