People are living longer.
Statistics from the World Health Organization confirm this. Within the growing population of elderly, many continue to enjoy active lifestyles. Yet, all of them are increasingly frail and need more care.
My father is 93. On weekends, he takes my son with him to go to a golf driving range to hit some balls. Two years ago, he won a club-sponsored golf tournament for seniors. The other players were in their 70s.
My neighbor’s father hit 100 recently, and held an art exhibit featuring his paintings, a hobby.
Healthy as they are for their ages, old folks need more care. In many Tsinoy minds, looking after one’s elderly parents is a given. We have benefited from their care growing up. Now it is payback time.
It sneaks up on you
It begins innocently enough: taking a parent to a dental check up, picking up the medication, or hiring household staff for them.
Then the number of tasks begin to grow. As their health declines, we spend more time – and money seeing to their needs: more trips to the doctor and drugstore, more time spent running their households for them and looking after more of their needs.
For those of us with children, we know looking after an elderly parent is nothing at all like raising a child. A toddler in distress and tears can be comforted on your lap with hugs. But how do you hold an upset elderly parent on your lap? You can put a dirty child in the bathtub and scrub him clean. But what to do when a parent refuses to shower?
One Tsinoy friend observes that when an ailing parent is angry and makes unreasonable demands, it is hard to draw the line, specially when the parent demands acquiescence by reminding you of filial piety (孝). Talk about emotional blackmail. No one else talks to you that way.
Boundaries? What boundaries?
Boundaries drawn in social and business lives may be harder to hold in relationships with parents. Their needs may necessitate that you change your own plans to accommodate them.
It is no longer unusual for friends – who shall remain unnamed for privacy’s sake – to miss a social luncheon, cancel appointments or to travel because of a sick parent.
To travel with a parent to seek medical help, a friend postpones prior commitments and make arrangements so her household will continue to function while she is away. Another recounted how, for the month she looked after a sick parent, her family lived on take-out meals.
An acquaintance, on short notice, travels to Pampanga to help a very sick uncle. While there, she arranges ambulance transport to bring him to Manila for hospital care. She also helps with the cost of treatment. All this takes a big bite out of her modest paycheck as a young professional with a family to support.
Another friend, whose ailing parents live in another country, shuttles back and forth between her parents’ home and Manila. She counts herself lucky that her children are grown, her husband understanding, and the housekeeper competent.
Yet, even with all the help we can hire living in the Philippines, the responsibility of elder care still rests ultimately with us.
Not the yaya
A caregiver is not just the yaya hired to be with Mama. Anyone is a caregiver when she accompanies Mama to the doctor, gives her a ride, runs her errands, helps with health and financial decisions, sees that she eats, bathes, takes her medication, or simply keeps her company.
Even when there is a yaya, supervision from an adult member of the family is needed. Consider that family member the primary caregiver.
I have not seen statistics on family members as caregivers in the Philippines, although I am willing to bet it is the norm.
In the United States, a 2012 survey said a third of Americans provide unpaid care to another adult with an illness or disability, according to the womenshealth website. Most of them are women, and three out of five also hold paying jobs outside the home.
I am willing to bet that primary caregivers in Tsinoy families are often the female members as well. It is often the daughter (or daughter-in-law) who takes the elderly parent to see the doctor, looks after a hospitalized parent, accompanies the ailing parent to physical therapy sessions or seek medical treatment.
My mother and her sisters looked after their parents, did the marketing, got medical help and hired the private nurses. My female cousins looked after an elderly spinster aunt. Now, my female friends and I are taking on similar responsibilities for the elderly in our families.
Occasionally, a son becomes the primary caregiver… more power to him! But my husband’s views seem to be the prevalent one: it’s the daughters who will look after you in old age.
Stress
The primary caregiver has to deal with anxiety over an ailing parent. If money is tight, the added expense – medication, trips to the doctor, eating out because there is no time to prepare meals at home – is a worry.
In addition, there are disruptions to your days’ plans and routines, because you are now on call any time, any day.Sometimes, a sick parent scolds or becomes difficult. One friend says she leaves the room because she does not want to talk back in anger and frustration to a cranky father suffering from dementia.
As well, the time commitment looking after the parent and his needs leaves less time for our own needs and family: the spouse and children.
It is just as stressful – or perhaps even more so – when the patient is not a parent, but a spouse. A friend says as her father sinks further into Alzheimer’s disease, he no longer recognizes his wife.
Sleepless nights, loss of appetite or bingeing on food to destress, feelings of helplessness or hopelessness, depression, are reportedly common among caregivers.
Signs of caregiver stress include feeling exhausted, sad, overwhelmed, constantly worried. One can feel physical aches and pains, get too much sleep or not enough, see unusual weight gain or loss, be irritable, lose interest in activities that used to be enjoyable, and become socially isolated. There is also a danger of turning to substance – alcohol or drugs – abuse.
Help yourself
When the going gets rough for you, look after your needs first. You must be well to help others.
• Take a realistic look at what you can do and how much time you have or can free up. No one should be expected to do everything solo. Also keep in mind you are in this for the long haul. Your commitment in time, energy – and often, patience ! – must be sustainable over time.
• Ask for help. Accept it when offered. Siblings and other family members can share tasks. If affordability is not an issue, hiring experienced yayas is a big help.
• Seek a support group, or organize one. All it takes is one friend. It helps to be with people in the same situation to compare notes with, or just to let off steam. It does wonders for morale when there is validation: your comments are met with understanding and sympathy. Sometimes, suggestions are insightful, problem-solving strategies may be offered, and may even work in your situation.
• Keep up your social connections. Make time to stay connected with friends and relatives who can provide non-judgmental emotional support. Chat on the phone, walk with a friend, have tea with a cousin.
• Make time for yourself. Read a bit before going to bed, or do 10 minutes of body stretching to get the kinks out. Play soothing music, do activities that are relaxing to you, be it tai chi, yoga, or meditation. If you are with your parents full time, then occasionally ask someone – a sibling, relative, family friend – to stay with them for a day so you can take a much-needed break.
• Get enough sleep. You need to be alert and well-rested to function effectively.
• Eat healthy, drink those eight glasses of water daily, and stay physically active. Do not forget your meals or to rehydrate, which can easily happen when busy or stressed. Good health is more important than ever to have the energy – and a clear mind – needed to deal with issues.
“Maintaining adequate sleep and nutrition are key to preventing caregiver burnout,” says the Harvard Health blog.
• Get your health checkup regularly and keep vaccines up to date.
• If you work outside the home, elder care may interfere with your doing your job. If so, talk to your human resources officer about an unpaid leave for an agreed period of time to let you set up a plan to manage elder care, be it hiring caregivers to do it, or finding an appropriate assisted living facility or day program for the elderly.
Someone’s gotta do it
No one says elder care is easy. Taking it on is a sign of concern and sense of responsibility.
Looking after your own well-being helps you meet the challenges more effectively, and meet them you will, simply because it has to be done.
Finally, the most important thing is to believe in yourself. Believe that you are doing your best to make the best decisions and take the best actions possible as situations arise.
No one can ask for more.
