Posts in "Senior Move Management"

Hi

For most of us, communication is like breathing; we do it naturally, without thinking. But for people with aphasia, communication can be an insurmountable challenge. Yet, if you listen, if you really listen, you would be amazed at how clear a message can be. 

stroke  Hi stroke1

Some time ago, we were moving residents on an assisted living floor to temporary quarters in the building so their apartments could be renovated.  One of the residents was a 61 year old man who had lost the ability to speak as well as the use of one side of his body, as a result of a stroke. He was able, with great difficulty, to shuffle his wheelchair along.  However, the only word he could say was “Hi”.

He positioned himself by his apartment, which was being prepared for construction, and kept trying to enter it.  He was clearly agitated and kept saying “Hi, Hi” over and over again to everyone passing by.

One of our staff followed him into his apartment – an immaculate area with beautiful hardwood floors.  Over the next hour, our staff member and this gentleman communicated, and by inflections, eye and hand movements and many “Hi’s,” we understood that he was extremely concerned that his floors would be damaged during construction. We assured him that his floors would be protected, and he smiled.

A week later, the renovations were complete. In spite of the many signs and warnings left for construction workers about protecting the floor, there were scratches and dirt everywhere.  One Moving Solutions staff member got Housekeeping on the phone and asked, “Can you get up here, stat?” while other team members assured the gentleman that his floors would be fixed properly.

For the next three hours, the floors were swept, mopped, waxed and waxed again. By the end of the afternoon, they were beautiful. Our staff escorted the gentleman back to his apartment, where the floors shone and everything was in place..  He looked at them, smiled, gave a thumbs-up sign with his good hand, and said loudly and joyfully, “Hi.”

I am always proud of Moving Solutions staff, but sometimes they humble me.

Moving Mom and Dad

Sometimes it starts with a phone call at 2 AM. “Your mom had a stroke.” Sometimes there is simply a gradual worsening of chronic conditions, and over time the home that worked so well for so many years is too burdensome. In either case, your life is turned upside down. There are hundreds of decisions to be made: where will your parents  move, what will go with them, what will happen to everything else? Your parents are overwhelmed, and so are you.

emotional  Moving Mom and Dad emotional

If you’re a typical Boomer, you take pride in multitasking, getting things done, crossing things off your list. The problem is, your parents may have a different agenda. Faced with the multitude of losses that accompany old age, they may cling fiercely to independence and the need to be in control. They may also be focused on reviewing their life and creating legacy. These different agendas can create conflict and impede progress. Listed below are our top 10 tips for Helping Mom and Dad Move. The tips are designed to maximize your parents’ sense of control and respect their need to reminisce, because honoring your parents includes honoring their agenda, as well.

Tip #1: Let your parents’ emotional and physical comfort guide the process.

Your parents’ priorities and perspective may differ from yours. Seemingly insignificant items may be loaded with personal meaning and memories, and objects of great material value may be less important. They may prefer old, worn objects to newer ones in better condition. Honor their decisions.

Your parents may have a sequence in which they need to proceed that differs from your own. If books are very special to your parents, for example, they may need to determine what will happen to the volumes not going with them before they are willing to focus on other issues. Attempting to force your parents to proceed in a sequence that doesn’t address their priorities usually results in arguments and inattention

Tip #2: Try to replicate the old environment.

Your parents will be experiencing a lot of change. It will be comforting to have some things stay the same. Take photos of each shelf in the china closet, the arrangement of pictures on the wall, and of items on bureaus and end tables. The photos will help you recreate the feel of the former home with speed and accuracy and will make the new residence look and feel more like home.

Tip #3: Focus on sorting, not packing.

Preparing for a senior move is a major organizational challenge. There may be decades of belongings to sort through in attics, basements, spare rooms and closets. In addition to what is going to your parents’ new home, there may be things going to family members throughout the country, as well as the church bazaar, Purple Heart, an auction house, and the township dump. It is here, more than anywhere else, that your help is needed. Helping your parents sort and organize their belongings is the single most important thing you can do to reduce stress, save money, and ensure a smooth move.

dadmichael  Moving Mom and Dad dadmichael

Tip #4: Accept their gifts.

Your parents may want to give you items they cannot use, including things you don’t want. Take them anyway. Store them in your basement if you must, but accept them graciously. Your parents will be parting with a great deal. Knowing that cherished objects, and even ordinary things, are with family members makes it easier to part with things and  reduces the feeling of loss. If your parents are warehousing things that belong to you or your siblings, take them now.

 

Tip #5: Be tactful.

Poor health, caregiving duties and failing eyesight can result in housekeeping practices that are less stringent than they once were. Tactfully clean things as you sort, but avoid making your parents feel embarrassed. If you find clothing that is torn or stained, suggest a donation site that recycles textiles or take worn towels to the S.P.C.A. Knowing that things will be used, regardless of their condition, makes parting with them easier.

Tip #6: Let your parents say good-bye.

Keep sorting sessions brief— 2-3 hours at the most. This may be difficult when you come to town for a weekend to blitz through things, but constant decision-making is exhausting and marathon sorting sessions usually result in diminishing returns. The sorting process brings up memories, so stories and reminiscing are natural. Accept that some days you will accomplish less than you had hoped for and let your parents enjoy their recollections. Storytelling is more than simply saying “goodbye.” Studies show that reminiscing calms people and reduces stress.  You may find that after telling a story, your parents are able to focus more on decision-making. In short, storytelling is a productivity tool, not a hindrance. Listen respectfully, ask questions. Remember that in the long run, it is your parents’ stories, not their belongings, that you will cherish.

Tip #7: Be realistic about how much time you can devote to the process.

If your parents live in the family home, allow 60-80 hours for the downsizing process, 20 hours for items not going with them, and 50-80 hours for helping them pack, move, unpack and get settled. If your time is limited, spend your time with them doing “fun” things and providing emotional support, and hire professional help for the rest. Senior Move Managers specialize in this type of support.

Tip #8: Concentrate on the big picture.

Senior moves are stressful for the entire family. In addition to their own homes, families and jobs, adult children are often assuming caregiving responsibilities. Conflicts sometimes develop between siblings over the disposition of items, and more frequently, over the sharing of caregiving duties. As you work with your parents and siblings, keep three objectives equally in mind: caring for your parents, taking care of yourself, and keeping the family in tact.

grandmothers  Moving Mom and Dad grandmothers

Tip #9: Hire a Senior Move Manager.

Downsizing and moving are challenging, but you don’t have to do it alone. A Senior Move Manger like Moving Solutions can provide expert planning, proven resources, and hands-on help to take the work and worry out of moving. You control how much you spend, and most provide a free, no-obligation home visit. Moving Solutions provides services throughout Southeastern PA, the Lehigh Valley, Delaware, and central New Jersey.  For help elsewhere in the US and Canada, go to the National Association of Senior Move Managers. Hiring a Senior Move Manager isn’t an expense, it’s an investment in your health, your relationships and your peace of mind.

Tip #10: Looking Back

“Things” were important to my grandmother. Perhaps it was living through the depression. Perhaps it was burying both her children. Perhaps she was holding on to what she could in the face of so much loss. When she moved, at age 88, she offered me many things.  I said “no” to everything. I had good reasons. I didn’t like it. I didn’t want it. I didn’t have room.

Today, I regret those decisions. It’s not that I’ve grown to like the things she offered.  It’s that I was thinking of myself, and I should have been thinking about her.

Lessons from Ziploc

When it comes to resealable plastic bags, I have always been Ziploc challenged. To be more exact, I am incapable of getting the little ridge into the little groove and having it stay closed. So when bags that actually zippered closed came out, I was thrilled. Finally, a bag for me! Then I realized they were more expensive than regular bags, so for years I didn’t allow myself to buy them. Finally, I gave in. I gave myself permission to spend a little more and I’ve been happily using zipper storage bags ever since.

ziploc  Lessons from Ziploc ziploc

 I’m an avid gardner, and every spring, armed with pitchfork and wheelbarrow, I apply mulch, usually 5 cubic yards. It’s a big job, and I seem to need more and more ibuprofen — before, during and after. But last year, I did something I had never done before. I PAID someone to do it for me. I didn’t just take care of my garden; I took care of myself. My garden and I both flourished.

It’s not that I am pampering myself more, it’s that I’ve changed what I am willing to spend money on. Years ago, I had a fancy job and bought myself fancy jewelry. It gave me pleasure, but things change. Today I pamper myself by doing Pilates. I probably spend the same each year on Pilates as I would have on nice jewelry. Pilates helps me not have lower back pain. These days, not being in pain is more important than having jewelry.

Which brings me, of course, to Senior Move Management. Some people don’t give themselves permission to use a Senior Move Manager because it seems extravagant, because they moved without help last time, because they never used this type of service before.

I never did Pilates before, but feeling good is important. I’m important, so I’m giving myself permission to use real zipper bags, have my mulch applied by someone else, and take exercise classes regularly. These are gifts to myself, and I’m worth it. So are you.

My Not So Big Home

Several years ago, my husband and I moved from our three-story, six-bedroom home to a one-story Mission bungalow. It’s charming. It’s in a location we love. It’s half the upkeep and half the cost of our former home. I saw our new house as perfect. My husband saw it only as “less.” Then I stumbled upon architect Sarah Susanka’s book, The Not So Big House, and it has made all the difference. Our new home isn’t less; in fact, it’s more. It’s a “not so big” house.

California Bungalow  My Not So Big Home house

The idea behind The Not So Big House is that homes should emphasize how we actually live in them, and not focus on square footage. In a Not So Big House, every space in the home is used every day, so a Not So Big house does not have formal rooms that are rarely used. What we really crave, says Susanka, is intimacy, not open space. She uses the example of a window seat or an alcove with a window and reading chair. We are naturally drawn to these cozy spaces, in spite of, or perhaps because of, their size and intimacy. “Bigger is not necessarily better,” says Susanska. “Home has almost nothing to do with square footage.”

Susanka’s second book, Creating the Not So Big House, describes things you can do to make your home feel larger, especially the impact of light and lighting. Many are surprisingly low cost.

Focusing on homes that reflect how we actually live in them lead Susanka to a third book, Not So Big Living, which encourages people to start living their passions, to start looking at “What have I always wanted to do,” and then do it. Susanka encourages people to declutter, both their houses and their lives, so they can slow down and “show up” more.

The Not So Big movement is reflected in many aspects of today’s society: the move toward smaller cars and small portions, the increased focus on simplifying, recycling and reducing waste; in short — sustainability.

Not so big thinking not only fits my new home; it also fits what I do professionally.   As a Senior Move Manager, I help older adults declutter and move into not so big spaces. For most people, appreciating not so big living takes time, but it’s a perspective worth having. I often think of a client who was moving from a villa in a retirement community to a two-bedroom apartment in the main building. The villa had a large linen closet in the master bath, and the new apartment did not. “Right now, that missing linen closet seems like a big problem,” my client said, “but I have many friends who live in the same size apartment I am moving to, and none of them complains about not having a linen closet.”

Individuals considering senior living options often focus on what they are giving up: the space, the garden, the extra rooms. Yet individuals who have already moved into senior communities seldom complain about missing these features from their prior home. They’re busy being in the present.

To learn more about not so big living, go to notsobig.com

The Ethics of Geriatric Fiblets

The Ethics of Geriatric Fiblets fiblet

The term “geriatric fiblet” was coined at the 2000 World Alzheimer’s Congress as “necessary white lies to redirect loved ones or discourage them from detrimental behavior.”  I have found the concept useful in analyzing my own actions as a Senior Move Manager.

The Senior Move Management industry is guided by a code of ethics that defines the values and principles of behavior for the profession. Developed in 2002 by the National Association of Senior Move Managers (NASMM), the code includes honoring the client’s right to determine their own future, client confidentiality, respecting the client’s belongings, acting with integrity, and more.
(You can view the entire code of ethics on www.NASMM.com).  The concept of “beneficial” white lies, particularly when working with individuals who do NOT have dementia, would seem to contradict these values. Or does it?

Scenario 1

Take, for example, a client who has 100 National Geographic magazines. He doesn’t want to keep them, but also doesn’t want them thrown away. “Can’t you find someone who wants them?” he asks. I contact a friend who teaches third grade and she agrees to take half the magazines for an art project. I give her half, recycle the rest, and inform my client, “I found a third grade teacher who is using the magazines in an art project.” I tell the truth, sort of, except I omit the detail that half the magazines were discarded. In short, I tell a geriatric fiblet. In this case, the geriatric fiblet is one I can live with. I think it shows respect for my client’s wishes and for his budget.

Scenario 2

Next, take the case of an adult daughter who is sorting through her parents’ belongings, much of which will not fit in their new home. “Throw this away and don’t tell my parents,” she asks. The daughter may tell this geriatric fiblet, but I will not. According to the NASMM code of ethics, my senior clients, not their children, determine what goes with them to their new home. I provide guidance but respect their decisions, even if
I don’t agree with them.

More complex, perhaps, is the daughter who throws something out without asking her parents and then asks me not to tell them. Do I blow the whistle on the daughter? On face value, it would appear that I should since the code of ethics says I should honor my clients’ decisions. However, I also consider the code of ethics requirement to ensure cooperation among all individuals involved in my client’s move. Thinking it through, I see this as the daughter’s ethical issue, not mine. I would explain to the daughter why it is important for her parents to feel in control, or I would likely opt to remain silent.

Scenario 3

Here is an even more complex issue —  adult children who ask me to represent my costs as lower than they are to their parents, and they (the adult children) will pay the balance. I recognize  they are trying to respect their parents’ desire for independence, but my relationship with my client is built on trust. Do I damage that trust by introducing deception?

As I ponder what to do,  I think back to thirty years ago, when I did the same thing for my grandmother. She was determined not to pay more than $200 per month for an apartment, but the apartment she wanted was $260 a month. We asked the leasing agent if we could pay the difference. “No problem,” she replied, and she  prepared a dummy lease. Amazingly, my grandmother accepted that she was being given a discount because her deceased son had been a doctor, and she agreed not to discuss her special deal with other residents.

I have no qualms about my rental fee deception.  My geriatric fiblet honored my grandmother by enabling her to preserve her fierce sense of independence. I was acting as a granddaughter, not a Senior Move Manager. As a family member, I was guided by love, not by a code of ethics.

As a Senior Move Manager, I would not misrepresent my costs to a client at the request of their children. I will not jeopardize my client’s trust.  I may have colleagues who disagree with this position, and that is okay. Codes of ethics have grey areas, where cogent arguments can sometimes be made on both sides of an issue.  Often it is the thought process that is most important.
Are geriatric fiblets appropriate? Maybe. It depends on the circumstances and on the person telling the fiblet. Behavior that is appropriate for family members may not be appropriate for professionals.

If my grandmother were alive today, would I do it again? Absolutely.

How Bubbie Got Her Groove Back

Sometimes a small change in routine can make a big difference.  After long discussion, my mother-in-law started using a weekly pill organizer. This simple little box, and some common sense questions to her physician,  made all the difference in the world.

How Bubbie Got Her Groove Back bubbie 300x204My mother-in-law (we called her Bubbie) took twelve different prescription medications, three types of eye drops, two stool softeners and three vitamins. Some medications were taken once daily, some twice, some with meals and some before bedtime,  for a total of 19 pills each day.  Although she had
a number of chronic conditions which required medication, she lived independently, was an avid computer solitaire player and read 2-3 books per week.

Bubbie understood her conditions and the importance of medication compliance, so she was careful to take each medication exactly as directed on the prescription bottle.  She managed her medications just fine, except it seemed more and more that her medications managed her.

One prescription bottle, scheduled for noon, said, “Take on an empty stomach.”  Another pill due at noon said, “Take with food.”  A medicine to be taken with breakfast called for two additional dosages six hours apart.  Since breakfast at her senior residence was served at 8 AM, she took these pills at 8 AM, 2 PM and 8 PM.  Another medication to be taken three times daily said “Take every eight hours.”  Her doctor told her to take this “when you wake up.”  Since she woke at 7, she took the first pill at 7 AM and subsequent pills at 3 PM and 11 PM. She went to sleep around 9 PM, so she would set her alarm for 11 PM. In order to be  compliant, Bubbie was taking pills at 7 AM, 8 AM, noon (before lunch) and noon (after lunch), 2 PM, 3 PM, 5 pm (before dinner) and 5 PM (after dinner), 9 PM and 11 PM. She constantly focused on her next medication dosage; the responsibility was burdensome and depressing.  Her medication schedule made her feel sickly and became an impediment to her going out and doing things (“I have to be home to take my medicines”). She became increasingly insular and self-absorbed.

When we suggested to Bubbie that she was being overly rigid with her schedule, she showed us the instructions on the prescription bottles.  She wanted to be a “good patient” and was adamant that the schedule had to be followed to the letter. Plus, like many people her age, Bubbie would never dream of questioning the  pharmacist or the physician.

I have long believed that bad events sometimes lead to surprisingly good outcomes, and so it happened with Bubbie. When an infection caused her to be hospitalized, my husband and I made an appointment with Bubbie’s physician to talk about her medication schedule.

We showed the doctor, who had prescribed most of the medications, what Bubbie’s daily routine looked like and how it impacted her quality of life.  The doctor had never thought about the cumulative effect of taking multiple medications, or dreamed that someone would take directions so literally. “Isn’t there some way she can take her medications just four times daily?” we asked.

To our delight, the doctor grouped all 19 pills into four administrations, instead of the previous 10. “What about the instructions on the prescription bottles?”  we asked.  The doctors assured us that the adjustments would not reduce the medications’ effectiveness, and made notes in Bubbie’s chart to revise the instructions on future renewals.  Although initially hesitant, Bubbie agreed to the adjusted, doctor-approved medication schedule. We found a weekly pill organizer with four sections per day, and Bubbie agreed to give it a try.

After that, I took over Bubbie’s prescription renewals and filling the weekly pill organzier. We knew the change in medication schedule made our life easier and hoped it would improve Bubbie’s life as well. We were not prepared for the changes we saw.

Bubbie was delighted to have the burden of refill management and pill sorting removed from her shoulders. With just four administrations daily and the pills already sorted for her, Bubbie began to see herself as less sickly and started going out more.

We asked ourselves what our take-aways were from this, as family members. Our first learning was that seemingly small changes can make a big difference in people’s lives.  When Bubbie saw herself as less sick, she acted less sick. This has big implications. Studies show that people with positive perceptions of their health live longer than those with negative perceptions. We also realized that we needed to be active advocates for Bubbie with her medical team.

As for Bubbie, she was one happy camper. She continued to carefully manage her medications, but her medications no longer managed her.

Medicine Cabinet Antiquity Challenge

“Mrs. Smith, these frozen chicken breasts are from 2006. That’s pretty old.
Do you want us to throw them out?”

“No, I sauté them with a little butter, salt and pepper and they taste just fine.”
“But they must be bad for you.”
“I’m 92, they can’t be that bad.”

Medicine Cabinet Antiquity Challenge medicine cabinet 300x225

I think about this conversation each time I explore our chest freezer and find items that resemble fossils. For most of us, it’s not just our freezers that have expired items, our pantries do too. So do our refrigerators, bathrooms and medicine cabinets.  For example, I recently found a jar of Henry and David Apple and Vidalia Onion relish. I remember tasting it in the store. It was delicious. Of course, the expiration date on the jar says 2007. While I am somewhat adventurous, that is too old even for me.

Most spices have a shelf life of up to 5 years. Some containers are marked with expiration dates, and most spice companies have guidelines on their websites as to how long the spice is good. Remember the little tin cans from McCormicks? If you have any, throw them out. With the exception of black pepper, McCormicks hasn’t made spices in tin cans since the 1990s. So what’s the harm of using expired spices? They probably won’t make you sick, but they won’t have much flavor either, or the flavor may have changed, so adding more may actually ruin your food. Some people believe that putting spices in your garden protect flowers from bugs and deer, so if putting them in the trash doesn’t sit well with you, you can always use them as a gardening aid.

I learned the perils of expired cosmetics the hard way. I was attending a wedding and decided to wear makeup, which I don’t often do. I guess “often” is not the right word, since years can go by between my makeup applications. At any rate, I applied the makeup, thought I looked pretty good, and then my eyes began killing me. “Wow, I really must be getting dry eye,” I thought, and made an appointment with my ophthalmologist. I explained what happened. “Your eyes are fine,” she said. “How old are the cosmetics?” Hummm. I wore eye makeup daily in my prior career before starting Moving Solutions, and I left in 1994…of course, the makeup wasn’t necessarily new when I left…so, say 15-18 years old, I told the doctor. “You can’t wear 15 year old cosmetics,” she said. “They develop bacteria.” Well, duh…I guess I should have known that. I went online and most sites recommend that once you open that blush, bronzer, concealer, eye shadow, eyeliner, foundation, lip liner, lipstick, mascara or other cosmetics product, you should only keep it for about three months. Even when products don’t become harmful, they can change smell, color and texture.  So into the trash went my decade-old cosmetics. I have a much smaller, new supply now, which I still wear infrequently.

Continuing on my expiration mission, I went to our medicine cabinet. Out went the Pepto Bismol, the bottom of which had solidified. Out went 6 bottles of nose spray, most over 3 years old, and dozens of unidentifiable cold pills that had been removed from their packages. These were joined by jars of left over antibiotics (with 2 or 3 capsules left because I had started to feel better). I assembled our collection of antibiotic ointments, and got rid of any that were more than 2 years old. I found 9 containers of sun block, most over 3 years old, and added them to the trash. I discovered 5 large unopened boxes of Q-tips. I expect that these have a long shelf-life, so we probably have a lifetime supply. Out went 3 jars of decade-old Vaseline, 11 partially used chapsticks, a dozen nail polishes (most solidified), 4 ancient body lotions, 3 huge extra firm hold hair sprays (do I even remember using hair spray?), 4 huge round hairbrushes (way too large for the short hair I’ve had short for over a decade), two curling irons, perfumes  (definitely can’t remember the last time I wore perfume), 4 tubes of muscle rub (now there is something I do use regularly) that were completely used up, and a heating pad whose cover had a disgusting growth on it. I found three hair dryers—good thing — I was thinking I needed to buy a new one, 9 unopened dental flosses (do they expire too??) and 6 brand new toothbrushes, so I parted with my old one (wonder how long I have been using that), so now there are just 5 new ones.

The ironic thing is, I would not have guessed that we had that much. It occupied a relatively small space; I am not even sure how it all fit. But my new medicine cabinet is a thing of beauty. Everything is organized in small white plastic baskets and three tiered shelves so there is clear visibility, and I know where everything is. When my husband asked where we now keep antibiotic ointment, I proudly told him, “in the white basket, third shelf down, in a small box holding 4 tubes of ointments”. He was impressed, and so was I. Being uncluttered, being in control, feels good.

So perhaps you are saying to yourself, “No way do I have that much stuff hanging around in my pantry or medicine closet.” Go ahead, empty your pantry and medicine cabinets and see. I challenge you.

In Defense of Plan B

In popular language, ‘Plan B’ is used to mean a reserved, secondary plan, in case a first plan (typically ‘Plan A’) fails. In short, Plan B is second best. I think Plan B gets a bad rap; there is a lot to be said for Plan B.

In Defense of Plan B planb 300x199

Take the client whose house sells more quickly than expected, and who needs to live in temporary housing for several weeks or months until the new apartment is available. The client groans at the thought of moving twice — Plan B — until I remind her that having your home sell for a price you want, not going through weeks of living in a home while keeping it “market ready,” and not having the anxiety of waiting and wondering if the house will sell… is actually a good problem to have. The ironic thing is that when these clients finally move into their permanent home, having spent weeks or months with things in storage, they invariably decide they did just fine with a lot less around them, and when things come out of storage, most end up parting with things they had previously thought “essential.”

Conventional wisdom is that it is best to sort through and dispose of everything not going with you before you move. But take the husband who announces, “I’ve been caregiving for my wife 24/7 for five years, and I am used up.” He is being clear that he is maxed out, so the solution for him is Plan B — a “new home” or “stays here” move plan that minimizes his pre-move involvement.  After the move, when his wife is being cared for by others, he can return to the house, better equipped physically and emotionally to make plans for items not taken.

Or take the couple, both very frail, who qualify – just barely – for independent living. It’s clear to everyone involved that they will soon need much more support, and that it might be easier for them to move once—directly into assisted living. Except the move to independent living is the move they are willing to make at this time, so Plan B, which will ultimately require another move, is the plan that gets them out of their three-story house.

As Senior Move Managers, it’s common for us to visit homes that have piles of paper in every room: mail, insurance forms, receipts, paid and unpaid bills, lists and notes, investment records, coupons…you name it. Rather than move piles that should be shredded or disposed of, it makes sense to urge the client to sort through the papers, right? Wrong. If the client could stand sorting through and organizing papers, she wouldn’t have piles of paper everywhere. Instead of asking her to do what is clearly a struggle for her, let’s develop Plan B — a move plan that enables her to be successful with things she doesn’t mind doing. The Senior Move Manager packs all her papers into boxes so later, when the stress of moving is over, she’ll be better positioned to tackle tasks that are a challenge.

The proverb “Perfect is the enemy of good,” attributed to Voltaire, is one of my favorite sayings. It reminds me of the Pareto principle, or 80-20 rule— that it commonly takes 20% of the time to complete 80% of the task, while the last 20% takes 80% of the effort. It’s not that achieving perfection is impossible, it’s that the increased effort often results in diminishing returns as further activity becomes increasingly inefficient. This principle speaks to the client who “must” recycle and dispose of everything properly, as well as to the Senior Move Manager who is adamant that every carton be unpacked and put away.

So Plan B is my plan of choice. Not because it is lesser or easier. Plan B is where wisdom meets reality and comes up with a solution.

Why My Purse Was in the Freezer

Why My Purse Was in the Freezer memory photo 189x300I found my purse in the freezer this week. After appropriate jokes about new meaning for the term “cold cash,” I considered what this might really indicate. The thought was chilling.

As a Senior Move Manager, I have taken courses on how memory changes over time, so I know that short term memory loss increases as we age, and brain processing speed slows down. This part of aging is referred to as normal age-related memory loss. I know that some people experience more than normal age-related memory loss, and this is referred to as mild cognitive impairment, or MCI. Both people with normal age-related memory loss and people with MCI can live independent, meaningful lives. I also know that 5 million people in the US, and 50% of people above 85, have some degree of dementia. Does finding my purse in the freezer mean that I will become one of them?

Dementia is more than memory loss alone. It is also characterized by problems with judgment, language, abstract thinking, and it interferes with daily and social functioning. So now I am doing what many people above a certain age do when they forget something or notice cognitive changes. I am asking myself if finding my purse in the freezer is a sign of something serious.

Do I forget things like people’s names, where I placed my keys or where I parked? Yes, but I have always done this. Although aggravating, this is common for me and for most people as they age, so I chalk this up to normal age-related memory loss and make a silent promise to write down where I parked and focus more on putting my keys in the same location.

Another warning sign of dementia is difficulty performing familiar tasks. I need to be retaught the rules of cribbage every time I play, but I have always been card-challenged. Other examples do not come to mind, so I cross this symptom off my list as well.

I check to see if I am disoriented about time and place. Do I forget how I got somewhere or how to get home from familiar places? Since I have gotten a GPS, I don’t need to focus on where I am going; the GPS does it for me. I haven’t noticed any changes in this area, however, so I decide I am good here as well.

Do I have poor or decreased judgment, like wearing heavy clothes on a warm day? Nothing jumps out as worrisome, so I move on to the next symptom.

Do I have trouble with abstract thinking, like forgetting how to balance a checkbook? I use Quicken to balance my checkbook, and I remember how to use the software each month. I decide this is not a problem area either.

Do I put things in unusual places,  like a purse in a freezer? Ooops. I need to delve into this one a little further. I have a tiny purse, just big enough for my cell phone, cash and credit cards. It is black, of course, and hard to find when it is misplaced, which is often. But how did it get in the freezer?  I consider my habits. While there is no reason the purse doesn’t stay on my shoulder, it seems I often place it in whatever I am carrying into the house… like a bag of bagels, for example, which is where I eventually found it when we defrosted the freezer. I decide to mull this over as I read the paper, and find my replacement purse, equally tiny, in the plastic bag next to the paper. I conclude that given my habits, a purse in the freezer, although bizarre even for me, is understandable.

Then I recall that six months ago, I found orange juice in the cabinet next to the refrigerator –another unusual location. Once again, I do a self-check. Since the cabinet is immediately next to the refrigerator, I decide I was probably multi-tasking and got distracted.

I think I am safe, for the time being. But I realize that I have crossed some threshold, after which actions that were laughed off decades ago, are now taken seriously. A worry lingers in the back of my mind each time I notice a change or something out of the ordinary. I’m OK with that. I’d rather be informed and worried, than unaware and untroubled.

I am glad to have my old purse back, and I am happy to report that 6 months of being frozen appears not to affect credit cards or cash. Will I experience other signs of normal age-related memory loss? I hope so, for decades to come.

To learn more about cognitive changes as we age, visit eSMMART.com and look at two courses: Memory and Forgettery, Parts 1 and 2.

90% of Aunt Betty

90% of Aunt Betty thoughtful old lady2 300x2001“Margie Dear, I am moving and I need your help.” So began the call from my 91-year old Aunt Betty. Never mind that I have used my real name, Margit, for 38 years. To Aunt Betty, I will always be Margie.  Betty has buried three husbands, and her only daughter, my first cousin, died at 20. So I went to Florida to help her move from a large 2-bedroom apartment to a retirement community.

Betty had moved into the community on Monday, taking only two suitcases.  New furniture had been purchased for the apartment, because she had brought none with her when she moved from Philadelphia 8 years earlier. My job was to help her go through her belongings at the old apartment, identify what she wanted, and have it brought to the retirement community.  In short, I needed to help her sort through and downsize. No problem. After all, I am a Senior Move Manager.  But I am also, I discovered, a niece, and throughout the weekend, these two different roles collided.

Like many of my clients, Aunt Betty had a hard time parting with items I knew she would never use. Sometimes, I could cajole her into letting something go.
“But I loved this lamp,” she said, pointing to a 40-inch tall lamp that was still in its shipping box from 8 years ago. “Well, not enough to use it for the past 8 years,” I replied. She laughed and said, “You’re right.”  These interactions – I refer to them as reality checks– were easy, because they did not diminish her as a person.

It was harder when we looked at large serving dishes.  “I may have a dinner party,” she said. Betty is very frail. She uses a walker and qualifies for independent living only because Bea, her aid, is with her 6 days per week. I couldn’t say to her, “Betty, you haven’t made a meal for yourself in months. “ She does not need to be reminded that reality is cruel. It was similar when we went through clothing she insisted she might wear someday. I couldn’t remind her that she wears only pants with elastic waists so she can pull them up herself, and that they need to be full enough to accommodate the disposable underwear she now uses. Some memories and images of ourselves need to be preserved as who we once were.

Even though much of what she wanted to take would never we worn or used, I knew there was space for it in the new apartment. Her decisions didn’t have to be perfect or wise, but they were her decisions, and the Senior Move Manager in me accepted that. Later that day we met with a Move Management colleague whose staff would handle the packing and transport of clothing and other items after I left.  When I took my colleague aside and said, “If you find any clothing that is torn or stained, discard it,” I was horrified. I would never say that about a client’s belongings! Suddenly, I was no longer a Senior Move Manager, I was a family member. The ease with which I had lost professional objectivity and slid into expediency was alarming. Yet, I understood why adult children are so often pulled in this direction. They’re coping with their own mixed feelings about their evolving role and added responsibilities, as well as with changes they see in their parents. When expediency wins, it’s not from lack of concern, it’s from lack of time.

As it turns out, the next day was when  the roles of Senior Move Manager and family member most collided. I had arrived Saturday morning and Betty and I had worked throughout the weekend. It was 8 PM Sunday evening when we arrived at her new apartment with a load of pictures and other items in the car.  Since Betty walks very slowly, I dropped her at the door and suggested that she start toward her second floor apartment while I unloaded everything onto the hotel dolly kept in the lobby for such purposes. When I reached the apartment 15 minutes later, there was no answer. Worried, I began walking through the hallways.  I found Betty on the first floor. “I got lost, I couldn’t find my apartment,” she said “Then I got so tired, I had to sit down.” “Your apartment number is on your walker and also on the keys around your neck,” I gently reminded her.  “I know, but I just couldn’t figure it out,” she said.  And then I realized, I was no longer the Senior Move Manager; I was family.

Like so many family members, I had come in for a weekend determined to get things done in the time frame I had allotted, and I had put my need for productivity ahead of Betty’s need to rest or enjoy my visit. I wanted to be finished; Betty wanted us to have time to talk.

The Senior Move Manager in me emerged again as I reflected on what I had seen and inadvertently, caused. Betty had moved on Monday, a transition that was both hard and emotional. She barely had time to adjust to her new environment, when I swooped in and created two incredibly long, emotional days. I was exhausted; I can’t imagine what she must have felt like.  As a Move Manager, I know that stress, emotions and anxiety take a particular toll on seniors, a toll that often manifests as memory loss and disorganized thinking. Whatever cognitive status Betty had before the move, what I had observed Sunday night was Betty under the worst conditions.  I had caused it, and I should have known better.

When I visited Betty Monday morning, I apologized for exhausting her so much over the weekend. “Oh honey, I just feel so badly that you worked so hard,” she said. And there she was, the Betty I knew, parenting me, rewarding me for coming down to help.  Yet, in her next sentence, she was confused about whether she was in Florida or Philadelphia. The juxtaposition of the old Betty and the new Betty was sobering.

In the days that followed, I alerted family members who might call that Betty might not be herself for a while. I explained that the stress and emotions of the move had taken a toll, and that with time, I was hopeful she would rebound and be more like her old self. And in fact, in recent phone conversations, she has sounded more like herself.

Yet Betty is aware that she has changed. “My memory has gotten so bad’ she said recently, clearly disturbed, “I am not the person I used to be.” To dispute what she knows to be true would be condescending. I want her to know that even if her cognitive status is changing, she is still the same person to me, and that I still love her. “I have noticed a change from months ago,” I responded. “I think you are about 90% of the Betty I know, and that’s OK with me.” Betty smiled. I think being 90% of Betty was OK with her, too.