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When the conversation gets tough
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Some of the most difficult moments can come when an aging loved one doesn’t want to discuss the issues or won’t agree to getting care that is truly needed. It’s important to respect how he or she feels. But, if safety or health is at stake, you may need to persist. For example, it may no longer be safe for an older adult to drive.
If you decide you need to intervene, try to be firm but kind. This is likely a very emotional situation for everyone. It may help to have a respected family member assist in difficult conversations or decision making. Also, discuss who should act as the family spokesperson. The following strategies may help you keep the conversation positive and open:
State your concerns using “I.” It may be less threatening to say “I’m concerned about your safety” than “You’re going to get hurt.”
Treat the person as an equal in the decision making process. It can be difficult, but you may need to let your loved one make his or her own choice. You might say, “These are the various options. What are your thoughts?” As long as the person is cognitively able, he or she has the right to make decisions about his or her own care.
Talk with your loved one’s doctor about options.
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Resources
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For more information, contact these organizations:
Administration on Aging. Call 1-800-677-1116 or visit www.aoa.gov.
National Institute on Aging Information Center. Call 1-800-222-2225 or visit www.nia.nih.gov.
The AGS Foundation for Health in Aging. Call 1-800-563-4916 or visit www.healthinaging.org.
AARP. Visit www.aarp.org/family/
caregiving.
You also may find the following books helpful:
How to Care for Aging Parents by Virginia Morris, Workman Publishing Company, Inc.
Caring for Elderly Parents by Ruth Whybrow, Crossroad Publishing Company
Learning to Speak Alzheimer’s by Joanne Koenig Coste, Mariner Books.
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 Your aging loved one: Finding the best care
Perhaps you visit your aging parents one weekend and notice that their refrigerator is running very low on food. Maybe you learn that your father hasn’t been taking his diabetes medicine. Or, you see that your mother has trouble getting down the stairs. It has become evident that they need a hand with daily activities. You’re most likely wondering where to begin. How do you balance your parents’ needs with your own hectic life?
It’s difficult to see your aging loved ones become less independent and even frail. There may be an element of sorrow in the reversal of roles. The ones who took care of you may now need to rely on your loving care. It’s also natural for you to feel scared or overwhelmed with this new and possibly daunting task.
Try not to be too hard on yourself. This is new ground. You won’t be an expert right away. Too often, decisions are made during a crisis. Try to have these conversations early. Work with your loved one to make changes before they need to happen. Arm yourself with good information, then pat yourself on the back for doing your best.
The right fit
Care for aging parents can take many forms — from help with housework to finding a skilled nursing facility for them. Before making a decision about what’s right for you and your family, look at the whole picture. The following considerations can help you get started:
Expenses
Thinking about how to pay for your loved-one’s care is one of the most important parts of planning. Costs will depend on the type of care provided. As you weigh your options, consider these questions:
- Does your loved one have financial resources?
- Is there health or long-term care insurance?
- What will Medicare and/or Medicaid cover? Visit www.medicare.gov for information about different care options.
- Will you or your other family members be able to contribute?
Once you have thought about which services are needed, you can find out about government benefits at www.govbenefits.gov or call 1-800-FED-INFO
(333-4636). You also may want to contact other organizations that focus on care for older adults. See the “Resources” sidebar.
Type of care
- How is your loved one handling personal care — taking medicines, grooming, eating?
- Does he or she need household help — shopping, cooking, cleaning, paying bills?
- Are there safety concerns — falling, mobility, memory or cognitive difficulties?
- What kind of medical care is needed — equipment, treatments, full-time nursing care?
Talk with your loved one’s doctor. He or she can be a great source of information about the appropriate level of care.
Family participation
- Do you or other family members live close enough to provide any level of daily care?
- How will your own family and work obligations impact your ability to provide or assist with care?
- If you live far away, how often can you travel to help out?
- If needed, how will family members make financial contributions? Will some contribute more or less? The decision should consider all the family members involved.
Cast a wide net for help
Caregiving is no doubt a labor of love. Realistically, it also can be challenging and tiring. Seeking help doesn’t mean that you care any less. You can be a better caregiver when you aren’t exhausted or frazzled. Not everyone is lucky enough to have family members who can pitch in. That’s why it’s important to consider all the possibilities. Here are some to get you started:
- Family members. If you do have family willing to help, divvy up tasks such as researching resources, following up with insurance questions and medical paperwork.
- Friends and neighbors. Don’t overlook any possible extra hands, even for short stints of assistance. But, recruit people who genuinely want to help. Be specific about what will be helpful.
- Community services. Connect with your local office on aging, community services board, social services office, or other county or state organizations. Also, some religious communities have programs to assist older adults.
- Associations. Look online or at the library for groups that supports aging individuals and their caregivers.
- Employer or health plan programs. If these programs are available to you, employee assistance or dependent care services can help you locate resources.
- Doctors and hospitals. Some can give you lists of resources and support groups.
- Geriatric care managers and hospital social workers. These professionals can work with you and your aging loved one to form a plan for long-term care and help you find resources.
Some basics about care options
A key piece of the caregiving puzzle is the appropriate setting for your loved one’s needs and comfort. Ideally, you should talk with your loved one and his or her doctor as you consider the possibilities together. These are some of the more common options:
Support and care at home. Most people would rather not move from their own homes, where they’ve made memories and feel comfortable. If possible, you may be able to adapt your loved one’s current living space to help meet his or her daily needs. For example, ramps instead of stairs, proper lighting, grab bars in showers and other assistive devices may be helpful. If the house has more than one floor, consider moving the bedroom to the ground floor, if that’s appropriate.
Some people may need to move from a larger home to a smaller one. But, they may still need help with tasks such as lawn care. A neighborhood association may be able to lend a hand.
In addition, you may need to arrange help with other chores and errands. They can be difficult for you to cover with work schedules and family activities. Depending on your budget or if insurance covers it, an outside resource can help. Home care agencies provide household help, for example. Home health agencies typically offer some types of medical care. And home health aides help with basic needs, such as bathing and dressing.
Living with a family member. You may be willing and able to provide the support your loved one needs in your own home. Living together can be very rewarding. But, it’s important to prepare for possible challenges. Be sure to consider:
- Physical accommodations — is there enough room? Do you need to make changes, and how expensive will they be?
- If your loved one has a pet, are you willing to take it in?
- Will you provide daily care or will you use an outside resource?
- Do other household members agree with this plan?
It’s important to realize that this transition can be difficult for your loved one, emotionally and physically. Keep the lines of communication open. Remember that he or she is part of the household now and may want to take an active role. For example, allow the person you’re caring for to be part of the decision making process, if possible. Also, ask for help and advice from others.
Assisted living facility. This may be an option if your loved one is fairly independent and doesn’t need constant medical care. Costs can vary, so that should be explored early in the decision process.
Residents usually have their own apartments or rooms. They also may have access to services such as housekeeping and transportation. Trained staff can help with eating, medicine reminders, bathing and other grooming needs. Keep in mind that these services may increase the cost.
Many assisted living facilities try to build a sense of community. They may offer diverse recreational and social activities as well as transportation to these events, if needed. This can add to the quality of your loved one’s daily life.
Skilled nursing facility. Families may choose this type of facility when their loved one needs regular medical supervision or other special care. This option may include nursing care and rehabilitation services. Of course, a wide range of daily living care also is provided.
The cost of nursing facilities depends on the level of care the individual needs. Check your loved one’s insurance plan to see if this type of facility and care are covered. Medicaid and Medicare coverage varies widely from state to state. Call to ask questions so there are no surprises.
Plan ahead
It may be difficult to face the idea of your parents or another family member getting older and losing independence. But, planning ahead may help you avoid having to make tough decisions in a time of crisis. For instance, you may suggest that your loved one create an advance directive, which can include a living will or a durable power of attorney. These documents can outline the type of care that should be provided when people can’t speak for themselves. Think of knowing your loved ones wishes as a gift they give to you.
The more you know about your options, the more you will be able to focus on putting your loved one at ease.
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Care for yourself
Caregiving can be a stressful responsibility. Learn strategies for managing stress at myuhc.com. Click “Health & Wellness,” then “Conditions AtoZ.” Choose “Stress” from the drop-down menu.
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