The Sandwich Generation

We are seeing more articles about the challenges of the sandwich generation - individuals who are caring for aging parents as well as their own children.

Paula Span has written a book entitled, "When the Time Comes." Excerpts from the book are summarized in an excellent article in today's Washington Post entitled "Their Parents' Keepers."

... It might be several years before he needed assisted living, but he also might have a health crisis and need a nursing home next week. Uncertainty was built into the process. We prepare for other major changes in life (marriage, parenting, retirement), but this one, caring for our aging parents, seems to take us by surprise. It shouldn't: Two-thirds of seniors will need some form of long-term care. I hoped I could be at least semi-prepared.

She mentions learning about options in elder care and having a conversation with your parents before they have a stroke or fall. What kind of care would your parents want, when the time comes? Who will you turn to for advice? In addition to family and friends, there are many geriatric care managers available in the Baltimore area.

Please comment with your challenges, rewards, and any books you might recommend regarding aging or caring for older adults.

Resources:

• ElderCare Link


• National Association of Professional Geriatric Care Managers, Resource Links

Caregiver Stress

Image by sheilaz413 via Flickr

A June 6, 2009 New York Times article by John Leland highlighted the economic stress being felt by family caregivers.

The economic crisis has spread its pain widely, but it has placed special stresses on the estimated 44 million Americans who provide care for an elderly or disabled relative or spouse, many of whom have already made themselves financially vulnerable trying to balance work and family. Many like Ms. Denk, who stepped away from the work force, are now facing ever-bleaker prospects.

Teresa Denk is 59 years old and lives with her father, a former mechanic who is 92 and requires constant care. Ms. Denk has not held a full-time job since 2000, when her mother developed cancer and required her daughter’s full-time care. Asked how she meets her monthly expenses, she said, “I do a lot of praying.”

In a recent survey of 1,005 caregivers, one in six said they had lost a job during the downturn, and 21 percent said they had to share housing with family members to save money. The survey was conducted by the National Alliance for Caregiving and Evercare, a division of the UnitedHealth Group, which provides long-term health care.

In many cases these caregivers, who rely on help from the government and nonprofit organizations to make ends meet, are finding that such services are being cut in the downturn and have had to assume even more care-related expenses.

“All the calls we’re getting are, ‘Is there money to assist me, either pay me to be a caregiver or assist me in other ways, like provide pro bono services,’ ” said Suzanne Mintz, president of the National Family Caregivers Association. [NFCA has a good resource for caregivers on their web site, Messages to Live By.]

Caregivers spend an average of $5,500 a year as part of their responsibilities, not counting lost wages, according to a 2007 survey by the National Alliance for Caregiving.

Caregivers are encouraged to take steps to keep themselves healthy, talk about their challenges, and seek ways to reduce stress. Many organizations are starting support groups for caregivers, including the Alzheimer's Association and Family and Children's Services.

Caregivers can obtain information and advice from the following web sites:

• The National Family Caregivers Association
• Family Caregiving 101
• Caring.Com.

Supporting our Parents in the Community

Image via Wikipedia

Older adults want to live in the community, as close to friends and families, as long as possible.
Many companies and organizations are working together to support elders in maintaining their independence and active lifestyles in the community of their choice, often their homes of many years. As some elders become older and frailer, they need more support from friends and family to keep independent. Typical challenges include transportation, home repairs, companionship, and eventually, care with activities of daily living (eating, dressing, bathing, walking, etc.). Action In Maturity is a not-for-profit transportation provider in North Baltimore.

Local government agencies have a wealth of information for older adults and their families:

• Baltimore City – Commission on Aging and Retirement Education
• Department of Aging, Baltimore County
• Department of Aging, State of Maryland

In many cases, family members want to keep their loved one safe, which may mean a move out of their home. Here's an interesting blog shared by Sarah Mashburn at AAHSA.

Aging at Home… Is It Overrated? I know my 85-year-old Grandma would answer with a resounding “no!”, but there is an emerging consensus among experts that aging at home may not be the best option for every older adult.

I recently read a blog post by Corinne Reider, the executive director and treasurer at The John A. Hartford Foundation. The foundation’s whole mission is to improve health care for older Americans, and Corinne believes sometimes that means residential care options.
In her post, Corinne describes her experience caring for her parents. The couple has 17 chronic diseases between them, including blindness and Alzheimer’s disease. They refused to consider moving into a retirement community or assisted living. While they moved a few blocks from Corinne’s brother, the siblings struggle to deal with their mother’s falls and their father’s refusal to get out of bed.

Are you having conversations with your family members regarding their personal challenges and their wishes to remain at home?