Tuesday, April 27, 2010

Aging Parents: Mother's Day Gifts-3

Gifts That Mothers (aging or not) And Grandmothers) Should Love

Aging parents (in spite of the fact that they don't want to accumulate more things) love gifts, as mentioned in the last post; and appreciate things that can--in most cases--be "used up."

Mothers who still drive or have convenient access to transportation, can more easily purchase what they need, if money isn't an issue; and younger mothers may not be so concerned with gifts that can be "used up." For example, one younger mother (in her 60's) likes having all her children chip in for one gift certificate. Then she goes shopping and buys "something special" that she normally wouldn't buy for herself.

We might think older aging parents for whom money and transportation aren't issues should feel the same. But for many aging mothers who live alone, insecurity--necessary or unnecessary--about spending money becomes an issue at a certain point.

The Mother's Day gift ideas below can be enriching, attractive and/or useful contributions in our effort to help parents age well. A few may be better afforded if siblings chip in.

---Adding pleasure to a mother's life.

Some children have taken over--as a gift--the bill-paying for something their mother wouldn't want to afford, but they know would add pleasure. Example: paying for something like Direct TV or HBO--you get the idea.

Grooming and beauty services (hair, manicure, pedicure, facial, massage) help a mother to feel special. Make arrangements to be billed--or give a gift certificate. (Since old skin can be very delicate, be certain to check that the preceding are OK for an older mother's situation.)

When thinking about gifting flowers or plants for mothers with a terrace, patio, or small yard, contact a landscape nursery to check the cost of having flowers planted (perhaps in a large container or several smaller containers) if you are a far-away-living child or can't plant them yourself. Otherwise, select the healthiest plants you can find at the grocery store (most sell plants and flowers) or nursery. Check if they go indoors or outdoors.

Flowering plants are living, they change, and brighten up an outdoor space or an indoor space near a sunny window. (Sun is necessary for most plants to flower.) Geraniums can be a good option: easy care, many colors, indoors or outdoors.

---Things: usable/needed gifts
Older people often feel cold (even when we feel warm); stories about children of aging parents sneaking to turn down the thermostat when they're in their parents' home are common. A good-looking sweater or jacket (that may or may not pull things together and make an outfit) may be a good idea, as is an attractive shawl or an easy-to-get-into comfy robe. (These can be light weight for what we consider the warm months, and definitely a heavier weight for colder months.)

A new nightgown, pajamas, or slippers may be a needed and welcome gift. One adviser (who's careful about falls and balance) says that Dear Foams makes a very soft, easy to put on, slipper that feels "wonderful" and isn't heavy.

Knowing and gifting a favorite lipstick/cream/lotion is always appreciated, especially when it saves a non-driving mother from having to go out and buy them. (Note: I'm told perfume isn't as popular with older people today because of allergies--check it out.)

An adviser reminds me that attractive postage stamps (a "LOVE" one was recently issued with beautiful flowers) are appreciated by mothers who lack transportation to a post office... so practical for older people who still write notes and pay bills by mail.

We know aging produces normal vision changes in many. The usefulness of night-lights is highlighted in the Falling and Fall Prevention posts. Also check the
mini-maglite, small flashlights that give great light in dark places.

And the small size lighted pocket
magnifying-glass gets rave reviews. Everyone seems to love it. It takes up little space, is light weight, inexpensive, and truly helps parents age well by providing enlarged, lit-up print--very helpful for older eyes. At $9.99 it makes a great, useful Mother's Day gift for your mother--and any older woman you wish to remember.

Lastly, the tried and true, flowers and candy... or what about a box of pretty cookies from the bakery?

When our goal is to help our parents age well, don't special occasions like Mother's Day give us a unique opportunity to contribute something pleasurable and useful to their lives!

Saturday, April 24, 2010

Aging Parents: Thinking Ahead About Mother's Day-2

Gifts That Mothers Will Welcome and Enjoy
"For the most part, we really don't need more things," said most of the older mothers I've spoken with.Their space is limited in many cases, so unless gifts can be eaten or used up, or unless there is something specific that they need, they really don't want "things." OK, what would they like?

---Being with family. Being with all of her offspring is "the best Mother's Day gift a mother could have," says 88-year-old R-2, one of my advisers. This thought is echoed by so many. R-2 further explains: "What I'd like most, if it can be worked out, is to have a big dinner at my apartment with my children, grandchildren, and great-grandchildren--all enjoying each other. My children are good cooks and they bring the food. We've done it before--but not all the time. But if they plan it early, it could work out. If it should work out, it would be a beautiful day."

A variation on this theme is expressed by another aging mother. "What I'd really love doesn't need to be on Mother's Day, because my children--you know they're all in their 40's, working, and all spread out (geographically)--they'd have to plan to be together. But I'd love it if they could plan a get-together--all of them with their children (my grandchildren)--somewhere, some time in the summer when the kids aren't in school...and I want everyone to get along, which means the kids behave well.... They could describe the plans on my Mother's Day card, letting me know that's my gift. It would be something I could look forward to."

---A child's time, is another treasured gift. There is more than one way to gift time:
First, as "alone time." Mothers say they like having alone time with their child (or each child) apart from spouses. This has nothing to do with spouses in most cases; it's simply precious alone time between mother and child.

Second, as dedicated time (see 3/23/10 post) carved out once every week or two--to help with errands, small fix-it jobs, possibly cleaning (for example the inside of her car) or taking down/putting up storm windows. The gift could be described in the Mother's Day card, in the form of an IOU. For example, IOU 2 hours every other Thursday night to help with errands or small fix-it jobs. (An specially smart offer if it keeps aging parents off ladders.)

"Pledge me hours," is the Mother's Day gift
Viola Vaughn wants. An individual whose personal gifts seem to come from giving to others--Dr. Vaughn, Founder and Executive Director of the Women's Health Education and Prevention Strategies Alliance and 10,000 girls in Kaolack, Senegal, West Africa, was honored today as a Distinguished Alumni by Teachers College, Columbia University. (She founded WHEPSA in 2001 to develop new strategies for offering health and educational service to girls in rural Senegal.) An American grandmother, who emigrated to Senegal in 2000, she values the volunteer hours pledged and given to her projects. For example her niece, a teacher in the US, is taking next year off to honor her aunt's wishes and teach in Senegal. The gift of time, can be given in a variety of ways--always welcome.

---Gifts that give mothers something to look forward to: for example tickets to something in the future....entertainment, a trip. While tickets usually cost money, spring flower shows are usually free of charge in many towns and cities and offer an inexpensive option for mothers who like flowers. Finally as mentioned above, planned-ahead family get-togethers are something to look forward to as well as being at the top of many mother's Mother's Day wish lists.

---Something a parent has asked for--Sometimes an aging parent asks for something, only to have it forgotten or put off. For example, a mother who recovered from a broken hip noted that for several years she had asked her son-in-law to put a railing up on the porch of the home he and her daughter live in. And she has asked again this year. This intelligent, independent mother is in her late 80's and doesn't want to take chances with falling---again. "He could let me know that he's putting up the railing as my Mother's Day gift with just a little note on my Mother's Day card," she said. "In fact, if they don't put up the railing, I don't think I'm going there for Mother's Day." I guess there's a moral here--if an older parents asks for something.............

As we try to help parents age well, the variety of gifts that parents welcome takes many forms.

* * *
This coming Tuesday's post will conclude with gifts that are better classified as "things." They are things that can help parents age well. Most take up very little space.

Tuesday, April 20, 2010


.....Dilemma or Delight?

May 9th is Mother's Day this year, so timely suggestions as we try to help parents age well make sense. Yet thinking about how to celebrate the day with older mothers can prove challenging; or perhaps not.

Proximity of mothers and mothers-in-law is a factor.
When both live within driving distance--One of my senior advisers, M, says she lives more than an hour away from her son's wife's mother. "Standing on their heads like a contortionist to be with both of us on Mother's Day doesn't make sense," she says. She suggests alternating years when adult children in this situation take their mothers out on Mother's Day. "A nice card and plans for another time we can be together (even the Saturday before) is fine." But in her case, she says, "they shouldn't worry about it."

D remembers well that she didn't have the dilemma, but her brother did. Both his mother and his wife's mother wanted their adult children with them on Mother's Day. While the mothers were within driving distance--they lacked a cozy relationship...didn't want to be together. So D's brother and wife had to make two long drives together in order to see both mothers.There really was no other choice, I'm told. Needless to say, D's brother and his wife were weary by the time they saw his mother. Never-the-less, each mother got her wish. Children often sacrifice for the sake of a parent!

Then, of course, mothers often have more than one child. So if each child celebrates on a different day, the mother gets double rewards. In fact, D suggests Saturday can be preferable because places aren't as crowded and staff can pay more attention to making the outing special.

Adult children with siblings who live near mothers can work out plans that benefit everyone if people are flexible. Indeed, D even suggests--perhaps in jest--"Mother's Weekend" instead of "Mother's Day." And thinking about today's blended and extended families, there may be some wisdom in this idea.

My husband and I are far-away living children, so the preceding never affected us. I have a sibling (who lived near my parents); my husband has none. Up until last year R, my mother-in law (now 96), flew East to spend Mother's Day with us. It coincided, more or less, with the Spring Flower Show at our local Woman's Club, which has a membership tending towards "older" women--primarily 55+, with a fair number in their 80's and 90's, so R and some of the women enjoyed a commonality.

We sent R a ticket, she stayed with us, and the flower show was a highlight--along with our being together for a week. We had a solution for the proximity problem and gift dilemma--which lasted over three decades.

Mother's Day gifts are the subject of this coming Saturday's post.

Reminder: to contact me use the gmail address at the right, not the "Comments" box below.

Friday, April 16, 2010

Aging Parents: Hurtful, Puzzling, Unwarrented, Criticism

We change the focus a bit today--old grandparents, instead of aging parents. But the situation is, I think, generic and applicable to either generation as we try to help them to age well.

I was with a former colleague this week. We began with the usual "how are you" to which he replied: "I'm really tired. I had such a hard night last night--couldn't sleep. My grandmother's in the hospital." (My first thought was that she was dying...but no. In all probability she was going home the next day.)

Our conversation continued. I learned he and his mother had visited his 92-year-old grandmother the night before. She asked for a glass of water with ice, which his mother left the room to get. When she returned, she gave the glass to her mother who complained there was too much ice and too much water.

Wanting to be helpful, her grandson (my former colleague), tossed some of the ice in the waste basket and took some gulps of water to reduce the water level, whereupon his grandmother criticized him saying something like "I don't want a glass you've put your lips to."

My former colleague said he was puzzled, hurt (to say the least). Then elaborated: "I'm her favorite grandchild, I'm the oldest. Since I was four years old we've always done things together, always been in touch. I said to her 'Look we're the same family--what kind of germs do you think you're going to get from me?'"

A bit of a defensive remark to be sure; but probably the way most of us would respond to an unappreciative, critical comment from a cared-about aging parent, grandparent, relative or older friend. And we most likely don't feel good about it afterward.

But we can understand--and have sympathy for--the 92-year-old grandmother's response. Let's get picky and examine the circumstances since these kinds of situations happen often--only the specifics will differ.

When we're accustomed to feeling we have control (and this is a feeling--and a reality--that keeps aging parents and others engaged in life), don't we fight to keep it? Being in a hospital, at least for me at a much younger age, greatly reduced feelings of having control. In fact depending on the circumstance we may feel helpless, definitely frustrated, and these feelings are probably intensified for an older person for reasons I think we can all understand.

Thus, to gain some feeling of control (in this case over the way she wants her water), the grandmother sets standards and asserts herself, at the expense of her grandson. Although it came across that way, it wasn't really criticism of her grandson. It was the expression of a greater need she had for control.

On a similar note I remember when my 93-year-old father gave up driving and was riding with me. On routes that we had taken a million times together, he would tell me--timing it perfectly--"turn right" or "turn left." He no longer drove, was no longer in control, but the need to have some control getting us to our destination was still there.

We are sensitive adult children or we wouldn't be doing what we're doing and caring the way we care. And our emotions will take bruising--if not battering--at times. (Note: I remember a list of things counselors should NOT do that my professor stressed many years ago. It included taking things personally, whereupon he said basically "If it's a family member forget it. Your immediate reaction will be emotional.") My former colleague's reaction--so normal.

Understanding the motivation of aging parents, grandparents and others when we feel criticized, lectured to, unnecessarily "helped" and unappreciated is important--not only to help parents age well, but to help ourselves.

Tuesday, April 13, 2010

Aging Parents: Falls and Fall Prevention-Part 3

"I tell my older patients they should have a night light in their bedroom," emphasized a highly esteemed practicing physician, on the faculty of a major teaching hospital. I had asked about his experience with older people falling, which he said increased as his long-time patients aged. And he made a case for night lights as he recounted this story about an 89-year-old man in excellent health, mentally sharp, and still working part time, who had recently experienced an avoidable, bad fall.

"Even though they know their surroundings and can find their way in the dark, a night light would have prevented this," he said. Like many, the elderly man read in bed at night. On this particular night he was reading work from his briefcase which, after finishing, he place on the floor next to his bed. He got up during the night in his unlit room, stepped--then tripped and fell--on the briefcase and papers, and sustained serious bruises, but fortunately no broken bones.

Call a night light an "environmental modification;" call it a "common sense" addition; call it a "using common sense"--like changing from unstable high heels to flattering low heels or flats.
There are many "environmental modifications" that can ensure--to the best of our ability-- that aging parents' homes won't invite falls. Most of us know that scatter rugs are an accident waiting to happen and that grab bars in showers and tubs and near toilets provide stability. It's also helpful to know about AARP's free booklet "Taking Steps to Prevent Falling Head Over Heels" (see Saturday's post), which provides a short, excellent, informative guide to simple adaptations that we can help our parents make.

And while it doesn't mention the pitfalls of reading in bed and placing the reading material on the floor to trip on (my helpful hit #2), it mentions the value of night lights and good lighting more than a few times.

So check out AARP's website and search "fall prevention" and "steps to prevent falling" in some of the bulletins and pamphlets (first result). ("Better Balance Prevents Falls" is an example). Also search "inner ear and balance" for more specifics on this past Saturday's post.

Additional helpful information can be found in the book, "Fall Prevention," by Gail Davies and Fran Scully (Infinity Publishing, 2006) and at: stopfalls.org. Stopfalls.org provides a "basics" fact sheet for downloading. It reminds us that a person is more likely to fall if he or she is 80 or older or has fallen in the past;

The above reinforces the importance of letting aging parents know we won't dump them in assisted living if they tell us they have fallen. Obviously we're trying to help parents age well, so it's important to gain an understanding of why they fell and possibly involve their physician-- (which shifts the responsibility from us and we avoid seeming like were meddling).

Saturday, April 10, 2010

Aging Parents: Falls and Fall Prevention-Part 2

Older people and the increased likelihood of their falling has been a major concern--no doubt for decades. The drug industry has come forth with medications to improve bone density. More recently gyms and senior centers offer programs aimed at improving balance, flexibility, muscle strength, and bone strength, among other things. And in the last 10 years or so--probably because people are living longer and the likelihood of falling increases the older one gets--the subject of older people falling has spawned considerable literature with ideas for prevention.

To say that older women suffer more fractures than older men probably comes as no surprise. But the statistics may surprise. After age 50--and increasing with age as just indicated-- up to one out of four women and one out of fifteen men can anticipate breaking a bone. Is this because: a) women outlive men; b) their bones are less strong; c) all of the preceding? No matter. If we have aging mothers we must be proactive (if they aren't) in our quest to help them age well. And let's not slight aging fathers. Bone density is also a problem for some men, so it may bear checking out in older men with slight frames.

It seems obvious that there is proactive prevention--to ward off problems before they become problems ; and reactive prevention--to deal with immediate problems. Of course, the proactive is easier. The reactive is difficult to begin with, but is made more difficult because many parents don't tell when they fall (see October post).

Starting with the proactive: When aging parents aren't already taking measures to ensure--to the extent possible--that they will not fall, what can be done that is effective, respectful, and supports self-esteem and competence. Note: I didn't write "confidence." Parents may think they have will never sustain a fall, or may be in denial, because they consider themselves healthy (they are) and "in charge."

It's best to begin this conversation before it's needed. Don't put it off if you think your parent is presently at risk of falling. If a friend should fall, this news usually travels quickly among older people and is sobering. It also provides a natural opening to suggest certain check-ups and provide some information--"some" information because we don't want to sound like "know-it-alls" (even when we think we do) or cause overload. 

The following are often associated with risk of falling, so check-ups to rule them out or identify them before they become problems makes sense.

Vision--Natural aging may cause problems distinguishing shades of dark colors that could result in missing a step at, for example, a curb or on uneven pavement on cloudy days or at night. (A small flashlight is a good gift.) Cataracts at a certain point may make night driving NOT advisable, but shouldn't affect daytime driving, until they worsen. And outdated prescription-glasses pose obvious risks.
Hearing--if balance seems to be a problem, rule out inner ear problems.
Balance, dizziness, falling asleep at the wheel (yes, it happens). Check with pharmacist to rule out medication reactions and/or contact doctor. An exam may be in order.

Proactive prevention:
Bones weaken, which makes falls more dangerous, thus becoming familiar with bone density medication, vitamins, and certain kinds of exercise (ie. walking, dancing, tai chi) to strengthen bones makes sense.
Muscles weaken, flexibility lessens, and reflexes can slow down. While this occurs naturally to some degree with aging, these changes become more pronounced for inactive people because of the "If you don't use it, you lose it" truism. 

An awareness of the above has led to fall-prevention offerings at senior centers and gyms.  Example: tai chi, a gentle but proven effective exercise for balance.  No doubt this is why these classes are popular and offered at senior centers, as are yoga and chair yoga (the latter for the less physically able). Check out "Silver Sneakers" (www.silversneakers.com), a nationally-offered exercise program designed for seniors, given at fitness centers, and covered by insurance companies (which vary by state).

Lastly, one of my two fall-prevention tips (tip 2 next post). An octogenarian tells me, that--at least with women-- vanity enters into the falls and fractures discussion. How? By the shoes women wear, that can make good balance very "ify" and perhaps even more worrisome if it's your aging mother who is teetering in them. This fall prevention "head's up" will probably be met with resistance. Indeed, this kind of discussion may be better coming from a physician. I'm not ready to give up my shoes yet and perhaps will never think I should. What about you?

"Fall Prevention" continues on Tuesday.  In the meantime, you might want to order a free copy of "Taking Steps to Prevent Falling Head Over Heels" using AARP's "Home and Community Booklets Online Order Form."

Tuesday, April 6, 2010

Aging Parents: Falls and Fall Prevention

Older people fall a lot. A researcher on a 2008 Oregon Research Institute study to prevent falls among older adults says "falls are a leading cause of mortality and morbidity among adults age 65 and older."*

Over the weekend I learned via email that two pioneer teachers from the early days of our high school, now in their 90's or nearly 90, had suffered broken hips. Mailing/email addresses, and telephone numbers were included so we could contact them.
The email also suggested contacting Mr. W. (see my jump start post), who I visited while on vacation last month, and who the email said had fallen several times but suffered no injury. I share, in part, my email to the classmate:

I did see Mr. W and his wife. Hadn't planned to stay more than 15 minutes, but ended up staying 2 hours. It was a good stay--talked about old times, some of our class members, I provided a bit of sworn-not-to-tell gossip and left with the satisfaction of seeing two 87-year-olds who have been through a lot together and are wonderfully grounded emotionally...each in his or her own way. I guess there have been more letters, cards, etc. than they can count. And with that, I think, comes reaffirmation of a life well lived, a life of purpose and contributions.....

On that visit I too learned that they fell "a lot." Their home is well carpeted and "nothing broke." I remember a friend of my mother's in her 90's telling me a similar story. This aging--no old, but young at heart--parent fell a lot on carpeted floors and "nothing broke." She admitted she should use a cane but kept losing it in her home--"and I keep 3 canes and can never find a one," she giggled.

It drove her adult children "crazy," but they were firm in their conviction of empowering aging parents and not undermining confidence. They also knew that continued discussion on the subject of falling accomplished nothing. But they succeeded in having her wear a pendant with a button she could push for help if she fell. They decided this was better than destroying what was a wonderful relationship. And because she was a rational, old parent she knew the pendant was a good idea. In fact she pushed that button quite often and let the paramedics know which door was never locked so they could easily come and pick her up! (This also drove her adult children "crazy" but no harm ever came.)

It's probably safe to say that every person over the age of 70 knows of an aging person who has fallen and, unlike a child's fall, has sustained more than just a skinned knee. Since bones thin with aging, they are weaker and can break more easily. And healing is slower in older people. Since fear of falling and breaking a bone is very high up on the list of older people's worries, shouldn't this also concern adult children?

I realize that adding the specific information and at least one creative idea aimed at helping aging parents reduce the risk of falls and fractures will necessitate this post being too long. Thus, Saturday's post will focus on some specifics that I believe are good to know--for both adult children and their aging parents.

Li, F., Harmer, P., Glasgow, R., Mack, K.A., Sleet, D., Fisher, K. J., Kohn, M.A., Millet, L.M., Mead, J., Xu, J., Lin, M.L., Yang, T., Sutton, B., & Tompkins, Y. (2008). Translation of an effective Tai Chi intervention into a community-based falls prevention program. American Journal of Public Health, 98(7), 1195-1198.

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Saturday, April 3, 2010

Aging Parents: Ideas/Thoughts for Passover and Easter...

...to Keep Older Parents Engaged and Help Them Age Well
This is a time when we celebrate miracles. The emancipation of the Israelites from slavery in ancient Egypt, when the Red Sea parted. The Resurrection of Christ after the Crucifixion. Older generations fondly recall Seders, when family members gathered together and children looked for the hidden matzo; or Easter services, and the children's Easter egg hunt, and the family brunch or dinner.

As with all major holidays there is joy for so many; but for those who are old and feel isolated and lonely there are no miracles.

Since Easter is here, not surprisingly my senior advisers tell me that Easter can be very lonely for older people living alone, without children to visit or take them out. On the other hand, suggestions for doing things that will bring pleasure are many.

The more obvious: taking aging parents out for brunch after church or for dinner later. This suggestion is embellished with:
... the suggestion of eating at a place with a lovely view or beautiful gardens to make the outing more special.
...a restaurant where aging parents who don't get out much can take a short walk (use a wheel chair or walker if necessary) so they can enjoy looking in shop windows, see normal activity.
...anything that includes grandchildren.

When the Easter meal is at a family member's home and older parents want to bring a special dish, by all means accept the offer. It feels good to participate.

Then there are older people who are alone and find it difficult to go out. A visit is welcome with or without a little gift. However, below are some gift suggestions:
...bring a little lunch or snack ("nothing big," I'm told) to share while you talk
...be sensitive to sugar and/or salt restrictions
...bring a living plant that isn't fussy. Check at a nursery or flower shop--suggestions: (philodendron [sweetheart plant], fern [nephrolepis], spathiphyllum [peace lilly--wallisi variety] or kalanchoe).
...bring flowers. They brighten up a room.
bring a blooming plant for those who still like to garden

Although Passover is almost over, one 89-year-old adviser proudly tells me she made: chopped liver, matzo balls, gefilte fish, and horse radish for the Seder. Not easy at 89, but she says she was able "to work it out so I could make everything ahead." And best of all perhaps for her, "It was a good feeling because everyone wanted to take some home and there wasn't enough left."

This final story comes from the West Coast. There were no children to look for the traditional hidden matzo at the Passover Seder this year, so the oldest guests were sent on the hunt. An 86-year-old male guest found the hidden matzo. While not traditional, life today with children and grandchildren living near is not as prevalent as in times past. So it would seem that adaptation, flexibility, inclusion and thoughtful creativity go a long way towards helping parents and others age well, especially during the holidays.