Health and Fitness

NEW FEATURE: Caregiving Guide for boomers and seniors

Editor’s note: is proud to present our comprehensive guide to caregiving services by longtime elder care advocate Jody Gastfriend. How to provide home care for a loved one is a major concern for both boomers and seniors. We hope to answer some of your most pressing questions with this ongoing series. Please check back regularly for updates.
About the Author
Author photoJody Gastfriend, VP of Senior Care Services,, is a licensed clinical social worker with more than 25 years of experience in the field of eldercare.
Jody’s broad range of leadership positions include Director of the Department of Social Services and Case Management at Lawrence Memorial Hospital, Clinical Supervisor within the Social Service Department of Massachusetts General Hospital, Chief Operating Officer of a Medicare-certified visiting nurse association, and Director of Adult Care Services at a national backup care company where she established a successful and expansive eldercare division serving more than 130,000 employees.
Jody shares the personal journey of her clients, having helped manage the care of her own parent with dementia for more than a decade. She has consulted to individuals, professional societies and corporations in the field of eldercare. Additionally, Jody has lectured widely on topics related to aging and work/family balance to audiences that include family caregivers, HR administrators, health care professionals and policymakers. A featured senior care expert on NBC and Fox News, Jody is a regular contributor to The Huffington Post’s Huff/Post50 section, and has published numerous articles on caregiving and aging, including a 5-part series in USA Today.
Jody received her BA, Magna Cum Laude, from Tufts University, and her Masters Degree in Social Work from Simmons College School of Social Work.
Part One, the Warning Signs
By Jody Gastfriend, LICSW
VP Senior Care Services,

I want to share a story with you. It’s the story of a friend of mine, Beth*-a typical sandwich-generation mom and daughter who had many people and priorities to juggle. But it was last year when she realized something needed to change.
Beth left home for college 30 years ago. After graduation, she got married, had two sons, and settled into a life in a small town north of Boston. But her roots, along with her aging parents, were still in Western Massachusetts. Among her three siblings, Beth lived the closest to her folks and was the most worried. Her brother, Mike lived on the west coast and typically chalked up Mom’s forgetfulness and Dad’s driving mishaps as part of getting older. Susan, the youngest, had her hands full with a rebellious teenager and a recent divorce. She had no room on her plate to worry about Mom and Dad.
So, as Beth drove to see her parents for their annual Labor Day end of summer soiree, she wistfully remembered summers past with Mom’s famous blueberry pie and Dad manning the grille. Beth also recalled the fractious squabbles that sometimes erupted amidst the merriment. Those tensions seemed far less weighty than the anxiety she now felt about her parent’s safety and welfare, and her siblings’ apparent dismissal of her fears.
Arriving at her parents’ home, Beth couldn’t help but stare at the peeling paint and the unkempt lawn. Years ago, she suggested her folks sell the house and find a place to live that was more senior-friendly. Dispelling her concerns, Beth’s parents quickly dismissed the idea. Beth, unsupported by her siblings, let the issue drop. Now, she regretted that decision. She opened the front door and got a whiff of something burnt. Turns out it was the pie.
Beth’s mother was apologetic. She had gotten distracted by the excitement of the day. Mom had always been a consummate cook. Beth also worried about her Dad who seemed unsteady and frail.  She asked how he was feeling and he replied “under the weather” but hadn’t seen the doctor in months. As the day progressed, Beth grew increasingly more concerned. She saw a stack of bills on the kitchen counter, some of them dating back months. She observed Mom forgetting simple things and got frazzled easily. While Beth did not want to worry excessively or make a scene, things seemed out of sorts and she could no longer pretend otherwise.
Family get-togethers are a time when emotions get stirred up. Excitement, joy, sadness and stress can all be part of the family recipe. Many adult children, like Beth, must face a changing reality and confront their own anxiety and grief as their parents lose their strength and independence. These changes are often more prominent around celebrations, particularly for adult children who live at a distance. It is easy to overreact when we see, as Beth did, bills piling up or a home not properly cared for. At the same time, it is important to differentiate changes in behavior. A newfound tendency to let the house go a bit can be part of normal aging, or it can represent illness and decline. When I later met Beth for coffee, she told me she worried that the burnt pie was an ominous sign. I assured her that one burnt pie does not foreshadow disaster, but a pattern of uncharacteristic behaviors, is more of a concern.
Family gatherings can be incredibly stressful. In the midst of all the activity and eating, they can also provide an opportunity to observe our parents as they age. So here’s what to look for to determine if your worries are justified and whether there are real concerns about your parent’s wellbeing and safety that need to be addressed:

  • Change in eating habits/weight loss
  • Forgetfulness-out of the ordinary
  • Neglected personal hygiene and cleanliness
  • Decrease in socialization and activity level
  • Significant mood changes
  • Unexplained dents in the car
  • Misuse of prescribed medications
  • Mishandling finances

Like Beth, so many adult children feel they shoulder the burden of worry on their own. Getting siblings on the same page, whenever possible is a good place to start. Sharing perspectives on Mom’s increasing forgetfulness or Dad’s unsteady gait can shed new light on your understanding of the problem. Has it been an ongoing progressive decline or an intermittent reaction to stress or illness?  Gathering information, as objectively as possible is the first step toward being an effective caregiver. Unlike Beth, you don’t have to go it alone. Getting the support and information you need early on can help you navigate the unexpected twists and turns along the caregiving journey.
Stay tuned:
Part Two: What Next?
Get on the same page with your sibling.
Hold a family meeting before a crisis erupts
Develop a plan to best care for your parents
Part Three:  Caring for our Parents — and our Selves.
Editor’s Note: Beth is a composite of friends and family caregivers

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