Tuesday, March 24, 2015

Drug Addiction and Grandparents: The Unfortunate Link

Drug addiction requires two things: Drugs and a User. 

To sustain a drug addiction requires three things: Drugs, a User, and an Enabler.  

Anybody can be an enabler. 

Your grandfather could be an enabler. Your grandmother could be an enabler. Your father could be an enabler. Or your mother. Or your mother to her grandchild. And in fact, a grandparent is often the most likely person to become the enabler.  

Grandparents are likely to become enablers because they may be raising the child of their son or daughter (often because their son or daughter is a drug addict). Grandparents may be lonely and seek the companionship of their grandchild. Grandparents have accumulated financial resources that the grandchild learns how to access.

Dr. Allan Schwartz writes (bold added): "It is a well know fact among drug and alcohol counselors that the worst enemy of the abuser is money. The reason for this is that money becomes the means the addict makes purchases of more drugs to feed the addiction. Because the addict is a person who has learned the fine art of manipulation to get what he wants, he knows how to convince loved ones to provide the money he needs to make more drug purchased. If it means telling lies the addict has no compunctions about doing so. Enabling occurs because loved ones generously provide money to the addict in the naive hope that no lies are being told and in the hope that it will help him recover. It is amazing how family and spouses blind themselves to the facts about what is really happening."

I have lived with this situation for many more years than I can count. It gets me dizzy thinking about how long. I could see the beginnings of the codependency long before the drug use began.

Many of us of the "sandwich" generation are experiencing the pain of watching our parents age, lose their health, their memories, and so on. A subgroup of this generation is also experiencing the pain of watching our parents simultaneously go broke, all due to their role as co-dependents to somebody with a drug addiction.

Treatment centers focus on the addict, on the actual drug addiction. They ask family members to participate in counseling, but it's completely voluntary on the part of the family members, the enabler(s). If the addict can go back to the codependent relationship, and continues to engage in the same behavior as before, denial, help with financial resources, lying, etc., the addiction goes on and on, and the grandparents resources will quickly run dry. 

When you are a family member and you see this happening before your very eyes, what can you do?  Anything?   

What is to guide us through these rip currents and perilous channels?

Wrote the wise King Solomon:


A time for tearing down and a time for building up;
A time for weeping and a time for laughing.
A time for wailing and a time for dancing...
A time for seeking and a time for losing.
A time for keeping and a time for discarding...
A time for silence and a time for speaking;
A time for loving and a time for hating;


Sunday, March 22, 2015

Doing Your Elderly Parent's Taxes - Today We're Doing Mom's Income Taxes

Yes, 60 can be the best age, the kids are out of the home, if we are lucky we still have our health, we may or may not have paid off the mortgage. But if you are sixty that means your parents are eighty or eighty five, or even ninety, and that means that your perfect age is now spent toiling over their health and over their wealth. Or the remnants of their wealth.

And that means toiling over their annual income taxes

Are you prepared for the day when you will have to prepare, or have prepared, your parents' income taxes? Among other things?

THE OLD DAYS 


My mom used to do her income taxes with a commercial establishment, in her case H&R Block. She worked full-time until she was 85 and would bring all her papers over there and it was easy.

By last year there were several significant changes: she had quit work, she couldn't drive any longer, and I had Power of Attorney. 

I contacted her tax agent, who said that if I could get all my mom's paperwork to her electronically, that she could file for her, as usual.

LAST YEAR 


Last year was an awful year: My mom sold her home, got divorced, and moved again.  I was often focused on those things, by necessity. It was also difficult for me to work my way through her paperwork, given her unique 'filing system'. And I don't know too much about taxes and mortgages or mortgage credits or what would constitute her tax paperwork in the first place. So this in itself involved several trips, airfare included, to go through her paperwork and seize the goods.

Once I had the goods, I had to scan everything, make electronic files out of it, and send everything to her tax preparer.

The fact that it was already April - NO BIG DEAL - I jest, because I enlisted my brother the lawyer to file for a late tax return.  Would I have known how to do that? Would I have had to time to figure out how to do that? Not in your life. 

From there it went rather easily, until it was time to actually file. I forgot to ask the tax returner to have the IRS direct deposit, until I remembered to tell her to have the IRS direct deposit into her checking account. So she had to do something - I don't know what - and get that corrected. DO NOT FORGET TO HAVE THE TAX AGENT DIRECT DEPOSIT.

Federal and state, done.

Another year later, another tax season. What would change? What could change?

Plenty. First of all, another move, another address. Second of all, a brother who has completely disconnected from me and almost entirely from my mother. Any chance of his filing for a late return? Next question. Putting my anger and resentment toward him aside....


NOW


What has also changed from last year is my mother's financial status. And how quickly it does change.

With less money now than ever, with the home sold and the proceeds now distributed between her and her ex-husband, and the monthly fees attached to living in independent living, she can no longer afford the tax filer. And she's no longer driving. That means my husband and I are downloading TurboTax on this windy but sunny Sunday afternoon, and doing and filing her taxes. I also think that it will be faster for me if we just do it ourselves, rather than my scanning everything, emailing everything, and doing through what I went through last year. Last year it was the most convenient thing. Even at that, the tax preparer and I were back and forth and back and forth with emails a zillion times, and it was me thinking through everything, "Is she entitled to medical deductions? Is she entitled to this and that?" This year I think doing it ourselves would be the most expedient thing.


TODAY

 

So today we are doing my mom's taxes. 

 

 And I suppose that this, among everything else associated with taking care of your senior parent, is now the way it will be. 

 

Are you prepared?








Sunday, March 15, 2015

Eat your vegetables, Mom.

Mom has to eat. 

But she likes to sleep very late. Very late. This is a problem because she occasionally wakes up slightly hypoglycemic and dehydrated.Then she doesn't have the strength to make it to the refrigerator or the kitchen.

Mom also likes to drink wine. She can get dinner with wine every night. This is nice. She feels great in the evening after dinner. But it is a double-edged sword because with the wine she feels great, but in the morning she wakes up slightly hypoglycemic and dehydrated.

Parenting magazines are encouraging parents to teach their kids to love vegetables and fruit. They're encouraging parents to not try to hide the vegetables and fruits in another dish, say a casserole, but to appreciate the veggies as is. They're encouraging parents to serve fruit for desert, rather than carbs.

Isn't fruit salad what we, when I was a kid, used to eat for desert?  I remember as a kid always having fresh fruit salad for desert. Even in restaurants. Rice pudding was about as sweet a dessert as we ever got. Ready-made cakes weren't as available as they are now. Economic policy and a more urban lifestyle has also made carbs cheaper and more affordable than fresh fruits and vegetables.

Over many years, Mom has become too dependent on sugar and cake: THAT IS, she has become too dependent on carbs for the main meal and carbs for desert. Carbs and simple sugars, which are carbs. 

Is my mom any different from most seniors? Or most of us, who want to hang onto eating what we like?

Now I ask her to tell me what she has in the refrigerator. 

"Cantelope."

"Great. Have that." I hear her chewing away. "What else is there?"

"Pineapple."

"Great. Have that. "I hear her chewing away." What else is there?"


"Spinach."

"Spinach? Great, Mom. Lots of potassium and low carbs, Vitamin A, Vitamin C...  Especially because the doctor doesn't want you eating bananas."


Of course I only know all this because my doctor is also telling me to watch what I eat because I have become pre-diabetic. He's warned me. I've learned the hard way. I'm also beginning to love my vegetables. I've been reading AARP, the magazine that nobody wants to admit they get. Frankly, my mom's not interested in nutrition. But she does listen to me. She is interested in life.

"Great, Mom. Eat your vegetables. What else is there in the refrigerator?"

Tuesday, March 10, 2015

Caregiver? STRESS ALERT: Take care of your own health.

"One sixty nine over eighty," the nurse at the CVS Minute Clinic said as she unwrapped and removed the inflatable cuff from my arm. "That's high. Do you always have high blood pressure?"

Always? I never had high blood pressure. I'm the one who everybody points to as living a healthy lifestyle and getting plenty of exercise.I'm the one who does yoga. Back home, I put the numbers into the search bar on the internet. 169 over 80. Hypertension. I don't know what those numbers really measure, but I know it's not good.

My annual medical exam was scheduled for the following week. I would get my blood pressure remeasured by my primary care physician, and we would discuss this.

One week later, it was slightly lower but basically the same thing. It was as high as that of some long-time heavy smokers I know. 

THIS is stress. Stress caused by a full year of managing, or dealing with, my elderly mother's issues. Trying to save her from financial devastation and medical destruction. All the while I was trying to write, publish, and promote my book, and other creative and professional endeavors (not to mention time and energy for my husband). I knew that I wasn't getting much exercise, I wasn't sleeping well at night, I knew that my routine was so centered around her, but I never gave a moment's thought to that this might be affecting my own health in some major way. I knew I didn't have as much time for my work and writing and my book as I would have liked, and that created internal - I would call them philosophical but they play out in the real world and in real lives - debates about taking care of others vs taking care of self. I knew I was stressed but you should see the looks on people's faces when I tell them I have hypertension.

"You?"

At my annual medical exam, my doctor asked the usual questions: "Are you getting exercise?" My response was limp. Sometimes riding my bike, but no long distances any more. Sometimes but rarely getting to yoga. Sometimes but rarely running. Playing tennis with my husband, but only on Sundays in the spring and summer.  And my doctor told me to get more exercise and come back in three months and get retested.

This in combination with also being told I was borderline diabetic created some serious talks and evaluations regarding how I manage my own health, diet, life, and also my mother's.

This is what I learned:
  • Walgreens is amazing for anybody with high or low blood pressure. They will take your blood pressure for free. When you go, write down the result, and date it. I keep mine on my "notes" on my iPhone. I went monthly. With Walgreen's, there is no excuse for not getting your BP checked. No Walgreens? There is surely some pharmacy nearby. Senior centers often have regular and free BP screening.

  • The gym was amazing, especially given this awful winter. Even without the winter, it gave me a routine that I could stick with. I usually went late afternoon or early evening. I made sure I listened to music on my iPod that was relaxing, but kept me moving. For me this meant Neil Young, especially "Harvest Moon." I had a full workout, including 20 minutes running on the indoor track. Once a month I would use the steps machine, which would measure my average and high heart rate. THIS TOO I would write down and keep a record of. Because I don't have enough time to go to the gym and do yoga, I incorporate my yoga breathing and 'asanas' and relaxation techniques into my gym workout.

  • Vulnerability. We know we are stressed but it's more difficult to acknowledge how that stress is affecting us physically, and the degree to which it is affecting us physically. While some physical conditions are beyond our control, high blood pressure is often well within our control.  As we age, we become more and more vulnerable to stresses on our system. We are faced with conflict - ourselves vs those we love. And some of us are in the "sandwich generation." There are things I couldn't not do: Help my mother with her divorce, help her move from her home to her apartment, help her move from her apartment to the senior community, and so on. But many things, such as maintaining her car and making sure those bills were paid monthly, were unnecessary and only added stress to my life and my body. oing off for the day or weekend or week with my husband became an big deal, because nobody else in my family was willing to share responsibility for our mother with me. Dealing with the continued blood-letting of my mother's finances in her codependent relationship was another that I ultimately had to take by the horns, be strong, and weather the harsh disapproval that I knew I'd be up against.

  • Don't miss your annual medical exam. Schedule it. Put it in the system. Then make it to your appointment. If you're afraid of what the results will say, then face that and ask yourself honestly what you can do differently to make sure that your health is not irreparably damaged and that you haven't given yourself reason to avoid going to the doctor's. Have this discussion with your spouse or significant other, if one is in the picture. My doctor warned me, and I gave myself a goal of three months to get my emotional and physical house in order. Me, the healthy one.

  • Do what you need to do to lighten your burden around your elderly parent. That will pit you against your parent but for your life you need to. For me, it meant selling her car, and other difficult actions I write about. We fought. Often the fights were about her desire to have her car, versus my need to reduce my stress level, which was, literally, killing me. The fights were horrible because they pit me and my needs, physical and emotional, against my mother, who couldn't "hear" me, and what she wanted to do. The fights brought up other feelings and long-term issues. But being dead is no picnic, either.


The next time I got my BP taken, just one month ago, it was 142/74. Lower but still hypertension. 

Today was my last visit before my three-month visit to my doctor for a retest. 

This morning I went before I had my morning cup of coffee. The pharmacist came out and took the reading. My BP was 120/79. I phoned my husband and reported the good news, as if I were 14 and had gotten straight A's on my report card. Then I came home, had my coffee, and made an appointment for my 3-month checkup.

And wrote this blog post.

Thursday, March 5, 2015

When Your Parents Lie to You

I know that much of what she tells me is a lie.

I didn't always know that. I knew in my gut something wasn't right. But I didn't KNOW it was a lie. And I didn't know why it was a lie or why she lied. I still don't know but such is the nature of a person's psyche. 

If your parents are lying to you, it's okay to know it. It's better to know and accept it than to not acknowledge it and try to convince yourself that what is a lie is actually true. Then you get really screwed up for life.

For a few days now her memory has been awful. Just awful. She also doesn't want to wake up and blames it on her cold. But people who have colds can get up and function. I know there's something else going on.

"Is it (this)?" 

"No."

"Are you depressed?"

"No. I'm just tired. Can't I be tired?"

"Did Unidentified Male Relative telephone you?"
 

"Maybe."

"What did he say?"

I don't remember.

If you're like me, you've learned to trust your gut. In my case, I have to wonder: A) She doesn't remember the telephone call because she doesn't want to remember; B) She remembers the call and its contents but she doesn't want to tell you/me. C) She doesn't remember the telephone call because she has some condition independent of all other emotional issues. After all, how am I ever going to prove that she remembers?  Or doesn't remember? The memory loss serves a practical and convenient function.

I have to harken back to just a few weeks ago, when Unidentified Male Relative showed up unexpectedly (on my end), and I discovered that he and she had gone to the bank together and had wiped out her savings account. At that time, she said nothing to me afterward, as it it hadn't happened at all. It was an awkward silence, me wondering if she'd say anything, giving her the opportunity to bring it up on her own, and she being quiet out of - fear? Of me? Of what I might say? Of having to deal with what she had just partnered in? But yesterday when the topic of finances and the savings account came up, she was quick to offer: "I did it because I wanted to." Memory loss? Or convenient 'memory loss'?

Sure enough, I find out late afternoon from Other Person that Unidentified Male Relative is there in her apartment. Other Person doesn't want me to call her and get elderly mom upset. I, however, need to call.  We have to do a reality check here.

"Was he there when you and I were talking a little while ago, and doing your meds?"


"Yes. I told you."

"No you didn't. You said you were getting ready to take a nap. That was all." I calmly informed my elderly mom that there is no money in the checking account, there is no money in the savings account, and all the credit cards have been shut down.  She argues that she's financially responsible. I say "No, you're not financially responsible." She says UMR has not asked for money. I say "Not yet." She's playing a game with me. But it's a fool's game.

What does it take to be a good liar? A persistent liar? All it takes is for the other person to be a fool, or to want to be fooled, to want to cling to a relationship or a dream more than you want to cling to reality and yourself

She says, "I don't lie to you."

At any age, it's hard to tell your parents that you've caught them in a lie. Let alone repeated lies. I think that what she's really saying is that she doesn't want to lie to me. For most of my life my parents presented things in one way but the truth was quite different. But time is running out and I have to just be blunt and honest about this - because we have to exist in a place of honesty. How much more time do we have to get to this place?

I say, "Yes you do, you lie all the time."  It hurts her to hear this, it hurts me say this. To KNOW this. Relationships cannot thrive in an atmosphere of falsifications. I can't imagine how much it destroys a person to be a liar. I take that back. I can imagine it. I see it all the time, every day. I can't imagine how destroyed a person must be to lie. A person's humanity. It's an awful way to live.


This time UMR can't get any money. My mom's finances are, for now, as they were. They are safe. I won't have to do any clean up of the mess tomorrow. She may not be very happy about it but I'm relieved. I've protected her finances, I've protected myself from the angst and stress of cleaning up the mess each time, which gets harder and harder each time, and I've eliminated one tool that fuels the codependency. I'm sad, but I'm relieved for the moment.

And for the moment, there is honesty.




Monday, March 2, 2015

Medicare Toe Nail Clippings for the Elderly - WHO KNEW???

Did you?

The last time I saw my mom, she made some comment about her feet. Okay, so they weren't so beautiful.. But who does have beautiful feet? Looking at my mother's feet is not one of my favorite activities, and so the conversation about her feet ended almost as quickly as it had begun.

Then, last week, she went to a physical therapist who suggested that she go to the in-house podiatrist for a toe nail clipping.

Although toenail clippers are a regularly used tool in our bathroom, I never thought about this for my elderly mother. Just another one of those things you don't associate with your parents, or their needs, I guess. But to go to a podiatrist for a toe nail clipping?

Not only that, but apparently Medicaid covers toenail clippings every nine weeks, my aunt told me.

I absolutely hate that expression who knew? but I can honestly say, with regard to Medicaid, WHO KNEW that Medicaid covers toe nail clippings every nine weeks? And if we had known, would we have even cared?
  Now... my mom has been at various physical therapists in a private PT place numerous times in the last few years for her back and knees and nobody but nobody mentioned this need, or this Medicaid service. Her walking has been increasingly problematic. Shoes are a also a big thing with the elderly: The proper size, the proper fit, the proper elevation and cushioning, etc. Come to think of it, toenails that are too long certainly do not help.

I can hardly imagine a physical therapist who does not work with seniors and I can even less imagine working with a senior and not working on their legs, their feet, their walking, their gait, their balance... so it's hard to understand NOW that they wouldn't have known.... So let's' not go there... I think you see where I'm going with this.

I never gave her toenails a second thought. And the professionals were not letting out this secret.


"Couldn't she just clip them by herself?" my husband asked, when I told him about this.

"No!" I retorted, gloating in my being right. "The nails are brittle and can easily crack." Not to mention that given their lack of flexibility, the elderly may have difficulty just plain doing the task. Cuts may cause other problems, such as infection. And so on.

It's something that has to be done by a physician, as the nails become more and more brittle.

My mom is now scheduled for a toe nail clipping with the podiatrist, as she will be every nine weeks.

I have a thought: Wouldn't it be something if our moms and dads had the same type of care from Medicaid as our cars do? Some like the little stickers that are placed on our car dashboards reminding us:

Like
  •  every 30,000 miles your car needs a new air filter...
  •  every 60,000 miles flush the power steering fluid . ..


I would like to see that magnet to place on the refrigerator: 

Have You Had Your 9-week Toe Nail Clipping? 
This magnet was brought to you by Medicare.

Now I know!