By Esther Mann, LCSW

Dear Esther,

My mother is 88 years old, b’li ayin ha’ra. She’s been quite a force of nature all her life. From a young age, she worked and helped support her family. She talks about how she helped raise her siblings, and it sounds like she did all things for all people.

As unusual as it was for someone of her generation, she attended university and was accomplished in many areas. And she always worked, until around five years ago, when she finally felt she had earned the right to retire.

In her retirement, she has remained just as busy, attending classes, shiurim, book clubs, and things of that nature. She learned how to play mah-jongg and had a steady game twice a week.

We have all always been very proud of my mother. And frankly, she has always been proud of herself and thrilled to share her accomplishments with everyone. People young and old admired her and always made her feel like some sort of hero.

Over the past year, my mother has changed considerably. It almost seems like before our very eyes, she has aged in one year the equivalent of ten years. Her short-term memory is totally gone. She can ask the same question again and again in the course of one half-hour conversation. Her long-term memory still seems to be intact, which is great. But she seems to forget some important things, like whether or not she took her medication. Or even whether or not she ate lunch!

My mother lives alone, as she has for the past 14 years, since my father passed away. She managed beautifully for most of that time, never acting needy in any way. Now it’s clear to me and my siblings that she is no longer the powerhouse woman she once was and that she truly needs help.

We started having a conversation with her many months ago, suggesting that we would all feel more comfortable knowing that someone was with her, making sure that all her needs were met. My mother’s reaction was a swift “no,” insisting that she’d know when she needs help.

Initially we accepted her answer. After all, our mother has always been one of the smartest people we know, and if she said she’d know when she needs help, who were we to challenge that? But we are finally realizing that the fact that she really does need help overrides her ability to recognize that she needs help!

Every day seems worse than the day before. There’s a new story daily of how my mother behaved in a way that is downright frightening. I’ve tried to sit down with my mother many times to tell her that we must look into either some sort of assisted living situation or getting her an aide. She flat out refuses. My two siblings have also tried again and again to explain the facts to her. She refuses to listen.

We all get frustrated, but then my mother will suddenly do something quite impressive and suddenly we’ll doubt ourselves and wonder whether we are overreacting and maybe she knows herself better than we know her.

But by and large, we’re all starting to know in our hearts that her days of being independent are gone and a change has to take place. How do we convince her that we know better than she does at this stage of her life? It’s a total role reversal, as she has always had the last word on just about everything. And that is why it’s so hard for us to challenge her and so hard for her to listen to what we have to say.

How do we make this happen?

Concerned Daughter

Dear Concerned,

As we all transition from one part of the lifecycle to the next, we are faced with the need to adapt to new realities within ourselves and our environments. The nuts and bolts of our daily lives can change quite dramatically, as we move along into the next stage of our lives.

Though sometimes a little intimidating or even frightening, growing older, wiser, and more mature is usually embraced with great excitement and joy. Each new juncture offers greater independence and a variety of choices. The world is our oyster; the possibilities endless.

But like the seats on a Ferris wheel, at some point the descent must begin. Some people embrace the slowing down of one’s life. Giving oneself permission to retire, to say no to doing favors just because, to indulge in spending days relaxing with a good book or just talking on the phone or watching TV. However one chooses to allow it to play out, the beginning of the slowing-down process can be embraced with joy.

Ultimately–we should all be blessed with many years–the cycle shifts from choosing to relax and take it easy to having no say in the matter. Whether it’s because of mental issues or physical issues, at that stage, no one is any longer the person they once were. And there’s no getting around it.

But everyone is different and everyone reacts to this final stage in a way that reflects the personality they’ve always displayed. Some people are able to go with the flow, accept what is, and make the best of things. And some people hold on, with white knuckles, to their former sense of self, refusing to accept that they are no longer capable of everything they were once capable of. Sometimes, far from it.

Obviously, your mother is in the latter group. She has a tremendous sense of self, for obvious reasons, and refuses to accept and believe that she is not her former self. Who would want to part with such an outstanding self-image? As you say, she was a “force of nature.” She was always in charge and probably can’t imagine giving up that power to anyone else.

There comes a time, however, when in certain ways, the child becomes the parent and the parent becomes the child. Not to say that your mother has lost it completely, because I understand that her long-term memory is still pretty sharp, and that is reflected in some of her behaviors. But without short-term memory, life can become quite perilous.

Just as a child might not understand or want to accept that he has to hold your hand when crossing the street, so too your mother might not understand or want to accept the fact that she needs someone around to help her with basic daily needs. It’s not a matter of asking her if it’s OK to hire help. It’s not up for discussion, hoping you will gain her approval. Like a parent with a child, it is now your role and responsibility to tell her what is right for her. Plainly put, you’re not asking anymore, you’re telling.

You can expect your mother to refuse flat-out. You can expect her to get angry, protest, and maybe even yell at you. But don’t let that undermine your good intentions. At the end of the day, in this respect, you and your siblings know what is best for her and are only acting out of love and concern.

It’s disturbing for everyone involved when the ones we love transition into the life stage that makes them appear old and somewhat helpless. It’s hard to live it and it’s hard to see it. But we all have to remain strong and clear-sighted, and maintain proper resolve to take control and do what’s right. And I believe you and your siblings can find the strength within yourselves to get this job done.

Just so you know, no matter how much your mother initially protests, I predict that within no time, she will be thrilled to know there is someone around whom she can rely on and will eventually relax in knowing that she no longer has to be super-mom but can enjoy being cared for, perhaps for the first time ever.


Esther Mann, LCSW, is a psychotherapist in Lawrence. Esther works with individuals and couples. She can be reached at or 516-314-2295.


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