"I'm taking 22 pills a day", said my elderly client proudly. That immediately raised a red flag with me. According to a recent study by the Toronto Star, the average 65 yr old takes 5 pills per day and only 12% take more than 10 pills a day.

So what were all these pills for? My client couldn't answer that simple question. She also indicated that even though she felt sleepy and sluggish all of the time she didn't want to question her doctor as he might "get mad". Four different doctors had prescribed these medications and she figured,her primary care physican wouldn't go against another doctors orders. That's very typical among the Greatest Generation. They were trained to do what they are told and not question authority.

Consulting with colleagues, I learned that many Seniors are taking too many meds. It is called is a growing problem that even has a name: Polypharmacy While one might assume that all the doctors actually shared patient information, they do not. Yes, all informaton should be in the collective files. Don't assume that is true. Even if it is true, most doctors don't read their patient's files, beyond scanning the first page. So in fact, 4 different doctors can be treating the same person and haven't the faintest idea what the other one is doing.

The results are frightening. Senior patients in particular are often taking old meds along with newly prescribed meds, not remembering or realizing that one is replacing the other. Pharmacists should be noticing this, but sadly they often do not - or the patient is filling prescriptions at more than one location and the information is not being shared between networks. The patient is trusting and nobody is watching!

Doubling up on meds and perhaps also taking meds that are contraindicated or even adversely react with one another is a very real possibility. That's a recipe for disaster, bleeding in the stomach or other complications, including death are real dangers. An overly drugged senior is also more apt to suffer falls.

So what, as a concerned family member,can you do? Check how many meds are being taken by your senior relative. Ignore your beloved seniors reluctance to "challenge the doctor" and insist upon what is called a "brown bag review". Get a 'brown paper bag" and collect each and every prescription bottle and take them with you to the pharmacist or primary care physician. A good doctor will welcome your concern. If they object, you know it is time to find another doctor.

As medical care becomes more and more automated, the human touch is ever so more needed. This is not the time to relax and trust that your beloved senior is getting the best care. Be ever vigilant and check to make sure that their medications are correct and that no harm is being done. That is the least we owe the Greatest Generation.

" I know, I need to move," said the lovely Amelia, aged 85, alone, frail and living in a run down house with multiple levels and too much clutter. "But I just have to go through a few papers first. My friend is helping me" She glanced at the huge pile of dusty papers that had obviously been sitting on her coffee table for months.

Amelia had been referred to me by the Director of a beautiful assisted living community that was holding a sunny, garden view apartment just for her. Was she ready to finally move in? They couldn't hold the apartment much longer.

We talked about her loneliness and boredom,and how much she was looking forward to being around people again. Amelia loved to talk and despite her frailty, was smart and funny and had interesting stories to tell. Now, widowed, no family or children, most of her friends also dead, her only connection to the outside world was her television and a life alert style necklace, which instead of being around her neck, she had tied, dangling to her walker. Even though I objected and suggested it go around her neck, she insisted on keeping it right where it was.

The house was dark, dirty and cluttered. Too many electrical cords,too much furniture. Amelia's TV watching chair was broken and missing the back cushion. The family room stepped down and the kitchen stepped up. The bathtub had no grab bars. I saw danger everywhere.

As a Senior Move Manager, it is my greatest pleasure to help seniors get to safer living and re connect with the world. I held both of Amelia's hands in mine, looked into her eyes and said, "Amelia, Let's get you to a safe place first and we can go through all your paperwork later. We'll take it with us. I'll help you sort it all out. This is an unsafe place for you. We can start immediately. I promise you'll love your new apartment. "I know", said Amelia. "I'll call you soon."

Amelia never called. Instead, the Director of the Assisted Living community called to tell me that Amelia had had an accident in her home. A "friend" had propped Amelia's TV chair on four bricks to make it easier for her to launch herself forward to get up. She and the chair came tumbling down. Amelia had broken both legs. Since she couldn't reach her life alert tied to her chair, Amelia had laid on the floor for 2 days before being discovered. Now in a nursing home, on oxygen, she was not expected to live. She would not be needing my services.

I hung up the phone and put my head in my hands. I thought back to my visit with this darling lady. She told me she had courageously traveled alone by train from New York all the way West during WWII, meeting her beloved husband Mike at a USO dance and making a life for herself in California, I wanted to cry. Oh, Amelia, you left it too late and now you are dying. I am so sad and so mad at you too!

This story is all too common and heartbreaking. I know it is hard to leave one's home, but delaying the important decision to move may result in having all decisions taken from you.This is what happened to Amelia. Now her sunny, garden view apartment would be going to someone else - someone who hadn't left it too late.

If you have a beloved senior that needs to move, but is delaying it "until", tell them Amelia's story, please. I'm really sad and tired of this story.

Clara, unmarried, childless, elderly, frail and disabled, hated the idea of moving to a nursing home. She wanted to remain in her home as long as possible but had decided that she could not afford an expensive agency caregiver. Her friends and neighbors suggested she try online advertising. Surely, lots of people find services through online lists! So that's exactly what Clara did. She posted a job for a senior caregiver online and within minutes received a reply. The next day, a well dressed, middle aged woman arrived at her door. Clara liked the woman immediately and friends and neighbors reported that she was excited to find such a perfect person to move in and help her with her daily living needs. The best part, Clara said, was the woman charged a lot less than local agencies. She was very pleased with herself at being such a smart shopper.

For the first few days, everything seemed perfect. The new caregiver was warm and friendly, a great cook and gently lifted Clara in and out of bath and bed with great care and ease. But things soon turned ugly. The woman, once friendly, became easily angered and denied Clara food and essential care. Frail and terrified of reprisal, she didn't tell her out of town family, who called often, or her neighbors who visited, that things had gone terribly wrong. One day, her next door neighbor rang Clara's front doorbell. There was no answer and no indication of movement in the house. That was unusual since the TV was usually blaring and Clara rarely left the house. Curious and also concerned, the neighbor walked around to the back of the house and peered in the window. There on the floor, dead, lay Clara.

The police determined that Clara had been dead for two days. The caregiver who was apprehended a week later, was identifed as a recently released mental patient who had already been found "innocent by reason of insanity" for killing another elderly woman. For some stupid reason, she had been released from incarceration and deemed no longer a danger to society. She also had a rap sheet a mile long for felony assault as well as robbery.

Failure to spend the money on a professional caregiver was Clara's first mistake. Failure to spend the money on a background check was Clara's second.

In addition to losing her life, Clara had also procrastinated about getting her estate in order. "I've got the papers right here", she had told a family member on the phone. "I know I should have a will or trust, but it will cost $1,500 or more. I can't afford it right now. I'll do it later". So Clara also died without any will or trust in place. That left her family not only with unbearable sadness but also with a costly and cumbersome probate process that ultimately cost the estate a lot more than the $1,500.

Should her family and friends be held to account? First of all, seniors can be very independent and not willing to admit they need help to family and friends. Even when they do, that doesn't mean they will take advice. Who could have predicted this terrible tragedy? Without relatives close by, it is hard for seniors to find someone whom they can trust and rely on.

Families also assume that unless they hear otherwise, all must be well. This is no longer true. In the 21st century, our lives, unlike our predecessors, are more complicated and families separated my miles. The "village" of family and friends is often shaky at best. Seniors are particularly at risk for abuse and theft. It's a dangerous world out there. In addition, we are only now learning how to adequately care for our elders, 21st century style. It's a whole new business model, filled with lots of loopholes and missing parts yet to be learned and filled. We are literally creating a model that our children will use to care for us. We better pay better attention to the details for our own sake as well.

Families should insist on trained professional care, regardless of the cost.While seniors are reluctant to spend money on themselves, there is nothing more important than their safety. Agencies do background checks, hold bonds and provide supervision and follow up on their employees. This is why it is important to hire professionals. This is why it costs more than hiring somebody off an online list. You get what you pay for.

So many seniors and their families are unaware of the help that is available to them. Had she hired an elder law or estate attorney, Clara would most likely have discovered that she qualified for financial aid programs due her limited income, health and her age. Elder law and care policies are complicated. Trained professionals know the ins and outs of elder law and elder services. Their expertise is truly priceless.

I think not only about Clara's last moments, but also about how it could have been. She didn't have to die in such a terrible manner and she didn't have to live in fear of running out of money either. With professional advice, she could have created a plan to hire a safe and qualified caregiver. And when the end came, her estate would have been in order. Her family, although grief stricken, would have happy memories of her life well lived and well ended.

Money isn't everything. Clara could have been saved. The sooner we all learn this important lesson, the better.

Baby Boomers are often called the Sandwich Generation. They earned this moniker because they are often faced with caring not only for their children but their aging parents as well. I'd like to add another layer of cheese, tomato and lettuce, along with a slice of bread to this Sandwich, making Baby Boomers the new Club Sandwich Generation.

In this current economy, Generation X and Y children are moving back home in record numbers often with spouses and children in tow. Thus, Boomers are now often supporting three other generations not just two. What a fine development that has got us into!

One of my favorite organizing clients is the classic Sandwich Generation. One aging mom needs financial support. Then her son came home with wife and two children. Because of the predatory real estate lending practices, he had been deluded into buying a house far beyond his means. Don't just get a loan for the house, said his lender, get some extra money for some fun stuff too. Like a fool, that's just what he did. He came home to Mom and Dad, having lost his house, but also with two flat screen TV's and a boat in tow. Now his parents, who have worked and saved carefully all of their lives and looking forward to a peaceful retirement, have been invaded by two extra adults and two babies ,losing all privacy and guest rooms, with chaos and toys scattered everywhere.

Dreams of cozy retirements have been replaced by supporting multi-generational households. Money is very tight, tensions are high and there's not a lot of solutions out there.

Here's what I suggest: The new Mantra has to be: All able bodied parties must be pro-active, not simply re active and feeling sorry for themselves while they mooch off mom and dad. That includes adult kids who screwed up and need some help. Give them your very best advice, a shoulder to cry on,a temporary roof, maybe, but send them out to find another place to live as soon as possible.

Relieving them of the consequences of their bad behavior is co dependency and isn't going to help your kids become responsible for their own lives. It actually further cripples their ability to learn from their mistakes and further diminishes their confidence. This is an easy pitfall for loving parents to fall into. Send them out to solve their own problems. They will be the better for it and so will you. It may be the best parenting you have ever done.

For those who have fallen on hard times,through no fault of their own, that is entirely another matter. This is what families are for. However, even under these circumstances, sympathy and loving help is no substitute for pro active planning and strategies - not just sleeping on the sofa and waiting for the economy to improve. Loving help should never morph into co dependence.

For aging parents, it's a different story. They don't fall into the able bodied category. They do need your help and you have an obligation to do so. However, even in this case, you must be realistic about what you can afford and what you can physically accomplish. You may not have the time, patience or physical strength to care for them. Don't be reluctant to ask for help. You will be amazed at how many services are available to you. You aging parents may have unrealistic expectations of what you can do for them. Dementia may also be involved and you might be in over your head.

There are plenty of senior service organizations out there who can help you. Contact your nearest Senior Community Services department in your town or city. They are a wealth of information and help.

Gone are the days when families lived nearby and aunts, uncles, cousins, friends and neighbors were there to help. Nowadays, we are mostly on our own and often feeling overwhelmed, if not downright invaded.

Becoming the Club Sandwich Generation may be a 21st century phenom, but that doesn't mean that you have to lose the quality of your own lives. Do you what you can, do what you must, but take care of yourselves too. If you don't, you won't be able to take care of anyone else anyway. Leave the club sandwich concept for the deli. It's not a very good model for living.