40 THE QUEENS COURIER • WELLNESS • AUGUST 19, 2021 FOR BREAKING NEWS VISIT WWW.QNS.COM
Role reversal and aging
BY DR. SHELDON ORNSTEIN
ED.D, RN, LNHA
Adult children are oft en said to reverse
roles with a parent when the parent
becomes old and physically or emotionally
dependent. Th is has a demeaning connotation,
as the elder is a child again in the
adult child’s eyes. Th ere is an abundance of
evidence that adult children may at times
feel it’s necessary to employ a role reversal
to the detriment of the aged individual.
Th e researchers Connides and Davies state,
“In illness and deterioration of the elderly
individual, the adult child may come to
feel ‘parental’ but the inner child will always
remain in search of the protective and guiding
Th ese dynamics can oft en make the caregiving
role diffi cult. Th e elderly, however,
may require specifi c assistance from
family or friends that will allow them to
live at home. Th e assistance may come in
the form of fi nancial advice or a ride to
the doctor with concerns about a medical
issue that apparently has been dominating
According to statisticians who cover the
fi eld of aging, “Relatives provide 85% of
all care to elderly males, and 79% to elderly
females. More than 1 in 3 elderly men
needing assistance is cared for by a wife
while 1 in 10 disabled elderly women is
cared for by a husband.”
If an aged parent is beginning to need
help, the following suggestions may be useful:
Involve the parent in all decisions that
aff ect their care.
Assist the elderly parent to remain as
independent as possible and provide assistance
only for those things that are stressful
Seek resources that provide options
between independent living and skilled
If a parent insists on promises never to
be admitted to a nursing facility, the family
may promise that they will do everything
possible to prevent it. However, if the
aged person requires skilled nursing care, a
nursing facility can provide the care needed
with professional staff ers available 24
hours a day.
If a nursing facility may be needed, then
suggest, if possible, for the aged to accompany
the family on a tour of the intended
A spouse, functioning as a full-time caregiver,
can off er a way of delaying the inevitable
i.e.: the decision by a loved one, other
than the caregiver to engage in role reversal
on a disabled parent.
Elderly spouses caring for a disabled
elderly partner may also have special needs.
Before performing their caregiving duties,
the caregiver should take into consideration
• calling on support groups or their allies
whenever advice is needed or if a care
issue arises that can’t be resolved at once.
• become aware of the care issues that may
require an interpretation whenever there is
a decline in the physical or mental state of
that individual being cared for.
• knowing when a brief respite for the caregiving
duties becomes necessary and may
require a time out.
• determining if fi nances are solvent and
available for purchasing food, paying bills
and ordering prescription medications.
• having the knowledge to act on when
administering prescribed medications
with side eff ects.
• having available phone numbers whenever
help may be required, such as ambulance
services, doctor’s offi ce, and signifi -
cant family members to contact.
Photo via Getty Images College, Columbia University.
Elderly spouses who perform caregiving
duties have special needs as well as the ill
partner. Respite care, for example, is essential
from the unremitting daily grind of the
care being given. A spouse may also have
signifi cant health problems that are often
neglected in deference to the greater needs
of the incapacitated partner. More often
the woman in the caregiver’s role may, in
fact, be in dire need of caring for herself.
However, because of concern for her mate,
she is unable to forgo her caregiving duties.
Life’s satisfaction tends to be limited
when illness, low income, multiple
demands on one’s time, the loss of intimacy
and companionship occurs to an ill conscientious
It is doubly diffi cult when the partner
is aphasic due to a stroke or incontinent.
Availability of adult children, relatives and
friends may become necessary in easing the
load and thereby increasing a level of satisfaction
to both caregiver and the ill individual
being cared for.
The question arises, who is an ideal caregiver
for an ill and/or injured elderly person?
From my years of experience as a
registered professional nurse in long-term
care, the “ideal” individual:
• is not threatened by the numerous psychological
issues that may occur while
in the process of physically caring for an
elderly disabled individual.
• maintains an eff ective and personable
communication with the individual being
cared for. How? By understanding the
ill individual’s connection and the world
around him or her and how it may aff ect
the psyche of the elderly individual.
• can show compassion, can employ fl exibility,
can utilize a sense of humor, can
avoid arguments, and above all, be able
to talk with the individual often, even
if they do not appear to respond. This
Dr. Sheldon Ornstein is a registered
professional nurse with
a doctoral degree in nursing
organization. He has specialized
in the care of older adults and
has published many articles on
the subject. He has done postgraduate
work in gerontology and
has taught at several universities.
In 2013, he was inducted into the
Nursing Hall of Fame at Teachers
may be due to a hearing issue, a multiple
stroke which can cause a speech impediment,
or perhaps a persistent drain on the
elderly person’s system, or a silent anger
at a deity who presumably abandoned
him when He was most needed.
Here are several coping strategies that
may reduce the burden from the care being
administered. Develop confi dence in facing
multiple problems that can arise during
the care being given. Understand the caring
issues by anticipating and employing
alternative ways of what fi rst appears as
an insolvable issue with the care. Prepare
a position suggesting passivity in reference
to things that cannot be changed and
share it with the ill aged. Have the confi -
dence to convey a spiritual environment
and share with concerned families and ill
aged when to contact clergy, use of prayer
when requested, etc.
In an earlier article I spoke of a nursing
home resident who often quoted a
line from his favorite poem entitled “Even
Withered.” He said, “There is no limit to
looking upwards.” Charlie was that resident.
He was a quadriplegic resident who
needed daily intensive care for his continued
survival. Yet, with all of his severe
physical limitations to function as we all
do, and as we take for granted, Charlie’s
survival was due, in part, to the aggressive
physical therapy program, an effi cient form
of nursing care, and the hope we all were
able to give him. Before Charlie’s passing,
he continued to quote, with the waning
strength he was able to muster, his favorite
oral poem, “there is no limit to looking
upwards.” Here’s hoping he eventually
achieved his goal, “looking upwards.”
All of us should also do the same as
Charlie did during his time with us: “Look
upward!” These two words envision a