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Chapter 11

Practicing Great Family Relationships in a "Sandwich Generation"

In This Chapter

  • Understanding the challenges of aging

  • Providing care for the elderly - and the caretaker

  • Planning a fabulous family reunion

For most people, reaching their 50s means that they find themselves living a "sandwich generation." Most middle agers' parents are now elderly and may require assistance to live independently, and at the same time, these middle agers are trying to stay connected with their children who are no longer children, but adults who may even have kids of their own.

This chapter gives you some tools for understanding the various generations (particularly the elderly) and the challenges they face, as well as some tips for taking care of yourself in the process. The chapter also gives you some ideas for how to plan a family reunion - a great way to have some fun and stay connected with all the generations.


Recognizing the Challenges of Aging

People over 65 are more diverse than people in any other age group. The varied lite experiences of those who live a long time probably account for much of the individual uniqueness. People also age in different ways. Some folks remain healthy and active into their 80s, while others _become frail early on. Even within every individual, organs age at different speeds. For example, Dad's ticker may be strong, but his digestive system may be falling apart.

Here are some situations to be aware of:

  • Slowed reflexes, memory lapses, and "senior moments": Even in the healthiest people, strength, flexibility, and reaction time diminish with age. The decline actually starts when you're a young adult but isn't noticeable until middle age, when knees aren't what they used to be and pesky memory lapses (senior moments) appear.

  • Diminished senses: In the normal healthy older adult, the five senses (vision, hearing, smell, taste, and touch) tend to decline somewhat with age. A dulling in the perception of pain (the sense of touch) may cause an elderly person to ignore a bedsore, burn, or other injury increasing their risk of serious infection or disability.

  • Age-related disease and disability: Lots of diseases strike older people more often than younger people. Interestingly, the same illnesses may pro­ duce different symptoms in older people than they produce in younger adults. For example, an underactive or overactive thyroid may cause con­ fusion in an older patient but not in a younger one. When the confusion is mistaken as dementia, the elder may be unnecessarily institutionalized and the underlying illness left untreated.

  • Changed family relationships: A parent who can't take care of himself or herself rattles the foundation of the family. Sometimes loved ones rise to the occasion with calmness and cooperation. More often, long-forgotten childhood rivalries and jealousies raise their ugly heads, creating chaos and strife.

Avoid the mistaken belief that taking care of your frail parent is "parenting your parent." Even though many eldercare tasks are the same as childcare tasks (feeding, bathing, toileting), emotionally your elder is still your parent. Trying to parent a grown-up (by speaking to him or her like a child, for example) ends up with the parent feeling insulted and angry and the caregiver feeling frustrated and ineffectual.


Acknowledging that help is needed

Sometimes, admitting to yourself that your older person is failing is tough to do, especially when that person assures you that everything is fine and dandy. But taking early action prevents more serious problems. If you observe the following warning signs, a thorough assessment of your older person's situation is in order:

  • Extreme clutter, especially in a former neatnik's home

  • Clothes strewn about

  • Items that used to be in drawers and cupboards now crowding countertops and other surfaces

  • Medication bottles left open

  • Uncertainty about what medications he or she is taking, and when and why medications are supposed to be taken

  • Unfilled prescriptions

  • Unpaid bills

  • Penalties for overdue bills

  • Dunning bill-collection notices

  • Disheveled and dirty clothes

  • The same outfit worn over and over again

  • Dangerous driving

  • Unkempt hair

  • Body odor (indications of Ioss of bowel and bladder control or difficulty bathing)

  • Bad breath (inability to brush or floss, gum disease, or infection in nose, throat, windpipe, or Iungs)

  • Not much food in the house

  • No nutritious or fresh food in the house

  • Decayed food in the refrigerator

  • Burnt pots and pans

  • Confusion, sadness, anxiety, no interest in friends and former pastimes

  • Evidence of falling prey to a telephone scam or door-to-door fraud

  • Compensation for losses in sometimes clever but dangerous ways

  • Bruises on body (could be a sign of falls)

You're always best to double-check. Ask neighbors and friends if they've observed similar problems or have concerns.


Making an assessment

When your elder appears to be struggling with some tasks but you're not sure if you have the full picture, the time is ripe for an organized assessment of his or her capabilities. The key to locating trouble spots is to list all the basic activities that people need to do to keep themselves healthy, safe, happy, and financially solvent. Then go down the list, one item at a time, determining whether your elderly person can manage each item without help.


Understanding your four options

Eldercare involves an ever-changing set of chores. Needs almost always grow.

As frailty increases, more decisions about care need to be made, such as:

  • Remaining in his or her own home: Most Americans want to "age in place," but doing so may take creative thinking. Like all adults, elders want to be surrounded by their own things and enjoy the freedom and privacy to do exactly as they please.

  • Living with you: When worrying about your mom affects your work and a phone ringing late at night gives you the shudders, entertain1ng thoughts of moving your elderly parent into your own household is only natural. The arrangement has its benefits, to be sure. Providing care yourself is less expensive than hiring others. Having mom dose by can alleviate your fears that she will burn her house down, not eat properly, or forget to take her medication. Such a move may seem especially right when a parent loses his or her spouse and is depressed and lonely.

  • Assisted living: Approximately one million elderly reside in assisted­ living facilities. The premise behind this option is that living in a home­ like group setting (with a menu of services available) enhances and extends an older adult's ability to live with dignity. Residents have private or shared rooms and receive only the services that they need or want. Services (some requiring an extra charge) include meals, house­ keeping, laundry, transportation, recreational activities, shopping assistance, and reminders to take medications. Assisted-living facilities do not provide medical care.

  • Nursing homes: Some people go to nursing homes for a short while to recuperate after a hospitalization. For the elderly who become residents, the nursing home will be the last place they'll live. We know of no nursing home residents who live in nursing homes because they simply like the lifestyle. They live there because their medical conditions are such that they need to have skilled nursing care and supervision within reach 24 hours a day.


Four ways to enhance the quality of life

The average life expectancy in the United States today is 72.5 for men and 79.3 for women, which averages out to 76 years. By 2050, the average life expectancy will be 80 years. You may have to take an array of pills to control a collection of chronic illnesses - but life will be long.

The now-important area for research isn't to keep people living longer (that's pretty much been accomplished!), it's to help them to make those extra years as good as they can be by doing the following:

  • Retaining health: Getting sufficient sleep, exercising regularly, eating a well-balanced diet (including breakfast), and not smoking help ward off disease - important advice at any age. Having a satisfying relationship with those closest to you has been shown to also be a factor in health promotion and disease prevention for the age-advantaged person and his or her caregiver.

  • Understanding emotions: Sometimes it's clear why grandpa is depressed or worried - he's lost his spouse, his health, or his confidence. On the other hand, it's sometimes a mystery. Sadness and apprehension can come without warning, seemingly unrelated to anything in daily life. Identifying and treating emotional upsets takes some investigation, perhaps medical intervention, and a whole lot of love and patience.

  • Keeping your loved one out of harm's way: A kitten underfoot, throw rugs, appliance cords tangled up like spaghetti, and shag rugs on stairs are accidents waiting to happen. A kitchen fire or a broken hip can signal the premature end of independent living. Elder-proofing mom's home can add months and years to her autonomy - and who knows how many gray hairs you will have saved!

  • Taking advantage of assistive devices: Resist doing things for your elder and help him or her devise ways to be more independent. Point out that most older people have some difficulties, but that today is a wonderful time in which many gizmos and gadgets can extend independence and preserve personhood.


BOX: A rose by any other name

Some find the term "old" insulting, while others wear it proudly. Ask your elderly person how he or she likes to be thought of. Consider the following terms:

  • Senior

  • Senior citizen v' Older person 1"" Older adult

  • Oldster

  • Elder

  • Old-timer

  • Golden-ager

  • Grandpa

  • Grandfather

  • Pop

  • Grandma

  • Granny

  • Auntie

  • Patriarch

  • Matriarch

  • Age-advantaged person

  • Long-living person (not to be confused with a "long liver," short kidney, or any other misshapen organ)


Preparing for a meaningful goodbye

Helping a dying person remain lucid and pain free in his last months, weeks, or hours of life opens the way for a dignified death. With pain management and comfort as priorities, the stage is set for richly meaningful discussions between the dying person and his loved ones. Elders and the family share past hurts, regrets, and unexpressed love, and ask for and return forgiveness.


Surviving caregiving

Eldercare is difficult. Shouldering the work by yourself is like being "it" in the game of tag. If you're lucky or swift, someone else will take his or her turn.

Lots of caregivers remain "it" simply because no one else is within tagging distance or because they don't know how to get anyone else involved in the game. As your elderly person grows ever more frail, the health, sanity, and well-being of you and your immediate family depend on getting others to pitch in. Anticipating the situations you're likely to encounter can help a lot, too!

Unlike professional caregivers who go home after their shift, you're always "on call," facing some of the following situations:

  • Handling a resentful spouse and angry children: Every hour spent on caregiving represents an hour you don't have available for family and friends (for example, less time to attend hockey games, less time to help with homework, and perhaps less time to share a hobby or interest with your partner). It's natural for your family members to start to feel cheated, even if they don't admit it. One solution is to include a spouse and kids in eldercare to enhance their understanding of the demands you face every day. Make it fun. f or example, grandchildren love assisting with exercise. They count the repetitions and cheer Grandpa on. Young teenage girls may get a kick out of doing their grandma's nails. Not only does it lighten your load a bit, it helps young people become more compassionate human beings.

  • Feeling unappreciated by the rest of the family: lf you're the one who takes care of most of your elder's needs, others may eventually take your hard work for granted -               especially when you do the job so well. Over time, you may begin to feel unappreciated and believe that sacrificing your life is your only option. You may find yourself dwelling on all the things that you're missing because eldercare dominates your days. Consider joining a support group. Your despair will be met with emotional support and helpful resources and ideas.

  • Feeling unappreciated by your elder: A lack of appreciation by family members stings, but criticism, complaints, and the Jack of gratitude from your elder cuts even deeper! lf you're in this situation, you may find your­ self visiting less and offering less care, even though the age-advantaged person needs it as much as ever. Share your pain with someone dose and take an objective look at the situation. lf the older person has always been ungrateful, it's unrealistic to expect anything different now. lf the oldster is newly unappreciative, cruelly critical, or apathetic, it's her illness making her so.

  • Making do with lower future earnings: Eldercare responsibilities lead to stress-related illness, lost time from work, lost career opportunities, and poor productivity on the job – all bound to affect earnings. Approximately one-third to one-half of all caregivers are employed. Under the 1993 Family and Medical Leave Act, companies with 50 or more employees must allow up to 12 weeks of leave for employees to care for a seriously ill parent or spouse. The leave is unpaid, but your job is secured. lf your elder's problem is a time-limited acute illness (heart attack) or condition (broken hip), and you can manage 12 weeks without pay, take advantage of family leave. Ask your boss whether you can take your 12 weeks in small chunks. Ask the Human Resources department at work for information about family leave, flexible work hours, or job sharing.

  • Suffering from unemployment: Approximately 12 percent of working caregivers eventually find they have to quit their jobs to provide full­ time care. Sometimes the people receiving the care want to make up the lost wages but they don't have the money. Even if they do have the money, an unwritten code says that accepting pay for family care is wrong. A study actually attempted to tally up how much all this free care (to impaired relatives of all ages) would cost if families had to pay for it. They estimated that the services provided each year are worth a whop­ ping $196 billion. A full accounting of your lost income as well as the cost of care (food, medication, transportation, and formal services) should be on the family conference agenda.

  • Dealing with feelings of guilt: The bane of eldercare is that no matter how much you do, you always feel that you could have done more. Even worse is the guilt felt when angry words toward the elder occasionally leap from your lips in the frustration and fatigue of the moment. Be realistic - you can't change your feelings. Nasty feelings are occupational hazards. Ali caregivers have them! Realize that you're doing the best you can with what's available. Think of unpleasant emotions as clouds that float in and float out. One goes away only to be replaced by another. Your guilt will flow in and out along with other negative and positive feelings.


When you live far away

The following suggestions are for the far-away caregivers who are trying to do it all:

  • Resist the "relocation reaction." Before moving your elder to your home, allow lots of time to consider other options.

  • Do an on-site comprehensive assessment of your elder's situation.

  • Arrange for home healthcare providers and special programs like Meals on Wheels and transportation services for the frail elderly.

  • Enlist family members and friends to fill in the gaps.

  • Ask neighbors, friends, or relatives to visit your elder regularly to spot problems impossible for you to detect by phone, such as mail or news­ papers piling up outside the home.

  • Contact the local postmaster. Informing the local letter carrier that a frail elder is on her route may encourage her to report worrisome signs on the property.

  • Tell the local police department that an elder lives alone in the community. This knowledge may encourage officers (especially in small towns) to give the oldster a little extra attention, like checking up on him during heat waves, cold spells, earthquakes, hurricanes, and tsunamis (huge sea waves caused by under-ocean disturbance).

  • Check with local utility companies, which may have "elder-watch" pro-­ grams designed to be sensitive to signs that something may be amiss with an elderly person or couple.

The following suggestions are for faraway caregivers who play second fiddle to the primary caregiver but nevertheless want to help:

  • Save vacation days and personal holidays for emergency visits.

  • Squirrel away funds for crisis air travel (or save frequent-flier miles).

  • Check your airline to find out how to get a ticket on short notice. Frequent-flier programs vary, and airline policies change frequently, but agents will try to help you plan for emergency travel - before the emergency!

  • Don't wait for eleventh-hour predicaments. Visit as much as possible. Call often.

  • Give the primary caregiver a welcome break by bringing the elder to your home or staying with her in her home.

  • Avoid stepping on the primary caregiver's toes. She is closest to the situ­ ation and knows things you don't. Be diplomatic. Tread lightly when dis­ agreeing or intervening.

  • Offer to research these areas:

    • Medical conditions (a task made in heaven for Internet surfers!)

    • Assistive devices (a task made in heaven for technology freaks!)

    • Benefits and entitlement programs (a task made in heaven for number crunchers!)

    • Health and social services providers (a task made in heaven for born organizers!)


Rotating care when necessary

Handing off caregiving chores to others can help you survive. As long as Mom agrees and doesn't get stressed out by travel or adjusting to different settings, six months at her daughter's home and then six months at her son's place can be fun for her and doable for both families. Family members can also take turns helping Mom in her own home. Here are some tips for making it work:

  • Don't allow offers of help to dry up. Every time someone offers, respond graciously with a specific task. Keep a list in your pocket or purse for just these occasions and add to your "chore list" whenever you think of something that needs doing.

  • Keeping uninvolved relatives in the loop about medical conditions, treatments, and finances increases the likelihood of their involvement. At the very least, it prevents later complaints that "nobody told me" or "I'd have never agreed to that had I known."

  • For elders who suffer from confusion, don't rotate personal care (bathing, feeding, dressing) unless absolutely necessary. Otherwise, you may find that your older person's symptoms worsen, and his or her emotional upsets become more frequent. Instead, focus on rotating behind-the­ scenes activities (making doctor's appointments, keeping financial records, hiring help, shopping, and emotionally supporting the primary caregiver).


Organizing the Perfect Family Reunion

Family reunions are a great way for all the generations to reconnect and reestablish family ties. You may have elderly parents, children, and grandchildren - and maybe even great-grandchildren - who would enjoy the opportunity to spend a day learning more about each other.

Family reunions come in all shapes and sizes, from small groups of immediate family to large groups pulled together from all corners of the globe. Family reunions can be as simple as a handful of kinfolk getting together fora backyard barbecue or lakeside picnic, or something as elaborate as a catered affair for hundreds of family members in a convention center or hotel ballroom.


Great reasons for having a family reunion

Having a family reunion is a simple way for kinfolk to reestablish family ties. But most families have a "big why"-                a main reason - to hold a reunion. Some families have a big why because it makes the amount of time and money spent on the reunion easier to justify.

You can choose from many big whys to have your reunion. For example, sup­ pose that

  • Granny is celebrating her 100th birthday.

  • Beth is graduating from medical school.

  • Pops is retiring.

  • Aunt Suzie and Uncle Joe are celebrating 50 years of marriage.

These examples are terrific reasons to hold a family reunion.

Consider having a theme for your reunion. Simply getting a bunch of people together for a meal or a barbecue can be boring. Having a theme livens things up. Perhaps your great-grandparents carne from the "old country," or maybe your relatives are chicken eaters and like to get together for grandma's famous fried cluck. Use these common bonds to your advantage.


Seven steps for planning the big event

The type of reunion that you plan depends on the number of people attending and the activities involved. For example, activities like a friendly game of croquet or kick-the-can call for a casual atmosphere, whereas a ballroom­ dancing competition calls for more of a shooshefafa (a silly pet term fora gala affair) atmosphere complete with black ties and evening gowns and some cute little finger sandwiches that barely fill a hole in your tooth.

Here's a list of things to plan for:

  • Figuring out who to invite: Here's a simple trick for formulating a guest list for a reunion: Compile the guest list based on a common or unifying factor. Having a common factor makes the reunion more enjoyable because everyone shares something special.

  • Locating everyone: Sometimes finding the clan can make the reunion planner (you) feel like a gumshoe in a detective movie. Folks move or disappear from the family holiday card list without a trace. Start with your immediate family and folks you know, and you may be surprised who among the missing turns up. The Internet is a great tool for finding people, too.

  • Pondering the time and location: Most family reunions take place during the summer, which makes it easier for families with kids and usually means that the weather will cooperate. For the location, you can choose from a wide range of options, from hotel ballrooms to camp­ grounds or the good old backyard. Wherever you decide to hold the reunion, be sure that the place can accommodate the guest list.

  • Organizing the big event: Family reunions are big events - usually too large for one person to manage efficiently. You may need some help. You can find that help in the form of reunion committees, which are groups of fellow kin that you put together to help you hash out all the reunion details.

  • Keeping everyone busy: A successful reunion needs activities. These activities can be as simple as storytelling and scavenger hunts or as energetic as carnival-sized games and the family Olympics.

  • Feeding the tribe: Everyone loves to eat. Your family reunion is a great time for everyone to show off their cooking skills by participating in a potluck meal. If you're not into potlucks (or cooking), you can hire a catering service to provide the eats.

  • Cleaning up the mess: Reunions are messy affairs, so prepare yourself for some hefty cleanup! Keeping your reunion site tidy makes the cleanup easier; for example, consider setting up areas for recycling and diaper changing.


Planning a family reunion on a budget

Staying close to family is a high priority, especially as you get older and all your kids spread out across the country. Check out these sites for bargain ways to bring them all back home: Just being well-organized can save you money. Use this helpful site to create a budget, secure food options (potluck, restaurant, or caterer), plan activities, decide on the guest list, find a location, select the date, choose a theme, form committees, and find lodging and travel. And if the info here isn't enough, post to the message board to get help from others. Don't you feel more organized already?  lf your family reunion is quite large and the details are getting out of hand, you might want to check out this family reunion soft­ ware. It helps you organize family and individual information in an address book, track your budget and expenses, make a schedule, create a family reunion Web site to let everyone know what's going on, plan themes and activities, and keep track of each person's assignments. You can review the free trial version or spend $30 for the full software. This site lists resources for caterers, hotels/lodging, decorations, party rentals, and other essential reunion needs. You can also post announcements or have family members take a poll to give you helpful feedback. Finding lodging for everyone can be a trying experience. At, you can post your family's lodging reservation needs and let hotels begin bidding rates for your rooms. Compare direct price quotes from aver 50,000 hotels worldwide without any obligations - and it's free. An important part of many reunions is recording family history and memories. Take a look at this easy-to­ use system for organizing and documenting your family's history. The system tracks all types of information about your family ­ dates, places, facts, and events of all kinds! You can then create pedigree charts, descendant charts, and family group sheets, as well as address labels, anniversary lists, and photo charts. The system runs about $30. lf you really want to plan as little as possible, consider a family reunion cruise. Cruising can be a great vacation value because the price includes all meals and entertainment.





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