July/August 2015 Print - Debra Levy Eldercare Associates

Is your parent frail?

“Frailty” used to be a rather vague description, like “old age.” Recently, however, it has been recognized as a cluster of conditions that deserve medical attention.

The signs of frailty are:

Complaints of weakness or fatigue
Inability to walk up one flight of stairs
Inability to walk more than one city block
More than five chronic diseases
Unintentional loss of 5% or more body weight in the past six months

Frail individuals over age 70 are more likely to become seriously ill from simple infections. They are more likely to be hospitalized and to become disabled. Not surprisingly, they are more likely to die sooner than their nonfrail peers.

If your older relative has three or more of the five conditions listed above, contact the doctor for an evaluation. Many of these conditions can be improved. For example:

Fatigue may be tied to depression. Or it may be caused by not enough iron or vitamin B12. Or a problem with the thyroid. Appropriate medications can help.
Muscle weakness can be offset with a 10-minute walk each day. Lifting light weights, such as a small can of vegetables, can increase strength. It is surprising how much even a little increase in activity can do to build muscle.
Unintentional weight loss might result from not getting enough calories and protein or simply forgetting to eat. A between-meals protein supplement, such as a specially formulated drink, might be advised.
Lack of stamina could be caused by too many medications. Changing prescriptions or changing when drugs are taken can do a lot to reduce dizziness, fatigue, and other common side effects that lead to frailty.

To keep your loved one out of the frail zone, help him or her stick to a wholesome diet and stay physically and mentally active.

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The "Sandwich Generation"

Parents are living longer. Children are often dependent for more years than expected. Add to this the ongoing responsibilities to spouse/partner and jobs, and there is little wiggle room for the millions of family caregivers who find themselves in today’s “Sandwich Generation.”

It’s easy to feel guilty and lose sight of the joy in your life when you are pressed on all sides. To support your resilience and make sandwich caregiving more gratifying, dedicate some quality time on a daily or weekly basis to each of your key relationships.

Ensure parent care is not just a rote set of to-dos. Instead, take stock of what you enjoy about the person or situation. Is there a daily comic you could share for a laugh? Or memories to savor by scrapbooking together or labeling old photos and recalling pastimes?
Enlist the help of children living at home or nearby. Maybe your teen or young adult child can cook meals, do shopping errands, or drive mom where she needs to go. As with parent care, also identify activities you and your child can enjoy together. Look for your child’s strengths and let him or her be the leader or teacher now and then.
Keep your noncaregiving relationships alive. Don’t neglect your partner! Make dates for one-on-one fun time. Watch out for continual conversation about caregiving. And don’t forget your friends. Caregiving may be a big part of your life, but it’s not all of who you are.
Do something once a week to boost your professional self. Read an article related to your career. Make a call to a colleague for a quick networking session.
Take some “being” time for yourself. It’s easy to get swept up in “doing” all the time. Give yourself at least 15 minutes a day for emotional or physical renewal.

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When Dad resists a walker

For many older adults, use of a walker carries great stigma. It’s a symbol of disability and often of isolation. In actual fact, a walker can be the key to staying safely and actively engaged with favorite activities.

A walker is superior to a cane because

it can bear up to 50% of a person’s weight. A cane can hold only 25% of one’s weight.
it supports good posture. A walker keeps a person upright by reinforcing both sides of the body. A cane steadies only one side.
it is designed for people with moderate to severe balance problems or those with generalized weakness and arthritis. A cane is best for only minor balance problems or injuries.
it may include a basket or other device for carrying items.
it may act as a chair when needed. Many walkers with wheels have a bench. Great for “standing” in line or when your loved one is suddenly tired or dizzy.
it stays where you put it! Canes seem to have a mind of their own, scooting out of reach when you least expect it.

If you have had the “let’s get a walker” talk without success, make an appointment with the doctor to discuss balance issues. You might ask the doctor, “What’s your experience with patients who fall? How careful should we be?”

Also get the doctor’s input about the type of walker that is best for your loved one. The doctor may recommend that a physical therapist do a mobility assessment to determine the best way to stay safe and secure while walking.

If resistance persists, empathize with Dad’s frustration that his body has given out on him in this way. Remind him that with a walker, he can still get around on his own to do what he pleases. Even if it’s personally not a favorite, it’s often the wisest choice for maintaining independence.

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