Wednesday, December 16, 2009

An emergency with ailing parents

With the sudden death of a 60-year old man this past snow storm. Adult children are often the ones called to help out. These are things you should have handy. You never know when tragedy will strike.

In addition, in the recent snow storm of Dec. 10/11, 2009, many seniors were stuck indoors. Cars were not moving, and the highways were closed both south of Huntsville and Gravenhurst, and near Bracebridge. OPP say to ensure you have your car winter ready: all fluids topped up.  Carrying a safety kit is a good idea, with water, snacks, a flashlight, a shovel, blankets, hats & mitts, and a candle to keep you warm.

Some seniors cannot shovel their walks, others depend on neighbours for mail and groceries. It is important to shovel both back and front steps, as ailing seniors are at risk for falls. There must be an emergency escape route out of the house, and ambulance crews must be able to get a gurney into the home.  (Ours was blocked by snow!)

Ontario man found dead under snowbank (Globe and Mail)

One man died in Bracebridge. Such a shame. Greg Shepherd (60 years old).  He leaves behind 6 children and his wife, who was on vacation at the time. He had been having chest pains that week, but went outdoors to shovel the metre of snow (39"). They found him buried in 1.5 m. of snow, having collapsed that morning.


In our case, living 430 km away, we didn't know that neighbours were covering up for my parents. Tey were doing many, many activities for them (shopping, banking, getting mail) and generally enabling them to live in a rural area, with services, when they were physically incapable of doing so. The help they needed was beyond what was offered by the Province.  Until I moved here, in a sudden fit of desperation, I did not realize how bad it was. Nor do I understand my mother was desperate to die at home. I was unprepared, and should have been told about Hospice, for example, who can help you.

Below — in order of importance — is a list of

10 things you need to know about your aging parents' health
 adapted from the Mayo CLinic, for Canadians.

1. Health Cards. This will have more information, and may be in a wallet, or not!

2. Names of their doctors. This is one of the first questions they will ask. Primary physicians, as well as specialists: heart, oncologists, will have the most up-to-date records. Also, find out the phone number and office locations.

3. List of allergies, infections, eating disorders, addictions. This is especially important if one of your parents is allergic to medication — penicillin, for example, or food allergies. Some seniors have Sundowner's Syndrome, and

4. Advance directives; Power of attorney for personal care. * Know where they are, and your parent's wishes for DNR orders, or other issues. This is an important discussion for you to have with them. Start be telling what YOU would wish.

5. Major medical comorbidities. This includes such conditions as diabetes or heart disease. My mother had colitis, celiac disease, skin conditions, white coat syndrome - high blood pressure, and she was lactose intolerant). She needed a special diet when in hospital.

6. List of medications and/or supplements.  Many seniors jump on bandwagons, and take over-the-counter vitamins, or herbal supplements, and these might interact with blood thinners, or other medications. You pharmacist can give you a list if you go with your parents and talk to them about it. If your parent is incapable of keeping them straight, talk to the pharmacist.

7. Prior surgeries and major medical procedures. List past medical procedures including implanted medical devices such as pacemakers. I wrote in my personal agenda whenever my mother had surgery, when she had radiation treatments or follow-up appointments. Once I scanned this, I realized she was developing a tumour a year between 2002 and 2006. Otherwise, it is worth it to write down all of their issues and concerns. If they have questions, e.g., my mom didn't know what Leukplakia was, her type of cancer. I collected this information for her.

8. Names and phone numbers of extended family and close friends. We were unaware of some of these people, and neglected to speak to some.

9. Activities of Daily Living. ADLs and IADLs (see below)  are a good indication of personal health. If your parent has been getting Meals on Wheels, or has been incapable of getting groceries, of banking on their own, a geriatrician may be able to help you with assistance. They need to know, before discharge, how able your parents are. I knew of a woman, my age, with a full-time job, and both parents and in-laws with health issues, including serious surgeries - all at the same time. She was expected to be their Charge Nurse, and Personal Support Worker.

10. Hospital discharge of seniors (I did a full post on this!). Another great resource is the newly established services locator website. Muskoka has just signed on and provides many resources.

Your parent should have a Geriatric Assessment, to determine their ability to manage alone. Stand firm, if you do not think they CAN manage alone. There should be pre-admission screening to assess functional impairment, medical complexity, psychological functioning, and social supports.

*Power of Attorney

Nov 01, 2009
I was at the Muskoka Elder Abuse Network* workshop. In a presentation by JoAnn Boulding, who is the Executive Director of the Muskoka Legal Aide Clinic. Power of Attorney(POA) The Office of the Public Guardian and Trustee has.

Aug 08, 2009
please make it stop! once an ailing parents cannot manage iadls ( eg, banking, driving, credit cards and the other less daily, but weekly activities) you are wise to cancel credit cards and stop the nonsense.when i phoned about mom's ...

Oct 17, 2009
It is important that caregivers, those with power of attorney, remain vigilant in determining that their loved ones are not facing extreme interventions, when it prolongs a difficult life. In this article, Infections, Eating Problems ...

Dec 19, 2008
many family members may not understand that their ailing relatives are incapable of adl or iadl when friends and neighbours are covering these duties. the risk of such enabling actions is great to both the senior and his or her family. ...

Mar 06, 2009
she refused to accept or admit she needed help with groceries, housecleaning, and other activities of daily living (adl). my mother, in her chemotherapy treatment lost her ability to think and act clearly. my father, after radiation ...

Dec 13, 2008
for ailing seniors help is nearby at ccac, they provide referrals to meals on wheels, or a limited amount of personal support workers who can assist seniors with their adl, or iadl. anyone can make a referral to ccac. ...

External Links

25000 seniors suffer broken hips: Study -

30 May 2007 ... Almost two-thirds of seniors who suffer a broken hip go under the knife ... that nearly 25000 seniors were admitted to hospital in Canada in 2005-2006 with a broken hip. ... with problems in setting the bones, said Dunbar, but other factors. ... identifying people at risk, working on fall prevention ...

The Scope of the Problem - Report on Seniors' Falls in Canada ...

1 Oct 2009 ... self-reports from the CCHS sample, broken down by gender and age group. .....hospitalizations for seniors in residential care ranged from .... Mortality data from Statistics Canada were analyzed for all direct ... " Fall-related
Antidepressants and the risk of falls among nursing home residents. ...

Seniors' Falls in Nova Scotia

seniors at risk was 124586. The rate of fall-related hospital admissions for .... hospitalization was almost twice as high for females aged 65 years and .... by its very nature serious, almost always involving at least one broken bone and often involving ... 6 Statistics Canada. “More seniors living with a spouse, ...

Meds put seniors at higher risk of falls - The Globe and Mail

23 Nov 2009 ... Meds put seniors at higher risk of falls. A new UBC report finds adults over 60 on ...Hospitalization can start a chain reaction, she says.

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