Collectively Wise

The Juggling Act: Holiday Style

[by Kirsten]

Oh, no, I'm not talking about interior decorating.  No, I'm talking about the juggling act that working, sandwich generation moms do around this time of year.

Today, I only forgot the appointment with the speech teacher.  I remembered everything else.  I think.  And 830pm on a school night, is a fine time to start a gingerbread house, is it not?  Not that I actually accomplished everything else, I just thought about it, at least once, today.  (Unless of course it's not on the calendar until tomorrow or later.  In that case, I did not think about it at all.)

Work is busy.  I have a project I'm managing that is really busy right now.  Problem is, half of my engineers are out of town.  Sure, I'll be ready for the design review in less than two days.  Sure.  (Can't say the design will be finished, but we can review it in great detail.)  So, it's busy for me.  I feel like I'm being pulled in at least four or five directions...  but that's ok.

Then it's time to pick up the girls and I race to the school to pick them up.  Luckily no one has a half arranged playdate to negotiate, so after only a few minutes, they pile themselves into the car.  We head home...  and just as I pull up to the house, the phone rings.  Do I recognize the number?  Of course not, but it looks like I'm in trouble.  I can just sense it.

Of course, I am.  I've forgotten the speech therapist's appointment to discuss two of my children.  Honestly, I can understand them fine so I guess the fire of need just hasn't burned a permanent action plan on my forehead, and I've forgotten.  I'm already 15 minutes late, and now at home.  I turn around and go back.  It's a lengthy discussion with the teachers.  Great content and stuff I need to be considering.

The phone rings and it's my daughter.  It's time for swim team practice, so I rush to get home and take her.  Later there's the 3rd grade musical.  Last night was the middle schooler's show and bake sale.  This evening, I'm hoping to pay some bills and buy a few gifts online.  I write a check and leave it on the counter, forgetting to bring it to the swim coach.  It's already a month late.  Two gifts get purchased...  It's not nearly enough.

The pile of old toys and furniture in my office is massive.  It had filled the living room, but we had to move it to accommodate a new soccer team meeting.  Now I can't walk in the office.  I guess I don't need to...  I post on facebook, looking for a place to donate it all.  My ads on craigslist have gone unanswered.

To make things even more exciting, I've decided to look into a private middle school.  It's a pipe dream, but sounds like it would be wonderful for my child.  I make a mental list of the deadlines and the application process, and nervously await her test scores...

Visits with relatives are only days away.  There's baking to do, cooking and more shopping.  Hopefully everyone will be satisfied and the pressing issues will hold off just long enough.

Because it is a juggle.  Sure is.

 

Lives and Jobs on Hold: After a Sister's Stroke

My older sister had a major hemorrhagic stroke on January 8, 2009 and was hospitalized for almost a month in intensive care and a rehabilitative hospital.

My daughter and I found her in her home and I did neurological checks and determined that she needed to go to the hospital emergency room immediately. She was reluctant to go but finally agreed when my daughter and I insisted. Within 20 minutes of arriving at the emergency room, the doctors diagnosed her stroke and placed her in the intensive care unit for about a week.

Because of her arterial bleed in the brain, she had intensive physical, occupational and speech therapy in the rehabilitation hospital and this care followed her home. My daughter and I initially felt relieved and blessed that my sister was alive when we found her in her home after not hearing from her for almost 3 days. We were also grateful that she was recovering when they upgraded her condition and she went to a telemetry unit and finally to a rehabilitation hospital.

But, from the time of the stroke and her hospitalization, my daughter and I had to put our lives and jobs on hold and attend to my sister’s personal and business affairs. I became her temporary power of attorney, we had to clear out and clean her townhouse apartment within the month of January in order to save her from additional rental charges.

Keeping Your Caregiving On Track

[by Joanne Reynolds]

Elder caregiving is a complicated enterprise, as most of you already know. Just staying on top of the medical appointments and general care while you try to juggle your “regular” life is probably about as much as you can manage.

But caregiving to someone with on-going medical problems calls for you to move into a higher level of care, and that’s where tracking comes in.

One of the workbooks that I’ve created is The Medical Journal, which contains pages for everything from your loved one’s health history to calendar templates so you can track appointments, to lists on which you can track all of the prescription medications, over-the-counter (OTC) drugs and supplements that your loved one is taking.

A RESILIENT LIFE

[by Joanne Reynolds]

Have you ever noticed how some people “can take a lickin’ and keep on tickin,” as the old TV ad used to say about watches?

Caregiving is demanding, stressful and often full of negative surprises. You can’t control what happens, but you can control your response to it. It’s what psychologists call resilience, and it’s not a trait we’re born with—we learn it.

Here are some suggestions for bringing that “bounce-back” or positive attitude into your life:

*Take on problem-solving one issue at a time. Don’t try to solve all of your problems—or caregiving challenges—at once. Think of building a wall. You do it one brick at a time.

*Choose to be happy. Yes, your parent is suffering, there are significant medical issues to be faced, and frustrations abound. Don’t go overboard, but instead, choose to find joy in small things in spite of the trials you both are facing.

T'was the Night Before School and All Through the House, Tomato Paste is Shampoo...

Here we are.  It's the night before school starts.

Forms are not filled out.  Only 2 of the three kids have new backpacks, and there's nothing planned for dinner. 

We hit the ice cream social at 4, and the younger girls have their teachers and room assignments.  The oldest brings home a stack of paper for us to to go through and fill out.  "Check here to donate more than you should."  "Check here to feel guilty."  Going to the fundraiser this fall?  Yes/No.  Buy a sweatshirt?  Cool kid?  Yes/No.  Cotillion?  (I tell me daughter she can pretend to be a debutant.  She rolls her eyes and walks away.)   Chicken dinner on Wednesday for $9/head?  9x5=$45.  Yeah, I guess...

We have yet to initiate the treatment.

Daddy is frustrated.  How can little girls care so much about green hair, he wonders.  But they do.  My 12 year old has the whitest hair of anyone in her school.  ...Well, she used to, anyway.

He thinks it's a right of passage.  "Tell everyone you spent the summer at the pool.", he tells her, thinking that that will be enough.  She's not so sure.  This has happened to us before.  The super blonde hair sucks up the combination of chlorinated water and copper pipes and becomes a not-at-all subtle shade of NEON GREEN.

Sharing the Care: Caring for loved ones near and far

Judy’s mom lives out of state, and is in failing health. The good—and bad—news for Judy is that her mom is living in a “Granny unit” apartment above her sister’s garage, so care is literally steps away.

But Judy suffers from guilt because she’s not the one carrying the burden of her mom’s care. “I call once a week, and sometimes I have to bite my tongue to keep from offering my ‘brilliant’ advice. I know my sister’s in it every day and probably has thought of or tried all the things I want to suggest. I just don’t think she’d take it very well if I wade into these issues from 1,500 miles away,” Judy says.

The same issue arises when Judy goes to visit, only it has a bit of a twist. Not only does Judy not want to come off as “the outsider arriving to save the world,” but she has begun to realize that her mom puts on a show of being stronger and healthier than she really is when Judy’s visiting.

The bottom line is that no one really is saying what’s true. Judy keeps her advice to herself, her sister isn’t talking about her real levels of caregiver stress, and mom is trying to convince Judy that she is well when she isn’t.

Tips for Finding a New Doctor

In my last post, I talked about when it’s necessary to find a new doctor for your loved one.

Some of the reasons people decide to change have to do with who’s going to have control over the medical decisions—the patient and family on one hand, or the medical team on the other.

But there are other reasons for changing doctors, such as lack of a bedside manner. I was not at all fond of my dad’s and sister’s oncologist. I found him abrupt and inattentive to them during office visits when I came along as the second set of ears. He rarely talked to them, but instead seemed to bark out orders like a drill sergeant.

However, he was a very highly regarded physician with an impressive success rate. So they stayed with him in spite of his poor communication and patient-care skills. You and your loved one may not want to put up with that kind of behavior.

If you’re going to make a change, here are some ideas for finding a good match between patient and medical team:

• What’s the physician’s background? This includes education, board certifications and professional history. Don’t be shy about checking for disciplinary actions and patient reviews. The Internet is a great source for these.

A Look at High Deductible Health Insurance Plans

This week, I’ve had the opportunity to learn more about small company and individual insurance plans. There is a newer package that seems to be gaining in popularity. No doubt, it’s a health insurance offering designed to cut premium costs. Learning about the details, though, has been an eye opener.

What I’ve been looking at is what’s called a High Deductible Health Plan  or HDHP. These are often offered in conjunction with a Health Savings Account or (HSA), which in my case is an employer funded, tax advantaged medical expense reimbursement fund which covers part of the high deductible for qualifying expenses.

What I’m seeing are options for either a PPO or an HMO with this high deductible and the introduction of the accounting task of submitting for each expense. It’s my nature, to do some risk assessment and scenario layout of the options prior to making any decisions. To some extent, I don’t even want to know, but as my eye scanned the benefit summaries of each of the plans and a more comprehensive understanding of the coverage became clear, I was surprised.

To begin with, just like with Medicare, there’s a donut hole. The donut hole is the gap between the HSA medical reimbursement level, and the high deductible amount. In a PPO, even after the deductible limit has been reached, there is likely to be a high co-pay until the annual out-of-pocket limit is reached.

What holds a sandwich generation family together? Glue

It's my job to be the glue.

Hi.  I'm new here, new to blogging.  But, I'm not a new mom.  Nope, not anymore.  In fact, I'm old. 

I don't worry about whether I should go back to work anymore, about cloth diapers, organic food or even pre-school.

We've moved on.

I didn't think it could get any more complicated.  Back before kids, and when they were young, it was all about getting set up.  Then it was about surrounding the kids with everything they needed to grow and thrive.  Books, food, quilts, language, love, fresh air.

Now the kids are a little older and I enjoy teaching them more complex concepts.  Not like math, I mean.  Things like whether to be upset about certain things or not, how to treat a sad heart, take care of each other or how to be safe.

The past year has been hard for us.  Over the years, we made decisions that were kind of banking on the expanding economy. "Dearest Tax Man:  You must have us confused with someone else..."

Advanced Directives: Let your family know your wishes

Two weeks ago a distant uncle had blood clots from recent back surgery lodge in his heart and cause a massive heart attack. By the time he reached the emergency room, he’d flat lined six times, leaving him comatose and, as it was determined later, with severe brain damage. The hardest part for his wife, daughter, and other family members—he had no Advance Directive.

While I’d heard of a DNR (Do Not Resuscitate) order, an Advance Directive (also called an Advanced Health Care Directive) was a new term to me. In essence, it’s healthcare instructions in the event someone is no longer able to make decisions for him or herself. According to Wikipedia, a living will is the oldest form of directive. Living Wills aren’t recognized in California, though can still offer guidance to medical professionals and loved ones. Some Advance Directives include a medical power of attorney, or health care proxy, to make decisions on your behalf.

For state-specific forms: http://www.caringinfo.org/stateaddownload

In the late 90’s, Aging with Dignity, developed a combination of a living will and a health care power of attorney, called the Five Wishes. Wishes 1 and 2 meet legal requirements in 42 states. Wishes 3 through 5 address more general issues of comfort and spirituality. This is a general description from Wikipedia:

Wish 1: The Person I Want to Make Care Decisions for Me When I Can't
This section is an assignment of a health care agent (also called proxy, surrogate, representative or health care power of attorney). This person makes medical decisions on your behalf if you are unable to speak for yourself.

Wish 2: The Kind of Medical Treatment I Want or Don't Want
This section is a living will—a definition of what life support treatment means to you, and when you would and would not want it.

Wish 3: How Comfortable I Want to Be