It’s called “role reversal.” Or it might be described as “upside down.” The adult child wonders,  “How can I tell my parents what to do?” and the senior feels, “I don’t want to depend on her.”

Although it is often a difficult situation for both parties, they usually have the same goal:  The senior wants to enjoy an easy, normal, and productive life as possible, considering medical conditions and finances.  The adult child or caregiver wants to help them reach that goal.  So what’s the problem?

The roles are indeed reversed, and people have trouble adjusting to a new and unfamiliar hierarchy.  The parent cared for the the child until adulthood.  Even during the rebellious teenage years, there was no question who was in charge.  The child is now an adult, and the senior is the one who needs some assistance, or just as frequently, is doing fine now but may need some level of assistance.  How does the adult child approach the delicate subject of “Would you like some help?”

The answer has two steps:

First, discuss the goals of the senior.  Start with the general wish for an “easy, normal, and productive life”.  Explain how you can help reduce some of the difficulties so that goal can be achieved.  Approach this effort as a “project,”  such as “We have the same goal, and we can work together to help accomplish that goal.”

Second, use the framework of open communication, mutual trust, support when needed, and respect for each other to make that joint effort successful.  Lack of those four elements can not only doom the effort to fail, but permanently damage the relationship between parent and child.


Good communications starts with a willingness to share all relevant  information, both good and bad. Communications requires a commitment to keep in regular contact, via phone, email, Skype, or whatever form the senior prefers. Communication requires the ability to choose terms, phrases, and ideas that are meaningful rather than vague.


Mutual trust is essential.  Conversations and discussions will fare better if both parties are willing to trust the other’s suggestions because they both assume “positive intent.”   The senior must assume the adult child is recommending actions consistent with the goal, and the adult child has to trust the senior to execute mutual decisions to the best of their ability.  Ultimately, of course, the senior is the final decision maker.


Support works both ways, and it is necessary to acknowledge the need for mutual support.  The adult child or caretaker must support the senior in bad times and good, and the senior must support the adult child as she works through medical contacts, insurance claims, financial problems, and health care issues on behalf of the senior.  If the senior doesn’t understand the difficulties and time needed to work through bureaucracies,  a third party such as priest, minister, rabbi, or old friend may need to gently explain the situation to the senior.


Respect is hard to define, difficult to explain, and challenging to gain.  Respect is often confused with love, or at least strong positive feelings of one person for another.

Two people who do not necessarily like each other can still develop mutual respect if they follow the principles of open communications, mutual trust, and two way support.  Two people who strongly and frequently disagree can still develop some level of mutual respect.  Too often a senior and an adult child can focus so much on their differences that they allow disagreements to degrade their relationships.  Many of these disagreements were left over from the past.  It is now time to forget, and time to heal.  

The focus should be on the goal, not the past.














  1. Consider a third party — maybe the family doctor — to help with the discussion. You may fail if you try this without someone else they trust in the room.


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