Top Ten Questions
Adult Children Have
About Parents’ Health Care
Presented by
RiverWoods

The following are some helpful facts and resources we have gathered that answer some of the top
questions adult children have about their parents’ future health care needs.

1) How do I become more informed about my parents’ heath care situation?

Ask your parents directly if you can become involved with their care. Tell them your concerns for them
or for their future. Ask permission to speak to their primary care doctor. With HIPAA rules, most medical
providers by law cannot speak to any one other than the patient without written consent. You will not
be given information even if you are named Durable Power of Attorney for Healthcare unless it is
activated by a physician because a parent has been deemed lacking capacity to make their own
healthcare decisions.

2) How do I differentiate between the start of Alzheimer’s versus typical agerelated memory loss?

Ten Signs to Watch (source: Alzheimer’s Association)

• Memory loss that disrupts daily life
One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned
information. Others include forgetting important dates or events; asking for the same information over
and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for
things they used to handle on their own.
What's a typical age-related change? Sometimes forgetting names or appointments, but remembering
them later.
• Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with
numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may
have difficulty concentrating and take much longer to do things than they did before.
What's a typical age-related change? Making occasional errors when balancing a checkbook.
• Difficulty completing familiar tasks at home, at work or at leisure
People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble
driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to
record a television show.
• Confusion with time or place
People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble
understanding something if it is not happening immediately. Sometimes they may forget where they are
or how they got there.
What's a typical age-related change? Getting confused about the day of the week but figuring it out
later.
• Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading,
judging distance and determining color or contrast. In terms of perception, they may pass a mirror and
think someone else is in the room. They may not realize they are the person in the mirror.
What's a typical age-related change? Vision changes related to cataracts.
• New problems with words in speaking or writing
People with Alzheimer's may have trouble following or joining a conversation. They may stop in the
middle of a conversation and have no idea how to continue or they may repeat themselves. They may
struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g.,
calling a "watch" a "hand-clock").
What's a typical age-related change? Sometimes having trouble finding the right word.
• Misplacing things and losing the ability to retrace steps
A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable
to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may
occur more frequently over time.
What's a typical age-related change? Misplacing things from time to time, such as a pair of glasses or
the remote control.
• Decreased or poor judgment
People with Alzheimer's may experience changes in judgment or decision-making. For example, they
may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay
less attention to grooming or keeping themselves clean.
What's a typical age-related change? Making a bad decision once in a while.
• Withdrawal from work or social activities
A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects
or sports. They may have trouble keeping up with a favorite sports team or remembering how to
complete a favorite hobby. They may also avoid being social because of the changes they have
experienced.
What's a typical age-related change? Sometimes feeling weary of work, family and social obligations.
• Changes in mood and personality
The mood and personalities of people with Alzheimer's can change. They can become confused,
suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in
places where they are out of their comfort zone.
What's a typical age-related change? Developing very specific ways of doing things and becoming
irritable when a routine is disrupted.

3) How will I know if a condition of my parent requires some in-home help or a
significant change in lifestyle?

10 Signs of Trouble (source: Caregiverstress.com)

1) Household bills piling up. Seniors can feel overwhelmed by the simple task of opening and
responding to daily mail, as well as balancing a checkbook.
2) Reluctance to leave the house. Rather than ask for help, seniors who are having trouble with
such functions as walking, remembering, and hearing will pull away from their community and
isolate themselves.
3) Losing interest in meals. Seniors who suddenly find themselves alone, perhaps after the death
of a spouse, can be easily discouraged by such tasks as cooking and tend not to eat properly.
4) Declining personal hygiene. Changes in appearance, unkempt hair and body odor, failing to
change clothes for days on end, or clothes inappropriate for the weather are among the most
obvious signs that senior needs assistance.
5) Declining driving skills. Look for evidence of parking or speeding tickets, fender benders, dents,
and scratches on the car.
6) Scorched pots and pans. Cooking ware left forgotten on top of an open flame may be a sign of
short-term memory loss or even Alzheimer’s disease.
7) Signs of depression. Feelings of hopelessness and despair, listlessness, fewer visits with friends
and family, a change of sleeping patterns, and lack of interest in the usual hobbies and activities
are indicators of depression.
8) Missed doctors’ appointments and social engagements. These can be signs of depression or
forgetfulness. But they can also be the result of no longer having a driver’s license and not
knowing how to get alternative transportation.
9) Unkempt house. Changes in housekeeping may come about because the senior is physically
tired. They could also result from depression.
10) Losing track of medication. Seniors often take multiple prescriptions for various health
conditions. Keeping track without reminders and assistance can be confusing.

4) How do I suggest to my parents that they bring in additional help?

• Consider your approach
• Give concrete examples of what you see that concerns you – dishes piled up, dirty laundry,
dents on the car
• Suggest – do not tell your parents what to do.
• Be compassionate

5) How do I help my parents manage their medications?

• Make sure you (and their doctor) know what other medications your parent is taking, including
over-the-counter drugs such as antacids, laxatives, and herbal medicines.
• Try and use just ONE pharmacy for all of their medications and prescriptions
• Understand the medication
• Follow directions
• Watch for changes in their health after starting a new medication
• Have completed medical records

6) When will I know if my parent’s driving is no longer safe?

A checklist on safe elderly driving (source: AARP Driver Safety website)
Watch for telltale signs of decline in the elderly person’s driving abilities. If the answer to one or more of
these questions is "yes," you should explore whether medical issues are affecting their driving skills. Do
they:
• Drive at inappropriate speeds, either too fast or too slow?
• Ask passengers to help check if it is clear to pass or turn?
• Respond slowly to or not notice pedestrians, bicyclists and other drivers?
• Ignore, disobey or misinterpret street signs and traffic lights?
• Fail to yield to other cars or pedestrians who have the right-of-way?
• Fail to judge distances between cars correctly?
• Become easily frustrated and angry?
• Appear drowsy, confused or frightened?
• Have one or more near accidents or near misses?
• Drift across lane markings or bump into curbs?
• Forget to turn on headlights after dusk?
• Have difficulty with glare from oncoming headlights, streetlights, or other bright or shiny
objects, especially at dawn, dusk and at night?
• Have difficulty turning their head, neck, shoulders or body while driving or parking?
• Ignore signs of mechanical problems, including underinflated tires? (one in 4 cars has at least
one tire that is underinflated by 8 pounds or more; low tire pressure is a major cause of
accidents.)
• Have too little strength to turn the wheel quickly in an emergency such as a tire failure, a child
darting into traffic, etc.?
• Get lost repeatedly, even in familiar areas?
For information on a local driving course, Drive Ability at Exeter Healthcare, call 603-580-7927, or visit
www.exeterhospital.com, click on physical and occupational therapy, click on driver rehabilitation.

7) How do I know that my parents are getting adequate nutrition?

Some studies estimate that 15-50% of the elderly population is malnourished—and there are a
variety of reasons for this, including: depression, a physical limitation such as arthritis that makes it
difficult or painful to prepare food, poor dental health, declining appetite due to a diminished sense
of smell and/or taste, concerns about money, medication side effects that can reduce appetite or
cause nausea, lack of transportation needed to buy groceries and forgetfulness or dementia.
You can help make sure your parents are receiving adequate nutrition by:
• Offering nutritionally “dense” foods that pack a lot of nutrition in a relatively small serving.
Focus on unprocessed foods like whole grains, protein-rich beans, meat, dairy and “healthy” fats
like nuts, nut butter, seeds and olive oil.
• Make dining more social. Some older adults who live alone fail to eat well because they are
lonely and/or depressed and mealtimes are no longer enjoyable. Bring over a hot meal or invite
them to your home for meals on a regular basis.
• Take them to the grocery store or set up a home delivery plan with a local grocery store or an
online service.
• Make sure they have good dental health. Take them to the dentist and make sure any dental
appliances fit properly.
• Facilitate healthy snacking. Preparing (or eating!) an entire meal becomes burdensome for
some older adults. Daily nutrition often consists of several, smaller meals and healthy snacks can
be a major help in delivering adequate minerals, vitamins, fats and even protein. Fortified
cereals, yogurt, fruits and vegetables are good choices.
• Access government assistance for those who need it. Home-delivered meals, transportation,
adult day care and even nutrition education is available. Visit www.aoa.gov for details.
• Give reminders: Often, an older adult simply needs to be reminded to eat. Try to schedule
meals at the same time each day and offer verbal or visual clues to remind them when it is time
to eat.
• Hydration: make sure your parent consumes enough water and says hydrated.
• Check the Refrigerator: to make sure that food is fresh and not out of date.
• Also visit:
• www.healthandage.com
• www.nutrition.gov
• www.usda.gov
• www.eatright.org (American Dietetic Association)

8) How do I encourage my parents to exercise?

The first question is have your parents ever exercised? If they haven’t then don’t expect a sudden
change to their sedentary lifestyle. Invite them to exercise with you and start slowly – a short walk. Time
with you might be encouragement enough. If your parent has exercised in the past, try to encourage
them to start again and offer to help. Also exercise can be many different activities and you might want
to help your parent to redefine exercise into something they enjoy and can benefit from doing.
There is plenty of scientific evidence that lack of exercise is a risk factor for heart disease and cancer,
among other age-related illnesses and conditions. According to the exercise guidelines published by the
American College of Sports Medicine (ACSM), by exercising regularly, older adults can delay many of the
debilitating effect of aging. "Exercise helps produce new red blood cells, and may also strengthen the
immune system," explained Atlanta-based fitness trainer Ulrick Bien-Aime. Exercise also improves bone
density, elevates the mood and improves overall mobility.

9) How do I support my parent after the death of a spouse?

Remember your parent’s loss is a very different loss than yours. Ask how you can help. Everyone reacts
to grief differently and everyone’s timeline can be different. Two things to remember about the death
and grief it is exhausting – mentally, physically and emotionally and it makes a widow/widower feel
overwhelmingly vulnerable.
Supporting Those Who Grieve (source: Kansas City Hospice)
How can we effectively support those who grieve? We all want to see a friend, family member, coworker
or employee begin to feel in control of their life again. The caring presence of another human
being is known to be one of the most important supports a grieving person can have. The type of
relationship you have with the grieving person may suggest what supportive role is appropriate. It may
not be possible for you to meet all of the support needs of a grieving person. Even so, you may be able
to refer them to where they can get that support. Here are some practical suggestions on how to be
supportive.
• Allow and encourage survivors to talk about their loss.
Talking about the loss in detail, and as often as is needed is an important part of healing. A grieving
person may need to “flush out” difficult emotions by going over the story of what happened again and
again. Most grieving persons find it painful when friends or co-workers choose not to mention the loss.
One woman commented, “They make me feel like my son never existed.”
If a survivor is not ready to talk about a loss, you can still establish yourself as someone who is willing to
listen whenever that person is ready. Some of us are afraid we will make a grieving person cry or feel
worse if we mention the loss. Tears are healing. Talking about our grief generally lightens the load even
as it brings up strong emotions. If survivors have limited opportunities to talk about their loss,
encourage them to join a support group or consider counseling.
• Help the grieving person identify and accept the many feeling that make up the grief process.
Many grieving persons may be uncomfortable with some of their feelings, such as rage, or relief. They
may question whether these feelings are normal. It is essential that they get solid information on the
grief process by talking to another person who has been through the experience, joining a support
group, reading handouts or books, listening to tapes about the grief process, or talking to a counselor
who is experienced in grief related issues.
• Give the grieving person permission to grieve in their own way
Each person grieves differently and needs to be encouraged to respect the own limits, timetables, and
gut feelings about that they are ready to handle. Survivors get a lot of unsolicited and confusing advice
about what they should be doing and feeling. Grieving people often need permission to not be okay. In a
society where we value self-control, grieving people often have unrealistic ideas about how well they
should be going. Grief hurts, and hurts for a long time.
• Be available over time.
Grieving persons need support through the first year and at the first anniversary of the death. Much of
the hardest grieving begins after a few months. Birthdays and wedding anniversaries can be difficult.
The greatest need for support often comes at a point when offers of support have significantly slacked
off.
• Reinforce that grief affects health and encourage self care activities.
Fatigue, loss of concentration and changes in appetite are just a few of the common physical symptoms
of grief. Survivors often feel reassured after a thorough physical exam and should be encouraged to
have one in the months after a loss. Exercise, attention to healthy eating and adequate rest are
important. Medication that alters moods should be taken conservatively under a doctor’s close
supervision. The use of excessive drugs or alcohol only delays the grieving process. Encourage the
grieving person to make his or her own needs a priority.

10) How do I discuss finances with my parents?

The most important thing is to start. It is uncomfortable for children to ask their parents if they are
paying the bills and have health coverage. As seniors age, they may struggle to keep up with their
finances. Some signs to look for are bills stacked up, unopened, not having cash in their waller to pay for items, few groceries in the house. Starting the conversation may be hard. Some parents may thing you are butting into their business or only interested in their estate. You need to get past this by being open and hones.

Some questions to ask:

• Do they have an overall financial plan?
• Do they have a financial advisor?
• Have they done any estate planning?
• Where do they keep their financial records?
• What are their monthly expenses?
• What is their income and where does it come from?
• Do they have a Durable Power of Attorney for Finances and where is it?
• What kind of medical insurance do they have in addition to Medicare?
• Do they have medical insurance to cover their medications?
• Do they have a Durable Power of Attorney for finances and a Living Will? Where is it located?