How to. . . Advance knowledge Taking care of the "business" part of things before anything happens will allow everyone to focus on the needs of the people involved rather than the requirements of an institution. There are some things that can be done now to make future illness or emergencies more manageable.
Friday, May 21, 2010 – TheIntellegencer.com – CONSUMER HOW TO GUIDE – Page 23
Parent your parent
The thought of having to make major life changing decisions for our parents is not a pleasant one. It is a complete role reversal. It is not easy to ask the people who put you through college what their bank balance is. It is difficult to have to go through the medicine cabinet in your parent’s home after he has either taken too much medicine or stopped taking it completely and discover that your father has medical issues that you never knew existed. Finding out that your mother is no longer able to remember when the last time she ate can is heartbreaking. Learning that none of your father ’s bills have been paid because he is no longer aware of what the mailbox or check book are is devastating. Working with hundreds of adult children over the years, I have learned that “one of the hardest things” that many of them have ever done was to make the decision to admit a parent to a long-term care facility. Given the choice, none of us would choose to go through any of those situations. However, according to Caregiving in the U.S., there are 43.5 million caregivers in the U.S. providing care for an adult family member or friend 50 years old or older. As the population in this country continues to age, that number will grow. Thus, it is important to develop a proactive plan to lessen the stress and burden when the time comes to parent your parent. Because discussing such issues with parents is so uncomfortable, most of us avoid doing so until a crisis occurs and there is no longer an alternative. Until an adult child is confronted with the dilemma of acting as the legal decision maker for a parent, he or she may have no idea what type of insurance coverage the parent has, where important documents are kept, what medications they take, when the last time they went to the doctor was, how many different physicians they see and for what conditions. The goal is to make informed decisions for our parents when they need us. In order to make the best choices during an emergency, children need to learn as much as possible about the parent’s life before the crisis occurs. The more knowledgeable adult children are of parents’ affairs before an emergency, the better equipped they will be to deal with the issues that have to be addressed. If the child is already aware of insurance and financial issues when they are called in the middle of the night to the hospital to assist with an admission, the confusion and stress are greatly reduced for all involved. Taking care of the “business” part of things before anything happens will allow everyone to focus on the needs of the people involved rather than the requirements of an institution. There are some things that can be done now to make future illness and emergencies more manageable. • Begin discussing potential issues with parents before there are any problems. In most instances, it is much easier to speak of hypothetical situations than ones that are currently troubling them. However, facing one’s mortality and possible future disabilities is not pleasant and you may have to address the topic several times before some parents will begin to talk about it. The key is to start early and let them know it is important to you to be prepared “just in case.” • If a parent is driving, take the time about once a month to ride with them or observe them from a far while they are driving. When you visit, inspect the vehicle for unexplained dents and scrapes. At the first signs of impairment, begin to discuss alternate transportation such as senior buses or private transportation providers. As a child, it is sometimes impossible to take car keys away from the person who taught you to drive. However, it is worse to have to deal with the results of an accident that he caused. If you are unable to enforce the decision, contact the local police department for assistance. • Know where important documents are located (i.e. insurance cards, advance directives, bank account information). Some people are very private and do not want their children to have access to financial information. Suggest that they begin to keep the information in one location such as a specific drawer or cabinet with the agreement that it will not be opened unless needed. • Be aware of whether or not advance directives have been executed and encourage parents to do so if they have not (i.e. living will, durable power of attorney (POA) for healthcare and finance). Creating these documents is difficult for some older adults because it reminds them of impending mortality. To ease anxiety, you can complete the same documents to show your parent that by doing so they are not “making the time come sooner.” In reality, everyone needs to have advance directives in place regardless of age. If financial issues are difficult to
discuss, build up to financial POA by executing the durable healthcare power of attorney first. Explain that the provisions of the documents do not become effective until the guarantor is no longer capable of making decisions for herself. • Ask them to keep a list of current medications, physicians and diagnosis in their wallet or purse. If someone is taken to the hospital by ambulance, that information needs to be given to the medical staff immediately. It is much more convenient and efficient to produce a list of medications than a bag full of prescription bottles. Most pharmacies routinely provide such information. • Know what insurance is active; just because someone has the tradition red, white, and blue Medicare card does not mean that it is effective. Many seniors have given up traditional Medicare for other options such as Advantra or Secure Horizons. While they have received a new card for the new insurance, most keep the original Medicare card which can easily be given to a hospital by a child who is unaware of a parent’s affairs. • Spend time in the home, check medicine planners to make sure pills have been taken and none are missing beyond the current date and time. Observe the overall appearance; make sure the mail has been checked and you do not see any unopened envelopes piled up. Look inside cabinets, making sure they are stocked as usual and there are no strange items that do not belong. • Talk about care options regarding assisted living, supportive living, and long-term care before they are needed. Encourage your parent to research and tour communities and let you know which ones they prefer. While having to leave one’s home is never easy, it is less threatening when the individual has been allowed to participate in the decision making process. • In the event you get involved in a parent’s affairs after problems have begun, be patient and remember it is a very humbling experience for them. If you have problems getting them to share information with you, enlist the help of a professional such as a physician or social worker for assistance. These are just a few things to consider as the time comes for roles to change and the parent to begin needing more support than the child. The hardest part is the first conversation. By initiating a discussion with your parent regarding any of these issues, the dialogue has begun. Even if it takes some time for her to open up about private details, the first step has been taken. Taking the time and making the effort to discuss potentially uncomfortable matters with parents before there are any problems will make the “crisis” times much less stressful. Just as there is no handbook for the correct way to raise children, there is no right or wrong way to “parent your parent.” If you have questions, do not hesitate to reach out to your Area Agency on Aging for answers and advice.
It is not easy to ask the people who put you through college what their bank account balance is.
Submitted by: Cambridge House of Maryville, Tracy A. Skaer-Henry, Administrator