The Sandwich Generation - Adult Children Caring For Their Aging Parents

Adults in 2008 are busier now versus prior generations. The internet, cell phones, texting and tivo keep us connected to others 24 hours a day. The concept to deliver more... both at work and at home with our families add stressors to us that our parents never faced.

Add on top of this... your aging parents, the ones you've always went to for advise... always reliable to be your anchor in times of need... now relying on you to meet their daily needs. For many, being thrown into this stress inducing role that is now labeled as the "Sandwich Generation" can be a huge challenge.

The Sandwich Generation, are those adults who find themselves not only caring for their dependant children, but now responsible for the care of their aging parents. Caring for ones parents can involve several different scenarios. The aging parents may or may not still live on their own, but will often require assistance with personal care, errands &/or financial assistance.

The Sandwich Generation is estimated to grow, given the current life expectancy increases. This will result in many middle aged adults, ages 45-56, finding themselves with at least one of their parents still living. Add to this the fact that women are having children at an older age and voila' - you find yourself parenting your parents, while parenting your children at the same time.

Women are working outside the home now more than ever, therefore providing your aging parents the support they may all of a sudden need will prove to be a difficult hurdle. In addition, with the baby boomers aging, this need is projected to snowball and you may find yourself knee-deep in the "Where do I go from here?" group.

If you find yourself suddenly faced with this dilemma, there are many resources available to get information. Researching the internet and discussing this with your parents Physicians are good places to start. Organizations can provide support and assistance for the Sandwich Generation; but locating who can provide quality care and be affordable at the same time, can get complicated. Seeking advice from friends or others who have been through this, will give you the valuable support you may need.

Helpful Resources

Kiplinger’s Financial Solutions for the Sandwich Generation: Ensuring You Have Enough for You, Your Children, and Your Parents

The Hard Questions For Adult Children And Their Aging Parents: 100 Essential Questions For Facing The Future Together, with Courage and Compassion

Caring for Your Aging Parents: A Common-Sense Guide for Transforming a Difficult Time Into a Loving, Cooperative Relationship

www.AgingAvenues.com offers a wide variety of resources for caregivers

Author: Angela Reeves, RN, Director of Clinical Services and Public Health Advocate, Sterling Healthcare Management Services

"I WAS JUST ADJUSTING THE HEAT"

Last November, I awoke to a phone call from my mother on an early Saturday morning telling me that she thought that she was having a heart attack. Her voice sounded weak and almost inaudible. Pure panic struck as I struggled to remember her address and apartment number. I managed to ask if her door was unlocked (I couldn’t remember where I had put her spare key) before I told her that I would call 911 and get there as fast as I could. When I arrived, two ambulance workers were loading her onto a stretcher. She was pale and grasping her chest. Later at the hospital, we learned that she had suffered a heart attack. After a week in the hospital and two weeks in rehabilitation, she came to stay with me a few days over the Thanksgiving holiday.

On the Sunday after the holiday, she announced that she was ready to return to her apartment. I had concerns because she still seemed weak and would fall asleep at the table while I was talking to her. She assured me that she was fine and that she was ready to drive home – a ten-minute drive. She had insisted that we keep her car at our house for safekeeping. My husband offered to drive her, and I would follow in our car. My mother is a very independent person and would not have it. She did agree to let me follow her in my car.

My husband warmed up her car, and she climbed behind the wheel. As I followed her down the street, I kept seeing her head and trunk go forward and she crossed the centerline five times. The same panic that struck me the morning of her heart attack was back full force. I attempted to motion for her to pull over into a parking lot. I struggled to get my cell phone out of my purse to call my husband – I still don’t know what I expected him to do. I was angry with myself for letting her control this situation against my gut feelings. After all, I am a driving rehabilitation specialist and should have known better.

It seemed like hours (actually only ten minutes) before she pulled into her apartment parking lot with me right behind her. As she opened her car door, I was already beside her car assessing the situation. She greeted me with a smile, and I greeted her with a “what in the heck were you doing?”
She laughed at me and stated “I was adjusting my heat – I just could not seem to get it set right.” I explained to her that it is not okay to cross the centerline, and she responded that she would not have crossed the line if someone were coming.

I learned a couple of important lessons last November. Keep addresses, phone numbers, keys, etc. accessible because you can’t think when you are in a panic. When it comes to my mother, I am going to go with my gut. It was a horrible feeling to think that I might have made a decision that resulted in her hurting herself or others.

Submitted by Laura Noblitt, OTR, Driver Rehabilitation Specialist

Retirees Dilemma

I spoke to a lovely lady last week about her financial situation. Let's call her Mrs. Mason. She thought she was all prepared for retirement and in fact has been retired for over 13 years. She worked for 42 years at a company and had a nice pension and her social security. Her car was paid for and she only owed a small equity loan on her house. Recently, however, she has had trouble making ends meet. She noticed it last winter when fuel bills went up. She noticed it again this summer with gas prices being so high and also her grocery bills increasing more than ever. It's just her and her two little dogs, but still the money is tight. When she got her new gas budget bill, it was a shock. She called the gas company and told them that she simply could not pay that much. They told her to "turn your thermostat down to 60 degrees". She said that her sister and brother-in-law did that and her poor sister died of pneumonia last winter. Mrs. Mason, said to me, "Brenda, I am not going to do that, but I don't know what else to do".
I suggested she we looked at her situation to see if a Reverse Mortgage is a good solutions for her. Based on the estimate of her home value and her age, she would be eligible to receive $500 per month on a Reverse Mortgage. In addition, it could pay off the equity loan and save her $122 per month. The new total income of $622 would make a huge difference for her. Mrs. Mason's situation is more common than people think. Many of them are living only on social security. Reverse Mortgages can definitely help them. The senior never makes a payment and the income they receive is tax free. One of Mrs. Mason's concerns is that she would have to give up her title, but that is NOT required on a Reverse Mortgage. She will retain her title to the property until she no longer lives in the home.

Fun with Alzheimer's

Fun? Nope...still not. Funny? Yes...but sometimes not even that.

By the time I realized Mom’s recipes, lovingly prepared for us for decades, should be written down because her memory was slowly fading…it was too late. For years, at Christmas, my Mom had made each family member’s favorite cookies or candy just for them. A few of the recipes I had called and asked for over the years. But, the sorghum cookie recipe was not one of those.

My niece, Becky, adored Grandma’s sorghum cookies. They were the taste highlight of her holiday. But the recipe was memorized by Mom many years before and either never written down or lost if it was. Becky lamented, “I can’t believe I’ll never taste those cookies again” as tears rolled down her cheeks. She grieved the cookies and her dimming Grandmother, I think.

I then made it my purpose to recreate them. At work, I asked everyone to search their cookbooks for molasses or sorghum cookie recipes. I got dozens. I read each recipe and finally chose the two that I thought showed the most promise, based on my own recollection of what went into them. It had to have ginger as an ingredient…and only a little cinnamon.

Two weeks before Christmas, I baked them. I rolled them into BIG walnut-sized balls because one of the things about the cookies was that they were as big as your head! I baked them. I cooled them. I tasted them. “Close but no cigar,” I thought. When Becky arrived, I told her the story of my quest. She tasted them, smiled and thanked me for being so thoughtful. The look on her face told me they were not the same.

The next year, I altered a few things. I rolled them EVEN BIGGER to try to replicate the soft center and outer chewiness. I serve them to Becky again. “These are good,” she said. “But not Grandma’s, right?” I asked. “No,” she said, “not Grandma’s.”

My mom died in January, 2000. She was a saint and had gone to officially be one with God, whom she had walked with every day of her life.

I remember it must have been late July or early August. It was hot and it was early in the morning when the sun is just starting to turn everything gray before dawn. I was asleep…dozing actually. Suddenly, there was a very loud crash, as though something had fallen off the wall. I sat bolt upright in bed, and in a clear and loud voice, my Mother said to me, “It’s margarine, Honey, not butter!”

I sat there stunned. I got up and walked the entire house, looking for what had fallen. Nothing was out of place. When I crawled, puzzled, back into bed, Michael aroused. “Are you okay?” he asked. I said, “Yes, but did you just hear my Mom say, ‘It’s margarine, honey, not butter?’” He fully opened his eyes and shook his head. “You must have been dreaming,” he said. “I guess I was,” I replied, knowing full well that wasn’t the case.

“What does that mean?” I thought. “Margarine…not butter.” You see, it was late July or early August and I wasn’t thinking about Christmas cookies.

In December, I dutifully got out all the recipes that I fix for my family every year. I pulled out the sorghum cookie recipe and sighed. Should I try again this year, for Becky? As I gazed at the recipe, my eyes fell on the first ingredient: butter. My mother NEVER baked with butter! She ALWAYS baked with Parkay margarine! I understood!

I went to the store. I bought Parkay margarine. I let it soften on the counter until it was limp. I put the Parkay into the KitchenAid mixer along with the sorghum. Unlike butter, the margarine and sorghum didn’t combine. They formed into little brown beads. I added the dry ingredients. I rolled them out into balls as big as your head. I baked them, cooled them and picked one up.

I knew.

When Becky arrived, I offered her a cookie. She smiled at me and dutifully took a bite. Her eyes filled with tears and she stuffed the whole thing into her mouth, chewing with her eyes closed as tears ran down.

“Oh,” she finally said. “I never thought I’d taste that again…they’re Grandma’s cookies!”

Take comfort: she never leaves you and she is there…in the gray colors of the morning, if you take time to listen.

Thanks, Mom!

Kim Woodward is owner of Senior Helpers of Avon, an in-home care and companionship company. Contact her at kwoodward@seniorhelpers.com or (317) 718-1806.

Reverse Mortgages Help Seniors Live Without Worry

Many seniors are not aware that a reverse mortgage can enables them to convert part of the equity in their homes into funds they can use now. Instead of paying a lender each month, the lender will pay you, the mortgage is reversed. They will not take your home, you do not have to give up the and you won't have to pay out-of pocket costs as loan fees are financed into the loan. You have the freedom to decide how to use the funds. Some homeowners use the money to supplement retirement income, repair or modify their home, cover health care costs, pay property taxes, reduce or pay off existing debt, take a trip or give money to the grandchildren for college. Reverse mortgages can even be used to get a home out of foreclosure. A line of credit is also an option and money can be withdrawn as needed. You could also choose a lump sum payment. The loan is repaid when you sell, transfer title, or no longer occupy the home as your primary residence. Any remaining equity goes to you or your heirs.
It's also easy to qualify for a Reverse Mortgage. You need to be at least 62 years old, occupy the property as your primary residence, and have sufficient equity. Eligible properties include single family homes, manufactured homes (meeting FHA guidelines) and qualified condominiums and townhouses. One of the features of a Reverse Mortgage is counseling provided by a HUD approved agency.
Brenda Wheeler, Reverse Mortgage Specialist M&I Bank

Fun with Alzheimer's

Nope...still not fun. But, funny? Yes!

So, I've shared with you that my mom had Alzheimer's and that she was a former school teacher. One day, at the nursing home where she and my dad lived, she had an idea.

Outside their window was a school. She noticed it and decided she needed a job there.

The nursing home had her cuffed with a sensing device that sounded an alarm if she went out through any door. She quickly figured out that, to silence it, you could wrap your hand around it and it wouldn't go off.

I had talked to the staff about mom's condition. I said, "About the only thing I can't stand the thought of is her wandering out in the cold and freezing to death." They assured me that they would do their utmost to prevent that.

One November afternoon, I got a call at work. The nurse that took care of mom and dad's wing told me that she had wandered away and they were looking for her. I said I'd leave right away and come to search for her, but the trip from my downtown office to the nursing home would take 30 minutes or more. Shaking, I left work, got in my car and started driving. About 10 minutes into the trip, I got another call that she had been found, safe and sound.

When I arrived, I found out the following:

Mom had silenced her cuff and headed out the back door toward the school. In a wheelchair, she had scooted across the parking lot, across a baseball diamond, across the school driveway and to the front door. She went inside, found the office and announced, "Hi! I'm Edith Linn and I've been a teacher for many years. I'm not working right now and I need a job...here...several days a week." The school secretary smiled and said, "Well, I think we can use you. Let me just make a call." She called the adjacent nursing home and said, "I think we have one of your folks over here."

When I arrived, the nursing staff directed me to the school. I went inside to find the director of the nursing home, my mom, the secretary and the school principal waiting for me. Mom was entertaining everyone with stories of her 44 year teaching career. They were all laughing and enjoying her stories. I said to her, "Mom, we need to get back home. School's over for today. Let's go."

The secretary asked, "She's such a sweetie! Could I go over and get her a couple of days a week and have her sit with me? It seems that she really misses being in school."

"Are you serious?" I asked. "You don't have to do that."

"I know," she replied. "But I think she would really enjoy it. We could have her staple things or stuff envelopes for us."

"Okay," I said. "I think she'd enjoy it, too."

So, she got the job! From that point forward, she would get up every day, get dressed, put on her makeup, fix her hair, and get ready for work. It gave her a purpose.

God bless the people who understand that, like children, it takes a whole village!

Kim is the owner of Senior Helpers of Avon, an in-home care and companionship company specializing in matching quality caregivers with clients. Go to www.seniorhelpers.com or email her at kwoodward@seniorhelpers.com for more information.

HOME SAFE HOME

As an occupational therapist and mobility specialist, I am often asked by my fellow boomers – How do I keep mom and/or dad safe in their home? According to a research study performed by the Home Safety Council on preventable injuries in the home, they found that preventable injuries:
- Result in nearly 20,000 deaths annually
- Cause nearly 21 million medical visits
- Cost our nation $380 billion dollars
The #1 risk for an independent living senior is a fall, which can ultimately lead to placement in a long-term care facility. While aging in place is the primary goal of most seniors, it just makes sense to take steps to enhance the safety and accessibility of one’s home.

There are a number of checklists for home safely available today. These may be helpful in making the environment safer. Unfortunately, they are not very helpful when it comes to identifying unsafe practices and the need for adaptive equipment and training for that equipment.

An occupational therapist has received specialized training in home and client assessment. A home safety assessment can benefit a senior by:
- Identifying in-home hazards
- Identifying unsafe practices
- Helping to determine the proper amount of assistance needed in the home
- Providing recommendations for equipment and referrals for supportive services
- Providing caregivers and clients with training on safe transfers, etc.

These assessments are relatively economical and may prolong safety, independence and happiness.

Submitted by Laura Noblitt, OTR, DRS Senior Driving & Mobility Services, LLC

The HELOC Blues

Many seniors today are singing the “HELOC BLUES” because of the tightening of credit by most banks. It was always more difficult for seniors to qualify for an equity line due to lower income and lack of credit history. However, today it’s even more difficult as all banks have tightened their lending guidelines for home equity lines of credit. The advantage of the HELOC is the low (or sometimes non-existent) closing costs. The disadvantage is that once the money is taken from their line of credit, the senior has to make payments on the loan.

The answer to the HELOC Blues is the Reverse Mortgage ! One of the ways to take out funds from a Reverse Mortgage is to take the money in the form of a credit line. Unlike a HELOC, the senior does not need a certain credit score or certain income to qualify. The senior only accumulates interest on the amount that they draw to use (remember there is never a payment on the Reverse Mortgage). The money that the senior is not using actually grows at an annual rate of approximately 4% (rates change without notice). This growth is TAX FREE !

According to AARP, this is the most popular way to take Reverse Mortgage funds. This gives the senior more control over when and how much of their equity they want to spend. The senior keeps the title to their house and the senior will keep any equity left after the loan is paid off. The loan is not due until the senior permanently vacates the property.
Talk to a Reverse Mortgage Specialist. This may be your new song to sing and it won't be the blues !

Brenda Wheeler, Reverse Mortgage Specialist, M & I Bank

Fun with Alzheimer's

No, it isn’t fun, but some of the things that elderly parents or other loved ones with Alzheimer's do are funny! My mother is a perfect example of those that, if allowed, can live and die with Alzheimer's and still keep their dignity.

My sister and I are a lot alike (except that she is MUCH older than I am). We look alike. We sound alike. We like the same sports. We like the same foods. Even my dog, who hates everyone except me, likes her. One area, though, where we were very different was how to cope with our mother’s memory loss.

She spent much time correcting when Mom said or did something outlandish or incorrect. “No, Mom,” she’d say. “You know you live here at the nursing home with Dad and can’t go home.” “No, Mom,” she’d say. “You remember that we talked about your bank account yesterday.” “Mom, that’s not a knife…it’s a fork.” It frustrated both of them.

I coped with Mom’s dementia by simply meeting her where she was. I’d walk in and say, “Hi Mom! Where are we today?” “Oh,” she’d say, her eyes lighting up, “we have to watch the turkeys that are in the front forty and make sure they don’t fly over the fence.” “Great!” I’d reply, “I love to watch those turkeys!”

It is terribly tempting to correct, remind, extol, exhort, appeal, correct, and even pander to your loved one with memory loss. You hope for a break through, a return to lucidity, and to have your fully functioning parent back for a few minutes or hours. But, I found that it only served to ruin the time you spent together. I believe I had 3 years longer with Mom than my sister did because I actually enjoyed her company, her stories, her fantasies, her hallucinations and her disorientation and my sister, well, she grieved it.

I’d encourage you to try letting go and allowing them to keep their dignity. Let them be where they are, doing whatever they’re doing, and join in. You might actually learn some facts from the past and you both will be able to simply enjoy each others' company.

Kim Woodward is owner of Senior Helpers, an in-home care and companionship service that provides elderly clients with the ability to live independently in their own homes and much needed respite for primary caregivers.

LET'S JUST STOP AND GET SOME MILK

One of the most difficult things that I have to do as a Driver Rehabilitation Specialist is to recommend driving retirement to a client. I realize the huge impact that stopping driving has on an individual and their family. This recommendation is only made after much testing, observing and consulting. I recently had a gentleman that I was working with at the request of his neurologist. His family had some concerns but thought that their father was actually doing better since his discharge from the hospital.

This gentleman did quite poorly on the in-clinic evaluation and even worse on the behind the wheel. During the drive, he turned into oncoming traffic at an intersection, stopped at a green light with heavy traffic behind him and accelerated through a red light when the cars next to him started to move (they had a green turn arrow). Finally, on the way back to the office, I had to apply the brake when he made no attempt to slow from 40 mph with traffic stopped at a light right in front of us.

I gave him and his family the retirement news. I met with him the next day to set him up with transportation options to be able to go to the grocery, his church and to his numerous upcoming doctor appointments. He was most concerned about an important cancer check appointment that he had the next day. His family was out of town and unable to take him. Having no appointments scheduled the next morning; I volunteered to take him to this appointment. On the way back to his apartment, he asked me to stop at a grocery so that he could get some milk. I waited in the parking lot as he reminded me that he was “not totally helpless”. A few minutes later, he emerged from the grocery and placed his milk in the back seat. At this point, he informed me that he had one more stop to make – the bank. He directed me to where he thought that his bank was located. Unfortunately, the bank was not at this location. He looked at me and stated, “Oh well, lets forget the bank and go get some milk.”

It occurred to me that the time that I had spent with him that morning taking him to his appointment and on his errands was as telling as the time that I had spent with him behind the wheel. If families are seeing these types of memory problems, they may well be affecting their loved one’s ability to drive. Submitted by Laura Noblitt, OTR, DRS

We have abandoned them

Recently I was asked to help a family that their father had dementia and their mother was bi-polar. He was currently in a nursing home for rehab but it was likely that he was going to have to stay because this wife was not really capable of watching after him. That was the easy part. What were they going to do with her was the tough part. Several years ago Indiana closed the majority of their mental health residential facilities. It's difficult to place a elderly person with a mental health issue because they take so much supervision. She really doesn't have a physical need to be in a nursing home anyway. The son has been living with them but works during the day and never really knows what condition he will find mom in when he comes home. The family just got guardianship because neither one of them were capable of making sound decisions. Now they need to figure out how much money they have and how much they owe. This will determine if they will be paying privately for the nursing home or if they can qualify for Medicaid. If they qualify for Medicaid then they will have a case worker who will help with the mental health options for her otherwise they will need to hire a Geriatric Case Manager to assist. Write your congressmen about mental health facilities for the aging.

Chapter 13, The Miller Story

Mr. and Mrs. Miller (not their real name) had been paying off a Chapter 13 Bankruptcy for several years. They paid $122 per month on their bankruptcy payment plan. They were able to retain their house and had a mortgage payment of $1000 per month. The payments were hard for them as they only had Social Security and a small pension every month. One day, while waiting in line at their M&I Bank branch, Mr. Miller saw a poster advertising Reverse Mortgages. He made an appointment with me to go over that program. I was concerned that we handle their bankruptcy carefully, so with his permission, I spoke to his attorney about our proposed Reverse Mortgage plan. We also spoke to a representative of the court. I sent them some information and the court agreed to let Mr. and Mrs. Miller do this loan. I got that permission in writing and we agreed to fax over their HUD 1 (closing document) as soon as the loan closed. The court gave us 30 days to close the loan…..we did it in 27 days ! Mr. and Mrs. Miller not only got completely out of monthly payment debt with their Reverse Mortgage but also got a little over $3000 at closing. Now they have additional income of $1122 per month (from not having to pay a mortgage payment or a BK payment) and they have a little cushion for emergencies. They are so relieved. They can live in their home for the rest of their lives and never make a payment. They kept the title to their home and any equity left will go to their children.

Brenda Wheeler, M & I Bank Reverse Mortgage Specialist

If She Only Still Had Her Money

Yesterday I went to help a senior friend of mine who has been wearing herself out getting ready to have a garage sale because she hopes to soon move to an assisted living. She needs to get her condo sold first in order to afford it - oh I mean her son's condo that was bought with her money and she rents from him. Unfortunately she didn't have an advisor to instruct her how to properly protect her assets and she gave all her money to her two boys several years ago. She gave one $80,000 towards building a house that she could live in with them. Well that didn't work out because her daughter in law felt threatened so she ask her other son to move back here. She gave him $80,000 to buy the condo in his name and still paid him $600 per month in rent. To make ends meet she had to use her credit cards and now has debt too. Even after the condo is sold she's living off of a small pension and social security of $1600 per month. In order to be able to afford their smallest independent living unit she's having to utilize her Veteran's Aid and Attendance benefit. I'm not sure what she'll do when she requires some assistance. She really needs the one bedroom because she's a quilter and wants to take her sewing machine and table. She's giving all her beautiful furniture to her other daughter in law. The least they can do is give mom enough money to pay for the one bedroom. This is a good example of the importance of being educated and advised on the best way to preserve assets. Consult an elder law attorney who specializes in long term estate planning. Learn more about this at www.agingavenues.com.