Chapter 2: Weighing the Options

She wants to stay in her house.  Her preference was made clear from the time she was widowed.  She does not want to move.  But can we keep her safe and keep her well cared for in her house?

I cannot begin a discussion on options for providing care for an elderly family member without discussing the topic of elder abuse.  Per the National Center on Elder Abuse, Bureau of Justice Statistics, 5,961,568 elderly persons were abused in 2010.  That’s 9.5% of the elderly population that year.  Fifty-eight percent (58%) of these cases involved neglect – the main problem we were trying to solve.  Twelve percent involved financial exploitation – a problem we were keen to prevent.  Mom needed what little money she had to pay for her care for the rest of her life.  We didn’t want to provide any unwanted opportunity for anyone – no matter how well meaning – to shatter her financial integrity.

Family discussions on providing better care for Mom revolved around three major options.

Option 1:  Find a family member or a college couple to move in and care for Mom. 

Pros:  Free rent in exchange for care would be the least expensive option.  Mom would be able to stay in her house.

Cons:  The person/people in question would likely not be professional caregivers.  And as much as we would hope to be able to screen a potential care giver, the opportunity for this type of caregiver to commit a form of elder abuse is quite high.

Option 2:  Pay a professional caregiver

Pros:  The person or company providing the care would be trained and licensed.  There would be a legal recourse if elder abuse were detected.

Cons:  It’s very expensive.  Caregivers charge an hourly rate; rates are higher if 24-hour care is needed.

Option 3:  Assisted Living

Pros:  24 hour professional care in a setting where she would not be alone.   We were surprised to learn that the assisted living facilities we researched were actually less expensive than paying a professional caregiver in her home.

Cons:  She would have to leave her home.

After the family meeting to discuss the options, and after all our research was done, we discussed the options – including the pros and cons – with Mom directly.  We decided together than she would consider assisted living.

Chapter 1: It's Our Turn

I wrote last week’s post, Prologue, to set the stage for this series on caregiving.  Suffice it to say that it is not fiction.

Per Caregiving in the U.S., The National Alliance for Caregiving and AARP 2009, “As our parents age, it’s likely a matter of when, not if, they will need our help.  Nearly 44 million Americans — 1 in 5 adults — are family caregivers for a relative or friend over age 50.” 

It’s our turn.  Dad died in August, leaving Mom alone in their big house.   In the few short months since Dad passed, we have watched as the Parkinson’s symptoms have caused her to lose mobility and feel almost constant pain.  While the informed sources on the Internet tell me that pain is not a classic symptom of Parkinson’s, most go on to say that most Parkinson’s patients do in fact have pain.

These sources also tell me that dementia and depression are symptoms.  We have observed evidence of forgetfulness.  She doesn't remember if she’s taken her pills.  She wakes in the night and becomes disoriented. 

And as for depression, well, I can’t even begin to comprehend the losses she’s suffered in so short a time.  Her husband of over 50 years.  Her mobility.  Her short-term memory.  Her independence.  Who wouldn't be depressed?  Who wouldn't be sad? And who wouldn't, at times, be angry?

Mostly, she is alone.  The regular visitors that came bearing food, gifts, and a shoulder to cry on stopped coming.  She can no longer drive, so she depends on others to transport her – but she really doesn't want to go anywhere.  She no longer feels up to going to church.  She no longer wants to go out to lunch.  She can no longer read, and operating the TV remote has become too complicated for her.  So she spends hours each day alone with her thoughts.

She seems to perk up when she has visitors.  Although she complains that food no longer tastes good to her, she will always sit down and eat something if it is prepared for her and someone else sits down and shares the meal with her.

It is clear to us that she needs more care than family visits can provide.  And she needs it sooner rather than later.  We have some decisions to make.

Prologue

She is frail.  Far more so than when last I saw her.  Was it really only two weeks ago?  Can she really be going downhill this quickly?

I take her arm and walk her to the car.  She weighs so little now that even I can support her easily.  She leans on me as I open the car door.  She sits awkwardly, unsure of how to adjust herself so she is facing forward on the seat.  My husband reaches in from the other side and pulls her toward him. 

It takes both of us to secure her seat belt.  He holds the strap across her body while I fumble for the clasp where the buckle end goes.  Finally we are all situated and back out of her driveway.

She is silent most of the trip.  I can only imagine what she is thinking.  Our destination is two hours from her home of more than 30 years.  We are meeting her youngest daughter, who has made appointments for her to visit two assisted living facilities.

She agreed to this visit last week.  In her more lucid moments she knows that she can no longer live alone.  But the loss of her independence must be unbearable to her.  For as long as I have known her, she has been physically strong, mentally alert, and the proud matriarch of her family.  So much loss – in so short a time.  Her heart must be breaking.

                “I’m as nervous as I can possibly be,” she finally admits.

We emphasize the positive.  You’ll be so much closer to family.  There will always be someone there with you.  They take care of everything.  They’ll make sure you get your medicine on time.  You won’t need to cook.  You won’t need to clean.   She says nothing more.

She is anxious to get out of the car when we finally reach the meeting place.  We are parked around the corner from the door to the convenience store.  We get her walker out of the trunk.

“Let’s walk inside and use the restroom,” I suggest.

She looks at the door and then looks at me.  “It’s too far to walk.”  I help her get back into the car and drag her walker to the front door while my husband drives her over.

Her daughter is there.  We go inside together.  We settle her into yet another vehicle for the second leg of this road trip.  We kiss her goodbye and assure her we’ll see her later that day. 

I turn away, hoping she didn’t catch the tears coming to my eyes.

The Perks of Positive Peer Pressure

My beautiful neighbor who lives in the beautiful house across the street had been working in her beautiful front yard for three days before I finally realized – yesterday – that I really should get out and take the Christmas lights off the front bushes and clean up the dregs from last season’s iris.  Grumbling all the while, I finally got out there, and lo and behold, it really did look a lot nicer once I’d done the work.  And I felt great.

This morning, as I ran with members of the Wasatch Training Group and approached the second aid station – which happened to be at the park where my car was parked – I really wanted to be done.  After all, I reasoned, 10 miles is a pretty good run.  But the rest of the group was continuing south for a total of 16 miles.  I fell in, and completed the 16 miles, which is the furthest I’ve ever run in my life.  And I felt great.  Really, really, really, tired – but great.

Peer pressure often gets a bad rap.  Thankfully, I’m old enough that no one will ever again convince me that wearing a skirt that barely covers my butt cheeks is cool.  No one will ever again convince me that wearing a seat belt is uncool.  I can pick and choose which peer pressure to succumb to.

I’m certainly not the only one who has figured this out.  Groups such as Weight Watchers use positive peer pressure to hold participants accountable for their weight loss.  I am grateful to my friends, neighbors, and fellow runners for providing me the kick start that I need from time to time.  Here’s hoping I can do the same for you someday.

Celebrating International Women's Day

International Women's Day, March 8 is an occasion marked by women's groups around the world. This date is also commemorated at the United Nations and is designated in many countries as a national holiday.  IWD is the story of ordinary women as makers of history; it is rooted in the centuries-old struggle of women to participate in society on an equal footing with men.

This year, on March 8, I will run a relay race with a team of accomplished women – both on and off the race course.  Four of the six of us are over 50 and took up running later in life.

Why didn’t we run on our high school track teams back in the day?  Because, back in the day, there were no girls track teams in our high schools.  Title IX, which states in part that, “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving federal financial assistance...” was signed into law in 1972. 

I graduated in 1974.  Just for fun, I looked at my senior year book and found the athletics pages.  There were a few girls athletics teams featured.  Girls played basketball and volleyball.  Our school had a girl’s gymnastics team.  And of course, we played powder puff football.  There were no girls swimming, golf, tennis, softball or track teams.   My sister in law wasn’t too far off when she said, “there weren’t any sports for me to play so I had to be a cheerleader.”

Thankfully, Title IX paved the way for girls to excel not only in athletics, but in the traditionally all-male math, science and engineering fields that girls were all too often dissuaded from.  Our daughters have equal opportunity to participate.  And while the movement that founded International Women’s Day and the legislation of Title IX are completely separate, I can’t help but think that the brave women who took a stand for equality are smiling down on today’s female athletes.

And they’ll be smiling on team "Girls' Day Out" as we cross the finish line strong.

Emotional Intelligence in the Rental Business

We had a fire in one of our rental units a few weeks ago.  We were fortunate.  No one was injured and the damages did not spread to the other half of the duplex.  Still, the unit was declared uninhabitable.  Of course, the fire was investigated.  It started in the kitchen.  In the end it was determined that the fire happened due to negligence on the part of the tenants.

The displaced tenants, a refugee family of six, found themselves homeless after the three day hotel stay covered by the Red Cross was up.  Their initial plan was to immediately find another place to live, which we agreed with.  We were surprised when they approached us a week later and asked if they would be allowed to move back in after the damage was repaired.  While Dad spoke with my husband through an interpreter, the two small daughters looked up at me with hopeful eyes.  My husband laid out the conditions upon which we would allow them to re-occupy the unit: a new lease, a new deposit, a rent increase, and payment in full for any damages their current deposit did not cover.  They agreed.  We put it in writing.

“This just doesn’t feel right,” he told me day before yesterday. 

He had been at the unit the past two days and was having a difficult time getting the tenants to get their belongings out of the unit so the disaster recovery team could do its work.   He continued.

“They are hoarders.  They’ve made no effort to clean up their belongings, and we can’t have their smoke-filled furniture back in the unit after it’s clean.  I’m just not comfortable with them moving back in.”

“But we told them they could.  We put it in writing.”  I argued

“And after we let them move back in, then what?” he countered.  “I’ll have to do inspections every month, and I’ll probably end up evicting them anyway.”

I argued with him for two days.  My emotional connection with this family had me hooked.  I wanted to help them.  I also felt a strong emotional need to not go back on my word.  This literally blinded me to the fact that allowing them back in would be a poor business decision.  When I finally recognized this, we both confessed to having made the decision to re-rent the unit to them based on emotion. 

This is so very easy to do.  We meet prospective tenants.  We see the wife gush about the glass top stove in the kitchen.  We see children fall in love with their new rooms in our apartment.   And when they don’t meet our qualifications, it’s really hard to turn them away.  But we have to do it anyway.

Thankfully, my husband is more emotionally intelligent than I am when it comes to our rental business.  He contacted the family yesterday and told them to find another place to live.  Yes, it was a difficult call to make.  Yes, they were disappointed.  And yes, it was the right business decision.

Have an Emotionally Intelligent Valentine's Day

Today is Valentine’s Day, and expectations are high all over the world.  The “holiday” of romance, fueled by the flower industry, the card industry, the chocolate industry, and the restaurant industry, promises once again to bring joy and delight to thousands.

And disappointment to thousands of others.  From the pre-pubescents hoping their crushes will put  valentines in their boxes, to the people in new relationships pining for a great display of enduring love, to the people in long standing relationships hoping that this year she/he will remember, romantics are hopeful for the wonderful validation of their worth that comes only through a spectacular remembrance of Valentine’s Day.  And it doesn’t happen.

This is where emotional intelligence comes in.  News flash – Valentine’s Day is a commercial holiday that has nothing to do with an individual’s self-worth.  However, disappointment can lead to a range of strong emotions:  sadness, fear, even anger.  I once got so angry at a boyfriend for not remembering me on Valentine’s Day that my emotional outburst scared him away completely. 

The skills of emotional intelligence can help.  Here’s one way of applying them to Valentine’s Day disappointment:

1.  Self-Awareness:  (The ability to accurately perceive your own emotions in the moment and to understand your own tendencies in different situations.)  Think about your own expectations and how you will feel if they are not met – and then look at the reality of those expectations.  Are they overstated?  Are you buying in to the commercialism?

2.  Self-Management:  (The ability to act – or not to act – on your own emotions.)  Can you put your disappointment aside?  If no, can you verbalize your disappointment without sadness, fear, or anger?

3. Social Awareness:  (The ability to accurately pick up on emotions of other people and to understand what is really going on with them.)  OK, some of us are pretty clueless when it comes to things romantic.  Can you perceive caring and concern in a relationship even when your significant other didn’t meet your expectations for a romantic Valentine’s Day?

4.  Relationship Management:  (The ability to use your awareness of your own emotions and those of others to manage interactions successfully.)  If being remembered on Valentine’s Day is important to you, communicate this to your significant other.  Have a discussion.  If she/he doesn’t value it as much as you do, take the initiative yourself.

Bottom line – you don’t have to allow the hype of Valentine’s Day to damage a relationship.  In fact, using your emotional intelligence skills and communicating may make the relationship stronger than ever.