Safety vs. Autonomy: The Struggles of Adult Children Assisting Parents with Mild Cognitive Impairment
Roberto, Karen A.
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The purposes of this qualitative analysis were to understand when, why, and how adult children decide to provide more intense support when a parent has mild cognitive impairment (MCI) and to identify gender similarities and differences in their responses to the new challenges they face. At Time 1 we interviewed 43 adult children (33 daughters) aged 27-65 by phone using semi-structured questions; 18 of them (12 daughters) participated in multiple interviews over 56 months. Analyses revealed perceived risks to parental safety as the main reason adult children stepped in to assist parents in new ways. Adult children struggled with balancing parental autonomy vs. safety needs. They were uncertain how much to intervene when the parent with MCI developed problems with routine independent living activities such as driving, finances, home maintenance, medication management, or meal preparation. Sons typically provided indirect support relating to financial planning and household maintenance, laterally supporting parents while focused on promoting long-term independence. Sons also tended to receive information about the MCI condition through the parent assisting the person with MCI. Daughters provided more direct nurturing support such as daily visits or phone calls to both parents as well as more immediate chores such as grocery shopping and transportation. Findings confirm that gendered patterns of assisting with MCI are similar to those found in other care situations. With MCI diagnosis, adult children struggle with transitioning into care partner roles and balancing parental independence while actively adhering to safety concerns.