While the future may not be ours to see, planning ahead gives us more options and control. Comprehensive future planning includes getting all of the necessary legal papers prepared, or updated; reviewing finances, including savings, current and future income, assets and realistic budgets for a variety of future scenarios. It means thinking about current and future living arrangements and having comprehensive information on medical conditions, medications and any current or likely future functional limitations. By being aware of community resources, you’ll be ready to tap into them when the time comes.

• Help you to develop a contingency plan
• Get a better sense of your potential needs and wants so at a time when the need emerges you don’t have to start from scratch
• Help our clients and their support systems understand what their options are
• Help you be prepared and proactive to avoid last minute reactive behaviors, which can be costly financially and emotionally

Driving is a key part of everyday life for most Americans. How do you get to the store or church or to see your friends and family if you can’t drive your car?  The ability to instantly move from home to wherever you want to go provides a powerful feeling of independence for most older people.  But, what if your father has been in three fender-benders in the past six months?  Perhaps you’ve noticed dings and dents on Mom’s car or wonder if she’ll get confused about her route. You have begun to fear more serious problems happening – what if someone is injured?  Here are a few tips to manage the conversation you need to have.

• Help you objectively evaluate and understand the risk involved
• Help you to facilitate the “conversation”
• Communicate with the DMV
• Identify other transportation options

During the current COVID-19 crisis, this problem that affects so many of our elders even in the best of times became a clear worry for many families.  There are concrete steps you can take to both manage your feelings and help your family member.

• Identify activities that the client used to enjoy and figure out ways to adapt to the current situation
• Focus on activities and people that could bring joy to a client’s life – focus on meaningful interactions
• Help mark time in meaningful ways
• Create a leisure calendar

Getting to the bottom of the cause of the falls is the first step. By understanding if there is a way to manage what is causing the falls you are then in a position to figure out what to do. If the situation is temporary, you may need to come up with a short-term plan and put new safety measures in place. But, in many cases, you’ll need a long-term plan to manage the situation to avoid life becoming one crisis after another. Even if your parent isn’t falling frequently (that you know of), falls are the #1 cause of injury and death in elders. So, if you want to help your parent age at home safely, start with a home safety assessment.

• • Complete a home safety evaluation, walk through the home making recommendations
  • Review risk factors for falls
    • Medications
    • Conditions
    • Incontinence
    • Footwear
    • Clutter
    • Vision
    • Lighting
  • Identify devices, services, and products that could help lower risk of falls
    • Handyman services
    • Emergency response systems
    • Medical equipment
    • PT/OT evaluations
    • Medical evaluation
    • Medication review

This is a challenge for anyone taking more than one medication—and when someone is taking three or more medications it can be a recipe for disaster! There are practical steps to follow to put a safe medication plan in place for your parents.

• Confirm the client is taking medications as prescribed by the doctor
• Make sure that all doctors know about all the medications and treatments
• Evaluate medications for contraindications
• Organize pills, put a reminder system in place that works best for the individual
• Put in place a means of documenting that the client took meds as prescribed

Unfortunately, your parents get caught in the middle and it may feel like you can’t get anything done when no one agrees. You need some way to manage the difficult situation you are experiencing today. To quote Leo Tolstoy: “All happy families are alike; each unhappy family is unhappy in its own way.” However, there are some approaches and recommendations that we have gained from working with thousands of families that can help you cope and move forward.

• Perform an objective evaluation
• Bring families together for family meetings and discussions
• Help build a consensus
• Mediate and facilitate conflict resolution
• Create a plan that compromises without compromising the elder’s needs; minimize conflict

Change is always stressful but to an elderly person who has had a fixed routine for years and wasn’t looking for change the stress can be both overwhelming and long-lasting. Many factors affect the adjustment process, and even changes you see as positive can be tough. How much did he or she participate in decisions about the change? How many resources, social as well as financial, do they have? Was the change the result of a crisis – unplanned and unwelcomed? How can we support the adjustment process and make transitions as smooth as possible?

• Identify all the tasks that need to be done, organize and prioritize, and then coordinate getting them done
• Work closely with hospital discharge planners to ensure a smooth transition home
• Deal with all of the “details” around the transition – from medical equipment to home health, medications, doctor’s appointments, follow-up, moving companies and packing, and all the little things in between
• Educate about costs and pros and cons; help with the management of expectations
• Assist with access to appropriate community resources
• Communicate and follow up with all involved
• Provide education about what to watch for and help with monitoring
• Give emotional support and coaching to help with the adjustment to the new arrangement

Managing a new medical problem poses challenges on many levels. Understanding the diagnosis, possibly getting a second opinion, dealing with a new medication or treatment, exploring how to integrate the physical and emotional impact of the new condition into your parent’s life and possibly your own – this is only some of what you’re facing. The information helps, as can access new resources that you may need. But, it also takes time and the proper support to integrate this new challenge into your parent’s life.

• • Educate the client, family, and care team
  • Provide emotional support and coaching
  • Identify questions to ask
  • Access information and resources to help support the client and family
  • Facilitate discussion about disease progression, prognosis, and management
  • Help develop a plan and next steps
  • Assist with obtaining second opinions
  • Gather a team of professionals that is right for you and your condition

   

Changes in your relative’s health condition can be immediate, short-term, or ongoing.  It may be obvious when something has changed, hard to pin down, or confusing. The challenge you’re facing is here now, but it also needs to be managed with the future in mind. How do you know where to start?

• Communicate with doctors
• Evaluate the level of care needed and access appropriate resources
• Provide emotional support and coaching
• Help move the situation from a crisis to stability and manageability
• Assist with adjustment to the new reality

Is your parent possibly the victim of elder abuse? The most typical form of elder abuse is financial abuse. This can take the form of simply stealing money or things of value from an elder to taking over the person’s entire financial life. Elder abuse is a serious and sometimes difficult problem to solve. Expert advice is often needed to understand how to approach the problem and best get help, from formally making a complaint of elder abuse to authorities to putting safeguards in place.

• • Educating family members regarding signs of abuse and undue influence
  • Gathering the facts and a clear picture of the situation
  • Evaluating legal tools and documents in place and needed; making referrals to professionals who can help
  • Evaluating capacity
  • Protection and prevention interventions to stop abuse and scams; interfacing with police, and aging organizations; exploring options such as phone blocks, screening mail, protected debit cards, etc.
  • Reporting and communication with Adult Protective Services

   

This can be one of the most difficult situations an adult child can face with an elderly parent. The person who seemed so responsible throughout your lifetime no longer seems to be thinking clearly or acting prudently. Or is it that you just don’t agree with a life choice your parent is making? Perhaps they’re staying too long in a house that is obviously too big, which is not being kept clean, and refusing all offers of help? Understanding the difference between making a poor decision and being beyond the capacity to make important life decisions can be tricky. There are many fine gradations along this path from being fully capable to being unable to make one’s own decisions. Where is your parent? How will you know when the line is, in fact, crossed?

• Better understand the context of why is the person acting in this way and what might be fueling their decisions
• Help to evaluate capacity and bring in external resources to be involved when needed
• Help determine the level of severity and coach the family through what questions to ask and what to look out for
• Educate families about the right to folly
• Help families wisely “pick their battles”  and prioritize the issues
• Assist families in determining when they may need to step in more assertively

Dementia is a term that covers many conditions from classic Alzheimer’s disease to Mild Cognitive Impairment. These medical terms denote a large variety of changes in an individual’s ability to think, understand, make decisions, and assess information. What to do? Luckily today these changes can be diagnosed with some accuracy. And getting a good differential diagnosis is important because what you and your family will need to do depends on understanding, as exactly as possible, what has caused these changes. From there, you can address concerns and prepare.

• • Help you obtain a differential diagnosis and discover any possible reversible causes
  • Identify where the person is in the stages and understand disease progression
  • Provide education
  • Assist with accessing resources
  • Provide emotional support
  • Help with the impact on the family caregiver and give everyone a sense of expectations and options

   

This may be exactly why many people decide they need to get professional assistance. Too much is being asked of them by too many people. It can feel like there’s never enough time available to feel that you are able to get a grip on anything: home, work, kids, and all those practical tasks of life. Seeking professional advice may be the best option, to get a handle on the situation and relieve some of your stress.

• Universalize and normalize what you’re going through; talk about your concerns and stress
• Helping you plan for the long run – caregiving is a marathon vs. a sprint
• Identify things that can be done to relieve the family burden so you can find balance and provide the best care to your loved ones