Undoubtedly, helping your elderly parents make decisions brings challenges, changes, and sometimes even resistance.
When you first notice your aging parents cognitively decline, you might recognize minor signs of memory loss, confusion, unusual activity, and out-of-the-ordinary behavior. You let it go for a while, but soon you find yourself trying to evaluate a host of “little things” that collectively add up to warning signs and the big question, “Is Mom or Dad making poor decisions?” and “Are my parents cognitively competent?”
We have some answers and some tough questions to help you evaluate your situation and the best solution going forward.
What is Mental Competence?
According to the Public Legal Education and Information Service of New Brunswick, “Mental competence is the key to rational decision-making. Unfortunately, disease or injury can affect the mind, making it hard for a person of any age to make sound decisions. Sometimes it may be impossible for the person to look after themselves or their affairs.”
When Do Adult Children Need to Step in to Make Decisions for Aging Parents?
When do you need to step in to help your aging parents make important decisions?
- Has your Mother given large sums of money to strangers who email her? Or does she frequently give away money to people she doesn’t know well?
- Your elderly sibling is draining their savings and retirement accounts and making poor financial decisions.
- One morning when you visit your Mother, you realize the oven is on from dinner the previous evening.
- An older parent refuses to take their medication, claiming they’ve been poisoned.
- Your parent’s want to keep their driver’s license, but as of late, they are becoming more forgetful, so they frequently get lost and go the wrong way. Your aging parent neglects basic driving principles.
Many of these situations are signs that your parents are becoming mentally incompetent and could use support with making important decisions, financial decisions, medical decisions, or make decisions associated with daily living.
As a family caregiver, something likely triggered your parent’s inability to care for themselves. Typically, age-related cognitive decline or a physical accident could be the culprit, but what if they showed signs of mental incompetence? When do adult children step in?
They have been the “parent” their whole lives; they think they know better – and they even might. But age, physical accidents, health issues, disease, and other factors can cause cognitive impairment, which may lead your loved ones to resist and refuse to make decisions on their own.
Do you recognize the “mind your own business” phrase? Parents who dig their heels in are pretty common. It’s never easy to admit that a parent is experiencing cognitive decline. But how do you know if they’ve reached the state of being unable to care for themselves or make their own decisions?
There’s no quick, identifiable time, and there is no easy formula for when to step in. But you, your family members, and other caregivers must have an open and honest conversation with your parents focused on SAFETY. Ideally, their physician would also partake in this conversation – or at least provide some insight.
Be mindful of distinguishing between a real safety issue and a “matter of opinion.” If you address your concerns to a physician, but they deem your concerns as “opinions,” – you might not need to worry just yet. Simply disagreeing on what is best for them doesn’t mean your aging parents aren’t capable of making their own decisions.
If a Physician is concerned, and there is a safety issue, then it may be an issue of mental competence and time to step in.
When You Know Your Aging Parent Needs Help, Do You Make All of the Decisions or Just Some?
Even if your aging parents need help, let them make as many decisions as possible, whether or not they are mentally competent. This gives them the feeling of autonomy and enables them to maintain some independence in their lives. You can always step in when necessary.
No one likes to lose their freedom. Especially as our parents age, they do not want to feel like the “child” in the relationship. You don’t want to reverse roles on them; they are your parents, after all.
Even if your aging parents can no longer drive, be creative in the way, you maintain their ability to have a say in what they do or where they go. For instance, give them the following options:
- “Do you want to go to the grocery store or the post office first?”
- “Would you like to stop for lunch before or after we pick up your prescription?”
Offering multiple choices can go a long way in helping your aging parents feel valued at a time when they may otherwise be feeling a sense of loss.
What if My Loved Ones Refuse Help?
Elderly parents might be making bad decisions because aging, in general, is scary. It is never easy to step in and help your parents through difficult times. You have to understand that a parent does not refuse help on purpose.
Many individuals fear the idea of change and the unknown, including losing freedom and independence. This fear may be why your parents are resisting help, making poor decisions, or freezing when it comes to even deciding on their own.
Approach and communication are everything! It can be frustrating to deal with a stubborn aging parent who refuses help. Often, how you approach your parents can make a huge difference.
We’ve listed some tips to help you manage conflict with a parent who refuses to make good decisions in a supportive rather than pushy way.
Listen and Be Sensitive
Listening is critical when dealing with a parent who is refusing help. Criticizing and arguing with your elderly parents will put them in defense mode. They are going through a whirlwind of change and difficulty. All you can do is listen and empathize.
It’s easy to get passionate about helping your parent through difficult times. Passion can turn pushy very quickly. Stay calm whenever you’re trying to help your parents. Speak your concerns in a soft and calming tone to reassure them.
Asking your parents questions will help them feel independent, wanted, and valued. Having some say in their decisions will also help them open up to getting more help.
As mentioned above, offering choices is a great way to ensure they feel independent and part of the decision-making process.
Seek Additional Support
If you’re at a loss, you can always host a family meeting and ask other family members for help. Sometimes, it takes a village, and families are a great support system in challenging times.
If you’re still struggling, seek professional help from a physician. They will be able to provide more insight into diagnosis and offer your parents guidance. Many seniors feel reassured when a professional can offer them advice.
Be prepared Even If Your Loved Ones Refuse Help
If They Are Competent
If your loved ones can make decisions for themselves, you can continue supporting as needed. And while there is nothing you can do to force your loved ones to accept help, you can still be prepared by understanding future options for care. Continue being alert for any changes in their condition that indicate they may be unable to make decisions on their own safely.
Encourage your parents to have all of their legal documents up to date. Ensure there is a Living Will (Advanced Directive) and Power of Attorney filled out (General, Medical, and Financial are all types of Power of Attorney) so that they are prepared in case of an emergency or issue of mental incompetence.
If They Are Incompetent
If they are NOT competent (they can’t make decisions for themselves) and you have a Power Of Attorney (POA), ensure their physician has them officially declared as “incompetent” so then you can assume decision-making for them.
Suppose a physician has officially declared them as “NOT competent” and you do not have a Power of Attorney, last resort. In that case, you can consult an elder law attorney to ensure appropriate legal documentation is created and implemented.
3 Questions to Ask Yourself When You’re Not Sure What to Do:
Is Mom or Dad mentally competent?
Always seek advice from a professional. A primary physician, or even a professional caregiver, like a registered nurse, can better understand what’s going on with your elderly parents. Getting more than one opinion will also be beneficial to get the complete picture of their mental competence.
- Do I Have A Team Ready?
Check with your family and parents to ensure they have a team ready for the worst. Your team should include the following:
- A good Elder Law Attorney (or Estate Planning attorney)
- A caregiving team.
- Financial Advisor
- Primary physician
- Key family member roles (know the contact information for anyone else that needs to be involved with a decision for your parents (i.e., their siblings, their caregivers, additional family.)
- Am I Ready For the Worst?
Stay organized and help your parents store vital information in one place; it will assist the people involved in your loved ones’ medical care (doctors, social worker, geriatric care manager) in case things take a turn.
Also, be prepared as much as possible. Do your research on managing difficult behaviors and caring for aging loved ones. It will significantly help you navigate this chapter of your parent’s care.
Even learning as much as possible about their health care, chronic diseases, and Alzheimer’s disease can be beneficial for a few reasons.
- It can bridge your understanding of the aging process
- Signs to look out for
- Helpful things advice on how to manage.
- Help you understand and empathize with your parents.
The bottom line: understand your options and make the best-informed decision possible with your resources.