written by: Stephanie Erickson, MSW, PSW, LCSW

If you have aging parents, you are most likely concerned about their physical, emotional and cognitive health.  As your parents get older, they will have medical appointment after medical appointment with a variety of medical professionals including doctors, nurses, social workers, physiotherapists, etc.  Your parents may have difficulty remembering the details of each of these appointments, as one specialist blends into another.

It is important for you to keep track of the dates and times of the appointments in order to remind and follow up with your parents.  However, this is not the only information you need to monitor.  The following list contains suggestions on how to record the essential details of your parents’ health so in case of an emergency or hospitalization, you have their full medical history available.

1. Buy a journal or make an excel spreadsheet that records all of the names, addresses, phone numbers and areas of specialty of each of your parents’ physicians and other health care professionals with whom they have contact.
2. Include the diagnosis or problem treated by each of these health professionals, as well as the medication(s) prescribed (dose, times of day, etc.)
3. Document the emergency procedure to contact each of these physicians in a time of crisis as well as their normal office/clinic hours.
4. Encourage your parents to sign a Consent to Release Information with each professional so you have the legal authority to exchange information.  (See our website for a free form).
5. Ask your parents to bring a list of questions and concerns to each appointment and to document the answers.  Include your questions on this list. 
6. Document the pharmacy name and location for each medication prescribed so you can discuss any medication concerns or interactions with the pharmacist.  Make sure your parents sign a Consent to Release Information at each pharmacy.
7. If possible, use only one pharmacy for all of your parents’ prescriptions for better monitoring by a pharmacist of possible drug interations.
8. Make a list of all medical diagnosis, medications, surgical history, current treatment regimes, and treating physicians and ask your parents to keep this list in his or her wallet or purse in the case of an emergency.  Place a copy of this form on the refrigerator and near each phone in their home.
9. Encourage your parents to draft a Mandate, Power of Attorney and/or Living Will so they will be ensured you can act on their behalf  if necessary.

The above information is the basic information needed to assist your parents with their overall health.  It is equally important to organize all of their personal and financial affairs to ensure that you can provide comprehensive support in all aspects of their life when the time approaches. 

For more information or for organizing tools, documents and tips for medical, financial and personal affairs, see our website e-store.

Written by: Stephanie Erickson, MSW, PSW, LCSW 

As our parents age, it becomes harder and harder to feel secure that they are safe and healthy in their home.  This becomes even more difficult if we do not live nearby and are unable to “pop in” to make sure they are okay.  We are left to rely on their self-report of their situation. 

If our parents have memory problems, we wonder if they are accurately reporting what is happening.  We may also believe that they are minimizing their struggles for fear that they will be forced out of their home.  Even if our parents live in senior’s community, assisted residence or full care facility, we still worry if they are getting all the care and attention they need.

There are some things we can do from a distance to increase our full understanding of their situation, to improve the communication we have with them, and to manage the risks inherent in long distance (and close distance) caregiving.  All of these suggestions can be done via the internet and phone.

1. Ask your parent to sign a consent to release information from all of their health care providers so that you can gather collateral information about their functioning.  Get a list of the names and phone numbers of these individuals.
2. Encourage your parent to complete a power of attorney at all of their financial institutions so you can monitor their management of money.  Make sure to tell them that you do not plan on taking over; you just want to oversee to ensure they are not being taken advantage of by another and if they have questions, you can assist them. 
3. Encourage your parent to draft a Mandate/Living Will/Durable Power of Attorney for Health Care so you have the legal authority to make decisions and manage their finances if they become unable to do so.
4. Ask your parent to list all of their utility providers, their mortgage carrier, car insurance, etc. and account numbers and to give these facilities authorization to share information with you so if they are confused about their accounts, you can assist them.  (See our website for a complete list). 
5. Arrange for automatic bill pay where applicable.
6. Ask your parents for the location of all important documents (power of attorney, birth certificate, deeds, etc.). 
7. Obtain LifeLine, Medic Alert, or another type of safety system so that your parent can access help if he/she falls or has another emergency.
8. Obtain a list of individuals nearby who could stop by your parents’ home if you have an immediate concern (neighbor, friend, relative, etc.)
9. Obtain a complete and updated list of all medications, prescribed and over-the-counter.
10. During a visit to your parents, conduct a home safety assessment and make all necessary modifications to the home.  (See our website for a complete list of areas to observe).
11. Prepare a list of private and community agencies that are available to make visits to your parents for future or immediate reference.
12. If your parent is at a facility, get the names, phone numbers, and emails of at least two professional staff members (nurse, social worker, etc.) and make contact with them periodically to foster an on-going relationship.
13. If you can afford it, arrange for a monthly visit from a social worker or nurse to monitor your parents’ safety and report back to you.  The money spent will be worth the peace of mind and may prevent major crises.
14. Begin a journal of all of the above information, as well as on-going updates about your impressions of their functioning, including specific examples (i.e., my mom called me again to ask about her phone bill; I noticed she has lost weight since our last visit, etc.). 
15. Monitor the following when you visit: Physical appearance and hygiene, medication administration habits, ambulation risks and falls, home cleanliness and organization, food acquisition and preparation, driving, memory loss, ability to express thoughts, social interaction or isolation, judgment, decision-making, etc.)

For further information and more detailed toolkits that outline each of the above areas in more detail, please refer to our website. http://www.ericksonresource.com/estore/

Written by: Stephanie Erickson, MSW, PSW, LCSW

It is very scary to know that our parents are living alone in their home as they begin to lose physical and cognitive functioning.  We want to respect their decision to remain autonomous at home for as long as possible so we search for ways to make this happen.  The following is a complete list of all of the areas in your home that present a danger to your parent or loved one, outlines the factors that increase risk and offers concrete suggestions to reduce the identified risks.

Emergency Preparation:

1. Get the name of neighbor/friend/relative and phone number to contact in the case of an emergency and you are not able to get to your loved one’s home.
2. Post your name and phone number next to every phone AND give this information to AT LEAST one neighbor/friend.
3. Obtain the name of a community member, social worker, other professional to contact in the case of an emergency and/or regular updates.
4. Give an extra key to a neighbor or friend, have an extra key for yourself, and hide one outside the home (if you feel comfortable) so someone can gain access to the home in an emergency.
5. Register with Medic-Alert or LifeLine and get a bracelet for your parent so he/she can access help if there is a fall.  See our website under Resources for a link.
6. Make sure all legal documents (power of attorney, mandates in the case of incapacity, etc. are updated and complete).

Risk Factors for a Fall:

1. Over 75 years old
2. Living alone
3. Housebound
4. Use of cane/walker
5. Previous falls
6. Acute illness, chronic conditions, tremors (neurological disorders)
7. Multiple medications
8. Cognitive impairment
9. Vision and hearing problems
10. Difficulty sitting/standing from a chair/bed
11. Foot problems
12. Alcohol/drug use
13. Poor nutrition
14. Balance/equilibrium problems

Bathroom Safety:

1. Install grab bars in the bathtub or shower and by the toilet
2. Use rubber mats in the bathtub or shower
3. Use a shower chair or bench
4. Take up floor mats when the bathtub or shower is not in use
5. Install a raised toilet seat
6. Remove tub and install a shower with a minimal step-up
7. Place a chair in shower stall
8. Use a telephone shower head

Kitchen Safety:

1. Use automatic tea pot
2. Remove rugs without a non-stick service
3. Place frequently used pots and pans at waist level to minimize bending and stretching
4. Use a microwave to reduce use of oven/stove
5. Disconnect stove/oven fuses if there are memory impairments and it has been left turned on in the past

Outdoor Safety:

1. Repair cracked sidewalks
2. Install handrails on stairs and steps or install a ramp
3. Trim shrubbery along the pathway to the home
4. Install adequate lighting by doorways and along walkways leading to doors

Living Space Safety:

1. Remove throw rugs, or tape down to secure
2. Secure carpet edges
3. Avoid visually distracting patterns on flooring/carpets
4. Mark transitions from carpet to flooring with a different color paint/stripe
5. Remove low furniture and chairs that are too low to get up/down
6. Remove objects on the floor
7. Reduce clutter
8. Remove cords and wires on the floor
9. Avoid floor wax or use nonskid wax
10. Ensure the telephone can be reach while laying on the floor

Stair Safety:

1. Install hand rails on both sides of staircases at elbow height
2. Make sure an adult can wrap their hand completely around the handrail
3. Attach them securely to walls or posts
4. Secure carpet on treads of stairs
5. Install light switches at the top/bottom of stairways
6. Do not reduce lighting in stairways; in fact, increase the lighting
7. Do not place rugs at the top/bottom of stairs
8. Leave one hand free to hold the handrail when carrying objects
9. Check lighting for adequate illumination at night, especially in the pathway to the bathroom and on stairs

General safety:

1. Wear shoes or slippers that fit properly and have a non-slip sole
2. Remove reading glasses when walking up/down stairs
3. Install a telephone on every level of the home, especially in the bedroom, kitchen, and bathroom
4. Install a bathroom on each floor
5. Understand side-effects of medications, such as dizziness
6. Avoid alcohol
7. Avoid carrying large or heavy objects, such as laundry baskets
8. Get up slowly from a sitting or laying position; sit on the side of the bed before rising
9. Wear clothing with an elastic waistband for easy removal

For further information, please contact Erickson Resource Group at www.ericksonresource.com

By: Stephanie Erickson, MSW, PSW, LCSW

You get a message from your employee stating that he cannot make it into the office.  His mother is in the hospital after falling in her home.

You notice that your employee seems to be spending excessive phone time speaking to her mother.  It seems her mother calls her daily needing help or guidance with even small matters.

Your employee just put in a request to take 3 weeks off to help his father find a home for his mother whose Alzheimer’s is getting worse.

Does this sound familiar?  How do you think caregiving issues are impacting the productivity of your company and the morale of your employees?  Do you even know?

Most employers are aware that some of their employees are what are referred to as “working caregivers,” that is, employees who have the responsibility of assisting their parents, or another loved one, with financial, health and personal matters.  These tasks can take just a few hours a week, or a few hours a day.

Most likely, there are more employees dealing with their aging parents’ needs than you are aware of.  Many suffer with their dual responsibilities of work and family in silence, afraid that there jobs will be at risk.

Even more employees are part of the “sandwich generation,” those individuals providing care for aging parents AND children simultaneously.  This matters to employers because business is directly impacted by the issues working caregivers face.

As our population ages, the negative fiscal impact on businesses will continue to grow as the baby boomers fall ill and the workforce is faced with the responsibility of caring for them and working for you.

Here are some clear facts about the impact of working caregivers on business:

• 87% of employed caregivers made telephone calls for caregiving responsibilities from work¹
• 64% arrived late or left early²
• 70% took time off²
• 20% reduced their hours¹
• 16% quit their jobs¹
• 13% retired early¹
• 56% developed health or stress problems that affected work productivity¹
• An estimated 46%-59% of caregivers are clinically depressed³
• 41% took time at work to discuss caregiving issues with colleagues²

(¹Advantage 50Plus magazine, ²LifeCare® Inc. February 2008, ³Family Caregiver Alliance 2000)

When employees are at work physically, but spending company time (and resources) researching placement facilities on-line, phoning financial institutions to assist their parents in making payments, or speaking with social workers to arrange for help in their parents’ home, this is “presenteeism.”

 “Researchers say that presenteeism—the problem of workers’ being on the job but, because of illness or other medical conditions, not fully functioning—can cut individual productivity by one-third or more. In fact, presenteeism appears to be a much costlier problem than its productivity-reducing counterpart, absenteeism. And, unlike absenteeism, presenteeism isn’t always apparent” (2004 Harvard Business School Publishing Corporation).

Here are other staggering statistics regarding the financial cost to businesses due to working caregivers:

• The estimated cost to employers for full-time employees with intense caregiving responsibilities is $17.1 billion.
• The average cost per employee for those with intense caregiving responsibilities is $2,441.
• The total estimated cost to employers for all full-time, employed caregivers is $33.6 billion.
• The average cost per employee for all full-time, employed caregivers is $2,110

(The MetLife Caregiver Cost Study: Productivity Losses to U.S. Business, July 2006, MetLife Mature Market Institute and National Alliance for Caregiving)

Research shows that those who used an Elder Care Program experienced dramatic changes in their ability to manage work and caregiving. 

• Presenteeism improved overtime for users of the Geriatric Care Management Program
• Users of this program were less likely to report deterioration in their health over time
• Users of this program were less likely to report negative impacts on their work performance (LifeCare® Inc. February 2008)

The demographics of the population are shifting dramatically.  In Canada:

• The number of seniors has more than doubled in the past 25 years¹ (Health Canada, July 2004)
• The proportion of Canadian seniors will grow from 17% in 2001 to 28.5% in 2031 (Conference Board of Canada 2001)
• Recent changes in the health care system have put further pressure on families (shorter hospital stays and more outpatient treatment) ¹

In the United States:

• In 2015, 78 million baby boomers will begin to turn 65
• The United States population aged 65 and over is expected to double in size within the next 25 years.
• By 2030, almost 1 out of every 5 Americans — some 72 million people — will be 65 years or older.
• The age group 85 and older is now the fastest growing segment of the U.S. population

(National Alliance for Caregiving, 2004, National Institutes of Health, 2006)

These population shifts will directly impact our workforce.  “With the aging Baby Boomers and the natural growth of the “sandwich generation”, it’s equally obvious the caregiving phenomenon is here to stay.”  (Family Caregiver Magazine Spring 2004)

Generally, EAP programs give out names and numbers of a local resource when an employee calls.  These are not prevention programs, nor programs that provide a step by step guide to managing the problem.  Companies like Erickson Resource Group can help. Erickson Resource Group provides information, resources and a wide range of comprehensive and simple tools to assist employees and employers in managing the many issues faced by caregivers, preventatively and reactively.

It’s not enough for businesses to sit and wait for the caregiving phenomenon to impact the bottom line.  Being proactive in providing your employees with knowledge, insight and practical tools to address their current and future caregiving needs will assist in reducing the negative impact this issue will have on your company.

This approach to employee benefits should be adopted throughout workplaces in terms of working caregivers.  Better informed and prepared working caregivers will be under less stress and be able to manage their work and life responsibilities more effectively.

The advantages of elder care training are numerous and include:

• Increase employee’s awareness of their current or future role of caregiving
• Increase employee productivity
• Decrease the number of employee absences
• Increase employee morale and concentration at work
• Equip employees with life-work balance skills
• Increase management’s ability to prepare and respond to employee work-life crises
• Meet company’s mission of being empathic to work-life balance and responsive to social trends
• Be progressive and innovative in employee training

“Demographics are critically important for business.  They probably won’t alter a company’s financial results from one financial quarter to the next.  But the management of a business that fails to pay attention to demographics for five years may wake up to find itself in a different business than it thought it was in – or not in business at all”  (David K. Foot, Boom, Bust & Echo, 1996).

Contact Erickson Resource Group for more information on how you can offer this value added benefit for your employees at www.ericksonresource.com

by: Stephanie Erickson, MSW, PSW, LCSW 

Every time you visit your parents, you notice that they are having more and more difficulty keeping the house clean.  They seem to be losing weight, and when you look in the refrigerator, you can see why. Clearly their nutritional needs are not being met.  You suggest they bring in private help a few days a week to help with the shopping, cooking and cleaning, but they will not even consider it.

Does this sound like your parents?

As a geriatric social worker, the question I get asked most often is, “Do you have any suggestions of how I can get someone in the home to help my parents?  They just won’t agree to help.”  Boy!  Do I wish I had a cookie cutter answer! 

In reality, there are so many different personality characteristics and past experiences that impact one’s openness and willingness to acknowledge deficits and accept help.  I cannot give you the guaranteed solution.

Below are some basic suggestions to assist you in introducing home care assistance.

1. Lower your own expectations.  It is not realistic to expect that individuals who have been managing their own life from A to Z are going to welcome others taking over.  Understand that things will not change overnight.
2. Acknowledge their fear.  Most seniors feel that once they accept help, even in the most minimal way, it is the “beginning of the end” for them.   This is scary and they want to prolong this first step for as long as possible.
3. Introduce the topic slowly. Start by asking your parents some open ended questions, such as, “Tell me how you’re managing the housekeeping?”  Not, “Can you do the housekeeping?” – which will draw a quick “yes” and an abrupt end to the discussion.
4. Start with housekeeping.  This is usually the least threatening type of help and the one most appreciated.  If your parent already has a housekeeper, how about suggesting that “large” chores are done by someone else, i.e., washing windows, and that you know of someone who is available and good.
5. Give the gift of help.  Instead of presenting help as a “need”, give your parent a gift for the holidays, a birthday or anniversary.  You can frame it that your spouse/friend gave you the same thing (i.e., housekeeper for 3 months), and you found it so incredible, you wanted to share the joy.  You may find that they are relieved once the assistance begins.
6. Qualifications.  Make sure that the housekeeper is a qualified nurse’s aide (attendant, caregiver) and able to assist with personal care (bathing, dressing, etc.), even though this service will not be introduced at this time.  Professionals will understand and expect that their introduction into the home may be about “housekeeping” for a period of time.  At least you know that this person has additional skills if needed in the future.
7. Introducing housecleaning.  Ask your parent what tasks in which they could use help.  DO NOT decide for them.  Suggest large tasks such as window washing, floors, toilets…this may feel less threatening than imaging a stranger washing their clothes.  Once the housekeeper is there, she can offer additional tasks gently and at your parents’ pace.
8. Building on existing housekeeping. When there is already a housekeeper in the home, ask if this person is available and willing to provide more help.  If they are, perhaps they could take some basic nurse’s aide courses to learn about assistance with transfers and bathing.  If not, this housekeeper could suggest a “friend” (the aide you find) to provide cleaning when she is out of town or busy.
9. Introducing groceries and cooking.  Suggest the housekeeper start to phone your parents prior to her visit to state that she is running to the grocery store on the way to their house and would your parents like her to pick up a few things (milk, coffee, bread).  Presented in this fashion, it will not feel like your parents are in “need”, but are benefitting from a convenience.
   1. Slowly, this person can ask if they would like her to “run to the store” quickly at the end of her day.  Soon, she can suggest she bring them along to do the shopping themselves.
   2. One day, this person can show up with a bag of groceries, stating they have a “surprise” and cook a meal WITH your parents (if they want).  By this time, there should be a nice rapport and relationship, so this would be a fun activity to do as “friends.”  Again, this is not a “need”. 
   3. Over time, this could build into a weekly/daily activity.
10. Introducing medication assistance.  Once this person is in the home, they can ask to assist your parents with minor organization, such as placing their medication and other supplies in one location.  Then, this person will have access to their medication and can slowly begin to monitor the medication to ensure it is being taken properly.
11. It costs too much!  When/if your parents resist due to finances, there are a few ways to proceed. 
    1. You can pay yourself, if you have the money. 
    2. You can sit down with your parents and review their finances to reassure them that they have the funds.  Look into tax write off’s for home health support.
    3. If you have a banking power of attorney, you can make the payments directly so your parents do not have to see the bill.
    4. You can find low cost support through a community agency.
    5. You can arrange with the provider/aide that services rendered more often are at a reduced rate, making it more affordable to your parents.
    6. IF you have discussed “assisted living” environments in the past, you can compare costs.
    7. Be honest! You can talk about the risks that are currently in the home.  Are your parents willing to end up hospitalized and then placed in a facility?  Or, would they rather spend some money up front?  Not eating well is a risk that can lead to hospitalization and subsequently a medical evaluation that finds the person incapable of living autonomously.
    8. You can look at existing insurance policies to assess if there are funds available, or if the policy can be “cashed out” and used towards help.
12. Following up.  When you ask your parents how this “housekeeping” is going, again, use open ended questions to encourage their verbalization of the benefits.  For example, “What did she do today?”  (Oh, how nice!)  “Are there ways she’s helping you that you didn’t expect?” (Oh, how nice).  If your parents do not want to “fess up” to all the things this person is doing, do not push it.  Does it really matter?  As long as they are getting what they need, you can find out from the aide/caregiver what she is doing straight from her!
13. Discuss your concerns lovingly.  When you were a child, your parents encouraged you to make healthy and appropriate decisions.  You are honoring them by behaving in the same way, making good decisions for their health and safety.  Share this with them.
14. Be honest.  Your parents will know if you are trying to “trick” them and this never works.  If you’re introducing someone through the existing housekeeper, make sure that the new person and the existing housekeeper meet ahead of time so when she is introduced to your parents, you can honestly say they know each other.  Or, if you give the gift of help, make sure you DO use it prior to honestly share what your experience was like.  Dishonesty will always backfire.

For more information or to obtain toolkits to assist in the organization or management of your loved one’s personal, health and financial affairs, visit my website at www.ericksonresource.com or contact me directly at stephanie@ericksonresource.com

Guest writer: Mark Pretorian at Manulife Securities Inc.

What should Canadians worry about most?  According to current monetary policies, deflation is the nearest and greatest monster intimidating the economy. Interest rates remaining at historical lows, regardless of the recent market rallies, indicate the Central Banks believe our economy is still sick. However, all the government prescribed medicine will also likely lead us to inflation in the future.

President Obama warned on November 18th that if government debt keeps piling up, a double-dip recession is likely. When combining the US unemployment rate reaching over 10%, a 26 year high; and the current extreme government debt levels, the prospect of another downturn appears very real.

On the other hand, Berkshire Hathaway CEO Warren Buffet recently stated ‘The financial panic is behind us’. According to the famed investor, the worst of the financial crisis is over and the US economy is still the largest of all, an optimism in stark contradiction to President Obama’s warning of trouble ahead.

So who do you believe? The President? The Investor?

Although neither has a crystal ball, some facts can shed some light into our near future:

• Leading indicators have improved.
• Global banks are repairing their balance sheets.
• China, India and the emerging world continue their growth.
• Governments remain in stimulus mode.

These four themes point towards a slow moving recovery albeit not without problems. Unemployment, increasing debt levels and concerns over the US dollar are among the most notable threats. It appears that our economy has narrowly escaped the worst case scenario and is nervously making a comeback to normalized levels. Inflation is now in the horizon. Interest rates are expected to increase to reflect a return to a normal economic cycle.

We are certainly living in interesting times. An opportunity for many to review, amend and improve their own finances- A chance to better manage risk. Learn what risks your investment portfolio is exposed to by seeking out a second professional opinion.

Investors looking for more information are encouraged to contact Mark Pretorian at Manulife Securities Inc. (514) 421-7090 ext 270 or mark.pretorian@manulifesecurities.ca

Parenting my parents: Where do I start?

 written by: Stephanie Erickson, MSW, LCSW

When we were young children, we looked to our parents to tell us right from wrong, to make decisions for us and to protect us.  As we became a young adult, our relationship to our parents became different.  We still turned to our parents, but more for guidance and support.  Never did we imagine or expect that one day we would be the parent to our parent.  When did it happen?  When was the shift?  Now we are the ones in the “worry seat.” 

As a geriatric social worker, I get calls from adult children expressing concern about their parents and looking for guidance.  My clients say things to me like:

 “I’m so worried about my mom living alone.  She keeps falling.” 

“Last time I was at my dad’s house, he asked me to look at some of his mail and I saw that he hasn’t paid the electricity in three months.”

“I’ve tried to talk to my parents about getting someone into the home to help them but they just won’t discuss it.”

Where do you start?

1. First, take a detailed inventory of all of the areas that you have observed to be of concern.  Use the following categories:
   • Memory (short term, long term, immediate)
   • Orientation problems (time, day, year, people, location)
   • Judgment and decision making
   • Safety concerns (isolation, driving, medication errors, leaving the stove on, etc.)
   • Ambulation (falls, assisted devices)
   • Hygiene
   • Appetite and meal preparation
   • Medication issues
   • Existing relationships and contact with others
   • Financial management
2. Locate an existing power of attorney to ensure your parents’ assets and personal affairs are protected.  If not, consult an attorney or notary and a financial advisor immediately and encourage your parent to draft these documents.
3. Contact your local community agency and share your “inventory” with your contact.  Ask about community services available to meet the identified needs.  What are the processes for finding an assisted living or full nursing care environment?  What are the costs?
4. Is your parent a veteran?  Contact the Veteran’s Affairs office to assess what services are available and what your parent can benefit from.
5. Do a search on line to access your provincial, state or federal government website.  You may have government sponsored programs or funding available to assist you.
6. You can also hire a private geriatric social worker to conduct a complete psychosocial evaluation and assist you in accessing appropriate resources.  If you do not live in the same city as your parent, this is a great resource to have.  Do a search on-line to locate a local referral.  Or, ask a community agency for a referral to a private social worker.  The local hospital social workers may also have a referral.
7. In terms of supportive services, depending on if your parent is autonomous, semi-autonomous or dependent, there are different services available.  You can look at home care support, a retirement community, assisted living, board and care, or a full care nursing facility.  You can find these resources with a search on-line, or a private, community or hospital social worker can provide referrals.

Once you have an idea of what your parent needs and what is available, you can begin to discuss or continue your discussions, sharing your concerns with your parent. I find that with most of my clients, this is the most difficult area.  See my article in next quarter’s newsletter in which initiating difficult topics with our parents will be discussed. 

If you have further questions or are interested in tools to help you assess and organize your parent’s affairs, feel free to contact me directly.

Written by, Stephanie Erickson, MSW, LCSW

www.ericksonresource.com

stephanie@ericksonresource.com

Guest Writer: Karin Mizgala  MBA, CFP

I’m not sure when it happened, but sometime a few years ago I realized that tables were turning in my relationship with my parents.  Although still extremely healthy and vibrant 70 years olds, my parents were starting to ask me for advice and I could feel a subtle shift in the power balance.  I didn’t (and still don’t) feel ready for what’s likely to come – but whoever is?

Most of the children of aging parents that I know are busy, stressed and ill-equipped to deal with the added time and financial demands of caring for elderly parents.  And often the need to step in comes during a crisis.  Needless to say, this isn’t a great time to make the emotional, financial and legal decisions that are often necessary.

If at all possible, have a conversation with your parents early.  Find out what your parents have in mind for their future, get a sense of where they stand financially and get an idea of the role that you and siblings might be called upon to play.  None of these points is easy to talk about and there is a need to be sensitive and to respect your parents need for privacy, dignity and sense of control.

Here are some simple guidelines to help in developing a “Care-Giving Plan of Action”:

1.  Start your dialogue with parents and siblings as soon as possible – strive for practicality and openness.  Remind yourself, and each other, that these issues will eventually have to be faced – and that it is best to be prepared well in advance.

2.  One of the chief objectives of your plan should be to maintain your parents’ self-esteem and a degree of personal independence.  Studies have shown that most seniors want to stay in their own homes as long as possible.

3.  Get informed.  Find out what services and assistance is available in your community. Local senior’s centers can provide a wealth of information and advice.

4.  Get a sense of your parents’ financial capacity and their desires.  Do they have enough money to cover medical expenses, the costs of home care or a retirement home?  Do they have a retirement community in mind?  Would they like to live nearer to you or other family?

5.  Find out where your parents keep financial and legal documents.  You don’t need to know all the details unless there’s a crisis, but know how to access the information quickly and easily if something does happen.

6.  Find out if your parents have up to date wills, powers of attorney and health care directives.

7.  Create a list of names and contact information for doctors, lawyers, accountants, brokers, financial planners, bankers, etc.

Don’t be discouraged if you try to broach the topic with your parents and it’s a non-starter.  Be patient and gently persistent.  (It took a couple of glasses of red wine to get the conversation going with my Dad!)

Knowing where your parents stand on these issues and having a plan in place will save your family much grief later.

Karin Mizgala is a Vancouver-based fee-only financial planner with an MBA and a degree in psychology. She’s the President of LifeDesign Financial and co-founder of the Women’s Financial Learning Centre.

Written by, Stephanie Erickson

www.ericksonresource.com

So often in working with families, adult children ask me for suggestions on how to get their parents to acknowledge their deficits and accept help.  The children believe their parent is no longer able to live autonomously, but is refusing to consider a supportive environment.  At times, the adult children add that they have a power of attorney and believe they have the right to facilitate the move, even without their parent’s consent.

That is not always true, legally speaking.  In addition, forcing a change upon another is not the way to preserve a relationship, nor help another to adjust to a major change in their life.

If you find yourself in this situation, I suggest the following:

1. Process and accept your own frustration.  Look at your frustration at a deeper emotional level.  Most likely your frustration and anger stems from the fear you feel.  Understanding and accepting this will help you to communicate differently with your loved one.
2. Imagine yourself in your loved one’s shoes.  The frustration and fear you are feeling is most probably identical to what your loved one feels.  Imagine if someone was telling you to leave your home.  You would be scared at the thought of losing control of your life too and dig your heels in and deny and resist help.
3. Don’t pull the “Power of Attorney” card.  Bringing up a position of power is not going to decrease defenses and open up the lines of communication.  In fact, it will do the opposite.
4. Engage the services of outside professionals.  Sometimes, including geriatric care managers, social workers, psychologists, physicians or other professionals can help to open up the lines of communication and mediate the discussions between family members.
5. Explore your state or provincial laws regarding your legal options.  Just because you may have a power of attorney, does not necessarily give you the right to initiate a placement.  Individuals, even when they are at risk or incapacitated, still have the legal right to advocate for themselves and make their own decisions.
6. Don’t rush things. It takes time for people to accept their limitations and make changes in their lives.  If a doctor tells you, “you must lose weight”, do you leave the doctor’s office and immediately start a diet and lose the weight?  Probably not.  People need time to process changes in their lives and make adjustments in increments.  Be sensitive to that.
7. Make small changes first. Whenever possible, start with small changes, like bringing in help a few hours a week, or visiting more often, to give your loved one time to see that the assistance is valuable.
8. When possible, let your loved one decide that the time is right. All people do better with change when it was a change they initiated, not one that was forced upon them.  Try to guide conversations, but allow your loved one to determine when the time is right.
9. Look at options together. You may need to do the initial research on the options available for a move, but do not make decisions autonomously.  Include your loved one in the decision making process at every level possible.
10. Understand that a crisis may need to occur. Unfortunately, it is often a crisis, like a major fall or hospitalization that facilitates a change.  It is not ideal, but it is often the reality.

If you find yourself in this challenging situation, enlist the support of friends, family, or a professional to guide you in navigating this difficult situation.  Feel free to contact me to discuss your personal situation at: stephanie@ericksonresource.com www.ericksonresource.com

Written by Valerie Houghton, RD LD

In the United States, the senior age group accounts for approximately 25% of all prescription drugs being dispensed and according to RX. Magazine, there are more than 140,000 hospital admissions each year in America due to adverse drug reactions.  Taking medication to help control diabetes, high blood pressure and arthritis is quite common but unfortunately, what is not so common is making sure the foods you eat are not negatively affecting how the drug(s) work to control your illness or ease pain and suffering. 

One way to ensure your medications are doing the absolute most for you is to be aware of any food or beverage that may hinder the effectiveness, or in some cases, be a danger, to your health. Being aware of any possible food and medication interaction is essential for effective medication therapy and peace of mind that harm will not result due to improper food consumption.

So who can help you determine if you have any food and medication issues?

Several health professionals should be involved in this process but the best place to start is with your doctor.  Review the list of medications with your physician and ask about any potential food or beverage that might impact the effectiveness of the drug.

Another health professional to consult regarding medications is a registered dietitian. These food and nutrition professionals work alongside medical staff in hospitals and clinics providing nutrition guidance and therapy to  improve health, speed healing and educate patients on how to optimize food and medication for the best possible health outcome.  Many of the patients the registered dietitian interacts with are on multiple medications and the dietitian can advise the doctor and the patient on potential foods that may interfere with the effectiveness of the medication.

The dietitian will often take a diet history from the patient asking specific questions about foods consumed to highlight any potential risk of food and medication interaction. The dietitian can then provide a list of foods to include or exclude from your diet that decrease the risk of food and drug interactions.  For example; foods high in fiber like, bran cereals, can slow the rate of digestion in the stomach. If you take certain medications with high fiber meals it could lower the amount of a medication being absorbed into the system or slow the rate of absorption.

Another source of food and medication information is the local pharmacist who dispenses your medications; they can provide advice on what foods to avoid or incorporate into your diet that allow your medications to work properly. If you are taking more than one medication and seeing more than one doctor, make sure they all know what medications you are taking and inquire about any possible interactions between medicines.

As a reminder; don’t skip mentioning vitamins, supplements or herbal medicines that you may be taking.

The more informed your healthcare providers are about your medications and the foods you normally eat, the less likely you are to incur any negative health consequences from food and drug interactions.

Here is a list of common medications taking by seniors and the foods to avoid and include for each category.

Valerie Houghton is practicing registered dietitian and free lance writer for magazines and websites.

For more information, contact Valerie Houghton at valerieonperdido@yahoo.com