Aging Well Care Management
Helpful tips for family caregivers
In this issue we talk about ways to help your loved one stay on track with his or her medications. We also draw on tips by the Mayo Clinic for helping you through stressful times—you know, when life gives you lemons. And last, for those who have a special needs sibling, we offer suggestions to help you address his or her needs should your parent no longer be able to provide care.
Is Dad taking his meds "as directed?"
A recent national survey suggests that every year nearly half of adults taking prescription medications for a chronic condition make errors in taking their meds. The most common problem areas:
- Memory: Forgetting to take a medication
- Organization: Failing to order a refill in time and running out of a drug
- Convenience: Being away from home and missing dose(s)
- Side effects: Experiencing unpleasant reactions
- Cost: Affording the drug
Any deviation from what’s prescribed is risky. This is especially true for older adults in fragile health. Here’s what you can do to support your loved one in following the doctor’s orders.
- Develop and monitor routines. A multiday pillbox may be all that’s necessary to resolve memory issues. Bring one as a present, along with your promise to keep the box filled and refills ordered on time. If more active reminders are needed, consider an automated, locking pill dispenser or a program that sends an alert when a dose is needed. See our earlier article about remembering to take medications.
- Collaborate with the doctor. When you visit your relative’s primary care doctor, bring in every prescription and over-the-counter (OTC) drug being taken. Review the purpose of each drug. Are all of them still needed? Can the treatment be simplified? Perhaps there are alternatives that involve fewer doses.
- Report problem side effects. Provide details about side effects that you and/or your relative have noticed. Simple changes in diet or the time a med is taken may help.
- Address cost issues. Let the doctor know if cost is a problem. A generic version may be available, or the doctor may have samples. Price shop among local stores for prescription and OTC drugs. Consider mail order.
- Connect with the pharmacy. The pharmacist can provide easy-off lids, large print on labels, and drug information. They can often help clarify doctor’s orders and offer advice concerning side effects.
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Make lemonade. Really?
“When life hands you lemons…” Well, you know the rest. While this adage can feel a bit trite, there is a certain grounded wisdom to it.
In fact, researchers at the Mayo Clinic have been studying stress and coping strategies. It turns out there are coping skills that are effective, and others that are not. Often the worst stress comes from the poor self-assessments we add on to the situation.
Especially for circumstances when you have very little ability to change what’s happening—the real lemons—here are strategies recommended to help you effectively adapt and accept:
- Stay positive. Train yourself to notice what’s going well or what feels good. Put your mind’s spotlight on the good. “Dad enjoyed watching the ball game today. He laughed just like old times.” Give yourself positive feedback for your accomplishments, no matter how “small” they seem.
- Forgive. It’s not that you have to forget an injustice. But carrying around the anger associated with it becomes its own heavy burden. Feel the emotion and then practice letting it go. If you don’t, the resentment you carry will damage you far more than the person did who treated you unfairly.
- Accept imperfection in yourself. You don’t expect perfection in others. Extend the same graciousness to yourself. Give each task your best attention, and then accept the outcome without harsh self-judgment. Remind yourself, “There are only 24 hours in the day. I did my best, and that is all anyone can do!”
- Find the lesson and move on. Dwelling on the negative takes energy and achieves nothing. Are you constantly revisiting a decision you made or an action of someone else’s that was not the wisest choice? Take some time to constructively reflect on what you could do differently “next time,” and then move forward.
- Promote perspective. Imagine yourself some years into the future. Looking back on today, does what you’re anxious about still seem important? If not, don’t let it run your life. Save your energy for issues that WILL matter five years from now.
What about your special needs sibling?
Is your aging parent still caring for your disabled brother or sister at home? Perhaps this care arrangement has worked fine for decades. But with your parent’s aging, it’s not too soon to start talking about your sibling’s future. Preparing now eliminates the potential for crisis and unnecessary stress.
The basics of care. The “future” can come very suddenly. If your parent has a health emergency, it will likely put you in charge. Assemble a binder to organize your sibling’s information:
- Personal identity. Birth certificate and social security card.
- Contact information for physicians, health providers, caseworkers, or special advocates.
- Daily routines. What happens and when (at home, school, work, place of worship). How much help is needed and from whom. Favorite pastimes and usual responsibilities. Transportation or other community services involved. Respite care providers. Friends’ names and contact information.
- Personal preferences. Special dietary needs or conditions. Special clothing or personal care needs. Best places to purchase these items.
- Special challenges. The kinds of settings that might be problematic. Best techniques for calming or distraction.
- Medical needs. Current medication list with details about drugs and dosage. Current health insurance information. Complete medical history.
- Financial and legal arrangements. Income sources and management arrangements. Account information for banks, trusts, investments. Copies of legal documents, including powers of attorney or guardianship appointment, if applicable.
A plan of care. Ask your parent to write out plans made for your sibling’s long-term future care. Review where he or she will live. Talk about who will be in charge of care management. How will care be financed?
Legal legwork. If your sibling might receive an inheritance, life insurance distribution or other gift money, consult an attorney. Such generosity may jeopardize important public benefits. Look for an attorney with expertise in “special” or “supplemental” needs trusts.
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