Concerns About Aging Parents: Why Won't They Listen to Me???

We often hear from adult children of aging parents who are worried about Mom or Dad, but struggle with how to approach the subject...or have tried with little success. The approach and the way things are presented can make all the difference in the outcome. Here are some pointers:

 Think about the person’s perspective and take time to listen to their concerns, thoughts and questions.
 Don’t push—sometimes it is better to drop the subject and let your relative process the information and come to some conclusions on his/her own.
 Be aware of differing communication styles, which often have an age and/or generational basis. You may want action and lose patience with styles you view as rambling, indecisive,and repetitive. Pick appropriate time and place for discussions and set aside time. Realize how your own emotions may be impacting the conversation and increasing resistance.
 Enlist the help of a professional geriatric care manager, trusted advisor, or other family members. Sometimes a different approach, differences in relationships (or the neutrality of not having a personal stake) makes a difference.
 Attempt to talk about proactive changes prior to crisis, with a focus on maintaining independence and choice. However, when a crisis occurs, use the opportunity to introduce necessary changes (i.e. this may be time for a “respite” or “rehab” stay at a care facility which perhaps will lead to an easier transition).
 Prioritize and rethink what you feel are “necessary” changes. Perhaps there is a compromise that can be reached that doesn’t compromise your loved one’s safety.
 Act as a facilitator. How can you help your loved one? Have your listened to them and looked for options that may better suit their desires? What are their objections and values underlying their choices?
 Talk to an expert when Alzheimer’s or other forms of dementia are involved. Memory disorders may change the needs, and mean your loved one is less able to logically process choices and make safe decisions, but it can be hard to draw these lines.
 Know what resources to turn to, particularly if your loved one becomes a danger to themselves or others. Visit www.eldercare.gov for local agencies and 1-800ABUSE in Florida for elder abuse or neglect reports.

We invite you to read more on our website, including books we recommend to help you better prepare for eldercare issues, addressing caregiving concerns with aging parents and resources to assist your family.

New Medicare Assistance Available to Help Retirees

In 2010, there were about 1500 stand alone (private drug plans, Part D) in the Medicare program. Average nationwide premiums for 2010 are about $38/month. However, in Florida there are Medicare Advantage plans that include drug costs for as little as $0/month and a range of options for receiving coverage, from standard Medicare with a stand alone drug plan, to Medicare Advantage (bundled services provided through insurance companies instead of standard Medicare), or dual eligibility such as Medicare/Medicaid, VA, and private employer/retiree plans.

As healthcare costs across the board continue to increase and as we each more carefully analyze how we will fund our longevity, healthcare coverage during retirement is a key component.

Aging Wisely offers a new service to help retirees and families with these important decisions:
New Medicare Assistance Available to Help Retirees

We also invite you to download our Medicare Fact Sheet for 2010.

Aging Wisely Care Manager Chosen as Finalist in National Healthcare Awards

Aging Wisely, LLC, is proud to announce that Julie Scott, Geriatric Care Manager, has been chosen as a national finalist in the Dorland Health People Awards.

Dorland Health, an influential healthcare publishing and educational organization, offers this description: “The Dorland Health People Awards set the benchmark for outstanding patient care and systems delivery achieved across the diverse healthcare team…the Awards honor the diligent, the influential—in short, the special—practitioners who coordinate and provide care.” The finalists will be honored at a banquet on October 4th at the National Press Club in Washington, D.C.

“Julie has worked as a Professional Geriatric Care Manager for Aging Wisely for 9 years and has had a tremendous impact on clients, families, our internal team/colleagues and the other professionals we see as part of our team,” states Linda Chamberlain, President of Aging Wisely, LLC. “We receive many thankful letters from families that Julie helps, but we also see the ways she uses her creativity, knowledge and leadership to help strengthen our team and processes.”

In addition to her work with older adults and their families, Julie specializes in care management for clients with special needs, Alzheimer’s client and family support and comprehensive assessments for complex cases and legal matters. Julie recently led the development of a new Medicare Analysis program. Last year, she contributed to a chapter on disaster preparedness in a textbook widely used by the geriatric care management profession. Click to view Julie Scott’s bio.

'News from Aging Wisely'

'News from Aging Wisely'

Tips for Being a Good Medical Advocate

Whether caring for an aging parent or helping a friend or spouse facing a diagnosis and treatment options, everyone needs an advocate at times. When any person is facing a diagnosis, surgery, or hospitalization, having such an advocate can be invaluable. Even if you are very savvy, there is a lot to absorb and consider in these situations. Here are some tips for you to be a good advocate:

1. Help gather important information. Help your loved one organize their medical records, health history and important documents (advance directives, insurance information).

2. If your loved one has not completed advance healthcare directives and decision making paperwork, encourage them to do so (including Durable Power of Attorney, Healthcare Surrogate/Power of Attorney, Living Will).

3. Help in preparation for the appointment, procedure, hospitalization (as feasible). Prepare purpose of the visit, symptoms, concerns, list of questions. For procedures or treatments, find out what to expect and ask questions. How long will you be there? What do you need to bring? Will the patient need a ride home? Will they need aftercare? While many people don’t need formal aftercare, consider the challenges one ofte faces after a surgery or hospital stay. Often, you can drive the patient home and get them settled, but it may be easier to have additional help as you may need to pick up prescriptions or may not be able to help if the patient is very weak or ill.

4. After an appointment, use your notes to review what was discussed and consider next steps/pros and cons, for example regarding treatment options. It is important to help the patient think through things in a less rushed/stressful manner, when possible. If you are making decisions on behalf of a loved one who cannot do so any longer, have an advocate for yourself…someone you can talk things through with. Sometimes an outside party is best for this and can help you think through all the ramifications, and gain a clearer picture.

5. Help your loved one ascertain second opinions when needed. However, bogging someone down with a lot of information (or misinformation) from the internet, for example, can be less than helpful. It is most helpful to identify the most expert resources and assist in clarifying information and making a comfortable decision feeling informed, not overwhelmed.

6. Review this NY Times article about 6 questions to ask for elderly patients being hospitalized. If you cannot be with your loved one at the hospital or emergency room, it is a good idea to get a friend, relative or geriatric care manager to be there. This is not only for your loved one’s well being, but to ensure the hospital staff gets the accurate information they need to do the best job. http://well.blogs.nytimes.com/2010/06/24/six-questions-to-protect-elderly-patients/?emc=eta1

Visit www.agingwisely.com for more information on healthcare advocacy services and ways you can prepare yourself or your loved one to take on your health needs head on.

Driving Safety & the Elderly

Every time I speak about this topic with people, they nod their heads knowingly and tell me a story about an older relative or client and their concerns...and usually the stress over trying to convince them it was time to stop driving. Here is a good article from the Mayo Clinic on this topic:
http://bit.ly/ahuY2O


We also have a handout which helps families consider how to approach this issue, and provides some resources to help: www.agingwisely.com .

It is important when you approach this issue with a loved one to consider how you are going to help your loved one maintain their life--so that taking away the car keys is not the end of life as they know it. Most areas of our country, unfortunately, don't have readily accessible, convenient public transportation systems--so if you don't live in an urban area, you'll probably have to search out options. Some aging services organizations offer transportation, particularly for medical needs. Most bus systems have an application process for individuals who cannot navigate the bus system due to disability, where there is access to either van or cab service at special rates. And, hiring private driving services is often more affordable than one might think. When you consider the average cost of operating a vehicle is about $600/month (per the Dept. of Labor Bureau of Statistics), that buys you a great deal of time/services. Most local private duty home care companies can provide these services. Check all of this out before you approach this issue...have a plan and options...

Long Distance Caregiving

If you are caring for a loved one from a distance, it can leave a scary feeling in the pit of your stomach--especially when the phone rings...

I hear many family members talk about "the call"--when they were suspicious Mom or Dad wasn't doing so well (or maybe they really were doing quite well), but were hoping for the best...and it all changes when you receive that dreaded call that he or she has fallen, is in the hospital, etc.

Here's a couple good articles to review on the subject:

http://www.agingwisely.com/what-happens-when-moms-neighbors-head-north-for-the-summer/

http://networkedblogs.com/4Axly