It helps to keep in mind that it isn't just how your care-receiver is feeling; it's what he or she is feeling. Quite often, it's a tremendous sense of loss.

In so many areas.

The process of aging is also a process of letting go. Bit by bit. It's losing so many things and being forced to accept the fact that many of them if not most will never be replaced.

True, life is filled with losses. But that doesn't mean how we feel a particular loss is the same at all the different stages of our lives.

Here are three examples:

--A tooth: If I'm 5 years old and my front tooth starts to wiggle, this is great news! I can hardly wait to show everyone. This proves I'm on my way to getting rid of my baby teeth -- and at five, I am no baby!  -- and having "big kid" teeth. It means the tooth fairy will be stopping by some night soon and I'll get money!

If I'm elderly and my tooth begins to wiggle, if it aches, if my gums become inflamed . . . . I wonder what it means. Where is it leading? Expensive and painful dental work? Dentures? A change in my diet, to soft, boiled, mushy food? Maybe it would be best just to ignore it. Maybe the pain will go away. There's no need to worry others, not to mention the expense. I'm so tired of trips to the doctor, I don't want to add visits to the dentist.

--A set of keys: If I'm 25 and I lose my keys, I mutter and fuss and fume because I might be late for work. Again. "Now where could I have put them? I'm always losing my keys." It's a minor inconvenience.

If I'm a senior and I misplace my keys, I can't help worrying that I'm exhibiting an early stage of Alzheimer's. Isn't this how it starts with some people? Like my sister-in-law. The one who could never seem to remember where she had parked her car in the mall lot and then, within a couple of years . . . .

--A friend: If I'm forty-five and a close friend moves away, I feel sad. I miss having frequent contact with that person and I suspect, as the years go by, we may drift apart. But I know I can pick up the phone and call him. I can send him a funny birthday card. I can drop him a line at Christmas and keep him up to date on what I've been doing. In the same way, he can stay in touch with me and share his latest adventures.

If I'm old and a good friend dies  --  and so many seem to be dying so close together these days  --  it's the end of our friendship. I can remember the good times and I can offer a prayer for his soul, but he is gone. I know there will never be another like him. Perhaps this was a relationship that stretched back to my youth. Someone who really knew me and understood what, together, we had come through. I have lost someone irreplaceable. And it hurts so much.

As any human body ages, there are adjustments that have to be made, limits that have to be admitted. When I am young and strong, I can go mountain climbing. I can scale snowy peaks and look out on fantastic views and feel a tremendous sense of accomplishment. As I get older, I have to limit myself to hiking.

Then walks through the park.

Around the neighborhood.

Until, finally, it may be that simply leaving the house takes more energy and effort than I am able to exert.

Step by step, I have told myself, "That's all right. I can still . . . . " But what now? What can I do? If I cannot climb a flight of stairs? If I cannot cross a room by myself? If I cannot get out of bed?

When, in my heart, I still want to be at the top of that mountain.

As a caregiver, what you discover is that as your parent gets older, the physical limitations can be compounded and the problems, the losses, occur more frequently. For example, he or she may experience diminishing or total loss of vision. Of hearing. The inability to control the bladder.

Now your father may think, "Here is my child trying to tactfully explain to me that I should wear . . . diapers! That's what they are. They may have a different name, but that's what they are. Even my grandchildren are old enough that they no longer wear diapers. This is so humiliating."

Or "A hearing aid! I don't need a hearing aid. If young people today would just quit mumbling and speak up."

Or "No, I'm not going to the eye doctor. Every time I go he gives me more bad news and my eyesight is just fine."

It may help you to also keep it in mind, that as Mom ages and becomes unable to perform the everyday tasks she used to love, she may feel she is losing a part of her identity. Your mother is no longer the "super housekeeper" with a spotless home. Her yard is no longer the prettiest one on the block. She can no longer bring her famous scalloped potatoes to family gatherings.

And if she isn't that great housekeeper, gardener or cook, what is she? Who is she?

At the same time, with the absolute best of intentions, a grown son or daughter may seem to be taking over. Being downright pushy, is what it feels like to Dad. "You think it's not safe for me to drive anymore! Just who do you think it was that taught you!"

"You think I need help writing checks? Why, I was a vice president in one of the largest corporations in . . . ."

"They make me so mad sometimes," a parent may think, "but what if I don't go along with them? Will they put me in a nursing home? Is there some kind of veiled threat here?"

"No!" you may immediately reply, but, again, this has to do with feelings. And feelings can be based on misconceptions.

There are other losses, of course. Among the most difficult is the death of an adult child. That one just doesn't seem right. Children are supposed to outlive their parents.

And probably the biggest loss of all is the death of a spouse.

"This was my best friend, my lover, my confidant, my partner, my support in so many ways for so many years and now that person is gone. Now I need him . . . now I need her . . . more than I ever did before, because I've never felt pain and loneliness like this."