The Playing Field

Last week I was driving to see a client in a very depressed, rural area and as I passed some homes that made me reflect on the socioeconomic discrepancies in this world it dawned on me, no matter the size of the home or bank account when you are dealing with death we are all on the same level playing field called, humanity.

As heart wrenching as my work can be some days, I love the fact it is filled with episodes of humility because humility seems to bring out the best in all of us.  In those moments when we are challenged or reminded of the fragility of life, stepping stones to the soul are created which propel us towards being kinder more caring human beings.

Tears were exchanged during my consultation and emotions aired.  The adult children wishing their dying parent could have shared their feelings years earlier, instead of now with days or weeks left to spend together.  It got me thinking, if we could remind ourselves to carry out acts of compassion in our everyday interactions instead of in times of crisis or on our death bed, life would be so beautiful.

“Humility is not thinking less of yourself but thinking of yourself less. “–C.S. Lewis

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Handi Ramps for Wheelchairs

The Trak® system from Handi-Ramp® is a lightweight, portable wheel and power chair track designed to be convenient and easy to use.  Traks are manufactured from durable, extruded aluminum with a non-skid surface for decades of useful ser­vice. They are available in a range of lengths corresponding to the single- and multiple-step barriers commonly encountered in everyday living.

LIGHTWEIGHT

The Trak line now includes the light­est, most portable wheelchair track products available on the market today. The new 30″ Traks weigh only 41/2 lbs. per track, while the new 45″ unit weighs only 61/2 lbs. per track. Yet both systems will easily accom­modate weights of up to 600 lbs.  Handi-Traks have been designed to be truly
portable.

EASY TO USE

All Handi-Trak systems feature a 63/4″ width (inner dimension) to accommodate the widest wheelchairs.  There are no difficult-to-manipulate buttons or telescoping parts to separate or catch on wheels.  All Traks feature Easy-Carry Handles that reduce stress on fin­gers and wrists.  Traks 60″and lon­ger are hinged for additional conve­nience and portability.

Cost:  $139.00 for the 30 inch ramp

http://www.handiramp.com/Trackramps.htm

 

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A Gentle Reminder

Keep Calm and Carry On was a propaganda poster produced by the British government in 1939 during the beginning of the Second World War, intended to raise the morale of the British public in the event of invasion. Seeing only limited distribution, it was little known.  The poster was rediscovered in 2000 and has been used as the decorative theme for a variety of products.  Recently I was given a gift by a dear friend and it had this slogan on the box.  Just reading the words gave me strength and courage.  Some days we just need a gentle reminder that we can get through the turmoil.

 

 

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Medicare Policy Updates

This week the President released the fiscal year (FY) 2013 Budget, which includes the
Department of Health and Human Services (DHHS).  The Medicare proposal resemble those from last year, asking seniors to pay more for Medicare while also cutting payments to health care providers.  Given the complexities of the legislative agenda this year, this budget is not expected to be enacted.

 The budget projects Medicare spending of $528 billion in fiscal 2013. The budget estimates that Medicare can save at least $370 billion over 10 years with a variety of cuts, such as paying hospitals less for bad debts, when seniors miss co-pays and deductibles, and cutting the cost of drugs for seniors who are also enrolled in Medicaid.

The plan requires wealthier seniors to pay more for Medicare, and changes the deductible for doctors’ visits for seniors who enrolled after 2017. The plan also adds a new co-payment for home health services and increases premiums if seniors choose to have a supplemental “Medigap” plan.

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The Three Biggest Mistakes Caregivers Make

Bart Astor is the featured guest writer for this blog, his book Baby Boomer’s Guide to Caring for Aging Parents, was one of the first books I purchased in 1998 when I started my practice. 

In seven or so years that my wife and I served as caregivers to her mother, we made many mistakes. Some of those I know were detrimental to my mother-in-law and some to the whole family. For example, we moved her 4 times in that short period: to a retirement community, then to an apartment, then to a long term care facility near us, and then to another facility that provided better care at a lower price that was near my wife’s sister. Four times in 7 years! Contrast that with the previous 35 that she spent in one house. It’s no wonder she was confused and disoriented. By the third place she probably had a hard time remembering how to get to the bathroom.

Our reasoning behind the moves was sound though. She tried the retirement community and it might have worked out ok if her husband of 54 years had remained alive longer. After he died, she wanted to “go home” (her words). We didn’t realize that what she meant was she wanted to go back in time. But we supported her choice to live independently in an apartment in the town she had spent most of her adulthood. That didn’t work well at all. She soon needed an emergency response system and we worked out arrangements with neighbors and the local police to check on her. But it was almost an hour away from us and although we visited at least once a week – more often as time went on – we quickly learned that she needed more attention than she could get in that apartment. We hired people to help her with cooking and cleaning and that worked okay. But gradually she needed more and more help so we encouraged her to consider a long term care facility. After much discussion and after repeated falls in her apartment she finally agreed. But the facility was a half hour away from us and had specific visiting hours that didn’t always work well for our schedules. It was also not near friends she had or the rest of the family. When the prices increased dramatically, we jointly decided she would be better off in a less expensive but nicer place near my wife’s sister in Texas. She moved there and a year of two later died there.

Our reasoning was, indeed sound. Or so we thought. But imagine the stress we put her through. Even though we were smart enough to have her be a part of the decision-making process, in retrospect I think we made some huge mistakes.

Our first mistake was that we didn’t think clearly enough about the future. We didn’t plan ahead and realize what would come next. How naïve we were to think she could actually live independently in an apartment, even though it was in the town she knew. She didn’t drive! She couldn’t take the bus. And she wouldn’t pay for a cab. How would she get around? How many of her friends would be able to come visit? How many were even still around? At least we did manage to set up some kind of health support system. But it was not enough. The mistake wasn’t just not thinking about the future, though. It was not hearing what she was saying when she said she wanted to go the town she called home. She meant the past; we thought she meant Cranford.

Our second big mistake was not considering the toll it would take on us as caregivers, and how much that toll would affect my mother-in-law. Sure, we had read about and discussed with others the stress that caregivers go through. But reality was far worse. Driving through awful traffic to get to her apartment several times a week was torture, especially after a long day of work. Weekends were better but that meant scheduling visits around our need to run errands and have some kind of social life. And traffic! The weekly visits soon became two or three times a week, and even that was not enough. After she fell for the third time and couldn’t get up, we scurried around and found a long term care facility that would take her. It was nearer to us, but still 20-30 minutes away. When we moved her to the last place she lived, in another state, we were so relieved. We just hadn’t taken into account all that was involved in being caregivers.

The third mistake is an offshoot of the previous one. We took it all on ourselves.  We thought we could do it alone. We didn’t involve my sister-in-law and her family. Or at least not enough. Sure it would have been hard for her to take an active role. She had teenage children and she lived far away. But she visited and called often. And to her credit she participated in all the decision-making and was willing to do more. But had we known more or been better prepared, there were things she could have done from afar that would have made it easier on my wife and me who bore the brunt, as do most caregivers who live nearby. We just didn’t know how to delegate to her. Had we done so, we all would have been better off. When my mother-in-law went to live near my sister-in-law, we continued to handle all of the financial and legal concerns. My sister-in-law still had the most work, but by making the whole kit-and-kaboodle a shared experience, it was easier on all of us.

So while we clearly made some big mistakes – at least three biggies – I want to emphasize that we did one thing right! During the entire ordeal we always kept my mother-in-law involved in all decision-making. We never overruled her, even when we disagreed. If I have one message to emphasize, it’s this: “Don’t try to parent your parent – they are not our children. It’s their lives so treat them with the respect you’ll want.”

Bart Astor is the author of “Baby Boomer’s Guide to Caring for Aging Parents.” You can get more information about this book at www.BabyBoomerEldercare.com.

 

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