Sunday, November 8, 2015
2014 had been a difficult year. My 93 year old Father had experienced a year of failing health. It felt like a slippery slope and no matter how we tried we couldn't find sure footing. As the holidays approached we knew that this would be the last Christmas we had Daddy with us. He was living in the nursing home now and wheelchair bound. He couldn't manage his own body weight so standing was almost impossible. The silver lining was that his mind was clear and he was alert.
(photo circa 2004)
My father had always been the life of the party. With Santa hat on his head and harmonica in his hand he conducted the entire family party from Giving Thanks for our many blessings to holding the annual gift swap of white elephants! He was master of ceremonies. He usually gave a short speech prior to the blessing on the importance of family and love, reminding us that all the gifts in the world couldn't replace the people and love that existing around that holiday table.
This year my Father was so frail we struggled. How would he be able to attend the holiday party? I must admit I was the one who was fearful that we wouldn't be able to manage getting him from the nursing home to my sister's house. How would we get him into the car? How would we get him in his wheelchair into the house? How would our children (his grandchildren) respond to seeing their grandfather in such a frail state? Thankfully my sister was adamant, Daddy would be at the holiday party! I can still hear her voice, "if we can't manage getting him into the house with four strong grandson's then what good are we?" The decision was made.
It wasn't easy but we bundled him up, got him into the car, and two of his four grandsons lifted the chair into the house like it was a feather. My father's eyes literally glowed that night and I don't think the smile left his face the entire time. Sitting there surrounding by the family that he and my mother had created with their love was the greatest gift we could have given him. Even though the grandchildren are all in their 20's and 30's now, you would have thought that my Father was Santa himself as they gathered around him hugging, laughing and sharing stories of holidays past.
At the end of the night it was bittersweet as we got him safely into the car and two of his grandson's took him back to the nursing home. . My sister was so right!! We would have this moment . He would have this moment. Our family would make it a reality. The memory of my Father's last Christmas is seared into my memory forever.
It was joyful, it was spiritual, it was and IS the true meaning of Christmas.
(photo circa 2007)
Sunday, September 13, 2015
We thought we were on top of Dad's finances. He had seemed able to manage his own affairs and we frequently discussed major decisions but shortly after my Mom passed my Father was approached by a broker selling an investment product. Since my Dad was still handling his own finances he chose to meet with the salesman. Before we were even aware Dad had invested quite a sum of money in a product that would not mature until 2036 (my Dad was 90 at the time.) Once we found out there was little we could do. Dad had been competent when he had signed the papers but was still very much grieving my Mom's passing. Even though we tried hard to protect our family - it happened to us.
According to a recent survey (2010 Investor Protection Trust) one out of five older Americans 65+ is the victim of financial fraud or abuse. It's not surprising since persons over age 50 control over 70% of our nation's wealth. Financial fraud and abuse is also not limited to unscrupulous salesman or scams. In fact a large portion of abuse against the elderly comes directly from people they know and trust ( children, grandchildren, caregivers and trusted professionals).
So, how does this happen? Sadly it's relatively simple and almost impossible to track. Since seniors are often dependent on family members and others for assistance with finances it exposes them to fraud. Also the lack of understanding of new banking and finance tracking through electronic means puts seniors at a disadvantage in monitoring their accounts. Often seniors aren't exactly sure what their total net worth is and the extent of the assets they have available to them. No one likes to think that a family member, friend or caregiver would misappropriate funds for personal use but it happens all the time.
Recently while working with a family who was seeking Medicaid assistance for their Mother I learned that Mom had owned a home in a nice suburb. I inquired as to whether that could be used as an asset to be sold to help pay for her care. Her son informed me that as Power of Attorney he had made arrangements for the home to be put in his name. When I advised him that Medicaid would do a 60 month "look back" period for transfer of assets he became very angry with me. He had already sold his home, pocketed the cash and moved into Mom's home with plans to have Medicaid handle her expenses. He wanted to shoot the messenger - and unfortunately the messenger was ME!
(for more information on asset allocation for seniors: www.elderlawanswers.com)
So where do we turn to keep our seniors safe from financial fraud and abuse?
1. Almost all states offer some form of Adult Protective Services. While in most cases an agency like APS can not punish the perpetrator they can take steps to protect the senior from further abuse.
2. Have more than one family member or trusted friend acting as a second fiduciary.
3. Sign up for the National DO NOT CALL registry 888-382-1222
4. Shred all out of date personal and financial papers - and keep all legal and financial papers in a locked safe location in your home.
5. Request a free annual credit report every year.
6. Do not enter contests, sweepstakes, giveaways through the mail or on line. Do not click on line links that request verification of personal data.
7. Donate only to charities that you are familiar with and preferably localized.
Integrity in dealing with the financial aspects of our senior's legacy is important. Knowing the pitfalls and what to look for can make a difference. For more information on financial abuse and how to avoid it :
Protecting our loved ones is our sacred trust.
If you have information to share on how to avoid financial abuse or a story that would benefit others please post it here.
Monday, August 3, 2015
I was working as the admission director in a upscale assisted living/ dementia care community when I met the sweetest gentleman. He approached my office door in almost a sheepish manner. "Do you have a minute?" he asked. "Absolutely," I answered, "please sit down." With stooped shoulders and rumpled shirt he slouched down into the chair and let out a small audible sigh. He was living alone with his wife of 52 years he explained. She was having trouble remembering things, and was very confused. "Sometimes, she doesn't even know me," he looked down at the carpet and shuffled his feet. "It's hard because she needs help with "things." I immediately knew what he meant. I could also see that he was exhausted mentally and physically.
All too often this is the scenario. Caregiver stress is a very real issue.
Wednesday, June 3, 2015
Since beginning my career as a Senior Advisor one of the most FAQ’s is, “How do I talk to Mom and Dad about the fact that they are aging?” It’s a challenge but truth be told we are all aging. Growing older begins the moment we let out our first cry gasping for air until the moment we take our last breath. It’s life.
In an effort to find the magic formula for facing mortality (our own and our parents), I scoured the internet. Surely someone had found the magic bullet for helping us communicate this chapter with Mom and Dad. I was shocked at how little information is available. Again the baby boomer children are blazing a new trail. Dealing with the challenges of aging parents is something we didn’t get to see our parent model because their parents passed earlier (60’s70’s and 80’s). Healthcare services, nutrition and exercise have increased life span for everyone. We’re seeing our own parents living into their late 80’s 90’s and even farther. Why in the world would they listen to us? Because they must. We are the responsible adults that must and will either assist in or ultimately make the decisions. So how do we begin?
“Listen to understand.” One of the most debilitating things I have seen while working with seniors and their families is the unwillingness of the adult children to accept the responsibilities of being an adult. It takes a strong loving child to make the best decisions for the parents they love. In some cases this will conflict with Mom or Dad’s immediate wishes. Stepping out of the role of “child” is challenging. Parents struggle with letting their child assist in making decisions. Truly understanding why your parent feels the way they do can go a long way toward coming to a consensus on next steps.
In the words of Steven Covey on his book, The 7 Habits of Highly Effective People,
“Communication is the most important skill in life.” We speak or otherwise relay our message, take in what other people have to say, and formulate a response. Dr. Covey posits, however, that “most people do not listen with the intent to understand; they listen with the intent to reply.” As Dr. Covey describes, sometimes we are so focused on getting our message across that we completely forget that the person we are attempting to communicate with is speaking from their own frame of reference.
“Start conversations early.” Discussing possible changes in health, financial situation and living arrangements will have better results if your family member is still able to manage well on their own and are not immediately confronted with the change. Fear is the biggest reason that our loved ones shut us out -fear of aging, fear of health concerns and fear of change. Talking it out before a significant life change or specific event can alleviate fear. This will give your parent a feeling of control and will assure that you know their true wishes.
“Seek the blessing and share it.” This journey of aging is challenging for both parent and child. Let your parent know that this is a time that you can “give back.” Parents will be much more accepting of your counsel and care if they feel that they are not a burden but a blessing. Even if your relationship with Mom or Dad has been rocky this can be an experience that allows you to expand your compassion and grow your spirit.
“Ask for help.” No parent or child can be expected to travel this road alone so access all the resources available to assist you. Don’t hesitate to enlist the help of family, friends, church members, community services, your healthcare providers, and make sure you READ and get informed.
It was our strong independent parents who survived a Great Depression, fought in a World War, saw man race to the moon, endured defiant children of the 60’s and70’s, and set the tone for a cultural and technological shift. They truly are the Greatest Generation! Many logistical things are involved with caring for our aging parents – finances, living arrangements, healthcare concerns, even end of life arrangements. We can honor our parents in this chapter of their lives by choosing to communicate.
It’s a simple message we seek to share with our parents,
“Do not be afraid, you are not alone, I am here.”
Tuesday, May 26, 2015
TRAVEL! It’s one of the brass rings of retirement but after two recent trips I’ve learned that there’s more involved than grabbing my purse and heading out the door. Baby Boomers and Seniors take note- it’s about the planning. First things first!
Where am I going?
Make a travel bucket list and start checking off destinations! Take your time and consider where you want to go and the best time of the year to visit (considering crowds, climate, and costs). Research is part of the fun and can save you time, money and blisters. The travel industry is anxious to help so if you have some limitations don’t let that squash your wanderlust. Go somewhere you’ve never been. If you’ve been to the beach on vacation your entire life then it’s definitely time to branch out. Sure you may have to work a little harder making sure that your trip meets your needs but don’t let that stop you.
How long will I be gone?
You may want to wander the world for weeks on end, or you may think a long weekend is too long to be away from home. Always a consideration are any medical needs or appointments so talk with your health care professionals. They can help you determine your needs. In addition consider the destination- are you staying in the USA, traveling to be with family, all of these can impact the length of your trip. Only you can determine how long you can be the adventurer.
Who will go with me?
Traveling companions can make or break a great trip. Consider if you are prepared to share living space or every meal with another couple, or those close friends. Are you comfortable sharing expenses with someone else? Knowing your tolerance and that of your traveling companions is important. Traveling alone or with just one other person can streamline your trip. So consider traveling companions as a part of the planning.
What should I pack?
Two words – pack light! I don’t think I’ve ever been on a trip that I didn’t pack too much or the wrong thing. Here are some tips:
Check the weather for your destination. You can even check historical data and see what conditions normally are in the region. See if your accommodations have laundry service or washer/dryer. If traveling by air – make sure you pack a hand carry bag. In your hand carry you should have:
· a minimum of one change of clothes,
· any prescription and over the counter medications in their ORIGINAL containers placed in a one quart clear freezer bag, (medication dosages put in a pill box will NOT go through security),
· a photocopy of any prescriptions, and/or physician instructions,
· a photocopy of all insurance cards, emergency contact information.
Documentation for travel. (A government passport is considered the highest level of identification by the federal TSA) I suggest making at least two photo copies of each of the following:
· driver’s license,
· Medicare or any other insurance cards,
· travel tickets and boarding pass,
· all confirmation receipts for events you have pre-scheduled for your trip. Keep one set in your hand carry bag, one on your person or your purse. (Remember health coverage here in the US is not considered coverage overseas – so please make arrangements when traveling out of the country for trip insurance/health insurance).
Think comfort. One pair of comfortable shoes can save your life. Of course we want to look stylish so make the pre-trip shopping part of the fun. After all anticipation is what makes things that much better.
Don’t take what you won’t need. You’ll have to carry it, pack it, unpack it, fold it, and sift past it so leave the extra keys, the five extra scarves, and that one extra pair of black pants at home.
How will I get there and once I arrive how will I get around?
Transportation is often a multi-faceted element of your trip. Traveling by car, plane, or train all have different pros and cons. If traveling by air consider asking for the aisle seat for easy in and out. If possible keep your hand carry bag between your feet under the seat in front of you or where you can monitor the overhead bin where it is stored. Don’t forget to stand periodically to get the blood moving. On long car trips factor in time for short stops to walk about at a rest stop or grab a bite to eat.
Consider if you will be using public or private transportation and the cost differences. Taxi service can be expensive and should be factored into the cost of your trip. Recently in NYC our hotel concierge found us a Town Car rental to take us to the airport that was more comfortable and less expensive than a taxi. Let your travel agency or your hotel concierge help with ground travel. They are the pros and know the ins and outs. If you’re lucky enough to have family or friends in a place you want to visit they can assist in navigation and travel. Last but not least thank heaven for GPS – it can provide navigation instruction whether walking to your destination or riding in a car.
Should I set an itinerary?
Yes, yes and yes! You may think you want to be a free spirit but when you can’t find a restaurant within 20 miles of your destination you’ll thank me. You can always go OFF the itinerary if you find something compelling or hear of an off the beaten path escape from one of the locals but there is no substitute for having a rough outline of a plan. Also planning an itinerary in advance means that you can go ahead and book the best reservations, excursions, and get the best tickets for the things you really want to do. Read TripAdvisor! www.tripadvisor.com
What a resource of real world reviews to find out just what things are the must see/must dos in the area you are visiting. (always give a photo copy of your itinerary with phone numbers and addresses of where you will be to your emergency contact)
Schedule some downtime and put it IN the itinerary.
I know you want to cram in as much fun as possible– but when your feet are tired and your back is aching you’ll thank me. Think of it as a time to reflect and recharge so you’ll enjoy each event of your trip that much more.
Should I consider a Tour or a Cruise?
Absolutely! Let someone else do the homework. A tour or cruise offers a special situation for baby boomers and seniors in that they have done most of the work for you. They are planned, operated and staffed to provide the best experiences. They also have the people to handle unforeseen circumstances that might arise. Many cruise companies and tour groups even allow you to go “off the grid” for a while and have your own adventure. Travel being handled by a professional could be the perfect combination of escape and security.
So, make a plan, grab your bags, and pack your comfortable shoes there’s no substitute for the brass ring travel can bring. I wish you the joys of discovery.
Tuesday, April 14, 2015
Accountability, it's the new watchword. We want our policemen, our teachers, our employees, our health care providers and for heaven's sake our politicians to all be accountable. We want to hold someone responsible. But when it comes to one of the most important things that can
impact our health and our ability to age successfully we aren't holding ourselves accountable. We want "someone else" to be the responsible party.
I'm talking about MEDICATION!
Mismanagement of medication is often the first thing that will cause someone to lose their independence. In the U.S. today over 40% of those over the age of 65 take between five and nine different medications. It can be very confusing and sometimes lethal.
It's not unusual for a senior to be seeing several different doctors for different conditions. That doesn't mean that those physicians are all "talking" to each other. Yes, there are a lot of cooks in the kitchen. Did you know that your primary physician is NOT responsible for monitoring your different medications? Did you know your pharmacist is also NOT responsible for monitoring your different medications. YOU are the one who must be accountable for the medications you take.
Is there any good news? Absolutely! Here are actions steps to make sure that the medicine we take not only benefits our health but is safely administered for ourselves or someone we love.
- Talk with ALL of your doctors about the medication they prescribe. What is it for? What is the medication supposed to do? How it should be taken ( w/food, water, intervals)? What could be the side effects? What if I miss a dose? Are there any other special instructions with this medication?
- Ask your doctor if the medicine could interact with other medicines either prescribed or "over-the-counter" ?
- Always have your medications filled at the SAME pharmacy. Pharmacists keep a computer record of those medications that you have filled with them and can often see potential conflicts or problems with drug interaction. Ask your pharmacist if you can fill out a client profile to include all your medications and any "over-the-counter" medicines that you may be taking.
- Review your medications with your doctor frequently. Ask the question, "Do I still need to be taking this medication?" "Is this still the correct dosage?"
- Always take a COMPLETE listing of the medications you are taking including "over-the-counter" medicines into your doctor's office each and every time you go for a visit. Make sure that you are providing every doctor that see you a COMPLETE list of medicines that they can keep on file. Update this with them on a regular basis.
- Provide your family members that participate in your healthcare with a complete listing of the medicines that you are taking in case of emergency.
- When traveling always make sure that you have your medicine "with you" in a carry on or handbag and not in your checked baggage in case your luggage may be lost.
- Don't wait until the last minute to have prescriptions filled in case there is a problem getting your medicine or the pharmacy is closed due to holiday or off hours.
- Never take medications that are not prescribed for you even if you know what they are. The dosage could be based on weight or it may interact negatively with something else you are already taking.
- Never take medication if you have ingested alcohol. Alcohol can enhance the effects of many medications or cause other adverse reactions.
- Organize your medications. There are multiple options for assisting with this - from pill organizers to digital reminder pill boxes.
- Keep medications in a cool dry place away from bright light. Do not store medicines in the refrigerator unless instructed by your doctor.
- Always keep medication in a safe place away from children and pets. This includes when you are away from home. Be cautious about storing your medications in your pockets or purse when away from home - which could cause easy access for children.
- Always read the inserts that are included with your prescriptions so that you aware of potential side effects and how the medication may interact with other substances.
- Be aware that herbal remedies and vitamins can also interact with medicines that you are taking.
- Remember nutrition, exercise and socialization are powerful tools to keep us healthy.
Medicine can be a tool to assist in our overall health. Knowledge is also a tool. Accountability for ourselves and those we love is also a tool. Let's use all the tools we have available to live our best life for our whole life!
To your health!
Monday, March 9, 2015
Philippians 4:6-7 (NKJV)
Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God;  and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus.
I love this passage. It has even more meaning for me since I recently lost my Father. As a Certified Senior Advisor* I have worked with many families going through the process of aging parents. Each situation is unique in its circumstances but inherently the same. In almost every situation the family has to face challenges that test them. Physical adjustments, changes in living arrangement, choices in caregivers, financial considerations, all will put a family to the test. One family pulled together – found strength, dug deep for patience, searched for answers. Another seemed to unravel at the seams, never quite finding the peace that could sustain them.
Somehow I thought with all my training and the fact that I had faced these challenges working with others that it would be different for me. I was going to have prospective and insight. The truth is that when I was there in the moment – all the training in the world wasn’t able to prepare me for the sense of loss, grief, and ultimately the sense of relief that I would experience.
Losing a parent is supposed to be the natural order of things. We are born, we live a life, we grow old and then we die. No one gets a hall pass on this one. It doesn’t matter your status in life, or how many friends you had, or the balance in your bank account. Death is very even handed that way. When it’s your time – it’s your time.
Unfortunately the same can’t be said for those that are left behind. While many of us believe that at death our loved ones experience a release and a rebirth –, those left behind still must manage the loss here on earth. What will help the ones who are left behind- find “the peace that surpasses all understanding?”
Even though it has only been weeks since I lost my Dad I’ve come to some important revelations regarding his old age and his death.
Revelation Number 1 – My Dad became old. I say old because there is a difference between being older and being old. As an older adult both my parents were vibrant and outgoing. It wasn’t until they became old that I was faced with their mortality. It actually happened quickly – there was a shift, a change and I felt it. I know for a fact that my Dad would say that he felt the shift as well. He told me so.
Revelation Number 2 – My sisters and I became the decision makers. My Father was no longer independent. This dramatic change effected our entire family. Decisions had to be made and they could not be made by my Dad – even though he wanted to. In fact he fought ferociously to hold on to his independence- it would not be possible. Understanding this shift in our dynamic was critical.
Revelation Number 3 –I was now grieving. It’s important to understand this. This sense of loss is a process. Each adjustment must be dealt with and considered. Selling the house and divesting of possessions is loss. Seeking new living arrangements and making those decisions is stressful. Hearing difficult medical news causes anxiety. You are grieving.
Revelation Number 4 –I will not be able to fix this. While doctor visits often mean that there is an agenda to “get better” - this is not the case here. The body may be shutting down incrementally. My Father was no longer the protector and the provider. We had always known him to be a strong presence and watching him weaken was hard. Becoming the parent of your parent is also hard. There is no school that prepares you for doing basic hygiene for your Father, brushing his teeth, doing his pedicure, dressing him head to toe – or even managing toileting issues.
Revelation Number 5 – My sisters and I were exhausted. We were exhausted mentally and physically. Making decisions, talking to doctors, managing finances, handling visits with my Father, making sure he had what he needed, even sitting by the bedside was exhausting.
Revelation Number 6 – Quality of life means everything. Knowing that my Dad was struggling to breathe, to move, to sleep, to eat was painful for him and for us. . I wanted him to have peace. Could we have gone on? Yes – we would have been by his side as long as he needed us – but quality of life is everything.
Revelation Number 7 – Peace does surpass our understanding. I can’t explain it but when my Father left this world – I knew that he was at peace. I could feel it. I also felt finally at peace. I knew he was safe, healthy, and in the company of those he loved.
A friend once told me that when we remember our loved ones it’s important to look at a life story as a whole and not just the last few pages of the book. A life such as my Dad’s 93 plus years was exciting and joyful. In fact – each chapter was more compelling than the next - it was a real page turner! So – no regrets.
The last two years of my Dad’s life were challenging – but I treasure every moment I got to spend with him. I loved my Dad intensely while he was here and I told him so.
` “ I’ll miss you Daddy – but I’ll see you soon.”
Monday, January 19, 2015
You get in the car, turn the key and drive to the store. Simple! You grab a hammer, take a nail, strike the nail with the hammer and hang the picture. Simple! You don't stop and think. You take advantage of what's appropriate and what's available to accomplish your task. It's called using a TOOL! According to a 2014 study by Global Social Enterprise Initiative (GSEI) at Georgetown University, 91% of all seniors want to age in their own home. If that statistic is true, then why do some seniors insist on not taking advantage of the tools that will allow us to accomplish that?
Recently, I went to visit a neighbor who had suffered a fall. She had worked hard in rehab to recover and was now able to return home, but under strict orders from her physician to use a walker. On her second day home, I knocked on the door just to check on her. Here she came, floppy bedroom shoes scuffing along, and NO WALKER. When she opened the door, I said, "Duffy, where's your walker? You're still recovering." Her reply, as she held precariously on to a chair, "Well, I don't need it here in the house, I really only use it when I have to go out."
Oh my goodness, how I wish i didn't see this as frequently as I do. The reality is far too many seniors don't take advantage of the tools that allow us to get healthy and stay healthy in our own homes. The stigma of using a walker or cane, or wearing a first alert bracelet or necklace because it "makes me look old" is putting our health and our continued mobility at risk. Per a 2014 article by the Center for Disease control, the fact is one in three of us over the age of 65 will fall this year.
Since many seniors live alone, falling becomes an even larger issue. My mother in law always felt confident because she "had her cell phone." One night, she fell getting out of the bed and broke a bone. Yes -- her cell phone was where she could SEE it, but she could not REACH it. She lay there in pain for hours until she crawled to her phone to call for help. If she had only had a first alert pendant, what a difference it would have made.
It's normal to think, "that will never happen to me"... until it does. We live in an age of technology and innovation. That technology and innovation is going to allow us to live at home longer - but only if we use it. There are many examples of low tech and high tech that can be harnessed to give us more independence and better lives.
Low tech -simple things to keep us safe:
- Using a walker or cane consistently as recommended by our physician for balance and mobility
- Adding grab bars to the shower or bath
- Reorganizing our kitchen and closet so that we are not reaching or using a stool
- Asking family, friends, or hiring a service for difficult yard work and home repair
- Asking family, friends, or even calling a service if we are unable to drive to do errands, doctor appointments, and social activities
- Opening ourselves up to services such as Meals on Wheels, Friendship Trays to insure proper nutrition
- Welcoming and asking for assistance from friends, and family
High tech - technologies that can enhance our lives:
- First alert bracelets or pendants that provide easy access to immediate assistance
- Electronic pill dispensers - a simple unit that alerts the user that medications are ready to be taken and delivers them in the proper dosage from the dispenser
- GPS tracking service on your cell phone so that family and friends can know your exact location in an emergency
- Mobile/rechargeable wheelchairs/ scooters allow for enhanced mobility
- Skype and other computer tools to stay in touch with family and friends
There are many more low and high tech tools of which we can take advantage, but the key is to remember the old adage "pride go before the fall." Don't put up roadblocks to the tools that can keep you healthy, happy, productive and mobile for as long as possible. The tools and technology are there - all we have to do is USE THEM!