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03/15/2018 12:00 AMFrom the time we are born, our parents have been there to take care of us. As they get older, the tables start to turn and children need to step up and take care of their elderly parents. Sometimes a full circle transition like this can be seamless, but what is often the case is that parents are resistant to change and it can be hard for their children to have conversations with them about not driving anymore, downsizing or moving to a senior living facility, or even something as simple as checking in on them to make sure they are taking their medications or eating properly. Some might not know how to start those conversations or that there are options available to help make decisions a little easier.
Nora Duncan, state director for the American Association of Retired Persons (AARP) in Connecticut, said AARP offers a seminar for family members of seniors called "We Need to Talk," which can help people asses their loved one's driving skills and give them the tools to have a conversation with that aging person.
"One of the things I learned from that program is that it may be time to stop driving, but obviously running in and grabbing the keys in a fit of anger and trying to take the car is probably not going to be your most productive way," Duncan said.
Running the numbers might be a good approach in the conversation. Duncan says retired people who don't need to drive every day might want to weigh the cost of paying taxes and insurance on a motor vehicle versus walkability and public transportation options, even including newer services like Lyft or Uber.
Dr. Thomas Gill, geriatrician and professor of medicine at the Yale University School of Medicine, agreed that it could be extremely difficult to convince elderly people to stop driving.
"It's a challenging issue because folks have been driving for 40, 50, sometimes 60 years," Gill said, adding it's something older people are resistant to give up because it represents a significant loss of independence.
If children think it might be time to talk about giving up driving with a parent, Gill suggested looking at the parent's car for dents or seeing if the parent has had any recent moving violations, and if there's concern, to perhaps ride with the parent as a passenger.
"As a physician, a question we often ask to determine if there's some concern is 'would they allow their children to drive with grandma and grandpa?'" Gill said.
He said a focus would be a medical examination on cognition and vision, as some problems can be corrected.
If someone wants to start thinking about the future for an aging parent, Gill said one thing that would be prudent to do is to have a discussion about granting someone in the family power of attorney, particularly if it's a single parent, as that's an avenue to protect financial resources and assets.
Duncan said documents and information regarding living wills and health care representatives can be found on the state's Attorney General website (portal.ct.gov/ag) and can be done without a lawyer. She also encourages any seniors to make their family aware of their wishes in a public way and get the supporting documentation in place.
There are several community resources that can be used, as well, with Gill naming Agencies on Aging as one of them. Duncan said that calling 211 or visiting a local senior center could provide resources for social services and concerns.
"We have so much stuff on our website that it's almost like the Google for this kind of stuff," Duncan said about resources on AARP's website (www.aarp.org) for making decisions as someone gets older, both for members and non-members.
One of those services is a livability index, so if seniors want to move to a new location to downsize or be closer to a relative, anyone can type in an address and see results.
The index gives the location a score from 0 to 100 based on housing (cost and accessibility), neighborhood (access to stores, parks, etc.), transportation, environment (air and water quality), health, engagement (social and civic), and opportunity (jobs, education, etc.). It, however, doesn't take weather and taxes into account.
"It lets you compare and contrast all these things right up next to each other," said Duncan, if, for example, children or seniors are exploring new housing options.
Another option that some may need is an end of life doula. Patti Urban, founder of Your End of Life Doula, said her practice is mostly on advanced care planning.
"A doula is not a caregiver, we don't take care of people physically," Urban said, "We're coaches and we educate people on...end of life care."
Urban said some services include giving workshops on topics like doing a living will and financial planning.
She can also accompany the patient and family members to a doctor's appointment to take notes and ask questions if someone she's working with is diagnosed with a life-threatening disease. "[I'm] sort of interpreting what's going on medically to a family that's just devastated and really is paralyzed and they don't know what to do," she said.
Urban also talks to people about life insurance policies, and mentioned a new type of policy where half of it turns into a long-term care policy when a person would need extra care. This type of policy is cheaper than long term care insurance.
"It's a great life insurance policy to have," Urban said. "You want to have life insurance. You have it, but then you've got that option to turn it into cash when you need extra care, so it's great."
Editor's Note:
When my parents were going through the process of transitioning their parents to a new lifestyle, one book that they found they could relate to that also offered some comic relief was Can't We Talk About Something More Pleasant, written and illustrated by New Yorker cartoonist Roz Chast. The memoir chronicles Chast's experience as an adult with her elderly parents with cartoons and written text, adding New Yorker cartoon-esque humor to a situation that many deal with as their parents get older.
-Erin Shanley