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Caregivers Resisting Help

Posted by on Jan 7, 2013 in Caregiving | 0 comments

Originally published January 2012 at www.kindethics.com. Reprinted with permission. I have never been very good at asking for help and, like many family caregivers, I didn’t think that my own needs mattered. Thinking I had to do everything all the time caused me to have two breakdowns; once during my early years of caregiving and again in the last year of my 17-year caregiving journey. I wish I had known about the following statistics from a recent MetLife Study: Family caregivers experiencing extreme stress have been shown to age prematurely and this level of stress can take as much as 10 years off a family caregiver’s life. 40% to 70% of family caregivers have clinically significant symptoms of depression with approximately 25%-50% of these caregivers meeting the diagnostic criteria for major depression. Stress of family caregiving for persons with dementia has been shown to impact a person’s immune system for up to three years after their caregiving ends thus increasing their chances of developing a chronic illness themselves. I don’t know which statistic frightens me the most. But I do know that I have paid an emotional, physical and financial cost for being a caregiver. (I also loved taking care of my family.) It didn’t have to be that way. I could have and should have asked for help. But I am a caregiver and when people told me, “Just make time for yourself,” it wasn’t that easy. If you think about who in a family becomes the caregiver, it will usually be the person who is more nurturing and generous with their time. So by nature, the caregiver is the type of person who already gives more than others. And this becomes a vicious cycle of give – give – give instead of give – receive – give – receive. I recently said to my friend who is an overwhelmed caregiver, “Maybe now is a good time for the rest of your family to learn what they need to do to help their grandfather.” What I heard back from her were lots of excuses: They don’t want to help They don’t know what to do They don’t know him like I do They will just make it worse I don’t have time to teach them It is just easier if I do it I get tired of asking I don’t think they would help, even if I asked Why should I have to ask, they should just know what to do I don’t want to be a bother It is too much effort to ask Sound familiar? I realized in that moment that it isn’t always that the family won’t help; it is the caregiver who is resisting asking for help. So let me ask you. If you had a broken shoulder, would it be okay to ask someone to carry your groceries to the car? If your car broke down, could you call for a tow truck? When your loved one needs help, don’t you get them the help you need? Then why don’t you deserve the same attention? Your needs matter and you deserve to have someone help you. Here’s my Four-Step Process, to help you identify what keeps you from asking for help and to overcome your reluctance. Step 1: I encourage you to explore...

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Avoid Investment Fraudsters

Posted by on Oct 17, 2012 in Financial and Tax Matters | 0 comments

This guest post is courtesy of the Alberta Securities Commission. Many people approaching – or already in – retirement are looking  to maximize the returns on their savings and investments. Sadly, many fall victim to fraudsters who are skilled at preying on our emotions, insecurities and vulnerability at this critical time. Up to 27% of Canadians have been approached with a possible fraudulent investment. Older persons are targeted for several reasons, but often because they are perceived to have the most disposable income or wealth.   With 4.6% of Canadians investing money in what has turned out to be an investment fraud, one may well wonder: “How can so many people fall for bogus investment schemes? ” Not being clear about our own risk tolerance or investment goals is certainly a factor. Also, successful fraudsters tailor their sales pitch to our “weak spots” and do so in a persuasive and professional-looking manner.     Here’s how investment fraudsters typically use three ways – the Internet, the telephone, and your personal connections – to attempt to separate you from your money:   The Internet and E-Mail   The Internet is a quick and easy way for scam artists to find potential victims. Online fraudsters can operate anonymously from anywhere in the world, making them hard to trace and catch.   Spam emails that reach thousands of people are cheap and simple to create. Online discussion boards and social networking websites, such as Facebook or Meetup, allow people to create groups around investing strategies, or advertise seminars for new investment products. Although some may be legitimate, approach these solicitations with extreme caution.   If you receive an investment solicitation via email, treat it as “spam” and take these steps:   * Do not reply to “spam” emails. Block further emails by adding them to your “blocked senders” list.   * Do not provide ANY personal information unless you have initiated the communication to a company or individual you know and trust.   * Many investing websites look legitimate, but watch out for non-relevant information or spelling and grammatical errors on the site. These red flags are signals to do more research; it could be a scam.   Cold calls   Phone calls are among the most common ways to inform people of investment opportunities. “Cold calls” can be valid ways for businesses or charities to identify and market to potential clients. However, these calls may come from a makeshift office or “boiler room,” promoting a business idea that sounds very profitable – a “sure thing”. These callers may falsify information, try to pressure you into a bad investment, or attempt to outright defraud you.   If you have “call display” on your phone, you can choose to ignore all calls when you don’t recognize a number. If you do choose to answer, protect yourself with these tips:   * Be wary of an investment opportunity that seems “too good to pass up”. Don’t feel pressure to make any decision on the spot.   * Don’t let someone persuade you to invest in an opportunity that isn’t right for your risk profile or time horizon.   * For peace of mind, do your own research about the company or individual offering the investment. Discuss it with your own accountant and financial adviser.   Through friends and family   Scam artists often will take advantage of common bonds developed throughreligious, professional or ethnic relationships or the close ties of family and friendship. This is also called “affinity fraud”. Fraudsters take...

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Downsizing Stress

Posted by on Jun 21, 2011 in Housing Options, Living Arrangements | 0 comments

You have made the decision to move and “downsize” your living arrangements. You have either decided on your own, acted in part because of pressure from family, or put the decision off for so long that now you must move to a care home for medical reasons. Whatever the reason, downsizing can be a stressful and uncertain life transition. There are common reasons behind the stress, and each person will experience them uniquely and in different proportions. Some common stress triggers are grief, resistance, uncertainty and overwhelm. Here are some thoughts on how to cope with them. Give Grief A Chance First and foremost, allow yourself to grieve. “Downsizing is an end to one phase of your life and it is okay to be sad”, says Dawn Rennie, President of Transitions – Your Moving Facilitators. “Like the day you watched your children move out, leaving your home will be bittersweet. Your new home and lifestyle will mean new friends, new activities and new adventures. But you are leaving your home of many years and possibly your community and friends.” Rennie says it’s vitally important to allow yourself the time to say good-bye to what you are leaving behind.  Hanging on to “Independence” As we age, our physical abilities decline, and we fear losing our “independence”. But we can choose what independence means to us. Does it mean doing everything ourselves? Or does it mean arranging for others to do demanding tasks, and focusing on doing the things you really love to do? When we arrange for others to do the cooking, cleaning, and maintenance, we gain time and energy to spend on travel, volunteering, friends and family, or new hobbies. “You don’t give up your independence when you are the one choosing what you want others to do and who those ‘others’ will be,” says Jan Sali, Managing Director at Transitions. “But you do give up your independence when you allow yourself to decline to the point where others make those decisions for you.”  Fear of the Unknown Not knowing your downsizing options can be stressful, even frightening. To combat this, prepare and gather information, to avoid feeling forced into a decision you know nothing about. Explore all your options – including condominium living, an independent seniors’ residence, or various levels of care homes. Consult a local seniors’ housing directory (in Calgary, published by the Kerby Centre). Inquire at the local seniors’ centre or your municipal offices. Consult with friends who have made the move, interview realtors (if you are buying or selling), or talk to eldercare specialists. Armed with a list of “must haves”, visit the places you are interested in. Many places will give you lunch or dinner and invite you to their special events. Tour their facilities, learn about services and activities. Sample the menus, get a feel for the staff and “culture” of the place, and learn what the particular community is like. Spend enough time at each place see whether it fits with your budget and desired lifestyle. Once you decided where you will move, you will feel relieved, but more anxiety could follow: How will we manage the move?!?!  To avoid feeling overwhelmed, develop a personal moving plan, which includes decisions on the following: 1. Your time frame, e.g., set a goal for...

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Hope, Promises & Reality: Eldercare Costs (Part 2)

Posted by on May 24, 2011 in Financial and Tax Matters, Planning | 0 comments

  In Part 1 of this article, we looked at the costs of home adaptation and the options for in-home care assistance for the elder Olivers. Part 2 examines mobility – both in the home, through assistive devices, and transportation options for seniors – as well as a few important tax considerations.   Assistive Devices/Aids for Daily Living   Brian Oliver reads off for his brother a price list of common devices that help frail seniors stay safely in their own homes: “Stair-lift, $3,000; walker, $350; custom wheelchair, $400; adjustable bed, $1,500 – are you kidding?”   Before hitting the panic button, here’s what Brian needs to do: A safety and accessibility audit can determine what’s specifically needed; your provincial society of occupational therapists (in Ontario, www.osot.on.ca) can provide a list of visiting therapists. Check whether your parent’s extended health benefits include coverage for medically necessary assistive devices and care, that aren’t provided by government programs. These may include purchase or rental of ‘durable medical equipment’ such as (non-electric) hospital beds, wheelchair, walker, crutches, canes; ambulance services, physiotherapy and paramedical services such as chiropractor or podiatrist; medical supplies; hearing and vision aids. Your provincial government may offer an assistive devices program that rebates part of the purchase price of eligible devices; in Ontario, consult www.health.gov.on.ca, or search “aids to daily living” for your province. Visit www.marchofdimes.ca to learn about their assistive devices program for manual & power wheelchairs, scooters, home and bath and personal aids, seating and walking aids, lifting equipment, threshold ramps and some repairs. Tax Considerations   Learn which of your parent’s essential medical services, care, equipment and even transportation may be tax-deductible.   If your parent is classified as disabled via the Canada Revenue Agency’s form T2201, Disability Tax Credit Certificate, they may claim a credit on their annual tax return. The form is completed by a physician or other healthcare professional, and certifies that the care recipient needs assistance to carry out the activities of daily living – such as bathing, eating, and ambulation.   Annual medical expenses must exceed 3% of net income or $1,813 to qualify for the credit. Check the Canada Revenue Agency’s website www.cra-arc.gc.ca and your tax professional for more information.   Transportation Options With the diagnosis of dementia, Mr. Oliver will no longer be driving. Patience, tact, and discussing options may help him cope with this loss. When so many financial pressures loom, a good exercise can be to look at the costs vs. benefits of car ownership.   Mr. Oliver paid $25,000 seven years ago, and only drove the car locally. With $1,000 per year to insure and $100 per month for gas, it has cost $40,400, or $5,700 per year to run. This annual amount could easily cover local transportation by taxi. Opening an account with a taxi company, with a monthly statement paid by credit card, is a convenient option that also allows easy tracking of expenses.   Other options include subsidized transit services such as Wheeltrans, and non-emergency ambulance and wheelchair transit fleets. Volunteer drivers are available for many community services, including day programs and congregate dining (eligibility criteria may apply).   Many medical and personal services (such as lab tests, physiotherapy and foot care) can also be delivered in the home.   So where does this leave the...

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Hope, Promises & Reality: Eldercare Costs (Part 1)

Posted by on Apr 24, 2011 in Financial and Tax Matters, Planning | 0 comments

Snapping his laptop shut, Brian Oliver looks at his brother. Mom’s recent fall has brought them both back to the family home for the first time in two years and they’re dismayed at what they see.   “No matter what I do, it doesn’t balance. We promised Mom and Dad they could stay at home but the money just isn’t there. Maybe you can kick in $1,000 a month, but I’ve got two kids in university”!   Here is the brothers’ worry list:   Mom has advancing osteoarthritis and Dad is showing signs of dementia. Their 1960’s suburban split level has at least four stairs to access either the bathroom, bedroom, kitchen or front door; a long driveway; huge lawn; and backyard pool.   Mom hasn’t been out of the house all winter; the house needs repair and the pool and yard are badly neglected. Dad’s seven-year-old car has expired plates and he can’t find the ownership or insurance. The pantry is full of canned food and there are mystery items in the freezer.   It’s pretty clear Dad hasn’t had a bath since a recent slip in the tub. Laundry is abandoned since Mom fell en route to the basement with an overflowing hamper.   Things have to change, and money will be required, but where to start?   Here’s what the family has to consider BEFORE getting estimates for home renovations and engaging help for homemaking and care:   Home Modification:   Any changes to the home must be guided by the strategy for accessibility and care. If the Olivers are determined to stay at home, what sort of care do they require now, and in the future, and how does that affect the home?   Modifications are urgently needed to allow both parents to easily walk – and eventually, to use a walker or wheelchair – around their home. They must be able to access the ‘golden triangle’ of bedroom, bathroom and kitchen. That may require ramping, stair lifts, or placing the bedroom, and possibly the laundry room, on the same level as the bathroom and kitchen. Finally, Mom must be able to easily reach the front door to access transportation and the outdoors.     Any renovations should incorporate grab bars, roll-in showers and non-slip flooring. Bedrooms need doorways wide enough for a wheelchair, with low-pile carpet or hardwood flooring. Improved lighting is needed inside and outside the house. Energy-efficiency upgrades to furnace, air conditioning, plumbing and electrical can add longer-term cost savings.   If they plan to stay longer-term, the family must consider what level of care they will need. If they opt for live-in care, how will they provide suitable accommodation? Even basic personal care assistance will require a shower stall or a tub with a hand-held shower attachment, grab bar and bath bench.   Sounds like a big ticket – and it is. However, these are viable capital improvements which will affect the home’s resale value. But where will the cash come from?   Research what’s available from Canada Mortgage and Housing’s Programs and Financial Assistance at www.cmhc-schl.gc.ca. National Resources Canada’s Office of Energy Efficiency offers grants for homeowners upgrading to more energy-efficient solutions at www.oee.nrcan.gc.ca. The March of Dimes’ home modification program offers a lifetime maximum of $15,000 for qualified applicants. See www.marchofdimes.ca   Other...

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Dementia, Depression or Delirium?

Posted by on Jan 18, 2011 in Health Signals | 0 comments

Three of the most common mental health problems experienced by the elderly start with the letter D: dementia, depression, and delirium. Their symptoms may, at times, appear similar. Comparing the conditions and highlighting the differences can alert you to when medical help may be needed. The most common form of dementia is Alzheimer Disease. Incidence increases with advancing age. It is not curable.  Depression affects about 10% of the general population, can occur at any age, and affects both men and women. Incidence is higher when other medical conditions are present. Delirium is often unrecognized and therefore not treated. To read the complete article in PDF format, open the attachment below. Dementia Depression Delirium...

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37 Reasons to Review Your Will & Estate Plan

Posted by on Nov 16, 2010 in Wills and Estate Planning | 0 comments

Whether we like it or not, some parts of life are complex. We need to enlist help with areas where we lack experience or expertise. This is certainly true when it comes to certain legal, financial and tax matters – all of which can come into play with estate planning. But we can also use expert insight when it comes to the emotional pitfalls and relationship issues that arise during estate planning.   Here is the first of 4 common mistakes we outlined in ElderWise Info (Vol 6.No. 11) Estate Planning – Part 2:    Not changing your documents as you and your family experience life-changing events. There are dozens of life-changing events which should trigger the review of your legal and financial decisions. These include health, employment and business changes, births and deaths, marriages and divorces. The attached checklist, provided by Fiduciary Trust Company of Canada, provides 37 life events which may prompt you to review your will and estate plan. 37 Reasons to Review Your Will & Estate...

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Memorial Societies in Canada

Posted by on Aug 26, 2010 in Final Wishes | 0 comments

When considering and planning your funeral arrangements, one option to consider is to become a member of your local memorial society. These are not-for-profit groups who can (a) guide you in documenting your wishes for funeral arrangements and (b) qualify you for preferred member rates for your funeral expenses. These societies enter into specific rate agreements with one or more local funeral service providers. Click here for: Contact information for all memorial societies operating in...

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Six Excuses for Stalling Estate Planning

Posted by on Aug 12, 2010 in Wills and Estate Planning | 0 comments

  “Most people take more time planning their annual vacation than they do planning their estate.”  This common saying may sound like an exaggeration, but the reality is that more than 50% of Canadians do not have a properly planned and executed Will, Power of Attorney and Health Care Directive.  Why not? In a word: procrastination. Most of us experience some combination of fear and avoidance when faced with the challenges of thinking about our own death…We know procrastination is the most common estate planning mistake. Based on our experience at Fiduciary Trust, here are several of the root causes that stall the process…and some suggestions to get past “go”. To read the full article, please open the file attachment below....

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When Aging Parents are Unwell (3 of 3) Where to get help if your parent has a mental illness

Posted by on Sep 1, 2009 in Health Care Team and System | 0 comments

When Aging Parents Are Unwell: Part III Where to get help if your parent has a mental illness Mental health problems can occur at any age and any stage of life. Some individuals have chronic mental health problems that they must manage during their life time. Other people develop mental illness in later life.  The most common problems are depression and anxiety. Depression Depression is not an emotion!  It is a disorder with affective (mood), cognitive (mental), and physical symptoms. Depression is not feeling sad about a loss or disappointment. Surveys show that about 10-15% of otherwise healthy older people suffer from depression.  Depression is much higher when the individual has other health problems. As high as 30 – 45% in those who have had a recent heart attack, cancer, stroke, diabetes, and Parkinson’s disease. Wondering if your parent might have depression?  Here are some warning signs that you can watch for or ask about: May or may not look sad May cry easily Low energy, excessive fatigue Sleep disturbance Eats too much or too little Feelings of guilt or regret Withdraws from usual activities Avoids family or friends Easily irritated Not keeping up personal appearance Poor concentration or memory Thoughts of suicide How can you help? If your parent is showing several of these signs over a period of time, it is wise to talk about your concerns. Depression is treatable. Ask mom or dad to see the doctor. The most important thing you can do is be supportive. Know that depression does not mean the person is weak.  You cannot simply “pull up your socks” and get over it. Being around someone who is depressed can be “depressing.”  Keep your perspective and sense of humour. Be patient. Anxiety Feelings of anxiety are a normal reaction to fear and uncertainty, and everyone feels anxious from time to time. The mental health problem of anxiety is much more: it is intense; it lasts for long periods of time, and can occur “out of the blue.” One study showed that 10-15% of seniors have anxiety. This is probably underestimated. Anxiety can occur along with depression. Anxiety is both frightening and confusing to the individual. Symptoms, such as pounding heartbeat, can be so intense that the person thinks it might be a heart attack. Because the symptoms can occur without warning, and without any apparent reasons, the person may report “I feel like I am going crazy.” Like depression, anxiety is not caused by personal weakness and cannot just be ignored. Wondering if your parent might have anxiety?  Here are some warning signs to ask about or notice: Physical Pounding heart beat Shortness of breath Sweating Nausea Sleep disturbance Vivid dreams Behaviour and Thinking Avoid social situations Excessive worry Difficulty concentrating Irritability Racing thoughts Memory loss How can you help? Anxiety is not well understood.  People need to know that anxiety is a real problem and that treatment is available. Some older adults do not want to talk about their feelings and may have fears about seeing a mental health professional.  You can help by encouraging them to talk to a doctor. You can also help by recognizing that anxiety is a serious problem that affects the quality of daily life.  It will not go away by using “mind over matter” approach....

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When Aging Parents Are Unwell (2 of 3): You CAN Prepare for a Visit to the Emergency Department!

Posted by on Jul 30, 2009 in Health Care Team and System | 0 comments

When Aging Parents are Unwell You CAN Prepare for a Visit to the Emergency Department Frail seniors are likely to go to a hospital emergency department because of falls or serious acute health problems such as stroke. In most emergency departments, 50% of the patients will be over the age of 65. You may be the first family member called when a parent is taken to hospital.  There are some things that you and your parents can do to be prepared for the visit to the emergency department. Talk before the call comes! Talk to your parents about important documents. Have they assigned enduring power of attorney and written a health care (advance) directive?  Be clear that you are not asking to be named their advocate but you need to know if they have written these legal documents and where to find them Mutual understanding Ideally, there should be an understanding and agreement between what your parents expect and what you can provide.  Talk about these expectations – have some “What If’ conversations. Beliefs Do your parents have strongly held religious beliefs? Are there any treatments they wish to refuse on religious grounds? Medical information Do some research to understand the terms and treatments related to your parent’s health and medical condition(s). Write down the following information and keep a copy where you can quickly find it. * Who is your parent’s doctor? * What specialists do they see? * What medications do they take? * What health problems do they have? * Do they have any allergies? * Do they have medical insurance? An emergency bag Create an “in case of emergency bag.”  Include the medical information above, as well as a notebook and pen – you will want to write down information as the health team gives it to you. Add important phone numbers. Think about your own comfort as well as that of your parent. Bring layers of clothing, water and snacks, and reading material. Your benefit program Have you talked to your employer about benefits and time away related to caring for your aging parent? You will need to be with your parent in the hospital, probably for many hours and possibly for many days. For more information, consult the ElderWise e-Guide, Seniors in the ER: Survival Strategies for You and Your...

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When Aging Parents Are Unwell (1 of 3): Who’s who on the healthcare team

Posted by on Jun 27, 2009 in Health Care Team and System | 0 comments

Originally published in the Lifespeak newsletter, January 2009. Compared to the younger population, seniors are more likely to use the health care system, including visits to the doctor’s office, medical clinics, the emergency room, and hospitals. Many older persons also require home care provided by the local public health services. During each encounter, senior sand family members will meet a variety of health care professionals. It can be confusing to figure out: Who is the best person to ask about problems or concerns? What role do these people play? Should we ask for professionals who are specialized in the care of older adults?  The following list identifies the most common health providers that you and your parents are likely to encounter in a hospital or in a community setting. When you meet these providers, ask for their name and their role. This might help you to know who to contact when you have questions or concerns.  Case Manager A case manager is a professional (often a registered nurse or social worker) who oversees the assessment and planning for care and services for an individual. Some Geriatric Case Managers can be hired privately on a fee-for-service basis. Discharge Planner A discharge planner is an individual who works in a hospital and assists patients to connect to healthcare services in the community following a hospital stay. Home Care Coordinator (Community Care Coordinator) A home or community care coordinator is a health professional who assesses and oversees the home care services that are provided to a client at home or in a community program. The coordinator determines eligibility for the services and then assigns the patient’s care to the most appropriate member of the team. Home Health Aide (Personal Care Aide) A home health aide or personal care aide is an individual who provides personal care: bathing, dressing, grooming, and assistance with eating. These aides may assist with rehabilitation; helping with range of motion exercises and other exercise programs under the direction of a professional such as a physiotherapist. The education of these workers is not standardized. In facility settings, this worker may be called a nursing attendant or assistant. Licensed Practical Nurse (LPN) or Registered Practical Nurse (RPN) A licensed or registered practical nurse is a graduate of an approved education program and registered with the provincial college that governs the profession. The LPN/RPN provides care as part of the health care team in hospitals, long-term care, and community programs. They administer medications and perform some nursing procedures. Registered Nurse (RN) and Nurse Practitioner (NP) A registered nurse is a professional who assesses a patient’s condition and makes decisions regarding appropriate nursing interventions. RNs can respond to complex situations involving patients with acute and chronic illnesses, deliver health education programs, and provide consultative nursing services to promote, maintain, and restore health of individuals and families. Nurse practitioners are registered nurses with advanced training in health assessment, health promotion, and illness prevention. NPs diagnose and treat health problems, order and interpret diagnostic tests, and prescribe drugs.  Pharmacist A pharmacist is a professional trained in the art and science of pharmacy. In some provinces, under certain conditions, pharmacists can prescribe medications. Should we ask for specialists? When older adults experience illness, they may need specialized care because of the complexities in diagnosis and treatment. Many...

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Responding to the Crisis Call

Posted by on Sep 15, 2008 in Caregiving, Health Emergencies | 0 comments

What can you do when you get the call that your parent has a health or medical crisis? You are likely to feel the pull of trying to be in two places at the same time. Now is the time to recruit help, both personal and professional, to assist you.  What kind of help is available? Financial resources will influence some of these suggestions. Consider the following ideas: Inquire about public health care services such as home care, companion programs, and palliative care programs. Be sure that your parent is receiving the services that are available. In the hospital or long-term-care settings, talk to the care providers, particularly, the physician, the nurse in charge, and members of the interdisciplinary team (i.e. physiotherapist, social worker, dietitian). Get their contact information, including email and provide yours, so that you can keep in touch even at a distance. Ask your parent for permission to be included in care planning. Inquire about “geriatric” services in the hospital or community. These health care providers have specialized in care of older persons. You might find a Geriatrician or a Geriatric Nurse Practitioner or Clinical Nurse Specialist who will help guide your family through the process. Check out private services, such as personal and private care, to provide some respite for you. Recruit help from family and friends. Your parents might have very close friends who are willing to take on some responsibilities such as visiting, checking the house or minding the pets. These friends might know the community resources better than you – ask their advice. Take care of yourself!  You need to attend to your own physical, emotional and mental health needs and this might mean that you cannot always do what others expect or what you demand of yourself! When called upon to support an ailing parent, we often do not know the timeline involved; the demands might go on for many months. We need to pace ourselves or we risk burning out. Helping a parent can take its toll. Mobilizing your support network and finding services can help you to be supportive without wearing yourself out....

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Caregiving From a Distance

Posted by on Sep 15, 2008 in Caregiving | 0 comments

  Living at a distance from aging parents presents several challenges. Visiting your parents for short periods – probably at special occasions – you may not be aware of how they are managing their day-to-day lives. Can they still do the everyday household chores? What about seasonal demands of yard work, snow removal and regular upkeep? With increasing age and frailty, are they living safely, particularly if still in their home? And when the crisis occurs, how can you manage the demands of your own work and family life and still travel to help your parents? Here are a few suggestions to consider while your parents are still managing well: Set up easy lines of communication such as email, video callint or regular telephone visits. Offer to pay for these communication vehicles (e.g., phone cards) as special occasion gifts.  During a visit, get to know your parents’ community – from their perspective. Who are their neighbors? Will they respond in time of need and will they give you their contact information? Will they take your phone number and call you if they have concerns? Find out about local services, e.g., gardening, home maintenance, housekeeping and transportation. A good place to start looking is with the local seniors’ clubs. The Chamber of Commerce or City information can also point you in the right direction. Find a hard-copy or online source for the local seniors’ service directory – it might be useful if you need to find support services. Set aside some time during a visit to make a list of important documents and their location (wills, advanced directives, personal health care numbers, name and contact information for the family doctor) Discuss the use of emergency response systems.  © 2009...

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Talking About Finances

Posted by on Apr 14, 2013 in Financial and Tax Matters, Power of Attorney | 0 comments

Many families experience problems with financial discussions – and therefore avoid them. The older generation may avoid discussions with adult children out of fear of losing privacy and control. Adult children may wish to respect a parent’s privacy but they wonder – not only about a parent’s well-being, but also whether a parent’s finances could affect their own retirement plans. In other families, money is a taboo subject or one that simply brings up too many negative emotions.  Why do adult children need to talk about money with their aging parents? First, knowing a parent’s situation can help adult children plan their own financial future. Second, being aware is especially important if an adult child has been appointed financial power of attorney for their parent. Third, a trusted adult child can stay alert and offer support when an older person’s health issues make dealing with finances more demanding.  As we get older, dealing with chronic health problems, pain, medication side effects, and vision loss are among our physical challenges. There are mental and emotional challenges, too. They can include increased anxiety and depression, as well life changes, such as losing a spouse (who may have been responsible for finances). All these factors can make dealing with money matters more challenging.   Here are some early signs that finances are getting more challenging, either for loved ones or for ourselves:   Trouble balancing bank statements Unpaid bills, notices or statements stacking up Penalties for late payment or services and utilities being cut off Trouble reading fine print or understanding financial notices More stress about paying bills and looking after finances Changed spending patterns or behaviour So where can we start if we have concerns? Here are some strategies for adult children that can help open doors with this sensitive subject.   Assist with minor, routine tasks. For example, suggest automatic debits for recurring bills or help introduce someone to on-line banking. This can give you some insight into someone’s finances. Once bigger issues or tasks arise later, working in tandem won’t seem such a drastic change.   Ask for their insights. If someone seems financially aware and is an active investor, start a conversation about investments to get a sense of their approach. Alternately, set the stage by asking about older persons’ insights from experiences such as the Great Depression or other financial setbacks. In the process, personal values can be uncovered, and that can create greater trust and open doors for deeper discussion.   Ask them to help give you peace of mind. Let your parents know you’ve been concerned and that you would feel better if you knew more about their plans. Point out that you could be the “go to” person who will need information in a crisis. If you have read or know of a case where a family was financially unprepared, sharing their story can provide food for thought.   Once trust is established, ask to participate in financial planning. It’s no secret that investment options today can be complex. Sound financial advice is more important than ever. If your parent uses an advisor, ask if you can come to a meeting with their advisor – as an observer. Notice whether your parents are following along and involved with the conversation. If they don’t have an...

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Stuck in the Middle: Retirement Planning

Posted by on Apr 9, 2013 in Financial and Tax Matters, Planning | 0 comments

Originally published at www.theglobeandmail.com on November 5, 2012.   “Many boomers are assisting parents financially or are losing income because of their eldercare obligations,” says Mara Osis, founder of ElderWise, an organization that provides information and coaching to help families caring for elderly loved ones. “They may turn down career opportunities or even retire early, if they feel it’s up to them to take on this responsibility and don’t see any other way of doing it.” Read the complete article:...

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Caring for Aging Parents: Are You Prepared?

Posted by on Apr 9, 2013 in Health Emergencies, Planning, Powers of Attorney | 0 comments

Originally published on June 24, 2011 at www.brighterlife.ca   When Iola Pryma was told she needed to have a lung biopsy to investigate the tumours a CT scan revealed, one of the first things she did was make her daughter, Kandis Pryma, her power of attorney for her finances. A 71-year-old widow, Pryma knew that in the event of a long recovery — or worse — she would feel much better checking into the hospital knowing that her finances were in order. This family was lucky. In their case, the parent was able to make this decision on her own and to guide her daughter through her financial portfolio and banking information without suspicion or embarrassment.  But many families aren’t so lucky, says Mara Osis, president of ElderWise, a Calgary-based company that coaches families on topics relating to aging parents.   Read the complete article:...

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Retirement: Families Planning Together

Posted by on Apr 3, 2013 in Planning | 0 comments

 Originally published May 2011 on www.lifespeak.ca Contribution by Mara Osis, eldercare consultant and speaker on LifeSpeak’s Calgary roster.If one or both of your parents is talking about “retirement”, they are using a term that is being re-defined so quickly and drastically that the word might actually soon disappear. For previous generations, mandatory retirement at 65 was not uncommon; nor was collecting a pension for 25 or more years of service. More recently, retirees were sold the “Freedom 55” concept – endless, carefree days of golf, travel and leisure. Today, because we are expected to live longer than previous generations, retirement is largely uncharted territory. Some older workers are financially secure, and looking forward to leaving the workforce. For others, career and financial upheavals have walloped retirement savings and even pensions. Still others are dreading retirement, fearing the loss of income, sense of purpose and social life that comes with the job. With more evidence that “inactive” retirement can lead to aggravation of health issues, those are real concerns. Today, more people are “getting” the message that they need to plan ahead for the transition. Involving the whole family can help. Whether you are nearing retirement age and wondering what’s next, or watching your parents as they plan ahead (or don’t), here are things for both generations to consider and discuss together. What will retirement look like? Who is retiring – one or both parents or marriage partners? Are your visions and expectations of retirement in sync with each other? If not, how will the gaps be closed? Many marriages undergo a period of adjustment, whether one or both spouses retire. Declining energy, mobility or health are behind some retirement decisions. Understanding the health issues and prognosis helps manage the present situation and plan for the future. If work is too demanding, health-wise, what activity or life focus will take its place? Often, retirees who embark on a “life of leisure” soon find it less than satisfying. The purpose and meaning that came with their careers evaporates; they might feel they’ve stopped contributing. Part-time, contract or volunteer work can be the solution for some. For others, it can be learning and exploring entirely new interests. Every retirement plan needs to answer the question: “How will this next chapter of my life be fulfilling, meaningful, and driven by my values?” How is the family affected? Retirement can change the family dynamic. For example, parents may want to retire to a warmer clime, thus affecting both regular and holiday family get-togethers. Some may want to move closer to adult children and/or take a more active role in grand-parenting. Others may actually crave fewer obligations, e.g., babysitting, and more time to pursue their own interests. How will each generation manage expectations and accept each others’ preferences and choices? A retirement transition is a good opportunity for families to take care of practical matters and look to the family’s future well-being. Here are three things families can discuss together: Caregiving: What kind of future support might the older adults need and even expect? Do your parents believe it’s a family’s obligation to care for its elders, or do they insist they won’t be a “burden” to their children? Whatever the attitudes, the reality is that people are living longer than ever; centenarians are a fast-growing...

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Emergency Response…Or Crisis Mode?

Posted by on Mar 11, 2013 in Health Emergencies | 0 comments

As family members age, it’s more and more likely that we’ll be faced with an “eldercare event” – a sudden, dramatic change in the status quo, usually related to health. Here are some common examples of what can happen: A frail older person, living alone, suffers a fall, a stroke, or a heart attack and is hospitalized. She must now leave the hospital but cannot safely live alone any more. A healthy spouse who cares for a frail senior dies suddenly. Family members are scattered throughout the country or live overseas. Your parent lives alone, several provinces away. Your last few phone conversations have seemed strange; your parent is rambling and, occasionally, incoherent. Your phone rings at work. The local hospital informs you that Dad has been admitted to the emergency department. We hope we will never have to deal with situations like these, but it’s unrealistic to believe either that it won’t happen to us or that “we’ll deal with it when something happens”. When eldercare events occur, it helps everyone if we respond and cope well. Otherwise, we may become part of the problem, not part of the solution. Here are four steps you can take to prevent an emergency turning into a crisis:  Acknowledge your emotions Even if you have thought about how you might deal with an elder care event, you cannot predict how you will feel when it happens. Elder care events can involve complex decisions, time pressures and the need to navigate unfamiliar situations and new relationships. Aim to reach a level of calm before responding to the news. Everyone can benefit from deep breathing and a few quiet minutes to wait for the adrenalin rush to subside. Change your self-talk if it’s making you more anxious. Self-talk can either increase your panic, or guide you to a more reasoned response. Tell yourself:  “I am calm and capable. I have handled other difficult situations and I will handle this one, too.” Remember the resources you have drawn on in the past to calm yourself and make reasoned decisions. Assemble your support team. Who might I ask to come and stay with me? Who can give me emotional support on the phone? Who else do I need to call to let them know what is happening? Who can I contact to help me figure out what the right thing is to do for someone else? Implement an Emergency Plan you have worked out in advance. Make a checklist. Some situations to consider: At home: Will you need someone to look after your children or anyone else at home that counts on your care? At work: Notify your supervisor. Ideally, you will have had a prior discussion that helps them prepare for this type of event. If you are at a distance from the event, who will you communicate with to monitor the situation? Will you need to travel? What will you take with you? What will you need if you may spend long hours in hospital? Can you pre-pack an emergency kit? What information and documents will you provide to help health care professionals?  Having a written plan, assembling your support team, and staying calm are important components of planning ahead for and managing an elder care event. © ElderWise Inc., 2013. You have permission to reprint this or any...

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Shingles: A Legacy of Chicken Pox

Posted by on Mar 4, 2013 in Health Signals | 0 comments

“Shingles” is a painful, blistering rash experienced by about 130,000 Canadians every year. Your risk of having an episode of shingles increases after age 50, but the majority of people experiencing shingles are 60 or older. Here are the ABC’s of shingles:   What are the symptoms of shingles? Shingles symptoms begin with headache, fever and the chills, and upset stomach. These often occur before the rash appears. Usually the rash occurs on one side of the trunk of the body but can also erupt on the buttocks, neck, face and scalp. The rash produces painful, reddish, fluid-filled blisters, which last 7 to 10 days. During this time, the blisters break, dry out, then crust over. The discomfort can range from an itchy, tingling sensation to severe pain. If severe, an infection can last more than a month. Unfortunately, some people have pain that persists even after the rash is gone (this is called post-herpetic neuralgia or PHN).  What causes shingles? Shingles is caused by the same virus that causes chickenpox; namely, varicella-zoster or herpes zoster. After chickenpox symptoms have passed, the virus can hide out in the root of some nerves and then re-activate at any time to cause a painful skin rash. The rash occurs in the area of the body connected to the infected nerves. Who can develop shingles? About 1 in 5 adults will develop shingles. You must have been previously exposed to the virus and had chickenpox. Although it can occur at any age, the majority of people experiencing shingles are those over the age of 60. Some people may have more than one episode. Often an attack occurs when your immune system is already compromised. How is shingles treated? If you suspect you might have shingles, see your physician as soon as possible. The rash is usually easy to identify. Anti-viral drugs can help stop the spread of the rash and reduce the length of the infection. However, to be effective, these drugs must be given early in the course of the illness. Cool, moist compresses, calamine lotion, or other ointments applied to the rash can reduce the pain. Your physician or pharmacist can suggest the best products for you to use.  Is shingles contagious? To get shingles, you must already have had chickenpox at some point in your life. When you have shingles, the fluid from the blisters does contain the virus. Therefore, you could give chickenpox to someone who has not had it already. Avoid contact with people who have not had chickenpox. However, the reverse is not true; a person with chickenpox cannot give shingles to someone else because shingles occurs from the virus that is already present inside the body. Can shingles be prevented? A shingles vaccine is now available. The vaccine is not 100% effective but it does reduce your chances of developing shingles by about 50 percent. If you do get shingles after receiving the vaccine, you are more likely to have a milder infection and less likely to experience PHN.  Currently the vaccine is not covered by provincial health plans; you must pay privately. Because it requires specialized storage, not all clinics offer the vaccine.  Consult your physician to decide if you should consider receiving this...

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What’s Your Next Move: Housing Options for Later Life

Posted by on Feb 18, 2013 in Uncategorized | 0 comments

What’s Your Next Move? Housing Options for Later Life Planning ahead for yourself – or together with family members? Join us as we discuss: Options for living arrangements as we grow older How to sort through, evaluate and choose the best option Specific things to do today, to avoid making poor decisions tomorrow This is a free presentation, but seating is limited. RSVP today by calling Courtney at (403) 258-1849 To see the event poster, click on the attachment below.    ...

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Secrets of Successful Conversations

Posted by on Dec 11, 2012 in Family Relationships, Sensitive Conversations | 0 comments

When we wish to talk with our aging parents or our adult children about difficult or sensitive topics, we have two things to manage: the task of the conversation…and the emotions that accompany it. Each party to the conversation has needs which the other can help them meet. Simply being heard is a huge need, but receiving support, understanding, and acceptance are also important.  For each family, the pressing topic(s) will be different. But before you talk about health issues, getting help around the house, downsizing, driving or any other concerns, take some time to prepare and consider your approach: Think about what has contributed to effective conversations in the past, either with family or in other parts of your life. See the conversation as a process, not an event. Address one issue at a time. Set a mini-goal for the conversation, rather than pressing for a major decision after a single discussion. Each family has its own topics of concern but calmly discussing “what if?” scenarios may get better results than pressuring for immediate decisions. Help the other person(s) prepare.  Send a letter, an email, or phone ahead if you think it’s time for a serious talk. Brush up your listening skills, such as watching body language, re-stating what you have heard, and asking open-ended questions.   Whatever topic you choose to discuss, include these ABCD’s in your conversation:   A is for attitudes and assumptions: Why does Mom think staying put is best? Why do you believe she should move closer to you?   B is for boundaries: The adult child can talk about what they can and cannot do for your parents. The older parent can clarify which decisions they want to make for themselves, without well-meaning interference from their grown children.   C is for changes, now and in the future: Talk about changes you’ve noticed, but do it without making a judgment or attaching meaning to them, e.g., “Dad, I notice the fridge isn’t as well stocked as it used to be.” Don’t express opinions or make suggestions at this point.   Once the changes are acknowledged, talk about what those changes might mean to the person experiencing them, e.g., “How is your appetite?” or “How are you managing with the grocery shopping?”     D is for decisions to be made or deferred:  The decision can be to take action on an issue now, or simply to schedule another time and place to keep planning. Wherever possible, ask – don’t tell – and decide on next steps collaboratively. Using this ABCD framework can help you move forward, guided by your family and personal values.    Sensitive conversations can help you know where things stand, what to expect, what needs to be done. They can build relationships, allowing you to express feelings, and learn how others feel. They are the foundation of building strong relationships and solid plans for the future.   For more tips on what to do during the conversation, and what to do when conversations get stuck, consult the Sensitive Conversations section in the ElderWise e-guide, Age-Smart Planning. This e-guide also covers the “top ten” topics you and your family need to address to be proactive and prepared.     (c) ElderWise Inc., 2012   You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Inc. We provide clear, concise...

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Health Risks & Family History

Posted by on Nov 18, 2012 in Health Signals | 0 comments

We don’t choose our blood relatives but, in some cases, our future health may depend on knowing more about them! Our genetic make-up may increase our risk or pre-dispose us to developing chronic conditions or diseases. Knowing our family’s health history may help us take steps today to prolong both our years of life…and add life to our years!   Lifestyle choices have a major effect on our health, but tuning into our family health history helps us know our risk of developing chronic conditions like heart disease, stroke, diabetes or cancer. Identifying these risks early on can spur us to take action to reduce them.   According to a recent article published by Manulife Financial, here are some things to look for in your family’s health history: several closely related individuals affected with the same or related conditions a common disease that occurred at an earlier age than expected (i.e., 10 to 20 years before most people would get the disease) sudden death in someone who seemed healthy an individual or couple with three or more pregnancy losses a disease that does not usually affect a certain gender (e.g., breast cancer in a male) certain combinations of diseases within a family (e.g., breast and ovarian cancer, or heart disease and diabetes) To put the risks in perspective, the article also suggests looking at the lifestyle habits of family members who have the same disease. This could be a key factor in increasing or decreasing your risk, depending on whether you share or avoid the same lifestyle habits.   Your whole family can benefit from you taking the lead on compiling your family’s health history. Include grandparents, parents and their immediate families as well as your own siblings, their children and yours, in these discussions.  Consult older family members who may recall information about relatives that you may never have known. Here are some things you can ask about: A list of health problems How long family members lived, and what they died from Pregnancy losses or birth defects Ethnicity (some conditions are more common in certain groups) Lifestyle habits that may have contributed to longevity, early illness or premature death   Share what you find out with your family doctor. Our family history is usually only one of several risk factors. Work with your doctor to help assess risks both for you and younger family members, and put together a plan for reducing those risks. (c) ElderWise Inc., 2012. You have permission to reprint any ElderWise INFO, provided you do so in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Inc., Canada’s go-to place for boomers with aging parents and for anyone who wants to do “age-smart” planning. For more information, visit www.elderwise.ca     Ready to compile your own or your family’s health history? Learn more about our interactive workbook, My Passport to Health and Wellness.  ...

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