Saturday, July 30, 2011

Aging Parents' Secrets: Tips for Getting Parents to Dislose Them

Aging parents' secrets.  Paving the way for them to share with us.

"If parents  keep secrets, they may well feel guilt about it," according to Dr. Bud, our Senior Advisor psychiatrist.   Confiding in someone can rid them of guilty feelings--be it someone outside the family or a family member if they feel the latter is safe and "coming clean" won't result in forced moving to assisted living, being car-less, or worse.

In my July 24th post, we learn that an 88-year-old woman suffered numerous falls, without telling supportive family members, and ultimately a broken hip. All caused by poor balance that a device in her shoe would have easily corrected. We learned some of the reasons in that post.
Tips to encourage secret sharing:

Mindset: think "tuning in to the age--to the stage in life--to the degree of their concern and our concern; realizing maybe it's also aging parents' concern, but they don't want to talk about it," suggests Dr. Bud.

Next look for opportunities--perhaps in other people-- that "open the door" for discussing commonly-held senior secrets. Simply using anecdotes about others will convey your empathy, compassion and your aversion to quick judgments and knee-jerk reactions.

Three examples of conversation starters:
1. Hearing about someone: "I saw your friend, Edith, the other day. She's now using a walker.  It must be really tough on Edith....."
2.  "Jim called me this morning. Said he didn't sleep well last night.  He made someone a promise it's not correct to keep, and it's bothering him because it's something the family needs to know--it involves an older person's well-being. He's really in a tough spot."
thinking out loud
3.  "I was getting out of the car. An older woman--older than you, Mom, fell then got herself up; and it occurred to me is she going to tell someone or is she afraid? And I thought about you and checking these things, and would you be able to tell me if it were you?

When we construct these scenarios, it helps aging parents understand not only their own fears but our sensitivity to them. And when older people can confide secrets, they get through the guilt or fear or feelings of foolishness (can acknowledge their fault if they did something stupid--ie. lost something important).

Dr. Bud agrees that it's OK to tell a little white lie by making up a story as in the above examples. It hurts no one and can lead to conversations that significantly affect older people's well being.

Dr. Bud also thinks acknowledging fear is helpful. There are probably many opportunities to do this--in an arm's length way of course.

Aging parents' friends are no doubt experiencing issues that could necessitate giving up their homes, their cars or making other significant changes.  Hearing about these issues from parents, presents an opportunity to chime in with something like: If the doctor recommended it, we would have to listen to his/her reasons before making a judgment and also see what others recommend--which could involve getting a second opinion. Have they thought about that?

Hopefully in our efforts to help parents age well some of these anecdotes define our empathy and understanding and make parents feel safe to share secrets. Remember our parents have known us for a long time.

Visit my other blog:   Same post, more information

Wednesday, July 27, 2011

You'll see this comment below Saturday's post.
"What a great article, it’s so true- seniors avoid telling their children important things for fear of the reaction. It would be great to get some tips on how to have these conversations with our aging parents, and yet still respect their independence and dignity."  
I've heard people say it's sometimes easier to "share feelings with strangers." Trying to personalize this I immediately thought of being on an airplane, sitting next to a complete stranger and sharing a conversation containing thoughts and feelings that could never have been shared with someone who knew anything about me or anyone who knew me  Have you experienced this?
There's a degree of safety in anonymity and there's a degree of safety on a plane.  There's also objective listening on the part of both participants, who know nothing about each other so if there's a judgment to be made, there's nothing personal attached--nor can anyone come back later to say "I told you so" (or "not to" or whatever).
Can this translate into a conversation of shared secrets with aging parents? We share secrets with parents when we're kids; but it doesn't seem to be prevalent the other way around, does it?
So the question is, can we create a safe environment in which aging parents feel as safe sharing secrets with us, as they might on an airplane with a stranger?
And here's what I see as the problem: With a complete stranger, trust isn't an issue since no ones knows who we are and we've chosen what we want them to know about us.  If we owned Harry Potter's wand, we could make the relationship with our aging parents disappear...and come back as new. But we can't, so how do we develop that trust? Must it be nurtured decades back? Is now too late?
I have some thoughts which I wanted to bounce off Senior Advisor, psychiatrist, Dr. Bud, but he's unavailable for a few days. In the meantime, feel free to contribute thoughts, and I'll be back Saturday--hopefully with a few good don't go away for long.

Visit my other site:  Same blog, more information

Tuesday, July 26, 2011

Tuesday's post Delayed Until Tomorrow

The renovation of the apartment plus things requiring attention but ignored in order to get our home ready to sell, made it impossible to post today's blog.  Tomorrow should work fine, so check back the later part of the day.

Sunday, July 24, 2011

Aging Parents' Well-being: 4 Things They Won't Tell Us and Why

The following situations and reactions are not exclusive to aging parents. Where older people are involved, however, the consequences are different.  They can significantly change parents' lives. Even in the best of relationships, most parents won’t tell us--

  Why? Pride: A remarkable 88-year-old mother fell and bounced back to normal many times without anyone’s knowing (or if they knew, they’d been sworn to secrecy) until she broke her 88-year-old hip and her devoted daughter found out. It turns out a simple corrective device, placed in her shoes, was all that was needed to solve the balance problem that caused the falls in the first place. But the solution came after enduring surgery and rehabilitation for her hip. While she’s still a spunky and amazing 88-year-old, it did “take her down a notch,” according to her daughter.
  Why? Fear of being forced to give up their home and go someplace where their adult children think falls are less likely—be it moving from a home with stairs to a one-floor apartment or to independent or assisted living, or coming to live with their adult children (granted, much less likely today than it was in previous generations).

  Why? Fear they'll be made to stop driving. But this needn’t be if solvable medical issues are involved and family members know about resources that evaluate older people's driving and may help them to drive longer: (click "health and safety" for The Effects of Aging on Driving Skills). Check AAA's brochures, click "products," "free," and scroll down for brochures that resonate ie. The Older and Wiser Driver and Drivers 65 Plus.

If safe-driving parents can legitimately continue to drive (possibly aided by programs like CarFit), it's easier and happier for everyone. If parents are no longer qualified to drive, it's based on objective evidence.

  Why? They still feel protective towards their children, don’t want to burden them, especially if the children have their own problems of deal with.
  Why? They don't want to chance being told what to do, they want someone to listen-- someone who they know cares--to bounce ideas off of.

  Why? No one wants a lecture or being told what to do, be they children, young adults or old adults. One independent-living, 80-something-year old father said  several years ago: “I told my daughter I was going to the movie with a friend and immediately was told it wasn’t wise because of swine flu. Come on. Children and people with certain conditions and are most at risk and I’m neither.” Another 80-year-old sums up the feelings of many when she confidently says “I still think I can make my own decisions.”

How many aging parents can identify with the short poem below?  Can't remember where it came from, but I saved it.

Our children have knowledge of important things
Things that they think we should know
Forgetting we told them those very same things
When they were young-- years ago.

As we try to help parents age well, it's food for thought.

Visit my other site:  Same blog, more resources

Saturday, July 23, 2011

Saturday's Post Postponed Until Sunday

Once we've moved I expect to post as originally planned--Tuesdays and Saturdays.  While in this transition, so much is unpredictable; so like today, there will be--and have been--times I must postpone my blog by a day.

Tuesday, July 19, 2011

Entertaining Aging Parents: Destination Outings and Short Drives

WHERE?  A drive of an hour (more or less) offers a change of scenery--a beautiful view from any coast, lake, or river, plus a perfect setting for lunch (or picnic if doable) with aging parents. (Remember the water and sunscreen.)

Touristy or not natural attractions take people out of themselves, into what's real. Clearly a change for aging parents who don't drive much--or at all.

For example, I think of Multnomah Falls (Columbia River Highway out of Portland, Oregon), which Sr. Advisor, R, visited with us 2 summers ago, when she was 95. Loved the drive along the river, the falls is spectacular, and the restaurant lovely (check to see if reservations are advised)...or take a picnic.

Last weekend, for example, we were in Massachusetts--the Stockbridge, Lenox, Williamstown, Bennington area--all within a short driving distance. Lots of music, art plus theater and dance. (Such options may be near you.)

We attended two Tanglewood performances--the Boston Symphony at night; the Boston Pops on Sunday afternoon. These kinds of concerts attract older people--lots of gray hair and canes and a few bus tours at night; loads of walkers, wheelchairs, canes as well as an uncountable number of buses, clearly marked "Senior Tours" for the daytime Boston Pops.

It seems loads of aging parents and grandparents enjoy summer music outings; so many take day bus tours.  An older woman in front of me proudly told me she had driven herself to the Sunday concert. She lived close and was soon joined by the 40-something (thoughtful) neighbors, who often give her a ticket.

Culture abounds: The Clark museum (Williamstown, Mass.)-- world-class paintings, user-friendly for older people (handicap accessible, wheelchairs, elevators, benches, excellent cafe). The Norman Rockwell Museum in Stockbridge, Mass. and the Bennington Museum in Vermont with its Grandma Moses collection, are gems. The latter should be uplifting. Grandma Moses was still painting at 100.

When living near parents, driving them to small towns they used to frequent but don't drive to any more, is a welcome outing...sometimes perhaps they can bring a friend. I know Sr. Advisor, R, has a friend whose daughter often includes R in short outings. She has a wonderful time--it means so much to her...and she usually treats them to lunch.

Zoos, local museums, a drive around the old neighborhood (past their old school if it's still standing), a picnic in a park, an unexpected trip to the mall--the options are only limited by our imagination and, I guess, finances. A destination outing or a simple drive with lunch or a midday meal helps parents age well--gives older people a lift--something to think and talk about. And we too can enjoy that.

Visit my other site for photos 

Saturday, July 16, 2011

Help Aging Parents: Discussing End-of-Life Issues

Discussing end-of-life issues with aging parents is uncomfortable for so many. Several previous posts discuss this, focusing on various aspects. For example, "Aging Parents, Adult Children: Control and End-of-Life Issues" (9/10/10) points out some of the reasons these discussions don't happen:

1. Denial on the part of parents and children (note: denial is an unconscious mechanism that keeps us from dealing with something until we are ready)
2. consciously not wanting to face the inevitable
3. superstition (if we talk about it, it may happen)
4. keeping children clueless (maintains parental control).
Dad was in his mid-80's. We needed to have this kind of conversation which I had thought about for quite a while. The question was how to begin. I don't remember exactly how I ultimately broached the subject, but after Mother began having tia's I managed to do it.
Fortunately the Wall Street Journal has just paved the way for such a discussion in an article aimed at older people, The 25 Documents You Need Before You Die (July 2, 2011). (Children in their 50's are used in the examples.) It is helpful, excellent information for aging parents. And therein lies our opportunity--or at least step one.
Our senior advisor, RHW, Esq., reviewed the article, thought it was very well done and offered one addition.  The article lists will, revocable trust, and "letter of instruction" as "The Essentials." While the Durable Financial Power of Attorney is mentioned as an "also" in the essentials paragraph, it is not an "also" in his opinion. 

He emphasizes "more than enything else the Durable Financial Power of Attorney can prevent the courts from having to appoint a guardian or conservator--an expensive and often cumbersome procedure." It is essential in giving parents control over who has this financial power and should be a 4th "essential."  You could mention that for starters--or not. Period.
A discussion about wills etc. needn't take place the moment we hand parents the WSJ article or (if they're WSJ subscribers) ask them if they've read it. We'll know, however, that they have good information at their fingertips. And isn't helping parents get their affairs in order part of helping parents age well? ......Of course we'll also know we've opened the door for future discussions.
Check out my other site:  More information, same blog.

Tuesday, July 12, 2011

Aging Parents: Taking Medications--or Perhaps Skipping Them?

How difficult is it to remember to take medications? Do the number of medications and a good memory determine that? Or is there more to consider? (Of course, read on.)

For young adults it's easy.  Most have few prescription medications and probably some vitamins--no doubt often gulped down at the same time each day. But what about older people and aging parents?

People over 55, on average, take  6-8 medications daily, according to a July 5, 2011 NY Times article.  I wonder if that number includes vitamins.

Dealing with 3 medical conditions is average for a 75-year-old, according to the Alliance for Aging Research presented in a Tufts University Health & Nutrition Letter article (August 2002). This necessitates about 5 prescription drugs simultaneously, although the article says the number could go as high as 15 prescription drugs.

There are of course organizers--from the inexpensive plastic pill-organizing boxes to the more expensive technological products like Philips and Guardian that remind people to take their medications.

But this may be only part of the issue.  The July 5, 2011 NY Times article, "When 'Take as Directed' Poses a Challenge" addresses  another important aspect. It never occurred to me that "take every 12 hours" and "take twice a day" could cause confusion or be burdensome.  In our efforts to help parents, who take medications, age well, this article is more than worthwhile....and if you wonder if aging parents may be skipping medications, it's a must-read.

Saturday, July 9, 2011

Help Aging Parents: Downsizing, Leaving Home, and Loss

Being smack in the middle of downsizing--preparing to move after decades in one's home--is daunting.  The thought was daunting even before we began.

Everyone comments "How exciting!" when hearing a NY city apartment awaits us. True, it is exciting to think about moving back to NYC where we lived for several years after graduate school; but we've been too busy to give much time to that kind of thinking.

Another kind of thinking continually pops into my head, however. It's the thought that moving from one's home at any age is unsettling.  When we consider the stress and feelings we experience and we've initiated the move, we can understand why thoughts of moving from their home is so distressing for older people.

 3 Reasons

If it's a move that aging parents haven't initiated, often to assisted living on a "campus" with facilities for levels of care, it's in-their-face recognition that:
---they are unable to carry on life as they have for so many decades
---others recognize this and no longer have confidence in their abilities to remain as  independent as they have been
---this is probably their last stop before the cemetery.

Moving under these circumstances understandably triggers feelings of many types of loss: of abilities, of self-esteem, of independence, of optimism.  It must be accompanied by an overarching sense of what was and what lies ahead.  For older people who feel forced to move this must be very sobering.

I think of all the memories that surface with every box and folder that is opened, with every photo and piece of saved stuff that is examined. My husband and I smile and think of how of good it was, forgetting the challenges which seemed so big at the time.

We are looking forward, not moving that far from our present community, and it's exciting.  Yet I know realistically there will be a time when we will look back, assuming we reach a ripe old age. Upon reaching 89 Dad often said, "When you can look back many more years than you can look forward, you know you're old." I truly don't think he felt old until he began saying that.

Perhaps it's because he never had to move, he never confronted that kind of sobering change and the feelings of loss that go with it. Yet clearly, living that long, Dad experienced many kinds of loss.

Understanding the components of moving--which involve change, energy, downsizing, and organization and loss--provides us with sensitivity to their impact and understandings to help our aging parents and think twice before initiating unnecessary change. Won't it also help us when the time comes?

Check out my other site:  Same blog, more information.

Thursday, July 7, 2011

Downsizing Aging Parents' Homes: Energy, Organization Part 2

According to the Myers-Briggs (its short-cut name) I am an ESTP and I'm positive my husband is an INTJ, even though he's never taken this inventory.  Very simply, our preferred way of doing things (which is what the Myers-Briggs scores) is quite different, even though we share values and the way we look at most things.
Note the first of the 4 letters.
My husband, the high-scoring "I" personality type--thinks before taking action. Example: the student who wants to digest the question and carefully think out the answer before raising his or her hand. On the other hand, the high-scoring "E" personality types' hands go up first, even if they have only a partial answer. More outwardly active describes the "E" personality type. (Teachers learn the slow-to-raise-their-hand-kids may have just as good or a better answer than the kids with the quickly raised hands.)
Then there's the 2nd letter showing our preferred way of looking at things--the Forest or Trees? High-scoring "N" types see the forest first (the overall picture, macro). High-scoring "S" types see the trees first (the specifics/details, micro).
We both scored high on the third letter "T" (thinking).  The other option is an "F" (feeling) and while I scored higher on the "T" part, I scored pretty high on the "F" part also--which happens. High-scoring "T" types begin thinking when looking for answers; "F" types lead with feelings.
Lastly, my husband's "J." High-scoring "J" types judge quickly; they put the facts together, make a decision. Done.  On the other hand "P" types take longer to make decisions--they're thinking of every possible option.
This is all very simplistic. Yet it helps us appreciate others' ways of doing things.
So how do we go about organizing for downsizing and moving?
As we work and organize with others--and realize we may approach things differently and still have successful results--we share the burden.
My husband and I give each other space to work in our comfort zones, although I'm certain my husband secretly wonders if I will even get through all the drawers, closets, boxes, papers etc.
He in his "super-organized fashion" decided to tackle the boxes of stuff in the attic first, then go to the file drawers.  I tackled things as the spirit moved me.  First: my clothes (closet and drawers). It felt good to give some away to people or to those clothing drop boxes, and to see closet and drawer space expand.
We both agreed about books we would keep, so that was easy; meanwhile, his boxes have been emptied, material shredded, keepsakes and meaningful stuff saved.
Needless to say, my pile of saved objects is larger than my husband's due to my "P" inclination.  I see many future uses for things, which causes delayed decision making.  I must remind myself I did score much lower on the "J" part of my preferences.  And I know my "P" inclination to save could keep me from ever finishing the task ahead, so at times I make judgments--dumping things I've come to realize I'll never use again, before I can change my mind.
My scattered successful attempts are not nearly as noticeable as my husband's dozens of empty cartons and cleared folders, but I know I'll finish by our deadline.  Fortunately, he leaves me alone to plow through in my own way. After many years he realizes I do meet my commitments on time, my way of doing it is just not his way.
If you want to delve further into Myers Briggs, check out the organization's site:  click My MBTI Personality Type then MBTI Basics or  / Indicator and scroll down to "Types."
You can take the inventory on line although I can't judge the sites. (I took it in class, under the guidance of a professional.) So I add a disclaimer as to its validity but for fun you might try the site above or
PS. The "S" in my  ESTP initially saw the specific contents of our home as overwhelming. But once I found a specific starting point that inspired me to action, I was on my way.
Good luck!

Tuesday, July 5, 2011

Downsizing Aging Parents' Homes: Energy, Organization Part 2

Good organization obviously saves energy, time, friction. Clearly some people seem born as good organizers, while others??? Clearly aren't.
Downsizing and moving involve daunting tasks--believe me, I know first hand right now.  I've also always known my husband is an excellent organizer--much more disciplined than I (I'm more often propelled by instinct and inspiration).
We are different personality types and have different ways of accomplishing things.  And we both get them done, which is the point of this post.  There is no right or wrong way if the goal is met.
More specifically there is a well-known personality type "test," the Myers-Briggs Personality Type Indicator. There's no right or wrong answer.  For example, if I ask you to raise your hand, some will raise the right hand, others the left.  There's a preferred way for some (use the right hand) while for others it's the left hand.  But neither way is better.  We teach this in some depth to our 10th graders.  You'll catch on quickly also.
Without going into too much detail, I'll illustrate examples as they affect my husband's and my organization for this move. When people work well--and the same way--together everyone is on the same page and things should work well.  But when people's way of organizing is radically different, needless friction can arise. Obviously if help is needed from someone who's never organized and who can never be counted on, a completely different strategy is called for.
We're talking about behavior here and organizing for a common goal. Since I only have time to write in snip-its due to my current downsizing/moving situation, tomorrow I will present opposite organizational habits with equally successful results. The immediate goal is to help aging parents when they need to downsize or move. Understanding the way they effectively organize (or not) and the way we organize should help things go more smoothly.

Saturday, July 2, 2011

Downsizing--Aging Parents' Homes...How Much Energy Does It Take?

.................And whose energy?

A former colleague, Anna, now a current friend in her late 80's, phoned me yesterday to tell me she was going away for the weekend; she was also wondering how I was progressing with our downsizing.  I enumerated the things I'd been doing and the fact that I was very tired at the end of the day. I started thinking about the impact of aging on one's energy.
I remembered a lunch date with another former colleague, a year ago. Because she's almost 60, retirement was part of our discussion.  And energy was a big part of that discussion.
She's a master teacher and brilliant. She has published, has a stellar reputation and a devoted following of students. While she believes that she's an even better teacher than when she was younger, she is also aware that the energy you have at almost 60 isn't the energy you had at 50. Looking back we agreed that in your 40's you have a great deal of energy, definitely enough to spare.
I've long held the notion most of us reach our peak in our 40's, remain at that level for quite a while. Yet, almost imperceptibly, energy begins to decline. We can easily compensate for it initially because we are older and wiser. But it finally catches up with us.
Less than two years ago Anna and her husband downsized from a large home with over 50 years of accumulation to a good-sized apartment. Anna's mind is excellent, she swam daily until the house was sold and she remains interested in everything.
Her many children and grandchildren were only too happy to help these aging parents/grandparents pack and move. But Anna tells me that, although she didn't have to be concerned with the physical part, the mental energy required was tiring.  Even after showing younger people what needed to be done and how to do it, it often wasn't done just the way Anna wanted. So she did much of it herself.
Can adult children argue with that? If we're creating additional mental stress while trying to be helpful and preserve older peoples' energy, are we helping? And how do we help in a way that respects everyone's wishes, time, and abilities? If we can answer that last question, we can offer our greater supply of energy, have grateful aging parents and grandparents, and feel good.
But most of our parents (as well as ourselves) put off downsizing until we realize we aren't as able as we were and may not have the energy if we wait much longer. The earlier everyone starts, the better.
Note, Boomers:  Some children, who are old enough to care, could care less about their parents' treasures.  Some parents--aging or not, moving or not--are giving things to their children, including old photos that may or may not be in albums. (The photos  of course need identification if they're to have meaning. I think we all know the frustration of looking through an old family album lacking identification.)
It takes a lot of energy and time to go through shelves and drawers, photos and folders of papers. If you're like me with deceased parents who kept everything--you not only have your things to evaluate, but must read and double check theirs before recycling one scrap of paper. Why?  Because, for example, my parents haven't been gone long enough for me to legally shred everything.
My almost 98-year-old mil, Sr. Advisor R, on the other hand, (recently recovered from her broken hip), is conscientiously tossing or giving "stuff" weekly.  Her energy hasn't returned completely, but she is disciplined as I've written previously. Says she doesn't want us to be stuck with it.
When aging parents aren't mentally capable, it's another story. But when they can do, if we didn't know how to help before, why not reread paragraphs 7, 8, and 9? Hopefully we can adapt the concepts, help our aging parents, help ourselves, and perhaps even our children.