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Communicating with Seniors
Talking with seniors about their living situations and the possible need for change is not always easy. A successful conversation depends to an extent upon the relationship we have with the senior, as well, of course, as on the senior’s mental, emotional and physical condition. While many people put off serious conversations to avoid conflict or awkwardness, both senior and adult child may lose an opportunity for closeness, understanding, access to information that may affect the decision, and optimum peace of mind.

To the extent possible, talk with your seniors gently and honestly about their wishes, their abilities and their options. Far more often than not, these conversations are helpful and put the adult child in a better position to make decisions later when the senior may not be able to do so.

The following are suggestions for conversations with your senior:
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  • Share your own feelings, and reassure the senior that you will support them and can be depended upon to help them solve their problems.
  • Help the senior to retain whatever control is possible in making his or her own decisions. Respect and try to honor their wishes wherever feasible.
  • Encourage the smallest change possible at each step, so that the senior is more able to adjust to the change.
  • Educate yourself on legal, financial and medical matters that pertain to your senior as background for your conversations, including current knowledge on the aging process.
  • Respect your own needs – be honest with your seniors about your time and energy limits.

If this kind of conversation seems impossible or the situation and relationship with the senior become overwhelming, professional counseling may be very helpful.

When a Change May Be Necessary
There are a number of danger signs that indicate an elderly person needs extra help or a change in living arrangement. Any marked change in personality or behavior should be heeded. However, no change in lifestyle should be made without discussions with the senior, other family members, and doctors or other health professionals.

Signals that a change may be necessary include:
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  • Sudden weight loss could be an indication that the elderly person is simply not eating or not preparing foods.
  • Failure to take medication or over-dosing may indicate confusion, forgetfulness, or a misunderstanding of the doctor’s instructions.
  • Burns or injury marks may indicate physical problems involving general weakness, forgetfulness, or a possible misuse of alcohol.
  • Deterioration of personal habits such as infrequent bathing and shampooing, not shaving, or not wearing dentures could be the result of either mental or physical problems.
  • Increased car accidents can indicate slowed reflexes, poor vision, physical weakness, or general inability to handle a vehicle.
  • General forgetfulness such as not paying bills, missing appointments, or consistently forgetting name, address, phone number, and meal times could be a signal.
  • Extreme suspiciousness could indicate some thought disorder. Your seniors thinking that their neighbors, friends, family, doctor, and lawyer are all conspiring against them would be an example. Intense ungrounded fears about dire consequences may be a danger signal.
  • A series of small fires could be caused by dozing off, forgetting to turn off the stove or appliances, or carelessness with matches. They may indicate blackouts or dizzy spells.
  • Bizarre behavior of any kind could be a warning sign. This behavior could be dressing in heavy gloves and overcoat in 90 degree weather or going outside without shoes when it’s snowing.
  • Watch for uncharacteristic actions or speech.
  • Disorientation of a consistent nature may indicate a need for help. Examples include not knowing who one is, where one is, who the family is, or talking to people who are not there.

Consider Creating a Document File
The American Association of Retired Persons recommends that elderly people use a document locator list to make sure their papers are in order. This list can then be given to the person(s) who will be responsible for them should an emergency arise. Going through the list with your seniors should ensure that their wishes are understood.

Here are some items that you may want to include.
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  • Name, address, and telephone number of senior’s attorney(s).
  • Location of seniors’ will and any trust instruments; complete list of beneficiaries with current addresses and telephone numbers.
  • Location of copies of the senior’s living will, medical directive, or durable power of attorney with the name, address, and telephone number of the agent.
  • Details of desired funeral arrangements; location of burial plots, if any, and deed to it. Name and address of clergy, if appropriate.
  • Location of any letter of instruction listing personal property not disposed of by will and the senior’s wishes for its distribution.
  • Location of important papers: birth certificate, social security card, marriage and divorce certificates, education and military records, other legal documents.
  • List of bank accounts, including name, address, and telephone number of each financial institution, account numbers, location of passbooks, checkbooks, certificates of deposits.
  • List of stocks, bonds, real estate, and other investments.
  • Name, addresses, and telephone numbers of financial planner, tax advisor, broker, and/or anyone else with knowledge of or control over finances.
  • All insurance data (health, life, auto, homeowner/renter policies; any employee benefit or pension plans), including name, address, and telephone number of each insurance company and agent, policy numbers, and locations.
  • Location of safe-deposit box and key(s) with a list of the contents and names of anyone with access to it.
  • Location of receipts and appraisals for valuables.
  • List of active credit accounts (mortgage companies, banks, oil companies, department stores, etc.), including name and address of each company, account number, and type.

Senior Care Options
There are many housing options available for seniors. Choosing the best one will depend on the person’s preference, age, health, and financial condition.

These options include:
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Aging in Place
Under this option, the elderly person continues to live in his/her own apartment. Many seniors live in retirement communities, apartment buildings, condominiums, or cooperatives not designed as retirement communities but where at least 50 percent of the residents are 62 years old or older. These buildings often have amenities such as grocery stores, pharmacies, limousine service, or shopping services.

Recent technological advances often make aging in place easier: Velcro® fasteners, lightweight wheelchairs, devices to control appliances and dial telephone numbers. There is even a “walk-in bathtub” for people who have difficulty climbing into an ordinary bathtub. Many services are available to help the elderly person stay in his/her home.

Home care services are available in many communities, providing appropriate, supervised personnel to help seniors with either health care (giving medications, changing dressings, catheter care, etc.) or personal care (bathing, dressing, and grooming).
Meals and transportation are available to older people to help them retain some independence. Group or home-delivered meal programs help ensure an adequate diet. Meals-On-Wheels® programs are available in most parts of the United States. A number of communities offer door-to-door transportation services to help older people get to and from medical facilities, community facilities, and other services.

Adult day care is similar to child day care. The senior goes to a community facility daily or 2 or 3 days per week. Activities include exercise programs, singing, guest lectures, and current events discussions.

Other Types of Care
There are several types of retirement communities that provide living arrangements and services to meet the needs of both independent seniors and those who need assistance. Large hotel corporations are in this field and other facilities are set up for members of a certain organization (retired military, Elks, etc.). It is important when investigating these housing options to understand completely the services provided and the cost.

Adult congregate communities are designed for the fully able-bodied, 55 and older. Residents buy co-ops or condominiums and pay a monthly fee for grass mowing, leaf raking, and snow shoveling. A pay-as-you-go medical center is on site and a nurse is on duty 24 hours a day to make home visits in emergencies.

Assisted living communities are rental retirement communities for independent seniors who need some assistance. A homelike atmosphere, three meals a day, maid, linen, and laundry service, availability of a registered nurse, and many personal care services are often provided in the all-inclusive rent.

Rental retirement communities with fee-for-service nursing units charge residents an entrance fee plus a substantial monthly rent. When the need for nursing care arises, residents pay an extra daily fee and stay in a nursing unit, usually located on site or nearby.

Life care or continuing care communities provide a continuum of care from independent living to nursing home care on the premises. The individual must be independent when s/he enters the community. Residents get meals in a dining room, maid service, linen service, maintenance, transportation to shopping and cultural events, travel planning, and a pull cord to an emergency nurse. If nursing care is needed, it is usually provided at no extra cost.

Personal care homes are licensed in many communities to provide shelter, supervision, meals, and personal care to a small number of residents. Usually, no round-the-clock care is provided but nurses come in to check blood pressure and assess a resident’s functioning. Residents take meals in a dining room and may have use of a library, recreation area, or beauty shop.

If the senior is not capable of independent living, a nursing home may be the appropriate option. Nursing homes offer two levels of care – skilled nursing and intermediate care – depending on the patient’s needs. Most nursing homes offer both levels of care on a single site.

Skilled nursing facilities provide 24-hour nursing services for people who have serious health care needs but do not require the intense level of care provided in a hospital. Rehabilitation services may also be provided.

Intermediate care facilities provide less extensive health care than skilled nursing facilities. Nursing and rehabilitation services are provided but not on a 24-hour basis. These facilities are for people who cannot live alone but need a minimum of medical assistance and help with personal and/or social care.