Feb 3, 2011— -- Over the past week "World News with Diane Sawyer" has heard from many of our viewers, asking questions about their own issues when it comes to aging parents and care giving. Virginia Morris, author of "How to Care for Aging Parents," has answered some of these questions below.
From Houston, Texas: It is really tough when there are no siblings to help with care of an aging parent. I'm an "only," and the decisions that I'm faced with are harder and harder. What resources are available to help?
People often talk about the difficulties of working with siblings, but they forget that it's pretty lonely doing this on your own. Contact the "agency on aging" that covers your parent's town. You can find them by going to www.eldercare.gov, or calling 800-677-1116. These agencies (they go by a variety of names) sometimes have a case worker who will help you assess the situation and walk you through some options. At the very least, they should be able to direct you to local programs and services.
If that doesn't help, you can hire a professional geriatric care manager who will come into your parents home, examine the situation, and help you develop a plan. It's not cheap – an initial visit will cost about $200 to $300 – but it's money well spent. You can hire them to do as much or as little as you want. You can find a care manager online at caremanager.org.
When you are juggling all the pieces by yourself, it's important seek out emotional support, as this is an incredibly difficult thing to do alone. Caregivers often don't realize just how much of a toll this takes on them. Even if you are not with your parent daily, it weighs on you constantly. Seek out friends, especially friends who have done this themselves, or join a support group. And make sure you walk away from it from time to time. You need to get some distance from it. Take time to take care of yourself.
Diana from Crofton, Md.: How does one handle long distance care?
It's important to be organized and plan ahead, no matter what your situation, but it's critical when you live far away. Think ahead, plan ahead. Talk with your parent early in the game about what will happen if he needs care or has to move. And learn about local services and housing options before he needs them. Contact the agency on aging for your parent's community through the eldercare locator (800-677-1116 or eldercare.gov). The local senior center, church or synagogue might also have leads. Organizations for specific diseases, like Alzheimer's or Parkinson's, offer all sorts of information and support. And as I said, a geriatric care manager (caremanager.org) can be very helpful when you can't be there yourself.
When you're far away, be sure someone has contact with your parent most every day. You might call often – and a visual conversation, via Skype or the like, is helpful – but it's important that someone actually see her. If there is a visitor or companion program, take advantage of it. Meals on Wheels is more than just food; it's a person at her door. Be sure you have phone numbers for a neighbor who can check in if you suspect a problem. From afar, you will also want to set up her accounts so bills are deposits and bills are handled automatically.
This is an abbreviated list of tips, but I should add, when you visit, be on the lookout for signs of trouble – an unsteady gait that might preclude a fall, moldy food in the fridge that suggests she's not eating well, a pile of unpaid bills, or a change in her personal hygiene or homecare.
Diana from Indianapolis, In: Do you know about a service that calls the frail, elderly and homebound every day, providing a check in service to be sure they have taken their medications?
Forgetting to take medications or taking too many medications is a serious problem for the elderly, causing thousands of deaths each year.
A number of services will call with a recorder reminder to take medications. Or you can buy an electronic pill box with that alerts someone when it's time to take a pill. You can also buy watches, pagers, and other alarms that can be programmed to go off when it's time to take medication. Some systems also let a person know what to take, how many, and how to take it. More elaborate systems actually dispense the medication.
It's not a bad idea to look into these systems even if you think your parent has this under control, because sometimes things just aren't as under control as you might think. Go online or visit a medical supply store. A large pharmacy might also have a few options.
From Brewster, N.Y.: My mom is 86 and she lives alone now. Do I have to wait for something to happen before we should talk about moving her somewhere?
Oh, please no! Do not wait. Talk to her right away. Look, there is no question about it, the sooner people talk to their parents about the future, the better. Otherwise, you'll be reacting to a crisis, which will mean a lot of work and stress for you, and it will mean fewer options for your parent.
You need to talk, not just about where she might live and what help she might need, but also how she will pay for care (in-home, assisted living, nursing home), which is very expensive. You should also talk to her at some length about her wishes concerning medical treatment and end-of-life care – how aggressively does she want to be treated, what does she fear, what would be comforting, etc. You should also be sure that she has an up-to-date will, a durable power of attorney (giving you or someone else the authority to make financial and legal decisions on her behalf, in case she cannot make them for herself), a power of attorney for health care and a living will that outlines her wishes concerning end-of-life care. Be proactive. Be ready. It will make the world of difference.
You have to start right away because, first of all, it takes a long time – often years -- to get these conversations going, to accept the idea of change, and to make plans. Also, it's easier to do this when it's all theoretical (what if….).
Finally, some of the better housing options have waiting lists.
Start by asking questions and listening to her thoughts and concerns. For example, "Mom, if at some point you couldn't live on your own here, what would you want to do? Where would you want to live? What's most important to you? What if you couldn't live with me?" Talk about her concerns and discuss the options. Don't try to do this in one sitting; it takes many conversations. Urge her to tour various facilities with you. Explore the options and make a plan. Don't delay.
April from Dallas, Texas: My mom is 88 and has cooked supper every day for 60 years. How can I convince her to stop cooking? I'm afraid she will set the kitchen on fire or burn herself seriously.
If your mother is at risk of setting the house on fire because she has some form of dementia and has poor judgment, then you need to get involved right away. Remove the stove handles or disconnect the stove. You might just tell her it's broken. Then, find a meal delivery program or be sure there are things she can heat in the microwave or eat cold. If cooking is her passion, find recipes that don't involve a flame. Some appliances, like toaster ovens and electric kettles, shut off automatically.
If, on the other hand, your parent is mentally competent, then it's a very different story. Visit during mealtimes and watch her cook. Is she really at any risk? What, exactly, is the danger? Is there some way to reduce the risk?
Perhaps you can get her a pair of good oven gloves; be sure the fire alarm works; keep a small fire extinguisher near the stove and show her how to work it; be sure there is a clear automatic dial button on the phone for the fire department; and be sure that she is not cooking in her bathrobe or anything with droopy sleeves that might catch on fire.