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.

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.

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.

Keep the Memories Alive

As we wind down from the hubbub of the holidays, we can look back on memories of holidays just passed and from long ago. We will have hopefully been spending time with family and friends catching up and reminiscing about the good old days. Now would be a good time to check with our aging family members to record memories from long ago.
Talking with aging relatives gives them the opportunity to relate cherished times in their lives and will give you a chance to understand events that made them the people they are today. Recording the conversations as audio or audio/video files will allow you to pass the family stories down to future generations. Remember to mark the records with the date, time and name of the persons involved in the discussion. It will also be necessary to move the records to newer technology as it becomes available, before there is no way to play back the recording due to changes.
Questions you might think about asking to start the conversation include (but are not limited to): Tell me about your favorite holiday memory from before you married Mother/Father. Tell me about your first holiday together. What do you remember about how holidays were celebrated when you were a child? Are there memories you are willing to share now that you kept from us as we were growing up?
Don't restrict your memories to pleasant memories if your family member wants to talk about something sad or disturbing. Let them direct the conversation after you get it started. You may find that your aging relatives have had a much more interesting life than you expect.

Dating and the Aging Mother

There is a commercial being aired in some markets in which a mature gentleman calls for his date. The woman's son answers the door and is very concerned as his mother and her date "lay rubber" as they leave the house. This is of course a dramatization but it makes an excellent point. Single Seniors are perfectly capable of enjoying the dating scene just as they were when they were younger. Be prepared to see this happen and do what you can to support them in establishing these relationships.
Another point to keep in mind, if you are introducing your relative to someone new, keep in mind their respective mental/emotional ages. I have a friend who has been introduced to several very nice women who are 10 to 15 years older than him, in their outlook on life. He has had the good fortune to meet a lady who is his age as it refers to his outlook on life. He met this lady incidentally through a friend and as a part of his usual social activity.

Family dynamics in crisis

As we are growing up we have the role that we play in the family and these will not change just because we are all grown up. In fact, the roles even become more rigid over time if nothing is done to change the dynamics. We also need to be aware that if one person changes everything else becomes unstable. When a family finds itself in a crisis situation, each person will usually act and react in a well established pattern.
There is the person who is "in charge" who takes care of everyone else and makes sure that what needs to get done gets done. The flaw here is that there is no one to step up if the person needing help is the one who has always been the organizer. This also interferes with other family members learning how to cope for themselves. This person is also less likely to ask for help or to accept help when it it offered.
The person who always finds humor in things can relieve pressure but can also keep folks from taking things as seriously as they should be. This person distracts everyone from the problem because they do not want to face the issue. This family member will find it hard to accept that Mother or Father needs help and may sabotage the efforts of the organizer.
There is also a behavior pattern that distracts from a problem by being a more "urgent" problem. This pattern will pull energy and resources from an aging relative who needs help. If this person has managed to grow out of this pattern it is hard for the family to trust that help offered will be there if it is accepted. Take the time to ask for help from this family member based on recent behavior rather than historic behavior.

Supporting New Hobbies and Pursuits

As we age many of us find that old hobbies and activities are not so pleasurable as we once thought. Our abilities change, the activity becomes associated with a negative memory or we simply lose interest. Those of us who are intellectually lively will usually seek out a new interest. Meeting a new friend or beginning to date someone may also stimulate the desire to learn new things. The same situation holds true for our aging relatives.
Just because someone decides to become involved with new pursuits does not mean that they have taken leave of their senses. Learning about new things or starting a new career are clear indications of being an active participant in life. Your loved ones deserve your support in the new activity.
One thing you need to do when this new activity breaks out is to be sure that your loved one has the physical capability of participating safely. Be sure that they have checked with the doctor and are taking appropriate safety precautions.

Making the Move, more in the saga of KS

KS has made the choice to move to an Assisted Living facility. This was not easy for her because she has trouble making decisions, hates/fears change and worries about the cost. In many cases cost will be a significant issue but in the case of KS, she has sufficient funds to make the move.
Now we begin the process of down sizing her belongings. The house she is moving from is a 4 bedroom home with a living room, dining room, family room and kitchen with 2 1/2 baths. The house is also a hoarder's nightmare. KS will be going through the things in the home to choose what she is taking. Because of cleanliness issues, she will only be taking her books and a few other personal objects. This will work for her, if your family is in a similar situation it may not be an easy sell.
Working with someone to move into a small space will require thought and tact. If you have helped them to make the decision to move, try to choose the space first. This will give you the opportunity to measure space available and present concrete limits to what can be moved into the apartment or room. You may even suggest new furniture to fit the new space if there are sufficient resources to accomplish that. Remember that second hand furniture can be a choice if you are careful about checking its condition.

Further facts on the Tale of KS

KS is rapidly closing on the day that she will make a decision regarding where she will live. The three significant choices are remaining in her current home with a significant clean-up, assisted living #1 or assisted living #2. We are now dealing with an issue that rises often enough to be almost usual, opinions offered by well meaning but incompletely informed family members.
If you remember, those of us assisting KS are not relatives, we are friends. KS has trouble making decisions and will agree with the last person to talk with her. Two relatives who are unable to understand the degree of the challenges she faces in getting from today to tomorrow are trying to get her to choose a living arrangement that would be suitable for them. Unfortunately this is without understanding her need for supervision, interpersonal interactions, and a need to limit further changes.
There need to be several conversations with these family members to help them to understand that KS is not well served by the conflicting advice and by advice based on incomplete information.

Living Arrangements for the Aging -What's out there

I have recently been posting about my friend's search for a new and more suitable living arrangement. We have been looking at Assisted Living facilities and tomorrow we will tour a Continuous Care facility. Many of the services that each of these offer are similar but there are specific differences between them.
Assisted Living facilities will usually charge a one time community fee and a monthly rental on the space to be occupied. This will be a room and bath at the least but will often also include a kitchenette with a space for a microwave and a small refrigerator. Some larger units will also have a small second room as well. Meals are supplied in a communal dining room and there will be support services to keep things clean, get the laundry done and support your loved one with taking medications. Depending on the facility, these services will be included in the rent or may be additional cost as needed. Nursing care will be available 24 hours a day when needed.
Continuous Care facilities have more options and a resident can move through the facility depending on the amount of care they need at any time. It is possible to move from independent living with meals and access to medical support all the way to a nursing home placement if it were to become necessary. There is generally a larger buy in fee than for Assisted Living along with the monthly rental fee but this will allow you to be sure that your loved one will be well cared for with a minimum of disruption as they age. There will also be an age restriction for the youngest age at entry to the facility.
Either option is worth considering if you can take your time and work through the process before there is an urgent need for a new place to live.

Finding an Appropriate Living Arrangement - Part 2

Last time I alluded to the challenges presented by KS's supposedly adult stepchildren. She has a life estate for the house. This means that she may stay in the house until she chooses to leave but the house will become the property of her stepsons if she moves to another home. Unfortunately, her stepsons and their wives are pushing her attorney to push her to leave the home as soon as possible. They are being everything but helpful.
These young men are prime examples of how to NOT handle your parent's second spouse. While there are those who prey on vulnerable seniors this is still the exception rather than the rule. You need to step back and put your first response in neutral to review the reality with a minimum of emotion in the mix.
Questions to ask yourself include: Is this person good to my parent? Does my parent appear to genuinely care for this person? If this is a union based on financial benefits, do they both benefit? Are they better together than separately?
It is also best to set greed aside in these situations. If there is a particular object you want to have from the house and it was left to the surviving spouse, ask nicely. If they do not want to give it up right away, maybe they will leave it to you in their will. If they feel that they need to sell items to provide for living expenses, ask to be offered the items before anyone else. Of course, if your step parent is reduced to sell items to make ends meet, you may consider how much more help you should try to offer.
All in all, talk to each other, open the lines of communication and try to see in this person what your parent did.

Keeping Connected through Faith

Today is Easter Sunday for many of us here in America and over the rest of the world. Passover began at sundown last Monday evening. There are Islamic observances during this time as well. As we age, it becomes more difficult to attend services at our local place of worship while it often becomes more important to our sense of well being to participate in religious practice. It is important for those of us who are still able to move about without problems to make the effort to support the desire to attend services for our aging relatives and friends.

There are also ways for mobility challenged persons to participate in religion via technology. More churches are broadcasting over the web as well as those that have broadcast on television or radio for many years. As it relates to smart phones…there’s an app for that. You can now download a copy of your holy book or stream video from your chosen place of worship. It would be a very good thing to help our aging relatives to be able to worship electronically.

Aging Relatives - One or Two?

As we age we will lose one parent before the other, most of the time. What will become clear at that time is that there is a different dynamic between caring (providing help) for both parents and providing the same or similar help for the remaining parent.
When both parents are still alive, they will be helping each other and maybe moving into new roles within their relationship. If Mother becomes ill, Daddy may find himself taking on the activities of daily life that she has usually been able to complete. This may be cooking, cleaning and other activities traditionally taken by women. If Daddy is ill, Mother may be taking on (or attempting to take on) maintenance for the house, keeping the car in good condition and any other task that Daddy usually completed. The bottom line is; if one parent becomes ill, the other will probably take on all of the activities of daily life while trying to provide care for the sick person. They will both need help with this, especially if they are still working. Be aware of the need and offer to help support the well parent and maybe take some responsibility for caring for the ill parent. The tricky issue here it to find the right amount of help to give.
After one parent dies, caring for the remaining parent is a different matter. You will be able to be sure that your remaining parent (statistically more likely to be your Mother) is trying to do it all alone. Knowing what part of the day to day tasks have not been easy for the remaining parent will help you to decide what type of help to offer. It is also to be remembered that you are not intruding in a relationship if you are caring for one remaining parent. There is still a dance to do but the steps will change.
These concerns will also apply to other aging relatives. If you are in the position to help other relatives, whether they are single or in a long term relationship your help will need to shift around that relationship.  It is well to have the conversation early and at intervals along the way.

Valentine’s Day and the Aging

Happy Valentine’s Day! This is a perfect time to spend with your aging relatives to listen to their tales of their dating days. Of course, they may have been walking out, courting or keeping company. The phrases we use to describe that wonderful and exciting time spent getting to know one another change over time but the activity has only had one significant change in the last century. That change was, of course, the acceptance of pre-marital intimacy.

Over the years, here in the US, we have spent a great deal of time and effort on romantic love. We write about it, read about it and it is a major theme in movies, plays and books. No wonder we all look for that one special person. Now is the time to take the opportunity to chat with your relative and listen to their stories. Do you know if your parents ever dated other people? Was their marriage arranged? Was it strongly encouraged or undertaken in defiance of their parents?

If your relatives are members of the “Greatest Generation” there are probably stories to be told about how they managed with the upheaval caused by World War II. Having this conversation will open the doors of communication for all sorts of information exchange concerning how well they are managing to stay connected socially. You may also hear something spicy.