Guide to Helping Your Aging Parents

GUIDE TO

HELPING YOUR 2018-

19

A G I N G PA R E N T S WELCOME TO THE SANDWICH GENERATION Surviving the squeeze in caring for two generations

MOM? DAD? DO YOU NEED HELP? Signs to look for and what to say

THE FINANCIAL ROLE REVERSAL Getting a grip on their money matters

TECHNOLOGY TO THE RESCUE! Apps and other tools to make life better for seniors

PA G E

19

INSIDE 5

Editor’s Note

PA G E

D E PA R T M E N T S

28

11 Reflections: I Am the Sandwich Generation 25

Know Your Options: Senior Housing Options

26 Reflections: Treasures or Trash 35

MP Checklist: Organizing Essential Documents

38

Know Your Options: Senior Health Care 101

41

MP Checklist: Becoming a Caregiver

46 Reflections: Ashes to Ashes PA G E

35

F E AT U R E S 6

Welcome to the Sandwich Generation

9

Top Resources for Michigan Seniors and Their Families

28

The Financial Role Reversal

32

What To Do If Your Parents Experience Cognitive Changes

42

Mom? Dad? Do You Need Help?

THE GOLDEN YEARS Brought to you by the Area Agency on Aging 1-B 15

MP Checklist: Senior Home Safety

17

Know Your Options: Transportation Options

18

Resource Roundup: Senior Centers

19

The Importance of Staying Active, Engaged and Social

22

How Technology Can Help Seniors Live Better

4 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

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EDITOR’S NOTE

GUIDE TO

HELPING YOUR AGING PARENTS EDITORIAL Editor-in-Chief: Julia Elliott Managing Editor: Jessica Schrader Digital Editor: Kim Kovelle Senior Editor: Stacey Winconek Associate Editor: Christina Clark Editor-at-Large: Kristen J. Gough Contributing Writers: Lynne Golodner, Pam Houghton, Amy Kuras, Melanie Stutler Editorial Intern: Emily Roth

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FROM ABCS TO MEDICARE PART D

O

nce upon a time, you were a little kid. Your parents made you grilled cheese sandwiches, helped you with your homework, taught you how to ride a bike and blow your nose and all the myriad other things that parents teach their kids. And then one day all of these things were second nature to you, so much so that you could barely remember learning these things when you were teaching your own kids. (Did your parents teach you how to blow your nose? They must have, right?)

And the next thing you know, your kids are getting older, and you are getting older, and so are your parents. And suddenly or slowly, depending on the story, you start to realize that those people who helped you navigate life and taught you your ABCs need your help in ways you almost couldn’t fully imagine. How is it possible that your calm and capable mother or strong and wise father would struggle with regular day-to-day tasks? That they would need you to help them balance their checkbook, find new housing or drive them to doctor’s appointments?

If you haven’t reached this part of your story yet, you will. It’s the story of the Sandwich Generation, those who are raising their kids and helping their aging parents. And this new publication, Guide to Helping Your Aging Parents, produced by Metro Parent, is here to help.

Navigating this time in your life isn’t easy, but our goal is to try to make it easier. In this issue, you’ll find explainers on senior health care and housing options, checklists on senior home safety and essential documents you should have, articles on how technology can help seniors and the importance of staying active. Plus, some personal perspectives on this journey and so much more.

Online at MetroParent.com/AgingParents, you’ll find even more resources and advice. If you are living the Sandwich Generation life, you should bookmark this page. We’ll be adding new resources every week. Got a particular topic you’d like us to address? Drop us a line at editor@metroparent.com. Tell us what you think of our new guide, share your own story and pass this along to everyone else you know who is feeling the fatigue of being the filling in this classic generational story.

The Metro Parent Guide to Helping Your Aging Parents (GHAP) is published once a year by Metro Parent Media Group. Articles and advertisements in GHAP do not necessarily reflect the opinion of the magazine. We do not assume responsibility for statements made by advertisers or editorial contributors. The acceptance of advertising by GHAP does not constitute an endorsement of the products, services or information being advertised. We do not knowingly present any product or service which is fraudulent or misleading. ©2018 Metro Parent Media Group. No portion of this publication may be reproduced in any way without written permission of the publisher.

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WELCOME TO THE

SANDWICH G E N E R AT I O N Are you wearing two caregiver hats – one for your kids and the other for your parents? Then you are not alone.

Read on for a primer on this all-important, exhausting role.

I

n the 1980s, a social worker by the name of Dorothy Miller came up with the term “sandwich generation.” At the time, she used it to describe women in their 30s and 40s tasked with caring both for children at home, and their aging parents. They were “sandwiched” between the two.

The idea – and the term – caught on.

Today, “sandwich generation” is used more broadly to describe both men and women who have dual caregiver roles over both their parents and children.

According to a Pew Research survey, nearly half (47 percent) of adults in their 40s and 50s can be defined as within this sandwich generation – having a parent age 65 or older, while also raising either a young child or financially supporting

BY KRISTEN J. GOUGH

a grown child (age 18 or older). Equally revealing, the survey notes, “about 1 in 7 middle-aged adults (15 percent) is providing financial support to both an aging parent and a child.”

The stats only hint at the toll placed on those within the sandwich generation: They’re pressed between responsibilities that at times feel understandably overwhelming. After all, it’s not just the financial burdens they’re facing, but also emotional and physical stress.

If you’re dealing with the strain of being a dual caregiver, there are steps you can take to alleviate some of the stress. And while there’s no way to eliminate all of challenges that are likely to come your way, by having a better understanding

6 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

of how to take care of your own needs, you’ll be better able to handle the needs of those around you.

TALK, TALK AND TALK SOME MORE Having regular conversations with those within your support network – and with yourself – are critical. “The most important thing you can do is to really sit down and have a conversation with yourself about what you can and can’t handle,” explains Jarrette S. Wright-Booker, a licensed professional counselor in Detroit. “I don’t know that we’re always really honest with ourselves, which can lead to taking on too much and then becoming burnt out.”

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Who Makes Up the

Wright-Booker notes that this isn’t a one-time conversation, but an ongoing check-in that you should have with yourself. The next step, then, is to talk to those around you involved in your aging parents’ care, such as your spouse and children, along with your siblings. Keep the lines of communication open to regularly discuss your aging parents’ needs and how the group can help handle them, together.

You might also consider seeking out an additional support network – whether that’s through a community or religious group, or a healthcare provider. “I talk to caregivers a lot,” says Shawn Bennis, a registered nurse and the C.A.R.E. program coordinator at Henry Ford Health System. “That’s often all they need is a listening ear – they tell me their story and tell me what’s going on. They’re looking to confide in someone they can trust who’s non-judgmental, just listen and not try to fix their problem.” She points out that Henry Ford offers a variety of caregiver support groups, including an innovative program that involves art therapy and a Facebook support group, as well.

ALLOW YOURSELF TO GRIEVE “Growing up, we kind of see our parents as super people, but as adult children take on the role of caregiver, it’s a process to accept that new role and to mourn the parent that was,” explains Wright-Booker. “The person that you used to go to for help and support is now coming to you and that can be a real struggle for everyone.”

Wright-Booker describes this as reverse parenting – where the child gradually assumes roles the aging parent once had. That role reversal can create challenges and strong emotions: For the aging parents, there’s a loss of identity and independence. And for the adult child, a recognition that the people you used to count on for support are now looking to you for help, and they may not always be open to accept the guidance you’re offering them.

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BE INTENTIONAL ABOUT SELF CARE It may sound simple, but when you’re managing the care for both your aging parents and your children at home, you may neglect your own needs. Even simple tasks, like making sure you’re eating regularly and getting exercise, can fall to the bottom of the to-do list. Yet, tending to your own needs can help you feel prepared to handle those of others.

“You need to be compassionate with yourself. Honor yourself,” advises Wright-Booker. “People in general have the tendency to put their own needs on the back burner.” She suggests instead that you prioritize what you need to do to stay emotionally and physically healthy.

Sandwich Generation?

19% are younger than 40 71% are between the ages of 40 to 59 10% are age 60 or older

Men and women share equally in being part of this group

ACCEPT HELP For many caregivers, letting others serve you can be difficult. However, you may find your friends and neighbors don’t mind pitching in – and may even appreciate the opportunity to lighten some of your burdens. For example, you might see if a neighbor can take over part of carpool duties for you, or perhaps a friend might take you out for lunch or dinner on occasion, just to catch up and chat.

Then again, your partner and children at home can also be a source of strength and support. “Make sure that you’re able to identify gaps in your schedule and then have it be a family endeavor to fill those gaps,” says Wright-Booker. “You may be surprised to see how much your children can help and look forward to helping.

Children are very willing to be involved in that process and they learn so much from watching their parents care for their parents.”

ACKNOWLEDGE GUILT, BUT DON’T WALLOW IN IT “Caregivers need to be given permission to feel overwhelmed and to have bad days,” says Bennis, who’s also the president of the iCare4U Employee Resource Group at Henry Ford Health System. Along with being overwhelmed, you’re likely to encounter times when you

31%

24%

21%

HISPANIC

WHITE

BLACK

31% of Hispanic adults have a parent age 65 or older and a dependent child compared with 24% of white and 21% of black adults

$100,000 Adults with annual incomes of more than $100,000 are more likely to be in this group

36% 10% 36% of married adults fall within the Sandwich Generation as opposed to 13% of those who are unmarried Source: Pew Research Survey

METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19 • 7

WELCOME TO THE

SANDWICH G E N E R AT I O N feel guilty too for all the things you think you could be doing better to care for either your aging parents, your children or even yourself.

These thoughts can be challenging to deal with. “You need to allow yourself to feel guilty. Those are normal feelings,” notes Wright-Booker. “You may know you’re doing everything you can and still feel like that’s not enough. Once again I can’t stress the importance of compassion enough – compassion is underrated.” She encourages caregivers to evaluate these feelings internally and also to reach out to your support network, too, to navigate these thoughts and emotions.

“There’s a good quote I like to use, ‘Your

mind is like a bad neighborhood; don’t go there alone.’ Sometimes, we’re our own worst critic, so it helps to have others to talk to.” Wright-Booker also points out that journaling can be a helpful way to sort out your feelings.

GET FINANCES IN ORDER Talking about money tends to be a taboo topic even in the best of circumstances. But when your aging parents are facing various choices with their care, it can help alleviate some of your anxiety if you know what their financial situation is and how their future plans fit into the picture.

Bennis points out as part of their care-

giver support group, there is a lawyer that comes in to teach a session about various financial considerations and estate planning. In general, however, Bennis says, “Talk to your parents about their goals and what they want for their future.” For example, are they OK with going into an assisted living center or a nursing home?

Are they planning on moving in with you when staying in their own home becomes too difficult? Do they have finances to support these goals? Knowing what your aging parents have in mind – long before it comes to those more challenging conversations – can help make the situation a little easier for everyone.

Kristen J. Gough is a frequent Metro Parent contributor and mother of three.

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TOP RESOURCES

FOR MICHIGAN SENIORS A N D T H E I R FA M I L I E S Mom and dad are going to need help as they age – and so will you. So, what’s out there to help fill the gaps that you can’t do or afford yourself? Here are some of the top local resources you should acquaint yourself with sooner rather than later.

BY AMY KURAS

A

s people wait longer to have children and life expectancy is increasing, it’s more and more common for people to be raising children and caring for aging parents at the same time. Balancing the demands of a busy family and an older loved one is a fraught situation. It can dredge up old feelings over family dynamics, exacerbate financial woes, or send both adult children and their parents through an emotional roller coaster as roles are reversed and parents confront their need to surrender some independence to a person whose diapers they once changed. However, a plethora of services exist for seniors and their caregivers to survive and even thrive through this challenging season of life.

The first place anyone caring for an older family member should contact is their local Area Agency on Aging.

There are 16 throughout the state. Area Agency on Aging 1-B is the largest, serving Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties. The Senior Alliance is the name for the Area Agency on Aging 1-C, which serves southern and western Wayne County. The Detroit Area Agency on Aging is known as The Senior Solution and serves Detroit, the five Grosse Pointe communities, Harper Woods, Hamtramck and Highland Park. “We really do consider ourselves the first place that people should call,” says Kathleen Yanik, communications manager for Area Agency on Aging 1-B. “We serve as a clearinghouse helping them walk through options and steering them to programs that can help, and it’s a

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free call.”

Other places seniors or their family members can turn to include disease-specific organizations such as the Alzheimer’s Association or the Multiple Sclerosis Association. The Veterans Administration offers a number of services for older veterans. Many communities have locally based councils on aging that coordinate services for seniors, and several also have lively, active senior centers that serve as a source of information and a powerful weapon against the isolation older people can feel – a role that also can be filled by a house of worship.

The most common needs are for personal care services such as bathing, dressing or using the bathroom, home delivered meals, housekeeping such as laundry and light cleaning, medical transportation and subsidized housing, based on what people who call the Area Agency on Aging 1-B are looking for, says Angela Lippard, resource center manager for Area Agency on Aging 1-B. She urges families to be prepared and think ahead, since very often programs have a waiting list. When that happens, agency staff can help families locate other sources of assistance, but knowing what is available and how to access it well before services are needed is key. “A lot of calls we get, people needed the services yesterday,” she says.

Callers can get referrals or access programs for a wide variety of concerns seniors or their caregivers may have. Among them are:

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TOP RESOURCES

FOR MICHIGAN SENIORS A N D T H E I R FA M I L I E S

FALL PREVENTION

PERSONAL CARE AND HOUSING OPTIONS

Falls can be deadly for older people and are a leading cause of nursing home admissions. To help people reduce their risk of falls and feel more confident, many Area Agencies on Aging offer evidence-based classes aimed at improving balance and preventing falls.

Navigating the various options for older people who need help with activities of daily living such as bathing, dressing and housekeeping can be intimidating. There are programs through the Veterans Administration or Medicaid that will pick up all or some of the cost of nursing homes.

However, there are also home care services that offer direct care to older adults. MI Choice is available to people 65 and older who need a nursing home level of care but prefer to stay in their homes. They provide a set of wraparound services that allow seniors to be cared for any place they may call home, whether it’s a senior apartment or a family member’s.

For a lower level of care, the Community Living Program provides three to 10 hours of care per month for people who are most in need financially. The program targets people who are socially isolated or have a cognitive decline and need help with at least one activity of daily living. While it is subsidized, it does require some financial contribution from the recipient on a sliding scale.

Veterans who have served at least one day in wartime have access to an in-home aide and attendant program through the VA, which also requires that the person would otherwise need to enter a nursing home.

Yanik says many people aren’t aware of these programs, and while they have certain financial requirements and there is a wait to access them, they can make the difference in allowing people to stay in their home as well as providing family caregivers much-needed relief.

CHRONIC DISEASE SUPPORT Chronic disease such as diabetes can worsen, or even present for the first time, with age. It’s never too late to work on managing the condition, so classes called PATH (Personal Action Toward Health) that focus either on diabetes management, other chronic diseases, or chronic pain are offered free of charge to people in the community. Not only does the class help teach strategies for dealing with the physical and emotional repercussions of chronic conditions, it can provide seniors with a community of peers who are also dealing with chronic conditions for support and encouragement.

TRANSPORTATION A major milestone that many seniors – and their families – dread is the need to give up driving. Older drivers are at higher risk of crashes, but they miss the freedom that getting behind the wheel gives them.

However, lack of car keys doesn’t need to translate to your loved one being stuck at home or getting socked with an enormous charge on a ride sharing app. Area Agencies on Aging can coordinate myride2, a transportation service that arranges rides for seniors with as little as two days’ notice. Many communities participate in SMART Transit for seniors, and many community senior centers have subsidized taxi or car share rides. Area Agency on Aging 1-B also works with seniors and their families to plan for their “driving retirement.”

NUTRITION Managing three meals a day can be difficult for older people, and appetites and preferences change as a person ages, making cooking less appealing. Area Agencies on Aging will refer seniors to a provider of home-delivered meals, such as Meals on Wheels, that brings a hot and nutritious meal to seniors daily. Another option for seniors that have an easier time getting around is a community meal site that combats both hunger and loneliness by serving a daily lunch in a communal setting, often a community center or senior center. Seniors can share a meal with others and form the connections so crucial to their overall health and well-being.

CAREGIVER SUPPORT Along with the programs that target seniors themselves, many places offer several support programs for the people who care for them. Support groups, classes and even adult day care programs that allow caregivers to work or simply run errands and take a break are all available by referral. “It’s often really worth it for caregivers to reach out to find that outside help.” Yanik says. “Caregiving can be a marathon rather than a sprint, and you need to take care of yourself so that you can keep going.”

LGBTQ SENIORS The three southeast Michigan senior agencies are founding members of Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) Metro Detroit. It can be intimidating for LGBTQ seniors to seek support, and they are less likely to have children or younger relatives they can rely on. SAGE created training to allow agency staff to approach LGBTQ elders with sensitivity, using appropriate language and questions.

Adjusting to new roles and expectations is challenging at any time, and especially so for caregivers in the squeeze of the sandwich generation. Information and preparation go a long way toward easing the transition for the whole family. “If you start sooner you have more choices, more opportunities and more directions you can go,” says Lippard. “If you wait until they have had a fall and need help with activities of daily living, at that point there are not as many options.”

Amy Kuras is a freelance writer from Detroit.

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REFLECTIONS

I AM THE SANDWICH GENERATION

T

B Y LY N N E G O L O D N E R

hree weeks after college graduation, I packed up my Ford Probe and my dad accompanied me as I drove to New York City to start my new adult life. I carted clothing, my stereo system and my tennis racquet, and set up camp in my cousin’s apartment until I got a paying job that allowed me to rent my own place.

Even then, I didn’t go looking for a lease without guidance. From long-distance, my dad directed a business colleague in New York to help me find the right neighborhood, at the right price. I never had to figure out a new city alone.

At the time, I gave no thought to my parents’ position.

They were in their 40s or 50s, their parents still alive and well, though aging, and myself, my brother and my sister were eager to spread our wings but still very dependent on their information and approval.

Why would I consider the dual responsibility my parents faced, of being parents to grown children and children of aging parents?

Today, however, I understand their unique predicament, because it’s where I am. Still, some part of me knew even then that a life far away from family posed its own set of complications.

I didn’t stay away long. After a year in New York, a transfer to the Washington, D.C. bureau of my newspaper, and nearly three years in the nation’s capital, I felt I was missing out on family connections. My parents, my grandparents, my cousins were all in Michigan, so I packed up my material goods and drove the same car, with my dad alongside me once again, north of the Mason-Dixon line, leaving Washington for my Motor City hometown.

I was in my 20s and eager to be free and independent, but I recognized the importance of turning to trusted, loved older relatives to guide me on my journey.

Today, in my mid-40s, I remain a 15-minute drive from my parents, and it’s as important to me today to be near family as it was in my earlier years.

Except, for different reasons.

As we age, we are independent and in need in different ways. With four children of my own, on the brink of their own adolescence, I still seek my parents’ counsel

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because they offer the wisdom of more years than I’ve walked the planet. They’ve parented successfully. They know things I don’t. They have the benefit of time to gain perspective, so when my teenage son and I struggle, my dad can calm me down and offer guidance on how to navigate the conversation.

I trust their insights, and it helps make my journey a little bit easier.

On the flip side, I have the energy of midlife rather than advanced years, and sometimes that comes in handy and helpful for people decades ahead of me. My parents are, thankfully, independent and strong, and they don’t need much from me. But it helps both of us to know that I’m here, if a need arises.

I am full-on part of the Sandwich Generation.

Some in the sandwich situation are caring for ill parents, financing aging parents, or otherwise helping in more ways than one. I’m lucky that I don’t need to do either at this point because the four children I am raising – three teens and a tween at this moment – are involved in activities, sports and other pursuits that drain my savings for sure.

Plus, I’m trying to save for the seemingly insurmountable mountain that is college. My eldest is a year and a half away from immersing in higher education, with dreams of Ivy League institutions that ring in at $70,000 a year. That’s a tough pill to swallow.

This is the thick of things. It’s busy. It’s expensive. It’s emotionally draining and emotionally rich simultaneously.

There are immense blessings about this stage of life.

For instance, my teenage son and my father have developed an incredible bond. They talk on the phone most nights, and I learn about both from the other sometimes.

That affirms my decision two decades ago to come home and be close to the people who matter most.

It was David Bowie who said, “Aging is an extraordinary process where you become the person you always should have been.”

As I get older, I find the impulsiveness of my youth calming, my words more thoughtful. I hear my father’s voice, “Out of your mouth, printed,” cautioning me to

METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19 • 11

REFLECTIONS

think before I speak or act. And I know that his words were actually his own late mother’s words, paving the path of wisdom a generation before him.

In 1985, older adults comprised 11 percent of the U.S. population, according to the Institute on Aging. By 2010, they made up 13 percent of the population. Today, more than 40 million Americans are age 65 or older, and by the year 2030, it is expected that seniors will fill 20 percent of our population.

As our population ages, it falls on the shoulders of those in midlife to help make those transitions, and those later years, manageable. According to PEW research surveys, 1 in 7 middle-aged adults provides financial support to both an aging parent and a child simultaneously.

From where I stand, I theorize that it would be my honor to help my parents. After all, they helped me. But I say that without having to do so today.

How would it feel, I wonder, if I had to welcome a parent into my home while trying to usher children out to stand on their own two feet? What additional stresses would I bear?

I think of my grandparents’ generation, when aging parents moved in with families without question, into far smaller houses than we inhabit today. In the sepia-tone of hindsight, I can idealize that situation – of course grandma can live with us! What a benefit to have three or four generations under one roof. You really learn who you are.

Or maybe the stress and burden caused early heart attacks and shorter lives. (My great-grandparents did not live nearly as long as their children or their grandchildren, for a variety of reasons.)

Whatever the reality, I can’t know until I’m there. In the meantime, I remain grateful to have my parents, active and involved, and my children, eager and kind, the bookends of my life. This sandwich generation position has benefits.

Lynne Golodner lives in Huntington Woods with her husband and four children. Her most recent book is The Flavors of Faith: Holy Breads. She owns and runs Your People LLC, a public relations boutique agency.

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THE

GOLDEN YEARS

THIS SECTION IS SPONSORED BY

SPONSORED CONTENT SPONSORED CONTENT

MP CHECKLIST

W H AT T O L O O K O U T F O R W H E N

W

ARE THEY SAFE ON THEIR OWN?

D o they understand how to leave the home if necessary? Do they know where the door is located and how to exit the building?

W ill they stay home or near the house rather than wander off?

I f they go outside, do they know where they live and how to get back inside?

Can they identify signals, such as smoke from the kitchen or fire alarms,

SPONSORED BY THE AREA AGENCY ON AGING 1-B

e all want our parents to be strong and capable and live independently as long as possible. But time marches on and with that comes many changes, sometimes ones that are slow and difficult to detect. According to the U.S. Consumer Product Safety Commission, more than 600,000 older Americans are treated each year in hospital emergency rooms for injuries they get at home. These injuries are often the result of hazards that could have been easily prevented with some forethought. Unfortunately, we are often slow to recognize our parents’ inability to consider these potential hazards themselves. That’s why we have to be ever-mindful whenever we visit our parents to check that they are doing well cognitively and have retained basic but important safety information they need. Here’s a helpful checklist, based on information provided by Senior Solutions of America, to consider to ensure your parents’ safety living on their own.

GOLDEN YEARS

BY MELANIE STUTLER

THE

VISITING AGING PARENTS

that would alert them to potential dangers?

D o they know how to access emergency services? Do they know how and when to dial 911?

Would they be able to communicate over the phone? Can they physically get to a phone no matter where they are?

D o they have frequent life-threatening medical emergencies that require immediate intervention? Do they know where any medication they might need is located? Can they reach it?

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METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19 • 15

MP CHECKLIST

Click to Page 42 for the seven common signs your aging parent may need help. Plus, get tips on having a conversation about their needs if they do.

IS THEIR HOME SAFE? Electrical outlets and switches: Make sure none are warm to the touch and that no wires are exposed.

Check lightbulbs to make sure they are the appropriate size and wattage for what they are being used for.

Electrical cords/extension cords: Make sure they are

GOLDEN YEARS

tucked away so they are not a trip hazard and that the cords are not frayed. Be sure extension cords are not overloaded with plugs.

Are all rugs/runners slip resistant, so they would not

THE

SPONSORED BY THE AREA AGENCY ON AGING 1-B

DO MOM OR DAD NEED HELP?

Can your parent hear the doorbell and phone, so they

be easily tripped up on?

Are shelves well-secured to the wall and not overloaded with items that would make them fall?

A re all plug-in appliances kept far away from water sources (sinks, showers, bathtubs)?

I s there good lighting over the stove and countertops so parents can see when they slice foods?

I f parents need a step stool to reach things, is it stable and sturdy?

A re all rooms and hallways well-lit to reduce tripping potential? Are the light switches located near the entrance, so parents don’t have to walk in a dark room before getting light? If not, consider adding high wattage, auto-sensor night lights.

A re bathtubs and showers equipped with non-slip mats and safety bars?

could respond if there was an emergency they were being warned of?

A re all medications stored in the containers they came in and clearly labeled?

Are smoke/carbon monoxide detectors working

I s there a working flashlight next to the bed in case of a power outage?

properly?

Are space heaters (if used) being turned off after use?

Does your parent have an emergency exit plan?

Are towels, curtains and other flammables being kept away from the stove and other heat sources?

I f there are stairs, are light switches located at the top and bottom of stairs?

A re steps secure and non-skid? Can they clearly see the edges of each step?

Melanie Stutler is a freelance writer and former Detroiter.

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KNOW YOUR OPTIONS

SENIOR TRANSPORTATION When mom and dad can’t drive, here are your options.

BY MELANIE STUTLER

MYRIDE2 TRANSPORTATION CONCIERGE SERVICE The Area Agency on Aging 1-B offers its myride2 transportation concierge service for seniors and adults with disabilities who live in Oakland, Macomb and western Wayne counties. It doesn’t provide the actual transportation. Instead, it helps find transportation providers that fit a senior’s needs – whether they need a low-cost option, wheelchair access, etc. Seniors call the service, let them know where they want to go and myride2 will arrange transportation from start to finish. This can be especially helpful when seniors need to go on longer trips that take them outside the range of the neighborhood transportation services they might usually use – like those provided by local senior centers or connector services. There is no charge for arranging transportation through myride2.

Payments are made directly to transportation providers.

Rides can be requested online at myride2.com or by calling 855-697-4332. Please allow at least two business days to arrange a ride.

Melanie Stutler is a freelance writer and former Detroiter.

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SMART CONNECTOR Beyond using the overall SMART bus system routes to get to local destinations, the SMART Connector service offers curb-to-curb transportation within a 10-mile radius of a designated service area. Advance reservations are required: six days is recommended for medical appointments and two days for other destinations. Those 65 years and older, and those with disabilities, pay just $1 each way for a trip. Those younger still get a deal at $4 each way.

All Connector buses are equipped to accommodate wheelchairs and walkers. Be mindful, though. There is no guarantee you will get a spot on the bus. It’s a first-come, first-served service, so make your reservation early by calling 866-962-5515. Press 1 for Connector, then press 1 again for reservations. Reservations can also be made

online at smartbus.org.

The service runs 6 a.m.-6 p.m. Monday-Friday (not on holidays).

GOLDEN YEARS

ne of the most important factors in living a full life as a senior is the ability to get around. If your parent doesn’t live in a senior community that offers transportation services, what are the options to help them get to activities or doctor’s appointments? Besides catching a ride with you or using a much pricier ride sharing service like Uber or Lyft, there are a couple of services that may be able to help.

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IMPROVING DRIVING SKILLS IN SENIORS

Decreased mobility or even certain medications can reduce a senior’s ability to drive safely. And while that might mean that your parent’s driving days are over, it could also be an opportunity to get some help that could extend their time driving themselves around town. Some insurance companies offer elder driver evaluations and training opportunities. In addition, AARP offers AARP Driver Safety Courses to help drivers ages 50-plus sharpen their driving skills. Finishing one of these courses can also help seniors save money on insurance premiums.

Get more information and sign up at aarp.org.

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RESOURCE ROUNDUP

SENIOR CENTERS S tudy after study shows something we all intuitively know: socialization is as essential for humans as food, water and air. Without human interaction and engagement, our physical and mental health suffers as does our overall quality of life. As our parents age, they can naturally become more isolated. What can fill the gap left from work, widowhood and kids who are grown? Local senior centers are a perfect place for aging parents to turn for activities and companionship.

Most southeast Michigan cities have senior centers that offer games, outings and opportunities to forge friendships. Here are a few with robust programming from each of the counties in our readership area. Check your parents’ hometown to see what their local senior center offers.

MACOMB COUNTY Clinton Township Senior Center 40730 Romeo Plank Road, Clinton Township 586-286-9333 clintontownship.com/senior-center. html Residents age 55-plus can enjoy card games, stained glass-making class, wood-carving, singalongs and more at this bustling center. Membership required, but it’s only $50 per person or $70 per couple for a lifetime.

OAKLAND COUNTY Troy Community Senior Center 3179 Livernois, Troy 248-524-3484 troymi.gov/community/senior_citizen_programs Offers nationally accredited 50-plus programs such as painting, ballroom dancing, quilting, mahjong, bingo and much more. Its Medi-Go Plus service provides door-to-door transporation for just $2 for a one-way ride.

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BY MELANIE STUTLER

WASHTENAW COUNTY Ann Arbor Senior Center 1320 Baldwin Ave., Ann Arbor 734-794-6250 a2gov.org/senior Games such as Bridge and Scrabble are augmented with informative classes on subjects like legal rights and physical fitness opportunities from chair yoga to tai chi. Requires a $25 annual membership or $35 for families.

WAYNE COUNTY Livonia Civic Park Senior Center 15218 Farmington Road, Livonia 734-466-2555 ci.livonia.mi.us/Departments/CommunityResources/SeniorCenter.aspx Offers roundtable discussions, continuing education classes, plus the regular roster of senior activities. There’s also a chore referral program for seniors who need help around their homes, plus hot meals for $3 at two sites in the city.

Melanie Stutler is a freelance writer and former Detroiter.

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T H E I M P O R TA N C E O F S TAY I N G AC T I V E , ENGAGED AND SOCIAL Why a social life matters in the golden years –

BY JESSICA SCHRADER

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and how to help your parents achieve it.

GOLDEN YEARS

eeding to stay active was never a concern that Sue Zaguroli had about her parents. Married for almost 60 years, they had a busy life together in retirement – dining out at their favorite restaurants every Wednesday and Saturday, going bowling with friends and spending time with their adult children and grandchildren.

Now, ever since her father’s death in 2017, Zaguroli worries about keeping her mother, Barbara, busy. The 83-year-old has been less apt to take friends up on offers to go out and spends most of her

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time at home doing crossword puzzles.

“She did her crossword puzzle all day, every day,” says Zaguroli, a mom of one in Novi. “We thought, ‘We’ve gotta add more spice to her life to keep her going.’”

START SMALL So Zaguroli and her three siblings started suggesting activities beyond the weekly dinners they had with her. Despite some initial resistance, Barbara finally agreed to try bingo.

“Finally my brother just said, ‘OK, I’m

going to go in with you and we’ll try it out.

If we don’t like it, we’ll just leave.’ They went in there and oh my gosh, the bingo is pretty intense,” she laughs. “You get shushed if you’re even talking at all.”

It was a fun outing and they went again the next week. “It’s helping her keep her mind sharp,” Zaguroli says. “It just adds a little diversity in her week.”

And it’s hopefully the start of more social activities to come.

“We have to take baby steps,” she says, adding that she and her siblings rotate

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S TAY I N G AC T I V E , ENGAGED AND SOCIAL

who attends bingo with her each week.

“Change is not easy for an older person.

They might accept the death of their spouse, but they still don’t want to deal with that change, which is living life without the other person.”

FINDING THE RIGHT FIT Fortunately, her mother is starting to show more interest in activities during the week. “She wants to. It’s just a matter of finding the right fit.”

The “right fit” is a key component to helping seniors stay active, says Kylie Gates-Barrett, the lifestyle director with Del Webb Grand Reserve, an active adult community in Grand Blanc. She plans events and activities for the around 700 residents at Grand Reserve, which also boasts 50 resident-run groups and clubs.

“Change is not easy for an older person. They might accept the death of their spouse, but they still don’t want to deal with that change, which is living life without the other person.”

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Ways to Socially Engage

Just being around similar-aged peers can have a positive effect, sometimes filling a need that adult children or grandchildren can’t meet.

“That seems to be a huge benefit because they have other people going through the same types of things,” she notes. “There are certain aspects that even the grandkids don’t necessarily understand.”

Jessica Schrader is Metro Parent's managing editor.

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Take a class at a local college.

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Play a sport.

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Spend time outdoors walking, hiking or bird-watching.

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Join a choir or band or take private music lessons in an instrument you want to learn.

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Get involved in a local church, temple or other religious organization.

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Join or start a book club.

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Volunteer for an organization you believe in.

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Register for a fitness class at a gym.

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Find a social group that fits your hobbies or interests.

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Get creative with an art class or a themed-dining club.

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PEERS AND COMMUNITY-BUILDING

‘IT KEEPS THEM YOUNG’ Another major benefit, of course, is the most simple one: fun. Whether seniors are enjoying a Thanksgiving feast together or trying out water volleyball for the first time, the laughs and smiles are contagious.

“It keeps them young, absolutely,” Gates-Barrett says. “We’ve got an environment where they’re thinking, they’re playing games, they’ve got friends that they can do it with. It’s fun. It’s a light atmosphere. Sometimes it feels like extended family.”

Adult children who are seeking out activities for their aging parent or parents can look into senior citizen centers, retirement communities and local recreation facilities to find programming that could be a good fit. Focus on your parents' interests and staying within their comfort zone – some seniors love holiday-themed dances, for example, while others would prefer a movie night at the theater.

“I really work hard to play to their talents,” Gates-Barrett adds. “I try to find a way to connect them to somebody else who loves (what they love).”

While it can be a challenge to find the right activities, it’s well worth the effort.

After all, as Zaguroli explains about her mother, “we want her to be happy.”

“They gave us such a great life,” she says of her parents. “We have to do it in return.”

There are many opportunities for senior citizens to get more physically and socially engaged in their communities.

If transportation is a concern, be sure to check whether your city, township or county offers a transportation service for seniors. Many local communities do, providing a simple and affordable way for seniors to get to and from doctor's appointments, shopping, senior programs and more. For tips on what seniors can do to stay active, consider these ideas from the Centers for Disease Control and Prevention.

GOLDEN YEARS

BIG BENEFITS The benefits of an active lifestyle for seniors can’t be understated, she adds.

“Physically, of course, the benefits are so many,” she says.

According to the Centers for Disease Control and Prevention, physical activity among older adults helps seniors maintain the ability to live independently, reduces the risk of dying from heart disease and other conditions, improves mental health and could reduce blood pressure.

There are plenty of health reasons to stay socially active, too. The CDC reports that being involved with others is “strongly associated” with better brain function, and that learning a new activity can be protective against memory loss among seniors.

One activity many seniors are enjoying is mahjong, a tile-based game developed in China. “It’s definitely exercising your brain,” Gates-Barrett says. “Research will show over and over again how good that is.”

That’s why her community recently launched support groups on various topics, including a caregivers group, grief support group and a social singles group.

Though many seniors don’t live in adult communities with built-in programming, it’s helpful for any senior to establish a support system outside their family – often by making friends at senior centers or senior programs offered by their city.

“It really helps with battling loneliness,” she says. “That’s one of the biggest things that people fear.”

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Activities include water aerobics, pinochle, yoga, kayaking and more.

While the residents at Del Webb communities tend to be seeking out a more active lifestyle to begin with, there’s still sometimes some hesitancy to make new friends or try new things.

“We make sure not to pressure them,” Gates-Barrett says. “We explain and say the great thing is you can get as involved as you want to get, when you want to get involved.”

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HOW

TECHNOLOGY CAN HELP SENIORS LIVE BETTER Tools to track their health, keep them safe, organize their lives and stay connected and engaged with family and friends are just a few clicks away. Here are some apps and tech services your parents should know about.

BY KRISTEN J. GOUGH

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“

om, I’ve got a 10-day streak going with grandma,” my 15-year-old boasted as I nodded my head trying to recall exactly how a Snapchat streak works. I had every intention of diligently following my teen’s posts via my own account, but I found I simply didn’t have the patience. Not so with Grandma! After my teen explained how it worked, Grandma G downloaded the app and became a bit of a Snapchat guru – and my teen relished their conversations, er, streaks.

Once thought of as technophobes, seniors are now beginning to embrace technology for many of the same reasons other demographics are – to stay connected with others and to make their lives a little easier. Today more and more seniors are active participants in the digital age: around 42 percent of adults ages 65 and older now own smartphones compared to 18 percent in 2013, according to the Pew Research Center. Equally telling, 67 percent of seniors are now

internet users, which the report notes is a “55-percentage-point increase in just under two decades.”

And yet seniors have other reasons they’re tapping into tech – for some, it makes it possible for them to stay in their homes longer, while helping loved ones keep track of their well-being. In a recent survey from The Home Depot, the majority of respondents – 90 percent – believed that “smart home devices make it easer for seniors to live independently, allowing them to remain in their homes for years to come.”

So what kind of tech should seniors consider (besides downloading Snapchat to keep up with the grandkids)? Here are a few guidelines and suggestions to get started.

MONITORING EVERYDAY HEALTH Before you begin searching the app store for the latest and greatest,

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remember that your smartphones already come equipped with built-in health apps. “There’s a lot of health information that smartphones are already tracking,” explains Sanket Shah, an instructor for the University of Illinois at Chicago Department of Biomedical and Health Information Systems. “It’s often kind of forgotten, but with just a few clicks you have a health monitoring device that can tell you how many steps you’re taking, your heart rate.” He also points out Apple’s Bedtime program tucked right into the clock that helps with reviewing sleep patterns.

Calorie- and exercise-tracking apps, like MyFitnessPal, have easy interfaces for watching what you eat and helping you stick to fitness goals. Many include a scanner, too, so you can simply use the food’s barcode to import calorie information.

Particularly for seniors, wearables and devices that work with smartphones are making it easier to track specific health

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GOLDEN YEARS

TRACKING YOUR MEDICATION USE Some seniors have several medications they’re taking on a regular basis.

Making sure you’re taking all of your medications on the right day can become challenging. Shah points out that skipping medications can have serious implications for seniors. To remember when to take medications, and which ones, he suggests the Medisafe app. Within the

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app, you’re able to set reminders of when to take medications, along with other features like drug interaction warnings and even family scheduling, where you can list out a caregiver who will also be informed if you miss taking your medication.

Beyond apps, there are a variety of different medication reminder devices available on the market, such as automatic pill dispensers (some that can connect in to smartphone apps), medicine caps with alarms and even pillboxes equipped with alarms.

HOUSING ALL YOUR MEDICAL RECORDS – AND MORE Take advantage of the apps that are connected with health services you already use. For example, your health insurance provider most likely has a digital system, and perhaps even an app, that makes it possible for you to schedule

doctor’s appointments, contact your physician, see your medical records, and access other health information. Shawn Bennis, a registered nurse and C.A.R.E. Program Coordinator for Henry Ford Health System, notes that seniors may want to consider lettinwg caregivers, or their adult children, have proxy access.

“At Henry Ford we have MyChart and the person can grant ‘proxy’ access through the system. You’re able to grant full or restricted access.” Again, this isn’t a new offering, but something that’s already available that you may not be using.

Your health insurer is also likely to offer desktop and mobile access to your account. Even if you don’t access all of the information related to your health insurance digitally – Shah offers a quick tip: See if you have a mobile insurance card through your insurer. So instead of having to worry about carrying your health insurance card, you can access it from your smartphone.

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concerns. “One that really stuck out to me is KardiaMobile, which takes technology that already exists and puts it right into people’s hands to offer on-site EKG readings,” notes Shah. The person places their fingers on the credit card-sized device and then the EKG readings pop up right on the smartphone screen. You can email the results to yourself or your doctor. The $99 device is FDA cleared and can even clip right onto your phone.

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HOW

TECHNOLOGY CAN HELP SENIORS LIVE BETTER

“Smart home devices make it easer for seniors to live independently,

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allowing them to remain in their homes for years to come.”

CHECK IN WITH A VIRTUAL PHYSICIAN Telehealth services are becoming more widely available, making it possible for patients of all ages to interact with healthcare providers remotely. Telehealth applications come in many different forms, according to the U.S. Department of Health and Human Services, but can be broken out into four general categories – including live (synchronous) videoconferencing with a healthcare provider; store-and-forward (asynchronous) videoconferencing where you send health information electronically to a healthcare provider for review at another time; remote patient monitoring (RPM), in which your medical data is transmitted from the individual’s electronic device to the physician for review; and mobile health (mHealth) where healthcare providers send general health information texts to your mobile device.

You might call or look online to see what type of telemedicine your healthcare provider offers. For example, Teledoc touts a median response time of 10 minutes – meaning the time you take clicking a few buttons within the app to describe your symptoms to the physician calling you takes far less time than driving to a doctor’s office. Keep in mind, however, the service is more applicable for general medical concerns, like colds, allergies and respiratory infections, not chronic disease treatments.

HELPING IN EMERGENCIES Falls are a serious concern for seniors.

The U.S. Centers for Disease Control and Prevention reports that “every 20 minutes an older adult dies from a fall in the United States. Many more are injured.”

Tech companies have taken notice of this and offer various solutions, like wearable devices such as the Lively Mobile Medical Alert (device costs and monthly plan fees apply) and MyNotifi (one-time fee and no ongoing costs for use), both of which include fall detection technology to automatically alert family or friends if a fall is detected.

STAYING CONNECTED Smart devices such as Amazon’s Echo and Google Home are making it simpler to do everything from playing music to ordering groceries and much more. These virtual assistants can handle multiple tasks via voice commands.

Other devices are taking face-to-face interactions to a whole new level. If you’re ready to go beyond video chat through your smartphone, Facebook’s Portal includes a smart camera that follows you as you move around the room (or the person on the other end, if they also have a Portal device, too). Portal can also handle multiple calls at once. Other family members don’t need to have the device to participate in the call.

Beyond these devices, tech companies are pushing towards devices that interact

with seniors using artificial intelligence and robotics. Dubbed an “active aging companion,” ElliQ aims to help seniors stay active, both physically and mentally.

The artificial intelligence device talks to you, making suggestions, like having you look at pictures, chat with friends, go out for a walk or listen to a podcast (the device will be available for pre-order in a few weeks). Other devices and services are designed more specifically to help seniors stay in their homes longer, with various levels of monitoring. For example, some monitoring services involve outfitting a home with devices that can detect when the fridge is opened and closed, to ensure seniors are eating regularly; when doors open and shut, to check that seniors aren’t staying indoors for a prolonged amount of time – all this information can be made available to caregivers to ensure seniors are doing OK. And it’s likely the devices for seniors will continue to become more advanced to allow seniors to stay in their home longer, through digital devices, while being able to stay better connected with their friends and love ones. “More and more organizations are really taking an innovative approach to developing products for seniors,” Shah says.

Engaging on social media platforms is another great way for seniors to stay connected to family – just like my mom did with my daughter. But it’s not something that all seniors feel comfortable with or understand how to use.

“I recommend that seniors take advantage of their public library and online tutorials. Sometimes all it takes is a quick tutorial, which often we do not get when we first use a comprehensive application,” Shah says. “Most libraries will have some sort of course or gathering where the focus is going to be on social media (using Facebook or Snapchat).”

Kristen J. Gough is a frequent Metro Parent contributor and mother of three.

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KNOW YOUR OPTIONS

SENIOR HOUSING OPTIONS Get a grip on the different residential choices for your aging parent.

BY MELANIE STUTLER

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f it’s looking more likely that staying in the family home isn’t the best option for your parent, it’s time to explore the different options available to them and find the right fit. One of the first steps is considering why your parent needs a change in where he or she lives. Is it a need for social interaction and perhaps some built-in services, like meals? Or

INDEPENDENT LIVING/ SENIOR APARTMENTS

ASSISTED LIVING Best for those who need daily assistance with their personal care needs.

Best for seniors who are seeking socialization, activities and a low-maintenance living situation.

• Apartments/condos usually geared at adults age 55-plus • Social outings and field trips • On-site amenities and activities, like pools, tennis courts, bingo, parties, etc.

• Limited housekeeping services, sometimes monthly • Meal plan options and breakfast buffets • Limited transportation services • Does not include personal care help Cost: Typically $1,500-$3,500/ month; private pay

do they need memory care or additional help?

Below, you’ll see the main senior housing options that can address these needs, according to A Place for Mom, a free service that helps seniors find the right housing option for their needs. Be sure to verify details of services and amenities offered when you contact specific locations.

• • • • •

Private and semi-private suites Transportation services Medication management Provides three meals a day Housekeeping and laundry services • Social outings and events • 24-hour access to caregivers Cost: Typically $2,500-$4,000plus/month; mostly private pay, but some take Medicaid

NURSING HOMES/ MEMORY CARE/GROUP HOMES Best for seniors with conditions like Alzheimer’s that require around-the-clock skilled care.

• Shared or private bedroom options • 24-hour skilled nursing/medical care • Assistance with bathing, dressing and other personal care needs • Three meals a day served on premise • Activities available to those who can partake Cost: Typically $3,000-$8,000plus/month; private pay and Medicare/Medicaid Melanie Stutler is a freelance writer and former Detroiter.

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REFLECTIONS

A LIFETIME OF ‘TREASURES’

BY JULIA ELLIOTT

Pinking shears shaped like a stork.

Antique oak sewing chest.

Collection of Harmony Garden treasure boxes.

Family photos, like the one of my parents all blotto and happy at some swinging ‘60s party.

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eyond this small list, I couldn’t care less about my mom’s “stuff.”

Truth be told, I could probably narrow it down to just those pinking shears. If you don’t know what pinking shears are, you clearly don’t sew. Neither do I. But my mom did for as long as I can remember. So, whenever I conjure up a memory of my mom from when I was growing up, those tiny shears shaped like a stork are front and center. Whether she was using them while making clothes for my Barbies or creating a quilt or mending my dad’s pants, those stork shears are intrinsically tied to my childhood and my mother. So, I do treasure them – unlike most everything else she owns.

For years my mom has commented on some possession or another and exclaimed with a smile, “You’ll get this when I die,” as if she was passing on the queen’s jewels. She’d look at me with those searching eyes, wanting me to smile back and seem happy about the prospect. I never was – except about those stork shears.

Turns out I’m not alone. An article last year in the New York Times detailed the dilemma. So many baby boomers are facing the reality that their kids don’t want the “treasures” they’ve accumulated over a lifetime. One woman felt so guilty telling her mom she had no use for her Lenox china. Me? I had no problem telling my mom that her Lenox china would never see the inside of my cupboards.

So, when my mom was moving back up to Michigan from Florida, and we were trying to figure out the smartest, most economical way to get her up here, I didn’t feel guilty tossing out the idea of leaving most of her stuff behind.

The cost to have her stuff hauled across the country ranged from $3,000 to $10,000, plus incidentals like hotel and flight if I headed down to lend a hand in a U-Haul scenario. That’s a lot of money to lug an unremarkable 40-year-old bedroom suite and some Country Frenchstyle Ethan Allen furniture that at one time would have been called shabby chic but was now just plain shabby.

Plus, some other odds and ends.

So, I suggested to my mom, “How about we just load up your Ford Edge (it’s roomy) with the most important stuff and use that moving money to get some new things?”

Now, it’s important to note that my mom can be nostalgic, but she also really likes new things. So, it was a toss-up how she’d react. I pictured her almost twitching with confusion over how to feel. “But my stuff? Leave it behind?” one side of her must have screamed. “Wait! Did you say new furniture?” as the other side lit up.

In the end she saw the beauty in my plan, but the real test was when she was faced with the limits of her Ford Edge cargo space.

In the weeks before she moved up here, she had a handyman reconfigure how he packed the car to optimize space. It was like a Tetris test for her worldly

“I’d opened Pandora’s box – and it was about to be sent Priority Mail.” treasures. Some things got the heave-ho based on sheer size and ease of replacement (so long, 8-year-old coffee pot). Others, like that antique sewing chest, had to be part of the puzzle.

At one point she was really struggling between bringing her wedding china and some sewing supplies she’d accumulated over the years. This was my mother’s version of a Sophie’s Choice. Every time I talked to her she’d share a different decision she’d ask me to validate.

“I’ve decided to bring the china. It might take a while to replenish all of my sewing supplies, but they aren’t as special as the plates. Don’t you agree?”

I remained Switzerland. “Whatever you think is best, Mom. It’s your decision.”

Finally, after a week of back-and-forth, I broke down and spouted off: “Mom, why don’t you pack the sewing supplies in a box and mail it up here?”

Almost as soon as I uttered this numbskull notion I knew I was in trouble.

“Oh, that’s a great idea! Maybe I could mail all of my bedding too. That would save space.”

I’d opened Pandora’s box – and it was about to be sent Priority Mail (don’t ask).

In the week before my mother and her filled-to-the-brim Ford Edge arrived, six of these boxes showed up on my porch, costing a grand total of almost $300 in shipping.

In the end, my mom made some tough choices – some she didn’t even mean to. An afghan my grandmother made accidentally got left behind. Some old cookbooks she meant to surrender somehow made the trip.

26 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

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There is no doubt that she had some regrets. She’s felt that mix of sadness and discombobulation from realizing that “thing” you’ve gotten so used to, that has made up the tapestry of your life, or what you think of as your life, is gone. Some of these things have occupied the same space as my mother for more than 50 years.

They’ve lived with her longer than I have, longer than my dad did. Yes, it’s just “stuff.” But it’s bigger than that.

Those serving platters and hand-knit sweaters, the knick-knacks and pots and pans, they are the collection of her life. Together and piece by piece, they tell her story – good and bad. And by looking at any one of those things, she’s back at that time and place, even if it seemed so unremarkable at the time. Those holiday glasses we got at Arby’s in the early ‘80s, this will be our first Christmas without them.

But some of the new stuff has taken the sting out of the loss of the old.

Case in point: my mom’s new power recliner.

I knew she’d be spending most of her waking hours

Brenda Elliott in the "Cadillac of recliners." in this spot, so it was important that it was comfortable and easy for her to get in and out of. So we headed to Art Van to test out some options. Like Goldilocks, she settled on the one that was “just right.” Less than a week later, it was delivered, set up and she’s been in some state of happy repose ever since. She says it’s the Cadillac of recliners, the best chair she’s ever owned.

“You’ll get this when I die,” she adds with that searching smile. I look away and say nothing. I still only care about the stork shears.

Julia Elliott is Metro Parent’s editor-in-chief.

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THE FINANCIAL

ROLE REVERSAL Mom and dad not keeping up on the bills? Are they struggling to file their tax returns? Perhaps they’re vulnerable to financial scams? It may be time to have a tough money talk and provide help. Here’s how.

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t wasn’t until her mother – a retired bookkeeper – got a letter from the IRS that Troy resident Sharon MacDonell figured something was off.

“Back in 2013, she kept telling me she was having problems with her taxes. And I just kept thinking, ‘Oh no, you’re not.

You’re fine with taxes.’”

Even though she encouraged her mother to get free assistance at the library, “I didn’t realize she wasn’t capable of figuring out when people were (scheduled to help with taxes). So I left her to her own devices. That’s when she made a mistake with the IRS that cost $1,000.”

Over time, she saw her mother struggle with the once-familiar computer program, Quicken, which made balancing her checkbook difficult. “So I started helping her write her checks for her bills,” says MacDonell, an advertising manager for Lawrence Technological University, whose name had been added to the account years earlier.

After her mother was diagnosed with dementia, MacDonell realized it was time

to take her credit cards away. “She would get calls from people who knew how to target seniors,” including a caller who convinced her that something was wrong with her computer and charged $200 to add software. “After a certain point, I didn’t want her to have her credit cards because she would just read the numbers to someone over the phone. So you really have to pay attention to scammers.”

MacDonell’s mother, a single parent, had only a few financial assets, including small retirement accounts.

“I didn’t realize I should close down her IRA until she was pretty far into her dementia.” It was then that she had trouble closing the smaller of two accounts – one worth $5,000. “My mom was diagnosed in 2014, but didn’t do her financial power of attorney until a year later.”

The bank questioned MacDonell’s authority. “They said, ‘Well, she was diagnosed in 2014; how did she know what she was doing in 2015?’ I said, ‘You know what, I don’t know what to tell you.

It’s 2017 and I’m her power of attorney.’ It took three or four visits to close down that

28 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

one small IRA. If I’d known better, I would have done it right away.”

While taking over her mother’s finances was a gradual process, “it was just as hard as taking her car keys away.

Because she kept telling me, ‘I can do it, I can do it.’ But she couldn’t do it.”

WHEN TO TALK FINANCES While MacDonell stepped in before her mother’s dementia was too far along, the timing may not have been ideal. Still, conversations with aging parents about finances can be painful, awkward and embarrassing no matter when they take place.

When is the best time to approach them?

“There is no best time,” says attorney Ed Gudeman, of Gudeman & Associates, P.C. in Royal Oak. “The best time to do it is now. See how they take care of things,” which may range from bank accounts, credit cards and insurance to IRAs, CDs and Social Security income. “People are often afraid to ask questions. They’re afraid their parents will say it’s none of their business. But it’s important to make sure things are set up properly, because

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once they get something like Alzheimer’s, it’s too late to do any planning for them.”

Gudeman’s mother – who died about 10 years ago – left behind a stellar example of information helpful to family members who need to sort through finances after a parent’s passing.

“She had a bit of a sense of humor about her situation and left a letter that said, ‘What to do in the inevitable death of your mom.’ In it, she wrote down the names of her accountant and attorney, information about her bank accounts and trusts, where they were located, and things like that, and that made things easy for when my brother and I had to deal with that situation. We really had very little to do … which was a good thing at a very sad, depressing and unfortunate time.”

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REALITY CHECK Getting parents to document financial information while they are still healthy may be ideal, but the reality isn’t always so orderly.

“I was starting from zero, with no knowledge of how their finances operated,” says Clarkston resident and retired teacher Mike Comos, who took over his mother’s finances after his dad passed away. “I didn’t know how many credit cards, bills or debts they had.”

Both of his parents had been involved in the family’s finances, but after his father’s death, “the situation was complicated by mom’s diagnosis of dementia.

She was not at a point where she could function. I saw entries in her checkbook, which were kind of a mess. The first thing I had to do was … decipher how they filed

things, where their tax returns were, how they paid their bills.”

Which meant digging through paperwork that told the story of their financial life, a task complicated by the separate desks his parents had maintained. “How do I pay bills out of their account?” he wondered.

After seeking expert advice, “I got power of attorney, which gives me the ability to handle my mom’s financial affairs. … You have to send a copy of the power of attorney document to an entity that wants proof you have the authority to handle things. Before, we’d have a threeway call with my mom and the insurance company,” to confirm he could make changes to her account, for instance, “and it got real confusing. It was a lot easier once I got power of attorney.”

METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19 • 29

THE FINANCIAL

ROLE REVERSAL GETTING THEIR MAIL

THE RIGHT TIME

To make sure he received his mother’s financial statements from the likes of insurance companies, creditors and banks, Comos requested that any correspondence be sent to him. So did Royal Oak writer and musician Roberta Brown after she took over her mother’s financial affairs. “I made sure all the bank statements came to my house. It was quite a point of friction between us, but I didn’t want her account statements lying around while housekeepers and others went in and out of her apartment.”

She also opted to pay her mother’s bills online. “I still checked to make sure the amounts were correct, but it was easier to make bill paying as automatic as possible.”

Comos set up a joint checking account with his mom after closing one his parents shared, a transaction that required a copy of his dad’s death certificate.

“She can still write checks, but we keep an eye on her.”

“It’s a tough conversation to have with a parent,” Brown says. “I know with my mother, it took having a medical crisis.

Up until that point, every time I brought it up it was, ‘no, no, no, no, no.’ But once she had the medical crisis, she realized she needed my name on her power of attorney document. Sometimes it takes a come-to-Jesus scare that makes your parents see that someday, they may not be able to handle everything.”

Carney agrees it’s a tricky subject to bring up. “It depends on the type of relationship you have with your parents. One approach could be to mention the avoidance of probate. Folks of their generation know about probate and resent it. In terms of day-to-day items, if bill due dates have been missed, perhaps you can start with just working with them to pay the bills and getting your name on their accounts, so you can quietly monitor them and make sure things get paid on time.”

Gudeman suggests a straightforward approach. “People have to say, ‘Mom and dad, we are really concerned about your financial well-being, and we want to make sure you are taking care of everything. It’s important that we know what’s going on so we can arrange things, and make sure everything works out for you financially.’”

Not all parents resist. “If my dad was still alive, I wouldn’t intervene, unless they asked me,” Comos explains. “I couldn’t see saying to my dad, ‘Hey, I’m taking over’. But my mom was not interested, nor was she capable. She said, ‘Here, do it.’”

No matter what, it was no easy task for Comos. “Things are running smoothly now,” but it took time to get there.

“Fortunately, I’m retired. If I was working full-time, [the work required to get her finances settled] would be a nightmare,” citing the physical need to be there as another time-consuming factor. “In my situation, I was lucky.”

LIVING TRUSTS Before Comos’ father passed away, he encouraged his parents to set up a living trust. “It makes things a lot easier than a will.” While not all finance professionals agree a living trust is the best option for families – it depends on the size of the estate and other factors – it worked for Michelle Carney, who grew up in Dearborn and was executor of her mom’s estate. “We had everything in the trust, with me as power of attorney. When she died, I was able to clear up everything without going to probate court.”

Even though experts agree probate – the process of validating a will and distributing assets to beneficiaries through the courts – is something to be avoided, it often depends on state laws, the size of the estate and the nature of the assets.

“A lawyer who draws up trust papers can explain the ins and outs,” Carney adds.

Pam Houghton is a freelance writer with two grown children. She and her husband live in Troy.

30 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

What is Power of Attorney or POA? POA is a legal document that gives someone else the authority to act as his or her representative.

When signing documents, the person designated as POA typically includes both names, adding “POA” next to their own.

Though there are several types of POA, durable power of attorney takes effect immediately and remains in effect until a parent’s death.

Here is a list of information helpful to have before taking charge of parents’ finances, according to personal finance magazine, Kiplinger:

state-planning documents, E including powers of attorney for finances and health care ocation of safe deposit box L and keys Social Security numbers Birth and marriage certificates ames and contact N information of financial institutions, including banks, credit unions, brokerage firms and insurance companies I nformation about pension(s), life insurance and annuities ames and contact N information of financial adviser and tax preparer eeds to property and D cemetery plots Vehicle titles and registration

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W H AT T O D O I F YO U R PA R E N T S E X P E R I E N C E COGNITIVE CHANGES It’s a painful reality for many adults. Find out how to get your parent evaluated and what to expect.

BY JESSICA SCHRADER

W

hat Darren St. Ledger misses most are the long conversations he used to have with his mom.

His mother, 77 years old, has good days and bad days in her battle with memory loss.

“Some days she reaches deep down to remember things and once she can’t she gets frustrated,” explains St. Ledger, a Westland resident and father of two. “She remembers people like you wouldn’t believe and gets very excited when people come to visit her. But if I ask her if my brother was visiting with her the day before I visited her, she couldn’t remember.”

In St. Ledger’s case, his mother’s memory loss seems to be related to a stroke she suffered two and a half years ago.

“When I first found out that my mom had had a stroke, I dropped to my knees,” he says, since he knew her speech, mem-

ory or ability to walk could be affected.

“She’s able to talk, but really you can’t understand anything she says. That frustrated me because my mom and I would have long conversations and we’re both very gregarious people.”

Since then, “I’ve seen my mom come and go,” he says. She now lives at an American House facility, where staff are able to understand her needs. “It took a while for her to get acclimated at the American House but once she did, the people that were there knew she was a special person. She knows everybody.”

St. Ledger tries to have the same kinds of conversations with his mom that he used to have, but it’s not the same. “She’ll call me on the phone and we try to talk, but it’s hard. I start to cry and wish that day that she had that stroke had never happened.”

32 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

DEMENTIA ON THE RISE The pain St. Ledger and his family are facing is not uncommon. Sadly, memory loss affects many older adults and the emotional impact is felt throughout the entire family.

Dr. Amita Pai, M.D., a geriatric specialist with Beaumont Health and the medical director of the Beaumont Geriatric Clinic, says the prevalence of dementia is increasing in the senior population.

“Even the diagnosis of dementia at present compared to even 10 years ago has gone up. The prevalence is basically increasing over time, too,” Pai explains.

Cognitive changes are more common at the age of 65 or older, though it can also happen earlier. “The biggest risk factor for cognitive impairment or dementia is age itself,” she says. “When you see parents living into their 80s and 90s, you start noticing it more.”

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“Not all memory loss is dementia. Sometimes it’s depression, side effects from medications, EARLY SIGNS Early signs of memory loss can include a failure to remember appointments, missing social engagements or a decrease in personal hygiene.

“Some of the objective signs are they start losing weight, they may be forgetting to eat, forgetting to bathe, tending to wear the same clothes over and over again,” she says.

It could even be more subtle, like noticing your mother used to go to the salon regularly to have her hair or nails done and no longer does. There could also be a slight personality change or you may notice your parent is withdrawing from some of their usual social activities.

“They don’t want to put themselves in social situations,” for example, Pai says.

“These may be indirect ways of finding out what’s happening.”

WHAT TO DO Before you rush your parent into a doctor’s office, try to have a non-confrontational conversation with him or her about the changes you’ve noticed.

“Some of them might be in self-denial or trying to cover it up,” Pai notes. In those cases, “opening up a conversation and showing empathy” is best. “That might lead to finding out what are they struggling with at home.”

An important step is finding out whether your parent has any insight into what’s going on, or whether they don’t realize the cognitive changes they’ve experienced. Once you’ve had that conversation, it’s time to pursue a diagnosis.

You can start with your parent’s primary care physician or go straight to a geriatric specialist or neurologist.

“Not all memory loss is dementia,” Pai points out, adding that several psychiatric disorders can mimic memory loss. “Sometimes it’s depression, side effects from medications, a mini stroke or a stroke that has happened. Let’s go to your physician and talk to them about this. The diagnosis helps with prognosis and planning for the future.”

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a mini stroke or a stroke that has happened.

Let’s go to your physician and talk to them about this. The diagnosis helps with prognosis and planning for the future.”

If your parent is reluctant to seek out an evaluation, remind them that you aren’t trying to take away their independence. As Pai tells her patients, “Everything we are doing is to support maintaining your independence,” she says. “The fear of losing independence I think is what makes most seniors resistant in seeking care. The goal, at least in the geriatric philosophy, is to maintain independence. We do everything possible to improve safety. It may still be possible to live at home.”

For help at home, several tools are available including medication reminders and even GPS tracking devices, so you can be sure your parent hasn’t left the house or to track them while out on a walk. Your parent’s physician will take care of a driving assessment to check whether driving is still safe.

“Understand that you have to be a child to this person and not just their caregiver. They don’t really accept the reversal of roles well where you’re the parent and they’re the child,” Pai says.

TREATMENT AND PROGNOSIS Dementia is essentially a symptom that means memory loss, Pai explains, and there are many causes of dementia. Alzheimer’s disease is one of the most common causes, accounting for almost 70 percent of dementia cases, she says. Other types include vascular dementia, Lewy body dementia and frontotemporal dementia.

Finding the cause of the dementia is critical, since treatment options are often

different for each condition. Although some diagnoses have no cure, various interventions can help improve quality of life or prevent it from getting worse. In some cases, patients can also participate in research studies that could help lead to a cure in the future.

“There are many different reasons for the memory loss,” she says. “It’s always good to not ignore it and to get it evaluated. The earlier we find it out, the better it is.”

Adult children may feel reassured to know that the majority of dementias are “slow-progressing,” Pai says. “Almost 70 percent (of patients with mild cognitive impairment) can stay the same without much progression if they’re doing the things recommended including exercise, diet and keeping mentally engaged.”

HOW TO RESPOND When a parent is experiencing memory loss, it’s important for adult children to exercise patience and never antagonize the parent about what’s happening – “even if you notice problems that are glaring,” Pai says.

For example, don’t say things like, “Mom, you’re not doing this right,” Pai advises. “That leads to a friction and impaired relationship. You want to maintain that trusting relationship because they need your help for many more years.”

And when it comes to delivering medical news that a parent may not want to hear, “Let the physicians be the bad guys.

We can give them the bad news,” Pai says.

It’s a difficult balancing act for children

METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19 • 33

W H AT T O D O I F YO U R PA R E N T S E X P E R I E N C E COGNITIVE CHANGES

acting in a caregiver role for their parents.

“Pick your battles,” Pai emphasizes. “You can’t solve every single thing. Keep safety as a priority. Let the medical professionals talk them into some of the other changes.

It’s hard for any of us to accept changes.”

FINDING SUPPORT Adult children and caregivers shouldn’t hesitate to seek out resources in their community for themselves and their aging parent.

“Having seen multiple patients with dementia at all ages, the patient is the one who has the disease, but it’s the family members who suffer behind the curtain,” Pai says. “Make sure whoever is taking care of the parent has to take care of themselves first. You have to be healthy enough to take care of the parent.”

St. Ledger and his brother found assistance through the Senior Alliance, Area Agency on Aging 1-C, a nonprofit serving southern and western Wayne County that provides services and resources for older adults.

“I would recommend using resources within your community if your parent has had a stroke or is in the stages of early dementia,” St. Ledger suggests. “We never did seek any counseling for ourselves even though we were exhausted with wondering what would happen next.”

Don’t be afraid to seek out professional help, and try to remember that “the person (you) love is still in that body,” he says.

And importantly, St. Ledger has peace of mind knowing his mother is happy and receiving quality care.

“She laughs, she tries to sing Beatles

34 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

songs and dances in my car. She’ll dance with me in the middle of her room just because it makes her happy,” he says.

“My mom raised four boys and each one of us act differently around her. But what I remember is that no matter what, she’s my mom and I love her just the way I did when I was able to begin loving her.”

His advice for families facing memory loss in an aging parent is to work as a team.

“Families need to stick together and work together to help their parents,” he says. “Most of all, you have to learn patience. Every day is something different, but one thing that never changes is our love for our family … so I’ll do whatever I can to make sure my mom is in good hands.”

Jessica Schrader is Metro Parent’s managing editor.

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ORGANIZING ESSENTIAL DOCUMENTS AND CONTACTS B Y E M I LY R O T H

D

OTHER THINGS/ DOCUMENTS TO DISCUSS

A ny letter of instruction listing personal property not disposed of by will and wishes for distribution R eceipts and appraisals for valuables T rust, banking and loan information T ax returns

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B irth certificate Driver’s license Social Security card M edicare / Medicaid / insurance coverage card Organ donor card

o you know where your car title is? How about your detailed life insurance policy? If yes, good for you. But many of us aren’t entirely sure where our own essential documents are. We may have an idea, and given 20 minutes, we could probably dig them up. But if you think managing our own essential documents can be daunting sometimes, imagine trying to identify and locate what you’ll need for your parents after they pass away. They won’t be there to provide breadcrumbs, so it will be up to you to just dig and dig and hope and hope. Unless you start now. Here’s a guide to what documents and contacts you should get a grip on now with the help of your parents.

S afe-deposit box and key, along with a list of the contents and names of anyone who has access to it

KEEP COPIES OF THESE DOCUMENTS

I nsurance policies S tocks, bonds, real estate and other investments L iving will, medical directives or Durable Power of Attorney B irth certificate, Social Security card, marriage and divorce certificates, education and military records B urial plots and desired funeral arrangements

Marriage certificate Credit cards Mortgage records Military records L egal power of attorney, healthcare proxy, living will, advance directives

IMPORTANT CONTACTS AND ACCOUNTS TO TRACK Clergy members Attorney, financial planner, tax advisor,

broker and/or anyone else with knowledge of or control over trusts, wills and finances

Beneficiaries Bank account, loan and credit card contacts

I nsurance agents

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DON’T FORGET ABOUT ONLINE ACCOUNTS A lot of us underestimate how many online accounts we have. Gene Newman, editorial director of Everplans, an online estate planning tool, says a person can have as many as 250 online accounts in his or her lifetime, from email accounts, social media, entertainment and much more.

So what happens to all of these accounts when someone dies? There is no easy answer if you don’t have a plan. Here’s what you should do sooner rather than later for yourself and your aging parent to get your digital house in order.

1. IDENTIFY ALL OF YOUR ONLINE ACCOUNTS The first step you should take with your loved one is identifying all of the online accounts they use. Some of these accounts really don’t need to be deleted, especially if there isn’t a credit card linked to it or it has been inactive for many years.

But others, like online financial accounts, really need to be identified.

“People have breakdowns saying, ‘We don’t even know where they bank,’” Newman says.

2. SHARE YOUR INFORMATION WITH A TRUSTED PERSON Make sure that all of your loved one’s passwords and email addresses are given to someone they trust to take over their account after they pass. This way this desig-

nated person will have access to all of your accounts and will have the power to delete or close them after you die.

Newman notes that the designated person can also be placed as an executor on the will, if you want to make this process legal and easier. Newman adds that there are also password manager apps, like LastPass, out there to keep all your passwords in one place if you need to make it easier for yourself and others.

“The iPad is reduced to a placemat because grandma didn’t share the password,” Newman says. “It’s important to plan this out beforehand.”

IF YOU DIDN’T DO ANY PRE-PLANNING We get it: The worst comes when you least expect it sometimes and you didn’t get digital account information from your parents before it was too late. At this point, however, the ways to delete online accounts are limited.

“You won’t get very far fast,” Newman says.

In the case of Facebook, there are options like naming a legacy account, which would give access to someone to different aspects of your account like changing and removing pictures and letting friends know that the person has died.

“But they can’t read messages,” Newman says.

But if you aren’t added onto a legacy

MICHIGAN STATE LAW ON DIGITAL ASSETS Select states have stepped up to weigh in on the legal ramifications of someone’s digital assets in the event of their death. Michigan is among them. HB 5034 The Fiduciary Access to Digital Assets Act, enacted in 2016, stipulates that digital assets and accounts are subject to the same rules as other assets when the owner dies. This means that you need to include your digital accounts in the list of items you bequeath to one of your loved ones or if you leave everyone all of your worldly possessions, your digital assets will be included within your estate.

account, this is when Facebook’s Special Request for Deceased Person’s Account form comes in.

According to cnet.com, you will need to provide the deceased person’s full name, email address, date of death and the URL of their timeline.

If that gets accepted, you then will then be given the choice to either memorialize the account, which means the account is inactive but people will still be able to post on it, or to delete it.

“Each service has its own rules,” says Newman.

Emily Roth is a Metro Parent editorial intern.

36 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

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KNOW YOUR OPTIONS

SENIOR HEALTH CARE 101 An overview of Medicare, supplements and other need-toknow health care issues affecting aging parents.

BY JESSICA SCHRADER

H

ealth insurance decisions are rarely simple, even when we’re making them for ourselves. When these choices are for someone else – especially an aging parent who may be eligible for Medicare – the challenge is multiplied.

There’s a lot to consider. Does your parent qualify for Medicare? Will they need a supplement plan? Which policy is best? What’s covered and not covered?

These questions are common and increasingly asked by adult children helping their parents through the enrollment process, says Randy Hoover, a chartered financial consultant and registered health underwriter with Hoover and Associates, an independent insurance and financial planning services firm based in Royal Oak. “It’s extremely confusing,” he says, which is why many people turn to firms like his for guidance. “Some people have different degrees of financial literacy. It’s stressful.

Most people don’t want to admit they’re turning 65, so there’s a mental barrier sometimes and they put it off until the last minute because they don’t want to think about it.”

But thinking about health care and planning ahead for it is critical for seniors and their caregivers. Here’s a look at some of the main aspects you should know about.

MEDICARE BASICS Medicare is the government health insurance program that covers people age 65 and older, along with younger people who have disabilities. While some people assume this coverage is free, it’s a bit more complicated than that.

Medicare Part A is considered hospital insurance and covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Most people don’t pay a monthly premium for Part A, according to the U.S. Centers for Medicare & Medicaid Services, as long as the individual or their spouse paid Medicare taxes for a certain amount of time while working.

Medicare Part B is medical insurance and covers a

portion of doctor’s office visits and services, outpatient care, medical supplies and preventative services. “For Part B, there is a charge attached,” Hoover explains.

In 2018, the standard Part B premium amount is $134 – but it can be higher or lower based on your income and Social Security status.

WHAT ELSE YOU NEED Together, Parts A and B are known as original Medicare, Hoover says. But there’s more to consider – including Medicare Part D, which covers prescriptions, and other supplemental coverage options. These help cover the costs that your plan doesn’t, such as coinsurance and deductibles.

“There’s a bunch of people in our country that just have original Medicare. They didn’t do anything else,” Hoover says. “They’re exposing themselves to huge financial liability.”

That’s because Medicare Part A and B don’t cover long-term care, prescriptions, dental care, eye exams related to glasses, dentures, hearing aids, foot care and more.

Instead of enrolling in original Medicare and buying a Part D plan, some people opt for a Medicare Advantage, or Medicare Part C, plan. This is a Medicare plan offered by a private company that contracts with Medicare. The plans include all of your Part A and Part B benefits. Premium rates vary and most Medicare Advantage Plans also offer prescription drug coverage. These plans usually have deductibles and copays, but they do have an outof-pocket limit – after that, the plan will pay 100 percent of your medical costs.

Another option is a Medigap policy. With these plans, seniors pay a monthly premium and the plan covers most of your Medicare out-of-pocket costs. You’ll still have original Medicare, and the remaining costs will be forwarded to your Medigap plan. These plans don’t usually cover prescriptions, so seniors would still need a Part D plan.

38 • METRO PARENT GUIDE TO HELPING YOUR AGING PARENTS 2018-19

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GET ENROLLED For more information on Medicare and how to enroll, visit medicare.gov.

“Our big thing is telling people their rights. People are smart and they’ll make the right choice, but if they don’t know it exists, they have no chance.”

MEDICAID CONSIDERATIONS Some seniors are eligible for both Medicare and Medicaid, which is a federal and state program that provides medical coverage for people with limited income and resources. If your parent is eligible for both, most of their health care costs will be completely covered – with Medicare paying first, and Medicaid picking up the remaining costs. They’ll also usually qualify for help paying for a Part D plan.

“Lower-income seniors could have Medicaid. It’s based on a percentage of the poverty level,” Hoover says. “These people are in tough shape, and they don’t need to be burdened with substantial expenses.”

STEPS YOU MUST TAKE Important steps must be taken to ensure seniors don’t miss out on optimal benefits. For example, a Part B plan must be chosen within six months of becoming eligible for Medicare – whether that’s at age 65 or when a senior retires and loses access to an employer-sponsored plan.

If you don’t sign up for a Part B plan when you first become eligible, a late enrollment penalty will be assessed

and you could face a gap in coverage.

“Once the window closes, they can only apply once a year during the Medicare open enrollment period, which is January through March and their coverage won’t start until the following July,” Hoover explains.

Depending on when you apply, you could also miss out on the chance to have all medical questions waived.

Always check into which doctors and prescription drugs are covered in the plans you’re considering – especially if you’re moving your aging parent from out of state to Michigan.

“The kids need to make sure that doctors that are suitable are going to be available in the plan. And where we spend most of our time is making sure that the pharmacy needs of these people are taken care of,” he says. “All these plans cover medicines differently. There can be thousands of dollars in difference.”

NAVIGATING THE OPTIONS As seniors approach the age of eligibility for Medicare, they’ll often be inundated with advertisements about different types of supplement plans.

“They get an avalanche of things in the mail from all the insurance companies. They’re trying to pander to them to get selected,” Hoover says.

Yet if the senior’s adult children are helping to make decisions, they won’t have any of the information the parent receives – so they’re often not aware of the options.

Sometimes, professional help is needed. “People are relieved after they meet with us,” he says. In addition to companies like Hoover’s, local nonprofits or senior centers could offer assistance.

But it’s important to think about the decision well in advance, because your choices now could impact what options are available in the future.

“Our big thing is telling people their rights,” he says.

“People are smart and they’ll make the right choice, but if they don’t know it exists, they have no chance.”

Jessica Schrader is Metro Parent’s managing editor.

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BECOMING A CAREGIVER FOR YOUR AGING PARENT

BY MELANIE STUTLER

O

ne day your parents seem totally self-sufficient and the next day they need help getting to doctor’s appointments. At least it feels that way. But the truth is your role in helping your aging parent often grows slowly. How do you prepare for their needs and your own before you’re fully a member of the Sandwich Generation? Here we offer some tips from the Family Caregiver Alliance.

COMMON CAREGIVER TASKS B uy groceries, cook, clean house, do laundry, provide transportation H elp your parent get dressed, take a shower, take medicine T ransfer senior out of bed/chair, help with physical therapy, perform medical interventions – injections, feeding tubes, wound treatment, breathing treatments A rrange medical appointments, drive to the doctor or arrange transportation, sit in during appointments, monitor medications T alk with doctors, nurses, care managers and others to understand what needs to be done

PREPARING TO BE A CAREGIVER

PRIORITIZE YOUR OWN NEEDS TOO

Identify yourself as a caregiver; recog-

Realize you cannot be perfect and that

G et a good diagnosis – from a specialist or geriatrician if necessary – of your parent’s health condition

S et realistic expectations – for yourself and your loved one

Learn what specific skills you might

your parent and which ones you are or are not able to perform

nize this new role you have assumed

need to care for someone with this diagnosis

Talk about finances and healthcare wishes

C omplete legal paperwork, like Powers of Attorney, Advance Directives, etc.

B ring family and friends together to discuss care and keep them up to date on the current situation

Identify resources, both personal and

you are entitled to your emotions

Learn the skills you need to care for

L earn to say “no” to things you cannot do

Learn to accept help from others Build resilience Identify your button-pushers/stressors Identify your coping skills Remember the big three for successful coping: eat well, exercise and sleep at least 7-8 hours a night

S pend time handling crises and arranging for assistance – especially for someone who cannot be left alone

in the community

F ind support for yourself and your loved one

out and get help

H andle finances and other legal matters

Remember that you are not alone

as important as taking care of others

Admit when you are experiencing burn Remember that taking care of yourself is

B e a companion B e a (usually) unpaid aide, on call 24/7

CAREGIVER SUPPORT GROUPS METROPARENT.COM/AGINGPARENTS

Melanie Stutler is a freelance writer and former Detroiter.

Many local senior centers and community organizations have caregiver support groups to offer tips, insight and a community that understands the challenges you face. Get a partial list of some of the top ones from around southeast Michigan at MetroParent.com/AgingParents.

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MOM? DAD?

DO YOU NEED HELP? Don’t expect your aging parent to ask you for help. They often don’t. That’s why we need to recognize the signs that they need our assistance – even if they don’t ask for it. Is it an easy conversation? Nope. But we’ve got pointers on how to broach it.

BY KRISTEN J. GOUGH

P

arents aren’t used to asking their kids for help. The conversation can be challenging for both aging parents – and their adult children. Yet as parents age, they’re likely to need added support to maintain their health and lifestyle. And that can lead to some difficult

conversations.

If you’re concerned that your aging parents may need more help than they’re letting on, there are some common signs to review, along with some gentle ways to jumpstart a conversation with them about their needs.

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7

COMMON SIGNS Y O U R A G I N G PA R E N T S M AY N E E D H E L P

1. T HEY DON’T QUITE LOOK PUT TOGETHER

Some signs may be subtler than others, but overall if your parent just doesn’t seem to be acting as she normally would, it may be a clue that she’s having difficulty taking care of herself. “Look for changes in their regular behavior,” explains Shawn Bennis, a registered nurse and the C.A.R.E. program coordinator at Henry Ford Health System. For example, if your mother always has her hair and nails done and all of a sudden she’s lost interest in maintaining her appearance, this could be a sign of an issue. You might also notice a lack, or lessening, of good hygiene habits. Maybe your dad doesn’t seem to be showering regularly, which may be because he’s afraid of falling in the shower or has difficulties bathing.

Then again, if he has unexplained bruises on his body, those may indicate trouble balancing and walking – or that he’s had a fall.

2. T HE HOUSE IS UNKEMPT

Are stacks of mail sitting around their home? Do the floors and living spaces seem dirty? Your parents’ mobility may be more limited than they’ve told you about – making it more difficult for them to bend over to pick up.

Their eyesight may be worsening to the point that they don’t see the dirt or grime. As far as the mail, they may be confused as to what to do with piles of letters, and leave bills unpaid.

3. T HEIR REFRIGERATOR HAS SPOILED FOOD

Take a peek in the fridge – is the majority of the food past its expiration date or showing visible signs of mold?

It could be that your parent is having difficulty driving to the grocery store for fresh food. And perhaps his vision isn’t sharp enough to catch that the strawberries have gone bad or his sense of smell strong enough to catch the odor of food that’s no longer edible.

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4. T HERE ARE DINGS AND DENTS ON THEIR CAR

Your parent may not be ready to admit that she’s not able to drive safely. Scrapes on her car may signal that she’s having difficulty parking her car properly, due to poor vision or lessening fine motor skills. You might consider going for a drive with your parent to assess her driving skills firsthand.

5. T HEY AREN’T TAKING THEIR MEDICATIONS

Figuring out whether your parent is taking his medications on time and in the right dosage can be difficult. This may take a little detective work, such as taking a peek at your parent’s medications. If the bottles are full, or his pillbox seems untouched, that may indicate he’s been forgetting to take his medications.

6. T HERE’S A SIGNIFICANT CHANGE IN THEIR SOCIAL BEHAVIOR “When there’s a lack of interest in doing activities they once really liked to do, that might be a cause for concern,” notes Bennis. “If they were really active in the community a year ago, or a few months ago, and they’re not any longer, that’s something to look for.” Conversely, if your parent has never been interested in going to a senior or community center, you shouldn’t expect that they’ll automatically start going once they reach a certain age.

7. T HEY ARE BECOMING FORGETFUL

Does your parent have duplicates of several grocery or other items? Does she forget something she just told you over the phone the next time you chat? Dementia affects about 10.5 percent of those ages 65 and older, according to a recent report published in The Journals of Gerontology.

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“ MOM? DAD?

DO YOU NEED HELP?

H O W T O S TA R T A C O N V E R S AT I O N ABOUT NEEDS Once you notice a worrisome change with your parents, the next step is to talk to them about it. Bennis suggests you start by asking your parent how he’s feeling and then describe your own feelings: For example, “I’ve noticed that – fill in the blank – and I’m concerned about you,” might be a way to initiate the conversation.

“Asking the person about how they’re feeling – truly getting at their feelings – will help the conversation and everything else can come after that,” advises Bennis.

Are they feeling sad? Frustrated? Lonely? “They need to work through those emotions before they can make any real changes.”

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“Asking the person about how they’re feeling – truly getting at their feelings – Aging can bring with it any number of difficult emotions for parents as they lose abilities they had previously. “There’s a lot of embarrassment and shame that can come as you’re dealing with some of the challenges of aging,” says Bennis. “It’s almost a grieving process because of the loss of identity, whether that’s through a sudden change in health from a stroke or heart attack, or it comes more gradually. There’s a sense of loss of themselves and of what they once were.”

Understanding your parents’ goals for their lives – both short- and long-term – can be a helpful way to guide the conversation. As part of that discussion, you might ask leading questions about how they’re planning for that goal. “No one likes being told what to do, but if you come up with the idea yourself, it’s often easier to follow through,” notes Bennis. For instance, does your parent see himself still living in his home a year or five years from now, or would he like to downsize for easier upkeep? If he’s planning on selling, talk through the steps and timing that he’ll need to make his goal possible.

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will help the conversation and everything else can come after that. They need to work through those emotions before they can make any real changes.”

Overall, having regular discussions with your parents will help make it easier when you need to bring up more sensitive topics. And if you find it’s too challenging for you to do this on your own, don’t hesitate to reach out to a healthcare provider or community caregiver support group for help.

Kristen J. Gough is a frequent Metro Parent contributor and mother of three.

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REFLECTIONS

ASHES TO ASHES B Y PA M H O U G H T O N

M

y dad’s ashes sit in my hallway closet. My sister keeps our mom’s ashes in her house. A while ago, she mentioned where in her house they reside, but I have since forgotten.

I know, I know. It sounds terrible.

Before you judge, let me explain.

My parents divorced in 1972, after it seemed like the civil unrest of the ’60s started to calm down and divorce became the next “in” thing to do. My dad was the rascally Bill Clinton-type, and my mom, the ever-faithful Hillary. Or to be bipartisan, Donald Trump and Melania. Mom didn’t want the divorce, Dad did, end of story.

Well, not really the end. It was the beginning of many painful memories. But suffice to say, my mom and her three children – 15, 12 and 5 at the time – rallied and returned to Michigan to be near family after having relocated to Chicago four years earlier.

We loved our dad, desperately, you might say, but over the years he made cameo appearances at best, dropping out of our lives for months and even years at a time. It’s hard to have a relationship with someone who doesn’t seem to want to have one with you.

Our mom, on the other hand, was a working mother, a role model, who alternated as a stalwart example of independence, supporting three kids on her own, and a sadder one filled with anger and depression, emotions that seemed to worsen as the years wore on. (In hindsight, she could have used a mood-altering prescription drug. Too bad she missed out on that revolution.)

When it came to those final resting place plans, we were about as prepared as a preschooler for a road test on I-75, though mom had been suffering from dementia, her death inevitable. While she’d joined a Methodist church in recent years, she didn’t have a burial plan, either.

We had a funeral, of course. My sister and I shopped for an elegant pink suit and the three of us chose a beautiful white casket, but we weren’t sure what to do with her afterwards.

I’d always felt like an oddball. So it wasn’t out of the ordinary to experience another uncomfortable dilemma.

Was this a situation people sought counsel for? Did we miss something – a burial plan signed, sealed and

delivered long before she was due to be placed six feet in the ground? I just didn’t know.

The three of us – older bro, younger sis and me – came together like good sibs do and made the decision to have her cremated (good for the environment, right?).

My sister and I had bracelets made, each of which contained a smidgeon of her ashes. My sister ended up with the rest ... in a box.

We joked about putting mom in an urn, dressing her up for different occasions, recreating her perfect hair and dapper wardrobe (especially anything designed by Liz Claiborne). But other than that, we figured my sister’s home was as good a resting place as any.

By the time my dad died in Florida a few years later, it was sad in a way a distant cousin’s death is. In an emotional way, I’d mourned his death years earlier. A slow death, if you will, with the many disappointments a child feels when a parent repeatedly neglects their parental duties – even the simple act of being there. Not that I wanted it that way.

So when I learned an uncle and his wife were traveling to Florida, I asked if he could bring my dad’s ashes back with him.

Now they sit in my hallway closet. And I’m not sure what to do with them either.

I’ve entertained thoughts of finally getting those two clowns together again – finding their final, FINAL resting place with the two side-by-side. Wouldn’t that be nice?

Even though I’m middle-aged (some might say beyond) nothing would make me happier than seeing them reunited. Yep – still.

Instead, I might need to settle for a change within, a feeling that they look out for me – maybe not in a Long Island Medium sort of way – but who knows?

I do know with absolute certainty we’re human and we all make mistakes. And I feel like my parents – two people who created three rocking kids – are always here, in my heart and mind, cheering me on, proud and happy. Anger and disappointment having dissipated over time – replaced by a very nice life of my own.

Is that better than a burial? I don’t know. But for now, I’ll take the feeling – and be ever grateful for it.

Pam Houghton is a freelance writer with two grown children. She and her husband live in Troy.

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