Taking Care of Mom and Dad, Part 1

[Editor’s note: Betty Booker, an expert writer on aging, begins a two-issue series examining first the caregiving challenges facing baby boomers and then the solutions.] 

There may come a day – perhaps this holiday season – when you notice changes in your parents for the first time. Or you detect a downhill slide from last year. Chances are you will want these problems to go away. 

Believe me, I understand the impulse to wait and see whether what you’re observing is serious enough to warrant intervention. Who has time to deal with a Big Thing like elders who need help?

Caregiving, the National Institute on Aging warns, “is often long-lasting and ever-expanding.” That’s the abbreviated description.

As a family caregiver, past and present, and as a journalist who has talked with hundreds of caregivers and senior experts, I can report that launching a mental debate designed to delay having to do something is not unusual.

But caregiving takes much less time if you deal with small issues instead of waiting until they are crises, whichbecome black holes that suck up time and energy.

THE ‘YELLOW FLAGS’

Look for “yellow flags.” Worrisome changes alert you to a need for “anticipatory caregiving,” said Dr. E. Ayn Welleford, chair and associate professor at Virginia Commonwealth University’s department of gerontology. “You need to find out what works for you before you become a caregiver.”

Before yellow flags turn into red ones.

Changes may be subtle or glaring: House and clothes aren’t clean. Driving habits are scary. Unsteady folks hold onto furniture as they walk. The stove is left on. Food reserves are insufficient, overstocked or spoiled. Medicines are disorganized or forgotten. Bills and contest promotions litter the house. Telemarketers call day and night. Recent conversations are forgotten. Decisions and judgment are impaired.

If your parents (or spouse, partner, sibling or friend) won’t discuss problems or solutions, educate yourself about caregiving anyway. (And parents, if your children avoid “what-if” discussions, make your own plans.) When a crisis comes, you want to already know whom you’ll call.

However, Welleford cautioned, forget the myth that grown offspring become Mommy’s or Daddy’s parent. They’re adults like you, with needs that you might face someday yourself.

Elders are entitled to their preferences, said Dave Panella, vice president of marketing at Care Advantage, a home health care and home nursing company.

It’s also your choice to help elders carry out reasonable goals. Assistance grounded in compassion and practicality works best. If that isn’t possible, find someone else to be caregiver or to help you with the job, he said.

YOU AND PARENTS ARE A TEAM

Media coverage and friends’ caregiving experience are nudging some folks to investigate options, said Marti Miller, marketing director at The Hermitage at Cedarfield. She was a long-distance caregiver for 17 years until her mother in North Carolina died at home at age 92.

“People in this day and time are a little more sophisticated,” Miller said. “Ten or 15 years ago, it was more ‘I don’t know what to do.’ Now they go to the Internet.”

Yet most families are flummoxed by caregiving emergencies, especially when a frail elder is discharged from the hospital, Panella said. Relatives with existing demanding responsibilities look at the elder care that’s required and say, “‘Yes, I want to help, but I can’t.’”

If you witness problems this holiday season, the first thing to do is – relax. Even if you think you’re coming unglued, access your inner grownup. Drama saps energy. It creates resistance in the people who need help. Would you want to rely on emotional offspring? Neither do your parents.

Now is the time to develop a collegial relationship with your parent or parents, if you haven’t already. You and elders are in this together as partners in a team, Welleford said.

With understanding and a kindly attitude, however, you can begin to deal with fundamentals, perhaps starting with some of the problems you’ve noticed.

Start here: Perhaps freeze single-portion entrées. Remove or secure booby-traps like scatter rugs. Put anti-slip mats in tubs and showers. Install brighter light bulbs. Clear clutter in pathways. Elevate toilet seats.

You also can begin working with parents to deal with chores: Yard work. House cleaning. Meals. Transportation. Bill-paying. Financial records. Legal documents. Medication management. Shopping. Appointments.

You may be the main relative who will be doing these things, but every aging expert and experienced caregiver

gives the same advice: Farm out as many tasks as possible to competent people, including reputable hired workers. Caregiving can be a stressful 24/7 job. Exhausting yourself can lead to resentment and additional problems.

For safety, only your parent’s legal health agent and power of attorney should handle money and consult with doctors, bankers, lawyers, tax preparers and investment advisers. Turn down offers from folks like the unprofessional health aide who wanted to “organize” my ailing mother’s financial files. She was replaced.

Getting organized is good for everyone at any age. This includes legally naming ethical persons to handle financial and health decisions when you can’t decide for yourself. If you have a single doubt, don’t name that person, even if it’s your only child.

NO SHORTAGE OF RESOURCES

One go-to source for services and information in every region nation-wide is an “area agency on aging.” These agencies have care coordinators who know local services and can offer no-cost options about what to do. Find aging agencies through the Eldercare Locator at eldercare.gov or 800-677-1116. In Central Virginia, the agency is Senior Connections, 804-343-3000.

If you discover unsafe dementia, however, interventions can’t wait, cautioned Sherry Peterson, CEO of the Alzheimer’s Association, Greater Richmond Chapter. Judgment fades when cognition is compromised, and that’s dangerous.

You can make life much easier if you prepare for the day when life goes from normal to trying to manage someone else’s life.

NEXT ISSUE: Decline requires attention. How can you stretch money for years of senior care? How can you retrofit your home to enable you to live there longer? What are options for middle-income elders? How do you find homemaker, medication and transportation services? When is it time to move to senior housing? How can families supervise from afar? And how do you do this and still have your own life? We’ll talk about these things and more inBOOMER’s December-January issue.

Betty Booker, a retired Richmond Times-Dispatch reporter and columnist, can be reached at betty@theboomermagazine.com.

Thoughts from the Experts

“Holidays are always our busiest times of the year. What happens is children come home and see that Mom and Dad don’t have the same physical or mental capacity as they did. They really need someone to assess the whole situation. It could be something short-term, like confusion caused by a urinary tract infection or not taking medications correctly.”

– Joan Shifflett, Always Best Care

“The week after Thanksgiving and the first week in January families are on the phone trying to find solutions. A lot more problems come out over a four-day holiday than you might detect in phone calls.”

– Nancy Lentz, Alzheimer’s Association, Greater Richmond Chapter

“So many people think [aging] is not going to happen to them, and then it does and they aren’t ready. If they have no liquid assets, and they’re living on Social Security with no pension and no long-term care insurance, their choices are more limited.”

– Marti Miller, The Hermitage at Cedarfield

“If you take the holiday time as an opportunity to reflect with your loved one you may find yourself getting further with formulating a ‘what-if’ plan. Seniors do not respond well to directives from family members; rather they want to be part of the solution.”

– Blair Lawson, Riverside Richmond PACE

“Not everybody is going to be receptive to receiving care from an outsider. They think it is an invasion of their privacy or they’re giving up their independence. Or so they think. Involving them as much as possible in the choice of caregivers is key. In time, strangers become friends.”

– Dave Panella, Care Advantage

“If you have a parent who keeps firing helpers, you might try having an aide come in to meet the parent as a friend of the child so that a personal relationship can be established. They might accept visits later because they aren’t a stranger.”

– Nancy Lentz, Alzheimer’s Association, Greater Richmond Chapter

“You can’t be an effective caregiver if you’re blustering and huffing and puffing around.”

– Dr. E. Ayn Welleford, Virginia Commonwealth University