Senior Life

Dear Jennifer,

My husband and I do everything for my father. We mow his lawn, rake his leaves, wash his windows, clean his gutters, and run all over town for his errands. Well, you get the idea. We have our own kids to worry about and our own house. My father won’t let us hire anybody to help and he won’t move. Is there anything we can say that would change his mind?

- Vivian
 
Dear Vivian,

It is time for you to assert yourself. First, sit down with your husband and talk this through. How much help can you reasonably provide your father? One day or evening a week? Or every two weeks?  To the best of your understanding, can your father afford to hire helpers? Can you afford to hire helpers for him?

Once you have defined the boundaries, set up a time to visit your father and talk with him. Let him know how much you love him, but there are limits to your energy. Let him know what you can do to help, with suggestions to cover his other needs. Sometimes, there is nothing better to say to his requests for help than, “No. We just can’t help out this weekend. Let’s get together and figure out what we can do about everything you need.”

If your conversation is met with stubbornness or anger, you may wish to make an appointment with Lifespan or hire a geriatric care manager. You and he need guidance at this point. If your father will take advice from someone, he will likely take advice from a professional in this field. If he won’t take advice, then get some for yourself.

Take comfort in the truths that you love him and want to help, but not at your own family’s expense. Hang in there.

- Jennifer

Question: How am I supposed to help care for my elderly mother when everywhere I turn, I get blocked by HIPAA laws? The doctor won’t tell me what’s going on, and she went into the emergency room last week and I didn’t even know about it. I live in California and I hate not knowing what’s going on. Is there some way around that law?
 
Dave, San Diego, CA

Answer: Oh boy. Trying to watch out for a parent from such a long distance is really tough.  I’m sure you’re maxed out in frustration when it seems you can’t do a simple thing like ask her doctor some questions.

The HIPPA law (Health Insurance Portabilty and Accountability Act of 1996) was intended to protect person’s private health information, and while doing so, there are occasions where supportive care is detoured until all the hoops are jumped through. This is highly frustrating to the family. But consider the physician’s take on this situation. He must wonder why your mother isn’t telling you the information herself. He has many experiences with many different families. Some families are dysfunctional and problems are caused with the disclosure of information. And in today’s litigious society, he must err on the side of caution.

Which brings us back to what you might do. First, talk with your mother. Ask her to clear the way with her doctor. She needs to sign a consent form with his office allowing her doctor to share information with you. Remind the doctor’s office that the consent is on file when you call.

Talk to your mother about making an appointment with a good eldercare attorney to name you (or a sibling if there is one – default to the oldest) as Power of Attorney and Health Care Proxy. Most attorneys will put a general consent in one or the other.

And of course, when an adult child is watching out for a long distance parent, consider hiring a geriatric care manager to oversee that all is well, provide your mom with local support, and to keep you in the loop. Keyword “geriatric care manager, Rochester NY ” into your search engine.

For more information go to:
United States Department of Health and Human Services
Senior Life website

Our Two Cents: What to say when your loved one forgets
Author: Jennifer Meagher
Owner, Senior Life Geriatric Care Management

For the purposes of this article, let’s look at two types of forgetfulness. 1. Simple forgetfulness. This is when the person temporarily forgets and once reminded, has recall. 2. Memory impairment. In this case, there is daily forgetfulness with no recall ability. And in this case, the person may not realize s/he is forgetting and may even become irate or defensive. The first thing you should keep in mind when helping someone who is forgetful, is that this is extremely stressful for both of you, particularly the person who is struggling with memory issues. Try to remain calm and supportive. Get a grip on your own feelings first. This is off-setting and frightening. It is a change and we worry what it will mean. My mother had Alzheimer’s disease back when it was a dirty word, and people didn’t want to openly admit it. Still, my mother and I had talked about everything, so we talked about her memory loss too. It was a very difficult discussion, but it helped. Talk to your loved one. Work out ways help; a calendar, a clock with the date and day of the week and time (office supply stores carry these) and medication reminder systems. Call more frequently. Visit more frequently. Get in to see the doctor. Check for urinary tract infections or other infections, for acute pain, dehydration and depression. Any of these may affect memory. When you are aware that your loved one has more than simple forgetfulness, it is time to do what is called “joining the journey.”  Remember, some memories are lost forever. You can’t remind them back into reality. And some memories become twisted and don’t match your recall or your sense of reality. It will not help to try to convince your loved one otherwise. Try to remain calm. Try to accept this very painful situation. Take a deep breath, and talk to your loved one from his or her point of view. For example, if he or she thinks they went horseback riding this morning, don’t argue. If he or she thinks their mother is still alive, don’t argue. Here are some suggestions to help, choose what feels right to you. 1. Go along with what your loved one is saying. “You went horseback riding? That sounds fun.”  Joining the journey is very soothing to your loved one. 2. Change the subject. Have something ready to say. “Oh! I meant to tell you about something that happened yesterday.”  This is a wonderful tip when you are asked something that makes you uncomfortable, or when the same question is being asked over and over. 3. Join your loved one’s reality and give it a twist. When your loved one says, “I’ve got to go to work,” and he or she doesn’t work anymore, it will not help to explain that. Instead, say, “The office called, you don’t have to go in today.” If your loved one says, “Have you seen my mother?” and you explain that she died, your loved one will react as if she just died this minute and react with full grief to this news. It is much better to say, “No, I haven’t seen her.” 4. Put on some music. Popular music from the time when your loved one was 20 – 30 years old will create comfort and may bring a smile. This is particularly helpful when your loved one has no more interest in television. Singing songs is a wonderful tonic for both of you. 5. Look at magazine pictures together and talk about what you see. There is likely a magazine that will match your loved one’s life interests. 6. Don’t bring out family photos and ask who the people are. Instead, label photos with each person’s name and put these in a prominent location like the front of the refrigerator. 7. Stop asking questions. “So, what did you do this morning?” This question will be anxiety provoking if the person doesn’t remember. Instead say, “It is a beautiful morning, isn’t it?” For both of your sakes, don’t ask: “Do you remember me? Do you know my name?” It will hurt your feelings and trouble your loved one if recall isn’t there.  8. Consider joining an Alzheimer’s Association support group. They are held all over town. It is extremely helpful to talk to other families going through similar situations. You’ll make friends and pick up a lot of tips. I know you’re busy. Try to fit this in anyway. The Alzheimer’s Association also has a 24/7 hotline to answer any of your questions:  1-800-272-3900 or visit their website.