By Carol Abaya,
Question: My parents
are still healthy, but are getting frailer and can’t do all the things
around the house that they used to do. They refuse to move and say they
want to die in their own home. What do we do?
people want to stay in their own home. So your objective should be to
make it safer for them to do so. At the same time this allows them to
maintain control of their daily life’s activities and their likes and
dislikes. Happier people are healthier people.
- Establish a crisis
- Safety proof the
house or apartment
- Identify things
they can’t do and bring in help.
- Exchange telephone
numbers with your parents’ neighbors and close friends and have them
call you, collect if they want, if they see something unusual. My
parent’s next to door used to call me every time an ambulance arrived
at the house as my father periodically had strokes. Even if you live
around the corner, such an alert system is helpful.
- Be sure and have
the names and telephone numbers of your parent’s doctors, accountant
and lawyer. Establish a relationship with them before a crisis occurs.
- If there is a
regular mailman, have him alert you if mail starts to pile up.
- Provide the town
tax collector’s office and utility companies with your name and address
so they can alert you if bills are not paid on time.
Safety proof house:
- Make sure electrical
wiring is not old and frayed; that plumbing is in working order.
- Rearrange lamp
locations if wires trail where a parent can trip on them. Do the same
thing with furniture and telephone wires. A cordless phone near a favorite
chair and/or bed can be a life saver.
- Throw out scatter
rugs and replace worn or buckling carpeting. These are always prime
- Install grab bars
in the tub and make sure there are rubber mats to prevent slipping.
A chair in a tub or shower can make it easier for a frail person to
- Increase the size
of bulbs used because vision often deteriorates with age.
- Redecorate the
house so that walls and floors are contrasting colors. This is especially
important for steps or stairways. If walls and the floor are the same
or similar tones, older people cannot see the difference and can easily
fall or bump themselves.
- Have tablecloths
or mats in contrasting colors with dishes and glasses. This avoids
spillage and breakage.
- Help them rearrange
kitchen and bedroom closets so they can easily reach the things they
use most often. Lower clothes bars and raise where shoes are placed.
Question: My mother,
74, has been having mini-strokes, which have affected her balance and
ability to walk. My father’s health is ok, but he is getting frailer
as he’s been taking care of my mother. I work full-time, so I can’t help
out as much as they seem to need. What should we do to make sure my father
doesn’t get sick? He wants to do it all.
Your question is a double-edged sword because there are two caregivers
-- your father and yourself.
Your objectives should
- encourage your
mother to do as much as possible for herself.
- help your father
so he doesn’t overburden himself and become stressed out.
- At the same time,
he should be encouraged to do what he can comfortably handle.
- balance their
needs with your own other responsibilities so that you don’t become
over stressed and tired.
- encourage your
parents to continue social contact with friends and the activities they
enjoy and to develop new friends and interests.
- nurture their
now fragile emotions as they lose the ability to take care of themselves
and need your help.
So, you need to:
- step back and
evaluate both parents needs and capabilities - the ADLs and the IADLs.
ADLs are activities of daily living, dressing, eating, toileting, bathing
and transferring. IADLs (incidental ADLs) include driving, shopping
cooking, cleaning, doing laundry, handling finances, taking medicine
- identify those
areas where help is really needed. Eliminate the areas you only think
they can use help at this time. But periodically reevaluate.
- identify options
(e.g. community or private resources) as to providing the “needs” help.
Your local Area Agency on Aging, hospital discharge planners, churches
and temples, volunteer organizations, senior centers and home care agencies
are all good sources of information and help.
- get help for chores
your father may be uncomfortable doing (such as bathing your mother)
or you cannot do because of time and other factors. If he has difficulty
driving, hire someone else to chauffeur them to doctors, supermarkets,
the mall, if you or another family member is unavailable.
- get other family
members to help with specific identified chores or to regularly visit,
take them out to lunch, dinner or just for a ride.
- identify the little
things they’ve always enjoyed/liked and bring more of those things/events
into their life -- flowers, a new tape, family pictures, telephone calls.
All caregivers, regardless
of age, need to take care of themselves and not over burden themselves
with trying to do too many chores. All those ‘little’ things add up.
The philosopher Plato
gives perhaps the best advice to us all when he said: “More will be accomplished,
and better, and with more ease, if every man does what he is best fitted
to do, and nothing else.”
Question: My aunt,
85, recently fell, broke her hip and had to have hip replacement surgery.
She is now in a nursing home, and we don’t know if she’ll ever be able
to come home. I’m afraid my mother, 83, will fall, and then we’ll have
The majority of elders aren’t seriously injured when they fall. Only
5% to 15% result in fractures or broken bones that lead to loss of independence.
My mother had total
hip replacement surgery at age 86, and my father had partial replacement
at 93. Two months after surgery, my mother resumed driving. My father
was walking up and down the hospital hall the next day.
But the seriousness
of falls, especially this time of year, and their impact on lifestyle
should not be overlooked. Evaluate your mother’s health and overall ability
to do things for herself. Does she have difficulty walking or with her
balance? Are there obstacles in the house (furniture blocking easy movement,
telephone or electric wires across a floor) that are problematic? Is
she on medication that can impact balance? Have her bones become less
dense and fragile to the point where they can just break. This happened
with my father. Bone density tests are now covered by Medicare.
During icy months,
there are a number of things that you can do to help protect her and head
Have the drugstore
deliver medications, rather than her picking them up. Make sure there
are extra staples in the freezer -- juice, bread, pre-cooked foods. Make
arrangements with a local grocery store or restaurant or a neighbor if
you live far away, to deliver food in really bad weather. Get someone
else to shovel snow.
exercise -- walking is the best. My father did 2 to 3 miles a day on
a stationary bike until he was 92. Have her use a cane or walker, if
she is unsteady on her feet. Good eating habits help retain bone and
Increase the number
of night lights in the house -- bedroom bathroom, hall and kitchen. It
is very common for elders to walk around at night.
And make sure medications
do not interact to make her mentally fuzzy or dizzy.
In your aunt’s case,
make sure she gets appropriate physical therapy in the nursing home and
continue it when she returns home. Medicare will pay for home visits.
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