Caregiver Role Reversal

The contents of my friend's  weekly email exchange read: 

"...one of my mom’s caregivers had a fall last week and dislocated her shoulder.  She’s not much older than I am but she has a very sedentary life and she seems in much worse shape than my mother.  Our church group has been having to bathe her, cook and drive for her.  I had her here for dinner and my mother was taking care of her and cutting her food….she felt great to be the caregiver for a change and she loved it.  Anyway, it got me thinking about taking better care of myself and not giving in to old age."

     . This reminds me of my mother, 98, who is every bit the hostess she always has been.  From her senior living apartment she is eager to share her bounty of yogurt, bottled water, bananas, or sweets.  She can readily replace a banana from the community's basket in the lobby or ask for one in the dining room.  Readily translates to walking what seems greater distances with a walker after hip surgery.  What continues to inspire you in the actions of courageous elders?

Why I Love My Doctor- We're Not Dead Yet

When I retired, I moved back to the area where my children grew up so that I could be closer to my family. As such, I had to go through the motions of changing everything. I changed doctors, most notably. I spend about 3 to 5 hours a month at the doctor, which doesn't sound like a lot but it sure isn't a walk in the park. Since I'm there a lot for checkups and other tests, I need a doctor that I feel comfortable with and can trust. I made the mistake of hiring the first doctor that I found, and quickly realized that I needed a better solution. The mistake? Let me explain.


I had been spending the day with my daughter, who just insisted on riding along with me to my appointment. She likely wanted to see and hear for herself that I was (or was not, perhaps) healthy. So I conceded and she came along. Mind you, this was only the second time I had been to see this doctor. I could have been his mother, too. He was fresh out of medical school and you could tell. But that day, it was painfully obvious that he'd missed the course on bedside manner and patient communication.

He came into the room, talked to me, talked to my daughter, and went about his business. As the appointment went on, I began to notice that he spent far more time talking ABOUT me to my daughter, as if I wasn't even there. After about 20 minutes, I was exasperated. I looked him straight in the face, excused myself, and said

"I'm not dead yet, you know."

He got a startled look on his face, and chuckled, as if I was joking before walking out of the room. In the process of finding my current doctor, whom I love dearly, I went through about 5 or 6 who all did the same thing. I made it a pet project, of sorts, and took my daughter along just to prove a point: doctors tend to treat older people like children who can't understand them. We understand just fine. As a health advocate, I am advocating for better education on patient communication. We ARE the patients, after all.

Contributed by Mary Albert, a blogger for a senior lifestyle web site that provides advice for the 55+ age group as well as medical alert reviews

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?

Social Networking and Caregiving

My friend has been a caregiver for her mother for sixteen years in my friend's home, including years of raising a young family.  Today she wrote that her mother, at 91, struggled halfway through writing a birthday note to her other daughter who lives a gazillion miles away and was confused with layers of clothing.  Though my friend has chosen not to share her journey with the world others take advantage of new technology whether by choice or by prescription.  

I remember having to convince my public policy professor to accept a research paper on telemedicine in the mid-90s.  Today one can readily access Telemedicine and e-Health as a 10-issue journal and its bi-weekly sister newsletter. http://www.liebertpub.com/products/product.aspx?pid=54 According to its website, "Telemedicine and e-Health covers all aspects of clinical telemedicine practice, technical advances, medical connectivity, enabling technologies, education, health policy and regulation and biomedical and health services research dealing with clinical effectiveness, efficacy and safety of telemedicine and its effects on quality, cost and accessibility of care, medical records and transmission of same."

Elders, caregivers, physicians, staff , and vendors are comfortably assured when virtually assessing, treating and monitoring chronic illness.  A video of an elder's home shared with an Aging in Place specialist can institute low cost modifications (compared to annual cost of assisted living).  Social networks where families can establish virtual support keeps long-distance caregivers informed and aids in decision making.

http://www.igi-global.com/bookstore/chapter.aspx?TitleId=42678

Tell us about your caregiving experience incorporating gerotechnology devices, telemedicine, and/or social networking.

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?

Medicaid Dilemma

This article www.gainesvilletimes.com/section/6/article/45169 is a blatant reminder that we all need to have our voices heard on healthcare reform. Home health care agencies not accepting Medicaid patients seems like discrimination to me. As close as this family appears, everyone needs respite and professional support in caring for a loved one.

What of elders who want to remain in their homes and qualify for Medicaid? What of those elders who have managed to live in senior communities with the help of their children until constant price increases made that impossible and now need to live with a family member in their mid-90s?

One of the chapter contributors for a gerontology text I am co-authoring had to step down from her obligation. As a leader in the National Association of Professional Geriatric Care Managers this business owner and professional care manager is adding to the voices of healthcare reform. What are the challenges you are witnessing in your family, your community?

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.

Can You Hear Me Now?

Listening effectively helps caregivers appreciate the present trading past roles and ill feelings for the richness of life through family history. Instead of responding in anger because a hearing loss prevents one from responding appropriately or in a timely manner, try speaking slower so an elder can read your lips. Smiling helps and alleviates fright. Staying with a paid caregiver while he/she becomes familiar with your parent or spouse helps soften the atmosphere with familiarity. The paid caregiver can see how you handle situations, acting rather reacting, and we can learn from them. Some of the best caregivers are professional geriatric care managers who interact with elders and their families, sometimes through mediation, but always with the best outcome in mind. What listening method have you found to be effective? No one can hear you when your head is in the refrigerator or 1/2 way out the patio door ensuring your smoking habit does not injure the house's inhabitants.

Grandparents Raising Grandchildren

There are many struggles and rewards of grandparents raising their grandchildren. I was moved learning that there are scholarships for small entities like the Children's Playhouse in Boone (and possibly INK in Gainesville). This allows grandparents who cannot otherwise afford even the most nominal fee respite and a place to share activities with their grandchildren. http://www.goplayhouse.org/ There are also many grandparents picking up their grandchildren from school and offering care until parents return from their professional obligations. And please remember there is a population of grandparents who take their grandchildren to see their son or daughter who is incarcerated. Share your thoughts here without disclosing names, companies, or institutions to observe privacy. Where possible, provide a link to support your beliefs and inform others. http://www.aarp.org/ has ongoing discussion/resources on this issue.

Everyone Needs An Advocate

When I went for an annual checkup at a hospital-based clinic 1 1/2 hours from my home, I was fortunate enough to be accompanied by a good friend. I saw a woman staring at the office roster, unsure of the next direction in the maze to turn. A warm "Follow-me" relaxed her and replaced the angst of my appointment with gratitude that I could help someone else. Though disappointed the specialist did not have recent records I was assured were faxed a month ago, she conducted simple neurological tests that left me with renewed confidence. What style of communication has affected the way or you healthcare professional are perceived?

Perception and Reminiscence

Communicating with elders is a daily challenge whether it is advocating or having a conversation. Locating documents, making appointments, and reminiscing -- across the spectrum -- takes patience and provides opportunity for clarity and bonding. Just yesterday, when apologizing for pointing a finger as my mother, 95, has done all through life, my colleague said, "Don't apologize, that was not a mean finger."

Communicating with an elder long distance can present challenges of time, lapse of daily contact, hunger to be part of someone's life or unsettled anger. Some families have the means and support to present in their parents' lives.  Others might have financial challenges, distance by miles, business or extended family that requires balanced time.  I write to my mother, 97, faithfully in 20 point font. "Your letters are beautiful and so easy to read", she comments.  A letter can be read ad infinitum and shared with visitors that provides opportunity for reminiscence.   If you have not been able to be physically present, how have you contributed your virtual presence?