Tuesday, October 14, 2008

Helping an aging parent in crisis - four categories to consider

October 14, 2008

Helping a parent in crisis. Here are the four categories of care/aid that I considered while helping my mother through her medical and living situation crisis.



Current living situation

Future living possibilities

Here are tips that helped me:

  1. Health
    1. Establish a relationship with your parent’s doctors
    2. I already had an email relationship with her specialist of 6 years at Johns Hopkins Hospital. I found his academic email address on the university website. He responded to my emails within 24 hours, often with a phone call.
    3. I had no relationship with her primary care doctor. But, when I arrived in Maryland, I went with her to her next appointment. My mother has a way of putting on a fa├žade that everything is ok. When the doctor left to get something, I followed him out into the hallway, pulled him aside and filled him in. I told him how I found stacks of unfilled prescriptions as well as numerous pills in her carpet. He immediately offered contacts at service agencies in the area to help.
    4. Ensure that your parent goes through the primary care doctor on everything. My mother was going to an ENT and dermatologist on her own. Sometimes their prognosis and new medications would negatively impact her overall health.
  2. Finances
    1. Establish your parent’s financial situation as soon as possible. Over the 20 years since my father’s death, my brother (who lives one state away) had accepted responsibility to keep an eye on her finances. I found out quickly all that meant was he ensured my mother received the same checks each month. He (and she) had no idea, long term, what the money flow would be.
    2. I looked at my mother’s last 1099s for her income tax and called every financial institution. I called each (with my mother present); she gave authorization for me to speak with the institution. I also made her listen and understand every conversation. I was willing to help her stabilize but I did not want to become a crutch. I found out what type of fund she had (annuity, IRA, pension…), the monthly disbursement, how long it would continue. We also put her on direct deposit for all funds. KEY: Knowing how much she money she had (long term) enabled my mother to consider all the alternatives of living situations. This was a very positive, freeing and turning point for her and me.
  3. Current living situation
    1. My mother had lived in her home alone for the past 20 years. She enjoyed visiting us so I rarely went back. I realized she had a shopaholic problem which I had tried to resolve previously with no success. But, since she had been confined to her home for 3 months (due to medication and being unable to drive), her house was in a horrible state (trash everywhere; dishes, mail, newspapers stuffed under furniture), refrigerator with much outdated food; kitchen piled high with dirty pots and pans, beds covered with feet of clothing she had nowhere for. When I arrived, I was overwhelmed by the condition.
    2. I hired a cleaning service to come in for 4 hours. They immediately told me they only did surfaces. So, I had them do the bathrooms and vacuum and dust as they could while I tackled the kitchen. I had to get the house in a liveable state to bring my mother home from the hospital.
    3. I had a friend of the family, a realtor, walk through and assess the house and tell me about the housing market. He also referred me to a refuse guy and a general contractor who could renovate the house if she decided to sell and move into a retirement community. She told me that she knew her living condition was bad. She just didn’t know what to do about it. She denied her friends and neighbors entry. The part that was difficult to understand was how my brother (who visited regularly) did not see there was a problem. There were bags throughout the house he had brought with cereal and canned goods. It was like trying to put a bandaid on a large wound.
    4. For the remainder of the week, I would get up at 5am, tackle paperwork until Mom awoke at 8. Then I tried to get her to learn to check her diabetes, learn to eat properly and clean up after herself.
    5. We began to map out her living options. She would need lots of interim help even if she did decide to sell her home and find a retirement community she liked.

The initial hard part is confronting all the problems and trying to create order out of chaos. I tried hard not to point blame at anyone or anything. You really need to channel all your energy into finding solutions. I tried to segment out parts of the day to address the various categories of need. And, above all, you can’t rush your parent. I often had to make myself stop and sit down and spend time with my mother. So many lessons learned for both of us.

Stay tuned tomorrow to find out how we explored the various options that first week.