Just over a year ago my father fell and broke his back resulting in two fusion surgeries and months of rehab. During this time my mother had to slog through forty-seven years of life’s goods, sell their house and relocate to a condominium all on one floor. This was, in my mother’s estimation at least, the beginning of Hell and they have been in and out of crisis since then. With their grown children living elsewhere, it has not been an easy time on them or us.
Along this difficult journey my siblings and I had to get educated fast on the ins and outs of eldercare. Here are a few thoughts on “parenting” the elderly gleaned from our journey so far.
1) Share your dilemma with friends. It is amazing how many people have been in this situation already and have been able to give us support, needed information (both medical and logistical) or even just a hug;
2) If you tend to be a worrier take on a new mantra. Mine is from my brother and is simply, “It is what it is.” This has helped so much at times when the rational choice seemed to be beating my parents over the head yet they refused to take it!
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3) Realize early on that if your parents have their faculties about them, then what they want is often the most important thing, even if what they want seems totally ridiculous to your non-elderly mind. They are human beings and are entitled to have their rights and wishes honored to the extent that we can do so.
4) Broach the subject of eldercare with your parents early and often. I wonder if we had brought this difficult topic up earlier our parents would have been more willing to consider it before they became so intractable. Even if they had not been more agreeable, we might not have felt so lost and harried when the current crisis descended on them and us.
5) Offer help to your aging parents, but not too much help. Or stated another way – pick and choose your battles. Both my sister and I found that offering what we could but still keeping boundaries around our own lives (i.e. we can’t fly up there to help you clear out the back bedroom but we certainly can be there to take you to your first oncology visit) actually showed my parents what the future was going to look like if they did not move near one of us, or at the least allow us to hire outside assistance for them.
6) Don’t be afraid to write to your parents’ primary care physician if you have concerns. Under HIPPA (the patient confidentiality laws) the doctor is not allowed to share info with you, but you can certainly share info with them. I have on occasion, written my parents’ doctor with serious concerns (slurred speech, medication issues) as well as mundane information (how to contact each adult child should there be an emergency).
7) Ask your parents to sign a form making you a health care proxy. This is imperative if your parents are facing a serious health issue and is a good idea even if they are not. Such a proxy allows you to call and talk with doctors and/or get copies of medical records. In our parents’ situation we were concerned about getting accurate info about their current medical conditions. A healthcare proxy has helped us be more aware of what they are really facing rather than what they want us to know and/or can recall from a very technical medical visit.
8) Gather information before it is needed. Luckily for us my mother began keeping a binder with all their personal information including financial data (bank accounts, funds, etc), insurance (health, life, and long-term care), and medical information (doctors, prescriptions, etc). This has been invaluable with regard to both their medical and financial issues.
9) If your parents are out of state and will not move near you, and they are failing, consider hiring a care coordinator to oversee their doctor’s visits, transportation, prescriptions (including making sure they are taken properly), etc. There are many companies that provide services like this. We are currently using Senior Bridge. They have provided assistance in: scheduling a temporary twenty-four aide (live-in); weekly prescription checks; transportation and attendance at important doctor’s visits and testing; once weekly in-home general well-being checks (including blood pressure and diabetic testing); twenty-four hour nurse-on-call for any middle of the night medical emergencies (when my parents have fallen); assistance in setting up lifeline services; social work services (insurance claims, completing necessary forms timely, etc); and home-safety evaluations.
In addition, to the above tips, the following websites were valuable in educating me on eldercare issues:
www.caps4caregivers.org (CAPS = Caring for Aging Parents) – an excellent clearing house of information including many web links (that is where I found the two below I like so much).
www.assistedseniorliving.net – another clearing house of valuable data including lists of questions to ask prospective assisted living places, descriptions of various eldercare residences, links to various facilities by area and general costs by state and the link to your state’s ombudsman, which is a great resource for eldercare information.
www.aging-parents-and-elder-care.com – this helpful website has lists of pertinent info such as: “how to get started” info, including a video, on how to have “the talk”; choosing the right facility (with downloadable checklists) and how to find financing; legal issues including patient advocacy; hospice help and Medicare issues.
http://v2.tlchoices.com/Connected.asp?CID=29&NewSession - a resource for determining the level of care that would be appropriate and insurance coverage.
http://www.todaysseniors.com/pages/Medicare_FAQs.html - summary of Medicare benefits and nasty surprises.
http://www.medicare.gov/Publications/Search/Results.asp?PubID=10050&Type=PubID&Language=English – another summary of Medicare benefits, etc.