Ask a care manager: How long can I take care of myself?

By From page A5 | April 17, 2013

With older adults living longer than ever, it would seem that being independent and taking care of oneself would just go on forever. Realistically, that is not true. There comes a time as a result of advanced age, disability and/or poor health when everyone needs some assistance. The questions are: Who – What – Where – When?

My mother and father feel they are the exceptions to the rule. They are in their 80’s and very healthy. They refuse to admit they will need help some day and will not share any information with any of their adult children about their finances or anything else. There are three adult children who love our parents but worry that we’ll be unprepared when they do need help. What should we do?

As long as individuals are physically healthy and mentally clear, they can and are completely independent and should be. It is the perfect time however to get together as a family to talk about when that changes. Who do they want to help? What kinds of changes have they thought about, discussed together? Chances are your parents have at least thought about how they want to grow old and may be waiting for the right time to bring it up. Note: Don’t start by asking how much money they have.

As an older person I have specific ideas of what I want to do as I age. I want to remain in my own home and believe that I have the financial resources to do this for some time. Most of my family do not live close to me and have been trying to convince me to move closer. As much as I love them, I wish to remain where I am. How can I be sure that when I need help, they will honor my wishes?

It’s important to talk with your family and let them know your plans. When choosing a Power of Attorney for finances and health, be sure the person you’re choosing knows what you want and will act in your stead the same way you would. Families act out of love and concern and during a crisis may not have the time or your input to rely on unless you’re clear ahead of time. It sounds redundant but it’s all about communicating.

Who do you want to live with or near?

My husband is in ill health and older than I am. My children have already hinted that when he dies, they expect me to move in with one of them. Is that something I should do? I can barely begin to think about life without my husband.

Your adult children are worried and trying to plan ahead knowing how hard it will be without their father and your husband. You probably have already thought about what you will do when you’re alone but until that happens, you may want to concentrate on your life as it is now. Tell your children you’ll let them know when the time comes and take your time. Experts recommend when you experience a loss to wait at least six months to one year before making any major decisions. A person needs time to grieve and adjust to a different life alone.

My wife has a chronic disease that doesn’t allow her to do much around the house. I’ve taken on more and more of the household chores and have begun helping her with her personal care and bathing as well. We agreed we’d stay at home together but I’m beginning to feel overwhelmed. Should I be looking at a place for her to go?

When is it time to see what’s out there? Is help needed?

It’s always difficult to decide exactly when a spouse “has had it.” In most cases, spouses care for their spouse way longer by themselves than they should. They jeopardize their own health and well-being because they feel it’s their job. There may even be a sense of shame if they have to look for help. There are all kinds of help and, in most cases, a few hours a week can make a big difference to both the caregiver and the care recipient. It’s always too bad when placement occurs not because the individual needs so much care but because the caregiver is exhausted and completely burned out. Look for resources before that happens and arrange for some type of part-time help early on. It’s much more affordable this way and can extend the person’s ability to stay at home longer.

I live alone, never married or had children. I have some close friends but we’re all getting older. What should I do about preparing for my elder years and having a support system in place? Isn’t it an imposition to involve someone who is not family? What kind of person should I look for?

You are wise to think about this important topic. You want to think about who you trust to make the decisions you want for your life, someone you can talk to and make clear what your wishes are about the 4 “Ws” above (who, what, where, when). It may be helpful to involve your elder law attorney when you have this discussion should you want to have it written into your Powers of Attorney. Although it may be easier to have someone listed who lives close by, it really is about trust and relationship rather than geographic location. If you have a great-niece who lives out of state but that who you’ve always respected and loved, you may want to ask her. If on the other hand you have no family that you feel comfortable with, you’ll need to find a trusted friend who will assume the responsibilities.

Once I’ve decided on the 4 “Ws” (who, what, where, when), how do I communicate these things to my family, friends and POAs? I’m afraid of my family’s and friend’s reactions.

So many times decisions are made because those in charge feel they are doing “what Mom wants.” This may not always be the case but they are doing their best. There are a number of ways to communicate your plans and wishes. Write a loving, respectful letter to all telling them what you’d like. Ask everyone over for dinner or coffee and tell them you want to talk about your future. Put together a family e-mail and tell them what you’re thinking about. Sit across the kitchen table with a close friend and use her as a sounding board. Write down a list and put with your POA forms and talk about it one adult child at a time. Every family is different. Give some thought as to what will work for you.

What is the worse that will happen if you don’t think about:

Who you want to live with?

What type of life do you want? What type of housing?

Where do you want to live? In your own home? Close to family? In retirement housing/assisted living?

When do want to make the changes? Within the next 6 mos.? When your hospitalized?

If you don’t start the conversation and make your intentions and wishes known, someone else will make those decisions for you.

Carol S. Heape, MSW, CMC , is a Professional Geriatric Care Manager and executive director/CEO of Elder Options Inc. serving clients and families in the Sacramento Region, Placerville and South Lake Tahoe.

Carol Heape


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