Lifelong Learning

We often read that lifelong learning is good for our brains. New ideas, new hobbies, new puzzles all help us keep sharp as we age. For some of us, it isn’t about crossword puzzles or Sodoku, it is who we are.

Are you curious about the world? Excited by changing ideas and technology? Always talking to people about what they are doing? Going to classes and seminars because you WANT to? You may be a lifelong learner.

We so much information at our fingertips, we don’t even have to leave the comfort of home to learn something new every day. Some of the most interesting articles I’ve read recently on aging, caregiving and dementia were posted on Twitter and Facebook.

Don’t like or use social media? Check out Alltop for blogs on so many subjects you could spend your whole day reading. Don’t like reading? Listen to TED talks on YouTube. Podcasts are also available through ITunes for download to your MP3 player. No matter how you learn, there ways to stay connected to the world and the interesting things happening in it.

Today I’m off to a conference in Las Vegas with my CarePath partner Beth. I know by the end of 2 days our brains will probably be full of new ideas. So much learning occurs in conversation with other care managers it is worth going just for that (and the opportunity to stay at the Bellagio!)

What are you going to learn today?

Book review: They’re Your Parents Too!

Have you ever experienced conflict with a sibling over Mom or Dad’s care?  Does it  sometimes seem like your brother or sister didn’t even grow up in the same home?  Are you the long distance daughter, the local 24 hour caregiver, the estranged son, or any of dozens of roles an adult child may play in the family?  If so, I recommend you read They’re Your Parents Too!  How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy by Francine Russo. Using real life situations, Russo illustrates the challenges and opportunities for siblings face with the care of their aging parent(s).

Dealing with their parent’s declining health often puts siblings in uncharted territory as they begin the transition to a new stage in life.  Haven’t spoken to your siblings beyond holiday greetings in 25 years?  See your siblings frequently and still play “Mom liked you best”?  What role will each of you play now in caring (or not caring) for your parents?

For each question Russo asks, she provides practical guidance and a compassionate voice to helping siblings understand each other and the choices they will need to make.   One of the most important themes running through They’re Your Parents Too! is the impact of seeing your siblings as the adults they are now, as well as seeing their perspective on the family of childhood. Even if your family were the Waltons, each sibling deals with aging issues and anticipated loss differently!

Russo deftly handles the issues of caregiving, navigating the minefields of sibling and parental relationships, end-of-life preparations, and grieving the loss from a variety of sibling perspectives.  Whether your siblings are close, distant, polite, estranged or some combination, you will see your relationships mirrored in the examples shared.  Russo understands that sometimes professional facilitation is needed to help adult siblings and/or their parents work through issues (both old and current) and gives suggestions for resources including the help of a therapist or geriatric care manager.

They’re Your Parents Too! is easy reading, practical and well worth your time.  If you and your siblings are currently caring for a parent or are preparing to, check your public library or bookstore for this valuable resource.

Fear of Falling?

We’ve all done it.  We tripped over the dog, the curb or the invisible line on the sidewalk.  Most of the time we are able to catch ourselves but sometimes we fall.  As we age, those falls become more frequent and more likely to cause injury.

Did you know that each year one in three adults over 65 have a fall?  According to the Centers for Disease Control (CDC),  of those who fall, 20-30% have a fracture.  Falls are the most common cause of nonfatal injuries and hospital admission for older adults.

Over the years, we have often seen that declining health in older adults often begins with a fall.  That doesn’t mean that the fall caused the decline, although a broken hip can have a serious impact on future health.  Sometimes a bone breaks due to osteoporosis and causes a fall.  More often, the fall is due to a change in medications, increasing muscle weakness or changes in vision.  Household items like throw rugs and electrical cords can become for of a tripping risk when feet shuffle or don’t lift as high as they used to.

Every seminar I’ve been to in recent years emphasized the importance of grab bars in the bathroom and non-skid surfaces in tubs and showers.  Many companies now make grab bars that blend well with bathroom decor and many styles of non-skid decals and mats are available.

Perhaps the most insidious effect of a fall is the fear that can create.  The fear makes people more cautious about going out and being alone.  Activities that previously had been a part of normal routine, like getting the mail, are now a reason for dread.

There are many things that older adults and their families can do to anticipate problems and prevent falls.  CarePath’s July newsletter includes tips for preventing falls and links to some additional free resources.  Take control of your fall safety now for a healthier and happier life!

When Work and Life Collide

Like many people in my generation, I have been juggling responsibility for work, home and an aging parent.  I have been grateful for the assistance of a supportive family and business partners as I made frequent trips across the country to see my dad.

I will admit to feeling just a little smug that I had the experience and knowledge to help Dad with the changes he was having.  “What do families do,” I wondered, “when they don’t even know where to start or what to expect?”  In our work as Geriatric Care Managers we recognize how often a crisis catches adult children unprepared for the tasks ahead.

Just such a crisis happened in our family when my father fell and hit his head in December. I knew his physical strength was declining but took comfort in the resources available at his Continuing Care Community.  The fall was a wake up call to both of us that life was changing even more.

After spending 9 days together creating a safety plan including additional support in his apartment, I wasn’t home 6 days before the phone rang with another health crisis.   Suddenly I wasn’t just providing knowledge, I was doing hands on caregiving.  That is where life finds us today – coping day to day and trying to plan for the future.

If you are an adult child, caring for an aging parent, what was the moment when you realized you had become a caregiver and how did it change your life?

A Book Review: Treat Me, Not My Age

Starting with December 2010, the CarePath partners will be posting a book review monthly to help you identify those important resources your family needs.  This month, I’m doing a review of  Treat Me, Not My Age , a Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older by Mark Lachs, MD, MPH.

Dr. Lachs is a first and foremost, a geriatrician.  If you are unfamiliar with this speciality it is a physician who specializes in the health care issues of aging.  He is also Professor of Medicine at Weill Cornell Medical College and Director of Geriatrics at New York Presbyterian Healthcare System.

If you heard a doctor tell your aging loved one, “You are old. What do you expect?”, this is the book for you.  Dr. Lachs does a wonderful job of discussing the impact of age on healthcare treatment, situations patients and families may face and options for dealing with them.  One of the things I liked best about this book is that it is written in a clear, practical fashion, sprinkled with humor and full of compassion for the challenges of aging.

Some of the topics in this gem of a book include:

The Biology of Aging (what really happens to our bodies and how does that affect healthcare)

Do No Harm, but for God’s Sake, Do Something! (what is important to treat regardless of age)

Cookbook Medicine (If you’ve seen one 80-year-old, you’ve seen one 80-year-old)

Bedside Matters (what can be learned from taking time with patients)

Dr. Lachs frequently points out that treatment choices should be based in large part on the patient’s ability to function, not their age.  The 88 year swimmer I met at recent health fair who competes in senior swimming events is much different from a 65-year-old with multiple chronic diseases that affect daily life.  How each will react to treatment depends less on the number of years in their life than the life they are currently living.

Reading this book, affirmed what I have experienced over years of working with older adults, including the importance of have a healthcare advocate and a physician who takes the time to really listen.  If you are nodding your head as you think about your 80-year-old mother, keep in mind that ageism in healthcare can begin as early as your 40′s – 50′s.  If you are a baby boomer, some of the issues Dr. Lachs explores may already be affecting YOU!

My one disappointment with this book is that it does not discuss the beneficial role of the Geriatric Care Manager as a healthcare advocate and support in maintaining independence.   Given the lack of geriatricians nationally, and particularly in the rural areas, a Geriatric Care Manager can be an important piece of your family’s plan for an aging loved one.

I strongly recommend this book as one that will help you, surprise you and make you think about the kind of healthcare you and your family expect and need.  If you’ve read the book, I’d love to hear what you thought of it.

I Remember When…

A recent visit with my father prompted me to ask the following question:

“What is your favorite memory of older generations when you were a child?”

People talked of cooking and baking with their grandmother, listening to stories of times long past, singing songs popular long before they were born, and being loved and supported. Many of these memories reflect the importance of passing down wisdom and history from one generation to another.

Reviewing one’s life, and its meaning, is a common task of aging. It is about validating the life one has lived and hopefully leaving a legacy to future generations. Your parent or grandparent may want to share pictures, tell stories or talk about the “good old days”. The only requirement of you is to listen.

Some families do written or video histories using interview questions. An ethical will gives older adults an opportunity to share their values and advice. If the older adults in your life aren’t comfortable doing something that formal, simple prompts about major life events or how decisions were made on jobs, family, buying a home can be great conversation starters. Heard that story 100 times before? Ask some clarifying questions to learn more about why this memory is so important. You might be surprised at the answers.

Please leave your message at the tone

I recently  had the chance to help friends and family who were trying to navigate the health care system.  Their frustration reminded me why Sylvia, Beth and I started CarePath to being with.  PEOPLE DON’T FEEL HEARD!

It is difficult to feel heard when dealing with the automated phone systems used by most physician offices and insurance companies.  How many times have you given up in frustration without even completing the call?  Add to that limited vision and hearing and the challenge increases.  When in doubt, go for the option that sends you to an operator (usually Press 0).  Even if you have to wait, they often can save you time by connecting you directly with the person you need.

Be prepared for the conversation.  When dealing with insurance companies, have all of the claim history, policy information and situation details in front of you.    Calling a busy physician’s office?  Write out your questions ahead of time and have a list of current medications and symptoms or issues ready to go.  Rather than just leaving a message for the doctor, ask to talk to his/her nurse or medical assistant.  They often can be your best ally in either getting the answers you seek.

Try to be patient as you work through the process and document the dates, times and people you talk to.  Be persistent but polite.  Many times the initial person you talk to does not have the knowledge or authority to answer your questions.  If you are not getting anywhere, ask to speak to a supervisor and keep going up the chain of command until you reach someone who can help you.

If you are helping an elderly family member with this process, ask them to sign a HIPAA  privacy release that allows you to discuss their confidential health information.  As frustrating as that can be, it also provides important patient protection.  Ask your family member if, or how they want to be involved and keep them informed of your progress.

When in doubt, consult a Geriatric Care Manager for guidance, or consult your area SHIP (State Health Insurance Assistance Program) for issues related to Medicare benefits, Medicare supplements, long term care insurance and other Medicare related issues.

A Video to Touch Your Heart

Just a few minutes ago I finished watching Judith Fox’s audio slide show “I Still Do: Loving and Living with Alzheimer’s“  as posted on the BBC website.  The photos, taken from her book , combine with comments from Judith to give us a poignant view in to their lives and his progressing dementia.

If you have not yet had the opportunity to watch this video, I encourage you to do so.  It may bring a tear to your eye, but also will warm your heart.

Help for local caregivers

On April 17th, 2010, CarePath Senior Solutions LLC will be hosting a 1 1/2 hour workshop for adult children titled “Finding Your Path Through the Caregiving Maze”.  It will beheld at the Hampton Inn, Lake Havasu City, AZ and is free to attendees.  Whether you are a local caregiver or trying to assist family from a distance, this overview will give you valuable information about the resources and options available to you.

Go to our website at www.yourcarepath.com and click on the workshop link to register online.  We look forward to seeing you there!

Lost in the maze?

I’ve been a geriatric care manager for the last 1 1/2 years and a social worker for over 30 years.  I had a pretty good idea of the kinds of needs families would have and what resources I had to offer.   Surprisingly, I’ve found the real need isn’t always for answers (though they are important) but for support in sorting through the maze of choices.

I wasn’t sure where to turn or even where to start.  It helps just to know I am not alone and you will be there to help me work through the decisions ahead.

Feelings like these are common, as baby boomer children face the challenges of aging parents.  The questions they face are tough.  Can we afford to keep mom at home?  Is she safe?  Will we have to sell the house?   The feelings of guilt, sorrow, fear, anger, or just being overwhelmed, can be even tougher.

Family and friends, while well-meaning, sometimes aren’t helpful.  Advice freely given, may not be accurate or appreciated.  Having a professional, who can listen and offer their support and experience, makes the process easier.

If you are struggling with decisions for your aging parent, contacting a Geriatric Care Manager, may help you find your path through the maze.