How do you know when you need to ask for help?

I recently had an interesting conversation with my brother-in-law's mother. She is a healthy, active lady in her 60s, and was inquiring about my business. When her son had previously approached her about this and utilizing our services, her response was that she was still in charge and that she will tell him when she would want his help. When she told me this, my response was "How are you going to know when that is? What if you can't tell him due to some unexpected problem?" These two questions had her start thinking that maybe she won't always be in charge, and may not be able to be foresightful enough to know when to ask for his or her other son's help.

I know it is difficult to ask for help when you are an active healthy adult in your 60s or older. From my professional experience of working in hospitals and emergency rooms, I can say most people admitted didn't anticipate whatever caused them to go to the hospital. Be it an accident, a fall, confusion, or sudden drop in blood pressure, many times neither the patient nor the family were prepared. That is why I strongly recommend families start talking about the inevitable now, when everyone is healthy and active. When the eventual care recipient can be part of the solution and provide many of the answers to some of the most difficult questions. Keep in mind, the questions won't disappear, in fact they will increase over time, but the person with the answers may not be able to tell you what they are.

What is the cost for not talking?

There are news articles and videos all over the internet (http://www.wfaa.com/video/yourdollar-index.html?nvid=353748) stressing the importance of talking to other family members about the care of an aging loved one. Unfortunately, families still tend to be reactive rather than proactive. It may be partly due to the aging parents not wanting to "burden" their adult children, or the children not wanting to face the reality of their parent's health. In either case, the adult children will be put in a situation that can quickly become overwhelming. Not only will the children be facing the possible financial responsibilities of their parents' care, but the emotional impact this care has on others in the children's lives. Let me describe a situation of a typical caregiver, Sally. She is a 46 year old married mother of two children, ages 12 and 9. She works outside the home, and given their current financial situation, not working is not an option. She is the oldest of 3 siblings, and none of them live in the same city as their parents or each other. One day, Sally gets a call from her parent's family doctor, who informs her that her mother is not doing well, and will need more assistance at home. Although her mother is still married to her father, his health is fragile. Furthermore, it is her mother who oversees many of the household responsibilities, such as cleaning, cooking, driving, and paying the bills.

• How is Sally supposed to go out of town for an unknown length of time?
  
• How will her two children be affected with their mother being gone?
  
• Will she lose her job?
  
• How bad is her father's health?
  
• Is he even able to take on some of the household duties his wife was doing?
  
• Will his health further decline?
  
• Does Sally's parents have any long term care insurance to cover the cost of in-home care?

These are just some of the questions families have to face if they are not prepared for a call like the one Sally received. These calls happen all the time. I know, as I was the one making these calls to the families. I was the one helping the families answers these and many other questions. I, also, know that many of these questions could and would have been answered if only the children would have talked prior to this phone call.

Don't be afraid to stand up and speak

Since introducing the idea of life transition planning, so many people have said what a great idea we have uncovered. In fact, people have stopped me and said that it is such an important thing and so necessary. I was in line the other day waiting for a coffee and I ran into somebody who had recently read an article about Full Circle. She said to me that she knew someone that needed our help.

So here is my issue. That woman that had a friend with a need, she too needs our help. You see she has parents and they are going to age soon. If you know that you will one day have to step into the role of being a caregiver or decision maker does it make sense to wait until a crisis hits? Absolutely not. So each time I bring up what we do and why it is important, I almost always get strong confirmation. It is not easy to sign up for something that nobody wants to be part of, but one way or another most of us will be in the role one day. I think of it like a person that hates to do public speaking but must give a huge presentation to a room full of people. One way or another you will be on stage so make sure to do the preparation and even rehearse. You will be assure a better performance this way.

Listen to your gut

Now that the holidays have passed, it is quite common to reflect on your time with the family you just left. You think about how big your nieces and nephews have gotten since your last visit. You tell everyone the same thing you say every year, “We really need to see each other more often.” As the whole visit runs through your mind, the image of one or both of your aging parents keeps popping up. “Mom didn’t seem herself this time.” “Dad looked older.” “Dad was more withdrawn than usual.” These thoughts happen to countless families every year, and can begin to illicit the breathe-gasping response, “Mom and dad aren’t doing as well as I thought they were.”

This is when phone calls begin to occur between you and your siblings and other relatives, looking for confirmation that what you saw was really what you saw. Of course, there will be some relatives who will say “You are crazy, mom and dad are fine.” “There is nothing wrong, they looked great and were no different than last year.” “You’re over-reacting.” But something just doesn’t sit right with you. Your stomach is telling you something. You start second guessing and doubting yourself. That leads to retrospective searching for other signs and red flags over the past several months. Although others may or may not have noticed a change, you did and that is what is important. From my years of professional experience, the signs are right before your eyes, but you are either unaware or in denial of their presence. Your stomach is probably right.

This can be the beginning of when the family could be more involved. This doesn’t mean it’s time to move across town, panic or start making drastic changes to anyone’s life. Being more engaged can simply be adding a few phone calls a month or visits to the home. By being more connected, you have the opportunity to see what other changes have been taking place. See if what you experienced during the holiday visit was just the result of the natural stress of the holidays or truly a pattern. Being more present, will not only allow you the opportunity spend more time with your parents in general, but also to begin the inevitable full circle process of caring for a loved one.

The biggest gift you can give to your parents this holiday

As the holidays approach and you are out looking for that perfect gift for mom or dad, consider giving them a gift that costs nothing but means everything. The gift of conversation. While you consider topics that have real value, none is more important than how they hope to age gracefully and what you the adult child can do to help make that a reality. Often this conversation is the elephant in the room, and the gift you give is setting it free. You see, neither parent nor child wants to think about a time when declining health or aging create a change in the most sacred of relationships. However, just knowing that there is a support system that will be there is comforting and validation of the tireless effort of raising you. In fact, that gift of nurturing love will now be returned as they face their later years.

Simply telling your parents that you want to be there to preserve their quality of life is significant. While the parent is reassured by the idea that the adult child will take care of them, it is the adult child that actually benefits most. The idea that giving is better than receiving is absolutely true in this case. Knowing what your parent expects and having the information to fulfill their wishes is invaluable. It means that you will not have to wonder what to do during a time of need. The stress of the process will be mitigated through planning. Best of all, that human feeling of guilt won't come into play because clear expectations have been stated. So this holiday, don't buy wrapping paper or bows. Don't fight traffic at the mall. Give the gift of conversation.