No matter how much we change physically as we grow older, our personalities remain much the same throughout our lives.
This can be good — or bad. Sometimes the hardest challenge in caregiving is the older person herself.Three rules operate at once:
First, personalities drive much of what happens when you care for an older person; the diagnosis is secondary. Whether your mom had a stroke, cancer or a bad cold, how she responds to the situation depends on who she is as a person, and that was created long ago.
I've been dumbfounded by the older people I've met who remain cheerful despite great pain and difficult circumstances, while others fall apart over nothing. It's why I believe, from the day we're born, it's important to work on our coping skills. Much of the quality of life we experience as we get older depends on our attitude.
The second rule is a cousin to the first, and it's called the "more so" theory: The older you are, the more you stay the same — only more so.
Just because a person needs a lot of help to make it through the day doesn't mean she'll become cooperative, pleasant or even nice to those who care for her if she wasn't that way from the beginning. You need to assume she'll be the way she's always been, but in stronger doses as she gets older and loses her independence.
Third, because caregiving is so personality-driven, you as the caregiver must recognize that the only person you can control is you. This means, once you've done as much as you can, you may need to let go.
Throughout my career, I've met a small group of older people I call the "parents from hell." Unspeakably vicious, rude, insulting and totally lacking in appreciation, nothing you or anyone else does is ever enough. Usually this is lifelong behavior, and following the "more so" theory, it becomes worse as they get older. It gets much worse if they become demented.
And many are remarkably long-lived. I used to think their nastiness pickled their organs somehow and kept them healthier than nice people. In fact, early in my career, I worked with so many people like this that I actually believed the adage, "The good die young."
Since then, I've realized that, just as we differ in height, weight, color and sex, so do we differ in personalities. Some are simply poisonous. I've met far more "mothers from hell" than dads, perhaps because men die younger.
Parents from hell are their own worst enemies. You can't be nasty, self-centered, negative, blaming or difficult without hurting inside. The most common cause is psychological, an array of complex mental disturbances that have never been resolved, probably never diagnosed.
It can tear their adult children apart. By definition, whatever anyone does for a difficult mother (especially close family members) is never enough. You can wait on her hand and foot, and she will be dissatisfied, then twist the knife by telling everyone.
She's narcissistic. Lacking empathy, she cannot see the anxiety her family members experience while failing to please her. Ignoring the sacrifices of others, she dwells only on herself.
She may be manipulative, making up stories about how staff mistreats her so her family will feel guilty, visit more often or take her home with them, where, of course, she complains that it's not good enough.
If ever there were a vicious circle, it's adult children trying to please a chronically complaining mom. Chances are, they've been doing it their entire lives and don't see how they enable her to set them up.
The solution? Well, the older person isn't going to change. At 84 or 94, no amount of talking, cajoling or reasoning will make her behave differently. It's the family members who need to understand the dynamics here and learn how to respond to the situation differently. That's not easy, but given the stress, it's important to try.
Because adult children have been conditioned to respond to their mother's manipulations, they need to unlearn these responses and adopt new behaviors. They're likely to even feel disrespectful not to behave as before.
With such long-standing patterns, I think a counselor would be well worth the investment — to talk through what's happening and explore new behaviors. Life is too short to endure constant abuse from a nasty parent.
Most of us age accidentally, without planning or forethought. Aging Deliberately tells us how to age on purpose. You can reach Liz Taylor at lizt@agingdeliberately.com or write to P.O. Box 11601, Bainbridge Island, WA 98110.