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How to Care for Aging Parents

We can't imagine our parents being old; until it happens. Our previously active and independent parents may have a sudden event that changes their lives, or it can happen so gradually that we don't realize we (and they) are in over our heads until we are overwhelmed with problems, decisions, worry and uncertainty. Because every family is different and every elder parent is different, there is no blueprint to follow. A sudden fall or accident or scary health diagnosis can be the first sign that requires "all hands on deck". In this case the immediacy of the situation forces decisions and change. It isn't easy, but at least everyone in the family is brought together for problem solving and planning.

But what if there is no sudden event? I've seen patients who simply become a little more disorganized with time. They aren't able to keep their home clean and clutter starts building up. Bills don't get paid and things just start falling down around the house. It takes awhile before the adult siblings see the problem. Mom starts forgetting things she was told a few days earlier and you realize when you get in the car with dad that his hands are shaking and he can hardly see over the steering wheel. There's no more denying that he shouldn't be driving.

Here are a few things to watch out for and plan for so the overwhelm can be prevented. It isn't easy. This I know is true.

  • Like that grinding sound you may hear in your car, if you think something is wrong with your parents, it is not likely to get better with time. In fact, like your car, it will get worse. That first inkling or sign you have, should prompt open-eyed investigation into their health and well being. With permission, go with them to a doctor appointment. Take notes. Check their medications and how they understand taking it. Are they taking it at all? Look at the bank account statement and how bills are being paid.

  • Start having difficult conversations. If your parents are 100% young and active, this advice is for you too. Bring over an advanced directive and go through it with them. (You can find them on line for free). It's not just a matter of "Do you want to be kept alive artificially?" Discussing it opens up the opportunity to talk about aging, bucket lists, fun, illness, what's important to them, and ultimately death and how each person views it personally. (Big plug here for Atul Gawande's book Being Mortal. A great book for everyone but especially with aging relatives)

  • Start looking into in-home help. This is a complicated area and not something you want to do in a crisis. Especially if you do not live close to your parents, it is critical that you know the resources available for the time you may need it. Don't be surprised that Medicare doesn't cover in-home aides. Don't be surprised that Medicare doesn't cover nursing care or old-age homes or even "observation" in the emergency room.

  • Meet their neighbors. Meet their physicians. Meet their church group. Just like your folks knew all about your friends when you were growing up, you should have someone to reach out to if they need help.

  • Use Technology to help. Medications can be delivered and even packaged by the day. ( One way to help them give up driving is to offer Gogograndparent, which will allow them to use Lyft or Uber by a simple phone call, rather than a complicated app. ( Depending upon their general health, there are wearables that can help alert problems and even monitor their activity.

  • Help declutter. No matter what, simplifying living will help with mobility, downsizing (if that is necessary) and a sense of control. None of this should be overbearing, of course.

All of this is delicate, I know, and depends upon family dynamics, sibling dynamics, where people live and just plain personality. Getting old ain't for sissies and helping our parents navigate isn't either.


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