Please follow this article to get free caregiving materials from a dedicated caregiver himself:

Former caregiver Robert Coyne reminds caregivers in attendance at the Frank R. Strang Senior Center in Farragut never to ignore the cardinal rule of caregiving – taking care of their emotional and physical needs first!

Why? Because he knows whats its like. Speaking of his wife he says “When she passed away in 2003, I was left with an incredible sense of guilt. How many mistakes did I make? Could I have done a better job? Could I have prolonged her life? There were no answers,”

Like I said in my last blog post, few people rarely prepare to be caregiver,

It’s a challenge very few are prepared for. It’s a labor of love that can quickly turn into a living nightmare for everyone involved.

Few people understand the terrible consequences better than Robert Coyne. His personal experiences now serve as a wake-up call to other individuals finding themselves in the role of caregiver.

Robert took an early retirement when his wife, Kathie was diagnosed with an illness that would eventually claim her life five-and-a-half years later. 

“Nothing in my professional background prepared me for this undertaking,” Robert said. “I experienced the entire gambit of emotional, physical and physiological issues resulting in my suffering a heart attack followed by open heart surgery. I was fortunate enough to recover and return to my duties as Kathie’s caregiver.

“When she passed away in 2003, I was left with an incredible sense of guilt. How many mistakes did I make? Could I have done a better job?

Could I have prolonged her life? There were no answers,” he recalled.

Naturally he fell into a deep depression and could not see any way out. The pain was to much too bear. “Finally a physician who I respected greatly told me in no uncertain terms to concentrate on something else, start thinking about other people. I did just that and began researching the availability of resources for caregivers. I needed to educate and help others caring for a loved one.”

Devoting all his labors to the memory of Kathie, wife, mother, grandmother and best friend, reaction to Coyne’s seminar was instantanious with inquiries and future bookings.

“It’s been nearly two years, and I’m still presenting the three- and six-hour sessions on a semi-regular basis. I do my best to keep the attendance down to between 10 and 20 for each session. It’s a private, intimate relationship, caregiving. You will find that those who attend quickly converse with one another in a manner of understanding and kinship. They rarely give their names but exchange personal experiences benefiting everyone.”

Local churches, non-profit organizations, area hospitals, senior groups are just a few of the outlets taking advantage of Robert’s knowledge. “Everyone attending receives a 90-page reference guide and handouts. The seminars are free of charge. I do ask for a small donation for printing expenses, but there is no pressure. My only concern is getting this information out into the hands of people who really need it,” Coyne said.

Coyne, may be contacted at bobcoyne@charter.net

I just emailed him myself, so I cannot guarantee the results, and if you do not want to take a chance, I will post my results in a couple of days. (lets see if I hear back myself?)

Source: Elizabeth A. Pooley/Special to the News Sentine

Day to day caregiving is difficult enough. However when dealing with Alzheimer’s, the very nature of this disease and the way it affects the brain frequently have added frustrations and difficulties, which make Caregiver’s lives just that much more difficult. Our mission at www.caregiverrelief.com is to make sure you have every advantage possible. Please join me at that site and sign up HERE on the upper-left corner, for a FREE newsletter and received a FREE stress management guided imagery recording.

Today, part two of our series, we are going to talk about incontinence. The primary source for the following is great booklet from my library called “Understanding Difficult Behaviors: Some Practical Suggestions for Coping with Alzheimer’s Disease and Related Illnesses”. It was written 20 years ago but has stood the test time, as one of the best resources for Alzheimer’s. It was first published by the Geriatric Education Center of Michigan.

INCONTINENCE

The first thing we should say is, it is not necessarily permanent. Except in the very late stages, it is controllable. It’s just a matter of how much time and effort you have to put into helping your loved one become autonomous when it comes to going to the bathroom. Remember there are different levels of incontinence. For example, a person may have bladder incontinence, or bowel incontinence, it could be only night time incontinence. Let’s take a look

Possible Causes are physiological, medical, and environmental.

Here’s a very long list of causes:

* Infections, such as urinary tract infection (UTI) urethritis or vaginitis, can cause loss of urine control.
* Men are especially susceptible to infections after prostate surgery.
* Prostrate problems in men can cause retention of urine
* In women, constipation or fecal impaction can block the bladder so that urine leaks past the blockage.
* In older women, weak pelvic muscles can sometimes cause “stress incontinence” or “leaking” This may happen when a person laughs, coughs, or sneezes.
* Chronic illnesses such as diabetes, Parkinson’s disease, strokes or any other condition which limits mobility and/or causes chronic pan (e.g., rheumatoid arthritis) can make it difficult to get to the bathroom.
* Vision changes can make it difficult to see the way to the bathroom or the bathroom door properly.
* Insufficient intake of fluids can cause irritation of the bladder.
* Dehydration may cause incontinence by lowering or eliminating the signal to urinate.
* The urge or signal to go to the toilet may no longer be understood or received by the brain (due to brain changes due to dementia).
* Fluids having a diuretic effect, such as coffee, tea, cocoa, beer, colas, can affect control of urine.
* Medications, especially tranquilizers, sedatives and antidepressants can affect incontinence. These are often given to facilitate sleep or calm behavior but these drugs can also affect bladder muscle function and/or reduce a person’s sensitivity to body signals. Diuretic medications such as Lasix can also increase frequency of urination.

ENVIRONMENTAL CAUSES

* Distance to the bathroom may be too far.
* Bed may be too high from the floor, making it difficult for the person to get up.
* Floor and toilet seat may be the same color, making it difficult to find the toilet.
* Improper footwear may cause person to be afraid of falling.
* Persons may have trouble undressing to go to the toilet.
* Lack of privacy, particularly in institutional settings, may inhibit the person.
* Poor lighting may make it difficult to find the bathroom or to locate the toilet inside the bathroom.
* Orientation cues (signs) may be lacking which could help the person locate the bathroom.
* In nursing homes, being in bed with rails, being restrained or lying on protective pads may give residents the message that they are expected to be incontinent.

OTHER CAUSES

* Person may not remember what to do once in the bathroom.
* The task may be too complicated.
* Person may need help undressing, sitting on the toilet, wiping or rising from the toilet.
* Person may be fearful or anxious about having to partially undress in front of an unfamiliar caregiver.
* Caregiver may not be giving simple or clear enough instructions.
* Caregiver may be rushing.
* The person may no longer be able express need to urinate.

COPING STRATEGIES

If you really want to help, observe carefully and assess the problem.

* Do accidents happen only at certain times of the day or only at night?
* How often does the person urinate?
* Did the incontinence begin suddenly?
* Is the person urinating in improper places, such as in flower pots or in closets or in the kitchen sink?
* Do accidents happen on the way to the bathroom?
* Keep a diary or a log for several days noting times when accidents occur and the amount of fluid intake and output. The information will give you clues and also be helpful to the doctor.
* Have a through medical examination to discover any possible infections or medication problems that may be contributing to the incontinence.
* If a person has a fever that persists for more than 24 hours, report it to the doctor at once. Urinary tract infections are often accompanied by fevers and can be dangerous if left untreated.
* Be aware that a number of medications can be used to treat incontinence. However, these drugs may cause side effects such as dry mouth and eye problems and therefore must be carefully monitored.
* If a diuretic is being taken, it is important to carefully consider the times of day when it is given.
* Consider a continence diagnostic evaluation if the cause of the incontinence is still unknown. This would involve a series of tests that can determine how well the urinary system is functioning. These procedures are, however, uncomfortable and expensive and the benefits need to be carefully evaluated on an individual basis.
* Be sure the person is drinking adequate fluids – a minimum of 5 – 8 glasses daily. Many dementia victims forget to drink or may no longer recognize the sensation of thirst. A wide variety of substances act as fluids, e.g., jello, popsicles, ice cream. Also, try herbal teas and decaffeinated coffee; caffeine can affect continence adversely.
* Set up a regular schedule with specific times for the persons to have something to drink, e.g., with meals and three daily snacks.
* Observe toileting pattern of the person both during the day and at night. Try and toilet just before his/her expected time. This may vary from every two to four hours.
* Remember to toilet them before and after meals and immediately before going to bed.
* Make sure the person actually urinates before getting off the toilet.

VERY IMPORTANT

* Communicating with some one that has Alzheimer’s takes a conscious effort: When trying to direct someone simplify the steps involved. Do one step at a time.
* Use short words and short, simple instructions. For example: “Sit down.”
* Watch for nonverbal clues that the person with dementia has to go to the bathroom, such as reaching for a belt, tugging at a zipper or taking pants down. Also watch for restless behavior or facial expressions that may signal distress.
* Make sure that sitters, nursing home staff or other paid caregivers understand the terms or words that are familiar. Some people may use children’s words or slang like “pee” “tinkle” or “take a leak”. Make sure that the Alzheimer’s sufferer knows the words they are using.
* Listen carefully, because the person may say the wrong word. For example “I want tea” or “take a peek”
* Even severely impaired people do care when they have had an accident. Saying something like “Soon, everything will be all right” or “Don’t worry, everything will be fine” may reassure the person.

CLOTHING

* Simplify clothing. Try Velcro tape instead of zippers or buttons.
* Try elastic waistbands for trousers or wrap around skirts.
* Use underpants when possible. They can serve as a reminder to stay dry and as a stimulus to use toilet when wet.
* Change clothes when they are wet. Try not to let the person become accustomed to wet clothes.
* Select clothing that is washable and does not need ironing. Tennis shoes may be easier to keep clean if person is incontinent.

PROTECTIVE GARMENTS

* Adult briefs, are sold small, medium, large and extra large. Make sure you get the right size. A little too small an they may pinch or be uncomfortable, too large and they will not be leak proof and fall down when wet.
* Washable briefs are available with snapping plastic outer layer. Disposable briefs are bit pricey.
* Washable pants with disposable pads are and alternative for urinary incontinence only.

SKIN CARE

* Wash the skin after any accident. It is important to keep the person’s skin clean and dry to prevent rashes and sores. There are special products available which act as both soaps and skin conditioners. Look into creams for adult diaper rash.

AT NIGHT

* Consider putting a commode beside the bed, especially if the person has trouble moving around.
* Make sure there are night lights in the bathroom, hallway and bedroom.
* Make sure there is no clutter or obstacles in the pathway to the toilet. Falls often occur on the way to the bathroom at night.
* Make sure footwear is not floppy or slippery.
* Use disposable pads and rubberized flannel sheets to protect bedding.

BATHROOM AIDS:

* A raised toilet seat with grab bars makes it easier for a person to get on and off the toilet.
* Make sure the seat is fastened securely to the toilet so that it does not slip when a person sits on it.
* Padded toilet seats are more comfortable for the person who must sit for some time.
* If getting to the toilet is a problem, place a chair style commode near the bed. Make sure you leave the top off at night.
* Grab bars attached to the toilet seat are wall-mounted.

OTHER CONSIDERATIONS

* Purchase washable chair cushion covers.
* Soiled clothing hidden in a closet, under the bed or in a dresser drawer may be signs of incontinence.
* It is very important to respect the privacy and dignity of the person who may be having problems with incontinence. Losing control can be a terribly humiliating and embarrassing experience and caregivers need to be sensitive to these feelings. Every effort should be made to preserve the person’s self-esteem, for many dementia victims are quite aware of their deficits.
* Family member s and other caregivers also may feel embarrassed to awkward when assisting with toileting and should be aware that these are normal feelings Sometimes people find cleaning up to be a very difficult and unpleasant task and may gag. Try to be calm and reassuring and recognize that both of you probably feel quite uncomfortable.
* It goes without saying, put lids on waste paper baskets and other trash containers.

Wow, that is big topic. Again, like the previous topic “anger and agitated behavior”, we are only scratching the surface of possible causes and solutions. But I sincerely hope you will help me by signing up for my newsletter at the following link and you will receive a free eBook on handling wandering and Sundowning Good luck, and write me with any questions that you have, Donahue

Technorati Tags: alzheimer's, caregiver, caregiver stress, caregivers, Donahue Vanderhider, family caregiver, incontinence, sundowning, wandering

This is the most amazing video, you will smile from ear to ear when you watch it.

Back to Caregiving now….

please sign up, I have a great newsletter coming out, and I want you to have it.

Technorati Tags: alzheimer's, caregiver, caregiver stress, caregivers, caregiving, dementia, Dr. Oz, family caregiver, health, human growth hormone, Oprah, Resveratrol, stress management

Hello! If you came here from another site, like www.caregiverrelief.wordpress.com or www.caregiverhelp.blogspot.com, then let me direct your gaze to the upper-left side of this page: you will see that sign up form? Please put in your information and I promise you two things. One, I will never give your information to another person, and two, I will never inundate you with useless, intrusive sales pitches. You will get an occasional newsletter, and when I we launch Alzheimer Secrets you will be offered first crack at the CD (there are limited quantities), and that’s it! But if you are a caregiver or have someone with Alzheimers in your family…you better sign up quick, there is information that you need ASAP.

If you did not come here through one of those sites mentioned above, please continue, I have a short message about anxiety and to deal effectively with it.

Learning to Relax with Anxiety

Many anxiety sufferers are learning the proper cognitive tools to overcome their anxiety. It isn’t easy. It takes commitment. Learning to relax with anxiety takes daily practice and commitment. Here are some relaxation tips to get you started:

1. Acceptance – Whatever we resist will persist. Try not to see yourself as fighting your anxiety. Instead, see yourself as moving toward your goal of relaxation.
2. Talk to someone – Many anxiety sufferers feel better almost immediately when they have a supportive person to talk with.
3. Knowledge – The more you know about your condition, the better equipped you’ll be. Things work better when we understand why we are doing them.
4. Breathing Techniques – Practice belly breathing. Breathe in to the count of 3 and out to the count of 4.
5. Meditation – Listen to guided meditation tapes or CDs.
6. Journal – Keep a notebook handy during the day, and when you recognize a “what if this happens?” thought forming, write it down. Review it later, when you are more relaxed. Ask the trigger question again, as if it were true. What would you do? Keeping a journal helps you discover possible hidden issues.
7. Take a nightly news vacation – Before bed, listen to relaxing music or read a book. If your habit is to watch the nightly news, try watching it first thing in the morning instead.

Learning to relax with anxiety will command your daily dedication. Be sure and celebrate even minor improvements. They are likely to be permanent ones!

Please make sure you sign up for the FREE stress management CD, and you will automatically put on the newsletter notification list.

Technorati Tags: alzheimer's, dementia, Donahue Vanderhider, Dr. Oz, Longevity

I’m on the speakers bureau of the Alzheimer’s Association and this weekend I am giving a talk on “Partnering with Your Doctor” In the materials that the Alzheimer’s Association provided me for the talk was a short little quiz. I was impressed with this short 12 question survey, and thought you would like to see it too.

In my experience, caregivers often lose focus when they take their loved one to a doctor. Maybe you do too? Do you feel rushed when the doctor finally comes into the examination room? Do you sometimes leave the office and remember something important you wanted to discuss with the doctor? Or do you start running at the mouth frittering away your time with the doctor talking about the minutiae of your loved one’s behavior or symptoms and get side tracked from the important changes that you should have covered.

Here’s the quiz, lets see how you do. And remember afterwards to go over to either www.easycaregiving.com or www.caregiverrelief.com and sign up for the newsletter.

One more thing: I noticed that the quiz seems to be written to you and about your own doctors visits. If you are a caregiver for a memory impaired person please mentally re-word the questions so they fit your circumstances.

(Keep track of your answers so you can determine your score afterward.)

Do you usually:

1. Make a list of questions, symptoms and concerns before your doctor visits? (Yes or No)
2. Bring a friend or family member with you to the doctor’s office? (Yes or No)
3. See the doctor right away when you feel like something is wrong? (Yes or No)
4. Ask your doctor questions about your symptoms and concerns? (Yes or No)
5. Bring a list of your medications and medicine bottles with you to your doctor visits? (Yes or No)
6. Ask your doctor what you need to do next about your illness? (Yes or No)
7. Make decisions about your care together wit the doctor? (Yes or No)
8. Ask your doctor what results and side effects you can expect from your medications and treatments? (Yes or No)
9. Take notes during doctor visits? (Yes or No)
10. Leave the doctor’s office with all your questions answered? (Yes or No)
11. Ask your doctor for written information about your medical condition? (Yes or No)
12. Ask the doctor for a diagnosis so you know exactly what the problem is? (Yes or No)

Count the number if times you circled “yes” (score: _________)

0 – 4 = I am not a very active health care partner

9 or more = I am a very active healthcare partner

So how did you do? Is there room for improvement? Not to worry – you are on the right track, you will be fine.

Remember you have two websites that can help you with all your caregiving questions. Start with www.caregiverrelief.com and stay updated with www.easycaregiving.com and don’t forget to sign up for the FREE newsletter at either site.

Please help me keep this blog active and at least visit my sponsors website. (Not to mention that its an amazing product that I use faithfully) “>CLICK HERE for the ResV site and you can get a FREE sample by using this link!

Technorati Tags: alzheimer's, caregiver, caregivers, Donahue Vanderhider

Today I want to share a grim story with you. If you watch the news it may have caught your eye. But I want to post it in its entirety here.  It may be that you are like Bobby, taking care of one or both parents with Alzheimer’s.  If you have been doing it a while then you may identify with Bobby quite a bit.  If you are a new caregivers, then let this be a cautionary tale. The point is caregiver stress is potent, and it sneaks up on you, and before you know it your whole life has changed and you are putting one foot in front of the other – day in and day out, and you have almost stopped asking yourself questions like: how did I get here?

The point is, there is a way out, there really is!  But you are going to have to open your mind to new information and take some NEW actions in your life. Please take a moment and read this article, and see how much of what Bobby was dealing with, you are dealing with too. I will have a little more information for you afterward:

Caregiver stress underlies death

The Associated Press

Published: November 9, 2009

FORT LAUDERDALE – The scenes seared into the minds of those who know Bobby Yurkanin differ only in place: Whether in the pool, dinner table or bowling alley, he was a 50-something man whose life had been handed over to the sickness of his parents. Always, his father was by his side. Yurkanin moved across the country to care for his dying mother. He did it again as his father sank into Alzheimer’s disease. When the father grew combative, his son would calm him. When he didn’t want to eat, his son would cajole him to take some fruit. Friends said the son assumed a caretaker role out of necessity, despite a strained family history. Those who saw him and his father together often described the younger Yurkanin as dutiful, patient, dedicated. All this disappears into a single scene: A beachside argument, the father’s lifeless body lying in the sand, and accusing fingers pointing to the son. Witnesses said they saw the son drag his father into the ocean, let the waves steal his breath, then tell a 911 dispatcher called by an onlooker to turn the ambulance around. Yurkanin arrived at his lowest point a relentless, thankless, solitary task of caring for someone with dementia. Millions know it. But Yurkanin’s downward spiral ended with a charge of murder.

Yurkanin’s father was a successful engineer, businessman and inventor. The family’s New Jersey home sold for nearly $1 million, and there were two more modest homes in Florida. Yurkanin told psychologists his father was an abusive alcoholic, his mother prone to psychotic episodes. He told his ex-wife his father abused his mother and his grandmother. For Bobby, an only child, growing up was traumatic, said his attorney, Michael Weinstein. Still, he finished college and graduate school. He started law school, dropped out and set up a paralegal business. He also excelled at something that would be cited when his father lay helpless on the beach. He was a lifeguard, whose skill is evident in newspaper clippings of his wins at competitions.

In the late 1990s, moved home to Short Hills, N.J., to help care for his mother, who had cancer. Not long after she died in 2001, his father showed signs of Alzheimer’s. When the father resisted going to a nursing home, his son felt he had no choice but to take over his care. Bobby Yurkanin assumed supervision and he and his father moved to Florida. The disease progressed. In time, Bobby showed signs of losing control. In Palm Coast, neighbor Kathy Mittelstadt told police she once saw the father wandering the street in a diaper. Numerous other times, she said she heard the son yelling and cursing. “I can’t wait till you’re no longer one of my problems,” she said she heard him say.

Troubles mount

At the Playa Del Sol condominiums in Fort Lauderdale, where father and son settled, complaints grew. The father was often wandered in hallways, sometimes nude, and into others’ condos. Residents complained he dressed in front of an open door. Once, when Yurkanin was alerted his dad had been wandering, condo employees said he went into a profane tirade in the lobby. Anna Fico, a friend who sometimes helped watch the father, said Bobby Yurkanin confided that it was all too much. It’s a dilemma many others have confronted. Sometimes the stress has led to physical abuse. People caring for a spouse or parent with dementia have been accused of killing them in rage or expression of mercy to end their misery. Caregivers have gone to prison. “The demands on caregivers are almost unfathomable,” said Gail Gazelle, an assistant professor at Harvard Medical School who is an advocate for Alzheimer’s patients and their families. “The anger, guilt, and shame that caregivers experience is intense.”

No one accused Yurkanin of abuse, Weinstein said. Many who saw him with his father said the son would grow frustrated by his father and sometimes raise his voice, but his care was undeniably loving. Kenneth Carter, an old friend of Yurkanin, said he saw him with his father during several visits. He described both men as alcoholics, but said he was impressed with the way his friend cared for his father. Carter said the old man would suddenly stand and recite the Gettysburg Address or sing “The Star-Spangled Banner.” He would take off his shorts and run down the street. His mood could change at a moment; he would kick, scream, and become combative “Bobby would always come to Bob’s rescue, and all would be forgiven,” Carter said. One Friday, Yurkanin had to give his father a shower and a shave, Fico, called and asked them to join her at the beach. Yurkanin agrees.

Fight over swimsuit

Not long after they arrive, the father pulls down his swimsuit and stands on the sand exposed. “Bob! Bob! Bob! Your father took off his clothes!” Fico yelled. What happened varies according to witness accounts. Yurkanin swears at his father, said a couple nearby. With the father resisting, the son took him into the water. Onlookers and Fico used the word “drag.” It’s the only way his father will learn, the only way he’ll listen, a witness quoted Yurkanin as saying with profanity. In waist-deep waters, Yurkanin removes his father’s shorts and diaper as Fico helps hold him up. The son goes ashore to throw out the diaper, returns, and dives underneath to try to put the shorts back on. It doesn’t work. Some say the father continues to fight his son. Some witnesses said Yurkanin pulled his father’s ankles upward to put the shorts on and the old man’s head went underwater. But attorney Weinstein said it’s not clear the father’s head was submerged. Whatever happened, it was clear to many watching the father was distressed. Joanne Turing, peering through binoculars from her balcony, saw the man’s face change color. “This guy’s dying,” she said.

After Yurkanin brought his father ashore, some witnesses were puzzled by his actions. He put him so close to the water, waves washed over his face, some said. Others didn’t know why it took so long for him to begin cardiopulmonary resuscitation. Some said he never did. Three witnesses called 911. In one call, an agitated Yurkanin is heard yelling that an ambulance isn’t needed. “Oh sir, you’re kidding,” the called said. “I’m his son!” he shouted. “Get out of here! Don’t send any ambulance. I don’t want any ambulance.” The caller pleads with the operator: “Help! Help! Help! Help! Help!” Yurkanin took the phone and told the dispatcher: “Forget it! Don’t you come! If you come, I’m not releasing this patient.” A man grabs the phone, asking the dispatcher to send help.Paramedics arrive. As they prepare to take the father to Holy Cross Hospital, where he arrived in critical condition, the son asked to ride along. He is told to wait for police, who asked Yurkanin why he forced his father in the water. “He smelled bad,” he replied.

The father died the next day. The death is ruled a homicide and Yurkanin, 53, is arrested two weeks later on a first-degree murder charge. He is free on bond while awaiting trial in January. If convicted, he could be sentenced to life in prison. Weinstein said Yurkanin’s response was a culmination of “deep-rooted psychological issues,” not malice. Psychologists hired by Weinstein said Yurkanin felt helpless, hopeless. They said caring for two chronically ill parents for many years resulted in post-traumatic stress disorder.

Technorati Tags: alzheimer's, caregiver, caregiver stress, caregivers, caregiving, dementia, Donahue Vanderhider, family, stress management

Caring for someone with Alzheimer’s is quite literally a thankless task. Which is not to say that it’s unappreciated, but aside from the first few months of an early diagnosis, Alzheimer’s sufferers are generally oblivious of their own condition and naturally cannot comprehend the sacrifices made by their loved ones to keep them healthy?
But please don’t read the above as being a condemnation of the unfortunate souls that have no control over what has happened to them. Clearly, the tragedy of Alzheimer’s is that sufferers very early on “forget” they are ill. Rather read it as a recognition and acknowledgement of the selflessness and integrity of their caregivers. Because I think something happens in the heart of most caregivers that gives them the resolve to commit, in all likelihood, the next decade of their life to the care and protection of the person they love the most in the world. But sadly at the same time that a caregiver is making this internal resolution, they are also grieving the finality of the diagnosis “Alzheimer’s” and everything that means.
Too often, the tragedy and heartbreak of the caregiver is pushed to the background, as the Alzheimer’s sufferer becomes the identified patient and the focus of everyone’s attention. Tragically, in addition to the personal commitment a caregiver makes to the care and well-being of their loved one, they often are subconsciously abandoning many of their own goals and desires. Caregivers, while taking on all these new tasks and challenges that they never expected, are subconsciously strapping themselves in for the long haul.

Stubbornness is Born
Rising to the occasion; facing financial, legal and other new responsibilities requires a certain amount of tenacity and determination. For this reason I find that caregivers seem to be uniquely strong-willed. Maybe it takes a stubborn streak to be able to focus on the day-to-day grind of meeting the needs of another adult that has lost the ability to reason and make their own ’safe’ decisions. But while stubbornness can be a positive personality trait when it keeps a caregiver going month after month, year after year; it can also be a negative trait when it suppresses an open mind to new and alternate solutions. Being hardheaded can prevent us from accepting and opening up to new concepts and ideas. It narrows our field of vision. Like blinders on a horse it creates a closed-mind.
I have seen it over and over again, maybe you have too. Too often I meet a caregiver that is wound up and ready to explode. It is obvious to everyone around them that they are extremely stressed out. Unfortunately they often have trouble admitting it. They will tell you that everything is under control. “I’m fine”, they say. And, tragically, to the extent that they are “fine”, they are heading for a very big crash. Besides the toxic effects of stress on one’s health. They are closed off to the concept of surrender and the acknowledgement that they need help. But that is exactly what every caregiver needs…help. Caregivers need to address and overcome long-term stress. It is a good bet that long-term stress is responsible for the statistic that more than 50% of caregivers die before the person they are caring for.
Dr. Jamie Huysman, the co-founder of Leeza’s Place, gives a great talk. In his speeches you can often hear him suggest that caregivers “take the oxygen first”. What an excellent analogy! This is an ideal comparison to the average caregiver’s dilemma. And, this is the very idea that I have been advocating all along. Flight attendants, when giving preflight instructions, tell people traveling with children, that if cabin pressure is lost and the oxygen masks are deployed, that they should put their own oxygen mask on before helping their children with their mask. The reason is that there are only a few second before you lose consciousness, and in order to be effective and save others, the parent (caregiver) needs to see to their own needs first.
So I plead with my stubborn caregivers. Acknowledge that you need help, and be willing to hand the job over to others whenever you can, and start taking care of your own needs. Remember that alarming statistic from above that over 50% of caregivers die before the person they are caring for. Well add another 10 – 20% that become incapacitated and no longer able to continue caregiving for their parent or spouse. The causes are many, it might be a major stroke, or a serious cancer, or a fractured pelvis. Unfortunately, I have seen too many a cases of older adults with profound Alzheimer’s whose caregiver is out of the picture.
Over the years I have spoken, one-on-one, with hundreds of caregivers. My overwhelming impression is their unwavering love and commitment they have to their loved one. They genuinely believe that no one can care for their parent or spouse as well as they can. They believe that no one can possibly know their loved one as well as them. To large degree I agree with them, and this is why I continue to recommend that they take action to preserve their health. Because if something happens to them, who will care for their loved one? So to manage their stress I encourage them to use adult day care, to find respite care options, and to attend support groups. For example; adult day care gives them a day off from their 24/7 caregiving, respite care allows them run errands and see to their own health care appoints, and in support groups they can share their experience with newer caregivers, while learning from older, more experienced caregivers.
I also recommend board and care and assisted living. Usually, this is the option that caregivers are very specific about NOT doing. And there you have it, before you can finish your sentence; they are railing how they will never allow it. These stubborn caregivers have made up their mind, sometimes decades earlier, and unfortunately they are not about to listen to anything that challenges their preconceived notions.
But there are some very good reasons for being open-minded about assisted living. For example there comes a time, especially with Alzheimer’s disease, that the care needs of the sufferer are greater than the caregiver’s ability to provide for them. Given this circumstance, it would be a terrible disservice to the loved one, to keep them at home with inadequate care. Unfortunately, when their care needs are this advanced, the only placement option is going to be a nursing home. Their care needs at that stage are medical not custodial, and therefore surpass the services offered by assisted living or board and care.
I want to propose a better course of action. If the caregiver relents, and a placement is made into an assisted living, you now have a home-like environment that will be comfortable and friendly towards the disabled family member. The caregiver is still able to oversee their loved one’s care. And as I will explain in a moment, the loved one can age in place and the assisted living will continue to provide care, even end-of-life care. The difference is this – an assisted living will accept a client that meets their resident profile, and when they do they generally make an unwritten commitment to their families. They will always provide the necessary care, and they will monitor the resident’s decline and keep the family and the doctors properly informed.
Generally the first level of care is bathing assistance, medication management, and personal laundry. As more care is need they will provide care and supervision, incontinence care, wheelchair transfers and escorts. They can also utilize home health care, which provides an added dimension of care. And when the end is approaching they can introduce the family to hospice, which in turn can provide the maximum amount of comfort measures to insure a peaceful passing.
So, if you approach board and care or assisted living while your loved one fairly high functioning, chances are they will keep your parent or spouse no matter how much they decline, thus permanently avoided a nursing home placement. But if you wait too long, no assisted living will touch them. Not so much because they don’t want to, but because the State regulations that govern them have strict admission criteria. But once a client is admitted, the same State regulations protect the resident’s ability to remain in the “community” thus aging in place. All told, we have a strong argument in favor of placement for your loved one, and preferably sooner than later.
Granted no one knows or loves your parent or spouse the way you do. No one understands them or their needs the way you do. There is not a person or facility that can replace you. So it behooves you and your loved one that you take proper care of yourself, so that you are around for the rest of their life. It makes sense that you use every available resource at your disposal.
Finally, let me give you one more reason for considering assisted living. There is only one of you. You prepare and provide meals, you ensure a safe and secure home, you provide transportation, you are the eyes and the ears for the doctor and you provide medication management. You also provide socialization and human contact and interaction. You make sure they have emotional stability, and feel loved. You provide entertainment. You do the laundry and make sure they bathe. You see to their grooming and you make sure they are dressed appropriately. However, if you were to place your loved one in a nice assisted living community, all these activities of daily living will be handled by their staff. This in turn frees you up to not only spend time on yourself, but to also spend quality time with your parent or spouse. So I suggest you take the oxygen first, and you health will improve, you will extend your life, and you will always be there to care and advocate for your loved one.

Thanks for reading this far. This post was actually published in ezines.com with you in mind…my goal is to provide caregivers like you a voice as well as recognition. I realize that assisted living may not be in the cards for you. Whatever the reason; be it financial or bad memories from another time in your life. But whatever your choice, I want you to feel supported. Please feel free to leave a message, ask a question or sign up to be the list for a free stress management CD.

The other day I was asked to speak to a large group about stress and stress management. It was not my typical audience. These were professionals of a large company that produces pace makers and other sophisticated medical equipment. Not the usual caregivers or healthcare professionals that I normally talk to.

In giving my credentials during my introduction, I included my gerontological experience and offered to stay afterward and talk to any caregivers that had questions or needed guidance. They were a great group and we had a lot of fun. Not surprisingly however, a half of a dozen people approached me afterward.

A couple of these caregivers brought up a dilemma that I find to be all too common. Of all the possible situations this scenario the one that stumps me the most: What to do when your parent, who obviously needs help, refuses it? There are many variations on this theme. But they all fall under the heading of “stubborn refusal”. As a professional, I can help families in just about any circumstances they find themselves in, but when it comes to that “dig your heels in” kind of situation, it’s the worst.

For example, Margaret who lives 60 miles away from her mother has been trying to get her mom to move in with her for some time now. Mom is 80, getting frail, unable to really take care of herself, as she should. She has fallen a couple of times, once requiring a 911 response, but has had not broken any bones yet. She does not suffer from dementia, but is showing some forgetfulness. I would guess “Mild Cognitive Impairment” (MCI). Mom calls Margaret several times per week; each is a demand for some kind of assistance. Mom can no longer drive safely, and fortunately, out of fear, she doesn’t. However, this is an added burden to Margaret, as she has to make the round trip several times per week to do mom’s shopping, to help her with appointments, help with laundry. You know the drill. As you can imagine, Margaret is exhausted. She has her full time job, her own marriage and her kids with whom she wishes to spend time.

She has asked her mom to move in with her and the family, but mom refuses. She stubbornly clings to that age old mantra so many older adults use, “I’m not going to give up my independence”. Margaret has also discussed a senior community for mom. But that idea meets the same resistance as the first. All the while, mom’s independence is a delusion cultivated by conveniently ignoring the evidence and selfishly continuing to completely wear her daughter out.

There are only a few options open to Margaret, here’s the milder sneaker solution for getting her into a senior community.

Margaret needs to plant a seed in mom’s mind, here’s how. First, Margaret should contact a ‘referral agency’. A referral agency is a free service that helps you find board and care and assisted living communities. Generally, the way they work is: you give them a physical description of your parent, a budget range, and preferred location, and they, in turn, give you a list of “communities” that fit your criteria.

The next step is to go visit a few senior communities, Alone! Don’t let your parent know what you are doing yet. Once you have toured a few of these places, pick your top two. Next, invite mom out to lunch. Make arrangements with the facility to come for lunch and tour with your mom. As you are driving with mom, tell her that something came up and you need her help. You have a friend who is looking for a place for her mom, and your friend needs your help to check out this place. Explain to mom that you made a lunch appointment and ask her to help you. (“After all mom, it’s a free lunch, what have we got to lose”?)

Make sure you tell the marketing director of the facility what you are up to, so she can play along. (Fear not; they do this kind of stuff all the time). Afterwards, you can pick mom’s brain about what she liked and didn’t like. Beyond that, don’t bring it up again, the seed is planted. It may be months but she will more than likely bring it up again on her own. Don’t be surprised when out of the blue, your mom says “I’ve been thinking about that place we had lunch at…”

Nevertheless, even if she does figure out the ruse, and finds out that you tried to trick her into looking at one “of those” places, the deed is done. Hopefully, she knows you meant well. But if she gets mad, that’s ok too, she will get over it. The important thing is to get her in to see what these communities look like. So many older adults have a warped idea of what they are. You can never hope to see your parent in a safe environment like this until their preconceived prejudices are dispelled.

Some other options are: Get your parent to agree to a temporary stay (a 2-week vacation stay). Or if they are warming to the idea and on the fence, ask them to try it for 3 months and that you will keep their home or apartment available. Ultimately, their health is at stake. That’s why you are pushing for this. The truth is, if they do not take the board and care assisted living option, something catastrophic will happen and they could end up in a nursing home instead…and many consider that a fate worse than death.

Now imagine (and some of you don’t have to imagine it) the same circumstances, except mom has Alzheimer’s. Unfortunately, this is all too common of scenario. Now this “stubborn refusal” becomes unreasonable and irrational. Mom might be messed up with her medications, practicing poor hygiene, not taking care of the bills, burning things on the stove, or not eating at all, driving when she shouldn’t and still refusing help. Mom might have even had a couple of trips to the hospital but she will not allow you to help her. Oh sure, you can take her calls at all hours, check on her every day, take over her bills, but if you try to hire people to stay with her, she sends them away. If you suggest finding a place for her, she reacts violently. What do you do?

That’s the question I pose to you! What do you do? Leave your answer bellow in the comments section.

Technorati Tags: assisted living, caregiver, caregiving, dementia, stress management

As a gerontologist working with Seniors and their Caregivers for over 15 years, I find it appalling at the lack of resources, programs and products available for caregivers.

Nowadays, the word is out and most caregivers have heard that stress is a physiological response in the body, and suffering from long-term stress is debilitating to your health, and you need to do something about it. When research shows over and over again that long-term stress increases a person’s risk for health attacks, stroke and even cancer, we are alarmed. After all, aren’t those the top three killers of Americans today? And if something happens to me, who is going to take care of my loved one? Even the Alzheimer’s Association once quoted a statistic that half of all caregivers passed away before the person they are caring for. The message is clear. We must do something, anything to dissolve the stress that is building up in us, day in and day out.

But I find caregivers asking: What? What can I do that doesn’t take me away from my responsibilities, or costs a lot of money? And that’s the challenge, because caregivers cannot take advantage of the same stress busting activities that the average person can do.

Caregivers can’t run off to the gym, or the movies. They can’t take a vacation, let alone a long hot bath. And few caregivers have family and friends that they can count on to “take over for a little while”.

Consequently the thing we are going to address here is the solution not the problem. Sure we have to state the problem for contextual reasons, but the bulk of this blog will be on what is available for caregivers and what they can do that makes their life better.

Technorati Tags: alzheimer's, caregiver, caregiver stress, caregiving, dementia, stress management

Finally, a website that has all of the latest, most current information about services, programs and products for caregivers taking care of a family member with Alzheimer’s Disease.

If you are a caregiver for someone with Alzheimer’s disease you have entered a new world. Not only are you dealing with a terrible disease that eventually robs the sufferer of their ability to function, but you are also struggling to negotiate the maze of health care and financial resources that come with the territory.  Chances are that you have put your own goal and plans on hold for the time being.  But beware, many who proceed without guidance often end up overwhelmed, stressed out, and develop a chronic illness themselves!

In a nutshell, a caregiver is someone who provides care and assistance to another person, usually a parent or a spouse, who is incapacitated either physically, mentally, or both. Currently, the largest group of caregivers in the country are daughters and/or wives who are caring for someone with Alzheimer’s or another illness (Stroke, Parkinson’s, etc..

If you give direct or indirect care for a parent, spouse or elderly family member, you are certainly under a lot of pressure and stress. The fact is, most caregivers do so without enough physical, emotional, or financial support. Compound this with the problem that caregivers often lack enough knowledge and information about services, programs, and products that can help them, and you have caregivers that are frustrated, tired and depressed.

Please stay tuned…we will not let you down. In future posts you will get answers to all of your question, and guidance to help you plan for the future.  Do not hesitate to make a comment below or ask a question in the comments section.

yours, Donahue Vanderhider, MSG CHt.

Technorati Tags: alzheimer's, caregiver stress, caregivers, caregiving, dementia, Donahue Vanderhider, stress management