Aging Adult Care with Anita Beckerman (cont.)

Moderator: When we talk, in this forum, of "older adults", which age bracket are we referring to?

Dr. Beckerman: That's a confusing kind of question, because at 69, do I consider myself old? No. But 65-plus, and then the older old, from 85 and up, a group of which we have more today and will have in years to come.

Moderator: How will geriatric care change in the coming years?

Dr. Beckerman: I think it's a happening that we can't do much about, and it's a positive happening. The Social Security Administration has recognized that factor, because they've done away with the amount of money that an older person can earn when they start getting social security. Older people are working later in life, and contributing more to society. There'll be an increased need for health care that will take into account the older adult's need. This focuses on the needs of the older adult, and the changes that take place, which are the normal changes to aging. The diseases usually encountered chronically need to be more acknowledged in how you treat and assess that person. Community resources as well. A lot of money will be needed to help the older adult live better, because they will live longer. They are now.

Moderator: Do you feel that the current medical establishment is adequately trained in gerontological medicine?

Dr. Beckerman: I feel both the medical and nursing establishment need more training in gerontology. There are more geriatricians available, but you have to look for them. There needs to be more specific courses in gerontology; not just added onto the program but focused on the needs of the older adult, just like pediatrics.

Moderator: How important will the need for geriatric care, or assisted-living facilities, become?

Dr. Beckerman: Very much, but it's getting a little over crowded. Most older adults live in their own homes, at this point in time, and are taken care of by community resources or family members. That was one of the reasons for this book -- that most of the caregivers are women. What happens is that the sandwich generation, or the children of the older adult, are getting older and have their own needs and stresses. Many are working later in life, and have children who are adult and growing up, so that the old older adult may need to go into a nursing home or assisted living. And that's very costly. Not all are able to go into Medicare or Medicaid, because most are private pay. The book discusses very clearly what you need to look at to judge a facility's quality, because many are very good.

Moderator: And conversely, some of them aren't as good?

Dr. Beckerman: In the book, we discuss the 10 most important indicators of a facility's quality, for example, the attitude of the staff towards the residents. Does the staff feel this is just a job, or is there a caring observed? Regarding the condition of the resident's rooms, and the quality of the care given, is it given with a friendly touch, or given kind of rough? As to adequate staffing, is there an RN (registered nurse) onsite at least eight hours during the day? Are the staff licensed certified by the state? The quality of the food served -- you may need to appear and ask if you can have a meal there, and see how it's served, and the environment where it's served. If the facility isn't located where the caregiver can travel to see if the person is there, then everything doesn't matter too much. And the cost -- is that within your budget? Some may need private pay; some Medicaid or Medicare will cover them. How are the public areas? When you walk in, is it lit and pleasant? And your overall impression -- gut feeling, most important. What was the impression you received of the place? You want to take a trial visit with the person you are thinking of having this facility as their home.

Moderator: What options are available if someone doesn't have a lot of money for geriatric care?

Dr. Beckerman: The options are, for the person who is the care receiver and needs to have the care, perhaps they need to go on Medicaid. This is something you may need to explore with a social agency of the state. That's one of the things our government needs to get more involved in, and make sure it's available on an equal basis to all older people. It should be that the resources are on an equal basis for all older people.

Moderator: What does care-giving for an older person entail?

Dr. Beckerman: It involves both physical involvement, emotional involvement -- and one of the things about this book, is that it's very comprehensive -- it takes in all areas of care-giving, and we want to make the task easier. We want to make people feel good about what they're doing, and to help them take care of themselves. We give advice on managing medications, aspect of dating, moving, incontinence, emotional support, and very importantly, the book starts out with emphasizing communication skills, and resolving care-giving issues. We give practical advice, and hopefully enough detailed instructions so the caregiver can give good care. It gives guidelines to balancing your own life. It's so important for the caregiver to look at the same area of nutrition. You also need to eat well and make sure you have a relaxing time for meals. If you can, get a neighbor or friend to perhaps sit with the person while you're eating your meal, or put a favorite movie on the VCR while you're eating or cooking. One of the things I say is serve on paper plates. You have to do things as they maybe were not done before, but know that's okay. Make these changes and know they're okay. Most caregivers are still working, and if you're juggling time constraints and personal needs, you need to know what to do, and to know that it's okay. You don't want to feel guilty about doing it.

Moderator: Can we address the role of adult children in this? What are some tips for balancing the needs of an aging parent and the needs of your immediate family?