Tuesday, March 30, 2010

'Honor Your Parents'--But How?

Every sacred book contains a truth we need to hear: Honor your parents.

This phrase is illuminated in a true story, set outside Jerusalem 2000 years ago. Hanging on a Roman cross, bearing suffering and shame, Jesus looked down at two people He loved most in all the world. His mother and his friend, John.

Jesus gazed at his mother, “Dear woman, here is your son.”
And to John, he said, “Here is your mother.”

History records the Apostle John took Mary to his home, where she lived the rest of her life.

Reading John 19:26-27 for the first time brought tears to my eyes. In the midst of incalculable agony, Jesus thoughts turned away from his pain to providing care for His widowed mother, who in that culture had no financial status. This passage tells us two truths: God cares about our parents. And he cares about us.

In today’s busy world, honoring our aging parents can be daunting. Stretched at both ends, distracted by a multitude of duties, we wonder, what does this honoring look like?

To me, it’s a matter of attitude as well as action. We make our parents a high priority; we bestow high standing to them in the family setting and we give respect, above all else.

Honoring includes asking, “How does this particular course of action sound to you?” “How would you like this to be done?” “What can I do to help?” It celebrates their expertise in baking, or baseball, or missionary work in Africa. Honoring can involve physical touch, and so much more.

Some of us honor our parents by bringing them into our home. That was the Apostle John’s way. But it may not be your way. It wasn’t mine. Depending on circumstances such as time and money, our honoring may take other forms: writing letters and making phone calls, if you live far away; or orchestrating home care, assisted living or nursing care. Don’t forget making visits with the sole purpose of saying, “I love you.”

People of all religions are united in loving their parents.

How have you decided to honor your loved one?

Boomers Bridge the Generation Gap, Part Two

Boomers are the bridge.

I discussed this analogy in the last post. Like any bridge--a covered bridge, the Golden Gate Bridge, a floating bridge--we Boomers connect people. In our families we bridge the gap between old and young. That's a good thing, usually.

Yet there is a darker side to being a bridge. "Sometimes we feel walked on from both sides," Author Dennis Gibson writes in his book, The Sandwich Years. Demands race at us from both our aging parents and younger generations, causing a traffic jam.

Daily we need to stop traffic and repair the bridge. For if we go down, nobody is served.

Sonja Lyubomirsky, a research scientist and author, offers help. In her highly documented and readable book, The How of Happiness, she distills years of empirical research on the science of happiness.

She lists 10 "Happiness Activities" that can help us repair our bridges. Here are four. The next blog will cover the remaining ones.

Happy People:

1. Express gratitude. Thankfulness brings back well being after we experience loss, fatigue and overload. It strengthens moral behavior, enabling us do do the right thing, even when our aging parent might not respond positively.

2. Avoid overthinking. Ruminating about a problem heightens sorrow, impairs our ability to solve problems and saps motivation. Whenever I find myself overthinking, I tell myself, "Stop!" If I'm diligent, the pattern will cease.

3. Suppress negative emotion. Happy people "schedule" their negative emotions. For example, if we feel sadness, we can tell ourselves, "Sadness, I can't see you now. I'll see you after supper."

4. Practice religion or spirituality. Prayerful people tend to live longer. They have higher deposits of hope, gratitude and love. Expecially helpful are prayers that seek God's presence in our lives, Lyubomirsky says.

Do you have any practices you'd like to share that help you "repair the bridge"?

Stay tuned to the next post.

Tuesday, March 23, 2010

Boomers Bridge the Generation Gap, Part One

I love word plays, especially describing Boomers.
My favorite: Boomers are the bridge.

I stumbled on this analogy a decade ago in "The Sandwich Years," a book ahead of its time. Author Dennis Gibson coined the phrase. It works for me.

Picture yourself as a bridge: an Indiana red covered bridge, the Golden Gate bridge, a floating bridge, a suspension bridge. In our families, we Boomers are like bridges because:

1. Boomers connect people. We remember endless jello salads filled with fruit and topped with Cool Whip. We recall manual typewriters and telephone "party lines." In our parents' homes, those were part of life. Yet we also share experiences with the younger set: I-phones, Webkins and Facebook. Our breadth of experience allows us to reach out to old and young. In a similar way, we link our parents with medical professionals. When a doctor slips into "Medicalese," we can translate for our parent or ask the physician, "Please rephrase that."
2. Boomers are strong and resilient. Having weathered the test of time, we've survived. Many of us have lost loved ones, endured layoffs and triumphed over other disappointments. No matter how difficult tonight is, we've learned tomorrow brings an opportunity for a new start. That unshakable optimism centers us.
3. Boomers are approachable. Adult children and the elderly tend to be self-focused. The young ones are launching. The older ones are waning. We're the go-to people for both generations. They have faith in us, precisely because we have a solid foundation that will not shake.

Yet there is a darker side to being a bridge. "Sometimes we feel walked on from both sides," Gibson writes. Demands race at us from both the generation above and below us, causing a traffic jam. The bridge is clogged with twenty-somethings and aging parents, screaming and honking their horns (figuratively.)

Periodically we need to stop the traffic and repair the bridge. In the next post, I'll offer some suggestions.

Saturday, March 20, 2010

Guilt, Guilt, Go Away!

Have you ever been "guilted"? I certainly have.

Lupe Maple, Director of Community Support at Northshore Baptist Church in Bothell, Washington, spoke about guilt March 20. Her topic? "Bummed Out Boomers: Dealing With Guilt, Loss and Shame."

Question: What is the source of our guilt?
The sources are many. Your aging parents give you the "look" that says, "You've let me down." Your sibling tells you, "You're not doing enough to help Mom and Dad." But sometimes guilt just pops up unbidden, as we walk the dog or fall off to sleep.

Question: What is it about our aging parent's situation that prompts so much guilt?
Our parents' needs seem like a deep well. We look at the well and think, "How can I do this? I haven't got it to give." We feel guilty when we don't meet all their needs, when in truth, no one person can.

Question: How do we escape the guilt trap?
Setting boundaries on our decision-making process brings relief. Instead of reacting to the huge need and either overworking or avoiding the situation altogether, we can make decisions based on "what I can do," allowing others to share the load.

Question: What is your advice to those with parents whose health is failing?

Choose to be a son or daughter. That is your calling. Take advantage of the many resources to fill in the gap between your parents' need and your ability to help.

Now You See Them, Now You Don't--Long Distance Caregiving

Your parents may live states away, but you worry anyway. And when you finally see them face to face, you realize why!

The angst of long-distance caregiving came home to me personally when my parents arrived at Sea-Tac airport for a 10-day visit to celebrate too many family occasions: two graduations, one wedding and a surprise celebration for Daddy and Mother's 50th anniversary. Father's Day capped it off.

My first shock came at the gate. Daddy suffered from Parkinson's, and Mother, a chronic illness. I knew his disease was progressing, but on the phone a week earlier, they'd assured me, "We're doing fine." Now, I wasn't so sure. I watched airline personnel push them in wheelchairs, their bodies hunched over.

At home, little details began to tell the real story: Mother's dress was packed unlaundered. Minor medical crises sprinkled every day with surprise. One day Mother tumbled from the car to the front lawn, landing flat on her back. Nothing broken, except her pride. The scene reminded me of a signature commercial, "I'm falling, and I can't get up!" Daddy, frail from Parkinson's, couldn't help me lift this 200-pound woman to an upright position. I managed, but my technique would have gotten me tossed out of a nursing assistant class.

"I need my Fleet enema. I need it now!" Daddy moaned another day. Until then, I hadn't heard of such a thing. But the constipating effects of the Parkinson's medication could not be ignored. I raced to the drugstore.

Daddy's biggest fear was he'd trip down the aisle at the wedding.

He didn't trip, thanks to our son's gentle handling. In fact, the kids all did well caring for their grandparents. But multiple social occasions coupled with unforeseen physical and emotional needs took their toll on us all.

On Father's Day, the day after Shari's wedding, I decided to skip church. Nothing doing. Daddy gave me that, "I'm so disappointed in you," look and I crumbled.

When I left the airport after delivering them to their outgoing flight and kissing them goodbye, I thought about what I'd learned about long-distance caregiving. Some thoughts:

1. Aging parents are notoriously terrible reporters. They don't mean to worry their kids, so they skirt around the truth. When they say on the phone, "We're doing fine," they may mean, "The house hasn't burned down, and we both have heart beats." We children have to do investigative reporting to get the real scoop.

2. A corollary is to listen to tone of voice. If your parents say on the phone, "Things are great," but sound like they're gasping for air, something is not right. Go with the voice, not the words.

3. A corollary to the corollary is, if they say, "I know flights are expensive; you don't have to come," don't believe it.

I'll be writing more about long-distance parenting. Do you have some thoughts or observations?

Tuesday, March 16, 2010

Free Help Just a Phone Call Away!

I love the information-laden Internet. But when it comes to receiving comfort, or clarifying meaning, or asking questions, there's nothing like picking up a phone and hearing a live voice. Especially when we need information ASAP to help our parents.

Fortunately, thanks to a nationwide program called Eldercare Locator, help is just one toll-free phone call away. Dial 1-800-677-1116, and you'll reach a trained counselor from your local area who will listen and problem solve, offering resources from a database of more than 1000 services. Some of the topics covered are meals, home care, transportation, adult day health, health maintenance, legal services, housing and assisted living and more.

The program is a public service of the National Aging Information Center. Its goal is to help keep people living safely and independently for as long as possible.

I can enthusiastically recommend the program. Clients have walked into my office in crisis with immediate needs that I couldn't solve. I'd dial the number and put the "phone social worker" on speaker phone. Within minutes, the "next step" was clear. The clients went away lighter.

There's also an online version of the program. Whichever you choose, I'm guessing you'll like it. It's something to keep in your arsenal of information.

Do you have other sources of free information you'd like to share?

Saturday, March 13, 2010

Five Ways to Break an Impasse

Your parent's behavior is driving you crazy. Maybe it's climbing a stepstool to reach the highest kitchen shelf, or driving like Mister Magoo, or refusing assisted living, even though he or she needs care. Whatever the cause, you're at your wit's end.

Joseph A. Ilardo and Carole Rothman discuss how to handle difficult situations with competent and independent but stubborn parents in “Are Your Parents Driving You Crazy?” Often all that's needed to break an impasse, they say, is finding a way for your parents to change their minds without losing face.

The following strategies are pulled from their book. Some of the examples are mine.

1.Alter the cast of characters. Consider bringing in a trusted outsider, such as a friend or minister, to offer a fresh approach. I remember one woman who feared moving to a retirement community. A talk with her pastor eased her concerns. If your parents change their course after a talk like that, they can give the minister credit for the decision.
2.Allow your parents to say no now, which may enable them to say yes later. Suppose your parents aren't managing living independently but refuse to move to an assisted living facility. Don't argue. Let them vent, and just listen. Listening creates a climate of openness, allowing them to hear themselves and reconsider their refusal. Leave information so they can read it and weigh the decision.
3.Accept partial or temporary solutions. I've had successful results when children asked Mom to try assisted living for a month or two, with the promise that they would refrain from selling her home during that trial period.
4.Turn disadvantages into advantages. If you can't prevail, use a statement like, “Mom, Dad, there's really nothing more I can say. You have the right to do what you want. I'm powerless.” This might prompt a generous sentiment. In changing their minds, they could say they “did it for the kids.”
5.Show your parents they really matter to you. If your parents' behavior is repeatedly out of line, consider an intervention in which family and friends confront your parent in love, pointing out how their behavior has affected them.

Tuesday, March 9, 2010

When Push Comes to Shove...Let It Go

Your parent needs help. You've presented the facts and offered a solution. Then he or she explodes, acting like an 85-year-old toddler throwing a tantrum in a grocery store. No way, no how. End of story. Or is it?

Certain issues tend to trigger the inner toddler in seniors who are competent but stubborn and fiercely independent. Asking your parent to give up driving, even in the face of recent fender benders, can feel like cruel and unusual punishment. For other seniors, the idea of strangers entering their home to assist with household tasks is out of the question. And what about bringing in help with personal care or moving to a retirement or assisted living community? You have the facts on your side. But your parent says, "Absolutely not."

So what do you do to end this tug of war? Muscle your power, and impose your will over theirs, sure that your course is right? I saw this dilemma play out between mother and daughter 15 years ago at the retirement community where I worked.

Their body language said it all. Sitting with me at the table, the two turned as far from each other as possible. The daughter spoke 90% of the time, despite my efforts to allow Mom to talk.

"I think Mom will really like it here, after she adjusts," she said. The retirement community was affiliated with Mom's church and Mom's sister-in-law already lived there. Mom, meanwhile, sat silent.

The icy atmosphere continued on tour. At one point the daughter whispered to me, "She's always been difficult."

When I asked her mother, "Is this what you want to do?" she said, "My daughter is making me do this."

A red flag went up. New to the industry, and lacking experience, I went against my better judgment. I continued the admissions process, hoping the older woman would eventually settle in.

Mom moved in. For six weeks, she repeated her mantra, "My daughter made me do this," to everyone she met: staff, residents, her sister, her daughter. By the time she moved away, I'd learned my lesson: pushing your parent into a corner is like putting a leash on a cat and expecting it to heel.

A great book on handling difficult situations is "Are Your Parents Driving You Crazy?" by Joseph A. Ilardo and Carole R. Rothman. They point out that, barring an immediate threat to your parent's safety, trying to impose your will on your parent will have one of four effects: 1. Your parents will stop talking with you, 2. They will become even more stubborn, 3. They will comply grudgingly, with anger and resentment, undermining your efforts, or 4. They will surrender and become completely dependent on you. None of these seem particularly desirable.

When you're tempted to push, let it go. In the next post, we'll discuss other better ways to handle these difficult issues.

Do you have any tips to share on handling a difficult situation?

Friday, March 5, 2010

A Way to Keep Your Parent From Wandering


Wandering can be a deadly word. If your parent suffers from dementia and lives at home with a spouse or caregiver, slipping out the door may spell death.

You've heard the stories: "Mom wandered out into the street, but fortunately a police officer found her." "Grandma walked to the park looking for her granddaughter."

Often one wandering incident prompts the family to place their loved one in a secured memory support community, and understandably so, since safety is a life-and-death matter.

Sometimes a wanderer is otherwise appropriate for living at home, however. The caregiver is handling the situation well. He or she is learning all about the disease and how to manage behaviors. If support is needed, he or she is receiving help with such tasks as preparing meals and cleaning house. So does a wanderer always have to live in a secured unit?

My friend Luise Volta is a wonderful caregiver for her husband, Val. She gave me some clarity on this issue in an email last week:

"I had a scare on Monday night when Val left the house in the middle of the night in his pajamas. I heard the front door and intercepted him out on the sidewalk. Got him back to bed but there was no sleep for me!"

The next morning she found "The Alzheimer's Store" and ordered key pad alarms (pictured above) for both doors by overnight UPS. They are similar to those installed in nursing homes. The device sounds an alarm if anyone tries to exit without punching the right "secret" code.

"I was able to figure them out, install and set them myself. What a relief,"
Luise added. For her, this system has proved an excellent solution. Living in a rented apartment, she was happy the system used double-sized thick tape, rather than screws, to adhere to the door.

The Alzheimer's Store also sells similar products such as an alarm which sounds in the caregiver's room, rather than at the front door.

Store owner Ellen Warner also suggests a redundant strategy. Besides a door alarm, she advises people to install a chain lock on the door near the knob so that if someone with dementia attempts to exit, the chain will slow him or her.

The Alzheimer's Store also carries information and products related to cueing, bathing, caregiver needs, fall prevention, incontinence management and more.

Wednesday, March 3, 2010

Need Long-Term Nursing Care? Meet Anna

If you're looking for long-term nursing care for your parent, you might want to meet Anna.*

It's 7 am. Outside her picture window, blue jays devour their breakfast from a bird feeder. Inside, prayer journals and devotional books sit ready at her desk. After a hearty meal of bacon and eggs, Anna will take a leisurely whirlpool bath in a spa, complete with fluffy towels, lotion and bath salts.

Anna lives at Warm Beach Health Care Center in Stanwood, Washington. It's one of hundreds of nursing homes nationwide involved in a sweeping movement begun in 1991. With names like Eden Alternative, Pioneer Network and Person-Directed Care, these programs aim to make nursing homes more like home.

In traditional nursing homes, residents rise, eat, bathe and sleep in lockstep fashion. Late risers are jolted awake at 6 am whether they like it or not. Night owls are put to bed with the chickens. Times for meals, baths and activities are set for the benefit of staff and schedules, not residents.

In 1991 Dr. Bill Thomas and his wife Judy Meyers Thomas decided, “Enough is enough.” They began with their nursing home in rural New York, determined to eradicate the three plagues: loneliness, helpless and boredom.

Thomas wrote: “We'll bring in 100 birds, two dogs, four cats, three rabbits and a flock of laying hens. Then we'll plow the lawn and start a larger organic vegetable garden outside our residents' windows.”

Eden Alternative was born.

Nursing homes since then have modified the cultural change emphasis to suit their staff, residents and locale. Many leaders have ripped up schedules, flow sheets and the lousy, tasteless menus.

They've introduced pets and plants and built playgrounds for children. And they've divided long stark halls into functioning neighborhoods, where residents and staff laugh and cry with each other.

The Federal Government has even ponied up funds for training nursing home staff in these voluntary programs. Several years ago in Washington State, 33 nursing homes including Warm Beach signed up for the three-year program called “Person Directed Care.”

Now when Warm Beach staff contemplate program changes, they ask, “Is this what the residents want?”

At residents' requests, staff have already remodeled the bathing rooms, added a continental breakfast for early risers, and divided the resident population into “neighborhoods,” with permanent caregivers. Residents choose a name for their neighborhood. They plan baby showers for staff, enjoy take-out Chinese and celebrate birthdays.

The new culture has trimmed staff turnover. Aides enjoy their permanent assignments, since they have five days a week to bond with the residents. Creativity has surged. On a clinical note, pressure sores and falls have decreased.

When I entered Anna's room, she handed me a thick guest book to sign. During our time together, as staff entered the room, she introduced me with comments like, “They're so good to me," and "Dawn puts lotion on my back every morning. It feels so good."

How do you find one of these nursing homes? Sometimes the nursing home's website will list an affiliation. Otherwise, when you visit in person, ask about “Eden Alternative,” “Pioneer Network,” or “Person Directed Care.”

*changed name.

For more information on cultural change, try this link:

Monday, March 1, 2010

Welcome!

Remember parenting a preschooler? Or if not, were you a doting aunt or uncle? Raising children, or helping nurture those of others, is an incredible roller coaster.

Today many of us boomers are riding another roller coaster, caring for our aging parents. This ride has its own set of highs and lows, but real nonetheless.

My goal is to help my peers deal with their aging parents, as I’ve done for 14 years working in health care settings. And while I know each relationship is unique, I've also observed similaries.

"I slipped into this new role, seemingly out of the blue," one Boomer said. "My mother-in-law, a wonderful home decorator, asked me for advice on a picture frame. I'm not even good at that."

As time passes we move from an influencer to an advocate: one who speaks for our parent when he or she can't.

Is this easy? Not always. Is it frustrating? Yes, for both generations. While it's true we can recycle some parenting lessons we learned long ago, we'll definitely do some tweaking. Our parents are still our parents. End of story.

Dealing with my own parents, who died 6 or 7 years ago, I realized the need for connection. In this blog you’ll hear from professionals. You’ll also hear from those traveling this journey today.

We’ll ask: How can I understand my changing parent? Deal with a difficult parent? How can I advocate well?

I’d love to hear from you. Anything relating to aging parents is fair game.
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