Cognition, Medical Costs and Sex

Back from an extended summer vacation, and during that (much needed) time away I made a few notes about some things that caught my attention:

•On July 18th, the New York Times wrote this post as a kind of lead-in to it's front page article of the same day, and it's well worth reading When You Know There’s Something Wrong. The Times reports that scientists are beginning to take seriously accounts of forgetfulness and cognitive problems in patients without obvious signs of dementia. Some are calling for recognition of “subjective cognitive decline,” a stage in which people sense that they are slipping long before others have noticed and even before cognitive testing can measure it... 

•Elisabeth Rosenthal, a terrific and well-informed writer, wrote in the August 3rd edition of the New York Times: "As the United States struggles to rein in its growing $2.7 trillion health care bill, the cost of medical devices like joint implants and pacemakers offers a cautionary tale. Like many medical products or procedures, they cost far more in the United States than in many other developed countries."  Cautionary tale is right.  Would the burgeoning "medical travel" industry (where people go to other countries for procedures that are far, far less expensive than here in the United States) even exist if we had a fair, equitable and controlled health care system?  I doubt it...

• Eldercare is the least sexy subject in the world.  The only thing that's less sexy is to contemplate the idea of your parent's having sex.   The following item, by Brian Gruley of Bloomberg News, comes as no surprise: "Boomer sex is expected to be an issue for elder-care homes. Recently, a nurse at the Hebrew Home in Riverdale, N.Y. saw two elderly people having sex in a room and asked Daniel A. Reingold, then the home's executive vice president, what she should do.  'Tiptoe out and close the door so you don't disturb them,' he told her."  Why does it seem surprising to so many that elderly people, particularly those still in reasonable health, still have sexual desires?  Sex is healthful (and fun) at any age, seniors included...

See my latest video and more on my website at http://www.jamielegon.com

Quality of Life et al.

After returning from my latest doctor visit, and living as I do amongst a large population of senior citizens, I was reminded once again that life without real quality of life isn't life at all – just a fading respiration process as we wind down into our terrestrial escape... 

The formula to delay the onset of problems caused by advanced aging is well known: proper sleep,  eating a Mediterranean diet, and exercising 4-5 days a week are the beginning of the equation, but it turns out that work and career are the glue that help tie it all together.  Exercising the mind is as important as exercising the body, and studies now show that working past retirement age slows, if not prevents, the onset of dementia...

As my father spiraled down the long road of dementia, he became angry and aggressive, a problem often compounded by the fact that he was getting urinary tract infections that made him act like an absolute lunatic.  Read Paula Span's (NY Times) New Old Age post "When Aggression Follows Dementia" at http://nyti.ms/13V9vVj  It's a common problem...

My father's dementia was worsened by the fact that he had macular degeneration, making him think that he was seeing writing on the walls.  When an elderly person of advanced age can see and hear, they feel that they're still here, still in the world.  Quality of life isn't a sexy subject, but in this writer's view, it's the only one that really counts...

Here are some more organizations to know about.  Visit my Resources page at http://bit.ly/12Pb695
to find many more...

Children of Aging Parents  http://www.caps4caregivers.org  Children of Aging Parents is a non-profit charitable organization whose mission is to assist caregivers... 

Association for Macular Diseases  http://www.macula.org  Like audiology and hearing loss, there's not enough attention paid to quality of life issues...

Experience Works http://www.experienceworks.org Experience Works is one of the nation’s leading nonprofit providers of training and job services for adults, aged 55 and over... 

LivHome.com http://livhome.com/  LivHome is one of the largest providers of professionally led at-home care for seniors... 

Aging Well Means Good Management

If you're one of the very few, very lucky, babyboomers without medical challenges, please accept my sincerest congratulations.   But if, like me, you're one of the vast majority of seniors with health issues who sometimes think (don't we all?) that you're a little unlucky, just consider the alternative.  I know a lot of people who never got the chance to get aches and pains...

A friend of mine, 79 and a lifelong athlete, was recently diagnosed with macular degeneration.  He didn't even blink (no pun intended), and only talked about what he had to do to continue living life as he always has.  He's a pretty vibrant guy, tall and muscular, and I'm pretty sure he could kick my ass in spite of being 20 years older than me.  He was already making transportation arrangements "just in case" he couldn't comfortably drive anymore.  He wasn't gonna wait until the worst might happen.  I wanna be like him when I grow up...

Another friend, almost 65 years old, finally had to have a troublesome knee replaced.  Never much of an athlete, he's still going to the gym every day to rehabilitate the knee.  "It would have been easy to hobble through the rest of my life with a cane, but the hell with that!." he said.  He's no gym rat – he's just another person who's voted for quality of life...

I've often heard it said that the day you don't want to drag yourself to the gym is the one day that you've got to go.  Regular exercise, both aerobic and weight-bearing, is the only way to maintain muscle mass, strengthen waning stability, and stave off aging.  Along with diet and sleep, exercise is the critical component in managing your aging body.  Don't want to have to use a cane?  Go to the gym...

And speaking of ego, if you're not used to needing help, then swallow some of that long-held pride and let friends and family give a helping hand.  It's all about common sense – and good management...

Chinese Love (and Law)

In the NY Times blog The New Old Age, there was a post yesterday about laws recently enacted in China, mandating that the children of aged parents visit at least a certain number of times and stay informed about the status of their parent's well-being.  The law also says that the children need to be responsive to "the spiritual needs of the elderly", and that punitive measures await  those who don't comply.  I'd written about this myself (The No Responsibility Zone) and at that time I imagined businesses springing up overnight to represent the adult children of the very aged, much like talent agencies do in Hollywood.  They'd threaten the parents with: “Listen, if you want to have direct negotiations with your kids, you’ll have to bequeath them an extra ten percent…in advance."

It's barely a joke... 

Are legal remedies the only way to insure that people oversee the care of their aging parents?  China made it plain that they think so, and enacted laws that obligate adult children to be involved in the care of their parents.  Past generations used to routinely take responsibility for the elderly.  Grandma or Grandpa lived with you, and though it was sometimes a bit of a strain, you didn't think twice about it.  It was just something you did – the normal course of business – before nursing homes became an industry, and a good investment for cut-the-corners profiteers. 

Read The New York Times blog on aging issues, The New Old Age, at: http://newoldage.blogs.nytimes.com/

Read my blog about China's new laws in "The No-Responsibility Zone" at http://jamielegon.blogspot.com/ and see more posts at jamielegon.com

Things To Come

It's getting harder and harder to read the news without becoming depressed.  While the general population is quickly aging before our collective eyes – mainly due to improved medical care and health habits – the punitive aspect of growing old without any safety net is growing exponentially.  Just this week, the San Francisco Chronicle reported that because of budgetary considerations decided on and passed by the California legislature back in 2011, organizations that accept Medi-Cal disbursements from the government are going to be hit with millions of dollars in payments retroactive to past years.  As an example, the Jewish Home of San Francisco, a venerable institution that supplies care to the aged, is, because it relies on Medi-Cal payments to stay afloat, going to be hit with an 11 million dollar payment for 2011 alone, simply because it accepts Medi-Cal disbursements!  These Medi-Cal payments are the only lifeline for many elderly people without means.  This is insane, and says much that is negative about our society, one in which rich people come first and foremost...

I'm not rich (or even close), and I have to admit that I'm greatly worried about my old age.  We Americans have always prided ourselves as living in the greatest country in the world, but I'm afraid that's just not the case, my friends.  We are shooting ourselves in the foot, unable or unwilling to recognize that one of those famous "inalienable rights" ought to provide senior citizens with respectable old-age care.  Various European countries have figured this out, but apparently we can't.  In America's profit-is-all-that-counts system, the powers that be (and we are to blame for electing them) just figure, "What the hell – let's just let all those poor, old people drop dead!  It's so much easier that way!"

If you're old, and without money, make no mistake: you are in serious trouble.  Count me as one of them...

Death is a Natural Part of Life (and it's okay to talk about it)

Paula Span, who writes for the New York Times blog, The New Old Age, published a blog post the other day about groups, called Death Cafes, springing up all over the country that meet, not for end-of-life planning or grief support, but rather to discuss death philosophically:Why do we fear it?  What do we think it's like?  And maybe most importantly, how does our view of death inform the way we go about living our lives?

I read some years ago about the various café mortel (mortal cafe) that were being started in France and Switzerland for people to discuss their philosophies about death, and these groups in the U.S. are offshoots of that same basic idea.  Ms. Span's blog post is, I think, important reading for just about anybody, if for no other reason than that the subject of death, much like eldercare, is so completely taboo and riddled with superstition.  People often feel that talking about death invites it closer, just like my parents, who thought that if they even made out a will they'd keel over and die right on the spot.  I think these are necessary forums – necessary because death, like taxes, is inevitable.   It seems to me that when we confront the subjects that we're most afraid of, they take on less of a sinister overtone.  People have often said to me that, since death is inevitable, why talk about it?  I respond by saying that since it's inevitable, why not demystify it and explore our thoughts and feeling about it?

For me, this brings up what I consider to be the bigger issue: quality-of-life.  In this blogger's view, our society, because of equal parts guilt and liability, often extends people's lives far beyond any reasonable bounds.  Maybe groups like the Death Cafe will allow people to talk about death in a way that isn't superstitious, and allow us to look at death as a natural cessation of life function, particularly in cases where the lack of a real quality-of-life makes life not...well...life anymore.

Read Ms. Span's piece at: http://newoldage.blogs.nytimes.com/2013/06/16/death-be-not-decaffeinated-over-cup-groups-face-taboo/  and follow this and other resources at www.jamielegon.com/resources

parenting your parents and kids at the same time: the eldercare sandwich

My father was almost ninety-one when my mother died. I was about fifty at the time, and my son was a little over two years old. My father, who had been a demanding and combative person his entire life, was now suddenly without the checks and balances provided by my mother's calming presence. He was an angry bull unleashed in a china shop – everybody was either a son-of-a-bitch or a no-good dirty bastard.  My mother, the buffer zone, was gone, I lived over 700 miles away, and my only brother lived in France.  Can you hear the sounds of crashing crystal?...

My father was almost deaf, so phone calls were always an ordeal.  Sometimes things were crazy and sometimes things were calm, but either way phone calls with my father were always loud, and sometimes anxiety-producing. Growing up in our small house, my son was an unfortunate witness to almost all of it. He heard it in the house, and saw it when we went to visit my father.  Exposing children to angry relatives like my father  probably constitutes some kind of child abuse, and though some of the crazy conversations and angry moments make for good comedy in the re-telling, they weren't funny at the time...

I was taking care of two people who were on opposite ends of the spectrum, each one more than forty years in age from me.  I was in a world between the very, very old and the very, very young, where my little son often exhibited great maturity while my aged father frequently acted like a baby...

Parenting the very young and the very old at the same time is interesting: while both need constant attention, the young child is (mainly) easily managed while the aging parent can often be very resistant. The adult child of the aging parent who still has at-home children often has life and death issues entering into their daily life.  Accidents, sickness, and encroaching infirmity are par for the course when caring for the aged parent, and in my house my son was far too aware of what was happening with my father and his regular emergencies. Elderly parents usually require increasing amounts of help, and even the youngest children can sense, if not plainly see, the difficulties that are involved.  Sometimes I think that my son, in some ways, grew up too fast...

I was an Oreo cookie in real life...

Visit my website at http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, engage in my conversation on aging, or to contact me directly...

my two cents on eldercare

Here’s my two-cent, eldercare rant:

Assisted or skilled care giving isn't just a job – it's also a calling.  Caring for those who can no longer care for themselves is, by its very nature, a sensitive issue.  You're dealing with increasingly vulnerable seniors whose self-esteem and self-respect are challenged every single day by the fact that they can no longer do for themselves what they were formerly accustomed to doing throughout their lives...

Unfortunately, far too much of the actual caregiving is done by often disinterested aides and assistants who are underpaid, under-trained, and who are frequently just passing through on their way somewhere else – transient workers of whom there are few who see healthcare as a desirable career path.  Many aides and assistants seem to think that it's better to have any job, however distasteful it might be, rather than none at all.  But it's not just about changing clothes, cleaning their rooms, or getting an aged person in the shower – it's about the tact, thoughtfulness, and sensitivity that one employs when doing it...

The rigorous oversight needed to control the private caregivers who cut too many corners is virtually nonexistent. Care for the aged needs to be a nonprofit, privately run program that is part of a completely revamped, not-for-profit, health care system. The whole health care industry needs to be run in the same way successful nonprofit foundations are run—controlled costs, clear rules, and strict regulations governing conduct and operations.

High-level assisted or skilled care should be available to everyone, not just the wealthy...

3 more orgs for seniors and their caregivers to know about...

   These organizations are all dedicated to the welfare of the senior population, and all cover different ground. The three organizations named in today's post are dedicated to areas of expertise different from ones I've mentioned in previous posts.  All of them will help you get started in finding out about the issues that concern your family the most.  All of the organizations that I write about on Real World Aging can also be found on the resources page of my website (jamielegon.com)...

1.  Meals on Wheels  http://mowaa.org  Meals on Wheels is a lifesaver for many people.  The elderly former butler who's a member of my health club, and a major gourmet and intellectual, absolutely raves about them – and they are a must for anyone who has difficulty getting food for themselves. They're already an institution, but just in case you don't already know...
2.  National Association of Social Workers (NASW) http://www.naswdc.org  With 145,000 members, NASW is the largest professional social worker organization in the world.  For the person who can remain in their home but still has various needs, the NASW site provides, among a great deal of other relevant information, references for local care managers, social workers, therapists, etc...
3.  LeadingAge (formerly  the American Association of Homes and Services) http://www.LeadingAge.org  LeadingAge is a broad global network of aging services that includes 6,000 not-for-profit organizations in the United States, 39 state partners, and hundreds of businesses.  Their easy-to-navigate website provides information and services to their members for housing, assisted living, nursing homes, home health, hospice care, senior housing and more...

The organizations that I've listed the past two posts are meant only to get you started, to find out from a broad perspective what's currently going on in the world of elder care, and help identify what needs you may have...

Visit my website at http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, engage in my conversation on aging, or to contact me directly...
 

5 elder care organizations you need to know about unless you're rich (or maybe even if you are)

This group of five organizations, dedicated to the advocacy, care and protection of the elderly,  are of special importance.  These are the groups who not only help individuals, but also maintain a voice for the elderly that reaches all the way to Capitol Hill.  Take a look at them – they could save you a lot of time in the present, and possibly, protect and defend you in the future...

AARP www.aarp.org - AARP (formerly the American Association of Retired Persons) is at the top of my list.  Based in Washington D.C., AARP provides benefits, services and special products for people over age 50, from supplemental medical and long-term care insurance to discounts on prescription drugs, and a whole lot in between.  They are one of the most powerful lobbying voices on behalf of elderly people in the United States and currently have almost 40,000,000 members...

The Consumer Voice http://theconsumervoice.org - If you want to know what your rights are as a long-term care consumer, you'll want to know about The Consumer Voice (formerly NCCNHR), one of the most important sources for long-term care advocacy, education and policy in the United States.  Nearly 40 years old, they are a watchdog in the fight against inadequate nursing home staffing, and they constantly advocate for the rights of residents and their families...

The National Council on Aging (NCOA) http://www.ncoa.org/  I didn't know until recently that NCOA is actually the first charitable organization (founded in 1950) that provided a voice for older Americans.  A nonprofit service and advocacy organization headquartered in Washington, DC., NCOA works as a kind of umbrella organization, bringing together thousands of community organizations, business, and other nonprofits in order to help seniors citizens improve their benefits, maintain good health, and remain active.  They are particularly concerned with the vulnerable and the disadvantaged...

FATE (Foundation Aiding The Elderly)  FATE is dedicated to protecting the elderly from abuse, as well as advocating for the reform and regulation of the laws governing the nursing home industry.  They are a privately funded organization and do not charge for their services: http://www.4Fate.org

Audient http://www.audientalliance.org/ Audiology is the poor stepchild of elder care who often has to take a backseat to the omnipresent life and death issues of the elderly.  But from my point of view, life without quality of life is a living death, and those who can't hear are effectively cut off from a good piece of what's going on in society.  Audient is a national nonprofit hearing care alliance of hearing health care professionals, suppliers, and others whose aim is to bring quality hearing aids and related care to low-income, hearing impaired, people.  My father was hearing-impaired, and I cannot express how much that issue affected his entire life, particularly at the end when his hearing was almost gone and the hearing aids he needed were too expensive for me to afford...

Check out my website at http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, engage in my conversation on aging as well as other topics, or to contact me directly...

5 strategies to help you and your aging parents stay sane

Losing your independence is hard.  I found that, at least half the time during my parent's old age, they were impatient with me when they were actually angry at themselves.  Why?  Because they couldn't perform at the level they had long grown used to, and they were embarrassed by it.  Here's a few reminders to keep in your back pocket... 

1.  Never Treat Your Parents Like Children-Although it becomes easier to do as your parents age, treating them as if they need child-like supervision will backfire every time.  Remember–they used to be your boss.  After that, taking orders isn't so easy.  Be gentle...

2.  Let Them Do As Much As They Can Do- Many adult children think they're helping their parents by doing everything they can for them, but you can easily overdo it.  Physical and mental activity helps older people fight problems like cognitive decline, decreased mobility/stability, and other age-related conditions...

3.  Listen- Sit back and hear how they're thinking about things-their health, their routine, their fears, etc.  If you have an open ear and an easy-going attitude, it'll allow your parents to open up to you on their own, without extra prodding.  If they feel that they can express themselves freely, you'll get a better perspective on how to deal with their changing state(s) of mind, ...

4.  Don't Be Judgmental- While you're listening, don't always try to come back with advice–it might make your parents think that you are feeling a burden to take care of them.  Nobody wants to feel like they're a burden, and if you're constantly offering them advice, it could make them stop confiding in you.  Be as laid-back as you can... 

5.  Be Patient-It was easy to be patient with my mother, a nice lady who had a good word for almost everyone.  Not so with my father, who was loud, demanding, and easy-to-anger.  But there's no other way–impatience just leads to unnecessary confrontations and lots of hurt feelings.  And of course, your parents will be getting slower and their reaction times will naturally decrease with age anyway.  It's no big deal–the only thing that counts is their safety.  Let them take their time, and you should remember to take yours.  They are merely the children and young people of yesteryear, and so don't forget that you're next in the aging line (if you're lucky)...

Check out my website at http://www.jamielegon.com to see an excerpt from my book FEET FIRST–Riding the Elder Care Rollercoaster with My Father, engage in my conversation on aging as well as other topics, or to contact me directly...

5 things to check when evaluating a nursing home for your aging parents

Putting your parents in a nursing home, assisted or skilled, is one of the most difficult things you can do.  And because it's easy to let the emotionality of the situation overwhelm you, here's a few simple things that will help you get started on making up your own checklist of what you want and expect from your nursing facility:

1.  THE SMELL
Don't visit nursing homes when you have a cold-you'll need to have all your senses working.  If you detect the faint odor of urine or other bodily functions, run in the other direction.  It usually means poor sanitary standards, possibly due to the home being understaffed.  You don't want poor old Mom in a home that's short on attendants.  Find out how many aides are on at any one time. Also, be aware that the use and overuse of strong disinfectants can exacerbate allergies, emphysema and other diseases of the respiratory system, particularly in the elderly.  A good nursing home will have a well-maintained ventilation system, effective sanitary procedures, and air that smells (relatively) fresh and clean...

2. THE LAUNDRY
Don't laugh-this is a big deal.  You wouldn't want to have the last vestiges of your  parent's wardrobe manhandled or lost.  Might upset old Dad, who still sees himself as fifty years-old (like my father did).  For many elderly people, clothes remain a form of expression, and feeling properly dressed helps make them feel like they're still in the world.  Ask whether the home does their laundry on-site, or sends it out to an industrial laundry service.  Laundry services are handling dozens, if not hundreds, of clients (other homes, businesses, etc.), and trying to find a lost article of clothing, or get restitution for ruined clothes, is close to impossible.  If the nursing home does their laundry on-site, they can better watch over the resident's apparel...

3.  THE FOOD
When visiting a home, make sure you sample the food that they're serving that day.  If you don't find it appetizing, you can bet your parents won't either.  Make sure to inspect the kitchen-look at its cleanliness and be aware of the odors emanating from it.  Check the upcoming menus (many homes have them planned well in advance) to see what kind of variety they provide.  If you see the same items again and again, that's not a good sign. And don't be shy-ask the residents if they like the food, and if possible talk to other adult children who might be there.  The diet your parents are served will affect their mood, their physical conditions and maybe even your own life...

4. SECURITY
This is, of course, especially important for people whose parents have dementia, Alzheimer's disease or are otherwise cognitively impaired.  But unless you're a security expert and can evaluate their system (yeah, right) the real key is having attentive staff and good 24/7 management.  Knowing the home's daily schedule should give you an idea of how and when their shift changes happen.  It's often during the shift changes that "accidents" occur...

5.  REFERENCES FROM REAL PEOPLE
Don't be shy.  Try to talk to people who might also be visiting while you're there. The nursing home will give you a billion references, but don't bother with them.  Those are references that have been carefully culled from their client list.  It's better to search the Internet and see what, if anything has been written about them.   Don't just go with your gut instinct, make sure you do your research...

Success is relative, and greatly depends on what conditions your parents are dealing with-no complaints from them means fewer sleepless nights for you, and that alone will constitute a certain measure of success.  There are no one-size-fits-all solutions to these problems.  Everyone has a different set of needs and desires, and only you can determine for yourself and your parent(s) what is the best course of action...

Check out my website: http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, engage in my conversation on aging, or contact me directly...
  

The older father...

I've been a full-time father and primary caregiver for the past thirteen years.  I was almost 48 when I had my son, and by that time in my life I didn't want to miss a minute of it.  Work no longer had any meaning for me, and though I didn't really have enough money, I decided to cut back on my work schedule anyway.  Having a child was, for me, the most profound experience of my profligate Hollywood life, and the first and only event that gave it any meaning.  Little else in my life before him had any resonance at all...

So... here I am.  I've spent a large portion of what I thought were my "savings" to bring him up the best way I possibly could, and tried to give him all the things that I thought (fingers crossed) would help him reach his maximum potential.  I'd often made choices in life for other-than-financial reasons, and I optimistically thought everything would somehow just work out. But I didn't count on 9/11, the Great Recession, or the death and retirement of almost every production client that I had...

I don't have any regrets.  Having a child is, without a doubt, the most important, insightful, joyous, loving and charming thing that I've ever done or ever will do.  But I'm deeply afraid of becoming a burden to my son in my old age...

I'm pretty worried, and frankly, who wouldn't be?  I was ridiculously naive-the cost of living and raising a child has been so far beyond my estimates that it's laughable.  Sometimes I wake up  in the middle of the night, wondering what will happen to my family and I in my rapidly approaching old age.  I'm almost a senior citizen with a thirteen year-old son, and I haven't made a significant amount of money in over 5 years... 

In the end, it doesn't matter. The only thing that really matters is the welfare of the young man who, seemingly, went to sleep the night before as the little boy who called for his daddy but woke up in the morning taller than his 5'7"mother.  Given how fast it's going, I think that the time I've spent with my son is far more valuable than any amount of money I might have made.  My particular job would have taken me away for weeks and months at a time, and deprived of me of the only thing I ever really cared about.  That's why I did it the way I did it, and quite honestly, I'd do it all over again...

Check out my website: http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, follow my blogs, or to contact me directly...

Talking about money...

One of the biggest mistakes I made was in not forcing my parents to talk about their finances. The clues were there but I chose to ignore them.  My parents had already, on several different occasions, asked my brother, Gary, and I for money.  Whenever we asked what they needed it for, they wouldn't tell us. "If you have to know what it's for, then forget it" they said, "We don't want the money."   We gave it to them anyway, hoping that whatever problems they had would somehow go away.  We didn't want to deal with it-my brother had a wife battling cancer and his work, and I was in production all the time while engaged in my bachelor social life...

While it's not abnormal for parents to continue the lifelong habit of shielding unpleasant or embarrassing information about themselves from their children, it is still severely counterproductive when parents withhold information from children trying to assist them in planning for old age.     Caring for aging parents takes a village-children, friends, relatives and professional caregivers- who all play a part in nurturing and protecting those who can no longer care for themselves. But it's really difficult when the people who need help don't want it, and who also happen to be your parents...

After my mother's death, my brother and I went over their accounts and discovered that they had been using one credit card to pay for another, using over 30 cards in all to keep themselves afloat.  It was a disaster-they were over $230,000 in debt and my father was forced to declare bankruptcy.  It was incredibly painful for him because, after a lifetime of working and making money, declaring bankruptcy represented an attack on his own sense of self-worth.  Sadly, none of it had to happen the way it ultimately unfolded...

Much of this occurred during a period when Gary and I weren't on speaking terms, and I think that if we had been talking, we might have helped each other to more clearly see the warning signs and avoid the tangled mess that emerged after my mother's passing.  Acting in concert would have made it much that much harder for my parents to hide anything...   

But there's only so much anyone, even the caring child, can do...

I often find myself writing about the mistakes that I've made. Some people have told me that it sounds negative to them, but I think that they are missing the point.  The fundamental truth is that if we can't be brutally honest with ourselves about our own mistakes, then how can we ever hope to improve on them?  Positive thinking is great, but honesty about our own behaviors, good, bad and indifferent, is even better...

Check out my website: http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, follow my blogs, or to contact me directly...

Staring into the abyss

I know people who say that they know people who claim to actually know people who have no aging challenges.  Those lucky devils who haven't had to deal with any of aging's complications: they've got plenty of money, relatively good health and have kids who who are attentive to them.  Of course, I myself don't actually know anyone like that, but that's what I've been told.  However, for most of us, the challenges of aging are endless...

Though some of us have money, few have enough cash to completely insulate themselves from the staggering costs of aggressive health care when faced with the need to fight for their own survival.

I know people who've wondered whether or not they should fight for life or just give in and let themselves die.  Why?  Because they're petrified of bankrupting themselves and ending up alive but wishing they were dead-Oh my God, we've spent all our money!!   They sometimes feel caught between a rock and a hard place because in a lot of cases, their main motivation was the desire to leave something for their kids, and now they're wracked with guilt over needing their own money for themselves...

People with no money are at the mercy of a merciless system that measures health care in terms of profit and loss.  Personally, I've spent a good deal of what I thought were my savings on the care of my late father, the raising of my now teenage son, and just trying stay abreast of inflation.  For me, being Mr. Mom was a choice made for other than financial reasons, and I wouldn't change a thing- the parenting experience is, in my opinion, the best and most important thing you can do in life. But I'm more than a little nervous about what might await me in my old age...

The antidote?  I’m afraid there is none.

But careful oversight-having your children, relatives, friends, or neighbors agree to advocate for you-is, with or without money, the key.  Watchful eyes force health care providers to adhere a little more closely to the good practices that they're actually supposed to be following anyway.  All too often, in their zeal to cater to "the bottom line", many providers just don't...

It embarrasses me when my French family and friends remind me that all the health care in France is provided for by their system, while we Americans still have a hodge-podge, crazy-quilt, money and profit-first medical and elder care system where, without significant ways and means, people can simply fall through the cracks...

That’s a system?

Check out my website: http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, follow my blogs, or to contact me directly...

Long distance care for the parent who's alone...

I was producing a show and couldn't visit very often-and even when I could, every 1200 mile round-trip had to be done in a weekend so I could be back on the set by Monday at 6 AM.  I would be thoroughly trashed after the trip, and my crew would wonder why I was in such a daze...

Everything I was trying to do for my father seemed like it was just a day late and a dollar short.  I drove 1200 miles to buy him groceries and clean up his house, but it was like trying to stop an avalanche with a shovel.  Filling prescriptions, going to doctor's appointments, doing laundry and even taking out the garbage were now major obstacles.  Despite his salesman's ability to occasionally charm people, he was increasingly disconnected from society-at-large by his often irascible nature and a lifelong lack of patience. And without any companionship and few friends, he tended to react angrily to things, as if he didn't have to adhere to any social norms.  He was a fighter from Brooklyn, N.Y. his entire life, and without my mother's sociable personality to provide a buffer zone, everything was falling apart...

There are choices to make when your parent is living, or trying to live, independently. My father choice was clear: he'd rather drop dead on the spot before depending on anyone else, and for him, accepting help meant dependency.  In his case, this was in large part about vanity, and I found myself in a constant battle with him about what was, or wasn't, in his own self-interest.  I could never make him understand that it would be better for everyone if he could adapt to having help.  And sorry to say, my worst fears were realized.  If he had been more willing to utilize a little bit of assistance (from doctors and nurses to friends and neighbors), he would have been able to continue to live independently for far longer than he actually did...

My family and I ran ourselves ragged trying to help my father, who wouldn't accept help from anyone but us.  And the combination of not being able to drive any longer and being unwilling to accept outside help turned me into a long distance caregiver-a job impossible to do and one in which almost nobody ever wins.  Long distance care, particularly for those over 90 years of age, is a ticking time bomb-too much can go wrong.  Without attentive help of some kind, bad things start to happen to the elder parent living alone.  And they did indeed happen to us.  More on this to come...


Check out my website: http://www.jamielegon.com to see an excerpt from my book FEET FIRST-Riding the Elder Care Rollercoaster with My Father, follow my blogs, or to contact me directly...

Driving (me crazy)

Other than the death of my mother, taking my father's car keys away changed my life more than any other single event. Though my father had been successfully driving for seventy-five years (at this point he was about ninety-one), during one of my visits his neighbors told me that his driving had deteriorated significantly, and that he was now a danger to himself as well as to other drivers .  I had no reason to doubt them-his vision had been getting worse, and when he went to the eye doctor to investigate, the doctor diagnosed him with macular degeneration...

I asked him to please give me his keys and not drive anymore.  "Like hell I will!!!" I responded that I was concerned about his safety-but what I couldn't tell him was that his neighbors had already alerted me to his diminished driving skills. If he knew that they had exposed him, it could easily escalate into an all-out war between him and them.  "Leave me alone!  There's nothing wrong with my driving!" he screamed...

My father finally did turn the keys over to me, but not without endless discussion and some fairly bitter arguments.  In fact, he only gave in because I wouldn't give up-but there was no win in this situation.  He was annoyed by the elder bus service I contracted for him ("They're never on time!"), and the temperature in the desert climate of Palm Springs often rose above 100º, forcing him to be outside in extreme temperatures that sapped what physical strength he had left. But he didn't care-he was a fighter, and he was  determined to fight until the end...

When are you turning into a bad driver?  If you have trouble timing the approach of other cars when you're in an intersection, or sometimes fail to see them altogether, then it's time for, at minimum, an online refresher course.   If you're taking medication, be aware that any prescription medication can impair your driving, some more than others.  There's a great website, http://roadwiserx.com/ that will tell how your meds can effect your driving.   Glasses aren't always enough to make the difference in your driving-a 60 year-old needs ten times as much light as a 19 year-old.  As you age, doing a majority of your driving during the day makes a lot of sense.  If you find yourself forgetting your destination, mixing up the gas and brake pedals, or having difficulty seeing traffic signs, you might have some kind of cognitive impairment.  There's an online course at https://www.drivesharp.com/aaaf/index that could help cut your crash risk. But first you've got to ADMIT it...and get the help the you need, both for you, and your family's, sake...

Check out my website: http://www.jamielegon.com to see an excerpt from my book, follow my blogs, or to contact me directly...

The No Responsibility Zone

In the Saturday, April 6, 2013 e-edition of the Toronto Star, there’s an article about China that details a new law, effective July 1, allowing aged parents to sue their adult children for not visiting them or attending to their welfare. With China’s elderly population expected to grow to almost 500 million within the next 40 years, there is pressure to curtail the looming health care costs of a soon-to-be bulging population of elderly Chinese. The government’s concern is that many of the economic gains now enjoyed by the Chinese people would be erased under the burden of what would be, by then, the enormous medical costs attached to such a sizable population.  They’re not wrong…

 

What if Americans were legally required to oversee the care of elderly parents?  Insurance companies, now paying out more and more every year for our rapidly expanding elderly population, would likely be paying out less.  Even insurance companies, usually immune to consumer sentiment, would recognize the good public relations inherent in passing a little of their savings back to the customer.  I imagine businesses would spring up overnight to represent the sons and daughters of the elderly.  They’d be like Hollywood agents, telling the parents: “Well, if you want to have direct negotiations with your kids, you’ll have to bequeath them an extra ten percent…in advance!”…

But what if you couldn’t have someone else deal with your parental care situation.  For many cultures around the world, taking care of the elderly was taken for granted-it was something that you just did.  When I was caring for my father, my friends told me what a good son I was, but it just didn’t compute.  Half the time I was either angry, frustrated or anxiety-ridden.  I didn’t have enough money to put my father somewhere good enough to ease my conscience, so all I could really do was to try and pay attention to him.  It turned out that paying attention was at least half the battle…

Isn’t it more than a little embarrassing to have to be ordered to watch over our parents? But the truth is that solving the elderly care problem is like solving drunk driving.  If you really put people proven to be driving while intoxicated in jail for an absolute minimum of 5-10 years and hit them with a million dollar fine, drunk driving would disappear overnight.  Hundreds of businesses would spring up to drive people who were drinking, and the death rates on the highways would be cut in half.  But cleaning up drunk driving using Draconian penalties is almost impossible-too many folks (many in positions of power and prestige) want to be able to drink and drive.  Are legal remedies the only way to insure that people oversee the care of their aging parents?  China thinks so, and in a few months there will be a law obligating adult children to look in on their aged parents.  I once read that Confucius said that only the supremely wise, or the supremely ignorant, never changes.  I can’t even imagine what it would be like if we enacted a similar law in the United States.  In my mind,  I see a parking sign in front of a nursing home that says “THIS IS A NO RESPONSIBILITY ZONE”…

See the article in the Toronto Star at:(http://www.thestar.com/news/world/2013/04/06/chinese_parents_can_sue_adult_kids_for_not_visiting_enough.html)

Take a look at my book about elder care, Feet First-Riding the Elder Care Rollercoaster with My Father (available at barnesandnoble.com and amazon.com) and my blog at http://www.jamielegon.com/

Stop Staring At Your Screens...

In the January 2013 issue of The Informative Report (http://theinformativereport.com/2013/01/personal-robots-to-assist-the-elderly-people-in-an-australian-university), Professor Rajiv Khosla talks about a study he’s doing in Australia that uses personal robots to assist the elderly.  Some of the robots even sing Hey Jude.

This study concentrates primarily on the issues of emotional well-being, not technology.  But the whole idea of technology replacing humans is a little disturbing. Not because there’s anything inherently wrong with a robot that surfs the Internet, checks your e-mail or orders your groceries. It just raises the question of whether or not we’re trying to replace ourselves with technology.  When my father had to go into an assisted care facility, the quality of his care was wholly dependent on his being watched over and continually reevaluated and reassessed.  No robot can do for your mom or dad what a good elderly care provider can do-analyze an elderly person’s mental acuity and physical stability.  When I read this report, I kept seeing a giant dollar bill resting on a computer chip that was being passed from one person to another in an endless line…

How do you care for actual human beings without any humanity?  Have we conned ourselves into believing that human interaction doesn’t count, so now we’re developing robots to do what we ourselves are supposed do?  Is the messy business of elder care just too much trouble for our selfish little lives, where we stare into screens instead of life?  Do you need to stare into your smartphone to look at the event you’re actually attending?

Has technology finally outstripped sanity? Many years ago Einstein said that he was afraid that, with all the new technology coming to the forefront, we were in danger of raising generations of button-pushing idiots.

 There’s a general social depersonalization going on that has grabbed hold of the next generations with a death grip. The profusion of young people on a date sitting in a restaurant but not talking to each other is startling.  Their heads are down while they stare intently at their mobile devices. Is that  considered a date in today’s society?  The answer is obviously, and frighteningly, yes…

It’s pretty well documented that social interplay helps to prevent and/or delay diseases like Alzheimer’s, dementia, aphasia and all the rest.  My father would have told the robot to drop dead because, even though he was the biggest pain in the ass in the world, he craved interacting with other human beings, not machines.  Don’t most people?  I personally don’t think there’s anything wrong with technology-I’ve got multiple computers, smartphones, music recording equipment, cameras, cable TV boxes, etc. etc. in my house.   But come on kids and caregivers, stop staring at your screens…

The Loss of Independence

My father had retired to the den after lunch, and as his snoring began to rattle the walls of my parent’s apartment, I rose from the table and asked my mother if I could help her clear the dishes.  “Just sit there, for Chrissakes!” my mother snapped…

I had asked the wrong question.  Though I had the right intentions, I didn’t recognize the depth of my mother’s sensitivity about her increasing frailty. In my zeal to be helpful, I ignored the fact that she needed to prove that she could still handle her normal duties.  She was used to being Big Mommy, Queen of the Kitchen, and she wasn’t able to tolerate anything less from herself…

It’s well known that exercise is a tonic for many physical ills, but it was a foreign language to my parents: “It’s not for me-not my cup of tea” my father always said. They only time they got their heart rate up was when they argued with a waitress about a restaurant bill.  Walking was California-style: to and from the car, or in and out of the grocery store.  And with housework as their only exercise, they slowly became more enfeebled and unsteady.  Every time my mother had to drag their laundry down the open-air hallway to the laundry room in 110° Palm Springs heat, it took a little more out of her than she had to give… 

For my mother and father, facing the cruel reality that they’re just not the same people that they once were, was crushing.  Overly prideful, they couldn’t admit that they needed help, and never adjusted to the fact that needing help was actually okay.  My simple question of assistance with the dishes spoke more to my mother about growing old than about helping in the kitchen.  And there were many more difficulties soon to come due to their gradual, but inexorable, loss of independence… 

Check out my website: http://www.jamielegon.com to see an excerpt from my book, follow my blogs, or to contact me directly...