WHAT TO DO ABOUT STUBBORNLY INDEPENDENT ELDERLY PARENTS
For Tony Gask, 92, a retired typographer, living independently in his suburban London home is essential to his health and happiness. “Our house is our identity. If we couldn’t continue living here, we’d lose our character and autonomy”. His wife Jeanne, also 92, a former tour guide, concurs. “In an old folks’ home, we’d sit waiting to be fed, with nothing else to do, and our state of mind would deteriorate. My sister was in residential care for her last few years, and she absolutely hated being patronised and called ‘dear’ by the staff. That’s not for me. Just because I’m 92, I don’t want to be treated like a child.”
With its 1950s jukebox, the electric piano and retro artefacts accumulated from years of rooting through junk shops, theirs is a home I know well. For me and my two sisters, Julie and Sophie, helping our parents remain independent matters enormously. But it is not without its challenges, for us as well as them. While they hate to ask for help, there are times when they really need it, times when we’re constantly on amber alert in our sisterly WhatsApp group in case one of us has to drop everything and rush over there. But work commitments, distance and our own parental responsibilities make this difficult when the need arises, as it did in January when both were bedridden with chest infections and needed food and medication. Not knowing when their pressing needs will arise means we struggle to organise our lives around them. It can take its toll on the whole family, and the worry and guilt that we should be doing more to help is never far from our minds.
Why independent living is on the rise
But our folks’ independence is a priority, as it is for many seniors. According to a recent study of the over 75s by Sure Safe, 96 per cent of elderly people would prefer to remain living on their own in their homes, rather than moving into a care home or a family member’s home. Of course, it’s not always preference that drives these figures. For family members, making room for them and their care needs isn’t always possible – or desirable. Also, the fact the state only funds care once a person’s assets and savings amount to less than £23,250, puts most people off moving into expensive residential care.
In 2021, there were 278,946 people aged 65 and over living in a care home in England and Wales. According to Age UK figures, it costs an average of £949 a week for a place in a care home, with the local council only contributing to your fees if you’re eligible for financial support, based on a care needs assessment. But for people who have lived in their own home for decades, building a strong sense of belonging, security and independence, the thought of selling their home and the family’s legacy to pay for expensive care that may not suit them is a bridge too far.
When things get complicated
My folks are lucky to have fairly good health and each other – people who live alone into old age are more vulnerable to falls, poor diet and issues with the basic activities of daily living. The number of people aged 80 and over is set to more than double to over six million in the next 40 years, and large numbers live alone. In 2023, there were around 1.68 million women aged 75 and over, and 786,000 men living alone. In some families no one wants to make time for visits and support. Other commitments and distance make regular help problematic.
For Jim Heath* and his two siblings, who all live more than 100 miles from their 90-year-old mum, who lives alone in Yorkshire, the stress of helping her cope with daily life is making them question whether something needs to change. “She was hospitalised over Christmas, with complications from a hip replacement. Knowing she’s struggling to manage on her own now she’s back home leaves us all wishing we could help her more. But she loves her house and garden and wouldn’t dream of giving up her home – it’s where she feels safe”.
Alison Griffith*, 55, feels guilty all the time because, with work commitments and a daughter taking GCSEs this year, she can’t visit her parents, in their 80s and living a two-hour drive away, more than once every six weeks. Like many adult children in this position, they rely on the kindness of neighbours to help in a crisis – of which there are many. “Last night Dad had another fall, and their neighbours had to lift him into the stairlift and get him into bed. Really, they need to be in residential care, but my parents would feel it’s an admission of failure even to get a carer and they’re cautious with money. They prefer to live independently – at the mention of moving into a home, Mum says ‘I’d rather you shot me’”.
The pitfalls of independence
Daily life can be full of pitfalls for older people living independently. This is a generation that grew up during the war and rationing, when no scrap of food was wasted. Heath says: “Mum prepares her own meals but she’s pretty cavalier about use-by-dates, so we’re constantly worried that spoilt products could give her food poisoning – it’s already happened twice”. Poor eyesight and minuscule wording on food labels can leave seniors resorting to the sniff test for foods like milk and meat, and with a weakened sense of smell, this is far from foolproof – and food poisoning can prove fatal for the elderly.
At times, Tony Gask finds the responsibility of managing their home too much. Modern life and the constant demands of repair, bills and admin are a lot to deal with when you’re older and less resilient. “To run a house, you need to be organised and the stress of it sometimes overwhelms me. Technology is increasingly hard to understand.” But Jeanne says keeping busy is good for them. “Sometimes we complain we’ve got too much to do, running and maintaining our house and garden, but popping out to the shops every day and cooking our own meals is keeping us active, sane and in the living world. As long as we stay in our home with our routines, we stay normal”.
Lesley Carter, Clinical Lead at Age UK, says: “That daily walk to the paper shop does so much. It’s not just about the paper, but your connections, community and exercise. We know that older people get fed up with being pushed around according to what society wants them to do. They want to make their own choices about how they live and as soon as you take those choices away, you take a layer of independence”.
When it’s time to step in
Most of the time my parents cope admirably, and their only outside help is a fortnightly visit from a cleaner. In fact, sometimes they are frustratingly independent, not wanting to trouble us. This can prove problematic when, for example, one of them is having hospital treatment, and ends up exhausted from spending hours on end waiting for more tests that they later can’t recall, leaving us struggling to help them get ongoing care. They say: “You’ve got busy lives – we don’t want to trouble you,” and this need for independence is understandable for people who’ve always taken care of themselves and don’t want to be treated like children. But there are times when we really need to advocate for them.
Lesley says: “This issue of how we help our parents manage their long-term conditions when they don’t want to bother us is a common one. They know you’re busy and don’t want to put that added pressure on you. This is why it’s important to have those conversations very early on about everybody’s responsibilities in the grown-up parent-child relationship, asking ‘How are we as a family going to support each other moving forward to make sure that you, as an older person, can remain as independent as possible?’ It’s their responsibility to keep you informed at those times when you may need to step in and to tell you what they’re finding difficult”.
These conversations can be hard, says Lesley, and sometimes can be had more easily with grandchildren or a cousin. “As our elderly parents’ grown-up child, we feel guilty if we can’t provide everything that we think they expect of us (but probably don’t), and this makes it hard to have a proper conversation with them. Involving the help of a third party is often the way forward.”And be prepared to keep having these conversations over time, acknowledging how their capabilities may have changed again, helping them to accept these changes and exploring what further help they need. “What practical solutions can you offer? Can you batch cook and fill their freezer with ready meals as back-up? Do they need mats to be removed to avoid a slipping hazard, or a motion-activated light to prevent falls during night-time bathroom trips, or Alexa programmed to call you in an emergency? Would a part-time home help make life easier? These are all things that could help keep your parents independent”.
Pick your battles
When having these difficult conversations, avoid imposing your values on them. “If they have crackers and cheese for a couple of days a week because they can’t be bothered to cook, that’s their absolute right. Does it really matter? They are making their own choices. They know they’re getting frailer, that they can’t do today what they could do two weeks ago, but they don’t want to be told what to do. So, unless what they’re doing is dangerous, leave them to it.” If what they are doing is potentially hazardous – whether it’s driving, forgetting medications or ignoring the rules of food hygiene, avoid being bossy – be gentle. “Pick your battles and remind them gently. We have to look at the motivation around the things that we’re saying to our parents and being mindful of the things that really matter”.
Ultimately the effort of helping our old folks to continue living the best lives they can, and in the way they want, is worth it. Vicky Portwin, 46, drove miles every week from St Neots to help her grandmother, who lived in the beloved St Albans neighbourhood where she’d spent her life. “She’d need our help with anything to do with doctors, the optician or chiropodist, and we had to check tradesmen weren’t ripping her off. I had to manage all this with three children at home. At times it was exhausting – but Nan didn’t see herself as an old person and living in an old people’s home just wasn’t an option. She died aged 94 and I miss her so much – I’d do it all again”.
* Some names have been changed.
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