read an excerpt
about care:
“If there were anonymous caregivers, the first step in the program would be to get rid of that little voice inside you that says, I can do everything, I’m responsible for everything, and whatever I do, it’s never enough.
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Of course she wants her parents to be okay, to be happy, to be safe. in fact, if it were possible for you to be with her every minute of the day, maybe you would be, but the truth is that you can’t personally do everything that needs to be done for her, and trying to do it will only exhaust and frustrate you without helping really help your parents in the long run.
so how do you use your energies most effectively? if your mother has a sudden and serious illness, of course you will want to be there. But when her needs are more chronic, when you find yourself taking on more and more responsibilities in a matter of months or years, you need to step back, look realistically at the situation, and draw some boundaries for yourself. determine what you can reasonably do for your parents and, more importantly, what you need to stop trying to do. As difficult as it is, you may be surprised to find that setting some boundaries will ease your guilt and ease some of the tension. and you will have more patience and energy for those things that only you can give.
“for a long time i visited my mother twice a week, but she was always running and always tired. i began to dread every visit and was angry with her because i felt that everything was her fault. she was ruining my life. then a friend She said, ‘This isn’t her fault, it’s your fault.’ And, you know, she was right.”
– fran m.
about medicaid and nursing homes:
There is a myth that anyone who receives Medicaid will automatically receive inadequate and unacceptable care in a nursing home. it is true that the most luxurious nursing homes do not accept people with medicaid. It is also true that most other homes limit the number of Medicaid patients they accept. But many attractive, well-mannered nursing homes accept Medicaid patients: About one-third of all nursing homes have at least some Medicaid patients.
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remember, an expensive nursing home is not a guarantee that your parents will receive dedicated, loving care, just as a dilapidated exterior doesn’t always mean shabby care. Appearance is an important clue as to what kind of service is provided, but the quality of care comes from the people who work in the establishment: the philosophy of the managers and the dedication of the staff.
Many of the nursing homes that accept Medicaid favor self-pay patients and admit only a small number of Medicaid patients. a 200-bed nursing home, for example, may admit only 15 or 20 Medicaid patients at any given time. Consequently, to get your parents into one of the best Medicaid-certified homes, you either have to put their name on waiting lists early or help you set aside enough money so they can apply as a self-pay resident. if your father has some savings, enough to cover at least six months of nursing home care, and preferably more, he will have a much better chance of being accepted into the home of his choosing. once he is admitted, he cannot be discharged when he goes to medicaid, even if the beds reserved for medicaid patients are full.
once your father is in a home, you can ensure he receives the best care possible by building a relationship with the staff and closely monitoring his care.
about dementia:
In the early stages, it’s hard to tell the difference between dementia and benign aging. dementia symptoms can be fairly innocuous at first, and most people compensate for minor slips of mind with reminders and notes, or find excuses for their mistakes. oh, sorry about our date. I was sure we said Tuesday. social skills are often the last to go, so during short visits a person with early dementia may seem perfectly fine. you can talk about the old days and remember who is who and what is going on. Family and friends, who don’t want to believe that something could be wrong, are more than happy to rule out a slightly scruffy appearance or a few lapses of memory.
At some point, however, problems become hard to ignore. dementia begins to interfere with relationships and the details of daily life, such as shopping, paying bills, or choosing clothes. your father may lose a particular skill: an avid crossword puzzle fan may have trouble filling in the blanks, a lifelong golfer may have difficulty selecting the right clubs.
If you suspect you have dementia, think carefully about what your parents were like before. are these problems really new or you just didn’t notice them before? we are all much more aware of memory errors in older people than in younger ones. when grandpa repeatedly loses his hat, an alarm sounds, but there’s not a second thought when a teenager keeps losing his.
Usually, in dementia, a person’s memory doesn’t slip, it disappears. he just doesn’t miss a date, he insists he never had one. he not only loses his glasses, he forgets he wears glasses. he doesn’t forget who spoke at a meeting, he doesn’t know he ever went to a meeting.
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In addition to memory problems related to specific events, a person with dementia can easily get lost or disoriented, even near home or in another familiar place, they may have problems with language, so they will fumble for the word correct, it will use the wrong word or resort to gibberish. her emotions can become intense and irrational, and unpleasant personality traits can be amplified. he may also become accusatory, critical, or unusually aggressive. you may have trouble sleeping. and you may have trouble concentrating, reasoning, and making decisions. whatever the symptoms, they usually get progressively worse.
good grief:
your father is gone. he was old and sick, and it was probably about time. however, the loss is jarring. your world has changed. a big piece is missing.
Grief comes as a series of waves, bathing you in sadness, confusion, anger, relief and regret, it can pulse through you evenly or crush you when you least expect it. if he was close to his father, he may feel that his very essence has been assaulted and that life will never be the same again. in fact, it will not be. over time, the hole will get smaller and less painful, but there will always be some left.
You can’t control your pain, shake it off or speed it up, and you shouldn’t try. Grief is a necessary and valuable process that allows you to come to terms with this loss, say goodbye to your parents, and move on with your life and other relationships. It’s not something to run or run away from. allowing you to feel it in your own way and at your own pace.
“I’ve been keeping myself very busy since she died, maybe because there was so much to do, maybe because I want to distract myself. But now I find myself crying sometimes when I drive home from work. During that quiet time alone , reality establishes that she is no longer here.”
– nelly o.
excerpted from caring for aging parents. copyright c 1996 by virginia morris. Reprinted with permission from workman publishing.
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