Your adult child has health challenges. How can you help?

They don't call it the “sandwich generation” for nothing.

When I look back on these columns, I see a fair number concern caring for aging parents, whether they live down the street or across the country. In my practice as a private patient advocate, I help a lot of families who are struggling to manage and coordinate care for their parents.

But what if you face the same struggles with an adult child? Should you take a hands-off approach, figuring grown-ups should be able to manage their own affairs? Or do you step in?

Thanks to the pandemic, a lot of parents are once again seeing their adult children up close and personal. A 2020 study by the Pew Research Center found that 52% of young adults ages 18 to 29 were living with their parents. The last time the number was even close to being that high was during the Great Depression. Young people are more likely to be living with their parents than with a spouse or partner.

And with that up-close relationship come a lot of observations. Are they drinking to excess? Using drugs? Not eating well? Are they taking prescribed medications for their chronic health conditions, such as high blood pressure?

I'm here to tell you: “Because I said so” doesn't work anymore.

The reasons for young people not complying with medications and generally not taking care of themselves are many and complex. They may feel they have failed themselves, and you. And they may feel a measure of shame for their own mental and physical conditions.

Add to that the usually complicated parent-child dynamics that had their roots years, even decades, ago. It's small wonder some parents don't know where to turn.

As the mother of adult children, here are some of the strategies I've used over the years. But first, a caveat: You don't really control the outcome when it comes to adult children. You can do everything right and still suffer the unimaginable pain of losing a child to a broken relationship, or even death.

1. Express concern over the behaviors you've noticed while also expressing unconditional love. Avoid the blame game; sentences that start with “You always …” or “You never …” are generally not helpful. If you're upset or angry, it's not the time to have this conversation. Wait until you can both speak calmly and listen to each other.

2. Don't abandon the rules you've mutually agreed on. What expenses are they expected to pay? Are they responsible for their laundry? Are there standards for how clean they keep their rooms and themselves? Are they allowed to smoke pot in the house (a larger question now that marijuana is legal in more states).

3. Show you want to help. Are you able to pay for doctor's appointments or tests? Drive them to appointments or pay for the Uber?

If you are concerned your child can't manage his or her own affairs, it might be time to consult a patient advocate or family law attorney about obtaining legal and health care powers of attorney and establishing a living will for him/her. This will require your child's cooperation, so have a calm conversation with them about who they want to see to their health care needs if they are unable to. You may need to remind them they're not invincible, or immortal.

Finally, don't be afraid to ask for help. Enlist siblings and other family and friends to support you and your child through difficult times. And if your child seems in imminent danger, call 911, take them to the emergency room, or call the police.

I know from personal experience how heartbreaking it is for a parent to see their child struggle with difficult emotional, physical and mental challenges. Just when you think you've launched them successfully into their own lives, you are once again their caregiver.

Take heart. You haven't failed and you are certainly not alone. Research has shown people who participate in support groups have improved outcomes over those who don't.

There are organizations you can turn to. For example, Family-to-Family is a free 12-week course for family members of people living with serious mental illness. It is led by local family members from the National Alliance on Mental Illness.

As parents, we will move heaven and earth to help our children get the help they need. Just remember that you don't have to do it all on your own.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). She is offering a free, 30-minute phone consultation by calling (312) 788-2640 to make an appointment.