How to Care for an Aging Parent

“Wrinkles will only go where the smiles have been.” -Jimmy Buffet

(This post has been sponsored by Kaiser Permanente)

My husband and I were recently talking about how we have phased out of the stage of life where all our friends are getting married and having babies. We have now embarked on the stage of life where we go to kids birthday parties and want to be in bed by 9pm. We have also been thrusted into a glimpse of what life will be like when we have to answer questions about the care of elderly parents. We have had so many questions, but up to this point, haven’t had a lot of answers. I was so excited when Kaiser Permanente wanted to partner with me to talk about aging parents and how to handle this unchartered stage for us. Here are the questions that my husband and I had regarding our own situation and we hope they can help you too…

These questions were answered by Dr. Neetu Bhola, a geriatrician, with Kaiser Permanente.

What are the first signs a parent needs help?

Are they able to perform daily activities independently? Can they cook for themselves? Bathe and get dressed? Do laundry? Go to the bathroom? Pay bills? If there was an emergency do they know who to call? Can they get to a phone to dial 911? Can they drive? If driving is an issue is it because they are disoriented or maybe they just need to get their eyes checked. These are all good questions to ask as a first step to knowing if your parent needs help.

What are some of the signs a parent may have Alzheimer’s or dementia? 

Alzheimer’s is a type of dementia. Does the parent have a hard time remembering things you just went over? Are they forgetting where they put things like keys, wallet, etc…? Have they lost certain language skills or trouble finding the right word? If any of these things are of concern a trip to see their family doctor is very important. You obviously can not diagnose this on your own, but memory testing, labs and getting supplemental information from family is helpful with diagnosis.

If a patient had earlier battles with mental illness or depression how do you know if they are developing Alzheimer’s/dementia or if it’s just the depression?

Dr. Bhola says that depression can most definitely cloud a diagnosis for Alzheimer’s or dementia. With depression the parent may be withdrawn, irritable or even angry. There is a questionaire screening that can be done at the office or even some lab work to try to properly diagnose the exact issue.

What should a child do to help?

The first step is to bring the parent to their doctor. Make sure to talk with your parent before going into the doctor’s office. You should make them aware that you have seen a few things that have been concerning and that you just want to make sure everything is alright. Try to make them feel you are looking after their best interest and want what is best for them.

If driving is an issue, a behind the wheel exam and possibly getting a driving stimulation would be helpful.

Maybe the next step is to have an occasional house keeper or care giver stop by once a week to help do regular checks on the parent. Once you have seen the doctor they can help you come up with a better plan for you and your parent.

What if they don’t have a retirement plan set up? Who is expected to pay for the extra care?

Doctor Bhola said this can be very difficult. At her office, she sees a social worker to discuss the different options for care. There are board and care facilities which are different from assisted living facilities and different from in-home care. All of these have different costs that a social worker can go over with you. Some insurance plans might be able to assist with the extra care, like Medicaid.

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What is the difference between Medicare and Medicaid?

Medicare is a federal program that provides health coverage if you are 65 and older OR have a severe disability, no matter your income.

Medicaid is a state and federal program that provides health and coverage if you have a very low income.

You can be eligible for both and they will work together to provide you with health coverage at a very low cost. If you have more questions about this options call 1-800-MEDICARE.

How do you find the right living situation for your parent?

Again, seeking a medical professional to give you a better understanding of what you parent is cleared to do will give you a good understanding of what type of care they need. Once you know those boundaries you can decide if they need a once a week check up or a full time nursing staff. Doctor Bhola said that the social worker will once again be your resource to find the best options in your area.

I did a little research on my own and found a website called A Place for Mom, which you can put in your city or zip code and find different care options near you. I also found a website called 211.org where you can put in your zip code and the problem you are dealing with and it finds different websites and phone numbers regarding your situation. I was able to find a list of local elderly care places that help with financial assistance for elderly.

When do you ask your parent about their end of life requests?

There is no better time than the present!! Although these are super tough questions that both parent and child may not want to address, it is vital to their care. You can make sure the doctor tackles this uncomfortable topic if the parent is not willing to discuss it with the child. Especially when it comes to the advanced medical directives; if they want to have CPR performed, how long they would want to be on life support, etc…In case of an emergency you need to know their wishes.

Honestly, this is a topic even my husband and I have talked about in our marriage. There are no easy answers, but it is important to have the conversations. Ideally you would be able to have the conversation before there is any kind of memory loss, dementia, or emergency.

Some final thoughts from the doctor…

The best idea as your parents get older is to keep an open line of communication. Be pro-active, talk and understand if they have certain wishes for their care. Reiterate the fact that you want to be of help to them, since some parents may feel attacked by kids all of a sudden trying to take over their life decisions. The more you know before they may have any kind of memory issues, the better. In the end, Dr. Bhola highly suggests to see a medical professional to get help and the proper diagnosis.

#THRIVE AMBASSADOR