Tag: elder

welcome to girlfriends with aging parents

a dreaded move to assisted living – help!

March 7, 2013

When is the time for a parent to move to assisted living? My father passed away four months ago and since then, my mother’s health has steadily deteriorated. Her depression has led her to an almost solitary existence except for the caretakers and my visits. She lives in a retirement home which has limited assisted units available and one has just opened up. It is a studio unit – much smaller than the two bedroom apartment she is living in now.

I know that change can be very difficult for older adults. However, her additional care in independent living is very costly and she is running through her savings at an alarming rate. Assisted living seems to offer better care and includes many of the extras she pays a premium for now.

I hesitate to be the one to make the final decision and desperately want her to “buy in”. She really doesn’t want to make the decision. I am torn between my feeling of responsibility to make sure that my mom is well cared for and my reluctance to become the bad guy – the one who forced her to make a move she really didn’t want to make. How have others dealt with this decision? written by Laurie in Tennessee

caregiving: unpacking the family baggage

December 20, 2012

No one can jump on another person like a family member can…it’s raw emotion, full of stale, unresolved baggage. It falls on you like a ton of bricks. When it comes to giving care to an aging parent, why should we believe it will be different?

5 tips for families taking care of family:

1. Remember the family baggage? The unresolved issues from the past you’ve neatly swept under the proverbial carpet? Once you start down the road of caring for an aging parent, the carpet takes flight and the baggage is exposed. Brothers and sisters who fought before, will fight again. You will revisit issues from the past. Stay alert.

2. Put yourself on the gentle cycle. Now is the time to get that massage, take a long walk, cuddle with your dog. Family caregiving brings a family back together under intense circumstances. You simply must be kind to yourself, which may translate to others as being selfish. Stay true to yourself. Keep your good, best friends on speed dial when you need a quick and supportive message of love.

3. Walk away. Hard as it may be, you may have to excuse yourself from the family. Just because someone needs care, doesn’t mean you have to expose yourself to bad behavior by others. This is not easy. But think of the family member who needs the care…they need calm rather than commotion. Explore just how you can honor your loved one while taking care of yourself.

4. Mom may not love you best. Now is not the time to fight to be mom’s number one kid. It’s not personal. If mom trusts the brother you think is incapable of making all her financial decisions, you must let it go. This is not the time to prove to your mother that you’re really better with finances. There are reasons you mother trusts your brother, and that is just how it is. Unless he’s crooked, he’s your mom’s choice.

5. It doesn’t have to be YOU. Even though you promised your parents “you wouldn’t put them in a nursing home,” you didn’t promise that you, all by yourself, would take care of them. You may not be the right fit to change Dad’s diapers or feed Mom. Get help. You may have promised you’d care for them, but that is not the same as doing the hands-on-caregiving.

If there are any tips you have used feel free to share!

Kari Berit (www.KariBerit.com) is a radio show host, speaker and the author of The Unexpected Caregiver: How Boomers Can Keep Mom & Dad Active, Safe and Independent.

elder law

August 22, 2012

On October 15, 2010, the Elder Law section of the Washington State Bar Association presented an award to Representative Jeannie Darneille (D) of the 27th District for her work to enact legislation to establish the Office of Public Guardianship. The mission of the Office is to make guardianship services available to individuals who need them and are alone (without family members or friends to serve as volunteers) and poor (without the means to pay for needed services). Many of these individuals are elderly and need a surrogate decision maker. A guardian is appointed by the court to make either personal or financial decisions.

If you are a care-giver, you should be aware of The Elder Law section. It focuses on legal issues that are pertinent to elders – including retirement issues, estate planning, powers of attorney, guardianship and other forms of substitute decision making, to private and long-term care, health care financing and elder abuse. Go to www.wsba.org for more information or to find an Elder Law attorney through the public resources directory.

treatment for osteoporosis a puzzle

August 8, 2012

PANIC! I am a middle aged woman diagnosed with severe osteoporosis. My mother, who is in her mid-80’s, suffers from a very advanced form of the disease, where merely reaching for a dish or rolling over in bed can cause a fracture. I took Fosamax for seven years in tandem with calcium supplements, per my physician’s instructions, until medical findings revealed the drug could actually cause much more harm than good. At that point, my doctor and I agreed that I would try a year of just calcium pills and see if my baseline bone scan changed at all.

On May 23rd, a study was released in the journal HEART, stating that supplementary calcium may be bad for your heart and raise the risk of heart attacks. It showed an 86 percent increase in heart attacks among those who regularly took the supplements compared to those who didn’t take any.

New recommendations just set forth by the U.S. Preventive Services Task Force state supplements of Vitamin D alone, or with calcium, may not help prevent osteoporosis caused by bone fractures.

“There isn’t evidence to suggest that 400 IU of vitamin D plus 1,000 milligrams calcium can prevent fractures among postmenopausal women who do not live in assisted living or nursing home facilities,” says Task Force member Kirsten Bibbins-Domingo, MD. She is an associate professor of medicine at the University of California at San Francisco.

At this point I am not sure where to turn. None of these studies seem to address alternatives. Am I doing more harm to my body than good?

mom’s clothes go MIA

June 13, 2012

My mother, who is in her late 70’s and lives in an elder care facility, recently fell and broke her hip. After surgery, she was moved to a nursing home to recover, which appeared to be a lovely facility. As it had both a recovery unit and independent living quarters, I even thought that this might be a great place for her to live after she was fully mobile again.

When I went to visit her this weekend, I was beyond shocked when I entered her room and found her only clothed in a pair of Depends and a hospital gown. When I asked her why she didn’t have her clothing on, she kept insisting that she didn’t have any. I reminded her that I had just bought her some comfortable new jeans and tops which were right in the closet in the room. After arguing back and forth, I flung open the closet door only to find that it was empty!

It took me a few moments to regain my composure and start to consider where these garments could have disappeared to. When I confronted an employee, I couldn’t seem to get a straight answer. After much questioning, as I got more and more insistent, he said that her clothing was being laundered. ALL of it I asked? And what was she supposed to wear meanwhile? Oh, they would clothe her in a hospital gown, he replied. What about when she goes to the dining room to eat? He replied that they would put a second gown over the first, reversing it so her backside would also be covered. To say I was appalled and angry didn’t even begin to cover it. He suggested that I visit one of the social workers to see if her clothes could be tracked down and even tried to place the blame on my shoulders, saying that I should have marked each item of clothing with her name in a permanent marker – something that was never brought up to me by the staff.

While I had heard that personal items may “disappear” in some care facilities, I had never imagined anything like this. Now I will have to go out and purchase new clothing, and, of course, will insist that I will pick up and launder her clothes. Meanwhile, if these items never show up again, shouldn’t the facility have to reimburse us? Who takes responsibility? I work full time and my brothers live out-of-state, so I am the one handling all of this. While making arrangements for my mom after her fall have been very stressful, now I will have to police her possessions and run back and forth doing laundry. Finding a different facility would be difficult and moving her again would be traumatic for her. Has anyone put their parent into a retirement facility & had this happen? WHAT DID YOU DO?

between a rock and …. well, you know

May 30, 2012

It is the time of year when we do honor to moms and dads (as well as grads). Lots of young people will be graduating and “moving on”. Yet, one of the challenges of our times is that many will be “moving back” instead of moving on. A recent PEW Foundation think tank, research report has dubbed the current generation of 25-34 year olds, the “boomerang generation”. The economic challenges that they face have caused a majority to find safety and comfort back home. The report was based on a survey that PEW conducted in December of 2011 of over 2,000 young adults across the USA. Thirty percent of that age cohort now live in what the study called “multi-generational” homes and, what may come as a surprise, “large majorities say they are satisfied with their living arrangements (78%) and upbeat about their future finances (77%).

At the same time, what also is happening is a growing concern about the economics of aging. A recent N.Y. Times article (May 6, 2012) on a type of dementia called frontotemporal dementia, again pointed out the growing challenge that it is going to cost our generation a lot of money to care for the rapid rise in chronic illness. And, we may not be able to count on our kids to help afford our own situations, as we have helped our parents. The lack of real debate in any level of government on the future of Social Security and Medicare only adds to the slowly growing reality that our boomer aging may very well be, in many ways, unaffordable. So, we need to ask them who will pay?

I raise this issue here only because it is so real and so many of us will be faced with these realities. We take for granted our health and mobility until that moment when we cannot…and then what?

The stresses and strains on families dealing with these issues are enormous. It appears that these will only continue to grow and I do not know if our generation is prepared. I would invite your comments on this issue.

Shalom,

Rabbi Richard F. Address, D.Min

www.jewishsacredaging.com

baby boomers effect on nursing homes

May 9, 2012

Projections: U.S. & Nursing Home Populations
	Actual	Projections
	2010	2020	2030
Total U.S. Population*	308,746,000	341,387,000	373,504,000
Rate of change		10.57%	9.41%
65 and Older Population**	40,267,000	54,804,000	72,092,000
Rate of change		36.10%	31.55%
Nursing Home Resident Population***	1,401,718
Residents 65 and older****	1,205,477	1,640,673	2,158,226

* U.S. 2010 Census
** U.S. Census 2008 “Projections and Distribution of the Total Population by Age for the United States: 2010 to 2050″
*** CDC “Health, United States, 2010, table 117″
**** npg.org estimates that 86 percent of nursing home residents are senior citizens; Projections for “Residents 65 and Older” were calculated by applying 2010′s Actual “Nursing Home Resident Population” to that estimate. That finding was then applied to both 2020 and 2030′s “Residents 65 and Older Rate of Change” to estimate both years Baby Boomer nursing home occupancy.

The nursing home industry is one plagued with a very big problem: 90 percent of nursing homes are understaffed, making staff to patient ratios too low according to the Centers for Disease Control’s (CDC) National Nursing Home Survey: 2004 Overview. Said report found there was only: 1 Registered Nurse for every 12.6 residents; 1 Practical Nurse for every 8.15 residents; 1 Nursing Assistant for every 2.5 residents; and 1 Nursing Aide/Orderly for every 120 residents. What this translates to is 1 nursing home staff member for every 1.64 residents.

As a result of inadequate staffing levels, the amount of time staff members spend with residents is also inadequate. A Health and Human Services (HHS) study in 2002 found that nursing homes could maximize quality of care if specific staff members met the following daily requirements of time spent with residents: Certified Nursing Assistants spent between 2.4 hours and 2.8 hours daily; Registered Nurses & Licensed Practical Nurses spent between 1.15 hours and 1.4 hours daily; and Registered Nurses spent .55 hours to .75 hours daily with each resident. However, the study found that given the current state of nursing home staffs, if said requirements were applied, only 3 percent of nursing homes would meet the maximum requirements and only 9 percent would meet the minimum requirements.

All of this data was representative of the nursing home population before Baby Boomers began to become senior citizens. Baby boomers began to be classified as such in 2011 and will continue to enter that age category through 2029. Future senior citizen populations applied to nursing homes can be seen in the above chart. Easily seen is this chart is that the senior citizen population increases in 2020, mid-Baby Boomer subversion, and in 2030, one year after full Baby Boomer subversion. And given that understaffing is a primary cause of both abuse and neglect in nursing homes, the increased demand Baby Boomers will put on a disordered industry may cause an increase in nursing home abuse and neglect. Additionally, elder abuse and neglect in general may increase, as people who would normally have placed their elder into a nursing home will be left with no choice but to care for the elder themselves.

Allison Dean is a writer bringing to us how the problems of nursing home abuse and neglect could be exacerbated by the Baby Boomer population’s demand for long-term care.

Allison also writes about

when surgery may not be the right choice

May 2, 2012

My mother, 87yo, lives across the country but close to my younger sister. I was called to D.C. suddenly to have a “family meeting” about a new development regarding our mother’s health.

My sister reported that my mom had exhibited uncharacteristic behavior. Besides shortness of breath, Mom tended to stop as she was walking along to “window shop and look around”. Not typical behavior. I asked why she did that? Heart beating quickly, can’t get her breath? She could not pinpoint why she stopped. My sister & I thought … just the aging process.

Unfortunately this seemed to be more frequent & we decided to see a heart specialist. Through a stethoscope exam, the physician diagnosed a huge heart murmur. He further stated that Mom’s life was threatened by this condition. The cardiologist recommended we scheduled an angiogram to see what it looked like inside.

After confirming on the angiogram and making an appointment with the surgeon to choose open heart or to try to get a procedure through a leg artery (that is still only available to her as a randomized trial) a close family friend, who is a physician, scheduled a second opinion.

The second physician confirmed that everything we heard was completely true. This cardiologist however, pointed out that Mom has a great lifestyle, & in her late 80’s, would not be offered this procedure in a European country because of her age. He said that since she is not symptomatic yet (but will be without any doubt) the third option was to do nothing at this time. The doctor said it is very likely that she would not come out of the surgery the same cheerful optimistic person that she is today.

Conclusion? There is no real conclusion in health care until the actual end. Ours is a wait and see. You never know what you will eventually do. But we chose lifestyle over surgery. Also, it is a huge decision (and the decision, in the end, is the patient’s) Truly, it was good to have both sisters there as well as my Mother’s sister for support in that.

Maybe you have a reason for a second opinion you would like to share. Written by Linda in Scottsdale

when a medical alert becomes alarming!

April 25, 2012

I have noticed that my 86 year old father has memory loss and while it is probably age appropriate, it has also made me wonder at times if overmedication is part of the cause. Then, when reading the New York Times, I saw that Federal health officials had released a safety alert regarding statins, which many seniors, like Dad, take for cholesterol. They said that there may be rare risks of forgetfulness, confusion, muscle pain and even diabetes. Lipitor, Vytorin, Crestor and Zocor were among those named.

This reminded me of when alerts were first released for Fosamax and other bisphosphonates which had been prescribed for my mother and her severe osteoporosis. After years on the drug, she suddenly lost her ability to swallow, also described as a rare side effect of this pill. She had never had any prior esophagus trouble, so Fosamax became suspect! Right?

How seriously should we view these warnings? Big drug companies understandably play down the side effects of these huge sellers. And how does one decide which is worse – using the drug to treat a serious medical problem and ignoring the “rare” consequences or refuse to take it and risk the health issue becoming much worse? Would love to hear from others how they weigh and make their decisions for both themselves and loved ones.

To read the article I refer to, go to: http://www.nytimes.com/2012/02/29/health/fda-warns-of-cholesterol-drugs-side-effects.html

submitted by Norma

is she over medicated?

March 28, 2012

My mom is not herself, but who could be when taking 19 different medications a day for various conditions? Is she over-medicated? Probably, but her doctor has prescribed and is very aware of every pill she takes. Which pill or pills would mom want to give up, as she has been reassured that each is necessary in itself? Her doctor seems to become indignant when she questions him about this.

A friend in the retirement home she lives in was talkative and vivacious. In the last few weeks this woman has become withdrawn and shaky. She had complained of headaches and is now taking medication to alleviate the pain, but at what price? Where is the Nancy we knew?

Drugs do save lives, treat symptoms and alleviate pain but how does one deal with the psychological side effects? According to Health Watchers’ News and Views in a November 2010 article, “Experts estimate that up to one-third of the elderly in our communities may be over-medicated and some 20% of their hospital admissions are due to adverse drug events. The costs related to over-medication in the elderly are thought to exceed $80 billion each year.”

Help me help my mom. What has been your experience with over medication in a loved one and how have you approached/confronted her primary physician? I could use some guidance as I tackle this seemingly delicate, but also crucial and common situation. Written by girlfriend in Iowa, Susan

welcome to girlfriends with aging parents

a dreaded move to assisted living – help!

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caregiving: unpacking the family baggage

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elder law

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treatment for osteoporosis a puzzle

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baby boomers effect on nursing homes

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when surgery may not be the right choice

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is she over medicated?

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