How to Visit Your Aging Parent the Right Way...

Taking a different approach can make things better for both of you Katherine Arnup, a retired professor at Carleton University in Ottawa, Canada, and now life coach, got an education in caregiving when her sister and parents got sick. She later became a hospice volunteer. She drew on those experiences for her latest book, I Don’t Have Time for This!: A Compassionate Guide to Caring for Your Aging Parents and Yourself. Arnup writes about the importance of being “being present” when you visit an aging parent. The following is excerpted from one of the book’s chapters. Settle In, Look Around When you arrive to visit your parents, take the time to get settled. It might help to take a few deep intentional breaths before you open the door to their house or apartment. Once inside, resist the urge to start blathering on and on just to fill the void, or to cover up your discomfort or nervousness. Listen. Observe. How does the house or apartment look? What changes do you notice since your last visit? Is your father wearing clothes with obvious stains? Are there a week’s worth of papers stacked up beside his chair? What might this mean? Is it typical? Might it be a hazard? Not Your House Because of our discomfort, we often fall into the habit of cleaning up, putting things “back in their place,” or throwing things out that we consider to be garbage or recycling. These actions are likely to cause unnecessary frustration and confusion for your parents. They know where everything is now, and you’re only disrupting that order. Sometimes it’s hard to remember that it’s their house, not yours. I’m not suggesting you ignore signs of distress or mental confusion. But...

4 Things to Do When Your Parents Are Resisting Help...

Taking these steps can reduce frustration and stress — for all of you “Doctor, my mom needs help, but she won’t accept it and she won’t listen.” Sound familiar? It’s a complaint I hear all the time from families worried about older parents and aging relatives. And it’s a very real issue that we must address. For better health and wellbeing in older adults, it’s not enough to identify the underlying health and life problems — although that is a key place to start. Because even if you’ve correctly identified the problems and learned how the experts recommend managing them, older parents often seem, well, resistant. Understandably, this causes families a lot of frustration and stress. Here are four actions I always recommend that families take when older parents are resisting help. Consider the possibility of cognitive impairment In other words, is a problem with brain function contributing to this resistance? Now, let me emphasize that you should not assume that your parents are in their wrong mind just because they are making health or safety decisions that you don’t agree with. That said, because it’s very common for the brain to become vulnerable or damaged as people age, decreased brain function is often a factor when an older person resists help. This can affect an older parent’s insight and judgment and can also affect how well they can process your logical arguments. It’s important to spot such cognitive impairment. Some of the impairment is often reversible. For example, older adults frequently develop delirium when ill or hospitalized, and an older person may need weeks or even months to recover to their best thinking abilities. Cognition can also be dampened by certain conditions, like hypothyroidism, or by medication side effects....

How to Help Mom and Dad Move to a New Home...

Here are five tips to make the transition less traumatic for your parents For most people, moving from one home to another is exhausting. Even when we get help with packing and transporting our possessions, moving means changing countless aspects of our everyday lives — from making a new place for the silverware to potentially finding new friends. And it can mean saying goodbye to memories we’ve made over the course of years. Older adults often have a much harder time with the transition. For your parents, moving can go from merely taxing to highly traumatic. That’s when it becomes transfer trauma, also known more broadly as relocation stress syndrome. “You’re literally transitioning to a completely different phase of life, to a completely different environment,” says Tach Branch-Dogans, president and CEO of Moving Memories and Mementos of Dallas, Texas, who spoke at the Aging in America 2015 [www.asaging.org/aia] conference of the American Society on Aging [www.asaging.org] I just attended. That’s true whether a person is voluntarily downsizing or being moved into a nursing home, she says. Symptoms of Transfer Trauma Moving can result in a host of physical and psychological changes, including loss of sleep, agitation, depression, withdrawal, short-term memory loss, irritable bowel syndrome, loss of appetite and nausea, Branch-Dogans says. Tracy Greene Mintz, a Licensed Clinical Social Worker in Redondo Beach, Calif., who has worked and lectured extensively in the area of relocation stress syndrome, says loss of control is at the core of transfer trauma. “This week you’re going to be at home living independently; next week you’re going to be in assisted living. The abruptness with which we move older people … is very damaging psychosocially and emotionally because it strips the older adult of control,”...

Help Parents Avoid Unwanted Medical Treatment...

A study shows older adults aren’t getting the care they want at life’s end A new poll shows that almost one in four older Americans — approximately 25 million people — experience excessive or unwanted medical treatment. This is especially true in the last year and very last days of life. During their final 24 to 48 hours, many terminally ill patients go to the hospital and receive treatments that don’t improve quality of life, says Daniel Wilson, national and federal programs director for Compassion & Choices, a nonprofit end-of-life advocacy organization. In fact, a person’s last days in the hospital are often “more traumatic than peaceful,” he says. Why, when 70 percent of us say we want to die at home, are we so often dying in the hospital? Several factors are driving the trend. A main issue is cultural discomfort with death and dying. “In America, we avoid these conversations,” says Wilson. A Need to Start Talking A 2012 survey  conducted by the California HealthCare Foundation found that 60 percent of respondents feel it is “extremely important” that their families not be burdened by tough decisions about their end of life care. Yet, 56 percent of those surveyed had not communicated their end-of-life wishes with their families. Anxiety about death also keeps people from talking openly with their doctors, leaving patients with incomplete or false information about many palliative care and end-of-life alternatives that would keep them out of the hospital in their last days. “This is your body, your health,” says Wilson. “You need to have the comfort level with your doctor.” If you don’t feel comfortable asking questions and having these types of conversations with your healthcare practitioner, he says, it might be time to...

When Should You Push For a Geriatric Assessment?...

Taking a team approach can net the best results for your parents Navigating the maze of eldercare options can be challenging. A geriatric assessment can help you figure out the level of care your loved one needs. “The phrase geriatric assessment is a bit confusing,” says Norbert “Bert” Rahl , director of mental health services at the Benjamin Rose Institute on Aging. Sometimes an assessment looks at just one issue that’s causing problems for a loved one. For instance: If you are concerned about your mother’s physical status, the medications she is taking or how she is (or isn’t) managing a chronic condition, a physical assessment may be in order. If your father has mobility issues and you’re worried about how well he is (or isn’t ) getting around on his own, he may need a functional assessment. If you are worried about the psychological and emotional well-being of your loved one, a mental health assessment could be helpful. If your aging relative is displaying issues with memory, decision making and financial management skills, a cognitive assessment should be scheduled. Or, to get the whole-person “picture” of what’s going on, Rahl suggests a comprehensive assessment, which looks at all those things and how they are interacting and overlapping in your older loved one’s life. A comprehensive assessment could be coordinated by your loved one’s primary care physician. However, since these assessments require the skills and expertise of a team of specialists, they are best coordinated by a geriatrician: a physician who has trained and specialized in the care and treatment of older adults. Ask for a referral from the primary care physician or click here to find a geriatrician in your area. Who’s On Your Team? The composition of...

How Sharing a Life Story Helps Dementia Caregivers...

Conveying personal info lets others connect with your loved one One day while I was volunteering at a local adult day care, we had a new visitor who was confused and very unhappy that her daughter had left her there with us. She was agitated and was trying to leave. Luckily, when they first arrived, her daughter had handed us a one-page life story about her mother who had dementia. After reading it, I was able to more easily connect with the lady. Sharing Your Knowledge As we discussed her career as a teacher, her agitation slipped away and we ended up having a very nice conversation. Without that knowledge, things would have been more difficult for both of us. If you’re the primary caregiver of a person with dementia, you know your loved one’s likes and dislikes. You can read their moods. You know their routines and the people in their world. Nobody can care for them the same way you do. But the act of sharing your loved one’s life story empowers others to better understand his or her traits, to connect and to provide better dementia care. In turn, you receive peace of mind when you take time for yourself. A Different Reality The reality of a person with dementia often slips into a past era of their life. For instance, it may be typical for the person to prepare for work each morning as they did for many years. Or they might start preparing to send their children off to school although their kids are fully grown and have left the nest. When the people around them don’t understand this different reality, they often struggle to accept what seems like strange behavior. They may even...

When Should You Step In to Help Your Parents?...

They may brush off your offers, so search out their true needs A parent may ask for the occasional favor, but most won’t ask for help around the house or with their daily activities, even when they need it, says Alberta Chokshi, a social worker and director of quality improvement for Benjamin Rose Institute on Aging. Chokshi, who has been working with families for 40 years, says that instead of seeking help, it’s typical for elderly parents to adapt and adjust their activities and routines. They do household chores more slowly (or not at all). They may use adaptive devices, such as a cane or a reacher or a magnifying glass. Perhaps they’ve lined up someone to pick them up for errands and appointments. And — often just to please their children — they will wear a medical alert bracelet or necklace. What Our Parents Don’t Admit But they usually aren’t admitting — especially to their adult children — that they tend to drop heavy pots, trip on the basement steps, are confused about when to take their medications or back into things with the car. They don’t think it’s any of their kids’ business. Or, they are in denial about what’s going on. Try To See The Big Picture Denial isn’t all on the parents’ side. Adult children are often deep in it, too. They don’t want to admit that a parent is declining and needs help. They may resist accepting that familial roles are starting to reverse and that they need to step in, either helping a parent themselves or lining up support. If you’re guilty of denial, it’s time for you to take a hard look around for the telltale signs that things aren’t going well...

When and How to Coax Your Parent to Move Closer...

If you’re wondering whether a faraway mom or dad should relocate closer to you, these tips can help Eight years ago, my dad moved to a tiny town in New Mexico after nearly four decades in New York City. Then an active 73-year-old retiree, he yearned for a taste of mythic Southwest living, four acres and a dog. But what seemed like an almost exotic locale when my husband and I first visited him (“Look, a tumbleweed!”) is now a growing source of worry and expense for my family as well as for my brother and his wife. There are no direct flights to my father’s area from our homes in New York and Connecticut, so it’s an 11-hour schlep. It costs about $1,200 for my husband, son and me to fly there, so it’s not like we can afford to just pop in whenever Dad needs us. Can Dad Still Manage to Live By Himself? On top of that, my father is now 81 and moving more slowly. He’s generally healthy, but when I visited him last fall, I was concerned about whether he could still take care of the house and yard and manage the two-hour drives to the nearest VA center for his medical checkups. (He’s a Korean War veteran.) My brother and I and our spouses have batted around the idea of moving Dad back East, but it’s hard to persuade a guy who’s (knock wood) still self-sufficient and happy where he is. Heck, he’s producing a local play as we speak. Apparently, however, we should try. And soon. Jean Levin, executive director of Caring From a Distance, a nonprofit in Washington, D.C., that connects caregivers with resources, says this is actually the ideal time...