ask the expert

Here are some typical questions and answers from ElderCareCanada clients.

1. Q. My mother just learned she has diabetes but neglects her medication and diet. How can I help her look after herself? go there
2. Q. I followed my dad, 78, enroute to a family party, and was appalled by his driving – erratic speed, unsafe lane changes and dangerous hesitation at on-ramps. He’d be devastated to give up his license – what can I do? go there
3. Q. My mother must take several medications at different times of the day. She has always managed them herself, but recently I notice there’s a mini drugstore on her night table. Does she really need all those drugs, and how can we be sure she’s keeping them straight? go there
4. Q. My mother refuses to discuss finances with me; doesn’t she trust me? go there

1. Q. My mother just learned she has diabetes but neglects her medication and diet. How can I help her look after herself?

A. Accepting any disability’s symptoms, limitations and prognosis is extremely difficult. Some ideas:

• Get informed – scour the Internet and publications so your advice has credibility
• Be a support – visit the doctor with your mom and record what is discussed; make a list of her medication schedule; find diabetic cookbooks and products
• Seek help – contact the Canadian Diabetes Association (416 214-1899) for resources and programs; if your mother won’t go, attend a caregiver support group yourself for ideas
• Get involved – consider doing volunteer work for the Diabetes Association, then try to involve your mom to see how others cope with the disease
• Back off – when you’ve done all you can, don’t nag – it can be counter-productive
• Above all, use humour
  • recall how she couldn’t ‘make’ you study or practice piano
  • talk about past successes and remind her you’re always there for her

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2. Q. I followed my dad, 78, enroute to a family party, and was appalled by his driving – erratic speed, unsafe lane changes and dangerous hesitation at on-ramps. He’d be devastated to give up his license – what can I do?

A. Research confirms that older drivers are involved in more accidents – per kilometer driven – than their middle-aged counterparts. Of course you want your dad to be independent as long as possible – and drive safely and confidently.

• Identify dad’s driving challenges – vision, reaction time, physical limitations
• Schedule a family doctor visit - to check vision, hearing, cognition, medication dosages and /or combinations.
• Get an evaluation - by a driver rehabilitation specialist who can make specific recommendations for improvement.
• The doctor - may write to the provincial Ministry of Transport recommending that the licence be revoked. With luck, this step may convince your dad to surrender his licence and keys voluntarily.
• Send a copy of the doctor’s letter - to the Ministry should be sent to his auto insurer, who will cancel his policy

No one wants to treat a family member in this way, but you must keep in mind the liability and potential for harm to your parent and to others. It’s an unhappy role-reversal for you to do this to your father, so make sure you have the understanding and support of all family members, and give yourself credit for having the courage to love your dad so much.

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3. Q. My mother must take several medications at different times of the day. She has always managed them herself, but recently I notice there’s a mini drugstore on her night table. Does she really need all those drugs, and how can we be sure she’s keeping them straight?

A. You are right to be concerned about this issue – it’s estimated that 50% of prescription drugs are ineffective because they are not taken properly. It’s also common to receive prescriptions from more than one physician, which may lead to inadvertent adverse reactions between various drugs. Add that to the very real possibility of confusing or missing a dose, and your mom could be at serious risk. Here is a plan:

• Verify all prescriptions - make notes, recap the decisions and leave the discarded medications with the clinic for disposal – if you take them home, they’ll find their way back to the night table!
• Set up a dispensing system – ideally, a pharmacy-filled dosette or blister pack. The pharmacist reviews all prescriptions and pre-fills all medications by day and time. The dosette or cardboard blister pack can be picked up or delivered on a weekly basis.
• Write it down - the blister pack labels outline the medication name, dosage and condition it’s prescribed for. Document this list, keep a copy and tuck one into your mom’s wallet beside her OHIP card, so that anytime she seeks medical attention – especially if she’s not able to communicate – the information is readily available.
• Stay involved - Do her medical practitioners know you? If she were incapacitated for any reason, do you know enough about her medical condition to direct her care? If not, get informed now – don’t wait for a health crisis.

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4. Q. My mother refuses to discuss finances with me; doesn’t she trust me?

A. Financial matters are often the last bastion of control, so you must reassure your mom that knowing doesn’t mean taking over:

• Remind her that all decisions she has made about her care and well-being will be respected, but they must be documented – are Powers of Attorney and a Will in place?
• Explain that to carry out her wishes, you need to know the relevant players now, not when a crisis occurs
• Meet her banker, accountant, financial advisor, insurance agent and lawyer before they need to contact you in a crisis
• Help simplify her banking arrangements by using electronic payments, direct deposits and consolidating accounts into one branch

Try not to take her attitude personally; your mom may be trying to spare you time and effort. As you work together on a solution, your mother may feel comfortable sharing more information and, ultimately, more responsibility.

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