This is the seventh in a series of articles about the issues that arise over time for older people who experience mental declines -- and how you, as a family member or friend, can help.
Your dad asks the same question 10 times in 15 minutes. Your mom has lost 20 pounds that she didn't need to lose. You suspect that they're not eating regular meals.
You live two hours - or two states - away.
Jennifer FitzPatrick, a licensed certified social worker and adjunct instructor in the gerontology program at Johns Hopkins University, has some suggestions:
"One option is hiring a geriatric care manager to come in and do an assessment. I recommend this to families all the time." The care manager can figure out what risks your parents face and offer options for next steps.
Geriatric care professionals - usually nurses or social workers -- can be located through the National Association of Professional Geriatric Care Managers, at caremanager.org.
In Prescott, you may need to expand the search range to 50 miles to get any results from a search on the site.
Of course, your parents would need to agree to the visit.
A second option, FitzPatrick notes, is to "get authority figures involved. . .if [your parents] still have the ability to make their own decisions, they may listen to the doctor. They may listen to a trusted accountant or attorney or rabbi or priest. A lot of time the adult child is not going to be listened to, because the [parents] still view them as a child."
A third option is to introduce your parents to assisted living possibilities near where they live, in a non-threatening way. FitzPatrick suggested, "Prescreen the places. Make sure that they are up to the standards of [your] parents. Every [site] is always hosting events to get the community to see what they have to offer. They almost always offer a free meal. A lot of times, they're very gourmet." Events might include concerts, lectures, antique shows, etc.
FitzPatrick noted, "Your parents may conclude, 'Oh, gosh, this is like living in a resort!' It's not the 1960s nursing home that they have in their minds."
A fourth option, FitzPatrick advised, can work if your parents have friends who live in a continuing care retirement community (CCRC) or assisted living community. CCRCs typically offer independent living apartments, assisted living and skilled nursing units. If the site seems like a good option for your parents, arrange to take them there to visit their friend. Again, this approach gives them a chance to see what the place is like.
Scott Rozman, a certified life/career coach in New Jersey -- who has had his own harrowing experiences with health care, which you can read about at www.scottrozman.com -- described his successful approach:
"I persuaded my parents to move to an assisted living facility by presenting it slowly. When I saw there was going to be a need, I first mentioned the idea, making clear it's 'not for now, but for in the future.' Then, I investigated many places myself, doing the legwork. I asked if they would be willing to check out one or two with me, again, 'not for now, but for in the future.'"
Rozman said, "It's important to prepare, just like writing a will, or retirement planning. I also made it clear that it would be helpful to simply have an idea -- what they liked, or didn't like ... 'not for now, but for in the future, when/if needed.' I followed up every month asking but not harping on my request to 'simply check it out.'"
He reported, "After they went, my dad had a comfort level that if/when my mom needed to go, when he couldn't care for her any longer, he now knew of a place that he was comfortable with. It was a major relief for him. Six months later when my mom's Alzheimer's condition worsened, we were ready to take action and there was a comfort level knowing in advance of a place that he felt good with."
What happens if none of the above works with your aging relative?
Next week's column offers additional approaches.