Saturday, February 04, 2012

Archive for April, 2010

Riptide: Excerpt from David Solie’s new book

This is the first of three posts from my new book Riptide.

Chapter One: Hidden Currents

One doesn’t discover new lands without consenting
to lose sight of the shore for a very long time.

-Andre Gide

Linda had her doubts and fears about the future. At fifty she could feel her life being pulled off course by currents beyond her control. She first thought the problem was chronic fatigue from being perpetually overbooked and behind. She found herself in middle age with an overwhelming “to do” list. Most of the time she felt defeated by a network of obligations that left her no time to recover and regroup. But her concerns about the future were coming from deeper currents that were conspiring to keep her off balance despite heroic efforts to keep “everything together.” Clearly, everything was not together. Take her husband Dan.

Dan was fifty-five and trying to stay afloat with his own issues. The acquisition of his company by a long time competitor forced him to decide the fate of people who had been both his friends and associates for most of his career. The pressure of this responsibility led to another issue: Dan’s late night trip to the ER with chest pain and a racing heart.

Fortunately, he did not have a heart attack. But Dan was diagnosed with an arrhythmia that would require medication including blood thinners to prevent a stroke. Dan was just getting use to his diagnosis when he was confronted with another complication. His father fell and broke his hip.

The fall wasn’t a total surprise; his father had been unsteady on his feet for the last year. While the fracture was not complicated, Dan’s brother Tom nearly provoked a family meltdown. Although single and having the luxury of a flexible work schedule, Tom resisted any attempt to get him involved in his father’s recovery. Attempts to get him to “do his part in helping of dad” quickly escalated into shouting, accusations and bitter feelings.

Linda’s brother’s situation wasn’t any better. At forty-eight, Brain had recently had a “cardiac event” that required emergency angioplasty to open up blocked arteries in his heart. Despite this close call, he stubbornly refused to modify his risk factors. He still smoked and rejected suggestions that he change his diet or start exercising. In the back of Linda’s mind was her lethal family history of premature heart disease. After having his first heart attack at forty-five, her father had died in his mid-sixties from a second one. Brain appeared destined to suffer the same fate.

Her mother was a dilemma in slow motion. After years of good health, an active social life, and independence, she had steadily grown more needy and indecisive over the last year. It had reached the point where she needed Linda’s help for everything. Soon her mother’s living alone was not going to be an option; but where would her mother live now that Lori had moved back home?

Her daughter had been in her final year of college with good grades and bright future when seemingly out of nowhere Lori began to slip into depression. At first it looked like the university health care system could manage it. But three months ago things got worse and Lori stopped going to most of her classes. Linda flew out to assess the situation and wound up packing up her daughter and bringing her home. Lori seemed to be doing better, but it was going to take time, medication, and the support of her family before she could resume her education.

Lastly, there were Linda’s own health issues that started to surface in her late forties. Hypertension was quickly followed by pre-diabetes. Despite dietary changes and attempts at regular exercise, she was on two medications to stave off full-blown diabetes. The hot flashes of menopause only added to her health concerns. Above all there was a persistent anxiety that haunted her about losing the two important men in her life to premature heart disease like she had lost her father. She feared winding up alone like so many middle aged women.

Seventy six million boomers are making the middle crossing, the volatile journey between forty something and sixty something. It is a pilgrimage from the last vestige of youth into a world of mature adulthood, a passage from the first half of life into the second and most daunting phase. They all share similar concerns with Linda about where this journey will take them. First and foremost they worry about their quality of life. How do they successfully navigate the unfamiliar and threatening waters of middle age? What are the obvious and not so obvious dangers they will face during the crossing? Is there any way to prepare for them? What do they do when things fall apart? What strategies give them the best chance of arriving at old age in good shape? None of these are easy questions and highlight the fact that boomers, despite being awash in information, need better information about the journey between their late forties to their early sixties. Although they have become the poster child of “The Aging of America” story, they remain unclear about the purpose and meaning of what they are experiencing.

Boomers have been told many things about their generation in the popular media. It has become part of the shared myth about who they are and their journey through aging. The predominant focus of this attention has been on cohort issues, themes and symbols that define the unique experiences of the baby boomer generation. Not surprisingly, much of this marketing attention has been paid to the hopes and dreams of a generation who set out to change society. Now in middle age, boomers are being touted as the generation that will “rewrite the book on aging.” But is this cohort focus really an unhealthy distraction from the real business of being middle age? Will the boomers discover a work around to a critical passage that is a prelude to a successful old age or will they come up short as they enter their seventies and the final phase of their lives? While cohort material is valuable for telling the boomer’s story, it is not that useful to middle age adults like Linda who are struggling with the “riptide” of middle age. Linda is not interested in rewriting the book on aging so much as she is in trying to understand the forces that are changing her world and, more important, what needs to change to make it better.

She is not alone. All boomers are at risk for missing the developmental mission of middle age, a setback that could dramatically undermine both the quality and length of their lives. The developmental currents of this age group are potentially lethal, leaving unprepared travelers confused, exhausted, and having to face a long string of poor outcomes. On the other hand, knowing the real purpose of the middle aging can arm boomers with a more useful perspective and the critical tools to successfully complete this phase of the journey. It will also prepare boomers for what is to follow. But what is it that boomers need to know that the popular media has failed to mention?

Boomers need to adopt realistic expectations about becoming older. They will not reinvent the aging process. The process is mandatory for the human personality and structured to unfold in definitive segments in the lifecycle. They may rewrite their response to the “mission” of being middle age, but they will not be excused from the task. The best example of how the uniqueness of any generation can only modify but not negate the developmental process is teenagers. Each generation of teenagers responds to the complex task of seeking independence from their parents while at the same time preserving familial ties. The music, fashion, and technology change, but the mission of being a teenager does not. And so it is with boomers. All of the education, experience, success, and social advantage will help shape their response to middle age, but the mission of being middle age will still prevail. But what is this mission?

When Am I Going Home From The Nursing Home?

This is one of the predictable dilemmas of aging we all wish we could avoid. We can’t. At some point we run out of aging-in-place options and a parent winds up in a place they never wanted to be, a nursing home. It is a painful transition that in most cases is irreversible. But they continue to ask us when they can go home. So how do we respond? How do we help them come to terms with this new reality?

Start with the truth. Tell them the painful truth. Tell that you have run out of options. Their health and care issues requires a new level of support. It’s not what either of you wanted, but it is the new starting point that both of you are going to have to use going forward. You wish it wasn’t so, but it is.

Start with control. Make a working list of all of the choices your parent still retains despite being in a nursing home. Can they choose their own food and when they eat? Can they choose their activities and when they leave the facility on outings? Can they choose pictures to hang, a special chair, music, blankets, and when family and friends can visit? The more ares of control you identify and orchestrate for them to manage, the easier it will be for them to come to terms with the transition.

Start with legacy. Make a working list of the people connected to your parent’s life who can “rise to the occasion” and help with the transition. This could include neighbors, co-workers, friends, clergy, and of course family members. Tell them to come ready with a story, pictures, food, and news. We all want to know our lives make a difference, but when we wind up in a nursing home, it doesn’t seem that way anymore. The more connections you mobilize to interact your parent, the easier it will be for them to come to terms with the transition.

Make ample room for tears. The losses of aging break our hearts and all of us need room to grieve openly. It helps us come to terms with the things we cannot change; it makes room for courage and compassion. Let your parent have his or her feelings and let them see yours. It will provide both of you comfort and deepen your partnership for what lies ahead.

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Communicate

No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.