Make the Best of Your Resources

As we and our loved ones age, we may find that accommodations need to be made to how we meet our daily activities. What we often forget is to think globally about what we really have in the form of resources. Most of us will readily identify the money that is available, what is covered by insurance and the current ability of the aging person. What we miss is that everything and everyone in our environment may have something to contribute, no matter how small.
There are two general categories of care givers, formal and informal. The healthcare professionals we work with are clearly formal care givers as are social workers and the persons who administer the provisions of our health care coverage. Informal caregivers are just about everyone else. This includes children in small ways.
I am reminded of the time "Grandma J" fell just as she was returning from her daily walk. Her small shadow, a 4 year old neighbor was able to run to tell Grandma J's daughter about the fall and to return with a pillow to place under Grandma J's head. She sat with her, held her hand and sang the song her mother sang when she needed scraped knees tended, Jesus Loves Me.
Be willing to expand your thoughts to include people who can do small things in loving ways. Keep in mind that an object or tool that you do not need may be just the thing to meet a need.

Watching out for One Another

Many years ago I worked at a small hotel in a major East Coast city. There was an older, homeless woman who would panhandle in the neighborhood. When she got enough for a couple of nights in the hotel she would check in and try to extend her stay by seeking enough money for another night at her usual stand. Every time she checked in she needed to fill in the registration card which included a space for permanent address, One of the secretary's would send a letter to the address on the card.
There came a long period of time when no one saw "Mary" and we, sad to say, stopped looking for her. Then, out of the blue the secretary "Susan" had a charming lady stop by to see her. It seems that "Mary" was homeless and in need of medical attention. Her family had been looking for her for more than a year without any luck. When she checked in the last time she gave an address that was accurate for her family, they came and found her, took her home and she got the medical attention that she needed.  She had come back to thank "Sue" for the persistence of her effort to locate her family
Now, we may not be able to help in such a dramatic way but if we are persistent in our efforts to help each other we can make things a bit better for all of us.

Pick you fights

I was speaking with a neighbor the other day about her frustration with her husband and his memory loss. You see, this gentleman has been diagnosed with Alzheimer's and has reached that stage in the process where he is argumentative and suspicious. She is finding it harder and harder to hold things together.
My suggestion to her and to anyone else with the same challenge is to choose your battles. Ask yourself if the issue is going to be important in 5 years. Is it a matter of safety? How about economic health? Also, allow some space for a topic to cool off to avoid a major conflict.
Some times you also need to agree at the moment and then do what needs to be done when the person forgets the topic ever came up. This will take a delicate touch but it is worth it to develop the ability to tread lightly when needed and take charge when you can.

This Is Not A Bill

There is a certain amount of concern about how much we are spending in the Medicare program. While there are some economies that have not been suggested, much has been put forward in an attempt to curb the rising cost of providing care for the elderly and the disabled. One area of expense that costs millions of dollars every year is fraud. Identifying fraud, prosecuting the perpetrators and retrieving the funds taken improperly will go a long way to stop this drain on the system.
One of the ways that fraud occurs is the fake provider. The scammers will set up a store front, file the paper work to become Medicare providers and recruit Medicare recipients to provide them with Medicare numbers and give them a portion of the money they get after they bill Medicare. This type of rip off needs to be tracked from the fraud unit but can be stopped (or slowed down) when alert consumers become aware of the recruiting efforts.
Another way for consumers to spot incorrect billing is the form you get in the mail after you have had some health care service provided. When the provider submits the bill, a payment is made and the covered person is sent a notice called an EOB (explanation of benefits) that should list when the care was provided, who provided the care, what care was provided, how much was billed and how much was paid. Always take the time to read the EOB. Check to be sure that this represents care you or your loved one received and that there are no extra charges. If there are charges for care you did not receive, call Medicare to report a concern. This will start the ball rolling to correct the error.

Keep it Clean

Just the other day, I was in a client's home for the first time and it comes to me that his situation is not all that unusual. There were plenty of informal care givers, children, friends etc but the house itself is in poor repair, cluttered and not clean. As we age our ability to keep things around us clean may be impaired due to medical or emotional issues. We need to step in to help when this begins to happen. Look around your relative's home and really take note of clutter that needs to be organized and trash that needs to be thrown away. Check the kitchen for proper food storage and get rid of spoiled food. Clean the counters, refrigerator and floor. Maybe clean the walls or paint them. Be sure that the bathrooms are clean and that the plumbing is in working order. This is all preparatory to brightening things up with a new coat of paint.
Another problem that pops up occurs when people move to small homes or apartments. The furniture that they own was made for larger rooms and now over fills the space. People will often hold onto things for memory's sake that are now only gathering dust. Sitting with your loved one to sort through the collected mound of stuff from a life time will take time but is worth the effort. You will be able to get them to toss or organize what they have elected to keep. You will also have the chance to reminisce about the good times.

Good locks equal safety, mostly

As things have changed since I was a girl (back in the Dark Ages) we are finding that we lock our doors when we leave the house and at night. This is instead of locking the front door so folks know you are not home but leaving the back door unlocked in case they need to get in. Images in movies include apartment doors with three, four and sometimes more deadbolt locks as well as chains. There is a perceived need for locks that is probably accurate. In order to be effective, the door jamb needs to be sturdy, the throw of the dead bolt (how far it goes into the door jamb) needs to be at least 1 1/2 inches and the door itself needs to be sturdy. A good locksmith will be able to set this up for a reasonable fee. It is also the law in many states that at least one door can be unlocked from the inside without a key. Just be sure that this door does not have a window that is easily broken to allow someone to reach through to turn the lock.
One thing we need to be aware of is that we cannot lock to house up so tightly that getting out in an emergency is a problem. If you have a family member who wanders, consider installing an alarm system to warn you if they leave the house. There are also pendants to be worn around the neck that are GPS equipped. These can be programmed to alert someone if the person goes beyond the perimeter that has been set up and to locate someone by pinpointing their location.

Making a list for the inevitable

Just the other day, a neighbor made reference to her list of who to contact in the event of her death. I asked for additional information and she told me that she has a single sheet of paper on which she has listed the people who need to be notified when she dies. This includes her family and friends but also includes business contacts such as the Electric Company, her bank and other entities that may need to know that the inevitable event has occurred.
If you were to fill in the worksheets in "Assisting Our Aging Parents and Patients" most of these contacts would be listed. It is a good idea to make such a list and to update it on a regular basis.

Why do performers live so long?

Early in December of last year, we had the opportunity to go on a cruise with the Turner Classic Movies people. (tcm./com) There were screenings of movies from the thirties, forties, fifties and sixties and best of all, there were performers from those movies to introduce them. I am still star-struck that I was able to meet Eva Marie Saint and Ernest Borgnine. We even had the chance to have our pictures taken with Mr. Borgnine. The interesting thing is that these people and others you can name are still active, healthy and vital despite being over 80 and in Mr. B's case over 90. What is it that keeps performers in such good shape at such an age?
There are a couple of things that leap out at you when you think about it. Obviously, they got past the critical age of 27, managed to not burn out on alcohol or drugs and stayed away from fast cars. Then they spent their working life in a job that requires them to keep in good shape. Personal trainers and people to help them to keep their weight where it should be are part of the perks of working in the theater, particularly if you are a star performer. Also, and maybe more importantly, they have been doing what they love. There is too much competition and disappointment to continue in entertainment if you don't love it.
The take away here is to make a point of staying physically fit and to do what you love. Nothing else will do as much to keep you alive, no matter how long you live.

Holiday Traditions: A time for change?

As the dust begins to settle from the holidays it is time to take stock of the traditions that our families have been observing for years. Is it required that we spend Christmas Eve with Grammy and PopPop? Do we always expect our parents to sit with the children on New Year's Eve? For years we have been going to the same places for the same meals from Thanksgiving to New Year's and maybe further into the new year.
We need to ask ourselves if these traditions still serve to help us celebrate or are they beginning to add to the stress we are already feeling at this time of year? Is Grammy still able to fix the big feast for 25 people or shall someone in the next generation step up to help? If Grammy's house is the only one big enough, can someone (or several someones) help with the cleaning the day before and the cooking as well? Would it be better to have a catered affair? Each family will have their unique response to the question. Now is the time to ask the question.

Resolutions for the New Year

As we enter the New Year, most of us will be making resolutions. Many will want to lose weight, stop smoking or change a negative habit. I am resolving to change my speech patterns to more socially acceptable language, you know, what I can say in front of my grandson. I am also resolving to blog at least twice a week, more often if there are questions to answer or something important to say.
There is an activity that we all can resolve to participate in, keeping closer contact with our aging relatives and friends. A quick phone call or e-mail to see how things are as well as a visit when possible will help our aging relatives to keep up with how the world is doing. We will also be in a better position to keep up with changes in our relatives' status. This is also a chance to take note of subtle shifts in abilities or areas where we need assistance.
It is hard for aging relatives to ask for help with home maintenance, shopping or handling money. Stepping up to volunteer for day to day help will often be appreciated. You may need to be sneaky in how you offer to help but if you have good communications things should go smoothly. If you don't have good communications, there is no time like the present to begin to build to a better state.