This toolkit provides practical tips and resources related to:

  • Recognizing and meeting the needs of elders
  • Talking to family about managing elderly care
  • Sharing the caregiving responsibilities among family members
  • Tips for avoiding caregiver burnout
This toolkit also includes:
This toolkit was authored by Sarina Bajwa, MA, Issra Killawi, BA and Sarrah AbuLughod, MA, with support from Tariq Elsaid, MSW candidate, Madiha Tahseen, Ph.D., and Sameera Ahmed Ph.D. It was reviewed by Dr. Kristine Ajrouch, Ph.D. whose research focuses on the experience of aging from the perspective of older adults.
A good percentage of the American population are part of the “sandwich generation” – people who care for their elderly parents while also raising their own children. The FYI Eldercare Toolkit was inspired by conversations about the unique needs and responsibilities that come with caring for an elderly parent or relative.

The Needs Of Elders

How do you know if your parent or elderly relative is reaching the stage where they might need extra help? Here are some signs you can look for:

  • Does their house or yard need care?
  • Do you notice disheveled clothing?
  • Are there broken appliances in their home that aren’t getting fixed?
  • Are there spoiled/expired groceries that don’t get thrown away?
  • Have you noticed changes in mood or extreme mood swings?
These are just some of the early signs that your loved one may need a little extra help. Click here to read more.  In addition to these signs, elders may have specific needs that may not occur to their caregivers. What are some needs they may have?
Empowerment and autonomy are key needs for elders, regardless of their living situation. To maintain a healthy level of well-being, elders need to feel independent and like they have the power to make decisions that affect their lives. In a study based in a nursing home, two groups of older patients were examined. One group was given the autonomy to decorate their rooms with their choice of plants, structure their day how they liked, and decide what activities to engage in. The other group had each of these factors pre-planned by the nursing home staff. Those who were given autonomy in decision making had happier moods and felt more hopeful.  Here are some ideas to empower elders with a sense of autonomy:
  • • Involve them in small decisions, like choosing their own meals or social activities.
  • • Give them an active role in arranging activities.
  • • Encourage them to make healthy life choices by presenting them with relevant information and asking their opinion on major decisions, especially those that concern them.
  • • Encourage them to do as much as they are able. If they can no longer perform a whole task, allow them to do what they can before assisting them with the task.
As a person ages, it can be easy to notice that their physical health is impacted. But aging takes a toll on a person’s mental health too. Elders can experience memory loss or dementia due to illness or aging. Various mental health problems become more likely with age, like depression and anxietyThese conditions are more common in elders than once thought. They can stem from:

    • An increase in life stressors like loss of mobility or the inability to perform tasks that were once easy.  
    • Loneliness due to loss of friends and family
    • The feeling of loss that may come with moving from a familiar home or a change in routine and/or environment
Identifying risk factors and signs of depression is crucial in caring for elders along with knowing how to help
For many parents, caring for their children occupies most of their time and energy. But what happens when their children become independent and eventually move out of the family home? This shift can leave elders with a large void and lack of purpose. What can help?

  • Planning regular visits with their children and extended family
  • Learning how to use technology to stay connected with family and friends 
  • Having a regular exercise routine
  • Being surrounded by social support from family members and/or community members from similar ethnic and cultural backgrounds
This new lifestyle will come with many adjustments. One such adjustment is the relationship that older parents have with their adult children. Check out this article by The FYI about nurturing a healthy relationship with adult children. Older adults also have enormous life experiences that are an important resource to the community. Their life experience, time, and energy that was once directed towards raising the family can be channeled elsewhere, such as:

  • Getting involved at the local mosque
  • Tutoring at schools
  • Reading to elementary school children
  • Mentoring young people
  • Teaching skills like cooking, knitting, making repairs
Elderly Pictures

Talking To Your Family About Elder Care

Talking to your elder parent(s) about their age, health, and the help they may need can be difficult and painful, yet important. These are some strategies that can make the conversation easier:
Eldercare Toolkit Images
As you begin having these discussions with your parent(s), don’t try to address all concerns at once. These conversations will be sensitive, so you’ll need to have more than one conversation and give things time. Not sure how to get started? Here are some conversation starters to help bring up the topic.
When you introduce the subject to your parent(s), make sure you explain the reasons for your concern with respect and consideration rather than by making demands. People tend to get defensive if they fear that some of their autonomy may be taken away. When discussing caregiving with siblings or relatives, avoid talking/arguing about the caregiving situation in front of the older adult being cared for, especially talking about him/her in the third person. This can make it feel as though s/he does not have as say or an opinion in the situation.
Empathize with what your parent or relative may be feeling. Realize that it can be hard for elders to accept help from their family. They may be afraid of losing their independence or burdening others with their needs.
Make room for them to express their needs and be respectful of their concerns and wishes.  If your help isn’t accepted even though it's needed, try to be tactful in offering care. If they understand that you are not trying to take control or manage their life without their consent, then your help may be better received.
Realize that these conversations are not easy for anyone involved (grandparents, parents, or children) especially in cases of serious illness. Make sure to talk about these issues with children who may be affected by the decisions being made about their grandparent(s).
Use spiritual resources to deal with loved ones’ sickness and mortality.
Explore different options for caregiving that the family can discuss together. There is no one-size-fits-all solution and each family is unique. For example, some families may consider external care, such as in-home caregiver or other such alternatives. 

    • Ensure that the person you are entrusting them with is certified and receives
      proper instructions regarding the care of your elder family member.
    • Make sure that you, your elder relative, and the caregiver are all on the same page about the tasks and services being provided. Try this sample contract as a starting point. 
    • If considering a nursing or senior home, here is a list of common pitfalls to avoid when choosing a facility for your parents. 
Familiarize yourself with the signs of possible elder abuse, and how to get help if this is something that you suspect.

Sharing Caregiving Responsibilities

With 2 out of every 3 caregivers a female, the role of caring for elder parents is more often filled by women than men, whether it be a daughter, daughter-in-law, or spouse. [1] Caregiving is a demanding responsibility, and an imbalance of gender roles in the family can lead to difficult conversations, hard feelings, sibling conflict and even broken relationships. It’s important to have honest conversations with your family members to discuss the responsibilities of caregiving.
Be honest with yourself and each other when discussing concerns regarding your parent(s) and their mortality.
 
  • Who is the closest to the parent/care recipient (which could potentially determine this sibling's particular role)?

  • Who should be in charge of overlooking and managing tasks related to the care of your parent(s)?
Create a plan to work towards sharing the load more fairly.
Everyone must contribute in some form or fashion.
Be open-mined about different ways to share care-giving responsibilities. Don't let fixed expectations about gender roles keep you from exploring practical solutions for your family.
It can be really difficult for caregiver to ask for help, so its important for family members to offer help rather than waiting to be asked. Also, especially as life circumstances change, responsibilities may need to shift among family members. Frequent check-ins about caregiving responsibilities can be helpful to avoid burnout or conflict in the family.
Many educational support programs exist to provide information about eldercare. Attending these programs with at least one other family member is an opportunity to maximize support for all. 
Eldercare Toolkit Images (1)
When managing conflict in the family related to caregiving, keep these things in mind:
Refer to this guide about how to handle family conflict.

Avoid Burnout Through Self Care

Those who are taking care of others are often in need of the most care themselves. Caring for an older adult  can be emotionally, physically, and even financially draining. Be mindful of “caregiver burnout.”  

Caregiver burnout
is a “state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned. It occurs when caregivers don’t get the help they need, or if they try to do more than they are able — either physically or financially.”
 

It’s difficult to provide the best care to your elder parent or relative if you don’t care for yourself. Look out for the signs of fatigue and burnout, and invest in your own care:
Eldercare Toolkit Images (2)
Find ways to help manage stress and practice self-care. Ignoring stress and fatigue harms both the caregiver and those they are caring for.
Help your elder loved one lean on a wider circle of support. See this article from The FYI for 3 practical tips.
Accept help from others. If you find it difficult to do so, read more here.

Finding creative ways to take breaks is another way to reduce stress.

Use an app to help manage your caregiving, responsibilities, connect with other caregivers for social support, and access resources and tips to overcome some of the daily challenges.

Additional Resources

Check out the following resources for more helpful information: To reach more about research related to this topic:
This toolkit update was generously funded by Ann Arbor Area Community Foundation.