When Lisa Winstel went home for the holidays to visit her in-laws, then in their late 70s several Thanksgivings ago, some warning bells went off: Expired milk in the refrigerator. Leftovers that looked like science projects growing mold. Aerosol cans resting on a stove with a pilot light.
And then one night at dinner, Lisa's mother-in-law slipped off her chair. Without missing a beat, her father-in-law helped his wife back into the chair like nothing had ever happened. Lisa's father-in-law admitted that his wife fell frequently. Apparently, he had grown accustomed to it. But the fall and her father-in-law's nonchalant reaction startled Lisa. Because deterioration can be gradual, it's not unusual for spouses to make allowances for many of the slips, falls and misplaced keys and disorientation.
How to Have the Tough Conversation
Today Lisa is the Chief Operating Officer of the National Family Caregivers Association and is intimately familiar with not only the signs of aging but the services to help find appropriate care. But at the time, she had no experience in senior care. In fact, Lisa was running a theater company in Ohio. But she was alarmed by what she had seen; and it prompted a conversation with both her husband and ultimately with her in-laws.
"The adult children of aging parents may not want to see the changes that are happening and may even overlook them because it's painful to see. Sometimes it takes the spouses of the adult children to delicately bring it up," Lisa says.
Lisa also advises that the best way to handle the conversation is delicately and not in a group situation.
"Because you can be dealing with multiple levels of emotions and relationships, you may want a softer approach when you bring it up such as, 'I noticed when we were at your parents' house there were some things that seemed unsafe.' And then discuss what may be best for them rather than saying 'wow, your parents have really aged.'"
This may make sense but it can be a tough conversation to even get started. Lisa says that it's important to recognize your spouse's feelings and the reality that they may not be emotionally ready to acknowledge or confront a big change.
"When people go home for the holidays they may simply just not want to see what's going on with their parents because it's too scary. They can be in denial because they fear that it's the beginning of the end," Lisa says.
And then there are the sibling conflicts. You may not always be united in recognizing that your parents need help or agreeing on the issues that need to be remedied. While you might see something that's out of the ordinary and worries you, your sibling may think you're crazy or being overly dramatic.
Lisa says that it's typical for the sibling who lives closest to the parents and visits them most frequently, to not see the changes because gradual changes tend to go unnoticed. It is usually the adult child from out of town who comes for a visit and becomes alarmed by the condition of their parents. Some signs to look out for include:
Warning signs include:
- Cleanliness: If you see mold or mildew growing, or insects, take notice. This can become health concern. Neglecting personal hygiene and cleanliness is also indicative.
- Forgetfulness: Misplacing a cell phone in the freezer more than once or other signs of out of the ordinary forgetfulness
- Decrease in socialization and activity level
- Driving issues: dents in a car, erratic or unsafe driving
- Mishandled finances
- Misuse of prescribed medications
It is also typical that one adult child will take on the role of family caregiver. But Lisa warns that you have to be careful to not resent the other siblings. In fact, there are now lots of things people can do from a distance to help care for their parents. And incremental steps can make a dramatic difference and keep your parents safely in their homes for as long as possible. These include:
Small Steps that Make a Big Difference:
- Paying for a service to do a weekly or bi-weekly cleaning can be the best gift to your parents
- You or a sibling can pay the bills and be in charge of handling the finances
- Have a friend, family member or paid help regularly check the refrigerator, stock it and clean it out
- You or a sibling can manage the doctor's appointments
- Fixing doorways and door knobs or adding safety bars in showers can prevent slips and falls. Anything you can do to prevent falls can often prolong living in one's own home
Lisa also recommends discussing with your parents their critical "Five Wishes." These are documents that provide for:
- Designation of the person you want to make care decisions for you when you can't (Power of Attorney - POA)
- The kind of medical treatment you want or don't want (Do Not Resuscitate - DNR)
- How comfortable you want to be (comfort and palliative care)
- How you want people to treat you (end of life/hospice issues)
- What you want you loved ones to know (Ethical Will)
Many people don't know if they need help or how to determine the next steps in finding care. You can take a Care.com quiz at: http://blog.care.com/sheila/2010/11/get-prepared-take-the-senior-care-quiz.html to see if you need help. Proper planning today can help alleviate stress in the future.