December 2013/January 2014 Print - Debra Levy Eldercare Associates

Constructive criticism: when to speak up

Caring for a family member often involves collaborating with other relatives. Sometimes you will agree. Sometimes you won’t. Debating every item may not be the best use of family time. In some situations, the wisest course is to be quiet and let others do it their way.

That said, there are times when you should speak up, specifically when another person’s safety or deep well-being is at risk.

One simple way to decide when to speak is to ask yourself the following three questions:

Is it true? Watch out for assumptions. Do you know the facts? Did your sister really miss giving mom her meds several nights last week? Or is that only what seems to make sense, based on what you’ve seen (or what you’ve heard from someone else)? Instead of jumping to a conclusion, acknowledge what you don’t know and ask for information. Most important, don’t ask a third party. Go directly to the source.
Is it kind? Focus on the problem rather than on the person. Avoid “you” statements (“You . . .”). They tend to make people defensive. Instead, switch your observation to an “I” statement. For example, instead of saying, “You’re not changing mom before taking her out,” say, “I’m concerned about keeping mom dry after what the doctor said about her skin.” Then express empathy and make it a shared goal, if possible: “Changing her is certainly my least favorite task. Still, I’d like us both to commit to changing her every . . .”
Is it necessary? Pick your battles. You stand a better chance of being heard if you are only occasionally raising issues. Keep your focus on the real risk of harm. So what if dad had spaghetti three nights in a row? Better that your brother fixed the grab bars in the bathroom than spent time in the kitchen! Let the small stuff go.

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Important documents

It’s easy to lose track of paperwork, especially someone else’s. Professionals recommend gathering important documents in one file for safekeeping. Put them in a locked and fireproof location. Consider a small safe at home. Or a safe deposit box at the bank.

Putting this file together with your relative’s help ensures that you know about all the accounts that exist. (Do it now, while he or she is still capable!) Following is a checklist of top priority health and financial documents. Make sure you have the signed originals. Copies may not be legally accepted.

Original will or trust documents. (These can also be kept at the lawyer’s office.)
Durable power of attorney for finance.
Advance healthcare directive (includes durable power of attorney for health and a living will).
Ownership documents. Title and loan documents for property and vehicles. Also include documents for assets, such as savings bonds, brokerage accounts, and cemetery plots.
Bank account information. Account numbers and login information. Don’t forget the key to any safe deposit box (and the number!).
Auto-pay arrangements. A listing of services being paid automatically from each bank account.
Insurance policies for life, disability, and long-term care. Get the full details, including policy numbers. Be sure you include policies provided by employers and any that were bought personally.
Health insurance cards. Make a copy of the front and back of each card. You’ll want Medicare A/B, Medicare supplement, and Prescription Benefit Plan.
Pension and individual retirement accounts. A person who worked for several companies may have multiple 401(k) accounts. Check for multiple IRAs also.
Debt and loan documents.
Past tax returns. You need to keep only the most recent three years of returns.

If it feels awkward to approach your relative for such personal information, mention this article. You’re just following through on an important recommendation!

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Keeping blood pressure in check

An estimated 30% of people who know they have high blood pressure aren’t doing anything to treat it. That’s a bit like playing Russian roulette! They’re at very high risk for death or disability through heart attack, heart failure, or stroke.

If you or your family member has blood pressure over 120/80, it’s time to get going. Literally. Research shows that changes in lifestyle, especially increased physical activity, are often enough to bring blood pressure under control.

The “lifestyle prescription” for blood pressure management includes

healthier eating. Fewer sweets and less red meat and packaged foods (high salt content). Instead, eat more fruits and vegetables, whole grains, and low-fat proteins.
greater activity. Aim for a weekly minimum of two and a half hours of moderate-intensity aerobic exercise every week. That might be 30 minutes of brisk walking, swimming, or dancing five days of the week. The point is to get the heart rate up and maybe even break a sweat.
losing weight. Even a 10-pound weight loss can reduce blood pressure. A healthy weight is a body mass index of 25 or less.
limiting alcohol. Too much alcohol raises blood pressure. Limit alcohol intake to one drink per day for women or two drinks per day for men.
no smoking. Every cigarette smoked causes a temporary increase in blood pressure.

When blood pressure reaches up to 140/90, the doctor will usually prescribe medication in addition to lifestyle changes. It may take several tries to find the drug that works best. Don’t cut back or quit, even when health seems improved. Talk to the doctor about overcoming barriers, such as uncomfortable side effects or concern about the cost. They don’t call high blood pressure the “silent killer” for nothing! Blood pressure treatment is for life.

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