Wednesday, December 31, 2014

Happy New Year 2015

As this year comes to a close, we often reflect back and make resolutions for the new year. Being the caregiver in a sandwich generation will probably be one of the hardest roles you will encounter in a lifetime. Take a deep breath and keep going! Remember to take time for YOU!

Make new memories with loved ones and set in motion plans for your own future to make the burden on your children less as you age. Take time to smell the roses every day and enjoy life. Remember this is not a dress rehearsal; it's the real deal. Enjoy. Happy 2015!

Thursday, September 11, 2014

Never Forget

In September, 2004 we visited NY and I shot this picture. There was nothing quite so sobering as standing at Ground Zero and surveying the damage and feeling the impact this heinous act has imposed on all of us for a lifetime.

Never Forget.

Thursday, July 10, 2014

Need to Have a Realistic Discussion About the Consequences of Falling?

Dealing with an elderly parent or other loved one is a challenge to say the least.  Sometimes it seems like you're dealing with a toddler or small child with an old soul. They want to do things they can no longer safely do and they can get cantankerous and downright obstinate. It's like dealing with a teenager who thinks he is invincible. They want to remain independent and are argumentative about almost everything! It can be most frustrating to deal with.

Safety is one huge issue as balance and gait changes begin to set in with the normal aging process. Chronic diseases such as arthritis, and Parkinson's can complicate the situation because they severely limit joint mobility and cause the gait to shuffle and scissor almost uncontrollably. Dizziness and vertigo play havoc when trying to ambulate and not feel like you're drunk or impaired.

The Fear of Falling
old woman on stairs
Google Images
A fear of falling can cause a person to tense and to make sudden sharp movements as they gain seconds of confidence. Ask your loved one if s/he is afraid of falling and the answer is likely YES! Yet where is that assistive device? The walker is probably back in the bedroom. The cane is next to the door so s/he might remember to take it if s/he ventures outside. And the lifeline device? Oh it's hanging on the lampshade or a doorknob.

Falling is the leading cause of death due to injury among seniors. This is due to complications such as head injury, fractures and immobility related pneumonia. Sometimes if your loved one falls and can't get up it could be considerable time before anyone discovers they are down. This can lead to all sorts of complications such as muscle breakdown that begin in 30-60 minutes, dehydration and hypothermia which can be life threatening or even fatal.

Fifty Percent of Seniors Will Fall Annually
So how do you get this proud, determined, elderly person to actually USE their assistive device and keep that lifeline around their neck?!!  By age 80, 50% of seniors will fall at least once a year. One fall can be too many.  Once a person falls they are more likely to fall again.

Sometimes you have to use the same type of reality scare tactics they used on you when you were that invincible young person. It's also important to remember your job is not to become the parent although it seems like that's what is happening. This makes your job incredibly more difficult and challenging!

These elderly loved ones, no matter how childlike they become, are still our parents, aunts, uncles, grand parents and friends. We need to be respectful while guiding them in the direction of making safe and sane decisions on their own if they are capable of doing so. Alzheimer's and other dementia can take this option off the table quickly.

Discuss Care Options if They Do Fall
But as long as your elder is capable of making decisions, try to have a hypothetical or logical and harshly realistic discussion about what they would want done in case they were injured in a fall. Do they really want to do something to jeopardize their current lifestyle? A typical fall for an elderly person doesn't just result in a skinned knee or bruises. All too often these falls result in broken bones (hips, wrists, shoulders), major skin tears requiring sutures, or head injury.

Would they want surgery to repair a broken hip, wrist, or other joint? Or would they prefer to spend weeks in bed hoping for the fracture to heal so they could eventually be pivoted to a chair or commode for a few hours each day? Would they want to be intubated if they ended up with a very bad case of pneumonia and couldn't breathe?

What if they hit their head and ended up with a brain injury? Would they want to have a feeding tube inserted and possibly need to be sustained on life support devices?

How would they feel about a long rehabilitation process? With a broken wrist for instance they will probably find themselves in need of assistance to dress, bathe, eat and even wipe their own bottom for several weeks! Who would they like to have helping them?

In the course of this conversation, you'll hopefully plant the seed to help them take stock in their own safety and actually use the devices, but you'll also gain some insight into their feelings about general end-of-life desires. It might just open the door to having that conversation soon too.

What Would Help Make the Device More Effective?
Meanwhile, help them to decide which devices they will use. Perhaps a cane needs some sprucing up or decoration to fit their lighthearted personality. Or the walker needs to be outfitted with a basket or tray so they can carry their clothes to the bathroom or bring their coffee cup and cereal bowl to the easy chair.

The device may not feel like it's the right height or doesn't give them the same feeling of stability that hugging the walls or furniture does. Perhaps it's too heavy, or feels flimsy. Maybe they need something different. Sometimes there's a completely logical explanation for leaving the device behind.And sometimes it's just a change they need to vent about and begin to accept.

Be gentle, be kind and be supportive. Change is NEVER easy. And growing old is not fun! But this is for their own good, and your piece of mind. Ahh you are giving them back all the same reasons they gave you growing up for worrying about your safety. Life is a circle and someday you'll be having these conversations with your adult children over your care and safety.  Start making plans to decorate your cane now!

Thursday, January 16, 2014

When the Best Plans Fall Apart....

We plan and we think we are ready for anything and then life happens…. Even with the best laid plans, expect that you are going to be knocked for a loop and totally discombobulated, if only for a little while.

In my observances and my experience, the best possible scenario for caring for aging parents doesn't always just happen. How many times I've heard, "Mom's the one in bad health and she'll die first….." And how many times it just doesn't happen that way.

Dad is a very young 80 and perfectly healthy as well as a good caregiver to Mom, but he needs a little assistance to make things easier. So you hire someone to help with Mom's personal care and a little housekeeping. Things should be OK for a while. Then suddenly Dad has a fatal heart attack and everything is turned upside down.

Mom has lived alone for 20 years and then she had to stop driving. She almost hit someone in her shared driveway and she surrendered the keys. Your friends are envious because it was so easy. You work out ways to assist her and help her stay in her own home. Then suddenly Mom has a small stroke and can no longer live alone. She has no savings. Her income is fixed and low. Her house has a reverse mortgage and the equity was eaten up long ago. Now what?

Suddenly you need to make decisions on a dime that will become permanent and impact your own life more than you ever expected. You thought this was in the bag and you would know what to do when more care was necessary. But life took cruel turns and you aren't prepared for what has to happen.

It will be overwhelming. You will have anger and fear and confusion and be somewhat paralyzed in trying to find solutions. You will want your life back more than you can imagine! And you will find yourself wanting to SCREAM!

My best advice: SCREAM!! Find somewhere where you can do so without scaring a neighbor or summoning the police. A train track can be ideal when the freight train passes by. Or a deserted beach. If all fails, turn on the shower, raise the volume on the TV or stereo, smother yourself into your pillow, and let go!

You will feel better. And you may find that over the course of the next months and years you need to do this regularly. It will help to save your sanity and your marriage. Teach your spouse your tricks and tips.

Prioritize and Delegate
Then you make lists and determine what you can and must do right away and then how you will sort through and find ways to make things work. Enlist your siblings and children to help with necessary tasks. They may not be willing or able to provide any direct care but they CAN help with other tasks so that you can do what has to be done. Don't let them off the hook and stop trying to do it all. It isn't easier to do it yourself now. And your sister won't do things exactly as you would, but she can do it and you can relax a bit. Learn to give up control and delegate.

Learn to Take Care of You
Slowly your wits will come back and your brain will begin to function again. You will find a semblance of routine and settle in to a new life. It won't be the one you had, but it won't be as awful as you recently imagined, at least not every day. You will see new options and make new plans.

Most of all take time for YOU! Don't lose yourself completely. Hang on and climb away from that knot at the end of your rope. Say NO to caregiver fatigue. Reward yourself with a few minutes of "me time" and take advantage every chance you get.

Thursday, December 19, 2013

Happy Holidays!

Wishing each of you a very happy holiday season as we close out the year. May the New year bring you renewed spirit and ways to accomplish new goals.

As caregivers remember to take time for YOU so that you can continue to be the caregiver. Reflect on how you have made a difference and know that things are better because you care. Noting is ever going to be perfect so don't become paralyzed trying to make it be.

Enjoy the beauty of all the decorations around us whether or not they are your culture. Warm glowing lights can help to lift all of our spirits. Take time to enjoy the aromas of the season. Close your eyes, breath them in and take a mini vacation.

Take time to make new memories with family and friends. Capture them on film, and in your mind. 

Set measurable and reasonable goals for the New Year and examine them often to be sure you are on path and reward your accomplishments along the way.


Thursday, October 24, 2013

The Art and Struggles of Caregiving

Caregiving is an art, and it's not something any of us comes to naturally. Not even nurses. It's something we learn over the course of time and through a variety of classes or experiences. We bring to each patient or loved one our own set of standards, beliefs and abilities as well as a desire to help others. We have the best of intentions and hope for the best possible outcomes.

We struggle to hold on to our own identity and to provide the very best care we can under whatever the circumstances present to us. Caregiving is never easy, and often you must reap your own rewards of knowing you made a difference. We can come to this role once or many times in our lives as children, parents, other relative or health care professional. The basic rule is to give it your best shot and to do no harm to anyone.

I received an email quite some time ago from a young man who has cared for his wife who is now a cancer survivor. He blogs about his experiences and he his bluntly honest about his feelings, emotions and everyday occurrences. I share this with you because there is always something to learn from someone else's journey and struggles. I hope you can gain some insight and find some tips to help you survive your own journey with your aging parents and loved ones.

View the video about their journey:

Thursday, July 11, 2013

Challenges of Aging in Place

"Aging in place" is a trend or buzz word phrase you may or may not have heard about. The basic idea is to allow older people to remain in their own home, community and environment and maintain as much independence as they safely can for as long as they can. It's not as simple as all that however.

As a member of the Baby Boom generation, I haven't yet hit 65, but I'm getting there. Perhaps not welcoming the fact, but kicking and screaming as I go along. Years back I had a discussion with a friend about considering moving to a single story home before the knees give out. And every day that I climb up and down those stairs I think about it more and more. Yes, it's good exercise, but some days it can be a very painful and unpleasant experience as well.

My mother has complained for years that we don't have a railing for our 2 front steps up to our porch. So we hold her hand and assist her up and down when she visits. But of late, I'm beginning to REALLY understand her concerns. When my knees want to act up, it's not so easy to get up and down those 2 short steps, and sometimes I don't feel all that safe anymore.

Another friend just remodeled her bathroom and her contractor talked her in to adding in some aging/safety considerations. She fought him on it at first and then conceded it would be economically sound to add them in now so that she can indeed age in place in her own home. SO she now has a beautiful walk in shower. Now it's not a gorgeous one like you see on HGTV, but it has all the amenities she can choose to use now and enjoy as she begins to need them way down the road.

Chances are good that when your home and the homes of your aging loved ones were built, there wasn't even a thought by the builder that an old person might live there someday. Picking up throw rugs and installing a hand-held shower device and a few well-placed grab bars may be relatively painless to do, but what about walk-in bathtubs and showers? Are your hallways and doorways wide enough to accommodate a 4-wheeled walker much less a scooter chair or wheel chair? Is there any place in your kitchen where you can sit and rest while preparing a meal or waiting for the microwave to finish heating? Can you rest anywhere while you move laundry from the washer to the dryer in short frequent steps? And on that subject, how far is it to the laundry area from where you hang and house your clothes? Energy conservation is a great tool to learn, but if you don't have the space to make it work well, it's not going to be an easy solution to shortness of breath, lack of energy and just plain feeling too old to do that today!

Even the housing in 55+ communities and assisted living facilities don't meet all of the challenges our aging populations presents today. They don't have the latest and best devices installed. They may not even have adequate ramps or elevators. As a result, some of these places are beginning to take a stance against aging in place. Many have always had specific guidelines as set by state laws, but now they are really enforcing them. For instance, residents have to be independent. They may be allowed to use a walker, but not the newer ones with the wheels and a seat that resemble a light weight wheelchair. These can be quite useful for those who can walk, but tire easily or who need to transport an oxygen tank with them. These are considerations you need to take into account if you're planning to move mom and dad. They may not be able to stay in that place the rest of their lives; opening up multiple challenges and scenarios you may not have ever considered as they age.

If for example, dad has a stroke and needs assistance with his activities of daily living you might have to place him somewhere else with a higher level of care. This leaves mom in one place and dad in another. The rent just doubled and now you have to get mom over to see dad on a regular basis. Transportation time and costs! Then if dad eventually needs hospice, the place you thought was excellent may not be able to let him stay there and you'll find yourself hunting for another place to move him.

Staying in their own home and having help may be the most economical factor of all, but some communities especially condominium and townhouse associations are balking at having people age in place in their communities. They don't want to deal with all of the changes needed such as ramps and railings that may degrade the property values if they stick out from the decor. Dealing with the annoyance of having emergency responders called at all hours of the day and night because dad slipped out of bed and needs assistance to get off the ground. Yes, this is age discrimination. But that's a whole issue unto itself. When you're faced with a situation where mom and dad need their situation handled right now, dealing with the politics of how wrong this is isn't a battle you can deal with and win in record time.

Be aware, and make informed decisions. Know that there will be obstacles even as you age as well. Take a deep breath and when your contractor suggests some aging in place modifications, be grateful you have the time and opportunity to be proactive.