By: Amoti K. Nyabongo
In certain cultures, the question asked is, “How are the children?” on the understanding that if the children are fine then all is well with everyone else. These days we ask, “How are the children AND your parents?”.
As our life expectancy extends towards the century mark and beyond for normal people, we are facing new challenges. In the past, our grandparents and their parents may have made it to the low seventies to the mid-eighties. They would transition, and then we would get on with living our lives. Caring for our children while caring for a parent in their late 80’s or 90’s was foreign to most western cultures but is quickly becoming the norm.
With the advent of modern medicine, nutritional awareness, and physical exercise, people are living longer. In Bermuda, according to the Department of Statistics, nearly 25% of the population will be over the age of sixty-five within the next eight years.
More and more, we are torn between time commitments for our elders, children and ourselves. In some cases, our parent(s) stay in the spare bedroom with us or an attached apartment; while others have their own place and have a caregiver to come in on a variety of scheduling options depending on the level of care required.
For most of our lives, we don’t really consider having to care for one or both of our parents for an extended period. If they take a fall suffering a broken bone, have a minor illness or need help to recover from surgery, because it’s short term, we can handle it with a minimal amount of stress. Picking up medications and administering them, making doctor’s appointments and clinical visits are blended into our routine of marketing, picking the children up or running our personal errands.
While this may seem simple, these temporary situations can become permanent without warning. In an ideal situation, there is enough flex-time to shuffle around or reposition things to get done during the day, but this is not always the case.
Most of us tend to think short term, but in this situation, it is advisable to think about what might be coming down the road. Our parents are living longer, and the quality of the life that they will experience may be highly dependent on what we can provide in areas ranging from health care requirements and financial fitness, to social safety net.
Some of our elders are healthy and physically fine, however, need to be in a supported living situation. A nursing home or rest home where they can interact with others and get a certain level of care (if needed).
These institutions provide the residents with 24-hour coverage, can intervene in emergency situations, whether illness or injury, and render care. They also organise activities that generate interaction with residents in the facility or outings with local or community-based organisations.
If you are becoming responsible for a parent, it is important to understand what level of health insurance they have and exactly what is and is not, covered. There is no time like the present to find this out.
Financial fitness is critical as well. If the insurance coverage is adequate, great. If not, creating a financial plan is essential. Everything is up for grabs in this instance. Pension, retirement benefits, savings and investments…and yes, even the young one’s college fund are all sources of revenue that may have to be drawn on for a parent or parents care.
The average elder may have insurance or a benefits package that covers the necessary expenses and a modest pension that may be able to financially bridge the shortfall. These are the things we need to know sooner rather than later.
There is also no perfect care solution, so it becomes a matter of what is available that meets your elder’s needs and the financial resources available.
The social safety net, siblings, spouse or partner, extended family or friends are a critical component to this equation. The challenges of caring for an elder will test the strength of these relationships. There are cases where the care of a parent will fall on either the youngest sibling or elder as opposed to sharing the load among the children. Then there’s the case of only children who depend on the extended family and close friends for support. These situations show who will step up to the plate.
While some circumstances may seem unfair, and some are, we rise to the occasion based on our personal makeup and/or gifts. Caring for an elder is not easy, and it is not for everyone. One issue to be mindful of is to manage our personal rest periods. We are no good as caregivers if we are not healthy. We must remember to keep a proper diet, get as much rest as possible and stay away from stressful situations.
In some countries, there are programs that provide a stipend when a family member is caring for an elder. This is given to offset the cost of care, food, gas, travel or other minor expenses. This is a new incentive presented as an alternative to hiring a caregiver when a family member can provide the level of service required.
The next consideration is when caring for an elder is beyond our personal capacity, and we need to place them in a supported living situation because they need supervision and care that we can no longer provide. This is probably one of the hardest decisions to make.
We are used to mom or dad being independent, living their lives, and on their terms, but we need to be alert to tell-tale signs that things are no longer as they should be.
Whether it’s coming in and finding the teapot on the stove, burner going and the water has boiled off, filling the kitchen with the odour of burning metal; having to answer the same question 4 or more times in a fifteen-minute time frame; or a decline in personal daily living skills, we need to accept what these things might mean.
Usually, the kitchen is clean, but lately, there have been dishes with unfinished food on the table, doors are left unlocked or open, or your loved one is taking an extraordinarily long time to get dressed, or asking for daily medications that they’ve already taken.
There are other signs, but the key is to pay attention, who knows our family members better than we do?
These things are further complicated if the elder becoming infirmed or injured lives in another city or country. An associate of mine received a phone call to come home quick, his father wasn’t doing too well and was in the hospital, home being London. This occurred on the cusp of the holiday season, so even though the family was on holiday, they hadn’t quite planned to spend it visiting dad in the hospital.
Having the difficult conversation with the doctors takes on new meaning when the prognosis is not simple. Planning for a week-long visit that may turn into three weeks or more presents financial challenges and adds major stress to an already stressful situation.
This is where a robust social safety net pays off. Staying with family as opposed to a hotel or motel, if there is not ready public transportation catching a lift with family or friends of the family can take a lot off your plate.
You may ask when should I start preparing? As they say with planting trees, when is the best time to plant one? Twenty years ago. When’s the next time? Now!
Every hour you spend in preparation now can take hours, days or weeks off stressful activities backtracking through bills, researching benefits, or looking for legal documentation.
Elders can be very cantankerous about your perceived interference, but you must try to reassure them that you are here to help and be aware that you must follow correct legal procedures in these matters. Please be sure to consult a legal expert in the drafting and correct use of documents.
Finally, whatever the situation; don’t go it alone – make sure you reach out for help. Even if it’s just someone you can talk to. To be able to share what we experience provides two things for us. First, we gain comfort in knowing we are not alone. Second, talking about what we’re going through may provide solutions to challenges we are experiencing or the person we’re sharing with.