Know Your Community Resources for Help as You Age
moderator Carolyn Rosenblatt, RN, Attorney, Mediator AgingParents.com. (followed by one-on-one 20 minute consultation with panelists)
This nonprofit organization consists of 7 expert volunteers from different fields.
Panelists include: Mikol S. Davis, Psychologist, AgingParents.com,
Suzanne Schneider, Schneider Insurance Services,
Greg Tull, CFA, Meritas Advisors, LLC,
Terri Abelar, CEO, Aging Solutions,
Vicki Clarke, Private Fiduciary, Financial Caregiving,
Clyde H. Charlton, Attorney, Elder Law & Estate Planning
Their mission is empowerment through education. they offer an overview of how to get help in Marin with age-related issues.
Topics will include:
* Care Management professionals: what they do and why you might need one
* Mental wellness: how to maintain it as you age and what to do when
emotions overwhelm you.
* In-home care: costs, how to find it, and the safest ways to get it
* Legal matters/estate planning: what basics everyone needs and how to
make the best use of elder law attorneys
* Family conflicts: what to do when family warfare interferes
with your peace of mind
* Handling money: what to do if you can’t do it yourself and you have no
family to trust with your finances
Seniors Resources Forum Web Site: www.seniorsresourceforum.com
I’ve just been talking to colleagues here in Marin County about helping to educate our community about anxiety, a problem that affects so many. Here is some information we’ve gathered to put on our local Psychological Association site to help everyone get a better understanding about anxiety.
Does this sound familiar? Many adult children caring for aging loved ones feel that tension and worry. They may also have penetrating, recurring thoughts. These recurring thoughts and worries can arise from day to day activities or specific events. Anxiety can physically manifest itself in symptoms like sweating, rapid heartbeat, dizziness, and trembling.
When these symptoms are extreme, a person might feel that she is suffering from a heart attack. Psychologists might call the more pronounced forms of anxiety a disorder that needs care and treatment. Those suffering from the more severe form of anxiety may find it challenging to accomplish even the simplest of tasks for fear that something bad may happen to them or the possibility that something might go wrong. They have trouble staying in the moment or living for now. They focus on the “what if” scenarios. They complain that they can’t turn off racing thoughts through the mind that evoke a sense of panic. Besides the negative emotional toll on the mind that anxiety can take, the physical residual effects are detrimental as well. Symptoms might include weight loss, weight gain, hair loss, and stomach discomfort, back or other pain.
Excessive, irrational fear and dread are hallmarks of a problem that can benefit greatly from treatment. The good news is that there are many good treatment options for anxiety. One treatment option that clinical psychologists offer is called cognitive behavioral therapy. This technique helps a person change the connection between specific thoughts and their irrational fear and dread. The ability to self-monitor one’s own thoughts can help the person gain control over their emotions. This directly aids in stopping the perpetuation of anxiety or depressive feelings.
In addition, psychologists help people learn breathing and relaxation techniques that can be used to eliminate, manage and assuage anxiety. In some cases especially when anxiety has been present in a patient’s life for many years, medications maybe the best way to provide rapid relieve of emotional symptoms. Newer anti-depressive mediations called selective serotonin reuptake inhibitors (SSRI’s) are often used as a first line of defense in the treatment of anxiety disorders. People often report experiencing less anxiety and improved mood from taking these medications within two to four weeks.
It is critical to understand that medications do not cure anxiety or anxiety depressive disorders. Professional treatment (“psychotherapy”) is needed to develop new coping methods, along with a deeper understanding of the complex workings of one’s mind. Once a person learns the techniques, successful alternative action strategies can assure and sustain ongoing changes for the better.
The heavy pressures of caring for aging parents in declining health, the rising demands on one’s time and the sadness of seeing a parent get worse over time can make anyone anxious. If the symptoms you are feeling are getting in the way of doing what you need to do in your life, don’t wait to get professional help. The problem is likely to only get worse over time.
Anxiety is often irrational and cannot be treated logically. Many people do not truly understand anxiety disorder, and think they can just will themselves to be cured. Or maybe the anxiety symptoms will just magically go away if they try to no longer think about them. Most people can’t cure themselves. There is no need to suffer when help from a professional can relieve the emotional pain. If these symptoms sound like what you are feeling, reach out. You can find a professional to help you through your local Mental Health Association or your insurance provider. Low cost services are available in many counties for those who do not have insurance or who are low income.
If your aging parent worries are getting you down and you need advice and support, contact me at firstname.lastname@example.org
Is Dad OK? What is clinical depression?
Clinical depression is the most common of mental conditions, which can be treated, but among elderly aging parents, it is one of the most overlooked. Sometimes, it’s because physicians don’t recognize the signs and symptoms. Sometimes it’s because of an overall attitude of society that perhaps feeling low is just part of getting old. The danger in overlooking clinical depression is twofold.
First, quality of life that could be improved isn’t, and unnecessary suffering goes on.
Second, the alarming fact of elder suicide looms. Clinical depression is both an emotional occurrence and a physical event. The physical component is triggered by brain chemistry, and can be helped.
Feeling low doesn’t have to be a permanent part of getting older. There are many elderly aging parents who are able to take aging in stride, and accept the many limitations that accompany getting along in years. Aging is frequently marked by losses. Loss of spouses, siblings and friends, as well as losses of physical strength and abilities can lead to sadness. The sadness associated with loss can often be lessened with time. But what if Dad, who lost his wife last year, just doesn’t seem to care about anything anymore? If more than a year has passed since loss of a spouse, and an aging parent still seems unable to move forward, it may to be time to see the doctor for a checkup.
If you are able to accompany Dad to the doctor, mention the problem specifically. Loss of enjoyment of things one normally likes is one of the symptoms of clinical depression. Other symptoms include feeling sad for extended periods, loss of appetite, sleeping too much or not enough, eating too much, difficulty making decisions, steady weight loss, or unusual weight gain, irritability, outbursts of temper which are not normal, and withdrawal from friends and family.
Clinical depression is one of the most treatable of all mental health problems. Many excellent medications can make a great difference in one’s mood and ability to participate in life. Counseling or talk therapy can also be a great help in managing feelings of loss and grief and in helping an aging parent to get through the grieving process.
If Dad is just not getting back to the way he was, and has an alarmingly long, ongoing period of sad mood and other symptoms, encourage him to see his doctor. Plan to go with him to be sure he doesn’t gloss over the problem. Many elders are unaccustomed to talking about their feelings. They may lack the basic vocabulary to describe them. The adult child can offer gentle assistance with this difficult area. If unchecked, clinical depression can become a downward spiral with no end. It can become worse and more miserable for the depressed person as time passes.
Addressing clinical depression in an aging parent can lead to relief, and improved quality of life. It is a loving act to suggest that the problem can be improved. It may take the initiative of a son or daughter to get help for Dad, but the effect of help if well worth your effort.
THE TEN RED FLAGS
Do you or a loved one experience any of these symptoms on a persistent basis?
1. Persistent feelings of sadness, hopelessness and emptiness
2. Feelings of worthlessness and guilt
3. Loss of interest in activities that used to be fun and rewarding
4. Lack of energy
5. Sleeping too much or too little,
6. Eating too much or too little
7. Poor concentration and focus
8. Irritability and restlessness
9. Persistent physical aches and pains, such as headaches, stomach problems
10. Wish to die or thoughts of suicide or self-harm
If you or a loved one experiences any of these symptoms, you should consider consulting with your physician and a mental health provider.
Dr. Mikol S. Davis, Psychologist
A report released today by the Centers for Disease Control and Prevention (CDC) reveals that the suicide rate among men and women aged 35 to 64 years increased by 28% between 1999 and 2010.
The increases were geographically widespread. Suicide rates for individuals aged 10 to 34 years and for those aged 65 years and older did not change significantly during this period.
The findings were published May 2 in the CDC’s journal, Morbidity and Mortality Weekly Report.
The report’s key findings include the following:
- Suicide rates among those aged 35 to 64 years increased 28% (32% for women, 27% for men).
- The greatest increases in suicide rates were among people aged 50 to 54 years (48%) and 55 to 59 years (49%).
- Suicide rates increased 81% for hanging/suffocation, compared with 14% for use of firearms and 24% for poisoning.
- Firearms and hanging/suffocation were the most common suicide mechanisms for middle-aged men. Poisoning and firearms were the most common mechanisms for middle-aged women.
According to the report’s authors, one possible contributing factor for the rise in suicide rates among middle-aged Americans is the recent economic downturn.
In addition, the observed risk in intentional overdoses may be due to the increased availability of prescription opioids.
MMWR. Published May 2, 2013. Full article
Cite this article: Suicide Rate Among Middle-aged Americans Soars. Medscape. May 02, 2013.
WATCH THE FILM FOR FREE
Age of Champions is the story of five competitors up to 100 years old who sprint, leap, and swim for gold at the National Senior Olympics. The Washington Post called the film “infectiously inspiring” and theater audiences across the country have fallen in love with its light-hearted take on growing older.
As a nurse and attorney, I can tell you I was so uncomfortable reading about the nurse who refused to give CPR to the dying resident in the seniors’ community where she worked. I got a sick feeling in my stomach. But there is a lot to this story.
I believe there should be exceptions in non health care residences for emergencies like the one involving this senior, Lorraine Bayless. A nurse who is on scene should be able to do what any trained lay person can do: administer CPR when someone stops breathing.
The press reports that there was no Do Not Resuscitate (DNR) direction in place. Ms. Bayliss’s family believed that she wanted “to die naturally and without any kind of life prolonging intervention” as they told the Associated Press. Glemwood Garden’s policy about what the nurse should do in an emergency was sufficiently unclear that owner Brookdale’s public statement was to the effect that the nurse had “misinterpreted the company’s guidelines.” What those guidelines were is not certain.
We have legal documents that allow anyone to make quite clear what they want in an emergency such as stopping breathing. There is a DNR statement or order. There is an advance health care directive to guide others if the person in no longer conscious or competent. There is a newer document called Physician’s Orders for Life Sustaining Treatment (POLST) in some states, also called Medical Orders for Life Sustaining Treatment (MOLST). A doctor signs it and it’s posted appropriately. It allows others to be comfortable following the person’s wishes, even if the wishes say don’t keep me alive.
This uncomfortable, ethically questionable, confusing scene over Ms. Bayliss’ end of life did not have to happen the way it did. If you don’t want to be in that kind of situation, you need to be responsible for deciding what you want and communicating it to those who will have to act on your behalf.
Either you want emergency intervention or you don’t. If you are very clear that you do not want to be resuscitated when you stop breathing, let the people where you live know what you want and put it in writing. Post it in a prominent place and give it to the administrator of any seniors residence you choose as your home. If you have clear statement that you don’t want resuscitation and you stop breathing, no one should call 911. Paramedics will attempt CPR every time. CPR is definitely life prolonging intervention. The legal documents mentioned above allow you to spell out under what circumstances you want to be kept alive. It is not always so straightforward as stopping breathing, or a sudden event.
We’re in a society that is generally phobic about death, much more than many other cultures in the world. Death in many other places is accepted as the natural end of life and people don’t spend as much time avoiding the very idea. In our culture, we seem to think it’s optional. We don’t like the idea of planning for the end.
Perhaps Lorraine Bayless has left us all with an important wake up call. Independent and assisted living senior residences need clear written policies about resuscitation of residents. If nurses happen to be working there, they should not be frozen in place when a resident collapses and CPR can be administered by someone, including themselves. Residents should be required to spell out their end of life wishes and emergency instructions and these should be available to those in charge. And each of us needs to face the reality that no one gets out of here alive. We need to think it out, write it out, and do our loved ones and those who help us the decency of making our wishes clear to them. If a person wants no resuscitation, we have to accept the idea that we don’t have to “do something” if they stop breathing.
As we’re in the elder and family consulting business, I made sure my husband Mikol and our kids know about my own wishes. I’m pretty sure that when it’s my time to kick the bucket, they’ll let me kick it and get out of the way. It’s not so bad to exit the way Lorraine did, fast, and probably without pain. Her family says she had it her way.
What would your way look like?
Until next time,
Learn how a son in Pennsylvania was ordered by a court to pay his mother’s $93,000 nursing home bill.
After his mom was injured and went to the hospital, she spend some time in a nursing home.
She then was discharged and left the U.S. The nursing home sued the son to pay the outstanding bill.
In this quick video, learn three things you can do to prevent this kind of nightmare from happening to you.
Have you heard one of these true stories recently?
A son ripped off his mother’s equity in her home to chase an investment scheme for himself that failed.
Two ruthless swindlers were arrested in New York for tricking an elderly woman out of her multi-milliion-dollar property in Harlem she had owned for over 40 years.
A home care worker bilked a frail elder out of her life’s savings of $350,000.
These shockers keep coming up. Family members do it. Salesmen touting unsuitable annuities do it. Realtors collude with thieves and they do it. Even lawyers do it. They prey on unsuspecting or impaired elders to rip them off.
Financial elder abuse is a problem all across the world and it’s growing. We need to be aware.
My mother in law, Alice, is 90 and still very sharp. She would be hard to fool, but I know the right thief could probably do some harm if we weren’t watching closely all that goes on financially. At least she has the good sense to question something that sounds too good to be true. Here’s an example.
She got a legitimate looking check in the mail for $3800, with a congratulatory letter advising that she was the second place winner of a sweepstakes in Canada. She does play various sweepstakes. All she had to do, of course, was to deposit it and “pay the taxes” on her “winnings”. She was advised to contact her “claims agent”. No doubt, that professional thief would have done a great job convincing someone unsuspecting to deposit the check and send “taxes”. Of course usually the check is rubber and the money is gone before the elder finds out that the check has bounced.
Classic scam. Alice called the number and said, “How do I know you’re legitimate?’ The thief told her if she was suspicious, she should hang up. She did. She then called my husband, Dr. Mikol Davis, who did an internet search for the phony address and told her she had just thwarted a thief. Alice is with it enough to question the check. Millions of seniors with any cognitive impairment are not so able to question things like this.
What we know from research into Alzheimer’s Disease is that one’s judgment about financial transactions may be the first thing to become impaired when the disease is in the earliest stages. “Mild cognitive impairment” as doctors may call it, is not so mild when you think about the financial damage that can result. And the elder with this early warning sign of dementia may be living independently, paying taxes on time and otherwise appearing socially normal. For a time.
Professional thieves have certainly studied what makes elders vulnerable. They buy names of people who have entered contests like sweepstakes, and troll for the isolated and lonely ones who will talk to someone on the phone. The sweepstakes officials get paid for selling the lists and no one cares what the buyer does with them.
Elders are truly sitting ducks, easy prey. Isolation, confusion, forgetfulness, and fears about running out of money can all drive the susceptibility to entering into a “deal” with a clever scammer.
If you have an aging parent or loved one with any form of mild cognitive impairment, early dementia or other disease that affects thinking and judgment, here are seven basic things family can do to reduce the risks of ripoff.
1. Check in often. If your aging parent lives alone this is crucial. One of my clients at AgingParents.com emails her dad every day to check in. Others call every day or close to it. Aging parents may not think they need this but they do.
2. Ask to be a co-signer on the main bank account in case of emergency. Some aging parents will agree and some will resist, but ask regardless. It will allow you to do online monitoring of the account activity. A “new friend” who gets money from them is a huge red flag.
3. Have your parent sign a Durable Power of Attorney appointing a competent and ethical agent, which could be you, a sibling or trusted other. If cognitive decline happens, the agent can at least get the money out of the account and put into another safer one that the impaired elder can’t access. This is one way to stop the thieves who are looking for impaired elders. Nothing in the account, no gain for them.
4. Suggest having your parent use a licensed fiduciary to handle money if they don’t want you to do it. If there are issues of not trusting you, an objective professional can protect them from abuse. You might do research to find a reputable one for them. This is also a safe bet for elders you know with no adult kids.
5. Provide and encourage parents’ connection to others. Think of isolation and loneliness as two big risk factors in why elders get financially abused. If you can provide encouragement for them to get involved in activities, it will make them less likely to want to talk to a smooth, slick “friendly” con artist on the phone.
6. Monitor who comes into your parents’ home regularly. Even the most trusted housekeeper, gardener, caregiver or bookkeeper can be tempted beyond reason when their own financial circumstances change for the worse. Your parents are all the more at risk when they trust the familiar person, who can use trust to exploit them.
7. Do background checks on any home care helpers who are hired to work for Mom or Dad. The cost is modest, and you can find out a lot: bankruptcies, poor driving records, and of course, criminal convictions and civil cases. Licensed home care agencies may do background checks, but ask to be sure.
The ripoff artists out there are both clever and relentless, but we can stop many of their opportunities. Please don’t take your aging parents’ financial judgment for granted. It can erode almost without notice, even in the brightest and most accomplished elders.
Until next time,
Carolyn Rosenblatt and Mikol Davis
****P.S. We are always here to help you get through the challenges of aging.
Please let us help you help the ones you love. We are offering a free strategy session to our readers, just click HERE.