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Section II

One or Both Parents Are Living & in Failing Health

PREPARING FOR THE TRANSITION

Part of preparing for a transition is to understand the available resources in your parents’ community, or your community, should additional support be needed as your parents begin to show signs of failing health. If the transition can occur over time, then some resources can be used as a means of providing support and care while still in their home. Prepare in advance of the crisis, and maintain a folder of these resources.

•Consult a geriatric care manager in the area (http://www.caremanager.org).

•Seek out community resources offering support to senior citizens at home.

Meals on Wheels

Senior citizen centers

Churches

Synagogues

Christian Ministries

Respite Care

Adult Day Care

Companion care at home

•Make frequent visits and daily phone calls a part of the routine.

•Alert parents’ neighbors.

•Notify local law enforcement and emergency personnel.

•Install home alarm or video monitoring system.

•Consider adding a trusted, local family member to bank accounts to assist with bill payment.

•Consider ordering a medical alert device.

•Investigate hiring a home health care nurse (in home care, either skilled or non-skilled).

•Consider the demands placed upon the nearest sibling or family member.

•Consider home modification or equipment needed to extend parents’ home stay.

Railings

Bathroom fixtures

Stair lift

Door handles

Move bed to first floor

Multiple walkers

Potty chairs

Elevated toilet seat

Grippers /arm extenders

Entrance ramp

Check door widths (3 ft)

Hallway widths (3 ft)

Roll-under sink

Light switch heights

•Obtain aids for parents such as pill distribution system, magnifiers, non-skid mats.

THE RELOCATION DECISION

With the eventual likelihood that they will need to be relocated, part of what needs to be decided is if they would relocate to live with or near you, another sibling, or stay in their hometown. To make the best decision for all, use these guidelines:

•Talk about it – What do your parents want? What are their wishes?

•Don’t wait until a crisis – many places have 1-3 year long waiting lists

•When discussing a new residence or lifestyle change, consider bringing in a Geriatric Care Manager (www.NAPGCM.com). They will assess needs, offer solutions and anticipate future needs.

•Consider their current health care level. As healthcare needs increase, new decisions will have to be made – that will be time to re-evaluate.

•What is the current financial situation?

•Can they afford assisted living? In-home health care? Go live with family member?

EASING THE TRANSITION

The most difficult part for your loved one is letting go. Suddenly, your parent(s) are being asked to let go of everything, from making everyday decisions to their much-loved home. They don’t want to leave or to let go of their “things” that they worked so hard to possess. These “things” contain a lifetime of memories. You might think it is clutter, but to them, everything is precious. If mentally capable, allow parents to be a part of the decision-making.

Once it is determined that being in someone’s care is essential, here are some transition guidelines and things to consider:

•Consider the actual square footage of the space to be occupied by your parent.

•Get a blueprint of the new space so furniture can be effectively placed.

•Determine what can realistically fit into the square footage.

•Determine what heirlooms need to be stored for safekeeping.

•Valuables should not go to a facility with them. They have a tendency to disappear while parents are either out or sleeping; often doors are left unlocked.

•Identify sentimental and small familiar items that can make the new space comfortable.

Pictures

Photo books

Accent items

Books

Family Bible

Favorite blanket/pillow

Hobby items

Craft supplies

Playing cards, board games

•Less is better. Typically too much is kept causing a tripping hazard or clutter.

•Be practical. Holiday decorations, books, magazines, etc do not need to go. Be minimalistic with these items as they can take up a lot of space.

•Be realistic. How much clothing and linens are truly needed? Loose fitting, comfortable, pull-on, or zip-up clothing items are best.

It also depends on the place in which your parent(s) are moving. Take these additional guidelines to heart depending on the scenario you are currently managing.

•If moving to your home or a sibling’s home:

Respect that they still need to feel at home in your home.

Allow their furniture and things to be in the room they will be staying in versus just moving them into an existing guest room with its existing furnishings, etc.

•If moving to an assisted living center:

You will only have one or two rooms with not much storage space.

•If moving to a nursing home:

You will not need furniture and for sanitary reasons many facilities will not allow furniture into the room

LEAVING A LEGACY

What kind of legacy will your parents leave? What stories will live on after they are gone? You, your children and grandchildren may or may not be able to recount the major events in your parents’ lives. Don’t wish you would have asked after your parents are gone. Start to capture these stories now. Ask them to share how these events changed their life and potentially yours as a result. Have them share how their military service, living through the Great Depression or the Civil Rights movement, growing up poor, immigrating to America, etc. impacted their thoughts and emotions. Invite them to share their stories in a way they can be preserved and remembered.

Some of the ways this can be done are:

•Writing a personal letter to each child and grandchild.

•Create a final love letter to comfort a spouse.

•Leave behind a thank you card or letter for caregiver(s).

•Ask a friend or writer to help you record written memories and stories.

•Set up a video camera to capture the memories and stories on tape.

•Have them share the stories behind special heirlooms they will inherit.

•Record them reading a favorite story.

While the thought of your parents leaving your family is painful to consider, your actions will provide great comfort and be a permanent, loving embrace to their memory and what can be passed down for generations to come.