Monday, December 27, 2010

Is a Continuing Care Retirement Community Right for Your Parent?

CCRC is short for Continuing Care Retirement Community. That's a buzzword for a type of community which works well for many aging parents. Perhaps yours.

In a CCRC, healthy, active seniors typically move into independent apartments. They pay an entrance fee, ranging from less than $100,000 to more than $1,000,000. The entrance fee reduces their monthly rent over what they'd pay in a comparable rental community. When a resident leaves the CCRC, part or all of the entrance fee often is returned to them or to their estate.

As in other communities, residents in a CCRC no longer worry about shopping, preparing meals and doing the dishes. Ditto for housekeeping and home maintenance. With the extra time, they can enjoy fun activities and fellowship with peers. If they give up driving, transportation is available.

A big difference: When independent residents of a CCRC need help with such things as bathing, dressing or medication management, they can move to on-site assisted living. And if they need either long or short-term nursing care, they can receive it in the on-campus health care center. As seniors travel through the system, they'll know the staff and the residents. For many, that brings security.

A CCRC works particularly for several groups of seniors (assuming the entrance fee is within their budget.) See if your aging parent falls into one of these categories:

1. Your parents are both living, but worry how the survivor (usually Mom) will do when the other passes. Typically when a couple moves into a CCRC, they begin developing friendships with neighbors. When a spouse dies, the survivor has support from others who've traveled the same road. Widows or widowers go out to dinner or to movies together. And sometimes, romance strikes the widowed, and marriage follows.
2. One of your parents cares for her spouse, who suffers from a chronic illness. A CCRC offers the healthy spouse help with the domestic duties so she can focus on caregiving. He or she can easily take a break by attending activities and support groups on campus. If the ill spouse needs assisted living or nursing care, it's an easy walk from the healthy spouse's apartment.
3. If you are advocating for an aunt or uncle without children, a CCRC can be extremely helpful. When your relative needs more care, the staff in a CCRC will bend over backward to make the transition as easy as possible.
4. Your mother or dad is alone and needs companionship. All types of retirement communities can help brighten someone's outlook. When I talk to senior clients and their families, I often say, "Retirement living is a little like living in a dorm, sorority or fraternity. There's a difference, though. No wild parties."

Do you have any experience with CCRCs you'd like to share?

Monday, December 20, 2010

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

If you're thinking about employing a senior-care referral agency, you'll need some education. For starters, read "Senior Care Placement Companies Scramble to Cash In," Michael Behrens' report published in The Seattle Times, Dec. 11.

The principle behind this rapidly growing industry is simple. Private agencies "match" seniors who need care with facilities that have openings. The receiving community pays a fee. The family pays nothing.

Behrens' article points out huge problems. Over the last three years 143 individuals in Washington were victimized after companies placed them in facilities that had documented serious violations.

How do you find a credible senior-care referral agency? (Yes, they're out there.) Ask these questions:

1. What are your credentials?

Many senior-care referral agencies are run by nurses, social workers, former assisted living administrators. Find out how long they've been operating and what experience they have working in long-term care.

2. Where do you receive most of your clients?

Some work exlusively on the Internet. Others find their clients from referral sources through networking, through referrals from satisfied customers, plus advertising and the Internet.

3. Do you check facilities often to make sure they have no violations with the state?
Behrens' article notes that one on-line agency, A Place for Mom, placed seniors in facilities with past records of substandard care.

4. How well do you know the facilities that contract with you?

Reputable agencies will have a profile on each contracted facility. They visit them periodically and look for potential problems.

5. How much time will you spend with me?
Internet-based agencies tend to do their business online and by phone. Other agencies will conduct a face-to-face interview with you, schedule tours and accompany you, to help you make your decision.

Do you have experiences with senior-care referral agencies? Tell us about it.

Saturday, December 18, 2010

Eldercare Placement Companies: The Good, the Bad & the Ugly

Panic. Stress. Our parent breaks a hip, suffers a stroke or other malady and can no longer live at home. We search online and find senior-care placement companies making alluring promises. They'll move heaven and hell to help us find the right fit--assisted living, adult family homes or home care. For free.

Not so fast. Last week, the Seattle Times published Michael Behrens'report, "Senior care placement companies scramble to cash in," the most recent in a series "Seniors for Sale." Behrens contends that while some companies do an excellent job in linking seniors with needed care, others have referred families to facilities with documented histories of substandard care.

Analyzing records of the Department of Social and Health Services over the past three years, the Times staff found 143 cases of seniors victimized after companies placed them in a care setting. Mentally ill adults were drugged into submission to control their behavior. Mentally ill adults were locked in rooms to prevent wandering. Bedbound seniors were left without assistance up to 16 hours.

The key problems:

1. Washington and many other states have no licensing, education or training requirements to open a placement agency. (This is a fairly new industry nationwide.)

2. Some companies don't screen for past violations. So a senior can end up in an abusive setting.

3. The largest company, A Place for Mom, sited in the Times report, works exclusively online and by phone. There is no face to face connection between the senior care adviser and the client.

As a marketing and admissions professional for 16 years in various care settings, I've worked with some great eldercare advisors, and a few who have driven me crazy. I've also worked with angry families who completed an online profile "just for the future," only to receive unwanted phone calls and emails from 7 to 8 different care organizations which had received the profile from the broker company, with the strong suggestion that this family wanted immediate placement.

Have you had experience with senior placement companies? My next step will give you questions to ask placement companies before you place the future of your loved one in their hands.

Sunday, December 12, 2010

Ways to Simplify the Holidays, For You and Your Aging Parent

Keep it simple. I've found that an excellent admonition for celebrating the holidays with an aging parent.

To capture the "good old times" your parent may remember, try one or more of these simplified traditions.

If your parent enjoyed attending the Nutcracker, the Messiah or other live musical performances, listen to CDs or DVD's of these favorites together.

If your parent hosted family and friends during the holidays, give him or her a guest book and a tin of cookies or other treats for guests.

If she sang in a church choir, hold a carol sing-along, even if there are only a few of you.

If he faithfully chopped down and decorated the family Christmas tree, take a drive through a lighted neighborhood, stopping for cocoa afterward.

If she filled your Christmas stockings to the max, provide some wrapped candies she can give to the grandchildren and great-grandchildren.

If she baked traditional breads and holiday cookies, hold a family baking session, using her recipes and encouraging her to help if possible.

Can you think of other simplified versions of holiday favorite traditions?

Wednesday, December 1, 2010

For You and Your Aging Parent, Simplicity is Key to Holiday Joy

Simplify. Simplify. Those words of Henry David Thoreau echo in my mind during the holidays, especially when I think about our aging parents.

If I have one piece of advice I've gleaned over the years, it's this: Don't let your parents' medical conditions steal your family's holiday joy.

First, you may want to start a conversation. Ask your parent, "What is most important to you during the holidays?" Just having the discussion honors your parent and may enlighten you as he or she shares memories of long ago.

Together, narrow the list to a few favorite activities that can be done with help from you and your family.

My father, a retired pastor, loved writing family Christmas letters. When he moved to a nursing home, he wanted to continue his favorite tradition. Parkinson's had robbed him of his ability to write. Fortunately, my younger brother Jim pitched in to help compose the letter. Jim's wife and children were enlisted to type, photocopy and address envelopes.

Your parent's list of favorite things will be unique. In the retirement community where I worked until recently, several residents make Christmas cookies every year. Their kids provide ingredients and support. Others in the community attended "The Nutcracker" as a group. Still others enjoy Christmas caroling.

Even if your parent is homebound, he or she may enjoy decorations, holiday music, movies and family recipes.

In my next post, I'll list more specific tips for bringing simple joy to the holidays.

Do you have any ideas you'd like to share for making the holidays special for your aging parent?

Tuesday, November 23, 2010

Your Parent Needs Cheerleaders, Quarterbacks

No matter how long I work with Boomers and their aging parents, I come up short.

As I speak with an adult child, I may paint a glorious picture of when, how, and why their parent might want to consider a transition. In my business, it's a move to a retirement and assisted living community. More than once, though, I've heard, "What you say makes sense. It really does. But I don't think it will fly with my Mom."

Bingo! As professionals, it's easy to forget that we don't have all the answers.

You know what trips your parent's switch, what tries her patience, what makes him grin or brings her to tears. The professionals in your life, whether doctors, nurses, attorneys, or customer service reps are cheerleaders. If they're worth their salt, they'll applaud your efforts and coach you, offering information and advice which has worked for others. They'll also give kudos to your parent!

When you're firm about your parent's desires, telling them, "No thanks," hopefully they'll back off their agenda and move to the sidelines. You're the quarterback, the one who makes the plays.

Cheerleaders? Quarterback? Your parent needs them both, on Thanksgiving and all year long. Happy Thanksgiving to you, your aging parent and your entire family.

Monday, November 22, 2010

Meet Your Parent's 'Guardian Angel,' the Long-Term Care Ombudsman

If your parent lives in a care setting--assisted living, adult family home or nursing home, chances are you worry. You can't be with him or her 24-7. You wonder, "Are his or her care needs being met?" and, "How can I be sure he or she isn't being exploited?"

You and your parent need a guardian angel, someone who can right the wrongs and fight for those who can't speak for themselves. Fortunately, there is such a person, called a long-term ombudsman. Assigned to your parent's health care center or assisted living community, he or she will visit, help solve problems and work to make changes at the local, state and national levels.

The National Long-term Ombudsmen Program is active in all 50 states and operates under the authority of the Older Americans Act. Each state has an office of the State Long-Term Care Ombudsmen, which oversees the work of the local paid and unpaid staff.

I spoke to a local ombudsman not long ago. A retired nurse, Bonnie, like other ombudsmen, has a heart for older people, especially those in care settings. Much of her job involves visiting with residents in her assigned nursing home. When problems arise, they feel comfortable to go to her.

If you don't know your long-term ombudsman, introduce yourself. He or she is especially trained to investigate complaints of family members, too, with a goal of helping improve the atmosphere for all.

Do you know your long-term care ombudsman?

Sunday, November 14, 2010

Your Parent Says, 'Slow Down, You Move Too Fast!'

Does your aging parent say anything like:

"You walk too fast!"
"You work too hard."
"You need to slow down."

I've heard these admonitions again and again from my elderly clients and my aging parents. Why? Their perspective is often worlds away from ours.

We Boomers are on fast forward, juggling jobs, relationships and generations. Our eyes are on the future, as we plan for vacations, dream of retirement or just anticipate the next challenge. Completing to-do lists and achieving goals is what we're wired to do.

Our aging parents, on the other hand, seem to have one speed: slow. If we're the hare, they're the tortoise, pondering each move. Weak legs, winded breath and pain dampers their physical progress. Their thinking is slow, too, deliberate and reflective. Everything takes longer: from doctor's appointments to shopping trips to decisions.

This pacing difference frustrates both generations. Some coping ideas I've picked up over the years:

1. Match your pace to theirs. At the first retirement community where I worked years ago, I kept hearing, "Alice, you walk so fast." That was a shocker! I'm 5'3". No one had ever accused me of speedwalking. But I decided if I wanted to connect, I needed to slow down. Ditto with my parents.

2. Don't overschedule. When planning activities with my aging parents, I had to divide my to-do list in half. One major event in a day was more than enough.

3. Let them ponder. If there's a big decision, like moving to a retirement community or bringing in home care, discuss the pros and cons but don't expect an immediate reaction. Leave literature with them so they can think about ramifications. That way, they can ponder on their own schedule.

Do you have any other ideas on slowing your pace or adjusting your speed for your aging parent?

Sunday, November 7, 2010

'Shopping' for Medicaid? Save Time With These Tips

Perhaps your parent needs a health care setting accepting Medicaid. The bad news is they're not located like Starbucks on virtually every corner. The good news is if you do your homework, on the phone and online, you can cut hours off your search.

Lists of assisted living communities, adult family homes and nursing homes accepting Medicaid are available from local agencies through a national government-funded website, Eldercare Locator. Look first within a half-hour's drive of your best destination--you may have to drive even farther to find current Medicaid availability.

Pick up the phone and ask:

1. Are you currently accepting Medicaid payment? Situations change, and your list may be out of date. If the answer is yes, ask:

2. Do you have any Medicaid openings today or in the near future? If the answer is yes, ask when you can tour. If not, ask:

3. Can we join a waiting list for Medicaid openings? (Ask this only if your parent can wait for placement.) Otherwise ask: Do you know of other communities or health care settings that might have current Medicaid openings?

Many communities give first priority to their existing private paying residents who run out of money. Some communities actually insist that new residents pay privately for a specific time period--often a year or two--before converting to Medicaid.

Once you've narrowed the field by phone, visit communities personally. If it's appropriate for your parent to join you, take her with you to the top two or so. Once you find something suitable, don't delay.

Be patient and flexible. Medicaid openings are few and far between, so don't expect to find a community five minutes from your home. Good luck!

Can you tell us about your journey looking for a Medicaid opening for your aging parent?

Sunday, October 31, 2010

Your Aging Parent Can't Attend Church? Tips to Foster Her Spiritual Health

Perhaps in days gone by your aging parent faithfully attended church. His or her devotion to God leavened every part of life: from praying and reading scripture, to visiting the sick, to serving and giving financially to the church or synagogue.

Today health issues may make church attendance impossible. Yet there are other ways to encourage your aging parent in his or her walk with God. Everyone is different, though, so I suggest you ask your parent, "How would you like to try ...?" before proceeding with any of the following ideas.

Some I've used some with my own parents. Other ideas come from adult children in the retirement and nursing homes where I've worked.

1. Your aging parent needs spiritual community. Worshiping God doesn't usually occur in a vacuum. If your parent has a connection with a congregation, a minister may arrange person in-home visits. Catholic parishes often train lay eucharistic ministers to take communion to the elderly. If your parent lives in an assisted living or nursing home, check into scheduled worship services, Bible studies or rosary groups.

2. Your aging parent needs inspiration. For many, the comforting words of the Bible are an anchor of hope in the midst of pain and suffering. When Daddy was struggling with Parkinson's in a nursing home halfway across the country, our family recorded his favorite Scripture verses. He enjoyed listening as our voices read those familiar, beautiful words. Other sources of inspiration for your aging parent are large print copies of devotional and inspirational magazines including, "The Upper Room," and "Guideposts." Inspirational DVDs, radio and television programs can also help fill the spiritual gap.

3. Your aging parent may need to be needed. Does that sound funny? As a retired minister, my dad wanted to continue to serve, even though his body didn't always cooperate. The Nurse Manager on the night shift called him when other residents showed anxiety. His prayers had a calming affect. Depending on your parent's physical and mental condition, his or her spiritual gifts may range from a thank-you note to a pastor, to a get-well-card to a friend who is hospitalized, to a hug and a knowing smile that says, without words, "God is here." And don't forget their prayers. My parents prayed for me and my family daily, and I was blessed.

4. Your aging parent may surprise you. Sometimes dormant faith springs to new life when nurtured, even in an older person. The mother of a friend was very religious in her early years, but shelved her faith in mid-life. Not long ago, at the invitation of a friend, she began attending church once again, exhibiting newfound fervor. "God works in mysterious ways," my friend says.

How have you endeavored to support your parent spiritually?

Tuesday, October 26, 2010

Suffering From 'Compassion Fatigue'? Here's Help

Do any of these sound like you?

1. Your aging parent's needs are ballooning, and your patience and energy are eroding.
2. When the phone rings past 10 pm, your blood pressure spikes, and your first thought is, "Is Mom OK?"
3. As a professional working with elderly clients and their families, your day is often punctuated by crises.

Can you relate? If so, you're at risk for stress overload, also known as caregiver burnout or compassion fatigue. The good things you do for your parents--or your clients--may be great for them but bad for you when done in excess, setting you up for illness.

How do you combat burnout? Rob Luck, Director of Social Services and Special Programs for Providence Hospice of Seattle, addressed this earlier this year at Seattle Senior Care Coalition, a group of professionals serving seniors and their families. He offered these suggestions.

1. Maintain boundaries. The Bible says it this way: "Let your 'yes' be 'yes' and your 'no' be 'no.' Set limits on your time, your work, your thoughts to keep balance in your life.
2. Create a written plan of care for yourself. Luck suggests we develop a personal mission state which includes four or five key values, such as intimacy, self care, spirituality, etc. For each value, plan daily activities. Exercising at the gym and scheduling doctor's appointments fall under self-care. Spending time with a spouse and children go under intimacy. For more help with mission statements, see Stephen Covey's Seven Habits of Highly Effective People.
3. Foster some sort of spiritual center, however you define it. Luck says that tapping into something bigger than ourselves will give us strength to work for our parents and still keep other parts of our lives intact. "The work we do (with our parents and our clients) is sacred," says Luck. "But so is caring for ourselves."

Do you have any suggestions for avoiding burnout?

Monday, October 18, 2010

Your Aging Parent Has Two Developmental Tasks

A toddler's "No!", a teen's rebellion, and your aging parent's attempts at control are all related to developmental tasks we tackle at key stages in life.

David Solie's well-written book, How to Say It to Seniors, discusses two main tasks of elders that are at once conflicting and potentially frustrating to us. Understanding our parents' developmental challenges, he says, will enable us to improve our communication and our relationship.

Your parent's first goal, says Solie, is to maintain as much control as possible, in the face of a litany of losses: of physical strength, friends and financial status, to name a few. Piled on top of each other, these losses often prompt him to cry, "No!" in toddler-style, figuratively stamping his feet, even to ideas that seem reasonable. Meanwhile our developmental agenda compels us to get things done, make decisions and act on them. As Solie says, "Our drivers can clash with theirs that compel them to hang on tight and to reflect."

The best tact is to avoid power struggles and to go with our parents' wishes whenever possible. If they are firm about wanting to stay in their home, for example, we may need to orchestrate an array of services to make that happen. Assuming that's possible.

Sometimes just giving our parents space and grace will enable them to make an informed decision that's right for them. Not long ago I met a 90-year-old woman who struggled with hoarding. Her home and furnishings were growing mold, with possessions and paper piled everywhere.

"By winter the house won't be inhabitable," her son said. Another issue: her failing memory. But Mom dug in her heels when he mentioned moving. A few months later, given time, patience and numerous visits, she called me: "I've decided to move into the apartment you offered."

Your parent's second developmental task is to preserve a legacy. "Every day, every hour, whether they mention it or not, the seventy-plus age group is reviewing their lives," Solie says. Consciously and unconsciously, they ponder how and by whom they would like to remembered. They repeat the same stories again and again in great detail, not so much for the facts as for the inherent values. And they often take a long time to make a decision.

Solie's biggest piece of advice is so listen to our parents. Really listen. If we do, we may pick up on what values they cherish. We may have the opportunity to watch the unveiling of a legacy right before our eyes.

Monday, October 11, 2010

Eldercare Blog Celebrates the Big 50--Posts, That Is

Whoo Hoo! On September 27, Boomer's Guide to Eldercare passed the 50-post mark.

I started in February with one goal--to provide help and hope to Boomers as they relate to their aging parents. This first "season," if you will, has stretched my mind as I've researched, interviewed experts and tapped into my 14-plus years in the eldercare field.

But blogging isn't about me. It's about you and your needs for help as you care for your aging parent.

According to Google Analytics, your favorite posts are:

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

2. Help! I've Lost My Way Searching for a Place for Mom

3. Three Kinds of In-Home Care

4. Can Your Parent be Happy in a Nursing Home?

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

Check them out, if you haven't read them yet.

Got any ideas for further topics? I'd love to hear from you. In the meantime, I'm ready to tackle another go-around: learning about how to understand our aging parents and ourselves, how to better communicate, and how to advocate.

Monday, September 27, 2010

Eldercare Tips: Finding a Great Adult Family Home

Adult family homes, also called group homes, recently took a hit in the press with Seattle Times' "Seniors for Sale." The five-part investigative report released in February and Sept. 4 and 5 uncovered widespread abuse and neglect in this ill-regulated and rapidly growing industry. My previous post examined the findings.

What does this mean for you if your aging parent needs care, and you want a small, homelike setting? Excellent adult family homes do exist, provided you do your homework.

Some ideas:

1. Once you find your desired location, do an Internet search to find several addresses. Or ask friends or associates for referrals. Drive by each home and look closely. Is the home in good repair? Is the grass mowed? Little things count.

2. Visit each home several times, at least one announced. Try to arrive at mealtime to observe the quality and quantity of the food. Are staff and residents enjoying one another? Or do residents seem stressed? Does the home look and smell clean and fresh? What about activities? Music? Look at the entire home, staff and program in the light of your parent's needs.

3. Ask the owner, manager or other representative to show you the most recent state inspection report. If you need help interpreting it, ask a friend in the medical field.

4. Call the Long Term Ombudsman in your area to see if any complaints have been filed recently against the home. Ombudsmen work to resolve problems of individual residents and to work on the local, state and national levels to improve care.

5. Contact the Better Business Bureau to check out the home's record.

6. If these steps sound like too much work, consider contacting an eldercare referral agency or a geriatric care manager. Both can be of help in locating a good fit.

Do you have personal experience with a good group home or a bad one?

Monday, September 20, 2010

Eldercare Tip: With Adult Family Homes, It's 'Buyer Beware'

Choosing an adult family home, or group home, for your aging parent can be dicey. Nationwide, this 20-year-old phenomenon is touted as cheaper and more homelike than a nursing home. But better?

That depends. Clean and comfortable, a well-run adult family home is staffed with consistent caregivers who love and understand the elderly. In such an atmosphere, music, nutritious meals and activities will fill your parent's day.

Finding such a place requires diligence. State regulators can't keep up with the pace of this rapidly growing industry, making it easy for ill-trained, money-grabbing owners to exploit the elderly and their families.

So says The Seattle Times. Last week it published the fourth and fifth segment of the investigative series "Seniors for Sale," a critical examination of adult family homes in Washington State. Earlier segments ran in January.

In reviewing years of state records, the reporter, Michael Berens, noted that of the 11,200 residents living in the state's 2,843 homes, thousands have been exploited financially or harmed by unqualified caregivers. He reported accounts of victims imprisoned in their beds at night, strapped to their chairs during the day or left without proper medical treatment for weeks.

In scores of cases, the report continued, owners collected monthly payments while playing the miser. They eliminated meals, turned off heat or left residents in soaked clothing for days.

The abuse and neglect mentioned above, as awful as it is, doesn't tell the whole story. Earlier this year I met an 80-something man named Paul at Northshore Senior Center. He lives in one of three adult family homes in the Shoreline, Washington, area, owned by Laura Cirves, RN. They're called For Senior's Sake.

Once a week Paul goes dancing at the senior center, thanks to transportation provided by the adult family home. Other times he and the other residents go out to lunch and attend baseball games. They receive manicures and permanents. Live musicians perform weekly.

Laura's homes are licensed for residents with dementia and mental health issues. Despite their medical diagnoses, the residents get every chance at life possible.

"My mission is to increase the quality of the lives in my care," Laura says.

The next post will give some guidelines in choosing an adult family home.

Sunday, September 12, 2010

Eldercare Dilemma: Grandpa Tells the Same Stories Over and Over

Does your aging parent lapse into stories at the drop of a hat? And does he or she repeat the same ones again and again, in great detail?

Grandpa Jake certainly does. When he tells of receiving his first pony, a Shetland named Bill, on his fourth birthday, he travels back in time. From that day on, Jake and his pony were inseparable. "A silly name for a horse," Jack recalls. "Lightening would have been better."

Jake has told this--and other stories--so many times that his family is not only bored; they're worried. Do repeated stories signal dementia? Or an unnatural drawing inward that is unhealthy?

Not so, says David Solie, author of "How to Say It To Seniors." He contends repeated stories are a vehicle for completing a key developmental task: the building of a legacy.

At the end of life, people want to be remembered for their time on earth and cherished by future generations, Solie says. They review the happenings of their lives and consider how those events figure into the way they want to be remembered.

That's where the repeated stories come in. And the detailed rendering of the events, Solie says. More important than the facts are the underlying values--building bricks of their legacy.

In Grandpa Jake's story, the thrill of receiving his horse may have explained his value of gratitude--both as a child during the Depression, and during the rest of his life. A lifelong love of animals may have caused Jack to repeat the horse story again and again. As the story is repeated, other life values may surface, evident to him and his family.

Bottom line: When our aging parents repeat stories, they are in the process of creating a legacy. We need to listen respectfully not just for the facts but for possible themes.

"Tell a similar story from your own life," Solie also suggests.

Connection is everything.

Does a senior in your life tell the same stories again and again?

Sunday, September 5, 2010

Eldercare Jargon Translated Here

Eldercare jargon is alive and well on Planet Earth--unfortunately. Senior Care Professionals often sprinkle their conversations with words which carry no meaning to you and me.

An elderly woman commented recently on the brochure I sent her about retirement living: "I have one question. I'm not sure what 'congregate living' means. Does it have to do with religion?"

Oops! I thought to myself. The word "congregate" is a little like the word "congregation." But that's not what I had in mind. In my brochure I'd committed the unpardonable sin of slipping into eldercare jargon without thinking. After owning my misdeed, I translated: Congregate living is retirement living offering meals, housekeeping, transportation and activities.

Here are other examples of eldercare jargon you may hear as you care for your elderly parent.

ALC--After 14 years working in this field, I heard this recently from a professional. "I often give talks in ALC's on veterans' benefits." When I asked the meaning of an ALC, she said, "ALC is an assisted living community." Really!

Interdisciplinary Assessment--It's a nursing home term. During the first 14 days of residency in a nursing home, all departments come together to report on the new resident's needs and determine how those will be met.

Transfer--This has two meanings. The first obvious meaning refers to an elderly person moving from one care setting to another, such as from an assisted living community to a nursing home. Transfer also refers to the process of getting up from a sitting or reclining position. If your parent is a two-person transfer, he needs two other people to help him get up.

Respite--In a broad sense, this word means "rest," usually for a caregiver. This usually takes the form of bringing their loved one to a care setting temporarily, so the caregiver can take a break.

Discharge--No, this doesn't refer to bodily fluids. It has to do with leaving a care setting, such as being discharged from a hospital, a rehab center or a nursing home. Sometimes discharge happens because the person needs more care; sometimes because the person's health has improved.

Spenddown--This occurs when your parent's limited funds are paying for health care and will soon run out. Yet he or she is not yet eligible for Medicaid. Each state has rules about how funds can be spent during this spenddown period.

Have you encountered other examples of eldercare jargon? Please share.

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.

Wednesday, July 28, 2010

Eldercare Tip: Making Visits to the Care Center Memorable

When you visit your aging parent in a care center, the cat can get your tongue. First, the pleasantries. Then the silence. What happened to those '80s platitudes about 'quality time'?

Fortunately we Boomers are creative. Here are 10 simple activities that may add zip to your visits. Most are geared for elders who are alert and oriented. Others may stimulate those with dementia as well.

1. Bring a loved one. Two is company; three or more is a party. Just the presence of another will brighten the visit and lighten your emotional load.

2. Add a child or more, preferably a grandchild or great-grandchild, and your group will gather a following. Add a baby and presto! Your aging parent will go gaga.

3. Bring small items to entertain the little ones--bubbles, balls, crayons and color books. Don't forget toy cars and dolls. Watching the little ones play will engage your aging parent.

4. Let your elderly parent play the host (or hostess.) Purchase a guest book and invite everyone who visits to sign and date it. That includes care staff workers, clergy and children. When you come again, open the book and ask about recent visitors.

5. Have a family sing-along. Try almost anything from "Row, Row, Row Your Boat" to "Let Me Call You Sweetheart" to "Amazing Grace." The public library and the care center's activities director may be able to provide CD's to help. My most treasured memory of Grandma Ethel was hearing her sing "Jesus Loves Me" long after she ceased to recognize us and after she had stopped talking.

6. Bring in your aging parent's favorite food,either home-cooked or takeout and eat together in the family visiting room. Better yet, plan a family potluck in which members all prepare Grandma's family recipes. As you eat, share memories revolving around the special dishes.

7. Root, root for the home team. Watch your favorite Major League team in your parent's room or apartment. Don caps and other sports regalia and call on the little ones to serve as pint-sized cheerleaders. And be sure to sing "Take Me Out to the Ballgame."

8. Get glued to the tube. Watch television classics together, whether "The Lone Ranger," "Mickey Mouse," or movie-length blockbusters like "Sound of Music" or Shirley Temple flicks. Bring popcorn, soda pop and movie candy.

9. Take a walk outside. The sunshine is a wonderful boost for a loved one spending day after day in a care setting.

10. Pray together. Everyone can take a turn, thanking God for the many blessings.

Can you think of other activities which have made your visits memorable?

Sunday, July 18, 2010

Eldercare Help: Three Kinds of In-Home Care

"I'm staying home until the undertaker takes me out."

If similar words have popped out of your aging parent's mouth, he or she is in good company. Until recently 85% of seniors said they wanted to remain home until they died, according to senior care national statistics. Today that number has swelled to between 91 and 92%.

Multiple reasons make "home sweet home" a natural choice. There's the draw of the familiar house, neighborhood, social connections and services. Add in other factors: new technology, a slow economy, and the availability of in-home help, and voila. A recipe for "staying home for life."

As your parent's health wanes, in-home help may become necessary. The dizzying array of choices falls into three types:

Chore Services--Yardwork, housecleaning, shopping, cooking and transportation all help seniors stay independent. These basic services cost relatively little--approximately $10 to $15 an hour. Sometimes there's no cost. In the Seattle area, Catholic Community Services trains volunteers from congregations to help low-income seniors remain at home. The program is called Volunteer Chore Services. Seniors of all incomes in the Greater Issaquah and Sammamish area are helped at no cost by another volunteer-based organization, Faith in Action. Other similar programs operate throughout the country. Related to Chore Services are Companion Services which provide a "watchful eye" to seniors with memory deficits.

Home Care--Trained caregivers help with bathing, dressing, grooming, toileting and other personal needs, as well as providing light housekeeping, meal preparation and chore services. These agencies employ their staff and provide benefits and training. The average hourly charge is between $20 and $25, and often there is a four-hour minimum charge. Home care agencies differ in the kind and amount of training they give workers and in the experience they require for hiring. Seniors Helping Seniors, a national company, hires only people age 50 or over.

Home Health Care--This is the highest level of in-home care. Home Health Care services are provided intermittently as needed by licensed nurses, physical therapists, speech therapists, medical social services, etc. A physician must write orders and people must be homebound. Medicare and insurance plans cover these services. People can also pay privately.

Have you had a positive--or negative--experience with in-home care services? Tell us about it.

Saturday, July 10, 2010

Eldercare Tip: When Choosing a Nursing Home, Be Wary of Advice

Choosing a nursing home is a race against time. In "The Greatest Race" style, the hospital social worker sets the rules. From the crack of the gun (not literally), you have one or two days to look for clues and find the right place.

How do you choose a good nursing home for your aging parent? Following a friend's advice may work. But don't take it as gospel truth without investigating, especially if his or her report isn't recent. Neither can you assume the nursing home your parent used for rehab three years ago is still a good choice.

Claudia Kelley, an occupational therapist with the State of Washington, spent more than a decade working in health care centers. But she admits she was caught off guard when her grandma was hospitalized for the second time. The family had been pleased with Grandma's earlier rehab experience at Nursing Home A, so they automatically chose it again.

"I couldn't believe the difference. You'd hardly know it was the same building," Claudia said. Between Grandma's two stays, administrators had changed. Organization plummeted, and staff now spent more time gossiping than caring for residents.

How do you check on a nursing home that you've been pleased with in the past or a friend has recommended? Some suggestions.

1. Call the nursing home and ask, "How long has your current administrator been working there?" or ask, "Is Administrator Jones still overseeing care?"

2. Double check your experience or your friend's recommendation by visiting the Medicare website which rates nursing home quality.

3. A personal visit is always a good idea, if possible.

Do you have any other suggestions for choosing a nursing home?

Wednesday, July 7, 2010

Eldercare Truth: All of Life is Junior High Recycled

Granted, elders are each unique. But as Art Linkletter says, "They say--and do--the darndest things."

See if you recognize your aging parent in any of the following:

1. Elders can be unpredictable. Cupid can strike willy-nilly, turning widowed 80-somethings into old versions of love-struck teens. At our retirement community we witnessed three marriages in one year. Sweet-talking and hand-holding led to quickie marriages, with grown children reeling in shock, initially. "It was sort of like a shotgun wedding without the baby," one Boomer said. Everyone adjusted, though, and it was fun to see the newlyweds coo and glow in their newfound love. But definitely unpredictable.

A different example of unpredictability involves autos. One day 96-year-old Ethel announced, for all to hear: "Alice, I have a surprise. Can you guess what it is?" I wondered. Had Ethel's car suffered one more owie? Her nephew had tried for years to convince her to give up driving.

"I've decided to contribute to the public good, to do my duty to my community," she said with a smile. "I won't be driving anymore." Who could have predicted her sudden change of mind? Her decisiveness reminded me of my two-year-old son who potty trained himself after months of my coaxing and "training." Unpredictable? Ya betcha!

2. Seniors sometimes see themselves as invincible. One morning I walked outside our community and spotted a 92-year-old resident standing on the top rung of a ladder which leaned against his cottage apartment. Tempted to yell, "Get down right now!" I tried to collect my thoughts before asking, "Are you OK? I get scared when I see you up there. You could fall." What was he doing? Watching a workman repair the roof on the sunroom. This elderly macho man assured me he was safe. After all, he had experience with ladders--40 years ago.

Ditto for the invincible elderly golf cart enthusiasts who began zipping down the sidewalk next to the nursing home. Picture the glee in their eyes as they zoomed around the corner. Staff, and frail residents with walkers, were not as entertained.

3. Our elders give us great stories to tell. You have your own sagas starring your elderly parents. Heartwarming, touching, hilarious, your stories can bring you to tears--or to laughter--when you share them with others, especially your kids and grandkids. Such tales bond generations.

Is life like junior high recycled? Or toddlerhood replayed? I think so. These periods of life revisit us unbidden, whether we're 14, 40 or four score and 10.

Do you have any stories starring your aging parent you'd like to share?

Thursday, July 1, 2010

Your Aging Parent Needs a Great Advocate: You!

Everyone needs an advocate. Especially your aging parent.

The value of advocacy hit home with me a decade ago. Home alone on a Saturday, I slipped down the stairs while attempting to carry out the trash. Boom! A broken ankle. The four-hour wait in the emergency room was easy street compared to Monday morning when I phoned for a referral to an orthopedist.

"The referral manager doesn't work Mondays," said the young woman. The Vicodin had eased my pain but muddled my brain. I was a health care professional, but the words I needed escaped me. Finally I blurted out:

"Someone in your office should be able to facilitate referrals, even on Monday."

Hours later, after many phone calls, I sat in the orthopedist's office, thinking to myself, " I really need an advocate."

So do our aging parents, on an ongoing basis. We interpret life, speak for them to authorities and serve as their cheerleader. Several qualities will help us do our best in the advocacy role.

1. Compassion. Good advocates place the welfare of their parents above everything else. Money, power and selfishness are cast aside. That doesn't mean we don't make mistakes, get tired of the role, or sometimes wonder, "How did I get into this?" But our mission--to help them finish life well--enables us to advocate well.

2. A Desire to Learn. There are so many bodies of knowledge to master: legal, financial, medical. The more we know, the better questions we can ask of the doctors, financial planners, lawyers and others in our parent's lives. The more we know, the clearer we can communicate with our parents.

3. A strong sense of ourselves. This is not to be confused as selfishness. But knowing who we are will keep us from being stepped on by others, including our siblings or our parents.

4. A willingness to ask for help. Advocacy sometimes is more than one person can bear. Finding partners--paid or unpaid--to share the load eases our burden. In addition, taking a break--for a few hours, a few days, or even a few weeks--can help us come back to our parents refreshed and renewed.

These qualities don't come packaged for us to unwrap. We develop them by seeing other advocates, and by doing the job ourselves. As our mothers said, "Practice makes perfect."

What is your most difficult task or role in serving as an advocate for your aging parent?

Friday, June 25, 2010

Eldercare Tip: Medicaid Q-A

Perhaps, like many Boomers, you worry about money. Especially when your aging parent's health begins to fail. Medical bills soar. The bank account drains. You may ask: Will my aging parent's money run out? And if we apply for Medicaid, how can we assure that Mom or Dad won't have to move?

First the question: "Will my aging parent's money run out?" We don't have a crystal ball, nor do we know if your parent will be the rare person who lives to be 105. But some figures may help. An average assisted living community charges roughly $4000 to $5000 a month; approximately $48,000 to $60,000 or more annually. Private pay skilled nursing costs on average $100,000 yearly. Wow!

If you know your parent's net worth, you can estimate a range of how long the money might last, barring some financial catastrophe. Long term care insurance helps the nest egg last longer.

Second: "How do I find assisted living, adult family homes or skilled nursing facilities that accept Medicaid?" Eldercare Locator, a national website sponsored by the United States Administration on Aging, offers a data base and phone line with a trained professional on the other end. Or you can obtain a list of Medicaid certified facilities from your local senior center, hospital or Department of Social and Health Services.

Third: "My parents can pay privately for a few years before needing Medicaid. Can they move into assisted living, and remain there after they run out of money?" It depends on the community. Some assisted living communities accept private funding only. When residents can't pay, they must leave. Other communities require new residents to pay privately for a specified length of time--often a year or two-- before switching to Medicaid. They can then stay. Other communities accept Medicaid funding from day one.

Fourth: "How available are Medicaid openings?" The majority of skilled nursing centers nationwide accept Medicaid and have openings. Availability of Medicaid openings for assisted living and adult family homes varies from state to state. In Washington State, it is easier to find an adult family home accepting Medicaid than an assisted living facility. Early research will help as you seek to find a good place for your aging parent. So will flexibility and an openness to accept a good community that may not be in your back yard.

Can you tell us about your search for a Medicaid-funded community for your aging parent?

Monday, June 21, 2010

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

Something is not right. Those words from Miss Clavel, the stern schoolmarm in the Madeline children's storybooks, may describe your aging parent. He or she needs eldercare NOW, and you don't know where to turn.

If you're like many Boomers, finding the right home for your aging parent quickly is akin to strolling into the casino at Monte Carlo with a fistful of Euros, hoping to hit the jackpot.

You don't have to go it alone. Free help is available nationwide through a myriad of senior care referral agencies. These organizations help families find the right level of eldercare that will match their parent's needs: home care, retirement or assisted living, adult family homes or nursing facilities. Once the family signs a contract and their loved one moves in or receives services, the provider pays a referral fee.

To find these organizations, look in the phone book or online for "senior care advisors," "eldercare advisors" or "eldercare referral services." Some are affiliated with a national organization, such as A Place for Mom. Others operate in a designated region, such as CHOICE Advisory Services,concentrating in parts of Oregon and Washington. Still others, like A Change is Afoot, focus locally, serving families in Northwestern Washington.

How do these agencies work? Some eldercare advisors work exclusively by phone. For example, suppose your mom is in a nursing home for rehab, needing to move to assisted living. You inquire by email or by phone. The organization hooks you up with a local advisor, who phones to chat about your mom: Her needs? Interests? And what about your specific wishes?

The advisor chooses as many as a handful of communities which might work. Marketing reps from the selected communities contact you to set up appointments. You tour and choose the winner. (It's a bit like The Batchelor!) The goal of the phone technique is to give you several tailored choices so the process becomes easier.

Other eldercare advisors work face to face. After their initial phone visit with the family, the advisor schedules an in-person visit, bringing together as many family members as possible. Once all needs are out on the table, the eldercare advisor will accompany the family to several selected communities, taking time afterwards to ask, "What did you like best?" "Did you notice this?" "How would you compare the strengths of community A with community B?" He or she will not tell you what to do, but will guide you in making an informed choice.

Does this type of service work? As a marketing director at Evergreen Court Retirement and Assisted Living Community in Bellevue, Washington, I've worked with some great eldercare advisors. One helped a woman who had few assets. Since she was most concerned about affordability, he took her to three budget-priced communities. Afterwards he developed a spreadsheet to help her in making the decision. The woman is moving into our community within two weeks. Best of all, she's happy with her choice.

I definitely prefer the in-person approach. With both methods, you'll find many eldercare advisors who shine, while a few lack follow-through. As a whole, though, these professionals provide a helpful service to families.

Before investing your time with a senior care advisory organization, check out their reputation with the Better Business Bureau.

Do you have an experience with a senior housing and care advisor? Tell us about it.

Wednesday, June 16, 2010

How to Sell Your Parents' Home in Seven Days

By Susan Peters, Guest Blogger

Susan Peters has more than 20 years experience selling real estate in the greater Seattle area. Like many realtors nationwide, she has developed an interest in helping seniors and their families market their home. Here is a true success story.

My clients were recently faced with the challenge of placing their parents in an assisted living facility and selling their home. This is how we did it, step by step, in seven days. (From the time we listed it!)

1. The adult children moved their folks into the assisted living facility before they even talked about selling the house. This is the most important part! Having your house on the market is stressful for anyone, but there is nothing more distressing for elderly sellers than having strangers tromp through their house day in and day out.

2. We set a budget of $15,000 for improvements that would give the best return. This included: paint, refinishing hardwood floors, new sink and counter tops in the kitchen, some new lighting fixtures, and a ton of yard work.

3. After the work was done, I brought in furniture, artwork, and accessories and then staged the living daylights out of it!

4. Instead of using my traditional real estate sign, I had a custom sign made that mimicked my flyer. On Sunday afternoon, over 200 people came through my open house. By Sunday night, we had a full price offer and we closed in 30 days.

The photos above show the biggest improvement: painting out the fireplace. Lightening up the drab green wall color paint helped to wake up the entire room.

If you'd like to sell your parent's home in seven days, give me a call!
The Better it Looks...The Better it Sells!

Wednesday, June 9, 2010

Eldercare Tip: To Your Aging Parent, the Written Word Has Power

Perhaps you've heard your aging parents say, "Put it in writing." You know they love your voice. But often they want to see your message written across the page.

Seniors' preference for the written word stems from many sources. Our parents' brains processing speed is diminished. So they compensate. To prod their memories, they scribble notes to themselves. To tackle technical information, they revisit words again and again. Those with hearing loss have another reason to prefer the written word. It fills in the gaps left by unheard verbal messages and opens up new horizons!

Seniors share a culture that honors reading and writing. They are among the most devoted readers of daily and weekly newspapers. Over the years, many elders enjoyed Time Magazine, Saturday Evening Post and Readers' Digest condensed books. They wrote love letters, corresponded with friends and penned letters to the editor.

How does this affect your relationship with your parent? If you're discussing new and/or difficult information, it's great to write a synopsis of what you covered. And when it comes to showing your affection, thank-you cards, birthday cards and even handwritten letters pack lots of power.

When my father-in-law was dying of cancer, friends and relatives sent cards and messages of support. And in the aftermath of his death, sympathy cards arrived. I remember many times walking into the house to spot my mother-in-law, her lap filled with an overflowing basket of cards. Reading them brought comfort.

Words. They're powerful. And writing them often helps.

Has the printed word been a tool for your relationship with your aging parent?

Saturday, June 5, 2010

Eldercare Tip: Your Aging Parent Won't Budge? Try Plan B

My friend Terri wrestled with a problem common to Boomers with aging parents. "My parents are accidents waiting to happen."

Indeed. Her dad, a 92-year-old cardiac patient who popped nitro as if it were candy, knew the hospital emergency room personnel by name. To add to his stress, he cared for Terri's mom, who had dementia. Their home had several flights of stairs.

"I brought up the subject of retirement and assisted living facilities, time and time again," she said. But her dad's answer was always: No way, no how.

Are you dealing with aging parents who need care but won't admit the problem? Instead of wringing her hands, Terri wisely came up with Plan B. See if her steps might work for you.

1. Think through the legal issues. Terri was able to convince her parents to execute a durable power of attorney, a legal document that gave one of their children authority to make financial and health care decisions for them, if they became incapable. Her parents also executed advance directives, spelling out their wishes for end-of-life issues. Even the most stubborn parent will usually understand the importance of making these decisions ahead of time. Offer to go to an attorney with them.

2. Research options. Even if your parents won't budge now, that doesn't prevent you from visiting possible retirement or assisted living communities or checking into home care, if you think that would work. Terri did her homework and told her parents about her research "for the future," or "in case you might need care sometime." She invited her parents to come along, too.

3. Avoid power struggles. Don't hammer your point into the ground.
And when you do bring up your concerns periodically, use "I-messages," such as "I'm worried that you're not eating properly" or "Those stairs are so steep; I would feel badly if you fell and hurt yourself." Discuss interim steps such as installing a pendant-type emergency response device or a sit-down shower stall.

4. Implement your plan. Work together with your siblings so everyone is on board. And then sit tight, knowing you've done your best. Later if an emergency arises, or if your parents change their minds, you'll be ready.

Have you developed a "Plan B" you'd like to share?

Monday, May 31, 2010

Eldercare 101: Boomers' Questions on Medicare

In 14 years working with Boomers and their aging parents, I've heard many questions about Medicare. These three are among the most frequently asked.

Q What part of Medicare covers assisted living?

A None. Assisted living is long-term supportive care. Medicare only covers acute care, such as hospitalization, or periodic outpatient events, such as doctor visits.

Q My dad is in a rehab receiving therapy for a fractured hip. Will Medicare pay 100 days of nursing home care?

A Not necessarily. One hundred is the maximum number of nursing home days allowed under Medicare A. When a patient reaches his potential, or stops improving, his Medicare time ceases. Very few people stay on Medicare A the full 100 days.

Q What about home care? Does Medicare pay for that?

No. Home care is not tied to a medical condition and is not covered under Medicare.

In a nutshell, Medicare's four parts include:

Medicare hospital insurance (Part A) provides basic coverage for hospital stays, post-hospital nursing home stays and home health care.

Medicare medical insurance (Part B) pays doctor and lab costs, and some out-patient medical services (i.e. medical equipment and supplies, home health care and physical therapy.)

Medicare Advantage (Part C) Sometimes called the HMO plan, this allows people to receive their Medicare benefits through a private health insurance, rather than through Medicare Part A and B.

Medicare Prescription Drug Coverage (Part D) pays some of the cost of prescription medications.

For more information on Medicare, visit the Medicare website.

Saturday, May 29, 2010

Eldercare 101: Medicare, Medicaid Made Simple

No eldercare blog would be complete without posts on Medicare and Medicaid. Why? Most Boomers mix them up. I did when I entered the senior care field in 1994. These programs sound alike and are spelled alike. But they're as different as night and day.

Your aging parent almost certainly qualifies for Medicare. Virtually everyone over 65 is eligible, since it's funded through employment or self-employment taxes. I'll devote my next blog to explaining Medicare's various parts: A, B, C and D.

Medicaid, on the other hand, covers low-income seniors who have medical needs. Think "AID" for Medicaid. The program is administered by each state; rules and programs differ widely. In many states, a single person can have no more than $2000 in assets. In the case of a married couple, if one spouse needs care, the other spouse can often keep the home and some assets to avoid becoming impoverished.

Programs may include in-home help (i.e. transporting to doctor visits and grocery stores, preparing meals, assisting with bathing), as well as assisted living, adult family homes and skilled nursing homes. In many states, Medicaid covers services and costs Medicare doesn't pay for, including prescription drugs, preventive care and eyeglasses.

If your parent moves to an assisted living facility, an adult family home or a skilled nursing home under Medicaid, he or she will contribute his or her income toward the cost of the care, with the state returning a small amount (approximately $50) for his or her incidental expenses.

For specifics on Medicaid in your state, do a google search of "(your state) Medicaid." Or contact your local county social services, welfare or department of human services office.

For information on Medicare, see my next post.

Is there anything on Medicaid you'd like to add?

Wednesday, May 19, 2010

Geriatric Care Managers Tackle Eldercare Issues With Grace

Perhaps you're stumped because...

1. Your aging parent lives across the country. Due to multiple medical crises, you've racked up enough Frequent Flyer miles to purchase a ticket to Fiji.

2. Your siblings and you can't make peace with your parent's care.

3. Demands of work and family overwhelm you, and managing your parent's medical needs seems daunting at best.

Geriatric Care Managers can help you tackle these eldercare issues and more. Steeped in experience and expertise in geriatrics, they generally hold advanced degrees in nursing, social work or psychology. As important, they've listened to problems like yours time and time again.

First, the care manager assesses the "big picture." While he or she focuses mainly on your parent, your needs are critical, too, as are the needs of your entire family.

Next, the care manager writes a comprehensive care plan, which includes a statement of the issues, and "next steps" for implementation. If needed, he or she taps into the services of eldercare attorneys, financial advisors and other professionals.

You can hire a Geriatric Care Manager on a one-time basis--for example, finding an assisting living community or hiring in-home care. You can also call on a care manager continually or as needed, especially if your parent lives far away. He or she can advocate for your Mom or Dad, standing in your place at care conferences, checking in on caregivers, etc.

Geriatric Care Managers charge families by the hour. Before you enter into an agreement, get the rates in writing.

For some Boomers, a care manager can make a world of difference.

Take the partners who lived in New Hampshire, across the country from their parents in Washington State. These Boomers had used up all their sick leave tending to their parents' care. They were exhausted! Hiring a care manager allowed them to breathe a sigh of relief, knowing Mom and Dad were in good hands.

For more information, contact the National Association of Professional Geriatric Care Managers.

Have you worked with a Geriatric Care Manager? Tell us about it.

Saturday, May 15, 2010

Does Your Parent Care for an Ailing Spouse? Here's Help

Emil and Louise moved into our retirement community with one goal in mind: "We want to be together no matter what." Louise suffered from dementia. Emil wanted to focus on his wife's care. This new setting allowed him to do just that, since staff took care of meals, housekeeping and other maintenance. Their daughter gave her full support.

Perhaps one of your parents cares for the other full time. You may be worried, and with good reason. Recent 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.

A woman taking care of a husband with dementia or psychiatric illness was at greater risk than if she were actually widowed, the study said. As an adult child, how can you help the reduce this stress?

1. Discover your caregiving parent's needs. That list may include help with housekeeping and home maintenance, meal preparation and shopping. As care needs increase, the ill spouse may need someone to help with bathing and dressing. And don't forget the caregiver's need for respite and renewal, as well as for friendship and camraderie.

2. Decide which needs you or other family members can meet, and which can be provided by professional service providers, such as home care agencies or adult day programs.

3. Consider a continuing care retirement community. Louise and Emil stayed together in their apartment for several years, thanks to this supportive setting. Toward the end of her life, Louise lived in the nursing home, just steps away from Emil's apartment.

4. Notice signs of stress with your caregiving parent. Some of those include high blood pressure, spiking blood sugars and shingles. Keep in close touch with your parent's physician, who may provide some objective advice. And finally, let your caregiving parent know that it's OK with you to place your other parent in a group home or nursing home, should the caregiving needs become too great.

Saturday, May 8, 2010

Is Your Aging Parent's Driving Driving You Crazy?

My 85-year-old friend Joe saddled up to me.

"Alice, guess what? I got my driver's license."

I knew about Joe's macular degeneration. How could he pass the eye exam in Washington State?

"I'm lucky," he said with a twinkle in his eye. "My cousin is an eye doctor practicing in Arizona. He signed off and I can drive." He added: "Don't tell my daughter!"

Elders will do the darndest things to continue driving. Taking away their car keys seems like cruel and unusual punishment. Yet at some point the safety factor overrules, and we must act.

Is it time for you to have the "Driving Talk"? Consider these tips.

1. Embark on a series of discussions with your parent, advises the writers of "Your Aging Parents: The American Bar Association Guide to Legal, Financial and Healthcare Issues, 2009.' Ask them, "When do you think someone should give up driving?" and "What are alternatives (carpools, public transportation, having a child drive, etc.)? Talk, too, about your own experiences with rude drivers and traffic, and the increasing difficulty so many people have in navigating the roadways.

2. As the talks progress, use "I-messages," such as "I feel worried," "I'm concerned," "I'm scared," says Dennis Gibson in "The Sandwich Years." Instead of "You're dangerous on the road," say, "I'm concerned about your safety because you've had fender benders and I don't want you to be injured!" And acknowledge your parent's feelings of disappointment in thinking about giving up driving.

3. If all else fails, ask a professional for help. Elderlaw Attorney Rajiv Nagaich, of "Aging Options" says that a neutral party, such as a physician or a geriatric care manager, often can help. "Let a care manager have a heart to heart," he says, adding that an intervention by a caring third party can avoid a winless power struggle.

As a last resort, the physician or family can report the senior negligent driver to the department of licensing. Contact your department of licensing, as laws vary by state.

Perhaps you've received some good advice on this subject. Tell us about it.

Wednesday, May 5, 2010

Mother's Day Gift Ideas from the Pros

Sees chocolates. A two-pound box, to be exact. For the last three years of my Mother's life, I knew the drill. Forget Godiva, or Russell Stover's, or Dove or Hersheys. Sees made her Queen for the Day, be it Mother's Day, birthday or any occasion.

Not everyone has it so easy. If you're stumped about what to buy your aging mother for Mother's Day, you're not alone. Today I polled professional staff and residents from Evergreen Court Retirement and Assisted Living Community, in Bellevue, Washington. I asked, "What are some great Mother's Day gifts?"

Here they are, in no particular order:

1. chocolate
2. homemade goodies (especially when you prepare their own recipes)
3. flowers (fresh or plants)
4. a cozy throw
5. framed pictures of family members
6. an electronic picture frame
7. DVD's
8. stationery and postage
9. a mini-vacuum

Happy Shopping! Can you add to the list?

Wednesday, April 28, 2010

Four Myths About Low-income Senior Housing

"It's as big as our other apartment and it's only $600 a month." Those were my father's words when he and Mother moved into a seniors-only HUD apartment complex.

As a minister, Daddy's retirement was minimal. So this one-bedroom apartment was a real blessing. Besides shelter, the apartment offered opportunities for fellowship with people their own age. The community was located close to the senior center, shopping and parks.

If your parents are struggling financially, affordable senior housing or retirement communities might just fit the bill. But first, here's a look at the myths.

Myth 1: Programs are uniform. Nationwide, various governmental agencies oversee low-income housing for the elderly. The most well-known are HUD-subsidized senior apartments, which give preferential treatment to those with very low incomes (30% of the average family income in the surrounding area.) In other affordable housing programs, for-profit and not-for-profit companies receive tax breaks if they rent a certain percentage of their building to seniors with low to moderate-incomes. Still other programs offer vouchers which seniors use in selected communities.

Myth 2: Affordable senior housing is only for people with practically no resources. Income limits are usually based on the average family income in the area. For certain programs in the Seattle area, single seniors can make $36,000 (60% of the median family income). A couple can make as much as $41,100.

Myth 3: Senior affordable housing consists of apartments with few amenities. Not always. Some have common areas such as lobbies, meeting rooms and game rooms. In addition, there are a few full-service retirement communities serving low to moderate income seniors and offering meals, housekeeping, activities, transportation and assisted living. Evergreen Court Retirement and Assisted Living in Bellevue, Washington, has such a program.

Myth 4: Affordable senior housing always has a years-long waiting list. Not always. My parents were able to move into their apartment near Milwaukee without waiting at all. Today in the Greater Seattle area, some affordable senior apartments have immediate openings. The longest waiting time is for housing serving seniors with very low incomes.

To locate affordable senior housing, contact your local senior center.

Do you have experience with low-income housing for your parents or loved ones?

Sunday, April 25, 2010

A Quiz: Is Your Parent Ready for a Retirement Community?

Check to see if your parent might be a good candicate for a retirement or assisted living community.

Does your parent say things like?

"I hate eating TV dinners or in restaurants all the time."

"Shopping, meal preparation and cleanup take too much time and energy."

"I'd like someone else to do the yardwork and housework."

"Asking people to take me places isn't fun."

"I have too much time on my hands."

"I'd like to resume some of the activities I used to enjoy."

"I'm lonely and want to be around people my own age."

"I'd like to simplify my life."

How many of these describe your aging parents? A retirement community isn't the answer for everyone, but a good one will eliminate tedious tasks like grocery shopping, meal preparation and cleanup, plus inside and outside maintenance and housekeeping. An excellent retirement community will provide opportunities for exploring new activities, meeting new friends, and rekindling interests from long ago.

If your parents are very frail and have great physical, emotional or cognitive needs, assisted living may be your answer. It offers all the elements of retirement living, plus personal care and staff that become like a second family. Ask yourself:

"Does my aging parent skip medications?"

"Does my parent need help with bathing or dressing or transferring (i.e. getting out of bed to a sitting or standing position or the reverse)?"

"Does my parent have an incontinence issue that's out of control?"

"Is my parent emotionally needy?"

"Does my parent have great medical needs?"

In-home services are another eldercare option for people desiring to stay in their own home. I'll discuss these in an upcoming blog.

Sunday, April 18, 2010

Search and Find a Great Home for Your Parents

In the best of all worlds, people plan for the future. Perhaps in their 60s or 70s, still in good health, they wake up and see their house with new eyes. They ask, "Is this really the perfect home for our retirement?" And they begin to dream...

This is the REAL world, however. Chances are, if you and other Boomers are reading this, your parents are older and more frail. They probably haven't planned for greater health needs. Now it's up to you. Here are some tips, cultivated from seniors and their families who have grappled with finding the best eldercare.

1. Make a wish list.When possible, involve your parents. Write down their desires, and yours, for their next home, or for fixing up their current home. Examine everything: location, size, meals, housekeeping, transportation? What about proximity to medical facilities and doctors and availability of extra health care?

Think through the things your parents enjoy now or in the past, which they might resume if given a chance. Pets? Gardening? Attending church? Playing musical instruments? Are your parents lonely, isolated?

If your parents choose to stay at home, what services will need to be brought in? And is that a workable solution?

Look through your list, and mark any "must haves," realizing that in doing your research, things will change. For example, Val and Luise, devout Catholics from the Seattle area, were sure they wanted a Catholic-sponsored continuing care retirement community. The good news was they found one. The bad news was it was in Memphis, Tennessee. They settled on a Protestant-sponsored community which proved to be a good fit.

2. Look around.With your list in hand, start your search. Ask friends, your parents' physicians and anyone who works in the senior care field. Check out websites to see if the communities meet your qualifications. Narrow your choices to three or four, and visit.

If possible, take your parents along to your top one or two choices. Nearly all retirement and assisted living communities offer tours with lunch. Some allow residents to stay for a weekend, experiencing life from the residents' vantage point. In the best communities, residents will brag about their home and ask your parents, "When are you moving in?"

3. Move ahead.If your parents stay at home but need help with chores or personal care, they'll experience adjustment to having people in their home. If they move to a retirement or assisted living community, the adjustment will be a bit different. They may mourn over the loss of their home and possessions. Staff will comfort, while attempting to engage them in community life. Within a few weeks, most frail elderly folks start making friends and feeling at home.

If this process sounds too time consuming, there are professionals who can shepherd you through the search process. More about them in an upcoming blog.

Can you think of other ways to help people in this search for a perfect retirement home?

Tuesday, April 13, 2010

Seize the Day: Celebrate Your Elder

Daddy's 77th birthday was approaching. And we siblings knew that due to his advanced Parkinson's, it would probably be his last. Sadness hung over our family like a grey cloud.

Then my sister Carol devised a plan. Daddy had been a minister for 50 years, giving his very lifeblood serving his congregations. Carol contacted four of his churches and asked, Would they send him birthday cards?

Some 70 cards flooded in, along with messages that expressed heartfelt celebration and appreciation. The nurses read and reread them to him. One card included a snapshot of a 45-year-old. "Who is that handsome man?" the nurse asked Daddy. He cracked a knowing smile, as she said, "That's you."

Five days after his birthday he died. How thankful I was for those kudos his people bestowed on him.

Celebrating our elder is a wonderful gift. Even in the face of suffering and death, we can offer appreciation. Here are some of my observations:

1. Celebrate milestones.Birthdays, of course. When Lucie turned 100, her family and the nursing home staff granted her wish. "I want a horse," she'd announced. The nursing home activities director procured a miniature horse from a nearby church camp, and a stuffed pony from a local store. Imagine Lucie's face when the miniature horse appeared before her very eyes.

Milestones aren't just birthdays, though. Mabel's family knew she dreaded moving from assisted living to the nursing home. So they gathered the extended family around in a "blessing ceremony," thanking God for the assisted living room that had been Mabel's home for several years. And they annointed her with oil, praying a blessing on her and the new room.

2. Savor life's simple joys.Celebrations don't have to include ice sculptures or high tea. The main thing is connection. Our family gathers for fresh strawberry shortcake, which in Washington, signals the beginning of summer. Others bring their elder to the dock for the opening of fishing season. And of course, there's baseball, possibly the most senior friendly sport of all.

3. Gather the generations. Aging parents seem to love those great-grandchildren! And there's something magical about the unconditional love kids give back. Those folks in between are enriched by their elders, too.

Despite the circumstances, I want to take the time to celebrate our elders.

What are the ways you celebrate your aging parent?

Thursday, April 8, 2010

Choosing the 'A-Team': Pros Who Work on Your Behalf

Remember B. A. Baracus? In the 80s blockbuster tv show, "The A-Team," B. A. led the charge. Buildings caved in, cars exploded and in the end, good triumphed over bad. Boys of all ages loved it!

We Boomers need an A-Team: pros who will charge forth on behalf of our parents, clearing obstacles, ripping through red tape, paving a way for excellence in eldercare.

Whether you're looking for home care, retirement living, assisted living, an adult family home or nursing care, or even in-home electronic devices, the first person you meet--the sales or marketing representative--might end up being a member of your "A-Team."

A great pro, of the A-plus variety will:

1. Put your parent on a pedestal. OK, not literally, but a great marketing rep will be more concerned about your parent's needs than "selling" unneeded services. In a friendly manner, the rep should ask open-ended questions, such as, "Tell me about your mom?" and "What prompted you to seek help?" and "What kind of timetable are you looking at?"

If your parent is with you, the rep should ask her some of the questions directly, and especially, "How do you feel about this?" Other questions will address finances, as well as the needs and desires of the entire family.

Hopefully, you won't feel like you're being grilled--the conversation aims to ferret out all the needs, and maybe unearth some you hadn't thought of earlier. Once everything is on the table, the marketer and you together can determine whether the services they have to offer will work.

2. Answer your questions. You may have questions relating to the quality of their services, such as, What is your caregiver turnover rate? Can I examine your state survey report? How long has leadership worked together in this organization? These are all potential indicators of quality. If the rep doesn't have the answer immediately, he or she should tell you that you'll get a phone call within a few days with the answer. Most important, he or she will keep this promise.

3. Never let "no" be the last word. If this company isn't the right fit for any reason, a great marketer should give you a next step: perhaps two referrals for local organizations that will work for you. And if you happen to see him or her on the street later, you'll receive a big smile, and a question, "How are things going with your mom?"

Have you met marketers that meet A-Team standards? Do you have experiences with others that you'd like to share?

Thursday, April 1, 2010

Boomers Bridge the Generation Gap, Part Three

Boomers are the bridge. We connect people, old and young. But sometimes we feel worn and splintered, walked on from both sides.

We need to stop traffic and repair the bridge.

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 ways to repair our bridges. In the last post, we discussed four. Here are the rest.

Happy people:

5. Take care of their body. When we feel like we're under siege, it's not the time to go for the Haagen Daas.
6. Nurture social relationships.Other people offer perspective, hope and humor. That's the rationale behind the success of support groups for family members of people suffering from Alzheimer's, Parkinson's and other diseases. But most any activity involving community can nurture us, from golfing to auditing classes at the community college to enjoying coffee with friends.
7. Learn to forgive. When we fail to forgive, we're more likely to seek revenge or avoid certain people altogether, Lyubomirsky says. Either option steels joy. Forgiveness involves grieving our losses: the what's, the how's and the why's. And then letting go and seizing happiness.
8. Increase their "flow" experiences. Lyubomirsky describes "flow" activities as those in which we lose sense of time: fishing? sewing? reading? gardening? Whatever floats your boat, go for it. These pastimes soothe our souls and prepare us for the next day.
9. Savor life's joys.Enjoying sunsets, walks with the dog and simple pleasures help us renew and repair.
10. Commit to goals. Keeping promises and seeing things through brings joy and strengthens our foundation.

When you're feeling stepped on by both generations, what do you do? Tell us.

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?
Related Posts with Thumbnails