As people wait longer to have children and life expectancy is increasing, it’s more and more common for people to be raising children and caring for aging parents at the same time.
Being part of the “sandwich generation”– that is, balancing the demands of a busy family and an older loved one – is a fraught situation.
It can dredge up old feelings over family dynamics, exacerbate financial woes, or send both adult children and their parents through an emotional roller coaster as roles are reversed and parents confront their need to surrender some independence to a person whose diapers they once changed.
However, a plethora of services exist for seniors and their caregivers to survive and even thrive through this challenging season of life.
The first place anyone caring for an older family member should contact is their local Area Agency on Aging.
There are 16 throughout the state. Area Agency on Aging 1-B is the largest, serving Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties. The Senior Alliance is the name for the Area Agency on Aging 1-C, which serves southern and western Wayne County.
The Detroit Area Agency on Aging is known as The Senior Solution and serves Detroit, the five Grosse Pointe communities, Harper Woods, Hamtramck and Highland Park.
“We really do consider ourselves the first place that people should call,” says Kathleen Yanik, communications manager for Area Agency on Aging 1-B. “We serve as a clearinghouse helping them walk through options and steering them to programs that can help, and it’s a free call.”
Other places seniors or their family members can turn to include disease-specific organizations such as the Alzheimer’s Association or the Multiple Sclerosis Association.
The Veterans Administration offers a number of services for older veterans.
Many communities have locally based councils on aging that coordinate services for seniors, and several also have lively, active senior centers that serve as a source of information and a powerful weapon against the isolation older people can feel – a role that also can be filled by a house of worship.
The most common needs are for personal care services such as bathing, dressing or using the bathroom, home delivered meals, housekeeping such as laundry and light cleaning, medical transportation and subsidized housing, based on what people who call the Area Agency on Aging 1-B are looking for, says Angela Lippard, resource center manager for Area Agency on Aging 1-B.
She urges families to be prepared and think ahead, since very often programs have a waiting list. When that happens, agency staff can help families locate other sources of assistance, but knowing what is available and how to access it well before services are needed is key.
“A lot of calls we get, people needed the services yesterday,” she says.
Callers can get referrals or access programs for a wide variety of concerns seniors or their caregivers may have. Among them are:
Fall prevention
Falls can be deadly for older people and are a leading cause of nursing home admissions.
To help people reduce their risk of falls and feel more confident, many Area Agencies on Aging offer evidence-based classes aimed at improving balance and preventing falls.
Chronic disease support
Chronic disease such as diabetes can worsen, or even present for the first time, with age. It’s never too late to work on managing the condition, so classes called PATH (Personal Action Toward Health) that focus either on diabetes management, other chronic diseases, or chronic pain are offered free of charge to people in the community.
Not only does the class help teach strategies for dealing with the physical and emotional repercussions of chronic conditions, it can provide seniors with a community of peers who are also dealing with chronic conditions for support and encouragement.
Transportation
A major milestone that many seniors – and their families – dread is the need to give up driving.
Older drivers are at higher risk of crashes, but they miss the freedom that getting behind the wheel gives them. However, lack of car keys doesn’t need to translate to your loved one being stuck at home or getting socked with an enormous charge on a ride sharing app.
Area Agencies on Aging can coordinate myride2, a transportation service that arranges rides for seniors with as little as two days’ notice.
Many communities participate in SMART Transit for seniors, and many community senior centers have subsidized taxi or car share rides. Area Agency on Aging 1-B also works with seniors and their families to plan for their “driving retirement.”
Nutrition
Managing three meals a day can be difficult for older people, and appetites and preferences change as a person ages, making cooking less appealing.
Area Agencies on Aging will refer seniors to a provider of home-delivered meals, such as Meals on Wheels, that brings a hot and nutritious meal to seniors daily.
Another option for seniors that have an easier time getting around is a community meal site that combats both hunger and loneliness by serving a daily lunch in a communal setting, often a community center or senior center.
Seniors can share a meal with others and form the connections so crucial to their overall health and well-being.
Personal care and housing options
Navigating the various options for older people who need help with activities of daily living such as bathing, dressing and housekeeping can be intimidating.
There are programs through the Veterans Administration or Medicaid that will pick up all or some of the cost of nursing homes. However, there are also home care services that offer direct care to older adults.
MI Choice is available to people 65 and older who need a nursing home level of care but prefer to stay in their homes. They provide a set of wraparound services that allow seniors to be cared for any place they may call home, whether it’s a senior apartment or a family member’s.
For a lower level of care, the Community Living Program provides three to 10 hours of care per month for people who are most in need financially.
The program targets people who are socially isolated or have a cognitive decline and need help with at least one activity of daily living. While it is subsidized, it does require some financial contribution from the recipient on a sliding scale.
Veterans who have served at least one day in wartime have access to an in-home aide and attendant program through the VA, which also requires that the person would otherwise need to enter a nursing home.
Yanik says many people aren’t aware of these programs, and while they have certain financial requirements and there is a wait to access them, they can make the difference in allowing people to stay in their home as well as providing family caregivers much-needed relief.
Caregiver support
Along with the programs that target seniors themselves, many places offer several support programs for the people who care for them. Support groups, classes and even adult day care programs that allow caregivers to work or simply run errands and take a break are all available by referral.
“It’s often really worth it for caregivers to reach out to find that outside help.” Yanik says. “Caregiving can be a marathon rather than a sprint, and you need to take care of yourself so that you can keep going.”
LGBTQ seniors
The three southeast Michigan senior agencies are founding members of Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) Metro Detroit.
It can be intimidating for LGBTQ seniors to seek support, and they are less likely to have children or younger relatives they can rely on.
SAGE created training to allow agency staff to approach LGBTQ elders with sensitivity, using appropriate language and questions.
Adjusting to new roles and expectations is challenging at any time, and especially so for caregivers in the squeeze of the sandwich generation. Information and preparation go a long way toward easing the transition for the whole family.
“If you start sooner you have more choices, more opportunities and more directions you can go,” says Lippard. “If you wait until they have had a fall and need help with activities of daily living, at that point there are not as many options.”
Amy Kuras is a freelance writer from Detroit.
