Honor your father and mother, that your days may be long in the land that the Lord your God is giving you” (Ex. 20:12). Caring for your father or mother or even a grandparent in their senior years brings a wonderful opportunity to serve and honor them, to fulfill God’s biblical command, and, in so doing, to love and serve Christ. When we are children, we need the support of our parents; when we age, we then need the support of our children. God places us in families and gives us this command pertaining to the family structure that yields blessings throughout life.

Above all, assisting or caring for parents should be done in a way that is pleasing to God and with love, dignity, and respect. The tables are turned when a child must play a key role in the life of an aging parent. Bill’s father once quipped to a friend, “I cared for him, but now he calls the shots for me!” Indeed, at times the child may feel uncomfortable in this role reversal.

Cultivating a relationship of open communication between the generations before the time of caring comes is key to easing the discomfort. Take time to listen and understand how your parent feels about the aging process and its inherent challenges. If your parent is a Christian, they may be more comfortable discussing end-of-life topics than if they are not. In either instance, encourage them to talk about these things, and don’t assume that you know all that they are feeling. When you do so, you will be better equipped to know what dignity and respect feel like to them.

Each of us probably desires to remain independent in managing our personal affairs throughout life. There is a godly desire for independence that does not want to burden our children; there is also an ungodly desire for independence that actually creates a burden for our children. In preparation for aging, we each need to prayerfully examine our hearts to prevent the latter. None of us knows what our future will hold, but it is likely that a day will come when some level of help will be needed. We may become unable to function independently in a variety of ways. It will greatly ease the burden on our children if steps are taken in advance to ensure that our desires are known and authorizations are in place so that they can be carried out.

Growing old takes on different shapes, sizes, and forms, and there is no one right way to support or directly care for mom and dad. Physical distance between parents and children, types of physical or mental health issues encountered, personal finances, and the availability of local support services can have a bearing on where, how, and to what extent children should care for parents. Neighbors, church family, and friends may play a helpful role when children are not able to effectively or successfully manage the phases that aging parents pass through. For those who have no children, the church—and especially the deacons—needs to be quick to act as family for those who do not have biological family. In addition, professional resources are available to help in support or care for older adults. In-home companion services, home health services, and visiting nurse services are some widely available services to explore when appropriate to the situation, as are adult day care programs. A check with your local Area Agency on Aging or web search will provide various avenues of outside resources to explore.

Loss of abilities due to aging will most likely occur gradually, but the order and speed of losses will vary. Children may observe their parents’ physical and mental decline in steps or stages. Some things to watch for that could signal a need for more assistance are repetition of thoughts or sentences, memory impairment, unpaid bills or bounced checks, a decline in safe ambulation, multiple scrapes or fender benders when driving, inability to accurately manage medications, poor eyesight, inaccurate communication with physicians, and a decline in personal hygiene. Any of the above, or a combination of such, should alert children that a need for change may be near at hand.

The decision of when an older adult should stop driving is often a very sensitive issue because it concludes the ability to be truly independent. Reliance on children or public transportation brings a significant change in lifestyle. However, children must balance their sympathy for this loss with consideration for the safety of both the parent and the general public. A practical in-between step is for driving to be limited to daylight hours and familiar surroundings. Awareness of surrounding vehicles and diminishing eyesight and reaction time are key factors to consider in the decision of when to give up the car keys.

Giving a trusted individual authority to act on your behalf is a very important decision. This is done through a power of attorney (POA) instrument. Financial and medical authority may be covered in one document or separate documents. A medical power of attorney gives advance medical directives regarding such issues as dementia, life-altering disabilities, feeding tubes, and breathing ventilators. Having a clear understanding of your parent’s wishes in this area could possibly save a lot of heartache and grief at some future point and ensure that your parent’s end-of-life wishes are carried out. Whether the authority is given to a child or another person, it should be done thoughtfully. For example, if the child is not financially astute, someone else may be a better financial POA. Children should encourage their parents to tell them where such a document is kept or provide them with a copy.

It will also be very helpful for the financial POA to have a list of the bank and investment accounts and their locations to aid in conducting business when the individual becomes unable to handle their own business affairs. Knowing the dollar values may be helpful but is of lesser importance.

Good communication with physicians is essential. One needs to be able to remember and clearly communicate important details regarding his health to his physician, and then remember and carry out the instructions of the physician. When your parent reaches the point in life when this no longer occurs, it’s very important to accompany him to medical appointments. As mom or dad’s health and abilities become more intricate or complicated, good and open communication with their primary care physician cannot be overemphasized. Provide and discuss a copy of your parent’s medical advanced directives. Having a physician who is on board with your parent’s and your life values and end-of-life wishes will greatly enhance mom or dad’s comfort level as they travel through their final years.

Safe ambulation in one’s residence is an important issue for seniors. Older adults would be well served to consider living in single-level accommodations, yet many tripping hazards still exist in a single-level home. Help your parent assess what is needed and get rid of throw rugs, excess furniture, and other items on the floor that don’t need to be there. Install well-anchored stair railings and bathroom grab bars. Consider purchasing an alarm system that provides the ability to press a button on a lanyard to call for help. Home maintenance presents challenges and dangers for seniors. Parents and children should give consideration as to when would it be best to give up household ownership responsibilities.

There may come a time when a change in location or surrounding supportive services may have to be made. Relocation of a parent to live in a child’s home, a retirement facility, a personal care or assisted living facility, or perhaps even a skilled nursing facility are various options to consider. A continuing care community, such as the Reformed Presbyterian Home, gives the opportunity to advance step-by-step through the levels of care as needed without making another move. Such a facility is particularly beneficial to married couples who may enter with the need for different levels of care, or they may come in at the same level but later have differing needs.

Children and parents should be aware of both the blessings and challenges of having parents live in their home with them. On one hand, parents living with children would provide a wonderful opportunity for grandchildren to grow their relationship with their grandparents. Depending on the type of care needed, they can participate in and learn the selflessness of caregiving.

However, multiple generations under one roof can provide challenges and stresses for all involved. There is an inherent lack of privacy, and family dynamics will be different. Family plans must be adjusted because of grandma or grandpa’s presence. The possible need for 24/7 caregiving can be demanding over an extended time. Work schedules may need to be adapted to fit care plans. “Sandwich Generation” well describes the dual role of caring for both parents and children at the same time. The double responsibilities may be overwhelming for the middle-aged child. Some provision will need to be made for adequate sleep, rest, and relaxation.

This article covered a number of practical considerations in what can be a complex situation. The decisions probably won’t be easy, and they may not be simple. Only with God’s help and guidance can we hope to navigate through them and best implement them. But when a refocusing is needed, pause and reflect on how God created humans: each one in His own image and likeness. When that is your focus, the way forward will be clearer, and you can be certain your decisions will honor your parents.

For additional help, we recommend the articles “Caring for Our Aging Parents” by Lisa Askey and Althea Scott (New Horizons, June 2017), and “Caring for Aging Parents” by Nancy Parker Brummett (Focus on the Family, Sept. 25, 2019).

Bill Weir is retired administrator and chief financial officer of the Reformed Presbyterian Home (rphome.org) and a ruling elder of North Hills (Pittsburgh, Pa.) RPC. His wife, Rose, recently retired from serving as financial administrator of Eden Christian Academy. They have two daughters, Jennifer George and Natalie Faris, and seven grandchildren.