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Posts Tagged ‘aging in place’

In the Movie, “Gran TorinoClint Eastwood plays a grumpy old man who has just lost his wife and his adult children want him to sell his house and move into one of those “nice retirement communities.” This is a classic aging in place dilemma. The adult child thinks he knows best and can’t fathom why his elder parent want to stay put.    Walt doesn’t really need caregiving–not yet–what he needs is to be heard and respected. 

It’s not what the character, Walt Kowalski, (Clint character’s name) wants. Even though he lives in a neighborhood that has changed and is in what most people would call the ‘bad side of town,” it’s where he wants to be.

The surprise of this film is that  Walt really has a soft underbelly and the most unlikely people bring it out–the Hmong Korean family who live next door. He fought in the Korean war and has a derogatory name for everybody. He pushes most people away. He’s rude, spouts politically incorrect comment about everybody, and seems miserable. Only he’s not. He’s created a world he likes. He keeps and lawn, his house, and yes, his car–a 1972 Gran Torino in mint condition. He misses his wife–who happened to be the one person who brought out the best of him–everyday.

In a believable and surprising turn, Walt befriends the Korean teens next door==after the kid tries to steal his beloved car. He becomes a reluctant mentor and eventually, their friend. The Korean family dynamics of closeness and honor is something  Walt admires (even though he doesn’t want to admit it).  Walt sees that this young boy, Thao, who is about 15 and not the thug his cousins are, needs to learn how to be a man. The 17 year old Korean girl, Sue, is like his wife–kind, thoughtful, and patient. She wriggles into his heart and life in tender and poignant ways.

This movie isn’t just about an old guy wanting to stay in his house. That’s just the catalyst. It’s about a quiet and unexpected hero. It’s about a man teaching a boy how to be a man. It shows that sometimes our families don’t get us. They have their own agendas. Sometimes we find family in unlikely places.

An interesting aspect of this film is that it’s a family affair. Clint’s younger son plays his movie son–the busy/upwardly mobile family man who thinks his dad is a fool for staying in that neighborhood and is pushing the move. His other son wrote the musical score for this film. It would be interesting to hear from the three of them what they think of this family’s dynamics and how they plan to handle their own “golden years–or their dad’s.

If you’re needing to talk to your family or adult children about your choices of where you’d like to live and how you’d like to live, start by asking them to watch this film. It can open their hearts and hopefully kickstart and honest–and respected–conversation.

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Caregivers are often told to take care of themselves, and sometimes this advice is a little annoying.

Exactly how am I supposed to take care of me? Not give my mom her pills in the morning? Go to the gym instead?  Not take her to physical therapy? Not help my kids with their homework or fix dinner? Just soak in the bathtub all day? Right…

Yes, the stress builds and you can’t sleep, you’ve gained 40 pounds and you’re pretty sure you’re depressed but you don’t care to go to the trouble it would take to find out. Self care sounds like a fairy tale most days, but don’t think that the self-help movement is some new-age 70s feel good way of thinking. It’s not. In fact, it’s as old as Socrates…

One of my favorite books is Eye Witness to History, edited by John Carey. It’s first hand accounts recorded throughout history, and as a memoirist and writer, I love having a front row seat to the most stunning and scary historical moments man has ever witnessed.

The first account is written by Plato and recounts the death of Socrates. The year was 399 B.C., and for those of you (us) who might be a bit fuzzy about Greek history, Socrates was a philosopher and teacher, (and he’s still widely debated today–both as an individual and for his teachings). He got in a bit of trouble with the Atenian government and was considered a “gadfly”  (a fly who stings the horse into action). He wound up in prison and was proved guilty of corrupting the minds of the youth of Athens (political minds, that is) and was  ordered to drink a deadly mix of hemlock poison, which killed him.

On the last day of Socrates life, his friends, including Plato came to visit him and asked,  “Do you wish to leave any directions with us about your children, or anything else. What can we do to serve you?” 

Socrates replied: “Nothing new. If you take care of yourselves , you will serve me and mine and yourselves.” 

So this idea of caring for yourself first is the best way to care for another isn’t new. It just makes sense and that’s why it’s been around for so long. When we “sacrifice” ourselves for too long, we lose ourselves, we deplete who we are. Sometimes it’s needed–giving all you have–but it isn’t a sustainable long-term model.

During the last couple of years of my mom’s life (she had Parkinson’s, heart disease and Alzheimer’s), I can tell you, there wasn’t a whole lot of self-care going on. I had to pull it out–long hours, lifting my mom, hospital stay after hospital stay. I rested when I could–napped in the middle of the day–or any other time for that matter, took long showers. when my family members could take over “mom duty.”

I simplified my life–letting go of work, friends, saying goodbye to many activities–but I held onto a few lifelines. I journaled every day. Not a lot, but when the tears or screams built inside, I’d anchor them onto a page. I slipped  outside to pray and think, allowing nature to nurture me. I returned to take a college class one night a week–up until the last six months of my mom’s life. I got a new puppy to bring us all joy and laughter and remind us that life does indeed go on. Other aspects of my life were put on hold. That’s just part of it–for a season.

Self-care isn’t always a bubble bath and candles. It isn’t impractical nor is it selfish. The only way for a caregiver to do it is to incorporate small amounts of self-care throughout the day. Read a line or two of a poem. Buy your favorite coffee and refuse to get up off that couch and take care of anyone until you drink that first cup. Put a lock on your bedroom door and use it. Take short five-minute walks in your yard. That may be all the self-care you get to, but those few snatched moments here and there add up.  You’ll find a sense of calm comes over you when you’ve honored your own soul.

Take care of you and yours and you will serve me well. Good advice. No wonder Socrates is still remembered today.

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Most people, in fact 85% don’t want to go into a nursing home–that’s what they used to call them.

Many of our seniors cringe at the word and imagine long, dark halls, people screaming, sitting in soiled diapers, horrible food, and being abused. Thank goodness, this is not the norm–and there’s more vigilance to report elder abuse and substandard care today.

According to surveys done by AARP, most of us would prefer to Age in Place–meaning, stay in our homes  and augment care as needed–a mix of family caregiving, professional caregiving services, adult day cares, and other elder-care community based resources.

I highly recommend staying at home, including various elements of family caregiving, paid care, and community care–but I do know that there are times and circumstances when this just isn’t enough.

What Are the Different Kinds of Care Facilities–and Which One Is Right For my Loved One?

Contining Care or Graduated Care is when you buy into a community in which you can choose your living condition (small home or condo at first), and then “trade” it in when/if your care needs increase. Within one “complex” you might see homes or duplexes, condos or apartments, a building (care facility) that houses many units of care, and all these may be near a hospital or hospice facility. These are usually a large development and can offer meals, hired care workers, transportation, activities, and other amenities.

Assisted Living is similar and can be a part of graduated care. Assisted living can be houses/duplex, condos/care facility where the person has their own apartment but has access to additional help. There may be a place for meals, a van for transportation, and non-skilled care workers can be hired to do various needs and levels of care. Some assited living and care facilities are individually owned while others are a part of a larger corporation.

Care Facility or Skilled Nursing Care is considered a full-care facility and is what people think of when they say, “nursing home.” They can be a part of other facilities, such as the continuing care, or assisted living home, but they have the added component of a skilled nursing staff (RN’s–registered nurses) as well as non-skilled care, usually called CNA’s (Clinical Nurse’s Assistant). Care facilities are for people who have medical needs, have severe mobility issues (can’t walk, falls), and need supervision as well as medical care. They often have a staff of doctors and other care workers who will come to visit them, prescribe medications, and offer in-house treatments such as physical therapy.

Memory Disorder Facility or Center can be a part of an assisted living or care facility and focuses on the needs and care of people with neurological disorders such as brain injuries, advanced Parkinson’s or Lewy Body, Alzheimer’s and dementia.This facility has the feature of secured doors and exits so that people who tend to wander can’t leave. They specialize in dealing with the behavoiral, psychological and physical issues that come with neurological disorders. Since this is an area that overlaps, many of their clients need medical care/skilled nursing care/visiting doctors, etc.

Rehabilitation Facility is usually a short term facility that focuses on people recovering from surgeries, accidents, and for those who need various care treatments such as physical or occupational rehabilitation therapies. They are a “half way” facility people go to when they’re not quite ready to go home, or need more care than a graduated or assisted living facility offers. Most rehabilitation facilities are corporate owned and work closely with hospitals and doctors. 

How Do I Assess If My Loved One Should Go Into a Care Facility?

  1. They choose a graduated/continual care or assisted living on their own.
  2. They have no family nearby and no one can or will coordinate their care (don’t forget how helpful geriatric care managers can be in figuring out various stage of care and evaluating care facilities)
  3. They need full-time care, perhaps with needs of skilled nursing care as well–and this has become too much to manage for a loved one to deal with.
  4. Their dementia/Alzheimer’s has increased to a level to where they’re not manageable at home–violent, escapes, can’t be managed by one care helper–needs more supervision, medication, and physical control than the family/and caregivers can provide.
  5. Are at the late stages of various diseases/aren’t mobile/and the family can’t manage their care–perhaps hospice is involved and there are end of life and palliative care needs (pain management).
  6. You, the family caregiver simply can’t do it anymore–your own health or finances are falling apart and you’ve done all you can.

There are valid reasons for your loved one to enter a care facility.

You have not failed as a caregiver–nor are you “done” when your loved one enters a care center/facility.

Your loved one needs you more than ever to oversee their care and make sure they are safe, respected, and receiving all the care they need and deserve.

Also know that the first care facility may not be your last one–it may not be a good fit, you may have to change and try a different one. Also, as time goes on and their care increases, you may have to move them again.

Don’t forget that hospice and palliative care is still needed (and must be asked for) to supplement their care at the end of life.

You may also consider letting them come “home” to die.

You  have many options.

Helpful Links:

Great article:

newoldage.blogs.nytimes.com/2008/07/14/faced-with-caregiving-even-experts-struggle/  

~Carol O’Dell, Author of Mothering Mother–an Amazon Bestseller in Alzeimer’s and Aging Parents.

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Today, I switch roles from the caregiver blogging perspective to that of the care receiver–

specifically, the aging parent.

If you’re a caregiver/son, daughter, please read this post.

You need to put yourself in their shoes.

But I don’t want to live with my adult children!

I don’t blame you. Me neither.

(And I wrote the book, Mothering Mother–and my mom lived with me the last (almost) three years of her life!) But that’s my point–my mother lived on her own–with Parkinson’s and early dementia until she was 89 years old!

We’ll all be in this predicament one day–if we live that long–so we need to be empathetic.

My kids are grown, responsible, and we all love each other–and I still don’t relish the thought of permanently living with them! I am a big proponent of family caregiving–but do it when the time is right.

No one wants to give up their independence.

We like things our way, our household “rules,” TV shows, and favorite laundry detergent. Things seemingly insignificant choices give us a sense of autonomy and joy to every day life.

I don’t want to be a burden. 

I hear this a lot. I feel it on a personal level, but know that when it’s necessary–cancer, end of life, when it’s really needed, then it’s not a burden. It’s a privilege–

Ad you still have much to give.

Encourgement, humor, appreciation, family togetherness is a rare and precious gift and should not be under-appreciated.

I feel privileged to have children. And I know if/when I have to, we would all do our best to make it work. I’m grateful I have the option if I needed it.

There are many people who do not have children. Or their children are not able or willing to help.

No time for a pity party. Get busy! Use this as a catalyst to get busy doing just that–planning your life–for quality and purpose.

If you don’t want to live in a care facility (prematurely, and hopefully never) or with someone else–family member or not, then I (and you) better have a plan.

Note: Decide today to be okay how your life turns out–either way. Who knows what wil happen? 

Have you heard of the aging in place movement?

This July AARP released a new report citing that 87% of people with disabilities age 50 and older want to receive long-term care (LTC) services in their own homes.

The National Aging in Place Organization is about collaboration and education to live at home as long as possible.

Aging in Place includes building/altering your home so that you can stay there safely as long as possible.

It might also include a ramp, ample doorways and bathrooms for wheelchair accommodation, safe flooring, and even a space for live-in care. It’s up to each individual to make these arrangements to suit (by anticipating) their needs. This term is also loosely used to help individuals begin to plan for their future in terms of how and where they want to live as life progresses.

Aging in place might even include moving so that you are living in an area where retirement and aging is not only enjoyable, but that you also have ample resources within your community for the care you might need.

Or…it might include living close enough to your adult children so that they can easily check on you and manage your care without having to live with you. ( I know of three families in our neighborhood whose mothers/parents also live in another house in the neighborhood).

Recently, after Tropical Storm Faye, I saw one of the son-in-laws picking up debris out of his mother-in-law’s yard. At least he didn’t have to drive an hour or two to do this little chore–or worry about someone charging her an exorbitant price for a job that took less than an hour.

How to Arrange Your Life So That You Can Live at Home Longer:

(consider one or more of the following suggestions)

  • Move your bedroom on the first/main floor
  • Do a computer search or call your council on aging and get a list of all your community’s resources now. Don’t wait until you need help to start this process.
  • Consider redoing your main bath to accommodate a wheelchair/walker–and make your shower easy to get in and out of
  • If your spouse has passed away, consider a roommate. Finish a garage or basement if you’d like it to be more private and separate. This $10-20,000 investment (if it’s done well) could give you added years at home–you could even trade rent for care.
  • Be sure that if you choose to do this that you both sign a contract for renting, you get driver’s license info, run a background check and never ever give them access or personal/financial information.
  • Even though there are risks involved, having someone live with you or on your property can provide a certain sense of security, companionship, and allow you to stay home much longer than living alone.
  • Consider an alarm system if you feel you live in an area where you’re vulnerable to break-ins. Check with your local police to see if this is a common occurrence. Elders can be targets for easy crimes.
  • Don’t blab to every cable and lawn guy that you live alone. Always act like your son/nephew is in the house, coming home, on the phone. Even if you don’t have one–never let others think you’re always alone. Don’t be an easy target!
  • Consider “the button,” a monitoring device you wear in case you fall. There are systems that will call and check on you morning and night (of course, you pay extra for this), but it might give you and those who love you a peace of mind to know that you can call for help at any time.
  • Wear the thing! My mom was terrible about leaving it on a piece of clothing she wasn’t wearing, forgetting where it was–and caregivers, family members–if your loved one has memory loss, this may not help them. They won’t necessarily remember they have “the button” on, or even what it’s for!
  • Get rid of clutter now! Clutter can cause you to fall and gets to be a real hassle for those caring for you. Don’t leave this to your family to do later–give those sentimental items to your family members now so that you can see the joy on their face when they use their grandmother’s dishes or wear a family heirloom piece of jewelry
  • Gather all your important documents–insurance info, cards, prescriptions, life insurance, house insurance and living will. Place these items in a portable box and let your loved ones know where it is–for easy access. 
  • Do that living will now–don’t make your loved ones have to guess or fight over whether you’d want to be put on a ventilator or not. Be clear. Make several copies and give them to all the important peopel–one for you, your main doctor, the hospital you’re likely to go to, and one or two loved ones/guardians who would get to you quickly in times of emergency.
  • Get a recliner chair that can lift you out easily (consider this your next purchase when the current chair needs to be replaced)
  • Eventually consider a bed that is motorized–this added expense really helps if you have back problems and can sometimes be covered on insurance
  • Place tread on any slick floors inside or outside your house to avoid slipping
  • Remove any throw rugs that might trip you–(you may need to do this later or if you tend to shuffle)
  • Begin to think about your options if/when you can no longer drive–is there a senior van in your area? Friends/neighbors who you can ride with or will pick up a few items for you? Even consider a taxi–most areas have taxis (even if you’ve never used one in your area before, they’re probably there). Don’t sit at home and waste away–even if your eyes or your coordination begin to wane, you can still get out and enjoy life.
  • Continue to be a part of your local church/temple. Make friends–you need them, and they need you! Churches and community organizations are there to help. Let them. Helping others make us feel good–don’t be so stubborn and independent that you don’t allow someone else to give and feel good. If someone is willing to pick you up to take you to Sunday School or choir practice–let them~ You still get to go to an activity (which is good for you), and they feel like they’ve helped someone. Win-win.
  • Get to know your neighbors. You can all keep an eye on each other. Be nice to the kids in your neighborhood–they can rake your leaves or bring you the mail. Most children and even teens long for a grandparent and don’t get to see theirs enough. Wave! Smile, get to know their moms and dads so they trust you. Bake a cake and take it to them. Cultivate relationships. Old-fashioned neighborliness and friendship never grows old and is never out of style.
  • Choose where you want to pass away. Hospice offers you the choice to spend your last few months/weeks/days at home and can offer palliative care (pain management). Most people choose to be in their own home and to surrounded by those they love. Let people know now–most areas of the country have access to hospice. The diagnosis is that you have a life-limiting condition with a diagnosis or a year or less to live.
  • Don’t wait until the last minute–ask for hospice. Anyone can refer you to hospice (including yourself or your physician). Also know that many cities have more than one hospice with varying levels of care and options. Check them out to see what’s available to you.

Bottom line:

Plan now. If you’re over 50, then you better start planning. Having a 401K isn’t enough. It doesn’t take care of the details and quality of life–and money won’t fix everything.

Adapt your house to suit your aging needs.

If it’s not too late, and you need to, move closer to family so that it’s not hard for them to drop by and check on you.

And…or…live in a community that is “elder friendly,” with lots of resources.

Stay involved with people. Accept their help. Give back any way you can. A smile, a hug, homemade cookies will get you lots of friends. Neighbors are important. Do more than wave. You might need them one day.

Stay/get involved in church and other community activities. The more plugged in you are, the more people you have in your life, the more your mind/body stays active. Staying active will keep you at home.

No longer driving is not the end of the world. Figure out how to make it work–taxi, community van, church members/neighbors.

Consider a roommate or a family member living arrangement. Just be safe, sign a contract, and do a background check. ( I know of several nieces/nephews who are young and starting out in life by sharing a house with an aunt or grandmother).

Get help when you need it–hiring day-time care is cheaper than a care facility. There are many great companies such as Comfort Keepers who are licensed, bonded, flexible and reasonable–usually less than $20.00 an hour.

Wherever you are and whatever life throws at you–continue to smile, see the good, and find ways to give and receive love.

Carol D. O’Dell, and I hope you’ll check out my book, Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir, available on Amazon, other online stores and in bookstores. Kunati Publishing

I’m a family advisor on Caring.com, and my syndicated blog appears on www.opentohope.com.

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Face it, times are tough.

Can you afford to stay in your own home? Are you well enough to manage everything on your own?

Are you recently widowed and wonder if living by yourself is such a good idea?

Are you a boomer or sandwich generationer wondering how to care for/pay for your kids, your parents and save for your own retirement?

You (or your elder loved one) might be the type of person who would rather live in your own home or with someone you know rather than move into a care facility. Besides, care costs are astronomical. Even with medicare and medicaid, there are still a lot of hidden and unexpected costs, not to mention how challenging it is to find a care facility where you enjoy the people and the staff and get the care you need and deserve.

There are many reasons why family caregiving is a great option–it’s easier to take care of your loved ones if they’re living with you, most people prefer being with or near family, you tend to get better care from relatives and close friends, and it’s cheaper.

No wonder 80% of the elderly population rely on family caregiving.

In today’s precarious economy, it might just be a necessity.

I know of several friends and neighbors who had lost their jobs due to downsizing, budget cuts, and forced (or high encouraged) early retirement. Gas is four dollars a gallon and I almost paid ten bucks for a two pound bag of cherries at the grocery store today. I told the cashier I wouldn’t be buying those, thank you very much.

The strapped economy is hitting everyone, particularly the elderly who have to have their meds, pay for rising electricity costs still get to their doctor appointments. These aren’t luxuries. Nursing home costs are staggering, and not all are covered my medicare and medicaid. On average, the daily cost ifor a care facility s $350.00 a day–and memory impaired units range from about $450.-700.00 a day. A day.

But moving in with your adult children might not be ideal either.

Most people want to remain independent for as long as possible.

How do you stay in your own home? 

Plan early. Look into www.aginginplace.org

Consider long term care, but make sure you go with a reputable company who will be in business and honor their contracts for years to come.

  • When you buy what you think will be your last home, consider city, driving distance, doctor’s, care facilities, and senior resources. Can you live there after you can no longer drive? Can you use a community van or are there taxis? Is your home/bedroom on the first floor? Can you manage the maintance of your house and yard? Plan, plan, plan.
  • Buy property and build a smaller house or a garage that could be converted for a caregiver or family member. It’s an investment you’ll get to keep–and when or if you need to sell, it’s only improved your property value.
  • Consder renting a room–to another senior and split certain home or home health care charges
  • Convert a garage or attic and rent to a relative or younger person. You might even consider rent in  in exchange for services–college age, divorcees, and many people would benefit from this arrangement as well as nieces or nephews just starting out in life
  • Build an apartment onto your home–or if you do move into your children’s home, build one onto theirs so you still have privacy and can come and go as you please
  • As time goes on, consider a small group home run by a licensed care worker who only takes in 4-8 persons–ususally, the charges are less although they can do less for you medically, so consider your health and medical needs in making this decision

How to Live with Family Members Without Hating Each Other

  • Establish rules up front–realistically know you’ll have differences and times when you need to talk honestly about what’s bothering you. Make sure you can sit down and do this knowing you’ll be heard and respected–and that you offer the same in return
  • Know that there will be a honeymoon time, aand a time of disillusionment when you wonder if you made the right decision–but also know that this too will pass
  • Accept that change is inevitable. Don’t pine away for what once was–embrace the now and choose to find the good in each day
  • Give each other privacy–still knock and be considerate of quiet, rest, and alone time
  • Be sensitive–if your loved one is acting odd, they might be going through something they can’t share or verbalize–there’s a time to be tender and patient with each other
  • Plan certain meals or times together–but don’t overdo it
  • Hire caregiving or chore help–don’t expect your family to do it all
  • Find ways to be needed and give. Help out–offer to do a consistent job
  • Try not to complain about your health or living conditions–everything may not be perfect, but it still might be better than your other choices
  • Refrain from commenting on their life choices–how they dress, where they go to church (or not), the state of their marriage–do more listening than advising
  • Make friends and connections, don’t rely on your family to be your everything
  • Smile, be easy to get along with, and show gratitude–it’s contagious, so maybe you’ll get some in return
  • If you do have an issue, don’t let it fester. Sit down, say your peace, have a possible solution in mind, and then deal with it and let it go
  • Eventually–about six months to a year after moving in together, you’ll begin to settle in but it may take up to two years for it to feel like home. You might feel lonely at times, lost and undefined.
  • Be sure to reach out to your new community–join a club, a senior citizen center or a church–make new friends–even if it’s hard or scary, it’ll be worth it. We all need friends.
  • Accept your place of honor and dignity–you hold a special place in the family, but you have to know that and own it first before anyone else does. Embody a sense of wisdom, confidence, and respect within yourself–others will begin to sense it when they’re around you.
  • Expect that at some point you’ll have a big fight or misunderstanding. Families do those kinds of things. It’s okay. Forgive each other. Be quick to say, “I’m sorry.” Laugh about it.  Even if there were yelling and pouting involved, so what? People act crazy at times. Who else can you act up with other than your family?

Family caregiving is part of who we are. No amount of money can buy love. If you’re blessed enough to have a brave enough family who are willing to be togehter, love and care for one another in one way or the other, be grateful.

I was a family caregiver. I brought my mother, who had Parkinson’s and Alzheimer’s, into our home. We built her an apartment onto our home. She lived with us for close to three years. So I know what caregivers face. I know how hard at times, it could be–the physical work, the emotional undertow that gets kicked up, the strain of living together after years of running your own house. All this takes some getting used to.

It’s okay to be mad, hurt, or frustrated with a family member. Families are resilient. They know how to love fierce and forgive easily (or in some cases, eventually). As my friend and fellow author Cheryl Kaye Tardif says, “It’s not about how to live with your family without hating them–it’s about living with your family without killing them! You can hate all you want!”

Emotions come and go. Family committment runs deep.

Life changes and people aren’t perfect, but a family is a great thing to have.

~Carol D. O’Dell

Author of Mothering Mother, available in hardback or on Kindle

www.caroldodell.com

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