Stages of Aging: What to Expect as Your Parents Age
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 childrearing 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. Stay here as long as you can, and enjoy it!
- Make sure they have a current estate plan. It can be hard to bring up, but any conversations about the future that you can have now will save time and stress as things change. (I’ve got some tips on talking about the future with your parents in this blog post.)
- Get to know their neighbors and friends. If your parents have invested in their relationships, you may be able to reach out to their friends or neighbors down the line — if you know who they are and how to reach them. Make it a point to get to know the other important people in your parents’ lives.
- Help them downsize. If they’re open to the discussion, this is a good time to help your parents figure out a long term housing plan. (But don’t be surprised if they’re too busy to think about it.)
Stages of Aging #2: Your parents need help, but don’t think they need help
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!)
- Consider your role. What kind of help do your parents want from you? How much are you willing (or able) to help? Your parents can stay in this stage a long time (maybe forever), with your help. That’s fine, as long as everyone is in clear agreement.
- Research options for getting additional help at home. You can figure out what options are available, with or without your parents’ involvement. Talk to some local home care agencies or independent care managers, see if there are any community organizations that offer assistance at home, call your local area agency on aging.
- Understand their financial situation. Figuring out what kind of help to get depends a lot on their finances, so try to talk about this as a family. Sometimes that’s easier said than done, but it’s necessary. One path into this conversation might be to offer help automating their bill payments or organizing their financial information.
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 requirements, 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 backfilling if your caregiver can’t make it on any given day. Agencies often have minimum hours requirements, because they know that getting reliable help requires a mutual commitment.
Here are a few things you can do if your parents resist getting the help they need:
- Evaluate home safety. Reduce the risk of falls or injuries by helping them make some changes to their home. AARP has some simple low-cost tips in these guides — think about things like improving lighting, adding grab rails, and removing tripping hazards. The safer your parents’ home is, the longer they can stay there.
- Anticipate the next level of care. Who will you rely on if and when your parents are ready for more help at home? Will they need to move? Can they afford to move? Think about next steps, even if your parents aren’t ready to take action. Do what you can to be ready if or when things change.
- Take a look at property. Are there things your parents don’t need or use anymore? This is a great time to sell unused property or vehicles or declutter the house. They may not agree, but it’s worth a try. If you encounter resistance, be patient and don’t give up! It may take several attempts to get them to see it’s in their best interests.
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. Congratulations!
There may be some additional transitions ahead, though, so this is a good time to:
- Reconsider your role. Is there a point at which you won’t be able to provide the kind of help you’re providing today? Where is “the line” for you, and what’s next when you get there?
- Reevaluate housing options. If you anticipate there will come a time when your parent(s) can’t stay at home, it’s time to consider other housing options. There are a lot of choices to make, and the more time you have to think about it and discuss, the better.
- Simplify. What can you do to help simplify your parents’ life? Are there things that cause them stress that can be taken off their plate?
- Prepare for a medical emergency, if you haven’t already. Know what medications your parents are on, and be prepared to share that information with medical professionals.
Stages of Aging #5: They need medical help
There may come a time when your parents need medical help. 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.” (Medical help includes managing and administering medication, giving injections, wound care, and other skilled nursing services.)
If your parent’s needs change, you may now need a nurse in addition to any caregivers that might already be helping. This is a good time to:
- Consider a move. If you can’t afford or find medical help at home, it may be time to move to a community that has skilled nurses on staff.
- Figure out how to get a break. If you’re doing this yourself, you may be feeling overwhelmed at this point. Know this: you can’t do it all, and you can’t do it alone if you want to stay sane. It’s important for your own health that you take a break if you can. Invest the time to identify ways to relieve your stress (and don’t let anyone tell you what that should look like.)
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.
- Talk about final wishes. Try to have a conversation about how their care decisions should be made at the end of their life, and how they want their lives celebrated. (Check out my advance care planning cheat sheet for help getting started.)
- Locate important documents. My dad was proud of his military service and requested military honors at his memorial service. If we hadn’t ordered a copy of his military service records ahead of time this would have been a difficult request to honor. There are many important documents you’ll need if and when your parents die; see if you can find them (or order copies) before you need them.
- Understand the estate settlement process. I cover the estate settlement process in this blog post.
Ok, but what now?
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?
About the Author
Karen Purze is the author of Life In Motion: A Guide for Gathering Life’s Vital Details, a workbook to help people get their affairs in order. She blogs about end-of-life and emergency planning at lifeinmotionguide.com.