First

Second, know our own limitations.  Caring for aging parents can become very time-consuming and emotionally wrenching as we watch our loved ones decline in health.  Trying to bravely go it alone, taking in an ailing parent, or assuming other large, long term chores is not for everyone.  It’s okay to say “no”.  Every adult child is not the same and many are simply unable to do a good job of being a primary caregiver.  Admitting this to ourselves is both healthy and necessary.

Third, forget trying for praise, appreciation or recognition of a caregiving job well done when our parent has dementia.  Our parent’s brain is not functioning normally with dementia.  The cognitive impairment may mean that he or she is unable to appreciate your efforts.  It may mean behavior changes, such as suspicion, accusations and nasty outbursts in your aging parent when that sort of thing didn’t happen before.  Do a good job for your own sake and because it’s right, not because you have to have your parent’s approval.

Fourth, we need to love ourselves for trying.  Our efforts may not always succeed. We may feel doubt about what we’re doing. We may feel guilty that we get mad at an aging parent who is so difficult.  But we keep trying to make life manageable, keep up their quality of life the best we can and go at it with sincere hearts.  We need to tell ourselves that we are brave and valued for forging on in the face of difficulty.  We need to appreciate our own efforts.

Fifth, we need to take breaks.  We get so lost in caregiving, directing others, managing our own jobs, families and problems, we forget how much time we’re putting in. We forget to stop.  This is really important!  To nurture our own bodies and soothe our own spirits is the very thing that gives us the strength to carry on and keep it up.

So, my friends, be very good to yourselves.  Love your own heartfelt work of helping aging parents, especially the most difficult ones.  It takes a strong will to put up with the resistance difficult parents put up.

Mikol and I are with you. We have difficult people in our lives, too.  My Mom was mentally ill and the challenge to my strength and patience was there for years on end.

We are on this journey together.  We can help each other along.

If your aging parent is driving you nuts, let us know about it,  We do like to address your questions.

Until next time,
All the best,

Carolyn Rosenblatt, RN, Attorney and Dr. Mikol Davis

                                               In Memoriam: Bruce Tokars

I am sad and feeling the loss very much.  And I am struggling to imagine what it would be like for my own spouse and kids if I were the one to go so unexpectedly.  I do this blog full of ideas about being prepared for disability or the end of life. And in my work I meet people face to face and help them get ready for their aging parents’ frailties and end of life.  Yet I am sure my kids would not be ready to step up and do the job of winding up all our affairs if I left this life without warning, as Bruce just did.

We always think we have more time.
So, here is my resolve, which I discussed with my husband, Mikol as we try to deal with the loss of our friend and an original founder of AgingParents.com.
We need to prepare our “exit papers”.
We need a hard copy and zip drive with the essentials our kids would need if we were suddenly no longer with them.

Fortunately, we have practiced what we preach in our work. We have let them know what we have, where our investments are and where we keep all records.  We have introduced them to our financial advisor and our tax preparer and they have relationships with both. We’ve taught our daughter about how to handle real estate transactions, as she is interested in them. We have our estate plan and a health care directive.  They know our wishes. It sounds like a lot.

But that is not enough. They need minutiae: account numbers, passwords, access to a great deal of information and a list of all the managers and professionals upon whom we rely to keep our lives and finances in order.  This is detailed stuff. It’s complicated.  These are part of the exit papers.

Is this risky, telling them all our business?  Yes.  If we give them all information, they could possibly take advantage of us if we become infirm and live to be 100. Of they could rip us off if we lost our minds.  I’ll take the chance.  I am certainly not a perfect mother, but I’ve tried hard to raise kids with integrity and values and they’ve definitely got them.  I am willing to trust them to do what is right and to never misuse the trust we place in them.  I know my kids are both honorable human beings and I’m very proud of that.

What if you don’t have kids or your kids don’t happen to be so trustworthy?  If they have a drug or alcohol problem or they’re not good with money?   In that caseI’d give my exit papers to a licensed professional fiduciary or appointed successor trustee and be sure everything that person or institution would need is in the exit papers. I would teach them while I could.

This goes a lot farther than standard estate planning.  It is about the minute details of daily life that our friend Bruce’s widow must now deal with in the midst of her profound grief.  Can she get into the email accounts?  Can she transfer the projects he was working on to the next person in charge?  When it’s my turn to go, I don’t want it to be any harder on my loved ones than it needs to be.  I can at least give them information in advance so they will not struggle to take care of business.

So, my husband, Mikol and I embark upon the Exit Papers Project. It will take the next two weeks or so to get it done.  It’s a matter of copying contacts, things and numbers into a document with explanations about what and where and why.  Then we sit down with the kids, both in their 20′s, and show them what it all means.

If you are willing to face the reality that we are indeed mortal, consider your own Exit Papers Project.  It might be the smartest, most caring and safest thing for your family.
And of course, we’ll have to update it every year.
I’m okay with that.  It’s an act of love.

Until next time,
Carolyn Rosenblatt
AgingParents.com

Howard, 92, loves women.  He has dementia and is legally blind.  He likes to give women checks when they tell him their sob stories about needing money.  He has one daughter, Missy, who is aghast at his conduct.

After her mother died, Missy felt obligated to try to keep Dad from throwing away all his money.  He would use up everything in the checking account and then use credit cards to the max. He got into debt. Missy warned him and warned him, but he just didn’t get it.  She had no legal authority to stop him from his stupid decisions about money.

He  got a housekeeper, Flossie, recommended by the manager of his building.  Flossie didn’t have much money, and needed to get her car fixed.  She hit up Howard and wrote herself a large check from his account, which she had him sign.

When Missy confronted him about giving Flossie money, he lashed out and tried to hit her.  He had a history of violence and Missy was fearful as well as very angry.  Dad had given away cash to five other women before Flossie!

Finally, Missy was able to get the checkbook away from dad and no one else could write checks for this blind man to sign.  He was now out of money.  She had not taken legal steps to do this before he was broke. Not smart.

Flossie decided she was “in love” with Howard.  She assured his daughter that she just wanted to be with him but they weren’t going to get married. Then Howard took a fall, was hospitalized and soon after, went to a nursing home.  Flossie kept hanging around. One day, she went down to City Hall and got a marriage license. She never told Missy. She found an officiant for marrying them and had the ceremony right there in the nursing home.

Missy was beyond furious.  She had reported Flossie to Adult Protective Services. The worker told her that Howard was “entitled to his folly”. She thought that was just plain stupid. She was advised that she could go to court and get a guardianship over her Dad. But, he had no money left and it seemed pointless by then. It was going to cost thousands of dollars too.

She sought advice at AgingParents.com.  Mediation of the dispute with Flossie was suggested.  Missy and Flossie both agreed to talk over the problem.

Missy wanted to have the marriage annulled.  She wanted Flossie to be able to visit Howard, as he did seem to like her company and he was lonely.  Missy and her  husband had a suspicious and mistrusting relationship with Flossie, but in a way she was actually helping them by keeping Howard company while they were at work. Flossie didn’t want an annulment. She liked the idea of being married. Apparently, she didn’t consider Howard’s credit card debt. She just wanted to get something from Howard, like his Social Security survivor’s benefits.

The dispute was mediated without involving lawyers or the court. Missy proposed that she would allow Flossie to continue to visit Howard as she wanted.  But, she was to refrain from discussing money and would report to Missy. When Missy asked Flossie if she was going to pay her Dad’s credit card bills, Flossie blanched.  Suddenly, she seemed a lot more interested in the annulment.

She agreed to Missy’s conditions. A deal was worked out between them with the mediator’s help. Flossie agreed not to tell Howard about the annulment. He had been declared incompetent long before, and would forget what it meant anyway.  Flossie agreed to the legal annulment.  In exchange, Missy and her husband agreed to attend a “marriage” ceremony between Flossie and Howard at Missy’s home, without any paperwork, without it being legally recognized, and Howard would be none the wiser.  Flossie could play married, without any legal consequences good or bad.  Howard would still have Flossie’s companionship and Missy was okay with that.

The resolution gave everyone at least some of what they wanted.  Before it got as far as it did, however, Missy might have tried other options.

By the second or third time a woman had ripped Howard off, she might have worked on persuading him to give her a Durable Power of Attorney for finances.  She could have moved funds out of his checking account and stopped the ripoffs by his “girlfriends”.  He eventually did sign one, but it was too late to keep his funds in the bank when he did.

She also could have gone to court for that guardianship.   His doctors were cooperative in declaring him incompetent to handle money.  Guardianship was a last resort, but it would have protected him.  He ended up on Medicaid, in a 3 bed room in a mediocre nursing home.  He will likely stay there for the rest of his days. Guess that’s how it works when one is “entitled to his folly”.

I’m hoping that anyone with an aging parent who is like Howard will look ahead.  Sometimes, your aging parent makes a string of stupid decisions and you can’t stop them. But sometimes you can stop the folly before it’s too late.  If you don’t know what to do, seek some outside advice.

Until next time,

Carolyn Rosenblatt

AgingParents.com

I believe there should be exceptions in non health care residences for emergencies like the one involving this senior, Lorraine Bayless.  A nurse who is on scene should be able to do what any trained lay person can do:  administer CPR when someone stops breathing.

The press reports that there was no Do Not Resuscitate (DNR) direction in place.  Ms. Bayliss’s family believed that she wanted “to die naturally and without any kind of life prolonging intervention” as they told the Associated Press. Glemwood Garden’s policy about what the nurse should do in an emergency was sufficiently unclear that  owner Brookdale’s public statement was to the effect that the nurse had “misinterpreted the company’s guidelines.”  What those guidelines were is not certain.

We have legal documents that allow anyone to make quite clear what they want in an emergency such as stopping breathing.  There is a DNR statement or order. There is an advance health care directive to guide others if the person in no longer conscious or competent.  There is a newer document called Physician’s Orders for Life Sustaining Treatment (POLST) in some states, also called Medical Orders for Life Sustaining Treatment (MOLST).  A doctor signs it and it’s posted appropriately. It allows others to be comfortable following the person’s wishes, even if the wishes say don’t keep me alive.

This uncomfortable, ethically questionable, confusing scene over Ms. Bayliss’ end of life did not have to happen the way it did.  If you don’t want to be in that kind of situation, you need to be responsible for deciding what you want and communicating it to those who will have to act on your behalf.

Either you want emergency intervention or you don’t. If you are very clear that you do not want to be resuscitated when you stop breathing, let the people where you live know what you want and put it in writing. Post it in a prominent place and give it to the administrator of any seniors residence you choose as your home. If you have clear statement that you don’t want resuscitation and you stop breathing, no one should call 911.  Paramedics will attempt CPR every time. CPR is definitely life prolonging intervention.  The legal documents mentioned above allow you to spell out  under what circumstances you want to be kept alive. It is not always so straightforward as stopping breathing, or a sudden event.

We’re in a society that is generally phobic about death, much more than many other cultures in the world. Death in many other places is accepted as the natural end of life and people don’t spend as much time avoiding the very idea.  In our culture, we seem to think it’s optional.  We don’t like the idea of planning for the end.

Perhaps Lorraine Bayless has left us all with an important wake up call.  Independent and assisted living senior residences need clear written policies about resuscitation of residents. If nurses happen to be working there, they should not be frozen in place when a resident collapses and CPR can be administered by someone, including themselves.  Residents should be required to spell out their end of life wishes and emergency instructions and these should be available to those in charge.  And each of us needs to face the reality that no one gets out of here alive.  We need to think it out, write it out, and do our loved ones and those who help us the decency of making our wishes clear to them.  If a person wants no resuscitation, we have to accept the idea that we don’t have to “do something” if they stop breathing.

As we’re  in the elder and family consulting business, I made sure my husband Mikol and  our kids know about my own wishes.  I’m pretty sure  that when it’s my time to kick the bucket, they’ll let me kick it and get out of the way.  It’s not so bad to exit the way Lorraine did, fast,  and probably without pain.  Her family says she had it her way.

What would your way look like?

Until next time,

Carolyn Rosenblatt

AgingParents.com

After his mom was injured and went to the hospital, she spend some time in a nursing home.

She then was discharged and left the U.S.  The nursing home sued the son to pay the outstanding bill.

In this quick video, learn three things you can do to prevent this kind of nightmare from happening to you.

A person who never said a bad word curses at you, or someone else.  Old Dad gets combative. Mom seems so irritable.  They can’t remember that you were coming when you showed up. What the heck is going on, you wonder.

If your parent is forgetting to pay bills, or forgets that you visited yesterday, it’s a huge red flag for you.  Most of us dismiss this at first. They’re just getting old. Or, getting forgetful is “normal”, you tell yourself.  You rush in to take care of things.  You offer to help. You are met with nasty resistance.

As time goes by, your parent is making more and more mistakes, the memory problems are getting worse and you now know leaving her to her own devices is dangerous.  She thinks she’s just fine.  Should you step in and get her all upset?  Should you just let her do whatever she wants? After all, she’s your mother.

The answer is “no”, you can’t just let a parent with significant memory problems go on as if nothing were wrong, even if she gets upset with you. At some point, the adult child who loves a parent must step in.  You may end up setting limits, making new rules, or taking over certain decisions.  This is not easy for most people. We are so accustomed to our parent making her own decisions, that to dare to tell her what to do is very uncomfortable.

Some people call this “switching roles” or “parenting your parent”.  What it means is that your job, one you’ve never done before, is to be sure your parent is safe and cared for, just as your parent once did for you.  The problem is, your parent is not going to grow up, become more mature and eventually appreciate your efforts.  So where does that leave you?

For most adult children who must learn this new job of safety monitor, it leaves you with a fair amount of stress and anxiety.  Some adult children still feel intimidated by an imperious aging parent, even one who is infirm, demented or unable to care for herself independently.  It takes some doing to face this and cope, but it can be done.

Here are five strategies to cope with switching roles and learning to manage your rebellious or difficult aging parent who doesn’t want you to take over anything.

1.  Make peace with the reality of your parent’s aging.  It isn’t going away. It isn’t going to get easier.  With dementia, memory loss and other conditions, behavior of an aging person can change dramatically.  The judgment your parent once had may be very damaged. It can’t be fixed.  Your parent needs your help. Accept that this may be hard for you.

2. Start to collect information as soon as your parent demonstrates those red flags, those signs of trouble you’ve been denying, or she has.  Does she have legal documents, such as durable power of attorney, trust and healthcare proxy? Where are they? When were they last updated?  You may need to take over on any one of them some day.  Find out about parent’s income, bank accounts and where their records are kept. It’s essential.

3.  If your parent is dangerous with her habitual activities such as driving, paying bills or buying groceries, step in.  Make rules. Learn a strategy for getting Mom to give up the car keys.  Gently insist on helping with bill payment.  Offer to hire someone to help keep groceries in the house or offer to do this chore if you live in the area.

4.  Do not expect your parent to accept logical arguments about why you need to help out.  It’s not about logic for her.  It’s about fear of losing control.  Acknowledge this with her and respect the feeling. And as you would with a teenager, do what is needed to keep her safe, even if she doesn’t like it.

5. Avoid being reactive when your parent gets upset with your “rules” or the limits you set.  You need not engage in an argument.  ”Let’s not fuss about this” is a perfectly acceptable response.  Then keep on doing what you need to do. Trying to explain why you need to keep a parent safe is unnecessary. She may forget the explanation anyway.  Keep your focus on safety and quality of life. Get past the fact that you don’t like telling Mom what to do.

If you are struggling with any of this, you are not alone.  Millions of adult children are facing this role reversal with aging parents.  If you find yourself at your wits’ end, help is here.  We give advice, work with you and your siblings, help you come up with a clear plan about what to do, and help you nip disagreements in the bud. You get a huge benefit and a great head start with relatively little expert advice from us. Click here for a quick, complimentary strategy session. We offer ongoing coaching too!

Until next time,

Carolyn Rosenblatt and Mikol Davis

AgingParents.com

****P.S.  We are always here to help you get through the challenges of aging.

Please let us help you help the ones you love.

We are offering a free strategy session to our readers, just click HERE.

Suppose you’ve done all that, and the fight rages on.  Anger flares. You’re frustrated.  It’s time to get help. Consider mediation, a smart way to resolve disputes without any courts or lawyers.  Here’s a 4 minute video we produced to illustrate the process.http://vimeo.com/ 11534608  We do family mediation by phone, Skype, Skype video and in person.  We’re here to help. Contact us at AgingParents.com

Thoughts On Turning 65

65! Yikes!  Isn’t that when you’re OLD?

I looked in the mirror and I didn’t see an old person, so maybe it’s a myth.   I definitely didn’t see a young person though.

I had lunch with my daughter and she asked me if I feel 65. I said, “yes and no”.  The “yes’ part is that life experience teaches us quite a lot. I’m very happy about that.  I have more confidence as a 65 year old human being than I ever could have had as a young person.  There can be no substitute for decades of dealing with and solving problems, of survival through hard things, of seeing our own progress in striving to get better at something.  When we can make it through all that, we are “seasoned”. I rather like being seasoned.  It certainly feels a lot better than being anxious, fearful that we won’t make it, unsure of our skills, or pressured to climb whatever ladder is before us. I’ll take seasoned any day.

The “no” part is that my image of 65 from the distortion of youth’s prism was that feeling 65 would be about feeling old.  About slowing down or being less interested in having fun and adventure.  We know that’s not true! , I’m happy to report that  I’m having more fun than ever at this point.  I work because I want to work, doing things I feel satisfied doing.  I am using all those years of experience in nursing and in practicing law combined in an effort to be useful to people whose elders and parents are failing in their health.  Their stories aren’t fun, but I like being able to help them solve their problems.

I am one of the lucky ones in excellent health at 65 and I am grateful every day for this.  One thing a nurse can learn from working with thousands of patients and clients is to appreciate all we have in the body and mind that works. One spends a lot of days facing folks with body parts or minds that don’t work. You get perspective that way.  A friend or classmate dies suddenly.  You get perespective that way, too.

If I can take a walk on a beautiful day, it’s a gift.  Every body part works fine.  And going beyond a casual walk, I can jog, bike and run, sometimes all in the same event (triathlon).  Never mind that in my county’s triathlon three months ago I was the oldest woman registered to complete the event.  I can just celebrate being able to do it at all.  And I do celebrate. With carrot cake.

I am among the millions of Boomers who have recently reached this milestone or who will do so soon.  We are glad and sad about some things.  We are already experiencing the loss of dear friends.  It sobers us.

I also think it’s a time to celebrate a lot of things.  I think about the political power we have as a group. I think about how we have changed society and will continue to do so, just because there are so many of us.  I think about how we, as a generation are changing the concept of aging.  I love it.

So, if you, too are a Boomer, celebrate with me. Raise a glass to a different and evolving idea of aging.  Toast to the beauty of experience and being wiser than we were at 20.  Find your joy in showing the younger generation that we know how to live these years in a meaningful way. We already changed the world when we were young. Now we can change it again as we get into the next phase of our seasoned lives.  We can share life’s lessons with others. We can set an example of being responsible. We understand that we must savor the moment. We can have a wonderful time appreciating what we are and all we have.  Let the beauty of this time of life shine on.

Until next time,
Carolyn Rosenblatt
AgingParents.com