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Throughout our lives we are usually identified by our
roles as son, daughter, brother, sister or parent. As
our parents age, however, roles often reverse or take on
new meanings. Because today's baby-boomers increasingly
find themselves assuming the role of "caregiver," they
begin to feel the necessity to become proactive in the
care of one or both parents. Issues surface that have
remained buried. Parents often find themselves battling
their adult children for authority in decision-making. Adults with elderly
parents need to educate themselves, not only with
written information but also with personal knowledge of
their parents' habits and problems. Timing is
everything, and that old adage certainly applies
to assisting a parent make the transition from
independent to needy or problematic.
Open communication
with elderly parents is the optimum situation but one
that is not an option in many families. Short of this,
adults with elderly parents need to realize that they
will always be the "child" in the eyes of their parents.
Baby boomers not only respect authority but are much
more health-conscious than those over 65 who feel
surprise at their still-existence on earth. Elderly
parents may never openly admit a problem or ask for
help, but the educated, alert offspring can easily pick
up subtle clues. Visiting parents presents an
opportunity to notice changes in habits. Slowness in
dressing, eating and walking are obvious changes. A
prolonged delay in opening mail or driving a familiar
route should be considered a cry for help.
A brief review of
the medicine cabinet can also provide offspring with
important medical knowledge as to what medicine is being
prescribed, not necessarily taken, by their parent. This
is by far one of the most common problems children face
when dealing with parents who are just beginning to
fail. While a parent may give up the fight in going to a
physician, and while the same parent may follow through
in getting a prescription filled, it is quite common for
the untouched bottle to remain in a medicine cabinet or
nightstand drawer. Breaking down and taking the medicine
would be admitting to themselves that a problem exists,
and this is simply not an option to many elders.
Therefore, adult children should be keenly aware of the
types of medicines prescribed and familiarize themselves
with the medical problems to which the medicines are
correlated.
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Rather than
involve the court system or attorneys as elders
begin to fail, adults need to reach out to
siblings, relatives, church friends and
volunteer services. Many siblings today live
hundreds of miles apart, and in many cases also
lived far distances from their parents. Family
members, all of them, need to become proactive
in the management of their parents' healthcare.
The familiarization with prescribed medicine is
the first important step, and if the elder
refuses to discuss their medical problems,
offspring should establish a relationship with
their parents' physician. The medical community
often welcomes this show of caring; however,
others dissuade the intrusion. Family members
should never withdraw when the first door slams
in their face, but should persist until finding
a method to establish some sort of common ground
with their parents' healthcare provider.
The alert,
knowledgeable offspring will also be more
prepared to deal with deeper issues as the
patient's condition worsens. Nursing homes and
home healthcare, in combination with finances
can become a full-time concern. Parents are
often reluctant to discuss both their medical
condition and financial situation with adult
children, but when health deteriorates to the
degree that outside help is necessary, it is
vital for the primary caregiver to be aware of
both. |
Most importantly,
children should be aware of their parents' insurance and
exactly what it covers. Financial awareness is crucial
here, for few elders are totally covered by any
insurance plan. When nursing homes appear to be the only
alternative to independent living, children often begin
to question the feasibility of having a parent move in
with them. Ironically, government aide is available to
eldercare housing facilities but not to adults who care
give to parents within their homes. The financial burden
to children is often the deciding factor in the decision
made regarding the elder's future home. Again, the more
knowledgeable the offspring is regarding insurance and
costs of facilities (including transportation, medicine
and meals) vs. cost of moving a parent into the child's
home, the easier a reasonable decision can be made.
On a personal note, my mother passed away in April
1999, after a yearlong illness. Before she lost the
capacity to communicate, she struggled to clarify all
legal matters to me, her only child. Utmost on her mind
were specifications regarding stocks, bonds and bank
accounts. This one act on her part enabled me to be
proactive not just in her medical needs but her overall
financial needs as well.
Every family is
different, as are the needs for every caregiver.
However, money seems to be one of the more basic
concerns for all parties involved. Regardless of whether
Mom is to be placed in a Nursing Home or move in with
offspring hundreds of miles away, money often becomes
the deciding factor upon which life-altering decisions
are made. Insurance companies need to be contacted to
find out what coverages policies provide. Financial
information is crucial in assisting adult offspring in
making decisions regarding the parent's healthcare.
A second
controversial issue between elders and their offspring
is independence, or the lack thereof. Mom has driven to
the grocery, drug store and all points in between all of
her adult life, only to be told now that she no longer
possesses the ability or good judgment to drive. In the
best of circumstances this is stressful, but to those
whose parents have truly lost the ability to make wise
decisions behind the wheel of a car, it can be
devastating. Now the subject of transportation becomes a
major issue. Who is to take off work to transport Mom
(or Dad) to the doctor? Chances are, Mom or Dad will
disagree with their limitations, thus setting the stage
for further confrontations. Battles never "solve"
confrontations; they merely deepen the resentment
already felt among all parties involved.
The loss of driving
ability, the relocation of a parent, and the need fo r
questions involving financial matters all are underlying
courses of the biggest fear an elder has. This is the
fear of losing independence. Although offspring
caregivers must deal with numerous situations as they
arise, the elder fears losing their "rights" more than
the sum of all the other parts. There's a juggling of
guilt vs. need for the elder. It is a battle that is
never quite won. We as caregivers need to be fully aware
of that battle raging inside the elder while we cope
with the daily tasks of caregiving. Any adult child with
the potential of caregiving should make it a priority to
watch for signs in aging family members for the onset of
illness or failure. Awareness can provide a caregiver
with the advantage he/she needs to plan, take necessary
steps, consult with health care professionals and be
prepared for what may lay ahead. Refusing to face the
inevitable cripples the caregiver, and ultimately the
elder, as the caregiver has chosen to remain ignorant of
choices that can and should be made.
Thousands of
articles, hundreds of books and numerous movies have
been based on the subject of caring for the elderly.
What has not been emphasized to the full extent is the
subject of what the elder experiences as his or her
world collapses, health deteriorates and independence
disappears. Those of us who are adult children and are
or have cared for an elder have no doubt witnessed
firsthand the effects that the loss of independence have
had on our loved ones. We take for granted so many of
life's "little things.” Last minute additions for dinner
only require a short drive to the corner market. The
batteries for the TV's remote control have gone out and
we have to manually get up to change channels. The phone
rings and you remember the cordless phone is still on
the charger instead of perched by your easy chair, which
makes you have to disengage yourself from the cushions
if you want to talk to the caller. These examples are
common in our daily lives and are easily rectified,
although most of us would classify them as impositions.
Now realize what an elder who is barely mobile or
perhaps already bedridden would go through in similar
circumstances. In the first place, she wouldn't be
fixing dinner and would only hope that a loved one would
be preparing it for her. To her, that would be the
imposition, having to cause further work for someone she
loved. Secondly, if her remote's batteries ran out,
chances are she would have to wait until a loved one
remedied the problem or merely shut the television off.
There again, to the elder the imposition would be in
having to rely on her caregiver for help instead of
being able to handle it herself. And the phone ringing?
Elders who are farther in their journey down the final
path of life rarely want to talk on a phone, much less
struggle to reach for it or find it amid their sheets or
blankets.
We all want to
believe our parents will live forever. We often don't
see them as men or women. They are simply Mom and Dad.
When we are faced with role reversals and find ourselves
making the decisions and often saying "no" to the people
who always made the rules for us, it effects all of us
in different ways. There are no rules for this game, and
no "rights" or "wrongs.” There are merely guidelines
from which we can take advise from those who have dealt
with these issues before us and hope we do all within
our power to make our elder's last years, months, and
days on earth peaceful, comfortable and loving. We must
go with our inner feelings much of the time as to what
would be right or wrong for our loved one, and as our
elder sees how difficult the attempts are on our part,
he or she often is willing to compromise on situations
that could have caused major rifts within the family.
The issues with which we must deal are numerous and
diversified, but the more open those involved can be
with each other and the better communication they can
achieve, the more successful they will be in working
toward the end in harmony and peace.
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