Contact Raleigh Geriatric Care Management, www.rgcmgmt.com 919-803-8025, lwatral@rgcmgmt.com for assistance from an Aging Life Care Professional™/Certified Geriatric Care Manager to navigate the myriad of eldercare resources for adult children and their aging parents.

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How to Talk About Money With Your Aging Parents

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by, Cameron Huddleston

7 Ways to Start Talking

There are several strategies you can use to get your aging parents to open up about their finances. If one doesn’t work, try another. Regardless of which of approach you take, though, the conversation needs to be respectful, Fodrini-Johnson said. And, you should make sure it’s clear you’re not trying to take over your parents’ finances.

“If you start with an area that doesn’t feel like a loss of power,” she said, “you’ll probably be more successful.”

1. Use a story. One of the best ways to get your parents talking about money is to tell them a story about someone who did or didn’t have information about his elderly parents’ finances and the impact it had, said both Morgan and Fodrini-Johnson.

For example, you could tell them a friend’s father recently passed away and it was a nightmare for him to clean up his father’s affairs because he didn’t have any information about his dad’s accounts or legal documents.

Then, let your parents know that you don’t want to be in the same situation if something happened to them, and gently suggest that they share some financial information with you.

2. Get help from your siblings. Fodrini-Johnson also recommends letting the child who has the closest relationship with Mom or Dad start the conversation. Then siblings can join later conversations to discuss specific details about your parents’ money.

“Every family has a different style of communication,” she said. “Some families share this information all their lives. Other times, families don’t have a clue.”

3. Talk about your own situation. You might be able to get your parents to open up by talking about what you’ve done to get your financial affairs in order, Morgan said. You could mention that you’ve met with an attorney to draft a willor created a list of your accounts and passwords to give to your spouse in case something happens to you. Then you could ask your parents what steps they’ve taken.

4. Discuss your parents’ future. Asking your parents about a broader topic, such as their plans for retirement, might get them talking more than if you ask them point-blank about money, Fodrini-Johnson said. Questions such as whether they plan to downsize or what sort of care they would like to receive if something happened to them could open the door to a discussion about their finances.

At the least, you might be able to find out what sort of legal documents they have and where they are if you tell them you want to make sure you follow their final wishes if something happens to them.

5. Take an indirect approach. Morgan said that her father was unwilling to talk about money with her or her brother because he thought they were being greedy. So, she gave him a copy of her What If … Workbook so he could write down his financial information without telling her directly. She said she didn’t need to see what he wrote, but he needed to put it in a safe place where she could access it if something happened to him.

“I think having a tool like that is helpful to approach it in a general way,” said Morgan.

Fodrini-Johnson said the National Council on Aging’s BenefitsCheckup.org site can be a good tool that adult children can use to get information from aging or elderly parents. The site can help older adults find out if they’re entitled to benefits that will help them pay for medication, health care, utilities and more.

To find out if your parents qualify, they have to provide details about benefits they’re already receiving, monthly income and household spending. But parents might be more willing to share information if they know it will get them benefits — and you can walk them through the process.

6. Offer to lighten their load. Ask your parents if there’s something you can help them with or take off their plates so they can have more time to enjoy the things they like doing. Fodrini-Johnson recommends starting with a task not related to money then gradually offering assistance with their finances.

You might have the most success offering to help with tax preparation because it’s a task most people don’t like, and it will give you access to important details about your parents’ finances.

7. Get professional help. If your parents aren’t willing to talk to you, suggest that they meet with an elder law attorney, financial planner or aging life care professional — you can find one through the Aging Life Care Association.

Most likely, these professionals will encourage your parents to share important financial information with you, Fodrini-Johnson said.

More Tips on Talking About Elderly Parents’ Finances

If your parents are willing to talk, start with the basics: what sources of income they have, where they bank, whether they still have a mortgage and what types of insurance they have. You’ll need to get contact information for the mortgage company and insurance agents and — if they have one — broker, financial planner and attorney.

Ideally, you should get their Social Security numbers, account numbers and passwords. You could always suggest, as Morgan did with her father, that they write down this information and store it somewhere you could access if necessary, such as a lock box. Also, ask about their medical history and the prescription drugs they take.

Most importantly, find out whether they have a will, living will and power of attorney documents. If they haven’t drafted these legal documents, they need to do so to specify their final wishes and to appoint someone they trust to make health and financial decisions for them if they are unable to themselves. These documents need to be drafted while they have the decision-making ability to do so.

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  1. Memory loss that disrupts daily life
  2. Difficulty completing familiar tasks
  3. Challenges with planning and problem solving
  4. Confusion with time and place
  5. Trouble understanding visual images and spatial relationships
  6. Misplacing things and losing the ability to retrace steps
  7. Decreased or poor judgment
  8. Withdrawal from work or social activities
  9. Changes in mood or personality
  10. Problems with speaking and writing

To learn more about reducing stress as a family caregiver, contact Raleigh Geriatric Care Management, http://www.rgcmgmt.com, or call 919-803-8025.  Call for your free 15 minute consultation. 

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OCD in Elderly for Caregivers

By Cheryl Ellis, Staff Writer @ caregiver.com

Obsessive-compulsive disorder (OCD) is defined in part by the Merck Manual as “anxiety provoking thoughts and urges.” While the publication (a staple in the medical field for years) notes that symptoms are not often prominent in the elderly, caregivers may disagree.

Early stage Alzheimer’s patients may obsess about minor issues, such as the garbage being taken out. In some cases, it may become a “chicken or the egg” question as to which came first, the OCD or Alzheimer’s.
Since part of OCD involves performing repetitive tasks that balance the anxiety (using hand sanitizer repeatedly to avoid germs), it may not be immediately visible that there is an obsessive component to the elder’s thought process. Grandma may spend twenty minutes wiping out the bathroom sink after she has gone to the bathroom. Part of her extended cleaning out of the sink may be due to poor vision, or remembering something from a past not known by current family.

Elder folks who can identify “habits” begin to disassemble the cycle of worry that accompanies OCD. Dorothy, who is well into her seventies and a former nurse, mentions that she has several “habits” that have cropped up since her husband passed away. “I’ll just go right to the refrigerator in the middle of the night, not turning on the light. That’s a HABIT.” She’s noted others, such as waking up several times in the middle of the night. During family visits, she wakes hardly at all, and concludes she’s conditioned herself to associating being alone with needing to wake up.

A bright woman who applied much rational thought and association in her nursing career, she is still able to do so today. Dorothy emphasizes that recognizing a habit is one thing. “Doing something about it, well that’s another!”
It’s evident that the key to her dealing with these habits is making a connection; but more importantly, she has removed the anxiety component. Acceptance of these behaviors and the knowledge that she will break them when she chooses give her a sense of autonomy.

Caregivers can work toward helping their older family members retain a sense of self-control by remaining calm when “habit” strikes. When Grandma spends 20 minutes cleaning the sink, she can be asked “What makes you do such a good job?” This will open the door for her to make her own connection as to why. The caregiver may learn about the past (“My grandfather was in the military and we had to make sure it was clean and sparkling”). Or they may learn about a contemporary occurrence (“I heard my son say the place is a mess. I don’t want him to think I’m a burden”).

In either case, an artful question combined with a compliment may draw out information. It also allows caregivers to begin the process of reassurance which can decrease anxiety.

OCD is designated as an anxiety disorder, and any type of stress reduction technique that is agreeable to the person and caregiver can help tremendously. Aromatherapy, guided meditation, relaxing music and changes in diet (like reducing caffeine) are alternative methods of stress reduction that may have some impact.

Howard Hughes, famous eccentric billionaire, suffered from OCD. Those who have seen the movie “The Aviator” or who remember accounts from decades before have an idea of how bizarre this individual became. While most people live undocumented lives, we can look at the experiences of individuals in public power to relate to.

The Anxiety Disorders Association of America (http://www.adaa.org/) has a great deal of information to educate the layperson on anxiety in OCD, as well as other types of anxiety. Caregivers may find themselves developing a generalized anxiety disorder in response to the OCD disorder for those they are caring for.

Remember that when elders switch locations (moving in with a child, or to assisted living), they are going “out of the box” and stress factors increase. This increase in stress may turn Mom’s “habit” of cleaning when she is a little nervous into a full blown obsession over time. Work on the root cause, always.

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Compulsive hoarding or collecting may have developed from not having enough basic supplies during younger years. The cliché “salad days” may literally have meant that there were only vegetables from the garden to eat. A parent who always made sure there was plenty of food in the house may now not only have 65 cans of green beans (bought at scratch and dent warehouses), but stacks of newspaper coupons that are beyond the expiration date.

Instead of cleaning house in one fell swoop, try getting the elder to focus on the abundant stores they have, and how they can help others who are less fortunate. Some caregivers may have tremendous stress when it comes to dealing with the situation. At that point, calling in the “cavalry” of friends and associates who offer vague help is in order.

“I need you to help by going through Dad’s canned goods to find out which ones are expired or near expiration. Can you go with us to donate them to the local shelter?”

Any problems with compulsive hoarding require help. The Obsessive Compulsive Foundation has a website (http://www.ocfoundation.org/hoarding/) designed to guide caregivers. Support groups and other information can be found there. From that point, work on recruiting friends and family to help you with this issue. In the case of animal hoarding, the local Humane Society may be of help. Never, ever give any pet (hoarded or just a small excess) to anyone you do not know, or to any shelter that you do not know.

Even caregivers can have some obsessive compulsive traits develop with the day-to-day caregiving of an OCD elder. Look through information to see where you may have borderline events, too. By working through your own, smaller issues, you may silently be helping your loved one.

Raleigh Geriatric Care Management, http://www.rgcmgmt.com

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Careful In The Kitchen

By  Jennifer Bradley, Staff Writer

The best place to be as a child was in Grandma’s kitchen, especially when she’s taking a fresh tray of cookies out of the oven.  Sneaking a bite of cookie dough was a must for any youngster. Grandma may have thought nothing of it then, but today, the risks of eating raw eggs are well known.  For seniors, these stakes are even higher.  A caregiver may be today’s gateway to good health for their loved one, starting at the basic knowledge of food safety.

My, how times have changed

It’s safe to say that the way the world “goes round” in 2010 is much more advanced than it was 10 years ago, at the turn of the century. A decade can make a big difference. In 2000, the Internet was just taking shape. Today, it’s a necessity for almost all people’s daily lives. So, if a decade can change things, what about four, or five, even more? Some loved ones may be reaching into their 80s or 90s, and in the 1950s or 60s, when they were raising their families, doing most of their own baking and cooking, life was a lot different.

The way food is produced, harvested, distributed and prepared has evolved hand-in-hand with technology. Scientific advances have shown that new and dangerous bacteria and viruses can be found in foods; these microorganisms were not even known years ago.  Food modification, mass production and mass distribution have led people away from homegrown, fresh vegetables and meat, leading almost all to rely on others, even those long distances away, to provide for their daily nutritional needs.

Science has identified illnesses that can come from food, as well as ways people in the later years of life are more susceptible to contracting foodborne health issues. A caregiver has the responsibility to know and respect the way a loved one used to live, while teaching and helping them understand the way they must live to be healthy today.

Special Risks for Seniors

Foodborne illness, also known as food poisoning, can be serious, even fatal. According to the Centers for Disease Control and Prevention, every year 76 million people fall ill, 325,000 are hospitalized, and 5,000 die from food-related infections and illness in the United States. Many of these victims are very young, very old, or have weakened immune systems, unable to fight infection normally.

Seniors have always been grouped with the “women and children” crowd. This has been for good reason; they are able to catch germs easier and also hold onto them longer. Age causes changes in a body, slowing the food digestion process. The stomach and intestinal tract process foods slower, and a loved one’s liver and kidneys are slower to rid their body of toxins. This even alters a person’s sense of taste and smell.  Added to the natural effects of aging, all chronic illnesses, and medications, and the unwelcome addition of food poisoning can become very serious very fast. Vigilance when handling, preparing and consuming foods is important for a loved one to have. For caregivers, awareness and education are crucial.

Are You Sick?

Teaching a loved one when to recognize they are experiencing a negative reaction to food will help identify the problem after the fact. First, caregivers must understand that there is a wide range of time that can pass between eating food with harmful bacteria and the onset of symptoms.

Usually, foodborne illness takes one to three days to develop. The common assumption is that it’s caused by a person’s last meal. This may be true, but not necessarily. There are many factors to consider, including the type of bacteria which was in the affected food. The range of time could be from 20 minutes to 6 weeks, at extreme circumstances. Even then, it’s possibly a different illness. Some common symptoms of food poisoning are feeling sick to the stomach, vomiting or diarrhea. Others could be flu-like, including a fever as well as head and body aches. Professionals suggest a caregiver check with their loved one’s doctor if they suspect food is to blame for an illness.

Eating In

It used to be all foods were grown at home. Today’s younger generations are trying to return to a semblance of that lifestyle; but for most, climate and convenience will never leave them completely independent for all food. Many elderly loved ones will remember the days gone by when they ate the same potato they dug the hole in the ground for and planted months prior. There was no need to worry about exactly where food came from. Because of this, a loved one may have a greater trust for food than the rest of society, or greater distrust.
The U.S. Food and Drug Administration offers some guidelines for proper food prep at home. First, “clean.” Wash hands and surfaces often and well. Bacteria can be found throughout a kitchen, including on utensils, cutting boards, sponges and countertops. Use warm water and soap for all washing of hands and cooking supplies. When cutting boards develop worn and hard to clean surfaces, they should be replaced. A loved one may consider paper towels just extra waste, but they are very good at preventing bacteria buildup.

Next, “separate.” Cross-contamination is how bacteria is spread, especially when handling raw meat, poultry and seafood.  Separate these foods from other foods in a shopping cart and also in the refrigerator. Use different cutting boards for them as well. Wash utensils and other dishes after coming in contact with raw meat, poultry, seafood, eggs and unwashed fresh produce. A big
“no-no” is putting cooked food on the same plate the raw was on previously. Bacterial residue on the plate could contaminate the cooked food.

After separating, “cook” foods to proper temperatures. The FDA explains that foods are cooked safely when heated for a long enough time and at a high enough temperature to kill the harmful bacteria. There are many guidelines available for temperatures to watch for when cooking a variety of foods. Visitwww.fda.gov/Food/ResourcesForYou/Consumers/Seniors/ucm182679.htm for more information.

Finally, the FDA advises seniors to “chill,” and not in the way a teenager would mean! While stored at room temperature, bacteria in food may double every 20 minutes. Caregivers should teach a loved one to refrigerate foods quickly to keep bacteria at bay. Many people believe it’s not good to put hot food in a refrigerator, but the FDA says it keeps a person safe to do so.

With some simple guidelines, a caregiver can show their loved one how to eat safely at home and avoid problems down the road.

Eating Out

The McDonald’s trend hit the United States in the late 1950s, and has grown into a full-blown way of life since then. No longer is eating out a “treat” for a special occasion, such as a birthday, anniversary or first date. Sure, people may still dine at a fancier restaurant for those times, but grabbing a sandwich or salad is a regular habit.  Today, nearly 50 percent of the money spent on food goes toward meals that other people prepare.

It can be easy to simply trust that the food served at a restaurant is suitable for consumption. Each person should learn to be their own advocate and a senior loved one is no exception. They may be experiencing an age-related dulling of the senses, minimizing their ability to recognize an unsafe situation. As at home, don’t eat raw or undercooked food. Make sure hot meals are hot and if the food is not cooked properly, encourage a loved one to speak up and send it back. It’s better to be safe than worry about “hurting someone’s feelings.”

The trend in restaurants today is leaning toward large meal portions. Many seniors end up packing the leftovers to take home. The FDA advises that if the leftover food will not be refrigerated within two hours of leaving the restaurant, it’s safer to leave it there. Some senior centers across the country won’t even allow food to be taken home because they know of the dangers when food is left sitting out too long.

Foods to Avoid

The FDA offers a list of foods seniors are advised to avoid:

  • Raw fin fish and shellfish, including oysters, clams, mussels, and scallops;
  • Hot dogs and luncheon meats, unless they are reheated until steaming hot;
  • Raw or unpasteurized milk or soft cheeses (such as Feta, Brie, Camembert, blue-veined, and Mexican-style cheese) unless they are labeled as made with pasteurized milk;
  • Refrigerated pates or meat spreads; (Canned or shelf-stable pates and meat spreads may be eaten.)
  • Refrigerated smoked seafood unless it is contained in a cooked dish, such as a casserole; (Canned or shelf-stable smoked seafood may be eaten.)
  • Raw or lightly cooked egg or egg products containing raw eggs such as salad dressings, cookie or cake batter, sauces, and beverages such as eggnog; (Foods made from commercially pasteurized eggs are safe to eat.)
  • Raw meat or poultry;
  • Raw sprouts (alfalfa, clover, and radish); and
  • Unpasteurized or untreated fruit or vegetable juice.

Be a Better Shopper

Reading labels is becoming more and more essential for all age groups. Many people have adverse affects from the ingredient MSG, especially those in the senior community. The other labels to look for are the open dates on raw foods such as meats, eggs and dairy products. Most important are the “sell by,” “best if used by,” and “use by” dates. Caregivers can teach their loved one how to read these labels and also check refrigerators to ensure food has not gone bad and poses a problem for bacteria growth.

Raw meat, poultry and seafood should also be placed in a separate plastic bag, so the juices do not leak onto other groceries. Buy only pasteurized milk, cheese and other dairy products. Teach a loved one to buy only eggs from the refrigerated section of the store, and check canned goods for dents, cracks or bulging lids.
With a few small tricks and tips, a caregiver can encourage a loved one to eat good, nutritious meals safely.

Raleigh Geriatric Care Management, Raleigh, NC.  www.rgcmgmt.com

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What is an Aging Life Care Professional ™?

We are still the same, but our name has changed to better reflect what we do and who we are. Our national association, formerly known as National Association of Professional Care Managers (NAPGCM), is now  the Aging Life Care Association™ (ALCA) and care managers are now refered to as Aging Life Care Experts™.

Conflicting demands on your heart, time, and energy can make it hard to care for an aging relative. If this sounds familiar, you could benefit from the services of an aging life care expert.

An aging life care expert provides relief. They work with you and your family member to develop a realistic care plan. The goal of the plan is to maximize your loved one’s independence, safety, and quality of life. A solid care plan addresses family resources. This includes making sure you are not called upon to do more than you are able.

An aging life care expert is a guide and an advocate. These experts are typically trained in the health professions or social work. Many have specialties in elder care. They bring to their role an understanding of the

  • local healthcare system;
  • emotional and physical challenges of aging and/or disability;
  • difficulties of adult children juggling work and family;
  • common legal and financial issues that arise in later life;
  • local housing options and other senior or disabled services.

Aging life care experts use a holistic approach. They begin with a thorough assessment of needs and capabilities. They can often resolve uncertainties and dispel family disagreements. Their emotional support may help your loved one come to terms with this new phase of life.

An aging life care expert’s input may save you time and money. After looking at money and other family resources, they can recommend appropriate housing situations. They can identify veteran assistance and other benefits. They can avoid duplication of medical services and potentially catch problems before a crisis blooms. They can also monitor the quality of care.

An aging life care expert works independently as the client’s advocate.They are not paid through referral fees. Nor are they employees of hospitals or insurance companies. In some cases, their services can be reimbursed by long-term care insurance.

If you think you and your loved one could benefit from the services of an aging life care expert, give us a call at Raleigh Geriatric Care Management, 919-803-8025, http://www.rgcmgmt.com

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Caregiver Burnout

By Dr. M. Ross Seligson

Being able to cope with the strains and stresses of being a Caregiver is part of the art of Caregiving In order to remain healthy so that we can continue to be Caregivers, we must be able to see our own limitations and learn to care for ourselves as well as others.

It is important for all of us to make the effort to recognize the signs of burnout, In order to do this we must be honest and willing to hear feedback from those around us. This is especially important for those caring for family or friends. Too often Caregivers who are not closely associated with the healthcare profession get overlooked and lost in the commotion of medical emergencies and procedures. Otherwise close friends begin to grow distant, and eventually the Caregiver is alone without a support structure. We must allow those who do care for us, who are interested enough to say something, to tell us about our behavior, a noticed decrease in energy or mood changes.

Burnout isn’t like a cold. You don’t always notice it when you are in its clutches. Very much like Post Traumatic Stress Syndrome, the symptoms of burnout can begin surfacing months after a traumatic episode. The following are symptoms we might notice in ourselves, or others might say they see in us. Think about what is being said, and consider the possibility of burnout.

  • Feelings of depression.
  • A sense of ongoing and constant fatigue.
  • Decreasing interest in work.
  • Decrease in work production.
  • Withdrawal from social contacts.
  • Increase in use of stimulants and alcohol.
  • Increasing fear of death.
  • Change in eating patterns.
  • Feelings of helplessness.

Strategies to ward off or cope with burnout are important. To counteract burnout, the following specific strategies are recommended

  • Participate in a support network.
  • Consult with professionals to explore burnout issues.
  • Attend a support group to receive feedback and coping strategies.
  • Vary the focus of caregiving responsibilities if possible (rotate responsibilities with family members).
  • Exercise daily and maintain a healthy diet.
  • Establish “quiet time” for meditation.
  • Get a weekly massage
  • Stay involved in hobbies.

By acknowledging the reality that being a Caregiver is filled with stress and anxiety, and understanding the potential for burnout, Caregivers can be forewarned and guard against this debilitating condition. As much as it is said, it can still not be said too often, the best way to be an effective Caregiver is to take care of yourself.

www.rgcmgmt.com  Raleigh Geriatric Care Managment

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