The population of older adults (65 and older) in the U.S. is growing rapidly, according to the U.S. Census Bureau. By 2030, the number of older Americans is expected to reach 73 million, making up more than 20% of the total population. As individuals age, they may require varying levels of care, which their adult children often provide. Adult children commonly experience uncertainty when confronted with the prospect of caring for their parents.
Caring for aging parents can be a rewarding and sometimes challenging experience, and each adult child-parent relationship is unique. People who provide care for their parents may take on different responsibilities as their parents’ needs change.
Adult children who become caregivers to their parents can avoid burnout and sustain themselves through challenging times by learning about the common experiences of adult-child caregivers, exploring different strategies for providing care, and practicing routine self-care.
Adult-Child Caregivers in the U.S.
Worldwide, people are living longer. The proportion of the global population over 60 years of age is expected to nearly double over the next two decades according to the World Health Organization (WHO), growing from 12% to 22% between 2015 and 2050.
Human beings generally require greater levels of care as they get older. Aging is associated with a decrease in physical and mental capacity and an increased risk of disease and injury, which can happen gradually or suddenly and may come as a surprise to older individuals and their families.
A caregiver is someone who provides assistance in meeting the daily needs of another person. Caregiving responsibilities typically include the following:
- Preparing meals
- Doing housework
- Grocery shopping
- Providing transportation and running errands
Caregivers may also help another person:
- Get dressed
- Get out of bed
- Shower
- Use the bathroom
- Deal with incontinence
- Take medications
Adult children of aging parents in the U.S. experience many changes in responsibility as their parent’s age. Around 17% of all adult children will provide care to their aging parents during their lifetimes, according to the scientific journal Healthcare. According to a Vox report, the majority of aging parents prefer “aging in place” (living in their own homes as they age) or moving in with a child over living in an assisted living facility.
Approximately 75% of older adults with multiple children reported receiving help from only one child, according to a study published in The Journals of Gerontology. This same study found that adult-child caregivers provided an average of 50 care hours to a parent per month and that adult children have a greater propensity to help as their parents’ needs increase. As a parent’s frailty grows, it becomes more common for more than one adult child to participate in caregiving.
Aging Parent Checklist
Caring for aging parents can be complicated, but knowing what contingencies may arise and what resources are available are two key starting points for the adult-child caregiver. Strategies for supporting older parents and helping them be as independent as possible at home, for as long as possible, may include using various home-based services, modifying the home to accommodate their needs, and hiring private caregivers to work in the home.
Many adult-child caregivers include these tactics (among others) on their aging parent checklists to ensure their parents can live comfortably as they grow older.
Establishing Home-Based Services
According to AARP, around 90% of adults over 65 want to remain in their current homes as they age. Establishing home-based services can be a great way to support aging parents.
Common home-based services that can be helpful to older adults include the following:
- Meal delivery
- Housekeeping
- Physical therapy
- Occupational therapy
- Speech therapy
- Music therapy
In addition to these services, hiring a private caregiver can help meet a family member’s care needs. Private caregivers can step in to support on a part- or full-time basis to prevent caring for a parent from becoming an overwhelming responsibility. Adult children should ask themselves certain questions when considering a private caregiver:
- What skills are needed to provide the best care for a parent at home?
- Are family members capable of providing this care, or are individuals in the family becoming overwhelmed?
- How does the parent feel about working with a private caregiver? Do they see the benefit of external care assistance?
Making Basic Modifications to the Home
Parents may need to modify their living environments to accommodate their needs as they age. Making basic modifications to a home or other dwelling can make spaces more accessible and safe for older adults.
Common physical modifications to living spaces include installing or creating:
- Bathroom grab bars
- No-step entryways
- Ramps
- Reachable outlets, knobs, and switches
- Improved lighting
- Emergency response systems
- Smart home devices, such as voice-activated home assistant technologies or doorbell cameras
Creating a Plan to Prevent and Mitigate the Risk of Falling
More than 1 in 4 people aged 65 and older fall each year, according to the Centers for Disease Control and Prevention (CDC). Of those who experience a fall, about 3 million end up in the emergency room as a result.
Falling once doubles a person’s chances of falling again, and 1 out of 5 falls causes a serious injury, such as head trauma or broken bones. But even falls that don’t cause injury can result in people becoming afraid of falling. Fear of falling can cause people to become less active, the CDC explains.
Creating a plan to prevent falls and mitigate injury due to falling is important for parents and their adult-child caregivers. Common safety measures include the following:
- Mobility aids such as walkers and canes
- Floor mats
- Nonslip mats for bathtubs and shower floors
- Chair seats
- Alarms, including wearable alarms
To reduce their risk factors for injurious falls, older people should take preventive measures such as:
- Improving or maintaining lower body strength
- Increasing or maintaining vitamin D intake
- Addressing vision and balance challenges
- Recognizing how medications, such as sedatives, can affect balance
- Wearing proper footwear
- Removing or adjusting for environmental hazards, such as uneven steps, rugs, and clutter, that can cause tripping
Resources for Creating Safe and Accessible Living Spaces
People can learn more about the tools and tactics associated with creating a safe environment for aging parents from the following resources:
- The Zebra’s home safety guide is a comprehensive guide for adult-child caregivers looking to transform their living spaces into accessible and safe dwellings for older adults.
- The National Institute on Aging’s tips for making the home safe and accessible can help older adults modify their living spaces to maintain independence for longer.
- The federal government’s Rural Housing Repair Loans and Grants program provides funding for low-income homeowners who are aged 62 or older to remove health and safety hazards and repair their homes.
- GoodRx offers a list of six evidence-based exercises that can help older adults maintain their health and independence.
- Forbes provides a visual guide of the best aerobic and balance exercises for older adults.
- The National Institute on Aging (NIA) explains how older adults can use strength training to increase mobility and slow sarcopenia (the decline in muscle mass, strength, and function as a person ages).
- Verywell Fit provides 20-minute strength training workouts and guides for older adults looking to increase their fitness and balance.
- SafeWise gives a room-by-room safety guide for older adult living spaces, with suggestions for improving the safety of bathrooms, bedrooms, living rooms, kitchens, garages, hallways, stairs, laundry rooms, and outdoor areas.
- Aging in Place offers tips for updating living spaces for security and safety.
- The CDC’s STEADI Initiative provides several resources to help reduce the risk of falling among older adults.
- STEADI’s caregiver brochures help adult children take action to prevent their parents from increasing their risk of falling.
- STEADI’s safety checklists help older adults and their caregivers find and fix hazards in their homes.
- STEADI’s self-assessment tool can help older adults evaluate their risk of falling.
How to Care for an Aging Parent
Adult-child caregivers can benefit from an understanding of the foundational challenges of caring for an aging parent; the challenges are correlated with the basic challenges of aging itself. Consider some of the many aspects of care that are related to the financial and social changes that an aging parent will experience.
Preparing for Financial Changes and Challenges
Older adults can experience a decline in their ability to manage their finances and may need support with navigating financial challenges. A decline in financial skills is often an early indicator of overall cognitive decline in older adults.
The National Endowment for Financial Education (NEFE) notes five warning signs of financial decline in older adults:
- Taking longer to complete daily financial tasks including bill payments, checking balances and accounts, and responding to financial messages
- Being inattentive to details such as bill due dates or required financial actions
- Declining calculation skills such as when they need to convert bills to change
- Increased difficulty in understanding financial terms such as an insurance deductible
- Engaging in risky or unwise financial activity, including falling for financial scams
In addition to the increasing difficulty of managing finances as they age, many older adults live in conditions of economic insecurity and debt. According to the National Council on Aging (NCOA), more than 15 million older adults have incomes below 200% of the federal poverty level.
Older adults may need assistance with applying for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Adult-child caregivers may need to help their parents navigate the federal benefits from the U.S. Social Security Administration (SSA) and choose between SSI and SSDI.
Additionally, older adults may need help applying for and managing their Medicaid health care services. People can learn more about Medicaid eligibility and apply for Medicaid at HealthCare.gov.
Another important money management tactic to consider is encouraging a parent to name a “trusted contact.” Banks, insurers, and brokerages use trusted contact programs to notify account holders about suspicious account activity or when they can’t reach the account holders.
This is different from a financial power of attorney (POA): a legal instrument empowering someone to make specific financial decisions on an account holder’s behalf. An account holder, called the “principal,” must be competent enough to establish a POA — so families shouldn’t wait until their loved one has advanced Alzheimer’s disease or another form of dementia before establishing a financial POA.
Preparing for Emotional and Social Changes and Challenges
Social isolation and loneliness plague the 65-and-older population, according to NCOA. Around 25% of adults aged 65 and older are socially isolated, according to the National Academies of Sciences, Engineering, and Medicine (NASEM). As people age, they often lose loved ones and experience bereavement at the same time that their own health is in decline.
Additionally, ageism in health care has the potential to further isolate and marginalize older adults. The diminishment of social connection as a person ages has direct physical, emotional, and mental health effects and significantly affects an older person’s quality of life. Many older adults experience depression and anxiety due to social isolation.
There are many ways to support an aging parent’s emotional and social wellness:
- Encourage visits from family members and friends.
- Connect through personal computing devices, such as a smartphone or tablet, that can be used for sharing pictures and video calling.
- Seek accommodations so that older adults with mobility challenges can connect using technology. For example, people with arthritis or poor circulation may have difficulty using their fingers to navigate a smartphone, but using speech recognition technology may make it more accessible.
- Encourage them to join local community groups and events to make friends and socialize with other older adults as well as people of all ages. Choirs, dancing, Tai Chi, and knitting groups can be great for older people looking to connect.
Caring for Aging Parents with Mental Illness
Mental illness isn’t a normal part of aging, yet its frequency and the suffering it causes make it a major concern for caregivers. While dementia is most commonly associated with aging, older adults can experience various mental health issues.
Depression and Anxiety
The CDC estimates that anywhere from 1-5% of older adults experience major depression, a treatable medical condition that’s commonly misdiagnosed and undertreated in older people. For older adults who require home health care, that percentage jumps to 13.5%.
Fostering social connection, addressing loneliness, and seeking mental health services for persistent symptoms of mental illness are all ways that caregivers can support the mental health and well-being of older adults.
Resources for Caring for Someone with Dementia
Many people experience dementia as they get older. Dementia is a syndrome that leads to cognitive deterioration. WHO estimates that 55 million people live with dementia around the world, with Alzheimer’s disease contributing to an estimated 60-70% of all cases.
Many resources are available to help adult children caring for aging parents with mental illness, including dementia:
- NIA provides health information on the everyday care needs of people with dementia, as well as tips for maintaining caregiver health while supporting someone with dementia.
- The Mayo Clinic’s Alzheimer’s and dementia care tips provide suggestions for improving safety for people with Alzheimer’s disease or other forms of dementia, as well as tips for reducing frustration and increasing patience while caring for people with dementia.
- The Population Reference Bureau has a resource library of infographics and reports on demographic research covering dementia trends in the U.S.
- NPR highlights caregivers supporting other caregivers over social media and illuminates the unique challenges of caring for family members with dementia.
- gov is an organization of the National Institutes of Health and the U.S. Department of Health & Human Services that’s devoted to supporting those living with dementia. Its libraries include tips for caregivers and families of people with dementia.
Self-Care for Caregivers
Caregiving can be personally meaningful and rewarding. The potential psychological benefits of caregiving include feelings of closeness or intimacy between the person cared for and the person giving care.
However, caring for another person daily, especially a parent, can take a physical and emotional toll. Caregivers must be proactive in taking steps to minimize the risk of burnout (chronic exhaustion or a feeling of being overwhelmed).
Adult children who care for their aging parents are particularly at risk of burnout. Caring for a parent whose faculties are in decline can lead to both relationship challenges and difficult emotional experiences such as anxiety, resentment, and grief. Caregiving can also be intense, with long hours and a sense of isolation from outside support groups.
To deal with the stress of caregiving and avoid burnout, adult children can employ various self-care strategies, such as:
- Getting regular exercise. Caregiving can be physically draining. Caregivers need to maintain their physical health to support others, so getting regular exercise is crucial. Exercising can also help with boosting and regulating mood, making it an especially important tool in any caregiver’s self-care tool kit.
- Seeking social support. There are millions of caregivers in the world, but many of them feel isolated. Meeting with other adult-child caregivers, whether in person or online, can remind caregivers that they’re not alone. Caregiver forums can offer advice and support to adult children navigating the care process with their parents.
- Making art. Creative expression is another great tool for developing a sense of control and agency while caring for a parent. Art can empower people to express their innermost feelings, experiment with ideas, create beauty, and share their experiences with others.
- Sparking laughter. Genuine laughter can improve mood, release stress, and improve the immune system long term, according to the Mayo Clinic. Finding the humor in daily life, relaying funny stories to friends, watching or listening to comedy, and being silly can spur laughter to prevent caregiver burnout.
- Ensuring proper nutrition. Caregivers need to meet their own basic needs, including consuming healthy and nutritious foods. Making special meals for oneself can also be an act of self-care.
- Getting rest. Everyone needs rest, but especially caregivers. Working with other caregivers (whether paid or unpaid) to take shifts for proper sleep and relaxation can be crucial for preventing burnout.
What Is Gerontological Nursing?
Adult children tasked with caring for aging parents may interact with or even rely on day-to-day care from gerontological nurses. Gerontological nursing (also called geriatric nursing) is an evidence-based nursing specialty that focuses on supporting older patients as they age.
Competencies of a Gerontological Nurse
Gerontological nurses develop skills to support older people in various environments, including in the patient’s own home. These skills range from health promotion and disease management to rehabilitation.
Gerontological nurses must also develop an awareness of the complex factors that impact older adults as they age, including the following:
- Socioeconomic challenges
- Mental health challenges (including depression, anxiety, and loneliness)
- Geropharmacology challenges (including side effects from taking multiple prescriptions simultaneously)
- Environmental factors
- Challenges associated with atypical presentation of illnesses
- Challenges with managing multiple chronic conditions
Gerontological Nursing Values
The driving principles and priorities of geriatric nurses include maintaining patient autonomy and dignity as a person ages.
Autonomy refers to a person’s ability to make independent choices. As people age, their adult children, nurses, and caregivers must do what they can to support the individual’s autonomy by:
- Making necessary accommodations to support the health and mobility of older adults, including any needed changes to living spaces
- Asking for consent
- Maintaining medical confidentiality
- Providing all necessary information so that older adults can make fully informed decisions
Dignity refers to a person’s right to be respected and valued. Nursing professionals who work with aging parents and their families can show respect for patients by listening to them, respecting their values and choices, and promoting relationships and activities that confirm the patients’ feelings of self-esteem and social inclusion.
Care for aging parents should promote their autonomy and dignity. A lack of respect can lead to feelings of humiliation and cause distrust between parents and their caregivers. Adult children must do what they can to prevent this from occurring, especially as a parent’s health and mobility decline.
Care for Older Adults
Caring for aging parents can be challenging but deeply rewarding. Planning for the future is vital so that parents can live long, dignified lives as they grow older. With careful planning, flexibility, and practice of self-care, adult-child caregivers can enjoy the rewards of taking on this important responsibility and cope with its burdens resiliently.
Adult-child caregivers should also know that they don’t need to care for their loved ones on their own; skilled nurse professionals can also provide support as members of a parent’s health care team. Some say it takes a village to raise a child, and it takes a network of caring people to support older adults as they age as well.