Summer 2000 , Vol 4 , Issue 1
Parent Care

When is it time to intervene?

This issue of the Senior Care Management newsletter is dedicated to Parent Care. We will cover: What are the signs that your parent may be having a problem? When is it time to intervene? What are effective communication techniques? What are the issues that must be discussed? Remember, it is never too early to discuss and plan for the future.

The Warning Signs that a Parent is in Trouble

If your parent is having difficulty performing the tasks of daily living, such as; cooking housekeeping, home maintenance, bill paying, and grooming/hygiene, it bears further investigation.

• If your parent was a good cook or housekeeper, or very conscientious about paying the bills, and you see a marked change in these habits, then there is reason for concern. On the other hand, if your mother is recently widowed and is having difficulty with the bills, she may just need a helping hand until she can master these new skills.
  
• If your parent is experiencing a decline in health concerning any of these issues: loss of appetite, change in sleeping patterns, loss of hearing, incontinence, or becoming accident-prone, medical intervention is required. All of these symptoms can be attributed to medical conditions that can be treated.
  
• If your parent is confused, suspicious or fearful?and this has not been a part of their personality or seems exaggerated?then this is a sign that there is a problem. If your parent goes to a familiar place and can't get home or doesn"t remember the names of longstanding friends or family, then it is time for you to act.
• If your parent focuses on negative attitudes and behaviors, this is often a sign of depression. If you notice a loss of initiative in the pursuit of hobbies or socializing, and this is a substantial change, then there is an issue that must be addressed.
• If your parent is drinking more alcohol than usual, or is using medication inappropriately, this is a sign that something is amiss.

Once you establish that there is an issue, the next step is to speak with your parent.

How to Approach Your Parent

Deciding to intervene on behalf of your aging parent is one of life's most difficult decisions.

First, take an inventory of your role in your family and your parent"s perception of you. Ask yourself: Am I the most appropriate person to address these issues?should I involve my siblings?

Keep in mind your parent's personal style. Are they very private or are they forthcoming? Reflect back on how other family matters have been hand-led for guidance on what style may be most comfortable for everyone.

Conveying your love and concern is important. A supportive approach is critical. Starting the conversation with an "I? statement such as "I am concerned because I have noticed...? or "I am worried? or "I feel?. Using these statements ensures that your parent will not feel blamed or judged. In using 'I? statements", you are expressing your feelings to which you are entitled and which are harder to argue with.

If you have a family member or mutual acquaintance who has had to deal with a similar problem, use that experience as a point of reference for discussion.

The goal is for you to engage your parent in a conversation. Make sure you are talking with and not at your parent. You will gain more by using tentative, exploring questions such as "What things bother you?? and ?What do you what to do about this problem?? Ask questions to help analyze your parents plans. It is important not to present answers or conclusions.

Provide your parent with possible resources and information. If your parent is capable, involve them in the process?empower them.

Lastly, be patient, keep a sense of humor. If things get too testy, drop it and try again later.

Remember that a geriatric care manager is a resource you can call on to help facilitate these meetings. Contact Senior Care Management at (609) 882-0322 or the New Jersey Chapter of Geriatric Care Managers at (856)795-8001.

RESOURCES FOR FAMILY MEMBERS

Alzheimer's Association/Greater N.J. Chapter
(609)514-1180
Information and referral, support and newsletter.

Children of Aging Parents
(800)227-7294 (toll-free)
Information and newsletter The Capsule.

Parent Care Advisor
(800)341-7874 (toll-free)
A monthly publication.

GERIATRIC CARE MANAGERS:

CENTRAL NEW JERSEY:

Senior Care Management®
(609) 882-0322 (phone)
(609) 882-9400 (fax)
http://www.seniorcaremgt.com
261 Upper Ferry Road
Ewing, NJ 08628
In-home assessments, home health aides and care management.

NEW JERSEY:

The N.J. Chapter of Geriatric Care Managers
(856)795-8001

NATIONAL:

National Association of Professional Geriatric Care Managers
(520)881-8008 For a fee—national list of professionals who care for elderly persons.

Important Issues to Discuss with Your Parents

Assuming that you are not having to deal with an immediate health or safety crisis the following is a list of items that you should discuss and document with your parent.

• If you lack information about the current medical professionals serving your parents, work with your parent to set-up a resource book with their names, addresses and phone numbers. This list should include specialists, such as their podiatrist and any rehabilitation services, as well as their pharmacy.
• Determine your parent"s assets as well as their location. Are there stocks, bonds, cd's, bank accounts, insurance? If you can, record the investment institutions, account numbers and telephone numbers.
• If you are not aware of a will, ask your parents if they have made one. Determine the name of their attorney and contact information, and the location of their will copy.
• Ask your parents if they have executed an advance directive (“living will”). It is imperative that you know what their feelings are on end-of-life issues, so that the family can act in accordance with their wishes. You need to know if anyone has been appointed to act as their health-care surrogate in the event they are unable give informed consent.
• Ask your parents if they have made any plans regarding their burial or cremation? Record any cemetery plots or pre-arrangements that have been made. Discuss with them their preferences in terms of a funeral or memorial service.

For expert legal advice, contact the Bar Association and ask for a list of Elder Law Attorneys. These attorneys are skilled in the areas of advance planning, estate planning and other important legal issues related to older persons.

Senior Care Management maintains a Personal Record of Assets and Property for each of our clients. If you would like a copy of your records, please contact our office at (609) 882-0322.

Consider Consulting with a Private Geriatric Care Manager

A growing number of professionals are offering private case or care management services designed to help caregivers locate and coordinate social services. Each care manager operates differently, but typically the care manager will evaluate the older person"s situation, make recommendations, arrange appropriate services and keep family members informed. Usually the caregiver needs to locate a care manager in the city or town where the relative resides. Some care managers, however, have a network of associates in various cities across the country.

Private care managers are frequently listed in the yellow pages under Social Services, Social Workers, Aging Services, Senior Citizen Services and Home Health Organizations.