Don’t beat yourself up

Start with kindness—to yourself.

We all want to spend time with people who care.

If you spend time
tending to someone who needs help in day-to-day life…
you are a caregiver.
You may not give yourself that title.
Wear it proudly—it’s a beautiful thing to be.

However, sometimes helping an older adult can overwhelm an already stress-filled life and caregivers often don’t have all the support they need or enough hours in the day. Caring can come at a cost, including to our mental wellbeing. Additionally, caregivers are often terribly hard on themselves.

A caring mental health response:
Self-compassion

The practice of offering internal kindness and grace—self-compassion—can help process caregiver stress, burnout, and mental health struggles.

Caregivers tend to compound the already challenging moments of life with their own harsh inner critic. The Cleveland Clinic notes that caregivers are overly burdened with feelings of guilt and unrealistic expectations of themselves. Self-critical statements might sound like, “I am such a jerk for snapping at mom when we were driving,” or, “I haven’t been to the gym in weeks; I am so lazy.” The brain thinks it is doing us a favor by motivating us to work hard or live up to our personal standards. Instead, negative self-talk leads to feelings of defeat and exhaustion. Some caregivers are great at offering patience, kindness and forgiveness to just about everyone but themselves.

What is self-compassion?

If compassion is about seeing the suffering in others and feeling compelled to help, then self-compassion is turning this instinct inward. A leading researcher of the concept, Dr Kristen Neff, thinks of self-compassion as “a healthy attitude towards oneself during times of struggle.” Or, as Christopher Germer succinctly puts it, “Self compassion is simply giving the same kindness to ourselves that we would give to others.” Self-compassion helps us to understand that suffering is a universal, shared experience and that we can best manage it with warmth instead of shame.

Honing the skill of self-compassion can take time and patience.

Three exercises to develop self-compassion

  • Get mindful and flip the script
    Notice when you are in a moment of difficulty and offer yourself a kinder assessment of the situation.
    In fact, research from McGill University says that treating ourselves more kindly “has been shown to be related to increased psychological well-being.”

    Compassionate self-statements will sound more like, “I have been under a lot of stress. I am going to ask my sister to help with driving mom.” Or, “I haven’t been exercising and I feel best when I do. How can I make space for this in my life?” Noticing negative self-talk and consciously reframing these thoughts will help this practice to become more automatic going forward. This shift can work wonders!
  • Talk to yourself like you would a dear friend
    Imagine you are sitting with a beloved friend who is struggling with her many responsibilities. Would you really tell her to get a grip and snap out of it or that she is a bad daughter for forgetting about dad’s 4th appointment this month, or call her a jerk for losing her patience with her kids?

    You would be more likely to remind her she is doing her best and that you love and accept her. You might then offer her a cup of tea and thank her for sharing her struggles with you. The next time you are beating yourself up, try to apply the same compassion to yourself that you would with someone else you love.
  • Write it out
    Writing about stressful events has been shown to improve our physical and emotional health. Practice self-compassion through journaling or by writing a letter with prompts. Writing out your stressful thoughts will help you to get them aligned with a kinder view of a difficult situation. The Center for Clinical Intervention has a Compassionate Letter Writing template (page 8) for how to write a compassionate letter to yourself. Or, you may want to make your own version.
  • Mental health needs minding
    While self-compassion is a great framework for coping with distress, sometimes we need more. If you are dealing with changes to your mental health at a level that is disrupting your life, read through the symptoms of depression below. This is not a comprehensive list, but show some of the most common symptoms of depression, one of the largest mental health challenges facing caregivers.

Common symptoms of depression*

  • Are you spending less time doing things you used to enjoy? Do you have less interest in activities you used to love?
  • Are you experiencing persistent feelings of sadness, hopelessness, or numbness?
  • What about feelings of irritability, restlessness or having difficulty concentrating?
  • Have you noticed changes to your sleep or appetite levels?
  • Are you feeling less energetic, fatigued and slowed-down?
  • Do you often feel a sense of guilt?
  • Do you experience thoughts about death or suicide?

*If you notice these symptoms for more than 2 weeks, it is important to be evaluated for clinical depression. Additionally, this list is not intended to make a diagnosis. If you think you may be suffering from depression, it’s important to reach out to a medical professional who can diagnose and support you.

If you are suffering, you are not alone

Caregivers deal with depression and other mental health disorders at higher rates than their peers. According to the Family Caregiver Alliance, “40% to 70% of family caregivers have clinically significant symptoms of depression, and about a quarter to half of these caregivers meet the diagnostic criteria for major depression.” In fact, the American Psychological Association recommends caregivers be screened for mental health conditions due to their elevated prevalence. This is startling but, maybe not surprising. Afterall, caregiving, while deeply rewarding, can also be tiring, confusing and isolating.

Mental health conditions, including clinical depression, are treatable

The good news is that most individuals will find relief from depression with effective treatment, according to Mental Health America. The most common and effective treatments for depression are psychotherapy and medication, or a combination of the two. A good place to start would be to talk to your primary care doctor and ask for referrals or to initiate treatment. In addition to formal treatment, doing things like eating a balanced diet, getting exercise, and spending time with loved ones are all helpful. These are great examples of self-care practices we can engage in to help bolster our mood. As caregivers, it is especially important to avoid isolation and reach out for support

Practical Books & Other Resources

If you want to dive deeper into books, podcasts and workbooks here are some recommendations:

Podcasts: 

Workbook:

If you’re in crisis, there are options available to help you cope. You can call the Lifeline at any time to speak to someone and get support. For confidential support available 24/7 for everyone in the United States, call 988.

You already know how to love well; that’s why you are a caregiver. But if caregiving or other life stressors have impacted your mental health, it is important to seek support from a professional.

Engaging social supports and asking for help from our loved ones is an important step. And if you can practice self-compassion and give yourself grace through the ups and downs of your caregiving and mental health journeys, it will be that much easier to manage. You deserve to care for yourself just as well as you care for others!

Siblings as Friends

Model a Solid Foundation

Sibling dynamics among children play into how well those siblings will work together later in life.

At some point, these same children will be in a position to work together to help manage your care. They are (or will be) watching how you work through care challenges with your own siblings. 

It’s hard to imagine your children as adults, but as Psychologist Dr. Albers states, “Role modeling is one of the most powerful and effective ways to teach your children how to get along with their siblings.” 

10 tips to prevent sibling rivalry

It’s a complex topic without a “one size fits all” solution, but this article from the Cleveland Clinic outlines 10 tips for dealing with sibling rivalry. A few of the main points include:

  • Create a cooperative environment
  • Celebrate individuality
  • Treat kids fairly, not equally
  • Give children problem-solving tools
  • Make discipline private
  • Have a family meeting

We’ve presented how powerful family meetings can be to manage care navigation for the older adults in your family circle. Imagine how useful it would be to have family meetings already a practiced habit from childhood!

May you find joy in loving one another well in and outside of your family meetings! 

Siblings: The Sticky Subjects

Conversations between siblings about care for an older adult are layered with emotion and just might have lasting impacts on the sibling relationships for years to come. 

The truth is that most siblings don’t talk about care management roles until it is essential. Nobody wants to have a stressful conversation in the hospital corridor. We want you to be prepared to calmly navigate care for your parent or in-law. 

You are not alone! There are common sibling care controversies. There are also tools to move forward with purposeful and peaceful care conversations.

My parents are healthy…

If you have healthy older adults in your care circle, why should you make a plan with siblings now? Let me illustrate why this is so important with a story.

Adam’s perfectly healthy dad, George, had a fall one afternoon where he hit his head so hard he had a brain injury resulting in him being unable to speak clearly or make decisions. In a matter of minutes, Adam went from “my dad is perfectly healthy” to trying to figure out if he or his sister was the healthcare proxy. He didn’t know if his dad had his wishes defined and where in the world that paperwork was, if it existed at all. His sister thought her dad had asked her to be the healthcare proxy, but Adam said his dad had talked to him about it over golf one day. His sister was furious with Adam over how he was directing the care for their father when she thought it was her role, but Adam felt he was just trying to do his best in a terrifying and chaotic situation. Neither of them thought the other person was in the right role nor did they know what their dad would want, except for them not to be fighting. 

Three sibling sticky areas

You may be thrust very suddenly into figuring out care for an older adult. Are there other family members involved also? If so, there are three common barriers to setting up a successful care team: personal agendas, childhood roles and division of responsibilities.

Challenge: Personal Agendas

At work, we clearly define project goals at the onset, so it’s clear when they’ve been achieved. While a caregiving journey is likely not as quantifiable as your work projects, it’s just as important to define the overarching goals.

Solution: Establishing common goals

Among siblings, start your conversation with your common goals. 

  1. We all want to respect our older adults’ wishes and needs as much as possible.
  2. We don’t want angst or division between us during this time or for the years following.

Once we agree on these basic goals, it’s much easier to shift care decisions and strategies. We recommend restating the common goals to start each care plan meeting.

Challenge: Childhood Roles

Let’s say you and your siblings have defined the key goals, but that doesn’t really make up for the fact that your brother has always been the (insert primary trait from childhood) one and your sister will likely be (insert primary trait from childhood). The roles your siblings played in your family are decades old. Are you assuming that they are the same people they were in childhood? You have likely evolved past those early stereotypes or roles and want your siblings to see you for who you are today, many years later. 

Solution: Recognize current strengths

Instead of dragging those old assumptions into this season, can you put yourself in a neutral, curious and even grace-filled posture when it comes to who your siblings are and what they are capable of? We all have different strengths. Each sibling has an opportunity to help in a way that fits their strengths and giftings. That’s a beautiful thing.

Challenge: What’s “fair”?

When you and your siblings were young, there were likely feelings of what was “fair” between you. Remember the heated argument of who got the piece of cake with the big green frosting-filled flower on it? Now that everyone is older you already know that most of life isn’t “fair”, but in addition to that, you and your sibling’s lives are significantly more complicated as there are geographic locations, spouses, kids, jobs, health and individual finances that factor in for each person. All of that wasn’t a factor when you were jockeying for the piece of cake with the green frosting-filled flower on it. The notion of siblings each covering their “fair share” of care navigation just isn’t realistic. 

Solution: Accept imbalance and ask for or offer support

The truth is that usually the majority of the caregiving responsibilities fall on one or two people’s shoulders. It’s helpful to accept that and let go of what’s “fair”. The individual taking on the bulk of the care can take time to define how others can help; other family members can support in the ways requested.

The power of the family meeting

A well-prepared family meeting creates a way forward. 

To help you suggest or run a family care meeting, we have two great options:

  1. Ask a friend to facilitate your family’s care meeting. Ask for input on an agenda from family members. Encourage everyone to arrive with the common goal of supporting the older adult (and with a “neutral” personal agenda.)
  2. Enlist the support of a Ways & Wane Care Advisor to facilitate a family meeting. Having an unbiased, professional third party involved can be a way to reach a decision especially if sibling relations are complex or the necessary decisions are weighty. 

You may not be able to get absolutely everything in place, but whatever steps you take, however small, can ease the stress of managing care for the older adults in your family circle.

Summer Camp & DayCare: Safety and Success

Summer camp schedules are out. Finding camps that match your kids’ interests and your schedule is not the only challenge. What about safety and supervision? 

This practical 15-minute webinar will give you checklists and tips, whether you are a seasoned parent or this is your first summer.

Tax Breaks: Do you qualify?

Review these tax credits

Disclaimer: We are not accountants, tax advisors or lawyers. Please consult professionals as you manage your finances and taxes.

Whether you have a child or are helping an older adult or both, you’ll want to make sure you are leveraging all relevant tax credits, deductions and employer-sponsored programs.

When it comes to children, ask your tax advisor about the following:

  • Child Tax Credit
  • Child Dependent Care Credit
  • Earned Income Tax Credit
  • Leveraging a Dependent Care Flexible Spending Account (DCFSA)

Child Tax Credit

The Child Tax Credit helps families with qualifying children get a tax break. You qualify for the full amount of the 2023 Child Tax Credit for each qualifying child if you meet all eligibility factors and your annual income is not more than $200,000 ($400,000 if filing a joint return). Parents and guardians with higher incomes may be eligible to claim a partial credit.

This IRS Interactive Tax Assistant tool helps clarify the question of, “Does My Child/Dependent Qualify for the Child Tax Credit or the Credit for Other Dependents?”

Child and Dependent Care Credit

According to the IRS, “You may be able to claim the child and dependent care credit if you paid expenses for the care of a qualifying individual to enable you (and your spouse, if filing a joint return) to work or actively look for work. The amount of the credit is a percentage of the amount of work-related expenses you paid to a care provider for the care of a qualifying individual. The percentage depends on your adjusted gross income. The total expenses that you may use to calculate the credit may not be more than $3,000 (for one qualifying individual) or $6,000 (for two or more qualifying individuals).”

This IRS Interactive Tax Assistant tool helps clarify the question of, “Am I Eligible to Claim the Child and Dependent Care Credit?”

Earned Income Tax Credit

The Earned Income Tax Credit (EITC), sometimes called EIC, is a tax credit for workers with low to moderate income. Eligibility for the tax credit is based on various factors including family size, filing status and income. You can start with an eligibility test at the bottom of this page. 

FSA or Dependent Care Credit

You may be wondering if you can use both your employer provided Dependent Care Flexible Spending Account (DCFSA) and the Dependent Care Tax Credit. The answer is maybe.

According to the FSAFEDS, “You are not permitted to claim the same expenses on both your federal income taxes and Dependent Care FSA (DCFSA), although in certain situations you may be able to take advantage of both the DCFSA and the Child and Dependent Care Tax Credit. If you have two or more qualifying individuals as dependents, the IRS allows you to apply up to $6,000 of dependent care expenses to your taxes. The maximum allowable under a DCFSA is $5,000, so you may apply the $1,000 incremental difference between the DCFSA maximum and the Child and Dependent Care Tax Credit if you have two or more dependents and your expenses exceed $5,000.”

If you have a DCFSA, you can use it to pay for a variety of child and adult care services. The IRS determines which expenses can be reimbursed by a DCFSA. This list from the FSAFEDS shows the eligibility of some of the most common dependent care expenses, but it’s not meant to be comprehensive.

Ask your tax professional to advise you on what is best for your situation.


When it comes to older adults, ask your tax advisor about the following:

  • Claiming an older adult as a dependent
  • Medical expense deductions for an older (dependent) adult
  • Head of household status

Claiming an older adult as a dependent

According to the IRS, you can claim your parent as a dependent if:

  • You (and your spouse if filing jointly) are not a dependent of another taxpayer.
  • Your parent, if married, doesn’t file a joint return, unless your parent and his or her spouse file a joint return only to claim a refund of income tax withheld or estimated tax paid.
  • Your parent is a U.S. citizen, U.S. national, U.S. resident alien, or a resident of Canada or Mexico.
  • You paid more than half of your parent’s support for the calendar year.
  • Your parent’s gross income for the calendar year was less than $4,400.
  • Your parent isn’t a qualifying child of another taxpayer.
  • If your parent is your foster parent, they must have lived with you all year in your main home and as a member of your household.
Two tips related to claiming an older adult as a dependent

If you are supporting more than 50% of their living expenses, medical care, and other care, you may be able to claim them as a dependent.To be claimed as a dependent, the family member doesn’t need to live in your home for the entire year as long as they meet other guidelines.

Medical expense deductions

According to the IRS’s guidelines for which medical expenses you can approve are defined here: “You can generally include medical expenses you pay for yourself, as well as those you pay for someone who was your spouse or your dependent either when the services were provided or when you paid for them.”

According to the IRS (with some exceptions) “If you itemize your deductions and your parent was your dependent either at the time the medical services were provided or at the time you paid the expenses, you may claim a deduction for the portion of their expenses that you paid during the taxable year, not compensated for by insurance or otherwise.

Your medical expense deduction is limited to the amount of medical expenses that exceeds 7.5% of your adjusted gross income.”

The IRS has a list of eligible medical expenses which includes things like dentures, hearing aids and medically necessary home modifications like ramps and handrails. 

Head of household status

The IRS’s ‘special rule for parent’: “If your qualifying person is your parent, you may be eligible to file as head of household even if your parent doesn’t live with you. However, you must be able to claim your parent as a dependent. Also, you must pay more than half the cost of keeping up a home that was the main home for the entire year for your parent. If you pay more than half the cost of keeping your parent in a rest home or home for the elderly, that counts as paying more than half the cost of keeping up your parent’s main home.”

If you are unmarried at the end of the year and can claim an older adult as your dependent, consider filing under ‘head of household’ instead of ‘single.’ If you are married but live apart from your spouse, ask your tax advisor if you can file as ‘head of household’.

TIP from the IRS:

Are you 50+ years old and need help filing for this year? 

AARP has a free tax filing program aimed at taxpayers who are 50 years and older. AARP Foundation Tax-Aide is the nation’s largest free filing program. It’s available across the country and staffed by volunteers who are trained and certified by the Internal Revenue Service. You don’t have to be an AARP member to use this service. An online site locator can help you find one near you. Even if you’ve already filed this year, keep this in mind for next year.

How to be involved in your parents’ finances

Common mistakes and best practices

How involved are you in your parents’ or in-laws’ finances?
How involved do they want you to be?
How involved do you think you should be?

You may not have talked in detail about managing your parent’s finances yet. The top two reasons (out of the 37) are:
1) it’s uncomfortable to talk about and;
2) you aren’t sure exactly what the next steps are.
The other 37 reasons include things like “I don’t want to talk to my siblings about it”, “I have a kid’s soccer game to go to” and “I’d rather have a colonoscopy than dive into this.” We cannot save you from the colonoscopy, but we’ll give you a brief “financial companion” overview to get started.

The Conversation

We’ll assume the older adult in your scope of care is currently managing their own finances (even if they are no longer doing it well.) Step One: Engage them in a conversation about their wishes. There are many ways to approach the conversation. One playful way is to use this “mad lib” as a springboard to a more serious conversation.

Who will manage their finances if/when they are no longer able to do it themselves? If you want a deeper dive into suggestions for how to start complex conversations like this, download the conversation guide.

Be open to the fact that, for whatever reason, the older adult may have a strong opinion about who will play this role—and it might not be you. If you are not the one chosen, don’t take it personally. Alternative possibilities include other family members or a professional financial planner.

Common financial “companion” strategies

There are a number of different ways to help older adults manage their finances. The following information outlines the drawbacks and risks of certain approaches and suggestions for successful structures

“Borrow” their log-in credentials
If you are helping the older adult by accessing their account using their credentials you could find yourself in a sticky situation. There may come a point when the older adult is not able to confirm that they’ve given you permission to do so.

Sign paperwork on the older adult’s behalf

If you do not have the legal documents in place (like the power of attorney), signing paperwork as the “responsible party, guarantor, or cosigner” means that you may be personally liable for the expense. If you are unsure of the financial obligations you could personally face by signing an agreement, seek legal counsel and don’t rush into signing something before you are certain how you could be personally liable.

Create a joint account
Setting up a joint account with an older adult or adding your name to their current account could seem like an easy solution, but there are clear drawbacks.

Let’s examine the pros and cons of the joint account structure.

Pros:

  • It is easy to monitor transactions and account balances which helps to protect against fraud.
  • It’s convenient to make deposits or withdrawals of cash to pay for the older adult’s expenses. There is immediate access to the funds in the account at the time of the older adult’s passing. Those funds could be used to pay for final expenses.

Cons:

  • Money in the account when either person dies belongs to the surviving account holder. This can create conflicts among siblings or other potential heirs.
  • If you have your own financial problems, creditors can take funds from the joint account to settle your debts which means the older adult’s funds are at risk.
  • If you have children seeking financial aid for college, assets in the joint account could affect their eligibility for aid.
  • The older adult’s eligibility for Medicaid could be impacted if you are making withdrawals from the account since those withdrawals could be considered a transfer of assets to you. The result could result in the older adult becoming ineligible for Medicaid for a certain period of time.
  • There could be tax implications of having a joint account. If the account earns interest, you’ll have to report the interest earned on your own federal income tax return, as well as the older adult’s tax return. Joint accounts also can have gift tax implications if the co-owners aren’t spouses.

What is the best way to set up account permissions?

There are structures that offer protection for all involved. Yes, they are also more complicated to set up. But as you’ve read, a purposeful account permission strategy can prevent long-lasting negative impacts both financially and relationally.

This table from the Consumer Financial Protection Bureau outlines the various structures for financial caregiving.

Legal permission to manage finances

A durable power of attorney is a legal document in which one person assigns another the power to make financial decisions on their behalf should they become unable to make sound decisions. The person assigned power of attorney is called an “agent” or “attorney-in-fact.” (This power of attorney is different from a healthcare power of attorney which appoints someone to make medical decisions on someone else’s behalf should they become incapacita

A financial power of attorney document makes you a fiduciary which separates your own personal finances from financial actions and decisions you make on behalf of the older adult. It’s important to note that the older adult must be of sound mind to grant and revoke the power of attorney.

If the older adult does not have a completed financial POA, an attorney isn’t required to get this completed, except if the older adult already has cognitive impairment. If they are already cognitively impaired they can’t legally sign the documents required to set up a power of attorney. (This is one reason why it’s a great idea to set up a POA early.)

The laws vary by state with some states requiring two witnesses and others a notarization. It’s wise to use an attorney for this process, but a notary at a minimum. If you want to hire an attorney to put together a POA, we recommend searching for one through the National Academy of Elder Law Attorneys where you can do a state-specific search.

What happens if a power of attorney is not in place?

Without power of attorney or a trust, the family is at risk of having to go to court later to file for guardianship if the older adult becomes incapacitated—a process that can be expensive, time-consuming and potentially divisive.

Using the power of attorney to manage accounts

Institutions have different guidelines for how to allow access to account information. It’s wise to contact the financial institution to ask what is required so you can easily put things in place outside of an emergency situation. For example, at a BECU bank in Seattle, once the Durable Power of Attorney is presented at the branch, the one designated as holding the DPA completes a form which is then signed and notarized at the branch.

Understanding your responsibility

If you are responsible for helping an older adult manage their finances, you must use that permission and money properly. Failing to do so is considered a form of abuse and caregivers are bound by the laws protecting older adults.

To help manage this responsibility, use these four tips to help handle funds in a transparent manner.

  1. Keep detailed notes with dates and details about how funds were used. Keep a written record of expenses paid from the joint account, including noting reasons in the checkbook register’s memo field. This record-keeping is actually required by law.
  2. Never borrow from the account.
  3. Consider putting an app in place that offers remote monitoring of financial transactions and provides alerts like unpaid bills or unusual activity. Email notifications can also be set up via the bank of choice.
  4. Share financial updates and decisions with siblings and other relevant family members even if they don’t ask. Doing so will help keep possible incriminations and disputes at bay. Consider setting up quarterly family meetings to review financials.

What’s next?

Once you have the right paperwork permissions in place, you are ready to gather and confirm an updated inventory of accounts and assets. Without this list, it’s just a “best of luck treasure hunt”. This Account Permissions Checklist shows where and what the power of attorney’s name needs to be added to. Additionally, your Ways & Wane GoKit Medical Planner has a place where all of this can be filled in.

While this may seem daunting, it’s worth it to carve out time to put things in place in order to show up as your best self for the older adult for whom you care. It’s what you can hope someone will do for you someday. You can do this and will be proud you did!

Now schedule that colonoscopy.

Elizabeth Dameron-Drew is President of Ways & Wane.

We are not accountants or lawyers. Please consult professionals as you manage your financial situation.

Holidays with Generations

Recipe for Gatherings with Older Adults

Take 12 pounds of holidays, toss in 6 tablespoons of dementia, a couple of hard-of-hearing ears, 2 creaky knee joints, a side of grumpy teenager and top with a lifetime of family history and you’ve found yourself with a multigenerational holiday that is sure to be memorable. It’s a special time. Not necessarily an easy time, but precious because of those who are present. In the spirit of wishing you the best version of a holiday recipe for success with the older adults in your life, we have ideas for activities, practical suggestions, safety tips and things to avoid.

Ideas for fun activities:
  • Go on a drive to see the holiday lights. If possible, drive through a neighborhood where the older adult used to live.
  • Listen to their favorite holiday songs and or watch a classic holiday movie together
  • Reminiscing about past holidays is a way to help keep older adults connected to their legacy. Talking about traditions and reminding them of your appreciation for what they have done over the years can be a sweet way of honoring them.
  • Decorate for the holiday together, either at their residence or yours. Unpacking decorations or setting out decorations on a table top can both be done from a seated position. For their room, even just a pre-lit tree or a string of hanukkah lights can make a big difference.
  • Host a gingerbread house decorating contest and divide your group into teams. Maybe the winners get something funny like these fuzzy flamingo slipper shoes. If a Hanukkah House is more relevant, this one is a fun choice.
  • Offer to create and help them mail holiday cards to their friends. A card with a photo of them with a silly filter could be fun. Maybe you address the envelopes and the older adult licks and seals them shut. Hopefully they’ll receive some in return. 
  • Play a new game as a family. The game, “Do you really know your family?” can be played across many generations and can mix up the conversation. Just be sure to make sure the older adult can clearly hear the questions/answers. 
  • If you are geographically far apart, arrange a video call and decorate together virtually or just have a cup of tea or cocoa.
Tips to remember:
  • If possible, schedule events for the older adult’s best time of day
  • Offer healthy options like pre-cut vegetables and fruits
  • Generally older adults have trouble staying hydrated. Make sure to have water available to them before, during and after the meal. A straw and stable glass can make things even simpler. 
  • If there are parts of the meal that are hard to cut, pre-cut the older adult’s portions beforehand so that it’s accessible once it’s on their plate.
  • Set up a quiet area for the older adult to be able to spend time if the excitement of the event becomes too overwhelming
  • Provide a place to sit that isn’t difficult to get out of like a chair with arm supports
Safety tips:
  • If prescription drugs are usually taken at meals, make sure they day’s events don’t throw off their medicine schedule. 
  • Arrange in advance who is available to help the older adult use the bathroom (should they need it). If the event is at your home, consider temporarily adding a raised toilet seat or spring mounted support pole to give the older adult independence and keep them safe in the bathroom.
  • Ensure that there are clear walking paths and remove trip hazards like throw rugs or extension cords.
What to avoid:
  • Activities that require a lot of fine motor coordination. Between arthritis and diminished eyesight these could just be frustrating for an older adult.
  • Activities that require standing or walking for extended periods of time.
  • Low and soft couches or chairs that are hard to get out of
  • Additional background noise (like music) that can make it difficult to hear and participate in conversations
  • Too many fatty or salty foods and ‘over doing it’ can be challenging for an older adult with a pre-existing health condition. 
  • An event that’s too long/tiring.

Lastly, remember that children (young or not so young) who are part of holiday events are watching how you love and honor the older adults who are present. Someday they may be loving and honoring you in those same ways. You are showing them how.

Which Medicare Plan?

Can you solve this word problem?

If A + B = C and D is only sometimes included in C, how many prescriptions does it take to make any sense of Medicare?

Does Medicare seem like an unsolvable word problem to you? If so, you are not alone. We’ve done our best to simplify it and pull out the key details that are really helpful to know.

Medicare’s open enrollment (aka Annual Election Period) is from typically in October through December every year. What does this mean for you? Why should you look at your policy and do you have to? Medicare says the answer is based on what type of plan you currently have. 

  • If you have Original Medicare (aka Part A and Part B) plus a supplemental plan (often called a Medigap) and are happy with your coverage, you do not need to make a change.
  • If you have a Part C Plan (aka Medicare Advantage) or a Part D plan, you should review all your coverage options even if you are happy with your current coverage because plans change their costs and benefits every year. To do that, read your Annual Notice of Change (ANOC), which you should have received from your plan by September 30. It lists the changes in your plan, such as the premium and copays, and will compare the benefits in 2023 with those in 2022. 

TIP: You are likely getting a LOT of solicitations related to Medicare right now. You can throw most of it out, but keep anything mailed to you from the Social Security office or the Centers for Medicare & Medicaid Services.

What if you want to make a change to your plan?

According to Medicare, if you want to make a change, the best way to enroll in a new plan is to call 1-800-MEDICARE (1-800-633-4227). Enrolling in a new plan directly through Medicare is the best way to protect yourself if there are problems with your enrollment. Medicare suggests that you write down everything about the conversation when you enroll through Medicare, including the date, the representative you spoke to, and any outcomes or next steps.

What about Medicare overall? What’s good to know about the different plans? Well, we’ve covered that here…

What is Medicare Part C? (aka Medicare Advantage Plans)

Part C bundles Part A and Part B and provides additional benefits. Here are some key things to know about Medicare Part C:

  • Plans are offered by private companies approved by Medicare. 
  • In most cases, you will need to use doctors that are in the plan’s network in order to get the lowest co-pays.
  • Plans may have lower out-of-pocket costs than coverage just under Part A and Part B.  
  • Each plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). 
  • Not all plans include coverage for prescription drugs so if you need prescription drug coverage, be sure to pick a plan that includes that.
  • Plans may offer some extra benefits that Plan A and Plan B don’t cover – like vision, hearing, and dental services.
  • Part D may be included in Part C.
  • The plan may include coverage for home modification and transportation to/from doctor appointments. 
  • Part C can be a good option for people with a limited income. 
  • The plan rules can change each year so you’ll want to review it every fall.

TIP: If you are shopping for a new plan and want free quotes and to compare or enroll in a Medicare Advantage plan in your area. This U.S. News World Report offers a list of the Best Medicare Plan Insurance Companies 2023.

What is Medicare Part D?

Medicare Part D helps cover the cost of prescription drugs, including many recommended shots and vaccines. (Just remember the word “drugs” begins with “D”.)

Here are some key things to know about Part D:

  • Plans are offered by private companies.
  • Anyone who has Part A or Part B is eligible for Medicare Part D. 
  • Joining a Part D plan is voluntary and you pay an extra monthly premium for the coverage.
  • Part D benefits are available as a standalone plan added to Plan A and B.
  • Part D may be included in Part C. 
  • TIP: Since insurance companies have different prescription drugs on their approved list, it’s important to check to make sure your current prescriptions are covered under the plan you are selecting. 

We haven’t gotten to Medigap yet, but if you already know you want help from someone to sort out your Medicare coverage, you can call your State Health Insurance Program (SHIP) for free and unbiased advice about Medicare programs. 

What is Medigap? (aka Plan G or Plan K)

Medigap is extra insurance you can buy from a private company that helps pay for things like your deductibles and copays. Basically it fills the gap between your Medicare benefit and what you’d pay out of pocket that is normally the percentage of your share. Here are some key things to know about Medigap:

  • It is purchased from a private insurance company. 
  • Medigap may be good for those with chronic illnesses or those who need expensive medical procedures.
  • The Medigap monthly premium is in addition to the monthly Part B premium that you pay to Medicare.
  • Medigap plans cost more than Part C plans because they are more comprehensive. 
  • Medigap plans allow you freedom of choice in your medical care. You can see any physician or healthcare provider that participates in Medicare (nearly 900,000 providers across the nation).
  • There are no networks and no referral needed nor are you required to choose a Primary Care Physician.
  • To sign up for Medigap, you must be enrolled in both Medicare Parts A and B. 
  • Medigap policies do not include Part D, so you will purchase your drug plan separately.
  • More information about Medigap can be found in the Centers for Medicare & Medicaid Services Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare
  • You can buy a Medigap policy from any insurance company that is licensed in your state to sell one.
  • FYI: Medicare beneficiaries who are also eligible for Medicaid do not need Medigap insurance since Medicaid will cover the cost of their health care expenses.

Finally, what is the difference between Medicare and Medicaid?

These two terms are so similar it’s easy to confuse them! Here is some help defining them and keeping them straight. 

Medicare and Medicaid are two separate, government-run programs. They are operated and funded by different parts of the government and primarily serve different groups.

  • Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income.
  • Medicaid is a state and federal program that provides health coverage if you have a very low income.

If you are eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide you with health coverage and lower your costs.

Make sure you remember the difference between the terms Medicare and Medicaid* since they are very easy to confuse. Try this trick to help…

Medicaid: Think of how it ends in “aid”. That will help you remember that it has to do with “financial AID”. *Medicaid is called Medi-Cal in California

Medicare: Think of how it ends in “care”. That will help you remember that it has to do with on-going “health CARE”

As always, if you want help making sense of any of this, contact Ways & Wane at hello@waysandwane.com! 

By consuming this information, you acknowledge and agree to assume the risk of any injury or harm that may result to any person resulting in whole or in part from actions or inactions and waive all claims against Ways & Wane, together with its subsidiaries, affiliates, officers, directors, agents, employees, attorneys, consultants, or advisors except those arising out of any gross negligence or wanton misconduct of Ways & Wane. 


Hearing Aids Easier to Get

Availability, Style & Denial

“M-O-U-T-H”

“Thank you John, but you don’t have to spell the word, just say the word you’ve heard.”

The very patient audiologist, my father and I were sitting together in a cramped, sound-proof room. I admit I had to chuckle at my dad spelling out the words instead of just repeating them. He always had been a good speller, but in this case spelling back the words was a reflection of his dementia.

He was also a surprisingly stubborn man which he applied to resisting hearing aids despite the fact that he knew he couldn’t hear clearly. 

We were lucky he eventually consented. 

His wife thanked me. 

Hearing Loss Increases Dementia Risk

One surprising aspect of hearing loss is the connection to dementia. In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D., found that mild hearing loss doubled dementia risk. Moderate loss tripled risk and people with a severe hearing impairment were five times more likely to develop dementia.

Not only can hearing loss dramatically increase the risk of dementia, but if an older adult cannot understand those around them they may avoid conversations and social gatherings. This dynamic can then lead to social isolation which could then lead to depression and further withdrawal from activities. All that can add up to a pretty good argument for using hearing aids. 

NEW! Hearing Aids Available
Over-the-Counter (OTC)

Starting mid-October 2022, the U.S. Food and Drug Administration is allowing some hearing aids to be purchased over the counter. The cost and required prescription for hearing aids has been an obstacle in the past. The FDA change establishes a new category of over-the-counter (OTC) hearing aids, enabling consumers with perceived mild to moderate hearing impairment to purchase hearing aids directly from stores or online retailers without the need for a medical exam, prescription or a fitting adjustment by an audiologist.

With OTC hearing aids available, there are essentially three different kinds of hearing enhancement product categories. 

  1. Personal Sound Amplification Products (PSAPs)
    1. Intended for people with normal hearing to amplify sounds in certain situations, such as recreational activities like birdwatching or hunting. 
  2. Over the Counter (OTC) Hearing Aids
    1. For mild to moderate hearing loss
    2. Sold in retail stores and online
    3. No prescription needed
  3. Standard prescription hearing aids
    1. For all levels of hearing loss, including severe
    2. Prescription is needed

OTC Purchases Can Be Online or Retail

You can purchase OTC hearing aids from either a brick and mortar retail store or through an online retailer. There are pros and cons to both.

When purchasing OTC hearing aids from a retail store, you can immediately have the product, but you won’t be able to customize the fit and the quality may not meet your expectations. You are also on your own in determining the level of hearing loss and selecting the kind of aid. When shopping, you’ll want to keep the following features in mind:

  • battery life
  • warranty
  • size and weight
  • volume control

When purchasing an OTC hearing aid from an online retailer you will have to wait for it to be shipped, but you have the benefit of the fact that online hearing aids are registered with the FDA. Even though they don’t require a visit to the doctor or a prescription to purchase online hearing aids, these aids are dispensed through audiologists. When purchasing online hearing aids, you’ll receive services like:

  • an online hearing test
  • personalized programming based on test results
  • telehealth support with an audiology team
  • remote adjustments
  • financing options

For OTC hearing aids sold by online retailers, we found four highly recommended brands: Lively, MDHearing, Eargo (which offers a 20% discount for Veterans on a specific model) and Lexie. They are different price points and have different features, but they all come with at least a 45-day risk-free trial (which on a side note is way more generous than what I got with my 70lb rescue dog). 

Hearing Aid Style Options

There are a range of options when it comes to hearing aid designs as they are no longer the bulky, highly visible kind that your grandpa had. The graphic below from the FDA shows the various styles.

How to Approach the “Hearing Aid Conversation” with an Older Adult

Among adults aged 70 and older with hearing loss who could benefit from hearing aids, 30 percent have never used them. If you have an older adult in your life who really needs hearing aids, but is resistant here are four tips for how to approach the topic: 

  1. Encourage dialogue. Let them know what you’ve observed about them not hearing or understanding conversations. Maybe point this out: Michelle Matyko, Au.D., an audiologist in New York says “You can explain that hearing aids are just like glasses, and if someone can’t see well, wouldn’t you suggest they try glasses to help them?” If they are concerned about how hearing aid will look it may help to point out that hearing loss is more obvious than a hearing aid. 
  2. Provide literature on hearing loss or give them this quiz to determine if seeing an audiologist would be helpful. You could mention the fact that nearly 30 million U.S. adults could benefit from using hearing aids. 
  3. Encourage them to talk to their doctor. Sometimes a recommendation from a medical provider makes the need legitimate.
  4. Be patient. This may be something that they need to decide to do (or not) and on their own timetable. It’s very possible that the best thing you can do is respect their decision.

If you want a deep dive into all things hearing aids, this article from the National Council on Aging is very comprehensive. 

[How To] Keep your joy even when the older adult in your life isn’t joyful

It’s one thing to occasionally tolerate . . . A long-time friend who lives five states away complaining on the phone a few times a year; or that person at work with the persistent frown lines and stream of “glass-half-empty” news. 

It’s another thing to stay joyful . . . when that person who is all negative, all the time, is in your family circle. 

Maybe it’s your dad and he lives with you. 
Maybe it’s your mom who you regularly talk to or visit. 
Maybe it is an in-law who is in pain and finds it hard to endure.

It’s not that you believe their perspective is unwarranted, it’s that it is truly hard to stay joyful around someone who has a “glass-is-always-empty” perspective. You are committed to maintaining your relationship with them, so what can you do to manage your response to someone else’s negativity so that your own happiness doesn’t get sucked out of you? 

Five Joy Strategies

1. Shift the conversation

One author says: “You have to practice who you want to be.” If you are trying to help practice a positive attitude, a tool is often helpful. For example, if you share time together like over a meal, start a tradition of asking: “What are you thankful for today?” Go back and forth several times. Or even just a simple game of: “What do you like better X or X?” (Insert two different choices in the same category, like mountains or beach, cake or pie, sweet or savory, blue or orange, etc.) It’s sort of silly, but it takes the focus to “what is liked better”.

2. Let them know how you feel (and know that they may not change)

Consider that they may not realize how much they complain and gently bring it to their attention. You might say something like, “Dad, I know life isn’t easy for you right now. I love you so much and if I could make everything better I would. Hearing you complain makes me feel so sad. Would you be willing to try to be more positive when we talk?” It’s okay to share your experience and ask for what you need. If they don’t respond with change, let it go and focus on what you can control, which is how you respond. 

3. You can’t change them

Especially if you are in some sort of care role you are likely accustomed to solving things for them. Try not to take their negativity personally and avoid self talk that says, “They’d be happy if I could just fix ___”. Some part of you knows that you cannot solve everything. Remember the truth of that and be gentle with yourself. 

4. Use compassion and curiosity

While you are being gentle with yourself, remember to be gentle with them too. If you can shift from a lens of frustration to compassionate curiosity it can allow you to support and understand them better. Try to have empathy for the older adult’s season of life which may be more and more defined by loss: less good health, less mobility, finite finances, loss of friends to sickness or retirement moves. It can also be understandably hard to be positive when dealing with physical pain, especially chronic pain. You can ask: “On a scale of 1-10, where is your pain today?”

5. Help them feel heard

Try using the reflective listening technique—where you repeat back what you’ve heard. It shows that you are with them and have heard their words. Focus on how the situation has made them feel, since it’s usually the resulting feeling that is at the root of the issue anyway. If your emotions start to get the best of you, take a moment (and a deep breath) and remind yourself that their feelings don’t have to be yours.