Parenting Your Aging Parents

Dear Robert:

My father is in his mid 70s, and generally healthy. But he has been taking several prescription drugs for more than a year. Last month, he began feeling unusually fatigued and mentally confused. He’s weaker and more depressed than he has been, too.

My father has always been an independent person, and these conditions are very upsetting to him. They also make my life more difficult, as I must now visit more often to check on him. I also worry more about him even when I’m not visiting.

Is this just the common downward progression due to aging, or is there something we can do to get him back to normal?

Signed, New Problems With Dad

Dear New:

It’s difficult for anyone to diagnose a complex set of changes like you describe, especially from a distance. But a light bulb went off in my head while reading your letter: it could be drug interactions.

As you probably know, what makes a drug restricted to use only with a doctor’s prescription is that it is dangerous. Taking two or more of these dangerous drugs at once is an invitation to additive or antagonistic interactions (that is, the drugs can work together or against each other to create extra problems for the patient). Even ordinary foods can interact with certain prescription drugs to produce unpleasant and dangerous conditions.

Adverse reactions to combinations of prescription drugs with other drugs, or with foods, need not begin just after medication changes. Sometimes it takes months for a reaction to build up and become noticeable.

And the incidence of adverse drug reactions is many times higher for older folks than for any other group. Many doctors dismiss these complaints as the result of “normal aging”, or normal worsening of existing medical conditions, but these need not be the culprits.

There are too many possible interactions to list here. So take Dad to a good geriatrician and let him or her screen your father for possible drug interactions. Sometimes just changing the dosage or timing of taking a drug will eliminate the problems.

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Dear Robert:

My mother died a year ago and I’m still getting bills from her doctors. My husband wants to write the checks so we can forget about this painful experience. But we don’t have a lot of extra money, and I’m not sure my Mom even received some of the services they’re asking us to pay for. What should we do?

Signed, Dunned and Stunned

Dear Dunned:

You’d think a trillion dollar industry would have its billing systems in order. But when it comes to asking for and tracking payments, most health care institutions are remarkably inefficient.

So there’s a good chance that no matter how formal they seem, these “bills” are not going to require actual cash payments from you.

For example, look closely at the paperwork you’re receiving and you may notice that some of these “bills” are not actually asking for payment. They are merely required “notices” meant to inform you of accounting transactions that have taken place between providers and insurers as a result of services provided to your mother.

If any of them are actually asking you to make payment, your first step should be to compare the bill you’re getting to the financial statements you received and the payments you and your mother made back when your Mom was actually receiving healthcare services. Many hospital and doctor billing systems are so messed up that payments you make don’t register, or services rendered and fully paid for pop up again marked as “unpaid” a year or two after the fact.

If money is really owed and hasn’t been paid until now, don’t reach for your checkbook right away. Instead, pass the bill to your Mom’s insurance company or companies. They may be first in line to make the required payments. Even if they aren’t liable to cover these bills, they may have contracts with the providers that give you significant discounts from the amounts initially requested.

Finally, recognize that the bills may be owed by your Mom’s estate, rather than you. If her estate is now out of money, the bill may simply remain uncollectible.

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To help your aging parents maintain their quality of life, think in terms of becoming like flowing water, which over time can create beautiful formations out of the toughest rocks.

Robert Moskowitz is the author of “Parenting Your Aging Parents, How To Protect Their Quality of Life — And Yours!” This 300 page hardcover book has been widely acclaimed as the classic work in the field since 1991. It is available at bookstores, or directly from Key Publications. The Web site is: “http://www.KeyPubs.com/pyapbook.html“. The cost is $21.95 plus $6.95 shipping and handling. If you wish, you can ask Robert Moskowitz your own question for this column by emailing him at: KeyPubs@KeyPubs.com..