What to do when your kids confront you about your health

You've spent most of your life worrying about your children's health and safety, and it can feel uncomfortable and unfamiliar when the roles are reversed.

That may be the case if your adult children express concerns that you're having a hard time walking, driving, or remembering details. How do you respond?

Here's advice and insight from Abby Altman, a geriatric psychologist at Harvard-affiliated Brigham and Women's Hospital, and Dr. Suzanne Salamon, associate chief of gerontology at ­Harvard-affiliated Beth Israel Deaconess Medical Center.

What should you keep in mind?

"These conversations often come from a place of concern and love. Your children value your life and your being in this world as long as possible," Altman says. "Also, your health and related treatment have an impact on the entire family unit. Ultimately, you are the one who makes the choices that can affect your health. But your children might have other perspectives on the best ways to keep you well. It's worth listening to their ideas."

What if it feels intrusive?

"In my work with families, I encourage parents to consider what is in their control in these interactions with their adult children and what is not. You cannot turn off the worries and feedback your children have about your health — and truly, it's nice that they care. But you always have the right to express how concerns are communicated to you, and the right to take on the situation without their help," Altman points out.

How do most parents react?

"It runs the entire gamut," Dr. Salamon says. "You have some patients who are thrilled their kids want to be involved. But some don't want that: just yesterday, I had an 88-year-old lady who left her adult child in the waiting room. She wanted me to speak only with her. Unfortunately, the people who don't want their kids involved are often the ones who actually need the help and support of the kids."

What should you say if you disagree?

"Responses to your adult children should express some appreciation for the feedback, like 'thanks for thinking of me.' Also, since your adult children might only see snapshots of your day-to-day life, you might be able to share your perspectives on the greater reality. For example, you could point out that one occasion of eating fast food or missing an appointment isn't the norm," Altman says. "At the end of the day, your adult children likely want to hear that you're trying your best to stick around as long as possible. If you disagree with their concerns, it's better to say that you'll think about their concerns than to say their concerns aren't valid. Also, offering your children some examples of what you are currently doing for health, such as trying a heart-healthy diet, might be helpful and decrease some of their concerns."

Do your kids' concerns warrant a doctor visit?

"If your child expresses a concern, don't disregard it because you don't like the sound of it. For example, if they notice that you're out of breath when you walk, that your legs are swollen, or that you can't hear as well as you used to, take these observations seriously. If you catch a condition early, you may be able to something about it," Dr. Salamon says. "So write down the concerns and then mention them at your next doctor appointment, or call your doctor if you're worried. Your doctor may say it's nothing."

What if their concerns are about cognitive health?

"These types of concerns can feel more sensitive due to the fears we have about a loss of independence. But certain symptoms are not part of age-related memory loss: frequent bouts of forgetfulness, difficulty communicating or finding words, difficulty keeping track of what happens within a day, not being sure where you are, having difficulty planning, organizing, or handling complex tasks. If those things are making it more challenging to do your day-to-day tasks — such as taking medications or managing finances — a doctor visit is certainly warranted," Altman says.

How do you let your kids help you and still retain some privacy?

"Unless your medical team has noted that your capacity to make medical decisions is significantly impaired, your doctor should speak to you first for all health decisions. If you want your medical team to be able to speak to your adult children directly, you can fill out a release of information form that specifies who your medical team can communicate with and which information is okay to share," Altman says. "When these release forms are signed, I will often call family members during a patient's appointment so that nothing is hidden from the patient. You can request similar setups with all of your doctors. Also, with your permission, adult children can be granted access to your electronic medical record, and also allowed to send your health care providers messages about you."

How much should you allow your kids to help?

"Be frank about asking them to do whatever you need," Dr. Salamon says, "You may not realize that you need any help. But there are times when you may. For example, if you're not taking medications as you're supposed to, or you can't open pill bottles, or if you notice that you're not getting refills, that's a good time to ask your child to set up a pillbox. Don't feel that you're bothering your kids. You've been trying to stay as independent as possible. You'll be healthier if everything is in order, and your kids will likely be willing and happy to assist you."

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