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Book Reviews

What Are We Going to Do Now? Helping Your Parents in Their Senior Years

by William Molloy

Take Care: A Practical Guide for Helping Elders

by Ann Rhodes

Canada is getting old. By the end of the decade, the proportion of the population over 65 will be 12%, and that number will continue to rise well into the next century.
For the growing number of us, then, who are concerned with how to care for aging parents, or elderly relatives and friends, these two complementary volumes will prove most helpful. Both span a similar range of caregiving issues but explore different aspects of the obligations and practicalities of looking after elders.
William Molloy, an Irish physician and geriatrician, aims What Are We Going to Do Now? specifically at people with aging parents. Drawing on his own experiences and those of his patients, Molloy probes complex parent-child relationships, showing how they influence caregiving attitudes. Old age, he says, can be a harsh sentence, and he suggests many ways in which children and their parents can best accept and deal with the situation.
Written in a compassionate and humorous style – from both a physician’s and a son’s viewpoint – Molloy’s book is more analytical than Rhodes’, looking in greater depth at the emotional and psychological roller-coaster ride that many people undergo in coping with elderly parents, and how it obliges them to confront their own mortality.
He gives unusual insight into recognizing and dealing with the hidden motives, resentments, and guilt that hamper most parent-child relationships, and how to get past the difficulty most parents find in talking to their children about aging and death – topics “uppermost in their minds but often considered taboo.”
Laced with personal anecdotes, Molloy’s book illustrates positive and counterproductive approaches to common caregiving dilemmas. Rather than laying down blanket rules, he uses specific cases to make his points, delineating the options in dealing with particular issues – such as health care, housing, legal arrangements – but leaves people to make their own choices.
In Take Care, Ann Rhodes covers much the same ground, also giving many diverse examples, but she relies more heavily on the views of professional and lay caregivers, offering more general do’s and don’ts. She looks at the societal costs of eldercare – the fact that women currently shoulder 80% of the burden – and stresses the need to compensate caregivers and to recognize the value of their efforts.
Rhodes critically examines the relationship between caregiver and care receiver, pointing out ways to assess and manage demands and engage various family members. Throughout, she provides useful “self-tests” for evaluating one’s ability or readiness to take on certain aspects of caregiving. She also deals at length with the living arrangements of elders, the pros and cons of living with relatives and how to work out family compromises, stressing the need to make seniors feel valued while setting limits on the extent of involvement and caregiving needed. Like Molloy, she underlines the need for caregivers to protect themselves, to be realistic about what they can or cannot undertake, and to avoid caregiver burnout.
Both books describe the normal physical changes of aging (the loss of vigour, looks, and vitality), list common health problems, and discuss diet, safety checks, memory loss, and ways to stay healthy and active in old age. Molloy deals more concretely with topics such as medical check-ups, choosing a doctor, safeguarding the home, distinguishing illnesses that need treatment (such as Parkinson’s disease or arthritis) from normal age-related changes, and maximizing quality of life.
Although both books deal with depression, Molloy more adequately describes its detection, showing how it is frequently ignored or misdiagnosed – not given the attention and antidepressant therapy that could relieve it. Discussing sexuality, he explodes prevailing myths, saying that while the frequency of intercourse may decline, many older people retain sexual desire and remain sexually interested and erotically active to a ripe old age.
On the other hand, Rhodes deals more thoroughly with societal and practical family matters, with particularly helpful sections on confinement, frailty, lifting, and assistive devices. She also describes ways for caregivers to evaluate their success in coping with stress and anxiety, and suggests methods for gaining peer support. Her section on “new age elderhelp” describes the use of many different therapies – from music, gardening, remembrance, and massage therapy to Shiatsu, reflexology (foot massage), pet therapy, aromatherapy, and the use of humour.
Both books cover neglect and elder abuse, and both stress the need to develop an “action plan” in preparation for such issues as loneliness, isolation, power of attorney, illness, healthcare directives, guardianship, living wills, loss, grief, bereavement, dying, and, eventually, death.