Planning for Your Parent's Future

by Betty-Anne Christie

A friend called me looking for some advice. She had just spoken with her sister, and it was clear that she was very worried. Their father died less than a year ago, and things were starting to unravel for their mother. She was now lonely, getting forgetful and simply not taking care of herself. The immediate issue was that she had fallen, and although not hurt, she was afraid to be alone. My friend and her sister were facing the emotionally difficult reality that they needed to start planning with their mother for her future. Their question was where on earth do they start? My first response was to congratulate them. They had taken the first step - recognizing that it was time to take some action before there was a more serious crisis.

Early Warning Signs

After the recognition that it's time to start planning, it's time to take stock. Some of the warning signs that may indicate your parent is in need of help include:

• Changes in eating habits…the tea and toast diet
• Slipping personal hygiene
• Changes in level of household cleanliness or safety concerns
• A change in interest or involvement with family or friends
• Changes in personality, becoming moody, teary or irritable
• Anxiety around tasks which previously did not create worry
• A noticeable change in ability to remember
• Medication mix ups - pills missing or not taken
• Falls

Very often these issues are interconnected and begin to create a downward spiral. Some of these warning signs may be an indication of problems that are correctable or can be improved. Confusion, falling, and personality changes are not a normal part of aging. My friend's mother's situation is an example of this spiral effect that began with the recent death of her husband. Her loneliness may have lead to a loss of interest in preparing proper meals, leading to poor nutrition, that may have then lead to medication mishandling, confusion and her recent fall.

First step

The place to start is to make an appointment with the family physician. Once you have taken stock and any medically based problems have been addressed, it's time to talk with your parent about their future. How these discussions progress and how much you need to "take charge" will be dependent upon the level of risk your parent is living with in their current situation, and their ability to make sound decisions. The balance of respecting your parent's values and wishes against supporting their well-being and safety can be very difficult. The view of what that balance should be may not be the same for your parent, for you, or for your siblings, but it is important to come to some common understanding, even if you are not in complete agreement. It is worthwhile getting a professional to help your family resolve this issue now, rather than face potential serious on-going differences in the future.

Starting to plan

Planning before any significant actions need to be taken allow you and your parent time to consider and discuss all of the "what if's". Discussing the "what if" questions enables your parent to think through and express their goals, preferences and fears. You will be able to identify the key "what if" questions that may affect your family, but typically they involve issues such as, how to manage financial and legal matters, transportation, shopping, laundry, home cleaning and maintenance, and sometimes meal preparation.

Services

When seniors begin to need more personal types of services, such as help with bathing, grooming and managing medications, there is sometimes a sense that as children we are being invasive. Consider, where possible, who may have the type of relationship with your parent to best have these discussions. All of these discussions should include the potential need to move to a different type of residence at sometime in the future.

Emergency preparedness

Planning with your parent should always include planning for emergencies. The old adage "things happen when you least expect it" couldn't be more true than when your parent suddenly has an injury or medical crisis. Being prepared does not need to be complicated. Start by gathering the information that will be needed and write it on a single sheet of paper. You will need:

• Your parents name as it would be filed on any medical file
• Their date of birth
• Any medical health insurance numbers
• Allergies
• A list of significant, current medical problems
• The family physicians name and phone number
• The pharmacy name and phone number
• Family contact numbers. Include enough that emergency personnel will be sure to be able to contact someone. Include day, evening and cell numbers.

You may wish to list medications; however, this is only a good idea if it is kept up to date. Another method you may wish to consider is to have the pharmacy print a profile of current medications when there is a change (not a prescription refill). This is, of course, only possible if your parent uses a single pharmacy, which is highly advisable. This profile and the information sheet you have prepared can simply be placed in a clearly labeled envelope and placed in a consistent place. The fridge door is one great place to spot quickly in an emergency!

Keep the dialogue ongoing

The discussions you have with your parents should provide both of you with a sense of direction and some peace of mind. Of course, raising the "what if" questions always raise the next level of questions. These questions are those about what resources are available in your community to meet the needs that may arise over the next months and years. Although the task of sorting through and gaining an understanding of the options for services may seem daunting, at least you and your parent will be a step ahead when you have already started the planning process. There are some excellent resources to help you, some of which I've listed at the end of this article to get you on your way.

Apparently my friend's mom has made the decision, with understandably very mixed emotions, that it is time for her to move from what has been the family home for many years. Next month we will talk more about that journey.

More sources of information for you

• The Complete Eldercare Planner, Second Edition by Joy Loverde (Three Rivers Press) is an comprehensive planner that walks you through all of the issues facing aging parents and families in an user-friendly work-book format.
• The Caregiver Resource Center is a web-based resource that address all of the key issues related to developing a plan for the future with your parents.
• The Care Guide@ Home is another web-based site with information about assessment of your parent's situation and step-by-step planning.

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