The next few blog entries are going to be about how to handle a declining family member and dealing with a nursing home or assisted living.  There isn't a manual identifying potential land mines or potholes.  It is generally learn as you go and playing catch up.   It is stressful and emotionally draining.  I want to give some tips starting with introducing the idea and having the conversation to picking the right placement to always being vigilant with the person's care.

The first step is having the conversation.  It is a conversation you don't want to have with your parents.  It is an essential conversation especially if you have noticed any health or memory changes.  The conversation is about the plans for the future.  Some parents have already decided the situation and are moving into a retirement community with multifaceted services for declining health situations.  Make sure you know this is happening so you can check out the facility or community.  For many, you may hit a brick wall of resistance but keep returning the conversation of time.  Enlist other family members if needed.  Unfortunately, sometimes nothing works until a critical event occurs.

It can be difficult for many seniors to accept the changes and the need for a different living situation.  Staying in their home is a possibility if it can be modified for safety. Some of these safety modifications are grab bars in the bathrooms, no throw rugs, stairs that are not to steep or a ramp. Local senior centers may have a person who can assess the home for safety. There are services that work with families to keep seniors in the home by providing care as needed and making sure all safety features are in place.  I also recommend a medical alert bottom.  Some towns provide them free but for most there is a monthly cost.  The greatest challenge will be getting the person to wear it!  My mother-in-law liked to put it on her bedpost because it just didn't look good.  It would have helped her when she fell in her house and suffered a huge head gash.  You can enlist the doctor to support and insist on the medical alert and to wear it!

Another important detail before an emergency occurs, is to work on getting legal papers for a Healthcare Proxy and Power of Attorney.  If a parent has a traumatic event, you want to be able to make medical decisions.  If there is no legal document allowing this, the hospital will make the decisions for you.  Included in this is the Living Will which designates end of life decisions as to resuscitation.

The Power of Attorney is a legal document that gives you right to manage all financial and legal matters.  It is important to be able to pay bills, speak with insurers, banks and state/federal agencies.  It doesn't mean that you will take over now but if an event occurs, you will be ready.  There can also be more than one name on the document.  Both documents are available at www.legalzoom.com or other legal websites.  Each state has separate requirements for how many copies are needed to be filed so check the individual state website.  All papers must be notarized.

It is not easy seeing a family member in decline but attempting to get things in place can help now.  A traumatic event is like a tornado changing the all familiar landscape.  A few preemptive actions can relieve a small amount of stress.  Even after multiple attempts at having a conversation, you just have to wait.  

Next segment:  An traumatic event.