Aboutmyparents.com

With Mother’s Day approaching I realize there are a lot of you who are the moms in the middle; caring for your aging parents and still going to soccer games. Take time to care of yourself as you balance all the duties of motherhood, your marriage and your family: set aside time for yourself, seek support, allow others to help, learn all you can about the condition or illness you are dealing with, reflect on the positives of the relationship, learn to delegate and keep lines of communication open in your significant relationships. Abraham Lincoln had the right idea when he said, "All that I am or hope to be I owe to my mother." You are the unsung heroes of everyday life and I honor you.

You can get Medicare hospice benefits when you meet all of the following conditions:

• You’re eligible for Medicare Part A (Hospital Insurance).
• Your doctor and the hospice medical director certify that you’re terminally ill and have 6 months or less to live if your illness runs its normal course.
• You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness.
• You get care from a Medicare-approved hospice program.

www.medicare.gov/publications/Pubs/pdf/02154.pdf

Yesterday I saw a couple at the hair salon and the image of them will forever be etched in my mind.  They were both in their nineties, in matching warm up suits, holding hands as they arrived for her appointment.  They shuffled in a single line, he leading her with the most adoring look I have ever been witnessed to.  With every move she made he was there, her knight in shining armor.  After all these years he looked at her as if he had just seen her for the first time.  All I could think about is when one passes away the other will go quickly, they could not sustain without the other, that kind of love permeates your soul when you have seen it firsthand.  Their daughter sees me watch their every move and she whispers, “That generation saw good times and very bad times and they believed in keeping their word.”  So it made me think about our disposable society and how these difficult economic times may bring us back to the basics, because without bad times do you not fully appreciate the good.  I happen to think there is something honorable and exceptional when you have experienced the highs and lows and remain standing as one.  Pride comes to mind as I look into the faces of clients who have been married for 60 plus years, “It wasn’t always easy,” they tell you and if you are married you know what they mean.   Today I see the glass half full and wish that kind of commitment for my children, your children or grandchildren and the generations to come.

I had a client who was hospitalized and there were seven siblings who were spread out across the country. We knew this was going to be a long hospitalization, so once everyone had to return to their lives we used this website so family members and grandchildren could post notes and stay up to date on her progress.

CaringBridge - Free

Many families wonder what they should do with prescriptions after a loved one has passed away. Here is a useful link:

Dispose My Meds | Online resource to help you to

These can be useful when siblings are not on the same page and you need to begin making some plans for the future care of your parent.  This can be an opportunity for everyone to air their feelings, support one another and find a way to work together for the best interest of your you parent.  Who should come?  Try to keep the meeting limited to only siblings and if there is a caregiver you may want to include them as well.  For the first meeting it may be wise to have you parent sit this one out, it will allow everyone to speak more openly about their true feelings. Family members who cannot attend due to distance can be brought in by conference call.  If there are deep wounds or issues you may want to enlist someone like a geriatric care manager or social worker to moderate the meeting.  This brings an element of neutrality to what can be a very heated discussion.  Designate someone to create the agenda and ground rules for the meeting.  No one should dominate the meeting and everyone must have an opportunity to voice their opinion.  The last part of the meeting should be a plan of how to divide the duties.  Those family members that live far away should be making calls to the agencies, handling bill paying and offering respite, distance does not exclude you from the responsibilities.  Make copies of the plan and make sure each member has one, then in an agreed time frame you should reconvene to see how the plan is working for everyone including your parent. 

Many older people need help paying for prescription drugs, health care, utilities and other basic needs. Ironically, millions of older Americans — especially those with limited incomes — are eligible for but not receiving benefits from existing federal, state and local programs. Ranging from heating and energy assistance to prescription savings programs to income supplements, there are many public programs available to seniors in need if they only knew about them and how to apply for them.

Get all the benefits you deserve. Find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs.

As of Monday, April 19, 2010 they have helped 2,473,237 people find over $8.2 billion worth of the annual benefits they deserve.

www.benefitscheckup.org

Today, the Centers for Medicare & Medicaid Services posted a new and easier to use version of www.medicare.gov.  The updated Web site is part of the steps Medicare is taking to make using their site easier for seniors and people who care for them to find the
information they need about Medicare. The improved Web site provides users with a summary of Medicare benefits, coverage options, rights and protections,
and answers to the most frequently asked questions about Medicare.

I remember when I was sixteen thinking I would rather die than be like my mom!  Now forty, I am starting to see more signs of our similarities than our differences; our laugh, interest in foreign politics and our sweet tooth.   How could this happen?   As I neurotically loaded my husband’s unfinished drink into the dishwasher last night just because he left the kitchen for a second, I am reminded of my mother’s insane cleaning binges.  I cringe at the thought that I am morphing into some mutant form of her,  don’t get me wrong, I love her and we are close but this is not how it is supposed to be.  I thought I would mature, wiser beyond my years and become ME.  Then I have a frightening thought and I begin to worry about my daughter, what twisted behavioral traits will she pick up from me.  Am I being a good role model or will I damage another generation with silly cleaning rituals?  God, this is complicated.  I am left to believe that as we begin to deal with aging parents and their issues we should pause before we roll our eyes; because the very issues we are criticizing in our parents may become issues our children have to deal with us.  So as I look in the mirror today I will accept the good traits my parents passed on, banish the bad, in an attempt to let my individuality shine…or so I think.

Benefits for veterans: Veterans and their spouses can qualify for VA-provided aid and attendance services, also known as assisted living. Visit their website for more details on all the long term care services veterans are eligible for.  www.va.gov

Adult day care centers, also known as adult day services, have been providing a form of respite for caregivers for more than twenty years, yet this valuable service is often not well known. Adult day care centers provide a break to the caregiver while providing health services, therapeutic services, and social activities for people with Alzheimer’s disease and related dementia, traumatic brain injuries, and other problems that increase their care needs. Adult day care allows caregivers to continue working outside the home, receive help with the physical care of a loved one, avoid the guilt of placing a loved one in institutional care, and have some relief from care giving.

A day at an adult day care center usually has supervised care; small group and individual activities such as reminiscence, sensory stimulation, music, art, and intergenerational activities; nutritious meals; transportation; case management; recreation and exercise; nursing care; education; family counseling; assistance with activities of daily living; and occupational, speech and physical therapies.

Good candidates for adult day care are seniors who:

• Can benefit from the friendship and functional assistance a day care center offers,
• May be physically or cognitively challenged but do not require 24-hour supervision,
• Are in the early stages of Alzheimer's disease.

Adult day care center participants need to be mobile, with the possible assistance of a cane, walker or wheelchair, and in most cases, they must also be continent.

You should seriously consider using adult day care when a senior:

• can no longer structure his or her own daily activities
• is isolated and desires companionship
• can't be safely left alone at home
• lives with someone who works outside the home or who is frequently away from home for other reasons

Fees can range from $25 per day to $70 per day, with the average costing around $50 per day. Many facilities provide services with a sliding fee scale, meaning that family members pay a fee based on their income.  While Medicare does not cover adult day care, Medicaid does.

Call your local Alzheimer’s Association, Area on Aging office or look in the phone book under adult day care to locate a center in your area.  Spend a day in the center to observe the staff and clients before making your decision.

We are out in California visiting my mom; it has been a year since my father passed away. It is a different visit for all of us. “She laughs less,” my daughter observes.  It is true, I see it myself, as she drifts in and out of conversations at any given time.  It must be hard to have the children here and he is not.  He loved them with all of his heart.  Like so many men of his generation he tried to make up with them what he lacked with me, time. He was the one who took them fishing, camping and played practical jokes.  So they miss his spirit.  I am trying to explain to my children that grandma has lost half of her soul after forty four years of marriage and that changes you forever.  We are all adjusting.  So as she begins to carve out a new life for herself, we cannot personalize her actions or inactions but love her and just be there for her.  A new journey has begun.

Use the Eldercare Locator, a public service of the U.S. Administration on Aging to find local agencies in every community for services such as transportation, meals, home care and caregiver support. www.eldercare.gov

Spring has sprung and it signals new beginnings. I am reminded of a class I taught about aging where I described one of my clients; I said she needs to be fed, bathed, clothed, cared for and she is exhausting for those who live with her; then I showed the class a picture of a baby. They were shocked. As we savor the sights and smells of spring let us remember the similarity between the beginning of life and the end of life. We are so excited about a newborn baby despite the 24 hour care they require. Let’s try to share this enthusiasm as we care for those in the end of their lives, it is the least we can do to honor them.

"There is a special kind of joy that forms in our hearts when we give without expecting anything in return, that kind of joy is worth pursuing regardless of the past."  from  Before the Storm, Essential Questions to Ask Your Aging Parents Today!

This weekend the New York Times ran an article regarding the difficultly of choosing a nursing home, here is the link for more information, http://www.nytimes.com/2010/03/20/health/20patient.html.

As a former social worker in a nursing home I can tell you that one person’s experience can be completely different for another because so many different factors such as staffing ratios, a rude nurse or bad food can affect the quality of a stay.   As you begin this task use the www.medicare.gov , nursing home tool to begin your search, make several inquiries within your community, visit at different times of the day and make sure you pick a facility that specializes in what you are looking for.  If your loved one is going to a nursing home for a short term rehabilitation stay for a fractured hip, pick a facility that has a top program; do not choose a facility that focuses on long term care dementia patients.  Lastly, do not let the discharge planners in the hospitals dictate where you would like your loved one to go.  Their job is to get patients out of the hospital and they have their “go to “nursing homes so do your research beforehand and make your preference known. 

Does your parent need to get their affairs in order?  If they do, consider using an attorney who specializes in eldercare.  The National Academy of Elder Law Attorneys, a.k.a NAELA is comprised of attorneys in the private and public sectors who deal with legal issues affecting seniors and people with disabilities. Members also include judges, professors of law, and students.  Log on to find an attorney in your area: www.naela.org

Yesterday my daughter said, “Mom I think you will be one of those old ladies in the nursing homes with bright red lips, lots of pearls hanging from your neck and I know you will be keeping everyone up with your loud laugh." It is hard to imagine myself in a nursing home but she has made several trips to them with me so I can see how she could envision this scenario.   Her comment made me think about one of my favorite clients Johnny.  Johnny was ninety-eight years old, golfed three times a week, drove, cooked all her own meals and watched my son when he was an infant.  Where did she find the strength to embrace life so tightly?  Let's face it she had good genes but she wanted to contribute and be involved in life.  So I have to think the old adage is true, you get what you put into things.  So if my loud embarrassing laugh encourages others to laugh with me, then that will be my contribution and it will keep me engaged with others and that is a pleasant thought.  How are you engaged in life and if your parents are aging and pulling away, what used to inspire them?

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 Please just love me for who I am and realize that I am the product of my environment and circumstances. 

Listen to my concerns because someday these may become your concerns too.

Provide a random act of kindness for people my age so we know that we are not forgotten. 

Hold my hand, hug me and watch my world come alive.

Respect me because my experiences do count for something.

Please do not shield me from bad news or the truth, it will only demean me.

If I have to stop driving realize this feels like the end of my independence.

If I am grouchy it is because I have more bad days than good ones and it is hard getting old.

Resolve your issues with me before it is too late, even if I wasn’t the best parent, this will set you free.

Sit with me and visit.  It is all I have to look forward to these days.

Ask my advice even when you don’t need it.  It will make me feel useful.

When my time has come please respect my wishes and let me go.  This is about me not you.

Don’t be so quick to tell me what you think I should do, just listen to me.

Be an advocate for me when I no longer have a voice.

If I no longer act like the same person you knew, please forgive me and remember the old me, I would want it that way.

Love, laugh and forgive.

Finally, enjoy each precious moment despite the mundane nature of every day life.  I wish someone would have told me to savor the sun rising and setting for the simple pleasures they are…the beauty of life.

Love,

Your Aging Parent

Written by Monique Snyder, MA, CMC

One of my new favorite sites is www.Elderluxe.com.  Here you will find a diverse collection of fashionable and functional products designed to improve the aging experience.  They have mobility devices, innovative electronics aides, medication managers, and dexterity tools displayed in a chic manner.  Out with the old stereotypes and in with a new way of shopping for assistive devices. 

Today I saw an old man at the grocery store, he must have been around eighty and he was dressed beautifully.  He had on a hat, a vest, a tie, wingtip shoes, the whole nine yards.  It was one of those moments where I had to stop what I was doing and pay someone a well deserved compliment.  He smiled and thanked me, he proceeded to tell me that no one takes the time anymore to dress up, visit with neighbors and eat together as a family.  He was right; we have become a very lazy society, albeit a very stressed, two income society but I think we have lost our way in so many little places.  I smiled as we went our separate ways, he was picking up a carton of milk and he thought enough of the world to make an effort for all of us who came in contact with him.  Here I am hoping that when I am eighty I can get out of bed and remember my children by name.  Appearances may not mean as much to one person as they do the other but I was struck by the principle of it all.  How much do we make an effort in our days to touch another human life in a positive way?  Do you stop for the older person in the crosswalk or are they just too slow for you? Do you hold open the door for the lady with two toddlers and an infant in tow?  Do you let a boss know when someone has provided you with excellent service? I called to make an appointment as a new patient with a doctor and the front office person, blew me away.  The customer service was over the top.  So I told him, “you are fantastic at your job and they are lucky to have you.” Think back to the last time someone went out of their way for you, paid you a compliment or exhibited a random act of kindness, didn’t it feel good.  Despite the difficulties we all face in our own little corners of the world, we have to remind ourselves to reach out, otherwise what are we left with…

I love my clients, they can range anywhere from sixty to ninety eight, they always teach me a lesson, remind me of a purpose.  So today I thank the man in the suit for reminding me that I should strive to always go that extra mile, and each mile has a different meaning for all of us.  So walk, sprint or run and make it a great day.

Excerpts from Before the Storm, Essential Questions to Ask Your Aging Parents Today!

As you set out to have some difficult conversations with your parent it is important that you pick a time of the day that is best for them.  Make sure it is conducive for conversation in terms of comfort, noise and privacy. 

Here are some questions you should be asking; they may be good indicators of how your parent is managing their life:

·         Do you know if your parent has a good geriatrician and when was their last appointment?

·         Have they lost weight?

·         Do they grocery shop or is the food spoiled?

·         Are they managing their medications?

·         Do they need assistance with their day to day activities?

·         Have they had any accidents in the kitchen or on the road?

·         Do they have a living will?

·         Are they behind on bills?

·         Do they need to move?

·         What is their financial situation?

·         Have they stopped doing the things they love, and why?

The information gathering process is an important first step in the journey of caring for your aging parent.  It may be difficult to broach these topics but try to engage your parent by letting them know you read an article in the paper or you have a neighbor who is experiencing some difficulty with these issues.  Remember everything does not need to be accomplished in one day!

For the last ten years I have been helping adult children from all over the country with their aging parents.  When my daughter was born in 1998 I decided to start keeping track of frequently asked questions from my clients regarding their aging parents.  My idea was to create a book that would address these common issues in a format that would be easy to read and useful for adult children.  Life happened; and all of a sudden I had two children, the book was never completed and my ideas sat on a zip buried in my desk.  Then I had a life changing moment, my own father died last year and it forced me to sit back down and finish this important book.  My dad and I had many discussions about my clients and he always said, “If I am in that condition I want you to be clear about my wishes.”  It was the clarity I had regarding his wishes that spoke to me.  I knew my dad, his health issues, his doctors and how he would have wanted his life to end.   I want other adult children to have that clarity and feel they have done the best job they are capable of in caring for their aging parents.  My book is the first step in this process.  It is all about sitting down with your parent and having some difficult discussions before there is a crisis. 

So today, tomorrow or next day ask yourself if you know what your parent’s needs and wishes are but don’t wait too long.  Don’t let the fear of looking at your own mortality block you from going down this path because it is not about you it is about your parent.

The next blog will contain excerpts from my book, Before the Storm, Essential Questions to Ask Your Aging Parents Today!

In January of 2010 I wrote an article for MORE.com detailing what Geriatric Care Managers can do for families and I think this is a good place for me to begin this blog. 

I have worked as a Professional Geriatric Care Manager since 1997, what we do is, we help families with their aging parents.  Many people have never heard of us but our profession has been in existence since the 80s.  We have been receiving more media attention as adult children across the country find themselves faced with the complex task of navigating long term care issues and living across the country from their parent. Despite the increased awareness we remain the best kept secret.  Professional Geriatric Care Managers are health and human services specialist who help families when they are caring for older relatives.  The National Association of Professional Geriatric Care Managers is based in Tucson, Arizona and promotes the highest standards of practice. Membership into NAPGCM as a Certified Geriatric Care Manager is open only to qualified individuals with specialized degrees and experience in human services, including social work, psychology, gerontology or nursing, and you hold one of four NAPGCM-approved certifications. 

As geriatric specialists our goal is to assess needs, identify problems and then draft a plan of care for the future.  Often times we are responsible for coordinating care, supervising other staff, assisting with a move or acting as an unbiased third person to mediate difficult family decisions.  Our job is to guide families through the maze of eldercare. 

When considering whether to engage the services of a Professional Geriatric Care Manager, you should evaluate whether you have the time, inclination, or skills to manage the challenges of eldercare care.  You can log on to the national website www.caremanager.org and plug in your parent’s zip code to locate a care manager in that area.  Our goal is to help you through the process of caring for your aging parents; this is what we do as professional geriatric care managers. 

 In the next days, weeks and months ahead I will be offering advice, posting relevant information as it pertains to aging and sharing stories from the experiences my clients bring to me.  All with the hopes of helping you through this journey by reminding you that you are not alone and giving you a place to ask your questions.  

I wish you the best today and everyday.

Yours Truly,

Monique