It all began six years ago, the year my parents turned 80 within a month of one another. Suddenly my strong father, a former steel worker, couldn’t lift most things. At the same time, my multitasking, do-it-all mother became increasingly frustrated by all that she couldn’t accomplish.

At least that’s how it felt to us, their five children, scattered across the country. Of course, it wasn’t true. We knew about and had discussed Dad’s diabetes and his heart disease. We had seen Mom develop balance problems and a slow, shuffling walk. But they both looked so robust, still able to travel to see those of us on either coast. They lived independently, taking care of their “new” smaller house after selling the family home 10 years earlier.

The small changes — Dad huffing and puffing more than usual, Mom slowing even more — seemed natural signs of aging, nothing to cause alarm.

During each of our visits home, though, we tried to be proactive, encouraging Mom and Dad to begin the process of downsizing. One of my brothers, a contractor, helped my father sort his garage full of tools and equipment, putting some aside for family members, others to sell. My other brother helped Mom purge clothing and papers.

We thought we were really thinking ahead, certain we would have plenty of time to help our parents eventually transition to a senior residence of some kind. But that fantasy dissipated as one health issue after another surfaced.

Almost overnight Mom became weaker, talking incessantly about her lack of energy and her fear of losing her balance.

Finally, my Chicago-based sister advised her to see a geriatrician, someone really skilled at diagnosing the symptoms of the elderly. The first appointment was a revelation and a relief. Here was a doctor who listened carefully and refused to use aging as an explanation or excuse. “Let’s get to the base of this problem,” he’d say. Or, “Tell me more about your symptoms.”

Slowly, we began to realize that we were pushing too hard; my parents were digging in, fighting for control of the process and decisions. They agreed to research their options.

As more information was gathered, the geriatrician became more of a medical coordinator, checking in with other specialists and Mom’s local, primary-care physician. No longer was my sister forced to run from doctor to doctor, attempting to connect the dots.

The picture that slowly developed was a complex combination of problems: neuropathy that deadened sensations in legs and feet, Parkinsonism (which exhibits some but not all of the symptoms of Parkinson’s disease) and, finally, lupus.

Meanwhile, my father — who looked as healthy as ever — began to complain frequently about his inability to control his diabetes or stick to a diabetic diet. We worried but could hardly believe anything was seriously wrong because he changed so little physically. But over time he experienced new, more serious problems.

An infection developed around the leads to his pacemaker, and the doctors recommended surgery to cut it out and replace it. The surgery did not go smoothly. My dad’s heart was punctured in two places and was repaired in a six-hour, open-heart surgery that left my mother hysterical and my sister exhausted.

The hospital required patients like Dad to participate in a cardiac recovery program. First came a visiting nurse who monitored weight, pulse, breathing issues, blood sugar levels and medications. Then came a physical therapist to help him do cardiac rehab exercises.

For the first time in their lives, Mom and Dad could not take care of one another. Still, recognizing the need for change is one thing, but being willing to make change is quite another.

My siblings and I wanted to move quickly. Six weeks after my father’s surgery, four of us gathered in my sister’s living room for a family meeting. We were scared. What especially haunted us was the vision of Mom and Dad alone in their home during the winter months — ice on the driveway, snow blocking doors, my sister only able to get to them once a week, at best, and feeling greater-than-ever pressure to keep them safe.

We, of course, knew exactly what should happen: They needed to move to some kind of assisted-living residence or bring help into their home. They were both impatient and frustrated with our suggestions that things needed to change immediately.

Slowly, we began to realize that we were pushing too hard; my parents were digging in, fighting for control of the process and decisions. They agreed to research their options.

My mother was absolutely clear that she did not want to move away from the community where she grew up, and we visited the two senior living facilities closest to my parents’ home. The first residence was in an ideal location close to friends, family, shopping and church. The other was 15 miles away, near several of their many doctors but not much else. Anything farther afield simply was not acceptable.

Knowing my mother’s concerns about finances, my husband revised the simple financial analysis he had helped my folks put together two years earlier, so she could see their current living expenses compared to their costs if they moved to a senior residence, or had at-home help. Knowing that my dad responded best when all his questions were answered, I put together a chart comparing the features of both residences, along with their costs.

That gave them the confidence to take one small step: Pay the $100 fee to put their name on a no-obligation waiting list at the senior residence that was farther away but clearly offered the most. No apartments were available immediately, which suited my parents just fine.

We were frustrated. What would we do about our parents being alone during the winter? Our fears and frustrations surfaced in the form of bickering among us. Some of us wanted to push to move more quickly, others more slowly.

We all understood our parents’ desire for control. But didn’t our feelings matter, too? Would we all have to schedule more visits home to help monitor them? How could my sister manage her business while constantly worrying about our parents?

Help came from an unexpected source, my 21-year-old niece. She asked if she could live with “Grammy and Grandpa” for a few months while hunting a job in Chicago. Her presence was a gift, alleviating our worries and giving all of us time to adapt to the new reality of my parents’ life.

In early March, nearly three months earlier than planned, there was a call from the residence director: A two-bedroom apartment with balcony was available. Did they want to look at it? They did, and they liked it — but it was still too soon to move, Mom said.

My sister negotiated a six-week delay, which felt a little better but still scary. Movers were scheduled, the most necessary items packed. Move-in day went well, my sister tells me. She and her husband worked to quickly make the apartment feel like home, unpacking boxes, getting the kitchen set up, making beds, installing shelves, hanging pictures and new color-coordinated towels. Within a week, Mom and Dad were comfortable in their new home.

Now it was my turn. I was charged with helping my folks to clean out the rest of their belongings, get the house on the market and continue the process of settling them into their new space. I arrived in late May and spent five days sorting items into piles for a yard sale, another to donate, a third for family members. It was slow going; my parents didn’t have the focus or stamina to work for more than a few hours a day. The following month my brother and his family came from Boston to pick up where I left off.

Now, the physical transition is over. We are waiting for the house to sell. My mother is slowly moving into her new community, meeting people and joining activities. My dad, slower to acclimate, still spends much of his time inside the apartment.

Our visits are very different from those of the past year. Now we see how each visit — especially those with the grandchildren — bring Mom and Dad the energy they need to move forward. They are happy as they anticipate our visits, and we are at peace knowing we’ve all managed to complete one of life’s most difficult transitions.

How to Relocate an Aging Parent

Avoid taking control. You may assume you know what’s best for your parent — and you might — but put yourself in their shoes. This is a time of massive transition that can be hard to accept mentally and emotionally. Each time we showed our impatience to “get things done,” we were met with resistance. But when we played the role of information gatherer, providing cost figures and housing options and allowed our parents to make the decisions, we were able to take forward steps.

Choose health care providers carefully. Medical care and guidance can make a major difference for you and your parents. The geriatrician who helped diagnose my mother’s complex symptoms and coordinate information with other medical providers gave confidence and consolation to my mother while saving my sister from the time and stress of connecting the dots. Geriatricians are trained to understand the physical, emotional and mental challenges that elders face and are sometimes a superior alternative to a general practice physician.

Get help. Look for resources and information wherever and whenever you can find it. Friends, family and colleagues — many of whom have their own personal stories of insight — can be a wealth of information. Even if you don’t think you need their resources now, take them anyway. You don’t know what’s around the next corner. In addition, every California county has a local area council on aging that can connect you with the providers and services you need.

Be compassionate and patient. If possible, take time in asking parents to make decisions about their many belongings, but act quickly to get them re-established comfortably in new surroundings. Giving them extra time to sort through their personal effects reduces stress, respects their attachment to beloved items and allows them to make better decisions about their property and priorities.

Be prepared to manage family conflict. Make it a priority to bring friends and family together for a meeting before moving a loved one. Determine roles and responsibilities for everyone involved, allow people to voice concerns about the process and be proactive about making sure those concerns are acknowledged and mitigated as thoroughly as possible. Anticipate disagreements about the pace of change, shared responsibilities and decision-making.

U.S. TRUST 2012 INSIGHTS ON WEALTH AND WORTH REPORT

Who thinks it is important to leave a financial inheritance to children?
76% of people ages 18 to 46
55% of people ages 47 to 66
73% of people over the age of 67

Who has a financial plan for a parent’s elder care needs?
40% of people ages 18 to 46
20% of people ages 47 to 66

Who has purchased long-term care insurance for their parents?
33% of people ages 18 to 46
6% of people ages 47 to 66

Who is personally financing the cost of long-term care for aging or infirm parents or relatives?
38% of people ages 18 to 46
30% of people ages 47 to 66

Did you know?

Local nonprofit Paratransit Inc., which provides public, wheelchair accessible transportation for the elderly and disabled, recently started a new division that helps people buy new or used mobility vehicles. Specially designed or modified vehicles can cost up to $70,000 new, and lower-cost, used models rarely are available from traditional dealers. Destinations Mobility now sells new and used vans from $7,500 to $50,000 at the Paratransit facility on Florin Road in Sacramento.

For more information about Noel Neuburger: noeln.zenfolio.com