Forming Your “Circle of Help”

Forming Your “Circle of Help”

Never go it alone. The best way to stand up to Alzheimer’s is to gang up on it.

The best way to defeat Alzheimer’s is to come together and gang up on the disease. If you or your spouse have been diagnosed with Alzheimer’s, please know that you are not alone. Right now, thousands of Alzheimer’s researchers, doctors, nurses, caregivers, support groups, and long-term care facilities are fighting for you on many fronts.

One of the most important fronts, of course, is the home front. My new book, Mike & Me, is one of several new books to chronicle the changing face of home care among Alzheimer’s couples and caregivers. Together, we are learning how the astonishing power of love, patience, compassion, and stay-at-home care can be mobilized by virtually every couple to help Alzheimer’s patients defy the old statistics and live a longer, fuller life.

My Husband and I Made A Deal

Early in my husband Mike’s 10-year journey with Alzheimer’s, we made a mutual commitment: As long as it was safe for him and me, Mike and I would live together in our home and make the Alzheimer’s journey together. Our goal was to keep Mike’s life as normal as possible for as long as possible, and that would entail staying in our home and community. It turned out that keeping that commitment to Mike was only possible because of a circle of friends and family who gradually formed around us and helped us every step of the way.

Looking back, I now realize that one of the most important things Alzheimer’s couples must learn in the early going is to simply reach out for help from friends and family. That probably sounds too obvious to mention, but you would be surprised to learn how many Alzheimer’s couples try, initially, to go it alone in their care. My husband Mike and I were one of those couples in the beginning. You see, we weren’t accustomed to asking people for help or bothering others with our difficulties. In the past, whenever a problem arose, Mike and I had always turned to each other for help, and, at first, that’s how we tried to deal with Alzheimer’s too.

Forming Your Circle of Help 

So why do I tell you these things? I tell you because I want you to believe that your “circle of help” – your friends, family, neighbors, and community – is waiting for you, too, if you will only let yourself reach out.

Perhaps like you, my challenge in the beginning was to simply open up to the idea of accepting help from others. But once I opened up, I quickly learned two things.

First, I was surprised at how many people were more than willing to help Mike and me. And second, I didn’t have to accept everyone’s help; I could still be selective about who I would let into our circle.

As time went on, I eventually built a small team of people – kindred spirits – who were helping me care for Mike. I like to think of them not just as a team, but as a “circle” of thoughtful people who surrounded us and helped care for our physical, emotional, and spiritual needs. It felt like such a natural process. One by one, along came certain friends and neighbors who thoughtfully recognized that we had a need of one kind or another and offered to help, each in his or her own way.

You may not know it yet, but you, too, have a circle of support quietly waiting for you. Watch for it, welcome it, be thankful for it. Yes, it’s a little scary at first to allow people in when you feel most vulnerable. But if you do plan to stay in your home together, rather than go to a care facility, then you too will have to turn to a circle of caring people who can help you.

Source: UsAgainstAlzheimer’s by Rosalys Peel

7 Common Flu Myths Debunked

Myths about the flu are everywhere. Is what you hear true, or is there too much misinformation floating around? Debunk the seven most common myths about influenza.7 Common Flu Myths Debunked

Myth #1: Getting Vaccinated Can Give You the Flu

According to the National Foundation for Infectious Disease, there is no way that the vaccine can make you sick. Vaccines only contain a weakened or inactivated form of the virus, which cannot infect you. The truth is that people often mistake the side effects of the vaccine for the illness itself. Side effects of inoculation may feel like mild symptoms of the flu, but soreness around the injection site is typically the only symptom people experience. Keep in mind that flu season (which generally lasts from October to March) coincides with a time of year when bugs causing colds and other respiratory illnesses are in the air. It is possible to get the vaccine and then get sick with a completely unrelated cold virus within a few days.

Myth #2: There Is No Treatment for the Flu

There are three FDA-approved antiviral drugs that are highly effective against the flu. Tamiflu (oseltamivir) is available in pill and liquid form, Relenza (zanamivir) comes in powder form, which is inhaled, and Rapivab (peramivir) is administered intravenously. While these antiviral medications do not cure the viral infection, they can minimize symptoms, reduce the amount of time you are sick by one or two days and make you less contagious to others. Furthermore, treatment can prevent complications of the flu, like pneumonia, which can be especially dangerous for older individuals. It’s best to take these drugs within 48 hours of getting sick, so do not hesitate to make a doctor’s appointment if you or a loved one have symptoms of the flu.

Myth #3: Antibiotics Can Fight the Flu

Antibiotics only fight bacterial infections. Since influenza is a virus, antibiotics have no effect. Furthermore, overuse and misuse of antibiotics can result in reduced effectiveness against the bacteria they are actually intended to kill and even “superbugs” that are entirely resistant to these treatments.

Myth #4: You Can’t Get the Flu More Than Once During Flu Season

You can certainly contract the flu more than once a year, because there are many different strains of the influenza virus. There are two main types of flu, Type A and Type B, and there are also different subtypes of each. It is possible that you could get infected with one strain and then another during a given season, especially if you have a compromised immune system.

Myth #5: If You’re Young and Healthy, You Don’t Need to Get the Vaccine

The Centers for Disease Control (CDC) recommends that everyone over 6 months of age get vaccinated each season. Healthy adults are just as susceptible to the virus as other demographics. If you are caring for an aging loved one, simply getting them vaccinated only provides some protection. You and other family members should also get the vaccine to avoid endangering their health.

Myth #6: Cold Weather Causes the Flu

The influenza virus is spread year-round. Contrary to popular belief, going outside during winter without a hat on does not directly increase your risk of getting sick. Influenza peaks in fall and winter for a few different reasons. Scientists speculate that the flu virus thrives in cooler, low-humidity environments. Of course, during the colder months, people tend to spend more time cooped up indoors, making it easier for the virus to spread from person to person. Furthermore, less time spent outside means that most people experience drops in vitamin D during winter that can weaken the immune system. All of these factors contribute to the timing of flu season, which is the same throughout the whole country, even in warmer states like Florida.

Myth #7: If You Haven’t Gotten a Flu Shot by November, It’s Too Late

Flu season often peaks between December and February, but the timing can vary. Some years heightened flu activity has lasted until May. No matter how late it is, if you have not been vaccinated yet, go get it done. You could spare yourself and your family a great deal of misery.

The Facts: How to Avoid Spreading the Flu

Influenza spreads from person to person, often through the air, and you can pass on the infection even before you begin feeling symptoms. An infected individual is also contagious for several days after the onset of symptoms. Infection can stem from a contagious person near you coughing, sneezing or talking, or even from touching a surface that the virus is on, like a telephone or doorknob.

To avoid contracting and spreading the virus, use the following tips:

  • Clean your hands regularly with soap and water or an alcohol-based hand sanitizer. This is especially important after you touch a sick person, common surfaces, used tissues or laundry.
  • Individuals with the flu should cover their mouth and nose with a tissue when coughing and sneezing to avoid spreading the virus to others.
  • Immediately throw away tissues and other disposable items used by an infected person.
  • Once diagnosed, talk to a healthcare provider about taking antiviral medication to prevent the virus from spreading to other family members, coworkers or friends.
  • Keep surfaces like bedside tables, bathroom surfaces, doorknobs and children’s toys clean by regularly wiping them down with a household disinfectant.
  • Do not share eating utensils, dishes or cups with a sick person. These items do not need to be cleaned separately, but they should not be shared without washing thoroughly first.
  • Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Use a basket to transport laundry prior to washing to prevent contaminating yourself.
  • Avoid touching your eyes, nose and mouth to minimize the likelihood of contracting the flu and other viral infections.

Source AgingCare  Marlo Sollitto

Caregiving is the Greatest Teacher for Future Planning

Our Guest Author this month will help many who are facing aging alone once their family caregiving role comes to an end. Carol Marak is the founder of CarolMarak.com, the Elder Orphan Facebook group, and @Carebuzz Facebook Live events. She is an expert about everything aging. Herself a former family caregiver, Carol is personally equipped with aging alone expertise.

No matter what stage of caregiving you’re in, if you’re past it, in the middle of it, or it’s a paying job, the lessons learned will equip you for your own older life.

That’s what happened to me.  After caring for both parents, I realized, “There’s no one here for me to do all that I’ve done for them.”  A thought like this will quickly jolt anyone into scrambling for a plan. I’ve always been the independent sort, and now I face growing older without a spouse, partner, or adult children.

Like me, there are many women, and men, who find themselves in the similar circumstances. Growing older alone. And most of you, I bet, are caring or have cared for a relative as well.


          Carol Marak,
      Aging Alone Expert

The lessons learned give insights into what’s ahead.  At first it’s scary, but soon you’re grateful because you know so much and feel prepared, sort of. You know how to respond in an emergency, what’s needed when making serious medical decisions and legal matters, how to prepare for a medical treatment, the out-of-pocket costs of medical and other necessities, what to expect when you ring a doctor at 2:00 AM, and how to arrange for extra help.

Above all, you know that one day you will need help!  That’s wisdom you cannot buy.

But what people like me, aging alone, don’t learn from helping parents is, who do we count on for assistance, to help us respond to an emergency, make medical decisions, bring us a cup of soup, take us to the doctor, run errands, and more.

We learn what’s to come. But we don’t know where to start when planning for it or even thinking about it.

Growing older for my parents was totally different than what it is for me. They didn’t feel the need or urgency to prepare.  Growing older was part of life and they had no doubts about knowing who would step up for them.

Caring for an older person is hard. Period. No ifs buts or maybes. And making a plan for that is even more difficult. Period.  It’s takes time, effort, and patience. But making a plan when aging alone, well, that’s titanic. We question:

  • Will my money outlast me?
  • Who do I call in case of an emergency?
  • Who will be my health care proxy?
  • What if I’m all alone and lonely, who will come over?
  • What if I’m sick, who will look in on me?

That’s the short list.

Future Planning

These are the tough questions and they’re the reason I started working on my future plan soon after my dad passed away.  I’ve created a FREE starter kit for people who have the urgency to prepare. It’s yours for free to download here.

The thing about planning, it’s not meant to be a once and done deal. Instead, it expands our understanding of the kind of world we want and shows us a path we’d need to take to get to a better place–or, at minimum, the paths we need to avoid.

I believe we all need to have a sense of what’s next, and a vision of the kind of world we want. Planning for the future should deal with tomorrow’s problems–which if not addressed will inevitably leave us weakened, vulnerable, and blind to challenges to come.

Source: Senior Care Corner

10 Farmer’s Market Foods That Are Senior Approved

10 Farmer’s Market Foods That Are Senior Approved

Spring is finally in the air! If you’re like most people, you and your loved ones may have fallen off the health and nutrition bandwagon this winter. With the harsh weather and indulgent holiday gatherings, it’s common to slip up and make poor diet choices that you normally wouldn’t.

If you’re looking for ways for your family to kick off spring on a healthier, more wholesome note, buying groceries at a farmer’s market is an affordable and fun way to incorporate more fruits and vegetables into your diet. The produce sold at these markets is usually locally grown, more likely to be organic and can even reduce your carbon footprint.

Healthy Springtime Produce Options for Caregivers and Seniors

  • Fava Beans
    Your loved one may remember eating fava beans boiled with a dollop of butter or margarine, but this method of cooking completely strips them of all their nutrients. Instead, try quickly sautéing the beans in a little olive oil. You can even mix cooked fava beans with steamed basmati rice, chopped dill and freshly minced garlic for a savory whole-grain dish that will surely wake up your elder’s taste buds.
  • Asparagus 
    Asparagus is another great spring vegetable that is naturally rich in glutathione, an antioxidant that fights aging and can potentially lower one’s cancer risk. Asparagus is usually harvested in the spring, making it a perfect pick for the farmer’s market this time of year. Try chopping the stalks into bite-sized pieces and adding it raw to salads. For a healthy alternative to French fries, you can also roast asparagus spears in the oven with a little olive oil, garlic powder and salt. Unlike roasted potatoes, asparagus won’t cause spikes in blood sugar.
  • Mint
    Many herbs flourish in spring, thanks to milder temperatures and plentiful rain and sunshine. Mint is a popular springtime herb that is not only refreshingly tasty, but it also has medicinal properties. Mint is a natural digestive aid that can soothe nausea and upset stomachs, which can be common in seniors as they age. Try adding fresh mint leaves to a salad. If you’re feeling adventurous, you can mix mint, garlic, salt and diced cucumbers into plain Greek yogurt for a tangy tzatziki sauce to serve with chicken or beef or to use as a dipping sauce for fresh vegetables. Additionally, steeping fresh mint leaves in boiling water with a few slices of lemon is an easy way to make a caffeine-free herbal tea that can be served hot or cold.
  • Radishes
    Usually root vegetables like carrots and potatoes are harvested in the fall, but radishes have a crisp bite to them that makes them perfect for spring. They are versatile, fiber-rich vegetables, packing pack up to two grams of dietary fiber per cup. Increasing a senior’s fiber intake can help ease constipation and improve digestion. Radishes are often an acquired taste, so try introducing them into your loved one’s diet gradually. They can be served raw, roasted or sautéed, and the peppery green tops are edible and nutrient dense as well!
  • Peas
    Green peas are no longer the vegetable you hated as a child. In fact, they are actually legumes that are low in calories and contain an impressive amount of vitamins, minerals and fiber. Peas are one of the best foods for reducing dangerous inflammation in an elder’s body that can contribute to conditions like indigestion, heart disease and even Alzheimer’s disease. Garden peas are also relatively high in protein and can be served as a side dish or added to salads, soups and pastas. My personal favorite use for peas is tossing them into a hearty chicken salad!
  • Strawberries
    Strawberries are one of the sweetest fruits to feed your loved one during spring. Loaded with vitamin C, they contain antioxidants which can help with all sorts of health problems and ailments. If your elder bruises easily, the high vitamin C content in strawberries is thought to alleviate their severity and aid in faster healing. Don’t be afraid to get creative with strawberries, as you can easily add them to oatmeal or cereal, layer slices of strawberries in a delicious yogurt parfait, blend them into a nutritious smoothie, or dice them with red onion, cilantro, jalapeno and some lime juice to create a zesty strawberry salsa.
  • Green Onions
    Also known as scallions, green onions add a punch of freshness to any dish. Unlike white onions, which can be rather pungent and acidic, scallions are much milder in flavor and texture. Topping a bowl of chili or soup with a handful of chopped scallions is an easy way to instantly elevate the dish. While most people usually use scallions as a garnish, keep in mind that the heartier white bottoms of the stalks can be used in the same way as white onions in a variety of recipes. Try sautéing green onions in a tomato sauce, adding them to an omelet, or incorporating them into Asian entrees like stir-fries, noodle dishes, and salads for subtle yet distinguished flavor.
  • Arugula
    As seniors age, their sense of taste and smell are likely to diminish over time. Instead of bland lettuce mixes like iceberg and romaine, opt for a bitter, leafy green like arugula. Arugula is rich in selenium, which is what gives it its peppery flavor. It’s also rich in a crucial B-vitamin called folate, making it a great base for spring salads. You can also use arugula in sandwiches and wraps, as a pizza topping, wilted into pasta dishes, and even as the main ingredient in a bright pesto sauce (in lieu of basil).
  • Artichokes
    Artichokes are one of the most overlooked veggies available in the spring and summer months. They are high in vitamins C and K and pack plenty of dietary fiber, but most people buy them canned or jarred because they aren’t sure how to prepare them fresh. Surprisingly, these large, intimidating looking flower buds aren’t all that difficult to cook. After washing, simply trim off the tight tops of the buds, trim and lightly peel the stalk, and carefully snip off the sharp thorns on the tips of the remaining petals. Prepared artichokes can be boiled, steamed, baked, grilled and even microwaved with your seasonings of choice. (Lemon juice, olive oil, garlic and herbs are popular accompaniments.)
    The cooked petals don’t yield much flesh, but the tender, sought-after artichoke hearts can be used in pastas, dips, spreads and sandwiches. Just be sure to avoid eating the hairy-looking choke! Everyone loves a warm spinach and artichoke dip, so why not use fresh artichokes when they’re in season? If your loved one enjoys sandwiches and wraps, try adding artichoke hearts to roasted red peppers and low-sodium turkey for a healthier take on an Italian cold cut.
  • Apricots
    These bright, sweet fruits are high in vitamins A and C, potassium, antioxidants, and dietary fiber. The nutritional value of apricots makes them an excellent dietary choice that helps to prevent eye diseases and promote cardiovascular health. Their small size makes them perfect for snacking, but they can also be made into jams, butters and other condiments. Another surprising use for apricots is grilling or roasting them alongside lean protein like chicken to produce an entrée with balanced sweet and savory notes.

Use the start of spring as an opportunity to wake up your taste buds and reestablish healthy eating habits. A farmer’s market is a great place to seek culinary inspiration, and attending one can be a fun outing idea for caregivers and their aging loved ones. Keep these ingredients and recipe ideas in mind the next time you hit your local farmer’s market!

Source: AgingCare  by Taji Mortazavi

What Happens When a Senior Can No Longer Care for Their Pet?

Howard Cutler knows the joy animals can bring to people. His childhood memories are filled with stories of his family’s two beloved dogs and cats. After moving into a senior housing complex in Atlanta, Georgia, Cutler acted on his love of animals and adopted a Shih Tzu named Ollie from a fellow resident who could no longer care for the animal. For seven years, the pair was inseparable until Cutler’s Parkinson’s disease forced him to move to a different assisted care facility that didn’t allow pets.

“He was my friend and my companion, and giving him up was very difficult for me,” Cutler explains. As much as he wanted to keep little Ollie, Cutler knew he needed to rehome his beloved pet. He began looking among his neighbors in the senior complex to find a new owner. “Ollie was loved by everyone there, but I was worried that I wouldn’t find the right person.”

Cutler was fortunate to find the perfect fit in his friend and neighbor Nancy Markovich. “Howard was heartsick that he had to give up Ollie,” Markovich recalls. “So, I offered to adopt the dog and promised to take good care of him.”

Ollie’s veterinarian, Dr. Duffy Jones, says pets provide much-needed comfort and companionship to people of all ages, especially seniors. “The value that animals bring to people is amazing,” he says. “I’ve seen older pet owners who are struggling financially choose not feed themselves so they can feed their animals. Their pet is the reason they get up in the morning.”

But when aging pet owners find themselves unable to care for their animals, surrendering the pet is often the best course of action. “Most owners understand they’re sick and their pet needs more care than they’re able to provide,” Dr. Jones says. “They want to make a plan for their pets; It’s a real source of comfort.”

Senior Pet Owners Must Plan for the Unexpected

Dr. Jones encourages all pet owners to devise a succession plan for their animals as early as possible. Having a “plan b” in place before the pet owner becomes too ill, needs to move to a care facility or passes away will offer invaluable peace of mind for the owner and added security for their pet. He offers the following tips for creating a contingency plan for a loving animal:

  • Consider adoption. Ask friends and family who are familiar with the pet if they are willing and able to offer the animal a new home. Those who interact with the pet regularly will be better equipped to determine if the animal’s size, personality, routine, etc. would fit well with their schedule and lifestyle.
  • Talk to a vet. Veterinarians have many resources at their disposal and can often help rehome a pet. No-kill shelters can also be a useful option, and there are many non-profit rescue organizations around the U.S. that will also assist older adults in finding new homes for their animals.
  • Get the owner’s input. Be sure to let the pet owner have a say in the decision. Ask them who they would like to look after their pet. “In some cases, older people don’t have a lot of family around and their friends are going through similar transitions, so they worry what will happen to their pets,” explains Dr. Jones. “Animal owners are visibly relieved when we tell them we’ve found their pets a new home. It’s not uncommon for them to cry.”
  • Allow for a smooth transition. Ideally, the current owner will be able to help the pet transition to its new home. The goal is to help the animal and new owner build trust and become familiar with one another incrementally. Try having the new owner come for extended visits with the pet, take the animal for walks and care for it in the new home for short periods before full-time ownership begins. Small steps are easier on everyone involved compared to an abrupt change.
  • Rehomed pets aren’t gone forever. While evaluating prospective adopters, discuss the possibility of allowing the original owner to continue visiting with the animal. Even a monthly visit with a cherished furry friend can brighten up a senior’s day.

Dr. Jones says euthanizing a pet should be the last resort. “Some older people think that putting a pet down is best because the animal is so bonded to their owner,” he says. “We usually try to talk them out of it, explain that there are so many other options and then we work with the owner to rehome their pet(s).”

When Is It Time to Rehome a Senior’s Pet?

With so much research touting the physical and mental benefits that animals provide to humans, Dr. Jones advises that older people keep their pets for as long as possible. Unfortunately, though, circumstances do change. If either the pet or their elderly owner is living in a neglectful situation or experiencing a reduced quality of life, then it is time to explore alternative options. It can be difficult to balance the health, safety and happiness of both the senior and their pet, but it must be done.

Dr. Jones sympathizes with family members who don’t know what to do about their aging loved ones and their furry friends. “For caregivers, the thought of taking care of a person and their pet can be overwhelming,” he notes. “Sometimes older people haven’t trained their pets well, which can amount to behavioral problems and unsanitary conditions. But what people don’t see is that these animals mean so much to their owners. Separation often causes physical and emotional decline in both parties.”

Balance What Is Best for the Senior and Their Pet

Markovich has no regrets about adopting Ollie. She tried to make the transition as smooth as possible for both pet and owner. Cutler now receives the care and assistance he requires while Ollie gets the love and stimulation that dogs thrive on. Markovich inherited Ollie’s food and water dishes from Cutler and even places them in the same spot in her apartment at the senior housing community. The twosome goes for daily walks and Markovich hopes that she’s kept Ollie trained to Cutler’s standards.

Every month, Cutler gets to see his favorite companion when Markovich brings Ollie for a pet therapy visit at the assisted living community. “When he comes to see me, he’s overjoyed,” says Cutler. “When Nancy is ready to leave, he goes to her side to let me know he was happy to see me, but he is leaving with Nancy. I feel sad about that, but also happy that I was able to find a good home for him.”

Markovich is equally grateful for the opportunity to help a friend in need and to find the loving companionship that a pet brings. “Ollie sits by me on the sofa, sleeps on my bed and we are thick as thieves. He is a true blessing for me,” she remarks.

Source: AgingCare  by Candace Rotolo

How to Motivate Without ‘Bullying’ During Caregiving

How to Motivate Without ‘Bullying’ During CaregivingDuring my caregiving years, my mother and I had many tense moments about rousing her from bed to get ready for medical appointments. I’d pop into her bedroom and wake her, then remind her a few minutes later that she really needed to get up, then cajole her, plead with her, and ultimately use my sternest, I-mean-business tone. I thought I was helping motivate her in those instances. She’d say she felt like I was bullying her.

I never liked being called a bully and denied it was so. After all, we were always in a rush. If I pressured her, I reasoned, then it was for her own good. But in retrospect now, 20 months after her death, I wonder if I was in the right. What really mattered to her during those times? Was she clinging to the comfort of her pillow because she was still tired or even depressed? Was it more important for her to have control over her own life and sleep in than submit to another routine exam with a doctor who couldn’t help her much anyway? Instead, I overruled her and expected her to “obey” me.

I don’t think I’m the only family caregiver to transgress the blurry line between supportive guidance and arm-twisting. Sometimes when tired or frustrated or impatient — or when there really is a situation of dire urgency — many caregivers are prone to pressure care receivers too hard to conform to schedules and regimens. We rationalize the approach we’ve taken on the basis of practicality and expedience. But many of us second-guess ourselves later about whether it was necessary.

Certain things do have to get done. Otherwise, family caregivers might feel that they are guilty of irresponsibility and neglect. But how can we manage to be coaches, not bosses, and effective motivators, not feared bullies? Here are some ideas.

Rarely put tasks over the relationship: There are few caregiving tasks so crucial that they warrant trampling a care receiver’s feelings in the process of accomplishing them. Rather, there are what I think of as front- and back-burner issues. On the front burner are mostly issues having to do with safety, such as taking medications appropriately or driving capably, for which the caregiver should be firm and persuasive. However, most other issues are on the back burner of importance and need for action. For these items, caregivers should allow care receivers to exercise as much choice as possible and shift plans accordingly. That means being more flexible and accommodating, as well as respectful. In retrospect I could have scheduled my mother’s doctor’s appointments later in the day, even if it was less convenient for me, or canceled them altogether.

Develop a range of approaches and strategies: Great coaches are attuned to the moods of their players and apply the right touches at the right time to encourage maximum effort and performance. Great caregivers, too, can sense what care receivers are feeling at a given moment and tailor their requests — for instance, appealing to reason, resorting to silly humor or changing the subject entirely — to the approach that will motivate.  In general, I found that a gentler style was more apt to work with my mother, but there were also times that she wouldn’t agree with me at all. That’s when I would turn to my wife, who, with a smile and an even softer tone, could somehow win my mother’s cooperation making the same request she’d already rejected from me.

Solicit and heed feedback: We can sometimes get so wrapped up in the hectic pace of caregiving life that we lose a sense of how we are coming across to others. But we can listen to feedback from family members about how we are conducting ourselves. Take a moment to say to the care receiver, “We are having to work together more closely nowadays than we ever have before. Am I treating you the way you want to be treated?” Regard the answer seriously.

Beware of creeping bullying: No caregiver sets out to be the sort who pushes others around. But if he finds that applying pressure to the care receiver is the most efficient way of completing his many tasks, then he may slowly tend toward using sheer force. Caregiving isn’t about efficiency, however; it’s about caring. And nothing could be less caring than bending people to one’s will. We need to be aware of the excesses of our own styles and never convince ourselves that the ends justify the means.

by Barry J. Jacobs

Source: AARP

Getting Compensated for Caregiving Can Change Family Dynamics

Getting Compensated for Caregiving Can Change Family DynamicsYou can be paid for your work and treated fairly

Does money change everything, as the old saying goes? If Alicia had won the lottery, then she might understand why her siblings were now treating her a little differently. But all she’d done was become certified as a home health aide so she could receive a modest hourly wage from her county for dressing, grooming and feeding her Parkinson’s disease-stricken mom. Nowadays, however, her sisters seemed less interested in pitching in with caregiving tasks since family caregiving had officially become her “job.” Even her mother seemed to be asking more of her, as if she were now the hired help and not her youngest daughter.

More states are allowing care recipients to hire and pay family members as their home health aides under what is sometimes called consumer-directed care. These are popular programs for obvious reasons: Family members — some of whom had to quit or cut back on work to take care of a loved one — are now being paid at least a little money for all the care they provide. No one is getting rich, but at least they are better able to cover some bills. More importantly, receiving an hourly wage gives them a feeling of being publicly acknowledged and valued rather than (as is too often the case) feeling invisible and underappreciated.

In my clinical practice, I’ve also worked with many families in which a parent’s decision to leave a house or the bulk of an inheritance to the primary caregiver roils family dynamics like nothing else. The caregiver who will receive money becomes immediately suspected by others of playing the Altruistic Child to cash in. Anger and conflict frequently result.

How can family caregivers earn some compensation for their devoted efforts but not be regarded as mercenaries by other family members? Here are some ideas:

Demonstrate transparency: Many of us are inclined to keep our financial affairs private, even when among family members. But because caregiving is inherently a family enterprise, it is vital that we are aboveboard about monetary transactions, especially if we are profiting in some way from a parent’s need for assistance. Let other family members know about the opportunity to earn an hourly wage for providing hands-on care. Tell them exactly what you’ll make. Communicate plainly that this money is going to offset costs incurred by caregiving activities — e.g., expenses for medication copays, lost salary, the price of fuel for driving to the doctor.

Keep in mind what others think is fair: It may seem fair to you to receive money for the many sacrifices you are making on behalf of someone you love. (I agree with you.) But there are other family members who may believe they are also making sacrifices — though, admittedly, not as many as you are — and deserve to be compensated to some degree as well. For them, it may seem patently unfair that you get glory and money and they get neither. Don’t begrudge or disagree with their feelings. Empathize with them instead and tell them that you greatly value their participation in caregiving. You don’t have to fork over some of your newly earned cash to prove that. Just express your appreciation that the two of you are part of a cohesive caregiving team whose sole mission is to help Mom.

Preserve your parent-child relationship: Care recipients can become increasingly demanding over time even when money is not involved. But when a family member has been hired for a caregiving job, there is a greater tendency for the care recipient to treat even close relatives with impatience and barked orders. Even when you’re on duty, though, you’re not just an employee. Complete the necessary tasks but let your parent know that you’re there for love, not money, and that you expect that your personal rapport with one another is not going to be suddenly altered by changed economics.

Weigh the money’s worth: For some families, receiving a caregiving salary will be an unmitigated boon about which everyone is thrilled. For others, there will be no end to the resentment, jealousy and sniping. Judge for yourself whether working as a loved one’s home health aide is worth it. If it isn’t, then don’t be resentful in kind. Instead, be consoled that peace in the family may ultimately be of greater value than any amount of money in the pocket.

by Barry J. Jacobs

Source: AARP

10 SURPRISING EARLY SIGNS OF DEMENTIA

10 SURPRISING EARLY SIGNS OF DEMENTIAFrequently falling, mismanaging your money, or staring into space? Find out if you should be concerned about Alzheimer’s disease or another form of dementia.

Dementia does more than rob people of their memories — research continues to show that this complicated condition is marked by a number of symptoms, especially at the onset. But they’re not always easy to recognize: From frequent falling to failing to recognize sarcasm, some of dementia’s early warning signs are subtle.

How can you know if you or a loved one is showing signs of Alzheimer’s disease or another form of dementia?  Any change that is different from a person’s usual behavior or abilities could be a cause for concern, explains Katherine Rankin, PhD, a neuropsychologist who conducts research at the University of California San Francisco (UCSF Memory and Aging Center. Take a look at some of the earliest signs of dementia — you may be surprised.

Failing to Pick Up on Sarcasm and Spot a Liar
You may or may not appreciate a sarcastic sense of humor, but sarcasm is a part of our culture. “We see it as a nice way to be critical and so we use it constantly, even when we are trying to be nice,” says Dr. Rankin, whose research found that people with both frontotemporal dementia (FTD) and Alzheimer’s disease tend to have a harder time picking up on sarcasm.

According to Dr. Rankin, people with FTD couldn’t tell when someone was lying, although people with Alzheimer’s disease could tell. “FTD patients don’t have that sense anymore that things that people do could turn out badly,” she says.

Falling More Frequently Than You Used To
Constantly tripping over your own two feet? Everyone falls now and again — but frequent falling could be an early signal of Alzheimer’s disease, according to research. A study published in July 2013 in the journal Neurology found that presumptive preclinical Alzheimer’s disease is a risk factor for falls in older adults. “People will come into our office concerned because they forgot what was on their grocery list last week, but when their spouse says they’ve fallen four times in the past year, that’s a sign of a problem,” says Rankin. Frequent falls may also be a symptom of other brain disorders, including progressive supranuclear palsy.

Disregarding the Law and Other Social Norms
Some people with dementia lose their sense of social norms. Shoplifting; breaking into someone’s house; inappropriate interpersonal behaviors, such as sexual comments or actions; and even criminal behavior, according to a study published in March 2015 in the journal of JAMA Neurology, all make the list of surprising dementia symptoms. This could lead to trouble with the law, too: Early-onset dementia can hit people as early as their thirties and forties, well before anyone around them would consider their out-of-character behavior as a sign of dementia.

Staring With ‘Reduced Gaze’ and Trouble Reading
“Reduced gaze” is the clinical term for the dementia symptom that alters people’s ability to move their eyes normally. “We all move our eyes and track with them frequently,” says Rankin. But people showing early signs of dementia look like they’re staring a lot. Rankin adds that, “they try to read, and they skip lines.” This is one of the signs of dementia that the patient might not completely be aware of, although people around them probably will be.

Eating Nonfood Objects and Rancid Foods
One surprising early sign of dementia is eating nonfood objects or foods that are rancid or spoiled. This is partly because the person forgets what to do with the things in front of them. For example, dementia patients might try to eat the flower in a vase on a restaurant table because they “know they are there to eat, but don’t know what the flower is doing there,” says Rankin. Unlike some other Alzheimer’s symptoms or dementia symptoms, this one has few other likely explanations.

Not Understanding What Objects Are Used For
Now and again, most people find themselves desperately searching for the right word. In fact, failing to find the word you are thinking of is surprisingly common and not necessarily a sign of dementia, says Rankin. But losing knowledge of objects — not just what they are called, but also what they are used for — is an early dementia symptom. Oddly enough, people who are losing this knowledge can be very competent in other areas of their lives.

Inappropriate Behavior and Loss of Empathy
If someone who is usually sweet, considerate, and polite starts to say insulting or inappropriate things — and shows no awareness of their inappropriateness or concern or regret about what they’ve said — they could be exhibiting an early sign of dementia. In the early stages of some types of dementia, symptoms can include losing the ability to read social cues and, therefore, the ability to understand why it’s not acceptable to say hurtful things.

An Increase in Compulsive, Ritualistic Behavior
One sign of dementia that most people don’t expect is the need to complete extreme rituals or compulsive behaviors. “Plenty of people have odd habits and like things done a certain way,” says Rankin. But while these habits are within the realm of normal, extreme hoarding or detailed rituals or compulsions, such as buying a crossword puzzle book every time they go to the store even if they have hundreds of them, can be dementia symptoms.

Having a Hard Time Managing Money
One of the classic early signs of Alzheimer’s disease is an increasing difficulty with money management. This might start off as having trouble balancing a checkbook or keeping up with expenses or bills, but as the disease progresses, poor financial decisions are often made across the board. Though many people brush this symptom off as just “a normal part of aging,” they shouldn’t. “We tend to associate aging with losing your mind. That’s not healthy aging –  it’s a disease,” emphasizes Rankin.

Difficulty Forming the Words to Speak
When people who used to be fluent and could speak smoothly stop being able to produce language that way, this may be a sign of dementia, says Rankin. Despite this symptom, patients are often crystal clear in other areas. They can run a business, manage their family, or draw beautifully, but they have increased difficulty actually forming the words to speak.

Written by: Madeline R. Vann, MPH

Source: agegracefullyamerica.comhttp://www.agegracefullyamerica.com/

WHEN IT’S TIME TO SEE A GERIATRICIAN

If you’re in your 60s or 70s, you may have wondered if you should start seeing a geriatrician instead of, or in addition to, your primary care provider. These are family doctors or internists with special training in the health needs of older adults. About 30 percent of people over age 65 need one, according to the American Geriatrics Society.

But you might not need to book an appointment at the same time you sign up for Medicare. “Geriatricians specialize in the care of people with multiple chronic medical conditions that cause challenges with their day-to-day physical and mental functioning,” explains Michael Steinman, a geriatrician at the University of California San Francisco. And so the reason for using this specialist is not determined by just age. “A 65-year-old with high blood pressure, high cholesterol and type 2 diabetes may benefit, but an 80-year-old who walks five miles a day and is only on one or two medications doesn’t need one.”

Usually, you see a geriatrician  for an initial consult, with follow-up as needed, says Mary Tinetti, M.D., chief of geriatrics at the Yale University School of Medicine. Most geriatricians work in centers and have a team-based approach; for example, besides meeting with the doctor, you’ll see a social worker, hearing specialist, nutritionist, and even physical or occupational therapists in the same visit. You’ll still see your primary care physician for day-to-day matters, like blood pressure checks or visits when you’re sick. If there isn’t a geriatrician near you and it’s hard for you to travel, Tinetti suggests seeing if a geriatric center will do a telemedicine consult. (You can check the American Geriatrics Society’s online locator serviceto find out if any of the nation’s 7,000 certified geriatricians practice near you.)

Reearch shows that it’s best to make an appointment sooner rather than later. Adults who see a geriatrician are less likely to end up in the hospital, possibly because these physicians are more likely to be on the lookout for warning signs such as frailty and appetite loss, and also are more likely to avoid prescribing potentially risky medications.

Here are four signs that you may need a geriatrician.

  • You’re on multiple medications. More than a third of adults over age 62 are taking at least five prescription drugs. Over 60 percent use some type of herbal or dietary supplement. But the more meds you’re on, the more likely you are to experience side effects, have cognitive problems or even end up in the hospital. “The older you get, the harder it is to metabolize and clear medicines from your body,” says Steinman. “And the more drugs you’re on, the more likely you are to experience drug-drug interaction.” A geriatrician can review all your meds and determine which ones you really need and which you can shelve.
  • You’re having trouble with your memory. Almost 60 percent of people over age 65 with probable dementia are undiagnosed or unaware that they have it, according to a Johns Hopkins University School of Medicine study published last year in the Journal of General Internal Medicine. A geriatrician can screen you for mild cognitive impairment (MCI), which is a precursor to dementia, as well as for depression, which can be more subtle in older adults, says Veronica Rivera, a geriatrician at the Icahn School of Medicine at Mount Sinai in New York City.
  • You’re less mobile. If you don’t feel as steady on your feet as you used to or are having trouble getting around, it’s a good idea to see a geriatrician who can assess your balance and gait, says Tinetti. (Falls are the leading cause of injuries and death from injuries among adults over age 65, according to the Centers for Disease Control and Prevention). A geriatrician can also give you balance-strengthening exercises to do at home and/or prescribe a course of physical therapy, as well as send a physical therapist or occupational therapist to your home to do a fall-risk assessment. All these steps can help keep you independent — and in your home — longer.
  • You’re hospitalized. Research shows that older adults who get care from a geriatrician in the hospital do better once they’re discharged. People over age 65 who got a geriatric consult while hospitalized for a traumatic injury such as a broken rib, head injury or fracture were able to resume about two-thirds more of their daily activities (like shopping, walking across a room, managing finances and self-care) than those who didn’t, according to a University of Michigan study published in JAMA Surgery. 

Written by: Hallie Levine, AARP

Source: agegracefullyamerica.com

Why Does My Elderly Loved One Sleep All Day?

As people age, they tend to sleep more lightly than when they were younger and often wake up during the night from achy joints or the need to use the restroom. Many seniors compensate for this lost sleep by catching a restorative nap during the day. That’s normal.

Daytime sleeping only becomes a problem when an elder spends most of their time dozing in bed or their favorite chair instead of engaging in life. If you want your elder to stay awake more during the day and sleep better at night, you will need to discover the underlying reason(s) why they are napping excessively. In some cases, you may need a doctor’s help to narrow down the cause and recommend treatments. Knowing what to look for can give you a jumpstart on improving a loved one’s sleep schedule.

Common Reasons Why Seniors Sleep So Much

Boredom in the Elderly

As people age, they may suffer from chronic health conditions and age-related changes that affect their ability to do the things they enjoy. When options for outings, activities and entertainment are limited, it can deal a serious blow to an elder’s quality of life. They aren’t working anymore, they may struggle with reading or puzzles because of poor eyesight, and eventually they get tired of watching TV. In these cases, elders may not be clinically depressed or even all that tired. Instead, their fatigue stems from the fact that they are incredibly bored. With no schedule to keep and not much going on in their lives, they slide into the habit of napping throughout most of the day.

Medication Side Effects and Interactions

The average senior in the U.S. takes several different medications each day. All medications have side effects, so it should come as no surprise that taking multiple drugs can produce interactions that magnify these effects. In addition, older individuals metabolize medications differently than their younger counterparts, meaning that they are even more susceptible to adverse effects like drowsiness and dizziness.

Over-the-counter and prescription medications for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson’s disease, nausea and allergies can all cause excessive sleepiness. Atypical (second generation) antipsychotics are notoriously hard on most elderly patients as well. If your loved one is on one of these medications, discuss the side effects and alternative medication options with their physician. You may even find that there are some medications in their regimen that could be reduced to smaller dosages or discontinued completely. Sometimes simply altering the timing of a senior’s medications can improve their alertness during the day.

Depression and Sleep

Many elders become sad and lose interest in life, but depression is in no way a normal part of aging. Most people are familiar with the basic signs of depression, but for older individuals, the red flags can be a little different. Sleep issues and fatigue can often indicate that a loved one is suffering from a mental health disorder. If you notice these symptoms in a loved one, do your best to talk with them about how they are feeling and make an appointment with their physician.

If a loved one is already on antidepressant medication or begins antidepressant therapy, keep in mind that finding the correct medication usually takes some trial and error. Again, sleepiness is a common side effect of these prescription drugs, so be sure to communicate with the doctor about any adverse effects to ensure your loved one finds the right medication.

Dementia and Difficulty Sleeping

Many seniors with dementia experience a wide array of sleep problems, especially in the later stages of the disease. As the brain deteriorates, issues arise with circadian rhythms and temporal awareness, making it difficult for dementia patients to sleep through the night and keep a normal schedule. In some cases, sleeping during the day is the only way that patients can make up for the shuteye they lose at night.

The resulting odd schedules can be frustrating for caregivers, but sleep deprivation can also exacerbate the symptoms of dementia, like sundowning. While there aren’t many foolproof methods for helping a loved one sleep through the night and stay awake during the day, sleeping pills typically aren’t advisable. The best methods for encouraging good sleep habits include using engaging activities during the daytime, scheduling brief naps as needed during the day, and sticking to a set sleep schedule as best as you can. A solid routine can be very helpful for helping a loved one stay oriented and managing behaviors and symptoms of dementia.

Excessive Sleep in the Elderly

In some instances, excessive sleeping in individuals with one or more serious medical conditions can indicate that their health has taken a downturn. This may not necessarily mean that death is near, but it certainly is cause for contacting the doctor to see if a specific treatment should be altered, added or removed. If a loved one is spending a great deal of time asleep, it is important to devise ways to ensure they still get the nutrition, personal care and medications they need. Otherwise, complications like dehydration, malnutrition and pressure ulcers can arise. In the most severe cases, the doctor may recommend an assessment for a different level of care, such as skilled nursing or hospice.

The Importance of Staying Active

In addition to being vigilant about an aging loved one’s medications and health, it is also important to encourage them to participate in life as fully as they can. Providing plenty of opportunities for social interaction, mental stimulation and physical activity is key to a high quality of life. But, for many family caregivers, seeing to all these needs in addition to their hands-on responsibilities and personal schedules is nearly impossible. Seeking out respite care that doubles as a source of stimulation for a loved one is a common solution for many families.

In-home care and adult day care are two such options. Both professional in-home caregivers and adult day care staff can help set and maintain daily routines, provide engaging activities and outings, and broaden a senior’s social circle. Assisted living and nursing home care can also offer these benefits in a residential setting. When elders spend more time engaged in life during the day, it reduces boredom, minimizes depressive symptoms and typically leads to better quality sleep at night.

Your goal is to determine why your loved one is so fatigued and how you can boost their spirits and energy level. The problems and solutions above may not apply to every senior, so don’t try to solve the problem alone. Communicate with your loved one as best you can and ask for help from physicians, friends and other caregivers. By doing so, you’ll get the support and reassurance you need, and you may find a workable solution.

Source: AgingCare by Carol Bradley Bursack