Newest book on aging and eldercare in the family is here

So it’s been eleven years that Dr. Michael Gordon, Canada’s leading geriatrician and then head of geriatrics and internal medicine at Toronto’s world-renowned Baycrest Centre for Geriatric Care and I had the first of our Parenting Your Parents book series published in Canada. We were way ahead of the curve with the book; the issues around aging and eldercare in the family just weren’t on people’s agenda, or even in most cases on their radar.

Our second co-authored edition of the book appeared in 2004, which pushed it into the best sellers category, and then an American version followed in 2005.

In bookstores across Canada on September 21st and in the United States on October 3rd is what’s officially called the third edition of the Parenting Your Parents book series, titled Parenting Your Parents: Straight Talk about Aging in the Family published again by Dundurn Press.

Why worry?

So what’s so important or pressing about aging in the family?

For one thing, it’s a familial and societal reality. Demographics are demonstrating that beyond a doubt, an ever-larger percentage of our population is nearing and exceeding the age of 65. And an amazing number of them still have at least one parent and often two living parents who are in their 80s or even their 90s.

At the same time, the actual cases of Alzheimer’s and other forms of dementia are soaring across North America and globally among those aging parents, meaning that we’re facing potentially more difficult challenges on the near horizon.

And those in the 45-65 age range are most vulnerable to the consequences of aging parents while aging themselves.

Few make plans. Various research shows that more than three-quarters of those with aging parents have ever sat down with them to understand their latter life wishes and build plans to achieve those wishes. And as a rule, they haven’t created an inventory of critical information regarding bank accounts, insurance policies, retirement funds, and the like.

So not if, but when, something goes wrong with either parent’s health, there’s more often than not nothing in place to help things move ahead as smoothly and flawlessly as possible.

What we need to know

Our new book offers 24 case histories that range from early elder issues like hip replacement to dementia to nursing home conflicts to death in the family. Each case history has it’s own geriatrician’s viewpoint of what the family might want to consider doing in the specific situation being presented, with options and implications.

What Michael and I have observed over the years is that families with aging parents and other loved ones in fact need to know more about what kind of issues and challenges they’ll probably have to face… and then, what to consider and do. However, that’s something most families opt not to do.

As I like to remind people, our aging parents are in denial and their boomer kids are in avoidance.

Every family and its dynamic is different, so likely will be the outcomes. But the core issues are usually similar enough that readers can learn from the case studies offered in the new Parenting Your Parents.

Vulnerability index, resources

A first in this edition of the book in a Vulnerability Index that asks the reader to score a series of specific statements about the current state of either parent. The total scores lead to a guide as to where one’s parents may be at the moment in terms of their vulnerabilities and what actions might be considered.

The goal of the Vulnerability Index is to help readers determine what they should be doing with and for their parents right now.

As well, there is a financial planning section that addresses both Canadian and American financial planning issues and challenges for aging parents. It explores everything from the status of banking accounts and insurance policies to RRSPs to RIFs and beyond.

There also is a fulsome Resources Directory that covers both Canada and the United States in terms of helpful major organizations providing services across the spectrum of needs of aging loved ones.

Facing the facts

Aging in families is real. It’s happening across Canada, the United States, and around the world. Our aging parents and other loved ones seek our support, actively or often passively. We know it, feel it, and truth be told, often just don’t know what to do or how to do it best.

Visit us at

It’s never easy, but it’s always possible if we plan ahead and put our minds to it.

Papal message about the elderly

So tonight the Pope is in Brazil.

Reported CNN about his flight to South America: Earlier Monday, aboard the papal plane en route to Rio, Francis worried aloud about a “throwaway culture” that neglects young people and the elderly. He said elderly persons can offer “the wisdom of life, the wisdom of the past, the wisdom of our country and our family.”

Isn’t that just a terrific reminder to us that our aging parents and other loved ones in fact do have wisdom to share, regardless of what we think of them or how they are. Dig carefully and persistently, and more often than not there is wisdom we can use. Sure, dementia and other health issues can play havoc with perceptions, but most always there are pearls is wisdom we can harvest and apply to our lives.

Summer elder-cautions

So it’s finally summer.

Make sure when you take an aging parent or other loved one out for a walk, a ride, a picnic, or any outing that you make sure they’re prepared.

Three tips:

1. Hydrate them often. They won’t feel like they need it, but they do. Sips and gulps of water often is important for all, but critical for them.

2. Sunscreen them. Make sure that you apply sunscreen to their faces, necks and arms and all exposed skin before going out and at least hourly while out. Plus make sure the level of screening is high enough to protect them.

3. Rest them. Don’t do too much or go too far. Respect their eagerness but also their age and vulnerability. Don’t tax their tolerance.

Remember, chances are you’re now the adult in charge so make sure you’re protecting those aging loved ones like you would your own little kids or yourself.

‘Medical aid to die’– what might that do for suffering aging and ill parents?

Here is some news from CTV that was just posted online and should be of interest to many of us…

A bill to give residents in Quebec the right to request “medical aid to die” has been introduced in the province’s National Assembly.
The bill spells out the conditions for someone to get medical assistance to die, as well as the necessary conditions for a doctor to become involved. If the bill passes, it would be the first legislation of its kind in Canada.
The controversial bill received its first reading Wednesday, just a few days before members of the legislative assembly break for the summer. While the bill is not likely to be debated before the fall, Quebec Social Services Minister Veronique Hivon had promised she would table the bill before the break.

This is important to all of have aging loved ones who may one day be suffering. The concept of assistance to die is not new, but it’s a thorny, often frightening concept at some point we as a society will have to come to terms with and decide about.

Certainly food for thought for all of us and what we might do or not, why or why not.

Lots of needs, lots of choices when it comes to eldercare support services

Families across Canada are more and more facing a dilemma: how to ensure aging parents and other loved ones have the kind of personal care support they need now or will soon.

And that’s precisely why we see an increasing number of the kinds of ads and billboards and posters offering a range of services to help aging parents and other loved ones.

The fact is, the need grows at a rapid pace and family members who genuinely want to be helpful strive to do all they can. But the fact also is that those family members often are squeezed at both ends: by meeting the needs of aging parents, and also meeting the new or renewed needs of growing children.

Whether in the health care field and thus generally more knowledgeable, or families outside health services, we’re all actually facing the same issues and challenges. And a growingly overriding one is how to get help.

While the health care system provides some relief, generally speaking it’s not nearly enough.

Many choices in the marketplace
That means looking for the kind of service pictured above. (I just need to make it clear that I was walking along the street and saw this poster and that prompted this column; I have now knowledge of or relationship with this organization. I know nothing about it other than being interested in the positioning of the messaging.)

There are now dozens of national and hundreds of regional and local such services. Some cater to the wider demographic, and some are very targeted to specific cultural swaths of our Canadian mosaic. Some offer every possible kind of service, while others focus on some specific kinds of needs like support for those suffering from some form of dementia.

Interestingly, virtually all have found the right phrases to use, the right emotional buttons to push with potential clients. These include: safe… reliable… professional… trained… dependable… experienced… caring… gentle… compassionate… licensed… understanding… meeting all your loved one’s needs… providing relief… bonded… and the list often goes on.

Most offer at least two levels of actual in-home support. One level is the personal support worker, who has taken special training usually in a community college and who has passed some testing and demonstrated a level of reliability. The other is the Registered Nurse or Registered Nursing Assistant, either of whom have much more extensive professional training and testing.

There are other personal helpers as well: drivers to take aging parents for medical, hair or other appointments; meal preparation support as needed, and others.

Support for aging family members is getting to be a serious and big business.

What to look for
And precisely because it’s all getting to be a big business, whether being delivered by a small local company or a large national company, if you’re in the market for this kind of support service now or in the future, there are some key guidelines you might want to consider in your selection process.

Here are twelve key questions to ask yourself and the management of the potential service you are considering hiring:

1. How do you identify and define what my love one really needs?
2. How do you determine and recommend how much time is required?
3. What’s the time on a daily and weekly basis; what’s the cumulative amount of time being recommended and what’s that going to cost me?
4. What specifically will be done during the course of each visit?
5. Who will come?
6. Do I have the right to first meet and approve of the person or those who will be helping my aging parent?
7. Can you guarantee that I get the same person or people all the time?
8. When and how do you provide regular updates on what the care team finds is happening or not with my parent?
9. How often do we have a formal review of how the relationship is going?
10. What process and procedures do you have in place to manage any sudden critical situations that might occur with my parent?
11. What past clients can I talk with to check on your work?
12. If my loved one or I aren’t pleased with the quality of service, what recourse do we have?

The bottom line
Obviously, the press of work, personal space, the needs our grown children may well have, plus the very real needs our aging loved ones will have, combine to make trying to do it all pretty well an impossibility.

Thus, the attraction of an outside specialized service. There are many choices. Lots do a good job, some do not as well; those that do poorly as a rule don’t survive.

But always take the time to probe and prod the nature and scope and record of any independent support service you may want to engage for a loved one. In other words, avoid surprises at the far side by doing solid research at the near side of decision making.

More Physiotherapy coming for the elderly, aging loved ones

So some good news at least in Ontario: the province is adding more than 200,000 physiotherapy spots mainly for the elderly across the province.

This means that aging loved ones in assisted living and nursing homes and also those being cared for at home will get much needed added physical stimulation to keep their muscles healthier and also in some cases to regain some motion.

Good news for all those elderly people who just don’t get the kind of physiotherapy support they need and will help them in cases remain more active and independent. And in some cases, it will help them be more mobile to some level.

To find out more, ask your local health authority.

The smile of an aging parent’s worth it all!

So for some reason this morning I found myself humming that Al Jolson classic…

My little Mammy,
I’d walk a million miles
For one of your smiles,
My Mammy!

And it reminded me how much I’d love to see my mother smile, or a faded smile from my father. How much that smile meant. It felt like a rich reward, a secret moment of warmth shared, to be recalled and relived vividly even years later.

I think getting an aging parent to smile is simply sensational: for her or him, and for us. A smile is a precious thing and the more smiles we can generate for aging parents and other older loved ones, the more life means to them.

What do you think?

Pain Management and our Elderly Loved Ones

So, pain is a big factor for many of our aging parents and other loved ones.
May I suggest you read my latest column in Hospital News on this important topic. Find it at here.

Attention to the loneliness of aging parents and other elderly people

So I have written here and elsewhere on many occasions about the impact of loneliness on the elderly.

It’s more profound that most of us who are busy with our lives can even imagine.

Here is a link to an article in The Guardian newspaper in the United Kingdom. It’s worth a read to help us understand again how important our call and visits are; how important arranging for others to also stay in touch with them really is.

Surely you’ve had experiences or know stories worth sharing about this sensitive subject.

When will we learn that quality caring for our elderly is critical?

So today there is a story in the Globe & Mail newspaper about a UK report that focuses on a Stafford, England hospital and its terrible record of service. In particular, it focuses on the kind of care that was being given– or, more aptly, not given– to the elderly patients there.

The report urges more attention to ‘medical training on the elderly’ and the start of a whole new nursing discipline called a ‘registered older person’s nurse’. Fascinating. Long overdue. Looks there there, and also here.

The story goes on to quote the report and this one is important for all of us children of aging parents. It says: ‘The time is gone when the care of the elderly can be comfortably regarded as a backwater of medicine; it is an area which requires a status in accordance with its proper social importance’. Well, rah, rah and hip, hip, hooray!

While our health care system tries to cope with and manage the size and scope of our aging population and its health needs, the consistent quality of care really needs to be elevated. Those old people have given a lot to this country, to our way of life, and to each one of us: their children. They should be basking in respect and dignity and never left to wallow in pain or disregard or disrespect.

That’s our challenge. Now, how can we make it work; how can we afford it… ‘we’ being our governments at all levels, and our social services, and our medical services, and each one of us? What do you think?