adult children

    How to talk with Mom and Dad

    Opening up a conversation with your elderly parents about important issues can often be a very stressful and difficult task. You know there are certain things you need to talk to them about but you often fear that they might speculate what your motives are. So how do you open up those conversations without embarrassing yourself and upsetting your parents?

    First you must remember that one of their primary concerns ( according to David Solie in his book, How to Say it to Seniors) is maintaining control of their lives. They don’t want to be told that they can’t drive anymore or that they have to move out of their house into a retirement community. Even if these choices are in their best interests, they will be very reluctant to comply if they don’t feel that they have made the decision.

    But you also need to know that you don’t want to wait until its a crisis to approach your parents. In my 30 years as a financial adviser to hundreds of families, I never saw things go well when families tried to make decisions after a loved one was already in trouble. These situations are fraught with emotion and people don’t often think very clearly when things are unraveling.

    Now, while your parents are still healthy (hopefully), plan out what issues you need to discuss with them before you approach them. Try writing them a letter expressing your concerns and thoughts. Don’t give them the letter but use it as tool to explore your own emotions. Narrow down your concerns to be as specific as possible. What are you anxious about? Enroll the ear of a friend or spouse and read your letter to them. Do they think your concerns are legitimate and worth discussing? Finally, listen to the letter as if you were your parents. Where do you think there will be resistance or stubbornness?

    Once you know the focus of your conversation, develop an ice-breaking phrase that you can use  with your parents. Make sure your questions are open-ended and leave room for them to express their opinions. For example,” Mom, recently one of my friends told me her mom was having difficulty keeping up with all the chores around the house. What do you think she should do?” Or, “Dad, can I get your opinion on a couple of things?” Or as simply as “Mom, can we talk?” One of my favorites was “ Dad, how are you enjoying those golden years?”

    Your parents probably want to talk about the same concerns you have, but they just don’t want to upset you or mention things that are uncomfortable. They certainly don’’t want to be told what to do. But by easing into the conversation and creating an environment that is safe, you can eliminate a lot of stress for them and yourself. You’ll also give them the opportunity to age with dignity and peace of mind.

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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Namaste Care: Embracing the Most Vulnerable in Nursing Homes

    Namaste Care is a program designed to improve the quality of life for people in nursing homes or assisted living facilities who are agitated, unresponsive or near the end of life. It is often used with people who have advanced dementia. Namaste, is a Hindu term meaning “to honor the spirit within” and was selected to describe a program that brings honor to people who can no longer tell us who they are or cannot care for themselves without assistance.

    Joyce Simard, a veteran elder-care social worker, founded the Namaste program. She was concerned that some residents were too frail or disoriented to participate in group activities in nursing homes. She noticed that they would often sleep or slump in their wheelchairs near the nurses station all day. She said, “ That’s not quality of life. What they really need is someone to touch them in a loving way” She has written a book entitled, The End of Life Namaste Care Program for People With Dementia.

    Namaste Care takes place in a designated space that helps to create a safe and comforting environment for all who enter, including residents, their families and staff. Hand and foot massage, carefully brushing or combing a persons hair, and moisturizing the ladies faces with “Ponds” cold cream, are a few ways that bring pleasure when done with a loving touch. Resistance to shaving that many men display because they do not realize that they need to be shaved disappears when shaving is accomplished the “old fashioned” way with shaving cream and “Old Spice” after shave lotion.

    Scents of the season are used to provide sensory stimulation.  Flowers that are in bloom, like lilacs in the spring, produce smiles as well as the scent of cinnamon in the fall and winter.  Almost everyone will smile when someone is blowing bubbles or may be wearing an outlandish hat!  Moving arms and legs to music helps keep limbs flexible.  Nourishment and beverages are offered throughout the day so that people with a diminished appetite have more opportunities to eat and drink.

    Namaste programs are being incorporated in facilities around the world. On Cape Cod the Epoch Group has made a very big commitment to the concept. It is now used in all Epoch living centers in Massachusetts and Rhode Island. At Epoch Senior Living in Brewster, MA 20 out of 160 residents may be in the program at any one time. A framed statement on the wall of the Namaste room spells out the Namaste Mission: “To embrace our most vulnerable and provide them with a sense of comfort, calmness and serenity because their lives are still relevant.”

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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    How to Find a Doctor for Your Mother

    I have been reading Jane Gross’s wonderful book, A Bittersweet Season. It is about her efforts to care for her mother in her last few years. Jane writes a blog for The New York Times entitled, The New Old Age. Not only is the book a very personal account of Jane’s experience with her mother, but it is the source of a lot of valuable information on caring for an aging parent.

    One of Jane’s problems was finding a family doctor for her mother when she moved from Florida back to the northeast to be close to Jane. She found it almost impossible to find someone that would take her mother.  Jane learned  a few facts about the medical profession that made things so difficult. First of all, fewer general practice physicians are coming out of medical school. These doctors just don’t make enough money. The average GP makes approximately $150,000 a year and their  loans from school are around $200,000. A typical anesthesiologist makes $400,000 a year. So medical  students are choosing to become much more highly-compensated specialists.

    Secondly, many doctors are choosing not to accept Medicare.  They can legally opt out of the program. Reimbursement from Medicare for various procedures is far less than what doctors often receive from insurance companies. In addition, reimbursement is not for time spent with a patient but for procedures ordered. If a doctor convinces an older patient not to have her hip replaced, he does not receive a dime. Often older patients take longer in an appointment than younger healthier patients, which also ends up costing the doctor more.

    Given these issues, Jane was advised to take the following steps when seeking a new doctor for her mother:

    First, get a referral from her existing doctor where Mom is now, before she moves. That doctor probably knows someone in the area she is moving to. That doctor will most likely be reluctant to turn down a referral from a peer.

    Second, get tightly-crafted summaries from her existing doctor and any specialists that have been involved. Less is more. The new doctor is much more likely to read something that is clear and concise.

    Third, if you can’t get a referral, scout the area for doctors in the area where Mom is relocating, before she moves. Check with local councils on aging, senior centers, medical societies, and similar organizations.

    Fourth, make it clear to the new doctor that one adult child will be the conduit for all communication. He won’t have to field calls from two or three siblings who all have questions. Prepare a plan within the family as to how communication will be disseminated from that key person. Show the doctor that you won’t waste his time.

    Lastly, the same sibling should accompany Mom to medical appointments and communicate the results to the rest of the family. A family that manages itself internally is more likely to find, keep and get the best service from a doctor.

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    PERMISSION TO REPRINT:
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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Time to talk Turkey

    Many families gather together during the holiday season. This is the perfect time to have a meaningful conversation with your elderly parents. But many of us have difficulty opening up a serious conversation with them. Let me give you some suggestions that will help to get the ball rolling.

    The experts have told us that there are two things that dominate the thoughts of our elder parents. The first is the desire to maintain control over their lives, to be able to stay in their home, to continue to drive, to do what they want to do when they want to do it. But as their health deteriorates this is often hard to do. That’s when the second most important thought takes over.  “What will be my legacy? How will my family remember me?”

    2600 families with elderly parents were interviewed by the Allianz Insurance Company. 70% of them responded that discussing how the parents would want to be remembered by their children was a conversation important to them. But when polled, only 30% of the families had made the effort to do so.

    When was the last time that you asked your parents, “How do you want to be remembered by your grandchildren and great grandchildren? If you are willing to ask that question, close your mouth and just listen. And remember to listen carefully. Drop all your preconceptions of what they will say and how they will say it. Listen with an open heart.

    But if you are not willing to open with that question, I suggest you start with a question that everyone is willing to answer, “How did the two of you meet?” That one was a shocker for me. When my mom was moving into assisted living I reviewed with her the important documents  that she held in a metal box. Amongst her legal papers, was an envelope marked “ Letter from Bob while overseas” This was a seven page poem that my father had written on his way across the Atlantic to fight at Normandy in the D-Day invasion. It was in perfect condition. It described how my parents met and their courtship and marriage. I was surprised to learn that my mother, at age 15, ( in 1930) had called my dad to take her to a party after they had met skating that afternoon. (She still denies it to this day).

    Once the conversation starts to flow, it’s important discus other areas. Things such as, “ Have you thought about what you want to do if one of you becomes sick? Do you want to stay in the house? Who do you want to take care of you? You might mention what happened in other families when these issues were not discussed. The crisis and confusion that followed.

    I’d suggest that you then share with them, a very valuable three page form, “Five Wishes”, a well organized and sensitive questionnaire that gives them the opportunity to write down their health care preferences in many different situations. It can be found at www.agingwithdignity.org. Don’t try to have them fill it out then. Leave it with them and check in with them at another time to discuss their answers. You can also read my book, “Can We Talk?” where I have a created a series of more that 20 forms to gather important information from your parents. You can find it at www.parentcareplanning.com

    2012 Resolutions for Boomers with Elderly Parents

    This is the time every year that we decide what we are going to do differently in the coming year, how we are going to improve, what we are going to stop doing and what we are going to start. I’d to suggest some resolutions that would be very helpful to you and your elderly parents. Here they are;

    Take the time to ask your parents how they met. Bring along a tape recorder or video camera and record their answers.

    At the same meeting ask them how they want to be remembered by their grandchildren and great grandchildren. Again record their answers.

    Schedule a family meeting with your parents, and your siblings to discuss the critical issues that your family will face as your parents get older.

    Complete the Five Wishes Questionnaire yourself and then bring copies to your parents for them to complete. You can find this form at www.agingwithdignity.org

    Find out where your parents keep all their important papers and make sure they are safe. These important papers should include wills, durable powers of attorney, health care proxies, life insurance policies and beneficiary statements for all annuities and retirement accounts.

    Ask your parents to record the names of all bank accounts and investment accounts   that they have. Ask them to include account numbers as well. Have them keep this information in the same place they keep their important papers.

    If your parents have online accounts ask them to record the URL addresses of these accounts, their user names and their passwords. Again keep this info in the same place as their important papers.

    If you complete these resolutions you will save your family much heartache and anxiety. You will also provide your parents with peace of mind, knowing that they have done the critical planning that will keep their family together.