Family mediation for elderly care

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Tuesday, December 14, 2010; 12:00 PM

Crystal Thorpe, a founder of Elder Decisions, will take your questions about how families and seniors can deal with elderly care issues.

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long-distance Grandpa: My family is very concerned about my grandfather, but aren't sure what to do. He lives far away (retired to Florida), and is alone after his second wife passed a few years ago. We aren't able to visit frequently, but I know he is a very dangerous driver, that he has a very poor memory, and he often complains about being lonely, but is unwilling to participate in any of his retirement-community activities where he might meet people or at least have some company. He has outlived both his children, who might have been able to talk to him, and my mother feels uncomfortable doing it. I worry about him being alone, driving, forgetting to do important things, and even little things like eating right and not drinking too much. He is difficult to talk to because he is always putting us on guilt trips about how we don't come to visit, and seems to have forgotten about things like limited vacation time at work and traveling long distances with an infant. Plus, a long time ago he did choose to move far away from any family, and part of me thinks he should have been expecting limited visits. I don't really know if there is anything I could/should be doing to help him, and I'm pretty sure he would never listen to me if I said "you shouldn't drive any more" or something similar.

Crystal Thorpe:

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Negotiating a move for a parent with demetia: Would a mediator be appropriate in a case where an elderly father with dementia insists on staying in his house and all of his children and his doctors can see the dementia and frailty in him? In this case, it is my father who has dementia, refuses to move (even though he can't live without one of his kids staying to cook and care for him). He has caused fires cooking and forgets to pay bills or take meds. I have taken him to see a very nice assisted living facility (looked more like a posh hotel to me), but he thinks he is fine and wants to stay put. How do people manage a move in this case ? Is it possible, or do we have to wait until he gets so sick, that there is no option. I have been caring for him in and now my health has become worse (cardiac issues). Any advice would be helpful.

Crystal Thorpe: See www.caremanager.org

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Home or assisted living?: Gramps is a sturdy and solid 88-year-old small business owner who continues to work 6 days a week. His wife, who has always worked by his side, is unfortunately, of declining health due to cancer. She is often uncomfortable in the office now, but no one wants to leave her home alone while Gramps is at work. There are no family members nearby who are suitable or available to spend the day with her at home. To force Gramps to stop working would be horrible for his well-being. Gram can still go to work sometimes.Is it realistic for her to get a nurse once or twice a week with little notice, on the days she wakes up not feeling up to it? They were considering assisted living, but I fear the physical and mental burden of moving will be very hard on them right now. Ideas on what's best?

Crystal Thorpe: If this conversation sounds challenging, a mediator can help.

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elder care: How can employers support their employees who have become the caretakers of their aging parents?

Crystal Thorpe: Offering "brown bag" programs about issues related to caregiving, and even an employee caregiver support group, can be helpful to provide information about resources available and give needed support to caregivers.

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DC: My grandmother is generally able to live on her own, but requires daily help in things like taking prescriptions (forgetting to take it all or taking too much), household chores (including food preparation, taking out the trash, etc), among other things (she doesn't drive).My mom had hired an assistant to help with the household chores but my grandmother eventually "let her go" because she claimed she didn't need the help. Now my mom takes care of everything, while still working full time.An assisted living community is out of the question because (1) we cannot afford it and (2) my grandmother would refuse to move. So, I have two questions.One, are there other options for assisting my grandmother that are low or no cost? And two, how can I support my mom when I don't live in their area (they are in New England)?

Crystal Thorpe: Asking her how you might help provide her with some respite can also help.

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Small town: How can I help my elderly father manage his house and such without insulting him? He's fairly perky for 88, but I do worry. I live in the same town, so distance isn't an issue. He does the "ADLs" with zero problems so far.

Crystal Thorpe: Remind him that you care about him and love him, and want to help if he'd find it to be helpful, but that you also don't want to "step on his toes."

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Hearing loss: Sometimes an elderly person experiences hearing loss without being aware of it. Family and friends should make sure he or she gets periodic checks. I've known several people confuse hearing loss symptoms with dementia - and look for nursing homes too soon!

Crystal Thorpe: Some physical issues (like urinary tract infections) can produce symptoms that are misleading and similar to dementia.

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Burnout: After being the main person [to care for] my frail and declining mother relied on for more than 10 years, I seem to be unable to re-energize and move on after her passing two years ago. I don't think it is depression, but more of a general emotional fatigue. I suppose it is different from, yet related to, real-time care-taker burnout(?). Do you know of any resources that might help me with this? Thank you for the chat.

Crystal Thorpe: Take the time now to treat yourself with loving care -- you deserve it!

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How to help: Do you have any suggestions on how grandchildren in their 20s can help? My friends and I discuss how we all live/work pretty far from our grandparents and therefore cannot provide much physical help, and in this economy we can't provide much financial help either. My parents are visiting, doing paperwork, contributing money... I feel terrible. I've been acting as a source of emotional support to my parents and do what I can when I go home for the holidays, but I feel that I should be doing more. Do you have any suggestions? Thanks!

Crystal Thorpe: Thanks for your caring.

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Stubborn parent: How do you help an elderly parent make decisions about the proper care needed for her spouse, who has dementia? My mother is very stubborn, needs to get VA benefit application done, needs to take care of banking issues, needs to place husband on a nursing home waiting list (which means getting a doctor to fill out a portion of the forms), etc. etc. but keeps letting other things get in the way. I have stopped making suggestions and just help out, no longer say anything. We could possibly be left having to make decisions on our own if she were to become incapacitated (not likely at the moment but one never knows). Thank you.

Crystal Thorpe: If this conversation seems too difficult to have on your own, a local mediator can help you talk together and hear each other.

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Caregvers inheritance share: Should the child who provided all the support for a parent in an assisted living home be entitled to more of an inheritance share if the will stipulated equal division?

Crystal Thorpe: s points of view, they can craft solutions that feel fair to everyone.


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