Wisdom Wednesday: Aging Wisdom's Podcast

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In this podcast episode, and the next two forthcoming episodes, Kristin McHugh, Lead Advisor with Brighton Jones, asks Lisa Mayfield, our principal and founder, answer some audience questions about Proactive Planning.

First question: Have you seen any data on what folks like the most as a type of care or how care types link to happiness or life satisfaction?

As Lisa reflects, in general, it's really individualized because there's certainly people who say, "I'll never leave my house. I love my house. I want to stay in my house.” And you can stay in your house. It's possible to make that happen.

But there are others for whom a retirement community might sound more appealing. It's very much a personal decision.

Figure out what makes you happy in life and how do you create a plan that ensures your values are being met.

Next question: What is the biggest mistake you see families make?

As Lisa reflects: “Not planning.” Planning isn't always easy or fun. Most often people avoid doing their planning, or you'll say to yourself, “Oh yeah, I need to plan,” but it gets pushed back and you never do it.

Making plans, having conversations with your family or support people is important. But the legal documentsare really the most important.

Resources to guide the process – variations on the theme of Proactive Planning

3 Questions You Should Ask About Long-Term Care Planning
Wholistic Estate Planning
The Power of Planning: Taking Charge of Your Own Aging Journey

Not quite sure what steps to take next? You can schedule a get-acquainted call with us to determine together whether our services are a good fit for your needs.

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Aside for Aging Life Care Professionals (aka Care Managers) like ourselves, the professionals below are also resources for help with planning. To find an Aging Life Care expert in your area, visit our professional association – the Aging Life Care Association at aginglifecare.org

Other professionals that can help you on the planning journey include:

Your financial advisor or wealth manager
Local senior centers often have social workers who can be a great resource for helping navigate changes or letting you know what help is available
The Alzheimer's Association -- https://www.alz.org
Elder Law attorneys -- https://waela.org
Primary care provider – yours or that of your parent/s

Proactively planning for yourself or your parents is best addressed by pulling together your professional team to help you prepare, anticipate, and walk you through changes.

You Are Not Alone! If you have these key supports engaged in planning, you will feel far less alone and better equipped to face what’s ahead.

Not sure where to start? Aging Wisdom can help! As your trusted advisor, we can help you plan for and help you navigate the best options. Schedule a free, get-acquainted call today to get the conversation started.

Additional Reading and Resources

Get in the Lifeboat: But Don’t Float Alone! Key Supports You’ll Want in Your Boat(Aging Wisdom blog article)
Preventing a Crisis(Aging Wisdom blog article)
When is Care Management the Best Option? (Aging Wisdom podcast)
What is “elder law”? (Aging Wisdom blog article)

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In addition to elder law and estate planning attorneys, and financial advisor and wealth managers, there is a third type of professional that can help you with care planning, Aging Life Care Professionals, aka Care Managers, like our team here at Aging Wisdom.

An Aging Life Care Professional provides consultation and comprehensive, personally tailored plans addressing health changes, family dynamics, housing, hands-on assistance, care planning, and more. We also assist in implementation and ongoing care management.

As Lisa shared in an earlier episode of this series, there are people like us all over the country. Aging Wisdom serves King and South Snohomish counties in Washington State. We are part of professional association – the Aging Life Care Association – and can help you find care management professionals in your area.

As you're planning ahead, whether for yourself or your parents, it is essential to consider where you will live.

Do you want to remain in your home? Is that important for you? Is home really “Home Sweet Home? There can be a lot of complications and unforeseen challenges to aging in place if we don’t plan.

And many baby boomers come to see us because their parents had refused help, didn't plan, and they, as the adult children, were stuck picking up the pieces and cleaning up the crisis that occurred.

When they come to us for consultation, their top priority is to proactively plan. “We don't want to be a burden to our children. We want to do this planning. We want to be prepared so that we're not a burden to our kids.”

This could include a move to a retirement community. That decision comes with lots of possibilities and questions as well. We help couples, individuals, and families navigate and narrow down the options.

Not quite sure what steps to take next? You can schedule a get-acquainted call with us to determine together whether our services are a good fit for your needs.

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The Seattle Times addressed the cost of long-term care in this recent article, Seattle-area assisted living comes with a crushing price tag.

The cost of long-term care often comes as a shock to many.

What does care cost? This slide provides a snapshot of the annual costs of home care, assisted living, skilled nursing, and adult family homes. (Memory care costs are not reflected in this graph). This data comes from the Genworth Cost of Care Survey.

As Lisa reflects, she has been doing this work for 20 years, and it's really over the last couple of years, certainly during the pandemic, that costs began to skyrocket in the greater Seattle area.

Good to note that no matter where you are in the country, costs in a major metro area will be more than outside the city. In the Seattle-Bellevue-Kirkland area, you don't have to go very far outside the metro area for costs to go down considerably.

The need for long-term supports and services usually grows over time. Someone may need a little bit of help and over time, depending on health and condition, it may gradually transition to needing round the clock support. When people first start to need help, it's often an affordable expense to have a little bit of help at home. And there may come a time when moving to a more supportive living environment makes sense.

How Much Help Will You Need? At some point, 70% of us will need help at some point in time, but how long will you need help? Statistics show that someone over 65 will need some type of long-term care assistance for three years.

Women tend to live a little longer, and that number is 3.7 years. For men it is a little less at 2.2 years. And 20% of us will need care for longer than five years.

So the question people will often ask is, What should I be planning for? What number should I use when I'm planning for care? How many years should I be using in my financial planning? It never hurts to be more conservative in your planning. So, if you have the resources to plan for five years, it's certainly much safer.

Uncertain about the cost of long-term care? Not sure what you want and how to engage your family? We can help! Click here to schedule a get-acquainted call with a Certified Care Manager to head in the right direction.

Additional Resources

· What is Long-Term Care?

· Paying for care at home

· Wholistic Estate Planning

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Financial planning. Whether it's for yourself or for your parents, having an understanding of assets in the context of when you're retired is essential. You'll need money for your basic needs, money to maintain the lifestyle that you want to live, money to still travel if that's a priority, and for charitable giving, if that's a priority. You will also need money to cover medical expenses and eventually for long-term care. So the care that we'll be talking about today, that money that you have saved needs to be able to cover these expenses as well.

Once you understand your assets or your parents' assets, the next piece is how much will it cost? Educating yourself on what options are available down the road if you or someone you care about needs help, and what will that cost (that’s what we’ll cover next week)? Because without that understanding, it's hard for you to plan. Examples include in-home care, community and assisted living, skilled nursing or nursing home care.

We refer our clients to the Genworth Cost of Care Survey to get a baseline of costs. You can access the Survey here.

Who pays for long-term care expenses? Most people think that Medicare will cover assistance, caregivers, and retirement communities. And I'm the bearer of bad news, but I'm here to let you know that Medicare does not cover the expenses that I'll be talking about. I think the easiest way to try to remember is to think of because Medicare is really a health insurance. Medicare really mimics and follows that. It pays for your healthcare needs only. It doesn't pay for your long-term care needs. There are a few exceptions for that (we cover that later). But in general, the care that you may need someday is a private pay, out of pocket expense.

One exception to that is if you have long-term care insurance. Long-term care insurance pays for the care referenced earlier, and that we'll review about next week. Another homework assignment: if you have long-term care insurance, review your policy with your financial advisor to remind yourself what is covered by your policy. It usually has a daily amount and then that daily amount kind of equals a monthly amount and then you've usually selected several years of coverage.

If you're helping your parents, you'll also want to find out if they have long term care insurance and what does that policy look like? Just having that knowledge will bring a lot of peace of mind if and when you need assistance.

Time to begin planning and better understanding the options? We have the knowledge and expertise to help guide your journey. Click here to schedule a free, get-acquainted call with one of our Certified Care Managers.

Additional Reading

Paying for care at home
3 Questions You Should Ask About Long-Term Care Planning
Navigating Long-Term Care Options (in greater Seattle Area) Part I
Navigating Long-Term Care Options (in greater Seattle Area) Part 2

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There may come a time when due to injury, failing health, or age, you are no longer able to communicate your wishes regarding your medical treatment. This could happen if you had a stroke, are living with Alzheimer’s or other dementia, were in a coma from an accident, or have an illness that has left you unable to communicate.

Advance directive is a broad term use to describe any legal documentation that spells out your future medical care if you are incapacitated or unable to communicate, as in the scenarios referenced above.

This would answer questions such as how much treatment do you want at the end of life? Do you want life support? Do you want a ventilator? Do you want a feeding tube?

Your medical power of attorney (POA) would be part of your advance directive, the person who will make decisions on your behalf, according to your wishes. Your living will guide your medical POA on your wishes.

A Do Not Resuscitate (DNR) order may be part of your advance directive as well. If you're someone that doesn't want full treatment, it's important to do have a DNR order because the default in the hospital and the default for medics that come to your home is always full treatment.

Have open conversations about these wishes. If you do have children and a spouse or a partner, making sure they understand your desire. If you're assisting your parents, these documents are really important.

And when adult children reach out to assist with their parents and maybe they're frustrated that their parents are refusing help or their parents need more immediate care, it's often frustrating to them that we're asking about these documents as kind of the very first thing upfront because they feel unimportant when you're managing kind of crises at the moment. But these documents are what allow adult children to step in on behalf of their parents to engage services to get them help.

So that's why these documents are really the first step in planning and preparing for yourself for your parents.

Not sure what your next steps should be? We’ve helped hundreds of families navigate these conversations. Click here to schedule a get-acquainted call with one of our Certified Care Managers.

Additional resources:

Advance Care Planning: Advance Directives for Health Care (National Institute on Aging)
Estate Planning Guide and Checklist for 2024 (National Council on Aging)

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Have your done your legal planning and paperwork? The first step, for yourself, or if you’re helping your parents, is the estate planning documents. Usually, estate planning is a package of documents.

Most people are most familiar with the will, but when we're talking about long-term care planning, the most important documents are the powers of attorney documents.

A comprehensive estate plan typically includes these essential documents:

financial power of attorney
health care power of attorney
advance care directive
a living trust
last will and testament

If you have done these documents already, but haven't looked at them in a few years, it’s a good idea to review and possible update them. As Lisa shares: “I'm giving you a homework assignment of finding the papers, remembering where you put them, maybe dusting them off, and then being able to answer these questions that I'm going to ask you now.”

If you're helping your parents, you'll want to ask them:

Have they done their legal paperwork?
Who did they name (or who did you name) as your powers of attorney (POA)?
Who did you name as the backup persons?
Are the documents written to be effective immediately? Or are they written to become effective upon incapacity, and what triggers that?
Do the people who are assigned as POAs know they are the POAs? Do they know where the documents are? Are they willing to serve in that role? Do they have the capacity to serve in that role? Do they have an interest?

If you're a solo ager: it's even more important to to do this planning and think about who would fill these roles for you -- who will navigate your health and finances if you don’t have a partner or adult children?

Looking for an attorney specializing in elder law or estate planning? Uncertain about the cost of long-term care? Not sure what you want and how to engage your family? We can help! Click here to schedule a get-acquainted call with a Certified Care Manager to head in the right direction.

Additional Resources

· Estate Planning Guide and Checklist for 2024 (National Council on Aging)

· Wholistic Estate Planning (Aging Wisdom blog article)

· What is “elder law”? (Aging Wisdom blog article)

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Are you ready to take charge of the future? Whether supporting an older parent or planning your own aging, it's crucial to understand the intricacies of long-term care and be prepared for any unexpected twists and turns.

Lisa Mayfield, our principal and founder, was invited by Kristin McHugh, Lead Advisor with Brighton Jones, to a conversation about proactive planning for the essentials of eldercare.

We’ve created a series of eleven episodes, this being the first, from this informative conversation. The next 11 weeks will provide a comprehensive review of the steps, supports, and services everyone needs to prepare for their own aging, that of their partner or spouse, or planning for your parents or others you care about.

Will you need help? According to the U.S. Administration on Aging, recent research shows that “most Americans turning age 65 will need long-term care services at some point in their lives.”1

The first step is to kind of build a team of support around you. Pull in professionals who can help you anticipate, plan for, and navigate changes.

Engaging knowledgeable professionals who can offer guidance and expertise, including:

An elder law or estate planning attorney ensures that key legal documents such as powers of attorney for finances and health care decisions and advanced directives are up to date. This gives others you trust, whom you’ve chosen, to legally to manage finances and medical decisions if you become incapacitated.
A financial advisor analyzes assets, projects future costs, assesses insurance options such as long-term care policies, and develops a financial plan to fund anticipated care needs. Learn how to select the right financial advisor for your needs.
An aging life care professional (aka geriatric care manager). We provide consultation and comprehensive, personally tailored plans addressing health changes, family dynamics, housing, hands-on assistance, and more. We also assist in implementation and ongoing care management. As Lisa shared, there are people like us all over the country. Aging Wisdom serves King and South Snohomish counties in Washington State. We are part of professional association – the Aging Life Care Association – and can help you find care management professionals.

Being proactive now leads to greater peace of mind and better outcomes. Preparation emerges as the key to embracing the evolving chapters of life while maintaining a sense of control and independence.

Who Needs Care? https://acl.gov/ltc/basic-needs/who-needs-care

Additional Resources:

What is Long Term Care? (Aging Wisdom fact sheet)
The Power of Planning: Taking Charge of Your Own Aging Journey (article written by Lisa Mayfield for 3rd Act magazine
Plan Your Lifespan (a website that helps you plan for health events such as hospitalizations, falls, and memory loss that may happen a

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It’s natural for disagreements to occur, even in families with strong functional relationships. However, when parents and other older adults you care about are experiencing memory and health changes, it can create tension. Rare is the family who are all on the same page and managing decisions and tasks smoothly.

An Aging Life Care professional (aka Care Manager) is an experienced, knowledgeable, and objective person who can:

help ease those tensions
provide space for everyone to voice concerns
then educate, guide, and mentor the family in support of the best options for the person in their mutual care.

At an impasse with your siblings or other relatives? Schedule a get-acquainted call to explore ways we can support and guide you on this journey.

Additional Resources:

Surviving and Soothing Sibling Strife When Caring for Aging Parents (Aging Wisdom blog article)
Clash of the Siblings: How to navigate family dynamics when your parent needs help (Aging Wisdom blog article)
Dementia and Family Dynamics (Aging Wisdom podcast episode)
Helping feuding families achieve harmony around what’s best for mom and dad (Aging Wisdom podcast episode)

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The depth and breadth of what care management is able to provide for clients is best answered by the needs and goals of each individual client. This is what we mean by person-directed, tailored care.

In this week’s podcast, Sheila and Keri take a deeper look at the holistic range of services and supports that can be provided and coordinated by Aging Life Care professionals like our Care Managers.

Our Care Managers can remain actively involved to optimize care and adjust to changing needs and circumstances. When clients are facing the transitions of aging, we facilitate and guide strategic planning, provide coaching, and implementation of solutions.

We can remain actively involved to optimize care and adjust to changing needs and circumstances through

care coordination
effective advocacy
responsive problem solving
clear, collaborative communication
personalized solutions

Whether a client needs support with a hospital or rehab discharge, planning for aging in place, selecting and making a move to a retirement community, assistance navigating the healthcare system, finding home health support, guidance in managing health conditions, to name several of the more common situations our Care Managers help clients navigate in support of well-being and quality of life.

Our team of Aging Life Care Experts brings unparalleled knowledge and experience. Our role is often described as coach, educator, stress reducer, navigator, and even life saver. We take a holistic, client-centered approach to guiding individuals, couples, and families navigating options for living well, caring well, and aging well.

Below are a few of our specialty areas:

Alzheimer's & Dementia Care Management
Elderly Parents Refusing Help
Moving Your Elderly Parent to a Retirement Community
Hospital Discharge Planning
Parkinson's Disease Care Management
Proactive Planning
Solo Aging and Aging Alone
Long-Distance Caregiving
Stroke Care Management

Are you at a crossroads and not sure how best to move forward with key decisions? Did you recently receive a diagnosis that requires future planning? We can help! Click here to schedule a get-acquainted call with one of our Certified Care Managers for some clarity and peace of mind.

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What happens when you contact Aging Wisdom? Part 3
We usually outlive our ability to drive safely by six to ten years. As we age, we naturally modify how we drive to address physical changes: Stiff joints, poor vision, slow reflexes. But a day will come when it’s unwise to continue behind the wheel.

Unfortunately, if you don’t have a plan to eventually retire the keys, and your driving becomes a safety issue, others will make the decision for you.

This is a common dilemma for families and friends, and an issue that prompts an inquiry call and consultation.

In this third episode ofWhat happens when you contact Aging Wisdom? Sheila and Keri talk about what happens before, during, and after a consultation that is primarily focused on driving and implementing effective changes with those in your care who shouldn’t be driving anymore.

Additional Reading

Retiring the Car Keys (an Aging Wisdom fact sheet)
My Mom Refuses to Accept Help! Lack of Insight May Be the Reason(an Aging Wisdom blog article)
Resistance to Care is a Common Challenge: What’s the Best Path Forward? (an Aging Wisdom blog article)

Putting the brakes on driving is a real challenge, but with Aging Wisdom’s help, the transition can be much smoother. Click here to Schedule a Get-acquainted Call with one of our Certified Care Managers.

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What happens during a consultation?In this second podcast episode of What happens when you contact Aging Wisdom?, Sheila and Keri talk about what happens after the get-acquainted (inquiry) call when the caller wants to take the next step.

Following the get-acquainted (inquiry) call, the next step is to schedule a consultation. During the initial consultation, you meet with an experienced and knowledgeable Certified Care Manager. We learn about your situation, listen to your concerns, and explore how we can help.

The situation may call for an assessment. An assessment is a person-centered review of a client’s health care needs, functional and accessibility needs, strengths and supports, goals, and other characteristics that will inform the care plan.

Consolation provides an opportunity to set priorities, review options, make informed decisions, and implement creative solutions. After the consultation, we follow up with a written report that is tailored and prioritized to the client’s needs.

Want to explore how a consultation can guide you to the best options for your situation? Click here to schedule a get-acquainted call to explore the possibilities.

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What happens when you contact Aging Wisdom?

A Get Acquainted Call is usually the first contact. This call is an opportunity to learn about your situation and determine if our services fit your needs.

“That first inquiry call is a time of discovery.They're telling us a little bit about what's going on. We're listening and then we're offering in general terms how we can provide assistance,” shares Sheila McKannay, New Client Services, Certified Care Manager.

Individuals, couples, families, and friends come to us with a variety of concerns and questions. Our get-acquainted call won’t answer all questions, but it does provide a sense of how our Aging Life Care professionals can provide guidance and support.

Common situations that prompt an inquiry call include but aren’t limited to:

An adult child calling about consistent uncharacteristic changes they’re observing in a parent that’s causing them concern such as personal hygiene, home maintenance, and managing finances or medications.
Recognizing they need help managing caregiving responsibilities for a spouse or partner as dementia or another health condition progresses.
Questions about moving and what makes sense when.
A recent diagnosis of Parkinson’s, MCI, Alzheimer’s or another dementia, or recovery from a stroke.
They’re referred by their primary care physician, neurologist, elder law attorney, or financial advisor.
Challenges when someone they care about is still driving and it’s no longer safe to do so.
Siblings in disagreement about what is best for mom and/or dad and could benefit from the objective, informed guidance of an Aging Life Care Manager.
A solo ager is having difficulty navigating the day-to-day and friends call to inquire about how to best help their friend.

Next week, Sheila and Keri will talk about next steps, assessments, and consultations.

Additional Resources:

Seven Signs Your Parent May Need Help
Retiring the Car Keys
Solo Aging: Eyes wide open
Clash of the siblings!

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Feeling truly seen and heard helps to build trust and relationship, and contributes to aging well, caring well, and living well.

Our Care Managers and Creative Engagement Specialists are incredibly adept at the powers of observation, asking questions, actively listening, making connections, learning about the person in front of them, and being in the moment. Each conversation provides opportunity to know a client more personally, find ways to add to their quality of life, and enhance well-being.

In this last segment of conversation between Tami Sandygren, Care Manager Associate, and Keri Pollock, our Director of Marketing and Communications, Tami reflects on her lifelong joy of discovery, listening to the life stories, and the lessons of older adults in her life. She also reflects on how this benefits her abilities to better support clients.

Need guidance navigating care and the best options for a parent or partner? For 20 years, we've helped hundreds of families just like yours. Click here to schedule a get-acquainted call with one of our Certified Care Managers.

Resources and Additional Reading

Thriving through life transitions
What is the Secret to Aging Well?
Father's Day and the Power of Story
Aging Wisdom Services Brochure

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We have a lot to celebrate this month. In addition to May being National Aging Life Care Month and Older Adults Month, our colleague Wendy Nathan celebrates ten years with Aging Wisdom!

If you know our team, you know our paths to Aging Life Care are varied, but we share a mutual mission: To inspire hope through creative solutions so our clients live well, care well, and age well.

As Wendy shares in this episode of Wisdom Wednesday, she has had a rich career, starting as a hospital respiratory therapist and in research. She then went back to school to become a massage therapist and worked predominantly with older adults.

Her work with older adults prompted a fascination with how different people age, their attitudes toward aging, and how massage and the power of touch allowed her clients to live more full lives.

This eventually led to pursing a Certificate in Gerontology through the University of Washington Professional & Continuing Education program and working at Aging Wisdom, first as a companion (what is now known as our Creative Engagement program) and eventually as a Certified Care Manager.

Want to learn more about Aging Life Care and how it can be of benefit to you? CLICK HERE to schedule a FREE get-acquainted call to determine together whether our services are a good fit for your needs.

Additional Reading:

8 Tips for Aging Well: Make Your Plan Now for a Healthy, Supported Future
What is Aging Life Care?
Aging Wisdom Senior Care Services

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A lack of insight or awareness is when a person living with a form dementia or a brain injury is unable to recognize changes in their behavior and emotions.

Adult children may interpret this as a parent being difficult or in denial. However, the part of the brain that is damaged, often by Alzheimer's, Lewy Body dementia, or a stroke, is what is affecting the individual's inability to see these changes. It is related to loss of activity in areas in the front of a person’s brain, known as the frontal lobes.

According to The Cleveland Clinic, the frontal lobes are responsible for reasoning, social understanding, executive functioning, voluntary muscle movements, and learning and recalling information.

Damage to the frontal lobes can result in the inability to plan a sequence of complex movements needed to complete multi-stepped tasks, loss of spontaneity in interacting with others, perseveration, inability to focus on a task and to filter out distractions, mood fluctuations, difficulty problem solving or inhibiting or controlling a response or impulse, reduced awareness or insight into difficulties, as well a changes in social behavior and/or personality.

Challenged by a parent's lack of awareness and not sure how to move forward? If you live in the greater Seattle-Bellevue area, schedule a free get-acquainted call with us at Aging Wisdom to explore how we can be a support.

Resources and Additional Reading

My Mom Refuses to Accept Help! Lack of Insight May Be the Reason
Seven Signs an Older Loved One May Need Help
What is Aging Life Care?

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Family disagreements are common as adult siblings navigate a parent's journey with aging.

Aging Wisdom's Director of Care Management, Nicole Amico Kane, joins our principal and founder,Lisa Mayfield, in a conversation about how and why family members have different perspectives and varying degrees of comfort with a parent's choices and preferences, and why that can lead to conflicts.

Aging Life Care professionals, aka Care Managers can serve as that neutral, unbiased expert in getting everyone on the same page and moving forward on addressing the issues that are causing concern.

If you live in the greater Seattle area, schedule a get-acquainted call with us at Aging Wisdom to explore how we can be help.

Resources and Additional Reading

Clash of the Siblings: How to navigate family dynamics when your parent needs help (Aging Wisdom blog article)
Surviving and Soothing Sibling Strife When Caring for Aging Parents (Aging Wisdom blog article)
Can freedom and safety co-exist? (Aging Wisdom blog article) https://agingwisdom.com/can-freedom-and-safety-co-exist/
When an ailing parent needs more care, sibling conflicts can arise and add to stress(article: Washington Post)

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Our colleague Wendy Nathan, along with Sandra Cook, Regional VP at Aegis Living, wrap up this series by talking about caregiver guilt and the need to make time for self-care.

Caregiver guilt is normal and a complicated emotion. You will likely experience moments of self-doubt, stress, exhaustion, and times of feeling overwhelmed, even frustrated. Again, that's all normal. Be aware, however, of caregiver burnout. Click here to take our Caregiver Burnout Quiz.
We encourage caregivers to find healthy ways to manage guilt before it turns into burnout. That's why self-care is so essential.

What's best for the person in your care (despite their protests)? Are they safe? Comfortable? Creatively and social engaged? Check out this article on Creativity, Connection, and Dementia from our colleague Juliet Powell to spark some ideas.

When it comes to self-care, it can be as simple as a walk around the block, a bubble bath, or a dance party! Here are some surefire ways to jumpstart self-care and recharge your batteries: Family Caregivers: Don't Let Your Flame Fizzle!

Feeling a bit overwhelmed? Struggling with your journey as a family caregiver? We can help! Schedule a free get-acquainted call with us today.

Additional Reading

Self-Care is Not Selfish: It's Essential for Family Caregiver Well-Being
The Dance: Finding Balance When Helping an Aging Parent

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Every situation has its own variables, just as each family has its own system and dynamics. This can often rank at the top of obstacles to providing the support an aging parent may need.

Risk assessment and risk tolerance play a part as well, especially if the person in your care is living with Alzheimer’s or another dementia.

Is mom OK living alone? Can dad safely drive his car, even if it is only to and from the grocery store? Is Aunt Mary a fall risk and broken hip just waiting to happen? These are important questions to which honest answers will help you to move forward with planning, mitigating risk, while honoring a parent's wishes, within reason.

Wendy touches on several challenges to getting someone the help they need. Are siblings a barrier? Is denial a factor? How about your parent? Are they resistant to support due to a lack of insight or awareness?

Recognizing and acknowledging these hindrances can lead you to finding the solution to overcoming or addressing them.

Sometimes you need an objective third party like us. As Aging Life Care experts, we help families navigate these obstacles every day. Our goal is the same as yours: respecting the autonomy and independence of the person in your care, while minimizing risk, optimizing safety, and enhancing quality of life.

Still challenged by obstacles? We can help. Click here to schedule a free, get-acquainted call today. Additional Resources

Clash of the Siblings: How to navigate family dynamics when your parent needs help
The Dance: Finding Balance with Helping an Aging Parent
Resistance to Care is a Common Challenge: What’s the Best Path Forward?
My Mom Refuses to Accept Help! Lack of Insight May Be the Reason

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In this segment, our colleague Wendy Nathan talks about long-distance caregiving and how families who live outside the immediate geographic area can benefit from engaging a Care Manager to help in the care of their parent who lives locally.

She and Sandra also talk about the services that a fiduciary provides in support of bill paying.

It's not uncommon for an adult child responsible for health care and/or financial decisions who lives in San Francisco or London, for example, to hire us as an advisor and support for a parent who lives in the greater Seattle area.

A Care Manager is engaged to serve as an advocate on behalf of the older adult in need of support when family lives elsewhere. We can be the boots-on-the-ground, if you will, for the family members who live at a distance, offering insight and observations that will help them make better decisions.

A Care Manager is able to make regular visits to monitor the parent's health and well-being. We can make recommendations and also accompany the parent to doctors appointments.

We are in regular communication with families as well, and always available to answer questions. And we are there for emergencies too.

Interested in learning how a Care Manager can assist you in support your parents from a distance? Click here to schedule a free, get-acquainted call with one of our Certified Care Managers.

Resources and Additional Reading

What is Aging Life Care?
Get in the Lifeboat: Don't Float Alone! Key Supports You Need
What is an Aging Life Care Manager?
Aging Wisdom Services brochure

This is part of a long conversation between our colleague Wendy Nathan, a Certified Care Manager here at Aging Wisdom, and Sandra Cook, Regional VP of Sales, Aegis Living.

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Moving a parent to memory care or and adult family home can be a difficult decision for families, but it’s often the best choice. The transition can be challenging initially, though your mom or dad will eventually become accustomed to the routines, sights, and sounds of their new residence.

In our experience as Care Managers, our clients who are living with a progressive condition such as Alzheimer’s or another dementia often do much better once they’ve made the move. Staff are adept at welcoming, orienting, and comforting new residents.

Facilitating a successful transition to a memory care community takes forethought and planning. Here are a few ideas to help make the change easier and the transition a success:

Family should be consistent, concise about the move in conversation with your parent. Everyone involved in the decision and the move should have the same simple though consistent, reassuring response. “Mom, we love you and want you to be comfortable and safe.” Or “Dad, you’re such a social person, and your new home offers lots of great activities AND they have incredible food!”
Pack belongings when your parent isn’t around. Plan to have someone take your loved one out for a meal and a little shopping, or while they are at an appointment, when you pack the essentials and some items that will make them feel at home in their new place.
Set up their room in a welcoming way. Be sure to including familiar clothes in the closet and dresser. Comforting, meaningful items such as their favorite easy chair and lap blanket, bedspread, bath towels, lotion and soap, pictures, books, and magazines can all say “Home.”
Understand that the change will take time. Change is difficult for all of us. For someone living with cognitive change, it can be more complex. But with time it will get better, and your parent will soon feel at home in their new residence.

As our colleague Wendy Nathan shares in this segment, don’t be shy about engaging in conversation with your parent once they’ve moved and are questioning the change. Saying “I want to go home” is common. In response, you can say "You really want to go home. Tell me what your home is like." Then listen. Just listen. This will bring comfort, and they’ll know that they're being heard.

Time to begin planning for a move? We have the knowledge and expertise to help guide the journey. Click here to schedule a free, get-acquainted call with one of our Certified Care Managers.

You may also enjoy this online course we created — Should I Move Mom? – to help you further understand the options and build confidence in helping an older loved one to move to a retirement community or stay at home. This is part of a long conversation between our colleague Wendy Nathan, a Certified Care Manager here at Aging Wisdom, and Sandra Cook, Regional VP of Sales, Aegis Living.

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As a society, we value self-sufficiency and driving is tied to that sense of independence. However, there may come a point in all our lives when driving is no longer practical.

If and when driving becomes a safety issue, how do we have conversations or implement effective changes with those in our care that shouldn’t be driving anymore?

In this presentation excerpt, our colleague Wendy Nathan, a Certified Care Manager, offers guidance on how to address this common though often difficult topic.

Not sure what to do next? Putting the brakes on driving can be a real challenge. CLICK HERE to schedule a free, get-acquainted call with one of our Certified Care Managers today.

Additional Reading

Retiring the Car Keys (an Aging Wisdom fact sheet)
My Mom Refuses to Accept Help! Lack of Insight May Be the Reason (an Aging Wisdom blog article)
Resistance to Care is a Common Challenge: What’s the Best Path Forward? (an Aging Wisdom blog article)

Resources Wendy Mentioned

EvergreenHealth Driving Skills Assessment
Northwest Driver Rehab

This is part of a long conversation between our colleague Wendy Nathan, a Certified Care Manager here at Aging Wisdom, and Sandra Cook, Regional VP of Sales, Aegis Living.

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During the Q & A period of this virtual presentation, an attendee asked about additional services – specifically around transportation and technology – that are available to residents when they live in assisted living or memory care, or at home.

As our colleague Nicole shares there’s typically some level of transportation available a long-term care setting; it depends on whether the resident needs to be accompanied and where they’re going. Some transportation is the responsibility of the family to manage, or they can hire somebody to do that. This is a great question to ask if that's a need and you're touring communities.

If you need to know about transportation resources for people still living at home, it depends on the community in which you live. This is a great question for your Area Agency on Aging or local senior center. Talk to the social worker at your senior center because they would be in your area and familiar with the available resources. You can also start your research here, through the U.S. Administration on Aging’s Eldercare Locator.

We have volunteer transportation services for some neighborhoods in our area that people can rely on, but it's usually for individuals who are somewhat independent. A good place to start is with Community Living Connections for Seattle and King County. You can call them toll free at 1-844-348-5464.

Regarding technology: more and more is out on the market these days with the mission of supporting people aging in place at home. As Nicole emphasized, don't let technology replace care. Technology can be an important for someone who's living at home, semi-alone, and has any potential for falls.

An emergency response pendant with automatic fall detection is one example. Some families use Alexa devices to remind their parent to take medications. There are lots of options available, the key is to not replace care with technology, but to use technology to support and enhance care and connection.

One of our favorite resources for technology to support us as we age is Laurie Orlov’s Aging and Health Technology Watch website. Laurie is a tech industry veteran, writer, speaker and elder care advocate, is the website’s founder.

Interested in learning more about technology and transportation options and coordination? We can help! Click here to schedule a free, get-acquainted call today.

Additional Reading and Resources

· Long-distance grandparenting: Toddlers and kids (Aging Wisdom blog article)

· Pros and Cons of Aging in Place (Aging Wisdom blog article)

· Smartwatches as medical alerts (Aging Wisdom blog article)

· Planning to “retire” from driving (Aging Wisdom blog article)

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As Aging Life Care professionals, we find Home Care works best when someone's willing to accept the care, and when the care needs are predictable. This can be difficult and cost-prohibitive, for example, when you're helping someone in the later stages of dementia.

It's one thing if needs include showering, medication reminders once a day, light housekeeping, and meals. That's easy to staff because it's on a routine schedule. It’s when needs are unpredictable that staffing a professional caregiver can be challenging unless you have 24-hour care, and you're covering all your bases. That option can be expensive as well as isolating.

When determining what makes the most sense for a client – home care or assisted living -- we help families look at the whole picture, including home accessibility, costs, as well as a client’s well-being and quality of life.

One of the things that can create challenges for families is getting a consistent, solid care team at home. Unfortunately, we're dealing with staff shortages in every industry and the caregiving industry has been hit particularly hard because of the pandemic.

Getting a good, consistent caregiver that has the right skill level and personality fit takes time. This can involve a lot of work. Sometimes families get frustrated, understandably, when it's not working, not realizing that it can take a lot of patience and persistence.

We tell families that home care doesn't just run itself. Somebody has to oversee it. Someone must be willing to manage caregiving staff. And sometimes that feels like more work to the spouse or the family member and the net gain on that is not enough for them.

It’s also not unusual for the person in your care to outgrown what you can provide at home, especially if they’re living with a progressive condition such as Alzheimer’s, another dementia, or Parkinson’s. Home can become isolating, especially when mobility and transportation become challenging.

An assisted living community can provide life enrichment, social engagement, 24/7 trained caregivers, nourishing meals, thoughtful building design that supports all levels of mobility.

Closing thought from Nicole: Be realistic about what one caregiver in a home can reasonably accomplish. Occasionally, I must advocate on behalf of caregivers because sometimes the client’s expectation is that they're going to do the care, the cooking, the cleaning, and they're going to be the companion and the activity director. And that's a lot of skills wrapped up into just one person; to some extent those are unfair expectations put on caregivers.

Interested in learning how a Care Manager can assist you in finding professional caregivers to support someone in your care? Click here to schedule a free, get-acquainted call with one of our Certified Care Managers.This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. You can view their full conversation by CLICKING HERE.

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What kind of medical staff is onsite at assisted living and memory care communities?

This varies from community to community, but a great question to ask when touring a facility.

Many communities have a registered nurse on site, Monday through Friday, 9:00 to 5:00, and the nurse might be available on call as needed. Professional caregivers are staffed 24/7, and long-term care communities also have medical technicians whose primary job is to distribute resident medications.

Some communities have visiting medical providers who come to the community and provide on-site primary care. This might be an MD or a nurse practitioner, and that's a great option for residents who want to ave more of that care provided onsite.

There are also ancillary medical services. For example, a foot care specialist may be on rotation once a month or medical lab technician to administer routine lab work. These additional services vary from community to community, but typically there's support in these areas.

Long-term care community residents usually only need to go outside their living community for medical care if they're seeing a specialist, require urgent care, or need hospitalization.

Don’t be shy about asking what specific supports and medical services are available to residents. Also ask about transportation to and from medical appointments.

As Aging Life Care professionals (AKA Care Managers), we frequently accompany clients who live in long-term care communities to their medical appointments off-site. Often our role is to serve as companion and patient-client advocate. We also provide clear communication to all designated parties following the appointment, including appropriate community staff, such as the Director of Nursing, and a client’s DPOA for health care.

Interested in learning how a Care Manager can assist your family with the healthcare of someone in your care?Click here to schedule a free, get-acquainted call with one of our Certified Care Managers.This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. You can view their full conversation by CLICKING HERE.

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You are not alone on this journey! Often families and individuals don’t realize they can save time, energy, money, and heartache by engaging the right professionals and knowledge experts along the way.

If you're starting to think about moving yourself or moving someone in your care, it's important to connect with a professional to help make sure that you're not overlooking something, and that you are aware of what the available options are so that you can make a solid, informed choice.

Senior center social workers. Most communities have a local senior center. Many senior centers have a social worker who can be a great resource of support and connect you to extra help in your area.

Placement coordinators. These are professionals are solely focused on helping people explore housing options. Typically, they work on commission.

Care Managers. Our Aging Life Care (aka Care Management) team at Aging Wisdom works closely with families to help them navigate all aspects of aging. Our primary focus is to help our clients make sense of all their care options and partner with them to make informed decisions.

Families often reach out to us for:

assistance finding a retirement community
finding in-home professional caregivers
help with hospital or skilled nursing discharge planning
providing local support when family is out of the area
assistance when a family member is refusing help

Families also seek our guidance when they aren’t sure where to start or what they need!

Having trouble navigating these decisions? It can be complicated. We are the experts guides. We can help. Schedule a free, get-acquainted call today with one of our Certified Care Managers.

RESOURCES

Aging Wisdom website
Eldercare Locator -- a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.
Washington State Aging and Long-Term Support Administration website

ADDITIONAL READING

Navigating Long-Term Care Options (in greater Seattle) Part II – an Aging Wisdom blog article
What is Long-Term Care? – an Aging Wisdom blog article
A Move to a Retirement Community Could Mean More Independence for Your Parent – an Aging Wisdom blog article

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What is Medicaid spenddown?

"Spenddown is a way for someone with Medicare to qualify for Medicaid even if the person’s income is higher than the state’s Medicaid limit. Under spenddown, a state lets the person subtract their non-covered medical expenses and cost sharing (like premiums and deductibles) from their available income, so that their countable income is lowered to a level that qualifies them for Medicaid." (Source: CMS fact sheet)

The timeframe from private pay to spend down to Medicare is anywhere from one to five years. We usually see this when someone has been living in assisted living, for example, a few years and their care needs are increasing. The family's starting to get concerned about their parent's finances and paying for care.

If someone's within a couple years of spending all of their money, it's time to regroup and think about the strategy. Our Care Managers help families strategize, plan, and connect with resources to get this in order.

Sometimes a client will move to an adult family home even before they'd anticipated doing so because that's a supportive living option for a Medicaid spenddown. Spenddown is basically an advanced strategy to get someone in a facility where they can pay privately for that long-term care for one to five years. And then when their money is gone, they can stay there on Medicaid.

What you want to avoid is running out of money and then having to move. If you're already on Medicaid and you're trying to get into a facility, you have very few options. And that's where that private pay period helps to increase the availability of quality options.

Concerned about a parent's finances and care? Not sure how to anticipate and/or plan for a possible spenddown? We can help. Schedule a free, get-acquainted call today with one of our Certified Care Managers.

Resources

Medicaid Spend Down & Extra Help (downloadable CMS fact sheet)
How a Medicaid Spend Down Works (Newsweek article)
What is "elder law"? (Aging Wisdom blog article)
Assembling your support team (Aging Wisdom blog article)

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How can a Certified Care Manager (AKA Aging Life Care professional) help a client, their family and supports after a fall?

A Care Manager is an essential tool in a client’s and their family’s toolbox of resources and supports.

The many systems that clients and their families encounter while garnering care and support -- be it at home, in a retirement community, or a hospital or clinical setting -- can be daunting and filled with barriers, U-turns, and the unexpected.

Care Managers understand this. We can anticipate, plan for, and avert a lot of the challenges. We also know how to ask the right questions, communicate with allied professionals, and advocate on behalf of clients.

We are adept at and deal with these situations every day.

In this podcast, our colleague Sheila McKannay provides a snapshot of the many ways a Care Manager can offer guidance, coordination, crisis intervention, and most importantly, peace of mind.

RESOURCES

· What is Aging Life Care? – fact sheet

· The Dance: Finding Balance When Helping an Aging Parent – article

· Aging Wisdom’s Services brochure – downloadable

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From experience, we know how important it is to get our eyes, ears, and feet checked at least annually. If you notice anything out of the ordinary, such a change in your vision, tingling in your legs, feet, and toes, or a challenge with hearing, it’s imperative you schedule an appointment with your primary care physician, podiatrist, and/or ophthalmologist.

There can be a ripple effect if we aren’t careful. Vision, hearing, and foot care all play key roles in health maintenance and fall risk prevention. Our eyes, ears, and feet also support our ability to get regular exercise. And regular exercise can contribute to so many positives: strength, balance, overall well-being, appetite, mental acuity and cognition, a good night’s sleep.

Other things that could contribute to fall risk?:

Trouble sleeping that could lead to tiredness, lack of focus. This article on Increasing concentration and focus may be helpful.
Medications – review possible side effects of each prescription and supplement; be careful about drug interactions (known as polypharmacy)
Alcohol consumption – too much alcohol can contribute to falls; also, be cautious about alcohol consumption and medications.
Alcohol can also contribute to dehydration.
Dehydration – are you getting enough fluids? Dehydration can result in numerous problems such as light-headedness, constipation, lethargy. This article on Hydration by our colleague Juliet may be helpful.
Assistive devices being used incorrectly or not being used when they should
Uncomfortable or ill-fitting shoes; shoes with slippery soles.
Foot problems not being addressed. Foot care and finding the right shoes can help considerably with balance, walking comfort, and physical activity.
Safety risks immediately within and outside your home setting. A Care Manager can provide a consultation and risk assessment of your home, and even help with home modification and maintenance recommendations. This article on Aging in Place should help you plan. This article on Age-friendly exteriors may prove insightful as well.

Who to engage in minimizing falls:

Health care professionals such as your primary care physician (PCP), eye doctor, and foot doctor
This includes your pharmacist, who may have insights on drug interactions and side effects
When recommended, a Physical Therapist
Doctor-approved or -recommended exercise program online, at a community or senior center, or regular walks with friends
And Aging Life Care expert (aka Care Manager); we can provide a home safety assessment, recommendations on home modification, and consultation to ensure safety and risk prevention measures are implemented.

Curious about what a home safety assessment provides? You can schedule a free get-acquainted call with one of our Certified Care Managers to get the conversation started. Click here to schedule a call today!

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How Your Healthcare Provider & Pharmacist Can Help with Falls Prevention

Health care providers have our best interests at heart. They help us maintain good health and overcome or manage a health condition. Being open and honest with them is important. If they don't know about something, they can't help us.

Talk with your doctor if you:

have a concern about your balance,
aren’t feeling as well as you usually do,
have concerns about the medications and supplements you're taking,
have had a stumble and you’re afraid of a fall.

Remember your primary care physician is there for you, to help you.

Our colleague Sheila McKannay, Certified Care Manager, offers insights and encouragement about partnering with your health care provider and pharmacist to address overall health, any concerns we may have, and how to engagement them in assessing and lower our risk of a fall. There are several health-related issues that might concern you, be it blood pressure, poor balance, medications and their side effects, use of assistive devices, knee and foot pain. But your primary care physician can help ease concerns and help with a plan forward.

Team with healthcare professionals (this may also include a referral to a Physical Therapist) to improve balance, strength, and endurance. Falls prevention truly is a team effort.

Physical activity and movement are good for us physically, mentally, and socially. Engage friends and family involved. Spend time outside, get some fresh air and Vitamin D. Don’t forget your senior or community center as a value resource for programs and supports to keep you fit, motivated, and engaged. This can all add to our well-being and minimize our risk of falls.

Not sure where to start? Schedule a consultation with one of our Certified Care Managers. CLICK HERE to schedule a free, get-acquainted call.

RESOURCES

Enhance Fitness
Northshore Senior Center – YouTube channel – yoga
Seattle Parks and Recreation Lifelong Recreation
Check your local senior or community center, or Y for classes!

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It's Falls Prevention Awareness Week -- September 18-24. We'll be taking the conversation beyond the week in a series of 6 podcasts with our colleagues Sheila McKannay, Certified Care Manager, and Keri Pollock, Director of Marketing and Communications.

Falls are not a normal part of aging. It's a great time to engage friends and family in an assessment of your home.

Here are a few tips to get you started:

• Keep floors and walkways clear of clutter and tripping hazards (shoes, boxes, pet accessories, your purse, books and magazines, etc.)

• Remove or secure throw rugs; move furniture from walking pathways

• Improve visibility through interior and exterior lighting

• Clip or tape cords securely to walls or floors

• Outside: Repair and mark uneven thresholds with contrasting tape or paint

You can reduce your risk of falling with regular exercise, reviewing medications with a health care provider, getting your eyes checked annually, and making your home safer by improving lighting and cleaning tripping hazards.

Could you benefit from a Falls Risk Assessment? Schedule a free, get-acquainted call today with one of Aging Wisdom's Certified Care Managers today to explore the benefits.

Resources

Six Steps to Prevent a Fall (and Injury)
Get a Leg Up on Falls Prevention
Falls Prevention, Assessment, and Evaluating Risk

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Helping a person in your care navigate health and cognitive changes can be a challenge. It's not always easy, or successful.

There are many reasons.

Sometimes it's the result of brain changes that result in a lack of insight, a lack of awareness on the part of your loved one. Other times it could be fear or a sense of loss upon loss.

Wendy and Sandra talk about driving and moving in particular, and offering approaches and guidance on how to help an older adult make choices and changes that are often difficult -- such as retiring from driving -- but necessary for safety.

Here are some links to the resources and additional reading that were discussed in this week's Wisdom Wednesday:

Northwest Driver Rehab
EvergreenHealth Driving Skills Assessment
Retiring the Car Keys
My Mom Refuses to Accept Help! Lack of Insight May Be the Reason
Resistance to Care is a Common Challenge: What’s the Best Path Forward?

Interested in exploring how best to navigate health and cognitive changes of an older adult in your care? Schedule a free, get-acquainted call here to talk with one of our care managers to get the conversation started.

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How can you best prepare ahead of a crisis? Or have things in order ahead of when changes start to become evident? Do your homework and research ahead of your parent needing help. Here are some key areas to consider:

We always advise families and individuals who come to Aging Wisdom for guidance and ongoing support to first get their legal paperwork in order. This is essential.

Legal paperwork: Have you and your parents completed completed estate planning documents (powers of attorney, wills, and advance directive)? If so, have you reviewed them lately to make sure they still reflect your/their wishes? And Elder Law attorney can help you prepare or review these documents. You can contact us for an attorney referral or you may find an Elder Law attorney here: https://waela.org

Finances: make sure you understand your parents' financial situation. What is their monthly income? Do they have long-term care insurance? If so, do you understand what it covers? When does it kicks in? If they don’t have long-term care insurance, how much do they have saved to pay for long-term care costs? How many years of care would this savings cover?

If your older loved one is at home and needed support, you can start slowly and start small by offering in-home assistance. Wendy offers some suggestions such as a home care nurse to manage medications, someone to come to the home to prepare fresh, healthy meals, or a professional caregiver to assist a few hours a week.

Sometimes coordinating some regular companionship is helpful too, to address isolation and improve overall quality of life. Social isolation can often happen as mobility and cognition changes. A companion can assist with driving, activities, outings, and engagement.

If you are interested in exploring in-home assistance or engaging a senior care companion for your parent, we can help. Schedule a free, get-acquainted call here to talk with one of our care managers.

Resources and Supports:

Aging Wisdom (serving King and south Snohomish Counties)
Sound Generations (King County)
Homage Senior Services (Snohomish County)
The Memory Hub (Seattle's First Hill)
Alzheimer's Association (WA State Chapter)
Providence ElderPlace (Everett, Kent, Redmond, Seattle, West Seattle)
Elderwise (Seattle's First Hill)

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This is a common scenario and often what brings families to Aging Wisdom for our expert guidance: The parent that refuses help, especially when it's clear they need it!

In this conversation, Wendy Nathan, Certified Care Manager at Aging Wisdom, and Sandra Cook, Executive Consultant for GenCare Lifestyle, discuss some of the scenarios they've experienced working with adult children and their parents.

Wendy advises to start small, just as she shared in the earlier podcast, which you can listen to by CLICKING HERE. Bring in a neutral third party, such as a geriatric Care Manager like Aging Wisdom, to help move the conversation forward and provide solutions and options that will work well for the person in your care.

Worst case scenario, as Wendy and Sandra shared, could be a house fire or Adult Protective Services (APS) is contacted because of a report of self-neglect on the part of the older person.

Find ways to work with your parents before it gets to that point. It takes patience and persistence, but it will pay off in the long run.

Hire a professional to help early on. Especially if you find yourself getting frustrated and overwhelmed. A person trained in guiding conversations and helping with older adults who are resistant to help can honor your parents' feelings and yours and streamline the process.

Looking for help? Schedule a free get-acquainted call **with one of our Aging Life Care Experts today.

Additional Reading**

The Dance: Finding Balance with Helping an Aging Parent
What is Aging Life Care?

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When families begin to see signs that an older adult needs help, how can they start having a conversation? Because nobody wants to say, "Hey mom, you need care. We need to move you." How do you get there before there's a crisis?

In this episode, Wendy Nathan, Certified Care Manager at Aging Wisdom, and Sandra Cook, Executive Consultant for GenCare Lifestyle, discuss some strategies to approaching a loved one who is needing help but may not be ready or doesn’t recognize the need.

As Wendy acknowledged, it important to preserve the relationship. Diving in with “you need to move!” isn’t a good approach. One of the methods our care managers coach families to use is to have a conversation about the future. For example. "Mom, in the future when you might need help, what might be some of the things that you would want? Would you be interested in moving? Would you be interested in having care at home?"

And talking about it in the future doesn't put the pressure on them to have to make any decisions right now.

Listen as Wendy and Sandra share additional strategies and concerns.

Additional Reading and Resources

The Dance: Finding Balance with Helping an Aging Parent
Resistance to Care is a Common Challenge: What's the Best Path Forward?
A Move to a Retirement Community Count Mean More Independence for Your Parent
What is Aging Life Care?

Not sure what to do next? Is the person in your care resistant to help? We are experts in guiding families on options and next steps. You can CLICK HERE to schedule a free get-acquainted call with one of our care managers. Learn more about our Senior Care Services.

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Having concerns about an older loved one’s well-being is normal. Striking the right balance between fostering independence and ensuring safety can be a struggle for adult children and other care partners. Sometimes we offer help and it’s ignored, dismissed, or refused. Granted, this can be frustrating. However, with patience, persistence, and some new approaches, you can build a foundation for conversation, collaboration, and mutual understanding.

In this first of ten bite-sized podcasts, our colleague Wendy Nathan, Certified Care Manager, and Sandra Cook, Executive Consultant for GenCare Lifestyle, share the common signs that someone may need help and how to help those in our care when they don't want help.

Changes and adjustments are normal for all of us during our lifespan, but sometimes they warrant a closer look. Striking the right balance between fostering independence, respecting autonomy, and ensuring safety can be a struggle for those of us who are part of an older adult’s life. You may find this article helpful too: Seven Signs an Older Loved One May Need Help

By the end of this series of podcasts, part of a larger virtual presentation given in February, you should have some great tools in your toolbox for managing resistance.

In this series of conversations with Wendy and Sandra, they will:

Discuss the value of independence in our society
Help us understand why older people may resist care/help
Offer techniques to help build and gain trust and cooperation
Provide creative ways to support to those who are reluctant to accept our assistance

Not sure what to do next? Are changes in an older loved one a source of worry for you? We are experts in guiding families on options and next steps. You can CLICK HERE to schedule a free get-acquainted call with one of our care managers.

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We're revisiting an interview Lisa Mayfield, founder, principal and care manager at Aging Wisdom, did with Suzanne Newman of Answers for Elders back in early 2020 on an evergreen topic: Family dynamics and caring for a parent living with dementia.

They talk about facing family conflicts and shifting dynamics. Even in families where all have tight relationships, caring for an aging parent can bring out conflicts.

Subtle and challenging symptoms of dementia may also mean that your parent is experiencing a lack of insight in the ways that the disease is affecting them.

Lisa and Suzanne share some great strategies for calming conflicts, recognizing your grief, addressing denial, and in the long run, doing what's best for mom or dad.

Additional Reading and Resources:

Clash of the Siblings: How to navigate family dynamics when your parents need help
My Mom Refuses to Accept Help! Lack of insight may be the reason
Surviving and Soothing Sibling Strife When Caring for Aging Parents
Get in the Lifeboat: But Don't Float Alone! Key Supports You'll Want in Your Boat

Not sure how to begin? Put our expertise to work for you! Schedule a free, get-acquainted call today with one of our Aging Life Care experts.

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Common issues resulting in an emergency: A fall. Wildfire. Health event. Flooding. Heatwave. Earthquake.

Either we have experienced some these issues, helped someone who has, or we may anticipate that one or more may affect us in the future.

Are you ready for a crisis or emergency?

Regardless of the cause or circumstance, when you are in the midst of an emergency, you are not thinking clearly, so it's important to do a bit of advance planning.

In anticipation, it's wise to have a plan, just as Herb "ConsumerMan" Weisbaum and Nicole Amico Kane, Aging Wisdom's Director of Care Management, discussed. To get started, here are some tried-and-true ideas to put into action:

A list of important contacts and their information. This may include your health care providers, family members, friends, and neighbors.
A list of your medications and pertinent medical issues.
Create a group text or phone call chain to keep family and friends informed.
A small "go bag" -- a change of clothing, sleepwear, extra phone/tablet charger, extra pair of glasses, hearing aid batteries, hygiene items, copies of the lists mention above -- anything that would make an overnight stay away from home more comfortable.
Consider including these items in your "go bag" as well:
- Copy of your advance directive and power of attorney documents
- Copy of your insurance cards and ID
- Comfort items: pillow, blanket, socks

Not sure to get started? We can guide you in creating a tailored emergency plan. Schedule a call today with one of our care management experts.

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Cost of Long-Term Care*

One of our favorite tools for getting a baseline on long-term care costs is the Genworth Cost of Care Survey. Enter your city, state, or zip code for the median cost of care for a variety of care settings (including your home) in your location.

We stress median costs, as our experience as geriatric Care Managers is that LTC costs more than the median reflected in the survey. But again, it's a great place to start to get a realistic picture of costs, options, and levels of care.

Skilled Nursing: As Nicole shares in the podcast, if you're privately paying for a skilled nursing facility, you could easily be paying $13,000 - $15,000 a month. It's expensive and a very clinical atmosphere. Skilled nursing, as discussed last week, is for those individuals who are rehabilitating following a hospitalization or needing 24/7 medical care. There are also residents that are who are utilizing Medicaid funding, with Medicaid covering the cost of their care. Skilled Nursing podcast.

Adult Family Homes (AFHs): AFHs in our area typically range from $7,500 to $10,000 a month. Occasionally, we see it go a little higher for someone who has a pretty substantial care needs. We've seen it go as high as $12,000. That's a little bit of an outlier. One of the things about adult family home costs is that they tend to be a little bit more contained over time. Adult Family Homes podcast.

Side note: There's more of a cost ceiling with adult family homes. And there are opportunities in some adult family homes for people to spend down to Medicaid.

Assisted Living: With Assisted Living there are different levels and points, and so costs can vary widely as a result. We may know what it'd cost today, but it's difficult to predict (though we encourage you to ask questions to be prepared for what care may cost in six months or two years. Assisted Living podcast 1. Assisted Living podcast 2.

Memory Care: Memory care cost are more closely aligned with assisted living. Total monthly cost we see usually range from $7,000 to $12,000 a month depending on the community and the care needs. Memory Care podcast.

* The costs of care that Nicole discusses in this podcast are what we see in the greater Seattle-Bellevue, Washington state area.

You may find this free online course of help. Should I Move Mom?
Choosing the Right Long-Term Care Facility (an article from AARP)

Interested in exploring and planning for long-term care housing and not sure where to start? We can help! Schedule a free get-acquainted call today.

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Skilled Nursing Facility (SNF)/Nursing Home

Skilled Nursing Facilities (SNFs), also known as Nursing Homes, are for individuals that have ongoing physical or mental conditions that require constant care and supervision or need rehabilitation following a hospitalization.

Skilled nursing services focus on medical care.

These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. They provide physical therapy, occupational therapy, speech therapy, and medical oversight.

The goal of rehab is to get patients back to their baseline and stabilize them so they can move on to the next step. Rehab is typically a Medicare-covered stay, following a hospitalization.

Many who live in a skilled nursing facility long-term are either relying on Medicaid funding or paying privately at $500+ per day.

Additional Resources

Skilled Nursing Facility Care Coverage - Medicare
Washington DSHS Long-Term Care Residential Options
Washington State Nursing Home Locator and Inspection Reports

Planning for long-term care and not sure where to start? We can help! Schedule a free get-acquainted call today to learn more about your situation and to determine together whether our services are a good fit for your needs.

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Adult Family Homes (AFH)

Adult Family Homes are residential homes licensed to care for up to six non-related residents. They provide room, board, laundry, necessary supervision, and necessary help with activities of daily living, personal care, and social services.

The adult family home model has created a space for people to get a high-level of care, but in a comfortable home-like setting. AFH are especially wonderful for residents who would benefit from more one-on-one support and a calmer environment.

There are a lot of adult family homes in our area (greater Seattle-Bellevue). We like this model when someone needs a lot of care related to physical changes (such as prone to falls) and medical challenges and especially care for people who are in the more advanced stages of dementia.

As Care Managers, we start talking to families about adult family homes if the person in their care has been in assisted living and makes the transition to memory care. It may be going well for a while, then something changes, and all of a sudden it doesn't feel right.

What we typically see is someone at a stage in their dementia where they're feeling overly stimulated by their environment. There's too much going on. They're having a harder time benefiting from the activities that are provided. There's a lot of coming and going and that's too much for them to process. They need a smaller, calmer environment. This is where adult family homes are so beneficial.

Sometimes people are experiencing behavioral or mood changes related to their dementia, and they need more focused one-on-one support. Staffing ratios are usually two caregivers to five or six residents. This way, residents can get more personalized attention.

It's also a great option for people who have medically complex needs. For example, we've had clients move to adult family homes where maybe they were on a ventilator or they had a feeding tube. Years ago, the only option for them would have been to live in a skilled nursing facility, which is a clinical, institutional atmosphere, rather than the more intimate, residential setting of an AFH.

The number of adult family homes to choose from in our area can be overwhelming. Families often aren’t sure what to look for or how to assess which AFH will be the best fit for the person in their care. We help families navigate and narrow down the options and find the best fit for their loved one.

If you’re anticipating a move and not sure how to move forward, click here to schedule a free, get acquainted call with one of our Care Managers.

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Memory care is specifically designed to provide a safe, supportive, and structured living environment, be it a stand-alone community or a separate unit within assisted living or a CCRC.

Staff provide support with activities of daily living, medication management, and meals, just like in assisted living, but are specially trained to support individuals living with Alzheimer’s or another dementia. Staff provide added structure and extra assistance as residents as experience cognitive change. Staff also offer social engagement and life enrichment activities.

While units or communities are often secure to protect residents, many offer enclosed exterior spaces for walking, access to greenspaces, gardening activities, fresh air, and sunshine. Others have circular interior walkways with supportive handrails, and windows offering comforting views of nature.

When touring communities, things to look for:

Are staff genuinely engaging with residents? Do they know residents on a personal level?
Is the setting welcoming and friendly? Is it clean and safe?
What life enrichment activities are offered? Would they appeal to the person in your care?
Do the residents seem happy, comfortable?

Is the person in your care appropriate for memory care?

It’s not uncommon for individuals diagnosed with a dementia such as Alzheimer’s to live on their own when they are in the early stages of the disease. This is especially true if there is someone such as a spouse, other family member, friend, or paid caregiver providing ongoing oversight and support.

There may come a time when the person in your care will require more support than you are able to provide. Alzheimer’s and many related dementias are progressive, meaning that changes to the brain are progressive, ongoing. Judgement, reasoning, mobility, executive functioning, memory, balance, and circadian rhythms are all affected. This can make caring for someone increasingly challenging and especially challenging for family caregivers.

These questions will help you assess the situation and determine if a move is appropriate:

Is the person in your care unsafe in their home? This article may be helpful in assessing home safety: Know Your Options: The Pros and Cons of Living at Home as You Age
Is your health or that of the primary caregiver at risk? Caregiving is stressful. Oftentimes, family caregivers don’t invest in self-care and this puts their health in jeopardy. You are a priority too. Read Self-Care is Not Selfish: It’s Essential for Family Caregiver Well-Being
Are you burnt out, stressed, and growing impatient? Take the Caregiver Burnout Quiz
Are the needs of the person in your care beyond your physical abilities?
Would the person in your care benefit from an environment that would provide social and creative engagement, structure, and support?

Looking for guidance on how best to move forward? Our Care Managers are experts in helping navigate important decisions about long-term care.

Click here to schedule a FREE get-acquainted call today.

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Cost of Assisted Living

Some assisted living communities require a one-time community fee and that could be quite the range.

A community fee for month-to-month assisted living is different than a buy-in fee or an entrance fee with a CCRC. This is a one-time fee. We typically see these as low as $3,000 and in some of the newer, higher-end buildings as high as $40,000 to $50,000.

In terms of the monthly fixed costs, it depends on the community you choose and the type of apartment you select. Make sure you ask what, specifically, is included. In most communities, food and beverage, housekeeping, Wi-Fi, laundry, some transportation, and activities are included.

In the Seattle area, we see apartment as low as $2 - $3,000 a month, and as high as $9,000 for a newer, high-end community for a two-bedroom apartment with a view.

In terms of care costs, someone needing a basic level of support such as medication management, costs are around $500 monthly. If the resident is prescribed a lot of medicine, it can be $1,000.

An important question our care managers coach families to ask is: “Tell me about the resident that's getting the highest level of care that you can provide and what does that person pay for their care?” The answer can help family plan for the highest levels of care if and when needed.

We like families to understand the high as well as the low range of fixed costs and care cost in planning. As we age, care needs often change, and it's helpful to anticipate the factors that impact assisted living costs because the price structure is dependent on the level of care that a resident requires.

The community care assessment helps with determining initial care needs. It's important for families to sit down with a representative at that community to understand what supports are needed and the associated cost for care. Now is also a good time to plan ahead. Plan for how mom is going to age and how the community can or cannot support her.

Be prepared to ask questions, if relevant to your situation now or in the future, such as:

· Can you provide a two-person assist or transfer?

· Can you do a Hoyer lift, or the Sara lift for a non-weight bearing resident?

· Can you provide sliding scale insulin?

· Talk to me about open wounds and wound care. What does that look like?

· What does their license permit them to provide?

Resources:

To get a baseline on the costs of long-term care, including assisted living, check the Genworth Cost of Care Survey: https://www.genworth.com/aging-and-you/finances/cost-of-care.html
How Much Does Assisted Living Cost? Prices by state and ways to pay (from Caring.com) https://www.caring.com/senior-living/assisted-living/how-to-pay/

Interested in exploring and planning for long-term care housing and not sure where to start? We can help! Schedule a free get-acquainted call today to learn more about your situation and to determine together whether our services are a good fit for your needs.

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Assisted Living is housing designed for individuals who need support with various levels of personal and medical care. Assisted living can benefit those needing assistance with transferring or functional mobility (transferring from bed to wheelchair, for example), showering or bathing, toileting, dressing, personal hygiene, and meal preparation, as well as medication management, housekeeping, laundry, transportation, and socialization.

MONTH-TO-MONTH. Assisted living is typically a month-to-month model, so you're not paying a sizable buy-in or entrance fee like you would with a CCRC or Life Plan Community (as we discussed last week).

FIXED COSTS. You choose your apartment: it could be a studio, one bedroom, or two bedroom, and you pay base rent for your apartment. So that's a fixed cost. Also included are utilities, activities (life enrichment programs and outings), many if not all meals, in addition to basic housekeeping, laundry, and certain transportation, depending on the community. Some communities also provided wireless internet access as part of the daily rate.

CARE COSTS. On top of those charges, you will have a care assessment that determines what your actual care needs are and what the nursing and caregiving team is going to be doing for you on a daily basis. This assessment determines your care costs.

ASK QUESTIONS SPECIFIC TO YOUR SITUATION. As Nicole points out, there's lots of variability from one assisted living to the next in terms of the care they can and cannot provide. It's really important to ask very specific questions that apply to your family's situation.

In Washington state it is a requirement that every facility provide a Disclosure of Services that clearly outlines what that facility does and does not provide. Sometimes it's a starting point and actually helps you know where to ask more questions.

SOME EXAMPLES OF CARE NEEDS NOT COVERED. Some of the limiting factors at communities that provide lighter Assisted Living support that Nicole has seen specific to care needs includes:

Transfers, also called functional mobility: how much help someone needs getting from bed to chair or standing.
Incontinence care.
Physical help with feeding or accommodating a modified diet.
Challenging behaviors related to dementia.

As you review potential communities, those are the key areas that we focus on. And ask yourself, Is this a community that can support those needs now? And what does that look like down the road if and when needs change?

Additional Resources

You may find this free online course of help. Should I Move Mom?
Types of Long-Term Care (article from the Aging Wisdom blog)
Choosing the Right Long-Term Care Facility (an article from AARP)

Interested in exploring and planning for long-term care housing and not sure where to start? We can help! Schedule a free get-acquainted call today.

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In today's podcast and over the coming weeks, Nicole will provide a general overview of different housing options for long-term care: Continuing Care Retirement Communities, Assisted Living, Memory Care, and Adult Family Homes

Today she looks at Continuing Care Retirement Communities (CCRCs), also known as Life Plan Communities.

As Nicole shares, "This is really an option for people who are at a stage in their life where they're proactively planning ahead. Maybe they're ready to downsize. They're attracted to that retirement lifestyle, relatively healthy and independent."

You move in to a CCRC as an independent resident and if you need more support over time, there are different levels of care within that building or campus that can support you over a continuum.

CCRCs typically include Independent living, Assisted living, Memory care, and Skilled Nursing. Some include Short-term rehab.

CCRCs are usually high end communities with lots of amenities. They require a buy-in or entry fee. In our area, that could mean a range from $300,000 to $1 million. This is in addition to your monthly maintenance or service fee. Each CCRC offers different contracts. It's important to understand the type of contract, what is covered, and if cost will increase as your needs change.

Additional Reading and Resources:

How Continuing Care Retirement Communities Work (AARP webpage)
Washington state DSHS CCRC Registry

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Focus on the true care needs of your parent, or your spouse, or yourself. Look at what is needed in the short term, and also consider how the situation may look and change over time.

You need to factor in the finances too.

Starting with next week's podcast, we'll talk specifically about the different levels and types of care and what that means in terms of the services and supports that are offered. Where we see the greatest variability is in assisted living communities in terms of care.

It can be so helpful for family members to have an objective care assessment of what their parent or spouse really needs -- again, looking at both the short term and what care might look like down the road.

One of the tips we give families, especially if someone has heavier care needs, or some complexity, is to ask: "Tell me about a resident that had to leave your community because you were no longer able to meet their needs."

Ask for some real life scenarios. Maybe it's that the physical care needs became too much, for example, someone that's in a wheelchair that needs two caregivers to help transfer them. There's a lot of communities that cannot provide that level of support. And then for people who have more needs around dementia, are there challenges with their care related to their dementia? How can that community support it?

It's important to ask questions. Bring a notebook.

If you're not sure where to start, and you live in the greater Seattle-Bellevue area, CLICK HERE to schedule a FREE get-acquainted call today!
If you live outside the area, you can find an Aging Life Care Expert near you by visiting the Aging Life Care Association.

Additional Resources

You may find this free online course of help. Should I Move Mom? Understand the options and build confidence in helping an older loved one to move to a retirement community.
Types of Long-Term Care (article from the Aging Wisdom blog)
Choosing the Right Long-Term Care Facility (an article from AARP)

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When we meet with families and start to talk about care and housing options, it's not unusual for them to ask if Medicare covers what we are recommending. Typically, the answer is no.

Medicare covers very limited supports around long-term care and typically that's a short-term care stay, such as an inpatient rehabilitation usually following a hospitalization -- for example, when someone has had a cardiac event, or they're recovering from a hip fracture and surgery. They go to rehabilitation to recover and get stronger, with the goal that they'll eventually transition back to their home. Medicare will cover that to some extent.

When it comes to paying for your long-term care, however, it's typically covered through personal funds as an out-of-pocket expense.

Some people have long-term care insurance policies that can also supplement those expenses.

Medicaid funding is available to individuals with limited income and meet other eligibility requirements. Eligibility and services covered vary from state to state.

There's a whole other universe of planning that comes along if someone's thinking that they will need Medicaid at some point in their life. That's also something that we can coach families about.

Additionally, depending on military service, the individual needing long-term care may also qualify for Department of Veterans Affairs benefits.

Here in Washington State we also have a number of PACE programs (Program of All-Inclusive Care for the Elderly) , a "Medicare program that provides care and services to people who otherwise would need care in a nursing home. PACE covers medical, social service, and long-term care costs for frail people."

Overwhelmed by the options and now sure where to start? We can help! If you live in the greater Seattle-Bellevue area, CLICK HERE to schedule a FREE get-acquainted call today! If you live outside the area, you can find an Aging Life Care Expert near you by visiting the Aging Life Care Association.

Resources

Paying for Care (National Institute on Aging webpage)
Parents Reluctant to Spend Money on Their Own Care (Aging Wisdom blog)
Should I Move Mom?free online course from Aging Wisdom
The Cost of Senior Housing and Long-term Care: Will it break the bank?online course from Aging Wisdom

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. You can catch Nicole and Brenda, virtually & LIVE, on May 19, from 3 PM to 4 PM Pacific, where they'll be talking about "Navigating Care and Housing Options." CLICK HERE to learn more and to register.

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Do you have a plan for the time when home is no longer safe and supportive for your parent/s, your spouse, or you?

Families are usually pragmatic and understand that an older adult who is living with a dementia or Parkinson's diagnosis, for example, will eventually need to move to a safer, more supportive environment in the future.

What are the signs that it's time for a move?

In this Wisdom Wednesday excerpt of a longer conversation, our colleague Nicole Amico Kane, talks with Brenda Dodd at Aegis Living, about the common concerns and signs that it's time to consider a move to a long-term care community:

Health and medical related changes, oftentimes memory and cognitive changes.
Supports and services such as a professional caregiver, a companion, or household help, have been brought into the home, but the efforts have failed.
The supports that have been brought into the home are no longer enough.
A family member or friend has been the primary caregiving support at home, and they feel their caregiving responsibilities are no longer sustainable. Caregiving is taking a toll on their health and well-being.
A consideration we've paid more attention to during the pandemic is that home can be isolating for someone who's aging in place because the world is just a little too small.
The cost of care is no longer financially sustainable. When you start to need a lot of care at home, things can get expensive real fast, and costs can become prohibitive especially when you're thinking about longer range planning and how resources will support someone over their lifetime. That's an important consideration.

Every family and every situation is different. Understanding the landscape and planning for what's to come can save a lot of stress and heartache in the long-run.

Our Aging Life Care Professionals (aka geriatric Care Managers) have the experience and knowledge to guide families on planning for today as well as the future.

Why is Change So Hard? (an Aging Wisdom blog article)
Seven Signs an Older Loved One May Need Help (an Aging Wisdom blog article)
What is Aging Life Care? (an Aging Wisdom fact sheet)

Not quite sure what steps to take next? You can schedule a free call with us to determine together whether our services are a good fit for your needs.

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What is Aging Life Care™?

Aging Life Care is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges.

Working with families, the expertise of Aging Life Care Professionals provides answers and clarity at a time of uncertainty.

Our guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through assessment and monitoring; planning and problem-solving; education and advocacy; family caregiver coaching, and more.

As our colleague Nicole Amico Kane, Director of Care Management at Aging Wisdom, explains, the role of a Care Manager can look a lot of different ways depending on what families need and want from us.

Each family is unique, so Care Managers are flexible and accommodating to each client's needs and goals. We offer a wide variety of services and supports in response.

It can be anything from a one-time consultation where we dive in comprehensively to get to know your situation well and then offer tailored, specific guidance. This saves families the usual stress of navigating their next steps and gets them headed in the right direction with some clarity on what options make the most sense for their circumstances.

For some families that's empowering them and educating them in their role so they feel more confident moving forward.

Other families have us do a little bit more. They may hire us for ongoing care management support, such as implementing plans, coordinating services, and take things off their plate that they would otherwise be responsible for.

If you live in the greater Seattle area, you can schedule a FREE get-acquainted call with one of our senior care managers.

If you live outside the greater Seattle area, you can find an Aging Life Care Professional (aka a geriatric Care Manager) near you by visiting the Aging Life Care Association.

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. You can catch Nicole and Brenda, virtually & LIVE, on May 19, from 3 PM to 4 PM Pacific, where they'll be talking about "Navigating Care and Housing Options." CLICK HERE to learn more and to register.

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Don't we all need a ray of sunshine or a beacon of hope when life gets challenging?

As a family caregiver, you can become comfortable with the daily routines and rhythms of caregiving and not realize how stressed, or physically and emotionally exhausted you've become.

You are doing an amazing job! Caregiving is difficult, complicated work.

But have you ever spilled coffee in the car or missed an important appointment and found yourself so overwhelmed in those moments that you couldn't take another step forward? This is when you've reached the point of burnout.

The good news is, you don't have to do it alone.

An Aging Life Care Professional (aka geriatric Care Manager) can bring that ray of sunshine and offer the beacon of hope you so richly deserve and need.

Outsourcing some of those tasks to a Care Manager frees up time for you to focus on yourself (and let us stress that self-care is not selfish, you are a priority!)

And as Lisa said, "My parting thought that's really been on my mind lately is hope, that it can feel so hopeless at times being an adult child supporting a parent, especially in the sandwich generation.

No matter how messy the situation, how frustrating, how complicated, it can get better. And your life can feel easier. And that there is hope, and that there are people out there to make it easier and to help you get some of your life back, and help you put some boundaries in place, and help you feel better."

Looking for guidance on how best to move forward? Our Care Managers are experts in helping family caregivers live well.

if you live in the greater Seattle area, CLICK HERE to schedule a FREE **get-acquainted call today.

If you live outside the greater Seattle area, click here to find an Aging Life Care Professional near you.**

This is an excerpt of a longer conversation between Lisa Mayfield, Aging Wisdom's founder and principal, and Laura Vaillancourt, MA, LMHC, GMHS on her 'Life on Repeat podcast'.

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AnAging Life Care Professional(aka geriatric Care Manager)is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Aging Life Care Professionals are educated and experienced in any of several fields related to Aging Life Care management, including, but not limited to counseling, gerontology, mental health, nursing, occupational therapy, physical therapy, psychology, or social work; with a specialized focus on issues related to aging and elder care.

To qualify for certification as a Care Manager, candidates must meet rigorous education standards, attain a certain number of years of experience and supervision, and pass a comprehensive test to demonstrate foundational knowledge.

To maintain certification, CMCs are required to participate in continuing education and professional development. Certification is renewed every three years to ensure that Care Managers are practicing at the highest professional level.

Many Aging Life Care Professionals also have graduate degrees.

We are all guided in our professional and business practices by a Code of Ethics and Standards of Practice.

You can find an Aging Life Care Professional in your area through the Aging Life Care Association websiteand search by zip code or city.

Aging Life Care Professionals typically bill for our time by the hour, very much like an attorney. The work we do with clients and the cost is really a reflection of how much time and support you need.

Sometimes, families will come for Consultation and just need one or two sessions to get the lay of the land, to understand the options, pros/cons, to have a plan created, to be connected with the right resources. They then implement that plan. They can certainly come back, and check in, and have further problem solving along the way. Whether it be three weeks down the road, whether it be three months down the road.

And then other families will have an Aging Life Care Professional involved in a much deeper, ongoing way. Whether that be checking in on their parents, where they're living in assisted living, or an adult family home, or coordinating doctor's appointments, going with the parent to a doctor's appointment to be able to make sure the doctor understands what's happening. Being able to follow through and be an ongoing emotional support as well as problem solver and advocate along the way.

This is an excerpt of a longer conversation between Lisa Mayfield, Aging Wisdom's founder and principal, and Laura Vaillancourt, MA, LMHC, GMHS on her 'Life on Repeat podcast'.

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Families often seek our geriatric care management services when they know a parent needs help. And it's not uncommon for the parent to resist assistance or support.

Adult children come to us at their wit's end, frustrated because "My Mom is in denial that she needs help!"

Or is she?

Sometimes, this unwillingness to accept or recognize the need for support is the result of a "lack of insight," which can be a symptom of dementia. The parent isn't denying that there are changes in their behavior or emotions, they are, in truth, unable to recognize the changes.

Lack of insight is the result of physical changes to the frontal lobes of the brain, the part of the brain that controls and manages insight. Insight is defined as "1: the ability to understand a person or a situation very clearly; also, 2 : the understanding of the truth of a situation." Merriam-Webster

Giving your parent the facts, confronting them, or trying to reason with them probably isn't having any affect. Lack of insight works that way: they are unable to understand that there are changes and reasons for concern.

Don't bang your head against the wall in frustration. As Care Managers, we can help you navigate these changes and provide education, as well as techniques, language, and approaches that will help you talk with your parent and guide them toward accepting choices that will support their safety while respecting them as a person, and bring you peace of mind.

If you live in the greater Seattle area, you can schedule a FREE get-acquainted call with us to determine together whether our services are a good fit for your needs.

There are Aging Life Care Professionals like us all over the country. To find a Care Manager near you, visit our professional association, the Aging Life Care Association.

This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal.

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Worried about your parents and fighting with your siblings over their care? When it comes to mom and dad, even families who get along well will experience disagreements from time to time.

Finding common ground and reaching a mutual understanding about how best to support your parent/s isn't always easy. With the help of an unbiased professional such as an Aging Life Care Professional (aka Geriatric Care Manager), you can find balance, as well as solutions.

Resources and Supports

Surviving and Soothing Sibling Strife When Caring for Aging Parents (Aging Wisdom blog)
Bringing families together when there's conflict (Aging Wisdom podcast)
The Empowered Caregiver by Linda Fordini-Johnson (book we highly recommend)
When Your Aging Parent Needs Help by Leslie Kernisan, MD, and Paula Spencer Scott (another book we highly recommend)

This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal.

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The systems that families encounter as they help a loved one navigate health and memory changes are dysfunctional.

As Aging Life Care Professionals, aka Care Managers, we work within these systems daily -- healthcare, housing, long-term care, legal, financial, local supports -- and support families as educators, interpreters, guides, and advisors.

Making the best decisions on behalf of a loved one can be overwhelming and made more complicated by these systems. Care managers are here to assist in translation, bring clarity, and turn discouragement and defeat into hope!

How Can a Care Manager Help?

What is Long Term Care? (downloadable fact sheet)
The Toughest Conversation: Retiring the Keys (downloadable fact sheet)
Helping feuding families achieve harmony (podcast)
Burnout Can Happen to Anyone (downloadable E-book)
The Dance: Finding Balance with Helping an Aging Parent (Aging Wisdom blog)

Could you benefit from the guidance of a Care Manager and live in the greater Seattle area? Click here **to schedule a free get acquainted call and to determine together whether our services are a good fit for your needs.

Looking for a Care Manager outside the Seattle area? Click here*.This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom*'s founder and principal.

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Our work as Care Managers may be focused on the well-being and quality of life of one person, our client, but it requires understanding and looking at the whole picture.

What is the whole picture? It includes everything in the client's life: health (and disability), family systems and dynamics, goals, preferences, personal history, finances, values, legal, housing, services & supports, and what brings joy and meaning.

Knowing the whole person, the whole picture, helps us to better guide families as they navigate options for aging well, caring well, and living well.

Additional Reading

What is Aging LIfe Care?
Get in the Lifeboat: Don't Float Alone! Key Supports You'll Want in Your Boat
Alzheimer's and the Family Caregiver
Why I Became an Aging Life Care Professional

Could you benefit from the guidance of a Care Manager? Click here to schedule a free get acquainted call and to determine together whether our services are a good fit for your needs.This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal.

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What is an Aging Life Care Professional? What is Care Management?

We are consultants who work with individuals and their families navigating all the complicated issues that arise with aging, dementia, in particular.

Care Managers are, as Dr. Leslie Kernisan likes to call us, Aging Life Care Ninjas.

With our extensive background, knowledge, and experience working with other families, health care systems, local services and supports, legal and financial matters, senior housing and long-term care, and as advocates, we bring an unbiased, yet informed perspective.

As our colleague in Florida, Amy O'Rourke says: we have a Crystal Ball into the future.

We help families in the midst of "overwhelm." Once we've helped them navigate challenges, we can then help them anticipate and be better prepared for what's ahead.

Through experience, we can help families plan for the issues to come, make the best decisions based on their particular situation, and see positive results and success.

What is Aging Life Care? (a downloadable fact sheet)
Alzheimer's and the Family Caregiver (an Aging Wisdom blog article)
Medical emergencies: Are you prepared? (an Aging Wisdom blog article)
Aging Life Care Association

Could you benefit from the wisdom and experience of a Care Manager? CLICK HERE to schedule a get-acquainted call with Aging Wisdom to determine together whether our services are a good fit for your needs.

This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal.

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As Amy Cameron O'Rourke reflects in her book The Fragile Years: "Most adult children are poorly prepared for the life-changing events that send their once-independent parents and loves into the fragile zone." (p. 15)

Our role as Care Managers, at its core, is to meet family caregivers where they are, be in relationship with them, and support them on the journey.

It's not unusual for families to experience a roller coaster of emotions. And we are experienced and knowledgeable on how to be with families and help them navigate these ups and downs of caring for an aging parent.

This bite-sized podcast was part of a long conversation between our founder & principal Lisa Mayfield with Laura Vaillancourt for her "Life on Repeat" podcast. Repurposed with permission.

Resources and Links

The Dance: Finding Balance with Helping an Aging Parent (Aging Wisdom blog article)
Self-Care is Not Selfish: It's Essential for Family Caregiver Well-Being (Aging Wisdom blog article)
The Fragile Years: Proven Strategies for the Care of Aging Loved Ones by Amy Cameron O'Rourke
What We Carry. A Memoir by Maya Shanbhag Lang

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Every business has an origin story. Here's ours: Lisa Mayfield, our founder and principal, shares here how she came to understand the challenges of dementia from an early age.

Later, as a Girl Scout earning her Gold Award, Lisa spent time with two residents at a local assisted living community. Lisa cherishes the memory of those relationships and how they continue to impact her affinity for and work with older adults.

Everyone at Aging Wisdom shares similar stories. For us, this is heart work <3

This episode of Wisdom Wednesday is part of a longer conversation with fellow Aging Life Care Professional Laura Vaillancourt, on her Life on Repeat: A Dementia Caregiver Podcast.ADDITIONAL INSIGHTS

Why I Became An Aging Life Care Professional by Harisa Paco
What is an Aging Life Care Manager?
Proactive Planning: Draft a road map that helps you prepare for the future

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What is an Aging Life Care Professionals (aka Care Managers)? In this podcast, Lisa Mayfield provides a snapshot of how we help individuals and families navigating options for aging well, caring well, and living well.

Meet our colleague Harisa Paco: Why I Became an Aging Life Care Professional
Who are Aging Wisdom's Aging Life Care Professionals? Read more.
To learn more about Aging Life Care, click here.
What are Aging Wisdom's services? Download our Services brochure.
Schedule a free, get-acquainted call with Aging Wisdom to determine together whether our services are a good fit for your needs.
Don't live in the greater Seattle area? Find an Aging Life Care professionalnear you.

This was an excerpt of a long conversation that Lisa Mayfield, our found and principal, had with Dr. Jane Tornatore, and Joanie Parsons or RevelEleven. You can listen to their enriching discussion HERE.

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Finding Balance. As Lisa shares, part of the process of helping your parent is assessing the landscape and determining if their living situation is really a crisis and requires you to act? Or is there something you can do to make their home safer; an opportunity to insert a little bit of help, starting small?

One suggestion Lisa makes is to ask your parent directly: "How will we know when it’s time for you to move? What will be the signs for us that it is no longer safe for you to be at home?”

This approach is open-ended and less confrontational.

Be patient and listen, truly listen. These simple yet straightforward questions might be the beginning of some wonderful communication and collaborative planning.

Helpful resources and reading:

The Dance: Finding Balance with Helping an Aging Parent (Aging Wisdom blog post)
Seven Signs an Aging Loved One May Need Help (Aging Wisdom blog post)
Know Your Options: The Pros and Cons of Living at Home as You Age (Aging Wisdom blog post)
What is Long Term Care? (a downloadable Aging Wisdom fact sheet)
Six Hidden Cost to Caring for an Aging Loved One (a downloadable Aging Wisdom EBook)
Engage a Care Manager. Aging Wisdom Care Managers are experts in aging and helping individuals and families prepare for and navigate options for aging, caring, and living well. You can schedule a free get-acquainted callwith us by clicking here.
- If you live outside the greater Seattle area, you can check the Aging Life Care Association, our professional association, for a care manager in your area by clicking here.

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Waiting for a crisis. You’ve tried everything to help your parents and nothing has worked. Sometimes you must wait for a crisis to happen before you can make changes. Geriatrician Leslie Kernisan refers to this as “watchful waiting.” In the meantime, you continue to monitor the situation. You stay engaged with your parents but pull back on suggestions. This is an opportunity for you to get better educated about resources, supports, and options ahead of a change or crisis.

Where to begin?

Online resources can be overwhelmingly abundant. One positive place to start is Better Health While Aging, a website started by geriatrician Leslie Kernisan, MD, MPH. Dr. Kernisan understands the landscape of aging, how it impacts families, and offers a comprehensive overview of topics and common concerns. She’s also co-written a book – When Your Aging Parent Needs Help – that you may find helpful.
Engage a Care Manager. Aging Wisdom Care Managers are experts in aging and helping individuals and families prepare for and navigate options for aging, caring, and living well. You can schedule a free get-acquainted call with us by clicking here.
- If you live outside the greater Seattle area, you can check the Aging Life Care Association, our professional association, for a care manager in your area by clicking here.
Cost of Long-Term Care. The Genworth Cost of Care Survey is a great place to start to understand the potential cost of long-term care in your parents' geographic area. The cost of that care varies based on care setting, geographic location of care and level of care required, among other things.
Support groups can be a great place to start. If your parent has dementia, for example, the Alzheimer’s Association likely has a family caregiver support group in your area. Most groups are virtual now due to the COVID pandemic. Many community and senior centers, as well as healthcare systems offer support groups as well. The insights of others on a similar journey are invaluable.
Your local library. In addition to books and other resource materials, many libraries offer classes and activities. Check the events board or calendar for specifics.

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Shift your perspective. If your parent is regularly experiencing memory changes, it's unlikely they have insight that they need help, won't accept support, and are unwilling to make changes.

This is where you need to shift your perspective and determine if your parent is able to make that decision anymore, or if this is a decision you're going to have to make on their behalf.

You can approach the discussion initially by framing it in the future. As Lisa suggested in this podcast, you can start by saying "Dad, you're 101, and it's likely you'll need help someday. I just want to know how I can best support you. I think it's important that we understand what's available so we'll be prepared when that time comes."

This might be the right time to bring in a care manager. In addition to helping identify the appropriate resources, a care manager understands the needs of older adults and their families, and can advise on options and supports for now and for the future.

Here are some resources you may find helpful:

Seven Signs An Aging Older One Needs Help a downloadable checklist
What Is Long Term Care? a downloadable resource guide
What's in an Alzheimer's test? from the Aging Wisdom blog
Should I Move Mom? a free online course at Aging Wisdom University

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Worried about your parents and fighting with you siblings over their care? Even families who get along well will experience disagreements and intensified emotions from time to time when it comes to mom and dad.

If finding a path forward with your siblings is adding to the stress of helping your parents, try some of ideas, offered in Helpful Links, below.

Aging Life Care professionals, aka Care Managers can serve as that neutral, unbiased expert in getting everyone on the same page and moving forward on addressing the issues the are causing concern.

If you live in the greater Seattle area, schedule a get-acquainted call with us at Aging Wisdom to explore how we can be help. Or, to find an Aging Life Care professional in your area, click on the link below.

Helpful Links:

Should I Move Mom?a free Aging Wisdom University online mini-course
When an ailing parent needs more care, sibling conflicts can arise and add to stress (article: Washington Post)
Can Freedom and Safety Co-exist? (original content on Aging Wisdom's blog)
Find an Aging Life Care professional (aka Care Manager) near you

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Picking Your Battles: We cannot wrap our parents in bubble wrap to keep them perfectly safe nor can we sit by idly allowing dad to put others at risk by driving beyond the point of doing it safely. How can we best help them?

Let go of the perfectionist standard you are putting on your loved one's situation. What's most important is safety. Finding balance between honoring independence and inserting safety is not always easy.

The best approach to getting your parents the support they need is to start small. Don't overwhelm them with lots of help. Start small, work your way up, and you'll have a lot more success in the long run.

Helpful Links:

Can freedom and safety co-exist?
Should I Move Mom? an Aging Wisdom University online mini-course
What is Aging Life Care?
Ambiguous Loss pioneered by Pauline Boss, Ph.D.

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Last week we talked about the mix of emotions around helping our parents, as well as setting healthy boundaries.

Caregiving is hard work. Managing it all can be challenging, on top of everything else: work, other family relationships, personal commitments, and finding time for yourself.

In the midst of it all, we need to remind ourselves to take time to engage in a mood shifter that can become a mood lifter. These are the little things we can do throughout the course of a tough day to help put it all in perspective. Not get burnt out. Lift our mood.

In this short excerpt from a longer conversation on helping our aging parents, Lisa Mayfield shares that she loves to crank music, dance and sing! It's energizing and effective.

Here are some other ways to shift and lift your mood: Top Tips You Should Know to Manage Caregiver Stress

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Do you find you have a mixed range of emotions when it comes to your aging parents? It's not uncommon to feel guilt, sadness, anger, obligation, exhaustion all at the same time.

In this excerpt of Aging Parents: What You Need to Know, Lisa Mayfield, Founder and Principal, Aging Wisdom, talks with Joanie Parsons, RevelEleven, about how to set health boundaries and best address time challenges.

Don't risk burning yourself out. You may find this eBook -- Burnout Can Happen to Anyone -- helpful! Take the Caregiver Burnout Quiz to find out if your flame is about to fizzle.

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Have you ever tried to talk with your parent about concerns you may have regarding their health or memory? Were your concerns dismissed, minimized, or completely shut down? In this episode of Aging Parents: What You Need to Know, Lisa Mayfield, Founder and Principal, Aging Wisdom, talks with Joanie Parsons, RevelEleven, about this common challenge.

Part of the issue might be an older loved one is experiencing "lack of insight." You may find this article helpful in understanding what this means and tips for new approaches in communication: My Mom Refuses to Accept Help! Lack of Insight May Be the Reason

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Talking with our parents or other older loved ones about their health or other topics of concern can be difficult. But it's necessary and important, especially if you are seeing worrisome signs of cognitive or physical change.

In this excerpt from Aging Parents: What You Need to Know , Lisa Mayfield, Founder and Principal of Aging Wisdom, and Joanie Parsons of RevelEleven, briefly touch on how to open up the conversation with your parents about your concerns.

Not sure where to start? We can help: What is Aging Life Care?

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In this recorded Zoom conversation, our founder, Lisa Mayfield, talks with Joanie Parsons of RevelEleven, about aging parents and what we as adult children need to know.

In this excerpt of a longer conversation, Lisa and Joanie talk about the more common signs that your parent/s may be experiencing health or memory changes.

You may find this article helpful as well: Seven Signs an Older Loved One May Need Help

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Fear of losing independence and freedom are common refrains we hear from clients when the topic of moving to a retirement community is proposed.

Our parents may be resistant to the idea because they immediately think of the traditional medical model nursing home when you mention a retirement community. It’s not unusual to perceive a senior housing as restrictive, filled with rules.

The reality is very different.

Here are some of the positive benefits we have witnessed when our clients move from their single-family homes, townhouses, or condos to a senior living community:

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Lack of insight is one reason an older adult may be resistant to accepting help and support. They simply don’t see the need. They are not aware of their changes and deficits.

With anosognosia, the frontal lobe of the brain is impaired. The frontal lobe is responsible for higher cognitive functions such as memory, emotions, impulse control, problem solving, social interaction, and motor function.

It’s not unusual for family members to misinterpret their loved one’s lack of insight or awareness as denial. Denial is a coping mechanism, a psychological response to something that is uncomfortable or difficult to accept. It is not anosognosia, though on the surface, they do resemble one another in how someone reacts to certain situations. <READ MORE HERE: My Mom Refuses to Accept Help! Lack of Insight May Be the Reason>

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Reluctance to spend money is often one of the top barriers to getting parents the help they need. Money discussions can be uncomfortable, especially with our parents.

Our parents have worked hard. They’ve invested wisely and saved diligently. And now, when they may need it most, they refuse to spend the money they’ve saved on themselves.

This is a common dilemma for many families. A parent who needs and can benefit greatly from support in their home or by moving to a supportive living environment says “No!” to the idea.

We have worked with hundreds of families through the years in similar circumstances. By applying the tips in the blog below, you can thoughtfully open the conversation, soften their hesitation, address their concerns, and take step forward to provide your parents with the care and support they deserve. < Parents Reluctant to Spend Money on Their Own Care>

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Uncertainty is scary. When we encounter uncertainty and change, the sympathetic nervous system is often engaged. This is what triggers “flight or fight.”

The topic of moving may prompt your parent to bristle at the suggestion. They resist the idea for a myriad of reasons: Home is familiar. They’re overwhelmed by all their stuff. Change is hard. The uncertainty is scary.

Sometimes the resistance stems from an outdated perception of a retirement community. They envision the old hospital-model nursing home. “You won’t ship me off to a home,” is a common response. How do you move forward? <CLICK HERE for tips>

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Change IS hard, no matter who you are, no matter how old you are.

Moving is on the list of the Top 10 most stressful life events. It's understandable why our parent may be resistant to make a move, even when it makes the most sense for their safety and our peace of mind.

Read more here --Why is Change is So Hard? -- to understand why change is difficult, and why resistance is often the default response on the part of an older parent to your suggest that they move. Perspective, persistence, and patience will win long-term.

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Are your parents resisting the idea of a move to a retirement community? One reason may be they're overwhelmed by the thought of a move given the amount of stuff they've accumulated through the years.

It can also be anxiety-provoking to contemplate how you will help your parents organize their belongings and move from a single-family home or condo to an apartment or room at a retirement community. The challenge might even cause you to ignore or delay the issue all together.

Planning ahead with a few simple steps can help you help your older loved ones make peace with their “stuff.” Check out this Aging Wisdom blog for tips on managing belongings and making a move less overwhelming: Should It Stay or Should It Go? Making Peace with Our ‘Stuff’

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Our homes are more than shelter, especially as we age. They often hold our hearts, our memories. We are creatures of comfort, we love familiarity.

But what happens when our parents are older and no longer safe in their own homes? Why do some fight so fiercely to remain?

Lisa Mayfield, founder and principal at Aging Wisdom, reflects on "Home is familiar" as one of many reasons an older adult may be resistant to consider the idea of a move or refusing support. It’s important to understand things from the perspective of an older loved one. Here’s one bite-sized insight.

Wisdom Wednesday: Aging Wisdom's Podcast: Recent Episodes

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