Caring For Aging Parents

By Nancy Moffett

Mom is starting to lose track of when and how much medicine she takes. Dad is in the early stages of Alzheimer’s, has set the microwave on fire and sometimes doesn’t know what day it is. Meanwhile, you’re trying to earn a living and have children who need attention, too. You want to help your parents and see that they’re taken care of, but how do you handle their care along with your other responsibilities?

Going It Alone

A recent study by the Pew Research Center found that one of every eight Baby Boomers is both raising children and caring for aging parents. The term “Sandwich Generation” describes their being “sandwiched” between the needs of their parents and those of their kids.

Monica Pompan of Easton has three daughters, ages nine and six (twins). Her mom and dad live nearby. Dad has Parkinson’s disease and Mom has arthritis in her knees and back, making it hard for her to care for Dad. Pompan helps out as much as she can. She does her parents laundry, helps with grocery shopping, takes them to doctor’s appointments and is generally available when they need help. It’s a struggle juggling everyone’s needs. “I feel like I’m not giving anyone enough attention and want to make everyone happy,” she says. “It’s a guilt issue.”

Assisted living is a relatively new concept. It’s not the end of the line. It provides all the physical things you can’t do anymore by yourself.

Pompan and her family moved to Easton about five years ago and have no relatives in the area to pick up the slack. She realizes the situation can be more intense for others, and says her parents try hard not to be a burden. She also realizes that there will come a time when she and her mother won’t be able to care for Dad. Meanwhile, Pompan has learned to say “no” to anything other than family. “I’m careful with my time, but I try to make time for myself.” She finds relief in paper crafting, and says, “You have to care for yourself so you can care for others.”

Joan Smith* of Allentown knows the caring scenario only too well. Her 86-year-old mother-in-law has been living with Smith and her family for several years. A typical day has Smith helping her mom-in-law with most of her ADLs (Activities of Daily Living) such as bathing, eating, dressing, taking medicines; and, because Mom has what Smith calls “a typical amount of dementia,” Smith isn’t comfortable leaving her alone for more than two hours at a time.

“I’m the primary bread-winner,” she explains. “And, even though I work from home, I’ve had to cut down on taking some assignments because I’m caring for Mom.” The Smiths have a daughter who is in college and helps when she can, but Joan is the primary caretaker. “I carve out time to earn a living and do the things that need doing, but I feel like I have a shadow life. I’m drained at this point.” When asked about getting outside care for Mom, Smith says she’ll keep going as long as she can. “I’m not the only person dealing with this,” she says, “and, as health care gets better [resulting in people living longer], this will become a more common scenario.”

Care on Wheels

Here’s a new service in the Lehigh Valley that could help Pompan, Smith and other children caring for aging parents. With many two-income families, scheduling and taking parents to doctor appointments can be a real problem. Community Resource Nurse Practitioners (CRNP) brings medical care directly to the patient. Nurse Practitioners, overseen by a physician, will visit seniors in assisted living facilities, nursing homes and even in their own homes. “We can do anything in terms of home visits,” says Clinical Services Director and NP Joe Eckstein, “including medical evaluations, diagnosis, recommending treatment and writing prescriptions.” CRNP takes most insurances and charges no fees during the visit.

“We are currently caring for about 400 people and see five to six patients a day,” Eckstein explains. One of the benefits of the service is spending more time with the patient, something busy in-office physicians may not be able to do. “We can schedule appointments when the family is there, and are giving families a reprieve by making care more convenient for them.”

Assisted Living

How do you know when it’s time to explore assisted living for your aging parent? According to David Seng, Director of Marketing at Abington Manor at Morgan Hill, the ideal situation is to find an alternative before there’s a crisis, such as a fall, that puts he parent in a nursing home. A good indicator is when the person needs help with two or more ADLs (bathing, dressing, ambulation, grooming, toileting and feeding). Assisted living facilities such as Abington Manor can provide care as long as the person is able to eat and transfer in and out of a wheelchair. “We can take them right up to the heels of nursing home care,” Seng explains.

He recommends families take these steps in making decisions:

1. Know when independence isn’t realistic anymore: when just being unsupervised is risky, and it’s almost negligent to leave the parent alone.

2. Proactively research assisted living facilities.

3. Discuss care and financial issues with the parent.

4. Stay focused. Elders will have good days and bad days, which can take the urgency away. “No one wants to give up their independence,” he says. And parents may try to stop their children from finding care.

5. Change their perceptions. “Assisted living is a relatively new concept. It’s not the end of the line or a nursing home. I liken it to hotel living, not hospital living. It provides all the physical things you can’t do anymore by yourself.”

Seng notes that Abington Manor allows seniors to live there for a short time as a test, which helps cut through objections. “We find that having the safety and security of care gives them ease. Within one to three weeks of moving in, most residents have a good perception of assisted living. This is not the old-time convalescent home. Residents still see their families; they get out as much as they wish. We even have people ordering take-out here,” he says.

Terry Ribeiro, marketing director for Alexandria Manor, knows how hard it is for families to care for aging parents and to take the next step into assisted living. “Many parents who are home alone spend a lot of time watching television. We find that when they come here, they start to thrive,” he says. “There are activities and people their own age to interact with. It takes a good month for them to be comfortable. We also find that when children see Mom and Dad doing well, they are happier and know they made the right decision,” Ribeiro explains.

He agrees with Seng in saying that families need to talk to several facilities and get the facts before making any decisions. As far as cost goes, many people are surprised to learn that monthly fees may equal out to the expenses parents had when they were at home, i.e., taxes, insurance, home maintenance, food, cable, etc. Some of the units at Alexandria Manor’s Nazareth location have kitchenettes to give residents more independence. Because people find it hard to leave their things behind, he tells children to encourage them to decorate so they feel more at home.

Whether you take on caring for an aging parent yourself or need other alternatives, there are many services available in the Lehigh Valley. A good place to start is with your county’s department of Aging and Adult Services where you’ll find listings of county services, home health care services, assisted living facilities, nursing homes, retirement communities, health insurance counseling and more. Take the time to explore your options. The help is out there if you can’t go it alone.

*Name has been changed to protect privacy.

Nancy Moffett has written about social issues such as aging-in-place, working with a disability, blended families and grandparenting for several publications. She and her husband are currently handling issues of elder care for his 92-year-old mother.

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