Posts tagged "caregiving"

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.

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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.

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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.

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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.

How to Handle Family Criticism During the Holidays

“You know, some of Mom’s shirts are stained. You should take her shopping for some new clothes.” My brother, who comes in town twice a year, was full of suggestions. He didn’t have time to help with any of them, but he had lots of ideas about what I should be doing.

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When holidays roll around, you are surrounded by siblings and family members who come to see Mom and Dad. Despite the fact that they live too far away to pitch in or can’t seem to fit it into their schedules, they all seem to have advice on how you could be a better caregiver. Then, to add salt to the wound, your Mom adds, “Look, Michael took me to the grocery store.” One trip to the grocery store and he is a saint.  What about the hours you log every week, doing all the things that need to be done?

If this happens to you, here are 5 great tips from Griswold Special Care on how to handle family criticism:

1. Communicate ahead of time.

Your siblings don’t know about the challenges you’re facing unless you tell them. Stave off criticism in advance by sending a letter or email to family members. Let them in on the details–that Dad now requires weekly trips to the physical therapist, or that Mom is on a new brand of medication because the other kind upsets her stomach. It’s likely they are unaware of the details of your parents’ care. If they understand the situation and the extent of your involvement, they may express appreciaion for all you do. At the very least, they may be less hurtful and more helpful.

2. Mentally prepare a response to critical comments.

Let’s say your sister likes to mention that you should be visiting Mom and Dad more often. If you go in with a response thought out ahead of time, you’ll be less likely to snap at her and make your holiday gathering uncomfortable. One way to deflect an argument is to simply agree, or to ask a question  — how often do they think you should be there? You may find that the issue is not really about how often you visit, but their worry about your parents.

3. Let them know how they can help.

Tell your family know how the burden of caregiving is impacting your life. Let them know there are specific ways they can pitch in from a distance. Give them a list and ask them to sign up before they leave town. If your brother criticizes you for not asking the doctor about a specific therapy, respond with, “I know you really care about this issue. Why don’t you ask Dad’s doctor about that yourself at his appointment next week? He would appreciate your being there, and if you go with him, you will know exactly what’s going on.” If he says he can’t go, offer to set up an email invitation to talk with the doctor.

4. Don’t take it personally.

This is easier said than done, but dealing with criticism is easier if you remind yourself that not every insult has to do with you. Your brother may be lashing out because he feels guilty for not visiting your parents enough. Your sister may be critical because she’s alone for the holidays. Sometimes siblings have had a dysfunctional relationship for a long time, and caregiving is simply another venue to play out old themes.  If you can detach yourself from the emotional aspect of the situation, it will help you stay in control. You may want to just ask what they are feeling. The holidays can also  be  loaded with “old family issues” that lurk behind emotional reactions in the present. If the holidays have been stressful for your family in the past, suggest that everyone makes the most of the time together and plan a time to talk about care issues after the  holidays when people are less tense and have more focus.

5. Don’t try to please everyone.

Remember that you’re doing your best to take care of Mom and Dad, and that most of the time, your best is pretty darn good. It’s because of you that your parents are here and able to enjoy the holidays with family. So give yourself a pat on the back and let the criticism roll has helped you in these tough family situations?

 

 

Saying Goodbye to Tiger

We buried Tiger on Saturday. When you have a very old pet, you hope they will give you a sign, letting you know that “it’s time.” And then, when they do, you don’t want to believe it. Tiger was 21 — really old for a cat — and we are grateful for every year we had with this wonderful, loving, dignified friend.

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A few months ago, I wrote about how we had modified our home in order to help Tiger age in place. (Helping Tiger Age in Place). Since Saturday, I’ve been thinking about how Bill and I became Tiger’s caregivers as he became increasingly frail. Although the tasks were sometimes unpleasant, we did them without disgust or resentment. I was in charge of litter duty. During his last year of life, Tiger drank huge quantities of water because his kidneys were failing and routinely urinated outside the litter box, even though we had lowered two sides so he could step in more easily. I also cleaned Tiger when he fell into the litter because his hind legs could no longer support him as he squatted. I am not surprised that Bill was a wonderful caregiver; nurturing is second nature to him. But I am a let-me-cross-things-off-my-list kind of person, not a let-me-help-you kind of person. I am worried about my ability to provide the kind of assistance a love one may need some day.

Yes, I prepared my mother-in-law’s medications each week and took care of my mother’s medical bills, but these were list-type tasks, not the intimate, embarrassing, personal tasks that often accompany caregiving. I’m worried I won’t be good enough, or selfless enough, when the time comes. I know I did it with Tiger, but Tiger was not my husband or my parent.

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Next week, we will rescue Jackson, a 12 week old kitten, from a nearby shelter, just as we rescued Tiger 21 years ago. It’s not that we are trying to replace Tiger —Tiger can’t be replaced. It’s that we have experienced the joy of living with pets and know that this is the way we want to live our lives. But I can’t get a replacement mother or husband a week later. Perhaps it is this permanence that makes caregiving for loved ones so much harder than caregiving for a pet. But who knows. I was a better caregiver than I thought I would be with Tiger, perhaps I will be better than I expect with the people I love as well. I hope so.

Helping Tiger Age in Place

Helping Tiger Age in Place tiger photo 169x300My cat, Tiger, is 21 years old. That makes him 101 in cat years. As he has gotten older, many things Tiger used to do have become hard for him, so we’ve responded by helping him age in place.

Tiger walks slowly, very slowly. His legs are bowed, his back is crooked, and his once powerful hind legs are wasted.  Years ago, Tiger easily leapt into the air. Now, he needs help getting on and off my husband’s chair. Externally, Tiger is very changed from the strong young cat he was. Internally, though, Tiger seems much the same. His favorite pastime is still sitting quietly on Bill’s lap, giving and receiving love. As we noticed physical changes in Tiger, we began to think about what we could do to help him remain independent and injury-free. In addition, we felt badly each time Tiger failed at something he had once done so easily; we worried that he was embarrassed, and we wanted to preserve his dignity. Tiger has always had a lot of dignity. So we began to implement a series of aging in place modifications.

Since Tiger can no longer jump onto my husband’s chair, we installed a three-step pet ladder so Tiger could get on and off the chair on his own. At first, Tiger distained using the ladder, but when attempts to jump resulted in falls, he quietly adopted it as his normal method of access. We built similar steps to and from a sunroom window, and while Tiger seldom goes outside anymore, when he does, he uses these steps rather than jump the 18 inches.

Some months ago, we noticed that Tiger was urinating outside the litter box. At first, we wondered if he had become confused, which can happen to old cats. Then we guessed that perhaps Tiger could no longer step over the 5-inch high walls of the litter box. We cut out a special entrance to the litter box with a one inch high lip, and Tiger immediately began using it. He wanted to continue his former behavior; he just needed some modifications.

We’ve changed other things for Tiger as well. To keep his weight up, Tiger gets a can of wet food every night – a welcome change no doubt from the dry food he has eaten his whole life.  So far, it’s working. Tiger tips the scales at 7 pounds—good for a very old cat. Like many old cats, Tiger has kidney problems and drinks huge quantities of water to compensate for his failing kidneys. As a result, the litter needs to be changed daily, and we’ve surrounded the entire litter box with paper since Tiger sometimes misses the actual entrance.

Tiger loses great quantities of hair, and because of his arthritis, he can no longer groom himself properly, so we brush him each night. We know that Tiger has cataracts in his eyes,  his hearing is impaired and his meow is scratchy, but in our eyes, he remains a handsome elderly gentleman.

We sometimes think about how Tiger spends his days now, as compared to his youth. He still naps in the sunlight, enjoys watching birds on our front porch and sits on our lap every night. Although he cannot do many of the things he used to do, it seems to us that the essential Tiger – the sweet, loving cat we have always known –is still there, and that Tiger has a good quality of life.

As I think about Tiger, I can’t help but make comparisons to how I would treat an elderly family member, or how I would want to be treated myself. I would want to be as independent as possible, in a familiar environment that maximized my dignity and minimized the impact of my impairments. I would want to be surrounded by people who accept me for who I am, even though I may be different in many ways from who I once was. I would want a good quality of life, where I could continue to do the things that are important to me. And like Tiger, I would want to give love as well as receive it.

So in addition to being the best cat in the world, Tiger has even taught me lessons on how to age.

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.

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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.