August/September 2013 Print - Debra Levy Eldercare Associates

"I can't get Dad to budge!"

Has your loved one ever flatly rejected your perfectly sensible solution to their problem?

Though your idea may seem like the obvious route to take, it’s not so simple when you’re caring for an older adult. Your loved one has had a lifetime of making his or her own choices.

If a decision must be made, start with one simple principle: Take your eye off the goal. Focus on the process instead. We all want to be treated like people rather than like a project in need of completion.

Involve your relative in decision making (assuming he or she is mentally up to the task). Do what you can to provide a range of choices so your relative retains as much control as possible.

Resist the allure of efficiency. Think in terms of teamwork. Coach yourself that the winning game plan is to go slow and steady. Sure, you could pick out an assisted living facility in a week. But without your relative’s buy-in, you likely won’t get cooperation for move-in! Embrace compromise. Even if the pace seems too slow and the solutions are not ideal, it’s still progress.

Honor their feelings. Aging involves so many losses. Acknowledge them during a private conversation. “Gosh, Dad, I can tell this is hard to swallow. What can we do to make it easier?” Your goal isn’t to become your parent’s therapist. But sometimes a demonstration of empathy is just what’s needed to melt resistance.

Give it time. Make your suggestion and if you get resistance, let it rest for a while. Hammering on your points could easily prompt your loved one to become more entrenched. Let the idea percolate. After some time and reflection, your relative may find ways to make it his or her own.

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What to do with their stuff?

If you are helping a relative downsize for a move, it is often helpful to sort belongings into four categories:

items to keep
items to throw away
items to sell
items to give to charity

Items to keep and to throw away have obvious action steps. If you have a lot to dispose of, ask the local waste hauler to drop a debris box at the curb. Be sure to shred anything that includes personal identification information.

Items to sell. There are a variety of options for professional help with reselling.

Estate liquidators do on-site sales. They review, organize, and price the goods and host a sale in the home. They typically take a percentage fee on what they sell, plus hourly charges. You can find a local referral through the American Society of Estate Liquidators.
Auctioneers take a fee for selling items off site.
Consignment shops offer items for a set period of time, such as 30 days. They take a commission on sales. Find out what happens if your items don’t sell.
Consider selling them on eBay or to an eBay reseller.

Items to donate. Get a dated, itemized receipt from the charity. You can claim a tax deduction for the fair-market value of items in good condition.

Want help with all of it? Once items are sorted, consider hiring

a senior move manager. They charge an hourly fee and will do everything from packing to coordinating with resellers to taking leftovers to charity. Check with the National Association of Senior Move Managers for someone nearby.
a junk removal service. These companies can remove everything. Get a cost estimate first (ask if there’s a fee). They resell items, recycle them, or dispose of them at the local landfill. A nice plus: they finish with a thorough cleanup!

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When to choose "Urgent Care"

Who wants to go to the ER? No one! But sometimes, distressing symptoms or illnesses arise that require prompt attention and your regular doctor is not available.

An urgent care center is appropriate when your relative’s condition is NOT severe but still calls for immediate medical care. Life-threatening symptoms include chest pain, heavy bleeding, significant breathing problems, or inability to move one side of the body. In those situations, get to the ER quickly! But less dire problems can be handled well and quickly (often within an hour or so) at an urgent care center.

Appropriate conditions for urgent care include

aches and pains from a headache or muscle sprain;
sinus, urinary tract, or other infection;
skin wound or swelling, such as from a skin tear or insect bite;
diarrhea or other digestive upset;
fever or flu;
broken finger or toe.

Treatment may be provided by a doctor, nurse practitioner, or physician assistant. Most centers provide x-rays, blood work, and other common diagnostic tests.

Get prepared to make use of this stress-saving option.

Ask your relative’s doctor to recommend a nearby center.
Contact the center. Ask what hours it is open. Middle of the night? On the weekend? Is a doctor always on site?
Check on insurance coverage. Find out if the center is in your relative’s health plan network. Ask about the copay, whether in or out of network. (It may still be less than going to the ER.)

When you go to an urgent care center, be sure to bring your relative’s

photo ID and health insurance card;
list of current medications; and
summary of health history.

Ask for a treatment statement before you leave. As soon as possible, contact your loved one’s primary care doctor. Let the doctor know what treatment was provided and schedule a follow-up office visit, if advised.

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