It often makes the news when elderly drivers get into accidents in Florida, such as the case of a 90 year old man crashing into a pawn shop in Clearwater.  These accidents tend to renew the discussion about driving laws and senior driving safety. While not every incident is age-related, it brings in to question whether individuals should be driving at such advanced ages or what testing/monitoring should be done. But, beyond the larger societal questions, this is a very personal issue for many families.

When you’re worried about an aging parent driving, it can be very difficult to 1. know when your concern truly merits that it is time to stop driving (or force the issue) and 2. convince the person that continuing to drive is unsafe (or have a dignified discussion about the situation).  A driver evaluation or assessment can be very helpful with both of these issues.  An elderly driver assessment:

• Provides objective testing criteria and evidence of potential problems with driving and continued safety
• Can offer middle-ground solutions, such as limiting driving at night, a refresher course or accommodations for the driver or car
• Frames the discussion/decision in the objective testing criteria versus emotions and potentially subjective feelings about safety

When should you consider a senior driving assessment?  If you have concerns or your loved one has had “small accidents” or incidents while driving (or mentions their own fears or concerns), now is the time.  If you have tried talking about the situation to no avail, this might be an ideal way to more effectively address your worries (and your loved one’s feelings that your worries aren’t warranted).  If you or a loved one has had a major health change or recently come out of the hospital/rehabilitation after some time, it might be appropriate to get an evaluation to be safe.

Florida offers a Fitness to Drive screening tool, which can be one place to start screening your concerns, if you have driven with the person recently.  Different hospitals and agencies offer elderly driver evaluations (though they are not necessarily just for the elderly, as they are often recommended to someone of any age who had a brain injury, stroke or other illness/injury which could impair driving).  You can check the Association for Driver Rehabilitation Specialists by state/area to locate resources near you or contact a local geriatric care manager to help you identify resources and handle the process.

How can a geriatric care manager help with elderly driver evaluations? An Aging Wisely care manager can help with a Tampa Bay senior driver assessment by:

• Assisting with a comprehensive evaluation of this and other safety and resource issues.  Providing you with prioritized recommendations and resources to help.
• Arranging and serving as a liaison for a family conference/discussion about driving safety or other concerns.  Helping your loved one maintain dignity and choice while coming up with safe solutions.
• Arranging a Tampa Bay elderly driver evaluation and help your family through the process.
• Helping you with a wide array of resources, such as CarFit, senior driver education courses and solutions to health and safety needs (related to driving or not).
• Planing alternatives for post-driving (transportation and services to ensure your loved one can maintain activity).  Depression and isolation are common for elders who stop driving with no alternative plans in place.  There are many great Clearwater senior driving services and resources.

Aging Wisely’s team has worked with many families over the years on evaluating elderly driver safety and coming up with solutions.  Our Senior Driving Safety handout has been widely read by families and professionals.  We recommend downloading it if this issue concerns you, and welcome you to share it with family members and friends.

At Aging Wisely, we are committed to helping families with this issue and offering the best possible solutions for elders.  We all understand the difficult pull between the independence driving affords and the real dangers driving presents.  When you’re worried about an aging parent driving, let us be your advocate in finding the balance with dignified solutions. Call us at 727-447-5845 to discuss how we can help.

*Image courtesy of Bill Longshaw/FreeDigitalPhotos.net

While celebrating Mother’s Day and Father’s Day, we reflected on how relationships with our parents change over time.  Senior caregiving in particular affects the relationship between parent and child in a number of ways.  Here we share some information about changing relationships in senior caregiving and tips for making the most of your time with elderly parents. 

Working with many caregiving families over the years, we recognize certain patterns that emerge as the younger family member takes on caregiving tasks and begins to handle various life issues for their older loved one. 

Sometimes people refer to this dynamic as a “role reversal” (or “parenting my parent”), in other words the adult child becomes like the parent to the elder.  We feel this is an oversimplification of the dynamics.  First, it is impossible to have a “role reversal” because of the past history and roles which your family has had throughout life.  Because of this, the changes that take place in caregiving are much more complex than a simple role reversal.  The elder parent is likely experiencing a great number of losses and many emotions of needing more help from adult children.  When you are raising a child, you’re there to support him/her in order to grow in to a healthy, independent adult.  It is a different feeling to recognize that a parent is becoming more dependent on you.  Your parent is an adult and this terminology seems to undermine that fact.

However, when people mention this “role reversal” they are simply looking for a way to express the role changes that do occur when an older person needs more assistance from the adult child.  The parent may now be calling the adult child for advice and relying on various forms of help.  No doubt, there is the very real feeling that things are changing and the nature of the relationship is much different than it once was.  Working closely with many different families handling senior caregiving, we have seen different strategies for dealing with these changes–some more successful than others.  To make the most of your time with older loved ones, consider some of these success strategies for preparing for and dealing with these relationship changes.

Here are some tips for maintaining quality family relationships as a senior caregiver:

• Figure out ways to incorporate non-task time in your visits with elder parents.  Especially if you are a long-distance caregiver, your visits may be rushed and filled with tasks that need to be handled.  This is a common regret we hear about from caregivers, who know that time with Mom or Dad may be limited.
• In order to accomplish the above and maintain a relationship not solely based on caregiving tasks, consider hiring outside help to assist.  If Mom or Dad has someone to help with one or more areas, it relieves some of your stress and creates room for more quality time.  It can be a big relief for Mom or Dad, too.  It is not always easy relying on your adult child for so many things.  Particularly if you’re feeling stressed about it, your parent might feel they’re overburdening you.
• Have an outlet to talk through your feelings.  A support group, counselor or geriatric care manager can be a valuable resource as you move through different stages of caregiving.  Friends and family members may be supportive, but ultimately it is nice to have a specific place to vent your feelings, get advice and perspective.  Caregiving can also bring up a lot of old resentments and highlight difficult dynamics that already exist.
• Devise a plan for dealing with your biggest stressors.  It may seem like some of the challenges that come with senior caregiving have no solutions, but many times there are ways to address/reduce them.  Think about what worries you most or causes you the most frustration.  Talk to others about ways they have addressed these concerns.  Consider getting a geriatric care management assessment or care consultation to pinpoint solutions.
• Don’t forget sibling dynamics.  If you have siblings or other relatives involved, they can be a great support but also an added source of stress.  Even siblings who get along very well may have different perspectives on caregiving or grow resentful of seemingly unbalanced roles.  Consider planning family conferences at regular intervals.  You might have a care manager involved with some or all of these, to organize the meetings and give input.  An outside, “neutral” opinion from an expert can help head off disputes.  Professional input and legal planning may be especially important if there are sibling disagreements or other family challenges prior to caregiving.  Make the professionals you work with aware of these concerns.

Need help?  Give us a call at 727-447-5845 or click below to request a phone consultation about your concerns.  Aging Wisely provides solutions when you need them to help you manage the challenges of senior caregiving. 

*Image courtesy of photostock / FreeDigitalPhotos.net

Frail elderly people are particularly vulnerable during hurricanes. Of the 1,330 people known to have perished along the Gulf Coast as a result of Hurricane Katrina, 71% of those in Louisiana were older than 60 years, 47% were older than 75 years, and at least 68 died in nursing homes.  Individuals with special needs, medical conditions, disabilities and those who are reliant upon caregivers and outside support face particular difficulties in managing during and after a natural disaster.

Here are some of the most common mistakes made in hurricane planning and senior safety tips for Florida elders to minimize risk and be more prepared:

• Being inadequately insured and logistically unprepared.  It is vital to talk with your insurance agent to make sure coverage is adequate and updated, understand your deductible and the details of going about a claim.  Organize important papers and have key numbers handy.  Complete a thorough home inventory.

• Not taking a serious look at both the home and resident(s)’ ability to self-preserve in a storm.  Now is the time to review overall home safety and consider hurricane reinforcement improvements, especially for older homes.  It is also the time to put together emergency supply kits, both for the home and for possible evacuations.  As far as the person(s) in the home, it is vital to assess the ability to care for one’s self through the storm and beyond.  Be realistic about the dirty and dangerous truth of what it can take to survive in rough conditions.

• Underestimating the aftermath of storms.  We all know that many residents, young and old, choose not to evacuate.  Many who have lived in the area for some time feel they have always made it through safely in the past and can continue to do so, a common refrain during Hurricane Katrina.  All of us must understand that even emergency personnel may not be available during dangerous weather (911 services are called off when winds reach a certain level), and during the aftermath of storms, basic infrastructure may take weeks or months to function normally. The individual should imagine functioning without electricity, limited/no services and support, and limited access to food or other supplies.  The environment is not conducive to health and wellbeing, to say nothing of personal hygiene or comfort.  Individuals in high-rise apartments or condos may be cut off by virtue of being unable to make it up and down many flights of stairs when elevators are not functioning.  It is important to take the weeks after a storm in to account in planning supplies and other needs.  Consider the aftermath carefully when deciding to weather out a storm at home.

• Counting on the public safety net as your first line of defense.  Pinellas County offers special needs shelters and assistance evacuating for those who need it (individuals should contact the county now to register).  These resources offer a safety net, but are not meant to be citizens’ first line of defense.  Special needs shelters, for example, cannot offer acute medical care, have few cots, no hospital beds and may well be without electricity (air conditioning).  Residents who evacuate there will need to bring their own bedding and supplies, medications and any special food items.  It is a safe, but not comfortable, environment.  Individuals should consider alternative arrangements such as evacuating to a relative or friend’s home in a safer area, or booking a respite stay at an assisted living or care facility. 

• Neglecting crucial details.  Get an emergency supply of medications.  In 2006, the Legislature passed the Emergency Prescription Refill bill, Florida Statute 252.358 and 462.0275. This law requires all insurers and managed-care organizations to suspend refill-too-soon restrictions when a patient seeks a refill in a county under a hurricane warning, state of emergency or activated Emergency Operations Center.  This law also allows patients outside of these areas to get an emergency 72- hour refill if the pharmacist is unable to readily obtain refill authorization from the doctor.  Put together a list of all medications, diagnoses and key contacts to keep with you.  Additionally, individuals should check with care providers to review their emergency plans (all Florida Agency for Healthcare Administration licensed providers must submit a plan to the state) and consider alternatives.  People who rely on medical equipment or outside services should make provisions.  If you use equipment that needs electricity, you can register with the power company for priority reconnection service and your medical equipment provider may be able to offer alternatives (battery backups, for example).

Aging Wisely is offering our Hurricane Preparedness Package for the affordable price of $199, to assist Tampa Bay area seniors with being better prepared for Florida hurricane season.  Our planning process addresses critical safety issues in the home as well as evacuation alternatives for different scenarios.

Hurricane warnings generally come within 72 hours of a storm’s hit.  At that point, it is too late to properly plan for someone who has mobility issues or special needs.  If you have questions or would like to have help with hurricane planning or other senior safety issues, give us a call at 727-447-5845.

Caring for elderly parents long distance? Aging Wisely conducts Florida geriatric care assessments on behalf of many families who live elsewhere around the country and world and are concerned about their elderly loved ones in Tampa Bay.  Here we will share with you the primary benefits of having a geriatric care management assessment done and the the types of solutions it offers for long-distance caregivers.

Caring for elderly parents long distance poses several major challenges:

1. Difficulty understanding what is really going on and how your loved one is managing day-to-day: often an elderly parent will rally for your visit (and phone calls) and what you see might not be a true picture of daily functioning. 
2. When you do not see a loved one frequently, changes may seem drastic.  You don’t see incremental change over time, so when you visit or a crisis occurs it can feel like it came on suddenly.  You may not feel like you have a real baseline of what’s normal for your loved one anymore.
3. Long-distance caregiving tends to be highly crisis-driven.  You may have already experienced the dreaded “phone call” when something has happened and you find yourself in a panic trying to get to Florida.  You may start to get anxious at the mere sound of the phone ringing.
4. Your visits often become extremely task-driven and overwhelming.  You probably have limited time and many important things to take care of for your loved one when you’re in town.  You may feel stressed to get everything accomplished, and it can be especially overwhelming for your older loved one.

How does a geriatric care management assessment help you with solutions to these long-distance caregiving issues?

1. An expert professional paints a clear picture of where things stand for you, outlining various areas of functioning and identifying concerns and resources.  Care managers are specialists in assessing elders.  We know how to see beyond what the client states and observe sometimes subtle signs/symptoms.
2. We help put changes and issues in to context.  The geriatric assessment also helps you to prioritize concerns and get reassurance about the situation, which provides a lot of peace of mind when caring from long distance. Beyond the initial assessment process and resulting report, regular care management visits also involve assessing ongoing status and spotting changes before they become a problem.
3. The assessment offers targeted recommendations, to proactively address potential concerns. The assessment is all about prevention and working towards a goal of reducing crisis by better management.  You get tailored recommendations and solutions that can really make a difference to your family.  You also gain a resource you can call upon as things change or issues arise.
4. We can help you implement recommendations and be your partner in managing care.  Families that we serve have often told us that the best thing about working with a care manager is the freedom it gives them to “be a daughter again” (or son, etc.).  When you have limited time with your elderly parent, that time is precious.  If you are planning a visit, the assessment gives you a starting point and helps you organize tasks better.  We can help take care of things before, during and after your visit.  We don’t take anything away from your role as family caregiver, but we can add to your ability to better manage that role and the many others you are likely juggling.

Are you caring for an elderly parent in Florida long distance?  Contact us at 727-447-5845 for questions or to schedule a geriatric care assessment.  Our Senior Care Consultant, Sue Talbott, is available to talk to you about your assessment needs and long-distance caregiving challenges.