Friendships Change over time

Friendships Ebb & Flow Naturally

I watch my daughter flow effortlessly in and out of friendships. Her friendships are as uncomplicated as the tides. They ebb and flow based on common interests. There are no complications from political or religious viewpoints. While children make an effort not to hurt each other's feelings they have no problem disagreeing on issues. Their opinions  are limited to concrete thoughts - which is the best video game or flavor of ice cream. Their main concern is whether to play princess or ponies.

My adult friendships are so much more complicated and I wonder - "why?"

I think it's because we form opinions as we age. And, the older we get the more entrenched our opinions become. Remember being in college when you could stay up half the night debating politics? Now, I am almost immediately turned off by people whose political viewpoints don't mesh with mine.


Maintaining friendships with people who don't share your views becomes harder as you age. By our mid-forties we are fairly set in our ways. We've had years to determine what we think about the world and are prepared to defend our views.

If you listen to children introduce themselves the typical conversation goes something like this,"Hi. What's your name? Wanna play tag?" If the child is too shy to answer or says no, the kid moves on to the next person and tries again.

As adults we exchanges names, ask about career, neighborhood and where their kids go to school. All of these things help us to unconsciously paint a picture of the person. With a few quick, innocuous questions we create our initial assessment of how closely the person's viewpoints align with ours.

We can estimate their income by their job and neighborhood. This may help us determine if they share common interests and opinions. For instance, people from lower incomes may not have the resources to participate in certain activities. They are less likely to own boats,  play polo or snow ski than people from higher economic brackets. On the other hand, people with higher incomes may make us feel inferior as they may have bigger homes, fancier cars and more expensive clothing.  People from affluent areas tend to be Republicans and therefore more conservative in their political and social views.

Where the children attend school also gives us a lot of information. Does the child go to public or private school?  If the child attends a private school it may indicate that the parents are elitist or that they are deeply religious. If it's a private school is it experimental (Montessori, Waldorf, etc.) or religious? Parents who homeschool their children are typically conservative Christians. They have generally removed their children from public education because they don't believe in evolution, modern medicine and science.

 Like most people, my opinions are based on my education, upbringing and the area of the country where I was raised. They are further influenced by where I went to school, worked and lived as an adult. I am a registered Democrat, relatively liberal in my social and political views. I believe in medicine,  probability, physics and evolution. I doubt the power of prayer and question blind faith.

I have friends with religious beliefs ranging from Christian to Wiccan. For the most part I am tolerant of a wide range of religious beliefs simply because I have no strong belief of my own. I lose patience when people use their religion as a way to discriminate against others or try to convert me. At this point, I am as comfortable with my own lack of religion as I am with my political affiliation.

I think that I am fairly mainstream in my outlook, but I realize that I am only mainstream for the area of the country where I spent most of my life. Living in the Bible Belt I find myself having to swallow my views in the interest of maintaining harmony. I sometimes want to scream when a person who has been seeing a doctor to treat a condition will say that God healed them. I wonder why they bothered with doctor's visits and medical treatments if prayer is so very powerful. It seems inconsistent with their stated belief.

Part of the ebb and flow of childhood friendships is they are often short-lived. Children don't feel a need to maintain a friendship once the mutual interest has ended. I find myself struggling to maintain relationships with people who don't share my interests or even my values. Sometimes I have to maintain these "friendships" due to work relationships or mutual friends. Other times the individual has been a friend for years, but we have changed over time due to our experiences. Sometimes a friendship has simply run its course.

I was friendly with a woman with whom I routinely disagreed because our children played together. I found myself constantly struggling to politely ignore behaviors that struck me as odd or views that I considered ignorant. Her children landed in the hospital with severe dehydration from rota virus because she didn't believe in vaccinations. She hosted a "chicken pox party" to expose other unvaccinated kids to the disease. I breathed a huge sigh of relief when my daughter moved on to other friends.

I am not as tolerant as I once was. Honestly, I am tired of being friends with people who aren't like me. I hate how close-minded that sounds, but I can't ignore the truth. I do enjoy people from different cultures and backgrounds, but I am not comfortable with people who are dramatically different from me. I struggle with friends whose spouses have been arrested as I am fundamentally law-abiding. Having a medically fragile child, I struggle with people who rely on faith to make decisions that impact their child's health or welfare.

I find myself returning to the simpler childhood model of friendship. I make new friends based on common interests. I don't want to argue politics. I don't want to discuss religion. I don't want to hear about their problems or bond for life. I just want to meet someone and say,"Hi, wanna play?"

Preparing Your Home for a Home Health Care Provider

Preparing Your Home for a  Home Health Care Provider

When you decide to employ a home health aide there are a number of changes that you need to consider - both in your home and in your lifestyle. What will it be like having another person in your home for hours or even days at a time? If you are a private person it may feel like an invasion. On the other hand, for some folks its welcome companionship - someone they can rely on to visit  daily.

You need to make your home as safe as possible for both your family member and their caregiver. Remove objects that may be easily broken. Prevent tripping by removing small rugs, runners, electrical and phone cords from pathways. Place non-skid adhesive strips to non-carpeted stairs. Make sure that your home is well lit - especially stairs and hallways.

You may need to purchase items that you don't already have. Things you should have include, but aren't limited to:

• smoke detectors
• carbon monoxide detector
• nonslip bath rugs
• nonslip stickers or mat in the bathtub or shower
• grab bars by the toilet and in the shower/tub
• flame resistant potholders
• fire extinguisher

Having help when you have a family member with a disability can be a blessing. Another set of hands to help with care giving and household tasks can seem like a dream come true at first.

However, anyone who has employed a home care worker knows that the honeymoon period wears off.  My initial reaction was to treat the person like a member of the family while they were in our home.  I did this in part because I saw my parents struggle with the aides who cared from my mother.

My parents were very private people. They were brought up in a different era. The combination of these factors meant that they didn't want their live in aide dining with them. There was one fundamental problem with this idea- they only had one table. There was no where to sit and eat in the kitchen. Those poor women had to stand in the kitchen to eat their meals.

My parents wanted their aide to be "on call" but essentially out of sight. That meant that they were relegated to spending large parts of the day in their room or on the back deck, waiting for my parents to page them. Being a home health aide is a difficult, physically demanding job. The pay is poor and there are often no benefits. Adding social isolation must have made the job so much harder.

My mother was a little confused toward the end and some of her aides took advantage of her. While I was visiting one afternoon I saw her "tip" the aide five dollars three times for filing her nails that day. After my mom passed way small pieces of jewelry and other items were missing. I think that if my parents had been even a little more tolerant these small abuses might never have occurred.

On the other hand, I've learned that without some boundaries people may also take advantage of your good-nature. My daughter's aide is generally included in everything we do. She eats with us, hangs out in the living room and watches TV with us, etc .

In the past I've been so casual that people forgot they worked for us. Some have wanted to watch graphic crimes dramas with my daughter in the room. I didn't realize that one woman was using my laptop for online shopping until I went to several websites and the "Your Store" zip was set to her town. We've had aides show up with their children and their dogs.  One showed up before a job interview so she could use our shower!

In addition to making sure your aide knows what you want done, be clear about what NOT to do as well. While I don't want to create a feeling of distrust I do want to maintain a semblance of privacy in my home.  Some of these suggestions may make you feel ridiculous, but consider the alternatives. Be specific about any areas that are for family-only. I would rather hang a sign on my door than find someone up to their elbows in my underwear drawer. Let the person know if they are welcome to watch your TV (and what shows you would prefer they not watch), use your computer, etc. Here are a few tips based on my experience:

• If you don't want your aide to pry into your bedroom, master bathroom or office, you need to clearly post a "PRIVATE" sign on the door.
• Password protect your computers and cell phones. Lock file cabinets. Consider blocking unwanted content on your TV.
• Label dresser drawers, kitchen cabinets, etc. to prevent "I was just looking for..." If everyone knows where to find necessary items there is no reason to look elsewhere. Most people will respect your privacy, but there is always one person that wants to go through your pantry or medicine cabinet.
• If you have cherished heirlooms or valuables, move them out of sight or store them safely somewhere else. A spilled drink can accidentally ruin an antique table that looks "second hand"to an aide.

Be sure to interview any person or agency carefully before you hire them!



For more information on home safety for the elderly or individuals with special needs please go to http://www.ces.ncsu.edu/depts/fcs/pdfs/FCS-461.pdf

How to Write Instructions for your Home Health Aide

Home Health Aide Daily Care Plan & Instructions

When we first had a home health aide for my daughter the job seemed obvious to me. Not so to the various care workers who were assigned to her. Truthfully a home health care aide or companion typically has very little to do. A live-in aide can retire to his/her room and read or watch TV until you need their help. A part-time aide is in an awkward position because there isn't much to fill the time. I don't mind if the aides read, text or use their laptops - provided they meet my daughter's basic needs in a timely manner.

Do your homework when you hire an aide. It turns out that most people will only do exactly what is asked of them - no more, no less. For instance, with an elderly parent if you ask the caregiver to make a pot of coffee it is very possible that they will only make coffee on the day that you make that request. If your parent wants a pot of coffee made every morning with breakfast that needs to be specified. You need to prepare your home when you have someone working in it so they can find the things they need.

Review the instructions on equipment and procedures. Make sure that the aide has the written instructions available for any unique equipment like a lift. WATCH them perform complex tasks at least once to make sure that they are being thorough and safe. Don't trust that "showering" means the same thing to everyone. Some people may spray your family member down quickly, others may sit them in the shower and walk away for 10 minutes. Be specific about your expectations.

Review and provide instructions for all medications that the patient requires. Don't forget non-routine medications. For instance, if the person has an Epi Pen make sure the aide knows where it is and how to use it.

If you expect the person to prepare meals or snacks, make sure that they know where the ingredients are as well as what food preferences or allergies the person may have. When in doubt, provide a printed recipe including the location of all ingredients. Decide if the person will be eating with your family member and provide adequate quantities of food (obviously live-ins expect meals).

While it seemed ridiculous at first, I learned to provide a detailed list of each task that I wanted done every day.  Each task is described including the timing (after school, at dinner),  tools to be used (special cup, broom, etc.)  and the frequency (daily, weekly, etc.). I also include check boxes so the person can keep track of what has been completed each day.

The last section of my daily list includes safety instructions. Make sure that you have your address written down in the event of an emergency. You'd be amazed at how many people simply follow their GPS and have no idea where they are. If you are not going to be there at all times include your contact information on this page as well.

Here is an example of a daily care plan for a 4-hour after school shift for our daughter. Your plan may be more detailed depending on medical needs and the extent of home care tasks you expect.


Daily Home Care Plan for __________________      Date:  _____________

Tasks include, but are not limited to:

Personal Care

         Meet & get her off school bus using wheelchair

         Change clothing if wet or dirty immediately after school

         Toilet or/change Depends every 2 hours   

o   Completed  at     time _____________       time _____________   

o    Check  Depends immediately after school. Change after shower & before bed

o   Thrown wet/dirty Depend in kitchen trash can

         Provide afternoon snack (prepared in frig) Complete at time _____________   

         Assist with ambulation around house (maintain contact guard at all times)

         Assist with TV remote, computer, etc.

         Shower daily    Completed at time _____________   

         Brush hair daily after shower

         Wash hair on Wednesdays   Completed date _____________   

         Assist with feeding during meals & snacks

o   Cut food into bite sized pieces for finger feeding

o   Assist with use of spoon or fork (may need to feed her)

o   Place dirty dishes, cups and utensils in the sink

         Provide companionship & supervision at all times

     Maintain safe environment while parents are away or otherwise occupied.

Home Care

         Make bed daily    Completed at time _____________   

         Fold & put away laundry as needed (2-3 times a week)

         Dust & vacuum bedroom on Mondays (weekly)  Date _____________   

o   Use Swiffer dusters and Shark carpet sweeper

         Clean bathroom on Fridays (weekly)    Date _____________   

o   Use disinfecting wipes to wipe down toilet & bathtub

o   Lift no slip mat and place on shower chair to air dry

Safety    I can be reached at 555-555-1234

Never allow her to walk around the house alone – be with her at all times.

Watch for choking while eating and drinking.

In the event of a clonic/tonic seizure (grand mal):

1.    Ensure her safety - roll her to her side, if possible

2.    Call 911 The address here is 123 Main Street Anywhere,ST

3.    Administer medication per instructions on label (outer pocket of blue backpack)

For insights on the aide's perspective please go to http://newoldage.blogs.nytimes.com/2009/01/21/advice-from-a-home-health-aide/

Questions to Consider Asking a Home Health Care Agency

Questions to Ask a Home Health Care Agency

DISCLAIMER: I am NOT a lawyer or insurance professional. Please check the local laws and regulations in your state.

We've had a home health care aide for my child with special needs for roughly 10 months. We located an agency through a list of state -approved providers. However, some of the caregivers they sent were completely unsatisfactory. For instance, one casually mentioned during a family dinner that her own family had called child protective services on her several times.

Another time an frail woman who appeared to be about 70 showed up. I was afraid she'd fall and break a hip! I ended up making her tea and letting her watch TV until the end of her shift. In my opinion, she couldn't handle the physical challenge of working with a 125 pound, autistic and mobility impaired person.

I finally discovered that the agency (which was approved by my state Medicaid) hired through Craigslist. Applicants were required to pay for their own background checks, but were allowed to start assignments before providing the agency with the results.

The agency was hiring them as independent contractors. These individuals had no worker's compensation insurance. Several told me that they had no personal health insurance. What would have happened if they were hurt on the job in my house? Most likely we would have been sued.

When I contacted the home health care agency I asked about these issues (none of which they refuted.) I also asked if they had any general liability insurance in case my child was injured by one of the people they sent to our home. The answer was that the business was insured, but the coverage only extended to their physical place of business (the office.) If my child was hurt or abused by someone they sent over I would be free to sue the individual involved!

These practices put both my family and the caregiver at risk. I had to ask the state to help me locate a more suitable agency. Rest assured that I asked A LOT of questions before I agreed to a new agency!

So, as a precaution to others I've compiled the following list of questions.

If you have a home health care or home care worker in your home, consider asking the agency* the following questions:

Are the workers you send to my home employees or independent contractors? This is important because the agency isn’t paying payroll taxes on independent contractors – including worker’s compensation insurance.

If an independent contractor is hurt on the job in your home or driving on your business you can be sued for medical costs and lost wages. Do not rely on Homeowners Insurance coverage to protect you, unless the insurance carrier has confirmed coverage for this risk. Many insurance companies have specific riders that can be added – at a cost- to cover in-home caregivers

Does the agency have general liability insurance?
In the event that your child or family member is injured while being cared for by an employee of the agency does the agency have coverage to pay for related medical expenses? Ask to see the documentation.

Does the agency have theft insurance?
Have employees been bonded? In the unfortunate case of theft by a caregiver is there insurance coverage to help you recover financially?  Ask to see the documentation.

Has the applicant had a criminal background check, drug screen and employment (not personal) references contacted?
Just because caregiver is provided by an agency or registry doesn’t mean that adequate screening has occurred. A number of smaller agencies recruit though Craigslist. Applicants may or not have been interviewed in person. 

Is the worker First Aid/CPR certified?
Tell the agency what your specific needs are. Don't assume that the worker will know how to operate your equipment, assist with transfers, etc.

Ask things such as: Has the caregiver had any specialized training (familiarity with equipment/supplies, received training in a specific illness, etc.)?  Are they capable of meeting any lifting requirements?

Does the caregiver have adequate auto insurance coverage?
If not, and the caregiver gets in a car accident in the course of running errands on your behalf, then you may be held liable for the damages caused by the caregiver.

 *If you hire an in-home caregiver yourself ensure that you have similar coverage!

If you hire a home care worker privately, you are not required to provide workers compensation (unless they are being paid through a funded program such as CCSP/PSS in Georgia.)

Like any employer, you must abide by the applicable disclosure and authorization provisions if you elect to perform a background check. You should only have a background check conducted by a professional third party. Do not attempt to do it yourself. If you elect to have a background check done be sure to adhere to all legal requirements regarding privacy and disclosure.

If you are hiring the worker privately be sure to have clear job guidelines including specific lifting requirements and safety precautions.

If the worker is injured lifting your family member, slips in a wet bathroom, etc. are you prepared for the financial costs of covering their lost wages and medical costs? What if they sue you – do you have an umbrella policy on your homeowners insurance that will protect you?

What if you are robbed by them? Will your insurance cover the damages?

If they injure your family member are you equipped to handle the related medical costs?

Be sure the worker knows what is expected of them while on the job in your home and that you have made your home safe for both the caregiver and your family member.

DISCLAIMER: I am NOT a lawyer or insurance professional. Please check the local laws and regulations in your state.

Not your average party...the Divorce Party

Divorce Party

I'm in NO WAY celebrating divorce. Personally, I have been happily married for well over 2 decades. However, I acknowledge that in some relationships divorce is the best solution for everyone involved.

I recently decided to throw a divorce party for a friend; not to trash her ex or focus on the past, but to help her transition into her new life and to celebrate her independence. Her friends all wanted to show their love and support, knowing that this was a difficult period in her life.

We didn't give her wedding shower-type gifts. Having been separated for more than a year she had already replaced the items she'd left with her ex - wine glasses, toaster oven, etc.

No, we did not give her tacky or trashy gifts - although a few gag gifts were included in the fun. I gave her a copy of The Paperbag Princess, a children's book with a very strong female protagonist. In the story "a prince is kidnapped by a dangerous dragon, and the dragon's breath burns up all the clothes in the palace. The princess who loves the prince can only find a paper bag to wear when she goes to rescue her love. Cleverly tricking the dragon, she enters the cave where the prince, still beautifully dressed, is held captive. Is true love rewarded? No! He at once complains she's "a disaster" badly dressed, dirty and all messed up. She replies that he is a fine and handsome prince--but completely useless. "And, in the end, they didn't marry." I think that marriage is wonderful - but it isn't always the happy ending. The story always continues...

Decorations weren't black or maudlin. There were no voodoo dolls. This wasn't a party about burying the past, but about embracing the future. We used silly cocktail napkins with phrases like "let's party - the prince can wait" and I Dream of Jeannie themed "I don't do the master thing any more".

We served plenty of wine and a cake with the words "Just Divorced" (chocolate, naturally).  The point we wanted to make is that we all supported her as she moved forward.  She had fun and hopefully it helped during a rough time.

This may have prove that I will use any excuse to throw a party...

Fulcrums and a Full Life

This weekend I hopped the last hurdle into middle-age: bifocals. I am now officially old. Grey hair, wrinkles, expanding waistline and declining vision. So why am I so content?

Maybe it’s because I can look back and be happy about where I’ve been. I’ve made good friends. I’ve gotten a good education. I’ve had the opportunity to work for a paycheck and the luxury to volunteer for a nonprofit. I have a fantastic family, both here in my home and stretched out across the country.

Life isn’t easy. Not for anyone, even if it looks like it is from the outside. We all struggle with our personal demons and challenges. I worry too much. I don’t work out enough. I am often out of balance. But not today. Today, as I turn 47, I am perfectly balanced on the fulcrum of my life. Life can be a see saw, tipping wildly in one direction then another. Your job pulls you one way; your family pulls you another – the see saw tips out of balance. The trick is adjusting the weight of each element so you can go up and down in harmony. Never letting one side weigh you down or keep you pinned to the ground.

The past month has left me teetering. The abrupt “thump” when Amanda broke her hip. The long days and nights in the hospital following… then endless piles of paperwork for insurance, Medicaid and lawyers. But today my friends have posted messages on Facebook, I had a little party, my father called… things have tipped back up and balance has temporarily returned.

My understanding of physics is limited to a fifth grade module on Simple Machines, but I found this website demonstrating how a fulcrum works. It’s not just the weight on both ends that impacts the balance, but also the placement of the fulcrum. It occurs to me that I can impact the placement of the fulcrum, myself, and how I view the world around me. I don’t need to allow outside factors to weight me down. I can alter where I stand in relation to the people and events around me. I can influence the balance of my own life.

There is power in the placement of a fulcrum. Archimedes is attributed with saying.”Give me a lever long enough, and a prop strong enough, I can single-handed move the world.” A fulcrum is also the pivot point for any lever. Today I feel like I can move the world. Not off its orbit, but maybe nudge it into a better place somehow.

Physics can also explain the wrinkles, but that's a topic for brighter minds than mine....

Cyclical Friendships

We all have them: friends that come and go throughout your life. Maybe you chose different paths, live in different states, or don’t like each other’s chosen partner…  The reasons are myriad. Facebook and social networking sites have created new cycles for us. We are able to reconnect with people we haven’t seen in decades and reassess our friendship.

I seem to have two categories of friends in my life. The first are those rare few who have never left, who stuck with me through the bad haircuts, bad boyfriends and big glasses and are with me today, intimately involved in my life. They not only know my kids names, they know their birthdays.  They were there (at least in spirit) when my children were born and when my mother died. More than friends, they are my true family.

Then I have my “guy friends,” as Kevin calls them. They aren’t necessarily guys. It’s just that our friendship is more like that between two guys. We share a common interest or enjoy a common activity. Sometimes I have to tread lightly because all we share is this interest. In these cases I know that if a conversation strays unto religious or political topics we may be in trouble.

When that stage in our lives ends we grow apart; perhaps we’ll come together again, perhaps not. There is no animosity or a single breaking point – circumstances change for one or both of us and we move on along our individual paths.

I’ve had some wonderful “guy friends”. There was Melanie who taught me to ride horses in my early 30s. I was about ten years older than her. In fact, I took her out for her first legal drink. We were at different points in our lives. I was married with a job; she was still in college. I didn’t have any kids yet and so we spent a lot of time together, riding, teaching, and going to clinics with famous equestrians. It was fun and we truly enjoyed being together.  However, it didn’t extend comfortably outside of the barn.  I’ve had a lot of barn friendships over the years that ended when I left the barn.

Then there were the friends I made when Amanda was a baby. For the most part we all still live in the same town, but we have grown apart. It may be because Amanda has special needs and so she doesn’t attend our home school. It may be because some of them have gone back to work or simply found other interests now that their kids are in school all day. If I see them at all it’s a chance meeting at the grocery store or Target. I still like them. I’m always happy to see them and hear how their kids are doing. I also know that (for the most part) the “let’s get together soon” comments are sort of like when a guy would say “I’ll call you” at the end of a date. I’d be surprised if anything came of either.

Now I have Danielle and a whole new group of “guy friends.” These are women I like and admire. Strong, smart women balancing complex lives. However, I am 15 years (or more!) older than most of them. I know that under other circumstances they wouldn’t think to ask me out to a movie or over for drinks. We have no common frame of reference. Some of them were born the year that I started high school. Songs I grew up loving have always been “oldies” for them.  They didn’t know that Madonna was Catholic before she embraced Kabbalah (really?!?) They can’t remember a divided Germany with the Berlin Wall still standing or a united Soviet Union.

I’ve been down this road before. As we move deeper into summer I can already sense the shift – the start of the cycle. The kids will all be going to different schools in the fall. Some of the mothers are looking for jobs. Others are expecting another child. As the kids form new friendships so will we. Instead of talking to each other every day, now we talk once a week. Eventually it will taper off to once or twice a month and then several months may go by. We’ll still like each other. We’ll still have fun when we see each other, but we won’t see other often. Only time will tell whether we stay in touch or drift apart. And the cycle will start again with a whole new group of friends for each of us…