At the age of 65, a pain in my mom’s thigh led to a sudden cancer diagnosis. Eight weeks later she was gone. I lived in the hospital with her for those eight weeks and was the executor of her estate.

Seven years later, at the age of 79, my father has passed away of more gradual, natural causes. He lived with us for many years. I was his person.

Walking through these experiences of loving parents through aging and end-of-life care has been a beautiful and brutal honor. Death is the inevitable bookend to birth, and it does something essential and profound for the spirit to show up for these transitions with consciousness and love. I feel deep gratitude for the depths of vulnerability and connection, for the gifts of grief, and for the version of me that has come through these fires a more authentic and heightened being.

And I want to name that being the person holding a parent’s hand in their final chapter is hard and sad.

As I stand on the recently orphaned shore, I’m reflecting on the choices that brought ease and peace, sharing them here with you now as an invitation for your own journey.

Willing, Wanting & Able

If we choose to bring life into this world, we do consciously enter into a commitment of care—a relational agreement that binds our children’s needs to our support for life. This responsibility, freely chosen, flows through our unconditional love in one direction.

The end-of-life care we are willing, wanting, and able to provide our parents is naturally a reflection of the care they provided us in our season of dependence. Ideally, aging parents get to rest in the safety and attunement of a relationship they established and nurtured across the lifespan.

But that reflection is honest. An adult child is not obligated to care for an aging parent (especially one who has not cared for them). An aging parent is not entitled to the support of their adult child. Family members are not responsible for another adult sheerly by the fact of blood relation. The relationship that has been long curated will inform the level of care reciprocated.

As a community, we are responsible for holistically tending each other’s needs—connected through care. But that labor is meant to be shared across the entire community, not carried by one person, or even family, alone. Historically, this country has relied on the unpaid caregiving labor of women to fill in the gaps of social welfare. That will not change so long as we continue to silently comply at our own expense. Caring for the dying should not necessitate the destruction of the living. (Paula Adams has a great article on this subject here).

At the end of my mom’s life, I was palpably aware of the irony that I was showing up for her in ways that she did not show up for me. I did so not out of obligation, but in service of my own healing, values, and peace. For example, as an infant, she left me to cry-it-out all night alone and afraid. When she was scared and confused in the dark, I laid beside her and held her hand all night long, which provided the security and comfort she needed to feel at peace (the same loving care she denied me in my season of dependence). I was willing, wanting, and able. It was a gift freely given, not an obligation or entitlement.

Balance of Autonomy and Support

In the Sage Mothering course, I talk about how our children are their own sovereign beings. Freedom is the default and we eclipse their autonomy with support only to prevent harm (to self, others, or the environment). As our children grow from dependent infant to independent adult, we are in an ever expanding transition of leaning back.

Toward the end of life, we move through the inverse of this same transition. We center autonomy, respecting their right to make and experience the consequences of their own choices, up to that line of harm, where we lean in with support.

My father lived with us for many years. We built out an in law suite just for him in a sweet lifestyle of intergenerational living. His every need was provided for and his heart was full. And then he chose to move back to the place that felt like home to him for his final years. I had empathy for this home-calling, clearly communicated my concerns, respected his autonomy, and then held boundaries that allowed for the natural consequences of this choice. As warned, his level of need continued to increase and I was not physically present to care for him and be with him in the ways he needed and wanted. That was hard, but it was his choice. I offered all the support and that is where I must derive my peace.

Sphere of Control

Unlike the relationship from parent to child, the relationship from adult child to aging parent lacks social support for this transitioning dynamic. It’s less visible. There are few institutional mechanisms in place to support this leaning in. Our culture and systems tend to unjustly hold adult children of aging parents responsible for their state.

So an additional layer here is awareness of the edges of your sphere of ownership or control. We can offer and invite help. Then we must accept and allow where they go from there. This is especially challenging with dementia or cognitive decline. Even when we’re talking about life or death, pain or suffering, we cannot force support.

In the final months of my father’s life, he would frequently need, agree to, or even request support that he would then reject upon delivery. For example, he asked for in-home nurse visits for wound care but then denied them entry when they showed up at his door. I had to give the gift of my labor for arranging support services and care with no attachment to the outcome of how he actually received those gifts (because that was beyond my control). I wanted to have done everything I could in support of his needs (within my capacity and boundaries) and was clear that that was where my sphere of ownership ended.

Boundaries

For care extended to feel good and be sustainable, it must live in alignment with our capacity. The mechanism for achieving that is a boundary.

You can learn all about boundaries here, but the most essential understanding to utilize them effectively is that a boundary is 100% within your control. You are welcome to make requests of others, but that tends to be futile with older adults, especially when any degree of cognitive decline or dementia is present.

When my mother was dying, I turned myself inside out, giving and receiving absolutely everything I could with her under such an unexpected and accelerated timeline. And it nearly killed me.

In contrast, the last decade of my father’s life was a long, gradual sunset, which necessitated boundaries for sustainability. For example, he called me at least ten times a day. I answered/called him twice a day—once on the long drive to pick up my son from school as soon as I finished my therapy and coaching sessions and once before bed. He was often physically uncomfortable and emotionally dysregulated (though there was sweet paternal love and characteristic humor too) and that was the amount of co-regulating phone support that was sustainably within my capacity. Being so very conscious and intentional about boundaries like that felt radical but like loving myself harmoniously with loving my dad—uncomfortable but healthy and good.

Minimalism

My mother was a functional hoarder and the act of cleaning out her avalanche of belongings after her death generated an immense amount of conflict and trauma.

My father was a minimalist, and while cleaning out his apartment after his death was so very sad (hugging his rack of shirts while sobbing on his closet floor felt almost like a final hug from my daddy), it wasn’t traumatic. Knowing that he had no emotional attachment to stuff made it significantly easier.

While our parents’ personal, lived values are not within our control, we can extend invitations to go through and clean out their belongings together while they still can. Open up the physical and proverbial boxes of their history and make meaning. Digitize and organize photos. This process creates a wonderful opportunity for our parents to connect with a lifetime of memories and stories to share with us.

Estate Planning

Ensure the important legal stuff is fully and completely in place. Verify it with your own eyes.

You need medical power of attorney in place so you can be the medical decision-maker for your parent when they are no longer able (and share regular conversations about what they would want and not want so you know how to honor their wishes for themselves well). You need to be listed as the beneficiary on any and all bank accounts or life insurance policies. Book final arrangements with a mortuary and/or a cemetery in alignment with the many conversations you casually have about how they want their body returned to the Earth.

The specifics will depend on your parent’s configuration of people and assets, but go all the way to the end of the line on the details while they are still here.

I get to move through the rest of my days with the peace of knowing that I showed up fully with all the love I had to give for each of my parents. That’s a tremendous gift that can easily slip through your fingers under the weight of caring for an aging parent, especially in a society who renders this support invisible and unvalued. I see you. And until I can change the world enough to systemically support adult children in caring for aging parents well, know that what you’re doing matters and you don’t have to do it alone. If you need supportive care in finding your way to doing this labor in a way that adds to your well-being instead of depleting your health, reach out a hand.