Posted by Sheri Samotin on Tue, Apr 13, 2010
A just published book for adult children and their aging parents is "The Daughter Trap: Taking Care of Mom and Dad ... and You" by Laurel Kennedy. This is a valuable resource for all adult children, daughters and sons alike. Ms. Kennedy bases her work on hundreds of interviews with baby boomers in the thick of caring for their parents and the anecdotes help to illustrate her key points and make the work come alive.
The first half or so of the book frames the problem. While this section doesn't introduce much in the way of new insights, it does effectively capture the issues faced by so many who care for aging parents and summarizes many of the important studies and resources that have been published on this important topic over the past few years. At the end of each chapter, Kennedy has a section of "what we've learned" where she tries to guide the reader on actions they might take or things to think about. Some of this tidbits are more helpful than others. For example, at the end of Chapter 4, Kennedy writes, "When you need outside help -- ask for it." This sort of feels like motherhood and apple pie. On the other hand, in the wrap up of Chapter 6, Kennedy wisely opines, "Acknowledge your limitations and those of your family. Develop a plan B if caregiving becomes overwhelming to the detriment of your life..."
The second portion of The Daughter Trap focuses on solutions and here is where Kennedy forges new ground. For example, in Chapter 9 entitled "It Takes A Village", Kennedy does an excellent job of bringing her readers up to date on the various initiatives underway to explore alternatvie senior living models and later chapters focus on ways that corporate America can make a difference and technology solutions that are needed.
Kudos to Kennedy for this well researched work. For those who are well versed in the issues of baby boomers and their aging parents the second half of the book provides some "aha" moments. For those who are just getting involved with this critical demographic reality the first half provides a thoughtful overview.
Posted by Sheri Samotin on Tue, Oct 20, 2009
I am often asked to describe the benefits derived by adult children of aging parents when they elect to work with a family transition coach. Perhaps the best way to answer this question is through an example. I've changed some of the personal details to preserve the privacy of those involved, but the situation itself is based on a real situation from my practice.
Jennifer found me by reading an article I had written and published about family transition coaching in a local senior resource publication. I was in a meeting when she initially called, so she left a voice mail message that began, "I really need help, and I need it fast!" When I called Jennifer back, she told me that she is one of four siblings and the long distance caregiver for her mother Nancy. Nancy lives in southwest Florida and Jennifer lives in Michigan. Jennifer's siblings are scattered across several states, but none live near their mother.
Nancy is 84 and suffers from memory loss and some confusion. She is otherwise in good health and remains fairly active. Ever since Dad died six years ago, Nancy has been managing herself. She continues to live in the condo that she and Dad moved to in 1995 when they first relocated to Florida and until recently has maintained an active social life with her friends from church. Jennifer usually visits Nancy a few times each year; her siblings visit less frequently. Several months ago, when Jennifer came to visit, she noticed that Nancy seemed confused and somewhat withdrawn. Jennifer accompanied Nancy to her doctor's appointment and learned that Nancy's condition is considered to be "age related memory impairment." It was explained that this is a "normal part of aging" and that "there is nothing to worry about." Nancy assured Jennifer that she was fine and still able to manage on her own.
Several weeks after returning home from that visit, Jennifer called Nancy for her regular check-in and found her agitated and confused. She became extremely concerned, and called Nancy's neighbor and asked her to check on Nancy. When the neighbor called back, she told Jennifer that Nancy seemed okay. The next morning, Nancy didn't answer the phone when Jennifer called, and didn't respond to a knock on the door by the same neighbor whom Jennifer had called again. Fearing the worst, Jennifer called 911 who responded and took Nancy to the hospital. It turns out that Nancy suffered a stroke. Jennifer jumped on a plane to come to be with Nancy. She has taken on the role of primary long distance caregiver by default. The family has never discussed Nancy's situation as a group.
That's when Jennifer called me. She knew that she had to return home to her job and her family within a few days and was in a panic about what would happen to Nancy. At the same time, she was getting frustrated trying to convey information to her siblings, each of whom offered lots of input but none of whom offered to come and take over so that she could get home. Jennifer was under extreme stress.
The first thing I helped Jennifer to do was to get organized and get her siblings involved. We started by making a list of all of the things that had to be done, the documents that had to be found, the bills that had to be paid, and the decisions that had to be made. We then scheduled a conference call among the siblings which I facilitated. The stated objective of the conference call was to identify Nancy's needs and the resources that could be provided by the family working as a team. These resources included knowledge, time, and money. Once we had an exhaustive list of what needed to be accomplished, we matched the available resources. By the end of that first call, each of the siblings had their assignments and was committed to working as a team. Within a few hours of Jennifer's initial call to me, she was feeling as though she was back in control of the situation and didn't need to carry the burden on her own shoulders.
Over the next several days, I worked with each of the siblings on their piece of the puzzle, making sure that everyone stayed on track. The family had one very important decision to make, and that was where Nancy was going to go upon her discharge from the hospital. We worked with a geriatric care manager to identify the options and concluded that she could return to her condo safely as long as she had appropriate in-home care. Nancy's family now needs to address whether this is a sustainable solution given the financial realities, and the siblings have arranged to all come to visit Nancy at the same time within the next month. During that visit, they plan to go and look at several assisted living facilities and determine if that might be a better solution for Nancy. In preparation for their visit, Jennifer has asked me to help her identify several alternative facilities and to gather all of the necessary information so that she can share that with her siblings in advance of their visit so that they can make the most of their time together.
Family transition coaching can be helpful during a crisis, as in the case study presented above. While it is always better to plan ahead, the reality is that most people avoid thinking about the inevitable issues that will arise as their parents age. If you find yourself in the midst of a caregiving crisis, don't hesitate to reach out to a family transition coach.
Posted by Sheri Samotin on Thu, Jul 30, 2009
One of the toughest parts of being a family caregiver, especially a long-distance caregiver, is keeping all of the balls you are juggling aloft. The truth is, the more organized you are, the less stressed you will be. Checklists and calendars are a big help for keeping yourself organized. But family caregivers are often expected to keep others informed too and taking the time to make all of those phone calls can sometimes just be too much. There are many wonderful tools available that will help you facilitate communication between yourself and your care recipient, your caregiving resources, and friends and family.
Conference calls can be a terrific way to get far-flung family members involved with important decisions. For example, if you are the primary caregiver, but have several siblings who each live in a different city, you can use one of the many free conference call services to set up a number that each of you can dial into at the appointed time. In this way, all of those who should be part of the decision-making process can participate in real time. Similarly, if you are a long-distance caregiver, you might find it helpful to convene a monthly conference call with all of your caregiving resources so that everyone is aware of the others' insights and concerns.
Care pages are a great way to keep your care recipient's friends, family, and support network up to date on his or her condition and activities. Also free of charge, care pages are essentially personal websites or blogs. They allow you as the caregiver to post entries and photos, and allow visitors to post words of encouragement to you and your care recipient. You can set up the care page with various levels of security so you can control who sees what. This can be a really convenient way to communicate when you don't have much time; you determine when you post, and when you read what others have posted. Many people who have used care pages find that they develop a wonderful network of others in similar situations, a virtual support group!
Social networking sites like Facebook can serve a similar function to care pages, in that you can post updates which interested parties can follow. You can create various levels of security on Facebook, so make sure that you don't expose personal or medical information to the world. Similarly, there are many sites where you can set up a blog. You can then post your thoughts or updates and viewers can post comments in return. Blogs are generally very public, so you might find that a care page is a better tool for this purpose.
Finally, webcams allow you to get a visual on your care recipient if you are a long-distance caregiver. Unlike a phone call where you can only hear their voice, the webcam allows you to both see and hear the person on the other end. Many computers today have built-in webcams, and freestanding ones are available inexpensively. Once the webcam is set up, many care recipients are able to follow simple instructions to use them.
By putting updates in one place and allowing those who wish to do so to access them, you eliminate the need to make multiple phone calls. You are freed from worrying about whether it is too late at night to call your sister who lives three time zones away since she can read your update when it's convenient for her. Likewise, if all of those involved with the hands on caregiving report their activities and observations in one place, the information is available to all of the caregivers without the need for long conversations. As you can see, using technology can be a big help in your caregiving journey.
Posted by Sheri Samotin on Sun, May 31, 2009
I thought I'd take a moment to bring an important caregiver support tool to your attention. I learned more about it in an interesting article from the WSJ Sunday page in today's Naples Daily News. The author, Jane Zhang, talks about the federal government's efforts to improve the quality of nursing-home care and their recent launch of a new online tool for consumers. You can access the tool, called "Nursing Home Compare" at medicare.gov/NHCompare.
I checked it out for the Naples, FL area. There are eleven nursing homes rated within 25 miles of my zipcode. There is only one "five star rated" facility -- Premier Place at the Glenview. There are five "four star rated" facilities. I'll let you take a look at the rest of the details on your own, but I'm troubled that three of our local options only received "one star".
It's great that we now have some way to research and compare nursing-home options if we need that solution for our care recipient. Ms. Zhang does reference some caveats about the ratings, however, from the National Citizens' Coalition for Nursing Home Reform who warn that some data is provided directly from the nursing homes to the NHCompare website and may contain errors.
As with any important decision, you have to do your homework. But I'm glad to see that there is at least a place to start that is based on some objective data.