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Team Approach can Help in Caring
for Elderly Relatives
By Lauralee Ortiz, Free Press
December 7, 2004
"We watch TV a lot and chat about whatever is on her mind," Rabitoy said. "I do her fingernails every week and go through her closet to organize outfits."
To be honest, she said, these visits are often emotional as she sees how age is robbing her once "very sharp" mom of her mental and physical health.
"It doesn't get any easier," Rabitoy said. "While she's still pretty lucid, she gets tired quickly."
Nearly two years ago, Stevenson, 80, moved into the nursing home where she has a semiprivate room decorated with family pictures and special mementos, a shared bathroom and full-time supervision. This was her fifth move in the eight years since declining health forced her to sell the Beverly Hills home that she shared with her husband before he died.
She has gone from independent living in an apartment to assisted living where she received part-time help to a nursing home where she is fully dependent on the staff.
"When she was in her apartment, I was there every day or every other day making sure she was eating," Rabitoy said. When her mother could no longer take her own medication, she was moved to an assisted-living environment.
When Stevenson's medical needs, which include careful monitoring of her blood sugar for diabetes, became too much for the staff, the family made the difficult decision to move her to a nursing home.
"She was very depressed at first," Rabitoy said. "But she knew that she could fall and get hurt. And, when she found out that a friend was moving there, too, she felt better about it."
Every step has been taken with careful consideration, Rabitoy said. And, thanks to her husband, close friends and a team of financial, legal and medical experts, the process hasn't been as grueling as she expected. Rabitoy said the group helped manage everything from selling her mother's home, managing her finances and finding accommodations that suited her quality of life.
"This is very difficult and not something you should do yourself," Rabitoy said.
A growing trend
Rabitoy was among about 40 designated family members of aging parents who attended a recent panel discussion, "Helping Your Parents with Aging -- Are You the Designated Daughter?" at the Westin of Southfield and sponsored by American Express Financial Advisors Inc., Southfield.
Event planner and moderator Katana Abbott, certified financial planner and founder of Smart Women's Coaching Program, said the goal was to give caregivers tips on how to take care of the necessary business long before their family is in a crisis situation.
"Once you are in a crisis, your options become more limited," she said, adding that the sooner you get involved, the better everybody will feel in the long run.
Easier said than done, panel members agreed, as aging people generally aren't pleased at their pending loss of control, loss of independence and loss of freedom.
"The whole process is talking about what your dangers, your opportunities and strengths are," Abbott said, noting that the most prevalent issues tend to dictate the route caregivers take in seeking advice.
For example, caregivers with physically or mentally ill parents likely start with medical advice. Those whose parents have legal issues go to an attorney first. And families looking to handle estate issues seek out financial experts.
While no first step is the wrong one, she said, the ideal plan is to set up a team that includes all of the above.
She recommended that families consult with financial advisers or eldercare planners who have special certification in elderly issues and can help determine the best route for their loved one, whether it be to simply hire home health care providers or start looking into nursing home care.
The American Express panel included attorney Sanford Mall of Mall Hamilton, Farmington Hills; Priscilla Strakovits, a certified public accountant, Farmington Hills; Sandra Lyness, a psychologist, Bloomfield Hills, and Tina Rowley, owner and president of Home Instead Senior Care, Birmingham.
Seek out quality
Mall, one of a handful of certified eldercare attorneys in Michigan, said the first consideration for aging parents should be "quality of life and quality of care."
"No matter which type of provider you start with, make sure you sense their openness to work with you and help maintain the dignity of your family elder," he said. "You want professionals that will take the time to understand what you want and are respectful of the people you are caring for."
Mall said he helps families wade through the complicated paperwork that includes wills, trusts, power of attorney rights, financial planning and insurance coverage.
"We can help you make sure the control is identified in advance," he said. "And include language" in legal documents "that addresses quality of care issues and special circumstances that allow the agent or trustee to carry out their parents wishes."
Mall said even families of modest means have options that will help their aging parents live their remaining years comfortably, but stressed the importance of planning to help build a nest egg and fully understand what private insurance, Medicare and Medicaid will and won't cover.
Home health care services cost as much as $50,000 a year while nursing home costs are about $80,000 annually.
"It's very important to have a little bit of a war chest for that extra care staff if you need it," he said.
Caregivers need support
Lyness stressed the importance of the caregivers to recognize their own limitations.
"There is very little hope for the aging person," she said. "And with that comes major emotions."
Beside frustration and guilt, caregivers often feel unappreciated for their efforts, Lyness said. At the same time, their aging parents are mourning the loss of their independence.
"It's a huge role reversal," Lyness said. "You are seeing someone go from a fully independent person to someone who begs for only one thing - dignity."
Talking about these issues with a professional, understanding that your aging parents who might not have been nurturing when you were growing up aren't going to suddenly change, and recognizing that medications alter personalities, can lessen the woes, she said.
Learn to ask for help
Fred Logan, 62, of Roseville, said he is becoming less and less capable of meeting the needs of his disabled wife, Kathleen. While the Area Agency on Aging sends staff to help him three hours a week, his responsibilities along with his own declining health are starting to take a toll on him.
Logan said he has a daughter who lives nearby, but has not asked her for help because she works full time and cares for a young child.
"I retired early because of my anxiety and stress," he said. "I'm doing too much and I know I should slow down, but I can't."
Lyness said Logan's situation drives home a point that caregivers need to reach out.
"You don't have to be a super person and do this on your own," she said, suggesting he go to the local senior center for suggestions on getting more help at home, even if it's just to do laundry, wash dishes or vacuum.
Rabitoy said she makes sure that all of her mother's needs are met and always speaks up when they aren't. She said she spends several hours during her weekly visits talking with nursing staff and administration about her mother's care.
Strakovits, who specializes in eldercare planning, makes monthly visits to homebound elderly clients to pay bills and balance checkbooks. She said she also observes surroundings to make sure they are in a safe, clean environment.
"I make sure I have the opportunity to see what kind of care that individual is getting," she said, adding that she offers suggestions to family members on how to improve situations.
Strakovits said her accounting services help keep family squabbles about finances under control and protect senior citizens who are often targets of financial scams by everyone from telemarketers to fake contractors.
Rabitoy said she feels fortunate that her mother acquired a substantial nest egg to cover her nursing homes costs. And, through careful research of several facilities and a recommendation by her mother's physician, she is in a "great place."
"I think there is a lot of truth to the saying that you get what you pay for," she said. "By planning ahead enough to take care of everything so this didn't prove to be a burden at all."
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