Your doctor may not even be aware they are prescribing medications that place you, the older adult, at risk unless they know about the Beers Criteria which is a result of research performed on medications that indicate high risk for older adults. Check out the list for yourself by doing some research and ask your physician about any medications you might be taking that are on the list.
The general public seems to accept divorce when it occurs in the young but when parents, especially older parents divorce the tragedy often affects grown children. More and more frequently divorce between older adult parents results from health care issues. One parent is ill and the other does not wish to have their entire retirement savings depleted to provide care for their spouse. Sometimes it’s a practical solution to avoid Medicaid. Other times it’s a situation where the health spouse simply wants out of the situation and until death do us part becomes until you become sick and I don’t want to care for you!
There are many types of different communities for older adults ranging from little or no care to twenty four hour care. These include: active retirement communities, gated communities of care, independent living, independent with services, assisted living, personal care homes, memory care, long term care/nursing homes, respite communities and hospice. It is important to assess current needs and project future health care needs to ensure that you or your loved one does not need to move again unnecessarily as each move is more difficult and disruptive than the last.
Available finances are also a long term consideration. Will your loved one be able to afford to pay privately or is Medicaid an eventual likelihood? This requires special planning. What about current and future health care needs? Is long term care insurance available? There are many considerations in planning for long term care needs that effect decisions related to an appropriate choice of a care community.
When seeking assistance relative to a care community for you or your loved one, it is best to consult an expert who can take into consideration all things related to long term care and who has no interests but your best interests, meaning that they are retained by you for a fee.
Many self named housing experts do not charge clients for their services, their services are touted as “free” however they receive financial incentives from the communities they recommend to clients. These housing experts do not look at the long term picture related to care. Nor are all communities willing to pay the “free service” providers, thus families may not be shown an excellent community that does not believe in offering undisclosed financial incentives or finder’s fees. If something is too good to be true, or free, there is a reason.
Ask how service providers you retain are paid and make sure they are working in your best interest, not the best interest of the communities or service providers they recommend — or it’s likely the next move for you or your loved one will not be the last move.
As owner of The Care Navigator, the company does not accept referral fees or financial incentives from business with whom we work as doing so would result in a conflict of interest. We refer the best businesses and communities for our clients and work only in their best interest.
In my weekly radio program, Parenting your Parents (www.parentingyourparentsradio.com), adult children frequently call to express frustration that they moved their parents or that their parents have moved only to be faced with having to move again. Why does this occur?
The need to move parents again often occurs because individuals or families did not consider planning for the long term. They planned for what they believed were needs for today not realizing that health care problems will arise and that care needs will increase as age advances. The situation also depends on the age at which an older adult first relocates. An individual moving at age 65 into an independent retirement community may be able to live in the same community for ten or more years. An individual at age 85, moving into an assisted living community, may only remain in the assisted living community for about two to three years until care needs again advance.
By the time an individual requires an assisted living level of care, consideration must be given to the realization that at some point near in the future, depending on the health of the individual, a higher level of care will be needed. Consideration must also be given to special care needs, such as individuals diagnosed with dementia or Alzheimer’s as a large percentage of individuals over age 85 have this diagnosis in common. Complications such as incontinence, vision difficulties, mobility difficulties and behaviors also must be taken into consideration.
If, on the other hand, both parents are in denial then the burden of initiating the conversation falls on you. It is slightly easier if you have been involved in the care needs of your parents because you have direct experience and understand their needs. You can also mention that as their care needs increase (and they will) you will be unable to meet these needs alone, thus the need for an evaluation and a plan. If they continue to resist you may have to draw the line by not offering any assistance until they are willing to compromise or have a discussion about planning for care needs. This is often a last resort and results in feelings of helplessness and hopelessness on the part of family members.
There are other situations where you may not have seen your parents in some time and you are shocked at the situation in the home and their inability to comprehend the seriousness of the situation. Your parents are both at risk physically and financially. This is the time when it may be appropriate to also contact a care navigator and an elder law attorney to discuss options for your family.
Relationship difficulties within families are more common than many believe. However it is important not to allow these difficulties prevent parents or loved ones from receiving needed care or making long term plans.
Are your parents at the point where the need for help is no longer optional? Have you talked to them about the subject and received a cold shoulder from one or both? Relationship difficulties are often at the root of challenges in accepting or discussing the need for care. These challenges exist not only between parental relationships but between relationships between children and their parents. Caregiving and long term care are subjects many find uncomfortable to discuss. Confronting our own mortality is difficult.
The challenge begins with the relationship between your parents. You lived with them as a child and likely remember which parent made most of the decisions, managed the finances, served as disciplinarian or organized the household. You may recall how well your parents managed or avoided conflict. These challenges do not become easier when parents age, they become more intensified, more prominent. And parents often resist when children suggest that they need help because they are the parent; it’s their job to give their children advice, not vice versa. Nor do parents want to be reminded that they are aging and may need help.
When one spouse needs care and the other resists, the situation becomes even more difficult. The caregiving spouse often receives pressure or experiences acts of retaliation from the resisting spouse. This child-like behavior likely existed during the marriage but in a much smaller scope. It often prevents or delays the caregiving spouse from receiving support for themselves or in caring for their loved one. If you are a child with parents in this situation this is the time to give your support. Talk to both of your parents about how the situation would benefit from an outside assessment to determine care needs. This takes the pressure off individuals emotionally involved in the situation and allows for discussion based on factual information. Give support to the parent needing care; however be realistic in your discussion so they know that not making the decision to accept help places the other parent and themselves at risk.
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