Our annual eldercare advice for the holidays

This seems to be a big favourite year over year:

Suggestions of how to bet support aging parents and loved ones through family events.

Please take a look, and share with your friends, too.

Here it is:  http://www.parentingyourparents.ca/plan-good-holida…derly-loved-ones/ ‎

Have a wonderful holiday season and we'll be back posting more in January.

Our annual eldercare advice for the holidays

This seems to be a big favourite year over year:

Suggestions of how to bet support aging parents and loved ones through family events.

Please take a look, and share with your friends, too.

Here it is:  http://www.parentingyourparents.ca/plan-good-holida…derly-loved-ones/ ‎

Summer safety for our elder parents and even us!

Most of us look forward to summer. Those who can often take vacation during this season, and many families use it for opportunities to visit their loved ones especially if they are far away from where we live year round.

For those who can, summer is often a time of recreational outdoor activities which may include long walks, swimming, going to beaches and such activities as cycling. Of interest is the fact that with the expansion of the older population many what have been referred to as seniors or elders are now actively involved in physical activities including those outdoors.

Continue reading “Summer safety for our elder parents and even us!”

Planning an elderly parent’s long trip

Planning an elderly parent's long trip requires thought and caution.

Your 80 year old mother wants to visit her sister who is older than she is and still lives in their small village in Scotland.

She says, "it is her 85th birthday coming up and if I do not visit her now I may never see her again". She is right and has a point; but the question is whether it is a good idea to go and if so alone or with someone? Flying has become a real chore and for elders it has many challenging components.

Continue reading “Planning an elderly parent’s long trip”

All our best wishes…

At this holiday period, we extend all our best wishes to you and your family.

Thank you for engaging with us.

Most importantly, thank you for caring about your elderly parents and other aging loved ones.

It is a journey that is not easy. We always say it's a journey of discovery. We all can and will learn so much. We will grow. We will eventually hurt and grieve. And we will recover and move on with loving memories.

Caring for aging parents is not something most of us plan for.

But it comes, happens, consumes us.

So again, all our best wishes as we all move forward with our lives and worlds.

          Bart & Michael


Plan good holidays for elderly loved ones

We posted this blog a year ago. Got lots of good feedback, so posting again and hope it's of help.

Best for the holidays from us both and back in the new year.

When you’re planning for the festive season, remember that older parents and other aging loved ones often have different needs than our children or we do.

Because they’re such an important part of our sense of family and the holidays, we need to plan good holidays for elderly loved ones. Too often we take for granted that our older family members can be as fully involved as we’d like. The fact is elderly family members may be lacking the stamina we’d wish they had.

That’s why it’s so important to plan all holiday events to ensure aging loved ones can enjoy them fully and that we can have the pleasure of their company.

Here are five steps for you to consider and apply in order to assure elder enjoyment at your family events this holiday season.

1. Reduce ‘wait time’. You can spend a lot of family wait time while meals are being prepared or people are dressing, or getting to a religious ceremony early in order to have good seating. But these are actually tiring times for the elderly. Help them by planning the latest time you can bring them to the event. That way, they don’t have to spend tiring ‘wait time’ doing nothing.

2. Build in ‘down time’. Make sure there’s at least half an hour or hour of rest time between events so your elderly parents can relax and perhaps catch a catnap or at least just have some personal quiet time. Their batteries run down faster now, and some recharge time becomes important.

3. Make meals more manageable. The more courses and the longer time a full meal takes, the more agitated little kids become… and the more aggravated older people become. Elderly parents will find long, drawn out meals fatiguing, even if they pretend to be enjoying themselves. So plan meals to be shorter, or plan strategies to respectfully give them options during a drawn out dinner so they’ll have some rest time.

4. Smart wrap for gift giving. Opening gifts that are tightly taped and tied with lots of ribbons is often difficult for the elderly. With reduced dexterity and maybe some arthritis, they can be stymied by some of the packages we present. Make it easier—and eliminate the embarrassment of being unable to open a package—by either wrapping their gifts much more loosely, or better yet, by putting them into attractive gift bags, covered with colorful issue paper.

5. Slow down and speak up. The elderly tend to process less quickly and don’t hear as well as once ago. To help them get the most out of your holiday events, slow down how fast you talk or do things, and speak more slowly and louder. Be sure to watch their reactions and body language very carefully for clues about how well they’re staying with you in terms of what’s being done and said.

And it’s also important to consider that for an elderly person who has lost a loved one, this is an especially difficult time of year. The loss, and the memories that inevitably freely flow especially during religious festivities, combine to create a level of personal hurt and pain we often don’t understand or respect to the extent we could and should.

When we consciously plan to meet the oft-unexpressed needs of our elderly family members, we’re ensuring they’ll be active participants in our holiday events. And we’ll know that their engagement is satisfying to them and to every person in the family.

The challenges of senior travel (part 2): the discomforts of traveling for seniors

Italian poet Cesar Pavese may well have had seniors in mind when he wrote,

“Traveling is a brutality. It forces you to trust strangers and to lose sight of all that familiar comfort of home and friends. You are constantly off balance. Nothing is yours except the essential things – air, sleep, dreams, the sea, the sky – all things tending towards the eternal or what we imagine of it.”

It may be that air travel, with all its attendant aggravations, would be too gruelling for elderly and frail individuals. Some possible issues:

·      The very long waits at airports due to heightened security

·      Access to washrooms and problems with continence

·      Problems with behavior or potential agitation may be difficult to deal with in flight, and unpleasant for staff and other passengers

·      Those with severe urinary urgency or incontinence should probably not to fly at all since the washroom wait on an airplane can be very long

Depending on trip length, driving might be an easier alternative for the older person.  For example, problems with urinary frequency or continence can be contained by planning to make frequent stops at service areas instead of waiting until the person says, “I have to go, now!!” Whatever the mode of travel, make sure that all necessary supplies, for example medications, absorbent pads and changes of underwear are easily accessible. The challenges of senior travel are many, thus the need to plan.

Keys to successful travel

Despite the challenges, travel may be worthwhile when previous experiences have always brought an improvement in the person’s sense of well-being. If the trip will really be a vacation, is safe, relieves the discomfort of a bad winter and/or offers a reunion with loved ones, it may well be worth the trouble.

The keys to a successful trip are:

·      Planning to ensure enough support and supervision to decrease potential danger during the trip and the actual travel

·      Providing any special considerations needed for comfort during the trip

·      Ensuring that travel insurance will cover any needed medical services, return travel costs and cancellation penalties

·      Defining beforehand how to obtain any necessary medical services, who to contact in an emergency, and how to return home early if necessary

Traveling with wings and roots

            Despite the enormous growth in destinations that cater to older people, travel is not as easy as it once was and the challenges of aging can magnify the difficulties.  But communication tools like cell phones, computers and Skype mean that seniors can be far way and still remain in contact with people who can help if an urgent need arises.

            With the right planning, many older people can travel in relative safety to enjoy those warmer climates and loving reunions.

The challenges of senior travel (part 1)

A patient of mine, whom I’ll call Juan, was in my office with his wife and daughter for a six-month check-up.  Juan suffered from progressive dementia and we had previously adjusted his medications to try to improve his mood and mental function and decrease his periods of agitation.

Originally from the Caribbean, Juan and his wife and children had made their home in Canada for many years. They still had lots of family and connections ‘back home,’ and travelled there often. With his increasing level of dementia, Juan began talking a lot about going home to the islands even though Canada was now his real home.

 “We used to take dad south to the islands every year to avoid the harsh winter,” said his daughter. “But now I am not sure if we can. What do you think, doctor?”

It was not the first time that family members or patients had asked about whether they should travel south as they had for the past 30 or 40 years. Some, like Juan, develop an almost ‘romantic’ association with their past and younger years in their former ‘homes.’ Unfortunately, with the past so vivid in their minds, these patients may have unrealistic views as to what awaits them should they be allowed to visit. Others seniors have second homes in a southern clime and feel something missing from their lives if they cannot escape the worst of the winter months.  In Juan’s case, I advised that a trip such as he is contemplating he and his family must clearly understand the implications, the potential risk and possible benefits that must be considered before a final decision to travel is made. It is not so simple as buying a ticket and getting on a plane. There are lots of challenges of senior travel.

When to stay home

 Do not travel if an existing medical condition requires frequent monitoring and has resulted in repeated, unexpected or serious or urgent admissions to hospitals or emergency rooms. Most travel insurance policies will not cover faraway treatment of such medical conditions especially if the cause of them is from what is called a “pre-existing” medical condition because of the potentially dangerous clinical uncertainty and extreme costs they entail.

Think Before You Go

When a disability has developed, the benefits of traveling don’t always outweigh the risks.  Here are some factors to consider when your older family member is contemplating travel—especially, but not exclusively, out of the country:

·      The medical condition

·      The medical implications of the actual traveling

·      Being far away from your normal professional caregivers

·      The need for reliable and adequate insurance to cover expected illness

·      The costs and other implications of getting needed care and /or having to return home in the event of sudden illness or injury

Check Travel Insurance Carefully

This means you could end up with potentially huge medical bills, especially but not exclusively from illness that occurs while outside the country. Insurance companies consider any medications changes that have occurred during a previously defined period (often 90 days) – may invalidate medical insurance coverage.

Clarify any such stipulations before the trip, as stopping or reducing a medication because of better outcomes of already-established treatment does not make the person a greater insurance risk for travelling. If medication changes do occur in the months prior to a planned trip, inform your doctors and ask for a note attesting that the reason for the change was for good and positive reasons that would not increase the risk of travel or illness.

Note:  This is not legal advice. The value of such a note prior really depends on the insurance company and on the traveler’s willingness to confront the insurance company if they reject the claim. Physicians who have written such a letter may be required to be called as witnesses should there be a claim that is denied and not every physician is willing to get involved in such complex and often contentious legal conflicts.

Part two of travelling with seniors to follow in next blog

Love your elders this Valentine’s Day

So men do it. Women do it. Even kids. When it comes to sending Valentine’s wishes, acts of love span all genders and ages. So remember to love your elders this Valentine’s Day.

Unfortunately, many people neglect to spread the love to aging parents and other elderly family members. Valentine’s Day is a perfect time to show aging loved ones you remember and respect all they’ve done over the years. All too often, we boomers caring for aging parents don’t show enough emotion or express enough appreciation and affection to those who over many years tried to give so much.
Here are five suggestions for sharing some “elderlove” this Valentine’s Day:

1. Go visit, even if it’s only a half an hour. Distance an issue? Call, or Skype.

2. Take a box of sugar-free sweets and a Valentine’s card. So many of our elderly parents and other loved ones have diabetes or weight issues that the taste will be welcome, but the sucrose won’t. And after the sweets are gone, they can look at your lovely card.

3. Take or send potted flowers, which last longer than cut flowers. Attach a note that explains why these flowers are especially meaningful.

4. Plan a lunch or dinner together and recollect childhood stories about how your parent demonstrated love and affection.

5. Build and present a small album of old photos, complete with brief descriptions.

And if you want to do even more, try gathering the family clan and creating a spontaneous love-in with your parents and other aging relatives. That means organizing at least a handful of close family members and with little notice show up with heart shaped balloons, treats to share, and some appropriate songs to play and engage them in a short but heartfelt event.

Or, try arranging a series of telephone calls to your parents spaced out over the course of Valentine’s Day, with family members and friends calling just to share a telephonic hug.
 All in all, it really doesn’t take a lot to make our parents and other aging family members feel like they’re at the centre of our universe and much loved. They’ll appreciate it, and relish in the attention and affection we’re showing them.

Pivotal year in eldercare closes with challenges for us all

In many ways, 2013 will be remembered as a pivotal year in the evolution of the brave new world of eldercare in the family.

In Canada, this year marked the start of a more open discussion of the moral and ethical implications of assisted suicide for the willing aging and ill.

It marked the Supreme Court of Canada ruling that a family’s decision to maintain it’s ill loved one on life support trumps the verdict of health care experts.

This year saw more media attention to the challenges families face in offering care and attention to the aging elderly.

As well, during 2013 we saw more reports of violence in nursing homes: elderly attacking elderly, suggesting cognitive issues perhaps not yet really defined, not to mention questions of supervisory and safety standards in nursing homes across the country.

Globally, the Canadian experience is being repeated over and over most everywhere. Perhaps it’s being most strongly felt in China and Japan where the aging population can no longer count in the sustained support of their children and grandchildren who are moving away from the traditional family home to find better jobs and brighter lifestyles.

Strikes close to home
Personally, this past year I’ve been in some way or shape engaged in a host of situations experienced by many friends involving some aspect of family care and resulting pressures and conflicts. Here are four examples:

•    A couple with a son who returned home six months ago ‘for just a few weeks’ after losing his job and with no firm new prospect while concurrently looking after three aging and frail parents and all the while still both working full time. They are struggling to make ends meet and keep getting up five days a week to long, long work days. They don’t know where all this leads; they’re too loving to challenge their son to be more proactive in getting back on his feet, and too loving to find better solutions to eldercare.

•     A 71 year old bachelor with a 94 year old ailing mother who still lives alone in a tiny apartment and is suffering from severe arthritis and mild diabetes; they live in the same region but he’s an hour’s drive away and expected to visit at least four or five times a week. And because both are strapped financially, he feels compelled to come help her, clean her apartment, and of course has to run errands for her and take her for doctor’s appointments. Problem is, while he’s in relatively good health, he needs time to live his own life. 

•    A couple in their early sixties in Toronto with both sets of parents still alive: one set in their early eighties and one in their latter eighties. What complicates their lives and stretches their resources is that her parents live in Kamloops and his in Halifax. Trying to provide long distance loving attention to both sets of parents is becoming ever more difficult and expensive for them. They have committed to at least annual visits to each set of parents and have been working on finding local support resources to help out.

•    A friend just past his mid seventies whose wife has been diagnosed with early stage Alzheimer’s and has lost her driving license while they still need to find ways to support her 94 year old mother in a close-by nursing home who demands a lot of time and attention. He is starting to fray at the edges as he juggles his wife’s expanding needs, his mother-in-laws continuing needs, his relations with his children and grandchildren, and the need for time for himself.

The common denominator
What all these friends and acquaintances share is the element of an aging and ever more needy parent. And it’s what growing numbers of Canadians are experiencing. More than four million of them, in fact. And hundreds of millions more worldwide. 

It’s what’s come from being hidden on the back streets of society to finally blasting onto main street: the monumental range of issues and challenges of eldercare in the family. We’re all listening now, experiencing it, starting to share it, finally learning how to deal with it.

The warning signs have been there for more than a decade, but we’ve elected to ignore them. Now we don’t have a choice. Now we share the enormous challenge of finding better and more ways to care for the elderly in humane and responsible ways.

It’s not easy. And that’s been a major lesson this year.

Michael and I wish you all good experiences for the next year.