Understanding the Challenge of Going from Child to Caregiver

Christopher Ciano is president of Medicare at Aetna—and caregiver to his 92-year-old parents

Stay in the game long enough, and many children will find they have reversed roles with their parents. Once, their parents protected and cared for them; now, they do the same job for their parents.

As president of Medicare at Aetna, Christopher Ciano is well aware of this dynamic. He leads a team that supports a senior population of more than 11 million members nationwide, including many who rely on their children.

But he’s not just an observer. Christopher is part of the dynamic, as well. For the past four years, he has been the primary caretaker for his 92-year-old parents, Arthur and Barbara Ciano.

“Being a caregiver myself makes me more aware of the challenges that come with it,” Christopher said.

 “I didn’t know how intense it would be until they came here. As much as I know about health care and health insurance, I didn’t know what it would be like.”

When Barbara fell and broke her hip and back four years ago, the Cianos’ three adult children were convinced that their parents could no longer live independently and unassisted in their Rhode Island home. But it raised a difficult question: Where would they live? Like many modern families, the Ciano children were scattered across the country, with a daughter in Arkansas, another in California, and their son, Christopher, in Florida.

“They didn’t want to look like they were choosing one child over another,” Christopher said.

In the end, Arthur and Barbara chose to live near Christopher in Fort Lauderdale. With a demanding job and a residence 20 minutes away, Christopher has to be extremely organized to give his parents the best version of what they want: “a sense of independence and control of their own lives.”

The elder Cianos are both mentally and emotionally alert, their son said, but suffering age-related ailments. Besides his mother’s broken back, due to osteoporosis, she also has lymphoma. His father had a brain tumor removed two years ago. They recently had to accept a 24-hour attendant to help with bathing, medications and other tasks to prevent falls and similar mishaps.

Like a lot of caregivers, Christopher Ciano juggles day-to-day care with a busy work schedule.

The attendant has made their son’s life easier (“knock wood,” Christopher said), but when something goes south, “you have to be ready to jump in.” Christopher makes a point to accompany them on as many doctor visits as he can manage and oversees as much of their day-to-day care as possible with a busy work schedule. These ordinary tasks yield the greatest rewards, he said. Being able to spend quality time, getting them out of their home on a nice day, and “having them enjoy life the way they want to live”—these are the things Christopher cherishes.

Those moments, though, come amidst a difficult and exhausting journey, helping your parents do things they once did for you. Christopher’s advice for others contemplating such a move? “Think about it hard and understand the ramifications and time commitment,” he said. “There is no singular way to think about this. If (an elder) is healthier and independent, it’s easier. But it’s not easy to generalize this.”

Christopher said that he has more appreciation now than ever for Aetna programs like Resources For LivingSM and Aetna Community Care, which offer resources and support to families in similar situations, ranging from help finding caregivers and transportation to assistance in putting together a care plan for older adults.

As for what the experience has taught him about how he wants his own late-in-life years to run, Christopher said he hasn’t had a chance to think much about that.

“I haven’t the time,” he said. “Every time my cell phone rings, I wonder if it might be another trip to the hospital.”

Page divider, heart icon