This week on Parents Are Hard To Raise, Diane catches up on listener questions as well as some common issues facing clients in her private practice.

Sharon from Bakersfield, California asks: “I fill mom’s pill box every week, but she still takes her meds wrong!” What can I do?

Talya from Ashdod, Israel  asks: “What are the most common complaints of children of aging parents? Is it normal to feel the way I do?”

Michele from Stratford, NJ asks:  “ Can a parent in a wheelchair still live in an assisted Living Facility?”


Show Transcript

Parents Are Hard To Raise S02 E62 Transcripts

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Announcer: [00:00:37] This week Parents Are Hard to Raise Diane catches up on listener questions as well as some common issues facing clients in private practice.

Diane: [00:00:59] Welcome to Parents Are Hard To Raise helping families grow old together without losing their minds. I am elder care expert, Diane Berardi.

[00:01:08] Welcome. I feel like I haven’t talked to you in a while because we’ve had guests on. I hope you’ve all enjoyed the guests we’ve been having and that you’ve gained information that was helpful for you in dealing with your parents. I certainly have. I think we’ve all learned a lot and I hope you’ve enjoyed them as much as I have.

[00:01:31] So I have some questions. We’re getting so many questions from people and that’s great. Please keep sending them in because your question, I’m sure, will help someone else as well.

[00:01:42] So I have a question from Sharon from Bakersfield California.

[00:01:46] “I fix my mom’s pillbox every week but she still doesn’t take her medications right. Do you have any suggestions?”

[00:01:55] Well… Medication compliance is an issue that a lot of people deal with. Our parents, they forget to take them. Maybe they you know they don’t take them because of poor vision, they can’t handle the tabs on a bottle or even on those organizers, or it’s just too complicated.

[00:02:17] And believe it or not statistics show that 125 thousand older adults die each year from improper use of medication. So we do find that pillboxes are the most effective. But you fill your mom’s pillbox but they still have to be taken correctly. So, herein lies the problem.

[00:02:40] I have one client this week where the children fill her pillboxes for two weeks. She takes morning and evening medication, and she has family visiting some of the days of the week and some of the days she’s on her own and she forgets to take her medications. And they said to me, “What can we do?”. Well… She’s Basically pretty good. But certain days she forgets, so one of the things that I would suggest is you can take that that sleeve… If the patient herself, she’s well enough to do as she can, just take the morning and evening on Sunday night– for Monday– and put it by her coffee. Because if that’s the first thing she does is go get coffee in the morning, she’s going to see that a.m. pill sleeve there and to take your coffee. We can try that. And then I tell them, keep that flap open for the morning so you know you took Monday morning’s… You took that medication. And then, what’s the last thing you do? You take that medication at night. Bring that by your bed or where you brush your teeth, wherever you’re going to see it, to take it before you go to bed.

[00:04:00] The same thing… Leave that open and then you could put that sleeve right back in the pillbox, but leave them open so you know you took your medications.

[00:04:10] There’s a lot of pill packs that pharmacies deliver, they were offered by pharmacies. They are individual packages and some are color coded. They list the date and the day. And the time that you take the medication and that’s good for people who were concerned their parents weren’t taking the right dosages the right times etc.. So you know those are done properly. But I have had a client who has that because she was not taking her medications properly when they were laid out she would forget to take them etc..

[00:04:47] So now these are delivered and you can just simply… Usually they’re like a month; these bags are all attached for a month. And they’re perforated, so you can take out the morning, you take out the afternoon etc…

[00:05:03] And so she’ll do that for a little while and she’ll be fine… You know, morning, afternoon, evening, bedtime. But then sometimes, out of nowhere, she’ll forget that she took maybe the evening pills and then she’ll just go into the month and just rip off some.

[00:05:23] And it’s not the right time that she’s taking it is not the right dosage and she doesn’t remember. We’ll say… Well, you took you took the wrong one. Why did you do that? You took your evening meds and then you went into Wednesdays and took Wednesdays too. And you took the night ones, too. “Well, I don’t know. Why did I do that?”.

[00:05:41] So those are good, just to have the dosages correct and they can remember. “OK. Yes. I take the morning and fine.” Those work well. There’s all kinds of reminders… Watches that remind you can set, all kinds of medication reminders.

[00:06:05] I like the one it’s called [00:06:07] Med Minder’s Jon [2.4] And it just looks like a regular pillbox… Seven day a week pillbox, having the 28 compartments and all you need for it is electricity. You don’t need internet, you don’t need Wi-Fi. Any of that stuff. And what it does is, it lights up when say… 12:00 med’s… So it lights it up and it locks all the other days and times. So all you can do is take the proper one. So you can’t go into another day and say, did I take the one and then go into another day and say…”I don’t remember and take that. So that’s a good feature for somebody who they just don’t remember if they took it.

[00:06:52] So, you can also be notified by text if you’re a family member it can update you on the medication regimen… that your mom or dad is taking those the right time.

[00:07:05] I like the fact that it just kind of lights up and flashes so you take it. Because sometimes people don’t hear those alarms. There’s some that have alarms so people don’t hear them. And if that cup you know that little cup isn’t removed at a certain time then you can decide… There’s different ways… They could call the patient. They can e-mail you. They can e-mail the patient. They can text the patient or they can have an alarm that goes off. So the records are kept remotely. And again you can have access to them.

[00:07:38] There’s also other ones that can remind you. There’s the [00:07:45] e-pill med glider, [1051.6] that one has alarms. They have a four alarm timer. So it really depends on your parents and what you think might work for them and what their problem is. If it’s just, you know, they’re fine just trying to remember to take the medication in the morning and in the evening, and if putting them in certain spots… If that doesn’t work, maybe just alarms will work.

[00:08:09] But if it’s someone who is kind of confusing all the medications I like the one that locks in so they’re not in and out of different things.

[00:08:17] This e-pill med glider. This is the one with the alarms and it has for a four alarm timer. So it sets off a loud beep when you’re supposed to take your medicine and it just resets automatically. And this one has a display so if you forget to take medication it will display. So that can help.

[00:08:40] It will flash and display and it just depends what your mom or dad might need. And you can decide you know what they might need. You could try different ones. A lot of people now are using the pharmacy ones because that helps. They don’t have to worry about bottles etc.

[00:08:59] Using even these pill containers, your pharmacy probably would be happy to fill them as well, so maybe you don’t have to do that. I know a lot of people maybe have to travel to their parents house to set up their medications.

[00:09:16] If you don’t use the baggies set up by the pharmacy, then they would be happy, probably, to fill those as well. It really just depends.

[00:09:24] I have people who say well I can call my mom. I call her in the morning and tell her to take it. But sometimes you call your mom and you say mom take your medicine and then you’re talking to her and your mom forgets to take it. And that happens a lot too. Same thing with dinner. And you’ll find that they haven’t taken their medication.

[00:09:42] Also I find that if you’re setting up those pill bottles or the medication reminders don’t kind of leave all the extra pills around too because sometimes people get confused. Even though they go into that, sometimes and they go, “Did I take it?” And then they go into the cabinet and they might take an additional pill, etc.

[00:10:03] So, I really like the one that… Seven days a week has all the compartments in it and you can’t take anything but the one that is flashing, because it locks everything else. And you might think, “jeez I don’t know if my parent needs that.” But I think that’s really good.

[00:10:19] I know… My mom, she forgets to take stuff. My dad… they have to kind of remind each other and then sometimes they both forget. Another thing to… My mom called me today she said she went to the eye doctor and he ordered her this prescription. And so she said to him… Which he is not going to know… “How much does it cost?”

[00:10:39] But of course they ask… She is like, “Well, how much do these eye drops cost?” And he said, “Well, really I don’t know.” So she goes to the pharmacy and the pharmacist says– it’s eye drops for allergies I guess her eyes are swollen– and the pharmacy says it’s like a hundred forty eight dollars for this little bottle. And the pharmacy tells her that her prescription plan doesn’t cover it. So of course my mom is like, “Well I’m gonna get this filled. I’m not going to pay a hundred 48 dollars.” So, I say to her, “Well mom. First of all, we can call and see. Maybe your prescription plan does pay for it. How do you know?”.

[00:11:15] So these are things… Sometimes she already made that decision before we really know what it is. Maybe there is a generic; something similar that her prescription plan does cover or is less expensive for her.

[00:11:27] So you have to kinda get the whole story from them, because otherwise they may not be taking them. They may not get the right stuff filled.

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[00:12:26] It’s not like it was in our grandmother’s day. Today just going to and from work or to the mall can have tragic consequences.

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Announcer: [00:13:57] You’re listening to Parents Are Hard To Raise… Now thanks to you, The number one elder care talk show on planet earth. Listen to this and other episodes on iTunes, Google Play and on demand using the i Heart Radio app.

Diane: [00:14:21] And I want to thank our sponsor lipstick bodyguard for making this show possible so please people support lipstick bodyguard it’s a great product because you do that. And here we go…

[00:14:32] They’ve supported us for so long and it’s a great product for you, your mom, your dad, your daughter, your son, your grandchildren.

[00:14:43] And I want to welcome our new listeners from British Columbia from Burnaby, Victoria, and Surrey. From Israel.. Ashdod, Nazareth and Beersheba. From California… Irvine, Modesto and Palm Springs. Welcome! So great to have you as new listeners.

[00:15:03] As a matter of fact we have an e-mail question from Talya from Ashdod Israel.

[00:15:10] “What do you find are the most common complaints that we as children caring for parents feel? [8.1] I have so many emotions and I worry that I shouldn’t feel sometimes the way I do things.”

[00:15:24] I think the number one thing I hear over and over again.. You know, we as children we’re not being able to fix what’s wrong. That’s one of our common complaints… Common ways we feel. Also guilt. There’s just conflict and guilt. You want to help. You want to be there for them, but then you want your own life. And then you feel guilty because you want your own life.

[00:15:57] I was out to dinner with a friend the other day, and her parents have been gone probably for about 10 years. And so you think… You know she isn’t thinking about any decisions that were made. You know, it’s 10 years ago. And I was talking to her and she was asking me how my parents are. They’re great, you know. I just wish they were closer to me, because that would make it easier for them, for me.

[00:16:28] And she said, you know with my mom and dad we moved them, because my sister and I, we were constantly traveling to their house and trying to do things for them. And I was never home at night, weekends… We both worked etc., she said. And then we finally, my sister built an area, I guess a suite, for her parents. She said. And we moved them there. And she said it was so much easier because you know they were right in my sisters home. And she said, after my dad died my mom was saying to me that, “I just wanted to stay home.” She said, “And I felt terrible,” she said.

[00:17:12] And I said to her at the time, “But you are so fortunate that you have a daughter who you know did this for you. Who made you this suite of rooms and moved in and takes care of you and it never hit me at that time that she just wanted to stay home. She said, I feel so guilty. And I said, oh my gosh. You know the decisions that you make. You make at the time and you have to believe that the right decisions, because at this particular time, I said to her, in your life, that was the decision that you made, and you included your mom and dad in it. And maybe after your mom, after she did it, things happened and your dad died, she might have thought, “jeez I just wanted to stay home,” or maybe she felt that way all along, but didn’t voice it.

[00:18:08] But you make the decisions you do with the time with the information you have with the availability and how things are going to work and how you think they’re going to work for everybody involved. And, I said to her… You did the right thing. My gosh, your sister and you took care of your parents. There are some people who wouldn’t do that. And your parents were very lucky that your sister took them into her home. So you can feel guilty. My gosh… I feel terrible that ten years later she feels this way.

[00:18:40] So, you know, this is tough. This is tough for us because you’re thrown into a job, you know, sometimes. You have no training. You’re thrown into something that you know nothing about. And this sometimes becomes a part time job, a full time job. And you know what… Sometimes you feel there’s no way out or it’s never going to end. And sometimes it can go on for years. Our Parents are living longer, so this is all new. It is not new, but it is new… To all of us. So, I trust you make the best decisions you can, and you’re listening to me, and I’m sure you get information from so many sources, so many resources and you try to do the best you can with the information that you have. So, that’s what you can do.

[00:19:39] You’re doing the best you can. And sometimes… One thing that a lot of people say is they don’t feel appreciated, and I think, sometimes like we do, we don’t always tell people how much we appreciate them or sometimes what they do for us. We don’t know we say it and we think… They know we feel that way. Sometimes our parents may think that you know. Sometimes maybe our parents are incapable to tell us that, but they do appreciate you.

[00:20:31] So… I think those are the most common things that we all feel the same way. And just remember your doing this and you know it’s your parent and you’re doing the best you can and you’re trying. And that’s the most important thing.

[00:20:25] And now we have another e-mail… Totally different kind of e-mail… This is from Michelle from Stratford New Jersey.

[00:20:35] “Can a parent live in an assisted living facility if they are wheelchair bound?” [12.6] [00:20:42] Well… Now remember, nursing homes are mandated and governed by federal regulations, but assisted living facilities they operate under State laws, which do vary. So there’s a lot of cases popping up now and I think there were several. Even in New York state where… There’s cases where assisted livings are discriminating against people with disabilities or some saying that wheelchairs aren’t permitted.

[00:21:10] So, in an assisted living a lot of them have apartments where they encourage independence. And some say that you have to be mobile that you you can’t be in a wheelchair. Then they have nursing homes that may be attached to them, memory care facilities. So, some say you know that they cannot accommodate a wheelchair bound person. I think it’s Oklahoma Alabama… They require residents to be ambulatory but like Kentucky will allow admission if you use a walk or you use a wheelchair.

[00:21:52] Some states say you have to be able to evacuate by yourself. So that would mean, in other words, no wheelchair.

[00:22:02] Some assisted living say a wheelchair is not prohibited. But the person has to be able to transfer from a bed to a chair, to their wheelchair and they can can do that with the assistance of one person. But if you need two people to assist you then you can be in the assisted living. Or if you are not weight bearing, because that would then exceed your licensure and then they wouldn’t be licensed as an assisted living etc..

[00:22:34] So they’re all worried about, you know, if something happens… When You have assisted living facilities and then they have the nursing homes, there’s a lot of…just Off the top of my head… Two couples that I had dealt, with where they went into an assisted living together but then one of them maybe needed a wheelchair or became bed bound and they could not stay in that apartment anymore. So they had to be separated. So, one had to go to the nursing home and live, and one lived in the assisted living facility.

[00:23:09] So you really have to be careful. Do all your research when you are looking into the assisted living facilities and even if your mom and dad they go into an assisted living facility, maybe one is using a rolling walk, or one’s using a cane, or maybe they’re both fine walking. But you want to ask that question… What happens later on? What happens if one of them needs a wheelchair? What happens if one becomes bedbound. Can they stay together? Those are questions that you want to raise.

[00:23:40] Very interesting article I was reading the other day. [00:23:43] “Can Yelp help you find the right nursing home?” [3.8] [00:23:46] So, researchers are looking at the ratings that the federal government does on that nursing home compare Web site… That is the federal government Web site about nursing homes. And they have a rating system up to five stars.

[00:24:01] So after 20 years, and all this money to create it it’s really just become a marketing tool. It’s kind of faulty. Because, what happened is this “nursing home compare” debuted in 1998. And then in 2009, they added this rating system after a senator complained at a congressional hearing that it was easier to shop for a washing machine than a nursing home.

[00:24:27] So they came up with this five star rating. So, on their site you’ll find they have hours of staff time per resident, per day… Deficiencies during their most recent inspection… And Medicare requires that they are inspected every 12 to 15 months. And then, how many residents have bedsores etc..

[00:24:49] Now they have two other categories… They have “staffing” category and a “quality measure” category but in those categories, the information is reported by the nursing home themselves. So of course, the results could be manipulated… Could be not trustworthy. So, let’s say even if these star ratings are accurate, there’s nothing saying how the residents feel or how the family feels about the facility. This is the most important part. This is what we want to know.

[00:25:44] The most well intentioned improvement efforts fail because we don’t consider the needs, preferences and the insights of who? The patients and their families, the clients.

[00:25:42] So we have all these systems and processes but we’re not thinking of the end user. We don’t see it from their perspective. So, that’s why we have all these things that are designed with application in mind that don’t help.

[00:25:56] So the “Nursing Home Compare” has no consumer feedback, of course. Why? Well… It’s expensive. That’s what the government says.

[00:26:07] Of course it’s expensive to find out… To get all this information from patients and families.

[00:26:15] So now Yelp got together with Pro Publica and they are now giving you more information.

[00:26:27] So if you take the information from Yelp and Nursing Home Compare, and Yelp joined with Pro Publica, and they made this other tool “NURSING HOME INSPECT.”.

[00:26:41] So you can gather all this information, but then you still have to do what we always said: you have to be the expert. You have to be the investigator. You have to visit the places. You have to talk to the patients. You have to go numerous times to talk to family and friends. You still have to do that, no matter what any Web site says…

[00:27:04] So remember, the very best conversations happen at Parents Are Hard to

[00:27:10] I Episode gave you some insight. And, Please… Please send your e-mails to us. Because whatever you’re asking can definitely help someone else. We’re all starving for community and connection. Please join us.

[00:27:24] Subscribe to our show on iTunes or I Heart Radio and I’d be so grateful if you share this episode with your family and friends. Episode 62.

[00:27:33] Parents Are Hard To Raise as a CounterThink Media production. The music used in this broadcast was managed by Cosmo Music, New York, New York.

[00:27:44] And I want to thank our New York producer Joshua Green, our broadcast engineer, Well Gambino. And from our London studios, the melodious voice of Dolly D. our Announcer.

[00:27:56] Thank you so much for listening. And I look forward to reading your comments. And can’t wait till we meet up again on the next episode of Parents Are Hard To Raise. Till then…

[00:28:14] May you forget everything you don’t want to remember and remember everything you don’t want to forget.

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