Too Close for Comfort

It’s happening in the White House and in homes throughout the United States.  When President Obama’s mother-in-law, Marian Robinson, settled in with her family in Washington earlier this year, they became part of a growing national trend.

The increasing number of seniors now living under the same roof with at least one other generation is more than just political news.  According to a recent survey conducted for the local company Home Instead Senior Care, 43 percent of adult caregivers in the U.S. ages 35 to 62 reside with the parent, stepparent, or older relative for whom they or someone else in their household provides care.¹  The Census Bureau confirms this growing trend:  In 2000, 2.3 million² older parents were living with their adult children; by contrast, in 2007, that number jumped to 3.6 million³ – a 55 percent increase.

The challenges that can arise from intergenerational living have prompted Home Instead Senior Care, to launch a public education campaign to help families determine if living together is a good idea and to provide tips on how to make such an arrangement work well for seniors as well as their family caregivers if they do decide to combine households.  This campaign will help adult children begin to address such issues as the stress of caregiving under one roof, adapting a home for two or more generations and merging household finances. 

Several factors are driving this trend, we see families coming together to share family caregiving duties for economic reasons and emotional support.   Sometimes the seniors need care, but in other instances the older adults could be providing care to their own grandchildren.  Seniors may feel they need the emotional support of an extended family and, in these difficult economic times, financial assistance.  Regardless of the reasons, combining households is a big decision.  Some families may decide that maintaining separate residences is the best alternative.”

At the center of the campaign is a handbook, available free from the local Home Instead Senior Care, which addresses the emotional, financial, and comfort and safety aspects of intergenerational living.  

The handbook was compiled with the assistance of three national experts:  Matthew Kaplan Ph.D., Penn State Intergenerational Programs extension specialist; Adriane Berg, CEO of Generation Bold and a consultant on reaching boomers and seniors; and Dan

Bawden, founder of the CAPS (Certified Aging in Place Specialists) program for the National Association of Home Builders (NAHB).  A Web site www.makewayformom.com  provides additional support and information, including a calculator that will help families compute and compare whether living together or maintaining separate residences is the best financial option.  In addition, the Web site features a virtual tour of an intergenerational home where visitors can hear from a real family and see firsthand how they’ve adapted their home.

 Penn State’s Matt Kaplan said that families should approach decisions of combining households from a partnership perspective.  “Ask yourself, ‘Can I get the whole family behind the idea?’  When a decision is made to combine families, expectations must be set right away.  Family members must listen and become engaged in conversation.  The more the entire family buys in at the beginning, the more likely they will be to come up with great ideas,” he noted.

 “People need independence, but seeking interdependence and family unity are important as well, particularly in today’s hectic and demanding world.” 

Matthew Kaplan Ph.D., Penn State Intergenerational Programs extension specialist, and Home Instead Senior Care, offer these tips:

1. Take a family partnership perspective.  Everyone needs to be informed and to give input into household arrangements.
2. Set expectations right away.  Avoid conflict by working to ensure upfront that family members see eye-to-eye about each person’s roles and responsibilities.
3. Ask for help.  Engage children in responsibilities around the home and make it clear to adult siblings that you want them to be involved.  If extended family will not help with respite care, arrange for a professional caregiver service.
4. Make family unity key.  Strive for routines, rituals and traditions that bring the family together including family movie night or a walk. 
5. Find threads of common interest and build on those to develop family activities that are conducive to building deeper relationships.  Focus on something very simple that seems to generate a common bond, such as ethnic cooking, family history, health or wellness.
6. Keep lines of communication open.  Recognize the importance of private time and family time for every member of the household.  Visit www.4070talk.com for more information.
7. Distinguish between private space and shared space.  Shared space should be stocked with material inviting for all ages and items that could stimulate discussion, such as a child’s project or “brag book” of photos.  Make clear rules regarding the private spaces set aside for each member of the household.  

Adult children who move a senior into their home, or who move into a senior’s home, should ensure that their loved ones are safe by conducting a physical inventory with an eye toward safety and comfort, according to Dan Bawden CGR, CAPS, GMB, owner of Legal Eagle Contractors in Houston and the founder of the Certified Aging in Place Specialists (CAPS) program.   Consider these suggestions for quick fixes and affordable remodeling projects:

1. Lower the peephole.  Osteoporosis changes the height of some seniors, making it difficult for them to look through a door’s peephole.  Why not add an additional, lower peephole to your front door for about $40.
2. Install outside shelves.  Seniors coming to the front door with groceries or other packages can be at risk of dropping their merchandise or falling.  Construct a shelf on the outside of the house on which to set keys and packages.  Shelves and brackets can be purchased at home improvement stores.  Cost is about $75 including installation.
3. Combine kitchen faucet and hose.  Kitchen faucets with a pull-out spray hose nearby may be replaced with an all-in-one faucet and spray hose for easier use.  A soap dispenser can then be placed in the hole that once held the spray hose.  Cost for the improvement, about $350.
4. Install commercial carpet.  If replacing a family room carpet, select a low-pile commercial grade that is cheaper than conventional carpet, which can run $35 to $40 a square yard.  Commercial carpet also is easier to keep clean and safer for walkers and wheelchairs.
5. Create attic storage.  Turn your attic into a store room for your senior’s possessions by attaching plywood boards to attic floor beams.  Cost of the remodel: about $2,000.

 Financial Affairs:

Financial Freedom or Household Headaches?

Managing household finances can be complicated when sharing a home with a senior parent.  Following, from Adriane Berg, author of “How Not to Go Broke at 102!,” CEO of the boomer consulting company Generation Bold, and a founder of the National Academy of Elder Law Attorneys, are financial considerations:

1. Compute the costs.  To do that, Home Instead Senior Care and Berg have created a calculator, located at www.makewayformom.com, which features 15 questions about your expenses and living habits.  Answer those questions and the calculator computes the results to help you determine whether living separately or together is the best option.
2. Share but beware.  Share overhead costs such as heat and water, but beware of the tax implications of combining households.  A tax adviser should be consulted before such a move.
3. Keep money separate.  Maintain separate bank accounts if the senior is of sound mind.  Seniors who stay in control of their finances thrive.
4. Consider caregiving.  While a healthy senior can serve as a grandchild’s caretaker, an unhealthy older adult will need care.  That can be a disruption of a household as well as loss of work income.  You must factor that into your budget.
5. What about deductions?  You may qualify for a dependency deduction for your older loved one if they’re living with you, however, seniors may lose a homeowner’s deduction if they move out of their own home.

CUTTING CORNERSPINCHED BY THE ECONOMY, OLDER ADULTS PUT THEMSELVES AT RISK

 It seems as though problems with the economy are affecting nearly every area of our lives.  Now, evidence is mounting that older adults are cutting everyday expenses to keep up with the economic downturn. 

 Local senior-care experts with Home Instead Senior Care in Knoxville, TN warn families to be on alert to make sure seniors aren’t cutting too deeply.  Warning signs include skipping medications, pulling the plug on air conditioning and canceling social outings. 

 In a report released in May by AARP titled “The Economic Slowdown’s Impact on Middle-Aged and Older Americans,” 59 percent of seniors 65 and older surveyed said they’d found it more difficult to pay for essential items.  Those are things like food, gas and medicine.  Nearly half (47 percent) said they found it more difficult to pay for utilities such as heating, cooling or phone service.  Forty-six percent have reduced the number of times they eat out and 45 percent cut back spending on entertainment.¹

 Cuts of essential items such as food and medication should be of immediate concern to seniors’ families.  Other reductions in spending can lead to less obvious issues.  One of the biggest problems that we see is senior isolation.  That issue has really been magnified during this troubled time in our economy with the high price of gas.

 An older adult can get in trouble very quickly.  Especially when families live a distance from their loved ones, or when Boomer children are busy trying to make ends meet themselves,  That’s why it’s so important that someone look out for the well-being of seniors.  You want to know they are safe in their homes and eating properly, taking their medications and able to maintain their appointments and social life.

 Falling interest rates, fixed incomes and seniors’ fears of past hardships can influence how they react to the current economic slowdown.  That’s according to Sheryl Garrett, author of Personal Finance Workbook For Dummies^® and several other books on financial planning.  Some seniors may be running short on money but, for others, there’s always that fear of running out because they lived through the Depression.  They know how ugly it can get, she explained.

 It’s important also for seniors to guard against fraud and too-good-to-be-true offers, Garrett advises.  Seniors want to get the best that they can from their investments without falling for scams or overselling tactics.  Older adults also should beware of CDs and fixed annuities that can promise higher interest rates, but force seniors to lock in their money for longer time periods, Garrett noted.  Always get a second opinion, she advises.

 Seniors at all income levels may be facing choices they haven’t had to make in the past.  They should know where to go for help before they put themselves or their health at risk.  Area Agencies on Aging, for instance, offer both food and gas assistance.  And companies such as Home Instead Senior Care can provide transportation assistance and help around the home.  We also serve as a second set of eyes for seniors’ families. 

 Families also can play an important role monitoring seniors who have decided to scale back because of the economy.  Even seemingly innocent decisions, like cutting back a little on groceries or air conditioning, can have a damaging impact.

So what signs should families look for to warn them that a senior might be putting themselves in harm’s way?  

Here’s some information from Home Instead Senior Care and the National Association of Area Agencies on Aging.  If you’re a family caregiver, ask yourself the following questions. 

1. Is your senior’s home too warm in the summer and too cold in the winter?
2. Is the lawn not getting mowed nor is the sidewalk getting cleaned in inclement weather?
3. Is your loved one complaining about not being able to afford medications?
4. Are home repairs not getting made?
5. Is there a shortage of food in the house?
6. Is your senior skipping doctor’s appointments?
7. Is your older adult staying home more and becoming isolated?
8. Is your senior cutting out entertainment?
9. Does your loved one eat out less?
10. Did your senior cancel a vacation?

If you’re an older adult experiencing difficulties because of the economy, contact your local Area Agency on Aging or Home Instead Senior Care office 865.523.1300.  Or, if you have a financial issue, contact the Garrett Planning Network. 

 Speaking of finances, Home Instead Senior Care and the Garrett Planning Network have come up with some tips for ways that seniors can stretch their finances. 

Seek the services of an objective financial planner.  Sheryl Garrett, founder of the Garrett Planning Network, said it’s important for seniors to seek the advice of an objective fiduciary. 

1. Get a second opinion on investments and financial purchases.  If you’re approached about changing your investments or making a purchase, make sure you get another opinion. 
2. Contact your local Area Agency on Aging if you’re having trouble paying for food and gas. 
3. Get back to gardening.  The economic downturn is generating a resurgence in gardening.  The over 55 crowd traditionally has been among the most avid gardeners. 
4. Avoid convenience foods, which are more expensive.  Watch for sales on fresh or canned fruits, vegetables and meats, which will be less expensive than convenience foods and better for you. 
5. Look for deals on generic medications.  Contact your pharmacist about ways to save money on your medications.
6. Walk when you can.  If the gas prices are cutting into your social life, organize a walking club or walk with friends. 
7. Carpool when you can’t walk.  There’s economy in numbers.  If you can’t afford to drive somewhere solo or in pairs, contact others you know going in the same direction or the same place and share costs. 
8. Keep drapes drawn during the heat of the day, and minimize opening and closing doors in the cold of the winter.  Close off parts of the house you’re not using to cut down on utility costs.
9. Financial planner Sheryl Garrett says that the ability of seniors to live at home helps cut costs as well.  If you or a loved one needs assistance around the house, contact Home Instead Senior Care or visit the company’s Web site at www.homeinstead.com.

Involving Siblings and Seniors in Eldercare Planning

In many instances, the responsibility for caring for a senior relative tends to fall on one person who becomes the Primary Family Caregiver, usually the spouse, the grown daughter of the senior, or the family member that lives the closest to the person needing assistance. However, this situation often occurs because families do little pre-planning for this care.

In fact, in a recent Home Instead Senior Care survey, more than half of families who plan to care for a senior in the next five years have made absolutely no plans for it, with a majority of families not even discussing it with their family members or the senior(s) themselves. It is usually not until an emergency arises that families realize they are unprepared….and then they are straddled with a caregiving crisis – having to make quick decisions in the heat of the moment.

Proper planning will help ease the crisis of family caregiving now or when it arises in the future. In addition, proper planning can help diminish the stress of placing all caregiving responsibilities on the shoulders of just one person.

By asking and involving as many family members as possible, including the senior himself/herself, early on so that everyone’s thoughts are heard, good plans can be made and agreed upon together as a family. If you are the organizer and don’t have siblings, consider including extended family members and friends into the mix.

During this meeting, roles should be discussed. Perhaps one adult child is responsible for going to the doctor with the senior each month to get a sense of the senior’s health/well-being, while another family member makes sure the checkbooks are balanced and bills are paid. Perhaps the sibling that lives across the country volunteers to fly in her parent(s) for a two-week visit during the summer so that the other siblings can get a break, and she also meets with the family when she comes home for the holidays. Whatever the arrangement that suits your family, it is important to split the responsibilities to help minimize caregiver burnout, but to also take into account the senior’s wishes and needs first.

Talking in advance to older family members about potential circumstances that might require someone to help them out, can be helpful preparation. Then, in the event that this help is needed, it won’t be seen as such a foreign idea to them.

Often, seniors can be resistant to the idea of care because they fear they will lose control of their lives or they are afraid of becoming a burden to their family. Instead, the senior needs to be reassured, early on, that if care is eventually needed from a family member or a professional resource, this care is for their benefit and will help them maintain their independence at home for as long as possible.

Family members should meet periodically to discuss their roles in the senior’s care. Families should also avail themselves of outside, professional resources, such as professional caregivers and other senior services, should the time come when the level of care needed is too much for the family to supply alone. Families may also benefit from seeking outside help to assist in resolving family disputes over care, medical decisions, finances, etc. that may arise. Researching planning for care resources now can help you avoid major issues later and prepare families and their aging relatives for whatever lies ahead.

BCBS of Georgia “Running on Empty” program

One out of every four persons – or more than 65 million people in the United States – serves as informal, unpaid caregivers, according to the National Alliance for Caregiving.

Providing assistance to another person who is ill, disabled or needs help with daily activities can be physically and emotionally draining. Blue Cross and Blue Shield of Georgia offers these tips to help caregivers navigate the system on behalf of their parents, grandparents and others:

• Gathering information: The first step is to gather as much information as possible about the loved one’s health and health benefits. While a loved one might be reluctant to share this information at first, experts recommend caregivers remain patient.
• Getting permission: While the Health Insurance Portability and Accountability Act protects patient privacy, it also can be an obstacle for caregivers.  It’s critical caregivers file the proper paperwork with their loved one’s health benefits provider.
• Enrolling in a chronic disease program: Eight out of 10 Americans age 65 and older have some chronic illness.  Those enrolled in a Medicare plan may have access to free programs to help them manage their diseases.
• Knowing your rights: Once the disclosure/authorization papers have been filed, caregivers can speak to a customer care agent on a beneficiary’s behalf and access information online.
• Investigating ‘extra help’: Extra help may be available to low-income people with a Medicare prescription drug plan through the Social Security office. Even if the senior doesn’t qualify for this extra help, other state and community resources may be available.
• Caring for yourself: The final and perhaps most important tip is for caregivers to take care of themselves. Get enough sleep, go for a walk, take an occasional day off, and maintain a sense of humor.

Five strategies to help counter a senior’s resistance to assistance

Following are strategies from Home Instead Senior Care® and family caregiving consultant Dr. Amy D’Aprix to help family caregivers turn resistance into assistance. 1. Understand where the resistance is coming from. Ask your parent why he or she is resisting. “Mom, I notice that every time I bring up the idea of someone coming in to help, you resist it. Why is that?” Oftentimes older adults don’t realize they are being resistant. 2. Explain your goals. Remind your loved one that you both want the same thing. Explain that a little extra help can keep her at home longer and will help put your mind at ease as well. Have a candid conversation with him about the impact this care is having on your life. Oftentimes seniors don’t understand the time commitment of a caregiver. 3. Bring in outside help. If a relationship with a parent is deteriorating, ask a professional, such as a geriatric care manager, for an assessment. A third-party professional can provide valuable input. Also, go to www.4070talk.com for tips on how to talk with a loved one. If you are having problems getting through to your older adult, consider asking another family member or close friend to intervene. If you’re not making headway, perhaps there’s someone better to talk with your parents. 4. Research your options to find the best resources for your loved one. Contact your local Area Agency on Aging or a geriatric care manager to research resources in your community. Or go to www.homeinstead.com and click on the resources tab for The Home Care Solution, a guide for family caregivers to help them find the best in-home care for their loved ones. If you decide outside help is needed, reassure your parents and tell them you have researched caregivers and you are confident you have found the best one you can find to come into the home to help. 5. Respect your parent’s decisions. Sometimes you won’t agree with your parent’s decisions and that’s O.K. As long as your loved one is of sound mind, he or she should have the final say. A note: If your senior has dementia, seek professional assistance from a doctor or geriatric care manager. Logic often will not work and other strategies must be employed.

ABOUT HOME INSTEAD SENIOR CARE Founded in 1994 in Omaha, the Home Instead Senior Care® network is the world’s largest provider of non-medical in-home care services for seniors, with more than 875 independently owned and operated franchises in 14 countries and 15 markets, spanning four continents.

Home Instead Senior Care – Knoxville services the Knox, Anderson and Roane Counties of Tennessee and helps seniors with  activities including companionship, meal preparation, medication reminders, light housekeeping, errands and shopping.

Summer Weather and Seniors

Summer Severe Weather Can Leave Seniors Vulnerable – U.S. It’s the season for floods, fires, tornadoes and hurricanes in the U.S. Because severe weather can strike any time, day or night, Home Instead CAREGiversSM may find themselves with an older adult when the unexpected happens. Here are some things you should remember before an emergency occurs:

Tune in. Contact the local emergency management office to learn about the most likely natural disasters to strike your area. Stay abreast of what’s going on through your local radio or television.

Take stock. Decide what a senior can or can’t do in the event of a natural disaster. Make a list of what would be needed if a disaster occurred. For example, if an older adult is wheelchair-bound, determine an evacuation strategy ahead of time. Prepare for whatever disaster could hit the area.

Make a plan. Encourage families you work with to develop a plan of action. Suggest they include in this plan key people – such as neighbors, friends, relatives and professional caregivers – who could help.

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