Thursday, April 30, 2015

Aging & Staying Positive

A positive attitude about aging plays 
an active role in health.

Life expectancy is increasing in the USA and other wealthy countries, yet as the population ages they are faced with very real prejudice.  Ageism against the elderly population manifests itself throughout the American culture.  From fighting against the “old geezer” stereotype, to the assumption of cognitive or physical impairment, to being the butt of the old timer jokes, today’s elderly constantly battle against Ageism.  In fact nearly 80% of the elderly population report experiencing Ageism. Despite the fact ageism is now recognized a problem in society, it is not decreasing at a fast enough rate.  American culture focuses and idolized youth. Negative stereotypes about the elderly often develop from of fear of the unknown and are established at a young age in a person’s mindset.  This fear of the aging process creates Ageism and is often expressed by the assumption that:
  • Elders are slow when they move about.
  • Elders are in ill health.
  • Elders cannot learn new things.
  • Elders are depressed and complain all the time about change.

The stereotype assumes that the elderly are needy, feeble, idle and demanding rather than deserving, yet in reality the majority of elderly today are self-sufficient, middle-class consumers with resources, talent and time to contribute to society. Unfortunately Ageism not only affects how society treats the elderly but also how the elderly perceive themselves.

Reliable research on today’s aging population shows an increased quality of life while aging. This research supports the idea that stereotypes held by people have a direct link to their health and well-being.  For example, Yale University found that older people who hold negative stereotypes about themselves getting older are more likely to display negative response to stress, self-efficacy, cognitive function, and are more likely to have a negative view of their own peers. Not only was it found that negative stereotypes affect performance and attitudes, it was also found that these beliefs contributed to the elderly’s will to live with healthy development.

These stereotypes may hold some value to the people who are suffering with later stages of an incurable diagnosis. Those with health issues who are active and hold a positive outlook on reaching developmental milestones throughout their entire life are not affected by negative stereotypes and do better physically and emotionally. The good news is that holding positive views of ageing has a real beneficial impact on people.  Keeping a positive attitude compared to a negative attitude on aging has been associated with a 44% greater likelihood of recovery from severe disability.
Holding a negative thought about aging is self discriminating.

“If you are a man you are prejudiced against women you will never know how a woman feels. If you are white and you are prejudiced against blacks, you will never know how a black person feels. But if you are young and you are prejudiced against the old, you are indeed prejudiced against yourself, because you, too, will have the honor of being old someday” (Lewis, C 1989)

Changing negative stereotypes is difficult because people hold predetermined social images reinforcing these stereotypes, and thus are resistant to change. Environmental and social impact of being comfortable with aging allows for a positive impact on healthy life choices for all generations.  

Journal of the American Medical Association

Lewis, C. 1989. How the myths of aging impact rehabilitive care for the older person. Occupational Therapy Forum

Susan Sherriff, CNA and Marketing student, is a contributing writer to Elder Topics as part of a Marketing Internship.  As a member of the HomeAid Health Care team, Susan uses over 10 years of Caregiver experience to assist our elderly and disabled Clients who wish to remain safe and independent at home.  HomeAid is a sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their Residents since 1999.  Together the two companies provide comprehensive care that meets the needs of the elderly and disabled in the Fox Valley of Wisconsin.

Friday, April 3, 2015

Sibling Troubles Revived

Caring for aging parents can revive
relationship troubles between siblings.

You grew up together.  You learned, played and fought together as children and were the best of friends and the worst of enemies all at the same time. You know your brothers and sisters well but now that your aging parents need their children to actively help them, you may find working with your siblings to be far more difficult than you ever imagined.

Martha‘s mother recently passed away.  When looking back at the whole experience, Martha could say she was now at peace with it but deeply regretted the relationship damage that took place with her brother and sisters during the months leading up to her mother’s death.  Conflicts over large and small issues drove a deep wedge between the siblings.  There was bickering over medications and doctor appointments.  There was squabbling over spending time with mom.  There was quarreling over who was to help with specific tasks.  There were out and out fights over expenses. It was like all the adults in the family reverted back to childhood battle lines and no one was fighting fair.

United in crisis
Ideally, siblings will unite and work together to care for their parents when they are ill or become too frail to care for themselves.  Yet in real life it is often a crisis that suddenly forces siblings to unite to provide care for an aging loved one.   These crisis situations trigger a lot of family friction.   Conflicts are made worse by brother and sister’s fine-tuned ability to push each other buttons and relive childhood rivalries.  Arguments over care sap the strength out of the family at the time when their parents need them to work together.  It is also very upsetting to the aging parents who depend on their children for help. 

To avoid conflicts siblings need to face the fact early on that they will someday be called on to care for their aging parents.  Preventing disputes over how best to provide that care is ideally done long before any care is needed.  Sitting down with parents before any care issues arise and discussing the realities of aging is the first step to keeping the family intact and working together through the care years later on.

Talk it out ahead of time
Long before the need exists, when the adult children are in their 40’s and the aging parents are roughly in their early 70’s, have a serious talk about the future.  Gather the family and openly discuss the possible scenarios of the parent’s future care needs.  It may feel premature and a bit morbid to discuss your loved one’s mortality, but it is foolish to pretend they will not age or face health issues someday.  Most people avoid this uncomfortable discussion and wait until a crisis forces the issue and then they must make quick decisions which often lead to mistakes, conflicts and frustration.  It is wise to talk about the parent’s wishes and how they could be honored so the entire family has a framework for the future.  Having a general care plan in place will go a long way if a crisis hits and also will serve to lay the ground work for future long term care. 

Figure out who will do what
Recognizing off the bat that the division of labor will never be perfectly fair, discuss among the siblings who could do which tasks and how much money each would be willing to pitch in to pay for care if necessary.  Try to roughly divide up the responsibilities according to ability.  Sketch out a game plan that all members of the family can theoretically agree to. Don’t assume that since you were all raised in the same family that you naturally agree on what is best for mom and dad.  There will be some emotionally intense moments when you will not agree at all and these will test your bond as siblings, so try to define roles and rules ahead of time to ward off extra conflict.

Gather all the important documents
The sibling(s) with strong organizational and finance skills should be appointed the Power of Attorney for finances by the parents.  Everyone in the family should have a clear understanding of under what situations that power would be activated and what tasks the Power of Attorney will take care of.  This sibling should know where all the money and accounts are kept as well as all the insurance and investment paperwork. Once activated, the POA of finance should gather the titles to the house and cars, safety deposit boxes, keys and passwords for all accounts. They should review any long term care insurance and all other insurance policies your parents have set up and understand the fine print about what is covered and how it will be covered.  The sibling in charge of finances will take care of organizing all the important paperwork, arrange the payments for all bills and should keep the rest of the family informed.  The POA of finances will become knowledgeable about their parent’s financial details and be able to manage the available money to cover care and end of life costs.  They will be responsible for exploring public assistance options if the funds run short. 

Health Care Decisions
As parents age, their health care becomes an increasing concern.  From managing their medications and doctor appointments, to helping with mild cognitive issues to working out end of life care, the amount of decisions can be overwhelming.  The sibling who has been appointed POA of health care will have their hands full once their power has been activated.  If the aging parents were clear about their health care directives and where they wish to be when full time care is needed, then the many decisions will not be such a major source of stress.  Yet even with clear guidelines in place there will be many health care issues where conflicting opinions between siblings cause stain.  One family set a rule that the sibling present at the moment gets to make the decision and, once made, it cannot be second guessed.  Even though all agreed to this rule in the beginning, the siblings found it quite difficult to abide by.  Again, it is having a clear understanding of the roles and rules between siblings that make the care years easier to manage. 

With long term family ties, a little grace will go a long way, especially when stressful situations demand a unified working cooperation.  Know ahead of time that all decisions regarding the aging loved ones will not be unanimously accepted but agree to disagree nicely for the sake of the parents and future family relationships. 

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.