March-April 2012 | Features in Bethesda Health

The Parent Trap

Meet members of the sandwich generation: raising children, dealing with elderly parents-and sometimes feeling as if they've bitten off more than they can chew

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Chris St. Clair moved her mother,  Joan Larson, from Texas to Kensington in order to better monitor her health. From left: daughter Jennifer, 16; Larson; St. Clair; and daughter Kate, 21. Leaving the old and the familiar can be devastating to many seniors, says Nancy Wesson, author of Moving Your Aging Parents (Loving Healing Press, 2008). There’s even a name for it: Relocation Stress Syndrome, which can be triggered by a simple move across the hall, she says.

The toll isn’t only emotional. There can be changes in blood pressure, loss of appetite, aches, pains and other problems. “They literally stop eating. They get depressed, anxious. These are real symptoms,” Wesson says.

Richard Birkel, a psychologist and vice president at the National Council on Aging in Washington, D.C., says people who are frail or suffer from dementia are particularly at risk. “For some people, it is extremely stressful to change,” he says. “For very vulnerable people, this may be the push over the cliff.”

But for others, moving can be a positive experience. “We’re seeing a lot of seniors moving back to their home communities when health care needs become a priority for them,” Birkel says. “…It can be a blessing when a family has the opportunity to re-establish close relations.”

Experts advise discussing relocation options—along with long-term care insurance and plans for power of attorney—before elderly parents have any serious mental impairment. And once a move is imminent, they say, place as many decisions as possible in parents’ hands.

Alyssa Sanders, a social worker and actress who lives in Kensington with her daughter, is planning to relocate her mother from Tamarac, Fla., this year. “I’d like to move her before it’s too difficult,” Sanders says. Her mother is 83 and has diabetes, macular degeneration and a blood cancer that’s in remission.  

Overall, she’s fine on her own, but she can’t manage the little things anymore. “They’re calling you and they need you to change the clock on the wall, and you can’t do it—and she’s so afraid to spend money [that] she won’t pay a handyman to come in,” Sanders says.  

Dealing with that will be easier if her mother is closer. And by moving her now, Sanders says, her mom will be able to choose an apartment, decorate it as she likes and build a social life.

Making small decisions such as those can mean the difference between excitement over a new living situation and rapid decline, Wesson says.

What furniture should they take? Which photos and candy dishes are meaningful? Would they be better off in a cozy group home or a larger facility with lots of activities, one that can take them from independent living to nursing care if necessary?

St. Clair found clearing out the old house in Texas to be the easiest part of the transition. Sure, there were mountains of inconsequential items to dispose of: 10 cans of insect repellant and more Pledge than she could ever use. The harder decisions were about furniture and personal items.

St. Clair took photos to help her mother decide. Two years later, much of the furniture that wouldn’t fit into her mother’s new apartment is crammed into St. Clair’s dining room and garage.

Robert Ray of Silver Spring is in the business of helping the elderly move. A former pastor, he’s president of Caring Transitions in Silver Spring, a franchise with locations in 42 states.

Recently he helped a woman relocate her mother from New York City to Chevy Chase. The New York staff conducted an inventory of her belongings and then created floor plans of both the old and new apartments in order to see what furniture would fit where.

When the elderly woman walked into her Chevy Chase apartment for the first time, it looked familiar. “We tried to position everything from the tables to the pictures in their same locations,” says Ray, who also conducts estate sales and hires cleaners.

Sometimes Ray finds himself back in his previous counseling role. All too often, he says, adult children forget that they need to focus on their parents’ wishes.

“As long as a parent is still alive and can articulate, I pay attention,” he says. “It’s what Mom or Dad has to say that matters.”