How would you like to pack up and move at age 84?

In the best of circumstances that could be unnerving, but in my parents' case there's a lot of change going on. Since I haven't posted in quite awhile, let me refresh your memory.

My parents came to California last year after we siblings got too many calls from concerned relatives that share retirement homes near Mom and Dad in Florida. After we got a good look at them we decided it was time to get them into assisted living. Actually it was my sister in Los Altos of the 5 of us, who had the good sense to make this happen, and for her convenience they moved into a facility near her.

But now my sister and her family are making a move to Portland, for business reasons, and Mom & Dad aren't invited. It's been very challenging, I can tell, to deal with the 3am phone calls and trips to the Emergency Room, plus all the regular trips to the doctors. She'll have enough on her plate moving her family out of state without caring for aging parents.

So they're moving to San Diego this weekend. Should they fly? Drive?

I eliminated the fly option; they can both get pretty worked up if they get too confused. On the other hand, I've had them in my car several times over the past year, once as far as Hearst Castle, and although they're not well suited for vacations any more, I expect they'll do just fine traveling by car.

I'll keep you posted. Wish me luck.

   (45:12)

If you think about abuse, child abuse is often quite visible and the public has become educated on domestic violence, but elder abuse often happens behind closed doors, often at the hands of family members.

When allegations of abuse or neglect are made, what's the process of investigation?

Carol Mitchell is the Program Manager of Adult Protective Services in Orange County, California.  We met through UC Irvine's Dr. Laura Mosqueda. Carol and Laura meet weekly together with other interested parties from law enforcement, mental health and shelter advocates to review cases of adults in jeopardy. If you suspect abuse call the Adult Protective Services hotline: 1-800-451-5155.

My mother's back in the hospital; is she on a 2 week cycle? This time it's because of a heart attack. Her angioplasty shows some heart damage with no opportunity for a stent. Other complications: her doctor describes her long term breathing problems as emphysema. It sounds like the correct term to me.

My sisters Maureen and Kathleen have been shuttling Dad from Assisted Living to the hospital for daily visits. It's been stressful, lots of tears. Yesterday her doctor was asking questions about the extent of care we want. He said most people who go on a ventilator usually don't come off. If she relapses, what response do we want? It's a difficult conversation.

This morning she's looking much better.

   (46:41)

Do you have a "wisdom tradition" for dealing with end of life issues? What is the Five Wishes Living Will? And what about Do Not Resuscitate directives, if you're taking care of Mom or Dad, when should you consider a DNR?

I always thought of grieving as a lonely experience, until I met Eileen Geller of Consoling Communities in Seattle. She shares her experiences as a hospice nurse, "amazingly, it's about living".

Download her free Guide to Care and Support During Serious Illness.

   (28:42)

What's the fastest growing segment of the population? According to Dr. Laura Mosqueda, Director of Geriatrics at the UC Irvine Center of Excellence on Elder Abuse and Neglect, it's 85 year-olds. Since this same demographic is so prone to dementia, you have all the components for elder abuse.

Maybe you're thinking of institutions like nursing homes, but "the vast majority of elder abuse occurs in private homes and the perpetrators typically are spouses or adult children". Surprised?

She and her colleagues have made hundreds of house calls with Orange County Adult Protective Services to look for signs of elder abuse. But that begs the question: is that a bruise because the elderly bruise easily, or is it abuse?

Assisted living doesn't look so bad. Here they are settled into their own place, making new friends and all of us siblings assured they're getting their meds correctly. Whew! What an ordeal it's been!

They've been visiting for 12 weeks, since Valentines Day. They came for a visit that had some business issues to deal with, like a new Last Will and Testament, a Living Will and a Power of Attorney. Everyone agreed those issues needed resolution, but then it's been one health calamity after another. An accident and pneumonia for Mom, a hernia then a heart stent followed by an infection for Dad. Doesn't sound like much as I write this list of ailments, but combined with their increasing dementia it's made for a difficult time for the siblings.

No matter how many times I answered their questions, "'I'm homesick; why can't we go home?" by the next day they just couldn't recall what I'd said, so round 2 would begin, each iteration a little bit more argumentative, followed by growing resentment and obstinate behavior. They were no fun to live with, nor to visit.

Then a crisis hit. Dad complaining of chest pains meant a trip to the emergency room. After more than a couple of exciting moments, he was out, but moving back in with my sister's family wasn't a suitable next step. He'd need more supervision and care; it turned out to be the deciding factor in favor of assisted living.

My mother moved in while Dad was still in the hospital. We knew he'd go wherever she went. She loved it as we thought she would. The social activities lead to making new friends and from there, life works as you'd expect; she was happy. An anti-anxiety prescription helped to calm her nerves; some of us regretted we hadn't focused on this earlier.

Last week as they settled in, it was time to revisit their doctor and get the results of their cognitive tests. We knew Dad had suffered mini strokes before, at least one, so that was no surprise; likewise his age related brain atrophy. But Mom's brain scan showed several mini strokes; that was news. The doctor adding that "things will only get worse". Mom found that upsetting.

   (38:39)

Just read this: if you sit on a nonprofit board don't think you're going anywhere soon, not until after you listen to Dan Pallotta describe Uncharitable, his riveting indictment of how we hobble nonprofits. It's a myth-busting, paradigm-shifting re-examination of what's going on in Charity, in my case, right under my nose.

I'd noticed the review in the New York Times awhile ago, so I picked up a copy then it sat in a pile. But since I sit on 4 nonprofit boards, the sub-title nagged: "How Restraints on Nonprofits Undermine Their Potential"; I took it on 2 long distance trips, a week each in Atlanta then Madrid. What a great companion this manifesto turned out to be.

Like many of my angel investor peers, in addition to sitting on for-profit boards of private companies, many of us end up on nonprofits, too. For myself, I'd learned quite a bit from fellow angels, especially Tech Coast Angels' Dave Berkus, and I'd enjoyed putting some new concepts on the table and into play for 2 nonprofit boards in the past year. I was enjoying the process: making an organizational change and seeing a pretty immediate positive result, then I did it again for the local school of the arts advisory board I sit on and again, an almost immediate positive change; this was fun, tweeking nonprofit boards was not only possible, but the feedback cycle could be immediate. Like learning to drive, I thought, maybe I can accelerate the cycle. So that makes me and maybe you, too, the perfect audience for Uncharitable author, Dan Pallotta. I need to create a new sub-category on this blog, "myth buster", then Dan could be cross referenced with the likes of Fools Gold author Scott Shane and Early Exits author Basil Peters.

On the 10 hour flight home from Madrid last month I lent my copy to Angel Capital Association Chairman, John Huston. Half way over the Atlantic he hands it back, "this makes my head hurt; I'm getting my own copy!". When I tell Dan, like the interviewer I'm supposed to be, he asks, "what do you think he meant by that?". I was pretty sure I knew and you'll be able to guess once you listen to Dan Pallotta.

It's been quite a weekend for the family. Dad was rushed to the hospital Thursday; when he got there they said he was in immediate danger of a heart attack. A stent the next morning cleared up that problem, but as I look back on the past few days, I see it as a momentary calm in a stormy weekend. Before the weekend is over my sister Mary will be in the Emergency Room herself.

Later Friday afternoon dad suffered a setback that turned into quite a panic. I think it was more serious than the doctor says, his vitals dropped sending every nurse and doctor on the floor into his room, shuffling my mom and sister Kathleen out into the hallway. Whatever color of Code Blue or Red included summoning the Chaplain and I got a teary phone call from Kathleen when they didn't know just how serious this incident was. It was up to me to contact the siblings.

In this day and age how can you reach out to 3 people and not get any response?

Washington State reported its first assisted suicide this week. A 66 year old pancreatic cancer sufferer took advantage of the state's new Death with Dignity law; Sandi Doughton reports for the Seattle Times. Read the article.

The New York Times reported on a group of cutthroat card players in a Laguna Woods, CA retirement community that are putting their sharp minds to work. The best of them exhibiting no dementia loss. Is there a correlation between competitive bridge and mental acuity? Read the article.