Julie: I think the biggest take-away from this 3 part conversation for me, is the importance of letting go of our own expectations and fears, by leaning into the process of aging and death. This may require some research and expanding our own emotional support system. Avoiding this deeper understanding exacerbates our fear of mortality and can cause us not only to desert our aging parents when they really need us, but also to self-isolate. Both situations are known to decrease lifespan. We have known for years that social relationships promote healthy behaviours in elderly and are critical in maintaining healthy independence, whereas loneliness has been independently associated with emergency hospitalisation – but not planned inpatient admissions – among community-dwelling older adults. This was published in the Journal of Geriatric Psychology as far back as 2001.

Paul: Loneliness features quite heavily in my client work. Some elderly clients who come for a massage for example, not only have issues around mobility but also those connected to intimacy and love. If they live alone, as many do, they may not have any physical contact for weeks or months, which I find very sad. We know from research that babies can die from lack of physical contact and so what does that do to us adults? It certainly increases our sense of aloneness in the world. Some of the aforementioned clients have children and friends living close by and therefore it is a shame that they are physically/emotionally neglected. I see adult children running around to do their parents’ shopping taking them to their hospital appointments etc, but I don’t always see much affection being exchanged. What are your thoughts Julie?

Julie: It is interesting that we can be surrounded by well-meaning people and still experience deep loneliness. There is a deep correlation between physical contact and loneliness. While the amount of physical contact depends on the individual, a study published in the journal "Psychology and Aging" found that older adults who received more frequent hugs and other forms of physical touch had lower levels of loneliness and social isolation. When we are touched, our brains release oxytocin, a hormone that is associated with feelings of bonding and attachment. For aging adults who don’t have much contact with loved ones massage, in particular, has been shown to increase levels of oxytocin, which can help promote feelings of well-being and relaxation. This is especially true for individuals who may be experiencing physical pain or discomfort.

You mention adult children who are focused on errands and tasks. I think this is something to think about, as it can be a way of avoiding our fears of inevitable loss (of our parents), or it can just be something that we believe to be more important than simply spending quality time sitting in close contact with our loved ones. While both are important, our parents will maintain their independence longer when they feel connected and relevant.

In conclusion here are some resources we (Julie and Paul) have come across that we hope people will find supportive while caring for their aging parents:

· Clinical Psychologist Dr Bhavna Barmi suggests that we focus on the present and celebrate the evolving relationship without giving advice. She adds that if parents have trouble asking for help, give them a few multiple-choice options to select from.

· Learn about the stages of grief. The pioneering work of Elizabeth Kubler Ross and David Kessler can be helpful for anyone going through this process. https://grief.com/the-five-stages-of-grief/

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· A very useful guide for coping with aging parents. www.actsretirement.org/retirement-resources/resources-advice/tips-for-adult-children/how-to-cope-with-aging-parents/

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· Some useful tips here for dealing with the difficulties of aging parents. https://www.transitionslifecare.org/2021/03/17/how-to-keep-your-calm-when-dealing-with-the-difficulties-of-aging-parents/

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· If you are often stuck what to say to your elderly parents or if you find yourself saying the wrong thing to them, this guide could be helpful

· https://dailycaring.com/7-things-you-should-never-say-to-your-aging-parents/

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· If you’re struggling to cope with your own emotions, this list of ways to reduce stress from caring could be beneficial. My own outlet is shouting into a pillow, and makes me feel much lighter - https://dailycaring.com/4-ways-to-reduce-stress-from-caregiver-emotions/

· And finally, this short article highlights the importance of touch for the elderly generation, https://www.firstchoiceseniorcare.com/is-your-parent-touch-deprived

Julie Merchant is a US based National Certified psychotherapist serving the Expat community in Portugal. She can be contacted through her website: Lifeisgr8.com

Paul Jokinen-Carter is a Holistic Therapist and works in the fields of massage, Reiki healing and counselling. You can contact him on 910 665 601.