Are Your Parents Old and Ill? A Chat With Dr. Tamara McClintock Greenberg

If you are like one of the millions that read The Huffington Post, it is safe to say your parents are aging and perhaps ill. How well do you understand what they are going through?

Dr. Tamra McClintock Greenberg, in her new book, Psychodynamic Perpectives on Aging and Illness (Springer, 2009) presents keen insights for understanding your parents feelings and behaviors. The book is geared towards professionals who work with the "aging population," but the serious reader can gain understanding too.

After reading her book, I thought you would find a session with Dr. Greenberg (Department of Psychitry, Univerity of California, San Francisco) interesting.

Dr. Hank: How did you get interested in working with the aging population?
Dr. Greenberg: In graduate school I specialized in health psychology, so a number of patients I saw (with on-going medical problems) tended to be older. I really got interested in the elderly when I started learning more about psychoanalytic theory, and that this theory historically has not been very inclusive of applying treatment approaches to older adults. I have wanted to find a way to help clinicians think about the unique needs of this population.

Dr. Hank: What did you learn about aging from your parents?
Dr. Greenberg: My mother became aware of the need to take better care of herself as she got older. In fact, I remember, when she was in her early thirties, she started to exercise regularly. She would go to the gym before work. We lived in a small rural town and she had to drive over 30 minutes to get to the gym. I don't recall that there was a "gym culture" where we lived, so it struck me as unique and also inspiring.

Dr. Hank: What observations have you made on how baby boomers deal with aging parents?
Dr. Greenberg: I think it is incredibly stressful for baby boomers, who are really the first generation to be taking care of older parents in such large numbers. They are the first generation to witness first-hand the impact of prolonged life-expectancy and how being alive does not necessarily mean having a good quality of life.
I think that there is not only the stress of taking care of elderly parents, but also the anxiety associated with their own future. But of course, there are inspiring examples of older women and men who remain quite healthy, even into their 9th decade.

Dr. Hank Why do so many baby boomers feel guilty if they put their parents in a nursing home?
Dr. Greenberg: I think boomers feel very sad about seeing their parents suffer. We all want our parents to be strong and capable. Seeing parents decline, particularly if children did not get all that they needed when they were young, can result in unbearable grief.
Care-taking of parents often is associated with a wish for a "last chance" to get what they might have missed out on. Guilt can be related to feeling pressured to provide everything for a parent, or angry feelings about having to be in charge, and/or frustration about their parent's vulnerability.

Dr. Hank: What health care reforms should be made to help our aging population?
Dr. Greenberg: My personal feeling is that health care should be available for all. This should include mental health care, not only because depression is under-treated in older adults, but because health care costs actually decrease when people have access to mental health services.

Dr. Hank A decade from now, what will be the challenges an aging population will face?
Dr. Greenberg: As this current generation of baby boomers gets older, they will be confronted with all of the things we have heard about in the media: the prospect of a longer life, uncertainties regarding health status, and for some, living with chronic illness.
Supportive mental health treatment, which can help people identify the normal struggles associated with aging, will need to be more available. As clinicians, we all need to become more sensitive to depression and anxiety in older adults, as well as how to make people feel safe enough to talk about their concerns. There is still a stigma regarding seeking mental health treatment and that is a barrier we need to overcome.

Dr. Hank: Thanks for taking the time to chat. My mother lives in an assisted living home so I will be sure to recommend your book to all the staff -- that way, they will understand her better!

Comments

[emzucker]

One reason boomers feel guilty when they have to put their parents into nursing homes is that they are unpleasant places and their parents don't want to be there. There is little privacy and an unfamiliar institutional environment. The resident is totally dependent on strangers to attend to toileting and other basic needs and Medicare standards for staffing are inadequate. As a result, many residents wear diapers (imagine if you had to wear diapers all the time) and wait and wait for an aide to take them to the bathroom if they are unable to walk. Nurses aides are poorly paid and too many don't want to be there.
The problem is that by the time a parent needs nursing home care, they cannot be cared for at home without 24/7 help and that is usually beyond the reach of those even with long-term care insurance.

[SonofLiberty1]

I hear you doc, but most of the folks here are too young and haven't traveled that route yet.