Life/Work Balance: The Sandwich Generation

By Harry Dennis, III for BizTimes. Read the full article in BizTimes HERE. 

How to care for ailing and aging parents. 

I’m dealing with aging parents, and I’ll bet many of you are, too. It’s a complicated, confusing subject, particularly if your parent is also ailing.

This month, I’ll scratch the surface and, hopefully, get you thinking about how you’ll handle this now or in the not-to-distant future.

Many thanks to Vistage for letting me borrow tips from a recent white paper on this topic.

When it’s time to intervene

How do you know when it’s time to step in and help your parent? When you see one or more problems related to:

• Basic tasks like walking, driving, getting dressed, preparing food, changes in appetite, or climbing stairs.
• Hygiene such as infrequent bathing or teeth brushing, unkempt or sloppy dress habits, or general appearance problems.
• Responsibilities such as unpaid bills, forgetting medications, not making key appointments or sloppy housekeeping.
• Health issues like weight loss, insomnia, hearing loss, bed wetting, difficulty swallowing or losing their balance and falling.
• Isolation such as lack of interest in hobbies, not keeping social commitments, unreturned phone calls, or showing signs of a “hermit-like” existence.
• Attitude, including unusual aggressive behavior, verbal abuse, drinking too much alcohol, showing they’re emotionally depressed and being overly defensive.
• Cognition such as memory lapses, suspect reasoning ability, asking “Where am I?” and not recognizing friends or family members.

How to call a family meeting

Getting siblings and others who are close to the family onboard early is critical. Arguments about what you should do to intervene will make the problem worse.

Here are three ways to keep that from happening.

First, select a family spokesperson, preferably a sibling, who should be the key contact for doctors and other professionals. Their job is to keep the family informed of decisions that are being suggested or made about the parent’s care.

Second, meet with your elderly parent, either with or without the primary family physician, for a “gentle” talk that the family spokesperson initiates. Cite specific behaviors that are potentially dangerous, and offer possible solutions. For example, you might tell your mother about her dangerous driving and suggest other family members or close friends who have volunteered to drive her where she needs to go.

Third, have an action plan. The toughest part of any intervention with aging or ailing parents is to get them to agree on an action plan that will keep them safe. The final part of the family meeting should discuss these alternatives.

Other considerations

Some options might be too expensive. Cheaper alternatives include Medicare, supplemental insurance, Tricare if the parent is retired from the military, and long-term care plans if the parent qualifies.

Don’t forget about the parent’s investments, pensions, 401(k)s and savings accounts.

Financial problems become more difficult when the parent isn’t just elderly, but ailing and needs around-the-clock care. It isn’t uncommon to hear about out-of-pocket costs of $100,000 a year to care for an ailing parent while maintaining their personal dignity and respect.

Here are two other important considerations I’d like to see on a billboard:

• Safety. If professional caregivers determine that a parent is behaving unsafely, especially unconsciously so, this limits the parent’s future alternatives.
• Independence. This is the magic word in the professions that deal with aging/ailing parents. Make sure your father can balance himself while walking, especially from the bedroom to the bathroom at night. Falling is the crucible of aging!

Here are the other options you can consider now or later:

• Aging in place. Your parent stays at home, and you hire in-home care to handle basic chores like cleaning, washing clothes and sheets, buying groceries and  preparing food.
• Professional certified companion. The companion comes to the parent’s home. You can ask for someone with some degree of medical knowledge who also can do things like help your parent go to the bathroom and bathe.
• Skilled nursing facilities. They provide medical and nonmedical care, and are especially useful if your parent has dementia or Alzheimers. They can be expensive.
• Senior daycare. They’re much like day care centers for children and offer a variety of activities in a safe environment.
• Assisted living. These facilities are usually offered by a nursing home. They provide daily meals and basic needs assistance, and have access to nearby medical care.
• Full-time home care. This is a popular but expensive option.

This issue is one of the most traumatic we will ever face in our lives, either as the adult child who must make the decision, or as the elderly or ailing parent who needs help.

So many other issues complicate the problem: medication management, separation from the spouse and family, and legal issues like health and general powers of attorney. I wish I had the space to discuss them.

Until next month, if you’re grappling with this problem, my heart goes out to you. By the way, Wisconsin and Michigan have wonderful resources that can help you.