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Saying Goodbye

photo courtesy of www.pixabay.com & Unsplash

photo courtesy of http://www.pixabay.com & Unsplash

None of us wants to address death. Just the thoughts of losing a loved one will move us to tears long before the event. Still death is inevitable for us all. So the question arises, how do we face this issue, remain strong, and allow our aging parent the dignity they deserve?

It’s a tedious balancing act. As much as we’d like to assume every family is issue free, they aren’t. Many families face on-going sibling rivalry, family disagreement, and long histories of conflict. Add in the reality of an aging parent facing death, and the frustration only escalates.

Sadly enough, family conflict will sometimes outweigh the feelings and needs of the loved one. The resolution of family disagreement may never happen, but it can be laid to the side for a short time.

According to studies done from the American Association for Geriatric Psychiatry, terminal patients recognize end-of-life symptoms long before their passing. Though they have no idea when their passing will occur, many will begin to make preparations such as:

* Will preparations
* Family discussion on funeral arrangements
* Distribution of meaningful belongings
* Final conversations
* Reminiscing

It’s not uncommon to have grandma begin to distribute belongings she holds dear to unsuspecting recipients. It’s important to remember, that though an ugly vase grandma kept on her dining room table may have no meaning to you, there is a special memory tied to it for grandma. She may never share the memory, or she may not know how to express the meaning, but to her, the vase you consider ugly . . . is beautiful and it means enough to her that she longs to share it with a loved one. When grandma offers the vase, accept it with love and joy. Show her the gratitude she deserves by allowing her the happiness of accepting it graciously. It’s not about you – it’s about her. If she is able, you may be surprised by the meaning and even more surprised if the object you’ve thought so ugly in the past, acquires a new meaning you now enjoy.

photo courtesy www.pixabay.com & geralt

photo courtesy http://www.pixabay.com & geralt

Listen to their stories even if you’ve heard them a hundred times. Listen closely for the details that may have passed over unwilling ears earlier. This is the legacy of your loved one. It’s history. It’s memories that, once the loved one is gone, you will cherish.

Find forgiveness. Perhaps you’ve been at odds with your loved one. For lack of better words, death is final. It’s irreversible. It was once said, “Regret is a horrible bedfellow.” The truth in this is overwhelming. There is no disagreement worth a lifetime of regret. Take time, if for no one other than yourself and your own future, to make amends. For example: a mother lost her estranged daughter in a car accident, her last memory was an argument three years earlier. As the daughter was laid to rest, all her mother could remember was three valuable years lost over bitter words.

The same thought process should be applied to learning to say I love you. Perhaps it’s not commonplace for these emotions to be exhibited, but when you’re approached by an aging parent who declares their love for you, return the courtesy. Your acceptance and gentle response, even if it is not your nature, will give peace and closure to a loved one facing their final months, weeks, or days. Once again, it’s not about you (though you will benefit), it’s about the loved one.

Family discussion over finances, wills, and personal effects can become heated and unfortunately no family, whether they are wealthy or poor, are immune to greed. If your family disagrees over possessions, make the effort to suspend those while your loved one works through the acceptance of their future. Despite the argument, allow your loved one to see a calm and peace for a short time. It’s a kind act in their behalf. The life of the loved one is far greater than any possession.

What if the tables are turned and your loved one is the center of conflict? The greatest advice is apply the golden rule – treat others the way you would want to be treated. You are always the winner when you choose the high road, even when your loved one may be condescending or difficult. Keep in mind that at times the anger and frustration an aging parent experiences may be fueled by dementia or Alzheimer’s. It may be spurred by disappointment in their own lives or things they have no control over – even the realization some actions of the past are unchangeable.

Ultimately we, as children, cannot repair the past of our loved ones but despite their obstinacy we can adopt an attitude of forgiveness – does it make the actions of those loved ones right? No. But in your own life, you will have peace for having “loved them anyway.”

Our immortality affects us each one in a deeply personal place. We’re forced to not only look ahead to the end but to look back over what has been. When your aging parent begins to make end-of-life preparations, spend quality time with them. Tell them you love them. Walk the path with them. Seek out their personal spiritual situation and guide them appropriately.

photo courtesy www.pixaby.com &  Gaertringen

photo courtesy http://www.pixaby.com & Gaertringen

Saying goodbye is never easy but we can choose gentleness, loving ways, and understanding. The rewards for both the aging parent and for you, are immeasurable. Years after the loss, you can look back and say, “I’m glad I did,” instead of “I wish I had.”

Making the Move – Home to Assisted Living

by Cindy Sproles

It goes without saying, the decision to move a parent into an assisted living or nursing home facility is both heart wrenching and guilt filled. There is no doubt parents are happier in their own environment. Ninety-nine percent of the time, they thrive much better from their homes due to this one simple thing: A sense of independence. But what happens when it is obvious a move must be made?
Many time aging parents are reluctant – even determined, they will not move into a facility and the one card they have to play, is the guilt card. “I’ve taken care of you all your life and you just want to put me away now?” Understandably, this is a normal response to the possibilities of losing your independence.

Even the most loving parent can dig into the depths and find something to make the decision harder. Despite our best efforts, the decision to make this move can tear a family apart. Your job, and the jobs of your siblings is to prepare in advance. Sometimes the best a child can hope for is cooperation, even if it’s begrudging.

There are ways to make the transition easier and they begin well before a parent needs the assistance:

*Have the discussion – Talk with aging parents early on and hash out scenarios that can be written down and placed into important papers. Address the what ifs. What if you fall and become unable to care for yourself? What if your memory becomes clouded and you cannot remember to eat, or bathe? What if your children are living in other states? There are lots of what ifs that your family can discuss. Address these things when parents are in good health and a bit more reasonable, then, many times the guilt of making this decision vanishes.

*Do the paperwork – Take time to make preparations for aging parents. Secure necessary power of attorney for health and durable power of attorney for daily living care. Check into setting up a revocable trust that parents can divert funds or their home into which remain untouched for their care. Seek the assistance of the bank to place one executer as an owner on all bank accounts, IRA and insurance policies (simply having your name on the signature card does not allow you access to necessary funds in the event of death or an emergency). Put a living will, as well as an after-life will, into play and have copies handy in the event of an emergency. Place insurance, doctor’s names and phone numbers, pharmacies, and even copies of prescriptions and medication lists into a 3-ring binder for easy access. Add copies of drivers licenses, social security card, insurance cards – any cards that you feel might be necessary as times progresses. Having these things in place saves chaos and confusion when they are needed.

*Visit facilities – Take time to visit facilities. See what each one offers. Check out costs, insurance coverages, and out-of-pocket expenses. Check with the families of other residents and see how the care stacks up with their loved one.

When the time arrives you feel a move is necessary for the health and safety of your parent, make a doctor’s appointment, first without the parent and then later with the parent affected. Ask your questions, express your concerns. Give the doctor a heads up on your loved one. Then schedule an appointment with the parent. Allow the doctor to do a fair assessment and testing, and if the medical professional deems it necessary, allow them to be the one to recommend a move. Many times, aging parents will listen to the doctor before they will listen to their children. Again, it’s the fear of losing independence. Have and exhibit a show of compassion for this blow to your aging parent. It hurts and honestly, it’s frightening, so try to roll with the punches.

Once the doctor has delivered the news, allow your parent some time to absorb the news. Don’t rush out of the office and into a facility. Offer your loved one some space to gather their thoughts and take in the reality of first – aging to this point; and secondly, releasing their independence. It is, after all, a life altering decision.

Making the Move

*Take time to sort through possessions as a family – A few weeks prior to moving your parent, take time to sift through belongings with them. Allow them to pick and choose what they need to take. Remember they, they have to mentally adjust to having their possessions dispersed. Help them choose the sentimental items they can take with them that will keep their family and sense of familiarity close. Allow aging parents to give certain items to particular family members.

elderly-handsA family recently moved their mother into an assisted living. Her great granddaughter had married a few months prior and grandmother was able to completely provide her granddaughter with all the necessities of homemaking – a new washer, dryer, refrigerator, stove, dishes, etc. It was a joy for this grandmother to give these items to her great grandchild knowing they would provide her with the same warmth and joy of housekeeping as they’d provided herself. The key to sorting through possessions with an aging parent is taking the time to reminisce as items are packed away. Once again, be compassionate.

*Purchase a new mattress – Though this can be costly, it’s worth the effort. It’s difficult enough to sleep in a strange surrounding, but making the most of rest is vital. It sounds silly, but a new mattress that is comfortable helps lull your loved one into a more restful sleep. And a good night’s sleep is worth the effort. Loved ones will rest better, eat better, and have a healthier attitude if they are well rested.

*Don’t forget to take the hobbies – If your mother is an active seamstress, take her sewing. If dad is an avid reader, make sure he has access to his reading. Try to make room for their favorite chair. It’s the little things that mean the most.

*Keep their routine – If you visit weekly prior to the move, continue to do so. Routine is important. If mom has her hair done weekly, keep the routine. Not only do these routines help maintain “normal,” they also allow a sense of independence to care for one’s self. Take parents shopping, to church, and on outings. Being pro-active is vital. Your job as a caregiver at home may have lessened but it has not ended. Remain in close contact with your aging parents. It will make all the difference in the world.

The decision to move into an assisted living or nursing home facility is hard but as a family, you can make the transition a joy and an adventure.

Adding a caregiver into the mix will help make the transition easier, especially in the evenings when family has gone home. Will there still be bumps in the road? More than likely. Will all transitions be an easy fix? Probably not. But if you make the effort to make the move as easy and natural as possible, the weight and guilt of the decision is easier.

How Do You Mend a Broken Heart?

Photo courtesy of Microsoft.com free photo gallery

Abigail folded her hands and bowed her head. “Thank you Jesus for our food. In Jesus Name. Amen.”

“That was sweet, Honey. Wasn’t it dad?” Marilyn patted her aging dad on the knee. “Dad. Didn’t Abby do a great job with the prayer?”

Her father stared at the table. He unfolded the plaid cloth napkin and placed it in his lap. Marilyn’s teenage son gently nudged his grandfather’s arm. “Green beans?” Still no response.

Marilyn spooned a small helping onto her dad’s plate. “They’re cooked just like Mom made them. Big chunk of pork and simmered until tender. Salt. You’ll love them Dad.”

The tension was thick. The moment uncomfortable. And Marilyn couldn’t ease the anxiety. Her had mother passed away a few months earlier and she’d moved her dad into her home so she could care for him.

Marilyn’s dad poked at the green beans then scooted his chair away from the table and excused himself. He pressed his palm against his chest, and groaned. “My chest hurts.”

Charles and Eleanor Morrison had spent 62 years of their lives together. Eleanor never left Charles’ side even after two strokes nearly took his life. She’d help him walk, literally helped him place food in his mouth when his face was numbed from the stroke. Eleanor was not only his lifelong soul mate, she was his caregiver – the joy of his life. So when Charles woke early that Saturday morning and Eleanor didn’t roll over to kiss his forehead, life as Charles knew it . . . ended.

Marilyn and her sister made numerous efforts to help “snap” their dad out of his sadness but nothing seemed to work. A trip to the doctor gained the diagnosis of “Broken Heart Syndrome.” Marilyn laughed. “You’re not serious?” But indeed, the doctor was very serious.

Broken Heart Syndrome is in fact a very real diagnosis with patients experiencing:
*shortness of breath
*chest pain
*irregular heartbeats
*an overall general weakness
*appetite loss
*weight loss
*depression and fatigue

According to Mayo Clinic the exact cause of Broken Heart Syndrome is unclear but when the body experiences a devastating event or trauma a surge of “stress” hormones are released (i.e. adrenaline) striking the heart and causing the symptoms to present.

Studies on the elderly show Broken Heart Syndrome is not uncommon for the surviving spouse after the loss of their mate. Stress, loneliness, depression all play into the effects. Insurance companies who pay life insurance benefits followed the mortality rate of widowers/widows to discover a higher mortality rate in the second spouse within in six months of the passing of the first. They also noted that women who suffer the loss of their husband are at higher risk than men to experience Broken Heart Syndrome, though men do also experience it as well and in a more devastating way.

What Do Families Do?
At best, the loss of an aging parent is difficult for children but the surviving spouse suffers far worse. It’s important for families to realize they cannot set a time frame for grief. Where their lives move ahead with the busyness of their immediate families, the lives of the aging parent becomes far more emptier. Children are grown, retirement has taken away the daily grind of work, and the glaring fact of their own immortality looms as a reality.

There is no real “best” way to ease the symptoms of Broken Heart Syndrome but families can follow these suggestions as a guideline:

*If the grieving process is remains severe after 60 days, contact the physician for a health exam.
*Plug into a grief/loss support group or become involved in an active seniors group through local churches or the Department of Aging.
*Encourage walking (exercise strengthens the body and allows the mind to process thoughts without interruption).
*Do not force the issue, rather work with the physician and even grief counselor to help bring a parent into acceptance.
*If the symptoms listed above are continual . . . seek medical attention (Broken Heart Syndrome mimics a heart attack. It’s always better safe than sorry.)
*Encourage family members to renew relationships with the parent. Calls, cards, communication is vital.
*Grieve WITH your parent. Sharing your own grief allows the parent to grieve as well. But be wise in how, what and when you share. It helps when a parent realizes they are not alone in vortex of void.
*Don’t try to replace the loss but encourage new adventures. Plant the seeds of activity so they can sprout.
*Be sensitive to the emptiness your parent feels and love them even when it’s hard.

Families often think a “quick fix” is moving the surviving parent into the home of a child. It’s important to remember that, unless it’s medically necessary, sudden uprooting may not be in the best interest of your loved one. When a loved one has spent over half of their life with a spouse, it’s enough to suddenly be without them, but uprooting the surviving parent without allowing them adequate time to grieve may be equally as detrimental.

Allow time for the family to come together and sort slowly through the memories that hang in the closet or are stacked in a cabinet. Physical possessions are something surviving parents can touch, feel, and identify with. Seeking to empty out personal belongings to quickly may be an effective coping mechanism for children, but not for the surviving parent. Be compassionate and understanding while walking your loved one through the loss.

The loss of a spouse is a traumatic thing. Seek out patient and effective ways to help your parent grieve and move past so a new beginning appears hopeful and not debilitating.

Time is the ultimate healer and for some that time is longer rather than shorter. Finding patience, offering hope, and praying together as a family, brings comfort. Nothing surpasses love. When families come together to support one another the process is bearable.

For more information on Broken Heart Syndrome visit The American Heart Association and their article on Broken Heart Syndrome or ( www.heart.org ).

Love Them Gently Into the Golden Years

Photo courtesy of www.openculture.com

Photo courtesy of http://www.openculture.com

Written and released originally by recording artist, Otis Redding, Respect became the signature and hit for R&B singer, Aretha Franklin and the anthem for many who appreciated what respect meant to them.

The very nature of humans teeter on respect. Our self-esteem, our confidence, even decision making, pends on how we feel about ourselves. When we feel pushed down or brushed off, the very thing that builds us, tears us down.

Our country is seeing the last of those veterans who served in World War II, laid to rest. Those who were an active part of this nations greatest technological, industrial, and medical technologies era are slowly fading. The age of work ethic, strong sense of family, and personal responsibility fades with them. As the new fast-paced world of instant messages and cell phones over take our seniors, it leaves behind the one thing valued most by them – their respect.

At a slower time in this country’s history, a man was known by his integrity and his word. If he committed to a task, he completed it regardless of issues. It was, by all due rights, what earned him the title of respected.

Our seniors are caught in a time warp. Nestled between the old and the new. In their lifetime, they’ve seen the invention of every major life’s convenience known to man. Yet, in the midst of the of all this development, our seniors – the creators of these modern conveniences, are forgotten. Treated as second class. Disrespected. And it has only served to break them.

In this world of instant gratification, the youth of our country grow impatient when grandma can’t operate a smart phone or granddaddy gives up on the newest remote control. Instead of showing grace or offering assistance, they quickly snap at them, leading seniors to feel less than adequate and incapable.Senior woman contemplating

It’s important to remember how the aging process works and then practice the necessary methods needed to uplift their aging loved ones rather than tear them down.

According to a recent article posted on WedMD.com,  Dr. Kenneth Minaker, MD, chief of geriatric medicine at Massachusetts General Hospital in Boston and associate professor of medicine at Harvard Medical School stated, “Aging is a life-saving process,” he says. “It is a process of lifelong adaptation to prevent us from developing cancers that would kill us.” Though we look at aging as a deterioration of our bodies, in essence, it’s an adaptation of our bodies to help us adjust as we slowly complete the life process.

Outside of the obvious decline in eyesight and hearing, reflexes, movement, and mental aspects begin to slow. The mind processes slightly slower. The ability of being agile lessens, joints and muscles tighten and stiffen. Our ability to problem solve lessens somewhat. The result of these things reveals itself through frustration and agitation.

Learning to be an encouragement to our aging parents is important. Make a concerted effort to offer them the respect they have earned in a lifetime of hard work, and family rearing. It’s enough to come to the realization that our bodies do not function the way they once did, but when seniors are constantly treated as second class or as a problem to the family, the respect is gone. And when the respect leaves, aging parents falter.

Practice these tips to learn a deeper respect for your aging parents:

Reflect over your own life – Regardless of our age, we have a past. Grant you, the past of a twenty-year-old is nothing compared to that of a eighty-year-old, but the fact remains, taking a small amount of time daily to reflect over your own life’s choices, successes and even failures, softens your attitude toward others. Self-reflection allows us to look into ourselves and take notes, which in turn, help us self-correct.

Joe, a thirty-year-old computer analyst, entered his workplace frustrated a co-worker had parked in his space. Even though it was an open parking lot, spaces were not labeled, Joe parked in the same spot everyday. Three rows back, second from the end, just enough space to get in easily and exit quickly. Today, a co-worker took his parking space. Madaline, an older receptionist, greeted Joe daily as he entered the building. Her smile and sweet nature was a joy.  Joe bolted through the front door angry. Breezing past Madaline, he remarked wasn’t it time she retired because she just didn’t “get” the needs of the employees any longer.

Self-reflection gave Joe the perspective he needed to understand his actions toward Madaline were  unwarranted and hurtful. Not only had he insulted Madaline out of anger, but as his elder and having forty plus years in the company, he disrespected her.

Elderly Man Touching ChinSpend time with the elderly – Take note of the company you keep. Do you spend time with seniors outside of your grandparents? If not, ask yourself why. Many times, aging seniors frighten us. Not because of who they are, but because of what they represent to us. In them, we see our own immortality. Our future; and that can be scary. However, making the effort to spend quality time with seniors allows us the opportunity to learn about our past and to understand the aging process is natural and nothing to be feared. Sensitivity develops and a deeper compassion for those who “can’t move”  as fast as they once did.

Notice the seniors around you – Pay attention to the seniors who surround you. Take note of their value and contributions both past and present. Build them up. Thank them for their wisdom and service. After all, without them, we would not be.

Be considerate of seniors’ well being – Learn patience. Take extra steps to assist a senior in the store, or on the street. Be kind and understand their hearing is not what it used to be. More so, treat them with respect. They’ve earned it. Treating a senior with respect lifts their spirits, encourages their health, and strengthens their desire to maintain.

Finally, be respectful – Remember, our seniors are from a different age in time when things were different. Manners were important. Practice good, old fashioned manners. Call them Mr. or Mrs. unless they request otherwise. Stand when they enter a room. Say thank you and please. Today’s world preaches for us to meet the youth of America, “where they are.” When in retrospect, the same should apply to our seniors. Meet them where they are. Help them where it is needed and be respectful of their past position and current status.

Respect comes in scores of ways. Our seniors deserve our patience and respect. Practice these skills and see how your own life improves.

Start the Year Right for Aging Seniors

MP900309664Now that the holidays have come to a close and the decorations are down and stored for the year, it’s a prime opportunity to sit with your senior and sort out the upcoming year. Being organized is the best way to start a new year, especially if your loved one has been ill throughout the previous year.

Arranging and rearranging the needs of our seniors can be a long task, but the effort more than repays you when the time comes. Follow these suggestions to start “new” in the New Year.

Make a portable carry file with individual file folders inside. Name each file with individual Doctor’s names, addresses and phone numbers. As medical, pharmaceutical bills, and EOB’s (Explanation of Benefits) forms arrive in the mail box, they can be easily filed and accessible.

Keep additional addressed envelopes and copies of every bill paid, the date, and when. Often, especially if the medical expenses are extensive, you may be asked to produce past paid invoices for physicians or even hospitals.

Update personal files. It pays to update medication lists twice to three times yearly. Sort through medications and dispose of old prescriptions. Make note of new ones. It’s always wise to make several copies of this list and keep them in your files for fast and easy access in the event of emergency or new doctor visits. We suggest a list inside your primary information notebook that states the drug, the last time purchased, and if the drug has been suspended, when and who suspended it. This is important too, to update dosage changes. Changes will be in order of date for easy reference.

Again, place a copy in your car and in the car of your senior (should they still be driving) along with a list of important phone numbers i.e. doctors, hospital of their choice, key family members so you and your loved one are always prepared.

Power of Attorney and Medical Power of Attorney are must have papers. Be sure Power of Attorney and Power of Medical Attorney are in place and keep copies with key family members as well as in your loved one’s personal file. Carry copies to doctor’s visits and add them to your senior’s medical files. Place copies of these papers along with Living Wills, DNR (Do Not Resuscitate), and other end-of-life requests in an envelope and tape them to the refrigerator or inside a cabinet door in the kitchen in the event EMT or Paramedic services are required.

Banking needs. Make arrangements with banks and lending institutions so that key family members are able to access funds in the event your loved one is unable to manage their personal business. It is important to understand, simply being listed on the signature card of the bank does not give you access to funds in the event of the loss of a parent. Check with all banking institutions, life insurance, 401K providers, and retiree benefits to be sure the proper paperwork is in place should access to funds become a necessity otherwise, accounts can be locked by the institution and made inaccessible.

Verify Insurance co-pays and coverages. The new year brings new co-pays and changes in old coverages. Take time to contact insurance companies and verify deductibles and co-pays. Inquire about old coverages, especially the most used ones, and verify nothing has changed. If changes have occurred, have the companies mail an updated coverage sheet so you are prepared. As unstable as the economy is, never assume that insurance remains unchanged. Healthcare is changing monthly with our government’s hand now forcing coverage for all individuals. There is no longer security in what you “once” had. This is one area you cannot afford to skip over. Failure to keep up-to-date on insurance can cost your loved one thousands of dollars.

Logs and calendars are important. Keep a log book of Doctor visits, what the issue was and anything discussed, any medication changes, and referrals. We tend to think we won’t forget instructions, but if an emergency arises the details are easily forgotten or confused—dates in particular, so keep a log book. If there is an in-home caregiver having this log book provides up-to-date information for the care of their patient, but for you, it provides accountability in how those caregivers are providing services.
Write upcoming dates on a large calendar so seniors can see the appointments clearly. Keeping a calendar can be one of the best things you do for your aging parent. It adds a sense of security and routine to their lives and it reduces stress and worry. Large erasable calendars are available at local office supply stores and make for easy updates.

Personal Emergency Response Button. PERS units are valuable assets for aging parents. Units are placed in the home and the client wears a button around their neck. In the event of a fall or an emergency, aging parents can simply press the button. A representative from a call center responds immediately securing the necessary emergency help necessary. Unit service costs range from $29-$59 per month, but it is a service well worth the investment. PERS units save lives by getting immediate response to family members and dispatching necessary emergency personnel.

Caregiver services are available to offer respite to families. Many seniors may need minimal assistance bathing, dressing, and help with daily living skills. Caregivers placed by in-home, non-medical companies can provide this assistance. It is important to remember that even though there are many willing individuals able to provide this service, they are not licensed, bonded, or insured and can be held accountable to the State for failure to adhere to state requirements for in-home care. The client is responsible for state and federal taxes, social security, and Medicare payments or for a Federal 1099 for these caregivers as long as they are employed by them. Seeking caregiver services through a company provides families with the security that individuals coming into the home are safe, reliable and fully meet state licensure requirements for in-home care.

Start the year by being prepared. Taking these advance steps will bring your loved one into the new year with a new sense of security and ease.

Senior Beware – Ask, Get Informed, then Decide

Photo courtesy microsoft free image gallery

Aging parents will reach a stage in their lives where families begin to question if living at home is best or should their aging senior move into assisted living. It’s a valid question and one that deserves a lot of attention and consideration. But, before families make the decision to move their loved ones into a facility, there are definite questions that need to be sought out and answered.

What is assisted living?  Honestly, there’s not a real definition by industry standard. It varies from state to state. The best explanation for assisted living is a facility with limited care. Most are not licensed for medical care like a nursing home. It’s important to understand assisted living facilities are not medical care facilities. For lack of better words, we can dumb down the explanation to this: Assisted living is group home living where residents can perform all the necessary assisted daily living skills (ADLs) with minimal help. The general rule for assisted living is, that in the event of an emergency, a resident must be able to remove themselves from the facility (without assistance) within a small time frame. If they cannot, they do not qualify to stay.

Assisted living facilities perform levels of care for residents from those who simply need daily monitoring to those who require assistance with personal care. Residents rent a room or small apartment where they can either cook for themselves or join others in a dining room area for meals. There is usually an RN or LPN on staff in the event of an emergency and who, if the service is needed, will regulate and distribute medications to residents. Those who live in assisted living facilities are fairly mobile and are charged according to the needs.

For example, if you require house cleaning, you may be charged. If a resident needs a higher level of care, i.e. assistance with a bath or dressing, they may be charged a higher price. Should they need transportation, this is additional as well (however, it’s fair to say this service will vary from facility to facility. Some provide transportation as part of the basic package while others charge per month or even per ride.)

Independent care living – It’s important to understand the difference between independent care living and assisted living. The best explanation for independent care living is:  A group retirement facility or community – a  place where seniors in good health can retire to be with friends their own age. They generally pay a homeowners association fee so their home maintenance is provided. They are able to maintain their own care in its entirety, able to function and drive without help. Cook, clean, bathe – all the things they would do in their home on Maple Street.

Some “communities” allow seniors to purchase condos, small homes or even build within a gated community (this instance requires in-depth understanding of the rules of habitation). They can sell their dwellings to other seniors should they come to a point where their care moves to the next level. It’s important to read every line on independent care contracts and notice where the line is drawn in the sand as far as qualifications to remain living in the facility/community.

Many pre-built homes, duplexes, condos or apartments revert back to the owners of the facility/community upon the death or the need for the resident to move away. Wording can be misleading and so can the sale of the properties. Potential residents may be told they are “purchasing” an apartment, condo, or duplex when in fact, it’s a glorified way to say leasing or renting. The purchase may even resemble the purchase of a home with a down payment and monthly payments, and a closing). The greatest surprise may come when independent care facilities or communities see residents growing frail and begin to push residents out, informing them there is no refund or resale on the property. Instead it reverts back in its entirety to the facility or community. This happens more in independent living facility complexes with apartments or condos but it’s important to know, it happens all the time. Read the contracts in their entirety. Invest in a visit with an attorney to read and understand the jargon and wording so your aging parent is not surprised when their needs shift and they are asked to leave. If there are HOA fees, verify they are yearly and not an extravagant amount monthly. To live in an independent care facility, residents must be fully able to maintain their own care completely. If that changes, they will be asked to move.

Seniors BEWARE! – Assisted living, independent care living, and nursing home facilities are expensive. Unfortunately, insurance does not cover what families assume it will. There is no coverage for independent care living and often with assisted living, there is little to no coverage. Families cannot depend on receiving financial assistance from resources, i.e. Medicaid. If seniors have Long Term Health insurance purchased early in their lives, they will receive some payment here, but as a rule, most insurance companies will pay limited amounts on assisted living facilities but far more on nursing home facilities when their resident requires full medical assistance and care.

Facilities are beautiful. Their lobbies are adorned with lovely flowers, pretty furniture, and smiling faces but none of that bears any thought to what actually goes on behind closed doors. Pay attention to the staff. Make unscheduled visits. Does the staff know the residents names, are they interactive, kind, and attentive?  Talk to residents. Are they happy with their care? Seek outside references. Ask past resident’s families about hidden charges or unexpected financial surprises. If ever there was a time to be due diligent, this is it.

In fairness to facilities, it’s important to know there is a horror story for them all. There are few businesses who are incident free. However, 98% of these facilities are wonderful and provide great care. There are those residents and family members who are demanding and are simply unable to please.  You, however, can look at the overall picture and get a good feel. Bottom line. If you walk into a facility and your gut says no. Stick with your gut. Instinct follows us for a reason. Listen to the nudge should you feel it.

Elderly Hand Holding Cane

Photo courtesy microsoft free image gallery

In-Home Care – The question that rises within families is this:  “Why pay for an assisted living when we can get someone to stay at home with our folks?”

It’s a valid question and one that deserves an answer. It is a proven statistical fact that seniors thrive in their own homes. Their own home is familiar and it gives them a sense of holding on to some control in their lives when their cognitive and physical abilities begin to slip away. Educating yourself is still important.

Private caregivers are a dime a dozen. Many are wonderful. But few, if any, meet state and federal regulations for in-home care. There are a few pros. Family members, friends, or someone’s best friend may be willing to care for your senior for a reasonable hourly rate.  They will help manage the household chores, take seniors to appointments and provide companionship.

The cons:  Many private duty caregivers take pay without paying income tax. Senior’s families are required to provide a 1099 to the caregiver and to pay Social Security/Medicare taxes to the state. Families can be sued if a caregiver is injured because homeowners insurance does not cover paid employees. This injury falls under workman’s compensation. Caregivers can call out and leave families in a bind with no one to care for their parent when they are required to go to work. Eldercare abuse, elder scam and thievery are at a higher rate because no background checks are done. Medical procedures are performed (i.e. sugar tests, feeding tubes, wound care, or injections) with no supervision and limited training. Important warning: This not acceptable by most states governing authorities and families tread on dangerous ground when they allow these procedures to be performed by non-medical personnel.

In fairness there are many private duty caregivers who provide excellent care for aging parents. Either way, this is a job that is regulated by the State and if your caregiver is not licensed, paying the taxes due the government, and receiving continued training, then families and the caregiver run the risk of being called out by the state.

The truth:  Cheaper is not always better.

In-Home Care Companies – There is security in hiring a caregiver through a company. First and foremost, caregivers are screened with background checks, credit checks, and motor vehicle driving records to provide the safest care possible. Companies are regulated and licensed through the state. This forces the highest level of care possible. Should a caregiver be ill and need to call out, companies can provide a replacement so families are not left in a bind.

In-home companies provide workman’s compensation. They provide W-2’s, assure federal and state income taxes, Social Security and Medicare taxes are withdrawn. Companies have liability insurance, provide full background, credit checks and motor vehicle reports on all caregivers, and caregivers are bonded. When all is said and done, in-home companies allow aging parents to remain in their homes as long as possible with exceptional care provided. Cost comparison on a senior who requires 24/7 care runs slightly less to equal to assisted living.

All things said, when it’s time to consider living situations, be pro-active. Do not hesitate to research every aspect of the facility or company you are considering. Understand the cheapest route may end up costing you the most due to hidden fees and agendas. Do the homework and find the facility or company that best suits the needs and care level of your aging parent.

Care for the Caregiver

More Baby Boomers are caring for their aging parents than ever before.  According to the Family Caregiving Alliance (The National Center on Caregiving) over 48.5 million Americans are caring for aging parents.With a swaying economy and more individuals now out of work, these people are stepping in to help care for their seniors.

The truth to these statistics is both good and bad. It’s wonderful more family members are caring for their aging parents. Americans are in the minority worldwide when it comes to caring for their family members.  Western countries show a priority in parent care by bringing their loved ones into their homes and caring for them until death.  The down side is  the majority of these caregivers are unpaid.

Family trends show when an elder parent needs assistance the task will generally fall solely on one family member. This is due to the logistics of that family member to the simple fact they are the only one to step up– and these individuals will burn out.

Caring for your caregiver is important. Their hearts are open and kind. They are generally very patient and willing people. Taking advantage of their generosity happens frequently. It is vital families band together to offer assistance to these warm-hearted caregivers.

What can you do to care for your caregiver? 

*Offer them a full 24 hours off.

*Occasionally pop by and help with household tasks

*Provide a meal

*Write a thank you note or card

*Call and chat with the caregiver. Make them feel loved

*Recommend hiring a non-medical in-home care company such as Comfort Keepers  to share the load

Many times caregivers feel as forgotten as those they care for. Make time for them. Show your appreciation. Sometimes all that is required is just a simple thank you.