How to Start a Conversation with Elderly Parents about Care Needs

As parents grow older our concerns steadily build. Can they cope? Are they at risk? Does something need to be done?

Often, though, one of the most difficult problems is actually talking about it! We’re all too aware of the fact our parents are independent people and won’t like the idea of family ‘interfering’.

We know they have pride which can be hurt and perhaps most of all we know they spent years caring for us, making a conversation about reversing that role seem very daunting indeed.

Yet it does no good putting it off or ignoring it. Sorting out help where it’s needed and planning sensibly for the future are important priorities, so there are strategies families can adopt to raise these issues sensitively with elderly parents in ways that are more likely to be productive.
Read the full article here: http://www.nobilis.co.uk/feeds/information-library/how-to-start-a-conversation-with-elderly-parents-about-care-needs.aspx

Care at Home – What are the Options?

When age or illness make living in your own home a challenge it creates worry and stress for the entire family. You don’t want to leave your home or lose your independence but deep down you know something has to be done.
Fortunately there are many options available meaning you don’t need to take the extreme step of moving into a care home. As a society we are all living longer and consequently many services have been set up which provide the support you need to stay in the home you love.

Home Care Services

The first and most important step is to find a trusted home care provider. This will give the essential support you need to remain safe and comfortable in your own home. Home care services are incredibly flexible and can be adapted to your particular circumstances.

When you take on home care services a professional carer comes to your home to deal with day-to-day tasks. This ranges from personal care for you, such as washing and dressing, to household jobs, such as cleaning, cooking meals and shopping. Whether your needs are for just half an hour a week or 24-hour live-in care, there are providers who can help.

Read the full article here: http://www.nobilis.co.uk/feeds/information-library/care-at-home--what-are-the-options.aspx

Am I Entitled to Attendance Allowance?

Age and illness can place all sorts of restrictions on your life. You may find it difficult to get washed and dressed and even walking around can be demanding. Dealing with these limitations can be difficult and before long it becomes clear you need help. Fortunately, in many cases the state is able to assist with the expense of this, meaning at least money doesn’t have to be an additional worry.

Attendance Allowance is intended to help pay for the costs of care and supervision, making it possible for you to cope with the daily tasks of looking after yourself. It is solely for people over 65, so if you are younger you should apply for Disability Living Allowance, which is actually more generous and can continue after the age of 65.

Attendance Allowance is different from many other benefits because it is not means-tested, so your savings and income are completely irrelevant to the decision about eligibility. It’s also tax-free and you can receive it even if you haven’t made National Insurance contributions. This means it’s a benefit which often goes unclaimed by people who could be entitled to it, so...

Read the full article here: http://www.nobilis.co.uk/feeds/information-library/am-i-entitled-to-attendance-allowance.aspx

Getting the Elderly Online – Improving Quality of Life

Let’s be honest, apart from mobility aids we tend to assume the elderly and technology don’t make for a good mix. We think they’re unwilling to embrace new things and come from a generation which struggles with programming the video.

We’d be wrong. Facebook an elderly-free zone? Definitely not – over-65s are the fastest growing age group there. Online dating a younger person’s game? Think again – over 50s are joining Match.com faster than any other age group.

Society is slowly waking up to the fact that the internet is a place which can benefit everyone and that the elderly are using it more than ever.

It’s no wonder, since this is the generation which has most to gain. Many parents bemoan the fact their kids spend too much time online and ought to be outside playing and being active. For the elderly, opportunities for going out can become more restricted, making the benefits to be had from surfing much greater. So it’s time for the young to start bemoaning the fact their elderly parents aren’t spending time online! Indeed, you should do everything you can to make that happen!

Read the full article here: http://www.nobilis.co.uk/feeds/information-library/getting-the-elderly-online--improving-quality-of-life.aspx

Warning Signs in Elderly Parents – Changes to Look For

Everyone changes. You’re not the same person you were ten years ago and we all have moments when we think how great it would be to turn back the clock to days when we were fitter.

However, such change is natural and we accept it. With elderly parents, though, the situation is not quite the same. We know they are going to find life progressively more challenging, but we’re also aware there is a difference between the problems of natural ageing and other, more serious changes. The stumbling block is knowing when to raise concerns that something could be a sign of medical conditions in need of treatment.

This is made all the more difficult by many changes being so gradual you barely notice them, particularly if you see your parents on a regular basis.

Read the full article at http://www.nobilis.co.uk/feeds/information-library/warning-signs-in-elderly-parents--changes-to-look-for.aspx

OBR warns of big tax rises as population ages

Hot on the heels of the Dilnot report recommending additional spending on elderly care to the tune of an extra £1.8 Bn per year, the FT today discussed a report released by the Office of Budget Responsibility.  The OBR reported:

• Pressures from an aging population would require a tax rise of £22 BILLION per year in 2016, if the UK is to achieve a reduction of its public sector debt from 84.5 to 40% of GDP by 2060.
• This increase reflects increases in Health, Long term care, and state pension.
• The OBR also conceded that its projections were extremely sensitive to different assumptions, the most important of these is the assumed modest rise in health spending.  With a rate of health spending growth closer to the historical average, this would add a further 5% of national income by 2060

Clearly this would suggest that the "unmentionable issue" of ongoing state funding for long term care for an increasingly elderly population cannot continue to be pushed onto future generations through increased tax.  I have spoken in my last post about the very real need to unlock some of the property equity gains to self-fund care, but this only applies in the short term. 

So what is the longer term solution?  Many people are still unaware that there is a pensions change being phased in over a few years from 2012 that will require compulsory contribution pension to a "Personal account".  Starting at 1% each, this will grow to 3% contribution by the employee and 5% by the employer.  I believe that this is wholly inadequate, and we need to have genuine debate about the need for greater self reliance in our retirement years, and reducing the dependance on the state for care (as I have oft expressed I think that this can only be provided on a low-quality, low-price basis with increasing rationing).

Being Australian, I look to my experience there.  (There it is called supperanuation).  Briefly:

1.   The government in 1992 recognised the coming major demographic shift and introduced a similar compulsory contribution regime, of 9% (employer funded) and this is to shortly grow to 12% from 2013.
2,   The taxpayer-funded age pension still provides core funding for retirement. The Australian state-funded age pension differs from its counterpart in most other western countries, being both modest (27.7 per cent of average wages for a couple) and means-tested (against both the income and the assets of the recipient).   This policy ensures the age pension in Australia will remain frugal and targeted, and Australians seeking a comfortable retirement lifestyle need to save for it.
3.   Pension savings enjoy various tax benefits. Contributions are deductible (within limits) against taxable income; earnings on investments in superannuation funds are taxed at concessional rates; and superannuation monies drawn down in retirement are lightly (or zero) taxed.

In the UK I believe we will need a much higher level of individual pension savings before we can adequately meet the retirement needs of our ageing population.  As politically unpalatable as the issue may be, I think the OBR report shows that time is running out to address the issue.  Continuing to think solely in terms of taxation rises to fund continued state-provision have gone beyond simply delaying the pain, they now represent a major issue to the whole UK economy.  Please, will someone in government take this issue by the horns?

Elderly and Driving – Do You Need to Act?

It’s a difficult decision. You know how much driving means to your mum or dad. It provides freedom and independence; it improves quality of life; and very importantly, it is a matter of pride.
Yet you’re also beginning to suspect age or illness could be making driving hazardous for your parent – and consequently for other drivers and pedestrians.
As with so many decisions you make in relation to family, it’s hard to detach yourself from the emotional issues. This can apply to both sides of the argument because it’s not just the fear of taking away something important from your parent. The news features alarming stories of the confused elderly driving the wrong way down motorways and even tragic tales of older drivers running over their own partners in driveways by pressing the accelerator instead of the brake or selecting reverse by accident. Of course such stories can make you worry, but the important thing is to consider the question in a balanced way.
There are many people in their twenties who are far more dangerous than drivers in their eighties or nineties who are still perfectly safe behind the wheel. In fact, by taking an active concern you could make differences which keep your mum or dad driving for many years to come.
So, what should you focus on and what action can you take?

Older Drivers Checklist

Eyesight
Probably the most common problem for elderly drivers is vision. Make sure your parent has regular check-ups with the optician and if glasses for distance viewing are needed they wear them! Various eye conditions such as cataracts, macular degeneration, glaucoma and diabetic retinopathy can all have an impact and often because deterioration is gradual it may not be obvious to the sufferer. It could be an idea to suggest your parent doesn’t drive at dusk or night-time if eyesight isn’t what it used to be.
Hearing
It’s easy to overlook how important good hearing is for older drivers. Make sure your parent’s ability to hear is adequate for safe driving.
Physical Ability
Even with power steering, driving requires a good level of dexterity and strength in both arms and legs. This may be an area to consider if you notice any weakness or problems with movement. Sometimes just making sure parents get enough physical activity can help strengthen muscles and dexterity, extending their driving life.
Also take a look at how your parent sits in the car. We all shrink a little with advancing years! Does the seat need to be raised or moved closer to the wheel? Is the rear-view mirror properly adjusted?
Diseases
If your parent suffers from a disease consider the impact of any symptoms on driving. Alzheimer’s disease creates confusion whilst those with severe diabetes could fall into a coma. If you have any concerns you should discuss them with your parent’s doctor.
Prescription Drugs
Medicines obviously help people, but even very common drugs have side-effects to consider. Feeling drowsy or having a slowed reaction time can create serious problems on the road, so read the leaflet that comes with your parent’s medication carefully and discuss any effects they have noticed.
Crucially, if your parent is taking various different medications – some of which their doctor may not be aware of – the interaction of these drugs can cause unexpected side-effects. It’s worth writing down everything your parent takes and checking with the doctor whether any problems could be created.

What Can I Do to Check Mum or Dad’s Driving?

Considering all the above is important, but the bottom line is what your parent is like on the road, so what should you do?
Think While You’re a Passenger
If you don’t normally ride as a passenger with your parent it’s a good idea to find a reason. You can, of course, just tell them you’d like to see how they’re getting on with driving, but you have to judge how they might react to that. It could be that making it seem like a ‘test’ will make them nervous and affect their driving.
You should think about all aspects of their driving:

• How confident are they on the road? Are there any signs of confusion?
• Do certain driving situations cause difficulty, such as junctions or roundabouts?
• Do they keep a good road position? Consider drifting within lanes or coming too close to parked cars.
• Do they indicate and turn/change lane in a safe manner?
• Do they keep a safe distance from the car in front?
• Is driving speed good? Remember very slow drivers can also create a hazard.
• Do they find it easy to turn the steering wheel or change gear?
• Do they scan the road properly, including using mirrors?
• Can they reverse safely?
• Can they cope with very bright or dim light?

If you have any concerns then it’s time to talk. Often this can just be a matter of reminding them about good driving practice to keep them and others safe. After many years of driving we all fall into bad habits! If it’s more serious then you have to consider as a family what’s best and consulting the doctor may once again be important – not least because this helps take out the emotional element for both you and your parent.
Check the Car
Now and again just take a quiet look at your parent’s car. Have there been any scrapes or dents? This could be a sign of driving difficulties.
You should also make sure the car is fully roadworthy – check tyre pressures, treads and oil levels.
Take Positive Action
Talking through your concerns is a positive thing to do and can actually help keep your parent on the road. If you have seen issues which worry you then act. Constructive advice for your mum or dad can improve their driving and did you know many driving schools offer courses for older drivers? This can be the perfect way to sort out those problems and help your parent keep his or her independence.

My Parent Ought to Give Up Driving – What Should I Do?

All of the above should help you in coming to a decision, but if you feel it really is time for your mum or dad to stop driving this is incredibly difficult, so how should you approach it?
Firstly, be sure. Mild problems should not lead to overreaction. Remember what a difference this will make to your parent’s life.
It’s important to deal with this as a family, so make sure everyone’s on board. There is no perfect way to raise this with parents – so much depends on the personalities involved – but the important points are:

• Stress how this is a question not only of their safety, but that of other road users and pedestrians.
• Talk though the specific facts which have led you to this decision.
• Make sure you include positive alternatives. Maybe the family can pull together to ensure plenty of people are available to drive them. Have clear information about the schemes in your area to help the non-driving elderly, such as volunteer hospital drivers. The more you can provide options to reduce damage to their lifestyle the better.
• Involve the doctor. He or she will provide the objectivity which may help convince your parent it’s time to hang up the keys.
• You could be surprised. In many cases elderly drivers have had concerns themselves or even had frightening near-misses which they haven’t shared. Sometimes a loved one raising their own concerns can be the push they secretly wanted to call it a day.

The bottom line is that given the choice of limiting your parent’s independence or seeing them badly hurt it becomes clear there’s actually no choice at all.
Do all you can to help your parent stay driving safely on the road, but when it’s clear that time’s up you can’t afford to put it off. The difficult decisions are almost always the most important ones.

Honest and Caring Advice

At Nobilis the elderly matter, but so do their families and we do all we can to support everyone in the difficult situations brought on by age.
If this article has raised questions or concerns you would like to discuss our friendly team has a great deal of experience. Whether your loved one is being looked after through our in-home care service or not, we’re happy to take some time to discuss any issues you may have about elderly driving problems.
Have a supportive and informative chat with us on 0845 680 0225