All of us want our elderly parents and relatives to be well cared for. Yet, despite the very best of intentions, we may be unable to do everything that is needed for our elders.
Meeting an
elder's needs can be exhausting and lead to a sense of failure.
One critical element of effective care giving is to learn to set limits
for yourself.
Determine
what you can and cannot do for an elderly relative. Doing
so will help you establish and maintain a healthy relationship with your
elder.
Caring for an elderly parent or relative is done best when it is a positive choice - not when it feels like an obligation or imposition. Look at your motivation and ask yourself "why do I want to help?"
The motivation for care giving, unfortunately, too often arises from a sense of guilt or desire to repay a parent for what they've given you. A parent's gifts of life and rearing are not debts to be paid back - there is no way to do that. Care giving can be motivated also by a desire for parental recognition, approval or closeness. Acting from a sense of guilt or need for approval may endanger your care giving of a parent or lead to disappointment for you and your parent.
To determine
what is best, begin by identifying your elder's needs: the physical,
social and emotional care giving that may be required. What does your elder
need to remain well cared for in his or her current environment?
How much is the elder capable of doing independently?
The input of a professional may help you to understand your elder's needs and to determine the best approach to take. Is dad's refusal to walk alone based on a bona fide physical limitation? Is it rooted in fear? Is it the result of desiring attention? You can learn how much help is needed and what private and public resources are available to assist.
Once you determine the types of assistance an elder requires, decide what you are able to provide. Consider how your time at care giving will affect other areas of your life, such as your relationship with a spouse and children or your career.
As you consider how to help an elder, do not underrate your own needs. As an airline attendant advises when we're starting on a journey, "the able person puts on their oxygen mask first." During a crisis, elder care concerns may lead to temporary disruption of your life. But don't allow long-term disruption. The health risks to you and to the elder and to the relationship between you outweighs the benefits of putting your life "on hold."
Don't over promise what you will do. Be conservative in deciding how much assistance you can provide and how available you will be. It is better to promise less and do more than to promise more and not fulfill your commitment.
If you elder wants you to do more than you can, be firm in your resolve. Focus on what you are doing and don't let the focus shift to what you are not doing. Acknowledge the elder's feeling with a simple, "I'm sorry you feel that way," rather than giving a lengthy explanation that will merely exhaust you without satisfying the elder.
When you think about what you can and want to do for an elder relative, consider these questions:
- Am I acting to relieve my own anxiety?
- Does the situation truly demand my involvement or can somebody else meet this need for my elder?
- How will my involvement impact other parts of my life?
- Am I trying to meet someone's standards other than my own?
Learning your limits and to say "no" are signs of strength. Make your care giving a positive choice, rather than a response to guilt or a sense of duty. Doing so will give you more patience and energy for the care you do provide. Contact ElderCare Solutions to help you and your family create and maintain healthy relationships.
Credit: ElderCare Solutions newsletter
A reverse mortgage is a relatively new way for a homeowner, age 62 or older, to use the equity in his or her home without selling or acquiring a loan with monthly payments. The primary reason older adults consider a reverse mortgage is that it provides cash, thus enabling them to stay in their own home.
As in every financial transaction, take a "buyer beware" stance and be sure you understand the terms and costs of the mortgage. Also, before getting a reverse mortgage, look at alternatives to staying in one's own home, compare the costs of staying or moving, and review any available public programs that supplement costs of living.
A reverse mortgage can be paid out as follows:
- in a single lump sum;
- in regular monthly cash payments; or
- as a credit line that can be used at any time.
The amount of the loan and how it is paid out may effect the eligibility for public benefit programs that are based on assets.
Unlike a regular mortgage in which the debt decreases over time, in most reverse mortgages debt increases while home equity decreases. With a reverse mortgage, the individual retains home ownership. Property taxes, insurance and repairs remain the owner's responsibility. The amount of the reverse mortgage cannot exceed the home's value. The lender can't look to sources other than the home for repayment. The loan doesn't have to be repaid until the owner dies, sells the home or permanently moves out.
The several types of reverse mortgages include a Home Equity Conversion Mortgage (HECM), offered by the private sector, and the Fannie Mae "Home Keeper" reverse mortgage, offered by a publicly-held lending company. Each has distinct features. The loan amount available depends on age, current interest rates and the home's value. While federal regulations limit the fees associated with a reverse mortgage, fees do differ between lenders. It pays to shop around.
Anyone seeking a HECM or Fannie Mae Home Keeper loan must first participate in a counseling or consumer information session. The borrower learns the benefits and limits of various types of reverse mortgages and other viable options to meet short- and long-term finance needs.
For more information, contact:
- AARP - www.aarp.org/revmort or call 800-424-3410 for a free booklet.
- Fannie Mae - www.fanniemae.com or call 800-7-FANNIE.
Credit: ElderCare Solutions newsletter
Alcohol Abuse is Often Hidden from View
The use and abuse of alcohol by the elderly is a growing problem and a uniquely difficult one to handle because the elderly and their families often are reluctant to talk about alcohol use. A 1998 study by the National Institute on Alcohol Abuse and Alcoholism estimates that as many as 11 percent of all elders admitted to hospitals exhibit symptoms of alcoholism. Although elders abuse alcohol less frequently than those younger, the incidence of abuse is increasing among the elderly, a growing part of our population.
Older adults who develop problems from alcohol fall into two general categories: a) those who drank moderately in the past and b) those who begin drinking later in life. Lifelong alcoholics are less common in the older adult population because they generally have abbreviated life spans.
Elders are more vulnerable to the harmful effects of alcohol than those who are younger. They become intoxicated more easily. The liver, which breaks down alcohol, becomes less efficient as one ages. They also take more medications, many of which enhance the ill effects of alcohol.
Alcoholism in the elderly is often hidden from view. An elder who maintains the same drinking pattern as in younger years may develop a problem gradually without recognizing it. A moderate drinker who uses alcohol as an emotional outlet may grow dependent on alcohol when facing life changes. Having faced the loss of a spouse, siblings and friends, many elders live day to day without social contact or structure. A older adult may turn to alcohol to cope with depression, loneliness and anxiety.
Traditional routes to diagnosis of alcohol abuse usually are not present with the elderly. Job-related issues usually don't occur to set off warning signs because most elders are retired. Marital conflicts are rarer as fewer elders have a living spouse. Also, physicians often misdiagnose physical ailments, especially neurological, heart and gastrointestinal problems, as signs of aging rather than alcohol abuse.
Despite well-known
and serious health consequences, often alcohol abuse
is only brought to light when the family no longer can ignore its effect
on cognition and the resulting erratic, uncharacteristic behavior, mood
changes, memory loss, or even brief blackouts.
Alcohol abuse in older adults, especially in one's parent, is a difficult condition to address. When the issue is raised, reactions may range from simple denial to angry accusations. Elders who haven't altered long-time drinking patterns often deny a problem. Many elders see alcoholism not as a disease but as a lack of will power and they attach a moral judgment or stigma. This misconception prevents some elders from dealing with alcohol abuse.
Family members who recognize an alcohol problem stand at a crossroads where neither path is easy. One choice avoids rocking the boat until an inevitable crisis occurs. The other is to confront the problem with resolve and compassion.
Treatment can be successful, if the family and professionals are willing to look at the problem. The elderly are more likely to complete treatment than those who are younger. However, intervention must be taken seriously, and handled with a structured and expert approach.
Ignoring the problem of abuse does not make it go away. Much can be gained by bringing the problem into the open. Contact ElderCare Solutions for more information about the use and abuse of alcohol by the elderly.
Credit: ElderCare Solutions newsletter