Marilyn Heins

My recent column on becoming 88 generated so many responses I am still answering them. Several emails asked about dealing with aging parents.

Reverse parenting is my term for situations when aging parents can no longer care for themselves and adult children must assume care. This always feels like upside-down parenting because we carry warm memories of our parents caring for us. It may be difficult.

Let me begin by sharing my experiences. My mother was an educated and talented woman born in 1908, 12 years before women could vote. She was an artist who drew department store goods for newspaper ads before photography and digital art. Her passion was painting flowers and her botanical art is in several museums.

My father died when mom was 87 and she lived alone in her art filled house with a beautiful garden she planted and tended. She drove and continued painting and gardening until she fell and broke her hip. She “aged in place” with round the clock help for more than 10 years. My sister lived 30 miles of Boston traffic away. I lived across the country, a day-long plane ride away.

There was nothing her daughters could do to cajole or convince mom to move closer to one of us (I even had plans for an attached guest house) or to a senior facility. First she said she needed her studio. When she could no longer paint, “I will NEVER leave my house!” became her mantra.

The garden was neglected, the house filled with magazines and much other “stuff ” she would not throw away. She refused to give away my father’s clothes. I spent a whole day in the basement going through many years of my father’s engineering journals to find the ones in which he had a paper or was cited. Sweaty and dusty I handed her those, which she cried over, and said the other journals were in trash bags. When I left, one of her caregivers was ordered to put them all back in chronological order.

I just received an email from the son of an 85-year-old man who wanted to move his father who had become a recluse and a hoarder. The house and garage were filled to the ceiling with things like old newspapers and magazines he would not let anyone dispose of.

Another wrote, “How can I get my parents who are almost 90 to dispose of their many items stacked in boxes in every nook and cranny in their house and garage? I am not talking about clutter, it is much worse than that. My children and I will do the work but we have to know what is valuable and what they want to keep.”

I have looked at this “…from both sides now” to quote Joni Mitchells’ nearly 50-year-old song. I was the child of aging parents and now I am an aging parent. Neither role is easy.

I worried and fretted over my mother living alone. My children already do or will worry about me as I become less able to be independent. What is the answer? How do we coax or convince aging parents to listen? Can we? Should we?

Whether I write about babies or oldies, safety is my first concern. Yes, we want our toddlers to develop autonomy but we prevent them from running into the street. We want our parents to remain and feel independent for as long as possible but not at the expense of their safety and well-being.

I advise children and parents talk about these issues before they happen although this didn’t work in my family. Fortunately, mom had the means to age in place. Most of us, including me, do not. Or do not want to.

I suggest both parents and children familiarize themselves with the issue. Learn what independent living is. Many of us have bad memories of visiting a relative in a nursing home (my parents would not permit me to visit my beloved grandfather so I imagined he was in a horrible dungeon). There is a big difference between nursing homes then and senior facilities now.

I visited several friends and my aunt in various independent living facilities both in Tucson and Boston. I saw individual apartments, dining rooms and/or restaurants, socialization instead of being in “solitary” which happens to many elderly when they can no longer drive.

What about hoarders? What about those oldies who are so attached to “stuff” that they cannot bear to throw it out? In extreme cases the parent lives in squalor and ignores self-care. You should first offer to help. Some parents may be physically unable or overwhelmed and will welcome your help.

What about those like my own mother who resist or even sabotage you? I installed fire alarms and worried. I also called my mother and her caregivers every day. One woman I knew took her mother, who was repeatedly falling, to lunch and then drove to her new assisted living home. I do not recommend this draconian action but sometimes children have to act.

Information is available from community agencies like Pima Council on Aging — a Tucson treasure. Talk to others who experience similar frustrations with aging parents. Visit facilities to be prepared to answer your parents’ questions (and plan for your own future).

Everyone should have a will, a power of attorney to make decisions for you if you become incapacitated, and a durable power of attorney and living will so your end of life decisions are spelled out in writing. I also signed a “Five Wishes” document available from a hospice that lets you spell out the specifics of what you do and do not want done.

Without these documents the issue between safety and autonomy may have to be decided in court. You will have to present evidence to the judge that your parent can no longer care for self or make decisions.

The best advice I can offer is talk to your parents long before they are in advanced old age. These days we hear dreadful language in movies and on cable TV. People talk and read about sex without batting an eye, as my mother used to say. But death? The last taboo.

Don’t be squeamish. Have “The Talk” about end of life decisions. Familiarize yourself with the issues. When? Long before your parents need it. Aging parents, if your kids don’t bring it up you should. Problems can best be resolved with knowledge and dialogue. Not silence and avoidance.

Dr. Heins is a pediatrician, parent, grandparent, great-step grandparent and the founder and CEO of She welcomes your questions about parenting throughout the life cycle, from birth to great-grandparenthood! Email