It is a fact of life, for those of us reaching retirement age, that our children have moved out and are starting families of their own – and that our elderly parents (if we’re still lucky enough to have them around) may now need our help and increasing attention.
Some, like my father and his wife, are healthy, independent and socially active in their late 80’s. Others are still mentally sharp and living on their own, but physically, they’re winding down like an old clock and need careful monitoring.
And then there are elderly parents who suffer from the after-effects of injuries (like falls), illnesses (like strokes, cancer or diabetes), or debilitating degenerative ailments like Alzheimer’s or Parkinson’s disease who require round-the-clock professional care.
Let’s say you’re on a business trip in Omaha when your Mom falls down the stairs in Florida and breaks her hip. Or maybe you live only one town away when you get the call that you’re father’s been found wandering down Rt. 6 in his pajamas at 4 a.m. We had Dr. Spock and Terry Brazelton to guide us on “how to raise children,” but where do we go and what do we do when it’s suddenly time to help “raise” our elderly parents?
Many of us grew up with Nana or Meme living with us in a multi-generational home, with aunts and uncles downstairs or around the corner. But the “great generation” of today’s elderly parents oftentimes prefer not to move in with their adult children, seeking to maintain their autonomy and activities for as long as possible. They fear losing their hard-earned independence, they’re frustrated by their declining health and abilities, they’re saddened by the loss of old friends and their familiar social network. Above all, they’re fiercely proud and dread being thought of as “a burden” or possibly resented for their perceived neediness and “uselessness.”
So what should you do?
Where do you, the adult child, go for advice and support? How can you best help your elderly parent without hurting yourself, your marriage/family, your finances, your job or your sanity?
Well, fear not. You’re not alone – there are many federal, state and local agencies/organizations/institutions, support services and professional resources for both your parent and you, their adult child caregiver.
Think first, then act
If your parent is reasonably healthy and independent enough to remain in his/her own home, or move to a retirement community or assisted-living facility, respect those wishes and offer what assistance, support and advice you can [see sidebar] – don’t try to convince them that it will be all sweetness and light if they move in with you instead. (You’ll both regret it.)
But first, start by taking an inventory of your and your parent’s situations. Do you even have room enough in your house to give you all some privacy with a minimum of disruption? Do you work full-time and need others to come in while you’re gone Monday through Friday to help care for your parent? Are your scattered siblings willing and able to help out in any way, whether financially or on weekends or by inviting the parent for weeks at a time during the year to give you some respite?
Are your spouse and still-at-home children willing to shoulder some of the additional daily chores and give you some time to relax in the bubble-bath or take a nap, or drive the grandparent to a social activity? Are you all willing and able to include the grandparent in daily life activities like shopping, soccer practice, backyard BBQs with your friends, and just goofing off and playing video games?
Welcoming an elderly parent into your home is a bit like bringing home a new baby – there will be sleepless nights, mad dashes to the doctor’s office, disrupted routines, and a change in daily priorities, resources and your undivided attention.
Anticipate the future
And what is the current and future picture of your parent’s situation? Can they manage on their own with some additional help and encouragement every day, or do they have physical/cognitive problems that necessitate 24/7 attention?
You may be willing to manage daily medications and insulin injections, but when it comes to the advanced skills required by dialysis, catheterization, and the like, or hefting a disoriented or disabled parent in and out of bed, the bathtub and the car (and you’re 5’2” and 110 lbs. soaking wet), you need to step back and make a better choice for their care – a nursing home, an assisted-living facility, or around-the-clock care in their own home, not your spare bedroom.
And understanding your parent’s current financial and legal situation is critical in helping them make the right choice.
Do they have an extended health insurance policy that will supplement Medicare? Are they eligible for veteran’s benefits? Are they willing and able to cash in some of their assets (house, car, retirement funds) to cover their expenses? Do they have a will, a health care proxy or documents for durable power of attorney, should you have to manage their finances, health care and day-to-day expenses?
What sources of ready income can they access (Social Security, pensions, annuities, stocks and other investments)? Many a family feud has resulted from issues like this, so make sure everyone is included in the discussion and decisions on how best your elderly parent can live the rest of his/her life to the fullest…
Whether living on their own, in your home, or in a senior facility of any kind, your parent needs to live in a fall-proof environment. Bathrooms are especially hazardous and may need remodeling or modification to minimize risks. Stabilizing grab-bars both inside and outside the tub/shower are a must. If finances allow, install a special walk-in tub/shower with a seat.
Throw rugs and slippery tile floors need to be covered with non-slip/trip carpeting. Booster-seats with hand-rails on toilets help tremendously. Get rid of oily toiletries (lotions, bath oils) that could make the bathroom slippery – and hang a “soap-on-a-rope” from the showerhead so your parent doesn’t have to bend over after dropping a bar of soap.
Middle-of-the-night trips to the bathroom are especially dangerous for the elderly. Install handrails in the hallway; ban wet-towels-on-the-bathroom-floor and book-bags or sleeping pets from the hallways; and install a sturdy gate at the top of any stairs. Make sure night-lights illuminate the way. Provide a glass of water, a sturdy flashlight and a large-number digital clock on the bedside table.
A cell-phone, intercom, Life-Alert system or even a whistle can help elders who awaken in the middle of the night in pain, or frightened by a noise outside, or in need of help getting to the bathroom.
If your parent lives alone
Those who live alone should carry the cell-phone or Life-Alert 24/7, even just going outside to get the mail – they can just as easily fall in the front yard as in the bathroom, especially in winter when stairs and sidewalks are icy or snow-covered. Make arrangements to provide prompt clearing of wet leaves, ice and snow from their porches, walkways and driveways.
And be a proactive advocate in helping your parent follow doctor’s orders about diet and medications – create a chart/schedule (and post it on the ‘fridge) of what pills needs to be taken and when (and make sure it’s followed). Too many older people either forget to take their pills or skip doses to save money, which can have life-threatening results.
If the pills are bitter or hard to swallow, remember how you coaxed your children – crush the pills and mix them with applesauce (or find a liquid version). You can even buy pill-cases with timers that alert your parent when it’s time to take certain medications. Ask you parent’s case manager, doctor and pharmacist for guidance.
Here’s where to start…
Every town and city has a Council on Aging, your first stop in helping your elderly parent live as safely and independently as possible. Many towns now offer daily wellness check-in calls for seniors, in case you’re not available. Contact, too, your parent’s church/synagogue about services and activities offered for senior citizens – everything from kosher meals delivered to the home to bus trips to social activities to transportation for doctor’s visits and shopping.
But the critical clearinghouse for information, services, referrals and advice will come from your designated Area Agency on Aging (AAA) and Aging Services Access Point (ASAP). Funded by the federal, state and local governments, these organizations are a godsend for your elderly parent – and you the adult child caregiver.
In Rhode Island, contact the Division of Elderly Affairs at www.dea.ri.gov or call 401-462-311 (their senior services hotline can be reached at 401-462-4000).
Multi-lingual case managers will evaluate your parent’s situation and needs, develop a service plan, provide you with information about in-home care options, elder law advice services, financial/estate planning advice, alternative living /healthcare options in the area, social activities and support services for you both – for free. You (and your parent) are not alone.
Helping your parent stay healthy
Six million senior citizens suffer from clinical depression, oftentimes mistaken as dementia, but more often it’s triggered by underlying illnesses, reactions to medications, as well as feelings of loss, frustration and abrupt changes in their living circumstances.
But feeling chronically sad, lonely, aimless and confused is not a “normal” part of aging, any more than it is a part of adolescence or middle age. As the adult child, do what you can to help your aging parent stay physically, socially and mentally active.
Your mother may cringe at the suggestion of playing bingo, but maybe she’d enjoying volunteering for “reading hour” at the library, mentoring students after school, or joining a quilting club.
Even opportunities for physical activity can be social events – participating in tai chi classes at the park, a dance class at the senior center, a nature walk at the local park, swim-ercise at the rec. center or Y. Physical activity helps improve balance and stamina, alleviates aches and pains, stimulates the appetite, and helps banish “the blahs.”
Equally important is encouraging your elderly parent to stay mentally stimulated. Reading, crossword/jigsaw puzzles and sudoku get boring real fast – introduce them to the Internet!
Many senior centers and libraries offer free skills workshops for seniors on computer uses. They can chat, shop, play “brain games” (like mahjongg), keep in touch with family and friends, write a cookbook or their memoirs [see sidebar] – or even start a blog! – all from the comfort of home. If they have a digital camera, they can download and send photos – or if they have Skype (free long-distance service online), they can speak with and see the grandkids in real time.
You and your elderly parent are not alone.
Find advice and support for adult child caregivers at www.caregiving.com.
Hospice and Palliative Care Federation of MA – www.hospicefed.org or 1-800-962-2973
“Aging in the Know” – www.healthinaging.org
Mass. Long Term Care – www.masslongtermcare.org
US Living Will Registry – www.uslivingwillregistry.com
www.seniorlist.com –great articles, links, advice
www.storycorps.org – a free, nonprofit program of the National Public Radio which allows seniors to record their personal history via a computer for the Library of Congress
Daily discounts and coupons in your area for seniors – www.sciddy.com.
For various daily care services for your parents or for caregiver respite care, contact Home Instead Senior Care at www.homeinstead.com or call 508-984-7900.
If your parent needs in-home medical care, contact the Visiting Nurses Association of the Southcoast Health System at www.southcoastvna.org or call 1-800-698-6877.