PARENTAL GUID­ANCE

Early com­mu­ni­ca­tion is key when plan­ning for the care of el­derly mums and dads

The Australian - - LIFE - CLARA PIRANI

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.”

LUKE MARSDEN

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

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