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My 85-year-old mom alternates between completely on-the-ball and totally confused by the details of daily life. I have gradually assumed responsibility for many things -- bills, doctors appointments, etc. -- that have proved difficult for her, and she is quite grateful. I am thrilled to be able to do this for her. However, in the moments when it dawns on her how much control she has ceded, she becomes angry and argumentative, feeling insulted and disrespected. On several occasions, I've given in to her demands to take back the reins on certain things -- only to have things go badly off track, creating more stress and anxiety for both of us. Which makes the whole process of caregiving emotionally exhausting -- even though the actual effort in "taking care of things" is not difficult to manage. Can you give some advice for navigating these issues of control that will help de-stress this situation? I'd really love to enjoy this time with my mom, but find we spend far too much time wrangling over these things. Lisa L., Miami, FL

Your question addresses many of the issues and emotions that family caregivers often experience. While we want to really help our aging parents this constant "one-step forward, and two-steps backwards results in a lot frustration and anger on our end.  Aging is associated with loss of roles and responsibilities, and it's likely very difficult for your mother to adapt to this new role reversal and loss of being totally in control and it's making her feel anxious.

I spoke with Neuropsychologist Melissa Friedman, from the Mount Sinai Medical Center who said "In some cases, taking time out to talk about underlying issues, or what the loss of such responsibilities may represent to the aging parent, can provide a feeling of relief for the parent. Sometimes they are simultaneously experiencing other difficult changes, such as loss of driving, decreased ability to participate in hobbies, increased social isolation, or loss of other duties (eg, work, volunteer jobs, reduced care-giving duties). "

It's possible that your mother is experiencing symptoms of depression or anxiety,  or that her agitation may be a symptom of a progressive dementia process. Dr. Friedman suggested that a psychiatric, psychological or neuropsychological evaluation can be helpful to understand the nature of the problem and to identify appropriate treatment which may include psychotherapy or psychiatric medications.

Finally she said that "Helping the aging parent to establish a routine of physical and mental activity, that is meaningful to them, can also have a beneficial effect on their mood and outlook."