What to Do About Parents Getting Older – The Caring Generation®

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The Caring Generation® – Episode 99 August 18, 2021. On this caregiving program, expert Pamela D Wilson talks about what to do about parents getting older. Guest. Dr. Claire Ankuda shares research about homebound older adults and the risks of becoming homebound to health and well-being.

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What to Do About Parents Getting Older

0:00:04.0 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

Watch More Videos About Caregiving and Aging on Pamela’s YouTube Channel

0:00:37:50 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring. Giving us permission to talk about aging, the challenges of caregiving, and everything in between. It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone.

0:01:03:06 Pamela D Wilson: You’re in exactly the right place to share stories, learn about caregiving programs and resources to help you and your loved ones plan for what’s ahead. Invite your aging parents, spouses, family, and friends to listen to the show. If you have a question or an idea for a future show, share your idea with me by responding to my social media posts on Facebook, Instagram, Twitter, or Linked In.

0:01:30:71 Pamela D Wilson: The focus of this show is talking about how to notice signs your parents are getting old and what to do about parents getting older. In the first part of the program, we will talk about the body and mind aging process and how these changes translate into increasing risks for physical disability to give you a larger perspective of aging. In the second half of the program, I will share practical signs your parents are getting old.

0:02:01:21 Pamela D Wilson: Things to watch for and how to make plans for their care. If you are a caregiver or an adult listening for yourself, you can learn about important aspects of health to monitor today to minimize the potential effects of aging in your body and think about planning for your own care needs. The guest for this program is Dr. Claire K Ankuda, Assistant Professor in Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai.

0:02:32:61 Pamela D Wilson: Dr. Ankuda joins us to share research about homebound older adults – their experiences and the risks homebound adults experience. She earned an MD from the University of Vermont and an MPH from the Harvard School of Public health before going to the University of Washington for family medicine residency. She was a Robert Wood Johnson

0:02:56:89 Pamela D Wilson: Clinical Scholar at the University of Michigan and conducted a 6-month policy externship at the Center for Medicare and Medicaid Innovation. Following this, she completed a Palliative medicine fellowship at Mount Sinai. Dr. Ankuda is a health services researcher who assesses the impact of payment policies and health systems on outcomes for seriously ill older adults and their families.

0:03:25:81 Pamela D Wilson: Part of the answer to what to do about parents getting older is understanding aspects and behaviors related to aging. If you are a young adult in your 20’s or 30’s, it might be difficult to empathize or understand how a parent in their 40’s or 50’s might feel if mom or dad is mentally or physically ill. It is normal for people to ignore their health until something goes wrong. For example, a diagnosis that has an impact on

0:03:58:85 Pamela D Wilson: daily activities or an ongoing physical decline worsens and results in a change in physical ability and daily habits. These are signs your parents are getting old. If you are a middle-aged caregiver in your 40’s or 50’s and you’re healthy, you also may find it difficult to empathize with the struggles of elderly parents with health concerns. Trying to help elderly parents who don’t think they need help or refuse help can be frustrating.

0:04:30:19 Pamela D Wilson: Let’s gain insights about aging to understand what to do about parents getting older. How old are you versus how old do you feel? This difference is known as body age versus spirit or mental age. Age, in part, is all in our minds. A person can feel young at heart or old in a 70-year-old body. Research from Clark in an article from Aging and the Body —you can visit the podcast page on my website to find the

0:05:05:19 Pamela D Wilson: link and read the article—confirms that healthy older adults feel 10 to 20 years younger while older adults in poor health usually feel older than their chronological age. Guage the accuracy of this research—how old or how young do you feel? How do you look at aging, health, and illness? Here in the United States, the media paints a positive picture of youth—and not such a positive picture of aging.

0:05:37:07 Pamela D Wilson: Older women are viewed as old, while older men as distinguished. Let me give two media examples of this. If you have Netflix, I suggest watching a couple of episodes of the Kaminsky Method starring Michael Douglas. I won’t ruin the surprise by saying more about either of the examples I am giving. On the other hand, if you have an Instagram or Twitter account, visit the account of Paulina Porizkova, the former supermodel. You can find her at @paulinaporizkov.

0:06:20:29 Pamela D Wilson: How do your parents view aging? How would mom or dad react if you suggested that they visit the senior center? Would your parents think of a senior center as a place to meet active and interesting peers or a senior center as a place for older people who your parents might frown upon as being not at all like them? The answer to this question might give you insights into signs your parents are getting old and their thoughts about aging.

0:06:55:71 Pamela D Wilson: Cultural values, beliefs about aging, and how people adjust to changes when young impact how people respond to aging when older. Some cultures value the elderly, while others view the elderly as disposable. The healthcare system—doctors and other practitioners—have a bias against the elderly, although this is rarely discussed. If you want to learn more about aging healthcare bias, listen to The Caring Generation

0:07:28:30 Pamela D Wilson: Podcast, Is Healthcare Forgetting the Elderly, and my interview with Dr. Mary Wyman from the University of Wisconsin. Making the idea of what to do about parents getting older even more challenging is the belief that a person is at a lower risk of health problems than peers. What do you think about this? Do you see yourself as being healthier or having fewer problems than your peers?

0:08:00:00 Pamela D Wilson: If so, you are in good company. This belief is confirmed by research. Unrealistic optimism exists at all ages, with people believing that they are healthier than they are. Plus that if health problems are not evident, they are not real or unlikely to occur in the future. High blood pressure and diabetes are two chronic diseases that always don’t have symptoms and frequently go undiagnosed.  Signs your parents are getting old may be the denial of the necessity of seeing a doctor for an annual check-up – do you?

0:08:37:89 Pamela D Wilson: Until a person is sick, there is little experience with the healthcare system or doctors. At the point of diagnosis, few patients realize they lack information or skills. Rather than fret or worry about what you don’t know, seek information and answers to support skill-building and competency when caring for parents or yourself. Caregiver courses online, caregiver support groups, and disease organizations can give you some of the information you need.

0:09:15:23 Pamela D Wilson:  Avoid going down the wrong path, struggling, or making mistakes. This lack of skill or competence specific to health is not limited to what to do about parents getting older. We all have blind spots.  Noticing signs that your parents are getting older involves understanding how changes in the body or the mind affect performing daily activities or push a health diagnosis to advance.

0:09:46:20 Pamela D Wilson:  Let’s talk about caregivers who, when highly involved in care situations, neglect self-care and medical care. Women who have been caregivers for years raising children, taking care of a husband or parents tend to downplay the importance of health concerns. Most caregivers avoid calling attention to themselves. In part because caregivers do not want to be seen as complainers about the duty and responsibility they feel to care for loved ones.

0:10:23:83 Pamela D Wilson:  When caregivers ask family members for help—many of you know this. The requests usually fall on deaf ears because siblings lack experience with the caregiver’s daily work and level of responsibility. Siblings lack the ability or interest to empathize or offer help. Caregivers hesitate to place burdens or worry on an elderly parent or a spouse by expressing any concerns about self-care or other matters. The result is a faulty belief that the

0:10:58:59 Pamela D Wilson:  caregiver’s health issues are less serious than other people. So caregivers wait to set medical appointments and are diagnosed with multiple or more severe health issues.  On the other hand, men avoid medical appointments because illness or being sick is perceived as a personal flaw or not being manly. Delayed medical care for men results in the diagnosis of advanced health conditions.

0:11:26:26 Pamela D Wilson:  My brother was a perfect example. He did not see a doctor in spite of not feeling well for months. My brother came home for my father’s funeral. The stress made him sick. He had to go to the hospital. He was diagnosed with leukemia and sent immediately home for treatment. My brother died less than a year later.  How many of you relate to one or more of these examples about beliefs about aging and health with yourself or an aging family member?

0:11:59:31 Pamela D Wilson:  Up next, we will talk more about how changes in health can change the living situations of older adults. Joining us is Dr. Claire K. Ankuda, Assistant Professor in Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. This is Pamela Wilson, caregiving expert, author, and speaker on The Caring Generation. Stay with me; I’ll be right back.

facts about getting old[music]

0:12:50:20 Pamela D Wilson:  This is Pamela D Wilson, caregiving expert and eldercare consultant on The Caring Generation. We’re back on the topic of what to do about parents getting older. How many of your parents—or you if you are an older adult—spend most of the time at home rarely going out, perhaps only for doctor appointments. Are you aware of what homebound status means for the elderly and the short and long-term effects? To help answer this question, I’d like you to meet Dr. Claire K. Ankuda.

0:13:25:59 Pamela D Wilson: Dr. Ankuda, thank you so much for joining me.

0:13:27:90 Dr. Claire Ankuda:  Thank you. It’s a pleasure to be here.

0:13:30:46 Pamela D. Wilson: So, about your research. Aging is associated with the potential for growing health concerns. When we hear the word homebound concerning an older adult—what is homebound status?

0:13:43:22 Dr. Claire Ankuda: Yes, that’s a great question, and I think what we’re learning is even that the definition of being homebound, it’s maybe a little more complex than we thought. So, I think the best way to think about homebound is really it is a question of degrees. Some people are completely homebound, meaning they really never leave the house. Some people are semi-homebound, meaning they leave the house but very rarely. So, once a week. And some people leave the house once a week, even a couple of times a week but they have a lot of difficulty leaving their homes, or they rely on other people to leave their homes. And that puts them in somewhat a fragile state. So, I would consider them to be homebound as well. So it really does vary quite and bit, and there are sort of multiple levels of being homebound.

0:14:36:02 Pamela D Wilson: So we’ve been dealing with COVID for quite some time. For purposes of clarity, can you contrast the difference between being homebound and purposely socially isolating due to COVID?

0:14:47:03 Dr. Claire Ankuda: That’s a great question, and that is something that my research team is really trying to elucidate because I think being homebound because of COVID and being homebound prior to COVID might be more alike than we think. So prior to COVID, we thought about people being homebound for multiple reasons. One reason is because of physical health impairment. So, for example, people who have a lot of pain with walking or who have difficulty with balance who might be worried about falling, or people who had fallen—who really just physically have trouble leaving the home.

0:15:22:68 Dr. Claire Ankuda: They also may not be leaving the home because of mental health issues. So, for example, people with severe depression or anxiety. And they also might not be leaving the home because of environmental issues. So people, you know I’m from Vermont, so people who live in places like Vermont where there might be heavy snowstorms for multiple days where they’re worried about falling on the ice. Or people who live in areas that can have heatwaves where it’s unsafe to leave the home. So that was true prior to COVID. With COVID, we, of course, saw more people staying at home because they were wisely abiding by guidance around social distancing.

0:16:02:83 Dr. Claire Ankuda: But what we don’t know is if those forms of being homebound are the same in terms of the implications. So it is possible that being homebound itself can increase social isolation. Meaning that people are moving less, which can create sort of a spiral that they move less so then they have more challenges moving. And we don’t know if being homebound because of COVID has similar effects to being homebound because of the reasons I mentioned before COVID.

0:16:31:39 Pamela D Wilson: How many older adults in the United States are estimated to be homebound, and what do they have in common?

0:16:37:58 Dr. Claire Ankuda: Prior to COVID, we know that about 2 million older adults, which is about 6% of older adults in the United States at any one time, were homebound. The things they have in common are that they tend to be older. They tend to have higher levels of illnesses like diabetes, and cancer, and heart disease. And they tend to report that their health is worse. They’re also more likely to be women compared to men, and part of that is because of patterns of aging. And they’re more likely to live in places like assisted living facilities where they have more support. Potentially because they’re more likely to have more levels of functional impairment. So needing help with activities of daily living. Like bathing and walking, which makes sense, given they’re leaving the home less often.

0:17:30:64 Pamela D Wilson: I noticed another term in your research, semi-homebound. How do older adults move between homebound to semi-homebound and maybe back and forth?

0:17:41:98 Dr. Claire Ankuda: Great question. So that was really the main finding from this research study. That was really something that surprised us. I think that prior to doing this research, we really thought about it more as okay, people become more homebound, and then they’re homebound for months or years. And what this research study showed us is that people are really fluctuating between what we call their homebound status. So some people, as we’ve been talking about, are completely homebound where they’re not really leaving the home. Some people are semi-homebound where they’re leaving the home, but they’re really having difficulty doing it, or they’re relying on a lot of help.

0:18:19:35 Dr Claire Ankuda: And what we found is that people really move between being completely homebound, semi-homebound, and recovered. So, in other words, it’s not so much a situation as where an older adult becomes homebound and then never leaves the home. But people who become homebound then often might recover for a time being. Might leave the house a little more, maybe when they have someone to help them. But then they become homebound again. So we just found a lot more fluctuation in homebound status than we thought we would find.

0:18:49:64 Pamela D Wilson: And you just said something. When they have someone to help them. You made me think of a new question. Did a lot of these older adults have caregivers if they were homebound, or were they just really alone?

0:19:01:70 Dr. Claire Ankuda: A lot of them did have, did have caregivers. And the majority of that was family and friend caregivers. But we all know, and I think the COVID pandemic has actually highlighted this. You know the incredible work that caregivers are doing. And so, while a lot of the folks in our study had caregivers, it’s possible that you know that at sometimes their caregivers were sick themselves. Or traveling or able to provide less care. So I found a lot of future research is needed in terms of what those care resources are and how we can sort of bolster them given what incredibly challenging work caregiving is. Because that might make a difference in terms of people being able to leave the home. Even if they do have difficulty or if they do need help.

0:19:48:95 Pamela D Wilson: On the subject of care resources, what did the research show about the ability to have access to resources at home specific to being homebound?

0:19:58:37 Dr. Claire Ankuda: Yes, in general, we see that those who are homebound are more likely to have paid help at home compared to those who are not homebound. But it’s still fairly low levels of older adults who are homebound to have someone who is paid to help them. And so I think this is really an area of ongoing work of how we get more people help at home that they need.

0:20:22:06 Pamela D Wilson: How does having medical conditions like the ones you mentioned and the ability to leave home or to access medical care in the home affect being homebound and mortality rates?

0:20:34:64 Dr. Claire Ankuda: That is also a great question. So what we know is that older adults who are homebound have much higher level of chronic illness than older adults who are non-homebound. So, for example, in our study of people who are homebound, about a quarter of them had a heart attack before, have had a stroke, have had cancer, have had heart disease. And the majority, just under 80% have high blood pressure, a third have diabetes. So those are a lot of illnesses that this population is struggling with and is having to manage at home. And we also know that those who are homebound have a much higher mortality rate. So let me pull up some statistics here.

0:21:24:25 Dr. Claire Ankuda:  So we know that in the two years. If we look at someone who is homebound over the next two years, about 40% of the homebound will die in the following two years. And that compares to 6% of those who are non-homebound. So a really stark difference in mortality in this population. The gap that we don’t know is how better care in the home could impact mortality. Our best guess is that those who are homebound having regular medical care, having regular caregiving at home, having things like meals, and other types of assistance could certainly help to improve their health outcomes. That is really an ongoing area of research, given how big the mortality rate is for this population.

0:22:15:53 Pamela D Wilson: And so in your opinion, what might be solutions to prevent older adults from getting, or from becoming that 40% that do become homebound and then they have high mortality rates. How can we prevent that?

0:22:27:03 Dr. Claire Ankuda: So my best guess is that what we know about losses, sort of challenges of aging, is that the best approach is a multi-pronged one. So there has been wonderful work by someone named Sarah Stanton, who is at John’s Hopkins, in developing an intervention that helps people. Actually sends handy workers into people’s homes to do things like installing grab bars and changing the physical environment to make it easier for people to navigate. So that I can certainly imagine that by helping older adults by making sure their physical environment is easy to navigate at home and also ideal for them to leave home so that things like safe sidewalks, public transportation that they can navigate. So that’s certainly one piece.

0:23:14:85 Dr. Claire Ankuda: Another piece is you know, is supporting their physical and mental health. So things like rehabilitation and also engagement in everyday activities. Things like Tai Chi that support balance. And then another component is social connection. So we do think, and this is, I think something we will be learning a lot about with COVID is that people who are socially isolated are more likely to become depressed, and they’re more likely to have diminished physical function. On the other hand, once you start becoming physically disabled, you’re more likely to become depressed. And so I think this combination of engaging in physical activities, engaging in social activities, maintaining strong social connections with friends, with family, with your community. All of those pieces are really important to keep older adults active and to reduce the chance that they become homebound.

0:24:11:18 Pamela D Wilson: So, anything else you’d like to share on this topic and then how do we reach these homebound people. If they’re homebound, they may not be listening to interviews like this one you and I are talking about or access information. How do we, how do we change this?

0:24:26:32 [chuckle] Dr. Claire Ankuda: that is an excellent question. So many great questions and so many things that I think we really need to work further on. So I should say we have new research that will be coming out at the end of August that is somewhat updated and looking at the COVID pandemic in terms of homebound older adults. And so, while I can’t share the specifics of those results yet, I can say that another really important point about the homebound is that rates of being homebound are really uneven across racial and ethnic groups. So we see that Hispanic and Latino older adults, as well as black older adults, are more likely to be homebound. And so I think one point I do think that this an important disparity in health outcomes for older adults. In terms of what to do about it, I think, as I said, it’s a multi-pronged approach. But I do also think there’s a lot of hope for it becoming a community-level approach in terms of how to support people and also how to reach them.

0:25:28:00 Dr. Claire Ankuda: One thing that we’ve learned with COVID is that older adults who are homebound, older adults who have serious illnesses are less likely to have access to technology. So while some of them might not have cellphones or computers, I think that some of the approaches we are now using to reach people involving technology are just going to miss out on a lot of older homebound older adults who really need connection and support. Therefore I think the best ways to reach them are some of the more old-fashioned ways involving connecting into the community. People have religious organizations that they’re a part of if they have adult day centers they go to. If they, just reaching people door to door and by phone by some more simpler modalities than technology. Just given, I really worry this population can’t be reached through technology the same way that other groups can.

0:26:27:51 Those are great suggestions. Dr. Ankuda, I thank you so much for joining me today.

0:26:32:91 Dr. Claire Ankuda: Of course, it was my pleasure, thank you very much.

0:26:36:10 Pamela D Wilson: Up next, what to do about parents getting older. We’ll talk about signs your parents are getting old.  If you are looking for help with decision-making about care for elderly parents or making a care plan for yourself, I can help. Visit my website PamelaDWilson.com to schedule an eldercare consultation. Click on How I Help, then Family Caregivers, and then Eldercare Consultation. Stay with me. I’ll be right back.


0:27:35:76 Pamela D Wilson: This is Pamela D Wilson, caregiving expert, eldercare consultant, and speaker on The Caring Generation.  Helpful information for caregivers and aging adults are in my book: The Caregiving Trap: Solutions for Life’s Unexpected Changes, available on my website www.PamelaDWilson.com where you can also check out my caregiver course online, Taking Care of Elderly Parents: Stay at Home and Beyond, 

0:28:00:63 Pamela D Wilson: with 30 hours of webinar videos and other information featuring practical steps for how to take care of elderly parents and make a plan for aging and health for a parent and yourself. It’s never too early to make a plan to live the best life possible today and in your later years.

Online Caregiver Course

0:28:20:42 Pamela D Wilson: Let’s talk about signs your parents are getting older and what you can do as a caregiver. As we talked about in the first part of the program, age is a number. You can feel 10 to 20 years younger than your age or 10 to 20 years older than your age, depending on physical and mental health conditions. If you are a young caregiver caring for a parent in their 40’s or 50’s your parent may

0:28:47:69 Pamela D Wilson: have physical or mental health concerns and seem older than their age. The same may be true if you are a caregiver taking care of elderly parents in their 70’s, 80’s, 90’s or beyond. One thing that caregivers in these situations have in common is that most of you are committing 20 hours or more each week of your time to the care of a parent. If you are not giving this amount of time yet, you are fortunate, and you may

0:29:21:09 Pamela D Wilson: be able to act to help a parent, and yourself avoid many of the health concerns I’m about to share that contribute to signs your parents are getting old. The first change that contributes to aging is any type of health concern. Many health concerns go unrecognized because of a lack of health education. You don’t know how to recognize your parents are getting old or even signs that indicate a health problem

0:29:53:77 Pamela D Wilson:  exists for you if you are young. The most common concerns contributing to a decline in health are cardiovascular issues, also known as heart disease. What to do about parents getting older is to notice small changes in their daily activities. Signs of heart concerns include any type of diagnosis of high blood pressure or heart disease. But—usually, before being diagnosed, you might notice shortness of

0:30:21:35 Pamela D Wilson: breath. Easily becoming out of breath with any type of activity like walking, mowing the lawn, shoveling snow, carrying groceries or heavy items, walking up and down steps. As you know, regular exercise increases heart and lung capacity. If you or a parent are a regular exerciser and experience any of this, make a doctor appointment to determine the cause. Other signs of heart or other health concerns

0:30:53:59 Pamela D Wilson:  include feeling tired or experiencing increasing physical weakness. Any type of swelling in the legs, ankles, or feet can indicate heart concerns due to a reduced inability of the heart to pump blood up the veins from the legs and feet up to the heart.  You might notice skin changes, infection, or skin ulcers on the legs of a parent who has poor leg circulation due to heart concerns. Diabetes can also result in loss of

0:31:29:66 Pamela D Wilson: feeling in the legs or feet, plus skin infections. Any type of heart condition, including a diagnosis of high blood pressure—if undiagnosed or ignored—can increase physical frailty or physical disability that can happen as early as the age of 40 or 50. Which is why there are so many young caregivers. According to research, more women than men become physically disabled in middle age and, as a result, you may reduce work schedules or stop working, which affects

0:32:05:79 Pamela D Wilson: income and the ability of women to support themselves. If you’d like to learn more about preventing midlife health concerns, especially for women, listen to my interview with Dr. Carrie Karvonen-Gutierrez in the podcast called Managing Work-Life Balance for Caregivers. I will place a link in the show transcript. Caregivers of all ages are as susceptible to getting older physically and mentally due to stresses in life.

0:32:35:83 Pamela D Wilson: That includes, no surprise, being a caregiver. Help your parents and yourself by learning how to identify health concerns before they become major problems. Or if health issues exist, learn how to manage, stabilize conditions and plan for future care needs.

is available in my online webinar video course Taking Care of Elderly Parents: Stay at Home and Beyond, available on my website. Health education and prevention are essential if you want to live independently and reduce the possibility of needing care when you are older or if you want to know what to do about parents getting older.

0:33:19:65 Pamela D Wilson: Other health issues relating to parents getting older that begin in middle age —30’s, 40’s, 50’s—are high cholesterol, depression, asthma, diabetes, arthritis, anxiety, osteoporosis, breathing problems like COPD or stroke. If you are a young caregiver for a parent, your parent probably has one of these common chronic diseases necessitating daily help and ongoing care. If you are a caregiver for an elderly parent, do whatever it

0:33:52:78 Pamela D Wilson:  takes to prevent you from being diagnosed with one of these diseases. What to do about parents getting older is to pay attention to the changes experienced when mom or dad retire or when you retire. While many of us dream of retiring and not having to go to work every day, the retirement experience is different from the expectations held by most people. With retirement can come anxiety, depression, a loss of purpose

0:34:23:96 Pamela D Wilson: and a loss of identity. Caregivers, do these feelings sound familiar to you? Caregivers experience similar feelings when becoming a caregiver and when caregiving ends. Because the role of caregiving can become all-consuming, many caregivers lose their identity as caregiving takes over your entire life. What to do about parents getting older is to be attentive to not giving up your identity—the aspects of you that make you—you

0:34:59:09 Pamela D Wilson: The other recommendation for caregivers is to not fall into the caregiving trap of being the only caregiver. Instead, find ways to get help when you first become a caregiver and throughout the time you care for an aging parent. Otherwise, you may find that you give up your life and lose your identity to care for elderly parents. More on the topic of giving up your life to care for elderly parents

0:35:27:95 Pamela D Wilson: and how to ask for help is in a Caring Generation podcast that features an interview with Dr. Vanessa Bohns – how to ask for help without feeling guilty. You’ll find the link to this podcast in the show transcript page on my website. Go to pameladwilson.com, the media tab, and The Caring Generation and this show. More on what to do about parents getting older after this break. The Caring Generation is not limited by

0:35:56:27 Pamela D Wilson: time zone or location. Caregivers worldwide can listen any time of day. The show and the transcript that you can read to find links to research and caregiver support tips mentioned during the program are all on my website at pameladwilson.com. Click on the Media Tab and then The Caring Generation to find the show transcript. You can find the Caring Generation on all of your favorite podcast and music apps.

0:36:22:67 Pamela D Wilson: Including Apple, Google, I Heart Radio, JioSaavn, Spreaker, Amazon Music, Breaker, Deezer, Listen Notes, Pandora, Player FM, Pocket Casts, Podcast Addict, Podchaser, Stitcher, Spotify, Tune In, and Vurbl. This is Pamela D Wilson on The Caring Generation. Stay with me. I’ll be right back.

parents getting older[music]

0:37:14:09 Pamela D Wilson: This is Pamela D Wilson, caregiving speaker, expert, and advocate on The Caring Generation program for caregivers and aging adults. Whether you are twenty or 100 years old, you’re in exactly the right place to learn about caregiver support programs to help you and your loved ones plan for what’s ahead. If you’re not sure how to talk to your children about caregiving issues or if you’ve tried to talk to your aging parents and failed. Let me start the conversation for you. If you are looking for information and tips about caregiving, visit the Caring for Aging Parents blog on my website pameladwilson.com and share this podcast.

0:37:54:99 Pamela D Wilson:  What to do about parents getting older. When your parents retire, ask them about their experiences. Are parents more physically and socially active, or are they staying home, sitting in a chair watching television all day?  In the last segment of the show, we talked about the risks of heart disease and other diseases as signs your parents are getting old. The diagnosis of one or more chronic diseases

0:38:25:88 Pamela D Wilson: affects the ability of the body and the mind to operate effectively. Parents—or any adult of any age—who becomes less physically active lose muscle mass and strength and continue to become physically weaker. When attempting to do an activity, the body the becomes tired. So you, mom, or dad do less of the activity that makes them tired. Instead of doing more to increase cardiovascular, lung ability and strength, and muscle mass.

0:39:02:30 Pamela D Wilson:  Doing less of anything is a sign you or your parents are getting older. Unless doing less is an intentional choice not to clean house because you want more free time to exercise, do hobbies, socialize, and you make the choice to hire a housekeeper. What to do about parents getting older? Notice combinations of doing less and any type of physical changes. These changes, over time, translate to more signs your parents are getting

0:39:35:39 Pamela D Wilson:  older, like weight loss, greater exhaustion, weakness, low physical activity, and slow walking speed. Slowing down is not a given for anyone. I knew older adults who were active well into their 90’s. Some are still hiking the Grand Canyon or walking several miles a day in their neighborhoods. Being inactive is a choice we make when choosing not to be proactive to address diseases that impact daily abilities.

0:40:10:23 Pamela D Wilson:  This choice results from a lack of education about health and prevention. Plus, as we discussed in the first part of this show, it’s having a blind spot to be unrealistically optimistic about health conditions and health risks by comparing ourselves to other people. Research confirms that many consumers lack experience and facts to support health beliefs because of believing the latest news without fully investigating and deciding for yourself.

0:40:43:19 Pamela D Wilson:  Needing care in later years results from flawed beliefs about available government support. For example, how many of you believe Medicare pays for everything? How many of you are misled by television commercials with actors talking about health plans that pay for everything for seniors because they deserve it? When you investigate this, you’ll find out that neither of these statements is true.

0:41:11:44 Pamela D Wilson:  So many caregivers I speak with are disillusioned by seeing this information. Because they become unrealistically optimistic instead of taking control of what to do about parents getting older by becoming more educated and finding reliable and trustworthy sources of information or experts like myself that you can trust.  What to do about parents getting older is to know that frailty can be prevented when concerns are identified early and when you or an aging parent is interested and committed to preserving your abilities rather than becoming weaker

0:41:54:79 Pamela D Wilson:  And more dependent on caregivers. So, as you can see, there is a lot of thinking, researching, education, action, and planning that goes into staying healthy and not needing care in old age. Consumers not taking care or control of their health and well-being, but instead, those who rely and trust the government to do the right thing will be waiting a long time. This is why the United States and other countries worldwide are in dire

0:42:26:25 Pamela D Wilson: situations with so many elderly who may have been overly optimistic about their health. About how they would receive care, about how to pay for care, and who would provide that care. The solution for many people is the public program of Medicaid in the United States. This program makes sure that people who need care and don’t have the money receive care, get the care they need. But even Medicaid takes planning ahead to apply and learn about the program.

0:42:59:14 Pamela D Wilson: Don’t wait until the last minute. Otherwise, you will be waiting. What to do about parents getting older is to learn about all of the care options, the costs and to talk about  plans with your parents before you are in a state of crisis or emergency. The idea of unrealistic optimism specific to health and aging means that for many,  discussions about becoming sick or dying are difficult. You may be noticing health declines and may be afraid to go to the doctor to find out what’s going on.

0:43:33:79 Pamela D Wilson:  You may be watching a parent decline and may be in denial about signs your parents are getting older because the thought makes you sad. What to do about parents getting older is being brave enough to talk about needing care, about parents’ health and physical abilities declining, and what to do about all of these concerns. As you work through these issues for your parents, do the same for yourself

0:44:02:85 Pamela D Wilson: Involve your children today so that they’re not in the same situation you are today twenty years down the road when you are the one who needs care.  Families choose to pass caregiving responsibilities down from generation to generation by not talking about aging, caregiving, and death. Be proactive. Ask your parents about family history and health concerns and do what you can to make sure you are taking positive steps every day to

0:44:36:25 Pamela D Wilson: avoid the heart attack that killed grandpa. The diabetes that led to grandma’s death. Smoking that caused heart, lung, and digestive problems for Uncle Joe, or the stroke that killed Aunt Mary. While health issues can be hereditary, lifestyle changes and choices can significantly improve health when implemented consistently. Be kind, be empathetic, and considerate when talking to parents about signs that they

0:45:10:03 Pamela D Wilson: Are getting old and at the same time, take into account whether you are experiencing any of these early concerns to prevent yourself from feeling 10 or 20 years older than your chronological age. We will all be the age of our parents someday if we’re lucky to live that long. It’s the actions we take today that will determine the level at which we will be able to live and embrace life in our 70s, 80s, and hopefully beyond that.

0:45:42:35 Pamela D Wilson:   We’re off to one more break. More on what to do about parents getting older who may be experiencing mental health or neurological concerns that affect activities of daily living and self-care. Caregivers seek information about caregiving programs and support in ways that are meaningful to you. If you’re here —podcasts may be your go-to source for information.

0:46:06:17 Pamela D Wilson: For others, videos, reading articles or blog posts, giving opinions by participating in caregiver surveys like the one on my website, reading a book, watching a webinar, taking an online caregiver course, or joining an online support group. No caregiving situation is the same. In whatever way you prefer to receive information—you’ll find all of those options on my website at pameladwilson.com. This is Pamela D Wilson. Stay with me. I’ll be right back.


0:47:06:38 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, and consultant on The Caring Generation. If you are an aging adult or a caregiver not sure what to do or how to plan for care, my website PamelaDWilson.com offers resources for caregivers. Check out my caregiving library, my Caring for Aging Parents blog, listen to all of The Caring Generation podcasts, read the show transcripts, watch videos, check out caregiver courses online, and introduce your parents, siblings, friends, co-workers, and the human resources department at your company to my YouTube Channel. It features hundreds of caregiver videos. There’s something for everyone at PamelaDWilson.com.

0:47:55:09 Pamela D Wilson: What to do about parents getting older? Slowing down mentally or physically or becoming apathetic, meaning not caring about life or not initiating activities, can mean memory loss, cognitive decline, or neurological disease. If you or your parents don’t have a regular primary care physician or a doctor that you see at least once a year for bloodwork or a health check-up, add this to your list of to-dos for health prevention.

0:48:30:12 Pamela D Wilson: According to assessing frailty and the potential of disability, poor health, and cognitive concerns—considering, believe it or not, walking speed at any age is a highly reliable measure of physical or mental declines. The slower you walk, the more likely you are to experience a decline. Earlier, we talked about noticing changes like weight loss and exhaustion as indicators of declines in health. Let’s add to this, being isolated, lacking social contacts. Feeling depressed or isolated,

0:49:10:63 Pamela D Wilson: these significantly affect the ability to perform activities of daily living and continue to live independently, which is the hope of almost everybody that I know. Who wants to become old, frail, sick, and live in a nursing home for the remainder of life? Nobody I know. How about you? Is this what you’re looking forward to? Is this what you’re hoping for? This may be your future if you don’t make a plan today – especially if you are a woman.

0:49:42:73 Pamela D Wilson: More women than men live out their lives in nursing homes. Can you guess why? It’s because women are the caregivers who take care of everyone else to the exclusion of their own health and well-being. If you’re a woman, refuse to place yourself in this position. Instead, learn about health, be proactive, and start saying no to unlimited requests for caregiving responsibilities. Talk about caregiving, aging, and health in your family.

0:50:15:01 Pamela D Wilson:  Stop expecting the government to solve aging problems or fix healthcare. We’ve talked about this before. There are too many political motivators that prevent permanent and lasting change, especially with the government, that consumers don’t even realize happen. Signs you or your elderly parents are getting old are losses, or what are called reserves. The ability to mentally and physically remain healthy and to recover from health concerns. Remember when you were young, and you got sick?

0:50:46:83 Pamela D Wilson: You probably recovered within a day and returned to normal. But, what happens today when you’re sick? Do you bounce back like that? Or does it take you several days or even weeks to recover from an illness? If you’re sick, do you recover, and then you’re sick again within a short period of time? Do you go out and have a busy day shopping and doing activities, and then you’re so exhausted you have to rest for a few days to recover before you can go out again?

0:51:17:72 Pamela D Wilson: If this is your experience, your health reserves are dwindling and increasing the likelihood of needing more care or having a severe health event. Let’s be honest, aging isn’t easy. Sometimes it’s not fun when we have to deal with health problems or other life complications. Aging parents and caregivers need all the reserves you can to maintain your health both mentally and physically, to keep going, and most of all, to maintain a positive outlook on life.

0:51:54:14 Pamela D Wilson: Caregivers of spouses and persons with dementia or Alzheimer’s are more stressed because of being a 24/7 caregiver. You never get a break unless someone else shows up to give you that break. Family members promise to help, and they never show up. I hear from caregivers who planned trips and vacations, and they were overly optimistic about the promise of a brother or a sister who canceled at the last minute.

0:52:22:49 Pamela D Wilson: How frustrating! As caregivers and aging adults with health issues, we have to stop waiting on others to help. Stop being overly optimistic that some solution is going to come down from the heavens. I don’t say this to focus on the negative but to help you focus on building your reserves. Your skills, your toolbox, your abilities, your competencies to make a plan for care and work your plan. Denying health changes or care needs will lead to future problems.

0:52:57:58 Pamela D Wilson: For example, how many of you have hearing or vision problems today that affect abilities, but you don’t want to wear hearing aids or glasses. Do you know that hearing loss is a significant contributor to a diagnosis of dementia—memory loss? I know people who are forgetful and have hearing loss. I give them articles, I give them information, and still, they don’t believe me. They don’t believe the research because they think they know better. Dementia—it’s not going to happen to them.

0:53:29:38 Pamela D Wilson: It’s something that happens to other people. Something is going to happen to all of us one day. Do you want to contribute to your health issues because of ignorance or unrealistic optimism? or would you rather take action, become educated, act to prevent the health issues so that you can live healthier longer? Or do you want to live longer but be sick for so many years at the end of your life? And maybe have to go into a nursing home. This is an important question to ask yourself, your children, and your parents about getting older today.

0:54:07:92 Pamela D Wilson: Because, believe it or not, we get to choose. We choose through our daily actions. How we view aging, health, our decision to take off those rose-colored glasses and confront our gaps of not exercising, not seeing the doctor yearly for check-ups. Refusing to take prescription medications or participate in preventative care. Caregivers experience so much grief watching a spouse or an elderly parent suffer.

0:54:39:20 Pamela D Wilson: As a caregiver, many of you feel it’s your responsibility to rescue that spouse or that parent who made poor health decisions. Who didn’t save money, or who knew the risks of having dementia and they didn’t make a single plan? At what point do all of us recognize that our health affects us, but it also affects our spouses, our children, and others when they have to step up and care for us? The quality of our health affects our daily abilities to be active, to get a job, to keep a job. To support our families who depend on us.

0:55:21:83 Pamela D Wilson: Yet, we all know this, health and prevention isn’t something we think about until we get sick or we know someone who gets sick. We have a heart attack, or we’re diagnosed with serious illness. Our body is our house. When the house starts to fall apart, life becomes so much more challenging. For those of you who own houses, you know what it’s like when you ignore repairs for a few years. The repairs grow, and grow, and grow. And all of a sudden, you have this huge mess, this huge expense to deal with.

0:55:56:35 Pamela D Wilson: It’s the same with your body. What to do about parents getting older? Be proactive, monitor changes in health and activities, learn about health, take advantage of preventative care so that you can identify concerns early. And most of all, have ongoing caregiving conversations in your family. Talk about legal planning that is so important. Who will be your medical power of attorney, financial power of attorney? Get your living wills and your wills done so that if or when you can’t make decisions for yourself, somebody you trust will help you and make the right decisions for you.

0:56:38:96 Pamela D Wilson: None of us are going to live forever. Start planning today for signs your parents are getting older and for your care so that the end of your life meets all of those expectations you have for retirement, health, and all your hopes and dreams. Only you can choose to make this happen. This is Pamela D Wilson, caregiving expert, speaker, and eldercare consultant. If you’d like to learn more about the experiences and interests of other caregivers, follow me on social media. My posts, many of my videos, respond to caregivers who communicate with me on social media, and complete the caregiver survey on my website.

0:57:23:56 Pamela D Wilson: On Facebook, follow me at @pameladwilsoncaregivingexpert, where you can join my online caregiver support group, The Caregiving Trap. Follow me on Twitter @caregivingspeak, Instagram at @wilsonpamelad, and Linked In pameladwilsoncaregiverexpert. Caregivers, thank you for joining me on The Caring Generation. You are all amazing. I appreciate you. This is the only program of its kind connecting caregivers and aging adults worldwide to talk about caregiving,

parents getting older0:57:56:47 Pamela D Wilson:  Pamela D Wilson: well-being, health, self-care, and everything in between. Invite your family and friends to listen to this, and all of the past shows on your favorite podcast and music apps.  This is Pamela D. Wilson, caregiving expert, advocate, and speaker. I look forward to being with you again soon. God bless you all. Sleep well tonight. Have a fabulous day tomorrow and safe journeys until we are here together again.

0:58:24:05 Announcer: Tune in each week for The Caring Generation with host Pamela D Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D Wilson’s The Caring Generation.


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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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