Non fiction

From Dependents to Dependable: Caring for Aging Parents

Group Therapy
Growing old means reversing roles. Pamela wonders about this delicate, decisive moment when the child becomes the guardian of the adult he once admired.

I write about old age as if I were already an old woman, but I am merely an observer. A spy.

I have always been close to the older generation as a granddaughter or a friend, but never as a daughter. I think it’s important to clarify this point. Having a grandparent with senile dementia or physical or psychological illnesses is much more manageable than if this person happens to be your parent. The role of a grandchild is to inspire an occasional smile, converse, clean, and assist with their grandparents when needed, with a significant emotional distance that remains between grandchild and grandparent.

Aging is a global challenge, especially in low- and mid-income countries. By 2050, 80% of these countries’ populations will be considered elderly. Very little is said about the desperation and anxiety people are facing in countries where children must step in financially because their parents’ pensions are insufficient for covering their basic needs, such as groceries, housing, and medicine. When the high costs of nursing homes or caregivers are factored in—often essential even when children are primary caregivers—the future of elderly generations looks bleak. As a result, children often find themselves navigating the complex role of both caregiver and financial provider for their aging parents, a responsibility that grows increasingly difficult each year.

Caring for aging parents is often seen as a personal choice rather than an obligation, yet there remains a deeply rooted taboo for those who opt out. This choice is often seen as neglectful or ungrateful. Finding a balance is crucial: completely relinquishing the responsibility can be seen as abandonment, while fully assuming it is a hugely daunting task that should not fall on any single individual. Some undertake caregiving out of love, others from a sense of duty or guilt, and many because they have no alternative. The ideal approach lies somewhere in between—perhaps hiring a caregiver and offering support when possible. However, this solution requires financial means and privilege, resources that are out of reach for much of the world’s population, opening the floodgates of stress and despair.

As parents age and become unable to care for themselves, family dynamics often reveal hidden tensions and conflicts. I’ve witnessed this firsthand with three grandparents (two grandmothers and one grandfather). Family arguments erupt, with shouting matches and long-held grudges coming to the surface. What begins as a rational discussion quickly escalates into an emotional battleground. Sometimes, the elderly parent ends up being bounced from one household to another, looked upon as more of a burden than a person with needs and emotions.

This was the case with my paternal grandmother, Aurora, who lived with me and my uncles and aunts at various times. Despite suffering from severe senility, she even traveled alone by plane to stay with one of her daughters. Her routine in each one of our households was consistent: most of her day was spent downstairs eating and watching television. The sound of channel 10 had to constantly be in the background. Changing the channel or turning off the TV would cause her to spiral. She sometimes didn’t even really watch the TV, but she still required its constant presence. That channel was like her true home.

 For a long time, she’s wished for death that doesn’t come. And who can blame her?

My other grandmother, Chepa, spent years traveling from house to house with a canary in a cage—a symbol of my grandfather—along with a suitcase and a rocking chair. Eventually, she became bedridden and insisted on staying in her own home, where she remains to this day. All of her children love her in their own ways, each sharing their own personal history with her. Chepa is a complex person, like a character from “One Hundred Years of Solitude,” very latina and dramatic. She no longer reads, but she used to be an avid reader. Her life was a tapestry of contradictions: quiet yet tough, somewhat masculine yet deeply feminine, fiercely independent yet tethered to a military husband. Her children were integral to her novel-like existence. Bedridden for over a year due to a poorly treated leg fracture and deep depression after losing a son, she now has both good and bad days. She’s grown more docile but remains unchanged at her core, resenting her life yet unable to change it. It’s not easy. For a long time, she’s wished for death that doesn’t come. And who can blame her? Who wants to continue living a life where others must clean up after you every day, where even chewing becomes a challenge?

A few months ago, she was convinced she was going to die. Being somewhat of a fortune teller, a sorceress, everyone believed her. We spent five days praying and preparing her favorite meals. She was struck on and off by fever. We fed her like a Christmas goose and even brought in a priest to administer last rites with sacred oils. Relatives traveled from the countryside to bid her farewell. Three months later, she was still alive. We played her favorite song, the Edith Piaf “La vie en rose,” on repeat. Quand il me prend dans ses bras/ Il me parle tout bas/ Je vois la vie en rose.

Now, whenever I hear that song, I can’t help but laugh at the absurdity of the situation: the whole family in tears, the exhausting days spent at her bedside, the expenditures on foods we could hardly afford just to make her happy—at witnessing my grandmother play-act her own death.

Not everyone understands this kind of situation. Some people move out of state or out of the country and belong to fragmented nuclear families. Perhaps health issues keep them at a distance from their aging relatives, shielding them from these types of challenges. Often, children who live far away end up being seen as the “good children” by their parents. Their relationships consist of occasional visits and phone calls. They wish their parents well, treat them kindly, show affection, and only hear about their issues as anecdotes told over the phone. That said, children who take on the role of caretakers become entangled in the daily difficulties, mood swings, and physical decline of their elderly parents. They find themselves assuming authority over their parents’ lives as the latter regress into a more childlike state. Consequently, they often end up being seen as the “bad children.”

Sometimes, the mannerisms of old age can verge on downright meanness. It is understandable that there is a bit of madness in the aging process, but when a person dedicates their time to caring for others, their heart always longs for gratitude and a smile in return for their services. When this doesn’t happen, it feels like a heavy weight, creating friction in this new, complex filial bond that bears little resemblance to its original form. The reality is that elderly individuals with senile dementia often seem happier than those around them. They frequently remain oblivious to their surroundings, while their children and relatives learn to cope with feelings of sadness, disorientation, hopelessness, shame, and even disgust. In such moments, it helps to remember the good times spent with your parents—the purest and simplest moments, like lazy Sundays sharing breakfast in bed, an unforgettable trip, or moments of shared complicity and humor.

It’s important to be understanding of the children who choose to leave. Many of these individuals were raised by terrible, oppressive parents that they successfully escaped from. Others face more ambiguous situations where their parents may appear nice on the surface, but in reality have archaic beliefs that somehow led to abuse. These individuals simply cannot live under the same roof as their parents, as it stifles their personal growth. Other cases are less severe yet comparably challenging: a mother who criticizes her daughter’s weight incessantly, or a father who struggles to accept his son’s homosexuality, for example, are targeted issues that create friction and make coexistence between parent and child impossible. These are the untold stories that gather dust in the cupboard like old cans of Campbell’s soup, illustrating how the relationship between parents and children can be one of the most difficult to navigate.

These children, whose parents either neglected them, humiliated them, or were simply just bad parents, will often remain by their aged parents’ side. It could be due to following prescribed patterns, because they’re better people than their parents were, or simply because they have no other choice. A child will care for his or her sick mother all while trying to forget the shared history and attempting to reconcile with the mother’s past behaviors. While the adult child wipes her intimate parts with baby wipes, the mother pretends not to remember the past and attempts to understand why her child, whom she mistreated, is now her care provider. Both parties pretend not to remember the past. Sometimes, this turn of events gives the parent-child relationship a second chance. Between adult diapers, applesauce and medication, countless emotions come to a boiling point in this relationship where the roles are suddenly flipped.    

When a child takes on the role of caregiver, the parent transitions into a patient with a body that carries its own history and memories.

In American poet Sharon Olds’ collection entitled “The Father,” she comes to terms with being the kind of daughter to her father as was just described above. In one of her poems, she reflects, “I might have wished to trade places with anyone raised on love,/ but how would anyone raised on love/ bear this death?” Olds tackles the theme of caring for a difficult father, stoically delving into the challenges of witnessing her elderly father in his vulnerable moments, which includes seeing him naked. This raw collection focuses intensely on illness and the process of caregiving into its latest stages. In certain poems, Olds discusses her father’s penis in an introspective dialogue with herself. She observes it almost as an object, comparing it to something like an ear or a tongue, making it less taboo while also acknowledging its former sexual functions. When a child takes on the role of caregiver, the parent transitions into a patient with a body that carries its own history and memories. This experience can induce a sense of moral vertigo, forcing the child-caregiver to confront the complexities of what that body once symbolized and what it means in its current altered state.

Geriatric illness transforms not only the patient’s body, but the entire household, confining the family to domestic spaces. A single room ends up serving as a bathroom, living room, clinic, or even dining room. When a space serves all these functions, it loses its identity as a distinct room, and the patient loses a sense of personal space. And it’s perhaps the objects within these spaces, remnants of time gone by, that charge the environment with the weight of the past.

My grandmother struggles to recognize her surroundings in the room she now occupies. She often needs to be guided out of the room because she believes she’s still in her own home. In moments of confusion, she thinks she’s in a nursing home and mistakes me and my mother for nurses. Her room is located on the second floor of the house, close to the kitchen, a room that was originally the library. It now serves as her primary living space, equipped with a small bathroom and two beds (a hospital bed and a normal bed where the caregiver sleeps).

Death in old age can unfold slowly over a long period or strike suddenly and violently. Two memories of the person endure: the first, of who they were in their independent years, and the second, the lingering presence they became while awaiting death.

Growing old is a deeply solitary journey for many people. I personally have contemplated the option of euthanasia. If I have children and become a burden, I would like to have the choice to peacefully end my life, leaving them to live theirs without the obligation of caring for me. These are topics seldom broached, perhaps because death remains a dark, taboo subject. Yet, the option to choose death in order to offer peace to others seems to me to be a sign of compassion. Aging inevitably encompasses the lives of families. There is much silence surrounding it; some even carry years of guilt and resentment.

I suggest delving deeper into the concept of aging while we’re young, exploring it not just from a perspective of health and good habits, but from a deep philosophical and even political standpoint. This involves creating communities and social programs for the elderly that promote free care, funded by the state. Such initiatives can address the anxieties of a millennial society increasingly reluctant to leave their homes, particularly in low-income Latin American countries. We need to consider what kind of elders we aspire to be. What are our expectations from our children, if any? What do we anticipate from our partners as we grow older? By preparing ahead of time, perhaps we can find greater happiness not only for ourselves but also for those who love us and are concerned about our well-being.

Watching parents and grandparents age is a dramatic, complex, and moving experience, mainly in that it is not glamorous. It’s a part of life, a rocky mountain that we choose to climb although we’ve never mountain climbed before and don’t even have the proper equipment. We keep climbing, looking out into the abyss, occasionally tempted to leap off a cliff. There is no summit, only stones that cause us to stumble over and over, causing the blood to rise to our knees until it’s the same color as the sky above, making the birds sing louder in our ears. Suddenly, the wind blows a bit harder, calling out just to you, when at last after an exhausting day you can take refuge in sleep.

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