Aging Care, The Crisis that Nobody Talks About

The traditional holiday time has finally arrived! The excitement of glowing lights, festivities and spending time with family is contagious. Everyone is rushing around trying to find the perfect gift and making decadent holiday meals. This time of the year is cheerful and nostalgic for many. Who doesn’t have a family “story” of the older family member who does weird things or is refreshingly candid? Yes, Aunt Mary or Big Daddy can be counted on for a memorable laugh or two at their expense.

For many, this time of the year is not the mirthful time filled with Christmas trees and cranberries.    

Senior citizens all around the country are hiding a secret. Some are spending the holidays (and lives) alone because they don’t have local family. Others are hiding the fact that they have limited mobility and can’t properly take care of themselves. Yet even others suffer from depression and loneliness as they grapple with the loss of loved ones and/or their own independence.  Many go hungry because they often don’t have enough food to eat or it is too exhausting for them to prepare a meal for themselves. They’ve become adept at keeping up the façade during a short phone call. They’re always happy on the phone when they talk to their relatives leaving few clues. Meanwhile, their family has no idea that their loved one is suffering; especially if they sporadically visit.  

According to the Center for Disease Control and Prevention (CDC) National Center for Health Statistics, the leading cause of death among persons aged 65 and over is heart disease, cancer, and chronic lower respiratory disease. In 2015, 21.8% of seniors are in fair or poor health. Now with the debate on health care and tax cuts, the elderly will likely be impacted even further.  

The Changes Aren’t Sudden

Are the following scenarios familiar to you?

You speak with your mother who lives in another State regularly. She’s usually chipper and always had the memory of a hawk. However, today’s conversation was different, maybe even bizarre. She spoke more slowly and shifted the subject of your conversation more than once.  She also seemed to forget what she was talking about mid-sentence more than once. The weirdest thing is when she talks about taking a drive in her car, but she hasn’t driven in 25 years.

Dad has always been independent and proud that at 83 he has been able to live alone since Mom died a few years ago.  Lately, he has been falling and skipping meals.  The last time you were at the house to visit, you found him on the floor in the bedroom.  He had fallen asleep because he had been on the floor for two hours. The alert button that you bought him for emergencies was on his bedside dresser. He forgot to put it around his neck. After you helped him get up and put him to bed, you checked his pantry and refrigerator. The food that you made for him with the days of the week on them hadn’t been touched. 

  

This scenario is common for many adult children who are faced with the reality of caring for aging parents.  It’s easy to want to believe that our parents will forever be young, vibrant and invincible; the heroes that raised us and made us feel safe. Now they are slower, less nimble and very forgetful. In fact, they seem to talk to themselves and is a shadow of who you remember. Then comes the hardest part.

You realize that they can no longer live alone. In retrospect, you saw the signs for years. It wasn’t until an unexpected critical event that jerks you out of the stupor. Deciding how to handle elder care can be highly stressful.  

Time to Act

Many children are caught by surprise when the decision on elder care occurs. If the parents struggled financially throughout their lives many may not have the financial ends to secure their housing situation. Children are often challenged as they may also have financial limitations. The following are ways to prepare ahead of time.

• Have the discussion with your parents while they are able to discuss their long-term care plan. Don’t allow them to avoid the conversation or minimize the possibility that they may eventually need care or assistance.   
• Be prepared by doing your research. Aging care and AARP are great resources. Check out local resources as well. 

• Living will. Think about what your loved one intentions for medical care if they are unable to properly communicate.
• Financials.  Long-term care solutions? Should you buy or not?
• Final will and testament. Make sure your parent has a will that is clear on their final wishes is also important. Amazingly common, siblings and families left behind are destroyed by inheritance disputes. Where is the paperwork? Do they have enough insurance?
• Housing options. Check out facilities before it is imperative.  Understand the costs involved, the care provided, licenses, the record of care. Speak to some of the residents for their opinion. Explore the costs and what is included.
• In-home nursing care: Understand the types of care available and what is included in the fees? What is covered by insurance? What will they do?  Is the firm reputable?  How do they vet their employees?  What is the agency’s turnover rate? Do they have referrals? While many are determined that there is absolutely no way their parent will go into a facility, there could a possibility that your loved one’s care may be beyond what is possible at home.  Don’t neglect to research this option

• Long-term Plan Logistics: If there are siblings, discuss thoroughly how the long-term care will work.  Who will be the primary caregiver? If the parent doesn’t have savings, how much money will everyone contribute? Who will the parent live with if they cannot live in senior living or nursing home? List the specific needs (include everything you can) and decide who will do what.  This is very important as there is usually one sibling that takes on 100% of the eldercare responsibilities. These caregivers are usually overwhelmed, financially devastated, physically exhausted and emotionally drained. Many caregivers, exhausted with arguing with siblings over help, ultimately carry the full load silently just to have peace for themselves. However, this plants the seed for feelings of abandonment and resentment that can be directed toward the parent and the siblings. Do the planning now as when it happens it will be too late. Explore several scenarios based on your unique situation and the parents’ current health habits. Discuss the plan every year to keep it up to date and to ensure that everyone still agrees with their contribution.
• Personal Financials: Discuss if the parent will sell their home, manage their bills and ensure that they have enough money to live. Do you notice piles of unopened mail?  
• Medical history and care: Are there any illnesses that run in your family?  Is there a medical situation that your parent has struggled with for several years? Alcoholism, diabetes, obesity, smoking? While we don’t want to think about it now, these habits can (and usually do) lead to complications later in life. It will have a tremendous impact on long-term care. What medications are they taking? What does it treat and what are the side effects? Also focus on diet, dental, vision and memory care.

Notice the Signs

Hopefully, this article is helpful for you. When I had to make a decision to care for my mother, I had to figure out things on my own. Whether we want to believe it or not, most of us will face the decision on long-term care for our parents or senior loved ones. For years, I saw the signs but avoided them. My mother cared for my father but after he died, she slowly deteriorated to the point that she had to go into rehabilitative care due to a fall.  Earlier this year, she had a critical heart event that was an additional wake-up call for me. While we struggled through it together, she has gotten a lot better. We control her diet, she gets more exercise and she is improving. However, the damage done to her heart is permanent. As we navigate through what our new normal is, the realities of the ups and downs of caring for a senior adult is sometimes overwhelming. I’ll write more about this in future blogs posts because it is important to increase awareness and help our seniors get the care and respect they deserve. 

Pay attention to the signs! The following are some of the signs that may indicate deteriorating health: 

1. Does your loved one struggle when they move around? 
2. Does your loved one seem withdrawn and rarely leave the house?  
3. Does he/she “lose” things a lot or “forget’ to do something? (i.e.; forget to turn off the stove).
4. Is your loved one suddenly gaining or losing weight?
5. Has his/her personal grooming changed?
6. Does your loved one repeat the same thing over and over and seems distracted during conversations?
7. Is their home unkempt? Or is it seemingly clean, but have a “funny” or “urine” smell in areas?  
8. Is unopened mail piling up? Is your loved starting to “save” things that are piling up?
9. Does your parent seem to run out of money frequently? Check their bank and credit account statements.  Are there regular amounts being automatically deducted from their account?  What is it?  Are there questionable purchases?
10. Who are the “helpful friends” who have access to your parent? Do they come around when you are around or do they conveniently avoid coming around when you are there? This is a red flag. Anyone who “loves’ your parent will want to meet you. 

Have the conversation today. Long-term care is not a decision you want to make at the last minute.