Sooner or later, most people will have to face a new challenge: how best to care for their aging parents.
“Getting older is a fact of life,” says Dr. Andrew Hoover, a Wise County family practice physician with an office in Rhome. “When our loved ones reach advanced age – seventies, eighties or beyond – they’re often unable to do all the things they used to do, the day-to-day activities that are taken for granted in younger years.”
Sometimes, the aging process is exacerbated by declining health. Chronic health conditions can limit activity and reduce quality of life. But even people who are relatively healthy at an advanced age need special considerations. Diminished eyesight, hearing, flexibility and reflexes are all normal as we get older, necessitating new safety measures.
The good news is that with proper planning and good communication, you can be prepared for the unexpected. And, as much as we hate to think about it, the day will come when our parents leave us. Planning in advance for end-of-life decisions will help make a difficult time more manageable.
Here’s a few things to keep in mind as your parents get older, steps that will help protect their health and safety and give you some peace of mind along the way.
What’s Realistic for Your Situation?
Maybe you live a 15-minute drive from where you grew up and you can drop by your mom and dad’s house every few days. Perhaps your parents live in another state or even a different country. Not everyone can check in on or take care of their parents in the exact same way – and that’s OK. Recognizing a few commonalities that all aging adults go through and then deciding the best way to manage them for your situation is the key.
If you do not live near your parents, then it helps to have a trusted person who is in the vicinity. This may be a neighbor, a friend or another relative. Maybe it’s a volunteer at your parents’ church, or someone you pay to look in on your parents. Bottom line, it is important to have a support system in place if you are not physically close.
Stay Connected
Even if you live a long distance from your parents, it is easier than ever to keep in touch with them. No longer are you limited to phone calls; video chat on a phone, tablet or computer is a great way to stay connected.
Doing this regularly so that your parents can see you and their grandkids is a great way to keep them engaged and feeling happy. It also allows you to get a better sense of how they are doing and if you notice any changes in their appearance that may indicate a new health concern.
Of course, if you do live close by, dropping in from time to time is a great way to stay connected and spot any noticeable changes in their health.
A Common Danger: Falling
“Falls are one of the most common – and most serious – safety threats for senior citizens,” says Dr. Grace Reynolds, an orthopedic surgeon in Fort Worth. “A fall can result in broken bones and head injuries. Most broken hips we see in older adults are a result of a fall.”
According to the National Institutes of Health, more than one out of three people age 65 and older fall each year. Falls are the leading cause of trauma-related hospital admissions for older adults and can lead to serious injury, disability, reduced quality of life and death.
A hip fracture is one of the worst injuries that can result from a fall, as it requires extensive rehabilitation. A senior who is in overall good health is more likely to be able to go home after surgery and rehabilitation. However, a patient who is already frail or has underlying chronic health conditions is more likely to end up in a nursing facility after leaving the hospital, dramatically reducing quality of life and increasing likelihood of mortality.
Reduce Fall Risk
Here are some of the most important, easiest and least expensive things your parents – and anyone – can do to reduce fall risk:
- Wear glasses or contacts when walking
- Install a grab bar in the shower/bathtub.
- Use a rubber mat in and outside the shower.
- Wear shoes with a rubber sole and avoid walking in socks or slippers.
- Maintain floors that are free of clutter
- Make sure rugs are secured to the floor. Get rid of loose rugs and mats.
- If the carpet is torn, repair it.
- Keep rooms well-lit and avoid trying to walk in the dark. Keep a flashlight near the bedside.
- If the home is two story, bring anything your mom and dad may need downstairs so they don’t need to go upstairs
- If steps cannot be avoided, always use the handrail
- If your parents have pets, make sure they are always mindful of where they are and don’t allow them to get under their feet
- Use a cane or walker for additional stability and control
Home Improvement Projects
If your parents’ bathroom has a combined bathtub/shower arrangement that is common in older houses – and you have the budget to do it – a tear out and replacement with a walk-in shower is a great safety investment. Stepping up and over the bathtub is a safety risk for older adults. A walk-in shower, with plenty of safety handrails and anti-slip flooring dramatically improves bathroom safety.
While most older adults are better off not attempting to go up or down flights of stairs, some homes have a few steps coming off the front or back porch or in the garage. Those should be evaluated carefully.
Older homes may have step heights that are outdated and no longer in code. These require the user to take higher steps up, which becomes more difficult the older we get. Consider replacing these types of older steps with ones that are shorter in height and have a deeper surface area. And of course, make sure there is a handrail, even if it’s just a step or two!
Leverage Technology for Safety
Depending on how tech-savvy your mom or dad is, there are some technologies they can use to enhance their safety. This is more important if you have a parent who lives by themselves.
One of the worst things that can happen to an elderly person is that they fall, they cannot get up and no one is around to help them.
To prevent this situation, you can get your mom or dad a wearable alert button that will call 911 should they fall. You generally pay a monthly subscription for this, but it is worth it for a loved one who lives alone.
An alternative – or backup – is to put a smart device in the home that they can talk to and tell it to call 911. Devices such as Amazon Alexa, Google Home or Apple HomePod can all do this and are relatively easy to set up and use.
Lastly, if your parent wears a smart watch, some have fall detection and can automatically call 911 if a fall is detected.
Other Safety Measures
Like any home, your parents’ house needs to have working smoke detectors and carbon monoxide detectors. Older adults may forget to change batteries, so this is an important safety measure to stay on top of.
It’s also important that your parents do not try to do certain household maintenance items themselves. They (or you) need to hire someone to do certain tasks.
“Basically, if it involves a ladder, it should be off-limits,” says Dr. Brittany Culp, a trauma surgeon in Grapevine. “Cleaning gutters, or even changing a ceiling light bulb should be left to someone else.”
Driving
How long is it safe to stay behind the wheel? That’s a question many people ask in regard to their aging parents – it’s also one that many seniors ask of themselves.
“There is not a hard and fast rule with respect to driving, as each person’s circumstances are different,” explains Dr. Mike Liu, a Fort Worth neurologist. “Turning a certain age does not mean someone needs to automatically hand over the car keys – rather, it’s important for the driver and family to make an honest assessment of driving skills.”
In Texas, when a driver turns 79, they must renew their driver license in person. The application will ask for medical history and a vision exam is required. Between the ages of 79-84, a new license will be good for six years. At age 85 and older, the license will be good for two years.
Driving Health Factors
If it is safe to do so, driving can be beneficial for older adults, as it helps to maintain their independence. There are several health factors to consider when determining if it is still safe to drive:
- Vision: Is eyesight still strong enough to safely see the road and other vehicles?
- Hearing: Can the driver hear car horns, trains and other important sounds?
- Reflexes: Is the driver still able to react in a timely way to a light turning red? Can he brake for a pedestrian or another vehicle?
- Flexibility: Does the driver get in and out of the car OK? Can he operate the steering wheel and pedals without pain and limitation?
- Medications: Does the driver take medications that can cause drowsiness or dull senses?
These are all factors that need to be honestly evaluated – by both family and the driver.
Some seniors are still able to safely drive but choose to do so in a more limited way. For example, some only drive during daylight. They may also only drive close to home and avoid highways.
For children of older parents, the best thing to do is have a driving talk before your parent is having problems. They will be more likely to agree to some limitations on their driving in advance of when it’s needed. This will help if and when the day comes to give up the car keys.
Health Care Help
Many older adults have increased health needs as they age. Adult children can help their parents navigate their health needs in several ways:
- Have a relationship with your parents’ health care providers: if your parents are comfortable with you going to their doctor appointments with them, this is a great way to make sure you are up to speed on what’s going on with their health, and any dos and don’ts with respect to diet and activity.
- Be aware of your parents’ medicines: knowing what medicines your parents take is important. Making sure they get their refills as needed and helping them understand their schedule is essential.
- Health insurance: Insurance coverage is complicated at any age. You can help your parents choose the right Medicare Advantage plan and Medicare Part D (prescription drug plan) so they have the benefits that do them the most good.
Medical Power of Attorney
Everyone, regardless of age, should consider a medical power of attorney (MPOA). An MPOA grants someone the authority to make decisions about medical care on behalf of another person and in accordance with their wishes. This is valuable to do if someone becomes incapacitated – for example, is in a coma or loses the ability to make decisions.
MPOAs can be established for a lifetime or to end on a certain date. They can also be revoked at any time. For family members of aging relatives, this is a valuable legal power to have if the relative becomes incapacitated. An MPOA is a normal and necessary part of end-of-life planning, just as a will is.
Advance Directives
Discuss with your parents if they would like to complete an advance directive, also called a living will. An advance directive directs physicians to the patient’s wishes in the event of a terminal condition. It instructs the physician and hospital staff on certain aspects of life-sustaining care, such as whether you want to be resuscitated if your heart stops and remain on life support with measures such as IV fluids, or if you wish to be allowed to die as peacefully as possible.
Out-of-hospital DNR
An out-of-hospital do-not-resuscitate (OOH-DNR) order is similar to an advance directive but pertains specifically to a situation where the patient is not hospitalized. This would provide instruction to paramedics or nursing home staff to not utilize cardiopulmonary resuscitation (CPR) or defibrillation to revive a person whose heart and breathing have stopped, allowing the person to pass away.
Take Care of Them – and Yourself
Caring for aging parents can be demanding and challenging, especially when balancing their needs with your job, your children and other commitments. Advance planning and clear and frequent communication will help ease this work and provide added peace of mind for you and your parents.
And if it gets to be too much, never hesitate to ask for help.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
Texas Health & Human Services Commission
