If my world were to cave in tomorrow, I would look back on all the pleasures, excitements and worthwhilenesses I have been lucky enough to have had. Not the sadness, not my miscarriages or my father leaving home, but the joy of everything else. It will have been enough. ― Audrey Hepburn, British actress and humanitarian (1929-1993)

Loving Your Parents when they can no longer love you by Dr. Terry D. Hargrave is a must read for every care giver.  Dr. Hargrave is professor of marital and family therapy at Fuller Seminary, Pasadena, California.  His professional interests include aging, and he is authored or co-authored 11 books.

In the book mentioned above, available on Amazon.com and other bookstore web sites, Dr. Hargrave has classified the ways in which older people tend to adapt or accept care giving into four types:  The “make lemonade” type, the “pretend it’s not happening” type, the “poor pitiful me” type and the “whatever” type.  In today’s column, emphasis is on the last two types.

The third type, “poor,pitiful me” is the opposite of the “pretend it’s not happening” person.  The poor, pitiful me person doesn’t resist care giving at all.  Instead, he wants the caregiver to envelope his whole life, and he soon becomes helpless to do anything at all. It is extremely challenging to provide appropriate care, say, for an elderly parent who sees their care as your full-time job.

The poor, pitiful me people are the most likely to use emotion and manipulation to make their caregivers behave as desired.  Dr. Hargrave writes that this manipulation is generally because the older person fears something.  He finds they feel anxious about their own competence, the idea of their own death, or the impending death of someone close to them.  The more anxious they become, the more they handle the anxiety by asking for help from others.

If you are the caregiver for a poor, pitiful me person, please pay attention to the vicious cycle explained in the book:  As a caregiver becomes annoyed or comes to the end of his or her rope, the older person then becomes anxious that the caregiver will leave them, which in turn can make the elder that much more anxious and manipulative.  It is an unending cycle of misery for all concerned.

When someone feels that anxious, it is most likely they’ve carried anxiety around all their lives. It might be helpful to discuss with them how they handled fears when they were younger, and see whether any of those behaviors could be adapted to today’s circumstances.  It’s also helpful to have a professional, such as a GCM (Geriatric Care Manager) assess the actual care giving needs of the person.  When that is done, the care giver needs to stick to those tasks alone.  You must, says Dr. Hargrave, do only the necessary care giving, or your older loved one will become dependent long before he or she should.

The last type of response, “whatever” is describing the individual who often accepts care giving with little problem, not because he or she is trying to adapt, but because he or she is passive.  It’s very important with this type of person to recognize and understand symptoms of depression.  Depression is sometimes called the “common cold” of mental health disorders simply because it strikes so many in the general population.  It is especially common among people aged sixty five and older—actually two times as common among older people than in the general population.  Twenty-five percent of all suicides committed in the United State occur among the elderly.  In the book we are recommending today, an entire chapter is devoted to the problem of depression and aging.

In giving care for a passive elderly recipient, it is sometimes helpful to assist them in looking back over their life.  An eighty year old man, for example, was a child in the Great Depression, may well have served in the armed forces during World War II, was married and raised children through the Cold War, and parented teens during the Vietnam War and the upheaval of the 1960s.  What a wealth of information and perspective.  Talking about such a life  is often extremely interesting for the listener, but most importantly, it helps the passive older person become more integrated in present day life.

The descriptions of four responses to care giving are not the only fascinating things in this book.  If you are a care giver, get this book as soon as you can. If you are not a care giver, but you know someone who is, the book will make a wonderfully appropriate and helpful gift.  Again, it’s called “Loving Your Parents When they Can No longer love you.”

If you are a care giver, don’t forget that you’re not the first person to travel this path.  Look for help and support all around you.  Helpful web sites include AgingCare.com, caregiving.com, caregiver.com, familycaregiving101.org and NFCACARES.org, the National Family Caregivers organization.  Additionally, caregiver support groups are available at the Bowie Senior Center.

Thank you for reading.  Stay well.  See you next week