Hosted by 4 Seasons Home Care in Atlanta, join Harrison and Ms. Joan as they delve into a thought-provoking conversation about aging, end-of-life decisions, and mental health. In this episode, they address a crucial question: should families encourage their aging loved ones to keep fighting or support their desire to wind down? They discuss the complexities of navigating an individual’s wishes, exploring factors such as depression, communication, and personal values. Discover valuable insights and learn how open and honest conversations can help families provide the support their loved ones need during this delicate phase of life. Gain practical tips and resources for addressing mental health concerns and facilitating important discussions. Tune in for a compassionate and informative episode on aging and the choices we make for ourselves and our families. Video and transcription below.
[ Harrison] Good morning, Ms. Joan.
[Joan] Good morning, Harrison.
Hey, so this question popped up recently in a conversation that I was having with a family member of, you know, a senior that we’re taking care of. And it, it got me thinking about a broader topic that I wanted to run past you. In this particular example, the client that we’re taking care of in an assisted living facility has really started to wind down their thinking towards aging and really wants to sort of ride off into the sunset and be done with the aging process.
What to do about a parent that’s “giving up”?
And essentially how, how the conversation came up is they were barring their children from coming to visit. And it, so it, it just kind of got me thinking about this whole concept of giving up and how that might relate to the family, specifically in the realm of whether or not the family should try to strike a balance between encouraging them to keep fighting and keep progressing and get better. Or if it’s okay at some level to say, you know what, mom, it’s, it’s okay that you want to, to wind down. So this is kind of an end of life conversation. And we don’t talk a lot about this because we want to try to keep our clients independent and healthy in their homes. But it does come to a point where the client and or patient may feel like, you know what, I’m just going to let. My disease, or I’m just going to let this situation play out rather than try to fight against it. So how has your thinking developed perhaps over the years on this subject? What do you think about some of these points?
[Ms. Joan] End of life things can be so complicated. It’s, it’s really who, let’s just say it’s a mother, but who has she been and what is her thought process about aging in general? We’ve talked in past meetings about the misconception of old age. If, you know, if I’m a, I’m a poor little old 85 year old lady, you know. If somebody has that, that image. That’s one thing. Then you have the other extreme, who, you know, despite that I’m 85 and I can’t do this, this, and this, and this, I’m going to do it anyway, you know.
Depression Among Seniors
So you have to kind of know where that person is. One thing that I always am concerned about is it is not unusual for an older person to become clinically depressed. So, if the mother has always been a fairly, self sufficient, realistic person and suddenly gives up, is she really depressed? And there are services that can really come in and do some counseling and just find out what’s really happening on an emotional or mental health isssue because depression is not uncommon. Another is just have, have the family really talked together about mama’s wishes and children’s wishes? I think I told you one time the story of a woman who was dying. And two daughters were on either side of her bed, one praying to God to please take Mama, the other praying to God to please not let Mama die.
Well, you know, a lot of times those dynamics are going on and Mama’s kind of in the middle. What has, does she have a living will? Has she told them what her wishes are? You know, most of the time, especially if you go into assisted living, they ask those questions up front, but sometimes if you’re going into someone’s home, you don’t know if they’ve ever had that discussion.
And so, do they want, if mom has a heart attack or a stroke, does she want to be resuscitated? Does she want to just die? You know, to have those open discussions about. What are her wishes? And then the family has to come to terms with what their wishes are. You know, there are some people that say, no matter what, I want mama resuscitated, whether she’s going to be a vegetable for the rest of her life or not. I want you to do everything for her. And some older people themselves will take that position. And others will say, don’t ever do this to me. Just let me die. You know, kind of thing. So it’s, it’s really looking at what’s really happening. Are there, is her lifestyle or her life, the forces that have caused her to not have the kind of life she would like to have?
Are those really serious things that are getting her down from what, where she’s been? Is she clinically depressed? Are there things that you can do to ease that? There are sometimes things that you can do to make life easier functionally if those are things that are bothering her. If she can’t…
If she’s always taken pride in her appearance, for example, and she no longer, she realizes when she looks in the mirror that she would never let herself go out looking like she does. So are there things that the family can work with you and your staff, for example, to say, you know, mama really, really wants to make sure she has lipstick on and that, you know, you do a little bit with her makeup and please don’t let her hair look like that.
You know, those are some things that sometimes can affect the, the feeling that an older person has about their self esteem. So looking, again, I almost always go back to this theme of communication. You know, what, what communication has occurred between, say, the mother and the daughter in this case?
Have they always communicated? Have they never communicated? And how can you facilitate communication at this place, honest communication? You know, what really is the disease that mama has, is she facing it, what is she doing about it, what are the long term implications, does she truly want to die, and if so why, does she feel like her life is just not worth anything anymore, and if that’s a normal kind of feeling, if there is such a thing as normal, or is she clinically depressed?
So, kind of really looking at the individual, looking at the communication between the mother and the daughter, where they can really sit down and the daughter can say, Mama, I love you and I really think that you could do this, this, and this and, you know, do you want to and if so, how can I help you? And if you don’t, then how can I help you with that?
What questions can kids ask their parents about a clinical evaluation?
[Harrison] Yeah. So, the idea of depression being a core element is, is very interesting. And I think in this situation that I’m describing, that might be a contributing factor. So what are some of the intelligent maybe questions that an adult child could ask to try to prompt their aging parent towards perhaps an evaluation, let’s say from somebody that could have the, the clinical depression conversation. What, what are some prompts and conversations that perhaps the adult child could bring up to maybe mine that out a bit more?
[Ms. Joan] How are you really feeling mom? You know, what, what are your thoughts about what’s going on with you? What are your, do you have any hopes for the future? You know, it’s people that are depressed, don’t see anything.
You know, if they don’t want to see their grandchildren, for example. That’s not a, unless they’ve always been that way. But, you know, if suddenly, those are symptoms. And if she’s in an assisted living or personal care home or something like that, can ask the staff, have you seen some changes in them? And they usually will have the names.
There are, there are a couple companies that I know of that have come in and during COVID, it was really bad because they couldn’t come in, but they are, they specialize in geriatric counseling, and they will actually come into someone’s home or wherever the home might be and do some short term counseling.
So is that something that mama’s willing to do and is that something that children are open to? So, ask, but asking mom just some honest questions, sitting down and say, and even say, you know, mom, I, I’m concerned. I don’t think you are…you seem depressed to me or you seem like you’re you’re losing your your zest for life. Are you feeling are you feeling like that?
And if she says yes, they would you be interested or willing to have us get someone who can help you kind of talk through this thing and maybe get to the other side.
[Harrison] Okay, that’s helpful. I think we’ll try to include some links to that as well Attached to this video. So I think that’s a great starting place and really an encouraging Some encouraging comments. So thanks so much, Ms. Joan.
[Ms. Joan] You’re welcome. Have a good week.