Friday, December 20, 2013

Have a Very "Geri" Christmas. Gift Ideas for Aging Parents.


Every year we go through it: the indecision, the frustration, the breathless anticipation, the faux gratitude, the gift receipts. What on earth do you get your aging parents for Christmas?! Children are relatively easy to shop for by comparison. Even the boxes have the ages listed on them. "This toy is appropriate for ages 8+." Bingo and thank you. There are, however, no such labels when it comes to shopping for an aging parent. "This Snuggie is ideally suited for ages 76+." This is my grown-up Christmas wish.

That is the age-old/old-age question I suppose. What do you get an aging parent for Christmas? After 70 Christmases worth of presents, what are the odds that Mom has any need for a new set of decorative dish towels or that Dad's workshop is lacking any tool under the sun? The obligatory item featuring this year's "Greatest Shot of the Grandkids Ever" will certainly find its way under the tree but social media tools like Facebook are beginning to render even that holiday classic obsolete. So where are you Christmas?Why can't I find you? Why have you gone away? (Admit it. You heard Faith Hill singing in your mind just then. It's alright. Only a few more days left.)

This year the fine folks at the University of California at San Fransisco have come to the holiday rescue with a list of gift ideas for the elderly which they posted on their blog, Geri-pal.

They've got a list and have clearly checked it twice because it is filled with great, thoughtful gift ideas for the aging parent in your life. The list begins with functional tools like jar openers and grab bars which are easily moveable. Do your parents still have records but no way to play them? Maybe a record player might be just the thing this year.

Edible goodies like petit fours, teas, and candies are wonderful gifts and are now available as sugar-free/ gluten-free options in a lot of fine retailers.

Medication Reminder Clocks are popular gifts and offer the feature of recording your own voice commands to take certain medications at certain times throughout the day.

Out of all the gift suggestions, my favorite is the suggestion to just do something. Aging parents will certainly appreciate any gift you give this year but they probably have enough "stuff." Offer to spend your holiday visit helping them with a project they have been putting off. Help them organize the junk drawer or make a few trips to Goodwill. Little things like that may not seem like much of a gift but to a senior who is potentially struggling with mobility problems it may be the gift that keeps on giving.

Merry Christmas Y'all!

See the full list here: http://www.geripal.org/2013/12/what-to-give-uncle-ernie-grandma-mabel.html

Tuesday, December 10, 2013

The Assisted Living Dilemma

http://www.pbs.org/wgbh/pages/frontline/life-and-death-in-assisted-living/

Yesterday, I watched a PBS program called Frontline. This particular episode was an investigative journey into the world of assisted living facilities. In particular, it was an excoriating look at communities run by the Emeritus corporation, the nation's largest provider of assisted living care.  The stories that were told were horrifying and embody everything that people fear about institutionalized senior care.

There is no question that the senior demographic is a fast growing market. The plain reality is that while there are numerous new and exciting options for aging boomers, there is still a desperate need for a solution to the "Age Wave." Assisted living facilities have largely stepped into that gap. Unfortunately, assisted living facilities find themselves in a perfect storm of controversy which is a combination of a number of complex factors.

Among those who work with seniors and their families it is common knowledge that "assisted living facilities" have become the new "skilled nursing facilities." A skilled nursing facility is what has traditionally been known as a nursing home. SNiF's, as they are commonly called, are places where seniors go when they are no longer able to live their lives without significant supervision and assistance. Regrettably, most seniors would rather die than go into a nursing home. That is a sadly ironic choice for many. Enter the Assisted Living Facilities or ALF's. These communities are designed to accomodate seniors who wish to live on their own but require basic assistance.  Meals are prepared. Activities and field trips are planned. Staff members are available to provide assistance with eating, bathing and walking 24/hrs a day...according to the brochure. The reality is that assisted living communities are set up to work like insurance policies. There should be some residents who are almost completely independent. There should be some residents who require more assistance. In a perfect world, the balance between the two provides an affordable option with adequate care.

But this is the real world.

There are several equally causal factors which create the assisted living dilemma as I see it.

1. Families don't want to put Mom into a nursing home.

The decision to put an aging parent into a facility is one of the most difficult any adult child is likely to face. In most cases, families neglect to sit down and rationally discuss the aging process until they are too far into the journey to be able to look at things without the understandable emotional entanglements. The choices become nothing more than well-intentioned guesses and many times carry with them regrets which will last a lifetime. A family may cognitively realize that their parent requires more care than can be reasonably expected of an ALF but emotionally not be able to handle placement into a nursing home. The assisted living facility becomes an enabler of sorts which acts as  a functional bridge of care until the reality is completely undeniable. In order to postpone the inevitable, families will sometimes shine the warmest possible light on the situation. Neglecting to paint a picture which resembles reality, they not only place their parents into dangerous situations, they deny the communities the information needed to hire adequate staff in order to provide the needed care.

2. Facilities do not like empty rooms.

While many business professionals may tell you that it isn't about the numbers, at some level it must be about the numbers. The directors and marketing professionals in senior living communities of every care level are held accountable to their census. If there is no room at the proverbial inn and a waiting list of seniors then all is well. This would seem to be a reasonable expectation given the rapidly aging populace and the limited number of alternative housing options available. However, human nature does not typically gravitate towards making difficult decisions. Without an understandable amount of coaxing on the part of the marketing personnel, most families would rather postpone a tough choice than pull the inevitable trigger. In a 'may the best salesperson win' environment the senior almost always loses.

3. Great Expectations.

Blindfolds and rose colored glasses do not typically produce great clarity. Facilities at some points over-promise. Families at some points under-disclose. Those two competing visions of reality can spell disaster for the senior stuck in the middle. Furthermore, fully two thirds of all seniors in assisted living communities have been diagnosed with Alzheimer's or some other form of dementia according to recent studies. This removes the possibility of receiving credible feedback from the one person best able to assess the situation. "Sure, Mom says that they are not attentive but she has dementia and doesn't always remember." "Mrs.Johnson in room 318 says she pressed the call button an hour ago but she has dementia and hasn't really been waiting that long." Combine ingredients and simmer until things begin to breakdown.

There is plenty of blame to be laid at the feet of assisted living facilities. While some issues are individual failures, still others are indicative of more systemic problems. My intent is not to take sides. I know how difficult it is for families to deal with decisions of this magnitude. I also know many of the people who take great pride in the work of making their facilities feel like home to the seniors in their care. There is not some vast conspiracy among senior living facilities to victimize seniors by providing them with substandard care. There is, however, a great chasm which exists between the needs of seniors and the way we meet them. Hopefully, the day will soon come when we can all stop pointing fingers and start joining hands to find a solution.





Friday, December 6, 2013

Forgiveness. Tis the Season.

http://www.lambtonshield.com/opinion-lets-let-the-system-not-social-media-complete-its-work/

I am frequently staggered by some of the situations in which we find ourselves at Home Instead Senior Care. While some seniors are blessed with families who love and support them throughout their aging journey others are largely left to fend for themselves. Family dynamics are unquestionably complicated and I have learned to attempt to refrain from passing judgment on what I see. While I  attempt to maintain an impartial perspective, human nature dictates that I cannot remain entirely neutral. How can a sister continue to support her brother both financially and emotionally after years of verbal abuse at every turn? How can a daughter refuse to visit or even speak to her ailing mother only a short drive down the road? How can a son deny his mother the care she requires in an attempt to preserve an inheritance for himself? These are the situations in which we find ourselves at Home Instead Senior Care and they never get any easier. In fact, much of what we see is actually getting worse.

Throughout the last century, the family unit has taken a tremendous blow. While there are a multitude of legitimate accusations regarding the cause of this deterioration, the reality of its fracturing is unavoidable. Many parents don't have a relationship with their children at all. In my opinion, an increasing number of parents are making "the friend mistake"; trading in the ability to speak truth, wisdom and discipline into their child's life so that they can be best friends. Families are indeed struggling. The evidence of this fact is apparent when working with the elderly.

My father has often joked about the baby boomers' dedication to career and advancement at the expense of all else. "As soon as they were big enough, we stuffed our kids into facilities so that we were free again to climb the corporate ladder. Now we're old. What makes us think that our children won't do to us exactly what we did to them?" Turnabout, I suppose, is fair play. But as the famous maxim quips: An eye for an eye leaves the whole world blind.

Yesterday, Nelson Mandela passed away at the age of 95. While it would be intellectually dishonest of me to say that I applauded all of the things for which he stood,  the legacy for which he seems to be most remembered is one of forgiveness. After more than two decades of political imprisonment, he was able to rise above the vengeful politics which would have been completely understandable to all. Instead, he resolved to change the system. He knew that if the nation of South Africa were ever to change, he would have to be the first in line.

Few of the families in crisis with whom I speak are happy about their state of affairs. Most express strong sentiments of regret and a desire that "maybe one day things will be different." But nothing ever changes. One year turns to another and opportunities are forever lost. A new sort of cold war wages as everyone waits for someone else to make the first move. In the meantime, everyone freezes.

Christmas is at its core the celebration of the birth of Jesus of Nazareth. As a Christian, I believe that Jesus was who he claimed to be; the son of God and Savior of the world. Who you believe him to be is a matter of utmost importance and yet has little bearing on his legacy of forgiveness. Put to death by the most cruel means imaginable for crimes he did not commit, Jesus of Nazareth was the poster child for the wrongfully accused. Yet in the darkest hour of his execution, after being savagely beaten within an inch of his life, stripped naked and nailed onto a splintered cross, he forgave. He begged the God of heaven to forgive those responsible. He made the first move.

We celebrate the occasion of his birth this month. We celebrate the way he gave himself for us as the ultimate gift by exchanging presents with each other. We should further celebrate by honoring his legacy of forgiveness in the most dyer and seemingly hopeless of circumstances. Take the first step toward reconciliation this year knowing that Christmas is a season for the miraculous. Chances are that the long lost person in your life is just waiting on you to make the first move. Merry Christmas!


Thursday, December 5, 2013

Tips to Fight the Winter Blues

http://articles.chicagotribune.com/2013-11-28/health/sc-health-1127-mental-health-elderly-20131128_1_mental-health-richard-birkel-depression

I am hanging around. I have nothing to do but frown. Rainy days and Mondays (or any day for that matter) always get me down. Truer words may never have been spoken. For me, grey rainy days are the pits. Throw in a winter chill and the prospect of me sliding out from under my down comforter at 5:30am sounds less and less appealing. I am not typically a coffee drinker but at this time of year my morning coffee quickly becomes a necessity if I expect to even pretend to get any meaningful work done.

I am not alone.

The winter blues attempt to rob all of us of our holiday joy and seniors are not exempted from the list. If anything, they find themselves particularly susceptible. But there are steps that can be taken for you and the aging parent in your life so that you can hopefully beat the blues this Christmas.

  1. Lace up your sneakers.
I have taken to doing this on Saturdays when there aren't a ton of mandatory things on my to-do list. Somehow just putting on my sneakers makes me feel sportier and more active. This trick has nothing to do with podiatry. It is really just a mental excuse to get moving. The more sedentary you are the more blah you're going to feel. So whether it's sneakers or just changing out of your pajamas before noon, do whatever it takes to get active. Your mind will follow your body's lead.
    
    2. Follow Dave Ramsey's advice.

Money is MAJOR contributor to winter blues. Financial demands around Christmas are taxing on your mind and body. Having a budget doesn't automatically multiply the pennies in your jar but having a handle on exactly where you are allows you to relax a little. So set a budget and stick to it. You still might not be able to afford that new Mercedes with a big red bow on the hood but you will be able to comfort yourself in knowing that the person driving it is probably too stressed out to enjoy it anyway. Tis the season!

    3. Put a Salad on the Table.

Nutritious foods feed both our minds and bodies. During the holidays, we tend to pay less attention to what goes into our bodies. A sweater does wonders to conceal a few extra pounds. Between parties and gatherings, fudge and cookies, it is no wonder that Santa's belly jiggles like a bowl full of jelly. The less balanced and nutritious your diet is the more susceptible your mind will be to the ups and DOWNS of the grey winter days. At Thanksgiving dinner this year, I insisted on putting a kale salad on the table. In an effort to be fair to all contributors, I always make sure to include a little (or a lot) of everything in the spread on my plate. Having the salad was a great reminder not to overdo it. Admittedly, I still overdid it but nowhere near as badly as in years past. If you are attending a party in the evening don't count the day as a total nutrition loss. Instead, focus on good choices during the day so that you don't feel guilty for that second helping of sausage balls.

    4. Booze It and You'll Blues It.

While alcohol may help us get to sleep it can also prevent us from actually getting restful sleep. I love a glass of single barrel bourbon as much as the next guy provided that the next guy really likes single barrel bourbon but if you aren't careful that holiday cocktail can ruin your next day. In this instance, it isn't about getting drunk and having a hangover. Alcohol can disrupt your body's natural sleep rhythms and prevent you from getting the rest you need. Can you have a second drink without becoming the slob of your office party and xeroxing your own derrier? Probably. Will you feel lousy tomorrow because you didn't get restful sleep? Also probably.

In a senior's life all of these issues are typically magnified. Staying active can be hampered by chronic conditions which are painfully worse during colder months. It is easy for me to lace up my sneakers on a Saturday morning but quite another matter for someone whose arthritis prevents them from being able to tie their shoes. Money woes are hardest to cope with for those on a fixed income. Nutrition is already an issue for most seniors and alcohol abuse/dependency dramatically escalates among the senior population during the Christmas season. For these and other problems there are no easy solutions. However, just being aware of these issues in your own life and the life of your aging parent is a great first step. If you are attempting to fight the winter blues, knowing is half the battle.

Tuesday, December 3, 2013

A Messy House at Christmas

http://www.rottenecards.com/card/7764/cleaning-with-kids-in-the--ho

As I have mentioned in this blog on many occasions, my wife and I have six boys. While I do not claim to be an expert father, there are several things that I can state with relative certainty.

1. Doing the laundry is a never-ending task.
The amount of clothing that six boys soil on a daily basis is worthy of mention as a potential cause of global warming. The alacrity with which they defile clean and folded piles of laundry is mesmerizing. If you have ever seen children playfully destroying a pile of leaves on an Autumn afternoon, then you have seen a picture of what my sons do to a pile of clean laundry each and every day. My wife often describes it as Groundhog Day.

2. Grownups are the only humans capable of flushing a toilet. The faux chrome handle on a toilet has apparently been ergonomically designed to make it impossible to be used by anyone under the age of 12. Whatever water we save by not flushing we use in futility to attempt to address the previous item on the list. I call it neutralizing our carbon footprint.

3. Clutter is the new order. "Ordo ab Chao." Out of chaos comes order. We live by these words. We live by them not as a life choice but mostly because in our lives we have no choice. In the popular Back to the Future movies of the 1980's, the danger in time traveling was that if you altered the past in some way you would create an alternate reality and thusly a paradox which would inescapably unravel the very fabric of the space time continuum. We live in that alternate reality.  And a flux capacitor doesn't help. Unless it could somehow help with the aforementioned laundry.

Growing up, my house was perfectly ordered at almost all times. I used to attribute that reality to a combination of my father being partially OCD and my wife and I's total failure as parents. I now realize that it was simply a numbers game. People in parenting circles talk about the huge difference between having 2 and 3 children. They talk about how much harder everything is once you are outnumbered as parents by your children. I think Jim Gaffigan said it best. "If you want to know what having 5 children is like just imagine that you're drowning...and someone hands you a baby." Messiness is relative.

Nevertheless, my parent's house remains impeccably clean. Each time we visit, I become aware of the pandemonium we bring to the party. That is the reality they live in and I love them for it. Whenever we arrive at their home, my wife and I often leave the children in the van in the driveway and just go inside and breathe in silence for a moment; knowing that all the pristine we see will shortly be destroyed by our spawn. Chao ab Minivan. Out of the minivan comes chaos.

Perhaps the difference between the way you keep your home and the way your parents keep theirs isn't that apparent. Regardless, you have a general idea of how your mom and dad keep their home on average. As you visit this holiday season, be sure to pay attention to changes in that process. If your aging parents are usually very particular about the way things are kept around the house and suddenly that isn't case then something could potentially be wrong. Keep in mind that what you see during a holiday visit is the E-harmony version of the truth. They have undoubtedly cleaned and prepared for your arrival. If bills are piling up, if laundry is piled up, if basic home maintenance and upkeep is being neglected then a conversation is probably in order. Growing older like having six small children is not for the faint of heart. Both stations in life require help from time to time. If you walked into my home and offered to help, it might be difficult to tell you exactly how you could. Only through conversation and observation would you be able to determine the best way to assist. (Reader hint: free babysitting) Similarly, seeing things are out of place in your parent's home won't automatically give you the answer for how to help. Spend some time getting to know what life is now like for them before you attempt to present potential solutions. The best Christmas gift you give them this year could simply be to look and listen.

Monday, December 2, 2013

Christmas-time to Talk

http://www.goodhousekeeping.com/health/womens-health/aging-parents-care

The Christmas season is upon us and it brings with it ubiquitous encounters with relatives of all shapes and sizes. Whether crazy Uncle Lou is set to stop by or whether you will be making the cross- country sleigh ride to your in-law's, one thing is certain, you will see some things that you don't see at any other time of year. In truth dear reader, I could regale you with stories of my own Christmases past that you would confidently state were scripts for an upcoming reality TV series. I digress.

For children of aging parents, Christmas visits often afford a much needed opportunity to put eyes on a situation that has likely changed since the last visit. While growing up, I can remember my mom's frustration with my brother and I's consistent answer of "Fine" whenever she would inquire about our day at school. I suppose turnabout is fair play because that is the same I answer I now get when checking in on her and my dad in Texas. At Home Instead, we have the opportunity to hear stories galore of adult children who come home for a visit during the Christmas holidays only to find that "Fine" isn't an accurate description.

As humans age our bodies change in a number of ways. I am no longer able to do the same things physically that I was able to doing my twenties. Correction, I probably could do them but it might require an ice pack and/or hospitalization after. Seniors are no exception. Some of the things that change as we age are our taste buds. This can bring about difficulties for seniors with regard to their diets.  A senior who is having difficulty tasting their food may overseason it with salt or other condiments which are detrimental to their health. In many instances, a senior may stop eating altogether or greatly reduce the amount of food they consume. In either instance, observing this change should be a relatively easy task. While the seasoning dilemma is worth a conversation, noticing that your aging parent has lost weight is a far more serious matter. Weight loss can be an indicator of a number of things. In the most optimistic of circumstances described above, it may simply be a result of not enjoying the task of eating. However, some weight loss may be caused by depression or more serious chronic conditions and illnesses.

So keep your eyes open this Christmas. What is in Mom's fridge? How much weight has Mom lost? How much Tabasco is Dad dumping into his soup? These can certainly be difficult conversations to have if approached indelicately. My best quick advice is to remember that questions are always better than answers. No one likes to be bossed around. Certainly no parent likes to be bossed around by their children of any age. Start by asking some questions and let the conversation take its natural course. Chances are it may be one of the most meaningful conversations you share this Christmas.