4 Fears Surrounding End of Life Care and How to Overcome Them

Many families find conversations about end of life care difficult to broach with a parent or aging loved one, but surely they have come up. Perhaps you were driving away from a nursing home visit with your mother when she told you she “never wants to live in a place like that.” 

Or, maybe you were sharing coffee after a family funeral when your father told you that he “never wants to be hooked up to ventilators like Uncle Mark was.” Statements like these open a window into their desires as they relate to end of life care, but they don’t provide you with the full picture you need to adequately plan ahead. 

The 40-70 Rule^® is a good rule of thumb: have an intentional conversation surrounding these concerns by the time you are 40 and your parent is 70. But no matter your age, it can bring immeasurable peace of mind to communicate openly with your family about end-of-life fears and wishes so you can plan ahead to ensure those wishes are honored.

Here are a few of some of the most common fears and ways to overcome them.

Fear #1: “I hate the thought of having feeding tubes and ventilators keeping me alive.”
What you can do about it: Consider establishing a living will. Living wills detail an individual’s treatment preferences in the event he or she is unable to make those decisions for him- or herself. The requirements for living wills vary from state to state, so you should also consider having a lawyer assist with this. Many lawyers will prepare a living will as part of an estate planning package.

Fear #2: “I’m afraid I will end up in a nursing home, and I don’t want to die in a hospital or institution.”
What you can do about it: There are many options for end of life care outside of nursing homes and hospitals. Make sure that you have a conversation with your parent about his or her wishes and look into home care options together so that you are prepared when the time comes.

Fear #3 “What if I get dementia and can no longer make my own decisions?”
What you can do about it: It’s wise to have your parents designate a trusted person with power of attorney (POA) who will act on their behalf in the event that they are no longer able to advocate for themselves. Designating a person with POA will give them peace of mind that their care wishes will be met regardless of their mental acuity.

Fear #4: “I don’t want to lose my independence.”
What you can do about it: Look into the home care options in your area so that your parent can have the help they need to continue living independently at home without feeling like they have to rely on you to help meet their daily needs.

The best way to address the end-of-life fears your parent may be struggling with is to communicate clearly with them about their wishes in advance. If the topic doesn’t come up naturally, set up a specific time to talk. Try to remain open and put yourself in your loved ones’ shoes to better understand their wishes and the reasoning behind them. Be sure to record your discussion by taking notes so you have something to refer back to when making plans and decisions in the future. 

For many, it’s normal to feel anxiety surrounding this topic, but know that having open communication with your loved ones will likely give your family a sense of peace that will far outweigh any anxiety you feel broaching the subject.

For additional guidance when it comes to discussing end-of-life wishes with your loved ones and developing a plan, download the 40-70 Rule: An Action Plan for Successful Aging^SM or call your local Home Instead Senior Care office.

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Research: Upbeat Attitude Spells Great Heart Health

According to at least one study, older people with a positive, upbeat attitude also typically have significantly better cardiovascular health. And, as the positive attitude scores climbed, so did the health scores in this study that included seniors up to age 85. Those with most optimism were twice as likely to enjoy a healthy heart.

“Individuals with the highest levels of optimism have twice the odds of being in ideal cardiovascular health compared to their more pessimistic counterparts,” said lead author Rosalba Hernandez, a professor of social work at the University of Illinois.

“This association remains significant, even after adjusting for socio-demographic characteristics and poor mental health.” Participants' cardiovascular health was assessed using the seven metrics that the American Heart Association uses to define heart health: blood pressure, body mass index,fasting plasma glucose and serum 

cholesterol levels, dietary intake, physical activity and tabacco use.

 To learn more about this study, visit http://news.illinois.edu/news/15/0108optimism_RosalbaHernandez.html.  

Balance Problems Could Be Warning Sign

A new study that finds seniors – average age 67 – who have trouble balancing on one leg for at least 20 seconds may have increased risk of small blood vessel damage in the brain – stroke – and reduced cognitive ability. The research included healthy older people with no clinical symptoms, according to the report in the American Heart Association’s journal Stroke.

 

“Our study found that the ability to balance on one leg is an important test for brain health,” said Yasuharu Tabara, Ph.D., lead study author and associate professor at the Center for Genomic Medicine at Kyoto University Graduate School of Medicine in Kyoto, Japan. “Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline.” 

The study consisted of 841 women and 546 men. To measure one-leg standing time, participants stood with their eyes open and raised one leg. The maximum time for keeping the leg raised was 60 seconds.

Participants performed this examination twice and the better of the two times was used in the study analysis. Cerebral small vessel disease was evaluated using brain magnetic resonance imaging.

Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with cerebral small vessel disease and the potential for strokes. 

To reduce your risk of falls, be sure your home is not a safety trap. Go to MakingHomeSaferforSeniors.com for a home safety tour and checklist that can alert you to the potential safety hazards in your home.

 

For more about the study, visit http://blog.heart.org/ability-balance-one-leg-may-reflect-brain-health-stroke-risk/.

Nearly Half of U.S. Seniors Need or Receive Help at Home

Nearly half of seniors in the U.S. – 18 million people – have difficulty with daily activities or get help managing them, according to a new study. Researchers from the University of Michigan and the Urban Institute analyzed data from a national sample of older adults drawn from Medicare enrollment files. In all, 8,245 people were included in the 2011 National Health and Aging Trends Study.

“Although 51 percent reported having no difficulty in the previous month, 29 percent received help taking care of themselves or their households or getting around,” said U-M researcher Vicki Freedman, co-author of the report with the Urban Institute's Brenda Spillman.“And another 20 percent said they had difficulty carrying out these activities on their own. Among those receiving help, one in four lived in either a supportive care setting (15 percent) or a nursing home (10 percent).

Nearly all older adults had at least one potential informal care network member – family or household member, or close friend – and the average network size was four people. Older adults who lived in the community reported receiving an average of 164 hours of care a month from informal caregivers – more than five hours a day, on average. Older adults living in supportive care settings reported nearly 50 hours of informal care per month.

About 70 percent of those getting help received assistance from family, friends and other unpaid caregivers, while about 30 percent received paid care.

Visit http://ns.umich.edu/new/releases/22363-almost-half-of-older-adults-have-care-needs for more information about the study.