Here's a research paper I wrote that I hope will be helpful (see references at the bottom).

Issues for Adult Children on Understanding and Caring for Aging Parents

Adult children and aging parents is a very important topic in developmental psychology.  While not all of us will have children, most of us have parents who will eventually need our support in some way.  Our parents were there for us when we were growing up and did the best that they could to take care of us.  Therefore, it is important to seriously plan ahead and think about providing for our parents’ future needs.  This way we can become more informed and better equipped to help our parents along with the elderly population, as a whole.     
                                                                                                                  
Discussing Important Issues with Aging Parents

Reports have shown that elderly people’s greatest worries are becoming dependent on others for help.  A 1992 survey found by The American Association of Retired Persons found that 84 percent of people over 55 years old wanted to remain in their own homes.  The same survey also found that 54 percent of the elderly had not planned for future needs in terms of housing (Alberts, 1995).  So it is consequential to talk to each other and clearly find out how the parent feels about future care.  Scenarios should be discussed so that if a situation should arise, such as the need for an at-home-aid, then the parent has made their own preferences known (Lancaster, 1995).  Although these discussions may feel uncomfortable, it is important to keep open communications so that the parent feels a sense of control over their life.  Also, a crisis may suddenly occur and everyone can be more prepared and create a swifter recovery of the situation.

Types of Services Available

According to Lancaster, there are only five percent of elderly people living in nursing homes.  The remaining population is living in “homes, apartments or assisted living units”.  However, about 80 percent of elderly care is given by family or someone living at their home (Alberts, 1995).  There are many types of assistance services for parents who want to remain independent but need help in certain areas.  Transportation, medicine and food deliveries, laundry and cleaning services, and elderly centers are among the many options available.

Information on these types of services can be found from any Office on Aging within each state’s social services branch or any senior citizen’s group.  Another way to seek out resources is to hire a private consultant.  The counselor will organize a comfortable plan of services for the parent, which will ensure the highest combination of independence and care possible at their own home .  The cost for this consultation usually ranges from 40 to 150 dollars an hour.  The results are well worth it, and a good plan can be reached within about an hour (Lancaster, 1995).  In addition, California has a program called the Statewide Caregiver Resource Center, which provides free assistance in arranging different types of care services (Alberts, 1995).  There is also a network agency called National Area Agencies Association, which provides referrals to local social services for elderly care (“Taking care,” 1995).    

The Caregiver’s Needs

“Twenty-five percent of Americans will eventually take care of an aging or sick parent or relative”.  Although men are increasing in numbers as parental caregivers, women currently make up 75% of all caregivers (“Parenting your,” 1994).  In order to create the best circumstances for aging parents, it is important to remember the needs of the caregiver as well.  Helping loved ones can be rewarding, but it can also be sad and frustrating to watch them grow more dependent.  The many responsibilities involved in caregiving can be draining on the caregiver and may create a sense of loneliness and despair.  Research has shown that caregivers are more likely to be clinically depressed (Alberts, 1995).

The most painful type of health problem for caregivers to observe of their elderly parent is cognitive impairment, because they may become very different from the person that they had always known (Kaplan, 1998).  It can also be difficult to realize that the roles are being reversed and the parent cannot be the nurturer anymore.  It is crucial for the caregiver not to feel alone or as if there is not anyone to fall back on.  With outside support and understanding, the situation is greatly improved, and can allow for a better quality of life for everyone involved.

There are some significant steps needed to ease the stress on caregivers.  One large part is to make sure that all siblings and family members are getting involved.  They may not realize how much work is actually required and must be reminded that their help is needed.  The primary caregiver must “have extreme strength to insist that help, love, and support are most welcome, but criticism and angry outbursts are not” (“Dealing with,” 1995).  If the siblings live far away, they can still participate in other ways, such as financially or providing support through phone calls.  Many services are also available to relieve heavy responsibility from just one person.  Emotional support groups are also important tools for caregivers (“Taking care,” 1995).

Another problem is that the focus has been mainly on negative aspects experienced by caregivers, not the positive ones such as the opportunity to reciprocate care of one’s parents.  This new attitude, in turn, can create more positive interactions and relationships with each other (Adams & Blieszner, 1995).  There is a certain satisfaction in giving something back to our parents, after all of the hard work that they put into us.  A study of successful women concluded that good relations with parents are strongly correlated with high self-esteem.  There are many positive contributions to gain from elderly parents.  They have a lot to offer families such as childcare and even housework (Kaplan, 1998).  Concurrently, this can make elderly parents feel happy that they are contributing to the family and increase their self-esteem as well. 

Elder Abuse

Despite recent gains on knowledge and research regarding elder abuse, this still remains a topic in serious need of attention.  Every year, there are about one million elderly victims of serious abuse.  There are four main types of abuse: physical, financial, psychological, and neglect.  The abuse may stem from a continuous cycle or may have resulted from more recent situations.  Abuse is generally strongly related to a caregiver or adult child who is alcohol or chemically dependent, mentally disturbed, financially dependent, or does not comprehend the special needs of sick or elderly individuals (Alberts, 1995).  Abuse may result when a caregiver feels isolated, alone, or completely responsible for their elderly parent.  Studies at this point have not shown poverty and job status to be linked to reasons for abuse.  The key element seems to be a pattern of unhealthy dependency on the elderly person.  Victims of severe neglect seem to be elderly people who are cognitively and physically impaired, isolated, and very old (Wolf, 1996).

It is crucial for a caregiver to always seek help from others and watch for signs of personal stress that may create anger, fatigue, or a feeling of being out of control. (Alberts, 1995).  Abuse may be directed at the caregiver as well, in verbal or demanding forms, by the frustrated parent Some caregivers may become obsessive in that they think that they are the only ones who can or should take care of their aging parent. These people feel that no one else can do the job as well or think that a helper would only get in their way (Lustbader, 1996).  Caregivers in these situations will eventually become so worn down that they are unable to take care of themselves and their abilities to care for the parent deteriorates.

Treatment for elder abusers, in the past, has mainly been through providing assistance to the caregiver in the form of nursing services, meal preparation, general housekeeping, placing the parent in day care, or through coping skills training.  Although these steps are beneficial for the situation, other approaches have recently evolved.  The new focus is on breaking the pattern of emotional and financial dependency of the perpetrator on the victim.  Some of these solutions include alcohol and drug treatment, vocational and psychological counseling, financial and housing assistance, along with counseling services for the elderly victim (Wolf, 1996). 

Loneliness

The feeling of loneliness takes a toll on any person, and especially on elderly persons, who are not as able to get out as much.  Ten percent of the elderly population’s health is seriously affected by loneliness.  Among the elderly, loneliness is also more likely to be found in immigrants, the physically disabled, those with limited income or in institutions, and widows or widowers.  Loneliness among the elderly is not as common in rural areas because there is still a sense of community, unlike many urban areas (Forbes, 1996).

The extent of elderly loneliness depends on a person’s personality and the degree of one’s preference for solitude.  Another important point about loneliness is that it is not always due to limited social contact.  The quality is more important than the quantity.  For example, a visit from a very special person is much more important than numerous superficial contacts.  There are many ways to offset or decrease loneliness for elderly parents, such as housing designs with meeting areas in the center to provide social opportunities.  Involvement and activities such as adult classes, community action groups, churches, history groups, and entertainment outings like theater or movies can bring elderly together with people of all ages (Forbes, 1996).
   
Well-being

Remaining a part of the community, family, and friendship circles is crucial for the elderly population’s coping abilities and aging well.  It has been found that in nursing homes, people with more friends have better vision, speech, and mental clarity.  As mentioned previously, merely having relationships is not the only factor.  Instead, the structure and dynamics of the relationships are most important (Adams & Blieszner, 1995).  People who are understanding, sharing, and can express their emotions well are crucial in elderly friendships (Sullivan, 1997). 

In addition, there are positive and negative aspects of having homogenous versus heterogeneous groups of friends.  Within homogenous groups, there is a close-knit circle of friends and family, providing comfort in the relationships.  There is also strong organization among the group in cases of illness or injuries, as they work together to help the individual in need.  However, there may also be more gossip, so it is more difficult to confide in someone within this type of group.  Although heterogeneous groups are more disconnected from each other, this may allow them to provide a wide variety of resources and connections to support the individual.  There is also more room for intimacy and confidentiality, since there is not as much contact within the individual’s network (Adams & Blieszner, 1995). 

Overall, family and friends seem to serve different purposes for the elderly person.  Family members take care of their needs in the way of daily living, chores, or finances.  Whereas friends provide enjoyment and company, and are also more able to relieve stress and bereavement as they can relate to each other’s situations.  Friends can also step in to help with things like transportation, shopping, or emergency situations.  Families provide more assistance when circumstances become long-term or chronic (Adams & Blieszner, 1995).   

Research on family relations has shown that the quality of the aging parent-adult child relationship, in terms of communication and affection, has a strong effect on the parent’s psychological health.  Elderly parents are also found to have a better feeling of well-being when they see their children are doing well in life (Kaplan, 1998).  Simply being active grandparents can increase mental health because they feel needed and can teach the children some of the family history.  However, if they become overwhelmed with responsibilities and their social life is interfered with, then their mental health may diminish (Adams & Blieszner, 1995).  

Medical Advances and Information

The good news about health and aging is that medical advances have drastically reduced illnesses and disabilities among the elderly.  We have drugs that control cholesterol and high blood pressure along with diabetes and heart disease.  There is also an increasing health consciousness, as elderly people are more cautious about diet and fat intake, exercise, smoking reduction, and seat belt usage (Alberts, 1995). 

According to a gerontologist, named Robert Butler, many disabilities are reversible if they are diagnosed right away.  The key to prevention is to ensure the right diagnosis early on, when any unusual symptoms appear.  Doctors can aggressively treat signs of aging like memory lapses or muscle atrophy, and can result in a minimization of senility and frailty.  The problem is that there are not enough physicians practicing geriatrics and, in fact, there are only 7,000 gerontologists in the United States.   This makes it difficult to obtain a proper diagnosis for elderly people as they are being grouped in with young people and being misdiagnosed.  For example, up to 20% of patients diagnosed with dementia are actually suffering unnecessarily, due to treatable causes such as malnutrition, insomnia, and endocrine imbalance.  Therefore, it is very important to begin with the proper physician.  Any local chapter of the Alzheimer’s Association gives referrals for geriatricians in surrounding geographical locations (Alberts, 1995).

Most of our society’s focus has been on raising and caring for children, however many of us are uninformed when it comes to taking care of aging parents.  There are real health concerns and signs that families need to monitor.  As a caregiver, one needs to be aware of medical or emotional changes like confusion, headaches, depression, loss of appetite, and other atypical health signs (Lancaster, 1995).  If there is a dramatic change in functioning, then it is likely to be an emergency situation and the elderly parent needs to go to the doctor immediately.  If the doctor suggests certain medications or treatments, the adult child should also clearly understand the instructions, as the parent may need reminders. 

Attitudes on Aging

Aging has held such a negative light in American culture, especially in comparison with many other countries like China.  Elderly Chinese people are looked upon as wise and crucial parts of their society.  American media portrayals and plastic surgery are the causes and effects of anxiety toward aging and getting old has become something to dread.  As Erik Erikson said, “Lacking a culturally viable ideal of old age, our civilization does not really harbor a concept of the whole of life” (Daniel, 1994).  This is damaging for everyone because we then live incomplete lives, since old age is often viewed as unimportant.

Instead of looking at aging as a time of “inevitable biological and social decline”, we can take on a more optimistic outlook and encourage positive thinking.  In fact, physicians have been looking at the importance of sustaining good morale and its favorable effects on health of elderly individuals (Sullivan, 1997).  There is a growing movement toward the way our society sees growing old.  This revolutionary idea of aging is called “conscious aging” and it gets rid of the growing denial of “the golden years”.  Instead, aging is given respect and credited with great wisdom.  It is a way of looking at aging as a natural process of life and not an affliction.  This movement is resulting from baby-boomers who are realizing their own mortality (Daniel, 1994).  

One study, by a psychologist named Langer, has shown that our own expectations of memory loss in old age may actually create a self-fulfilling prophecy.  And fear is the strongest force in creating many of the problems.  Elderly people may avoid medical attention or challenging activities out of this fear, which only makes the problems worse.  Studies by two Harvard professors, Langer and Levy, looked at elderly Chinese people and compared them to Americans in the same age group.  What they found was that the elderly Chinese scored much higher on memory tests than the elderly Americans.  This seemed to confirm the fact that attitudes have a lot to do with performance and health, since elderly Chinese are held in very positive and high esteem among their culture (Daniel, 1994). 

Perhaps the growing technological focus of our society emphasizes information over wisdom and the elderly population’s potential contributions are often ignored.  We are also moving at such a fast pace, and looking mainly toward the future, that we have almost lost our sense of history (Daniel, 1994).  We are also facing a situation in which intergenerational relations are being looked at as voluntary instead of an obligation  (Pillemer & Suitor, 1998).  Our society needs to regain the focus on the richness and significance that life with our aging parents and families can provide.  

Bibliography

Adams, R., & Blieszner, R.  (1995). Aging well with friends and family. American Behavioral Scientist, 39(2), 209-224.

Alberts, N. (1995). Your aging parents: how to help. American Health, 14(3), 54-60.

Daniel, J. (1994, September-October). Learning to love (gulp!) growing old. Psychology Today, pp. 60-66.

Dealing with attitudes of family & siblings (when caring for an aged parent). (1995, April). Executive Health’s Good Health Report, 31(7), 1.

Forbes, A. (1996). Loneliness (Caring for Older People, part 5). British Medical Journal, 313(7053), 352-354.

Kaplan, P. (1998). The Human Odyssey Life-Span Development (3rd ed.). California: Brooks/Cole Publishing Company.

Lancaster, B. (1995). Reversing roles: caring for our parents. Executive Health’s Good Health Report, 31(7), 1-2.

Lustbader, W. (1996). Self-neglect: a practitioner’s view (social worker’s view of the aged at risk). Aging, 367, 51-60.

Parenting your parents. (1994, April). NEA Today, 12(8), p. 27.

Pillemer, K., & Suitor, J. (1998). Baby boom families: relations with aging parents. Generations, 22(1), 65-69.

Sullivan, M. (1997). Maintaining good morale in old age. The Western Journal of Medicine, 167(4), 276-284.

Taking care of elderly parents. (1995, December). USA Today, 124(2607), pp. 3-4.

Wolf, R., (1996). Understanding elder abuse and neglect. Aging, 367, 4-9.