Role Reversal

Some of the toughest days for families can be the initial stages of the realization that their aging loved one doesn’t need to be alone.  Maybe it’s Dad’s reoccurring falls that are frightening or the scare of an ER trip because Mom accidentally took too much medication.  Whatever the cause for concern, don’t beat yourself up. As human beings, the aging process is difficult.  Watching our parents or other loved ones’ deal with this is altogether more trying. It becomes at times a battle of wills. It is what many refer to as role reversal.   And while it may seem like you are being paid back for your hard-headed childhood days…you must be strong and use good judgment.

First, you must come to terms with the role reversal.  It is hard for us to wrap our heads around the idea that we are now the decision maker. Now, with this in mind…tread lightly and respectfully.  We still respect our elders.  But we must respect them enough to CARE for them and make tough decisions.  It’s a difficult conversation when they don’t seem to want our help or don’t want to be a bother.  But stay strong.  It can be so trying to see our parents or aging loved ones become so vulnerable. If you have siblings try not to allow this time to be one where you pull apart or old sibling rivalries rear their heads.  Pull together rather than away from each other.  Regardless if you are an only child or have siblings, find a way to talk things out with a trusted friend.  This role reversal is tough!

STAY STRONG!  This can be hard when a parent becomes angry over independence issues but you are concerned for their safety.  Don’t cave in or just put a literal band-aid on a gaping wound.  Address the tough issues.  Avoid letting them shut you out or try and convince you that everything is fine when you know clearly it is not.  Don’t wait until you are in crisis mode before you address the issues that are at hand.

Talk to them with their physician.  Go to those appointments and help be an advocate.  Many parents welcome time with their children.  It may be that during these appointments there is information that family members are not getting the full story.  It also could be that the physician may need some information as to what is “really” going on.  Your loved ones may not always remember or understand everything their physicians tell them either.  As a complete CARE TEAM…you and your parent in conjunction with their primary care physician can make good sound choices.

Role reversal is no walk in the park.  But much like raising children can be so incredibly tough…tending to aging parents in role reversal can be gut-wrenching because we view them as well…the parent.  Remind them how much you love them.  Be nurturing and be kind.  Let them know that you want to help take care of them just as they took care of you. Maybe it wasn’t perfect.  But life just isn’t.  Do the right thing and seek guidance from a physician and trusted friends along the way.

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Preparation for the Situation

When it comes to emergency room visits, I probably have been more times than the average person due to the nature of my job.  But this year with the flu hitting near epidemic levels not only just in Alabama but also nationwide, emergency room visits have been experienced by many.  Trips to the ER can be a scary situation at any age.  The ER can prove particularly challenging for the elderly.  Here are some suggestions to help you keep it cool when you find yourself in the hot seat taking a senior loved one to the ER.

Emergency Files

The first week on the job as a brand-new administrator I found myself headed to the ER following an ambulance with one of my residents who I had obviously just met that week.  Now mind you, I had called their family and notified the proper folks of the situation.  But for a short time, it was just me and this resident (who was experiencing chest pains) in a room in the ER as they were being seen by the doctors and nurses.  I was grateful for a paperwork process that was in place in our community so I had the answers to the questions that were being asked by hospital personnel.   We use what we call an Emergency Red File for each resident in our community for such an occasion.  Inside we keep copies of the residents’ most recent medical exam and plan of care, insurance cards and other ID as well as advance directives and Power of Attorney documentation if they have them.  It is called a red file because well, it’s red in color.  Our local hospital staff has gotten very acclimated to our “red files” and it makes registration and getting medical staff some initial information on the resident so much easier.  It also helps keep the resident calm because they aren’t having to give answers to so many questions.  Our families appreciate this as well. They are usually a barrel of nerves at the call that their loved one is being taken to the ER anyway.  It is a relief for us to go ahead and have all of this information readily available.  Most regulations require assisted living communities to have this as part of the chart and way.  It is so much easier to have this type of file ready to go at a moment’s notice versus stopping to make copies.  We just make sure to secure them in a safe location, update them as appropriate and add the most recent medication list at an emergency occurrence.

Pack like a Pro

In addition to an emergency file, having a small bag packed is a huge help. I have been in situations where family members couldn’t get to the hospital that day due to travel outside the country, illness and more.  I’m typically going to ensure that the resident has someone with them to be there and comfort them and so that I can get the information to pass along to the family.  That is why having a bag packed and ready is a huge help.  Now, this bag doesn’t need to be big and bulky or loaded down and cumbersome.  But there are a few items I would suggest to take to help the resident and you be set up for as smooth “as possible” visit to the ER.  Some things to consider packing include:

  • Depends (pads, etc) for residents that require them
  • Snacks (for both you and the resident)
  • Phone charger
  • Small blanket
  • Water bottle(s)
  • Wipes
  • Ziplock bag

Now I know that most hospitals can provide you with many of these items.  But it doesn’t take much preparation to have these things ready to go. Sure, there are some emergency situations that emotions will be high and some of these items will be the last thing on your mind. But if you make gathering this and your emergency file part of your process, they can make a tough situation a little more bearable.  Remember that these items may be necessary for your resident and you.  So, pack accordingly.  I suffer from migraine headaches.  My triggers for them include multiple things.  But ranking up pretty high include:  stress, dehydration and skipping meals.  I’m no good to anyone else and can’t take care of them if I don’t take care of myself.  I say all of this to say that proper planning can help you be more effective to your residents and their families.

Blog note*

At present date, the Alabama Department Health has made the following recommendations regarding visiting the ER or doctor’s office for FLU RELATED ISSUES:

“For people with mild to moderate flu or flu-like symptoms, please do not go to your doctor’s office without calling first and do not go to the emergency room. Please call your doctor to see if you are eligible for antivirals without an appointment. Many insurance companies now have a “call a provider” service to help with mild to moderate illnesses; please take advantage of this service before going to doctor or hospital.  Mild to moderate cases of the flu usually do not require a hospital visit. Patients who do visit an emergency department or outpatient clinic should be aware of long wait times.” 

As with all emergency situations use your best judgment, especially when it comes to an elderly person who may have a reduced immune system.

 

Keep It Clean

There are many reasons that family members become concerned that an elderly loved one is not doing well.  One issue that is a cause for concern is bathing or rather the lack thereof.  A parent not bathing is a topic that many families are reluctant to discuss as they may be uncomfortable bringing it up. But be assured that this is an issue that many people face.  It is common…but there may be multiple root causes.  It is important to understand why they are reluctant.  Only when you understand that the underlying reasons can you better approach and address successfully.  Let’s look at some of the more common reasons.

 

  1. Fear of Falling

The bathroom can be a very dangerous place. If you have every slipped in the shower, you can relate. Now you pair the environment with physical issues like foot problems, balance issues, arthritis and more…and you have a recipe for disaster and fear.

 

  1. Depression

Often elderly have issues with depression that can zap their get up and go. When you lack motivation, bathing and concerns for your grooming often go by the wayside.

 

  1. Cognitive Issues

Another reason that is very common are memory issues. If your parent has dementia or other cognitive decline, keeping up with a bathing schedule can be extremely difficult.  Realizing that you haven’t taken a bath is not something they may be able to keep up with easily.

 

While it may be a difficult subject to approach, you must develop a plan. For some simply adding grab bars or safety equipment may help. Some may be able to follow a chart.  But if it is a depression or memory issue, it may be time to consider getting help.  As always discuss your concerns with a doctor.  A physician may want to consider medications to help with depression.  It may be time to enlist the help of a caregiver or look into an assisted living community where your loved one can have daily assistance with their activities of daily life like bathing and grooming.  But don’t avoid the topic because it is messy and uncomfortable.  The health benefits of cleanliness are far too important to ignore.

Just Breathe

Recently someone said to me that I seemed to always have it together.  Me?  Together?  Now that is funny!  Most days I feel like I am chasing my tail.  Did they know my day that morning started with dry shampoo??  But isn’t that life?   Most of us are convinced that everyone else always has it TOGETHER.  We envision everyone with cleaner houses, perfectly cooked dinners and flawless families.  In reality, we are all doing our best…to do our best.  One thing that will de-rail our “best” in a hurry is stress.  It is very common to hear from families of seniors dealing with “role reversal” that it is one of the most stressful tasks they have ever endured.  It’s one thing to raise and help our children…but when it comes to helping our parents…this is no easy task.  We don’t want to disrespect, but we also want to keep them safe.  Here are some tips to help you be proactive and avoid making situations frustrating for both you and your loved ones.

Don’t forget your Vitamin ZZZZZ

It sounds simple, but get your sleep!  According to the National Sleep Foundation, most adults need between seven and nine hours of sleep each night for optimum performance, health, and safety. The Foundation advises: “When we don’t get adequate sleep, we accumulate a sleep debt that can be difficult to “pay back” if it becomes too big. The resulting sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior.”  Getting a good night sleep is important to your health and will help you be more effective in helping others and that includes your elderly parents.

Track Down a Paper Trail

According to AARP, an important part of getting things untangled for your elderly parents is organizing paperwork and documentation.  “The first thing to do is ask your parents where they store important papers. It may be in a file cabinet at home, or in a safety deposit box or with an attorney. You can’t get organized if you can’t find anything, so come up with a checklist to write down where everything is. Documents that should be assembled and accounted for include”:

  • birth certificate
  • marriage certificate
  • death certificate (for deceased spouse)
  • divorce papers
  • military records
  • driver’s license/organ donor card
  • passport/citizen papers
  • will
  • living will
  • durable power of attorney
  • health care power of attorney
  • trust
  • letter of instruction — with funeral arrangements, important contact information such as insurance agent or broker.
  • insurance policies (life, disability, long-term care)
  • information about safety deposit boxes (e.g., location, number, key)

 

Remember to Enjoy Each Other

elderly smile.jpg

In this fast-paced world that we all get caught up in, it seems we can lose sight of the things that are important.  Yes, making sure that everyone is safe and sound is huge!  But Mom may also really enjoy sharing a cup of coffee with you.  Dad may want to talk about the weather.  Take time to enjoy the blessings each day.  These small moments together will become larger than life soon enough.  Make time to take time and as my Mom reminds me when I feel I’m at my wits end…just breathe.

If it is time to help Mom or Dad look at the option of Assisted Living please give us a call today.  We would love to have you and your loved one come have lunch with us and see all that our communities have to offer.

Get more information at www.greatoaksmanagement.com