“Older adults don’t want to have this conversation because they’re afraid if they say to their adult child, ‘can you help me bring in the groceries?’ that there’s no gray area. It’s black or white. They think once they ask that question it’s like, ‘I’ll have no access to my bank account, I won’t be able to drive, and someone will have to be with me 24/7.’ And that’s not the truth but fear makes everything black and white,” said Dr. Ashley Blackington, Entrepreneur, Board Certified Occupational Therapist and Caregiver Advocate.
When our parents face a medical emergency or need support with daily life, it can be sudden and terrifying. We can’t predict what they will need as they age. It’s often called “the sandwich generation” because honoring our parents changing needs while raising kids can make us feel pretty squeezed. However, it’s possible to plan, manage the process, and evolve your skills and systems in concert with family life.
Accept the Identity Shift
Aging is a gift that not everyone is fortunate to receive but many of us struggle to open the long-term care discussion with our parents. Why is it so hard to get aligned? Ashley said, “Adult children fundamentally don’t want to have that conversation. Or confront the fact that your parent is getting older. Because it feels upside down with this person who taught you how to use a spoon, ride a bike and facilitated your independence.”
Despite How Difficult it Can Be
Everyone needs care at some point in their lives, for a wide range of reasons, including aging, disability or illness. Ashley explained, “Aging parents do not want to have this conversation either because it’s confronting mortality and decreased independence. There is a boatload of fear around that because we value self-reliance in our society. Independence sounds really great if you are healthy and all of the stars have aligned.” Indeed, life’s conditions can change quickly.
Recognize How Fast your Role May Change
Many of us are called into service for our parents during an emergency. Ashley worked in hospital settings for over a decade before launching her private practice to support aging in place, a growing trend to make staying at home possible versus institutional care. And she was surprised how often she had to open this dialog between adult children and their parents.
She said, “At the time, I did not realize that’s what I was going to be doing. I thought I was going to go in and help people with the mechanics of occupational therapy. Like figuring out where to put grab bars and ramp entrances into their homes.”
Assemble the Family Care Team
There is no ‘one size fits all’ senior care scenario but we often need a fast education in the long-term care, healthcare, Medicare and financial systems. Which feels herculean in the middle of a situation. Ashley said, “I’m going to shout out to the oldest daughters that are listening, there’s a tendency to think you are ‘the one’ when everything has hit the fan. Suddenly, you’ve got all these eyeballs looking at you as if to say, ‘you’re up’ like you’re the one who knows all the things.”
Whether it’s because you’re the oldest, or from a culture where care expectations were laid out before you reached kindergarten, it’s different to imagine what your parents might need in the future versus having to respond in real time.
Be Realistic With Yourself and Others
Ashley said, “In a crisis with quick turnaround decisions, one person will often step in and say, ‘nope I’ve got this don’t worry.’ What I’ve seen succeed is when people are honest about what they can do. In terms of their bandwidth, knowledge and experience.”
Engage other family stakeholders like siblings, aunts, uncles or your other parent, if possible. She explained, “Have everyone try to piece the puzzle together. For example, ‘I can do this but I’m not good with that.’ But if you’re an only child and your parent is single or widowed, then you’ve got to ‘got this’ until you can bring in some other people.”
Don’t ‘Take Over’ if Your Parent is Partnered
It can be tricky when one parent needs care and the other one, cannot be expected to provide hands-on full-time care, based on their health, age or energy. However, acknowledging that person is key.
Ashley said, “Your dad may not provide as much care in one regard if he also needs help, but I would always defer to the spouse to ask, ‘where are you comfortable in this?’ And give them the first layer of the onion. As the adult child, you cannot swoop in and say, ‘you have no use here’ when people have been together for a length of time, living independent lives. Empower the partner in that relationship to ask for help.”
List What Needs to be Done
How much work involves family, versus medical staff or other paid caregivers? It depends and you need clarity to plan. Eldercare is generally more expensive and much harder to find than childcare.
Ashley said, “My first suggestion is always to get everything into one place. You don’t necessarily have to deal with everything in that very second. If hospital case management says they need to know where your next your next destination is, do you need to have grab bars installed tomorrow, or next week?” Seeing the full list can be daunting but then you can tackle it in pieces.
And a Timeline
Ashley explained, “You do not have to prioritize everything at the same time. If that’s not the biggest motherhood crossover lesson, in general, I don’t know what it is! Everyone comes at you with their emergency and it’s figuring out in the moment how to sort through things.” Why yes.
She added, “For example, ‘okay, I don’t need to have grab bars installed till next Thursday. But I do need to pick the next space that we’re going to go while work is being set up in the house.’ And then coming up with a timeline based on that information.”
Assess (and Convey) Priorities in Stages
Project management for anything complicated and new is messy. Especially when you’re already on point for dozens of other care and work-related projects. To reduce your mental load and increasing stress for yourself and your parent, Ashley recommends a pragmatic approach. “Get really specific about what needs to happen in the next chunk of time and share that. For example, ‘Okay mom, while you’re in the hospital we’re going to make sure that you can get into the house, that you can go to the bathroom, get washed up and that you can get food. I’m not saying that we’re going to tear apart your house, we’re going to make everything safe and that’s what we need to focus on right now.’”
Work on Your Priority List One Week at a Time
You may get questions or push back, from your parent or other family members. Give yourself time. Ashley said, “Keep the focus really narrow on the supreme basic needs and explain why. For example, ‘to keep you safe while you are healing and getting better. Because the core of all this is to make sure that you are safe, healthy, fed and you’re able to heal.’ As you move through that phase then you can talk about what some next steps are. You don’t need to have a five-year plan in a two-week hospital stay. You need to have a one-week plan and then when you go through your one-week plan then just gradually move out.”
Enlist Support for Your Own Respite
Again, not every hospital stay is short term and sometimes parents need ongoing physical or mental health support. There are resources you can hire if that’s financially feasible. And often, hospitals have social workers who help you navigate aspects of the medical support. However, the road can be very long.
Ashley said, “I think that keeping self-care on the map is essential. There’s a ton of research on the health outcomes of caregivers in long-term care situations and it’s poor. Caregiving as it is facilitated right now for people in the US, is bad for your health especially caregiving for older people.”
Schedule Your Preventative and Medical Care
Many family caregivers, or those caring for adults, also parent children at home. And skip critical medical appointments, preventative self-care or anything non emergent. Ashley reminds us, that our medical screenings are essential.“Ask a neighbor from down the street, ‘hey, can you come and hang out with my mom for an hour so that I can go to this appointment?’ We schedule what we prioritize. Including our parents’ doctor’s appointments, therapy and rehab and we schedule our kids’ stuff. If you are the one holding the pen and you don’t write it on the calendar, it’s not going to happen.”
She added, “If you keep carving out from yourself, as caregivers, there’s nothing left and then you run the risk of being in a worse off situation. So, think of it as doing the best that you can to keep yourself healthy so that you can continue in all of the roles in your life that you want to be a part of.”
Many thanks to the talented Dr. Ashley Blackington!
Learn more about her company’s new app to support family caregiving on the website, Facebook and Instagram. Follow her show the And/Both podcast and her great adventures on Instagram, Pinterest and, LinkedIn.
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About Ashley:
Dr. Ashley Blackington is a board-certified Occupational Therapist, founder of Dovetail®, creator of Home Field Advantage and host of the AND/BOTH podcast, all layering together to create a multi-platform ecosystem designed to support the people doing the hardest job of all: caregiving.
After more than 14 years working in hospitals, homes, and care systems, and living the realities of caregiving herself, Ashley saw firsthand the emotional, logistical, and systemic weight family caregivers carry. She built Dovetail to address those needs directly: a CareTech platform that helps families organize care, communicate clearly, and build sustainable support networks.
Through Home Field Advantage, she offers virtual consulting and group coaching for caregivers and the workplaces that employ them. And through AND/BOTH, she holds space for the often-unspoken emotional truths of caregiving life.
Together, these projects form a new kind of care infrastructure- one that centers on the caregiver, honors the complexity of their journey, and meets them with clarity, compassion, and tools that truly help.
