Blog

Once an aging family member loses mobility and the independence to come and go as needed and desired, it can be very challenging for families to decide what living environment options and caregiver assistance needs to be provided. Because the loss of mobility will likely increase over time, the family has to be vigilant and flexible about tweaks and changes which need to be made to both living and caregiver options. It is a delicate balance which continually requires calibration of circumstances.

I experienced this progression with my grandmother. Once she lost mobility, she progressed through several living arrangements as her needs increased. When she was self-sufficient (could cook, clean, bath, etc.) and only needed transportation for errands, food, and medical appointments, we chose a single apartment in an age restricted community and several family members shared the responsibility of making sure her transportation needs were met.

As her eyesight deteriorated, we noticed that it was becoming unsafe for her to live on her own. Cooking and preparing meals became difficult, so we immediately arranged “meals on wheels” to deliver all of her daily meals. We then noticed her having difficulty cleaning as we were finding broken pieces of things that had dropped and she could not see or reach to clean up.

Unfortunately, she tripped and broke her elbow and it became apparent that she needed to move to an assisted living facility where she still had her own independent apartment space, but all of her meals and needs were met on site. Our family still shared the transportation responsibilities, which were less difficult as more of her needs were met at the facility. She eventually progressed to needing assistance with most needs and was able to continue to live in the same space with a stepped up care role from the staff. This arrangement worked well for our family and gave her peace and happiness as her needs changed not to be uprooted multiple times to have her needs met.

In the example above, we were fortunate to begin this journey with her aging at home in a senior living apartment community. Other aging at home options might include, sharing housing with a roommate, moving in to a very small space so there is less square footage to negotiate, or moving in with a child. Any of these options can be paired with different options for care-giving as aging progresses.

There are several in-home helper options including, hiring a service (or individual) to assist with needs on different schedules depending on the level of need. The service may begin on a so many times a week basis to provide cleaning, running errands, cooking, and companionship. This service may progress to daily help to provide needs such as bathing and assisting with medication compliance.

Many families will choose to combine personal assistance to their family member for some duties and hire in home helpers to address needs they are not able to accommodate. This helps reduce the burden of cost for the service and stress to the family member(s) to handle all needs personally.

What is so important to realize is that no two families are identical. Every family’s circumstances are unique and having conversations which explore all available options and decisions about what will work best for the elderly family member and the supporting family members financially, logistically and emotionally is the key to preserving quality of life for all.

I received a call from a friend who went to visit her parents out of town for a few days with the unfortunate news that her mother had a stroke. They were sitting in a restaurant eating dinner and all of a sudden she slumped out of her chair on to the floor. She was fine one minute and was on the floor the next.

Needless to say, everyone was devastated and because her mother was enjoying good health prior to this moment, the family had never considered that something like this could happen or had important conversations about “what if”? What do I want my elderly years to look like?

When some unexpected decline in an elder’s health occurs, such as a stroke, we are often thrown into chaos if we have never had any conversations with that person or other family members about what their wishes are as they age. These wishes might include living arrangements, receiving assistance with tasks, the ability to be independent, financial arrangements and end of life decisions. Suddenly, we are forced to figure these important details out in a pressure cooker time frame and may not have the benefit of having their input given their sudden declined health.

The family which is left to make these important decisions may find when they begin discussing what to do that they don’t agree how these different matters should be handled or they may find that financially the resources are not available to cover the expenses which now exist. Even more overwhelming is they often don’t know what options exist or have the time it will take to fully explore these options and come to a decision.

Having proactive conversations with your elderly family member to plan for these important life transitions which can honor their happiness and the family’s peace as their needs change is so valuable. Mediation is an amazing process to assist with achieving this goal. We help facilitate conversation about the ways in which the elderly family member could lose their independence and discuss the choices which would be available.

A simple example could be when it is time for the elderly family member to stop driving. This is a huge loss of independence and the elderly person may feel “perfectly fine” physically and not realize that cognitively or due to a physical decline such as vision, they are really posing a risk to their safety as well as others on the road.

We can help families determine what factors will be a trigger for the elderly person to “give up the keys” and if that time comes, create an action plan for how they will receive assistance with their daily needs. This allows the family to design the best future plan honoring everyone’s needs in a peaceful and fulfilling way. Mediation offers families the peace of mind to avoid experiencing conflict in unexpected, catastrophic situations where family unity is so vital as well as more gradual situations where loss of independence can create tremendous family turmoil.

My grandmother lived to the wonderful age of 95 and up until the last two weeks of her life when she was hospitalized with pneumonia, she maintained an active daily routine which I believe (and studies show) is the key to a long and fulfilling journey as we age. I did not realize as I grew up that she always had a plan. She filled her days with things that mattered to her, that were good for her, and that kept her active both mentally and physically.

For example, she played cards several times a week, practiced yoga once a week (she could stand on her head in her 90’s), went to the beauty parlor every Friday, read and napped daily, attended a weekly religious service, volunteered, attended community events and spent time with family. She was lucky that her mobility and motor skills made it possible for her to be self-sufficient to accomplish this schedule without assistance, but when she couldn’t drive herself, she immediately phoned one of her family members and arranged a ride.

What my grandmother demonstrated so well, is how important it is to maintain connection to others and to the things that matter to that person as they age. It is a part of a person’s identity and self-worth. It motivates them to wake up each day and know they have something to which they can look forward. This can be challenging as a person loses independence and the ability to come and go without the assistance of another.

You can help your aging family member maintain activity in a variety of ways. Begin by speaking with them about what they enjoy doing both inside and outside their home. For example, in home activities might include reading, writing, cooking, taking a walk and playing games. Depending on their living arrangement, they may have neighbors with whom they could do many of these activities.

If they are mobile or able to arrange transportation, a local recreation center or senior center could provide a wonderful opportunity to spend time with others doing a variety of activities, volunteering, taking fitness classes and other classes on a variety of interests. Some communities have public transportation at a low cost which assists seniors with mobility limitations.

For seniors who are not mobile and don’t have transportation resources, many faith communities and senior centers have volunteers who will come visit at their home. This provides the opportunity for them to practice spiritually and interact with others. Libraries offer a free service to send books, CDs, magazines, and movies to residents who can’t visit them.
Computers can be a great way to stimulate your brain and memory with programs such as luminosity.com and on line board games. For mobile seniors who don’t have computer access at home, local libraries provide computers for use to the community and the opportunity to engage with others while visiting. Libraries also provide volunteer opportunities for seniors to serve others.

In addition to experiencing a grandmother who was self-sufficient, I also experienced a grandmother who did not drive and relied completely on family for transportation and interaction. We helped grandma stay connected by moving her into an apartment complex for seniors so she could be surrounded by others who were available to interact. They had a common area where they would have potlucks, watch TV, play games, celebrate occasions and enjoy each other’s company.

We enrolled her in the Silver Sneakers program by her house so she could exercise and have friends outside of her apartment building. She continued to attend religious services weekly and family members spent time with her every week. She had a grocery store in walking distance if she needed a few items in between her weekly shopping trips. We looked for an opportunity to help her interact and maintain accessibility.

Every senior has their own unique interests and challenges with creating a healthy social life as they age. The wonderful news is that resources are continually expanding and new and innovative opportunities are developing continually to help families provide their senior family members with the best quality of life possible during their senior years.

Someone shared with me recently about a family who has a terminally ill member. As this person’s health continues to decline, their appearance, energy level and mood are dramatically impacted on a daily basis. This person has reached a point where they don’t even want to see people, including members of their own family.

The challenge this presents is that the family members still want and need to spend time with this person during the time they have remaining. This is a dilemma I am sure many families experiencing these circumstances face. It is such a delicate balance between the wishes of the person who is ill and those who are incredibly sad and desperate to share and create memories of any kind during this time.

This is where mediation can be such a valuable tool to assist a family. It can be really difficult given all of the emotion and stress that each family member has to discuss each person’s needs and wishes about staying connected. Each can have ideas that are not synonymous with other and this can lead to feeling overwhelmed and unable to find solutions that will serve the needs of everyone.

A mediator can facilitate conversation in a safe environment to help families navigate a way for each to be honored in their relationship through this journey. This journey is unique to each family who faces these circumstances and they deserve assistance to find as much peace and comfort as can be possible at this time.