Friday, January 28, 2011

The WILL part I - Are you Gambling?

Most people would not think they are gambling by doing nothing, but when you do nothing about having a will made, you certainly are.  Caregivers are often the first to realize this need as they helped loved ones put their affairs in order.

What is a will? According to good ol’ Mr. Webster it’s an act of your wish, desire, or longing. It is of course also a “legal statement of a person’s wishes concerning the disposal of his property after death.”  But better still is the definition offered by Attorney Art McQueen. “A will is simply the certificate of title – for your life,” he explained. No one would work hard to earn the money to purchase a car without being sure to get the title to it.  So why would we put off getting the title for all we’ve worked hard for our lives?

This is a wonderful example of perspective. Ask someone if they’ve had their will made and you’re likely to get a gruff answer, if any. Death is a topic no one wants to talk about because most associate wills with dying. It’s a natural response given our society’s incredible drive to hide from the reality of our own mortality. But taking care of business is a part of everyday life. We know that if we don’t pay the power bill, eventually, our lights won’t turn on. If we don’t get our legal affairs in order, we lose control of them.

Caregivers often have a hard time getting their loved ones to face their own mortality and deal with legal issues such as will making, end-of-life care issues, and money management. Putting these issues into an unexpected perspective may be just the fresh approach needed to get the job done.

So what does this certificate of title relate to?  It really depends on the person. That is why legal counsel is important. Attorneys will often offer a free consultation which may be what your aging parent needs to feel comfortable about starting this process.

Having trouble getting that parent in the door of the attorney’s office?  Here are some tips:
  • Focus on one issue, the will – let the attorney discuss related concerns like powers of attorney and health care proxies. Bringing up too many legalities at once can feel like an attack to a person who already knows and doesn't want to admit that there are important issues they've neglected.
  • Don’t press to be involved – a parent might not want to discuss these issues with children until after a consultation or after the legalities are finalized. 
  • Suggest non-family involvement – Encourage your parent to talk to others for attorney recommendations. This may open the door for your parent to ask questions that he or she might not feel comfortable asking you.
  • Provide resources – find articles about will making that you feel would be helpful and leave them with a parent with a gentle reminder that you hope they’ll look into this
  • Make sure your parent understands your motives. It’s not about you, it’s about your parent’s wishes. You cannot honor their wishes if you don't know them and have the legal support you need to ensure those wishes are met. Even if you, the primary caregiver, is not the executor of the will, you can offer assurance of your desire to support whatever your parent's wishes will be.  
In the long term, taking care of business for one, gives peace of mind for all.  Perspective can make all the difference.

Caregivers, while you're at it, check into your own will - it's never to early to get the certificate of title for your life too!

Tuesday, January 25, 2011

Long Distance Caregiving: How To Be There – When You Can’t

What do CD players, travel pillows, cell phones and zany socks have in common?  They're little ways you can have a big impact on a loved one who lives far away.

In our mobile society, it isn’t uncommon for caring family members and friends to live away from aging loved ones. So what happens when an illness strikes, there’s a hospitalization, or a complete transition in living circumstance? There are many ways to keep the connection of love and care strong, even if you can’t be on site to offer help and comfort. Here are some examples that can be used for distant caregivers as well as those nearby:

Comfort Care:  We send care packages to our college kids and military personnel, but we can also send them for our aging loved ones who live away and may be facing challenging times. Consider a small neck pillow. Those hospital beds rarely feel right and just a little extra cushioning can make a difference. How about warm socks? Most hospitals offer anti-slip socks, but what about sending some in a favorite color, or personality-suited. There’s nothing like Gran being the only one walking the halls with bright red striped no-slip socks or slippers while she’s recuperating. Think of her smile when the nurses all stop to ask her about her fun attire and she can tell them her grand children sent them. 

Easy Listening:  Dad or Grandma in the hospital? Moving to a new living situation? Make a compilation CD of songs you have enjoyed together. Send or bring an easy-to-use CD player with it. Label the items you send clearly. If you have to, jazz up the CD player to make it easy to use. You can put a green sticker on the PLAY button and a red one on the STOP button to highlight them if vision is an issue. (You can even paint those buttons with nail polish). Send a CD of yourself or your kids reading or telling stories. Many churches will record their weekly sermons. Help make arrangements for those to be delivered.  Not into CD's?  Send a preloaded MP3 player - just check for ease of use and make sure the earphones are too difficult to manage- specially if hearing aids are involved!

Viewing Pleasure:  Send a family DVD. Make a home movie of your well wishes. Have a bunch of old photos?  Have them put on a DVD – or send a pre-loaded digital frame.  (Again, label it and make sure it’s easy to use.) Send cards and photos - they are looked at over and over again.

Stay Connected: Send a phone. Many times during transitional care, phones are a problem. If you can send an inexpensive (and easy to use) phone with important numbers pre-programmed, you send more then the phone. You leave the message that you want to stay connected and you may relieve a concern for an on-site caregiver who is busy handling a hundred other details of care.



Caring for the Caregiver:  With all these suggestions, make sure to run them past any on-site primary caregiver first to eliminate duplication. And while you’re at it, send that primary caregiver a thank you note and a gift card to his or her favorite coffee shop. It’s always great to feel appreciated!

Friday, January 21, 2011

The Power of a Bucket List


Morgan Freeman and Jack Nicholson
The Bucket List
Warner Brothers, 2007


To me, any movie with Morgan Freeman and/or Jack Nicholson in it will be worth the price of going to the theater. A definite must-see is when the two joined forces for the movie The Bucket List, which came out in 2007. It’s a great movie to watch for people of any age, but I highly recommend it for caregivers and their aging loved ones. The movie has so many poignant and valuable lessons for living life to the fullest, letting go, not giving up, and making moments count. 

I consistently encourage caregivers and seniors to make space in the busy-ness of daily life, health challenges, and caregiving to have those powerful moments and fully participate in them. Sit down with your loved one(s) and watch the movie. Laugh with it, cry with it, and let it have an impact. Whether you then work on writing a bucket list or simply joke about “hey, we need to put that on our bucket list,” it’s a tool for dreaming and remaining hopeful about the potential life has to offer. It’s a connection.

Does the bucket list include things that seem totally out of reach? Is Mom living in an assisted living facility and in a wheelchair with limited finances? Well, that cruise around the world on her list might not be possible. That’s okay. Use the bucket list to help you envision what IS possible.  It may be a trip to the local water park during their ‘off’ hours can be arranged so she can dip her feet into the wave pool and hear the water will be all you can manage. Or, gather travel videos from the local library and have an in-home cruise around the world. Involved the kids and grandkids... fun for all. Even when you have to make adjustments to the origianal dream, the effort you’ve made will be appreciated and the memory of experience will last long after Mom is gone.

When my mother wanted to take a trip to somewhere she’d never been to celebrate turning 70, she’d already lost most of her vision and needed at least a cane, sometimes a rolling walker to help her get around. Hawaii and Aruba were both destinations on her mental bucket list. Thankfully she had the money to travel, yet the decision was made for Aruba because none of us felt that her body would do well with the long flight to Hawaii. Though she didn’t say she’d never go to Hawaii, she made the choice that would be a best fit for the time. Did we all know that she’d likely never go to Hawaii? Yes.  Did we have to say it or make a big deal of it? No. A bucket list is, in its simplest form, a tool for communication. At its most complex, it’s a to-do list for an already overtaxed caregiver. What perception you choose to have of it is yours, but it’s a valuable tool to consider.


Connecting with others:  If you visit the movie website at http://thebucketlist.warnerbros.com/ there are lots of photos, great music, and even information about creating a bucket list on Facebook that can be shared!

Tuesday, January 18, 2011

Living an 'engaged' Life Despite Physical Challenges

I had the great fortune to speak with several seniors this weekend who shared very interesting views of life and how they are choosing to live it. One lives in the wilds of British Columbia, Canada, and has only in the last few years taken up flying. Due to his location, it’s actually easier to hop into the plane to get to the nearest big town to do any ‘real’ shopping than drive the car more than 30 miles to the nearest small town. Then he shared about trips to the Baja Peninsula taking his small plane and camping on the beach. Later, he said that he was glad that the commercial flights he’d take home from Pennsylvania, where we met, were broken up with a few layovers so that he could get out and stretch his knees that were beginning to show their age. 

I was struck by the contradiction. Aching knees needing a break were on one hand then flying one’s own plane to exotic locations for adventures on another. Yet BRAVO is what I wanted to say to this man. Despite his admission that his adventures might not come so often, he still envisions them. He’s held on to his own sense of adventure and zest for life. He’s taking into account the challenges of an aging body but not letting them keep him from doing the things he wants to do.

On my own flight home, I sat near several seniors who were headed off to a cruise to Buenos Aires. One gentleman in the group had lost vision in one of his eyes but yet managed to get along just fine with the help of his wife. I have no doubt that members of the group had their own list of age related aches and pains, but they made the choice to manage them as well as they could and live active lives. 

None of these people seemed to be in need of a caregiver, yet there is no doubt that others care about them. As people age, and health challenges occur, it’s often a loving friend or family member, whether serving as an intense caregiver or not, who can help encourage their parent, loved one, or friend, to step back into life, or just to keep living it.

Seniors don’t have to travel to exotic locations to lead active, engaged lives, and they don’t have to let the challenges their bodies impose during the aging process be an excuse to stop being active, either. Often caregivers see their loved ones retreat from life because of physical challenges. At these times it’s the caregiver who can be the cheerleader. Find information about senior-friendly community events and social groups, even travel.  After an illness or hospitalization, help your loved one reconnect with friends and activities they enjoy. It's all about reminding someone that they can still pilot their plane!

Friday, January 14, 2011

Music - a Portable Tool

Photo by Darren Hester www.DarrenHester.com
Sometimes we're at a loss for how to help ease the frustration of a loved one enduring a hospital stay. Sleep patterns are disrupted, the body is struggling, and the mind often becomes unsettled. Sounds of carts rolling through the hallways, doctors and staff talking just outside a doorway, and the droning on from the television in the room (or the one next door) can add to restlessness. But paying attention to sounds can make a difference when you bring the right ones into the room.

Consider music. There may be a radio channel on the television in the hospital room, but it may be difficult to find or may not play music soothing to the patient. Caregivers can bring the right sounds from home. Pick up an inexpensive portable CD player or bring one from home.  Make sure you label it with your or the patient's name and address. Bring a few CD's from your loved one's collection. Label those too and make note of what ones were brought. Don't know what he or she likes? That's a great conversation starter. Talk about concerts and dances attended in the past. Talk about favorite movies - perhaps you can find a soundtrack. It's quite likely that the music you find calming, energizing, or comforting is not the same kind your beloved patient will. This gives you positive, non-health related topcis of conversation - another reprieve from the hospital stay. The same applies to movies and television shows. Some hospital rooms have televisions with DVD players. Does Grandma love "The Andy Griffith Show" - bring a DVD with several episodes. 

Proactive step: Try asking your parent or aging loved one about their music and movie likes/dislikes before any kind of medical crisis. Take notes. This becomes helpful for birthday/holiday gifts but can provide valuable clues to what may bring peace and comfort. If you know you are likely to be dealing with multiple hospital/care facility stays, keep a stash of CD's and a CD player with the bag of supplies you have tucked away for just those times.

Note of Caution:  With so many staff and visitors in a hospital, items from home can disappear. Don't invest too much in anything you bring to leave in a patient's hospital room. Labeling helps, but is no guarantee. 

Tuesday, January 11, 2011

Asking for a Gift May be One for All

During Sunday's radio interview on the Dr. Stan Frager Show, a caller asked me about when it's time to look into a move when a person is concerned about their aging parents' safety in the home. It's a tough call, but safety and mobility issues are often the trigger point for such discussions. 

Another way to approach this touchy subject ideally occurs long before any concern over safety. Have a dream session with your aging loved ones about what they envision for their future. Remember, it's not your vision for their future, it's THEIRS. But listen. If the idea of moving closer to family (ie: you) for support with health issues does not enter the conversation, now's a good time to bring it up. Doing it when there is no pressure makes discussions like these so much easier. 

If you have a vision that includes them moving to a retirement community closer to you, or to one in their current town, ask them to give you a gift - the gift of knowledge. Ask them to visit the area retirement communities or assisted living facilities with you so you can learn about options for the future with them. Just checking these places out doesn't mean you are asking them to choose one and move tomorrow. It's about educating yourselves on the options for the future. 

If the idea of a retirement community isn't in their future due to finances or resistance, the gift could be the gift if knowledge about what resources are available if the need arises. "I'm concerned about you getting caught in a crisis situation," is a good way to approach it. Your concern as a caregiver, whether you've actively stepped into that role or not yet, is concern for them, not your needs, at this point.

Once these discussions are opened, it may well be that you can interject your concerns about how your world and life would change if their need for your involvement increases. "You know, Mom and Dad, I'd really want to live here forever too if I were you, but I'm a little concerned that if you ever needed my help, I might not be able to get to you since I live three hours away and I travel a lot for work. What can we do together to ease all our minds that you have the resources to live the way you want to in the event of a health crisis?" 

Asking for the gift of education can be a gift of peace of mind for the recipient, and the gift giver.

Tuesday, January 4, 2011

Screaming for Screening Brings Unexpected Education

For caregivers, we can fall into the trap of not knowing the underlying reason for a loved one's resistance to care for themselves.

"Mom, you know, I just had my first colonoscopy.  It wasn't that bad.  Have you ever had one?"
"No. Don't need one."
"You know they're recommended at and after age 50."
"I'm fine. I'm not having problems."
"Yes, and we want to keep it that way."
"No need, I'm fine."

Indeed, some aging parents are simply stubborn. They either don't want you in their business or they just don't want to deal with their own mortality.
Some put off the idea of screening tests because they just don't want to know if there is a problem to deal with.  (Sound familiar anyone?)
Perhaps they've been jaded by all the talk of the cost of tests and don't see any point to put money in the hands of the doctors, hosptials, etc., when they feel just fine thank-you-very-much. For the oldest generation now, it's often a case of Depression Era financial perspectives.  No need for the cost no matter who is paying it.

There is often a generational challenge when it comes to medical screening issues.  The younger generation has watched as friends have received scary diagnoses from early detection screenings and survived because of that early detection. We're often more inclined to get screened ourselves. But the older generation is not as accustomed to having what they often see as 'unnecessary' tests. In their minds, tests are used to determine the cause of a problem. No problem = no test. Screening, no matter how strongly its benefits are touted in the media seems unnecessary - and an unnecessary expense.  The rallying cry of the American Heart Association and American Cancer Society is get screened! But in their minds, it can simply be a justification to fill someone's pocket, rather than the life-saving tool that screening can be.

When caregivers hit this wall with a loved one it may be more of your own mindset that needs stretching than that of your loved one. Why is she or he so resistant? It truly may be much more than stubbornness. 

It may just boil down to the need for a reality check about the costs. Does Mom have insurance to cover screenings? Does she even know? Is she worried about the costs to her? The level of insurance coverage for aging loved ones is often not a topic of discussion. It's like asking about a parent's finances for the first time. She's always handled that and you've never thought about it. Why broach it now?  It may be the real reason that your loved one is resisting screening tests and proactive rather reactive medical care. 

Concerns about the out-of-pocket expenses related to screenings, or in the worst case, what is found from a screening, may be a significant part of the resistance. What if there is no health insurance? What if Mom is embarrassed to tell you she didn't purchase the retirement insurance and she is just waiting for Medicare to start? What if Medicare hasn't kicked in or the plan chosen may have higher deductibles or co-pays than can be managed? It's time for an insurance check-up. If your loved one does have medicare, take time to go to  http://www.medicare.gov/ and do a little research. If not, take some time to help your loved one feel more comfortable about the resources available. Look through the insurance plan together to see if screenings are covered. If there is no insurance, look into free screening options in your community and keep looking into the options for medical insurance. In this time of change in healthcare, no one can know it all. But being willing to learn is always a key to peace of mind.