The aging process is often accompanied by a number of changes and challenges. A decline in medical or psychological health may necessitate varying levels of assistance with tasks such as personal care, managing medication, scheduling appointments, transportation, preparing meals, paying bills and maintaining the household.
Adult children, grandchildren, or friends may be unclear about how to help aging parents maximize their safety, health and independence. Good first steps include learning about aging, establishing good communication with the senior, evaluating the older person's needs, and researching programs and services available in the community.
According to the U.S. Department of Health and Human Services, Administration on Aging, family members are the primary long-term caregivers for older people in the country. More than 22.4 million are informal caregivers. I recommend that adult children begin to address the issues of aging with their parents before challenges arise. When older people actually start to experience problems, they may not want to admit they need help because they are embarrassed, they don't want to be a burden, or are afraid of losing their independence. Starting a dialogue earlier rather than later can pave the way.
The need for assistance sometimes develops quickly, as is the case following a major event such as a fall, heart attack or stroke. More likely, however, is a gradual decline in the ability to manage the details of day-to-day living. In addition to the ongoing conversations, family members can look for subtle clues that an elderly loved one needs help. Are the bills stacked unopened on a table? Is there fresh food in the refrigerator? Is your loved one well-groomed and dressed in clean clothes? Is the house unusually unkempt? Is your loved one withdrawn? If issues need to be addressed, do it in a manner that allows seniors to maintain their dignity, respect and sense of control.
Numerous services are available to help adult caregivers care for an elderly person. The Older Americans Act Amendments of 2000 established the National Family Caregiver Support Program that requires all states, working in partnership with area agencies on aging and local community-service providers, to provide information, assist with access to services, provide counseling, organize support groups, provide training to assist caregivers with decision-making and problem-solving, provide respite care, and provide supplemental services.
Establishing a good rapport with health-care providers is an essential element of managing the challenges aging can present. It's helpful to seek care at a facility that offers multiple services in one location. In many cases, an elderly person must deal with more than one complex medical condition, multiple medications and emotional issues in addition to medical ones. Access to care in one location ensures continuity of care, eases transportation issues and helps the patient develop a sense of trust and security when going to appointments. In addition to coordinated medical care, staff members at a health facility geared specifically to the needs of the elderly can provide critical information and help with the sometimes difficult decisions older people and their caregivers face.
Depending on the circumstances, patients and caregivers may need information about help in the home, such as home health aides, visiting nurses or occupational therapists. They may want to look into alternative living arrangements, such as independent or assisted living facilities. After a major event, they may need to learn more about skilled rehabilitation and nursing facilities.
Each case is different, and needs may continue to change. My advice to elderly people in need of assistance and those who care for them is to work with doctors, nurses and counselors to learn about assistance programs and services, and coordinate services in a way that ensures the safety, well-being and quality of life of the older person as well as the caregiver.
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Dr. Kevin J. Ennis is a geriatric care physician at the Beverly Hospital Center for Healthy Aging at Beverly Hospital Hunt Center in Danvers and the Addison Gilbert Hospital in Gloucester.
