By Ronni Sandroff | October 2017| Health Central

The shift in the relationship that occurs when a parent becomes disabled is an uneasy one for parent and child alike. The crucial issue is often one of control, says Kurt Kazanowski, R.N., owner of Homewatch Caregivers, a Plymouth, Mich., company that provides families with home health aides.

Here are three ways to handle the touchy issue of providing care while leaving some important choices to your loved one.

1. Have a heart-to-heart

It helps if the family has put at least a general plan in place for what to do if a parent becomes disabled. The time for that conversation is no later than their early 70s, Kazanowski advises when parents can clearly express a preference on such issues as power of attorney and where they would prefer to live if they became unable to care for themselves.

Whenever the conversation takes place, start by listening deeply. Sometimes a person with a history of rejecting advice is simply trying to exert some control. Allow the person to talk and complain, so he or she feels supported and understood.

Then try to talk with your parent about how his or her actions and decisions make you feel. As your dynamic changes to caregiver, it can be a good time for healing past wounds, Kazanowski says.

2. Use positive reinforcement

Give your full attention and support when your parent is being reasonable, and share memories and opinions. Allow him or her to make decisions when feasible, such as choosing a restaurant or an outfit. Offer to help your parent find projects to work on, such as painting or knitting, where he or she can exercise creative control.

If your parent seems unusually irritable or out of character, talk to the doctor about whether pain and/or medication reactions are responsible. Perhaps medicines can be changed or dosages reduced. And simple exercises and occupational therapy techniques can help reduce pain symptoms.

3. Pave the way regarding driving

When it’s time to have “the talk” about transportation, try an oblique approach. Instead of suggesting that your parent hand over the car keys, begin by discussing the alternatives, such as today’s availability of van services for the elderly and private cabs through Uber and Lyft for getting to doctor and other appointments.

Then ask your parent how he or she now feels about driving. Sometimes your parent will let you know that he or she is having problems.

Tell your parent what you have observed. It’s best if the older person voluntarily decides not to drive, but it may be necessary to apply tough love to keep your parent and others safe. The Family Caregiver Alliance offers some useful tips on how to handle this situation.

If your parent becomes angry or upset, try to respond with kindness and offer to discuss it. If that doesn’t work, leave the conversation and say you’ll resume it at a better time to avoid responding in anger or getting upset yourself.

Don’t delay hospice

Unfortunately, many people whose parents have chronic conditions like COPD don’t realize they are eligible for hospice care. “Many people tell me, ‘I should have signed up my parent for hospice sooner,’ “ says Kazanowski, who also advises hospice organizations.

Along with medical and nursing management, hospice care offers home health aides, touch therapy, music therapy, spiritual components, and dementia programs. The staff can also help relatives and caregivers relate to the older person and deal with the grieving process.