Things changed pretty quickly after my mom was disabled by a stroke, and I learned a lot about different "stages of aging" along the way. Both of my parents went from healthy and active to really, really not in a relatively short period of time, and none of us were prepared for the transitions they went through.
In my case, the lack of preparation wasn’t for lack of trying. I did tons of research, online and in libraries and bookstores. In the library, I noticed child rearing and caregiving books are close together but only one shelf was overflowing with books (hint: not the one on caregiving.) There are generally accepted norms for childhood development, and racks and racks of books to help you understand what they are.
While everyone ages, it seems to be harder to find resources on the stages of aging that can help you prepare. The information is out there, but practical information was hard for me to find. What I discovered (and what professionals who work with older adults already know) is that there is no single path that everyone follows as they age.
That said, there are some fairly predictable scenarios, or what I think of as stages of aging.
Stages of Aging #1: Your Parents Don't Need Help
This is the stage where you call up your parents and they’re too busy to meet up, or are traveling, or spending half a year in a different town. Or maybe they’re nearby, and eager to babysit your kids. They're fully independent and don't need any help from you. Stay here as long as you can, and enjoy it!
Stages of Aging #2: Your Parents Think They Don't Need Help (But They Do)
At this point, you’ve noticed some things that have you concerned. Maybe they aren’t able to maintain their house like they used to, or are having a hard time getting groceries or making meals — but they’re compensating somehow and are getting by. Or maybe there are physical or mental changes, foreshadowing something bigger that hasn’t yet arrived. In our case, it was nearly all of these things.
My parents needed help long before they accepted it, especially “outside” help.
This stage was purgatory for me because my parents were getting a lot of help — from me and my brothers. Yet they reacted to suggestions that they hire help as if they were independent. I was anxious and scared and wanted to pass through this stage as quickly as possible.
If that sounds like you, remember, your parents likely value their independence as much as you value your own, so try to be patient. See if you can have some conversations about what they’d like to happen if they were, one day far in the future, to hypothetically need help at home. (Remember only you know your parents already need help!)
Stages of Aging #3: Your Parents Don't Need Enough Help
After I told my parents I would no longer 15 miles out of my way to special deliver orange juice on my way home from work, they agreed to hire some help.
This is a version of their initial request: “We’d like someone to come in for an hour and a half in the mornings, and an hour at night. But maybe not every day.” Maybe your mom wants some help four hours a week, but not on the same day of the week. In this stage, your parents want some help, but not “enough”.
Here’s what I mean by that: it’s possible to get help to fit these really flexible needs, but it’s going to be hard to find. And it’s unlikely to be from a bonded, insured agency who can handle the hiring and back-filling if your caregiver can’t make it on any given day. Agencies often have minimum hours requirements, too, because they know that getting reliable help requires a mutual commitment.
If your parents can’t commit, you or they will need to start interviewing. You’ll need to find caregivers yourselves, through referrals or online platforms.
Stages of Aging #4: Your Parents Need Daily Help (And They Have It)
If you can’t stay in Stage 1 forever, stay here (not that you can choose or control much about this process!) You’ve finally figured out the right balance. Maybe someone in the family stepped up and is providing the care your parents need, maybe you’ve hired an agency, maybe your parents moved to a senior living community or assisted living. You’ve adapted to whatever came your way, and it’s working out. I hope things stay this way! Just in case, though, there are two more stages to consider.
Stages of Aging #5: They Need Medical Help
There may come a time when your parents need medical help that a home care agency or private caregiver can't provide. Medical help includes managing and administering medication, giving injections, wound care, and other skilled nursing services. This is a really stressful stage because the stakes have gotten higher. The need for medical help is often a turning point for someone who wanted to stay at home. It can dramatically increase the cost of care because many home care agencies are not licensed to provide “medical help.” so private-duty nurses must be hired.
Stages of Aging #6: They Need Full-Time Help
There may come a time when it’s not safe for your parent(s) to be left alone. The choices you have at this point are similar to those you’ve had all along. You can help them yourself (with as much support from others as you can muster), you can hire help in their home (or your own), or you can move your parents to a community that provides the necessary support.
Despite the stage numbers, this isn’t a linear path. Your parents may experience all of these stages or may skip some stages altogether. My mother went from needing no help at all to needing daily help in one day. She was stable for years and now needs daily help in a skilled nursing setting. My dad went through almost all of these stages in just two years before he died.
Change can be sudden, or gradual — but it is inevitable. Have you done all you can to prepare?