Elder care: Intervene only when danger threatens elderly relatives

BY CAROL ABAYA

NEWJERSEYNEWSROOM.COM

THE SANDWICH GENERATION

Question: My mother, 77, lives alone and seems to be getting thinner and frailer. But she refuses to move. At what point should I step in and say,
"Enough is enough. You must move?"

Answer: Undoubtedly you are on an emotional roller coaster. This is not an easy situation, yet it is very common. Identify the help needs for ADLs (activities of daily living) and IADLs
(incidental activities). ADLs are dressing, bathing, eating, toileting, transferring. IADLs include household chores, grocery shopping, banking, driving, etc.

The second step would be to identify help resources to handle the true "needs" and enable her to remain in her own home. Needless to say, finances are important as more income equals more choices.

Intervention should be on a "need" basis and zero in on areas of safety, health and financial well-being. Keep a close eye on lifestyle: eating habits; personal hygiene, bills being paid or not paid; socializing or not.

When "needs" reach a high level a move decision might be appropriate. If the elder refuses, bring in a third party. A clergy person, the person's lawyer or doctor, or a geriatric case manager as a non-child often has more success in helping the elder make the decision to move.

If your mother still refuses at-home help or to move, then you need to talk to her. Discuss choices, decisions and ramifications of not making appropriate decisions.

If the situation is really bad and she refuses everything, tell her the state under Adult Protective Services (complete strangers) can come in and make decisions for her. Self-neglect is top on the abuse list and allows the state to become involved. Or you could go to court to gain guardianship.

Bottom line involves safety — physical, health and financial. When safety is jeopardized, you should take active steps to protect your mother.

Question: My father, 76, has Parkinson's, trouble walking, and now uses a walker. My parents used to go out to eat regularly and really enjoyed the change in environment and meeting friends. Now my father absolutely refuses. Guidance please.

Answer: While you can encourage and help, you can't force your father to go to a restaurant.

Next best would be to bring the restaurant to your parents. Order in, so your mother doesn't have to cook. Set the dining table with nice placemats and a flower arrangement (real or silk). Invite friends in. Arrange for a grandchild who lives nearby or a neighborhood teenager to serve the meal, like in a restaurant.

Parkinson's affects the nervous system, so your father may be afraid of falling or might get embarrassed if he accidentally knocks over the glass of water. He may also be embarrassed that he needs the walker and doesn't want people to stare at him.

If another member of the family went with them, your father may feel more secure. That person can also point out all the others in the restaurant who use walkers.

The Sandwich Generation (R) is an interactive column. Questions from readers are welcome. To contact Carol Abaya visit her web site www.sandwichgeneration.com or e-mail her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it