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Texas Department of Aging
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Changing the Game
The Sound of Healing
Overcoming the Jitters
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Illustrations by Shannon Mooney('96)
Illustrations by Shannon Mooney('96)

LAST YEAR, PAM KERL'S 80-YEAR-OLD FATHER found it increasingly difficult to care for her 74-year-old mother, who is in a wheelchair.

"He was trying to get her in and out of bed, and the house was too much for him to keep up," says Kerl, a Highland Village resident. "My brother, sister and I were worried."

Richardson resident Caren Houston was equally worried about her 84-year-old widowed mother, who takes painkillers for a spine fracture as well as medication for high blood pressure and glaucoma. She skipped meals and became confused about which medication to take at which time.

"I was over at Mother's apartment five days a week and saw that she wasn't getting around well. I was nervous about her falling," Houston says.

Kerl's parents and Houston's mother were both evaluated by geriatric care professionals, who suggested new living arrangements.

Kerl's mother moved into the nursing home unit at The Vintage retirement community in Denton. Her father lives nearby in an independent living apartment.

Kerl says that although her parents are living separately after 58 years of marriage, they're happy.

"I feel better knowing that Dad isn't left alone," she says. "The staff knows if he isn't eating because they know if he doesn't come to the dining room. The staff also calls residents each morning to see if they're okay."

Houston's mother has an assisted living apartment in Presbyterian Village North in Dallas. She receives meals and daily visits from a nurse, who keeps track of her medication. The apartment is equipped with an alarm to summon help 24 hours a day.

"It's a big relief because I know that Mother is safe," Houston says.


The boom in caregiving

According to the U.S. Census Bureau, more than 25 percent of the population will be 65 or older by the middle of the century, and the population will have as many people 85 and older as people age 65 to 69.

Geriatric case manager Kay Paggi ('68, '90 M.Ed.) says those 100 years old and older are the fastest growing segment of the population, while those 85 and older are the second fastest. While medical advances have led to Americans living longer, many of the "oldest old" and some younger seniors will become unable to live independently in their own homes, Paggi says.

Numerous American households, like Houston's and Kerl's, will care for an elderly relative for an average of 18 years, she adds.

"The Baby Boomer generation is the first to provide long-term caregiving, but we generally don't know how to do it," Paggi says.


Confronting elderly parents

Richard Lusky, chair of UNT's Department of Applied Gerontology, says that while many adult children are concerned about their aging parents' health problems, making sure that their parents are meeting basic needs, such as feeding themselves, bathing and dressing, is also important.

He cites a 1994-95 federal study that showed one in five older Americans experiencing difficulty with at least two self-care activities each day. The percentage of reported problems rose with the age of the respondents.

"Not meeting basic needs may take a toll on health," he says. "A person who can't drive anymore can't grocery shop, and that will cause serious decline because of lack of nutrition. If someone looks physically frail, you should look for an underlying problem. Don't assume it's just a normal part of aging."

He adds that adult children should think in terms of "successful aging" for their parents helping them maintain physical functioning and remain engaged with life.

"Even a chronic health problem like diabetes can be managed," Lusky says. "The most important thing is to know who your aged parent is, and what he or she would want to help maintain independence."

Bert Hayslip Jr., Regents Professor of psychology, says that because many older people value their independence, they are often reluctant to acknowledge declining skills. Adult children may have to intervene, particularly when their parents may cause danger to themselves or others, he adds.

"Ask them to demonstrate a skill, such as cooking," he says. "Talk to them about things that have become chores for them and discuss giving them some help."

This requires adult children to have good relationships with their parents before the parents become elderly, he says.

"When they set the house on fire because they forgot to turn off the stove, it's not the time to discover you can't talk to them," Hayslip says.

Paggi adds that adult children should avoid telling their parents that they can't do something.

"Use 'I' statements so that it's your problem. The best thing to say is, 'I'm uncomfortable with you driving.' Saying 'You can't drive anymore' is accusatory and aggressive," she says.

Hayslip says adult children often experience a mixture of dread and grief when they realize they must confront an elderly parent.

"When you think about a parent needing help, you may think about that person dying, and you grieve for the loss of the person you grew up with," he says.


Senior living options

As recently as 20 years ago, older people who could not care for themselves had few options other than living with adult children or in nursing homes, Lusky says.

Today, assisted living is the most popular option, he says. Other options include independent living, continuing care facilities, in-home care services and adult day-care facilities.

All assisted living communities provide meals, housekeeping services, 24-hour healthcare services, and assistance in bathing, dressing and taking medication. Many also offer regular transportation for shopping, daily social activities, volunteer opportunities and field trips.

Cheryl Harding, UNT assistant professor of applied gerontology, says assisted living communities provide a positive alternative to nursing homes for many people.

"Only 5 percent of seniors live in nursing homes, and the number of nursing home beds is decreasing. The ones left are for seniors requiring very skilled medical care," she says.

Independent living retirement facilities also offer housekeeping, transportation and meals, but unlike assisted living facilities, they do not offer home healthcare services. Large facilities have exercise and game rooms, libraries, beauty shops and swimming pools.

Continuing care communities, like Presbyterian Village North and The Vintage, have independent living, assisted living and nursing home facilities in one location.

If a parent wishes to stay in his or her home, adult children can contact their local Area Agency on Aging for information on in-home programs such as housecleaning, meal delivery and healthcare aides, Harding says.

Adult day care centers are another option. These programs provide transportation to and from the centers and offer meals, social activities and medication monitoring.

While many seniors are cared for in their adult children's homes, UNT faculty say that this may not be the best option for everyone. Adult children and aging parents may have different values, Hayslip says, and friction can result from the child taking on the parental role.


Helping parents adjust

UNT faculty do suggest that adult children work with their parents to find the best living option or home services.

Hayslip notes that elderly people who can't participate in deciding their living situation generally have the most adjustment problems.

"You must involve your parents in the process," he says. "Take them with you to tour a facility and ask them if they would like to stay there. I would certainly not dump elderly parents in a situation where you know they will be uncomfortable because they will feel abandoned."

Elderly people who adjust best, he says, maintain their identities by keeping some routines and possessions.

Kerl's mother has some of her furniture in her Vintage nursing home room. Her father kept his cats when he moved to his apartment.

Lusky says many retirement community staffs are trained to help new residents adjust.

"Usually, what happens in the first week will determine if a person stays," he says.

Regular contact with family members through informal visits or traditional family gatherings is equally important, Hayslip says.

"Reassure them that you still love them, but that this is the best situation for them," he says.

Illustrations by Shannon Mooney('96)

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