Car Talk: How to Have a Caring Conversation About Safe Driving with Your Aging Parent

For teens it’s a given: drive safely or lose the car keys. But if your parents’ driving skills are slipping due to age or infirmity, the conversation can get pretty dicey.

Driving is a mark of personal independence, a way to get around when you want, where you want. Losing the ability to drive can be a serious blow to self-esteem, not to mention a major obstacle to managing on your own. No wonder that any challenge to a parent’s driving abilities can spark serious family conflicts.

But the greater risk, when a parent shows sigs of no longer being in full control behind the wheel, is safety—not only for your parent, but also for any passengers and others on the road.

Taking away the keys is certainly a last resort. In an ideal world, your parent would recognize that he or she really needs to give up the car without any prompting. Between those two poles are a range of options, depending on your aging elder’s specific issues. Chances of a peaceful resolution that works for all will increase if you can broach the issues of safety and “retiring” from driving before there’s a crisis.

Watch for Warning Signs

Seventy-eight is now the average life expectancy for Americans. Even for healthy adults, the ’70s are a decade of increasing physical changes that can affect driving—weakened eyesight, difficulties with night vision, hearing loss, longer response times, declining physical coordination or range of motion, to name a few. Cognitive acuity may begin to slide, evidenced by shortened attention and memory loss.

Among the warning signs that your loved one may be approaching the point when driving has become a safety issue:

  • Unexplained dents or scrapes on the car
  • Getting lost on familiar routes
  • Riding the brake
  • Difficulty turning around when backing up
  • Trouble navigating turns
  • Inability to anticipate a dangerous situation on the road
  • Lateness to events when the individual has always been punctual
  • Switch to new medications that affect alertness and response times
  • Increased irritability or decreased confidence when driving

How to Broach Safe Driving Concerns

So, how to open up the subject without starting World War III? Your best bet is to speak and act with empathy:

  • Share your concerns without criticizing. Explain what you’ve witnessed that has raised concerns for your loved one’s safety and the safety of others. Avoid judging and lecturing. Speak as you would like to be spoken to when it’s your turn to face your driving limitations.
  • Encourage your loved one’s efforts to modify driving. Support any attempt to cut back driving at night or limit long-distance driving. Offer to help with transportation to evening events if your location and schedule allows, or arrange ride alternatives with reliable friends or transportation services. Provide assistance in planning long-distance trips to family events.
  • Accompany your loved one on public transit. Go with Mom or Dad on the bus or subway to get to appointments and help them learn the system. This will also enable you to assess how safe these alternatives actually are for your aging parent.
  • Research ride sharing alternatives. An abundance of options exist that can provide timely, responsive transportation. Ride sharing services like Uber and Lyft, specialized senior group transit, and personal ride services just for seniors are among the alternatives. Find out what’s available and affordable, and accompany your loved one to find the right fit and discover new ways to get around.
  • Help your loved one to analyze cost savings. Maintaining a car is expensive—even if the car is paid for, you have insurance, taxes, gasoline and repairs. It’s possible that taxis or ride sharing services are cheaper over the course of a year than keeping the car. Saving money on transportation can be a compelling reason for your loved one to quit driving.

But what if your parent refuses to consider giving up the keys, despite growing evidence of serious risks? Be compassionate but honest about safety:

  • In case of a minor accident, be candid about what could happen next time. Avoid guilt-tripping (“You could have killed someone!”) but be realistic. Your loved one may not even have been at fault, but his inability to drive defensively or respond in time could cause a serious accident in the future. Speak from the heart about your concerns for your aging parent’s safety and the safety of others.
  • Set boundaries about who can be a passenger. If your loved one’s driving has become too risky, you can calmly but honestly tell her that you no longer feel safe riding with her, or will no longer allow your children to ride with her. It’s a powerful and fair way to get the message across. Safety trumps hurt feelings.
  • Arrange a consult with your loved one’s physician. Shift the conversation to your loved one’s health. It’s best to speak to the physician in advance in order to determine whether he or she is willing to make an unbiased recommendation. You can also request that the physician order an independent driving evaluation.

Sooner than later, self-driving cars may eliminate the need for this difficult conversation. In the meantime, it’s best to discuss the possibilities of giving up the car long before there is a real and present danger. Once you’ve agreed on a plan, put it in writing so all will remember their commitments. An Aging Life Care Professional® can help you to navigate these complex conversations and work out a safe, viable driving solution for everyone involved.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care Manager™. Drawing on more than 35 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

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Memory Cafés Abound in Massachusetts

You’ll find them in coffee houses, museums or other community organizations. Memory cafés are safe, welcoming spaces for people living with forgetfulness or other cognitive challenges, as well as their families and friends. Some memory cafés invite guest artists, others focus on educational programs, and still others just provide a friendly social space for chatting and enjoying each other’s company.

This one-minute video provides a quick overview (if you cannot see the embedded video, click here to view on YouTube):

Click here to view the video in Spanish.

To find a memory café in your part of Massachusetts, click here for a directory from Jewish Family & Children’s Service.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care Manager™. Drawing on more than 35 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

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When It’s Too Hot for Comfort, How to Keep Your Elder Safe

Temperatures in the 90s. Humid air thick as pea soup. Relentless, hot sun, with no relief under shade trees. Yep, it’s summer, all right, here in New England.

Even for hardy souls, when the heat index soars, it’s hard to get through the day without feeling totally exhausted. For aging loved ones, extreme high temperatures bring added risk of heat exhaustion or heat stroke. That’s because, as we age, our bodies are less able to adjust to excessive heat or sudden changes in temperature.

Chronic medical conditions can also compromise the body’s internal thermostats, and the prescription medications that treat those conditions can wreak more havoc on elders’ ability to adapt to heat. Some drugs may even hinder perspiration, which is essential to cooling.

Here are some tips to help the elder in your life stay cool and safe in hot weather:

  1. Stay indoors and avoid strenuous activities. Be sure the home or indoor space is comfortably cool. Keep shades down, windows closed against extreme heat and humidity, and use good fans or air conditioning. Make sure fans do not present mobility hazards. Inexpensive solar curtains can help maintain cooler indoor spaces. If those amenities aren’t available, encourage your aging loved one to relax at a library, movie, mall, museum, senior center or other public space that has good air conditioning.
  2. Keep hydrated. Don’t wait until thirst becomes insistent. Drink cold water or other cool beverages throughout the day—but avoid caffeine and alcohol, which can actually dehydrate the body.
  3. Wear lightweight, light-colored cotton or other natural fiber clothing that breathes. Layers help to moderate extremes when moving from outdoor heat to indoor air conditioning.
  4. Stay cool during the day with a foot bath, a shower or body bath, or a washcloth on the back of the neck. Water in all cases should be just below body temperature for the best cooling effect.
  5. Eat light, cold meals and avoid heavy, hot foods. Extreme heat tends to suppress appetite, but it’s important to get nourishment, even in small portions throughout the day. Cold snacks like popsicles or slightly frozen grapes can provide a boost.
  6. Watch for signs of heat exhaustion. Your loved one may complain of feeling faint, dizzy or nauseated, or have muscle cramps. Excessive sweating, a rapid and weak pulse, and cool, pale skin that feels clammy to the touch are all red flags. Get your elder to a cool place, help her drink water, and apply a cool compress to her forehead or back of the neck. She may need to lie down and rest.
  7. Beware of heat stroke. This is more dangerous. Throbbing headache, nausea or vomiting, and a strong, rapid pulse are all symptoms. Most importantly, your elder will not be perspiring, despite a body temperature above 103° F and red, hot, dry skin. He may lose consciousness. Call 9-1-1 immediately, get your loved one to a cool place and apply cold compresses until help arrives.

We can’t control the weather, but we can make plans and take precautions against extreme heat—for ourselves and those we love who are at greatest risk. Here’s hoping those hot, hot days are the exception and not the rule this summer!

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care Manager™. Drawing on more than 35 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

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Should Mom Move In With You? The Answer Isn’t Obvious

For some families, it’s a no-brainer. Mom or Dad can’t live alone anymore. Time to give back for all those years of care and support, and make room for your aging parent in your home. To do otherwise would be unacceptable.

But the decision to have a parent (or other aging family member) live with you and your family is often not that clear-cut. Even when intentions are good and motivations selfless, the move may actually not be in your parent’s best interest—or your family’s.

Indeed, since the move affects everyone, it needs to be a family decision. Guilt over perceived obligations can be a strong influence, but shouldn’t be the determining factor. After all, what you want to achieve is a living situation that is truly going to help your parent, not simply assuage your guilt or ease social pressure.

Here are some key questions to consider:

1. What are your parent’s needs?

In an ideal world, inviting your aging parent to live in your home can be a great boon to everyone. There is a renewed opportunity to deepen your relationship, a chance to strengthen bonds with your children, a time to learn from and share with each other. If your parent is still in relatively good physical and cognitive health, the responsibilities and cost of care may be minimal.

Typically, however, the decision to move a parent is spurred by a health crisis. Your parent’s care needs may be significant and intensifying with time. That introduces a host of variables that may or may not be within your ability or means to address. A realistic, independent assessment by an Aging Life Care Professional® will help you to understand what’s at stake.

2. What help can you truly provide?

All the best intentions in the world can’t compensate for the real demands of caregiving for a frail adult whose health is compromised. You need both reliable information about your loved one’s health (consult with your parent’s physician) as well as an honest assessment of what you can actually do for your parent.

This includes being realistic about your own health, any family issues at home that demand attention and energy, work expectations and other time commitments. Are you really home enough to provide needed support? Do you need to hire outside support when you are not available? Can you afford to?

3. How well do you get along with your parent?

While the idea of having Mom or Dad live with you may sound like a wonderful chance for closeness, old issues and resentments are sure to surface. It’s certainly possible to resolve past conflicts, but living in close proximity can also intensify friction. In addition, clashes with your parent can aggravate conflicts with your own children or spouse. Once again, being realistic about your ability to get along and work through issues rather than simply hoping that everything will be fine is essential for everyone’s sanity and well-being.

4. Can your home accommodate your parent’s needs?

The physical layout of your home is a key factor in any decision to house your aging parent. Stairs, hallways too narrow for a wheelchair, bathrooms that present too many obstacles—these can create serious safety concerns. If your home is small, will moving your parent require one of your children to lose his or her bedroom, or a family room? How will that affect your family’s ability to be accepting of your parent—or will it cause too much resentment? If modifications are required to make your home accessible and safe for your parent, who will pay?

5. How will your parent’s presence affect the life of your family?

If you take on the role of primary caregiver for your parent at home, what will you be giving up? Caregiving is a serious time commitment. It can also be physically and emotionally stressful. Will you need to cut back at work, if you are employed? How will that affect your family finances?

If your parent demands more of your attention, your children may feel slighted and act out. They may also feel uncomfortable about bringing home friends or constrained in other ways about socializing. While you might argue that your parent sacrificed for you, and now it’s your turn to sacrifice for him or her, foisting that on the rest of your family without taking their true feelings and needs into consideration may not be either fair or wise.

6. How will your siblings or other family members be involved?

Your siblings may be grateful that you’ve stepped up to take care of Mom or Dad. They may also be jealous, judgmental and otherwise difficult. At the very least, it’s wise to discuss the move with your siblings, not only to keep open communications, but also to establish realistic expectations.

Caregiving, even if you do it yourself, can be costly—both in terms of needed equipment or home modification, as well as foregone income. Who will help you pay? You’ll also want to discuss ground rules regarding visits, advice and your own needs for emotional support and respite, so that you and your family can get away for vacations and other special times alone.

7. What is really best for your parent?

Your parent’s medical needs aren’t the only issues at stake. Mom or Dad’s emotional well-being is crucial, too. Even if you have a wonderful relationship, will you be home enough to provide the social companionship and stimulation that your parent needs? If dementia is a factor, while early stages may be manageable, do you have the time and patience—let alone physical and emotional strength—to be present and supportive of him or her as the disease advances?

None of us can really predict whether and how we could rise to the occasion of caring for an aging parent at home. The most important thing to remember is that the decision is not yours alone to make. Your parent’s desires should be respected, as well as your family’s. You, too, need to care for yourself. An Aging Life Care Professional® can help you to sort out the complexities and determine the best solution for everyone involved.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® Manager. Drawing on more than 35 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

View Privacy Policy here.

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What to Do When Fighting Over Mom’s Care Threatens to Destroy Your Family

“All happy families are alike; each unhappy family is unhappy in its own way.”

So goes the oft-quoted opening sentence of Tolstoy’s classic Russian tragedy, Anna Karenina. Perhaps an oversimplification, but his words capture a basic truth that harmonious families often have common qualities, such as mutual respect and good communication skills. And families that fight find many ways to despise each other.

Especially when an aging parent needs care and siblings disagree over how to help, who is responsible, what care should cost and who’s paying, relationships can strain to the breaking point. Just because everyone is now an adult doesn’t mean that old family roles—the favorite, the decision-maker, the black sheep—disappear. For a family that struggles with power dynamics and listening to one another, the stress of watching Mom or Dad weaken can bring out the worst.

Triggers for disputes are many, but the big ones usually involve time, money and who’s in charge:

Who is going to care for Mom?
Often, this falls to the sibling who lives the closest. More often than not, even if several siblings live nearby, it falls to a daughter rather than a son, given social bias that caregiving is a woman’s responsibility. Problems arise when other siblings try to override whoever has taken on the mantle of primary caregiver. Sometimes those concerns are legitimate; maybe the sibling on the ground lacks capacity or good judgment. Other times, the faraway siblings may be butting in without taking any responsibility for their demands. Mom may complicate the picture by playing favorites. Or the primary caregiver may try to manipulate other siblings by playing the martyr.

Where should Dad live?
For some families, sending Dad to a nursing home is a violation of deeply held values about what children owe their parents. For others, the big issue is money. Keeping an ailing parent at home is an expensive proposition that can foster disputes over who is paying for what—especially if Dad’s savings can’t cover the expenses, or if an inheritance will be diminished in the process. The same goes for placement in assisted living or a nursing home. And the solution of moving Dad to live with one sibling or another involves a host of other issues—cost, accommodations, time constraints, competition with other family and/or work responsibilities, to name a few. Not to mention fighting over who gets him.

Who decides?
Whatever the argument, the ultimate question of a parent’s fate depends on whether Mom or Dad is competent to make decisions. If the answer is yes, but Mom leans on a favorite adult child (“Mom always liked you best!”) or rejects another, resentments fester. If the answer is maybe, siblings can get stuck arguing over Dad’s true intentions. And if the answer is no, more power struggles can arise over what to do if a parent’s desires were never clearly communicated and put into writing—and who should be designated to make those decisions.

How to Resolve Sibling Disputes

Bottom line: It’s complicated. What to do if sibling infighting is tearing the family apart—and eclipsing appropriate care for Mom or Dad? One solution is to bring in a certified mediator who specializes in elder care disputes. These professionals are trained to help your family resolve issues ranging from caregiver burnout to inheritance infighting. They focus on facilitating good communication, crafting thoughtful strategies and developing workable solutions for all parties involved.

Another option, if all are willing, is to work with a family therapist to deal with longstanding, destructive family dynamics that are impeding your ability to cooperate in your parent’s best interest.

Aging Life Care Managers® can also help your family to determine what your aging parent actually needs for services, appropriate living accommodations. access to qualified professional caregivers, resources for financial planning, how to assess the value of providing care, as well as guidance for resolving conflicts.

While it’s not always possible to mend all the ways that unhappy families are unhappy, when it comes to working through sibling conflicts over Mom or Dad’s care, an impartial, professional third party can help you take important steps toward mending relationships in order to reach the best decision with or for your parent. And that, of course, is what you all really want.

Related Posts
End-of-Life Choices: Honoring Your Loved One’s Humanity
Planning Ahead for a Medical Crisis: Must-Have Directives, Consents and Contact Information

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care® manager. Drawing on more than 35 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

View Privacy Policy here.

Image Credit: CloudVisual

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