February 6, 2012

3 Tips To Better Understanding Elder Care


My Grandparents at my wedding

My grandparents at my wedding

My Bubbe is in the hospital. In another state. And I’m her primary point of contact. While her brother is still alive, he’s in his 80s and lives in yet another state.

My Bubbe (Grandmother) lives alone. At 91, I hope I’m still as independent as she is. And while I may not think her driving is up to par, the state thinks so and she still drives.

Unfortunately, several weeks ago she fell. She blacked out or got light headed while putting her groceries away in the garage. She’s not so sure of all the details. Fortunately, she didn’t break anything. Unfortunately, with two knee replacements and not being about to use her arms to pull herself up due to limitations from her single radical mastectomy and lymph node removal, Bubbe was stuck. So she did what she had to do and she scooted herself back into the house. It took her about an hour to do that. In doing this she pulled leg and arm muscles and was unable to stand on her own.

I get a lof of questions from friends and family as to why she doesn’t have a medical emergency bracelet or necklace, and why she’s still living on her own, and how I can allow this to happen. Here’s the thing, she’s 91 years old. Listening to me isn’t how she got to be 91 so she’s not going to start. Sure, I provide suggestions and offer insight but she makes her own decisions.

So here are my 3 Tips to Understanding Elder Care. Whether you’re the one who has to have the discussion with your older family member or if you’re thinking ahead or offering suggestions to friends or family, I hope these help you.

1. Competent adults don’t have to do what other people want them to do – My Bubbe is sharp as razor wire on a maximum security prison! She may not hear as well and she may be slower when it comes to getting around, but don’t test her mental capacity. This goes for almost everything – convincing them they shouldn’t drive, suggesting they eat more healthfully, offering insight about health care or where they should live. This is one of those situations where you need to break out the honey and pack that vinegar far, far away. Gentle suggestions will always work better than ultimatums. Best way to tick off an older family member is to think they’re incompetent just because they’re slow or hard of hearing.

2. You are their advocate, regardless of how strong they are – This is my role. While Bubbe likes to threaten inept health care providers with me suing them (which I’ve never done because I don’t do litigation), the fact remains that if she’s not getting the care she needs, whether at home or in a hospital/care facility setting, it is my job to advocate for her. There are ways to do it in a professional and appropriate manner. But just as you can’t make them do something they don’t want to do, care professionals must follow the patient’s wishes unless there are medical reasons not to do so. For me, this is my biggest challenge – ensuring my grandmother gets the care she’s supposed to get. If you’ve ever seen the bills following the hospital stay of your elder relative I’m sure you were surprised to see all the services charged for but never received. In this instance, Bubbe needs physical therapy and despite the doctor’s orders she’s not getting it. When I’m in another state I have to rely on her to tell me she’s not getting the care. Then it’s my job to talk to the care facility. She’s my number one priority in this discussion, regardless of what excuses may be made. Unless I am given a legitimate reason for not giving her the therapy, they’ll continue to hear from me. Even if it requires me to go there in person. No, it’s not always convenient but I take this role seriously.

3. Have signed paperwork! – You never know when your elder family member won’t be able to make decisions for themselves. That is not the time to find out they don’t have a health care power of attorney or advanced directive. It’s not an easy discussion, but it needs to be done ‘in case’. Furthermore, in this day of HIPPA where most, if not all, healthcare information is private you don’t want to be in a situation where you can’t get answers and you can’t offer help or make decisions. This doesn’t just apply to elder family members, this applies to any family member (other than minor children) where you could potentially be a decision maker. While I have all the paperwork I need, the health care industry is not equipped to deal with long distance decision making. Without being able to properly identify you over the phone, getting information about your family member is futile. And frustrating. Some facilities and institutions do have processes in place for setting up PIN codes or security words, but getting that information after the fact isn’t helpful. Ask ahead of time!

Our parents and grandparents are living longer. We’re dealing with issues that prior generations didn’t have to deal with – HIPPA, living far away, financial matters. It’s not always the child needing to care for an elder parent. Often it’s stepchildren, or nieces/nephews or grandchildren or cousins. The extended family has created these strong relationships that have lead to these new relationships when it comes to elder care. It’s not an easy discussion, I know. But, we’re all dealing with it in some way. Whether it’s our parent going through this with an older family member or a friend caring for their older relative, we all come face to face with the reality that elder care is not only on the rise but potentially on our own horizon.

Does elder care impact you or your family? If so, what suggestions or tip can you offer to help others care for their family member with honor and dignity?




Erin February 6, 2012 at 12:48 pm

Thanks for this, Sara – we also learned a lot through my grandmother’s decline. These tips, if known in advance, really do help to navigate those difficult seas.
And, I might add, for those of you out there in your prime, who still can’t imagine life in your 80s and 90s, now’s the time to get long-term care insurance (before pre-existing conditions make it an impossibility).

Sara February 7, 2012 at 12:05 am


Thank you for visiting and for sharing your insight. Thanks for adding in the information about LTC insurance. It is something we’ll all likely need as we live longer. LTC insurance is definitely best purchased early.

rhonda February 8, 2012 at 11:35 pm

thinking of you and hoping bubbe is improving

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