Doris Bersing

Planning to Age Well: Age Planning & Caregivers

So you want to stay in the family home until you die? “Age Planning” will help you achieve this goal. We are all clear that savvy financial planning optimizes choices and promotes financial freedom. Today, let’s discuss “Age Planning,” which is designed to prepare your home and personal networks for the physical, mental, and social changes that occur with aging.

Why Should I Be Interested in Age Planning?

The process of age planning is best done with a professional who understands the social, housing , and medical challenges of aging. When done properly and in conjunction with your wealth manager, it is a powerful process that protects your autonomy throughout the aging process.

While research shows that those who create a personalized Age Plan are significantly more successful in living their older years according to their own wishes and values, many people put off making concrete plans and find themselves losing control of their living environment.

Over the years of running Living Well at Home, my team and I frequently meet people who have become frail and who did not make a plan for aging. Too often, these elder people’s homes and social environment have not been adapted to meet their changed needs, and instead of being a source of support, these environments have become a danger to the older person’s well being. Sometimes, people move out of their homes prematurely, because they did not understand their options.

How Do I Start an Aging Plan?

An Aging Plan starts with identifying your key values and desires for where and how you want to live when you are older. It also identifies the type of medical or social support you would want if your health declines or your family situation changes. Then, it reviews your current living environment and identifies how it can be adapted to support you as you age.

People’s choices for the location and type of living situation are highly personal. Some people look forward to selling their family home and moving to a home on the golf course. For others, staying at home is the only acceptable option. Some make the decision to move to a different country where US money has greater purchasing power, while being close to family and long term friends is essential for others.

Questions to Ask When Age Planning

More than 90% of Americans want to age in their own homes. For them, age planning includes looking at physical aspects of the home and seeing what can be adapted. For example, can doorways and halls be widened to accommodate a wheelchair? Can the beautiful 3-storied Victorian house with narrow staircases and long corridors be successfully modified for somebody with mobility problems? Can the kitchen be retrofitted to make cooking easier and safer? What can be done with the garden to make it easier to maintain and more accessible?

Location is important too.

Is the home well-situated for people who do not drive? How easy is it to get to medical care and to good hospitals? Is it located within walking distance to cultural or sporting events? What can be done to reduce the risk of potential isolation and loneliness?

What about technology?

Technology can be used to modify homes for different needs: “smart floors” adjust for people with balance problems, unobtrusive monitoring systems provide real time safety checks, and robots can provide personal care. Tele-medicine offers virtual access to doctors, social networks can overcome isolation, smart transport systems offer independent options that don’t depend on driving.

Understanding these options of “assisted living at home” enhances the flexibility of the Aging Plan.

Age Planning & Home Care

Most people aged over 75 need some sort of personal care. Whether it’s short term care while recovering from surgery or 24/7 support from caregivers who understand memory loss, the Aging Plan identifies the environment that makes you most comfortable when receiving care and the type of care that best suits your personality. Some people only feel safe knowing that their caregiver is a highly-trained-and-certified professional, while others prefer a more informal caregiving environment.

Financial Implications

Of course, these options have financial implications. Some support is covered by long-term care insurance, some annuities can be converted to pay for care, or reverse mortgages may be an option for some. An Aging Plan obviously must be based on the financial footing that is realistic for every individual.

Keeping an Aging Plan Flexible

Aging is not a static process. Your needs at 75 may be very different to those when you are 90. Widowhood and other personal losses can make you decide to seek social connection in a residential community. Sudden or chronic health changes can force changes in your personal care needs. Working out an aging plan in advance that addresses these potential challenges allows you to explore options and communicate your wishes.

It’s easy to put off age planning, and we cannot predict the future. But being proactive early on significantly increases the possibility of aging your own way in your own home.

  CareAcademy offers online classes for professional and family caregivers. Check out our updated class schedule!  

Doris BersingPlanning to Age Well: Age Planning & Caregivers
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Aging in the 21st Century: High Tech and the Human Touch

89% of Americans do not want to leave their homes when they age. Most of these people will live alone and receive support from health and community-based providers or family caregivers. How will the home care system provide care to a growing number of seniors living in increasingly scattered locations? Technology has the potential to play a critical role in launching a new model of geriatric care that allows older people to live independently for as long as possible, supports family caregivers in the important work they do, and gives health care providers the tools they need to deliver high-quality care at a reasonable cost. Some of the useful types of technologies available for eldercare services include:
  • Home Monitoring Systems – connect monitoring devices with web interface including: emergency response, fall detection, passive motion monitoring (for persons with Dementia/wander risks), bed monitoring (for fall risks and incontinence).
  • Tele-medicine Devices: Blood pressure, weight scale, pulse oximeter, all blue-tooth devices connected to a main platform that communicates information to the caregivers or medical centers.
  • GPS Shoes: footwear designed with a built-in GPS device that could help track down “wandering” seniors suffering from Alzheimer’s disease. This will provide the location of the individual wearing the shoes anywhere on the planet and provide a virtual fence around the elder, enabling them to walk to familiar places but alerting others if they veer off track.
  • Medication Monitoring Systems that range from electronic pill boxes  to the “smart” pill dispensers that work with sensors to alert them to missed dosages and give reminders of the appropriate time to take their medications.
  • Walking aides like walkers that steer away from obstacles and can be retrieved by remote control. Canes that detect warning signs when a person is in danger of falling
  • Intelligent phones helping people with memory problems to remember the name and relationship of the person calling
  • Robotic nurses developed to help nurses, home health workers and caregivers lift people who cannot walk or help older folks with other activities. A prototype is developed by Vecna Technologies of College Park, MD, with funding from the U.S. military
More research needs to be done on the value of technologies for older adults. Designers should involve older adults and caregivers in product design.

Seniors Use Technology More Than You Know

A common belief is that seniors do not use gadgets or Internet, but research shows that older people are doing more online. The largest age group to increase their internet use in the past decade is the 70-79 year old group. As people are confined to their homes, they seek new ways to communicate. Although technologies are badly needed, we also need to remember the human factor. People need to be involved with other people.  Sometimes in the discussion of new high tech devices, the human side of high tech gets left out. Common sense and the human touch in caregiving can save lives and keep elders safe at home. The mix of caring people, technology, and expertise in eldercare is the key to being able to keep people living and aging within their own homes regardless of whether they are healthy and engaged or dealing with chronic physical illness or dementia.  

Communication skills are essential in every role as a caregiver for senior adults. Increase yours with online classes from CareAcademy.

Doris BersingAging in the 21st Century: High Tech and the Human Touch
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Older Women Are Feminism’s New Mentors

I know that an assisted living facility would not look as the cradle of feminism or the women’s liberation movement. Usually, these facilities are sprinkled with a few older women and men in rapid decline, some others who still are feisty and engaged, and others between these two categories. Most of the time, these places are covered with the veil of home-away-from home, and a hectic pace of activities and things that need to be done. One day, in the swirl of this rapid tempo, I met Laura. Laura was a 75 year-old woman, with a nice southern accent, who was diagnosed with mild cognitive impairment, high risk for falls, and incontinence, and who has been at the residential care facility for almost two years. In the middle of the lobby, Laura, with a very firm voice, was ordering one of the employees, to look for her cat that has been lost for most of the day. Trying to be helpful, I approached Laura and introduced myself and offered her to help with her cat search. After few actions addressed to find the cat, I invited Laura for a tea. Never would I have thought that what was about to unfold was going to be quite so interesting and thought provoking.  After telling Laura that she seemed that one of the very spirited older women in the facility, she commented that “Once a fighter, always a fighter…” Curious about the meaning of her statement, I asked her what fights she has fought and then, a rather unusual conversation started that was to stir some ideas in my mind about feminism. When asked about her week and what the highlights of the week were, Laura’s face beamed and she said that she looked forward to meeting with a couple of interns and volunteers coming to the facility to work on some activities. Laura was not to keen to what these younger people’s agendas actually were, yet she was very appreciative of the fact of them listening to her stories. She said in a eloquent way, “They really want to know, to learn from the past and my experiences. They ask, I answer. They want to hear about struggles and conquests of older women.” Although Laura was not exactly the “older version” that I had in my mind of a feminist, her stories of the battles for civil rights, equality, and women’s rights in the late 1960s and 1970s, resonated to my knowledge and first hand-experience of feminism. Her tale made me think of what is next for aging women, in a world that does not take well aging. A world that is plagued with ageism and sexism.  She was presenting a shift of the feminist paradigm from liberation to mentoring, and she opened a door into meaningful opportunities for these ”aging women” into their later years.

From Crone to Mentor: A New Role for Older Women in Later Years

Seldom do we question how the women’s movement has affected women of age, those women who took what they learned as activists in the civil-rights movement and applied it to rampant sexism. That phase of the women’s movement spawned two generations of equal rights, abortion rights, lesbian and gay rights, anti-ageism, and AIDS activists; a devoted, beleaguered army of caretakers of abused women and children in the shelter movement; and labor groups such as the CLUW and Women in the Trades. To name only a few “special-interest” groups. Elderly women today face different challenges, some triggering deep, personal questions—namely, what is their role as they age? Reproduction is no longer a goal; nor is raising children. If they had a career, it is in the past, or nearly so. Other traditional caregiver roles—parenting the grandchildren, caring for a husband or other family members—are still available, but this new identity may be difficult to bear. The “aging” woman, with her dry skin and wrinkled body, is no longer regarded as pretty, sexy, vital, or accomplished; she is in her “dimmed time.” Jean Shinoda Bolen has said that “In a youth-oriented patriarchy, especially, to become an older woman is to become invisible: a nonentity.”
What’s the future for this woman? What role should older women play in our society? What, if anything, is the role of feminists, activist women?
As Laura expressed when talking about “the highlight of her week,” perhaps we could create that new role where these fighters pass the baton; build a bridge to new generations of feminists, our sisters who still have a long road ahead of fighting for equality and identity. We need to find a way from which all generations of advocates of feminism can gain a way to replace the schism between “generations” with an understanding of scales. This will require a deep understanding of difference and especially, in this case, the marker of age as that difference. Younger generations are interested in how growing old has affected the perspective of older women who’ve struggled for decades with language-embedded sexism and rampant ageism in our culture.

Ageing Feminists – Who Are We Now?

Within the baby-boomer crowd, we find three different “generations”—those born in the mid-1940s, the mid-1950s, and the early 1960s. All three find themselves lost in the battlefield. Members of the first generation, especially, often discouraged by the meager results of the equal-rights “victory,” have difficulty empowering themselves and their sisters. Weary of trying to raise others’ awareness, seeing their self-esteem slip away, they can’t help questioning, yet again, who they are. Battling their own dependency issues, they now consider retirement—and what do they see? Living 20, 30, 40 years on the edges of society, without an audience interested in their experiences, knowledge or wisdom.

Mentors, Sages, Baton-Carriers

Following Laura’s first impressions, I have interviewed hundreds of older women who have stressed the importance of becoming mentors, sages, to help younger women meet their needs. One of them has said, “It’s not about me as an individual, anymore … I’ve done whatever I can to express my individuality, develop my personal self, now I want to contribute to the well-being of my daughters … and the Earth.” Others have remarked that the aging phase is a prime time to reinvent ourselves, to use the still-formidable energy of our mature years with compassion and wisdom. There is, after all, a difference between growing old and growing into an elder.
To become an elder takes work and a willingness to struggle continuously for awareness.
This struggle for awareness demands a relentless engagement with life and its constantly emerging challenges.

The Depth of Older Women’s Wisdom

Women need to understand that along with a left-brain linear intelligence, they also possess a deeper intelligence, more creative and respectful of life. Some call it intuition, but it is really a kind of an emotional intelligence, a spiritual force allowing those who have it to deal with both the quotidian and the divine. Imagine a world in which the wisdom and power of aging Goddesses guides us through our next challenges, with the shared goal of building a global village that is tolerant, nonviolent, and life affirming. It is time for all older women to tap into their wisdom, and guide people on a journey of healing and transformation. We need this for ourselves, and for the planet. It is time to nourish the soul, to mentor our daughters and sisters, and, at last, to regard our aging selves in a celebratory light.  

Develop your skills as an eldercare professional. CareAcademy online class to for effective inter-generational communication.

Doris BersingOlder Women Are Feminism’s New Mentors
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Identity and Dementia: Where Do I Go?

Most of us spend a big part of our life searching for meaning, trying to find our identity, and although Thomas Szasz said in The Second Sin (1973):  “The self is not something one finds, it is something one creates.” We set ourselves for the pursuit of that elusive “identity,” and our meaning as human beings. What is life all about? And overall, what is our role in life? What do we really live for? Who are we? We pass many of our prime years looking for our identity, fighting for one, trying to assert one, if we are ever given a glimpse of it; we wrestle to have our needs met and to have our dreams come true. That search for identity comes sometimes in a puzzle of circumstances, challenges and exploits, and like the overprotected Nemo, we need to swim the oceans of uncertainty and grow until finding ourselves Through the journey in search of our identity, we attempt to unfold our potential, our desires, and to adjust to the best of our abilities to the challenges of daily life. We build our life upon joys, shadows, and sorrows and fill that life with the mementos and the facts we carve in our memory, those we gathered throughout our journey. But one day, zas! You are diagnosed with dementia. There you are, all of a sudden lost, confused, and soon to be stripped – if not of your identity, at least, officially, of your mind. I know, hopefully, we all have lost our minds out of excitement, passion, or love, yet, after the diagnosis of dementia, it is not the same. Of course, we could discuss what really the “mind” is, there is so much more to the mind than the cognitive aspect of it, yet for any purpose – the mind someone loses to dementia is THAT mind – the one holding memories, pains, and joys. It is ready to go with the wind. In reality, with the plaques and tangles created in your brain, after a certain time you will not even remember the diagnosis. Just as Clark Gable stated while playing Rhett Butler in Gone with the Wind, you may well say: “Frankly, my dear, I don’t give a damn.” But the clock is ticking. Professionals will offer all that they have. They talk and teach how to calm you down, how to deal with your mood swings and your challenging behaviors, but do they really know what a person with dementia is going through? What you or your loved one are going through? Do they know that you are going through the tunnel? In and out of the darkness. Do they know about the uncertainty and the challenge of living an existential tale of the here and now, for which, you did not sign up, and have never practiced for? Then come the drugs, the optimism, the clinical trials, the walking to fund more research. Hopefully, before it is too late for you. There is so much that is done, said, so much still to do, yet nobody really knows what you are going through. We try and theorize about the phenomenon of dementia – the neurological, psychological, emotional, and practical side of it. Even the spiritual side of it. Needless to say, we appreciate all the nice, legitimate attempts people make writing new books about breakthrough treatments and findings. They present lectures and write articles about you, but what if you could really explain how it is to know that your life is slipping away, fading away? What if you had a voice? What if they found a cure? I wish I could be more helpful, but I really do not know how it is. All this is my best efforts to explain a phenomenon, I can only observe and witness with powerlessness, compassion, and horror. I do not have dementia, and I wonder if I had it how I would feel. What would it be like? Again, I do not know, but if I could, if I were you, I would not like to go there. That said, I hope I would react calmly and with patience for myself, although I doubt it. But let the journey continue and keep on swimming. For now, I find some solace and motivation to keep on swimming in Thoreau’s wisdom: “I went to the woods because I wished to live deliberately… only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived. ~Henry David Thoreau, 1854  
Doris BersingIdentity and Dementia: Where Do I Go?
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