Looking After Aging Relatives

As people live longer, more residents of the Finger Lakes region worry about aging parents, spouses, relatives, friends, even themselves. They may be feisty, independent souls, but they’re starting to need help with yard work, housework, and basic daily activities. No one wants to insult their self-sufficient natures, but it is natural to be concerned about whether they are safe, especially if their children live out of town or out of state.

In this four-part series, Life in the Finger Lakes provides an overview of what to think about before crises occur, warning signs to watch for, residential options, resources and more.

What to think about now
The time to start planning for this time of life, is before problems arise. Few things are as scary as getting a call in the middle of the night saying a parent is on the way to the emergency room, especially if you do not live nearby.

Health status can change gradually or immediately, and being prepared makes a huge difference in how situations are handled. Here are things to think about now.

Important documents
We need to know what our parents want to do or have done for them before decisions have to be made under the pressure of an emergency and its related fear, dismay or sorrow. Tactfully bring up important documents. Everyone should have wills, advance directives, life insurance policies, health and/or legal proxies, and powers of attorney once they have children or own property, but it can be emotionally challenging to discuss these things with parents. Figure out a way of asking them whether they have these yet and, if so, where they keep the documents. If not, ask their advice about having these for yourself, which may make it easier to learn about what your parents have done or to encourage them to take action.

Difficult conversations
One way to open the conversation about changing circumstances is to use anecdotes about friends’ families. It can be easier to discuss a situation that seems to be about someone else. Bring up friends who are facing age-related issues and decisions on behalf of their parents – what they are seeing and how they are coping. Let your parents know that you want to help when they are no longer up to managing. Mention the value of knowing how to contact each other’s doctors, attorneys and other professionals.

The anecdotal approach should work equally well for a spouse or friend.

Siblings may need to start planning how to respond to their parents’ changing needs, based on who lives where, who has family or business responsibilities of their own, and who has what financial resources. Try not to make assumptions about who will do what. The sibling who lives in the same city as the parents should not shoulder the entire burden.

Try not to assume that the kids know best, even collectively. We know a couple whose children live far from Rochester and have been arguing over whom the parents will go to when no longer up to maintaining the family home. However, the parents do not want to move to a new city. Leaving their house of more than 50 years will be enough of a wrench without leaving longtime friends and colleagues. Their kids may have to agree to help the parents find a safer place to live in Rochester.

Current health, strength and safety
Stay in tune with the health, strength and safety of aging parents and friends. Try to find out who their doctors are, and make sure those professionals know how to reach you. If your spouse is starting to have health issues, figure out ways to break down barriers to discussing those issues so you can address them together. Some people, especially men, are shy of revealing such issues and not all couples visit their doctors together or see the same one, so one partner can be unaware of subtle changes in the other’s health.

Finances
If a parent’s or spouse’s health or independence should decline, coping financially will become a factor, especially for baby boomers who may end up with both children to raise and ailing parents to look after. You might have to find tactful ways to learn about your parents’ bills and sources of income. You may need to start saving to help them out, or to cover your expenses in traveling more often to help them manage. You may need a power of attorney to take on their financial planning, or be added to their bank account to make sure bills get paid on time.

Mobility
The classic moment of truth is taking away the car keys when someone is no longer a safe driver. Try riding along one day to observe and assess your parents’ driving behaviors, and be prepared for an argument. I was lucky that my mother broached the topic, but many parents will not do that for you.

Finger Lakes towns and cities do not have subway systems, and many older people prefer not to take buses. Not being able to drive will be more frightening here than to New Yorkers or DC residents, but there are alternatives – driver and van services, and accounts with taxi companies.

Backups
One way to prepare for getting older is to develop back-up systems. See if local friends would be willing to drop in on occasion to make sure your parents are safe and healthy. Stay in touch with your parents’ friends, so someone knows how to reach you if they become concerned about your parents’ situation or a crisis occurs. If you are the one starting to need help or make major lifestyle changes because of age, reach out to your friends and their kids to set up similar support systems.

Friends of any age might be facing these issues and have resources to share. I was able to recommend aides when one of my high-school friends had to move his mother, who has severe Alzheimer’s, to Ithaca.

Your parents might be more proactive about looking after themselves than you realize. After my dad died, my mother and a neighbor set up a buddy system. If one did not phone the other by 8:30 a.m., the other called or walked down the block to make sure everything was okay. They had keys to each other’s homes and the phone numbers of each other’s children. If anything happened to Mom, at least she would be found within a few hours rather than not for several days.

Avoiding the big move
One of the biggest fears of older people is having to move out of a beloved family home because they can no longer maintain it or feel safe in it. There are ways to make a current home safer using an emergency alert system, handrails, walk-in tubs, and buddy systems. Removing scatter rugs can help.

When a friend in Illinois became worried that her parents in Rochester might fall in their family home, she hired another friend to do minor repairs, including installing railings.

Ask friends to recommend housekeepers, maids or cleaners (either individuals or services); drivers; lawn-care companies (including snow plowers); and more.

Easy changes
If it looks like staying in the family home is going to be too difficult even with household help, start researching area alternatives. Many assume that giving up a house means going to a nursing home. The thought of a nursing home is anathema for many parents and children. The good news is that it may be a more extreme step than needed. Many simply do not need nursing-home level of care. A one-story house, a condo or an apartment in a building with a variety of onsite services might do the trick. Moving out of a long-held family home is still going to be traumatic, but it does not have to mean giving up on life.
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Watch for Part 2, which will look at the warning signs of aging. Part 3 will discuss residential options, and Part 4 will present regional and national resources.
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Ruth E. Thaler-Carter is an award-winning freelance writer/editor, coauthor of The Who, What and Where of Elder Care: A handy, step-by-step guide to help navigate the maze of caregiving (2006). She is her mother’s primary caregiver.“We’re very lucky,” she said, “My husband and I moved back to Rochester because we wanted to and before my mother needed us. She is financially secure; we don’t have children; my career is both flexible and portable; and my brothers are supportive, even though they don’t live nearby.”