Older people rebel to keep sense of control, research finds

[MereDintofPandiculation]

www.theguardian.com/society/2022/dec/21/older-people-rebel-to-keep-sense-of-control-study-finds

so next time your elder is being awkward, remember it’s good for them

Oh yes, that's the other thing, my mum is absolutely obsessed with passing on as much money as she possibly can to me and my brother so doesn't want to spend it on carers. No matter that I tell her that I've lost more money through my business being constantly interrupted to do bits and pieces a carer could do than she's saving!

I'm fully expecting to be exactly the same in 25 years. I definitely think it's something we all say we won't do, won't put our kids through, but when old age and decrepitude looms I should imagine the thought of losing everything familiar on top of losing your health is fairly terrifying.

Did you read the nasty post that I responded to?

It's this 'rebellion' that leads to them in and out of A&E like a revolving door and sadly blocking beds with the inevitable broken bones. Insisting on living in unsuitable living accommodation, refusing to pay for carers and falling about all over the place.
I saw this many many times as a district nurse and more recently as an in patient.

Oh, if we're playing that game, I am happy to forfeit.

Good luck, all. It has been a thought provoking thread. I have clearly hit the point where I can't cope - in fact I probably walked past it ages ago and didn't realise - so I need to make a plan.

I think moving at the right time is key, my mum has some friends who live in sheltered accommodation, they all have their own flat or bungalows, but there is support on site for them. They have the opportunity to make friends with others so there are people around when they want them, but they're able to have their own space too, problem is they need to anticipate poor health and move into them at a point at which they are still relatively fit. For my mum at nearly 90 with many disabilities, it doesn't make sense to move into that sort of set up, if she does move anywhere, it will need to be into a care home.

SierraSapphire, DMum's neighbour moved into sheltered accomodation after her DH died. She was 89, a few mobility issues but otherwise fairly healthy. She loves it - has a small one bedroomed apartment with a wetroom and combined kitchen and living room. There are communal areas if she wants company, she can order meals and there's a warden and enough room in her flat for family to come for tea. It does seem the ideal solution, a sort of half way house.

Yes, is it rebellion to retain a sense of independence and control, or is it an inability to accurately assess risk and consequences due to cognitive decline in higher executive function.

in my mums case, she rebels by saying “sod it” a lot, doesn’t wash, or put her teeth in, and stays in bed all day. Leading to neighbours texting me out of concern when she call round to them as she can’t work her TV any more, wearing nothing but her nightie with her lunch, tea and coffee spilled down it. Mum doesn’t care, but everyone else sees an old woman not coping any more.

I'm one of the authors of this research study (and a long standing MN member! I've namechanged) - just to say, thanks everyone for your interest in it.

How amazing that you’re here! Don’t suppose you fancy doing an AMA about it?!

Oh bless you! Yes, I'd be more than happy to answer any questions about it, it was a fascinating piece of research to carry out.
I was also caring for a close elderly relative until last year and the write up in the Guardian (which we aren't involved in writing BTW) definitely made me raise a wry smile...!

The research paper is here by the way:
journals.plos.org/plosone/article/authors?id=10.1371/journal.pone.0279098

I have two elderly parents (late eighties) who live 200 miles away and who never want to worry or burden me. My DH has cancer. There's only me.

There have been several incidents, including one where my mum collapsed while they were out, and my dad broke down because he thought she had died. She had a short admission to hospital over that. They didn't even tell me it had happened until we saw them next (weeks later), and this has happened a couple of times before.

I worry about them every day, especially if I don't hear from them. It's stressful now while there's two of them, I'm dreading when there's only one. I do love them. They are not "difficult" but it's a constant low level worry that never goes away.

I was mistakenly content in the knowledge DM was pottering about, though a bit chilly, because I could see her heating going on and off manually on hive. I was wrong, she's just set the thermostat really low, so it was coming on and off on its own.

She was fine, though chilly, and absolutely adamant she doesn't need it any warmer (it's not about the money).

Solidarity to all of us dealing with ageing parents! My surviving one is up to no good on a fairly regular basis too.
I'm in no doubt that she's feeling rebellious, and i applaud that to an extent, but it is frustrating when we are expected to pick up the pieces when the decisions made are not sensible.
I have made an active decision to not worry about her. She's actively chosen to stay in her less than suitable home. She's finally accept a lifeline, thankfully.
My siblings frequently tell me how worried they are - but do very little for her. It gets landed on me more often than not when there is an emergency.
I love her to bits but she can be infuriating!

It's not just me then! Mine are driving me mad. Both are suffering from cognitive decline but my main issue with that is that neither will accept it. They each moan about the other starting to 'lose it' but neither will admit it to themselves, which makes life very difficult. They refuse to accept that we've had certain conversations and made specific agreements about five times already and I'm fed up with constantly repeating myself. If they would just accept it when I explain they've forgotten something or that they're confused somehow but oh no, they can never be wrong! Not possible that at nearly 80 they may have forgotten the odd detail 🙄. They accuse me of gaslighting them about it but I can't even think of any good reason to do that! How can I get them to understand what's happening?

@niknakniknak thanks for the link to the paper. I’m not at all familiar with Positioning Theory, but the overall message I get is that the study participants had constructed a world for themselves in which they consider themselves fortunate compared to their peers, and in some instances downplayed their illnesses and conditions. And in constructing this world, this helped them feel content with their lives, whatever their constraints.

Some of the quotes from the study participants underline exactly what the carers in this thread are saying about safety vs risk. Eg “Penny” leaving her door open all night for the carers (we had that, we installed a key safe).

I know when you do qualitative interviews you often get far more material that you can use in the publication, so in that context I’d like to ask if the interviewees said any more about the familial roles that didn’t make the cut. It was fascinating to see that the participants seemed to think they were indulging their overly fussy children rather than acknowledging that they had a point and were right to be worried about their parents. I have a vested interest to ask this as my mum needs more care and is being stubbornly resistant and insisting she can manage. I’m hoping for further insights into her possible frame of mind that could help us both find the right way forward.

You're spot on re the message of the paper. And also about the sheer volume of data!

From memory, there were a handful of participants who acknowledged that they needed more care, usually linked to particular precipitating events (e.g. a bad fall, hospitalisation) and their children subsequently making suggestions about changes in the house / living situation. Others didn't take on their children's suggestions but took the advice of their GP or other trusted (to them) authority. These participants spoke less about being rebellious in general and focused more on positive comparisons with others... they seemed to me to be more open to reasonable-ness.

One lady who sticks in my memory was very keen to keep her independence and refused all offers of help, until she ended up being stuck upstairs (or downstairs - I forget now) due to her mobility issues, which presented an immediate problem re access to kitchen/bathroom/etc. It was only then that she agreed to have a stairlift fitted.

I feel your pain, by the way. My relative refused all help, even when he was wheelchair bound and unable to mobilise at all (after a hip replacement, no engagement with physio and very long periods of complete inactivity), we as family were forced to beg him to take up the offer of a rehabilitation focused care home stay whilst the social services nurses stood there... he still refused, and the nurses advised us they couldn't force him as he had capacity at that time.
These experiences drive a lot of my interest in this research topic, although I was already researching it (along with others) before my relative became unwell.

Do you have any comments on the criticisms some PP have made, eg about small sample size?

Thanks, appreciate the reply. No single key to unlock the stubbornness then, just taking comfort where we can in knowing we’re not alone in this situation! We’re trying the appealing to independent authorities route with very limited results. She has capacity, but is at least more cooperative than your relative.

the more research the better in this area, so thanks.

Sure - interviews with 23 individuals was, we found, more than enough to achieve data and meaning sufficiency (older terminology for this is data saturation) for the research question and analysis method, especially when taking into account the very small size of this group more generally. There's a section on the strengths and limitations of the study in the paper which is hopefully helpful to contextualise our findings.

Read this and forwarded it straight to my mate because it reminded me do much if her mom and dad

23 participants in a qualitative interview study that is itself a follow on from a larger observational study is pretty good. I had five interviewees for the qualitative interview part of my Dissertation research (following on from a quantitative survey) for my MSc, and that was accepted. I still had tons of data left over from five, I can’t imagine having to sift through 23!

I wonder where the people are getting mixed up between quantitive research in which statistical robustness is important, and qualitative research, which seeks rigour in different ways and sets out to understand why something happens, rather than making numerical claims about how much it happens. So it may be important to make sure that you interview a cross-section of people, and you can interview until you get theoretical saturation when you're not hearing any new points for example. Or you may do a first set of interviews and analyse them, and then seek to do further interviews based on what you found, any gaps and further questions. It's a completely different methodology.

funnelfan and SierraSapphire - absolutely, many thanks!