I don't know what to do. I'm overwhelmed and feel helpless.
Where do I turn?
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This is a problem many of us face when our parents grow older. You always think of them as independent and strong -- able to take care of themselves, but now you're starting to see signs. Little signs . . . stacks of unpaid bills, letters promising lottery winnings, a house that's not as clean as it once was, forgetfulness, weight loss, depression, loss of physical or organizational abilities, a dented car bumper, health issues that don't seem to be improving. You ask and hear exasperation in their voice, denial that anything is wrong.
Unless you have experience with issues that result from aging or the health care system you will find the situation frustrating and very confusing.
My name is Pamela Wilson and my role is to help families relieve the emotional stress of dealing with an aging parent. I am here to help you navigate issues of aging, the health care system and to help your parents in their time of need. Seeing my own father deal with his declining health after my mother's death made me feel helpless, lost and a somewhat embarrassed that I couldn't do more to ease my father's pain and make his life easier. This experience and years of working with others in similar situations showed me that there are better ways to deal with the inevitable - that we will all one day experience ourselves.
So where do you go for help? My experience with my parents, my in-laws and hundreds of clients taught me that knowledge is power. Education is the first step. There are many resources available to you and your parents to make the later years less stressful and more enjoyable. I offer support by providing educational materials and in person and telephone consultations.
I have written a series of articles to help children of aging parents work through the issues that arise as parents move to the stage of dependency instead self-sufficiency. We often hear that we begin as helpless children and end our life in a similar way. In some cases this is true. These articles are written to provide ideas, suggestions and guidance as you look for options to help your parents. I'm also available to answer questions and help you work through these difficult situations. Subjects like:
How to talk to your parents - understanding their perspective
Medicare versus Medicaid, what's the difference?
Dealing with the financial implications of needing care
What to do when siblings are "not all on the same page" regarding parent care
Planning an effective visit with the doctor
Setting up home care
Is it time to move?
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Moving Your Parents Once -- Not Twice
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
In my weekly radio program, Parenting your Parents (www.parentingyourparentsradio.com), adult children frequently call to express frustration that they moved their parents or that their parents have moved only to be faced with having to move again. Why does this occur?
The need to move parents again often occurs because individuals or families did not consider planning for the long term. They planned for what they believed were needs for today not realizing that health care problems will arise and that care needs will increase as age advances. The situation also depends on the age at which an older adult first relocates. An individual moving at age 65 into an independent retirement community may be able to live in the same community for ten or more years. An individual at age 85, moving into an assisted living community, may only remain in the assisted living community for about two to three years until care needs again advance.
By the time an individual requires an assisted living level of care, consideration must be given to the realization that at some point near in the future, depending on the health of the individual, a higher level of care will be needed. Consideration must also be given to special care needs, such as individuals diagnosed with dementia or Alzheimer's as a large percentage of individuals over age 85 have this diagnosis in common. Complications such as incontinence, vision difficulties, mobility difficulties and behaviors also must be taken into consideration.
Between the Ages of 51-61? Expect At Least One Major Lifestyle Change
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
According to a study by the Center for Retirement Research at Boston College (1), nearly seventy five percent of individuals between the ages of 51-61 will experience a negative event that will affect their long term financial security and lifestyle. These shocks include job layoffs, widowhood, divorce, diagnosis of new health problems, or having to help frail parents or in-laws; 28% of these adults already have their own health issues.
Adding to the complexity of helping frail parents or in-laws, a recent study by the Alzheimer's Association (2) indicates that ten million caregivers provide care to a person age 60 or older with Alzheimer's disease. Many of these individuals are generally unprepared for what may be a very long journey of providing care to a loved one that is physically and emotionally exhausting not to mention financially draining.
The study cites that total per-person payments from all sources for health and long-term care were three times higher for Medicare beneficiaries aged 65 and older with Alzheimer's and other dementias than for other Medicare beneficiaries in the same age group ($33,007 compared with $10,603 per person). (3)
These issues not only have a profound effect on our daily lives but on society in general because they exert cost pressures on health care, government benefits, employment, social security, long term care and many related areas. With available statistics like this, why are individuals so shocked when an event occurs that tosses their lives into uncertainty? The reality is that many of us go through life day to day just making due, unable to plan for our future. Even when young, we dispute the wisdom and advice of our parents; especially the importance of education.
When Relationship Difficulties Prevent Care Planning
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
Are your parents at the point where the need for help is no longer optional? Have you talked to them about the subject and received a cold shoulder from one or both? Relationship difficulties are often at the root of challenges in accepting or discussing the need for care. These challenges exist not only between parental relationships but between relationships between children and their parents. Caregiving and long term care are subjects many find uncomfortable to discuss. Confronting our own mortality is difficult.
The challenge begins with the relationship between your parents. You lived with them as a child and likely remember which parent made most of the decisions, managed the finances, served as disciplinarian or organized the household. You may recall how well your parents managed or avoided conflict. These challenges do not become easier when parents age, they become more intensified, more prominent. And parents often resist when children suggest that they need help because they are the parent; it's their job to give their children advice, not vice versa. Nor do parents want to be reminded that they are aging and may need help.
Do Medical Quality Measures Result in Greater Harm than Good?
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
There is discussion in health care circles about "quality metrics" for example standards that must be met by physicians in order to ensure certain levels of patient care and in return that ensure certain levels of physician reimbursement. Many states also have pay for performance programs.
Hand washing is a simple example. Imagine that the likelihood of infection being passed hand to hand or hand to mouth decreases with the activity of hand washing. Washing your hands is a very simple act that can help you avoid catching a cold. According to the Centers for Disease Control, hand washing is the single most important means of preventing the spread of infection. Thus it would be logical to believe that by implementing a standardized protocol for hand washing (quality metric) in hospitals, medical offices etc. that the risk of passing on infection is likely to decrease.
In a recent Wall Street Journal Article, (1) mention was made of physicians in California dropping non-compliant patients or refusing to treat people with complicated illnesses because their less than stellar outcomes may result in poor scores and lower financial reimbursement for physicians. This questions the logic of quality metrics in compromising the care of critically ill patients. If the likelihood of failure is great in any endeavor and there is a financial or personal penalty then who will be willing to try at all?
A study recently released by the ACCORD group closely monitored blood glucose levels in individuals with Type II diabetes. (2) Unless you've had a family member hospitalized, you may or may not know that monitoring blood glucose levels became a quality measure in hospital intensive care wards. I've questioned the need myself when my clients in the hospital were given insulin injections when they've never had a diabetic day in their life. Why treat something that never existed in the first place? Answer: quality metrics.
Children & Caregivers
