Hope for living, loving, and caring with no regrets!

Knowing When and How to Step In

Episode 140

Rayna Neises, ACC, host, reflects on her interview last week with Carolyn Birrell (Episode 139).  Carolyn is the author of Walking with Fay: A Mother’s Unchartered Path into Dementia. While describing her caregiving journey, she talked about how difficult it was to navigate knowing when and how to step in to offer support for her mother. Since most everyone will deal with this issue, Rayna continues with the topic offering the following suggestions:

  • [1:10] There are eight areas to consider when determining whether or not parents need more support:
    • [2:00] Family Relationships
    • [4:13] Home Safety
    • [6:03] Medical Needs
    • [7:27] Cognitive Health
    • [10:33] Mobility
    • [12:19] Meals/Meal Prep
    • [13:02] Social Interaction
    • [13:48] Personal Hygiene
  • [15:43] Use this free survey (www.aseasonofcaring.com/2022/10/20/knowing-when-and-how-to-step-in/) to assess and reassess the situation.
  • [17:52] If you are concerned, there are people who can support you in having these conversations.
  • [19:12] The more things you talk about with your parents, the more you know their immediate needs and also their desires for the future.
  • [19:52] This episode is brought to you by the Encouragement Series which offers inspiration, encouragement, and hope during this season of your life. Enrollment is open now at EncouragementSeries.com for this free series that will help you take care of yourself while caring for them.

This Episode was Sponsored by:

Encouragement Series


*Transcript is an actual recount of the live conversation

[00:00:00] Rayna Neises: To care for those who once cared for us is one of the highest honors. This is a quote by Tia Walker. Welcome to A Season of Caring Podcast where there’s hope for living, loving and caring, with no regrets. This is your host, Rayna Neises. Last episode, episode 139, I interviewed Carolyn Birrell, and Carolyn is the author of Walking with Fay, a Mother’s Unchartered Path into Dementia. One of the things that really stood out to me in my interview with Carolyn was how difficult it was for her to navigate knowing when to step in and how to step in to offer the support that her mom needed because of the dementia trail she was on. So as I thought more about that, I wanted to help you answer the question, What do I do when my parents need help? I know not all of you are in the boat of caring for aging parent, or maybe you are already in the middle of it, and it’s [00:01:00] difficult to navigate but I thought this would be a good topic for us to visit because unless your parents are already gone, it’s something you’re gonna be dealing with. 

[00:01:10] So there’s some specific things you need to think about in order to determine if it’s time to step in and try to offer additional support and care for your aging parents. There are eight different areas we wanna consider when we’re determining whether or not our parents need more support than they have right now. So I’m gonna go through those eight different areas. Just talk a little bit about each one of them and hopefully that will help kind of spur some thoughts for you of, is it safe? Is this something I need to think more about? So I want you to think in your mind just kind of how are they doing? Changes need to happen as soon as possible, or they seem to be doing okay. They might need a little support, or, I think they’re doing great in this area no need to worry. 

[00:01:59] The [00:02:00] first area to consider is family relationships. And immediately I think when we think of family relationships, we think of our relationship with our parents, us and our siblings. But you know, there’s a lot bigger world for all of us. Your parents have siblings, well, they might, but maybe even their parents are still living. So those relationships, how are they going? Are they being able to see each other as often as they used to? Are they enjoying their time together? Is there anything that’s in the way? Considering how often they see each other can be really important.

[00:02:38] I know my dad, we obviously dealt with Alzheimer’s with him, but in the early stages, He and his sister actually lived together. It was a great opportunity for them to support each other and just enjoy their relationship. They’d always been really close. That was his baby sister. His older sister, Dotty, lived in New Jersey, and Dotty would actually fly [00:03:00] in and spend a week or two with them at different times during the year, and they all had a really good relationship.

[00:03:07] As Aunt Dotty continued to age and dad continued to progress in his disease, it became impossible for them to maintain their relationship. From being able to figure out the phone, to understanding who you’re talking to by just recognizing a voice that sounds a little different, or even dealing with Aunt Dotty moving from one assisted living to another and having a different phone number. It became impossible the last few years of their lives to be able to maintain that relationship. Because my Aunt Colleen lived close by and was actually one of his caregivers for part of the time period of his progression of his disease. We definitely maintained that relationship with her, but as a daughter, I assisted with that. I made sure he got to visit her, they got to spend time together. So just considering, location makes a difference. If something changes [00:04:00] as far as driving or those kinds of things, we might find some changes in those relationships, but we wanna be sure that they’re maintaining relationships because isolation can be a warning sign that something’s changing and it’s not right.

[00:04:13] The second area to consider is home safety. This is one that I think everybody thinks a lot about, are they safe at home? And that’s an important question, but I would like to challenge you to consider what makes them safe. Are there things that are unsafe because their home has deteriorated and they haven’t been able to keep up on some of the upkeep, or are there lights? That need to be new light bulbs replaced, or do we need some new light fixtures in order to bring more light into trouble areas like possibly the doorway or the walkway in and out. Sometimes age can make those really un steady, uneven areas and that becomes a fall risk. So we definitely wanna consider how [00:05:00] safe is their home and what things might need to be done to make it safer.

[00:05:05] They have great lights now that you can actually line the hallways with that are motion sensitive. That will come on for a short period of time and then automatically go off. They’re perfect to put in the hallway on the way to the bathroom so that they can easily see the path. And then they will automatically shut off without them having to shut them off. Sometimes turning on those really bright lights, wake us up too much or actually cause the eyes to not adjust to the darkness again very well. So considering how can you support them in that way? 

[00:05:38] The last area I wanna talk about is the bathroom. Considering do we need grab bars placed somewhere in the shower? Do we need supports near the stool? What kinds of things will make their environment as safe as possible? It’s definitely something to consider earlier rather than later, because those grab bars can really come in handy in just creating [00:06:00] a feeling of being safe, which is so important.

[00:06:03] The third area to consider is medical needs. Are their medications being taken regularly and are they according to the prescription? The doctor specifically tells them to take them morning and night or take it at night. There’s specific times, often a prescription will have, and we wanna make sure that we’re following those directions. There’s reasons behind those specific directions, so helping to make sure that they’re taking them at the correct time, that they’re not skipping doses and that they know that they’ve taken their medications. So setting up a system that works, there’s some great automatic pill dispensers that are a little complicated, could actually be a burden for many older people. But there’s also just a pill box that can be really simple for you to check up on. Did they take the medicine? Do they not take the medicine? You will Wanna pay attention if they’re getting their prescriptions refilled in a timely manner. And then also, are they getting to [00:07:00] the doctor? Sometimes it’s easy to overlook that dentist or optometrist appointments, so making sure that they’re regularly attending those.

[00:07:08] I think one of the things that’s really helpful is when you go to the eye doctor, ask them, When was the last time you got new glasses? Mom, do you have an appointment for your eye doctor coming up here soon? I just saw such and such, you know, just remembering because you do it regularly, you can check up on them and make sure that they’re doing it regularly.

[00:07:27] The fourth area to consider if they need more support or if there’s a chance that they’re not safe at home any longer would be cognitive health. Obviously, cognitive health is important. When I consider, you know, the journey that I’ve had with my parents, I think it can be really tricky. We oftentimes are so worried about cognitive health that we are concerned about things we don’t need to be concerned about. So I would say one of the best recommendations I would have is to really learn what the signs of disease are. [00:08:00] Is this normal aging or is this not normal aging? It’s a million dollar question. There’s some great resources available out there from free workshops with the Alzheimer’s Association to the Positive Approach to Care workshops that I have available, that talk in depth about what’s happening in the brain with normal aging versus not normal aging. It is very important to consider, you know, mental sharpness it does decline and that’s natural and normal, but there’s definitely some things that are not normal. Forgetfulness is a normal thing as long as they can remember it later, but the issue with cognitive health is that it can impact not only memory, but problem solving and other things as well. Knowing that your processing becomes slower with normal aging is important to understand. At the ta, same time understanding the warning signs when we crossed into [00:09:00] not normal.

[00:09:01] Medicare does pay for our annual health check, and in that healthy appointment you can ask for a cognitive evaluation. This is something that’s available, but oftentimes you have to ask for it, so it’s really helpful to go ahead and get that scheduled. Another thing though, Teepa Snow talks. A really simple animal recall test, and she recommends that you just spend 60 seconds.

[00:09:31] You can do this together. Ask your parent to name as many animals as they can think of in 60 seconds, and you’ll just tally all of those down and get account and then have them do the same thing for you. Have you list as many animals as you can in 60 seconds. Have them write your number down. Maybe add it to your calendar in a year from now do it again. It doesn’t matter how big of a difference there is between how many animals you can name and how [00:10:00] many animals they can name. What’s important is noticing what the change is in your recall or in their recall. So if they went from 26 animals last year down to 18, that’s a pretty big jump. So you might wanna look into that and make sure that there’s not any other concerns, but just seeing that progression and how you’re doing at, being able to recall something as simple as animals, all different kinds of animals can be a really great way to check in on overall cognitive health.

[00:10:33] Our fifth area to consider is mobility. Have there been any falls? Falls are one of the most difficult things for parents to rebound from. We don’t bounce like we used to. I always say, and I’m not even up there in age yet.

[00:10:48] So, you know, just considering a fall can be the beginning of a very difficult recovery for your parents. So it’s important to understand their mobility concerns. And [00:11:00] one of the things that I think is very important to understand is how our vision changes. Normal aging, there are changes in the vision, the peripheral vision, and that can become very challenging. When we’re looking at just walking across the floor. We have a little less peripheral vision, so there might be things that we bump into that we haven’t been having a problem with before, and then we don’t have quite the reaction time that we used to, which can cause those falls. So realizing that what was safe at one time might not be safe now is important to consider that lighting is a big piece of it. Clearing the pathways, making sure they stay clear, and then just making sure that they are able to get around and as agile as possible. If they do have assisted devices, are they using the walker and the cane? Is it something that they understand how to use and that, do they feel that it’s supportive of them?

[00:11:59] And then the other [00:12:00] piece, when we think about mobility, we think about driving. Are there any new bumps on the car, Any bumping into the garage door, dings or, or things like that. You want to consider if we start noticing changes in that to definitely be asking more questions and digging in a little bit more.

[00:12:19] Our sixth area to consider is meals, meal prep. Are they able to get to the store? Are they still able to follow their recipes? Are they eating a well balanced meal? Our appetites definitely change as we age, how much we eat, but what we enjoy eating is probably the same. So helping them to navigate that checking in and making sure that they have access to good, healthy food is very important. If you can help them with meal prep or even freezing meals, that type of thing can be really helpful if they’re having a day that they’re more tired and instead of skipping that meal, [00:13:00] having something available that’s quick and easy.

[00:13:02] Our seventh area is that social interaction. Are they still doing the same social activities that they’ve always enjoyed? As we age, we might get to a point where the weather inhibits our getting out. The driving might become a little bit more of an issue, but do we still have that social engagement? Social engagement is so crucial for continued cognitive health. We want to make sure that we’re finding ways for them to stay engaged. So thinking about, are they still bowling, going to church, going to bridge, golfing, whatever their habits are. When we start seeing those things drop off, we want to ask some questions. Is it physical? What is it? That’s the hurdle. Why are they discontinuing that regular activity?

[00:13:48] The final area to consider is personal hygiene. Are their clothes clean? Are they bathing regularly? Is their hair maintained? My dad got a haircut I [00:14:00] think every two, three weeks, very regularly when he was able to do that for himself. So realizing when they start to get a little shaggy, and that’s not really them asking questions, what’s in the way, what’s, what’s the challenge for them? Dentist making sure that. Keeping that dentist appointment, getting those teeth cleaned, able to remember to brush their teeth and that type of thing. So personal hygiene, again, I think the important thing is if you’re having concerns in these areas, is to dig in and make sure that it’s not cognitively motivated, but rather it could be something else. For example, my Aunt Colleen has macular degenerations, so when she has clothes on that have stains, it’s because she can’t see them. Her vision has been significantly impacted, and so she can’t see to treat that stain. Keep in mind if those are some challenges that they have keep in mind what it is that’s causing the challenge. It might be that [00:15:00] they don’t care, they’re not paying close attention, they’re depressed or having some other underlying concerns, but it might also be vision. 

[00:15:09] So considering those eight areas, when you’re looking at, do I need to step in what to do when my parent needs help, it’s an important place to start taking that overall summary now.

[00:15:24] It can be challenging to do this together. I’m not even sure you could do it together. I think you could have, if you have a great relationship, you’re having great conversations, you could have them take a look at it and kind of score themselves. How are they doing all these things? You could score them and see how you think they’re doing, and kind of compare notes.

[00:15:43] But most of us don’t talk that freely about aging and about needing support. So I would recommend that you take a look at. I actually have created a survey that you can print out. It’s available in the show notes at a season of caring.com, [00:16:00] and you can print that, you can set it aside, pick it up six months later, take a look at it, see if anything’s changed, maybe do it again in a year. Just a way to be able to kind of check in and see how you really are objectively noticing how your parents are aging and if they need additional support. 

[00:16:19] As far as the conversation goes, if you find in the need survey that you have a lot of concern areas, definitely starting to have that conversation. Asking them, how are you feeling about the lighting? How do you feel about navigating your house? What about the stairs? I often hear adult children say, Well, I told her not to go up in the attic , but if she has access to it, she’s probably gonna do that on her own cuz she’s done it for years. So you wanna make sure to lock things down or set a plan if they need to get the Christmas tree down, make sure that you’re listening and [00:17:00] being proactive in doing that. Before they try to do it for themselves.

[00:17:05] But definitely conversation is so important. It is something that many of us want to avoid. Either the adult children or the parents, depending on who it is. There just seems to be somebody that’s resistant to the conversation. But I think the easiest way to have these difficult conversations is to start out by just kind of bringing up either a friend who’s had a similar experience or something that you’ve done. Like I said, when you go to. Eye doctor asked when the last time they went to the eye doctor was. You might find an article about information that has to do with something that you’re concerned with, and then share that article and ask ’em what they think. If they aren’t open to the conversation, to just back off and give ’em a little time, come back in again.

[00:17:52] I think it’s really important to pay close attention. To their response and how they feel about things. [00:18:00] At the same time, making sure that you’re starting to move forward. If you’re really concerned, there are people who can support you in these conversations, who can support your parents in being able to start to make decisions about where they’d like to live and what they would like to do in their later years from Gerontologists who help you navigate doctors and living environments, medications, a lot of those types of things to move specialists who can help you downsize. There’s all different types of professionals out there, so finding the right support can make a big difference. 

[00:18:40] We’re all getting older, we’re all aging, and it’s important to remember. We wanna start to build that team to support us as we’re doing that, having these conversations and starting to make a plan. For what your parent really wants as they age, can be really helpful. I think the earlier you start to have the [00:19:00] conversations, the better, because then it’s more normal to be talking about these things. So a plan doesn’t have to be extensive or fancy. Really, you can’t. Really anticipate what’s going to come up.

[00:19:12] But if you, the more things you talk about, the more you know what they would like, then you’d be able to see what their immediate needs are, as well as what their desires are in the future, and kind of look at some goals and see where they are and how realistic their ideas are, depending on their finances and the willingness of others to come around and support in the community and the services that are available. A caregiving plan just helps you get to that. You know where some options are before the crisis hits, and that is always important. 

[00:19:43] So I hope this has been helpful today. Again, you can download a need survey at the show notes page on www.aseasonofcaring.com. Thank you for joining me.

[00:19:52] This episode has been brought to you by the Encouragement Series offering inspiration, encouragement, and hope for you during this [00:20:00] season of your life. This is a free series offering you the opportunity to think about your self care and how you can take care of you while caring for them. Enrollment is open now, so visit www.Encouragement series.com. A Season of Caring Podcast has been created for the encouragement of family caregivers. If you have financial, medical, or legal questions, be sure to consult your local professionals and take heart in your season of caring.

*This transcript is a literal recount of the live recording, please forgive the grammatical errors



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Meet Your Host

Rayna Neises, ACC

An ICF Certified Coach, Author of No Regrets:  Hope for Your Caregiving Season, Podcaster, Positive Approach® to Care (PAC)Independent Certified Trainer & Speaker, offering encouragement, support, and resources to those who are in a Season of Caring for Aging Parents.

Her passion is for those caring and their parents, that they might be seen, not forgotten & cared for, not neglected.

Rayna Neises

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