The agony of role reversal

For many of us, the most challenging and sensitive issue that we will come up against in the Other Talk are the changes that we will experience in our last chapter of life.

I’m not referring to the evolving physical condition that we notice as we get older:

  • Stamina gets shorter
  • Recovery time takes longer
  • Morning stiffness is part of waking up
  • The row of plastic pill bottles gets longer
  • Looking for your reading glasses becomes an hourly event
  • Wondering why you just walked into a particular room becomes a regular occurrence

All of this can be mildly annoying but none of it is debilitating.

There is a much more fundamental and potentially difficult adjustment that occurs as we enter our last chapter of life, as I learned from the hundreds of interviews I conducted with doctors, nurses and hospice workers as well as families.

It is the reversal of roles between parent and child that is triggered when you reach the point, physically and/or mentally, where you can no longer operate independently.

In essence, you become the child and your child becomes the parent.

Why is this reversal of roles so difficult and potentially life-changing for both parties? Because it is not merely a mechanical re-assignment of responsibilities; it is the shattering of the relationship that you as a parent have had with your children since the day of their birth. As a result, you lose the power and control of being the adult and your kids give up the security and freedom of being the child.

Impact on the Parent

For the parent, it’s the crushing realization that

I’m about to lose control of the life and lifestyle that I’ve worked so hard to create for myself and my spouse.

Despite all the successes you may have achieved throughout life, all the good deeds bestowed on others, all the love and support heaped on family and friends, the great injustice at the end of life is the fear of losing control.

As the aging process continues, I learned from my research with parents and their families as well as social workers and hospice practitioners that the primary reason that the elderly begin to actively resist turning over responsibility and decision-making to their offspring is due to their escalating fear of:

  • powerlessness
  • becoming a burden on the family, physically and financially
  • loss of self-worth, self-respect and self-dignity
  • abandonment by the family

To make matters worse, since most people wait until a crisis hits before confronting the need to transfer power and control to the kids, role reversal is often forced on the parents with little or no discussion.

Impact on the Child

For the child, it’s the sinking feeling that

I need to start taking responsibility for my parents’ life . . . physically, financially, socially.

Typically for the kids, the shock of responsibility at the “moment of truth” is followed by feelings of inadequacy, embarrassment and resentment as the plight of their parents comes to dominate their lives. This cauldron of emotional reactions is hardly surprising since, for the child who is about to morph into the parent, there is little training and often no warning that it’s time to step into the care-giving role for the parents.

Unlike another major event in life, childbirth, there are no pre-natal classes on care-giving issues and techniques, there are no baby showers to help with the expense of the care giving responsibility . . . and there’s no parent to turn to for advice or just a shoulder to cry on.

As a result, for the “child cum parental responsibility”, the world of role reversal can be a very dark and lonely place. Again, the comparison with the childbirth event is instructive:

For child care, there are nine months to prepare, the evolution to term is usually predictable and straightforward, and there is a general crowding around of friends to share in the event.

For parent care, the catalyst is often a sudden, unexpected crisis, the decline is unpredictable and full of unpleasant surprises, and there is almost never any crowding around of friends to share in the event.

The Other Talk as a “game changer”

Bottom line, the impact of the role reversal process can be very debilitating . . . for both parent and child. The power of the Other Talk to mitigate this situation is that it isn’t just a checklist for the necessary transactions at the end of life like a will, life insurance, advanced directives and funeral plans.

Rather, it goes deep under the surface, delving into the judgments and decisions that need to be made throughout your last chapter and how your children will impact and be affected by them.

It accomplishes this by first creating in you the parent, then sharing with your kids, a tone and attitude that permeates the Other Talk:

  1. You, the parent are proactively taking the responsibility for empowering and preparing your kids for the reversal of roles that will take place in your last chapter
  2. You, the parent embrace the eventual reversal of roles as, not giving up power and control, but rather achieving security and freedom

It then turns to building a mental framework that will allow a smooth transition when the time comes to shift decision-making responsibilities:

  1. First, acknowledging the inevitability of the need and the wisdom to transfer decision-making and management of the day-to-day
  2. Second, discussing and establishing ground rules on the potential circumstances or triggers that effect the change of responsibilities on key functions such as bill paying, driving, living arrangements, money and asset management and medical decisions

Finally it culminates in a series of conversations that cover in-depth how you would like to deal with four facts of life in the last chapter of life

  1. Financing your uncertain future
  2. Living in your home (or not)
  3. Getting the medical care you need
  4. Taking charge at the end of life