As our parents age, chances are that we will find ourselves switching roles; we are no longer just their child, we are now their caregiver. This change in roles can be confusing for both the parent and the child.
Add the wide variation in the aging process; some adults remain physical active and mentally acute throughout their life, while others struggle with physical and mental health issues, and the situation becomes even more complex.
To be able to provide for our parents, we need a better understanding of aging. We need to know whether a change in activity, behavior or health is part of “getting older,” or a symptom of an illness.
Listen in as Jan Osborne, APRN, explains that by listening to our parents and understanding their needs, we can help them live longer, healthier, better quality lives.
Things You Should Know About Your Aging Parent
Featured Speaker:
Jan Osborne, APRN - Gerontological Clinical Nurse Specialist
Jan Osborne is a gerontological clinical nurse specialist at Unity Hospital in Fridley. She is the nursing coordinator for the Nurses Improving Care of Healthsytem Elders, NICHE, program working to improve geriatric care housewide. She was influential in establishing Allina's first Acute Care for Elders, ACE, unit at Unity. Her practice includes patient consultation for patients with delirium, dementia and management of geriatric syndromes, and site lead for fall prevention. Transcription:
Things You Should Know About Your Aging Parent
Melanie Cole (Host): As our parents age, chances are good that we'll find ourselves switching roles. We're no longer just their child, we're now the caregiver. This change in roles can be confusing for both the parent and the child. My guest today is Jan Osborne. She's a gerontological clinical nurse specialist at Unity Hospital in Fridley, part of Allina Health. Welcome to the show, Jan. What's the most important thing? What do you tell people every single day about aging, that can help us better care for our parents?
Jan Osborne (Guest): Well, thank you, Melanie on having me on this show today. I'm very excited to talk about the older adult and aging. I think the number one thing that most people don't understand is that as we age, older adults don't show the same symptoms of illness that a younger adult may show. The first sign of an illness may be a fall, or a new confusion, or just forgetting to take their medication. So, I think sometimes that gets it's overlooked as a sign of an illness. It's called “atypical presentation of disease” and older adults may have that type of symptom instead of a high fever, instead of a cough. They may have a fall or a confusion as the first sign of an illness.
Melanie: So then, if you're dealing with your parents, one of the things that people run into on occasion is that resistance of their parents to let them help if they fell or if now they maybe need the bathroom to be redone and bars in the shower. There's a resistance there, Jen. What do you tell people about dealing with that resistance?
Jan: I think that it's very important to let your parents have control and show to them that they're in control of their life and their health, and you are there to help them. I think many older adults feel that if you tell someone that “I've fallen or I've forgotten to take my medications” that they're going to put you in a nursing home, and there's a big fear of that. We don't want to put our older adults in nursing homes; we want them to age in place. Part of that aging in place is keeping their home safe for them, having someone to come in and look and see if their home is safe by picking up loose rugs, giving them a bar in the shower to hold on to. If we focus on that and have open conversation with our parents to let them know that we're on their side. I think that goes a long way with the older adult.
Melanie: Another thing people run into is the big driving thing, Jen. So, you know, your parents and you get to be middle-aged, so you're that sandwich generation, and all of a sudden now, maybe your parents shouldn't be driving any more. How do you start that conversation with them?
Jan: Yes. I think that conversation has to start with your parents because you want to let them know that they're still in control of their lives. Ask them if they have any concerns about driving. I think one of the things that older adults can do proactively is to have their vision checked annually to make sure that they are seeing properly when they drive. Older adults may limit their driving when they know that they're having problems. They may just stay in their neighborhood. They may just only go to the grocery store and back, another way that we can tackle this is talk to the primary care physician about, “Do you think I should be driving?” So many times, the daughter or the son may send a letter to the physician saying, "I have concerns about my parents' driving," and that physician could perhaps do some type of testing with them or send them to a driving evaluation and have that done. Many times it's become quite a tug of war between the children and the parents about taking away the keys. So, that's a very tricky situation and it’s not a very easy one to take care of.
Melanie: Jan, parents' personalities start to change and we've heard that sort of old myth that if you were a sweetheart in your younger days, you turn a little bit meaner as you get older and vice versa. Is that true and what do you tell people about the changes that happen in personalities as people get older?
Jan: Well, usually as we get older our personalities stays the same. That is consistent throughout the lifespan. But, if you notice a distinct personality change, then I think it could be due to many reasons. It could be due to chronic pain that they're suffering from and that they're not mentioning to anyone and they're suffering underneath their personality. Or, it could be just changes in the brain which could be a sign of a mental health issue. So, I think it's something that you'd want to go and have their primary care physician check out. Just have a visit and talk about things like maybe anger or paranoia or fear, something that they can talk about with their primary care physician. They may not want to talk to their children about it, but they may want to talk to a mental health professional.
Melanie: What about sleep? Does that change as we age? Do older adults really need less sleep?
Jan: Well, sleep does change as we age, but the one thing about sleep that does not change is the amount of sleep we need. We definitely need 7 to 8 hours sleep as we get older. When we do get older, our sleep becomes more light. It becomes a little bit more difficult to fall asleep and then stay asleep. We may wake up in the middle of the night more easily. We don't have that deep sleep as we age. One of the things that impedes our sleep as we age is the amount of time that we need to get up to urinate during the middle of the night. For some reason, older adults produce more urine over the nighttime span than younger adults do. And so, we want to limit our fluids just a couple of hours before we go to bed, maybe put our feet up on the lounge chair at that time, too. Then, try to urinate before bedtime and then try to get a good night's sleep. When you get up 1 or 2 times a night during your sleeping time to urinate, that can really impede your sleep and really makes you feel crummy the next day.
Melanie: When the time comes when you feel your parents need either a caregiver or to move into assisted living, tell us how to begin that conversation.
Jan: Well, that conversation should be probably started well before that process ever happens. I think it's always good to talk about, as we get older with our parents, when they're starting to get older, not when they probably need to move the next week. So, having that open conversation, saying, “What would you like to see as you get older? Where would you like to live when you feel that you no longer can work this out yourself?” I think it's that process of communication and talking to your physician and knowing the resources in your neighborhood. We have a Senior LinkAge Line that is a 1-800 number that you can call, and it can really connect you to all kinds of services in Minnesota from home care to housekeeping to meals delivery. So, that can be a very helpful free service provided by the Minnesota Board on Aging.
Melanie: that Senior LinkAge Line is 1-800-333-2433. That's 1-800-333-2433. So now, tell us about some of the things at Allina that can help people who have aging parents.
Jan: Well, Allina has a very good website on health issues. You can go to AllinaHealth.org and listen to different podcasts, look at different diseases and issues. Allina Health hosts a Stepping On program, which is an outpatient or “open to the public” falls prevention program for older adults. It is for older adults to prevent falls by teaching them how to walk in the community, the types of shoes that are best for support for adequate walking, teaches them what medication side effects may impair with their walking. It's a very good, proven, research-based, program to reduce falls in older adults.
Melanie: So, that's called the Stepping On program, yes?
Jan: Yes.
Melanie: What a wonderful service that is. So now, wrap it up for us. Give your best advice when people come to you and their parents come to you, maybe they're starting to get a little forgetful and the son or daughter is concerned that it's Alzheimer's or dementia. What do you tell families when they come to you every day about this aging process and what they can expect?
Jan: I tell my patients' families that they should keep a close eye on their older adult relatives and keep asking questions, keep following up with them, monitoring what is going on and talking with them every day. When you see a change, report it to the physician, call that physician's office, make an appointment to see them, make sure that they're being safe, first of all. There are all kinds of resources out there on the web, there's the WWWAALZ.org for Alzheimer's. They provide a lot of support for our patients and family members who have loved ones with dementia. You can find out a lot of information there that can show you the top 10 signs of dementia and how to get help. There's always help out there and Allina Health is here to help with that aging process and realizing that we're all getting older every day. The more we know about our aging body, the better we can take care of ourselves.
Melanie: What great information. Thanks so much, Jan, for being with us. I applaud all the great work you do with families. You're listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That's AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.
Things You Should Know About Your Aging Parent
Melanie Cole (Host): As our parents age, chances are good that we'll find ourselves switching roles. We're no longer just their child, we're now the caregiver. This change in roles can be confusing for both the parent and the child. My guest today is Jan Osborne. She's a gerontological clinical nurse specialist at Unity Hospital in Fridley, part of Allina Health. Welcome to the show, Jan. What's the most important thing? What do you tell people every single day about aging, that can help us better care for our parents?
Jan Osborne (Guest): Well, thank you, Melanie on having me on this show today. I'm very excited to talk about the older adult and aging. I think the number one thing that most people don't understand is that as we age, older adults don't show the same symptoms of illness that a younger adult may show. The first sign of an illness may be a fall, or a new confusion, or just forgetting to take their medication. So, I think sometimes that gets it's overlooked as a sign of an illness. It's called “atypical presentation of disease” and older adults may have that type of symptom instead of a high fever, instead of a cough. They may have a fall or a confusion as the first sign of an illness.
Melanie: So then, if you're dealing with your parents, one of the things that people run into on occasion is that resistance of their parents to let them help if they fell or if now they maybe need the bathroom to be redone and bars in the shower. There's a resistance there, Jen. What do you tell people about dealing with that resistance?
Jan: I think that it's very important to let your parents have control and show to them that they're in control of their life and their health, and you are there to help them. I think many older adults feel that if you tell someone that “I've fallen or I've forgotten to take my medications” that they're going to put you in a nursing home, and there's a big fear of that. We don't want to put our older adults in nursing homes; we want them to age in place. Part of that aging in place is keeping their home safe for them, having someone to come in and look and see if their home is safe by picking up loose rugs, giving them a bar in the shower to hold on to. If we focus on that and have open conversation with our parents to let them know that we're on their side. I think that goes a long way with the older adult.
Melanie: Another thing people run into is the big driving thing, Jen. So, you know, your parents and you get to be middle-aged, so you're that sandwich generation, and all of a sudden now, maybe your parents shouldn't be driving any more. How do you start that conversation with them?
Jan: Yes. I think that conversation has to start with your parents because you want to let them know that they're still in control of their lives. Ask them if they have any concerns about driving. I think one of the things that older adults can do proactively is to have their vision checked annually to make sure that they are seeing properly when they drive. Older adults may limit their driving when they know that they're having problems. They may just stay in their neighborhood. They may just only go to the grocery store and back, another way that we can tackle this is talk to the primary care physician about, “Do you think I should be driving?” So many times, the daughter or the son may send a letter to the physician saying, "I have concerns about my parents' driving," and that physician could perhaps do some type of testing with them or send them to a driving evaluation and have that done. Many times it's become quite a tug of war between the children and the parents about taking away the keys. So, that's a very tricky situation and it’s not a very easy one to take care of.
Melanie: Jan, parents' personalities start to change and we've heard that sort of old myth that if you were a sweetheart in your younger days, you turn a little bit meaner as you get older and vice versa. Is that true and what do you tell people about the changes that happen in personalities as people get older?
Jan: Well, usually as we get older our personalities stays the same. That is consistent throughout the lifespan. But, if you notice a distinct personality change, then I think it could be due to many reasons. It could be due to chronic pain that they're suffering from and that they're not mentioning to anyone and they're suffering underneath their personality. Or, it could be just changes in the brain which could be a sign of a mental health issue. So, I think it's something that you'd want to go and have their primary care physician check out. Just have a visit and talk about things like maybe anger or paranoia or fear, something that they can talk about with their primary care physician. They may not want to talk to their children about it, but they may want to talk to a mental health professional.
Melanie: What about sleep? Does that change as we age? Do older adults really need less sleep?
Jan: Well, sleep does change as we age, but the one thing about sleep that does not change is the amount of sleep we need. We definitely need 7 to 8 hours sleep as we get older. When we do get older, our sleep becomes more light. It becomes a little bit more difficult to fall asleep and then stay asleep. We may wake up in the middle of the night more easily. We don't have that deep sleep as we age. One of the things that impedes our sleep as we age is the amount of time that we need to get up to urinate during the middle of the night. For some reason, older adults produce more urine over the nighttime span than younger adults do. And so, we want to limit our fluids just a couple of hours before we go to bed, maybe put our feet up on the lounge chair at that time, too. Then, try to urinate before bedtime and then try to get a good night's sleep. When you get up 1 or 2 times a night during your sleeping time to urinate, that can really impede your sleep and really makes you feel crummy the next day.
Melanie: When the time comes when you feel your parents need either a caregiver or to move into assisted living, tell us how to begin that conversation.
Jan: Well, that conversation should be probably started well before that process ever happens. I think it's always good to talk about, as we get older with our parents, when they're starting to get older, not when they probably need to move the next week. So, having that open conversation, saying, “What would you like to see as you get older? Where would you like to live when you feel that you no longer can work this out yourself?” I think it's that process of communication and talking to your physician and knowing the resources in your neighborhood. We have a Senior LinkAge Line that is a 1-800 number that you can call, and it can really connect you to all kinds of services in Minnesota from home care to housekeeping to meals delivery. So, that can be a very helpful free service provided by the Minnesota Board on Aging.
Melanie: that Senior LinkAge Line is 1-800-333-2433. That's 1-800-333-2433. So now, tell us about some of the things at Allina that can help people who have aging parents.
Jan: Well, Allina has a very good website on health issues. You can go to AllinaHealth.org and listen to different podcasts, look at different diseases and issues. Allina Health hosts a Stepping On program, which is an outpatient or “open to the public” falls prevention program for older adults. It is for older adults to prevent falls by teaching them how to walk in the community, the types of shoes that are best for support for adequate walking, teaches them what medication side effects may impair with their walking. It's a very good, proven, research-based, program to reduce falls in older adults.
Melanie: So, that's called the Stepping On program, yes?
Jan: Yes.
Melanie: What a wonderful service that is. So now, wrap it up for us. Give your best advice when people come to you and their parents come to you, maybe they're starting to get a little forgetful and the son or daughter is concerned that it's Alzheimer's or dementia. What do you tell families when they come to you every day about this aging process and what they can expect?
Jan: I tell my patients' families that they should keep a close eye on their older adult relatives and keep asking questions, keep following up with them, monitoring what is going on and talking with them every day. When you see a change, report it to the physician, call that physician's office, make an appointment to see them, make sure that they're being safe, first of all. There are all kinds of resources out there on the web, there's the WWWAALZ.org for Alzheimer's. They provide a lot of support for our patients and family members who have loved ones with dementia. You can find out a lot of information there that can show you the top 10 signs of dementia and how to get help. There's always help out there and Allina Health is here to help with that aging process and realizing that we're all getting older every day. The more we know about our aging body, the better we can take care of ourselves.
Melanie: What great information. Thanks so much, Jan, for being with us. I applaud all the great work you do with families. You're listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That's AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.