Responsibility to Care for ParentsAccording to the California 3rd District Court of Appeals, adult children have a legal responsibility to provide reasonable a care for their aging parents.
It’s sad that we need laws and courts to enforce what, in most societies, is the norm. Even all the discussion about being part of Gen Sandwich assumes that caring for aging parents and children is a burden. Underlying most of the literature and blogs is the assumption that this care interferes with my right to “my” life. I confess I sometimes feel that way when I’m feeling smooshed between conflicting demands. But is that wrong? Normal? Cultural?
I love the attitude of Patricia in Washing the Feet of the Saints. Read her November 25 and 29 posts. Would that more of us had her heart of service. Would that I had her heart of service more often.
Recently we visited a Native American pueblo in New Mexico. While on the tour, someone asked what happens to the elderly in their community. The tour guide responded matter-of-factly that they are cared for in the home of one of their children or grandchildren. “They cared for us when we were babies, so we take care of them when they are babies.”
This reminds me of a phrase we often said when our son was growing up. When we’d do something especially nice for him, we’d joke, “We’re being good to you when you’re little so that you’ll be good to us when we’re little.” We sort of assumed we were just talking about the period we’re in now, when he’s physically bigger than us and off living his own life. And so far, he is pretty good to us.
But the bigger question is how he’ll treat us when we are old and frail. When we need the type of help my parents need now. We can only hope that he takes note of how we care for them, and will do at least that much for us. Maybe more.
Monday, November 27, 2006
How about a Robot-Sitter?Here’s an alternative to caring for Mom or Dad yourself. According to the Korea Times, hundreds of the scientists in the Asian county are developing robots that will be equipped with voice recognition software and capable of performing routine eldercare.
Well, it’s efficient all right. But think about it. “Mom, I really don’t have time for you. Here’s an R2D2. He’ll make sure you take your meds, take your vitals, and sing you a lullaby. Call if you need me.” I wonder if they can engineer a personality? I wonder if they can convince an elderly person that they’re loved? Would a robot be more personal than Life Alert?
On the other hand, I constantly worry about my mom falling at home, yet, she won’t even consider assisted living or a companion. If the robot could really recognize a fall or health problem and contact emergency services, it might provide an alternative for still-independent seniors.
My mother-in-law passed away in her home. She was active, driving, traveling the world. She loved her independence and we certainly didn’t want to rob her of it. We never knew where she was, even though we begged her to let us know when she knew she’d be gone for a few days. We’d try to check in every day or so without hovering. After two or three days of not hearing, we’d call around and eventually find her visiting a friend. One day when we made the calls, none of her friends had heard from her either. They were beginning to wonder as well. We drove up to her home and found her in her bed. Probably a heart attack. Could a robot have given her safety and independence?
These are strange days we live in. Days where technology is making science fiction real. So, what do you think? Do you want a robot caring for your mom?
Sunday, November 26, 2006
Medicare--How Savy Are You?How much do you know about Medicare and long term care? You can take a quick quiz and test your understanding. if you haven't run into these terms, chances are, you will. I know when my step dad first fell and was covered by Medicare for skilled care, we learned a whole new vocabulary. The reality is, Medicare covers less than you might expect.
Saturday, November 25, 2006
Sandwich Generation VideoTake 11 minutes and watch the video, “The Sandwich Generation,” and you'll know you aren't alone.
In this emotionally charged account of family caregiving, filmmaker Julie Winokur and her husband, photojournalist Ed Kashi, expose their personal lives with unflinching candor. Winokur and Kashi uprooted their two children and their business in order to move 3,000 miles cross-country to care for Winokur's father, Herbie.
At 83, Herbie suffers from dementia and can no longer live alone. Winokur and Kashi are faced with difficult choices and overwhelming responsibility as they charge head on through their Sandwich years. It is a story of love, family dynamics and the immeasurable sacrifice of those who are caught in the middle.
Wednesday, November 22, 2006
Thanksgiving SurpriseI’m so excited. Our son and daughter-in-love are coming home after all. It’s been hard for them to decide what to do on their first holiday. But her mom works all day, so they will celebrate on Saturday. I had urged them not to come because of the traffic. The usual seven-hour drive would easily become nine or ten tonight. And the same going back on Sunday. So they were going to take a little trip or hang out tomorrow.
But when we talked today, it was clear that we were all missing one another terribly. So tonight, he called and said they’re driving up tomorrow and will be here in time for breakfast. The friends we celebrate with are setting two extra places at the table. Their boys are also coming home, so we’ll all be together again.
It’s so wonderful to have raised a son we LOVE being with. The pain of missing him was actually palpable, so I really appreciate their willingness to make a fast-turn-around trip just to be with us. I’ve made my traditional sticky buns, which will be waiting when they drive up tomorrow. Life is good!
Labels: adult children
Eldercare ResourcesUS News and World Report offers a series of articles on caring for aging parents. They provide information on switching Medicare Part D plans, Long Term Care Insurance, the possibility of eldercare benefits from employers, and the new Medicaid rules which make it much harder for the elderly to get coverage. Great information, as well as a list of useful resources.
MedicareAdvocacy.org provides “Part D by the Numbers,” a useful chart that compares the 2006 and 2007 benefits. It also includes helpful info on getting out of the donut hole. This is helpful. I spent a couple of hours at Mom’s reading the whole Medicare manual and I’ve gotta’ tell you, I’m more confused than ever.
And just a reminder. You have until December 31 to change your Part D Plan—assuming you can find something in your area that will serve your parents better—or you’re locked in for another year. In my parents’ area, there aren’t many options.
Monday, November 20, 2006
Attitudes on Aging and LossWhile at Mom’s, we talked about the many losses she’s faced this year. Dad has been in care for almost a year and a half. They’ve lost their hopes and dreams of traveling, enjoying the remaining years of their lives together, doing the things they enjoy. They’ve lost many friends this year. Finances are getting tight. It’s hard for her to look forward to what lies ahead when all she sees is what she’s lost.
I try to encourage her to find joy in life, to be thankful for what they still have together, to enjoy their memories, and to take care of herself. I see the fruit of depression in her aches and pains and her outlook on life. I printed out the American Heart Association’s Caregiver Manual and encouraged her to read it and work through some of the journal pages. I doubt that she will, but I keep trying.
As I’ve watched her this year and as I’ve faced my own health issues, I’m making a concerted effort to focus on what I CAN do and what I DO have to look forward to. I want to be a delightful older woman, not a depressed or cranky one. I can’t control the circumstances I’ll face, but I want to control the way I face my circumstances. An important skill for Gen Sandwichers who want to avoid feeling smooshed.
Sunday, November 19, 2006
Holiday Decisions--ResolvedWe just got home from my parents. We celebrated our family Thanksgiving yesterday and it turned out well. After vacillating about whether to go out or stay in, we decided to simplify the meal and stay in. The deciding factor was my step dad’s needs. He wanted to spend the day in his home. The only time he can come home now is when there are a couple of strong men to help him in. To bring him over for part of the day and then go to a restaurant would mean an additional transfer in and out of the car, which is always hard on him. So we had everyone bring one item so no one carried the whole load. We switched from turkey to pork loin and from mashed potatoes and gravy to scalloped potatoes from a box, which are far easier to cook and serve. We kept the rest of the menu simple and served on paper plates. Everyone pitched in and at least some of the men helped with clean up, so it wasn’t a burden on anyone. We had time to visit and enjoy one another’s company. And Mom got to have another holiday in her home.
Wednesday, November 15, 2006
Parenting KidultsPhyllis Goldberg and Rosemary Lichtman offer some great advice to parents whose kidadults who have headed off to college in “How to Lay Low as Helicopter Parents.” Contrary to their advice, we remained quite involved with him during his college years. But we also gave him a lot of freedom and a lot of encouragement. We were available to listen and to reflect and suggest, but tried not to mandate. We got to know his friends, and had wonderful hour-plus weekly conversations with him. We often felt we were walking a tightrope.
Boy, in my opinion, there’s nothing harder than parenting adult children! Knowing when to step in and when to shut up is far tougher than dealing with a screaming two-year old or a moody teenager. We’ve been incredibly blessed with the relationship we’ve been able to maintain with our adult son. He’s a delightful young man who seems to have forgiven us and continues to forgive us when we overstep. It took most of his college years for us to really let go, but now we feel as if we have a pretty good adult-to-adult relationship. I hope he feels the same.
Labels: adult children
Tuesday, November 14, 2006
Holidays Decisions for Gen SandwichersWell, it’s time to make our holiday plans for the year. I always dread this time of year. What was always assumed—we’ll go to Mom’s—is no longer as easy as it used to be. It used to be that my sister and I would pitch in and the three of us managed to get a festive meal on the table. In our family, kitchen work is women’s work, so we’d often end of cleaning up as well—sometimes with a little help from my husband (whom I trained well from the beginning).
Every year it becomes harder for Mom to host the holiday celebrations, yet she’s unwilling to give them up. She still wants the family to come “home” even though none of us has ever lived in their current home or even in their town. But home is where Mom is, and no on is willing to challenge that. I’ve offered, but since I live the farthest away, no one wants to drive that far. So each year, we gather at Mom’s for Thanksgiving and Christmas with the family.
Years ago Mom found a way to be sure that her whole family would be at the celebration. She gave up having the holiday on the Holiday. I guess it started when some had to work the Friday after Thanksgiving, so we moved our celebration to the Saturday after, and then eventually to the Saturday before. Makes travel easier and reduces the excuses. We also celebrate Christmas on the Saturday before December 25th, facilitating travel for all of us. However, for the past four years, that has meant that our son has missed out since he was away at school, and even now, lives too far to make the drive on a weekend
So as we prepare to celebrate Thanksgiving on the 18th, we now have other decisions to make. My sister has a serious back injury and can’t stand long enough to do much in the kitchen. Mom is growing more frail and is easily overwhelmed. My step dad is in a care home and may or may not be able to climb the steps into their home. And I have a hip in need of replacing. So what do we do? Mom still wants the family dinner with the big table and the smell of turkey roasting in the oven. But none of us can manage it anymore.
In the past, we’ve gone to restaurants but that really loses something in the translation. We’ve tried the dinners from Safeway, but there is still more prep than we have energy for this year. We’ve tried changing the menu to something easier, but then Mom and Dad feel they haven’t had a holiday. While the rest of us celebrate again on the actual day, they often are home alone or perhaps go to a community meal.
So the discussion is on again. Who has the energy and stamina to do what? Should we try a restaurant? Does anyone have a new idea? We need to decide pretty soon! But most important, we’ll all be together in one place and spend a day renewing our relationships, playing with the grandkids, and being “at home.”
As you think about your holidays, remember that being together is more important than what or where you eat or how fancy the table is or even what day you gather on. And remember that as our parents age, these times together become more precious to them as well as to us. We never know which holiday will be our last with them. So knowing that, how do we want to spend this Thanksgiving and this Christmas with them? What can we do to make the day special, whenever we celebrate?
Grhomeboy offers some additional thoughts about managing the holidays with our aging parents.
Sunday, November 12, 2006
Is Your Parent Being Overmedicated?Phyllis Staff writes an informative article on how her father was severely overmedicated after entering a nursing home. She also offers resources to assess this problem.
We had a similar experience when my step dad went into the nursing home. They prescribed a new pill for every problem. His diabetes, which had always been controlled by diet, now required insulin. They prescribed diuretics to counteract meds that increased water retention. And of course, his medication costs went up significantly. Since moving to the board and care home, he no longer needs insulin. And we’ve been able to drop a couple of other meds, although he’s still taking more than I’d like him to.
One problem we faced with the nursing home was that, rather than having his primary care physician follow him, his medical group hires a nursing home physician. This person who didn’t know him or his history was suddenly in charge and there was absolutely nothing we could do about it. This physician was never around and never returned my phone calls. I was able to work through the nurse manager, but would have preferred to deal directly with the doctor. Now we’re back with his primary, and we feel a lot better about the medication management. We’ve asked him to also manage and monitor the meds prescribed by Dad’s various specialists.
However in the final analysis, it’s important that we monitor our parents’ meds, whether they are in a nursing home, a care home, or at home, especially if they have several doctors prescribing for them. It’s all too easy for an interaction or allergy to slip through the cracks.
Caregiver ResourceThe American Heart Association has produced a beautiful and thoughtful site called The Heart of Caregiving, honoring and encouraging those who provide care for others. It features eight categories: Rights, Responsibility, Reality Check, Refresh, Rejuvenate, Replenish, Reach Out, and Resources. In each section, there’s a discussion encouraging caregivers to take care of themselves. In addition, there’s a beautiful journal you can download and print. I’m going to print and bind this as a Thanksgiving gift for my mom. Maybe she’ll pay attention if it comes from someone other than me.
Saturday, November 11, 2006
November is National Family Caregivers’ MonthFamily caregiving is the bedrock on which our loved ones and our health care system depends. The services these family caregivers provide represent 80 percent of all home care services and are conservatively valued at $257 billion a year--more than twice the amount spent on paid home care and nursing home services combined.
Caregivers, who may be anyone meeting the needs of a loved one with a chronic illness, provide a vast array of emotional, financial, nursing, social, homemaking and other services on a daily or intermittent basis.
An article from the Lafayette County (WI) Health Department suggests ways to honor and help these loving servants. Take a few minutes and thank a family caregiver today—and then do something to give them a break.
Thursday, November 09, 2006
AARP and Medicare Part DI get tired of writing about Medicare Part D, but seriously folks, it’s a huge decision, as some of us learned this year. And it’s way too complex for any elderly person I know to understand. Another problem seems to be that we’re shooting at a moving target. The plan you had last year may change in any of several ways. And from what I’ve heard, they can even change during the year.
AARP provides an easy-to-understand synopsis of the program. Please don’t just assume that you’ll do what you did last year.
Now I need to get my mom to send me the materials from their plan so I can see what changes they’re making and then compare them with the others in the area. Problem is, my folks are in an HMO. I wonder what happens if you opt out of the HMO’s Part D plan but want to stay with the HMO. Anyone know?
More Retirement Planning InsightsAs if following up on yesterday’s post here, CNNMoney.com discusses 401(k) Flubs-5 to Avoid. They add great insights to planning for your retirement. This is so important because, as reported by WNBC.com, Gen Sandwichers are facing later retirement because of being smooshed between kids and parents. We need to be wise as we navigate this stream.
Wednesday, November 08, 2006
Who Will Fund Your Retirement?A study from the Harvard University Generations Policy Program edited by Paul Hodge, Chair, Global Generations Policy Institute, suggests that the aging of America’s baby boomer women is the most urgent issue facing our nation in the 21st century.
He points that that since women spend more of their years in care-giving for both children and aging parents, they have less time to build for retirement. In addition, women generally earn less than men.
There’s really nothing new in this study. It reinforces what we’ve known for years. What it can do, however, is serve as a reminder to Gen Sandwich women (and men) to plan for our own retirement. Don’t count on Social Security, which penalizes those who move in and out of the workforce and which may not be solvent by the time we get there anyway. (What we know for sure is that there will be a lot of Boomer retirees and far fewer workers to support us, so the prognosis for Social Security isn’t one I plan to bank on.)
Anything you can do to take control of your retirement fund will pay off in the long run. Invest a little each month in your own IRA. You’ll be amazed at what a small amount, invested regularly, will grow into when it can accumulate free from taxes and can reap the power of compounding. And the earlier you start, the better off you’ll be. We started investing very small amounts in our 30s and have watched those IRAs grow into sizable nest eggs for our retirement.
It’s not depending on the government that’s going to give you security as you age. Government policies can change overnight, blown as they are by the winds of politics. This nation was founded on individual responsibility, and that’s what will give us the best hope for our retirement.
Tuesday, November 07, 2006
Acts of LoveA post by “pdevadiga” reminds us of the importance of those little acts of love. Consider how you can honor your parents today, while you still can.
Labels: aging parents
Monday, November 06, 2006
More Medicare Part DDavid at The Delaware Right makes a very good point that prior to Part D, there was nothing for many seniors. For them, what we have now is definitely better. He’s right. $2250 in coverage is better than nothing. Amazing how quickly we grow accustomed to "entitlements!" However, I still think the plan is too confusing for mere mortals (especially confused 85-year-olds) to understand.
Unfortunately, my parents had better coverage before with their Medigap program and are now in the donut hole, so it's easy to be critical. I was suspicious when their plan announced that they were adopting the Medicare Part D plan. I’m sure it is better for those whose prescription drug use is low, but it’s sure a kicker for those who have several branded meds for which there is no generic.
Here’s what we’re doing: As much as my mom hates to ask for help (and she feels that asking is begging), I’ve convinced her to ask all of my step dad’s doctors for samples of all of his meds. Even if Doctor A didn’t prescribe the drug, he may have samples while the prescribing doc doesn’t. Many of the drug companies have plans were seniors in the donut hole can ask them directly for help, but since they also provide physicians with samples, that’s the easiest way for seniors to meet the need for the next two months.
Saturday, November 04, 2006
The Complexities of Medicare Part DForgive me if I sound like a broken record. I know that many of my posts relate to the Medical Prescription Drug Plan. I guess I continue to be appalled at the complexities and the fact that mere mortals don't have a hope to understand it. Here’s yet another article trying to make the complex understandable.
Frankly, I still have my head in the sand. I’m not pleased with the plan my parents have, but I don’t know if I have the time or energy to try to find something better. And as the author points out, it seems that the plans reserve the option to change in the in middle of the year, but the beneficiaries don’t have that option. Go figure!
Labels: Medicare Part D
Friday, November 03, 2006
Caring for the Ones We LoveI ran across this on an email. My apologies to the author, whose name was not attached. However, I wanted to share it with you since it expresses a wonderful sentiment and gives us something to think about in the midst of being smooshed. Why do we do it? Because our loved ones are worth it.
I grew up in the 40s/50s with practical parents. A mother, God love her, who washed aluminum foil after she cooked in it, then reused it. She was the original recycle queen, before they had a Name for it... A father who was happier getting old shoes fixed than buying new ones.
Their marriage was good, their dreams focused. Their best friends lived barely a wave away. I can see them now, Dad in trousers, tee shirt and a hat and Mom in a house dress, lawn mower in one hand, and a dish-towel in the other. It was the time for fixing things. A curtain rod, the kitchen radio, screen door, the oven door, the hem in a dress , Things we keep.
It was a way of life, and sometimes it made me crazy. All that re-fixing, eating, renewing, I wanted just once to be wasteful. Waste meant affluence. Throwing things away meant you knew there'd always be more.
But then my mother died, and on that clear summer's night, in the warmth of the hospital room, I was struck with the pain of learning that sometimes there isn't any more.
Sometimes, what we care about most gets all used up and goes away...never to return. So... while we have it... it's best we love it.... and care for it.... and fix it when it's broken...... and heal it when it's sick.
This is true. for marriage..... and old cars.... and children with bad report cards..... and dogs with bad hips.... and aging parents..... and grandparents. We keep them because they are worth it, because we are worth it. Some things we keep. Like a best friend that moved away or a classmate we grew up with.
There are just some things that make life important, like people we know who are special... and so, we keep them close!
Thursday, November 02, 2006
Aging and IndependenceMy step dad fell earlier this week and is in a lot of pain, making it difficult to walk, sit, or just about anything. He was trying to pick up something he had dropped on the floor and fell out of his wheelchair. The brakes weren’t locked, but from the description, I’m not sure it would have made a lot of difference.
I think one of the hardest things about getting old must be to accurately gauge your present abilities, rather than living in the memory of your past abilities. I know I feel that way. My body is 59 and aging quickly; my mind is still 35 and can’t figure out why I can’t do what I’ve always done.
Dad’s generation is famous for their fierce independence. Now, at 90, he still believes that if he can think it, he can do it. Nearly blind, he continued to work on his truck until just before he fell a year ago. He would describe to Mom what needed to be done and use her as his eyes and hands. Even after several falls and a year in a nursing home, he stubbornly refuses to ask for help. And Mom is about as bad as she continues to try to help him, steady him, and now, get him in and out of bed and wheelchair.
I ask her why she does it. Doesn’t she realize the risk she’s putting herself at? Yes, she says she does. But he needs help, and she doesn’t like asking for help or telling him no. So she lifts, pulls, pushes, and steadies. My greatest fear is that she will fall and end up needing care herself. What a shame since she is engaging in a known risk. But she's an adult, and I don't seem to have a lot of influence with her.
I can barely keep up with their needs at this stage, where she is still able to handle the day-to-day issues. Managing two of them in care would, I think, stretch me beyond my limits, and yet, like her, I suppose I’d do it. Yes, once again, I feel smooshed.