Dealing with the issue of Aging Parents – by Andy Berger of Senior Wellness Specialists

I am writing this in response to an article published in the Mercury News titled “Savvy Senior: Elder mediation can help adult families resolve conflicts”

How you deal with the issue of aging parents has a lot to do with the way you were raised. As kids do you remember having dinner with grandparents? Visiting with them at their home? Watching your parents interact with them? Was there respect shown the grandparents? Many cultures revere their elders and gain tremendous insight into many wonderful things through them. But when respect and reverence are absent resentment and anger tend to show their ugly face. Solutions exist before the first salvo is fired, making mediation the choice of last resort.

Money matters among other things, as we have read, bring out the worst in people. The expenses associated with maintaining an independent and dignified lifestyle are enormous.. Insurance and medical costs have gone through the roof. Parents and adult children find themselves in a very stressful situation, as each worries about how they will manage in retirement.

Mom and Dad are living longer and are going through their savings fast, Most Boomers want to be able to help in some way. But they worry about their own retirement. They fret and fight amongst themselves over whether they can or should help out their parents if the need arises, as in the case of a parent having to enter an assisted living facility or a nursing home. Sadly, there have been instances reported where their kids have had to sell off jewelry and other possessions to pay for more time in a facility. From here the frustration and resentment continue to mount.

Boomers who were fortunate enough to have had positive family role models in their youth usually show a strong willingness and a certain calmness when faced with being put in the role of caregiver. Not so much for those whose memories of family time in their childhood were less positive … love, compassion, and tolerance are learned. We all have the capacity to acquire them. We just need better role models.

  • How willing are you to give of your time if your parents need you?
  • Sibling rivalry in adulthood can be as intense in this scenario as it was in your youth?
  • Who’s going to take charge of your parents’ finances to make sure their needs are met?
  • Which of you is nearest Mom and Dad to check up on them if they’re still living on their own? Chances are one of you is going to feel put out.
  • On whom does the responsibility fall to be the primary caregiver in old age?

The need for greater involvement of one’s family in the care of loved ones in later years has never been presented with this much clarity. The government wants you to participate more; heck they’re willing to pay you to stay home with Mom/Dad instead of Medicare and Medicaid picking up the tab at a much higher cost. Unless you have a plan to implement to get you through some of these tough times, expect chaos, apathy and total resentment from your siblings.

The last thing any parent wants to see is their kids miserable. Even if you weren’t lucky enough to have great role models growing up, there are things you can do to make the transition to caregiver an enjoyable one. Start by meeting with an attorney to map out how your parents will be cared for as they age; he/she will help determine who among you is best equipped (emotionally and financially) to act on behalf of the parents; as well as who gets what when the parents pass. Long-term life-care insurance should be purchased in your 30s, 40s and 50s; any later and it is cost prohibitive. Insurance companies are also looking into insurance policies that let you age-in-place at home by paying for modifications to your house. And there are communities in suburban areas popping up where neighbors share various expenses, making aging-in-place more affordable. Concierge programs and services exist that can help you plan and assist with all your health and wellness needs.

This guest post was authored by Andy Berger of Senior Wellness Specialists.

Evaluating a Patient’s Ability to Live Independently

As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully.  It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.

There is much to consider. Are the patients physically able to maneuver within their household safely?  If sleep is being interrupted constantly by the night time urge to urinate, can the patient safely navigate the trip to the bathroom without suffering a fall? If they get to the bathroom can they easily manipulate a standard toilet?   If they need to clean themselves and bathe can they get in and out of the shower or bath without falling and injuring themselves?

Fortunately there are elderly home experts who will travel to the home and evaluate it for safety.  They make an assessment and provide a written report to the patient and the ordering physician. Many of these safety personnel are specially trained home health company nurses sent into the home by the patient’s physician. In many cases, Medicare or the patients’ insurance will cover the cost of the evaluation. Once the evaluation is complete, they will suggest certified and responsible contractors to do the home safety alterations.

While our goal is always to keep the patient in their home if possible there are many issues other than the safety of the physical plant to consider. One needs to consider how much supervision and assistance the patient needs to perform their normal activities of daily living?  Can they dress and groom themselves independently?  Can they prepare meals for themselves and clean up after them?  Can they get to the store to shop for food and supplies?  Can they get to their doctors’ appointments? What happens if they become injured or ill?  Do they wear a device which allows them to call for help if they are immobile and cannot get to the phone?

The option of paying someone to care for your elderly loved one is quite expensive. It will cost a minimum of $15 per hour to supply inexpensive help. You may need more than one person so that the staff has time off for their personal needs.  Some families choose to hire a companion who in exchange for room and board supplies help and supervision. This is always risky especially if you don’t/cannot check the background of the individual you are inviting into the home.

If you can afford to pay for help and to alter the home for safety there is always the issue of socialization. Many of my patients who have lost their mates have also lost their friends. They no longer have someone or a group to pal around with.

One particularly spry 93 year old patient was still playing golf, going to the gym and aerobics class three days a week and playing cards regularly. Her golf foursome and card game participants all had passed away or moved closer to their children for support.  Although she had the finances to hire a wonderful aide around the clock she was lonely for companionship despite living in a large country club on a golf course.   She became a wonderful candidate for the correct assisted living facility with a broad range of social activities and residents of a similar age looking for companionship as well.

These are complex issues which require the assistance of the individual’s physician in most cases. It is important for the individual to choose and retain a physician who will take the time to talk to family and professionals involved in the enrichment of their lives.