Thursday, September 27, 2012

Eldercare Q-A: How Can I Help My Aging Parent Build a Legacy?

My short baseball career began--and ended--in second grade.  A fly ball smacked me in the face.  Specifically in the nose.  Years later, though, I found myself editing a book on teaching baseball techniques to children.  How did that happen?  My husband's elderly uncle decided to build a legacy.  And I wanted to help.

Your aging parent is also involved in building legacy, says author David Solie of "How To Say It to Seniors."  It's his or her developmental task.  ""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.

For Uncle Dale, the legacy idea was simple.  He wanted to publish a book that would help children master the fundamentals of baseball.  He also wanted to honor his own grandchildren's accomplishments in the sport.  So he gathered together a team that would help him with the task:  sportswriters, baseball players, a graphic artist and more.  Like all seniors creating a legacy, Uncle Dale is doing this in his time and in his way.  When the product is finished, it will have his indelible stamp on it.

Unfortunately, we adult children can miss the signs when our aging parents are trying to build a legacy.  I know.  My dad was a minister.  After retirement he would "hint" from time to time that parishioners had suggested he publish his sermons.  He suffered from Parkinsons and depression, though, and his inner voice was weak enough that we kids didn't get the message.  His disparaging comments, "Probably no one will read them," didn't help the project to gather steam.  Unfortunately, the sermons never were published.

As I grow older, I'm trying to listen for the sounds of legacy.  For example, my friend Don, in his mid 80s, has been writing letters to his grandchildren for years.  "I write about what is important in life, and I encourage them to make good decisions," he says.  Another friend, Tillman, builds legacy by reviewing slides of his years as a missionary to Zimbabwe, and telling stories of God's work in that land.

When seniors create legacy, they repeat the same stories again and again in great detail, not so much for the facts as the inherent values.  Solie urges us as their children to listen, really listen, and help, if we can.  Even if we know more about commas than baseball.

Have you picked up on your aging parent's desire to create a legacy?  How have you been able to help?

Monday, September 24, 2012

Eldercare 101: A Hands-on Primer on Washington Adult Family Homes

Question: What eldercare option is growing by leaps and bounds in Washington State?  
Answer:  Adult family homes.

King County alone has more than 1065 homes.  No wonder they're springing up everywhere.  Adult family homes cost one third to one half of a nursing home.  They provide a more homelike setting. All in all, adult family homes are worth considering if your aging parent needs considerable care.

These homes usually have six residents cared for around the clock by trained caregivers. But is the right one hard to find?  One that will fit your parent's needs?

Last week I began checking them out in Bothell, my hometown.  I wanted to experience the "hunt," and offer a few tips to you and others who might be looking for your aging parent.  Here are some things I discovered.

1.  Washington State's DSHS website has a page devoted to finding adult family homes. Other states have similar listings.  I did an advanced search for the three Bothell zip codes.  My printed list included 84 homes.  In my zip code alone there were 24 homes.  Quite a few, all within a mile or two of my house.

2.  The DSHS website lists key items for each home including
  • Enforcement letters.  These are letters the State issues the home for violations of statutes.  They can be for anything for failing to pay the annual required fees to not reporting an emergency in a timely manner. 
  • Medicaid acceptance.  This is more than a little tricky.  Most homes say they will accept Medicaid but require between 18 months and 3 years of private pay before a resident can convert to state assistance.
  • Specialties.  Most adult family homes specialize in caring for residents with dementia and/or mental health issues.  A few also accept developmentally disabled residents.
3.  In my ongoing visits, I've found.
  • Diversity.  Two homes only take Russian-speaking residents.  One home I visited specializes in older developmentally disabled males.  Other homes desire females only who are frail. Most homes cannot accept exit-seekers--residents who continually try to leave.  Yet other homes with locking devices feel comfortable with these types of residents.  Still others take on pretty much any kind of a challenge, from post-strokes to recovering hip fractures to dementia in its many stages.
  • Somewhat uniform pricing.  Older homes may have a smaller price tag than newer ones, but not by much.  Generally adult family homes start at $3500-$4000, with higher fees for residents with greater needs.
  • Visiting is important but wearing.  Family members may want to trust a professional, such as a senior housing specialist or a geriatric care manager, to help them with the hunt. 
Have you looked for an adult family home for your aging parent?  If so, what has helped in your search?

Friday, September 14, 2012

Eldercare Dilemma: I don't want Mom to Have to Move TWICE!

"I definitely want to move Mom only once."  After all, moving is hard on elderly parents, and it's not easy on children, either. So how can you make sure you won't be carting Mom, her possessions and furniture to a new community months or years from now?

What about dementia? A marketing representative told my client, "Our community can take care of your mom for the rest of her life!"  A problem:  his mom had early dementia.  She was engaging and cogent for fifteen minutes or so, until she began her pattern of repeating questions and phrases. Her short-term memory was zip. For now, her needs were simple: friendly staff directing her to meals and activities, and helping her bathe and take her medications. Later, though, problems could arise. Depending on the progression of her disease, she might begin to wander or yell at residents or staff. Because the community had no memory support area, with specially trained staff, she could be asked to leave. The implied promise of "taking care of Mom forever" wouldn't hold water.

What about other progressive diseases?  George lived for five-plus years at the assisted living where I worked.  He made friends, was the star of the art group, and every Friday toasted with four men in an informal "Happy Hour."  Eventually, though, as he approached 100, he became weaker.  It took two people to get him out of bed. We could no longer meet his needs. George had to pull up stakes and move to a heavier care assisted living. Another potential move-out criterion is diabetic care. If your parent needs sliding-scale insulin, he or may need to move to higher care.

What can you do? No one has a crystal ball, but it's good to be prepared for the possibility of a second move. The community you're choosing now may be perfect today. When your parent's needs increase, an adult family home, a heavier care assisted living community or one with memory support might work better.  If funds aren't an issue, you have more options from the beginning: move Mom to a more expensive community with progressive care and specialized wings. When her needs grow, you simply move her down the hall.  Another option, especially if your parent has extensive needs, is to bring in extra home care staffing to assist the assisted living staff in caring for your parent.

Is this easy?  No. The Boy Scout motto makes sense here:  Be prepared.

Do you have any other ideas concerning a "second move"?  Or stories of your own experience with this?
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