Just in front of every baby boomer, there is a parent. Or parents. Like me, on the brink of old age, with all that aging brings.
Let us suppose that I am your mother.
Chances are, when you ask me, "How are you Mom?" I will answer "Fine". Am I?
Or am I in denial, protecting you from the truth, afraid to admit to my physical, mental lapses, covering up?
What do you know about me? Not assume, but really know?
Let's do the factual check first. Have I identified someone as an emergency contact? Have I informed that person, and the rest of the family about this? Is this information, along with my basic medical history, in my wallet? If that person is you, do you know the name and telephone number of my doctor?
Are you up to date with my various diseases, surgeries, illnesses, and meds? Do I have a living will? Have I named a health care proxy? Does the doctor have copies of this? Do you? If you are the health care proxy, are you prepared to say no to an insistent doctor if he wants to perform a procedure I want declined? Can you stand up to that pressure? Do you know your rights as a proxy? Are your siblings on board with my decision, and your obligation to enforce my decision? Have you had a family discussion about my aging process and what it might mean to everyone, not just me?
Depending on where I live, do you know how much my old age care will cost? What insurance do I have? If I want to remain independent, in my own home, do I have the financial resources to support that? For how long? Who would be the caregivers? Have you discussed this with your siblings and/or step-siblings? If I must go into assisted living or a nursing home, what do you know about the available facilities? Do you know what the government program would cover, and what expenses would have to come from my income? Or from you and your siblings? Just when you finish with paying for your childrens' college education, will you have to start paying for your parents' care?
Are you aware of the tests that are labelled ADLs -- Activities of Daily Living -- assessments of the abilities people need to have in order to live by themselves? How do I rank? Can I bathe, dress, use the toilet myself, move without help, eat without assistance? Loss of two or three of those is usually considered to be the qualification for admittance to a nursing home. Do you know my end of life wishes?
Now, let's consider what I think of as the eyeball/ intuitive check.
If you live far away, how often do you contact me? Do you know me well enough to recognize changes in my voice that might indicate a problem? Do you hear different things in my voice at various times of the day? If I don't answer the telephone for some time, whom would you call to check on me? When you were a teenager, your parents wanted to know who your friends were: You need to know who your parents' friends are.
When you visit me, do you look at me? Closely? Am I as well-groomed and carefully dressed as has been my habit? Can I hear you? If not, has my hearing been checked? Have I had wax removed from my ears? What pills are on my night table and in my medicine cabinet? Do you know that almost a third of all hospitalizations of elders are medication-related?* Have I lost weight? Do I seem frailer? What food is in the refrigerator? Are there new dents in the car? Do I seem to be overloaded with new magazine subscriptions? If so, I am probably the target of telemarketers: You might want to see what else I might have been ordering. Is the checkbook in order? How much alcohol am I drinking? Do familiar objects seem to be missing?
Take a walk with me. How is my balance? My posture? My gait? Am I getting enough exercise? Do I still have a life outside my home, friends, activities? Am I still engaged with life or have I been withdrawing from events, people, I once embraced?
Are you prepared to step in and ask these questions and have this discussion before there is a crisis? I might welcome your taking over some of my responsibilities. And, yes, I might be testy, even angry at the suggestion that I can't manage everything myself. I am the parent, you are the child. I may well resist. But I hope, in my heart, that you will continue to push because I know, in my brain, that if we face the problems of my aging as a family, we will make better, more informed, less pressured decisions, and that when I die, as I must, you will have no regrets, and I will have the good death that each of us prays for.
*source: My Mother, Your Mother, Dennis McCullough, M.D., Harper, 2008.