As your parents get older and you have to assume more responsibility for their care, it can be a challenge. You want to do what is best for them, but you also want them to remain as independent as possible. Balancing the two – and your own life – can be one of the most difficult things you will ever have to do.

Years of being on their own and making decisions for themselves can lead to resentment when you try to take over the decision-making for your aging parents. Your parents see you as the child – someone that needs taking care of – not someone to take care of them. Here are some things you can do to help deal with difficult parents.

Consider what is best for everyone. Its easy to put their needs ahead of all else, especially if you are in an emergency situation. Before making any decisions, make sure you look at all options and understand the pros and cons to each. Don’t assume something will get better over time. Sometimes you have to seek help to accomplish what is best for everyone. Do not be afraid to ask for help when you need it.

Sometimes you have to say “no”. Not everyone can deal with the situations that arise when caring for difficult parents.  Realistically look at your lifestyle and work in your new requirements. Can you fit in extra duties every week? Can you cut back in other areas? Remember, this will more than likely be a long term plan. If you cannot handle the burden, do not feel guilty. It is best for your parents to be cared for in an environment that is prepared for the challenge.

Do not expect something in return. Many times, as your parents age, mental illness and dementia leave them unable to understand what you are doing for them and why. Fights may start. And resentment may grow quickly. Go forth without expecting a lot of gratitude – in other words, do it because you want to, not because you want glory. When times get tough and you have trouble keeping perspective, reach out to others in your community to receive help for yourself.

Feel good about your efforts. Sometimes, despite your best efforts, you cannot provide the care that a loved one requires. If you do your best and it is still not enough, that is alright. Be proud of giving it your best shot and do whatever is best for your parents – even if it means receiving help from outside sources. Even small amounts of help several times per week can lift the load off of your shoulders, and give you much needed time for yourself.

Don’t forget about you. When faced with a busy schedule, family responsibilities, and caring for a difficult parent, you can easily forget about yourself.  You must take time to care for your own physical and mental well-being or you will not be able to provide the care and attention that your loved one needs.

It happens all the time.

Your father (or mother) ends up in the hospital in an emergency situation. They quickly move through the different areas – ER, surgery, recovery – and before you know it you hear the most frightening words imaginable.

“We’re releasing your Mother in the morning.”

What do you do? Especially if you know there is know way she can go home and take care of herself in her current situation.

While many hospitals are working on their discharge protocol these days, it still comes as a shock to many. You’re quickly faced with major decisions, such as

• Do I move Mom home with me?

• Do I find a nursing home or rehab center?

• Can she manage in her own home?

• What options do I have?

If you haven’t heard these words yet, keep these tips in mind in case the day ever comes.

Find out who is in charge

As soon as your family member is stabilized and out of immediate danger, start asking to find out who will ultimately be in charge of the discharge process. In some hospitals they have a discharge coordinator. In some, it’s the patient’s primary nurse. Whoever it is, start the conversation early.  Early communication keeps you up to speed on the situation, and in some cases can allow you to find resources that will be of help to you, yet take longer than 24 hours to plan for. Find out what condition your loved one is truly in, and what other families have done in situations like yours.

Do your own research

While you’ll probably be spending a lot of time in the hospital, the good news is most hospitals have wi-fi access and you should be able to use the Internet through your smart phone, tablet or computer. Start searching for information that applies to you. The NY Times has a great resource section that offers a slew or resources on caring for the elderly.  Also spend some time on our blog. We’ve been writing for almost four years now; you’ll find a wealth of information on everything from handling caregiver stress, to understanding the symptoms of Alzheimer’s. And much more.

What will you have to do?

Even though discharge may be days or weeks away, start the conversation early to find out exactly what a typical day will be like when your loved one leaves, especially if you are considering taking on the responsibility of caregivng. Will your loved one be able to use the restroom on their own, or will you have to help? Can they climb stairs? Will you be changing bandages? Will you need special training? This may give you a better understanding of what you are in for, and help you determine if you need in home caregiving help from the start.

Don’t expect it to go according to plans

While you can plan and think you’ll be prepared, very rarely do things run smoothly. Discharge plans can be illegible if handwritten, and many things can be left out in the last minute rush. Medications may not be sent home with your loved one, and you’re first “panic” moment may be running to the drugstore while worrying about the family member at home.

Instead of making plans for your first day, keep it simple. Don’t go into it with any expectations, other than moving your loved one and making them comfortable. Consider having two or more people there for the move – its always good to have extra hands for moving and extra ears for listening to last minute changes. Stay calm and remember you can always confirm with a quick phone call if something doesn’t appear to be quite right.

Stressful lives, lack of exercise and poor diet are contributing factors to hypertension and high blood pressure. Most people know about these risk factors and how to prevent them. The problem is that many patients who are at risk for hypertension and high blood pressure issues are missing vital knowledge. There are certain aspects of both illnesses that patients in potential high-risk categories should know about.

1.    Hypertension and high blood pressure are one in the same. Though some doctors, nurse practitioners and medical articles may refer to them as separate issues they are, in fact, the same illness.

2.    Each patient should know the two basic terms, which are systolic and diastolic pressure. The systolic pressure is how much force is behind the blood or the real pressure of the blood as it moves through the body. The diastolic pressure is the pressure between heartbeats. The systolic number is always given first when giving a blood pressure reading. An example is a reading of 120 over 80. The 120 is the systolic and the 80 is the diastolic.

3.    Patients who are at risk for hypertension should know the different levels of blood pressure, as well as the meaning of each level. For example, a normal blood pressure reading is 120 over 80.

4.    Hypertension blood pressure readings have two stages. Stage one is any reading with a systolic pressure of 140-159 and a diastolic pressure of 90-99. Stage two is any reading with a systolic of 160 or higher and a diastolic of 100 or higher.

5.    There may be no signs or symptoms to high blood pressure or hypertension. Chronic headaches and chest pains, however, may lead to a diagnosis of high blood pressure complications related to other illnesses.

6.    Changes in diet, increased exercise, weight loss, decreases in alcohol consumption and lowered stress levels are ways for preventing or reducing the issues associated with hypertension.

7.    Some over the counter medications that contain pseudo-ephedrine can increase the risk for hypertension.

8.    Patients should be aware of the drug interactions and possible hypertension side effects of their current prescriptions. If you are not sure of the complications speak with a pharmacist to make sure there are no severe interaction issues.

A living will is an important protective tool to help you specify your wishes about a number of things in advance. This document not only protects your desires in the event of incapacitation or death but it also protects your loved ones. During difficult times, it can be hard to make those deeply personal choices and a living will enables you to have your desires already heard.

The steps taken in drafting a living will are actually not as difficult as you may think. Hiring an attorney is a critical step in ensuring that your will is applicable in all situations. The laws on living wills can vary from state to state and your attorney can help you to draft a document that protects you in all situations. There are also a number of pre-made forms available for this, but you need to take care to ensure that they apply to all of your needs.

The steps you’ll usually take in creating a living will are:

Exploring your options. When you are considering putting together your living will, it is important to research your choices well. Most experts recommend that a living will be in place for everyone over the age of 18. This will protect you in the event that something unforeseen causes you to be incapable of making important medical decisions about your care. It’s vital that you research and understand those things to make the most informed decision ahead of time.

Select someone to carry it out. Who do you trust in your life to make the utmost decisions? This is the person the may literally have your life in their hands. Keep in mind that this person may change over time; make sure you update your living will if this is the case.

Protect your rights and your decisions. Talking with your family and others close to you about your desires is important. This can better help you to fortify your will so that your needs and wants are taken care of. Being completely clear about what it is you expect will help to create an airtight will that serves your needs.

Update as needed. After you have drafted your living will, it stands to reason that your needs, desires and even your opinions of things may change from year to year. Life changes – needs and wants can change as we age, and it’s important to update your living will accordingly as those changes occur.

Creating a living will is the best way to ensure that should the unexpected happen, your desires and needs are met according to your wishes. This important document will help you ensure that your loved ones don’t have to make difficult decisions and also offers you peace of mind knowing you are protected.

It can be a difficult situation when you realize that one of your parents needs help. Yet the stress can increase tenfold when you realize both parents need help – in different ways.

Dad may be ready to give up the “chores” around the home, such as mowing the lawn and taking care of the large, family home, while Mom may need help remembering to take her medicines.

Dad may be suffering from a recent stroke, while Mom is dealing with her own issues caused from dementia.

In either case, the question is usually left for the siblings to decide.

Do we put Mom and Dad in assisted living? Do we let them live at home? Should they be in different facilities?

First, affirm the wishes of your parents. What do they prefer? Are they ready to move into assisted living or do they want to stay at home? If possible, have them talk about each option and offer what the pros and cons are to each. Then talk with each of your siblings. Take into account the wishes of those closest to Mom and Dad, as they may be dealing with more of the daily tasks.

Then work towards a compromise. If Mom is looking forward to assisted living because she can relinquish her cooking duties and have more access to social activities, how can you make in home care satisfy her needs? An in home care professional may be able to cook lunches every day of the week, and bring her to activities twice per week at the local senior center.

Reevaluate the situation on a regular basis. Talk with the in home caregiver to find out how Mom and Dad are truly doing. Speak with your parents about any concerns. And be willing to change things around as needed.

The holidays are a great time to catch up with old friends and reminisce about the “good ol’ days”. Yet for some, the holidays also become a wake up call. Did you notice your parents are slowing down? Are there piles of “stuff” everywhere in their home? Are you starting to question what you can do to help them maintain their current lifestyle?

Before you get upset and start tossing things out on your own, take a minute and educate yourself. There are reasons why your parents hang on to stuff. Understanding the reasons might make you more sympathetic and understanding of their different stashes. At the very least, you will learn how to make the most of their stuff, while helping them pare down at the same time.

Sentimental value is one of the main reasons why your parents hang on to various items. Instead of undermining their value, you should talk to your parents about the items. Let them tell you their stories – you may be surprised to learn that the tattered blanket in the corner actually belonged to your great-great grandfather. You can also try convincing your parents to let you make them a memory quilt. Simply take a piece of each valued item and quilt them together. Your parents will have their precious memories in one place and you can free up some valuable space in their home.

Some people save items because they do not have the heart to give them away. These are often gifts from friends and family. Your mom or dad might not like or even use a gift, but they feel guilty about letting it go. Encourage them to donate the unused items to someone that will get some use out of it.

You may also notice that your parents save things like empty bottles, bags and other items. They do this because they are trying to conserve – after all, they grew up in a different time than you. Teach them about conservation through other means, such as energy-saving appliances and light bulbs. Your parents just want to feel that they are doing their part – so help them.

Finally, some people hang onto items because they are lonely. The items become a companion to them, a way to remember times gone by. If you think this might be the case with your parents, it is time to be a more active part of their life. Instead of dropping by a few times a month, stop by a few times a week. Find different activities that will get them out and communicating with other people. Make your parents feel wanted and needed and they just might stop collecting things.

When it becomes apparent that your mother or father need round-the-clock care, it can be difficult to find the perfect caregiver.

First, emotions are likely to run high for your parents and for you and your siblings. Giving up independence can be quite stressful.

Second, you want to find someone that fits into your parent’s life and makes it easier – not the other way around.

Finally, sad as it is to say, there are some in the caregiving profession that have less than admirable qualities. You want to ensure that your Mom or Dad is in good hands – hands that care. These tips will help you find the perfect caregiver for your parent.

Do not be afraid to ask questions – as many as you want. You are in control of the interview, so be prepared. Have a list of questions that you want to ask and be sure to leave enough time during the interview for the potential caregiver to ask questions. Remember that your list is only an outline – if a question occurs to you during the interview, ask. The goal is to gain as much information as possible, as well as gain perspective on the personality.

Test your potential caregiver. Before the interview, provide the caregiver with an address and nothing more. This is an easy way to find out if your caregiver will be on time. Because you will be relying on them to fit within your schedule and rely on them to get your parent to appointments on time, this is a great way to find out how reliable your potential caregiver will be.

Time is of the essence – if your potential caregiver is late to the interview, find another prospect. It is important for the caregiver to understand the importance of being on time, especially if they are going to be taking your parent to appointments.

If your potential caregiver pays more attention to their cell phone than you, end the interview process. Your parent needs the undivided attention of their caregiver – if they are not willing to put down the cell phone, your parent could receive improper care.

Watch mannerisms and body language throughout your meeting. A caregiver will be on best behavior at an initial meeting. If you begin having reservations, trust your instincts. Caregiving is a difficult service; if you don’t feel comfortable in the beginning with someone, keep interviewing until you find the right person.

As Winter descends once again it brings with it lower temperatures and harsher weather.  For the elderly, this time of year can be especially hazardous.  As the season approaches, be sure that you and your elderly loved one are prepared for their special needs during the colder months of the year.

1.    Heating the house - Elderly people are more susceptible to the cold, and therefore more likely to catch hypothermia.  This is not just a danger of the great outdoors though.  Due to their lower body fat, slower metabolism, and slower circulation an elderly individual is more easily chilled and can even catch hypothermia indoors.  Protect your loved on from the cold inside.  Be sure the thermostat is set to at least 65, preferably 72.

2.    Fending off Dehydration - Seniors tend to eat and drink less than younger people.  As a result, they are more prone to dehydration.  Make sure your elderly loved on has plenty of fluids available.  While water is of course the best choice, be sure to also provide them with things they enjoy drinking like juice or tea.

3.    Clearing the grounds - A fall can be a huge health hazard for a senior citizen and winter provides even greater potential for falls.  Slippery ground, icy conditions, even the salt that people use to clear sidewalks can all cause a fall.  Be sure your loved one is provided with the best possible shoes for walking in winter weather.  Also, do what you can to keep their walkways and driveways clear of snow and ice.

4.    Keeping warm - In addition to maintaining a comfortable temperature in the house, be sure your loved one has the extra little things that will keep them cozy this winter.  Layers of clothing like sweaters, scarves, mittens, and hats can be added or removed at any time to keep your loved one comfortable inside and out.

The holidays are fast approaching. With family members coming from a variety of places this holiday season, you may have a lot on your plate. Family dynamics can be difficult any time of the year, but especially as we move into the holiday season. And if you are a part of the sandwich generation, and will be having elderly relatives as well as new babies and active toddlers around the dinner table, finding the right mix of activities can be a challenge.

Here is a variety of tips and activities that will keep both the young and the old entertained all holiday long.

Start with a bag of balloons, and let the fun begin. Keep a simple balloon pump handy, and let every child choose a balloon to blow up and play with. Children love to hit balloons and jump around trying to catch them. And if they play nicely, they can even bat the balloon back and forth to their elderly grandparent or great-grandparent. Balloons are the perfect item to keep a child entertained, yet won’t cause problems as it bumps into treasures around the room.

Invest in a jigsaw puzzle or two. Puzzles come in a variety of shapes and sizes. Have an easy one set up on a table for the small children, and a harder one for the older ones. Elderly grandparents can choose which table to join, enjoy conversation with the grandkids, and even put in a piece or two along the way.

Books are always a great option. Have each child bring their favorite book to share with the relatives. They can show off their new reading skills, or snuggle up and enjoy the story being read by a family member. You can also choose books that the whole family can enjoy together, such as ‘Twas The Night Before Christmas.

Have plenty of games on hand. Simple games are loved by everyone, and can be played just about anywhere. Have card games like Go Fish, Crazy 8’s or Old Maid, or bring out Dominoes or Checkers. Choose a game that is enjoyable, and won’t be frustrating for your elderly loved one to remember the rules.

When things start getting a little too wild and energectic, quiet things down with a movie. Choose movies appropriate for everyone in the group. You can always go with classics like Shrek, Beauty and the Beast, or Mickey Mouse. Check your local big box store, and you’ll find a selection of movies at low prices – perfect to keep around for those times you need a moment of silence.

Holidays are a wonderful time for getting together with family that you might not see much during the rest of the year.  For adult children of aging parents this can be a sad time as well.  For many adult children, the holidays are the time when they get the best view of Mom and Dad’s true health condition, and sometimes it’s not good.  If you are concerned about your loved ones, here are some of the warning signs you should look for.

Changes in weight – Weight loss could be caused by a loved one forgetting to eat regular meals.  Weight gain could be caused by a loved one eating meals over and over again because they forgot they had already eaten.

Changes in movement – Does your loved one have difficulty with dizziness?  Do they tend to shuffle around rather than walk?  Do they have greater difficulty sitting or standing?  Motions associated with day to day life can tell you a great deal about your loved one’s true condition.

Changes in personal hygiene – Does your loved one have an odd smell to them?  Forgetting to care for personal hygiene is yet another symptom of Dementia and Alzheimer’s.

Changes in the kitchen – Does your loved one have an unusual amount of spoiled food in the house?  Are their 10 bottles of ketchup in the pantry?  Are there signs of a fire in the pots or around the stove?  Any of these things could be a sign that your loved one is less capable of caring for him or herself.

Changes in focus – Does your loved one seem more distracted than usual?  Do they struggle to stay keyed in?  Can they carry on complete conversations, or take place in family activities? Have they begun to drive erratically?  Any of these may be signs that your loved one is suffering from dwindling health and in need of further medical attention.