Archive for the ‘caregiving’ CategoryBy night (and weekends) I run several websites designed to help familes that are dealing with parent or other loved one with declining health. By day (for the past 18 years), I am the executive director of an assisted living community. So it was natural for my old high school friend to write me when his mother-in-law was in the hospital and could not safely return to her home. I used our emails and wrote to articles for an on-line magazine website called ezinearticles.com (http://ezinearticles.com/?Assisted-Living-Insider-Secrets-From-a-Veteran-Administrator&id=3795816). And I am going to share them with you here. Yesterday, an old friend contacted me, asking about placing his mother-in-law in an assisted living. However, after answering him in a series of emails, I realized that other people facing the same decision might be interested in the same information. Here’s the interesting thing I discovered about myself in the process – my tone with him was different than if I were going to write for my blog or for an Ezine article. As a result, so were the tips that I would normally give – they were not very ‘politically correct’. But thinking about it, I would not change a word. In many ways, it was much better because of my mind set. I was focused on giving my friend advice rather than writing a “well written” article. So except for a few deleted lines that would identify my friend, here is some good advice about picking an assisted living: Hi Donahue, How’s everything? We need to catch up soon. Need your input – soon – We are looking at places (assisted living) for Mary’s mom – she has continuing health issues primarily heart and respiratory. Would you look at the attachments and let me know your thoughts on these two places? Thanks so much, John Hey John, I will look at the attachments closer later, but let me first highlight some important stuff to consider: First of all, if there is a non-refundable “community fee” of any kind, it is negotiable. What is going to be more important than the room layout and the view and the transportation and all the other B.S., is how much care is going to cost. How do they charge for extra care? By levels of care? or by minutes? And when you find out – figure out what your maximum budget is, and what the most she will have to pay if she gets ALL their services. Next, ask the facility about what would cause her to HAVE to move out? Ask them if they have a hospice waiver. (they are in California, so their rules are exactly like mine and I can tell you, if they do not have a hospice waiver, then when she gets towards the end, they will kick her out to a nursing home). Ask them about house doctors (do they have a doctor that comes to the facility to see clients), and are home health care agencies allowed in the building? and if so, do they require that you use theirs or if you can pick your own. I will explain why this important later. Ask about wheelchairs. Are they allowed? What about motorized ones? Does mom have a dog or cat? Many place will let you bring it…for a fee. It too is negotiable. The important thing to understand is how they charge between the room (and basic services) and care (optional services). They are much more likely to negotiate the room but they rarely negotiate care services. The best case scenario for you is to get them to lock in the rate for two years (or more). That is where they will try to screw you later, because they can raise their rent as much as they like. So make sure you trust the place. Anyway, think about this stuff and I will get back to you after I look at the marketing materials you sent me. cheers, DV The second round of emails really got interesting and some never revealed stuff about assisted living gets revealed, so stay tuned. Better yet, sign up at www.easycaregiving.com Donahue Vanderhider, a Gerontologist practicing in Southern California, can be found at http://www.caregiverrelief.com. Donahue has a deep understanding and extensive knowledge of Aging and all its related disorders: both normal and abnormal. He has a Masters Degree from USC and postgraduate training in Clinical Guided Imagery, Metaphysics, and Neuro-linguistic Programming. He is also on an advisory board to the Alzheimer’s Association. His passion and life-long goal is to improve the quality of life of caregivers, especially those dealing with Alzheimer’s. Currently his active blogs are at the site mentioned above.
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. ENVIRONMENTAL CAUSES * Distance to the bathroom may be too far. OTHER CAUSES * Person may not remember what to do once in the bathroom. 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? 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. CLOTHING * Simplify clothing. Try Velcro tape instead of zippers or buttons. 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. 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. BATHROOM AIDS: * A raised toilet seat with grab bars makes it easier for a person to get on and off the toilet. OTHER CONSIDERATIONS * Purchase washable chair cushion covers. 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 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. 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:
Count the number if times you circled “yes” (score: _________) 0 – 4 = I am not a very active health care partner 5 – 8 = I am somewhat of an active 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! 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? Stubbornness is Born 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. 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. 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. |