caregiving
My parents never planned for this situation . Married for 69 years , they deftly arranged their financial and legal affairs — but never contemplated a future inwhich one would be alone in their suburban split-level house , unable to drive . And as deficits in my father ’ s vision , hearing , memory and mobility pile up , sodomyworries . But it ’ snearly impossible to talk with myfather about my concerns . Hestubbornly resists change and proudly refuses help ; he doesn ’ t want unfamiliar people in his home . Forcing the issue could sever our relationship . And so my brother and I hold our breaths , one fall from catastrophe . Ishould know better , right ?
ELDER CARE OPTIONS : MOVE OR STAY IN PLACE ?
Though the details vary , there are countless others like us . Jill Stright , who lives in Florida , faced asimilar situation when her stepmother died and her father was left alone in Emerson . She was his only child . “ Everybody said he should move to Florida — the attorney , the financial adviser , they all said the cost of living issomuch less ,” she says . “ He just refused . He said ,‘ Iwas born here ( in New Jersey ). I ’ m going to die here .’”
In some cases , anadult child may insist upon moving aparent closer to their own home , when the parent ’ s needs for safety and care outweigh the comfort that comes from staying in familiar surroundings . But that loss of familiar places and habits can accelerate cognitive decline . And without friends or acquaintances nearby , the parent becomes totally dependent on the adult child for social contact .
They may beeven better off moving within their home community to an agefriendlier house or apartment . Consider whether their existing home ’ slayout and condition is appropriate as their needs increase : Are there alot of stairs ? Is there abathroom with ashower or bathtub on the first floor ? Can astair lift or other accommodations for mobility be added ? Are the necessary renovations doable and affordable ?
Stright , who is adental hygienist , heard from one of her patients about professional geriatric care managers . Through areferral from her father ’ s doctor , she arranged aconsultation and
FUN ON FACETIME Mary Schassler Shwidock , right , and Diane Krakower catch up with loved ones at the Jewish Home Assisted Living in River Vale .
hired Bonnie Constabile of Aronson CareAssociates .
“ My father was avery stubborn man , likeArchie Bunker ,” Stright says , referring to the father figure inthe ’ 70s sitcom All in the Family .“ He didn ’ t want to listen to anybody .… Itold him , if you ’ re going to be staying in New Jersey , then this person has to be watching over you for me . From then on , she was my other set of eyes because I couldn ’ t be there .”
HOWGERIATRIC CARE MANAGERS CANBRIDGE THE GAP
The National Institute on Aging describes geriatric care managers as a sort of “ professional relative ,” usually alicensed nurse or social worker . They help families identify needs and find services . They can make home visits , set up short- and long-term plans , select care personnel , coordinate medical services , evaluate prospective living arrangements , and bring up complex or difficult topics for discussion inan objective way .
Over the years , Constabile helped Stright ’ sfather move to an apartment , then aided with his transitions from hospital to rehabilitation and ultimately long-term care . They usually charge by the hour ; I ’ ve seen fees of $ 125 an hour where myfather lives and $ 250 an hour inNew Jersey . Their services are generally not covered by Medicare or Medicaid . Those who can ’ t afford such services rely on their own frequent visits and the help of trusted relatives and neighbors who can get there inan emergency orsend an alert .
Area Agencies on Aging — so-called “ Triple A ’ s ” — exist in every state , funded by the federal government , to inform senior residents and their families about services . They can make aconnection with Meals on Wheels or other feeding programs or arrange help with chores or aneed for companionship . Some can be quite helpful inassisting out-of-town family members as they make arrangements .
TheAlzheimer ’ sAssociation has a call line —( 800 ) 272-3900 — to support caregivers available around the clock .
But as all caregivers know , life is unpredictable and emergencies arise — even with plans .“ The sooner you can have these conversations with your loved ones , when they are physically well and cognitively healthy , the better ,” says Roman , from the Center for Health Care Strategies .“ Really ask some of the tough questions : Do they want to stay intheir own home ? Do they want in-home care ? Can they afford it ? It ’ sbetter to be upfront about it and not get caught in acrisis . Know what your next steps will be .” ■
DANIELLE PARHIZKARAN
20 2023 EDITION ( 201 ) HEALTH