Tag Archive for: Aging

How to Care for Independent Aging Parents

If you’re in the midst of raising children or grandchildren, managing a career and caring for an aging parent or relative, you are not alone. In fact, a 2012 Pew Research report found that about half of all U.S. adults in their 40s or 50s have a parent age 65 or older and are raising a young child or financially supporting a grown child.

When our parents have strong desires to remain independent and we have strong desires to care for them, it can be a real challenge.

“I always like to focus on the things that are necessary for aging parents to stay as independent as possible,” says Amy Boulware, (LAP, MSW) Geriatric and Special Needs care manager for Chambliss Law. “The desire to remain independent is so strong, sometimes parents are willing to go to great lengths to keep up the appearance they are doing well on their own. I call this ‘malicious independence.’ They know they aren’t doing well, but they keep it from their family members. The sad thing is, often, they have already lost their independence because they are isolating themselves and not getting to do the things they enjoy doing.”

Getting older and more fragile is a hard thing to deal with, but things do happen as we age. Boulware believes the goal of providing good care to our parents is to avoid making decisions in the midst of a crisis.

“If we can help parents think about the things that are becoming more difficult for them such as going to the grocery store, cooking or keeping the house clean, then we can develop a plan to remove some of the burdens and help them stay as independent as possible,” Boulware says. 

“Most people do estate planning, but few think about doing elder care planning,” Boulware shares. “Inevitably, something happens and then you are thrown into making quick decisions.”

So, how do you have that hard conversation? Boulware suggests that you begin the process by asking questions like:

  • What are the things that are important to you as you age?
  • How can we work together to help you have quality care later in life? What does that look like for you? 
  • What are the lifelong behaviors or details that make you tick that would be very important to know? For example, do you have a nightly routine, always have a certain snack, use something to help you sleep at night, etc.? There may be routines and rituals that you know nothing about that if discontinued, could cause agitation, fear or frustration for your parent. 
  • Who would you like to designate to make decisions should you become unable to do so? When do you think would be a good time to take care of that? 
  • What can you afford?
  • If we see you struggling, how would you like us to handle that?

If you try to have the conversation and your aging parents won’t let you, seek help from a trustworthy third party.

This conversation in particular is often one we put off because it’s just plain uncomfortable and nobody wants to think about the end of life. Mapping out a plan ahead of time can pave the way for smoother transitions in the future. It can also strengthen your family relationships because the choices your parents make are truly theirs and it will be easier to honor them by following through with their wishes.

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Embracing the Second Half of Life

Embracing the second half of life is hard. A few years ago my mom attended the Wednesday night program at her place of worship. Afterward, she called me and shared the speaker’s topic: “Your Kids Don’t Want Your Stuff.” Then she asked me the dreaded question: “You really don’t want all these treasures I have accumulated through the years?”

While I appreciate the sentimental significance of some of her things, I honestly appreciated the speaker’s point. This is just one of the complicated moments the second half of life often brings.

Our daughter surprised us with a visit a few days ago and as we were talking with friends, someone commented to her, “I can’t believe you’re 25!” She responded, “I know, I realize I’m halfway to 50!”

It occurred to me that if she’s halfway to 50, I’m halfway to 114. Whoa. This second half of life does have a way of sneaking up on us. Growing old is hard, especially when you still feel young and vibrant, but your body is screaming, “Not!”

Recently, my mom shared that her best friend was really struggling with giving up driving. She was trying to help her understand that it really was a loving gesture from her kids. I couldn’t help but wonder what it will be like when I have to have that same conversation with her or our daughter has to make that decision for one of us.

Plenty of us are independent folks, and the idea of losing that independence is really scary. In fact, many of us are unwilling to think about it, much less have some of the difficult conversations we need to have with our loved ones. When it comes to living life well to the end, what will your legacy be where relationships are concerned?

Many of us can look in the rearview mirror and think about situations or relationships we wish we had handled differently, perhaps with our children, our own parents or a close friend. Sometimes we believe it’s too late to do anything about it. If you’re reading this, you still have time.

While working on my Master’s in counseling, I completed an internship on one of the cancer floors at UTK Medical Center. I will never forget the many times I walked into a room where the patient was literally ready to die but held on because there was unfinished business with the people standing around the bedside.

Do you have unfinished business to take care of with the people who mean the most to you? It is abundantly clear that people take their relationship with their parents to the grave. And, I can tell you based on research, a parent’s words and actions matter.

I recently heard a very successful man share that his parents have never told him they loved him, and he become very emotional. There was this big, burly, manly-man in his 60s who still longs/wants/needs/wishes to hear his parents say I love you.

What is your relationship like with your children? Do they know you love them and believe in them? If that’s a hard place for you, remember that you can’t control their response, but you can control what you do.

When our daughter was growing up, I used to tell her that I loved her but I didn’t like her behavior. Over time I transitioned to telling her there is nothing she can do to make me love her more or less. That doesn’t mean I will agree with all of her decisions, but I want her to know I believe in her and I love her, period. If I unexpectedly died in my sleep, I don’t want her to wonder how I feel about her.

A young man in his 30s with a brain tumor was talking with his father after a medical appointment, and he reminded his dad that our life on this earth is “terminal.” There is some serious wisdom. A lot of us hate talking about dying, yet it’s inevitable. So here’s another question: How do you want to live until you die? That’s a huge part of your legacy, and you are teaching those around you.

There is no super-secret formula for this. We are all different. Whether it’s driving, turning over the reins of the company, moving out of the house you have lived in forever or getting rid of your stuff, what do you want to pass on to the next generation?

If you don’t already have a plan, there’s no time like the present to create one and share it with your loved ones. Make sure there are no surprises, because it’s often the surprises after someone is gone that create huge rifts in families. Talking about it might be hard, but it’s healthy. It really is important for us to model, even for adult children, how to live and die well.

Finally, perhaps life hasn’t gone as you planned it and anger and bitterness have taken up residence in your heart and mind. Instead of talking about it, perhaps you behave badly and take it out on the ones you love the most. Growing old sometimes stinks, but there are lots of shifts and decisions to make, and things to talk about. Seeking help in this area isn’t a sign of weakness; it’s a sign of strength and health.

Moving forward, how will you go about creating a meaningful life with your family and friends in your second half of life?

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Aging Parents and Broken Families

“In 2010, the first Baby Boomers turned 65. By 2030, 20 percent of America’s population will be over 65. As the Baby Boom generation moves into later life, the proportion of American elders who are divorced is skyrocketing,” says researcher and author Elizabeth Marquardt. “The McKinsey Global Institute predicts that by 2015, 46 percent of boomers will live in divorced or unmarried households. These trends raise concerns for Baby Boomers as they age – and challenges for their grown children – as they become caregivers for their aging parents.”

Marquardt and Amy Ziettlow are co-researchers in a 3-year project funded by the Lilly Endowment to investigate aging, death and dying in an era of high family fragmentation.

Marquardt and Ziettlow are asking Gen Xers about things like:

  • How does your generation care for parents who may live far apart?
  • Is there an obligation to care for stepparents?
  • How do you grieve the loss of a parent when you have grieved the loss at the time of the divorce?
  • How do you honor your father and mother when a parent abandons their child?

During an interview, one man said, “My parent’s cold war lasted until my dad died. Then my mom wanted me to mourn the loss of my dad with her. I had already mourned the loss of my father.”

“Married parents will do their best to protect their kids from the worst of a dying parents’ illness,” Marquardt says. “Fragmented families don’t have that luxury. In fact, many of the people interviewed talked about stepparents who don’t communicate anymore once the biological parent has passed away. Family change is not the only stressor. Longer life span, smaller family size and rapid economic changes have a ripple effect on family breakdown.

“We have never thought forward to the impact of divorce on an aging nation,” Marquardt says. “Marriage used to be ‘until death do us part.’ Now it is ‘until it doesn’t feel good anymore.’ There are people who will die a lonely death due to family fragmentation. Leaders are asking who will be taking care of the old people.”

Marquardt and Ziettlow have found there is a lot of hope with Generation X.

“There is something about telling your story,” Marquardt says. “Out of sharing tears, raw memories and family craziness there is a hope that seems to emerge. They take a deep breath and at the end seem to feel a sense of relief.”

Many of those interviewed said they agreed to do it because they wanted to honor their parent.

“The golden rule doesn’t say, ‘Do unto others as they have done to you,’” Marquardt says. “Of the Gen Xers we have interviewed, many say their only hope is to rise above what has happened to them and to ‘Do unto others as you would have them do unto you.’”

Who will be there to take care of you when you can’t take care of yourself?

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Helping People Finish Life Well

How can you help people finish life well? Several years ago Carol Courtney found herself in an interesting position. Her mother called to say that her father was in the hospital due to breathing problems. As a healthcare professional, all kinds of things were running through Courtney’s mind.

“I knew he had been having episodes where he would black out, but not pass out. This made me think he was having respiratory issues,” says Courtney. “As time went by and I kept asking my mother for information, I realized she did not know the names of my father’s doctors nor did she have any idea what was happening other than he had breathing issues.”

As a nurse, Courtney knew that this lack of information was not uncommon for people who are unfamiliar with healthcare.

“Most people are intimidated by doctors, are often afraid to ask questions or don’t know the right questions to ask,” Courtney says. “My goal was to get my father out of the hospital. In spite of trying to coach my mom from a distance on the kinds of questions she should ask, what to say and how to get to know the physicians, when my father was discharged she did not know his diagnosis or the care that would be required to keep him at home.”

At this point, Courtney decided to take action. She wrote down every question she had before calling the physician. She knew from experience that if you ask the right questions you will get the answers.

The key is knowing what to ask.

“From my conversation with the physician I learned my dad had terminal pulmonary fibrosis and he was expected to live approximately three months,” Courtney says. “I was the one who told my parents about pulmonary fibrosis, what the coming days would probably look like and what we needed to do to make this time as pleasant as possible.”

This is when things tend to get tough for families with members about to finish life, explains Courtney. The stress can fracture a family’s ‘fault lines’ and lead to a falling out – right at the time when the dying person needs their support.

“I knew we had a very short amount of time to do what I considered important business,” Courtney says. “My mom emailed all of Dad’s relatives and friends and explained that he was terminally ill. She invited all of them to come for a visit as soon as possible. My dad died 11 weeks after being discharged from the hospital. But, in those 11 weeks, 32 people came to see my father. We laughed, cried, shared stories and truly enjoyed each other’s company.”

Courtney’s sons brought their grandfather tons of chocolate when they came to visit him. He loved chocolate, but hadn’t been allowed to have it because of high cholesterol. They had a serious party!

“When my father died, his funeral was truly a celebration of his life,” Courtney says. “This whole experience changed my focus in life. I realized I was passionate about helping people finish life well. My goal is for people to have reconciliation and celebration before they die.”

Most people don’t want to think about dying or planning what they want that process to look like. That includes arranging their funeral.

“Talking about the end of life and what you want it to look like with your spouse and children is revolutionary,” Courtney says. “I encourage people to plan and communicate about what they want and how their family and friends can help. They can take a methodical and thorough approach, and end life well.”

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Caring for the Caregiver

As part of her job, Amy Boulware walks alongside caregivers. So when she found herself caregiving for her grandmother and mother, she thought she had the tools she needed.

“I did not expect to be caregiving for two,” says Boulware. “My grandmother moved closer so we could take care of her. Shortly after she moved, my mom was diagnosed with cancer. I quickly realized caregiving is very different when it is your own family.”

At one point, Boulware found herself running between hospital rooms trying to care for her mom and grandmother. On top of her caregiving responsibilities, she continued working and taking care her own family.

“I was definitely burning the candle at both ends trying to keep up,” Boulware says. “One night, I came home late. As I walked through the door, my youngest daughter yelled from the bathroom, ‘Mom, can you get me some toilet paper?’ I went to where we usually keep toilet paper, but there was none. I searched the other bathrooms.  There was no toilet paper in the house. I had a complete meltdown over no toilet paper. As I’m lying on the bed sobbing, my oldest daughter comes in the room with a very large package of toilet paper.

“She says to me, ‘Mom, Daddy and I talked on the way to the store and we are pretty sure this really isn’t about toilet paper, but here is toilet paper and a pint of chocolate ice cream because we thought you needed it.’”

Surprisingly, the “toilet paper incident” made Boulware realize she was exhausting herself.

“Carrying the load by myself was not the answer,” Boulware says. “I called my uncle and asked him to take over the finances. I called my sister and asked her to come home more often. We hired caregivers to help with my grandmother and we did some other creative things that made a huge difference.”

Since she has walked this road, Boulware offers words of wisdom for caregivers:

  • Ask for help. Recognize other people’s strengths and ask them to help you in those areas. Help can come from many places, including family, the faith community, friends and paid caregivers.
  • Time off is a must. Thursday night became date night for the Boulwares, and nothing interfered with it. Caregivers, family, friends and co-workers all knew that evening was sacred, so they helped them to have much-needed time away. The Boulwares turned their phones off and decided not to discuss caregiving at all.
  • Routine changes can help. Boulware’s grandmother lived close to her daughters’ school so the girls went to her home in the afternoon. The family ate dinner there one night a week. Making this change eliminated a lot of stress. Plus, they made memories with their grandmother that are forever etched in their minds.
  • Be a supportive spouse. Never once did Boulware’s husband tell her it was too much. In fact, she describes him as supportive and as a great gift as he walked alongside her. It brought them closer together as a couple.

Being a caregiver is innately stressful, so properly caring for yourself is a vital part of the process. If you are running on empty, it is difficult to effectively care for others, but asking for help is not a sign of weakness. A helping hand or two can make all the difference.

***If you or someone you know is in an abusive relationship, contact the National Hotline for Domestic Abuse. At this link, you can access a private chat with someone who can help you 24/7. If you fear your computer or device is being monitored, call the hotline 24/7 at: 1−800−799−7233. For a clear understanding of what defines an abusive relationship, click here.***

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