Tuesday, August 31, 2010

Eldercare Dilemma: In My Aging Parent's Eyes, I've Failed!

Raise your hand if you've...

Failed to keep a promise to your aging parent.

Forgotten their birthday or anniversary.

In frustration, said words you wish you could eat.


I raised my hand more than once. For many reasons--commitment overload, personality differences and the human condition--we Boomers do and say things to let our parents down.

Ten years ago I opened my parents' apartment door to pick them up for a doctor's appointment my sister had set. Daddy, who had Parkinson's Disease, was dropping pounds as if he'd won the "Biggest Loser" competition. My sister forgot to tell them about the appointment. I showed up on their doorstep.

"What's this about going to the doctor's?" Daddy snapped. "Why didn't anybody tell me? If I do see the doctor, you're not coming in!"

A simple misunderstanding, in most people's eyes. But to him, we'd failed, miserably.

Several months ago I listened to Stephen Towles, an ordained minister and elder care advisor with Choice Advisory Services. He spoke to a group of 80 Seattle area professionals in the senior care field. Besides working with elders daily, many of them struggle with communicating with their own parents.

Our first reaction, when we fail, or when someone (like our parent) thinks we fail, Towles said, is to self-deprecate (the I'm no good, nobody loves me, I'm going to eat some worms mentality) in which we ruminate over our failure, playing it again and again. Or we blame the other person for our mistake. Either tact, while understandable, doesn't help. We wallow in our humiliation and are stuck, like Winnie the Pooh, in a hole of our own making. Have you been there? I have.

A better way to react, Towles said, is to calm ourselves and realize that "No one or nothing is against me. That means everything is for me." I found a similar thought in the book of Romans in the New Testament, where the Apostle Paul writes, "Nothing can separate us from the love of God." Towles said when he failed a key person in his life, just thinking about the truth that no one was against him transformed his perspective.

Towles says this exercise moves us from self-focused humiliation to other-centered humility. Instead of beating ourselves up when we fail our aging parent, we ask, "What can I do to repair this situation?" That change in thought pattern propels actions which may include apologizing and making amends.

With my dad, I first calmed myself, and later him. And yes, I got to accompany them into the doctor's office, thanks to a kindly nurse.

Do you have a story of a time when you've failed your parent and worked through the process from humiliation to humility?

Saturday, August 21, 2010

Ready, Set, Go: Tips for Moving Your Parent Close to You, Part 2

If you're moving your aging parent close to you, there are endless details to address. The last post discussed some medical and insurance issues.

Here are a few other concerns:

1. If your parent moves across state lines and needs Medicaid services (in-home care, assisted living, adult family homes or nursing home), he or she must establish residency in the new state before applying. In other words, even if your Mom or Dad lived in a Medicaid-funded facility in Idaho, he or she can't check into a similar care center in California and expect Medicaid to pay from day one.

To work through this, some children bring their parents into their own home temporarily, filing the Medicaid application as soon as their parent arrives. Once the application is approved, they admit their parent to the health care center. Other children bring their parent to the health care center upon arrival in the new state, applying on that day and paying privately until funding is obtained. If you're relocating your parent across state lines, the federally-funded Eldercare Locator program may offer help and advice. Trained telephone counselors have many resources. Or google Medicaid (your state) for specifics.

2. Powers of attorney and advance directives are worded differently from state to state. A visit to an attorney in your state is a good idea, so you and your parent can make changes if needed.

3. To help your parent establish a social network in your area, do some homework (or delegate this to other family members.) If he's a bridge player, check out opportunities at the local senior center. If she has attended a church or other religious group, find a similar congregation locally. Other associations your parent has had in the past: garden clubs, the Elks, Rotary, etc., may be available in your area.

What other steps would you advise other Boomers to take to help their parent make a good transition to their new home? I'd like to hear from you.

Thursday, August 19, 2010

Ready, Set, Go: Tips for Moving Your Parent Close to You, Part 1

Miles--and even states--may separate you from your aging parent. That distance may not have posed a problem until now. But recent falls, depression, dementia or other issues are sending a clear message. Your parent needs to move close to you.

Once you and your family decide on where Mom or Dad should live, and who will sell the home and sort through the "stuff," you'll encounter other issues.

1. If your parent has straight Medicare coverage, the good news is that it is portable throughout the country. The bad news is that fewer physicians are accepting new Medicare patients than in the past. A call to your own doctor may help you locate one. If you're moving your parent to an assisted living facility or nursing home, the admissions staff can usually provide referrals.

2. Medicare Advantage plans, a specific type of managed care, operate in a limited service area. If your parent is enrolled in such a plan, see if it offers coverage in your locale. If not, you'll disenroll your parent from his current plan, and enroll in a Medicare Advantage plan near you. Touch base with customer service representatives from both companies to assure a smooth transition.

3. Once you've chosen a new doctor, ask for your parent's records to be transferred. As soon as possible, schedule a visit with the new physician. If you're moving him or her to an assisted living, adult family home or nursing home, the physician will need to see your parent before he or she can move in.

More tips for moving your parent close to you are in the next post.

Monday, August 9, 2010

Can Your Parent Be Happy in a Nursing Home?

Looking for long-term care for your aging parents? Of course you want the best. But perhaps, due to Medicaid issues or heavy care needs, the only answer is a nursing home.

No need to feel guilty, says health writer Paula Span in the August 6, 2010 issue of the New York Times. Her article, "Finding the Right Home and Contentment, Too," suggests that the type of facility our parents live in might matter less than we've thought.

Quality of care, a pleasant environment, and responsive staff are essential, she says. But a posh facility with all the bells and whistles may not be where your parent wants to live. The brand-new assisted living decked out with a bistro, gourmet meals and a spa may not be a great improvement over a nursing home.

Span sites a study in the Journal of Applied Gerontology which surveyed 150 Connecticut residents of assisted living, skilled nursing facilities and adult care homes. Researchers from the Connecticut Health Center asked residents questions about their quality of life, emotional well being and social interaction.

Initially, assisted living residents were less likely to be bored or lonely and scored higher on social interaction. But when researchers considered other things, differences eroded.

A resident's well being is the sum total of several factors, says lead author, Julie Robison, associate professor of medicine at the university. "It's the characteristic of the specific environment they're in, combined with their own personal characteristics--how healthy they feel they are, their age and marital status."

An elderly person reporting being in poor health might be as depressed living in an assisted living facility as in a nursing home.

Residents who had input in the moving decision and who had lived there long enough to adapt did equally well in all care settings.

Bottom line: If finances or health issues necessitate a nursing home for your parent, don't feel guilty. Do your best in seeking a good, supportive facility, with friendly, competent staff. And involve your parent in the process--after all, it's his or her new home.

To see the entire article, go to "Finding the Right Home, and Contentment, Too," Paula Span, New York Times, August 6, 2010.

Thursday, August 5, 2010

Questions About Your Parent's Insurance? National Program Offers Free Help

Good help is hard to find. Especially if it's free.

When it comes to our aging parents' insurance--Medicare, Medicaid, long-term care or life products--we Boomers may need help to understand the benefits and clarify the issues. All the better if the advisor is well trained, doesn't charge a fee and won't try to sell us something we don't need.

Such qualified, impartial advisors are just a call or a visit away, thanks to a nationwide government-funded network called State Health Insurance Assistance Programs (SHIPS). Specially trained in senior health insurance issues, the counselors can answer your questions and help you understand your health care choices.

Besides consulting one-on-one on the phone or in person, they also give group presentations on insurance-related topics.

You might call a SHIPS advisor if you're:

1. Choosing a Medicare policy for your parent and need advice.

2. Considering purchasing a long-term care policy for your parent or yourself, and wonder what questions to ask.

3. Purchasing a Medicare Part D Prescription Drug Plan and need help comparing the various plans.

4. Having trouble making sense of your parent's Medicare statements and medical bills.

SHIPS operate under slightly different names in all 50 states. In Washington State, for example, the program is called Statewide Health Insurance Benefits Advisors (SHIBA). For information on a program in your state, visit the SHIPS page on the Medicare website.
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