Thursday, December 29, 2011

Retirement Communities Help Caregiving Couples, Pt. II

Your aging parent cares for a spouse who suffers from a chronic illness. You suppose that the "strong healthy" one will outlive the one who needs care.

Not always true. Just this week at Evergreen Court Retirement Community, where I work, one of our most vibrant residents died following a stroke. Her name was June. She cared for her husband, who suffers from dementia. Last May, with the blessing of their adult children, the couple moved to Evergreen Court primarily to simplify her life. Without cooking, cleaning and other chores, she could focus on caring for John.

The family assumed June would survive her husband by many years. That's not how life played out.

Research has shown that the stress of caring for a spouse with a disabling illness can shorten the life of the caregiving spouse. Dr. Nicholas Christakis, a Harvard Medical School physician and sociologist, came to this conclusion in a study published in February, 2006, in the American Sociological Review.

With 518,240 couples aged 65 and older, the study found that the causes of excess death in the caregiving spouse included accidents, heart attacks, lung disease and diabetes.

What will happen to John? Residents and staff in our community have showered him with love and will continue to do so. We've met with family members to discuss future options. In John's case, bringing home care into his current apartment wouldn't work because he needs direction and guidance around the clock.

The family chose an apartment in our assisted living. He'll move in two weeks. By staying in the same community but in a different area, he'll still enjoy his favorite things: chatting with others over a meal in the dining room, drinking coffee and reading the newspaper in the lobby. But assisted living staff will offer the support he'll need to process his grief in his own way.

When things work right, retirement communities can help make difficult times better for caregiving couples.

Do you have an experience with an aging parent who cares for a spouse? What support have they found that works?

Thursday, December 22, 2011

Retirement Communities Help Caregiving Couples, Pt. 1

You have two aging parents, and one cares for the other. If the caregiver goes down, they're both down. What's the answer?

A retirement community could offer a win-win situation.

The well spouse ditches domestic duties like shopping, cooking, cleaning and focuses on caregiving, hobbies and socializing with others. If caregiving gets to be too much, extra help such as assisted living or skilled nursing is available. Staff can help monitor how things are going.

Today I saw these truths with my own eyes. Emergency technicians entered Evergreen Retirement Community, where I work. June, a resident, had suffered a stroke. It happened in the activity room during a musical performance.

June cares for her husband John. Due to cognitive issues, he can't live alone.

Six months ago, they moved in. June immediately began immersing herself in volunteering and activities. She is chair of the welcoming committee. "I love people," she said. "I like getting to know everyone." She also says she doesn't mind giving up things like cooking meals and washing dishes.

Retirement community living offers John benefits, as well. He loves to drink coffee in the lobby and chat with residents and staff.

Today, staff supported John as he waited for his daughter to take him to the hospital to visit his wife. They offered hugs and listening ears.

What will happen? No one knows. We're praying that June will soon return home. In the meantime, we will work with their family to make sure John is ok. If June needs rehab in a nursing home for a while, John might stay temporarily in our assisted living. Or a daughter might care for him in the retirement apartment. If John needs transportation to visit his wife in the nursing home, we can provide it.

And of course, the coffee is always on. On a more serious note, I can't help but think June might not have made it to the hospital as early if she had been living with John in a single family home. Retirement communities aren't for every caregiving couple. But they're certainly worth considering.

Thursday, December 15, 2011

Eldercare Tip: Tried & True Holiday Gifts for Caregivers

Today candies, cookies and other sweet treats fill the staff rooms where your aging parent lives. And with good reason. You want to play Santa to the caregivers who've doled out unconditional love all year long. Even when Mom or Dad is naughty, they've been nice.

Great idea! Just a favor. PLEASE skip the sugar and other junk food!

I like the idea of group gifts. Most eldercare organizations don't allow family members to give individual staffers money or gifts. The rationale is that the housekeepers may not be as visible in your parent's care, but they play a key role nevertheless. Ditto for workers in the financial office or the groundskeepers.

Here are some tried and true Holiday group gifts that are light on the waistline and actually boost energy.

1. A fruit bowl, with mandarines, oranges, grapefruit, plus any-time favorites like apples and pears. Provide a paring knife. If you'd like to add some protein, nuts are a good selection.

2. A crockpot filled with hot spiced cider. Or bottles of sparkling juices.

3. A holiday-decorated tin of popcorn. Yum.

4. Cheeses and whole-grained crackers or a make-your-own sandwich spread. Toppings can be refrigerated.

5. Pizza for all or a group sub-sandwich.

6. A crockpot filled with chili or soup.

7. Cash. See if your eldercare organization has an employee appreciation fund that takes donations. In the retirement community where I work, Evergreen Court in Bellevue, Washington, families are encouraged to give money to the resident council which divides it evenly among all employees.

8. Donations toward a specific item all employees can share. Often the administration knows of needs that can benefit everyone: a new television (or money toward one) for the staff room, an espresso machine, a piece of exercise equipment, etc.

Can you think of other gifts for caregivers and others in your aging parent's life?

Saturday, November 26, 2011

Hooray! My Eldercare Blog Has Hit 100--Posts, That Is!

My friends Hope and Pete just turned 100. Wow! I now have a tiny taste of their thrill in reaching this magic number. This is my 100th post since I began "A Boomer's Guide to Eldercare" in February, 2010.

Thank you, readers! Most of you are Boomers who seek how-to help and inspiration dealing with your aging parents. Others of you work with seniors and their families every day. A toast to you all!

In celebration, I'm reprising some of my most popular posts, and a few personal favorites.

Most Popular:

1. Affordable Senior Housing--Three Models

2. How to Sell Your Parent's Home in Seven Days

3. Before Using a Senior-Care Referral Agency, Ask These Questions...

My Favorites:
1. Your Aging Parent Has Two Developmental Tasks

2. Ready, Set, Go! Tips for Moving Your Parent Closer to You, Part Two

3. Seize the Day! Celebrate Your Elder

I'm always looking for new ideas. Do you have a particular challenge with your ading parent that you'd like help in problem solving? I'm game.

Thursday, November 17, 2011

Eldercare Nurses: Seek Out the Good, Run from the Bad

As our parents age, we Boomers meet lots of nurses. Most are good--of the Florence Nightengale or Clara Barton ilk. But we also may encounter our own version of Nurse Ratchett, the infamous character in One Flew Under the Cuckoo's Nest.

I met my Nurse Ratchett in the final weeks of Daddy's life. I was visiting from out of state. Daddy's Parkinson's was taking its toll; the doctor gave us children the option of installing a feeding tube. We gave the ok for the procedure, knowing that he still could aspirate, even with the tube.

My gut told me Daddy might not live too long. I struggled with when to book flights for our kids to visit. They had to give notice at work, but time was not on our side. I needed advice--support--from someone in the medical field. So I approached Daddy's nurse at the nursing home.

"Do you have any idea how long my Dad has? My kids haven't seen him in a long time, and I'm wondering about booking flights?"

Her answer blew me away. "Your father could live two days, two weeks, two months or two years," she said. I felt as if an ice storm blew through the room.

I could have come up with that answer on my own, without an RN after my name.

I found Mother's nurse. I asked the same question, adding, "I wasn't exactly asking when Daddy would die. No one knows that. I was asking her advice on when I should book flights for the kids, given the situation."

"Did anyone mention 'comfort measures only'?" she asked. I shook my head.

"Comfort measures only refers to the treatment a person receives during the final hours or days before death."

"If you were me, you'd book the flights soon, though?"

"Absolutely."

She was my Clara Barton. Or Florence Nightengale. Take your pick. I wouldn't hold her responsible if things didn't turn out like she'd predicted. After all, she wasn't God.

Just a messenger from God. I learned to take my nursing advice with a grain of salt. To seek out the angels of the long-term battlefield, and to run from the others.

Have you encountered nurses who helped--or hindered--your decision-making in regard to your parent's care?

Friday, November 4, 2011

Eldercare Moving Tip: Corral Your Kin to Get the Job Done

Your to-do list stretches to the sky. Why? Your parent is moving to retirement or assisted living. But how will it to happen?

A few days ago two siblings and spouses sat at my table. Their 85-year-old mother was lonely and wasn't eating. Her income was low. Our affordable retirement community worked for her. But Mom hesitated. Subject to Mom's approval, the siblings set the date and "the team" sprung into action.

"Be sure to take Mom to Social Security within the next few days to get her benefit letter," one daughter said to a brother-in-law.

The group started assigning tasks including:

1. Financial paperwork--one daughter with expertise tackled the job

2. The "talk" with Mom and subsequent tour and lunch--a son and son-in-law decided Mom might feel "ganged up on" if the whole group met with her. Their approach worked and Mom got on board.

3. A main contact and a back-up for me during the process--two siblings gave me business cards. As the financial approval process moved forward, or if I needed additional information, I emailed them.

4. Move-day organization--one son-in-law took on the job, contacting grandchildren about availability of strong, healthy young adults.

5. Change-of-address forms, shut-off utility notices, and television and telephone installation--another sibling said "yes" to the job.

This doesn't include all the tasks, but you get the idea. The process of "Divide and Conquer" is working. My first and second contacts are keeping in touch, and I with them. Things are getting done, and people are talking.

Best of all, Mom is warming up to the idea. Her move date is set for November 19.

But what happens when you're all alone helping your parent or parents move? How do you tackle that huge job? Good question. If you have some answers, please share. I'll also treat that subject in a future post.

Tuesday, October 25, 2011

Spending Down to Medicaid--Prepaying Funeral Costs

Your aging parent has more care needs than dinero. He or she is on the road to Medicaid. As the dollars shrink, mostly to cover eldercare, you can do some things to provide for your parent's future.

Welcome to the world of the Medicaid spend-down. Each state sets its own rules for Medicaid eligibility and how people can spend their limited funds before they reach the asset limit--usually $2000.

My favorite spend-down strategy is prepaying funeral costs, probably because my family's experience ended happily.

The story went like this: Daddy and Mother's tiny retirement nest egg of $60,000 dwindled rapidly soon after they both moved to a Wisconsin nursing home. My sister Carol landed on a great idea. Having power of attorney, she set aside in a specific account, earmarked funds to pay all their funeral costs, including preparation of the body, minister's and soloist's fees, and other expenses related to the service.

In addition, the plan included monies for plots, burial stones, and even enough for a dinner for family and friends. Funds were set aside for our family's out-of-state flights, hotel costs, and car rentals, too. When the time came for the funerals, we adult children didn't worry about money.

What a blessing not to be stressed about finances! And later, after all the accounting, there was money left over--not much, but some.

It was a good way to spend down money before they converted to Medicaid funding.

Wednesday, October 19, 2011

Losing Your Marbles? A New Way of Looking at Eldercare

Juggling generations is dicey. The needs of an eighty-year-old aging parent for peace and quiet run counter to a two-year-old grandson's penchant toward screaming. And it's up to us Boomers to keep it all together.

Try as we might, life often unravels before our eyes. We start losing our marbles. For me, it happened on the eve of my parents' fiftieth anniversary surprise celebration. When I met them a week earlier at the airport, they were hunched in wheelchairs, exhausted from their five-hour-flight. What a shocker! Daddy's Parkinson's had progressed so much since I'd seen them last. Mother, also frail, looked like she could tip over.

During their two-week visit, we crammed in two graduations--one high school and one college--plus a wedding and the surprise 50th anniversary celebration. But what I remember most was the continual feeling of being split in a hundred pieces. Teenage sons crying, "We're out of milk, AGAIN." Mother and Daddy shuffling here and there, accidents waiting to happen. Like little birds, they chirped out their needs: Fleet enemas, dry cleaning, clean underwear. And of course, there were the needs of our daughter, the bride.

One day I remembered the "marbles" presentation. Years earlier at a conference for senior care professionals, a motivational speaker underscored the importance of positive words. To help him remember to say kind things to his spouse, his coworkers, his family, he placed 10 marbles in his left pocket at the beginning of the day. With every sincere compliment he would transfer a marble to his right pocket. His goal was to give 10 compliments a day.

During my parents' visit I didn't actually buy marbles to transfer from pocket to pocket. But the idea of intentionally complimenting folks in all the generations helped me cope. I started "seeing" the good, rather than just the sea of need. One day I caught my Dad, a retired minister, explaining a New Testament passage to our 18-year-old son. "Grandpa can really help you understand the Bible, can't he?" I said.

When Grandpa voiced his fears of tripping as he walked down the aisle at Shari's wedding, I assured him, "Tim is strong. He loves you. He'll make sure you're OK."

No, the marbles idea didn't take all the stress away, but it did give me a better handle on things. Just thinking of the marbles put a smile on my face.

If you think you're losing your marbles, you might be right. But try transferring them, from pocket to pocket, as you say kind things about the generations. The situation won't always get better. But you probably will. Take it from soneone who knows.

Monday, October 10, 2011

Your Aging Parent Refuses to Spend Money on Eldercare

A penny saved is a penny earned. All her life your aging parent has lived by Ben Franklin's words. But now, she needs assisted living or in-home care. The cost scares her to death.

Eighty-three-year-old Lois felt that way. Over the years she'd collected diagnoses like barnacles: diabetes, congestive heart failure, and more. She needed medication management, plus help with showers, dressing and other daily activities. As we talked, she fixated on the expense.

"It's SO expensive. It's SO expensive," she repeated.

"You can afford it," her son said, citing numerous investments. Lois wasn't convinced. So what to do?

Perhaps your parent's story is similar. Before you point out the "facts," try drawing her out with an open ended question. Something like: "I know you're really concerned about spending so much money. What troubles you most about that?"

You might be surprised at what you hear. Having grown up in the Depression, she may feel a sense of failure at spending money on herself, even though needed, instead of providing a larger nest egg for the kids. I've heard other elders say, "I've always given a substantial amount of money to the church. If I go to assisted living, I won't have as much to give." Still others are paranoid they'll run out of money. They've never spent more than their monthly income.

Whatever they say, listen before speaking your peace. And try to affirm their concerns. Then you can calmly point out how what the monthly fees will cover and how life will be better should they get care. Another tactic: Let them know that you'd like to move to assisted living or hire home care so YOU don't worry. The idea of sacrificing for you and your family members may make sense.

I often use this phrase:

"Remember during your lifetime you always saved for a rainy day?" "Well, right now it's beginning to drizzle." Or "It's pouring!"

Have you used other words to help convince your parent to get care? Tell me about it.

Friday, September 30, 2011

Selling Your Parent's Home--A Broker's Tips



Van Cooper sells seniors' homes. As a Senior Real Estate Specialist (SRES) with Windermere in Kirkland, Washington, he helps Boomers and their parents market what is usually the family's largest asset with the most emotional value.

"Lots of feelings can pop up during the process including loss of control and abandonment," he says. "My goal is to treat people fairly, with dignity and respect. My position is to facilitate a sale that's as easy and low stress as possible."

Cooper shares his tips on selling your parent's home.

1. Give your parent as much support as possible. Depending on your situation, you may be handling the decision making yourself, or taking a lesser role. Even if your parent says, "I want to do this on my own," offer your eyes, ears and thoughts, to ask questions and clarify things. Point out that this is a difficult transaction for anyone, and you'd like to help wherever you can.

2. Interview at least three potential real estate agents. Chatting with them will give you a good idea if they're a good emotional fit. During the interviews, they will offer you competitive market analyses, including comparable properties. If some of those homes are still active, ask to drive with the realtor to look and compare them with your parent's home. Another tip: "Ask for a second visit. If he or she is edgy, that's a huge red flag," Cooper says.

3. Ask more questions. Does the agent tell you how much it will cost to update your parent's home, and what updates will boost the selling price the most? Is the agent offering a team of professionals who can do the remodeling, clean the home, stage it, hold estate sales, and do other tasks as needed?

4. Decide on the details of the process. Will your parents move before the house is upgraded and listed, or will they stay in the home? Cooper says both ways work. If your parents continue to live in the home, it's best that viewings are done by appointment, so you or others can take them out of the home while strangers are looking around.

5. Determine how often the agent will communicate with you and in what manner. Emails? Phone calls? Personal visits? Letters and cards? If time goes on, you may need to discuss lowering the price, usually 3 to 5 percent if the property was priced correctly at the beginning.

Is this easy? Probably not. But working with a real estate agent who knows and understands seniors helps tremendously, Cooper says.

Have you heard of an SRES (Senior Real Estate Specialist)? It's an endorsement that requires two days of study, plus fees and exams. "People who get this certification are more likely to have an interest in providing seniors the service they have earned," Cooper says.

Sunday, September 18, 2011

Aging Parent Alert: Watch Out for Scams on Veterans Aid & Attendance Program

Phone scams. Mail scams. Just days ago, a client named Vicki told me about another scam that almost got the best of her aging mother. It involved the Veterans Aid and Attendance Program.

The VAA Program is legitimate. If your parent is a veteran who served in wartime, or the surviving spouse of a wartime veteran, he or she may qualify for monthly help of as much as $1644 for a veteran, or $1056 for a surviving spouse, and still more for married veterans. To be eligible, the applicant must have limited assets and income and also need help with activities such as bathing, dressing or medication management.

Unfortunately, some "professionals" are twisting the intent of this program and taking vulnerable seniors for a ride. In Vicki's mom's case, she'd served in Korea years earlier. Recently the 76-year old woman toured a retirement community in rural Southwestern Washington, more than 100 miles away from her daughter.

"My mom was ready to move in," Vicki said. Her mom placed a deposit on an apartment. One huge problem: the monthly fee was $2500. Her income was less than $1500. She had few assets.

"You're a veteran, and I can help you apply for a program that will give you up to $1644 a month," the marketing representative said. She pulled out an application for Aid and Attendance. Once approved, Vicki's mom could receive benefits, retroactively to the date of application. The monthly benefit would help cover her fees.

Over the next few days the marketing rep "helped" Vicki's mom complete the lengthy application and kept assuring the older woman this was a sure thing. But something didn't seem right.

"You walk with a cane, don't you?" Vicki's mom shook her head. "Well, you do now!"

The marketing rep blew out of proportion the older woman's disability. Another troubling thing: Vicki's mom would need to take out a loan or find other funding to help pay her retirement community rent until her application was approved.

By this time, Vicki knew something was amiss. "I discovered that if the application didn't go through, my mother would still be liable for her retirement community rent!"

Vicki pulled her mom's deposit. The story ended happily.

If you think your parent might be eligible for Aid and Assistance, go straight to your nearest Veterans Office. Specially trained service officers can answer your questions and help your and your parent through the application.

Monday, September 5, 2011

Your Aging Parent's Move Prompts Grief? Relief? or Both, Part II

I'd love to have a dollar every time a Boomer confides in me, "I know moving to an assisted living community is best for Mom. But I worry that she might not adjust and be happy."

Grief. Relief. Or some of both. On moving to an assisted living community, elders often experience all or any of the above. "I miss my house, my flowerbeds, and my cat," one woman said. Others grieve the loss of physical ability, their memory and relationships.

On the other hand, others almost jump for joy. "I cooked all my life, and now it's time to give it up," is the sentiment. And yet other elders bounce between grief and relief during those first days and weeks.

How can we help them adjust?

1. Probably the biggest gift we can give our aging parent is to listen, without censorship. While it's easy to answer a complaint like, "I so miss our house!" with, "But it was so big and so difficult to keep up," it's far better if we bite our tongues, and sympathize. A statement like "I know you loved that house. And you took such good care of it," lets your parent know her opinion is valued.

2. Upon move-in, trust your instincts as to how much of your time your parent will need. Often it's best to set up the apartment in advance, so it's ready to go when your parent moves in. Some adult children will sleep the first few nights in their parent's new apartment. Other family members eat meals with their elderly parent as often as possible during the first few days.

3. Give your aging parent time to adjust. Fortunately staff of assisted living communities are used to listening to their new residents' stories: of grief, and of relief. Staff can also distract new residents by getting them involved with Bingo, Bridge or other diversions. After a month or two, given lots of tender, loving care, your mom or dad will begin thinking, "This is my home!"

Do any of you have any other ideas on how to help your aging parent adjust to a new setting, such as assisted living, or a nursing home?

Monday, August 29, 2011

Your Parent's Move Prompts Grief, Relief, or Both, Part 1

Do you recall your child's first day of kindergarten? If you're like me, you bit your nails and downed M and M's wondering: Will her teacher be a mix of Mary Poppins and Fraulein Maria? Will the kids like her? Will she return that afternoon wearing a smile?

Fast forward many years. That same angst can return when our elderly parent moves to a retirement community or care setting. When faced with this huge change, will he or she experience grief? Relief? Or some of both? In 16 years of working with seniors and their families, I've seen all of the above.

Grief--For many seniors, the idea of leaving their posessions tears at their soul. One client struggled with downsizing. She said, "Looking through my papers and other stuff reconnects me with what I've done and where I've been. Getting rid of things is like getting rid of part of me." Others grieve their loss of independence, physical strength and self esteem. Seeing walkers, wheelchairs and oxygen tanks in the hallways of their new home reminds them daily of their mortality. Still others grieve the loss of a mate or friends gone by. The new setting may not take those losses away.

Relief--Recently three newly widowed women moved to our retirement community. When each came into my office, the old adage, "Don't make any major changes in the first six months" ran through my mind. I bit my tongue, though. They all settled in. One of them expressed her relief in giving up the care of a big house: "I'm starting a new chapter in my life. I want to do things I've never done before." Even seniors not facing the loss of a spouse may relax by moving into a smaller space, where they can focus on enjoyable activities, and not on chores.

A little of both--That's where many seniors land--sad about leaving familiar things behind yet realizing there may be light at the end of the tunnel. Teary one moment and beaming the next--that, too, is normal. There are some things you can do to help ease the transition.

The next post tackles ways you can help make your parent's move easier.

Monday, August 15, 2011

Write a Great Thank-You Note to Your Parent's Caregiver

So many word searches from my readers--and would-be readers--include phrases like, "How do I write a thank-you letter to my parent's caregiver?" Here are my thoughts.

First, congratulations on desiring to show appreciation for your parent's caregiver. Saying "Thank you" is something you can do daily. Writing is even better! Read and reread, your thank-you letters are valued by your parent's caregiver, shared with his or her family and often with coworkers.

Second, thank-you letters aren't hard to write. They are similar to a professional recommendation. You'll start by brainstorming. Think about the specific acts of kindness you've seen your parent's caregiver perform. Some examples are: "I love how you dress Mom in her favorite colors, and style her hair with matching hair clips." Or "I enjoy how you remember to turn on the television to the major league baseball game which Dad so enjoys." Or "When I mention your name to Mom, her eyes light up, because you make her feel special."

Third, think about specific character qualities you've observed in your parent's caregiver: compassion, humor, dedication, patience. Soon concrete examples of these character traits will spring to mind.

Fourth, write a rough draft. Be warm and sincere. If appropriate, you may want to run the rough draft by your parent for his or her input. Don't hesitate to ask a friend or family member to edit your draft. For the final take, hand write it on a decorative sheet of paper.

Deliver it and see what happens. Chances are good the work you put into this project will pay off!

Have you written a letter to your parent's caregiver?

Monday, August 8, 2011

Eldercare Dilemma: One Parent Says, 'Let's Move,' the Other Says, 'No Way!'

It's a common tug of war. Your elderly mom wants to say goodby to the big house, leaving the driving, shopping, cooking and cleaning behind. Retirement living sounds like a dream come true.

"No way," counters Dad. In his eyes, the house in which they raised you, cared for your pets and babysat your children is fine forever.

Like many men in the Greatest Generation, your dad may resist moving to a retirement community (or getting in-home help). Here's why:

He already lives at home in a retirement community. It has one employee--your mom--who provides everything. He forgets that when he stopped working in his sixties, his wife didn't. Like the EverReady battery, she kept going and going--cooking, cleaning and tending to his needs. Now, years later, she's spent. But he may not see this.

Your dad may think retirement communities aren't for "real men." If he enjoys gardening, woodworking or puttering, he may wonder, "How will I continue to keep busy?" He may not realize that many retirement communities do offer woodshops, gardening areas and poker clubs. Another option: he can continue to help you with your home projects, as he is willing and able.

He may not see the "big picture." Statistically, your mom will probably outlive your dad. He may not want to think about the difficulties she might face in moving alone, especially in the face of grief. Those challenges include choosing the community, selling the home, downsizing, moving, establishing new friendships. If a married couple moves together to a retirement community, the widow's later adjustment is often easier.

So how do you help your parents in making a decision when both are at loggerheads? Although ultimately the "To Move or Not To Move" question is theirs to resolve, you certainly can offer your listening ear and even your opinion, especially if one person doesn't seem to be heard.

Have any of you faced this dilemma, either with your parents or your clients? Tell us about it.

Sunday, July 31, 2011

Eldercare Review: Red Cross Family Caregiving Program is Worth Your Time

I'd blame my tardiness on sun stroke. Except I'm from Seattle, where sun is in short supply. During May and June I attended the American Red Cross Family Caregiving Program, held at Evergreen Retirement Community, where I work. I promised a review.

If you care for your aging parent either full-time or part-time, or are supporting your parent who is caring for his or her spouse, this national program is worth your time. First, there's no cost. Second, caregivers can select one or more segments. Third, sessions are facilitated by Red-Cross certified leaders. Mike Davis, of Always Best Care-Eastside, led our discussions.

Booklets on the various topics--home safety, general caregiving skills, positioning and helping your loved one move, assisting with personal care, promoting healthy eating and caring for the caregiver--were helpful, as were the videos.

The best part of these sessions was the lively discussion. Some participants worked in the eldercare field, helping adult children and their aging parents. Others were caregivers themselves.

"There's great value in people getting together to discuss caregiving issues and to work toward problem-solving," said Mike Davis.

For more information on the program and locations near you, contact the Red Cross Family Caregiving Directory.

Monday, July 25, 2011

What's MOST Important to Your Aging Parent?

What does your elderly parent want most? Especially if he or she is facing a transition? Is it comfort, tasty food, friendliness, or excellent care?

In my job as Marketing Director for Evergreen Court Retirement and Assisted Living Community, I ask that question daily. One recent response caught me off guard.

"I want to be treated with kindness," 85-year-old Jean told me on the phone.

"Tell me more," I asked.

"It's not that I haven't been treated with kindness," she said, "But I want that to continue. I need to be treated with dignity and respect."

After Jean moved in, she confided she'd experienced some hurts earlier in life. She needed a safe place to land, where she was cared for.

Have you asked your elderly parent to name what's most important? If you do, don't be surprised at what you hear. The words "kindness, respect, dignity," may surface. Together, you can help him or her find that good place.

Sunday, July 17, 2011

Eldercare Dilemma, Part II--Listening to the Same Old Story

Your elderly parent launches into "the story." You know it by heart. After all, you've listened--sort of--until your ears ache. Do you:

1. Pinch yourself periodically, as you struggle to stay awake?

2. Put on a happy face and nod now and then?

3. Worry that your aging parent is losing his mind--or you're losing yours?

A month ago, on Father's Day, my friend Linda had an Epiphany relating to this subject. When her 91-year-old dad began to recount scenes from his boyhood, as he'd done so many times, Linda said, "I began listening with new ears."

She asked questions. "What did you like most about the walk to school?" "Tell me about your favorite teacher?" "Was recess fun?" "How did you deal with bullies?"

"My questions set Dad off in a different direction," she said. New information surfaced, and the old, old story suddenly came alive. In the process, Linda honored her dad by her active listening. He gave her information about her heritage. Both their minds were fed.

Does engaging your parent during the story sound like it's worth a try?

And as to the repetive stories indicating dementia, either for you or your aging parent, rest your mind. Nearly every elderly person repeats stories. It's just what they do.

How do you respond when your aging parent repeats stories?

Sunday, July 10, 2011

Affordable Senior Housing: Tips on Applying

Remember the FAFSA? Years ago, many of our parents burned the midnight oil submitting this multi-page financial aid application. The goal? Scholarships and grants for us. Today if your aging parent is seeking low-income senior housing, you could be facing a "mini" FAFSA.

Once you've chosen a community offering subsidized senior housing or retirement living, your parent will receive an application. Similar to FAFSA, but simpler, this document "proves" that your parent's income meets the community's limits, which are based on a percentage of the average income in that county. In King County, where Seattle is located, a single person can have income no higher than $36,000 for most programs, and $41,100 for a couple.

Most seniors I work with at Evergreen Court Retirement Community ask their adult children to help with the application. They helped you with the FAFSA; now it's your turn.

Some commonly asked questions:

1. What is the application process? A representative from the community will give you and/or your parent the paperwork and explain how to complete it. When you've finished, you'll have a second meeting to go over it and check documentation. The community sends the package to a third-party compliance officer, to double-check the numbers and determine eligibility.

2. Do assets count? Assets such as brokerage accounts, money market accounts, CD's, homes, real estate, etc., must be declared, and documented by presenting the most recent statement. For a home not yet sold, the county assessor's last assessment statement will prove its value. In computing total income, the compliance officer looks at the income (or potential income) generated from the assets and adds it to the monthly income. For more specifics, consult the manager or marketing director of the community you're looking into.

2. What other items need to be submitted? A driver's license or ID card, provides proof of age. Other documents: Pension statements and a Social Security benefit letter, which the agency sends to all recipients in December of each year. You'll look at the top line for the gross monthly amount, before Medicare is taken out.

3. What about bank accounts? All must be declared. For checking accounts, six months of statements may be required. For savings and money market accounts, the most recent statement is sufficient.

Does that sound daunting? The process may be a bit grueling, but the payoff makes it worthwhile. Often seniors can save $500 a month or more over market rate rent by opting for subsidized senior housing. For help in locating options, contact Eldercare Locator.

Thursday, June 30, 2011

Eldercare Organizations: Consider a Not-for-profit for Your Aging Parent

I'd swear on a stack of Bibles. Not-for-profit eldercare organizations aren't perfect. After all, they're headed by fallible people.

Still, not-for-profits are worth considering for your aging parent's health care needs. Nationwide some 5400 such organizations deliver excellent retirement and assisted living, skilled nursing care, home care, etc. Since my entry into the eldercare field in 1994, I've worked for three not-for-profits. I've seen and applauded their good work.

What sets not-for-profits apart?

1. Corporate investors don't set the organization's policy. Rather, boards of directors, who are community volunteers with various areas of expertise, make the key decisions. Extra dollars go, not to stockholders or owners, but to improving staffing ratios, training employees and building innovative programs that make seniors smile. No wonder Consumer Reports recommends not-for-profit nursing homes over others when seeking quality care.

2. Not-for-profits are mission-driven and accountable to the community at large. Many are connected with a church or a hospital, and their responsibility to the community is well defined. Their tax exempt status presupposes the practice of "giving back." For example, in Everett, Washington, Bethany of the Northwest hosts an annual elder health fair for the city's seniors. In Seattle, Foss Home and Village, a nursing home and asssisted living facility, sponsors a countywide senior annual volunteer recognition. Another big plus: not-for-profits often sponsor benevolent funds for elders who run out of money. Many not-for-profits take Medicaid funding.

3. In general, not-for-profits have lower staff turnover. I've watched the organizations I've worked in do many things--big and small--to attract excellent caregivers and other employees and to keep them. In-services, scholarship opportunities and specialized training build staff morale and increase longevity. It's not uncommon for an eldercare worker to celebrate 25 years of service. That number is growing! Staff longevity builds confidence by the elders and families.

For more information on not-for-profit eldercare organizations, contact their national association, LeadingAge.

Not-for-profit eldercare organizations aren't perfect, but definitely worth your consideration. Have you had experiences--good or bad--with not-for-profits?

Wednesday, June 22, 2011

Eldercare Trend: Top Factors That Influence Your Choice of Retirement Communities

Shopping for a retirement community for your aging parent? As you weigh the factors involved in choosing this new home, the following key words may come into play. I've heard these again and again over the last 16 years.

1. Location. Does your parent want to live close to one child? Or somewhere between several children? And what about rural versus urban living? Consider these questions: Is your parent a city girl at heart? Or a died in the wool country boy? Still another factor for many elders is living close to their current physicians and hospital or to their church.

2. Affordability. For some seniors, the question isn't "Can I afford this community?" but rather, "Even if I have the money, do I want to spend that much?" I remember the words of one resident named Wallace, "It's important to be able to give my children a certain amount of money. At the end of the day, that's important to me." For those at the other end of the economic spectrum, a great option may be "affordable" senior housing, designed for elders with low to moderate incomes.

3. Comfort. Retirement communities are a little like going on vacation, or living in a dorm or sorority, except with no drunken parties. Meals are prepared, activities are planned, and life is simpler than it used to be. It's "Leave the driving to us." But within those parameters, there are many variables. If your parent enjoys dressing up for a steak dinner or equivalent virtually every night, he can opt for that lifestyle at some retirement communities. Or maybe he prefers wearing blue jeans and a golf shirt for his favorite meal of macaroni and cheese. That option is available, too, and all shades of in between.

4. Food. Some key issues here are: "Do staff assign seats to residents?" and "Is there one seating for meals, or can residents come and go during a certain time period?" Seniors often have strong options on both these issues. If you don't discuss these questions with your parent beforehand, you may hear his or her complaints afterward. Often they're not pretty!

5. Space. One size certainly doesn't fit all. One daughter was adament in her desires: "My mother has to have a studio. Anything larger would overwhelm her." We didn't have studios, so I referred her to the lucky retirement community down the street. Other space considerations: square footage, closets, outside access, storage compartments.

6. Activities. For many, the trips to museums, drives to the country and live music on site make their day. But not everyone is created equal! Weigh your parent's preferences against the community's activity schedule to see if it's a match.

Good luck in your search! This post didn't have the space to address the most important element in any retirement community: caring staff. More later.

Thursday, June 9, 2011

Eldercare Tip: Ways to Cut the Cost of Retirement Living

Your parent lives in a retirement community. Chances are, once a year the dinnertime chatter erupts into a chorus: "How much will they raise the rent?" and "Can I still afford to live here?"

If your aging parent worries about running out of funds, she is not alone. Fortunately seniors can save money without giving up meals, housekeeping, transportation and activities--the main reasons they chose retirement living in the first place. Consider these tested ideas.

1. Ask to transfer to a smaller or cheaper apartment within the same community. Often building managers would rather keep a resident than spend time, effort and dollars to move in someone new. My friend Eleanor moved twice in seven years, first from two bedrooms to one after her husband's death. Later she chose a studio when her assets dwindled. Keep in mind the transfer option is not without sacrifice. Downsizing is difficult, but writing a smaller check each month can pay off in peace of mind.

2. Move to a retirement community with fewer amenities. If your parent enjoys cooking, for example, he or she can often save about $300 to $500 a month by moving to a retirement community offering one meal a day, rather than three.

3. Consider a lower priced retirement community. In Bellevue, Washington, where I work, independent retirement living can range from $1560 for a studio, one-meal program, to over $9000 for two-bedrooms with three meals.

4. If your parent is beginning to need services such as bathing, dressing and medications, a home care agency can help her remain in her retirement apartment. In our community, an independent resident can save $1000 or more a month by using home care instead of moving to assisted living. One caveat: if your parent needs staff support all day long, home care agencies will not save money over a transfer to assisted living.

Can you think of other money-saving ideas?

Tuesday, May 31, 2011

Red Cross Family Caregiving Class Gets an A at Mid-Term

So far so good. That's my take on the American Red Cross Family Caregiving Program, being held at Evergreen Court Retirement Community, where I work. With the first three segments behind us--Home Safety, General Caregiving Skills and Positioning and Helping Your Loved One Move--the program rates an A in my book.

If you care for your aging parent either full or part-time, this free nationwide program is for you. Facilitated by Red Cross-certified leaders, the series has eight modules in all--we're using six. Mike Davis, of Always Best Care-Eastside, leads our discussion. Videos and booklets bring the content to life. Another plus: caregivers can choose the segment or segments they'd like to attend.

Things I learned from the Home Safety module:

It's important to check the water temperature with a bath thermometer or the back of your hand before your loved one enters the tub or shower. The temperature should not exceed 105 degrees.

Set the hot water heater to low or set no higher than 120 degrees.

During "Positioning and Helping Your Loved One Move," I watched with interest caregivers use correct body mechanics and work with their loved one on performing range of motion exercises.

I look forward to the next three segments: Assisting With Personal Care, June 1; Healthy Eating, June 8 and Caregiving for the Caregiver, June 15, all beginning at 7 pm.

I'll tell you what I think. For more information on the program and locations near you, contact the Red Cross Family Caregiving Directory.

Wednesday, May 25, 2011

Fall Prevention: Steps You & Your Parent Can Take

"I'm falling and I can't get up."

Remember that silly commercial? It brought belly laughs 20 years ago. But not today. Especially when it's your parent who's at risk.

"A fall is the number one reason for a senior's illness or death," said Kerry Hopkins, Care Manager for HomeWell Senior Care in Seattle. "Our bodies can handle the impact of a fall, but for seniors, it's another story."

We can't follow our parents around all day long, but we can work with them to reduce the risk of falls. Here are a few of Hopkins' pointers.

1. Most falls occur at night.Upon waking, either low or high blood pressure can trigger dizziness and/or disorientation. If your parent feels lightheaded, encourage him or her to sit for a moment before trying to stand.

2. A corollary to the above: Place nightlights in both your parent's bedroom and in the bathroom. Seniors rely on light--both in the room they're leaving and in their destination--to help with balance.

3. In the evening, encourage your parent to limit, not only liquids, but also sugary foods. The energy rush can spark shakiness, possibly resulting in a fall.

4. Fluids in the daytime are great! They help prevent dehydration and urinary track infections, both potential causes of falls.

5. Check the house, especially stairs. "Falls happen most on the bottom two stairs or the top two stairs," Hopkins says. Marking those stairs with tape or fabric may encourage safety. Another home safety tip: clear walkways of toys, books, etc.

6. Most important? "Learn to slow down and think before you move," says Hopkins. It's good advice for our aging parents--and ourselves.

Saturday, May 14, 2011

Advocating for an Aging Parent? Choose Your Words Wisely

The eldercare field would do well to learn from hotels.

In a well-run hotel, staff bend over backwards to anticipate needs. A forgotten toothbrush? No problem. A special birthday? A birthday cake arrives at the door. But in your parent's physician's office, hospital, nursing home or other care setting, you're on your own. At their dizzying pace, health care staff can't read your mind to see what you or your parent needs.

To combat frustration, try these simple words: "Could you tell me...?"

As in "Could you tell me approximately how long we'll wait to see the doctor?" Or "Could you tell me when my parent has a change in his or her medical condition?" Or "Could you tell me the signs a person exhibits when death is imminent?"

When you ask in a direct, yet friendly way, "Could you tell me why I've seen the call lights flash more lately?" or "Could you tell me why my mother's bed was wet this morning?" it's obvious you want an answer. You're not whining, or complaining; you're asking.

Even if the answer isn't what you want, your friendliness will cause the other person to take notice of your concern and address you with respect. Your positive attitude will pay off in many ways, including making life better for your aging parent.

"Could you tell me...?" has worked in addressing medical professionals involved in my own aging parents' care. I've also seen my clients use these words with me, with remarkable success.

Friday, May 6, 2011

Seeking Eldercare for Your Parent? Look for Happy Employees

Searching for health care for your aging parent? Consider this phrase: "The Customer Comes Second."

In 1993 Hal Rosenbluth coined this phrase for the title of his best seller aimed at business management. The book was revised in 2003. But does "The Customer Comes Second," apply to eldercare? Especially when the primary customers--you and your parents--need lots of attention and care?

For 16 years I've seen Rosenbluth's premise play out in the senior care field. I agree with his words: "Hire people who have the right personality, and then train them to have the right skill." If employees feel valued and have opportunities to grow and enjoy their work, their enthusiasm will rub off on the customers and result in excellent service, he says.

When you're looking for eldercare for your parent, ask questions of management about "employee care." Do caregivers, food servers and housekeepers have vehicles for public recognition and for encouraging each other? Are they given opportunities for in-service training? Does the organization encourage entry level workers to move up the ranks or to finish nurse's training? Does the organization hire for the right personalities and then train employees for the tasks? Are employees encouraged to have fun with their elderly clients?

Ask about staff retention. In the senior care field, turnover for caregivers is extremely high--averaging 70% or more. That means that at the beginning of a year, if 100 employees were hired the previous year, only 30 would remain. Some health care settings are able to keep their staff longer, promoting consistent care.

Carol, a daughter of a resident of our retirement community, said she moved her mother out of another local retirement community because of high turnover. "Employees were coming and going all the time. That lack of continuity was unsettling to the residents," she said.

Besides speaking with management, visit the community or care setting and observe employees in action. Watch for smiles on the faces of workers and elderly like. Listen for jokes. These will tell you whether the organization puts their people first.

Bottom line: Happy employees are more likely to treat your mom or dad like royalty. Remember Queen for a Day? That's the goal.

Note: I first read "The Customer Comes Second" when I entered the senior care field in 1994. It's well worth reading.

Saturday, April 30, 2011

To Mom With Love: Mother's Day Gifts, Celebration Tips

Two Questions:

What do you give your aging mother for Mother's Day?

And how do you celebrate any occasion with your aging parent despite difficult circumstances?


I'm reprising two posts from the archive which address these topics. Enjoy!

Mother's Day Gift Ideas From the Pros

Seize the Day: Celebrate Your Elder

Tuesday, April 19, 2011

Moving Mom to a Retirement Community? Her Wish List May Surprise You

Moving is tough. But if your parent moves to a retirement community, his or her "wish list" may be shorter than you'd think. And your parent's "must-haves" may have little to do with the building's age or decor.

In both vintage and spanking brand new communities, I've watched Boomers and staff team together to make their elders' dreams come true.

A 90-something woman said: "I can't live without baking cookies to give away." She kept the flame of her baking passion alive in her new retirement community, thanks to a toaster oven which baked eight cookies at a time. On Wednesday, baking day, the aroma of chocolate, vanilla and other sweet ingredients wafted down the hall. On Thursday she fed residents and staff, as well as feeding her own soul.

A gardener who by his own admission was older than dirt said: "My green thumb keeps me sane. I have to plant." He and his daughter chose a retirement apartment at ground level. He planted annuals and bulbs, and enjoyed watching his garden grow.

A self-proclaimed standup comedian at 85 said: "I want to make people laugh." Procuring a tutor at his new retirement community, he learned to surf the Internet, finding corny jokes to add to his already hefty store of humor, culled from a lifetime.

Even more than living in beautiful surroundings, these seniors wanted to continue to do their favorite things, and be themselves. As adult children, it's our job, not to worry so much about creating a fairytale perfect world for our parents, but to help make their simple dreams come true.

"Look beyond the chandelier," says Marcia Byrd, Executive Director of Patriots Glen, a cozy assisted living community in Bellevue, Washington, not too far from mine. I couldn't have said it better. Simple pleasures don't always come in glitzy packages.

Does your parent have a skill, pasttime or passion that feeds his or her soul? Try to enable your parent to continue it, even in a new setting.

Thursday, April 14, 2011

Warning: Your Aging Parents' Home May Be Hazardous to Their Health

We Boomers remember the childproofing years. Our kitchen sported cupboards that toddlers couldn't pry open (sometimes we couldn't, either) and gates kept little ones from tumbling down the stairs.

Your aging parent may need the same level of vigilance. Falling at age 80-plus is almost a recipe for a broken hip. And hazards that we Boomers can skirt around are deadly for them.

So snoop around. I give you permission to peruse your parent's house for anything that may present a safety issue. Better yet, take your parent along. Specifically, look in these rooms:

Tour the kitchen. Open the refrigerator door. Does it contain ketchup, mustard, mayonnaise, green olives and little else? Not a good sign. The other extreme is also bad: it's crammed full of odds and ends, many with "interesting" aromas and colors, mostly green.

Check out the living room. Are the carpets secure? And what about those piles of "Saturday Evening Post" and "Life" magazines on the floor? Are there extension cords lying about, ready to be tripped on? What about easy chairs--do they fit well?

Walk through the bathroom. Look around: if your parent has a bathtub, is there a bath bench or seat? What about grab bars? If he or she uses a toilet riser, is it secured well? On the door of the medicine cabinet, is there a list of the medications, along with the doctor's name and phone number? This helps emergency technicians tremendously.

Stroll through other rooms. Does the laundry room look like the "Wreck of the Hesperus?" Or maybe the bedroom has become the laundry room, with clean and dirty clothes strewn around. Another room to check is wherever your parent keeps his or her medications. Do the medi-sets look exactly the same as they did a month ago?

This obviously isn't a complete list, nor is it meant to be. You'll see other things, too. As you make your tour, you'll notice some "themes" running through the home. Does your parent need help with shopping? Cooking? Preparing food? Housecleaning? Laundry? Medication management?

Our elders are notoriously poor reporters. They may say, "I'm great!" when their homes say otherwise. Once you do your tour, discuss your findings and chart a plan.

Tell me about your "tour of dreams." Did you find some surprises? We usually do.

Monday, April 11, 2011

Afraid of Talking About End-of-Life? 'Five Wishes' Helps

Talking about end of life issues with your aging parent can be tough. How do you begin? What do you say?

A powerful booklet called "Five Wishes," can help. Jim Towey, who worked with Mother Teresa for 12 years and spent one of those living in a hospice in Washington, DC, wrote "Five Wishes." Recognized by 42 states, "Five Wishes" aims to help people plan for the time when they might be seriously ill.

The booklet has been called a "Living Will With a Heart." Easy to use, and stripped of medical and legal jargon, it has check boxes and blanks to fill in. You can discuss it together with your parent, tackling the wishes in any order.

The Five Wishes deal with naming a health care agent, deciding which medical care someone wants or doesn't want, specifying their preferred comfort measures, deciding how they want to be treated; and determining what they want their loved ones to know when they pass.

At Evergreen Court Retirement Community in Bellevue, Washington, where I work, we had a Five Wishes presentation by Greg Robbins, Social Worker from Providence Hospice of Seattle, a few weeks ago. Besides the residents, adult children, a pastor and other members of the public came. The response was positive.

Do you have experiences with "Five Wishes?" For more information, contact Aging With Dignity.

Thursday, March 31, 2011

Good Grief! Helping Your Aging Parent Cope With Loss

Your aging parent's losses are legion. (That means many.) But longevity has taught him or her how to cope.

That was the message Chaplain Greg Malone of Providence Hospice of Seattle gave last month to the residents of Evergreen Court, where I work. His topic, "The Care and Feeding of the Human Spirit," explored grief and ways to handle it.

Writing the word, LOSS, on the white board, Malone asked the residents--people in their 70s to 90s--to list the losses they'd faced: mate, mother, father, child, pet, friend, sibling. These elders also mentioned balance, independence, memory, sight, hearing, employment, home.

Wow! Your parent could probably come up with quite a list, as well.

Grieving, though difficult, helps us cope with loss. "If you don't grieve, it sits inside you and comes out in negative ways," said Chaplain Malone.

Singing, crying, telling one's story, participating in counseling, plus praying, writing, and creating are all ways to express grief. The group mentioned they nourished themselves in the midst of loss by serving others, enjoying nature, doing crossword puzzles, and being with people.

We can help our parents deal with their grief by realizing their methods might not be ours. A newspaper food columnist told me she remembered hearing from a frantic reader who had just lost her husband. "I can't find my recipe for apple butter. It was his favorite. And I just have to make it!"

A close relative of mine buried herself in reading while grieving the loss of her husband. In the middle of the night, surrounded by stacks of books, she immersed herself in the words. In the process, she worked through the immense grief page by page.

How has your parent dealt with loss? How do you see your role?

Friday, March 25, 2011

Red Cross Rolls Out New Family Caregiver Training

Are you caring for an aging parent? Whether you share the role with others or shoulder it by yourself, it's not easy. Some say it's a recipe for stress.

Knowledge can help. That's the premise of the American Red Cross' new program, Family Caregiving, being taught nationwide. With eight one-hour sessions, the course covers topics from home safety and general caregiving, to nutrition and personal care, to self-care for the caregiver, to legal and financial issues.

There are two options. Attend a class, led by a Red Cross-certified facilitator, or learn on your own through a modular home study program. Either method allows you to pick and choose any session, at little or no cost.

Are you already involved in a caregiver support group? Family Caregiving can come to you.

I'm personally excited about this program. Evergreen Court of Bellevue, Washington, the retirement and assisted living community where I work, is hosting the Family Caregiving Program, weekly from May 11 through June 15, beginning at 6 pm. A certified facilitator from Always Best Care-Eastside will lead the class.

I plan to publish posts about what we learn. If you'd like to attend, please RSVP by calling 425-455-4333.

To locate an American Red Cross Family Caregiving training, contact their directory.

Sunday, March 20, 2011

Penny-wise Advice About Medicap Policies

Suppose your aging parent decides to save money by dropping his Medicare Supplement. What do you do? Joy Nicholson-Kane has a ready answer: "Just say 'No.'"

Nicholson-Kane is a social worker at Skagit Valley Hospital's Kidney Center in Mount Vernon, Washington. Working with elders and their families daily has convinced her of the value of Medicare Supplement plans. They're also called Medigap plans.

"The biggest mistake people make in dealing with Medicare is not buying a supplement. People are sure Medicare will cover all their medical expenses, but it won't," she says.

If people depend solely on Medicare coverage, they could be paying hundreds--or even thousands of dollars out of pocket for things like hospital, nursing home, and home care costs.

Here's how these plans can help your parent.

In the hospital: Most Medicare supplements pay the $1,132 hospital deductible. Without a Medicap plan, your parent is out $1,132.

In a nursing home: If your parent is sent to rehab after hospitalization, Medicare A pays in full for the first 20 days. For day 21 and thereafter, there's a daily coinsurance of $141.50. Most Medicare supplements cover this; without such a plan, your parent pays out of pocket.

For medical appointments, therapy, and home health care: After a $162 deductible, Medicare pays 80%, leaving your parent with 20% unless he has a supplement.

All Medicare supplement plans are not alike, however. Ten plans are categorized from A through J. They vary in cost and coverage. Nicholson-Kane advises her patients to purchase an F plan, because its coverage is the most comprehensive.

For more information about these kinds of plans, contact State Health Insurance Assistance Programs (SHIPS). This federally funded national program has trained telephone counselors who can give advice on your parent's insurance options.

Sunday, March 6, 2011

Your Aging Parent and the Age-Old Generation Gap

A balanced blog works on a formula: 85% information; 15% sales.

Today I'm pitching me--I love to speak to Boomers on issues relating to their aging parents. If you need a presenter, I'm ready, willing and able!

Now for information. Remember the 60's term "Generation Gap?" Does it generate images of long-haired Hippies and finger-pointing parents? That term came up last week in a presentation I gave to 40 Boomers at First Free Methodist Church in Seattle. We were finishing a series "Understanding Your Aging Parent."

"Does a generation gap exist today?" I asked. Together, in a lively discussion, we came up with the answer. Yes. Fortunately, we're older and wiser now than in the Flower Power Days and more willing to examine the events that shaped our parents' view of the world. With hindsight, we can also better understand ourselves.

Our aging parents want RESPECT. They survived the Great Depression and World War II--both periods of national sacrifice. One 83-year-old resident of Evergreen Court, where I work, told me,"As a kid I remember standing in soup lines. And one day I had a tooth pulled in a government-run dental clinic. Without Novocaine." In the same breath, she said, "My mother did the very best she could."

Later in World War II our parents rallied their support in countless ways. They lost limbs, siblings and friends, while learning respect--for clergy, the military and authority. Afterwards they sacrificed to build longstanding marriages, forge lifelong careers and send us to college. No wonder they value RESPECT, even today.

Our key value as Boomers is APPRECIATION. During our growing up years, unity and respect for authority gave way to change and turmoil, beginning with the assassination of President John F. Kennedy--remember that fateful day?--and continuing with the Civil Rights and Women's Movements, the Viet Nam War and aftermath. We finally calmed down, but even today, we are less committed to the term respect. Our word is appreciation. We want to be thanked for our contributions, appreciated for our good work, praised for our helpfulness. Convinced of its value, we find it easy to give others appreciation.

Our understanding of these values can help bridge the generation gap. We can show respect, our parent's key value, by being on time to appointments or by keeping them apprised if we can't do something we promised. We can keep them in the loop--about medical issues, about income tax, etc. The biggest thing we can do is minimize our expectation about receiving appreciation for our role in their lives. They may not say, "I'm so thankful for all you do for me," or "I truly appreciate you." We can get our appreciation fix from our peers. Our parents just need our respect.

Saturday, February 26, 2011

My Eldercare Blog Turns One Year Old!

A Boomer's Guide to Eldercare is a year old! Like the mother of a toddler who stuffs an entire piece of birthday cake in her mouth, I'm beaming!

Help me celebrate. I'd love to hear from you as I toddle along into the second year. I promise I won't be a "terrible two" next time.

Here are several of my most popular posts. Enjoy! They're less fattening than chocolate cake.

Help! I've Lost My Way Finding a New Place for Mom


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

How to Sell Your Parent's Home in Seven Days

Before Using a Senior Care Referral Agency, Ask These Questions...

Friday, February 18, 2011

'Affordable' Senior Housing--Three Models

"Affordable Senior Housing" isn't a marketing term. It describes housing for low to moderate-income elders that offers clean, well-maintained apartments at a low price. Perhaps your aging parent might be interested.

Nationwide,low-budget senior living options take many forms. While they all have age and income limits, they differ in terms of cost, sponsorship, services and amenities. Here are three models in the Greater Seattle area.

HUD Affordable Housing--Northaven Retirement Apartments in North Seattle, offers more services than most HUD communities. Its 194 apartments have "market rates" rents from $468 to $624. Even lower rates are possible for those with incomes of $18,000 or less. The biggest plus about Northaven are the extras--one meal each weekday for $125 a month, plus housekeeping, transportation and on-site assisted living.

Other Income Qualified Apartments--Woodlands at Forbes Lake in Kirkland, Washington, offers subsidized senior housing of a different sort. A newer building, it has spacious common areas including a library, dining area, kitchen and computer area. Apartments are larger than found in HUD housing--no studios. Rents range from $726 to $1050, well below market. This community is owned by SHAG (Senior Housing Assistance Group.)

Full-Service Retirement Community--Evergreen Court in Bellevue, Washington, is a retirement and assisted living community for low to moderate-income seniors. With three meals a day, weekly housekeeping, transportation and activities, it fills a unique niche in this region. Besides retirement living, ranging from $1712 to $2446 for spacious one and two-bedrooms, assisted living is also available.

Affordable senior housing takes other forms: vouchers and apartments set aside for low-income people within a building which is otherwise market rate.

To find affordable senior housing in your area, contact your senior services department.

Wednesday, February 16, 2011

Is 'Affordable' Senior Housing in Your Parent's Future?

For many elders on limited incomes, "affordable senior housing" is a magical term. It promises low and/or subsidized rents, plus services and social contact. Perhaps it's an answer to your aging parent's prayers.

Low-income senior housing began in the early 60s with the HUD model. More recently other subsidized programs have sprung up nationwide to fill in the gap between fixed incomes and rising rents. These affordable options have the following characteristics:

Location: Affordable housing programs are often located near bus lines, hospitals, medical clinics, senior centers and shopping.

Services/Amenities: Most affordable senior apartments don't have a dining program. They offer limited transportation--trips to the grocery store, senior center, and infrequent excursions. Monthly potlucks, frequent card and game nights, and exercise classes are examples of calendar items and are generally led by volunteers. With notable exceptions, assisted living is not usually located on campus.

Age Qualifications: In most communities, residents must be at least 55 or 62. Some affordable senior apartments accept disabled younger people.

Financial Qualifications: Eligibility is based on a percentage of the median household income of the surrounding area. For example, in Bellevue, Washington, where I work at Evergreen Court Retirement and Assisted Living Community, our residents qualify for the tax credit (subsidized) program if their income is not more than $36,000 for a single or $41,100 for a couple. That number is 60% of the median household income of King County.

The next post will profile three different kinds of senior affordable housing. Stay tuned!

Sunday, February 6, 2011

Do You Know Your Aging Parent's 'Love Language'?

Valentine's Day is coming! What a perfect season to dust off The Five Love Languages, Gary Chapman's best-seller from 1992. Initially aimed at married couples, the book's popularity continues today. There are hundreds of discussion groups and spinoffs including The Five Love Languages of Children and The Five Love Languages of Teenagers. Chapman's premise is useful in any relationship, including with our aging parent.

Chapman asserts that everyone has a primary "language" to give and receive love. Those are: acts of service, quality time, giving and receiving gifts, physical touch and words of affirmation. When we undertand our aging parent's primary love language, and give him what he needs, he receives a sort of electronic shock in his soul.

The key is identifying your aging parent's "language." If she gives love in a certain way, she will likely appreciate receiving in that same language. Here's how the love languages work in some of my family members.

1. Acts of Service: Grandpa Harley, a man of few words, mowed the church's lawn, tended to the flowers and quietly prayed for the pastor every Saturday night. He appreciated Grandma Lena's incredible meals and help with domestic chores.

2. Quality Time: My father-in-law enjoys taking friends and family out to lunch. He loves an invitation to our extended family dinners.

3. Receiving Gifts: Every chance she gets, my mother-in-law brings all of us homemade jam, soup and other goodies. She appreciates cards and gifts and hand-colored pictures from the grandchildren.

4. Physical Touch: Carolyn, our hugging relative, can't let five minutes go by at a family gathering before she corners the kids and anyone else within reach, giving them a bear hug. Obviously, she likes to receive them, too.

5. Words of Affirmation: Uncle Dale is a "connector." When he introduces people, he affirms each person with positive comments about their achievements. He appreciates the same.

Try to observe your aging parent. Can you guess their primary love language? Their secondary one? Tell us about it.

Monday, January 24, 2011

Surprise! State Surveyors Pay a Visit to Your Parent's Nursing Home

Suppose strangers enter your home unannounced. They rummage through your cupboards, financial statements, medical records and more. And then they tell you what's not up to snuff. If your aging parent lives in a nursing home, assisted living or adult family home, that's what happens yearly when state surveyors pay their surprise visit.

Nursing home surveys are the strictest. The licensors look for noncompliance with hundreds of federal and state laws. When they find something wrong, they deem it a "deficiency." Deficiencies can be as minor as finding crumbs in the toaster or as severe as discovering evidence of abuse and neglect.

Surveys in assisted living and adult family homes focus on state laws only, are generally shorter (often two or three days as opposed to four to five for a nursing home), and concentrate on issues relating to quality of life.

Many long-term care employees shake in their boots figuratively when surveyors arrive. Some facilities will hire extra help the day their visitors arrive, so they'll "pass the test." Such tactics remind me of college students cramming for a final exam, hoping the information will enter their brains in time.

You can help the surveyors do their job. They want to know what the facility is like on a daily basis, so they ask mentally competent residents, and family members, too. That's where your valuable input comes into play.

Before finishing the visit, surveyors discuss the results with the staff. If surveyors issue deficiencies, the staff have 10 days to submit a plan of correction in writing.

You don't have to wait until a state survey happens to voice your concerns. In between surveys, the ombudsman is your go-to person if you suspect neglect or abuse.

Do you have experience with state surveys?

Friday, January 7, 2011

Adult Day Programs: Just the Facts, Ma'am

Adult day programs are booming. And for good reason. Similar to children's day care centers, they give caregivers a much-needed break. For the ill loved one, these centers can open doors to the wider world.

Perhaps your aging parents could benefit from such a program. Last week Sandy Sabersky, Executive Director of Elderwise Adult Day Care in Seattle, spoke to a group of senior care professionals. Here are some facts about adult day care, from Sabersky and other sources.

1. Adult day social programs focus on community, friendship and engaging activity. Elderwise is such a program. "The aging person is a whole person," Sabersky says. Her goal is to stimulate the physical, mental, emotional and spiritual parts of the elder's life.

2. A second type of day care, adult day health, specializes in health-related services such as physical, occupational and speech therapy.

3. Programs vary. Some offer drop-in options, others are a four-hour session, from 10 am to 2 pm, etc. Some are designed for elders with memory issues.

4. Adult day sessions often begin with a greeting/coffee time, similar to a supported coffee shop experience.

5. Water color painting, working with clay, and focused discussion on current topics are some of the possible activities.

6. Lunch is included. "We do everything together," Sabersky says.

For more information on adult day programs, check out the National Adult Day Services Association.


Sunday, January 2, 2011

Forgot Your Parent's Caregiver During the Holidays? Try These Free Gift Ideas

In the holiday gift buying frenzy, you may have forgotten your aging parent's caregiver. Though you missed the deadline, you can still remember that special person, without breaking your piggy bank.

The following gifts cost absolutely nothing, except a bit of your time and attention. I've seen caregivers, wait staff and housekeepers beam when they receive these.

1. Give sincere compliments. Does your parent's special person shine when singled out for public recognition? Or do they prefer a quiet whisper? Whatever their style, they'll appreciate your attention.
2. Write them a thank-you note. I have a folder stuffed with notes from adult children and their parents with whom I've worked over the years. Just thinking about those kind words makes me smile. When you write, be as specific as possible, such as, "I so appreciate the backrubs you give my mom. It makes her feel so special."
3. Write a thank-you note to the special person's supervisor. Fill it with glowing compliments about the caregiver's compassion, creativity, dedication, etc. Use examples. Close by asking the supervisor to consider including this letter in the caregiver's personnel file. Mail or hand-carry a copy to your caregiver.

Perhaps you can think of other ways to show appreciation to caregivers and other key people in your aging parent's life. Tell us about them.
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