In his 1933 inaugural address, Franklin D. Roosevelt delivered these famous words to generations of Americans steeped in the depression, “The only thing we have to fear is fear itself-nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” Eighty two years later, generations of Americans are steeped in another discussion about the future. What will it mean to be an aging society? According to the Population Reference Bureau, “In 2011, the oldest baby boomers, Americans born between the years 1946-1964, started turning 65. Today, 40 million people in the United States are ages 65 and older, but this number is projected to more than double to 89 million by 2050.” How will that impact our families, businesses, financial systems, job and housing markets, healthcare system, and long-term care?
Names for Fear
As we care for and consult with numerous families dealing with difficult eldercare challenges, we encounter a lot of fear. Even adult children who have thought extensively about the logistics of assisting aging loved ones often find themselves unprepared when it comes to their own emotional responses to the changes. “Fear” is one of those large words that is so encompassing, it becomes unspecific, much like the word love. There are so many different varieties of fear, but one blanket term for all of it. In Hebrew, there is actually more than one word for fear. According to Rabbi Alan Lew, there is “pachad”, which can be described as the fear of projected or imagined things. All our minds naturally do this at times. It is the over-reactive imagining of worst-case scenarios. The second word for fear is “norah” which can be described as something like awe. It is the type of fear that we feel when we suddenly inhabit a space that is larger than the one we are used to inhabiting. This type of fear is associated with the vulnerability that we feel when we are called to do something larger than we previously thought possible. The key difference is that there is fear that can shut us down and there is fear that can signal a time of change and growth.
This distinction is actually quite helpful in parsing out our emotions while in the midst of caring for a generation of aging loved ones. It helps us understand that while fear is an inevitable part of the human experience, not all fear is a bad thing and we certainly do not need to be controlled or paralyzed by our fears. We can be intimately aware of our vulnerability when stepping into new territory and stretching into new roles, but we do not have to be overcome by it. Most importantly, as we accompany aging loved ones on the journey, we can grow from it.
Both adult children and their aging loved ones tend to have their fears overlap around 3 key themes in elder care:
A. Fear of Diminishment or Decline: This is really about the fear of a loss of function. For many individuals, the thought of a debilitating chronic illness such as Alzheimer’s or another dementia is often more feared than death. This category also includes the fear of a fall or injury. Not only do we want longevity for ourselves and our loved ones, but we want quality of life. Fear of declining has to do with the fear of “dying before we die”.
B. Fear of Loss: Loss is always an aspect of life experience. However, as we age, the losses can increase in intensity and frequency. Big life changes such as retirement or moving can trigger fear of a loss of identity and control in aging adults. For adult children, there can also be a fear of losing loved ones and a fear of change in the relationship dynamics.
C. Fear of Life Logistics: In addition to the emotional fears, the logistics of everyday living trigger the third most common fear in eldercare. Especially for family caregivers, these fears center around housing, finances, coordinating long-term care, healthcare, driving, etc. and are often compounded by family overwhelm or burnout.
Impacts of Fear
In Roosevelt’s quote, he spells out the dangerous impact of debilitating fear that we see time and again: paralysis and retreat. For families facing challenges with aging loved ones, this type of fear often expresses itself in the form of:
- Strained or missing family conversations
- Families waiting for a crisis before addressing care needs
- Amplified family dynamics and stressed relationships
- Impetuous or irrational decisions
- Lack of decision making
- Diminished sense of options, creativity, and problem-solving skills
How we cope with fear and/or relieve anxiety is often more important than avoiding it in the first place. By developing the skill set of recognizing and naming fears we can begin to view them as something external to ourselves. We can gain a sense of perspective, making them observable, something we can learn from rather than something we are subject to. Educator and author Parker Palmer reflects that, “It is no accident that all of the world’s wisdom traditions address the fact of fear… And all of these traditions, despite their great diversity, unite in one exhortation to those who walk in their ways, ‘Be not afraid.’ As one who is no stranger to fear, I have had to read those words with care so as not to twist them into a discouraging counsel of perfection. ‘Be not afraid’ does not mean we cannot have fear. Everyone has fear, and people who embrace the call to leadership often find fear abounding. Instead, the words say we do not need to be the fear we have. We do not have to lead from a place of fear… We have places of fear inside of us, but we have other places as well- places with names like trust and hope. We can choose to lead from one of those places…”
Fear and Emotional Intelligence
To recap from our reflection, here are six concepts to remember when tackling fears in eldercare:
- Remember that not all fear is bad. Ask yourself if this fear is a projected worst-case scenario or if your fear could be signaling the vulnerability from stepping into new territory and growing.
- We do not need to be the fear we have. Emotions are observable tools and not something we need to be subject to. Try pinpointing your fears and writing them down. That simple act of naming and externalizing what is making us anxious is an important first step in moving toward a solution.
- Adult children and aging adults often share similar fears, but from different perspectives. Dialogue helps us communicate both the differences and commonality we are holding.
- Our “fight or flight” response may be helpful in life or death situations, but often isn’t a helpful response in addressing the nuances of our vulnerability. When we don’t address our fears, they can often lead to paralysis and stress.
- Fear can often be at play in challenging behaviors and family dynamics and may initially be expressed in other ways such as anger or contempt, denial or withdrawal.
- Asking generous questions can be a helpful tool in navigating your own fears and the fears of others. When you don’t understand a response or emotion, take a stance of curiosity instead of judgment.
Published on July 6, 2015.