Not Exactly a Role Reversal

(Time Period: Toward the end of Mom’s first year in memory care.)

What is Happening?

“Now the roles are reversed.” It’s a statement that is often made with regard to caring for elderly parents and there is something to it. We are trying to describe what’s going on, to make sense of the changes that are occurring. Our parents need help taking care of things around the house, managing their finances, or deciphering medical diagnoses and treatments. We declare, “It’s our turn to take care of them.”

In addition to these practical matters, our support is needed on an emotional level. It is then that the relationship dynamic is impacted significantly and the role reversal issue becomes unavoidable. Particularly in the case of dementia, the behavior is often like that of a child and requires patience. That’s what makes it complex and more difficult to accept. We expect a child to act like a child but when a parent does, it feels strange.

These changes are unsettling and cause us to examine our roles and identity. With conversations now altered, we miss the type of intellectual exchanges we were able to have previously. Even so, they are still adults and still our parents.

I would catch myself if I thought I was talking to Mom a little too much as if she were a child. It was appropriate to simplify explanations when I answered her questions or to soothe her when she was anxious, as you would a child, but I wanted to stop short of anything that resembled baby talk. Infantilizing was not the right approach. There were many times Mom would say something that demonstrated she still comprehended on an adult level.

Saying, “I am now the parent,” didn’t cover it. The absolute pronouncement didn’t fit. Certainly there was an element of reversal and it was true that I was now the one taking care of her, but she was not my child. I was mothering my mother because she was in need. I was caring for her, protecting her, and reassuring her just as she had taught me, yet she was still my mother. I would let her be.

Beyond the Limits

It was a beautiful November day in Scottsdale. Gabriel helped Mom into the wheelchair while I grabbed her fleece jacket, sunglasses, and a light blanket for her lap. After we lifted her over the threshold of the front door, Gabriel smiled broadly and waved to Mom, “Have a nice walk, Grace.” He was happy to see her enjoy the sunshine and fresh air with her daughter.

I loved taking Mom through her neighborhood. Though only ten minutes apart in distance, it had a different landscape than where I lived. Each street had an extraordinary variety of trees, cacti, and unique desert flowers to discover together. Through periods of quiet, chatting, and occasional singing, I relished the moment, fully aware that our time together was precious and how special an ordinary neighborhood walk was. I noted each element that was part of our excursion: the mix of cool air and warmth of the sun; the quiet streets with occasional neighbors in cars who waved as they went by; the chirps of birds and all the colors that were on display for our eyes.

Her contentedness that day allowed a longer than usual walk. Turning down another street and extending the boundaries of our outing felt like a bit of freedom. We were beyond the limits of our typical radius geographically speaking, and for that hour, beyond the containment of Alzheimer’s. Did she feel that sense of freedom, too?

While conversing with Mom, my view as I looked down was the top of her head. Occasionally I would pause briefly to lean around and see her face, just to make sure she was comfortable.

As I continued our stroll, an image flashed through my imagination of Mom as a forty year-old mother of four children. I pictured her strolling through our neighborhood in Mount Vernon, New York, while pushing me in a baby carriage. Just as I was contemplating the role reversal, that now it was I who was pushing her in a wheelchair, her voice softly floated up and interrupted my thoughts.

“Do you have a sweater on? Are you comfortable?”

In an instant, I was daughter again.

Child or Parent?

On another afternoon at the care home, Angela gave Mom a napkin with a mid-afternoon snack: two miniature donuts. Mom immediately handed one to me. That she wanted to share part of her snack, even these tiny, little donuts, made my heart melt. It was something Mom would do as Mom and it also reminded me of when toddlers hold out their sticky fingers to offer you whatever they are eating. I wondered which one it was this time. Was she being the child or the mother?

There is another memory involving donuts, this one with my Dad. About a year before mini-donuts with Mom, my father was in the hospital. It was the morning of the day he died but I didn’t know it at the time. Having gotten there early to catch the doctor then learning his arrival was delayed, I stopped at the Dunkin’ Donuts across the street. With coffee too hot to sip, I spotted a chair. Taking a deep breath, I tried to relax but just as I unfurled the bag and broke off a piece of the old-fashioned donut, the phone rang. The nurse spoke in a manner that conveyed calm yet told me I should get to his room as soon as possible.

I darted across the busy street of commuters and hospital traffic. With piping hot coffee in hand, I prayed out loud that I would make it there in time to see him. Thankfully it turned out that I would have the whole day with Dad. As I arrived to his unit, they sat me down in a chair outside his room, so they could finish getting him settled after a period of respiratory distress. Once in the room, I greeted him, then took a seat by his bed. I told him that the doctor wanted him transferred to the ICU where they could take better care of him. Dad was concerned that I had rushed over so early in the morning. His first question was not about his health status but rather, “Did you have breakfast?”

Two memories with donuts in the picture: one of my father who was healthy from a cognitive perspective but in his final decline physically; the other of my mother who was otherwise healthy physically but compromised cognitively. They are different situations yet both are memories of elderly parents in need, who, though being cared for by their adult child, retained their instincts as father or mother. Did you have breakfast? Do you have a sweater on?

They did not shed the role of parent, nor did I shed my role as their child. All the roles we’ve ever had remain part of us.

All the Roles Remain

It is a reversal of sorts. For as strange as it feels and along with the inevitable sense of loss, there is a sweetness and a tenderness in the mix. They need our help in a variety of ways, yet despite the significant changes that occur, the parent is not the child.

That day, on our extended walk through the neighborhood, the light streamed through tall tree branches to reach desert plants and flowers in brilliant array. The air was cool and clear. I might have been the one who bundled her up in a fleece jacket and the one who was wheeling her around, but I was still her daughter and she was still my mother, making sure I was wearing a sweater.

Note: The names of Grace’s caregivers, Gabriel and Angela, have been changed for privacy.