Put “The Conversation” on Your Calendar Soon...

The conversations about what we would like at our end-of-life are so avoidable … and so important. Anyone who has been through the experience of being with a loved for their final months, weeks, and days know how very difficult and emotional this can be. One type of experience leaves a feeling that a loved one having died a “good death”, living life on their terms, surrounded by loved ones and with a sense of peace. The other experience can be when there have been medical heroics and the loved one had no quality-of-life. They may not have had any of the aspects of life that make life worth living. In these cases, there can be a sense it was a “bad death”, with a lingering sense of sadness and guilt for the survivors. The difference between these experiences can be having had “the conversation” about end-of-life choices. During my lifetime, I have had the honor of being a part of this process with loved ones a number of times. Recently I heard that one of our very elderly cousins was in the midst of her transition. I was able to be there with her and her daughter as she passed away very peacefully. In talking to her daughter, I saw how beautifully her family had listened to their mother and honored her wishes for how she wanted to live her last days here on earth. My cousin had been on a feeding tube because of the danger of choking but this was not the way she wanted to live. When all three of her adult children were in town, they had the conversation with her, exploring the medical options, and how that would change how she could live....

4 Things to Do When Your Parents Are Resisting Help...

Taking these steps can reduce frustration and stress — for all of you “Doctor, my mom needs help, but she won’t accept it and she won’t listen.” Sound familiar? It’s a complaint I hear all the time from families worried about older parents and aging relatives. And it’s a very real issue that we must address. For better health and wellbeing in older adults, it’s not enough to identify the underlying health and life problems — although that is a key place to start. Because even if you’ve correctly identified the problems and learned how the experts recommend managing them, older parents often seem, well, resistant. Understandably, this causes families a lot of frustration and stress. Here are four actions I always recommend that families take when older parents are resisting help. Consider the possibility of cognitive impairment In other words, is a problem with brain function contributing to this resistance? Now, let me emphasize that you should not assume that your parents are in their wrong mind just because they are making health or safety decisions that you don’t agree with. That said, because it’s very common for the brain to become vulnerable or damaged as people age, decreased brain function is often a factor when an older person resists help. This can affect an older parent’s insight and judgment and can also affect how well they can process your logical arguments. It’s important to spot such cognitive impairment. Some of the impairment is often reversible. For example, older adults frequently develop delirium when ill or hospitalized, and an older person may need weeks or even months to recover to their best thinking abilities. Cognition can also be dampened by certain conditions, like hypothyroidism, or by medication side effects....

How to Help Mom and Dad Move to a New Home...

Here are five tips to make the transition less traumatic for your parents For most people, moving from one home to another is exhausting. Even when we get help with packing and transporting our possessions, moving means changing countless aspects of our everyday lives — from making a new place for the silverware to potentially finding new friends. And it can mean saying goodbye to memories we’ve made over the course of years. Older adults often have a much harder time with the transition. For your parents, moving can go from merely taxing to highly traumatic. That’s when it becomes transfer trauma, also known more broadly as relocation stress syndrome. “You’re literally transitioning to a completely different phase of life, to a completely different environment,” says Tach Branch-Dogans, president and CEO of Moving Memories and Mementos of Dallas, Texas, who spoke at the Aging in America 2015 [www.asaging.org/aia] conference of the American Society on Aging [www.asaging.org] I just attended. That’s true whether a person is voluntarily downsizing or being moved into a nursing home, she says. Symptoms of Transfer Trauma Moving can result in a host of physical and psychological changes, including loss of sleep, agitation, depression, withdrawal, short-term memory loss, irritable bowel syndrome, loss of appetite and nausea, Branch-Dogans says. Tracy Greene Mintz, a Licensed Clinical Social Worker in Redondo Beach, Calif., who has worked and lectured extensively in the area of relocation stress syndrome, says loss of control is at the core of transfer trauma. “This week you’re going to be at home living independently; next week you’re going to be in assisted living. The abruptness with which we move older people … is very damaging psychosocially and emotionally because it strips the older adult of control,”...

Help Parents Avoid Unwanted Medical Treatment...

A study shows older adults aren’t getting the care they want at life’s end A new poll shows that almost one in four older Americans — approximately 25 million people — experience excessive or unwanted medical treatment. This is especially true in the last year and very last days of life. During their final 24 to 48 hours, many terminally ill patients go to the hospital and receive treatments that don’t improve quality of life, says Daniel Wilson, national and federal programs director for Compassion & Choices, a nonprofit end-of-life advocacy organization. In fact, a person’s last days in the hospital are often “more traumatic than peaceful,” he says. Why, when 70 percent of us say we want to die at home, are we so often dying in the hospital? Several factors are driving the trend. A main issue is cultural discomfort with death and dying. “In America, we avoid these conversations,” says Wilson. A Need to Start Talking A 2012 survey  conducted by the California HealthCare Foundation found that 60 percent of respondents feel it is “extremely important” that their families not be burdened by tough decisions about their end of life care. Yet, 56 percent of those surveyed had not communicated their end-of-life wishes with their families. Anxiety about death also keeps people from talking openly with their doctors, leaving patients with incomplete or false information about many palliative care and end-of-life alternatives that would keep them out of the hospital in their last days. “This is your body, your health,” says Wilson. “You need to have the comfort level with your doctor.” If you don’t feel comfortable asking questions and having these types of conversations with your healthcare practitioner, he says, it might be time to...