May is Arthritis Awareness Month

by Anne Pagnoni

According to the CDC, over 50 million Americans are living with the pain and discomfort of arthritis.  Of these, 21 million are experiencing physical limitations due to the disease.  While arthritis is a word that most of us have heard, did you know that arthritis is actually a general term used to describe joint inflammation and that the term arthritis is used to describe over 100 different conditions impacting the joints?   While osteoarthritis is the most common type of arthritis, rheumatoid arthritis, fibromyalgia, lupus, and gout are other frequently occurring forms of arthritis.  Arthritis is seen more commonly in adults over age 65, but it can impact anyone including children. 

Arthritis is seen as a public health problem as it impacts such a large number of people.  As our population continues to age, the number of people living with arthritis is going to increase.  It is predicted that the number of adults living with arthritis will increase to 67 million by the year 2030 with at least one third being impacted with limited activity as a result. 

There are a variety of factors that have been shown to increase a person's risk for arthritis.  The risk of developing arthritis increases with age. Women are at a greater chance of developing arthritis than men.  Almost 60% of all people with arthritis are women.  Certain genes can increase a person's chance of developing certain types of arthritis including rheumatoid arthritis and systemic lupus.  Excess weight can lead to someone developing osteoarthritis of the knees.  If someone has a job that involves them repeatedly bending and squatting, then they are at an increased risk of developing arthritis. 

There are things that you can do to protect your joints and help prevent osteoarthritis in particular.  Maintain your ideal body weight.  The more you weigh the more stress you're putting on your knees, back, hip, and feet joints.  Exercise regularly.  Exercise protects joints by strengthening the muscles around them.  Strong muscles keep joints from rubbing on each other.  When lifting or carrying items, use your largest and strongest joints and muscles.  This helps alleviate stress and prevent injury to smaller joints. Listen to your body.  If you're in pain, then you probably overstressed your joints. 

If you or someone you know has been diagnosed with arthritis, there are things that you can do to continue to live a relatively pain-free life.  While there are medications that can help alleviate joint pain and swelling, there are many things that can be done that don't involve medications.  Physical and occupational therapy, splints or assistive devices, and weight loss can all help control pain and maintain function.  For more suggestions on how to "do it easier" with arthritis, please visit Arthritis Today. 

For more detailed information about arthritis, please visit the Arthritis Foundation and Centers for Disease Control and Prevention. 

Happy St. Patrick's Day!

Some might be surprised to learn that St. Patrick's Day is actually a religious holiday celebrated yearly on March 17th.  St. Patrick's Day commemorates the arrival of Christianity in Ireland as well as the life of St. Patrick, who is the patron saint of Ireland.  It became an official Feast day in the 17th century but has gradually become a secular festival, which celebrates Irish culture in general. 

St. Patrick is said to have been born into a wealthy Roman Britain family sometime in the 4th century.  Both his father and grandfather were deacons in the church.  When he was 16 years old, he was taken captive by Irish raiders and was taken to Ireland where he was imprisoned as a slave.  Eventually Patrick was able to flee captivity and return to Britain.  Upon his return, he joined the church and studied to become a priest. 

In 432, Patrick said that God called him to return to Ireland so that he could bring Christianity to them.  After spending 30 years in Ireland, Patrick passed away on March 17, 461, and was buried in Downpatrick.  Patrick is held in esteem in the Irish church and is heralded for bringing Christianity to Ireland.  According to Irish folklore, Patrick taught the pagan Irish about the holy trinity by using the example of the three leaf shamrock. 

In the early days, the original color associated with St. Patrick's Day was blue.  Over time, however, green began to grow in popularity.  In the 1798 rebellion, Irish soldiers hoping to make a political statement and gather public attention, wore green on March 17th. 

In the mid 1990s, the Irish government began an initiative to globally showcase Ireland and its culture on St. Patrick's Day.  In doing so, the government hoped to make a day whereby all Irish descendents could join in on festivities celebrating their heritage and to have a celebration that was amongst the largest and greatest in the world.  March 17, 1996 marked the first St. Patrick's Day festival in Ireland.  By 2006, the festival had become five days long with almost 1 million people in attendance. 

In the United States, every year since 1991 March has been proclaimed Irish-American Heritage month.  Today St. Patrick's Day is celebrated by both the Irish and non-Irish alike.  For most Irish Americans, St. Patrick's Day is both a religious and festive day.  Many Irish-Americans start the day off with church services followed by parades, parties, Irish music and food, and dances.  Alcohol consumption on St. Patrick's Day has soared over the past several years as individuals are allowed to break their Lenten sacrifices in order to celebrate the day. 

One would think that the largest St. Patrick's Day parade would take place in Ireland; however, this isn't true.  The largest St. Patrick's Day parade takes place in New York City.  It has close to 15,000 people marching in the parade with almost 2 million in spectators lining the NYC streets. 

It needs to be mentioned that there are more Irish-Americans than there are Irish!  There are 36.5 million Americans claiming an Irish heritage.  Ireland, on the other hand, only has a population of about 6 million. 

Erin go braugh! 

Don't Ignore Signs of Caregiver Stress

Caring for a person with Alzheimer's disease can cause depression, anger and irritability, in addition to taking a physical toll that results in exhaustion and sleeplessness. These are real issues caregivers shouldn't ignore.

November is National Alzheimer's Disease Awareness Month and National Family Caregivers Month. The Alzheimer's Association offers a number of resources to help caregivers manage stress:

• The Alzheimer's Association Caregiver Notebook offers tips for care and planning for the future, as well as a list of resources to use when additional information is needed. To learn more or purchase the Caregiver Notebook, visit www.alz.org/caregivernotebook.
• Caregiver Stress Check, an interactive quiz that helps caregivers to identify symptoms of stress and provides a tailored list of helpful referrals and other support. Take the quiz at www.alz.org/stresscheck.
• Alzheimer's Association CareSource™, an easy-to-use, one-stop online portal for everything you need to widen your care options and plan for care for a person with Alzheimer's. Find out how CareSource can help at www.alz.org/caresource.

Learn more about Alzheimer's disease and caregiver stress by visiting http://www.alz.org/.

 

Make the Holidays Brighter

The holidays are a busy but wonderful time of the year for most of us. However, for an older adult who has physical and/or cognitive limitations, the holidays can be a confusing, depressing, and very stressful time of year. Here are a few tips for how you can make the holidays more enjoyable for the older adults in your life:

• Reminisce: older adults with memory impairment have difficulty recalling recent events, but often times remember past events clearly. Allow them the opportunity to share their favorite memories. You might just learn something!
• Plan accordingly: some older adults tire quickly or respond poorly to over stimulation. Avoid cramming too many activities in to one day. Allow the time for a nap if necessary. If your loved one becomes easily confused or agitated by noise, then set aside a quiet area for him or her to relax. Instead of having the entire family over for one visit, consider having a couple of holiday gatherings over a few days.
• Physical environment: if older adults are visiting outside of their home, then ensure that the physical environment is a safe environment. Eliminate throw rugs and other tripping hazards. If visiting in the older adult's home, do not rearrange furniture as this can increase confusion.
• Avoid embarrassment: an older adult with early memory impairment may embarrass easily if unable to remember an earlier conversation or the name of a rarely seen family member. Avoid adding to their embarrassment by saying, "Don't you remember?" They don't remember and no amount of prodding will make them remember.
• Involve your loved one: invite them to help make cookies, wrap gifts, or set the dinner table. Involve them in the conversation at the holiday meal.

By making a few small adjustments, you'll guarantee a happier holiday season for all involved!

 

Good vs. Bad Cholesterol

Here are some great additional resources to check out regarding cholesterol: 

Good vs. Bad Cholesterol

National Cholesterol Education Month

High Cholesterol Foods

Low Cholesterol Foods

Eldercare...Planning for Baby Boomers, Providing the Answers You Need

Zarephath Christian Church invites the public to their upcoming panel presentation on Saturday, October 16th at 9:00 a.m. at the church. This valuable program entitled “Eldercare Planning for Baby Boomers– Providing the Answers you need” addresses caregivers who share the common issues of being overwhelmed and under informed when an older adult needs their help. The panel presentation will be moderated by Maryann Porosky, LCSW, Care Management Specialist of Caring Choices and will feature four experts: Michelle Bucci, Outreach Director at the Chelsea of Warren, Kevin McClarren, President, Home Care Assistance; Jeff Knapp, Eldercare Law Attorney of Knapp Law Firm, and Terri Erbacher, LPN, Elder Care Advocate.

The panel of speakers will explain ways to avoid costly mistakes, both emotional and financial by planning now rather than facing a crisis unprepared. They will discuss choosing the right venue for care, whether it be your home, an assisted living facility or a nursing home and minimizing the financial impact it can have on your family and loved ones. You will also have an opportunity to participate in a Q&A session after the presentation.

There is no charge for this invaluable presentation and a nice continental breakfast will be served. Advance reservations are requested by confirming your attendance by calling Terri Erbacher at 908-526-5279. Zarephath Christian is located at 14 Chapel Drive in Zarephath, NJ.

Home Care Assistance of Greater New Jersey Delivers Cost-Free Caregiver Support

By Anne Pagnoni

Being a primary caregiver for another individual is a daunting experience. In addition to making sure that the individual's personal care needs are met, the caregiver is responsible for making financial and health care decisions, managing doctors' appointments, and maintaining a safe living environment for the care recipient. The caregiver needs support, too, during this tumultuous time. Where can the caregiver turn for help? Home Care Assistance of New Jersey is excited to announce its partnership with a free, online, caregiver support program called MyCareCommunity.

Studies show that caregivers find stress-relief in three ways: access to information and tools, support from other caregivers, and the ability to share caregiving responsibilities with family and friends. MyCareCommunity allows caregivers to do just that, by providing a convenient, easy-to-use website that offers:

• Practical advice and expert information
  
• Caregiver blogs, discussion forums and sharing of real-life stories and experiences
  
• Ability to get answers from local NJ professionals on a variety of health and elderly care issues
  
• Search features for care services, care providers and community resources
  
• Access to a private webpage that is focused on the care of a loved one
  

MyCareCommunity has a true Ask the Expert feature. Experts in the field of aging from all over New Jersey have availed themselves to caregivers. Each expert is listed with a short biography which allows caregivers the opportunity to direct their questions to the expert best able to answer their questions.

One of the greatest features of MyCareCommunity is the Personal Communities, which enable users to create a webpage for their loved one and then invite other family members or friends to view it. The caregiver is able to provide updates about their loved one via the personal community, which alleviates the need for the caregiver to make numerous phone calls or send multiple emails with notifications. There is a care scheduler feature, which allows the caregiver to enter appointments into a calendar. All other personal community members are able to see the appointments and offer assistance to the caregiver accordingly.

If you're a caregiver, then take a few minutes and check out all of the features of MyCareCommunity. It's an invaluable resource that will make your caregiving responsibilities easier. By visiting www.mycarecommunityNJ.org, caregivers will find the support and information that they need to assist them in managing their caregiving journey.

Support Groups for Caregivers

By Anne Pagnoni

Being a caregiver for a loved one is an overwhelming responsibility. Many caregivers hold full time jobs; juggle children with their many extracurricular activities; and maintain their own household with laundry, bill paying, meal preparation, grocery shopping, yard work, cleaning, etc. In addition to their own familial responsibilities, they are responsible for the care of another adult individual, who typically has multiple physical and cognitive limitations. While initially the caregiving responsibilities may not be too taxing, as the aging loved one's limitations increase so does the time that the caregiver needs to spend caregiving. Overtime the caregiver will become overwhelmed and will need a support system in place to help him or her through the rough times.

Professionally run support groups are an excellent resource for the caregiver. Caregivers have the opportunity to talk with each other and share tips on things that have and haven't worked. Professional facilitators are available to provide useful information on relevant caregiving topics and to steer caregivers in the right direction when looking for additional services. Support groups usually meet for a couple of hours either weekly or biweekly. But what about the caregivers who aren't able to make the meetings or caregivers who need support between meetings? How do they get the help that they need?

Home Care Assistance of New Jersey has teamed up with an online caregiver support group designed to provide resources to caregivers and link them with professionals, who can share insight on particular caregiving issues. On Wednesday, September 1^st Home Care Assistance will be making an announcement regarding this partnership with information on how individuals can begin utilizing the site. Stay tuned for more information!

5 Steps To Protect Against Extreme Heat’s Effects On Seniors

Article written by the Co-Founder of Home Care Assistance.  Great tips to consider especially during the dog days of summer, which are upon us! 

5 Steps To Protect Against Extreme Heat’s Effects On Seniors

Applying for the Veteran’s Aid and Attendance Pension: My Personal Experience

My previous blog entry was about this exact government program – Veteran's Aid and Attendance. Read on to learn more about the application process for one family. Please keep in mind that this pension program also exists for a Veteran, who wishes to remain in his or her home with home care services.  –Anne Pagnoni

 

Applying for the Veteran's Aid and Attendance Pension
My Personal Experience
By Melissa Howell

12:20 a.m. The clock was blurry as I rubbed the sleep from my eyes to answer the phone.
"Hello", I said. A weak and frightened voice on the other end pleaded, "Melissa? Is Bryan there? I can't get out of my chair. Could you or Bryan come over?"

I sighed as I handed the phone to my husband and heard him say, "I'll be right over, Dad."
When Bryan left, I pondered on my father-in-law, John, and his situation. John had just come out of the hospital after a serious illness and although the doctor had assured us he would be fine, we quickly learned that he was not able to care for himself. He lived alone in a small apartment and had in-home health care assistance through his Medicare plan. They came once a day to help him with a shower and to aid him with incontinence. Bryan and I came over three times a day to help him with changing his clothes and to make his meals. In addition, we helped him with his bills and took him to his frequent doctor appointments. Tonight was the first time he had called to ask for help in the middle of the night. We needed to do something different. We were both exhausted between working our jobs and caring for our four young children and constantly running out to take care of John's needs. It was becoming more than we could handle. We realized we really needed to get him into assisted living.

John lived comfortably on an income consisting of social security and a retirement pension, but as we visited different assisted living homes in our immediate area, we quickly realized that this income was not enough. Assisted living was really expensive!

John had served in the Navy during the Korean conflict and we had heard through a friend that veterans could receive assistance through the Department of Veteran's affairs for health care. The catch was doing it correctly. Our friend referred us to a Veteran's Consultant from the National Care Planning Council to provide information for the challenging task of filling out the paperwork to receive this benefit. A Veteran's Consultant can provide general information on how a claim is filed. Our consultant told us about all of the necessary supporting documents we would need to make sure it was approved.  The paper work was pretty daunting, but we worked through each form thoroughly to be sure that we were providing all the information Veterans Affairs (VA) would need in order to expedite John's payments.

First, I obtained a medical report from John's doctor -- the most crucial step in the process. This form would prove that John needed aid and attendance. In our case, the doctor described his medical condition and then noted specifically his need for help with incontinence and showers, his lack of motivation to make meals for himself and his inability to leave the house alone. It was, however; important to us that the doctor wrote that John was mentally capable of making his own decisions, because we did not want to go through a delaying process of having VA assign somebody who would need to pay his bills for him (VA calls this person a fiduciary).

Another key thing was that John had to show evidence to VA that his care costs were close to or exceeded his income. Fortunately, John had a small amount of savings and he was able to pay in full for the first month's payment to his assisted living home. This was important, because the statement showing this payment was important evidence needed to present to VA. Since his assisted living cost exceeded his income by $1,000 per month, we arranged with the director, to pay what John could afford until the benefit from VA came in and then the director agreed to pay the remaining debt balance on the account at that time.

An important form was John's original DD-214, which was the official record showing that he had been honorably discharged from the military. I quickly found a certificate of honorable discharge (DD-256) but this was not the correct form. We searched through all of his files and boxes and couldn't find the DD-214. So I got on the Internet and found a website for the National repository where the official forms can be obtained. It appeared that it could take up to 6 weeks to receive an official copy. Fortunately, we found the original document folded in his wallet and we did not have to delay our process.

One of the forms my Consultant made me aware of was a VA power of attorney form (VA form 21-22a) that gave me the authority to fill out and submit the forms to VA on behalf of John. Although John was mentally sound, he was weak and tired and didn't really want to do anything but watch television and eat. With this form, I was able to communicate with VA in his behalf.
There were several other forms to fill out and after all the paperwork was finished, my Veteran's consultant gave us the address of where to send all of them. Our particular VA processing office was located in St. Paul, Minnesota.

After about two weeks, John and I each received a letter stating that VA was working on his case and they assigned him a case file number. After another two weeks, we received a letter stating that we needed to fill out some other paper work. I showed these to my consultant, who assured me, in our case, that it was standard procedure and that the paper work I had originally filed was sufficient. Within another two weeks, John received his first payment.
Because his care cost exceeded his income, he was awarded the full $1644.00 per month. VA sent another payment from the date that they had first issued his case number. So in the first month, we received two payments. These were sufficient to catch up the debt he owed to his assisted living and to continue with full payments each month.

Applying for the VA Aid and Attendance Pension was detailed, but it was not terribly frustrating because of the general information on the application process I received from my consultant. It did require extra work on my part, but it was well worth the end result of getting the care that John needed and the relief that Bryan and I needed in the end. I am grateful that we had such a wonderful resource in National Care Planning Council to help us find a capable and informative Veteran's Consultant.

Bryan and I now see John twice a week and visit with his assisted living staff often to help him have a comfortable and enjoyable life in his new home. He is able to enjoy activities and meals with other people, have quality personal care and have the peace of mind that someone is always there to help him. I now sleep at ease through the night, knowing that his needs are taken care of and that there won't be any middle of the night calls asking for help.

The National Care Planning Council wishes to thank Melissa for providing her experience. We maintain a list of consultants across the country which can be found at the following address: www.veteranslisting.com. We also provide a book with instructions to help people who want to file an application by themselves. This book can be purchased online at http://www.longtermcarelink.net/a16books.htm.

Little-Known Government Program Pays the Cost of Elder Care

By Anne Pagnoni
WHAT IF 33% OF ALL SENIORS IN THIS COUNTRY could receive up to $1,949 a month in additional income from the government to help cover their elder care costs? THEY CAN!
Under the right circumstances, a little-known federal program will pay additional income to cover long term care costs for at least 1/3 of all US senior households -- that's how many war veterans or their surviving spouses there are in this country. But the provisions of this program are such a well-kept secret that only 4.7% of US seniors are actually receiving the benefit. The great news about this program is the Department of Veterans Affairs will pay you to hire your family, friends or just about anyone to take care of you (Caregiving spouses can't be paid under this program). The program is called "Veterans Pension."
Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit can also be used to pay for home care.
It also comes as a surprise to most people that the Department of Veterans Affairs will allow veterans' households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower "countable income" which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the special provision in the regulations -- allowing for deduction for care costs -- households earning between $3,000 to $6,000 a month or more can still qualify for Pension under the right conditions.
This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $1,056 a month for a single surviving spouse of a veteran, up to $1,644 a month for a single veteran or up to $1,949 a month for a couple.
If the disabled care recipient has been rated "housebound" or in need of "aid and attendance" by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and nonmedical services -- all are deductible.
For a disabled person who has been rated "in need of aid and attendance" or "housebound", a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.
The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly invoice billing for services. Money must exchange hands and federal law requires employment taxes must be withheld and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources. VA will allow, however, family caregivers being paid by their loved ones, to turn around and pay the household bills for their loved ones to help defray the cost of the care.
Due to the need for a rating, documentation for annualizing care costs and the extensive proof needed to show the caregiver is indeed an employee of the care recipient, most people should not try this on their own. An expert in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits. For a list of individuals or companies in your area who understand how to get this benefit go to http://www.longtermcarelink.net/ref_veterans_consultants.htm

Aftercare Tips for Elderly Patients Checking Out of the Hospital

Readmission into the hospital after surgery or another procedure is extremely common, costly and time consuming. Since it is one of our main priorities to keep our clients healthy and living at home rather than in the hospital, I wanted to share this article from The New York Times as it provides great tips for hospital checkout and avoiding readmission.
In 2009,The New England Journal of Medicine reported “one in five Medicare patients returns to the hospital within 30 days of being discharged.” Dr. Mark V. Williams, who worked on this study, suggests that part of the issue is due to the fact that doctors place much of their focus on the admission process, when the patient is most sick. When the patient leaves the hospital, they often have more medications and treatments to worry about than when they first entered. Some doctors suggest that this problem may also occur because it may benefit the hospital financially for patients to be readmitted.
Dr. Eric A. Coleman, professor of medicine at the University of Colorado Denver, has developed a program called Care Transitions Intervention to help seniors take initiative in their care after leaving the hospital. The steps of the program include taking charge of your care, checking the medication list for errors, making a comprehendible discharge plan and contacting your primary physician if you have any questions or concerns. To further help the cause, some medical centers are providing financial incentives for lowering readmission rates and are providing guidance for improving the discharge process.

Recognizing Symptoms of Dementia

By Anne Pagnoni

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone's favorite foods are always on the agenda. On the top of the menu is Grandma's Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side - perhaps a half cupful of salty.

Though the family was disappointed over the cake, of more concern was Grandma's confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?

One might say that for an older adult a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia? An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia:

"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
  Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
• Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
  Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer's disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer's. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.  "The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive. The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning

 Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients.

The National Care Planning Council supports caregiving services throughout the country. Visit www.longtermcarelink.net for more information.

Why Any and All Activity Matters

By Anne Pagnoni

The health benefits of exercise are extraordinarily well documented. Regular exercise lowers your risk of a stroke by 27%, reduces instances of both high blood pressure and Alzheimer's disease by 40%, cuts your chance of developing diabetes by 50%, and lowers your risk of developing colon cancer by a whopping 60%. As well, it obviously helps maintain a healthy weight. Plus, exercise has been shown to be just as effective at fighting depression as both SSRIs (like Prozac) and therapy.

A recent study from the Appalachian State University's Human Performance Lab even showed that people who took a brisk walk five days a week had fewer and less severe colds and flus than sedentary control subjects. So it's not just long-term chronic and fatal conditions that being fit staves off – regular exercise actually helps you battle the common cold, too!

Beyond full-on exercise, however, a recent study out of Australia also shows the health risk of being inactive. The study from the physical activity lab at the Baker IDI Heart and Diabetes Institute in Victoria, Australia found that the more television its subjects watched, the greater risk they had of dying at a younger age, particularly from heart disease.

Subjects in the study who watched four hours or more of television per day were 80% more likely to die from heart disease and 46% more likely to die from all causes, even when factors such as: education levels, overall health, age, past smoking, waist circumference, cholesterol levels, and blood pressure of the subjects was taken into account.

The study concluded that the real problem with television watching is that it is done while sitting, and sitting with extraordinarily little muscle movement. Such "extreme" inactivity affects metabolism overall, not just during the time spent inactive. A study from July 2008 showed that standing engages muscles and promotes the distribution of lipase, a fat-absorbing enzyme that triggers the body to process fat and cholesterol. Most important, the benefits of this regular, unremarkable movement are independent from the amount of time subjects spent exercising.

That same study found that the health consequences that develop from too much sitting are very different and independent from those that result from too little exercise. Along with the recent Australian study, it found that the negative health consequences of prolonged periods of sitting – larger waistlines, higher bad cholesterol levels, lower good cholesterol levels, heart disease risks – were not fully counteracted by regular exercise.

In other words, regular exercise – beneficial as it is – doesn't counteract the negative effects of long periods of inactivity.

Part of the issue is that television watching is fundamentally inactive. Harvard Health Publications estimates that, when it comes to calories burned, watching television (56 calories per hour) is closer to sleeping (46 calories per hour) than it is to sitting and reading (84 calories per hour), which itself is more akin to standing in line (94 calories per hour) than it is to watching television. (Note: calorie counts are for a 155-pound person.) In other words, watching television is an inactive as a person can get without sleeping.

Along with limiting television watching, these studies point to the importance of remaining active throughout the day. The good news is that it ends up that the simple physical movements of standing and moving between rooms has significant health benefits. When watching television, standing up during commercial breaks, going to get a glass of water, or even putting down the remote control and getting up to change channels and adjust volume the old-fashioned way can help people from staying in one extremely inactive position for extended periods of time.

Light household tasks and self-care – activities encouraged by the Balanced Care Method™ whenever clients are physically able – can help keep people moving. Not only does such daily activity help keep people physically active longer, we now know it also can help fight heart disease and other health risks.

 

Caregiver Stress: Hazardous to Your Health

By Anne Pagnoni
UNDERSTANDING CAREGIVER STRESS
A 2003 study of caregivers by a research team at Ohio State University has proven the off-repeated adage "stress can kill you" is true. The focus of the investigation was the effect the stress of caregiving had on caregivers. The team, led by Dr. Janice Kiecolt-Glaser, reports on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. The study not only found a significant deterioration in the health of caregivers when compared to a similar group of non-caregivers but also found the caregivers had a 63% higher death rate than the control group.
The demands on a caregiver result in a great deal of stress. It is often observed in aging publications that stress can induce illness and depression. The resulting poor health can further decrease the effectiveness of the caregiver and in some cases, as proven by the study mentioned above, even cause premature death.
Stress can be defined as a physiological reaction to a threat. The greater the threat -- the greater the level of stress. A threat is a real or perceived action against our person. Threats may include the anticipated possibility of death or injury but may also include challenges to our self-esteem, social standing or relationships to others or a threat may simply be a potential or real disruption of our established routines. What is stressful to one person may not be to another. For example, bumper-to-bumper traffic might be stressful to the woman executive who is late for an important meeting but to the delivery man who has no deadline and is being paid by the hour, it may be a welcome respite to relax and listen to the radio.
Stress produces real physical changes. In some unknown way the fears in our mind, both conscious and unconscious, cause the hypothalamus and pituitary glands, deep in our brain, to initiate a cascade of hormones and immune system proteins that temporarily alter our physical body. This is a normal human physiological response inherent to the human body when a threat is perceived--real or not. It is often called the "fight-or-flight response" or the "stress response". The purpose is to give us clearer thought and increased strength as well as to activate the immune system to deal with potential injury and to repair potential wounds. When the perceived threat is removed, assuming no damage is done, the body returns to normal.
A team of researchers at Ohio State University Medical Center has found a chemical marker in the blood that shows a significant increase under chronic stress and is linked to an impaired immune system response in aging adults. The team, led by Dr. Janice Kiecolt-Glaser, reports in the June 30, 2003 issue of Proceedings of the National Academy of Sciences on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. With the caregivers, the team found a four-fold increase in an immune system protein -- interleukin 6 (IL-6) -- as compared to an identically matched control group of non-caregivers. Only the stress of caregiving correlated to the marked increase of IL-6 in the caregiver group. All other factors, including age, were not significant to the outcome. Even the younger caregivers saw an increase in IL-6.
The study also found that the caregivers had a 63% higher death rate than the control group. About 70% of the caregivers died before the end of the study and had to be replaced by new subjects. Another surprising result was that high levels of IL-6 continued even three years after the caregiving stopped. Dr. Glaser proposes the prolonged stress may have triggered a permanent abnormality of the immune system.
IL-6 is only one cytokine--an immune system mediator protein--in a cascade of endocrine hormones and cytokines that are released when the brain signals a person is threatened with harm, injury, undue mental or physical stress or death. The hormones prepare the body to react quickly by increasing heart rate, making muscles more reactive, stimulating thought, altering sugar metabolism and producing many more changes that result in the "rush" people experience when they think they may be harmed.
The cytokine release is mediated by IL-6, which takes the role of directing the immune system to gear up to prevent infection, promote wound healing and repair organs and muscles from any injury that may result from the imminent danger. The release of cytokines such as IL-1, IL-6, IL-8, TNF and other proteins such as CRP (C reactive protein) also promote development of inflammation, which is essential for blood cells to home in on injury or infection. In addition, these chemicals promote development of various types of immune system blood cells in bone marrow. This response to harm -- either real or perceived -- is an important and beneficial life-saving activity of a normally functioning body.
The problem is if this response is initiated over and over again, frequently, and over a long period; it can have a dangerous effect on the body. This constant initiation of the stress response is common among caregivers -- especially those caring for loved ones with dementia. Providing supervision or physical assistance many hours a week and over a period of years turns out to be extremely stressful. This type of stress is often unrelenting, occurring day after day and week after week. And the long-term effects of this stress are more pronounced in middle-aged and older people who are precisely the group most likely offering long term care to loved ones.

In most younger people, when the threat lessens or disappears, the body reacts fairly quickly to shut down the stress response and return things to normal. But numerous studies have shown, as people age, the chemical cascade from stress lingers. Over a period of time, this constant chemical stimulus impairs the immune system and results in early aging, development of debilitating disease and early death. In this altered state, the body maintains high, potentially harmful levels of IL-6. The body does not return to normal without intervention.
Prolonged high levels of IL-6 and the accompanying hormones and cytokines have been linked to: cardiovascular disease, type II diabetes, frequent viral infections, intestinal, stomach and colon disorders, osteoporosis, periodontal disease, various cancers and auto immune disorders such as lupus, rheumatoid arthritis and multiple sclerosis. Alzheimer's, dementia, nerve damage and mental problems are also linked to high IL-6. Wounds heal slower, vaccinations are less likely to take and recovery from infectious disease is impaired. People who have depression also have high levels of IL-6. Depression in caregivers is about 8 times higher than the non-cargiving population.
This debilitating response to chronic stress is not unique to humans. Animals are affected as well. A 2004 PBS Scientific American Frontiers Special entitled "Worried Sick", explored the effect of chronic stress on animals. Observations in the field and experiments on animals exposed to chronic stress, uncovered the same phenomenon of debilitating disease and early death found in humans. Blood tests on the affected animals confirmed high levels of IL-6. The work of Dr. Janice Kiecolt-Glaser's team was also followed in the Special.

STRATEGIES TO REDUCE CAREGIVER STRESS
Ask for help.
Most caregivers are reluctantly thrust into their role without preparation because the need for care usually comes with little warning. Caregivers end up operating in a "crisis" mode--arranging medical care and living arrangements, scheduling care time, providing meals and household chores and so forth. Because they are so stressed and burdened, they rarely take time to find out what resources are available to help them. Ironically, caregivers often sever ties with family, friends and support groups about this time just when help from these people is most needed.
As a caregiver you must ask for help. The stress of going it alone is dangerous to your health. If it's difficult to ask for yourself, use an advocate--a sibling, friend or professional care manager --to arrange a meeting and get formal, written commitments from those people who are willing to help you. The extra help will give you breathing room to find all those resources that are there to help you.
Seek care management advice.
A number of organizations and private companies will give you advice and guidance -- many for free. If your care recipient has a very low income, you might get free help from your local Area Agency on Aging. A lot depends on available funds. Go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm for statewide lists of agencies.
A good source of free professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and these companies will also provide paid aides to help you with your loved-one…such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult daycare or other community services. Go to http://www.longtermcarelink.net/a7homecare.htm for a nationwide list.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. Go to http://www.longtermcarelink.net/a2bfindmanager.htm for a nationwide list of these valuable care specialists. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.
Take time off--find temporary substitutes.
Taking a break from caregiving is just as important as taking a break at work or taking that long-awaited vacation. A care manager may be of help in selecting the best temporary help to give you a break. Or you may make arrangements with family or friends to give you a break from caregiving.
Make plans for funding future care arrangements for you or for a healthy parent.
The analysis of data from three national surveys (Mature Market Institute, National Alliance for Caregiving and LifePlans, Inc) points out that employees caring for disabled elders who have long term care insurance (LTCI) are nearly two times more likely to be able to continue working than those caring for non-insured relatives. In addition, working caregivers of those with long term care insurance said that they were less likely to experience some type of stress, such as having to give constant attention to the care recipient or having to provide care while not feeling well themselves. Also, the group with insurance devoted more "quality time"--more companionship and less hands-on assistance--than the group without.
See if your healthy parent can still buy insurance. If he or she can't afford it, see if other family members might contribute to premiums. There are also useful strategies using a reverse mortgage to buy long-term care insurance and life insurance for your loved ones. You should also consider insurance for yourself so when you need care someday, it won't be so stressful on your caregivers. To learn all about long term care insurance and reverse mortgages go to www.longtermcarelink.net.
Use assistive technology.
There are a number of technologies to make sure your loved-ones are safe while you're away. Such things as emergency alert bracelets and pendants, GPS tracking for wandering, remote video surveillance, telehomecare, sensory augmentation and all sorts of assistive devices to help disabled people cope on their own. Go to www.longtermcarelink.net for more information.
FINDING RESOURCES FOR CAREGIVERS
The free resources of www.longtermcarelink.net are designed to provide you with government provider lists, free care assessments, information and care provider lists for reducing your eldercare burden and the attending stress. The site is a non-commercial source of help. It is the largest and most comprehensive free source of long term care information on the Internet. There are no ads or solicitations or pop-ups. A related site for the veterans aid and attendance benefit is found at www.veteransaidbenefit.org. This is a benefit that could be available to up to one third of all US residents over the age of 65 under certain conditions. It could provide an additional monthly income of up to $1,843 a month for qualifying veterans households.
Stay tuned for additional options that are available to managing caregiver stress!

Happy Holidays?

By Anne Pagnoni

Getting together and celebrating a special occasion with the family can be a wonderful time. It can also be a time when you begin noticing changes in your aging loved one. Perhaps as you celebrated the recent holidays, you noticed that your mother's hygiene isn't what it used to be. You may have noticed that her short term memory is declining or that she has been losing weight. Perhaps she mentioned being lonely during the day but being unable to get out of the house on her own due to physical ailments. You are working and taking care of your own busy family and can't imagine taking on additional caregiving responsibilities even though you want to. So what do you do? Now is the time to call Home Care Assistance.

Home Care Assistance is a full service home care agency offering hourly services but with a specialty in live-in caregivers. Our caregivers are specifically trained in our exclusive Balanced Care Method^TM . Focusing on lifestyle and dietary choices, the Balanced Care Method^TM promotes healthy activity, stress reduction, and social interaction to help seniors live their best possible lives – in the comfort of home. But, what exactly does this mean for your mother?

1. When it comes to physical hygiene, our caregivers are able to provide assistance with bathing, dressing, and grooming. A little help here can go a long way in improving your mom's willingness to interact with others and her own self-image.
   
2. From planning the menu to preparing the meal, the caregiver will ensure that your mother is eating three, well balanced meals per day. If your mother has food preferences or enjoys cooking, then she and her caregiver will enjoy doing this together.
   
3. Exercise. Not a word that most of us like to think about, but it's a necessity nonetheless. Your mom isn't going to be training for a marathon by any stretch, but the caregiver will work to improve her physical stamina. From simply doing stretches and chair exercises to walking to the mailbox or around the block, she won't be sitting in her favorite chair all day long anymore!
   
4. You know the old saying, use it or lose it. It applies to short term memory, too! While our caregivers can't reverse memory loss associated with dementia and Alzheimer's Disease, they can provide social interaction, which has been shown to improve cognitive function. A game of cards, anyone?
   

When it comes to caring for your aging loved one, accept help from the professionals. While this is new to you, it isn't new to us. For more information about Home Care Assistance, please visit our website at www.homecareassistance.com. To be directed to your local Home Care Assistance office, please call 1-866-4-LIVEIN.

Difficulties Facing Stressed & Overwhelmed Family Caregivers

by Anne Pagnoni

Many family caregivers find themselves unprepared for the physical and emotional demands of caring for a loved one and quickly become stressed and overloaded. When this occurs many caregivers find themselves unable to provide the level of care necessary to nurture their loved one at home.

Situation One: The care receiver lives with the care provider

If the caregiver is working outside of the home or has a very active social calendar, then the care receiver often finds him or herself at home alone for the greater part of the day. As a result the care receiver quite often becomes imprisoned by the home environment due to functional limitation. Receiving little or no social stimulus, the care recipient spends day after day sleeping and watching television. Physical exercise consists of moving to or from the bathroom. The care receiver typically will not prepare a meal. Many times drinking and eating are deliberately avoided to lessen trips to the bathroom. When the care receiver lacks adequate food and fluid intake the result is malnutrition and dehydration both of which result in poor mental reasoning and stupor; hence, the cycle of sleeping and television watching continues.

Solution: A home health aide is a great option if you wish to have your loved one remain in your home while being properly care for during your daily absences. In addition to a home health aide, consider having your loved one attend an adult day care center either daily or several times per week. An assisted living community is another viable option if you feel that your home is no longer an appropriate setting for your loved one.

Situation Two: The care receiver lives alone

Care recipients who live alone can be guilty of self-neglect. Self-neglect is when the care recipient is not interested or is incapable of taking care of his or her own needs. Examples of self-neglect include not eating or drinking enough; not tending to personal hygiene including bathing and grooming; allowing garbage to accumulate within the home; having unattended pets, which urinate and defecate in living spaces; and refusing assistance. When a caregiver is providing care to a care recipient who lives alone, it is imperative that the caregiver work to provide a stimulating environment for the care receiver. Self-neglect with or without a caregiver is a form of elder abuse and in some states it is required by law that its existence be reported. A caregiver allowing self-neglect to happen could be criminally charged.

Solution: A home health aide can assist your loved one with meal preparation, bathing, dressing, grooming, and housekeeping. Many live-in caregivers will tend to family pets. For social interaction have your loved one attend an adult day care center or senior center. Seek out the services of a Geriatric Care Manager for guidance on how to make your loved one safe at home.

Situation Three: Failure to bring in outside help

The biggest mistake made by caregivers is not asking for help. The reasons for this vary. Sometimes the caregiver is a child, who is a long distance caregiver, and doesn't fully appreciate the severity of the situation. Other times money can be the big motivator. Stressed and overwhelmed caregivers become so involved with their loved one that they isolate themselves from others. This isolation makes them reluctant to contact those who can help. Regardless of the cause, failure to ask for help or to hire help can have dire consequences on the welfare of the care recipient and the caregiver.

Solution: Ask for help!! Talk to a local home care agency about available options. While you may think that home care services aren't affordable, you may find yourself pleasantly surprised. Contact your local area agency on aging. If you are a long distance caregiver, then enlist the services of a Geriatric Care Manager so that there is someone locally managing your loved one's care.

If you are the primary caregiver for another individual, then please do not allow yourself and your loved one to fall into one of the situations described above. Ask for help. Be involved. Know your options.

Please direct comments or questions on this post to apagnoni@homecareassistance.com. For more information on Home Care Assistance, please visit us at http://www.homecareassistance.com/ or call 1-866-4-LIVEIN.

Travel Tips for Seniors on the Go!

by Dr. Kathy Johnson, PhD, CMC

Going on a trip? Are you traveling by plane, train or bus and you want to pack light? Here are some great travel suggestions for Seniors Citizens who plan to travel for a one week stay to almost anywhere for two:

» If you have to take shampoos, lotions, tooth paste, mouth wash, etc. either buy the small traveler sizes or, if small bottles are available, transfer liquids to these.
» Pack only cotton underwear (3) and cotton socks (men 3 pr.- women one pr. panty-hose, one pr. knee-highs one pr. cotton socks), and roll these to save space (they can be placed into shoes). Note: you can wash these items while there.
» Pack items of clothing to ‘layer’, i.e. one light-weight cotton knit cardigan to wear over two or three different cotton knit shirts or blouses (NO bulky sweaters).
» No more than TWO pairs of shoes (one pr. comfortable walking and one pr. dress), the comfortable clothes will probably be worn in travel.
» Two pairs slacks (you'll be wearing the third pair) or skirts (if preferred). Choose items that can mix/match with everything packed.
» Pack medicines, book/magazine, snack, flat slippers (in case the feet swell) and only other necessary items in the carry-on tote. If there is a necessity for dress clothes, pack these in the fold-up hanging bag; shoes can fit in these, also, along with odd/end items.
» Don’t carry on board anything but the tote and a jacket/coat (when necessary-but don’t pack them); leave the ‘handling’ to others. If going to visit friends/family, and want to take gifts, box them and mail ahead of time; let the postal dept. help! Pack your needs, but pack them wisely! Happy traveling!

Airport Security Measures
Before you go on that senior travel tour make sure to check security measures and what you can and cannot take on board with you. Go to www.tsa.gov and click on “travel and consumers.” You will find a list of prohibited and permitted items for checked and carry-on luggage.

Invest in Portable Luggage
How many of us are still dragging around those heavy pieces of luggage? Well, it’s time for some new pieces! You know the kind that has the expandable tote-handle and wheels! Ah, what relief for our backs! I found these sizes to be so handy: 21″/22″ Carry-on (but don’t carry on :o) 27″ Upright, then add the 15″ Tote (to carry with you containing your medications and other absolute senior travel necessities), and the hang-up/zip-close ’suitor’ that has great extra compartments. These latter two MUST have handles, so you can lap these over either the Upright or Carry-on extended handles, and shuffle along your way! Don’t throw out the old luggage, however; use to store old keepsakes, clothing, books, whatever, and place in the attic to one day give to your grandchildren!

Traveling Off Season, The Senior Way!
Remember when we were younger and took the kids on vacation? And how crowded places of interest were? We had to make reservations far in advance to get a motel room. I’ve enjoyed a much slower pace of senior citizen travel and find it not hard to get reservation when traveling in the ‘off-season’; that is, when kids are back in school! We’ll also be giving families a break by not competing with their ‘time’. So try to plan your trips around this time of year (school summer vacations); you’ll find your trips more relaxing and easier to make plans.

How to Improve Senior Sleep Patterns

How to improve senior sleep patterns.
-Dr. Kathy Johnson, PhD CMC

Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. “sleep hygiene”) as outlined below.

Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don’t conflict with bedtime, and physically comfortable in a quiet and dimly lit place.

Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.

For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these “sleep hygiene” tips and habits are the first steps to take:

Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.

1.Eat a big meal at lunchtime, and have a lighter dinner.
2.Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
3.Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
4.Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
5.Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
6.Avoid television right before bed.
7.Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
8.Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.

If you don’t fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape. Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.

The Need for Outside Help in Family Caregiving

by Anne Pagnoni

Being a family caregiver for a loved one makes for a very stressful situation especially in the long-term. After a prolonged period of time, caregiving can become too difficult to endure any longer, and the caregiver reaches a crisis point. At this point outside help is typically needed.

When someone initially takes on the role of caregiver, he or she is confident and has everything under control. The caregiver is coping well with the situation. However, as time continues and the care recipient begins needing more help, the caregiver may begin to isolate from family and friends. The caregiver starts to feel alone and helpless. If the caregiver doesn’t look for outside help at this point, then the caregiver may begin to find his or her physical health deteriorating. Once the physical health of the caregiver is compromised, the caregiver loses focus and extreme fatigue will cloud judgment resulting in the caregiver being unable to make rational decisions or ask for help. Without intervention, the caregiver may find him or herself requiring care.

When assuming the responsibility of a family caregiver, it is important to enlist the help of outside professionals. A financial planner or reverse mortgage specialist may find funds to pay for professional in-home care services. An elder law attorney can help stave off future legal issues. A geriatric care manager can be a guide through the maze of long-term care issues. A home care agency can provide care services to allow the primary caregiver to take a much-needed break. Having a strong support system in place at the beginning will often make the difference between allowing a loved one to remain at home and needing to relocate to a nursing facility.

Family caregivers need the support of family, friends, and professionals. Doing it alone almost never works. If you find yourself in the position of being a family caregiver for a loved one, take the necessary steps at the beginning to get a support system in place. In the long run you’ll be happy that you did!