by Robert Stall MD, Geriatrician

If you’re fortunate enough to have one or both parents still living, you may have noticed a role reversal taking place in your relationship. Remember the days when Mom shuttled you to the doctor whenever you were sick? Now, it may be you who’s driving her to her medical appointments. Perhaps you’ve become even more involved in managing her healthcare needs – serving as her healthcare proxy, moving her into your home to care for her, or even having to select a nursing home for her to live in.

Whatever the case, it’s natural to feel challenged – and, yes, intimidated – in the role you’ve undertaken. But if you stay positive and proactive, you’ll be in a great position to advocate for your parents’ optimal care. And, really, what better way is there to say “Thank You” for all they’ve done for you over the years?

The following six recommendations will help you understand what may be happening to your parents as they age – and what you can do to help.

1. Stay vigilant to sudden changes.
Typically, sudden changes arise from sudden problems. Your elderly father who becomes confused one week but was alert and oriented the week before, or becomes unsteady walking and starts falling, is likely experiencing an acute problem – an infection, medication side effect, or perhaps, a heart attack or stroke.

If you pay attention to your parent’s baseline health and behavior, you’ll be alert to sudden, and subtle, fluctuations. Being attuned to what’s “normal” for your parent is critical in advocating for his care. By informing his physician of these changes, you help ensure that he receives a proper diagnosis and timely treatment – especially important in acute conditions.

2. Investigate the source of gradual decline.
Several years ago, I met an elderly woman living in a nursing home. Her family, assuming she had dementia, had moved her there after she had gradually stopped speaking.

After performing a brief procedure on her, I asked how she was doing. “I’m OK,” she replied.

A miracle? Not exactly. I’d removed bullet-sized pieces of wax from her ears. She’d stopped speaking because her ears were too plugged to hear.

A host of conditions can cause gradual decline. Before jumping to the conclusion – as many people do – that Alzheimer’s disease is the culprit, recognize that your parent may be experiencing an altogether different problem: a vitamin B12 deficiency, an underactive thyroid, Parkinson’s disease or depression, to name a few.

When discussing your parent’s decline with her physician, make sure the two of you consider all the possibilities. To prepare for the appointment, make notes detailing how her decline has manifested itself – loss of appetite, a failing short-term memory and so forth – and how long you’ve noticed these changes. That way, you won’t leave anything out. To help you, I’ve created a free checklist that either you or your parent can complete at seniorselfassessment.com – make sure you print or email the “Test Result Details” at the bottom of the page to analyze your responses and give you advice based on your answers.

3. Know thy parent’s medicine cabinet.
Familiarize yourself with the medications your parent takes: what each one is for and how often he takes them. Make sure you notify each doctor your parent visits of all the medicine he takes, including over-the-counter products. Ask what side effects you might observe from each medication and whether it’s potentially dangerous if your parent takes them together. You also want to tell the doctor whether your parent drinks alcohol or caffeinated drinks and whether he smokes, as these substances can affect some medications’ efficacy and safety. To recognize which medications might cause the symptoms your parent experiences, check out  drugscanmakeyousick.com .

4. Discourage ageist attitudes.
Simply put, ageism is prejudice against the elderly. It exists in many forms but can be particularly damaging to an older person’s self-esteem when it assumes that all of her woes are age-related. Here are a couple of ways of expressing ageism to an elderly parent:

“What do you expect at your age?”
“You’re not getting any younger.”

If you’re ever tempted to utter something similar, remind yourself that by chalking up everything that ails her to her age, you sell your parent short. If she’s depressed, it may have nothing to do with the fact that she’s 80 and everything to do with a biological predisposition to depression. And remember that right-knee pain in a 90 year-old can’t be just from age if there’s no problem with her left knee. (More about Dr. Stall and a more in-depth article on the attitude of society towards medical care for the elderly can be found at http://www.longtermcarelink.net/eldercare/medical_care_issues.htm )

5. Address not just symptoms—but emotions, too.
There is disease and then there is “dis-ease” – that is, a lack of ease, security or well-being. “Dis-ease” can manifest itself as myriad emotions in an elderly person: fear, grief, boredom, embarrassment and sadness among them. The fact is, these emotions can be every bit as debilitating as disease.

Take the case of a parent who’s incontinent. Too embarrassed to socialize, she cuts herself off from friends. Without companionship, she becomes lonely. Instead of allowing her to become a hermit, discuss with her doctor how to address the incontinence. Together, you can consider different solutions that will ease her embarrassment and reinvigorate her social life.

6. Strive to maximize your parent’s quality of life.
No matter our age, we all want to enjoy life to the fullest and have the capability to do the things we want to. Improving the enjoyment of life and a patient’s functional ability are the cardinal goals of geriatric care. But you don’t need a medical diploma on your wall to help your parent achieve either of those goals.

Being there to solve a problem or provide company are tremendously worthwhile services you can provide – no expertise required. Remember, as your parent gets older, his quality of life becomes more important to him than how much longer he lives. And he doesn’t necessarily need medications or surgery to ensure that he’s living the latter part of his life to the fullest.

If he enjoys books but has difficulty reading regular-sized type, check out sight-saving titles at the library. If he’s grieving the loss of his best buddy, introduce him to new acquaintances at the senior center. If he’s living in a nursing home, bring your kids there to share a meal with him.

Sometimes, it’s the small gestures that have the most profound impact. As the child of an elderly parent, you are uniquely positioned to deliver these life-changing gifts.

Dr. Robert Stall is a geriatrician practicing in Tonawanda, New York and a clinical associate professor at the University of Buffalo’s School of Medicine and Biomedical Sciences. He serves as medical director and attending physician at Beechwood Homes in Getzville and Blocher Homes in Williamsville. To learn more about senior care issues, visit his website at stallgeriatrics.com or call 716-213-4345. For information on a new program offering balance assessment and fall prevention tips, call 716-213-0772.

By: Brian Tracy

To deal with change, perhaps the most valuable quality you can develop is flexibility. Form the habit of remaining open-minded and adaptable to new information and circumstances. When things go wrong, as they sometimes will, instead of becoming upset or frustrated, practice looking into the change or reversal for the opportunity or benefit it might contain.

Superior men and women are invariably those who remain calm and keep their wits about them in the midst of unexpected turbulence. They take a deep breath, they relax, and they assess the situation objectively. They keep themselves calm and unemotional by asking questions and seeking information when things don’t work out as they expected. For example, if someone doesn’t fulfill a commitment, or if a sale is canceled, or fails to go through, they keep their minds clear and steady by asking questions, such as “What exactly happened in this situation?” They deal with change by focusing on getting the facts before reacting. They develop the ability to cut through the confusion and ask questions such as “Why did this happen? How did it happen? How serious is it? Now that it has happened, what are the various things we can do?”

The critical issue in dealing with change is the subject of control. Most of your stress and unhappiness comes as a result of feeling out of control in a particular area of your life. If you think about the times or places where you feel the very best about yourself, you will notice that you have a high degree of control in those places. One of the reasons why you like to get home after a trip is that, after you walk through your front door, you feel completely in control of your environment. You know where everything is. You don’t have to answer to anyone. You can relax completely. You are back in control.

With a clear idea of where you’re going and what you want to accomplish, you develop resilience, which is the ability to bounce back rather than to break. You develop what is called the “hardy personality” and become the type of person who is resistant to the negative emotions that affect people who have no goals or direction.

The first step in dealing with any change is simply to accept the change as a reality. Acceptance is the opposite of rejection or resistance. Acceptance keeps your mind calm and positive. The minute you accept that a change has occurred, and that you can’t cry over spilled milk, you become more capable of dealing with the change and turning it to your advantage.

One of the best ways to deal with the worry that is often generated by unexpected changes is to sit down and answer, on paper, the question: “What exactly am I worrying about?”

In medicine, it is said that accurate diagnosis is half the cure. When you sit down and define a worry situation clearly on paper, it suddenly becomes less stressful to you, and it will often resolve itself. In any case, when it is clearly defined, you have diagnosed it, and you can now do something about it.

The second step is to ask yourself, “What is the worst possible thing that can happen in this worry situation?” Much worry and stress comes from the refusal to face what might happen as a result of your difficulty or problem. When you clearly define the worst possible outcome, and write it down next to the definition of the problem, you will find that, whatever it is, you can handle it. Often your worries will begin to evaporate as soon as you have clearly determined the worst that might happen as a result.

Now decide to accept the worst possible outcome should it occur. Mentally resolve that, even if the worst possible consequences ensue from this situation, it will not be the end of the world for you. You will accept it and carry on. In fact, it could probably be a lot worse. The very act of accepting the worst possible outcome completes the cycle of eliminating from your mind the stress and anxiety associated with the situation.

You are now ready for the third step in dealing with change, and that is to adjust your behaviors and actions to the new situation. Ask yourself, “What are all the things I can do to make sure that the worst possible outcome does not occur?” Sometimes we call this “damage control.” In the business schools, this is an important part of decision making, and it is called the “mini-max regret solution.” What can you do to minimize the maximum damage that can occur from an unexpected change or setback? As you begin thinking of all the things you can do, you are adjusting your mind to the new information and preparing to take steps to deal with the change effectively.

The final part of this four-step method for dealing with change is to improve on the existing situation. Often, a change signals that your plans are incomplete or that you might be heading in the wrong direction. Serious changes, which seemingly create real problems, are often signals that you are on the wrong track. There is an old saying, “Crisis is change trying to take place.” If, instead of resisting change, like a pine tree that snaps in a strong wind, you bend with change, like a willow tree, you will often find that the change is a healthy and positive step toward achieving your goals.

W. Clement Stone, the founder of Combined Insurance Company of America, is famous for his attitude of being an “inverse paranoid.” He is convinced that everything that happens is part of a conspiracy to help him to be more successful. Whenever something unexpected occurs, he immediately says, “That’s good!” and then looks into the situation to find out exactly what is good about it.

The mark of a superior person is what is called “tolerance for ambiguity.” This simply means that you have the capacity to deal effectively in a rapidly changing situation. The higher up you gothe greater your income and responsibilities, the higher your status and positionthe faster the rate of change will be around you. At every stage, it will be your ability to function with calmness, clarity and quiet assurance that will mark you as the kind of person who is going places in life. In the final analysis, your ability to perform effectively in a world of ongoing change is the true measure of how well developed a person you really are. And the keys are to accept change, to adjust to change, to improve upon change, and then to move on to the next situation. As you continue to do this, you will have such a wonderful feeling of self-control and self-determination that your whole life will be bright and positive, and so will your results.

About the author:

Brian Tracy is legendary in the fields of management, leadership, and sales.  He has produced more than 300 audio/video programs and has written 28 books, including his just-released book “The Psychology of Selling.” Special offer: To receive your free copy of “Crunch Time!, just visit www.briantracy.com and click on the Crunch Time! icon.  He can be reached at (858) 481-2977 or www.briantracy.com.