Saturday, January 30, 2010

Aging Parents: One Size, Of Course, Doesn't Fit All

We all know that one size doesn't fit all. Does that relate to medications? Does a big man take the same dose of medicine (the dose marked "For Adults" on the bottle) as an 80-year-old woman or a petite 50-year-old woman? Do older adults--aging parents whose whose physical bodies have often shrunk since their younger days-- require the same "adult dose" as when they were younger adults?

Being a very instruction-abiding person (I worked in schools remember), I've mulled this question over many times since my husband is big and I am rather petite. Taking the "adult dose" on a bottle of nonprescription pain killer works for him. I don't need that much. I have learned to take less.

Thus I read with special interest the Tuesday, January 26th, New York Times Science Section, "Vital Signs" column. It had a segment, "Tailoring Drug Doses to a Patient's Size," that to me is such common sense I'm surprised someone didn't put it in major headlines a long time ago. &st=cse.

Now we read that two doctors, one in Athens, Greece the other a professor of medicine at Tufts Medical School in Boston, have addressed this subject in a medical journal, The Lancet.

In my November 3 post, "Old Parents vs. Vacation Plans," I write about my unplanned return to the US from Italy because my mother was supposedly dying. I was able to get her quickly to a geriatrician who ordered lab work and x'rays while we waited at the teaching hospital. It turned out, after looking at the results and the medication list I brought, that medications--too much and some unnecessary--caused the seemingly urgent problems.

From then on, whenever medications were discussed, I respectfully mentioned Mother's small size and low weight and asked about the minimum dose she could take and still get the necessary results.
Actually I discuss this with my physicians today. And I know they take my relatively smaller size into consideration, especially if an antibiotic is involved.

The "one size doesn't fit all" concept seems very important when it involves aging parents and their medication. Yet I think it has merit for adult children too. If we don't stay healthy and so we can be there for our aging parents, who will be?

Tuesday, January 26, 2010

A Jump Start, Aging Parents, and Others

My thoughts for today’s post, “jump-starting aging parents,” were organized, ready for posting and I will still share them. However, I begin--thinking about what hearing from former students could mean to an aging teacher. Could that, at the very least, be a psychological jump start?

Today I learned that Mr. W, my high school chemistry teacher who was so important to me that he was the subject of my college application essays, has cancer. An email arrived this afternoon from a high school classmate, one of my closest friends during those teenage years. Although separated by 3,000 miles, he updates me about important situations.

The thought is that Mr. W would no doubt enjoy hearing from people in our class. Mr. W is probably in his 80's now, possibly an aging parent. I tried but couldn’t remember whether or not he and his wife have children.

The idea of giving back in some small way to people who mean or have meant a lot to us, clearly has merit. If they mean/meant so much, we are probably special to them. So although this post was initially intended for adult children of aging parents, I realize the idea of a jump-start is equally relevant for all adult children and applicable to all aging people important in our lives.

When we stop and think about it, can’t human beings of all ages use a jump start now and then? No doubt there have been days when we’ve all felt lackluster; when our spirits needed lifting; when we would rather stay in bed than get up and have to perform whatever’s expected of us. But we usually can’t languish (unless we’re seriously depressed), because of family demands, expectations of friends and colleagues, and because our circle of contacts and our ongoing involvements coax us mentally to get up and get going.

Most aging parents in the chronologically younger group, no doubt have many people and activities in their lives; thus many possibilities to trigger the jump-start mechanism exist. As people become chronologically older, however, the outside influences in their lives lessen, their support group dwindles and a needed jump-start may be harder to come by.

A jump-start takes many forms; but in all cases it makes people feel better and can be empowering--the unexpected phone call, anticipation of something to look forward to (like a grandchild’s visit), a spontaneous invitation, a surprise visit, invited participation in some endeavor. Far-away living adult children often find the simple fact that they’ve come to visit provides a jump-start for their aging parents. The possibilities are only limited by our imagination.

Saturday, January 23, 2010

Is Helping Aging Parents Always Helpful?

Are We Controlling? Do We Have a Hidden Agenda?

Our wig-shopping spree over, my husband’s mother, R, said she could use a little “rest.” I’
ve never researched aging parents’ idea of a “rest.” Her idea at 96: sitting and talking with her son, my husband, for almost two hours. (I took a nap.) Then we all went to R’s best friend N’s home for a Swedish dinner.

If we needed proof that aging parents can organize and cook to perfection for company, we had it! N, at 86, is an awesome (and I don’t use that word lightly) cook. Even more awesome when you consider her age and the food she prepared. Our meal—green salad with just-picked grape tomatoes, fresh salmon with dill, the best small potatoes imaginable, creamy spinach, home-baked
limpa bread and a Tosca cake for dessert—was equal to that of the finest New York restaurant.

The fifth guest was N’s child, a daughter in her fifties, who runs a demanding, time-consuming business, yet brought the tomatoes and dill from her garden. The relationship between N and her daughter is respectful, mutually supportive and obviously loving. Many daughters’ instinct would be to come in and take over when an 86-year-old mother undertakes a “company dinner.” We can only imagine how much energy goes into preparing such a dinner—at any age…but at 86?! This very able daughter did it right. She quietly helped as needed; but it was clearly her mother’s dinner party.

I began to think about adult children who insist on taking over major responsibility for holiday family dinners once older mothers reach a certain age. Reason: They’
ve decided (rightly or wrongly) it’s too much work for an aging parent. Some older parents give in. Others question the motive, especially that of far-away-living daughters. These mothers are skeptical. “They say it makes it easier for us, but I think it makes it easier for them. It saves them the trouble of bringing the kids (our grandchildren) to us,” says one grandmother, who’s not yet ready to give up the tradition.

Think back to raising children. Remember how often the experts say that it’s important to let a child perhaps struggle a bit but do for him or herself, as opposed to jumping in to help because we can do it better or easier. This reinforces confidence and self- esteem. The same reasoning holds true for aging parents,
doesn’t it? Don’t we want our aging parents to continue to feel competent and proud of the fact that we think they are, when indeed that is true?

This brings us to one of our key thoughts: Assuming there’s no threat to life and limb, should we intervene and/or offer suggestions to make it better or easier for ourselves or focus on what makes it better for our parents?

Tuesday, January 19, 2010

Aging Parents and Wigs

What happens when you put a new wig on an aging parent’s head? Surprise! At least for me.

Neither my husband’s mother nor I (I think I can speak for her, she’s often more attuned to these kind of things than I) realized that the majority of ready-made, out of the box, and thus less expensive, synthetic wigs are geared for the faces of relatively younger women. It’s not necessarily a problem of hair color; rather it’s a problem of style.

And when you think about it, it makes sense. While companies are beginning to act on the realization that people are living well longer, it seems these wig manufacturers are still catering to women who are newly-minted senior citizens and younger.

That said, it is possible to purchase synthetic wigs that compliment an older face. The skill of the people working in the wig boutique/shop is what makes the difference. For that reason, going on line to purchase a wig (unless you know the style # and have worn that wig previously) is not recommended; neither is using the Yellow Pages to make the initial phone call unless it’s to check whether or not the shop has someone who is experienced at thinning down and styling a ready-made wig.

Reason: these wigs are manufactured using a basic, simplistic, universal, oval face as the model and the commercially styled hair is thicker/fuller than the hair of most older people, whose hair often thins due to age. (This certainly would include many of our parents or we wouldn’t be thinking about wigs.)

Aging parents probably want a more conservative hairstyle. If making the phone call, ask about more conservative hairstyles for older people. Yes, I know, the styles are for “anyone” but frame an old face with a cool new style and there’s a major disconnect. This doesn’t mean a 70-something-year-old, with a young face, can’t wear a new style. The wig may need to be thinned a bit, but it works. For a 70-something-year-old with a lined or older looking face, however, forget it and go for the more conservative style.

I was curious about men who lose their hair and, as expected, learned women far outnumber men when it comes to purchasing a wig. Then I was told about a man who came into a wig shop catering to men and women. He was wearing a hat over his obviously balding head and wanted to purchase a “hairpiece.” (I am told the word “toupee” is passé.) It would have been trimmed and blended into his own hair. However, he tried on a wig; it looked “awesome.” It was trimmed to compliment his face and “off he went into the sunset without his hat—a happy camper.”

Michelle, at Wigs Amor and Forever Young in Arizona, says at both shops people come in thinking they know what they want but “more often than not, you like something you weren’t expecting.” It may take a while to decide on the right wig for the right natural look. And older people may not make decisions as quickly as younger ones, possibly because they take less risks and/or want more time to digest things.

So plan on taking some time if you have aging parents who want or need a wig. One thing I can vouch for: it’s not only helpful and supportive to shop for wigs with a mother or mother-in-law; it’s fun. And a lot of laughs!

Saturday, January 16, 2010

Appearance and Aging

“Year of birth is 1913,” I respond. Long pause…. “Is that a problem for your computer?” I ask. “Ummm, I think I can do it.” Another long pause. “OK. You have an appointment for a wig fitting."

My husband’s mother has been concerned about thinning hair for several years. She has been doing research and decided on two good wig places. One is a normal wig store/boutique or whatever they’re called, the other a cancer center with an excellent reputation for seeing that patients have natural looking, flattering wigs.

"Most of our clients are much younger...chemo patients,” volunteered the obviously much younger woman on the phone. “I know you said your mother-in-law didn’t have cancer; but date of birth information is required for insurance purposes even though you said she won't be using insurance. 1913…she’s 96? Wow! And she cares how she looks! I look forward to meeting her.”

I’ve now made the appointment at the cancer center (the normal wig store needs no appointment). Monday will be our day to check things out and hopefully emerge with something to enhance our hair.

I say “our hair” because, although this initially held no interest for me, I have friends in Florida who own wigs so they can look great after a swim--as well as friends who have wigs and “pieces.” This should be fun.

Hair is one of the first things we notice when we look at someone. Hair, age-appropriately styled and in order (as opposed to messy and unkempt), is as important for the young as it is for aging parents who don’t want to look like dumpy old men or little old women—for aging parents who care about appearance.

And now that I think of it, it’s also important for adult children to have a vested interest in their parents’ appearance. Why? If we want to empower and lessen the possibility of strangers categorizing them as old and responding to them in ways that diminish self-esteem, aging parents need to look in order.

Tuesday’s post will have the update.

Tuesday, January 12, 2010

Family+Needy Parents=?

Do you know that "family" has been compared to a mobile—a decorative hanging work of balanced art forms, popular in the last half of the 1900’s? When one of the forms is moved, weight shifts and the entire work becomes unbalanced. To correct this, something must be changed to counter the moved form’s weight.

The same holds true for families. Take a normal two-parent family with children. If one parent gets sick the other parent will try to help out, or perhaps an aunt or grandmother will come in to help keep things "normal"-- to keep the balance, so to speak. So what happens when aging-parent issues cause adult children to take their time and emotional energy from the family and reallocate it to aging parents?

Possibly we all know adult children who become consumed by their parents' problems. It's such an easy trap to fall into. We read about it in the "Sad Story" post about Rodney and his caring, capable, efficient but overloaded daughter. I just learned there was a price to pay. Rodney's daughter and her husband have divorced.

Bringing another person—or another person’s problems--into a family’s dynamics will affect the balance and can create problems. So it helps to keep asking ourselves “What’s the goal?” In both Rodney’s situation and the case of the older parent’s driver’s license, (last Saturday's post) considering these relevant “Key Thoughts” in the sidebar would seem to have been a big help:

  • issues of safety,
  • whether actions and thoughts are in the best interest of the parent or whether they are undertaken to make it easier (or less worrisome) for the adult child
  • whether all possible information was studied before taking action.

Can honest discussion, guided by the key thoughts above, help reasonable people reach reasonable conclusions? While it definitely helps in many situations, the honest response is: “yes,” but sometimes “no.”

Involving an experienced professional (probably a social worker who works with the elderly and their families) can be a great help in resolving conflicts and is an excellent (and probably the least expensive) resource. Some work privately, others work in counseling services or agencies. Advantages:

· An adult child can be helped to realize and understand the impact the added responsibilities have on her/his family.

· S(he) would have support--wouldn’t feel s(he) had to “go it” alone.

· S(he) would have professional decision-making help from experts who’d “been there” with previous clients.

However, let’s face it. When we are overburdened, it's often hard to think about doing things in any other way, but the way we're doing them. So involving a social worker to help with aging parent-family issues may be rejected at first, yet it's worth pursuing. There’s a bottom line to consider: the time spent with a professional counselor can save untold hours of stress and yield good results. A win-win for all.

Saturday, January 9, 2010

Aging Parents, ID's and the Driver's License

Often a topic of conversation when friends who go “way back” get together: “Aging Parents.” And so it was at a small dinner party last night. Many guests had known each other since high school. And when you think back to people you knew well in high school, you realize in most cases you also knew a lot about their families, even their pets.

Last night brought a story from someone who was not part of the high school group. But many can relate to the story she shared.

Her mother had come west to live with this adult daughter (the story teller) and her husband. The mother, relatively healthy but having minor memory problems, said she wanted to get a driver’s license so she’d have an official ID now that she was living in another state. Her adult daughter’s husband was not in favor. Did not want to encourage his mother-in-law’s driving at her advanced age.

As often happens, the adult child felt caught in the middle. She didn’t want to deprive her mother, on the one hand. And on the other, her husband had a point. But since her mother hadn’t shown herself to be a dangerous driver, the daughter gave in and accompanied her mother to the Motor Vehicle Department.

Her mother passed the vision test—no problem. Then advanced from one station to the next—passing without problems. Then she had her picture taken. The last part of the procedure was to sign the official form, which was handed to her to sign. For whatever reason, she was confused about where to sign or how to sign.

The Motor Vehicle Department official seemed puzzled and looked at the adult daughter. Her eyes met his (and perhaps she discretely shook her head). Whatever. He got the message. He explained to the mother that he couldn’t give her a driver’s license, but he could give her an identification card with her picture on it. That wasn’t a problem, she said. All she wanted in the first place was an ID with her picture on it.

Tuesday, January 5, 2010

2010-Connections and Peace in the Family

Thanks to those of you who told me how gratifying it was to make contact with older friends during the last week. It's a win-win for everyone, isn't it?

Thanks also to those who questioned the solution of the "opinionated" grandmother who kept family peace by basically saying everything the younger generation did was "fine." The questioning is valid and the grandmother's solution is appropriate and understandable if we go back, reread and digest the November 7th, "What's the Goal?" post.

In that post I related something helpful from my counseling experience: suggesting that parents ask themselves "What's the Goal?" when dealing with their children's difficult behavior. It's simple, easy-to-follow guidance that's equally applicable here. Keeping the goal first and foremost in mind, when facing potentially heated situations, is just plain smart. It prevents getting sidetracked, prevents exacerbating a situation, and avoids a lot of unpleasantness.

If the goal of the self-described "opinionated" grandmother is to maintain good relations and peace in the family, she has made a decision that works well for her. And this highlights another, perhaps more difficult, aspect: the importance of knowing ourselves and the impact we have on others. Understanding this is not always easy and sometimes it takes counseling to gain this awareness. In any event, having this understanding serves us well as we deal with many challenging situations.

I want to note here that there may be a time when we need to change goals mid-stream so to speak. And that would be a time when discussion discloses that there's a threat to life and limb. While that doesn't happen often, the possibility someone could hurt him or herself or others is serious and would probably necessitate a quick change in goals.

Lastly remembering to keep "What's the Goal?" in mind is as important for the older generation interacting with the younger generation as it is for the younger generation interacting with their aging parents.

Saturday, January 2, 2010

New Year's Resolutions 2010

Many traditions disappeared with the last century yet New Year's Resolutions continue. One teenager thinks today's resolutions are more self-serving (exercising regularly, losing weight) than focusing on others. Perhaps. An octogenarian recalls her teenage resolutions like giving up candy didn't last very long. But she says that her resolution to be nicer to and spend more time with her widowed grandmother who lived with her family sticks in her mind as lasting.

When talking about resolutions that involve family as opposed to self, my small sample of older people (from Arizona, Delaware, New York, and Oregon) care deeply about their children and grandchldren and are making--or have made--resolutions to further cement the relationship.

For example, resolutions to "let go"--or at the least not pressure--when family situations and values upset an older generation prevail:

"I will try to accept what my grandchildren and children do. (I must learn to accept it 'cause there's nothing I can do about it.)"

"I'm going to try and figure out how to take a "stand" that would work and not destroy family relations."

"I speak for myself and other friends--we've just been discussing values. I'm making a resolution not to get upset by the fact that adult children may be wonderful; but they don't value the same material things we do...old family heirloom things: furniture, a cup collection from my grandmother, my great-grandmother's Christmas tree ornament etc."

Other resolutions involve family in a different way:

"I'm going to tidy up this year. If I die I'd hate for my kids to come in and have to clean up all the stuff I've accumulated over the years."

"I'm going to make it a point to listen more, to find out more about my far-away-living grandchildren and what they're doing. I visited at Christmas, listened to their music with them, discussed the lyrics, learned who Taylor Swift is and what's important in their lives. I even learned about hockey and watched a game. My grandchild is a star hockey player. Now we have a commonality to email about and discuss."

"I am going to accept the fact that my far-away living son and family are very busy with their own lives. While they're at the top of my priority list, I know my husband and I are not at the top of theirs even though we all get along very well. So if we want to be with them more often than twice a year, we have to make the accommodations."

"I want to maintain my health (I'm 92) so I can be around to see my great-grandchildren develop; and I want to keep working at my business."

One admittedly "very opinionated" grandmother says "This is a big stretch for me, it's so unlike me not to say anything, but I made a resolution years ago--I have many children and grandchildren--and it has worked to keep our family together. It goes like this:
Whatever they do is fine.
Whatever they say is fine.
Whatever they want is fine."

It seems adult children and grandchildren, whether living near or far, live large in their parents' and grandparents' minds, perhaps even beyond what we might expect. A 92-year-old puts keeping herself in good health because she wants to watch her great-grandchildren "develop," ahead of continuing to run her business. That says a lot. Is a New Year's resolution by adult children and grandchildren to make an effort to regularly communicate with and include the older generation in order? Perhaps it already exists.