Everyone needs an advocate

Three years ago I had a TIA (mini-stroke) and pay attention to warning signs.  This week, two days after a "perfect" checkup with a new physician, I stopped at my ophthalmologist's office to check out double vision that was plaguing me for 24 hours.



The ophthalmologist exchanged numbers with his assistant, scheduled a MRI two weeks hence, prescribed blood work then asked to see me in six weeks.  When I asked if he could send his review of our visit to my neurologist, his reply was "What are you seeing her for?"  I shared my TIA earlier which was in his records,   I am 71 years of age.  I would have valued if I were asked, "Did you drive here by yourself today?" "Is there someone you might like us to call?"  Especially when I was told to curtail my driving.


I cannot help but think of others who might not be as active as I am in a new sales position receiving alarming news.  Do they automatically accept their fate?  Do they have someone to share the news with who might accompany them for the MRI?  In a well-equipped office, and with HIPPA regulations, cannot one receive news other than in the hallway?  Everyone needs an advocate, even physicians.

Living Well

Girl trip anyone? My friends' trip was not born of grade school, high school, or university reunions.  These women, authors in common, a nurse practitioner, photographer, and retreat coordinator met in our mountain community about eight years ago.  Their husbands or partner fostered their interests at home while these adventure-seeking dames explored Peru.   





Harsh mountain winters motivated other friends to rent a condo in Naples from their friends who took advantage of the real estate bust and upgraded their home. Joining them for our regularly scheduled Friday lunch with ten others, one friend laughingly admitted, "We did not miss you at all.  We had the best time in Hawaii for my birthday - the children surprised us with birthday decorations for our cruise cabin.  We had the best winter.   Turkey, more travel to my aunt's 95th birthday, then Hawaii."    How fortunate for this couple (she traveled  to Turkey with her sisters).


"Live fully" is the signature with which a favorite relative closes her correspondence.   That can translate to knowing when it is time to sell the house and enjoy a retirement community.  With those with smaller pockets that might mean selling the one-bedroom condo on two floors and moving to a one-floor ranch within her price range and delight in a two-car garage to make winters more manageable.  Another with wanderlust and a fixed income lives with high cost of energy bills, caregiving, and maintaining a home that remains on the market in another state. An arm-chair traveler for now.  Romance was intimated by another answering a personal ad for a mountain gal.   Advice?  Don't sell the house.


What travel experience is on your bucket list, have you recently enjoyed, or remains in your memory?

Ethical issues

  At the personal invitation of my geronology professor Dr. Rita Gugel, the founder of National Association of Professional Care Managers (NAPGCM) visited our class at Lynn University in the early 90s.  Within the next few years I enlisted the help of a professional geriatric care manager to address a caregiving situation that ultimately provided opportunity for my second husband's distant four children to care for their father, albeit long distance.  "I won't come until my father is situated", are the dispassionate words heard from one son.  

Wanting to do the right thing, I found a level of care that mirrored Mr.S.'s lifestyle, ensured he was settled and visited from time to time in the assisted living community and hospital to ensure staff knew there was someone local who observed his care. 

The one-hour assessment by the professional care manager was the best $200 I ever spent.  My children deserved me to present in their lives and share their joy.

And now it is time again to call on professional care management, to call on professionals who are familiar with levels of care for dementia and ensure transition sans physical and emotional challenges of family, near and distant.  Far too personal when it comes to a parent.   "I just cannot do it anymore" echoes from various challenges within a family including finances, introduction of extended family with different history.  


The terse words of management eager to make way for "healthier" residents are 360 degrees of the welcome less than two years ago.   Ethical issues in discharge, a webinar offered by SeniorBridge this month, is one that professionals in aging need to hear. Consider discharges from hospitals, rehab centers, and communities.  What is the appropriate setting, timing?   What has been your experience in handling transitions of family members or close friends.  Did you handle the move(s) yourself ? Did you call on a professional care manager?   If so, what is a positive experience or one that could have been improved?  Share with us so others can benefit.  

Evasive talk about emotion

Acknowledging my co-authoring a gerontology text entitled Conversations: Effective Communication with the Elderly, my dear friend in her early 80s sent me this article.  http:/www.nytimes.com/2011/03/08/opinion/08brooks.html

How many times do families, like mine, gather and talk about material things rather than about emotion?  My siblings are 65, 75, and 75 - not a typo.  Talk is centered around accessories in the house, golf games, travel, grandchildren, food, the world situation.  Doctors, but not chronic illness.   Cars but not individual financial challenges.  Healthcare but not about Medicare supplements, long-term care insurance - reasons people are working well into their 70s if given an opportunity.   My father, a pharmacist, worked until he was 83, because he wanted to serve the public.

Note in David Brooks' article the range of deep talents which span reason and emotion and make hash of narrower definitions of IQs, degrees, and professional skills.  Brooks cites "Limerence: This isn't a talent as a much as a motivation."  And so some siblings must delay a mortgage payment in order to purchase airfare to respond to crisis, a last opportunity to see a loved one. 

What common threads of understanding or lack of understanding have you witnessed as primary caregiver or a long-distance caregiver trying to keep your head above water while your feelings are being questioned?

Coping with Sudden Change

Update on Sarah. Don't you love the crisis subject lines? OMG. We were supposed to share theatre with Sarah and her husband on Sunday, arrangements made less than a week ago. What happened? Sarah, 65, fell halfway down a staircase in the home she and her husband lived for nearly 30 years. Looking to the future when they might not be able to step over a tub, they remodeled a bathroom on the first floor to include a shower. How welcome that convenience will be once she returns from physical therapy.

Living two hours away I was unaware Sarah was using crutches for a knee problem as my quiet partner had not mentioned that after conversations with his brother. I can only assume Sarah was putting off knee replacement until the school program she retired from but still was involved with completed its academic year. And until she was there for her children or could attend a family celebration. We all know procrastination when it comes to personal challenges that requires recovery time and, heaven forbid, accepting help from others.


Then there is my friend Kathleen, a bubbly, savvy 65. Kathleen is about to marry her Internet sweetheart. The duo have biked from GA to the NC mountains more than once and are planning more trips with biker friends. Recovering from minor surgery she is planning her backyard wedding while treating emergency hospital visits for her sweetheart as blips on the screen.

Why play it safe when hit with health challenges? One can moan or take the high road...or lower road as my friends Gary and Sally have done going South for three weeks to enjoy easier climes and celebrate lifelong friendships. Two surgeries for him, breast cancer surgery for her were met head on, dodging bullets finding laughter and always moving the best medicine. Who are your heroes that keep on truckin' no matter what?

Simultaneous Financial Struggles

The recent release "Wall Street: Money Never Sleeps" illustrates behavior when financial struggles simultaneously befall two generations. A dependent mother whose real estate income is depleted in a challenging economy turns to her son when he is enmeshed in high-stakes brokering. Of course, Hollywood solved the challenge in the next half hour.

Hollywood's glamorous resoltutions differ from real-life scenarios that have temporary remedies affected by layoffs, healthcare coverage or lack of, housing alternatives, and divorce that halves emotional, physical, and financial support. I have been fortunate to know three physicians in the past 20 years who treat body, mind, and spirit sensing that physical concerns can stem from emotional concerns. Extended and daily caregiving can cause physical damage to caregivers. How many adult children share their physical concerns with an aging parent(s)...or financial challenges, if this has not been a subject between them until they come to an end of resources?


In her book, "You Mean I Have To Look At The Body?: Stories of Dying and Living", retired minister Marcia Cham confronts her own fear of death through her pastoral experiences. Her journey, colored by humor, respectful irreverence, and honesty, helps others open dialogue about end-of-life issues.

I am eager to hear about your caregiving journey whether you are in the throes or just beginning.