“Jane Gross’s journey as child of an aging and ill parent is one that too many of us will be making. How wonderful to have her mix of sage advice, pithy insights and practical discoveries at hand when and if that time comes.” —Abraham Verghese, MD, author of Cutting for Stone
In telling the warmhearted story of caring for her own aged and ailing mother, New York Times journalist Jane Gross offers indispensable advice on virtually every aspect of elder care. Here are just a few of the vitally important lessons in caring for your aging parent—and yourself:
• Slow down: The collision of fear and ignorance leads to bad decisions and most don’t have to be made as quickly as it may seem.
• As painful as the role reversal between parent and child may be for you, assume it is worse for your mother or father, so take care not to demean or humiliate them.
• Denial, more often on your part than theirs, is the biggest obstacle to thoughtful planning. Talk to them, no matter how uncomfortable it makes you, about the future—medically, financially, residentially and in terms of end-of-life choices.
• Do not assume that a parent who reaches the age of 85 is going to die quickly or easily. He or she will likely need years of help with simple tasks like bathing, dressing, eating and toileting, which is not covered by Medicare. Only the very wealthy or the indigent get through this without spending enormous sums of money.
• Be sure your parent has a trusted internist, or, better yet, a geriatrician, to quarterback his or her care, explain that not every medical procedure that can be done should be done and constantly reassess your mother or father’s views on longevity vs. quality of life. Specialists often treat body parts not human beings.
• Avoid hospitals and emergency rooms, as well as multiple relocations from home to assisted living facility to nursing home, since all can cause dramatic declines in physical and cognitive well-being among the aged.
• Do not accept the canard that no decent child sends a parent to a nursing home. Good nursing home care, which supports the entire family, can be vastly superior to the pretty trappings but thin staffing of assisted living or the solitude of being at home, even with round-the-clock help.
• Lie if you must to keep a parent safe. Examples of this might include disabling a car if your parent will not relinquish the keys and is a risk to himself or herself, or others, or having a college student look in on a parent under the guise of doing a school project.
• Keep with you at all times an updated list of your parent’s health conditions and medications, a cell phone charger, a spare pair of eyeglasses, a credit card or wad of cash or anything else you might need if summoned without notice to deal with an emergency.
• Many doctors will not accept new Medicare patients, nor are they legally required to do so, especially significant if a parent is moving a long distance to be near family in old age.
• A standard Do Not Resuscitate Order is useless in an ambulance since paramedics are required by law to take what some may consider unwelcome heroic measures in the event of, say, cardiac arrest.
• A licensed home health aide is limited in what he or she can do without consultation with a supervisor. This can mean not being permitted to pick up your mother or father from the floor if they fall, not being able to administer medication but merely supervise and not being allowed to use their credit cards or automobiles, even with their permission.
• Every state has its own laws, eligibility standards, and licensing requirements for financial, legal, residential, and other matters that affect the elderly, including qualification for Medicare. Assume anything you understand in the state where your parents once lived no longer applies if they move.
• Long-term care insurance is not a panacea. The daily benefit, for example, will go directly to a nursing home for a resident paying his or her own way or to the government for one on Medicaid and not be available for expenses like a private-duty aide, if staffing is inadequate, or certain non-reimbursable medical equipment.
• An adult child with power of attorney can use a parent’s money for legitimate expenses and thus hasten the spend-down to Medicaid eligibility. In other words, you are doing your parent no favor—assuming he or she is likely to exhaust personal financial resources—by paying rent, stocking the refrigerator, buying clothes, or taking him or her to the hairdresser or barber.
Read the prologue of A Bittersweet Season
Memoir Highlights Long-Term Health Care Challenges—ABC News
A Bittersweet Season Puts Debate Into Perspective—Daily Reporter
Jane Gross was a reporter for Sports Illustrated and Newsday before joining The New York Times in 1978. Her twenty-nine-year tenure there included national assignments as well as coverage of aging. In 2008, she launched a blog for the Times called The New Old Age, to which she still contributes. She has taught journalism at the University of California, Berkeley, and at Columbia University, and was the recipient of a John S. Knight Fellowship. She lives in Westchester County, New York. Visit Jane Gross’s Facebook page