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| | by Janet Louise Gibson
We plan ahead for everything—birthdays, anniversaries, vacations, meetings, trips to the grocery store… For the birth of a child, we spend nine months in concentrated preparation. But when it comes to our senior years, or those of people we love, we fall flat.
Our youth-obsessed culture neither embraces nor celebrates aging. Americans in particular have a tendency to ignore the elderly and greatly fear illness, dying, and death. We have migrated away from our families. We are working and caring for children. We no longer have multi-generational households. Therefore, when we find ourselves or a loved one approaching life’s last crossroad, we are generally under-educated and ill prepared.
Caregivers in their 50s and 60s are trailblazers. Never before has a generation faced the prospect of caring for aging parents or loved ones over such a long time. The near-doubling of life expectancy over the 20th century is good news and bad news. Advances in medicine can keep us alive much longer, but we are socially, psychologically, and financially unprepared.
Chances are that, despite our avoidance and denial, there will come a time when we must assist an aging family member or friend. And, for those who do not die young, there definitely will come a time when we must face the issues of aging—health, finances, living arrangements, legal matters, end-of-life wishes—for ourselves. For so many reasons, it is a daunting task. Left undone, though, it is a formula for disaster.
Helping an elderly parent or friend prepare for this transition is a good preliminary to helping yourself. The basics are the same.
The solution, of course, is to plan ahead. Planning before a crisis can greatly reduce apprehension, fear, frustration, and resentment. It will ease any transition, as expectations and desires, as well as financial concerns, will be understood long before any lifestyle changes have to be made.
It’s never too early to develop “The Plan”
What is “The Plan”? Suddenly we might find ourselves caring for aging parents, siblings, friends, or spouses. We might help with daily activities such as cooking, cleaning, monetary matters, and transportation. Or we may care for them in a full-care capacity at home or as either their advocate or active participant in their care plan in a long-term care center.
*Don’t wait until a crisis forces action. Decisions made during a crisis are rarely the most effectual, cost-effective, or informed. Further, if you wait until an illness or accident to start planning, the person you’re helping may not be able to communicate his or her preferences or financial and medical information, and you or someone else will have to make the decisions for him or her.
Early planning allows you and your loved one to take things at your own pace, emotionally, psychologically, and physically. With more lead time, you are also more likely to find a facility or support services that meet the person’s specific needs.
*Call a meeting. Start by calling a family conference to ensure that information, opinions, needs, and changes are being addressed. Regular family meetings also help to make everyone feel involved. For people with no immediate or extended family, a friend or geriatric care manager can assume advocacy.
Medical information
Following is a list of information and items you should start to gather and topics you should begin to discuss:
*Name, specialty, and contact information for all doctors and dentists.
*Birth date and Social Security number.
*Existing medical conditions.
*Updateable list of results from the most current medical and/or psychological exams and tests.
*List of current medications—prescription, herbal, vitamins, and over-the-counter (OTC)
*What aspects of everyday life are important are important to this person? Does she exercise? What is her diet like? Does she use tobacco or alcohol?
*List of past surgeries or medical conditions.
*Copies of Medicare card and health and supplemental insurance cards.
*Health insurance policies and long-term care insurance policies.
Now is also the time to either prepare or update advance directives. (See article on page xx.) A medical, financial or legal advance directive specifies a person’s wishes for end-of-life care and appoints someone to speak for him when he can no longer do so himself.
Other records that may be part of an advance directive, or maintained separately, include funeral arrangements; a durable power of attorney for financial matters; trusts, executors, conservatorships, or guardianships; investments, retirement fund/pension plan, annuities, CDs, Social Security income, and banking information; asset appraisals and/or inventories; mortgages, titles, and leases. House or apartment keys, as well as keys and rental information for a safe deposit box, are also important to locate in advance.
Research
*Do your homework. Start to investigate what services/facilities are available in the area where the person lives.
*Speak to legal, financial, medical, and religious advisers. Ask what paperwork or actions are necessary to ensure that all wishes and directives can be implemented efficiently. Be very thorough.
*Research any applicable medical or psychological conditions. Be aware of progression, warning signs, what to expect, and how to react.
How to speak to an aging loved one
For the elderly, change is particularly traumatic. Conversation is the key to managing expectations and alleviating fear. Initiate a series of discussions. Be prepared—these conversations can be daunting. Your family member or friend may resist the prospect of losing independence and control. Fear of illness and mortality may make him or her defensive. Resistance and defensiveness can be magnified if you and the person you’re helping have been physically or emotionally distant. The situation is emotionally disconcerting for everyone involved. As always, preparation is the key.
*Ask for permission to have the conversation. It is important that the person who needs help be ready to have the conversation and not coerced. It may take several tries before you are successful.
*Be respectful. These issues are very personal. Remember that it is your loved one who is at the center of this discussion, not you. This is her life and her decision. None of us wish to suddenly be told what to do.
*Be casual initially. For instance, ask the person if she has read of any new research about aging, or tell a story about a friend who might be going through the same situation. Ask for her opinion. This will help make her feel a part of the conversation and, eventually, the decision.
*Do your homework. Have answers to questions that may arise.
*Keep it a conversation. Express your th |
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"As the deer pants for streams of water, so my soul pants for you, O God."
- Psalm 42:1
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