The 40-70 Rule: Solving Communication Issues Within Families

Many experts agree: by the time someone is approaching age 40 and their loved one is around 70, they should have had “the talk” about issues so many families want to avoid. Topics such as living and financial choices, health, driving, dating and the end of life can be perplexing.

The Home Instead Senior Care franchise network refer to this concept as the 40-70 Rule, a program launched to start important conversations early, before a crisis occurs.

Backed by recent research with seniors, their adult children, senior care and legal professionals, Home Instead, Inc. now wants to take those important conversations further.

The 40-70 Rule: An Action Plan for Successful Aging and accompanying resources encourage individuals and families not only to start those vital conversations soon, but to finish them with a plan that can help take the guesswork out of aging.

The plan encourrages individuals of all ages to ACT (Assess, Consider, Talk) on their desires and wishes for the future, then put their plan into action.

Whether you want to know more about being better prepared for growing older or you want to help your clients be ready, pre-register for this month’s web conference, which will feature more about the Action Plan for Successful Aging and a variety of other resources

Continuing Education Credits (CEU)
April 8, 2015
10AM Pacific  / 11AM Mountain  /  12PM Central  /  1PM Eastern

For more information about the Action Plan for Successful Aging and how to make sure others know about your plans and wishes, attend a free web conference and earn free CEUs. These CEUs are offered in cooperation with the American Society on Aging.

For more information and to complete the required pre-registration, go to caregiverstress.com/professionaleducation for more information.

Cooking Under Pressure: An Introduction

Healthy eating is essential for people of all ages, but for many seniors, a well-balanced diet is the key to feeling their best. In fact, nutrition experts consider good nutrition the first line of defense in the fight to stay healthy.

Research conducted by the Home Instead Senior Care franchise network supports the important role healthy eating plays in successful aging. The caregiving network found that eating 62 percent of adult children in the U.S. and 57 percent in Canada caring for an older adult said their senior had three or more nutritional risks including:

1. Three or more prescribed or over-the-counter drugs per day

2. An illness or condition that made the senior change his or her diet

3. Having lost or gained more than 10 pounds in the past six months without trying

A variety of issues, from medications and illnesses to memory problems and physical constraints, can jeopardize a senior’s ability to maintain a balanced diet. Seniors may find grocery shopping difficult, feel uncomfortable in the kitchen or lack the skills necessary to maintain a well-balanced diet. Caregivers often want to help but may not have the time or ability to assist with daily meal planning. Factor in mixed incomes and a shaky economy, and it’s easy to see why achieving a healthy meal plan can be a pressure cooker of stress for seniors and caregivers alike.

With so many “cooks in the kitchen,” a senior’s diet is sure to suffer. This handbook is designed to help you understand the importance of senior nutrition and offer some no-nonsense ideas to transform mealtime into a healthy and pleasurable experience for everyone.

Thank You!

Often times the senior citizens in our community can get overlooked and sadly around the holiday times is when they need our support the most. This year Home Instead Senior Care wrapped over 3,000 gifts for Senior Citizens in need this holiday season with our ‘Be a Santa to a Senior’ program.

Thank you to everyone who donated gifts and to all of our volunteers who helped put this together! It means so much to us and means so much more to our senior citizens that you would give your time and support.
Thank you again and we wish you all a wonderful holiday season with
your friends and loved ones!

What Is Home Care?

The term home care actually describes two very different types of care:

• Home health care provided by licensed medical professionals, in which you need a prescription.
• Non-medical home care, such as personal care, homemaker or companionship services provided by professional caregivers.

In broader terms, home care that seniors require often revolves around the Activities of Daily Living (ADLs) and the Instrumental Activities of Daily Living (IADLs). These are provided under non-medical home care.

ADLs are basic activities and functions performed on a daily basis that are usually done without assistance. The six ADLs are:

• Eating
• Dressing
• Bathing
• Toileting
• Transferring
• Continence

IADLs, on the other hand, are those activities instrumental to our daily routines such as:

• Driving
• Preparing Meals
• Doing Housework
• Shopping
• Managing Finances
• Managing Medication
• Using The Telephone

The 40-70 Rule: Advanced Directives

Life Legacies

Your 80-year-old widowed father is starting to have health problems. You know your parents have a will but, beyond that, you have no idea what else needs to be in place. What more does your dad need and how do you begin the conversation with your parents about these issues?

Vital Designations

Aside from a will (and finding it), there is much information needed to prepare for leaving a lasting legacy. First, has your father considered advance care planning and has he named a Personal Representative and powers of attorney? A web search of “advance directions” will provide state-by-state details about legal documents required to ensure trusted people will be able to make decisions for your father if he is not able to do so for himself.

A durable power of attorney for health care, also called a health-care proxy, can protect your parents’ desire to carry out their end-of-life wishes. It will be important for your family to educate yourselves about various medical treatment options then put those wishes in writing. A living will is a document that specifies your wishes about important health-care decisions

Getting Started

Second, your dad needs a personal, pre-planning checklist. This is a list that will help his family know the friends and professionals he would like notified if something happens to him, what accounts to close, what announcements to post, which wishes to carry out and the non-titled property to be disbursed. Brainstorm a list of information that would possibly be needed. Include names along with contact and account numbers for: retirement pay, insurance policies, investments, back accounts and safe-deposit boxes, properties, preferred law and accountant firms, pre-paid arrangements for death – anything that comes to mind.

Important Details

Don’t forget to make note of phone service, newspaper delivery, real estate agent, veterinarian, association memberships, family, friends and neighbors who should be called. Detail wishes for final arrangements. Has your parent written an obituary? In what newspaper or newsletter would he like an obituary to appear? Is there a place where donations should be made in your parent’s name? If there will be a memorial service, who will deliver the eulogy and how should the funeral be conducted?

Perhaps a credit card could be made available for your father’s Personal Representative to use when carrying out official duties after his death. (Suggestions: Carefully stipulate how the card is to be used and that it is to be destroyed once the duties are carried out.) Property disbursement – specific items that go to specific people – might also be discussed and written down. Let your checklist evolve as you learn and talk with others. If all this information is signed, dated and kept together (with the will) in a safe location know by his adult children, then Dad will be truly good to go.

What to Say

So how do you begin the discussion with your dad about such a sensitive subject? How about designing a pre-planning checklist for yourself? (After all, you’ll need one someday, too.) You might begin by engaging your dad in conversation: “Dad, I’m preparing a checklist in the event something happens to me…and for the inevitable. Would you look this over and see if this makes sense to you?” If possible, involve all siblings in the process. If you make copies of this checklist for Dad and your siblings, he would be more likely to pull one together for himself. This could even turn into a family project, whereby the adult children help suggest and gather the information, so that everyone stays in the loop. And, if everyone is working on their own checklist, Dad won’t feel so “singled out.”

The 40-70 Rule: Conversation Starters (Part 4)

The Money Talk

Your parents have always been very independent and private about handling their finances. Lately you’ve seen that they’ve been cutting back on food and other necessary products. You’re concerned that their staples are in short supply. How do you broach this subject?

This is a tough one and probably a situation where you need to “bite the bullet” and talk about it, no matter how uncomfortable. Some reasonable conversation starters might be, “Boy, there’s not much food around the place – what are you guys eating?” Pay attention to the tone you use. This sentence could be said in an accusatory or a humorous fashion. Obviously the latter is more likely to get a positive response.

If this is too informal, try a more straightforward approach: “Mom, I’m a bit concerned about whether you and Dad are eating enough.” Malnourishment can be a significant problem with older adults, and can be a sign of other issues that might need attention over and above finances – such as poor-fitting dentures or even depression.

If the other evidence points to a financial issue, ask about that directly or simply make an offer: “I know you’re pretty private about money, but you know that if you ever ran into problems I’d do what I could to help, right?”

And don’t forget about different communication channels. Sometimes, it’s easier to at least start the discussion of emotional or private issues in a less personal communication medium, even if it’s only to say that you want to talk to them about the issue. For  some people, raising this kind of issue can be easier on the phone, or even in an e-mail. Once you’ve said what you want to talk to them about in an e-mail, it’ll be a lot easier to raise the topic in person. You may even find them doing it for you. For example. “What’s with this e-mail you sent us, eh?”

When Dad Starts to Date

Since your mother died a year ago, your 77-year-old father has started dating a widowed family friend. You’d like to know more about what’s going on, but how do you begin the conversation?

If you want to introduce the topic, a gentle inquiry like the following would be fine: “So it seems that you’ve been seeing quite a bit of ‘Fran’ recently.” After this, you should probably see whether your dad wants to share additional information. If he doesn’t, that’s his prerogative.

One exception would be if you have some information that there is abuse or exploitation in the scenario. For instance, if you sense that your dad’s love interest may be taking advantage of him financially, some additional probing might be justified, depending on the specifics.

If your dad has money and this friend doesn’t, and suddenly the friend shows up driving a new luxury car, you might ask your dad, “Do you know who bought her that car?” If the friend moves in with your dad and a lot of new things appear around the house, which don’t fit your dad’s style, you might ask, “This doesn’t look like your kind of thing, Dad. Did you buy this?” Otherwise, be happy that your dad has a girlfriend and don’t force him to disclose more than he’s comfortable telling you.

The 40-70 Rule: Conversation Starters (Part 3)

Sibling Communication

After finding many of the light bulbs burned out in your 86-year-old parents’ house, you believe that they’re beginning to need more assistance. As the oldest of five children in the family, how do you approach your siblings? What other resources can you tap into?

Siblings can be a good reality check. You might say to a brother or sister, “I think that Mom and Dad may be having problems changing their light bulbs. Have you noticed anything?” But it’s important not to get involved in a group-think cycle where the siblings all start seeing problems and building grand disaster scenarios.

If a parent needs a little more help around the house, that shouldn’t result in siblings picking out a nursing home and putting their parents’ house on the market. Perhaps all the parents need is a little extra assistance. Go to your Home Instead Senior Care office or Area Agency on Aging for resources that can help. A geriatric care manager also can be of benefit.

Research: Nearly three-fourths of respondents said it would be helpful to involve siblings in talking with parents, while nearly half said seeking counsel from a senior-care professional would be useful

Mom’s Not Safe at Home

Lately when you’ve been visiting your widowed 83-year-old mother, your notice bruises on her arms and legs. She said she’s just clumsy, but you suspect she’s been falling. You know she’s too independent to ask for help. How do you find out?

Bruising is a complicated issue. On one hand, bruising occurs more easily in older people; sometimes (especially with certain medications) bruising can occur without any injury, fall or impact of any kind. So depending on your relationship with your mom you may be able to believe her if she says that she’s not falling. On the other hand – and at the other extreme – repeated bruising might indicate either falling or some other form of physical trauma (e.g., physical abuse of some kind, perhaps). Of course, these two considerations lead to completely different solutions.

In the first case, there’s no cause for concern. However, if the bruising is significant she might want to consider medication adjustments. Ask her to consult her doctor. In the second case, intervention is clearly needed. It’s another case where considering the entire context is important. Has the increase in bruising occurred at the same time as some other change in her life? For instance, noticing significant bruising soon after your mom started working with a new home health care assistant, or after she moved into an assisted living environment, would be a red flag. Similarly, seeing bruising after she’s started on some new medication also might be a reason to attend carefully to the issue (e.g., certain medications might cause disorientation that leads to falls).

Why not start the conversation like this: “Mom, that’s a nasty-looking bruise! Where did you get that?” And then probe with another question if she gives a generic response such as “I’m just clumsy.” For instance: “Sure Mom, this whole family is clumsy, but we aren’t all walking around with big bruises on our arms and legs. So how did it happen?”

Research: Health was among other difficult topics for Baby Boomers to broach with their senior loved ones.

The 40-70 Rule: Conversation Starters (Part 2)

When the House Is a Mess

You find that your 77-year-old mother’s house is often in disarray when you visit. You believe it’s time for her to make a change in her living arrangement. What do you say?

Observation and careful attention to the problem should be your first course of action. Avoid diagnosing a problem and deciding on a solution quickly. Approach your mother with a sense of working together to find a solution rather than telling her what to do.

The specific circumstances – such as financial constraints – may be relevant. Is the problem simply that your mother is physically challenged by strenuous housework or is she deteriorating mentally? Does she just need help tidying up around the house or are other aspects of her personal care, such as bathing, going downhill?

Assuming that the problem is physical – where activities such as vacuuming or bending are becoming issues – then begin the conversation with an offer: “Mom, I have some extra cash. What do you say we find someone to help you with the heavy stuff, like vacuuming? It will be my treat.” Seniors are often very willing to accept help around the house. And most communities have ample resources such as cleaning services and companies like Home Instead Senior Care that can help.

Research: The most difficult topic for adult children to discuss with their aging parents was that they have to leave their home. That conversation was a problem for more than half of those who were still in the parent-child role, as well as more than one-third who didn’t have the communication obstacles.

A Senior Moment or Something More?

You’ve just stopped by your parents’ house and for the second time in a month, noticed that your 70-year-old mother has forgotten the name of a close friend. Is it Alzheimer’s disease or dementia, a senior moment or just a passing phase? More importantly, how do you find out?

Make sure you consider you mom’s history and personality so that you can determine if this is a change. Some people have always been bad with names, but if your mom is forgetting a close friend’s name and you notice signs of disorientation, you might say: “Gee Mom, perhaps you should see a doctor and get checked out. I’m sure it’s nothing, but it would really put my mind at ease if you’d let a doctor make sure your memory is O.K.” Such a conversation starter focuses on the positive not the negative.”

Research: A parent’s cognitive condition was a topic that 50 percent of Baby Boomers wanted to know more about.

The Medication Quagmire

When visiting your 85-year-old dad, you see bottles of medication on the kitchen counter, on the bathroom counter and on his nightstand. You wonder how he is keeping all of his medications straight. What do you ask?

It’s good to use humor and, in a situation like this, to assume that he is keeping them straight (innocent until proven guilty). There may be good reasons why some of his medications are in the kitchen (he’s taking them with food), while others are on the nightstand (he’s taking them before bed).

Pointing to a bottle and asking, “How the heck do you keep all these pills straight, Dad?” would be a good conversation starter. If the response includes the reasons you suspected above, then it sound like things are under control. If, however, he says, “I don’t know. I do my best. I’m not even sure what some of them are,” then the situation probably needs more attention.

If he’s having a problem, talk to him about a pill organizer, which could help him keep his medications better organized: “Dad, I’ve heard about organizers that can help you keep all your pills in one place and make it easier for  you to keep them straight. Why don’t I check into it?” In addition, one service that Home Instead Senior CAREGivers provide seniors is medication reminders to assist them in managing their daily medications.

Research: Forty-nine percent of adult children said they were interested in learning more about their parents’ medication management.

The 40-70 Rule: Conversation Starters

To help adult children of older adults know what to say, following are various scenarios of common senior topics. Each is backed by Home Instead Senior Care research conducted in the U.S. Responses were developed in cooperation with Jake Harwood, Ph.D., communication professor and author from the University of Arizona.

When Health Changes Lifestyles

Your 70-year-old widowed mother has just been diagnosed with macular degeneration, a disease that causes deterioration of eyesight. How do you begin a conversation with her about the possible ramifications of this disease on her life?

Many seniors in this situation might begin the conversation with family themselves. If not, then it would be good to think about her personal circumstances and important areas to address. For example, if your mother lives in a remote area, transportation is probably the most immediate issue. Approach the conversation with the goal of trying to resolve this one issue, rather than multiple issues.

Timing is the key. There are rarely urgent deadlines that have to be met immediately – give yourself and your parent time to think about issues. Your mom would likely be receptive to a conversation that begins: “Let’s figure out a plan for how you can get around town if you no longer feel safe driving.”

Research: Nearly one-third of Baby Boomers said their biggest communication obstacle with aging parents is continuation of the parent-child roles that emerged in childhood, making discussion of sensitive issues even more difficult.

Did Dad Hit a Light Pole?

A neighbor of your 83-year-old dad has called to tell you he saw your father back his car into a light pole. What do you say?

If the damage is visible, you could ask, “Hey Dad, what happened to the car?” Or you could bring up the phone call from his neighbor. “Fred from next door called and said he saw you run your car into the light pole.” This is an example of a situation that calls for more general observation. Take the opportunity to drive with your parent. Even a short drive would help you gauge your dad’s skills and deficits.

For instance, an older adult who consciously reduces driving at night because of vision issues or who drives a little slower to account for reaction time is probably safe. On the other hand, an 83-year-old who insists on driving icy highways at night while doing 75 mph is probably in need of immediate intervention. Then gear your comments accordingly. If you’re concerned that your dad is unsafe on the roads, make this safety and that of others your focus. “Dad, I’m worried that you’re no longer safe on the roads and that others could be at risk at well.”

You’re Going to Wear That?

You’re planning a birthday party for your 85-year-old mother and she insists on wearing her favorite blue dress. Because her eyesight is poor, she can’t see that the dress is stained and worn. What do you do?

It’s important to determine whether this really is an issue – that the stains are worth addressing with your mother. If so, be direct: “Mom, did you know that your party dress is stained?” Then offer to have it cleaned, or better yet, suggest a shopping trip: “Mom, this is a really special occasion. I’d love to buy you a new outfit. Let’s go shopping.”

If she still wants to wear the dress, then a family council or a fight with your mom is simply not worth it. You may need to figure out a way to overcome any embarrassment that you feel at your mom’s appearance, but ultimately what she wears should be her choice. The embarrassment that you feel is your problem, not hers. Chances are, though, if she knows you are apprehensive about the dress and willing to help her find a new one, she will agree.

The 40-70 Rule: 7 Tips To Help Boomer Children Communicate With Their Aging Parents

Many adult children are aging adults know how difficult it can be to talk with their parents about certain topics. Following, from Home Instead Senior Care and communication expert Jake Harwood, Ph.D., from the University of Arizona, are tips to help family caregivers communicate with their aging parents on sensitive subjects.

1. Get started. If you’re 40 or your parents are 70, it’s time to start observing and gathering information carefully and thoughtfully. Don’t reach a conclusion from a single observation and decide on the best solution until you have gathered information with an open mind and talked with your parents.

2. Talk it out. Approach your parents with a conversation. Discuss what you’ve observed and ask your parents what they think is going on. If your parents acknowledge the situation, ask what they think would be good solutions. If your parents don’t recognize a problem, use concrete example to support your case.

3. Sooner is best. Talk sooner rather than later when a crisis has occured. If you know your loved one has poor eyesight or has trouble driving at night, begin to address those issues before a problem arises.

4. Forget the baby talk. Remember you are talking to an adult, not a child. Patronizing speech or baby talk will put older adults on the defensive and convey a lack of respect for them. Put yourself in your parents’ shoes and think of how you would want to be addressed in the situation.

5. Maximize independence. Always try to move toward solutions that provide the maximum amount of independence for the older person. Look for answers that optimize strengths and compensate for problems. For instance, if your loved ones need help at home, look for tools that can help them maintain their strengths. Professional caregiving services, such as those offered by Home Instead Senior Care, provide assistance in a number of areas including meal preparation, light housekeeping or medication reminders. Or find friends who can help.

6. Be aware of the whole situation. If your dad dies and soon afterward your mom’s house seems to be in disarray, it’s probably not because she suddenly became ill. It’s much more likely to stem from a lack of social support and the loss of a life-long relationship. Make sure that your mom has friends and a social life.

7. Ask for help. Many of the issues of aging can be solved by providing parents with the support they need to continues to maintain their independence. Resources such as Home Instead Senior Care, Area Agencies on Aging and local senior centers can help provide those solutions.