Never in my wildest dreams did I anticipate how stressful the aging and subsequent deaths of my parents, Conrad and Helen, would be. I thought being a nurse and health-care professional would make it easier. It didn’t. The same thing goes for my brother Garrett, a respiratory therapist. We simply didn’t comprehend the physical, emotional and financial tolls of caring for our parents. Neither did we know where to look for help and support. I figured if my brother and I, both of us in health care, had a hard time dealing with all these challenges, how were other people dealing with the myriad issues of home-health and end-of-life care? The feelings of helplessness and the loss of control in trying to care for an aging loved one was not something we had thought about prior to our parents falling ill. Yet, that’s one of the main reasons I wrote this book.
I was driving home from a Detroit Pistons basketball game in November 1996 when I received a call from my mother saying that Dad had suffered a stroke. My life changed forever at that moment. This started a 20-year journey for my brother and me as we dealt with my father trying to recover from his stroke, while being cognizant and respectful of Mom as she aged. Our journey was filled with many unknowns, lots of tears and, most of all, genuine love, as we cared for our parents.
As I drove home that cold November night, flashback memories of my father, mother and brother filled my thoughts. I grew up on the west side of Detroit, where I went to Redford High School. I received my bachelor’s degree in Nursing from Mercy College in Detroit. I came from your typical middle-class family. Mom was a school teacher and Dad worked at Detroit Receiving Hospital in the shipping and receiving area.
My early years truly formed my life in health care but I didn’t know it at the time.
My brother Garrett and I never had to have the hard talk with our parents about giving up the keys to the car. Dad’s debilitating stroke and rapid decline until the day he died a few months later kept us from having to broach this difficult topic. It was just understood his days of driving were over. And my mother, God bless her, gave up her keys on her own one day, saying it was time she not drive anymore. That was a pleasant surprise for my brother and me. This was a good thing, as one of the last times I drove with my mom, I was telling myself it was time for that talk! You should have been in the car with me. Let’s just say it was a wild ride.
My mother wasn’t one of those typical “old lady drivers” who go 25 in the fast lane on the highway. On the contrary, she drove like a race car driver on the Indianapolis Speedway! Now I know where I got my lead foot! I am certain that if she would have kept on driving, she would have hit something or someone one day with such a great deal of force that she would have done a lot of damage. But my brother and I never had to have that tough conversation with her, thankfully. We did, however, speak to her about getting a caregiver to come into the home when she needed some assistance. In retrospect, we should have had that talk with her much sooner. Thousands of families are faced with having these types of conversations with their elder parents. I hope this chapter will help you and your loved ones by giving you the tools to manage this type of discussion and others.
My mother started to have short-term memory issues at age 83, three years before she died. Unfortunately, this is all too common an occurrence as we age. One day, while I was at my brother’s house visiting my mom, my brother Garrett told me Mom was starting to become forgetful, mostly in the form of asking the same questions over and over again. For example, she would ask, “Did the mail come?” and it had come. Or, “Did Karla call?” and Karla had called just an hour ago and, “Is it time for dinner?” and she had just finished eating. Mom’s long-term memory was still strong, thankfully. Mom didn’t have Alzheimer’s but nonetheless, her memory was starting to diminish.
Seeing all these changes occurring in Mom during her 80s was unsettling to me and, I must admit, I was in a state of denial with most of them. The thought of my mother starting to decline in any way was upsetting to me. I felt helpless! Denial was my defense mechanism. Unfortunately, “Denial isn’t just a river in Egypt.” Denial, for me, however, was a much cleaner and easier way for me to deal with what was happening to my mother. My brother, on the other hand, was much more realistic and in tune than me to what was going on with our mom. I guess living with her made it hard to avoid the signs and symptoms. My brother Garrett actually helped me be more comfortable with the changes occurring in Mom.
I will remember this day forever. It was Monday, June 11, 2012, and a beautiful summer morning. I was in my office enjoying my second cup of green tea when my mobile phone rang. It was 11:10 a.m. and the display showed it was my brother’s home phone number. A flash of panic went through me, as I knew my brother was working and mother was home alone that day at the house where she lived with my brother. I quickly answered the phone and my mother said, “Son, I fell and hurt myself. Please come here now.” Her voice was shaky and I could hear the fear in her voice. I remember I became faint and nearly passed out from a surge of panic in my body. I have never heard my mother’s voice like that and it scared the hell out of me!
I called my brother at work and then drove right over to my mother’s place with a staff person from my office. My mother was sitting on the sofa in her robe with a small gash in her forehead and her face all covered with blood. I nearly fainted again. I couldn’t tell how bad she was hurt or whether she had broken any bones. My mom was shaking all over, as the fall had totally frightened her. I remember I nearly started to cry, not so much for what just happened to her but for the fact I saw my mother as I have never seen her before. She was so vulnerable looking. I knew she was hurt and could only imagine her fear and what she was going through. As a nurse, I also knew that falls are usually the start of a sequence of decline in some seniors.
I am ashamed to say that both my mother and father died without the gift of hospice.
I am ashamed of this because both my parents were eligible for hospice under Medicare guidelines and we did not access this valued resource. Further, I work as a hospice professional and should have known better. My mom and dad, as well as my brother and I, could have benefited greatly from the gift of hospice.
Hospice is one of the best-kept secrets that can make an end-of-life journey more peaceful, as opposed to filled with drama and pain. As I wrote about it in chapter one, it’s hard to be both a caregiver and a loved one. It was so obvious that my parents could have benefited from hospice. Instead, because I was trying to be a loved one and caregiver at the same time, their needs when right over my head. So again, I wonder how people with no healthcare experience deal with such challenges.
This chapter will help you understand better how hospice and palliative care can help you and your family members de-mystify all the false assumptions around hospice and how to select the best hospice for you and your loved one.
Throughout my journey of taking care of my mom and dad, I have gathered many useful resources and pieces of information that I would like to pass along to you. This chapter contains 100-plus helpful tips, tools and resources to help you on your journey of taking care of your loved ones, including:10 Tips for Communicating with a Person with Dementia10 Helpful Tips to Prevent Caregiver Burnout
-10 Things You Should Know About Your Parent’s Finances
-5 Important Things Your Loved Ones Should Put in Writing
-The Top Questions to Ask a Personal Care Home Health Company
-Common Medical Conditions for People Over Age 65
-Helpful Resources on Medical Conditions that Affect the Elderly
-10 Helpful Tips About Taking Medication
-Proper Nutrition for the Elderly
-Mental Health Concerns in Seniors
-7 Tips for Long-Distance Caregivers
I fell in love with Svetlana in 2007 when I went to Moscow to meet her. I’ll tell you more about that a bit later. I didn’t realize at that time, however, that my relationship with Svetlana would lead me on a wonderful journey experiencing life and love in Russia and Ukraine and resulting in expanded business opportunities. You see, Svetlana is the major reason that I developed First Home Care, a personal home care company in Moscow. I have been fortunate to have visited Russia and Ukraine more than 30 times over the past 15 years.
During my time in Moscow, I realized that the issues of aging, and all the family challenges related to that, are worldwide and not just exclusive to the United States. Pain, suffering and grieving affect us all, no matter what country you live in. This last chapter tells of my journey throughout Eastern Europe and into Asia and the impact it had on me.
As I started my exploration of Russia, I learned so many interesting things. For example, in 1992, a very unusual trend emerged in Russia: There were more deaths than births. The reason for this is not only because of the aging of the Russian population but the de-population that was caused by the profound catastrophic events of the 20th century, including two world wars, the Russian civil war of 1917-1922 and famines in the early 1920s and ’30s. These catastrophes have distorted the population pyramid in Russia so much that the typical age distribution and balance between male and female in the population is skewed more toward women. In fact, the huge loss of life during World War II caused Russia to have the lowest overall male-to-female ratio in the world, especially among the elderly. The irregularities of this pyramid will continue to have an impact on the number of births and the rate of population growth and aging for several decades. This pattern affects such vital spheres as school enrollment, employment, retirement and care of the aging population. It also spawned the international dating industry in Russia and Eastern Europe.
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