Help Aging Parents: A Plea for HELP!

DOES THIS INSURANCE PLAN AND ITS DOCTORS
TRY TO SAVE MONEY AT YOUR PARENTS’ EXPENSE?

Have you had this experience? If so, please respond with situation and resolution (or not) of problem using our blog email: helpagingparents@gmail.com or simply comment below. children in their 50’s-60’s and two elderly, ailing parents will be eternally grateful.

Details: Father and his wife (92 and 90 respectively) have been paying for Kaiser Plan Health Coverage for 25 years. Father’s prostate cancer of 20 years has metastasized to his ribs and tail bone, making it difficult for him to bathe himself and perform other normal daily functions. He just returned home after 6 days in the hospital and 12 days of rehab due to a fall. Other health problems: dementia, COPD and asthma.

The wife, at 90, has mobility problems, walks with a cane, can’t help husband’s physical needs.

The family interviewed caregivers before their father came home, some of whom didn’t want the job because–after hearing the situation—didn’t think he’d live many more months. That said, his Kaiser doctor refuses to give permission for Hospice. She says it’s “too early” and they can talk about it later.

Specifically, the children met with the Kaiser doctor last week and inquired about hospice or palliative care. The doctor said “when the time comes” it would be addressed and, according to the child who inquired, doctor looked puzzled that they knew about palliative care.

The Kaiser doctor further says if the kids don’t get their parents into assisted living or get home care help, both will end up in a nursing home. They have hired a caregiver, but funds are limited. They don’t understand why Hospice–or at the least–palliative care isn’t being offered.

This blog follower and her siblings are hoping you will respond asap with suggestions. They don’t know where to turn next.

When Aging Parents Can No Longer “Do.” Ways To Empower So They Can Continue to “Do.”

“No one likes to see a lessening of themself.”
Julia age 80+

I’ve never forgotten a counseling course at Teachers College.  We were told how important it is NOT to take something away from one’s psychological foundation (it gives us our psychological strength/confidence) without replacing it with something positive/helpful. To take something away and not replace it, weakens the foundation.

Yet normal age-related changes can take away–or at best lessen vision, hearing, energy, flexibility, strength and much else. As we try to help parents age well at some point we become aware of the “lessening” (which parents may have tried to cover up–think driving).

How can we support, compensate, empower or substitute so elders can continue to “do?”

While we know one size doesn’t fit all, we can do some of the leg-work and perhaps partner in the final “doing.”

Five Examples

1.  Julia, a noted master gardener and very proud woman–then in her 80’s– had less energy, less muscle strength and was physically less flexible. Bending and digging in her garden was painful. As a Mother’s Day gift, her adult children accompanied Julia (she still drove) to the nursery. She selected the plants; they planted Julia’s garden. Julia could continue to pick and enjoy the vegetables and flowers and pull a few weeds when she wanted to. With her children doing the physical labor, Julia  continued to do what she loved.

2.  Karen was an instinctively supportive daughter. She always bought more than she needed when items were on sale at the grocery store. Her mother (87) loved cooking, but food shopping was difficult and tiring, especially in NYC with taxis involved. So Karen, who worked full-time, would plan–on a weekly basis– an afternoon, take the “extras” to her mother and they’d cook together. Karen’s mother could continue to “do.” Priceless togetherness–plus her mother had a new supply of nutritious, delicious prepared food–some of which they froze.

3.  Failing hearing was creating a significant loss for Linda’s friend’s mother, whose mainstay was playing bridge. Her bridge group no longer wanted to play with her because of her hearing loss. The friend’s idea: replace  She continued her mother’s weekly bridge games–by asking 6 good friends to play in every-other-week rotations. (See “How a Good Friend Helps.”)

4.  Mobility problems can cause additional problems from falling to isolation. Thus how we support and substitute is key. If it isn’t easy for elders (and those who transport them) to get around, they don’t.  This means doing the research and getting it as right as possible the first time. Translated: initially buying the best required equipment, making certain it’s adjusted so the fit is right, and making certain one uses it correctly–especially canes and walkers (light-weight ones, heavier ones with a basket or tray and/or seat); and wheelchairs (companion wheelchairs, “regular” wheelchairs).  For still-driving people, perhaps a mini-van, whose back area easily accommodates a wheel chair (and obviously a walker), makes everything more doable.

(A polio victim’s son found a used Chrysler Town and Country mini-van for his 74-year-old mother, with a remote that opens/closes doors and the tailgate and a pushbutton inside that opens/closes the aforementioned. She has continued her life, causing little additional burden to anyone.)

5.  Safe driving requires good vision, hearing and reflexes. Carefully-planned solutions need to be substituted or result in isolation or unsafe driving. One daughter offered transportation for social outings when parents no longer drove at night. Since she or her siblings needed to know ahead of time, they and the parents decided on the one night parents would go out each week. With advanced notice they’d make themselves available 1-2 additional nights.

Towns/cities provide transportation services for seniors. Getting them to replace being able to jump into the car and go at will with a bus schedule can be difficult. That said, Aunt Mildred took the bus downtown to the Beauty School in Portland until she was in her early 90’s (and baked cookies for the drivers). When she moved to assisted living, a small bus came, by appointment, so she could continue her hair appointments at the Beauty School (where she also enjoyed gossip, and her manicure).

Creative thinking isn’t everyone’s forte. But we can tap our parents’ doctors, out-of-the-box-thinking friends with aging parents, and professionals specializing in geriatrics (ie. geriatric social workers) for ideas to supplement the “lessening”—as we try to help parents age well by continuing to “do.”

RELATED:  Mayo Clinic article on Canes
                        NY Times article re: problems from non-fitting canes
                        How to buy a cane
                        The Right Cane for Aging Parents  8/13/11 Help! Aging Parents

Note: “Of Current Interest” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.
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Blog Award

Again this year Help! Aging Parents has been nominated in the Seniorhomes.com Best Senior Living Awards 2014 “Best Blogs by  Individuals” category. We were honored to be judged the sole first runner-up and part of a 3-way tie for first runner-up in this category in 2012 and 2013 respectively.

How this works: Initially it’s sort of a popularity contest which, this year, ends April 28th. A certain number of popular votes qualifies us for the judging round. After that, it’s up to the judges.

Meanwhile, there’s a virtual universe of informative, humorous, personal, and commercial blogs and resources that focus on various aspects of aging. You can check them out by clicking on the badge above. It’s a win-win for everyone……and of course, we appreciate your vote which, as you will see, is via Facebook.

Changing often: “Of Current Interest” (right sidebar). Timely links to research and information from top universities, plus some fun stuff to help parents age well.

Aging Parents: Stark Reality–When Eyesight Fails

Letting Go–Preparing The Last Income Tax at 100

This is the last time Sr. Advisor R is doing her income tax preparation for the accountants. Yes, she’s 100. Yes, she still lives independently, alone in her home of over 60 years. Yes, she has a blood clot that has greatly diminished vision in one eye. Yes, she uses not 1, but 2 magnifying glasses when the normal print is too small. And yes, all of this is pretty amazing, but it has been extremely arduous and overly time-consuming this winter and has been a source of stress.

That said, R has worked at simplifying everything in her life as age has slowed her down. Giving up income tax preparation  (still using legal pad and adding machine), is a big concession. She has been doing it over 40 years. As Julia, another independent elder referred to in past posts, said many years ago “No one likes to see a lessening of themself.”

(R prided herself on doing the preparatory tax work and has been praised since widowhood for her understanding and accurate attention to detail in this regard. In fact, in the early 1060’s, when most women her age knew little about their husband’s [or their] finances, one accounting firm asked if she would do the intake and explain the process to widows.)

Although there’s some peripheral vision, I’m quite certain R’s left eye (with the clot) would qualify as legally blind. She was just told it cannot improve. That’s a big blow.  Especially to R, who always does exactly as the doctor orders. Aging, however, takes its toll on the body and stuff happens–sooner or later–as we know.

So where’s the sunshine on this cloudy day? It could be that in spite of macular degeneration, R’s right eye has fairly good vision; yet the ophthalmologist indicated it could change. Sunshine? R feels there just isn’t any. Yet I believe all mental health professionals would agree–at times like this it helps no one to play the Pollyanna role. Support and a lot of listening is the operative advice for caring friends and family.

We’re talking about loss. It’s hard.  It’s real and no doubt scary; particularly for an independent centenarian with a still-good mind. So unless a friend or family member has recently had the same experience, many sayings like “I know how hard this must be” aren’t helpful. Rather “What can I do for you?” or “I’d like to do something to make it easier this week–can I …………..?” show caring.

We may not do everything perfectly from here on out and consulting with people from Lighthouse will be–or possibly has been–suggested, subject to R’s agreeing. Many cities have Lighthouse branches that, I hear, do a great job making life better for people with compromised vision.

So we say a prayer, try to be there if possible to lend support and love, and will do the best we can as we help R face another hurdle. As R’s mother used to say, “Angels Can Do No More.”

Changing often: “Of Current Interest” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.
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 3/26/14 Help! Aging Parents was again nominated for a blog award. Click the top gold badge (right sidebar) to vote and view all senior living categories. Deadline 4/28/14 

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Aging–Macular Degeneration: A Determined 100-year-old’s Efforts to Maintain Quality of Life

R's 100th Birthday

                                                               R’s 100th Birthday

Sr. Advisor R has been called “amazing” for years by so many 40-60-year-olds, who also call her “terrific” and “timeless.” Past posts have underscored their respect for her wisdom and admiration for her ways of handling things. She’s both an advisor to this bog, and my m-i-l. And currently she is facing another challenge: a big round spot blocking vision in one eye–macular degeneration.

During 100 years of living she has overcome much–the last big hurdle: her impressive recovery from a broken hip (femur) at 97. That was three years ago. Her mind remains excellent for her age and she was aware her sight was suffering “a little” degeneration, but was getting no professional treatment and hadn’t noticed that her sight was changing until it suddenly began over several days.

Coincidently she had an opthalmologist appointment scheduled a few days later. While she began immediate treatment, the prognosis from two ophthalmologists is that results will be slow and no doubt limited. With her vision impacted and depth perception a real problem she is making adjustments.

“We take eyesight for granted–don’t realize how important it is–it’s your connection to the world,” says R, who adds “I’ll do the best I can with it.” With one “weak but useable” eye, she is using two magnifying glasses of different magnifications to finish doing her income taxes (making itemized lists) for the accountant next week. Everything takes much more time now, and planning how long something will take is “ify,” especially getting ready to go some place.

R acknowledges that when facing serious challenges in the past, she had to let go of some things and prioritize others in order to redirect her energy towards maintaining independence. This is the last year she will do her taxes. Which brings us to yesterday.

R continues with her life, albeit at a slower pace because vision problems affect simple things like putting on make-up and doing her hair. Yesterday she needed to go to the bank.  My husband or I could have done that errand for her but she didn’t want to give in to that.

She requested I pick her up more than an hour later than the usual time. The young woman who usually helps at the bank, J, was away when we arrived. She later heard R was there and appeared as R was finishing her business. “I haven’t seen you in months and I was worried,” was J’s greeting. Then ensued a conversation about R’s eye situation and being 100 and how much she admires R.

J then told what I believe to be a true story about a friend’s grandfather. We seem to like to talk about amazing older people who still make the effort.  At age 103, he still works out at the gym 4 days a week. Evidently one of the trainers told him that perhaps he should cut down the number of workouts–or at least shorten them. To which the grandfather asked: “How old are you?” Response: “30 something.” “I’m 103,” said the grandfather.

Whereupon a thought entered my mind: When older people are doing great and still have a good mind, why do younger people feel a need to give them advice? I know R doesn’t believe in what she calls “unsolicited advice.”

We hear more and more about people living into old, old age. No doubt all have some aging problems. The ones who “soldier through,” who make the effort, are the amazing ones. They have been called “The Greatest Generation.” I wonder if we will do as well.

R has often said “I’m a realist.” Yet I’ve never heard her say anything like “Growing old is not for sissies.” Instead she will be the first to tell you getting old “isn’t easy,” explaining “it takes willpower, energy, and common sense–more every year.” She has been widowed half of her life, thinks deeply and shares knowledge of a lifetime when appropriate. Her younger friends say she has taught them so much about living. It has cemented a special bond.

“They care about me and I care about them too,” she says.

If that doesn’t provide the bedrock for quality of life and a reason for making the effort, I don’t know what does.

Related:
In sidebar– 12/11/13 Mayo Clinic’s Age-Related Vision Problems and How the Eye Perceives Them

3/26/14 Help! Aging Parents has been nominated for 2014 “Best Blogs by Individuals” recognition and we would appreciate your vote by 4/28 if you’re on Facebook. We were honored to be judged part of a 3-way tie for first runner-up last year thanks to your votes which took us to the judging round. Click top badge at right to view a universe of helpful aging blogs and resources, even if you can’t vote on Facebook.

Changing often: “Of Current Interest” (right sidebar). Timely links to research and information from top universities, plus some fun stuff to help parents age well.

 

Aging Parents and Us: Must Age, Health Decline, and Dependency go Hand in Hand?

 Growing Older Doesn’t Necessarily Mean Growing Old

We may question this assumption if we’re in the midst of caring for aging parents with health issues. On the other hand, the results of research, published last month in the Journals of Gerontology, may be heartening for us if our parents are still relatively healthy and independent–and also heartening as we think about our years ahead. It’s written by Dana Goldman, a most distinguished professor at USC, who is an adjunct professor at UCLA as well.

In short: after analyzing extensive survey data of Americans aged 51+, researchers  from U. of Illinois at Chicago, Stanford, and the University of Southern California, “found that a substantial group of individuals at all ages experienced not just exceptional health, but their mental and physical functioning was at a level exhibited by people decades younger.” (The MacArthur Foundation, a longtime a leader in aging research  and the  National Institute on Aging funded the study.)   Isn’t that good news!

Dr. Goldman’s article is an easy, quick read (less than 2 minutes) with interesting details. Sometimes, when we feel burdened, hearing something positive, based on  facts, is just “what the doctor ordered.”

And if you need/want more of “what the doctor ordered,” watch/listen to the interview link below, courtesy of the 12/2/13 Huffington Post, for a futuristic way of delivering medical information and services.

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If we’re currently dealing with parents’ health issues, and frustrated with the communication problems that often arise, this interview from the 12/2/13   Huffington Post, with Dr./billionaire Patrick-Soon-Shiong is a must-watch. I believe cancer was an initial motivating factor in his work, but everyone who has health issues will benefit.

Using the cloud, genome data, a specially designed super-computer, and more, he has created an infrastructure for a new medical delivery system that includes a “fluid medical information highway.” This could soon bode well for everyone’s health care, regardless of age. (FYI– Pancreatic cancer patients have been free of the disease for 5 years using these futuristic technologies.)

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The Thanksgiving holiday provided me time to catch up on some reading and  learn a bit about telomeres and aging from my husband’s cousin (a highly respected researcher at one of the two top institutes of technology in the US). It also caused me to post this a day late.  (Returned to NY last night.) A post about telomeres will appear once I’ve had it vetted for accuracy.

Research clearly provides us with interesting, exciting and hopefully personally helpful information, as we continue to meet the challenges of helping parents age well.

Changing weekly: “Of Current Interest”(right sidebar). Links to timely information and research from top universities, plus some free and some fun stuff–to help parents age well.

 

VELCRO–Part 2: Shoes for Aging Parents

Velcro ClosuresNot all shoe styles with Velcro are suitable for old people!

…Yet some styles fulfill a need. Think: one foot wider than the other; arthritic or old fingers that make using buckles difficult.

Sr. Advisor R, like other older and old people, has a fear of falling (especially after breaking her hip two years ago). She’s concerned about maintaining good balance when walking. Yet she has never purchased those unfashionable-looking shoes that so many elders wear for balance.

Instead she has invested time and energy to find sandals that give her feet support, are comfortable and look good, and provide what she calls “a solid platform” that’s “weighty enough” to give her confidence when walking.

As people age, feet can widen and/or develop bunions, hammer toes or other problems that cause one foot to be wider than the other. This is where Velcro comes to the rescue. Proper fitting sandals, with velcro closures that accommodate a wider foot near the base of the toe, have been the answer for R. Rather than buying shoes in two sizes, Velcro lets her adjust for each foot’s width. The sandals look contemporary when one lives year-round in a warm climate. Currently R is wearing Naturalizer’s Valero style.

Researching for this post, made me aware of older people’s shoes as I was riding the bus to visit a friend in NYC. We’ve been having warm weather so sandals are still seen everywhere. Many have Velcro-type closures.

Click to enlarge

Click to enlarge

Dr. Jonathan Moore’s article, Our Vital Role in Fall Prevention (pp. 13-15) in “Podiatry Management–the most influential publication for the podiatry profession” mentions Velcro with this caution: “Velcro laces are ideal, but Velcro latching is often neglected, thus creating a situation where the shoe can become loose.  Shoes with lace are fine, so long as they are tied snug to create a good fit.” (While Dr. Moore’s brace invention comes under criticism in other articles, his shoe information re: Velcro makes sense.)

Being able to walk is important exercise with many health benefits in addition to the freedom it gives a person. We know this. And properly caring for–especially–old feet should be part of one’s regimen. When aging parents have foot problems, a podiatrist, preferably a DPM, should be consulted and no doubt shoes should be part of the discussion.

Can sandals with Velcro closures–fastened snug enough to create a good fit–offer a contemporary shoe alternative for your aging parent’s feet needing different width shoes? His or her podiatrist can answer that question.