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No stopping the sands of time.

WITH 76,100,000 AMERICANS born fight after World War II, a groundswell of baby boomers are in midlife transitional stages. A critical transition that affects all aspects of our lives is the aging and death of our parents. For one, it implies our own aging and mortality. As we age, inevitably, we arrive at a crucial crossroads, with paths pointing in different directions. Crowding the road is a thicket of tangled emotions. Who am I at this age? Who have I been at various ages? Who will I be as I grow older? We have choices to make. Succumbing to the anxieties--maybe even fears--of aging are easy enough. Dread of death and the unknown dovetail with the aging process. While it takes considerable effort, a journey of self-exploration can be exciting and rewarding, serving to illuminate the road ahead for a smoother, more enlightened experience. This can be a turning point, a time of self-transformation, of re-creating your world, of embracing your age. It can be a time of hope instead of dread.

Before coping with aging parents, it is necessary to deal with one's own aging process. Indeed, as the signs of aging encroach, fears may swirl around and settle in a person's psyche. Forgot the name of the movie you saw last week? No big deal--or is it? Parents suffering from dementia raise a red flag. Is this a forecast of your future? Not really, not rationally, but fears are fears.

So it is with physical symptoms as well. Sun exposure, environmental impurities, stress, mental anguish, and hormonal changes affect health and cause damage, appearing as wrinkles--or more serious degenerative diseases like heart ailments, arthritis, diabetes, dementia, and cancer. There are, however, medical treatments and health food supplements to protect us, but that is only one part of the secret to aging successfully. One's frame of mind and choices for a healthy lifestyle are vital, too. A positive outlook, exercise, sensible and balanced diet, meaningful work, creative endeavors, learning new things, and enjoying loving relationships are essential pieces of the puzzle.

Hormonal changes coupled with psychological issues are related to emotional chaos. Some people endure wide mood swings, over-reacting to commonplace events. Yet, once the underlying issues and conflicts are confronted, much of this distress is likely to be ameliorated. Indeed, aging can be unsettling, hence, individuals have a tendency to deny their aging and subsequent psychological dilemmas. Avoidance of these issues may manifest as depression, anxiety, substance abuse, even adultery.

Alterations in physiology may affect sexual functioning. Pre- and post-menopause bring hormonal changes, and some women experience discomfort during intercourse. Women may avoid sex. This only worsens the situation and is the first step to the decline in the quality of intimate relationships. Over-the-counter lubricants are one solution. Plenty of tofu coupled with health food supplements may be another. Hormonal replacement therapy, on the other hand, can have side effects. So, exercise caution and research the issue.

Many men, too, experience unwanted changes in their sexual performance as they age. I encourage my male patients to speak to their partners about their concerns, rather than avoiding them. Express some ways that your partner can help you. She will feel closer to you and that is what intimacy is all about. If you have enjoyed an active sex life until now, chances are good that you will continue to do so. New medications, meanwhile, may or may not be for you. A urologist will inform you of benefits and drawbacks. Everyone is different, but inevitably, we grow older.

The attitude you have about your aging self will be of the utmost importance to the quality of your love life. Instead of fearing the decline of your sex drive, a discussion of these concerns with your partner can act as foreplay and sex can become an arena for greater communication and intimacy. The quality of the relationship surely will be enhanced when couples turn to, rather than away from, each other.

Culture is another influence that shapes the meaning of our aging selves. We, in turn, shape the culture, which gives rise to the issue of free will and the choices we make. Television sound bites reflect the thin veneer and pseudo-insight of today's culture. The message is that there is no time for contemplation, profound thinking, or an inner life. According to the media and the mental health field, faster is better. Psychotropic drugs, with possible harmful side effects, promise to replace talk therapy. Health insurance limits talk therapy to a scant number of sessions. Caring for the welfare of patients apparently comes last.

Mass media bombards us with youthful images. The cures for aging make it sound like a disease rather than a natural stage of development. You cannot pick up a magazine or turn on the TV without a commercial for instant youth in a cream--or Botox--hitting you smack in the face. For those who shirk exercise, tight tummies are available overnight with plastic surgery.

Such superficial cultural ideals present us with an urgency to transcend and challenge these messages. Let us be clear. Cosmetic surgery is not necessarily a bad thing; it just depends on your goals. If the aim is instant youth, vitality, and romance, you will be sorely disappointed. A face-lift is not a guarantee of a younger or better life. It merely is a tool; the rest is up to you. Quick fixes will not do; coming face to face with aging is a lengthy process.

One of the most unsettling relationship issues when caring for aging parents is role reversal, which occurs when the adult child becomes the caregiver and the parent becomes the dependent. Emotional upheaval is not uncommon. As small, dependent children, we looked to parents for emotional security, protection, and comfort. Many harbor the illusion that parents always will be here for us. When that illusion is relinquished by the reality of the situation, sadness, anxiety, or anger may ensue. Surrendering these illusions can be heartbreaking. Indeed, the change in identities suddenly may leave the elder individual feeling off-balance and insecure, not unlike a small, helpless child. Holding onto an old identity as the protected child prevents us from moving on with our lives. It places the burden on aging parents of caring for us, just when they so sorely need us to care for them. With lagging health and waning vigor, parents no longer are the guides and the givers--the powerful ones. A number of elderly parents feel shame and outrage at their plight. Some feel frightened and insecure--and their reaction may be hard to deal with.

Let us take a look at the inner life of aging and ailing parents. As we develop, we seek control of our own bodily states and environment. Infirm parents, though, are unable to control physical conditions or their surroundings. Feeling endangered by their aging and illness, they try to control their adult offspring. Deep inside, they feel like terrorized, helpless children. They may fear abandonment and death. They may cling to their children, or they may fuss and fume. Whether parents are enraged, cantankerous, obstinate, or simply frail, it is an overwhelming experience.

You have assumed other roles in your life: parent, grandparent, lover, spouse, partner, friend, coworker, etc. In some of these, you may have been stretched to the limit: adolescent offspring in disarray; relationship complications; difficulties at work. You may be reluctant to accommodate aging parents. Then there is the sense of duty, obligation, and guilt. The love and satisfaction that can be derived from the caregiver role are not always recognized.

We strive to be vigorous and pulled together. Yet, powerful emotions evoked by aging parents may leave us feeling depleted and fragmented. Recognizing that negative emotions are normal is central to attaining cohesiveness. Once our dark sides are embraced, we feel more complete. Taking accountability for hurting someone, unwittingly or not, is a necessary step to feeling stronger. It is only then that we can repair any harm done. Moreover, we can channel undesirable feelings into desirable experiences. Indeed, aggression, once recognized, may be transformed into assertion.

What about dark feelings towards parents? Are they forbidden because it makes you feel like a bad person? Hating parents whom you love is confusing and prohibited, even when they are emotionally and verbally abusive. Wishing beloved parents forever silenced or dead feels worse. Wanting to enjoy your own life while they are ailing engenders guilt. Underscore the fact that feelings are not synonymous with actions. Feelings are just feelings, and we have many that contradict each other.

Can love conquer all?

Loving relationships go awry in the face of intense stress and strain. We may lose it and lash out, only to feel guilty and miserable afterwards. Sometimes, we displace our anger, sadness, frustration, and anxieties from parents onto our spouses, partners, or children. To arrive at a place of understanding and compassion, you first must forgive yourself. If busy hating yourself, you are apt to foreclose tender communications and sympathy. There is a vast divide between blaming yourself and taking responsibility. Blaming yourself is enfeebling and depressing. Taking responsibility affords the opportunity to change one's behavior. In doing so, you are fortified with greater buoyancy to weather the storm.

Caring for yourself cannot be emphasized enough. The more you care for aging parents and the less you take care of yourself, the more depleted you feel and the less they benefit. A review of successful self-soothing practices can be helpful. Then there is humor. Seeing the irony of the situation and laughing at yourself is great fun. Comedic movies, TV shows, and joke books evoke mirth and mitigate stress. Find time to enhance your emotional and physical health. Sports, walks, gardening, working out, or other activities refurbish the spirit.

Feeling guilty about enjoying sex while your parent is suffering? Perhaps a better understanding of the gains derived from sex with a loving partner will ease some of that discomfort. This is a time when you need comfort and healthy distraction, which sex affords. Sex with a responsive partner feeds the body, mind, and soul. Sexual satisfaction leads to feelings of gratitude, tenderness, and love. These positive evocations carry over to how you experience and care for your parents.

Now also is the time for supportive relationships. Sign up for a system that validates you. On-line support, therapy groups, friends, and family are resources. Emotional support is beneficial. Positive feedback does wonders. Feeling better about yourself aids functioning in diverse and difficult roles. Reach out to people who listen, are considerate, and respond to you with concern and compassion.

The final separation is replete with loss and mourning. Although we have survived dark nights of the soul in our lifetimes, in this period of sorrow, we suffer anew. Suffering brings greater dimension to our experience and helps us to be more valiant and powerful. Nevertheless, the grieving process itself is not about bravery or strength; it is about the sting of undiluted pain. Separation from intimate partners is a wrenching, innermost loss. The relationship between parent and child is an intimate one, throughout life and beyond. Whether the relationship was a devoted, loving one or conflicted and frictional, the attachment is intense. Loss is felt deeply.

As parents depart, memories live on. Not everyone grieves in the same way. People with differing histories, personalities, and experiences mourn in their own way. Everyone has a different timetable. For some, it is immediate, severe, and shortlived. For others, it creeps along slowly and takes a lifetime to resolve.

One of the most disquieting and ominous effects of our parents' mortality is recognizing it in ourselves. Suddenly, with the death of parents, the dark specter of death hovers over-head. Is that all there is? Probably not; there is a lot of living left; it all depends on how you look at it. While aging is humbling (with decided limitations), it also can point to new, empowering paths for exploration. With greater wisdom, energies more focused, good and bad experiences to draw upon, this era can be meaningful in new ways. Youthful passions need not dissipate. Instead, with maturity, passions are more directed. Many zealously embark on new trajectories in careers, cultural activities, educational or recreational classes-all of which had been put off previously. It is your turn now.

Accepting death is fearsome, but essential, for a meaningful journey. Indeed, our mortality gives impetus to life. If death is denied, so is life. Facing our mortality provides an internal shift--a different perspective on time. The sobering new focus presents us with an urgent call to live fully. Embracing life and seizing the moment are the best antidotes for trepidation of the future. Nothing in life is certain, only death. Hence, it is essential to live every precious moment of our lives with courage and meaning.

Frances Cohen Prayer is a clinical psychologist in private practice in Locust Valley; N.Y., and author of Crossroads at Midlife: Your Aging Parents, Your Emotions, and Your Self.
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Title Annotation:Life in America; changes involved in aging
Author:Praver, Frances Cohen
Publication:USA Today (Magazine)
Geographic Code:1USA
Date:May 1, 2005
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