Saturday, May 18, 2013

So what’s in the world come over you…

The title of this blog is taken from John Prine’s song “Speed of the Sound of Loneliness,” which seems apropos for an article on the profound impact of loneliness on the health of aging parents. Here’s the first punch line:

“Assessment of loneliness is not routine in clinical practice and it may be viewed as beyond the scope of medical practice,” the authors conclude. “However, loneliness may be as an important of a predictor of adverse health outcomes as many traditional medical risk factors.”

Beyond the scope of medical practice? Really? Cure when possible, comfort always but too busy to assess loneliness in a high risk population? Here’s the risk:

“After controlling for confounding factors (including depression), loneliness was associated with a nearly 60-percent increased risk of functional decline (loss of ability to perform everyday tasks such as bathing and feeding themselves, climbing stairs, walking, lifting things with their arms, and so forth) during the six-year follow-up period than the folks who were not deemed lonely. Worse yet, loneliness was linked to a 45 percent higher risk of dying during the follow-up period.”

Worth an assessment in my book, but there’s more. Here is the second punch line:

“Those findings deliver an extra jolt when you consider that just 18 percent of the people surveyed lived alone – and nearly 75 percent were married.”

Loneliness plagues the married and unmarried alike, which harkens back to the pressing need to maintain “nourishing” social connections in the final phase of life. It also intensifies the dilemma of where to live when we get old. Aging in place may maximize personal control but may inadvertently worsen loneliness. Senior housing may do the opposite.

Bottom Line: Wherever our aging parents live, they are at risk for loneliness. The good news is that this is a risk we can mitigate with creativity, determination, and compassion.

Here is the link to the article…

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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 will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this:http://www.aging.org/i4a/pages/index.cfm?pageid=2103&textonly=1

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.