Adult children in the dark about aging parents

A psychologist at Washington University in St. Louis is conducting research that shows two adult siblings may have radically different views on what their parents would want. In fact, he says that a random stranger might have the same chance at guessing parental wishes as some children would.

According to Brian Carpenter, Ph.D., Washington University assistant professor of psychology in Arts & Sciences, there is no clear indicator of which children will be “good” predictors, nor which ones will be “bad” predictors of their parental lifestyle preferences. There is some evidence that children who perceive their relationships as emotionally closer are better. There seems to be no significant correlation between gender, age or geographical proximity of children and parents and whether or not a child is a “good” or “poor” predictor of parental wishes. Carpenter’s research, which is ongoing, will seek to determine what characteristics do correlate with being a “good” predictor.

Carpenter discussed the nature of his research in the September 2005 edition of the American Psychological Association Newsletter. The Brookdale Foundation and the Administration on Aging support his research.

Carpenter has conducted research suggesting that adult children have a broad range of accuracy at predicting parental lifestyle, financial, housing and medical preferences. Some children are no more apt to make the correct choice for parents than a random stranger, while other children can accurately determine the wishes of their parents.

As indicated in the Terry Schiavo case, determining what a loved one would want is neither a simple nor clear decision.

“When you’re at that moment, when you have to say, ‘Yes, let’s discontinue life support,’ that’s really challenging psychologically, no matter what your beliefs were before that moment,” said Carpenter. “That’s the one case that made the news, but these kinds of decisions get made every day.”

Autonomy, personal growth matter to aging parents

Initially, Carpenter began the study by interviewing one child of aging parents, asking them to guess what their parents might answer to questions about everyday lifestyle choices. The study was expanded by then extrapolating the method to study more than one child of aging parents and determining responses to a broad array of preferences, such as psychosocial preferences, preferences regarding medical care and pragmatic preferences such as financial decisions.

Overall, the most poorly predicted decisions involved preferences regarding autonomy and personal growth. Children tend to believe that independence and continued education, exploration and growth are less important to parents than parents say they are. So children think their parents aren’t that interested in attending cultural events, traveling, reading, staying abreast of current events and making their own everyday choices when those things remain important to older adults.

The question that Carpenter and his colleagues seek answers to is: “What makes children good at predicting parental responses to these questions?” The research team is examining whether family dynamics and interaction style — a tendency to interrupt one another speak over one another, or make critical comments — could predict the ability of a child to be a “good” predictor. Additionally, once they identify what characteristics of the family relationship make children good predictors of parental wishes, how can those characteristics be applied or taught in other families?

Starting the conversation

Carpenter’s research also includes an educative portion, in which they construct a workbook for each family member, matching parental and child answers to each question.

“In the workbook and family education session, we also provide tips about communications skills and decision-making strategies, helping families figure out how to start and then have these conversations in a way that’s most useful,” Carpenter said.

Disparities in answers are discussed together, thereby facilitating the initial conversations about parental mortality and wishes later in life, topics that some families find difficult to bring up.

Carpenter stresses that such conversations are part of a larger process. It takes many conversations and much time to know parents well enough to determine their wishes and desires later in life.

During the holidays, when we spend time with our families and friends, it is difficult to imagine a parent falling ill. And while the holidays might not be the timeliest occasion for potentially difficult conversations, Carpenter says that it is essential to begin an open dialogue between parents and children regarding wishes later in life.

From Washington University in St Louis School of Medicine

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