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Aging In Place

Giving Proper Care to Mom and Dad

By Diane J. Heltsley, MSW, LCSW Resource: www.CaregiversMagazine.com

Many adult children report feeling uneasy after they visit their aging parents.  They have a gnawing feeling that “something is amiss,” but they are unable to pinpoint their concern.  Not knowing exactly how to express their worries and not wanting to communicate to their parents that they see them as incompetent, they often leave without voicing their thoughts, telling themselves that their worries are probably unwarranted.  This passivity and self-denial can be a grave mistake that can lead to unfortunate, even tragic, consequences.

If you have an aging parent, here are five critical areas of your parents’ lives that you need to make your concern.  Focusing on these will help you to replace your anxiety about their well-being with well-informed, constructive action.

ARE THEY HEALTHY?
As our parents age, they are more prone to health problems, forgetfulness and medication errors.  The challenge for us is knowing if and when they need our help.  Rather than do nothing and simply hope that no problems surface, here are three concerns you should monitor to help prevent serious health issues from developing without your knowledge.

Are your parents having regular medical check-ups to diagnose new problems and to monitor existing medical issues?  Are they seeing the right doctors for their problems and are they communicating their needs and conditions accurately?
You need to become aware of your parents’ medical problems and of their doctor visits.  If your parents are willing, inform their doctors that they want you to be involved in their ongoing medical care. Have your parents complete the necessary forms at the doctors’ offices to allow your involvement.  Accompany your parents to their doctor visits to ensure all concerns are properly addressed.

Are they taking the correct medication?
Have all of your parents’ doctors regularly review all the medications your
parents are taking.  You want to make sure your parents are taking the
medications they really need, and also to avoid possible negative drug
interactions.

Are your parents eating right?
Many of our elderly develop anemia and dehydration, and are malnourished due to poor eating habits. Check to see that your parents have access to groceries and are able to fix their own meals. Assess whether they might benefit from having groceries delivered or in receiving home delivered meals.

ARE THEY SAFE?
Most accidents happen because our parents mistakenly think they are safe.  They get very used to that loose step, the missing handrail, and the poorly lit hallway.  It usually takes an accident or a near-miss to push us into fixing the obvious problem.  You can offer to be the extra pair of eyes to help your parents make sure that their homes are as safe as possible.

Are your parents living in a safe environment?
Make sure that your parents’ home is free from clutter that can lead to a fall, electric cords that can cause them to trip, and throw rugs that can cause them to slip. Be certain that lighting inside and outside the home is adequate, that all stairs and ramps are secure, and that grab bars are installed where needed. Make certain smoke alarms are working and have fresh batteries.

Is there a plan for an emergency?
Find a responsible person who will agree to be available to check on the safety of your parent as needed.  This person can also be the one to respond to an emergency your loved one may have, and handle the situation until you arrive.

ARE THEY FINANCIALLY SECURE?
Many of our parents have fixed incomes, and need to be careful in their spending.  With the price of food, medications and utilities always increasing, we have an obligation to see that our parents are able to meet these basic needs.

Note: Finances can be a very private and touchy subject with our parents.  They may become very defensive if you arrogantly inquire in this area.  So you must display tact and diplomacy, thus gaining their trust in letting you help them with any problems they may be having.

Are your parents living within their means?
Make sure that their income is adequate for their needs, and that their expenses are appropriate for their income level.  Some utility companies, banks, hair salons and stores have discounted rates for seniors, and you should take the initiative to request this for them.

Are your parents likely to be victims of fraud?
Stay current with the latest con-artist schemes against the elderly. (Fraud.org is a good Web site for the latest news).  Your parents may be the target of appeals from bogus charities and home improvement scams.  Encourage them to save all the appeals they get, and do nothing until you can review them together.

Are they unable to independently manage their finances?
If you notice bills piling up in their house, or if you find late or final notices from utility companies and other creditors and services, this could be a clear signal that someone needs to start helping them manage their finances.  If you lack the time or expertise, then help your parents line up a financial advisor, lawyer, or bank manager that you can trust.

Are your parents’ medical policies and prescription plans adequate for their needs? Dealing with insurance companies is confusing for anyone, let alone the elderly.  Review your parents’ medical insurance policies regularly to make certain no changes in reimbursement have occurred and that their doctors are still covered by their health plan.  If necessary, get on the phone with your parent to check with insurance companies that your parents’ policies are still in effect and that claims are being adequately processed.

ARE THEY SOCIALIZING ENOUGH?
You need to make sure that the problems associated with aging do not prevent your parents from having a rich social life.  Too often, decreased confidence in driving may isolate them from participating in activities as often as they want.  Problems with incontinence, poor hearing and vision may cause them to become further isolated.

Are your parents going out less often?
Find out the reason for this change.  If it is because they are scared to drive, or that their license has been taken away, help them to find local transportation services available in their community, such as Dial-a-Ride.

Are you regularly interacting with your parents?
As your parents age, it is important that you increase regular contact with them. Calling and visiting them regularly will allow you to monitor any behaviors that can be cause for concern and to check for any unmet needs.

IS THEIR PAPERWORK IN ORDER?
If your parents were to become unable to make their own healthcare decisions, a medical emergency may result in procedures being taken that go against their wishes.

Is the necessary paperwork in order to ensure your parents’ desires are followed?
Important documents required by your state can be the Durable Power of Attorney, Durable Power of Attorney for Health Care, Living Will, and Advance Directive.  Check with an attorney to see which documents are needed.  Help your parent get these documents in order and make sure they are placed in a secure location where they can be found when needed.

IN CONCLUSION:
Other special areas of concern may exist with your parents that hold equal weight to the ones presented here.  However, these are the most fundamental and critical ones.  If you focus on these few simple things, you will go a long way toward ensuring the well-being of your parents and removing those nagging worries about whether you are attending to their needs in a responsible way.
Diane Heltsley is a Licensed Clinical Social Worker who has 29 years of experience working with families, the elderly, the chronically ill, and the dying in a variety of settings (hospitals, home health agencies, nursing homes, retirement homes, adult day health care centers and hospices).  She has noted with concern how individuals and their loved ones are often not prepared to handle the decisions facing them in the complex areas of health and aging.

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