Exploring a Future Move for Your Parents

If you are a baby boomer, the chances are there is a new topic at your cocktail parties - war stories on the struggle to care for elderly parents. Persuading aging parents or relatives that it is time to move to some type of facility (independent living, assisted living, retirement home, nursing home, etc.) is excruciating for the parents and exasperating for the children. If you watched "The Sopranos" on HBO, just think of what Paulie went through with his mother! This article will attempt to give some ideas on how to cope with this complex challenge.

Helen Peterkin, our dear friend of sparkling personality and a certain age, is our personal hero on this subject. She and her husband, Gordon, acted decisively when he was diagnosed with Alzheimer's in the early 1990's. Gordon, whose father also had the disease, saw his future and announced that they had to move to an assisted living facility. Helen cried at the prospect of moving out of their lovely home, so he gave her another year. Then they moved to Evergreen Woods, a top-notch facility in Branford, CT. The couple was able to live together for a few years in their beautiful and spacious apartment there, until the progression of Gordon's disease meant he had to be moved to the health center. Economically their decision was a smart one: his extensive health needs were taken care of at no extra cost. But socially it was the right move too. Helen made friends and built a rich life in her new community. Since Gordon's death Helen has soldiered on, traveling the world and continuing to play an impressive game of golf. Recently she was kind enough to share observations about what she has seen as her friends have had to face a life change.

Helen's experience with her senior friends is similar to that of many of us - it is very difficult to get the elderly to admit that it is time to move, and even then to take the steps that will get them into a good facility. Helen is quite definite that every time she has seen a couple wait too long, "it has been a disaster". What that usually means is that when one or the other of the couple becomes seriously ill, they either can't get into the facility of their choice, they have to pay a premium of several thousand dollars per month, or they have to settle for the least attractive facilities and/or units. Stress levels rise and families are disrupted as worried children scramble to research and gain admittance for their parents into the right kind of facility.

The Bionic Parents - We're Not Ready... Yet

This editor's parents are in their 90's and up to recently in near perfect health, playing golf and bridge almost every day. But since no one lasts forever we children have been trying to persuade them to move from their retirement community in Fort Myers FL, to an assisted or independent living community near most of their children in Connecticut. All of our entreaties have fallen on deaf ears - with concerns cited such as "having to move in with all the old people", or "where would we play golf". Now that my father has a serious health condition they have finally put down a deposit at an independent living facility in Ft. Myers - but they haven't moved in yet!

A Check List for Exploring a Move to a Senior Living Community

Please note that these ideas are just suggestions. Every family's situation is different and requires individual approaches. The forces keeping seniors from moving out of their homes are real and powerful. There are many kinds of success - so be reasonable, persistent, and hopeful.

1. Start early. Don't wait for the first sign of health deterioration.
2. Be consistent. If it looks like they will need help soon, be honest and keep presenting a consistent message. Try to get all family members on the same message - you don't want Suzy promising to take care of them if Don thinks they need to enter a facility.
3. Act on Bad News. When the elderly get sick they are often more able to see more clearly what is in store for them ahead. A situation like that might provide a good time for discussion.
4. Visit facilities now. Take your loved ones around to facilities now. You will like some, and your parents will like others. Having an idea of where they would like to go will help.
5. Get them to visit their friends who've moved. The visit with the marketing people is one thing, which most people view skeptically. But if you or they have friends who live in a facility, have them invite your folks over for a meal or social event. Seeing the good life in person can overcome a lot of negativity and doubt.
6. Make a deposit. This is an insurance policy. For a small deposit most assisted living facilities or continuing care retirement communities (CCRC) will guarantee a spot for your loved ones for a certain period, IF they can pass a medical exam at that time. Even if they don't ultimately decide to move in they will at least have somewhere to go if (and when) disaster strikes.
7. Be understanding - but firm. Leaving their homes and giving up privacy and independence is a traumatic step, so don't ignore those feelings. But on the other hand be firm about your capabilities and intentions. If you cannot care for the parent, either in theirs or your own home, say so. As Helen Peterkin told us, the power of a child saying "I can't take care of you anymore" can be the tug that brings about change.
8. Stress the positive. Helen's advice on this point was great. Take your parents to a facility. Once they see what a good time everyone is having socially, with so many friends and things going on so close, they will want to move. She adds this is particularly effective with single women, who often face the triple problems of social isolation, declining ability to drive, and ready access to good medical care.
9. It's not your decision. Remember that this is ultimately your parents' choice--regardless of your strong opinions and preferences.
10. There may be other, better options. Consider that there may well be other and better options for your loved one. For example in-home care might be possible, keeping them in their normal home and avoiding a traumatic move. And of course, some parents live quite happily with one of their children.

References:  topretirements.com  Article Title: “How to handle When it is Time for Your Parent to Move”

The Sandwich Generation: Confronting the Aging of Your Senior Parents

By Philip D. Shapiro, M.H.A., M.S.P.H.

As a 45 to 59 year old living in the greater Steamboat Springs area, there’s a reasonable likelihood that you are financially obliged to a child or two, yet are also carrying the more obvious burden of emotionally engaging your Senior-Parent(s) evolving needs that require your intervention, support, and guidance. It sounds like you need to have a professional background in counseling, or possibly you may be in need of some, yourself. If so, you have now become a card-carrying member of the “Sandwich Generation”, stuck in the middle between high school/college age kids and your parents; you are now on double-duty that can financially and emotionally stress you into un-chartered waters.

Unlike the days of the “Walton’s”, however, our society very rarely combines multiple generations in one household, let alone the same geographic area. The phenomenon of geographic displacement of generations poses yet another challenge- how do we become effective problem solvers and navigate through the entangled web of financial, emotional, health, and social complications that effect teenagers and senior’s, when we don’t have any training to do so? Further challenging us in mid-life, our biological disposition drives us closer to the ideal of gaining control of our lives, so, how ironic it is that the control we seek is now being compromised by the uncertainty of the aging of our children and parents. And we, too, are not getting any younger (you can become a member of AARP at age 50)!

Since we’ve had better practice at parenting than coping with our parent’s aging, I suggest we focus on the latter. On average, add 25 years to your age and that will bring you close enough to your parent’s ages, which may range from the early 70’s to mid- 80’s. Your prime goal should be to effectively gauge your parent’s physical and cognitive capabilities and limitations, and identify which ones are more dominant than the others. Health care professionals utilize normative scales that measure IADL’s and ADLS, or “instrumental activities of daily living” and “activities of daily living”. Some examples of IADL’s include the ability to manage money, grocery shopping, preparing meals, and the ability to travel to places beyond walking distances, while examples of ADL’s include eating, bathing, dressing, toileting, and transferring. These are some of the fundamental traits that are obvious and can provide insight into aging trends. If you are not in regular geographic striking distance to your parents, however, you will need to rely on family and/or friends to be your eyes and ears.

Recent research in the Aging field suggests that it’s important for seniors to maintain a consistent focus on body, mind, and spirit. All of these avenues have the common denominator of striving to live an independent and purposeful life, while keeping in check any diminishment of ADL and IADL’s. In a recently published book, “Leisure in Later Life”, 2004, Haworth Press, Michael and Sara Leitner emphasize the importance of senior’s continuing to exercise, participate socially with peers, seeking out new hobbies, and even considering new living environments, such as active senior living communities.

Exercise programs for today’s seniors exist in far greater scope than placing markers on a bingo sheet. Research shows the importance of maintaining flexibility in later life and stretching, Yoga, and Tai Chi are now in vogue in many senior’s communities and public senior centers. Walking and swimming are still considered the “gold standard” for aerobic conditioning, as they have are considered non-impacting on joints. The importance of building a small layer of muscle mass cannot be understated, as the number one reason that drives senior’s to the hospital is not heart attacks or cancer, amazingly, it’s falling. Being resilient to avert breakages is a preventive measure in later life.

Exercising the “mind” is also expressing itself in the form of national studies on Dementia’s and Alzheimer’s Disease. Preliminary findings suggest a strong correlate between staying mentally active and combating the diseases that affect memory loss. Many colleges and universities offer “Elder College”, which allows seniors to attend courses (no tests) and continue lifelong learning. Additionally, colleges and universities house “Small Business Centers” that offer “S.C.O.R.E.” – the Service Corps of Retired Executives, which provides a mentoring program for retired business people to work with younger small business owners.

You most likely made the move to the mountains to “get away from it all”. I encourage you, however, to not remove yourself from interaction and communication with your senior parent(s). Stay in regular communication and be cognizant of the importance of putting the “shoe on the other foot”- in other words, it may be time for you to become the one that encourages change in your parent(s) lives to help them achieve new found purpose. It could be as simple as allowing them to excel at being grandparents if they reside locally, or as cumbersome as encouraging them to relocate closer to you.

To be an effective advocate for your aging parents, you will undoubtedly have to overcome the “ageism” (prejudice towards older adults in our society) that is prevalent in our country. Why is it that we “expect” to retire at age 65, and assume government-sponsored Medicare and Social Security benefits, quit our professions, get the company gold watch, and ride off into the sunset? In recent years “reality shows” have engulfed the airways, but none are based in a retirement community or nursing home setting! We must appreciate the wisdom that is inherent in older people, and not forget their contributions to our families and communities.

Ageism struck me right between the eyes while recently listening to the radio in route from work to home. The DJ said “…playing Oldies but Goodies…” But the music was only from 1975? I’m 52, but guess what? I’m confronting ageism, too. I was labeled by a DJ that may be 15 years younger than me as someone who identifies with “old music”. The song that had just been played is one of my favorites and a “hit” for the ages- “Hotel California” by the Eagles. I grew up listening to their music in the ‘70’s.

I was in my teens then. The band members were in their 20’s. I did some web-browsing to confirm the current ages of the Eagles, and I’m happy to note that they could all be card-carrying members of AARP! Glen Frey- 64; Don Henley- 64; Timothy B. Schmidt- 64; ; Joe Walsh (yes, he’s still alive)-63. Joe was recently quoted as saying "We're all older now, and we're a little more emotionally predictable and we don't have substances in our brains and we have kids. 

My wife and I saw an Eagles concert a few years ago and they sounded better than the last time I saw them live at a concert in the University of Florida Gator Football Stadium over 35 years ago (my Alma Mater)! Older…Better…what a concept! Possibly a little more mature? Maybe some better acoustical technology? Should I carry this metaphor into the wine field? Don’t they say the fine wine matures as it ages? We commonly say that older people are “over the hill”, but these older singers are stilling rocking, and not in chairs!

The closer in geographic proximity you are to your parent(s), the easier it will be to identify their needs. A migration trend of senior-parents has emerged showing significant relocation to the mountain states and southwest. Senior parents are moving from all quadrants of our nation to be living closer to their adult children. This phenomenon is strongly evidenced by many senior living communities having half of their residents migrating from out-of-state.

Being a sandwich generation member doesn’t infer that you will have to press the self-destruct button. It will undoubtedly add some complication to your life that can be neutralized by you taking a more proactive role in understanding, confronting, and respecting your parent’s aging, while doing what you do best in raising or supporting your children.