Using the Holidays to Your Advantage

The holidays are the time of year when even far away family members travel in order to gather together. This makes the holidays the perfect time to do some planning for the future. With parents aging and their health and lifestyles changing, children need to discuss some changes and decisions that will be needed in the near future. Parents should take the time to tell their children where important documents are kept and what their wishes are in the event of needing health care directives or experiencing long term care needs.

For those children who live away, the change they see in their parent's health and mental capacity may be alarming -- whereas siblings that have daily contact are working with these issues constantly. Here is the chance to compare notes and work together as a complete family in the long term care planning process.

For you parents who are well and active, this is a good time to hold a family meeting and share with your children your plan for long term care. Tell them where financial and legal documents are located. Review health care directives, living wills and long term care alternatives.

Experience has shown that even families that are close can quickly grow angry, jealous and hostile towards each other when an aging parent begins to need long term care. If a sibling moves into the parent's home, others can easily be suspicious of ulterior motives and fear losing their inheritance. On the other hand, the child who assumes the role of caregiver becomes bitter and feels there is no support or help from siblings. Meetings for the purpose of making a plan, before eldercare becomes imminent, avoids these types of conflicts.

In its book, The 4 Steps of Long Term Care Planning, the National Care Planning Council provides guidelines and checklists for family planning meetings. Here are some suggestions as taken from the book:

• Get all interested persons together in one place at one time. Taking advantage of the holidays or another special event can be a great way to get everyone together. If this isn't conducive, then perhaps a special dinner might be an incentive.
• Depending on the circumstances surrounding the meeting, the facilitator can be the parent, caregiver, family friend, or a professional advisor. 
• The agenda can be formal or informal. If you want a formal agenda, then a care plan should be prepared prior to the meeting and presented to all attendees. The facilitator should work to encourage input from everyone involved through active discussion.  
• After a thorough discussion of the issues and the presentation of the solutions to the problems that will be encountered, there should be a consensus of all attending to support the plan. It is not always possible to please everyone so there must sometimes be compromise.  
• The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. GET IT IN WRITING! All good intentions seem to be forgotten with time. It may be years after this meeting before the long term care plan begins.

The U.S Department of Health and Human Services states: "No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future."

Whether you plan a formal meeting with an agenda or informally gather for a discussion, when the family is together make it a point to start the long term care planning process. There is a lot to learn and many decisions to make concerning finances, health issues and legal work. It may take research and a lot of time to put a plan together, but if everyone is involved it will work, and be worth it.

For more information, please visit Home Care Assistance or the National Care Planning Council. 

 

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!

 

The Perfect Holiday Caregiver: It’s All a State of Mind

by Anne Pagnoni

The holidays are always a wonderful time of year for family gatherings, reflection on what we have and the spirit of giving. The television is packed with specials showing relationships and families coming together for the holidays. But the holidays can also be a time of stress and sadness for those who are caring for family members that are struggling with health problems, frailty, dementia and loss. Those who care for these individuals may feel overwhelmed, frustrated, depressed or resentful as they watch “perfect” families enjoying the holidays. There are many surveys and documents that show that caregivers are highly susceptible to these feelings. If you are a caregiver, there are measures you can take to avoid this.

First: you are not alone.

If you are new to caregiving or have been caring for someone for a very long time, remember that the perfect family on television is not reality for many Americans. You are not the only one with these challenges. A recent study by the National Alliance for Caregiving and AARP found that 44.4 million Americans age 18 or older are providing unpaid care to an adult. In fact according to the survey provided by the National Family Caregivers Association:

• The typical caregiver is a 46-year-old Baby Boomer woman with some college education who works and spends more than 20 hours per week caring for her mother who lives nearby.

• Female caregivers provide more hours of care and provide a higher level of care than male caregivers.

• Almost seven in ten 69%) caregivers say they help one person.

• The average length of caregiving is 4.3 years.

• Many caregivers fulfill multiple roles. Most caregivers are married or living with a partner (62%), and most have worked and managed caregiving responsibilities at the same time (74%).

Second:  find help.

There are many resources available to a caregiver. Some of these include family members, friends, a local religious group, elder care agencies and homecare providers. The internet provides many great resources and help. The National Care Planning Council offers many articles, brochures and local referrals to help caregivers find the help that they need.

“When my husband’s stepfather was released from the hospital in December of 2009, he called us to give him a ride home. Once he was home, we quickly realized that he was not able to care for himself at all. He lived alone and we found ourselves driving back and forth three or four times a day to assist all of his needs. It was overwhelming and frightening to suddenly become a caregiver to a man we weren’t even that close to. With my husband working full time days, I became his primary caregiver. I would pack up my two little girls every day to come with me to take him to the doctor, do his laundry and feed him his meals, do his grocery shopping and help him with his bills. I had no idea what his finances were like or how to pay his medical bills. He was too sick to care or even understand what I was saying to him. I quickly realized I was going to have to find help. First I called his children. They were sympathetic, but gave all kinds of excuses as to why they could not help. Next, I went to the internet. I went to the website for National Care Planning Council www.longtermcarelink.net and found and contacted a Care planner in my area. The Care Planner came to my stepfather’s house and met with the two of us. They helped me get organized and set up time to meet with someone to explain his Medicare services and what my next steps would be. It was such a relief to have a plan and to know what to do.” MH- Salt Lake City, Utah

Most family members are willing to help, but just don’t know what to do. Many caregivers feel that they are the only one who can give the best care. It is important to communicate with other family members about what kind of help you need and let them know specifically what they can do.

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. Click here for a nationwide list of agencies.

A good source for professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and will provide paid aides to help you with your loved-one with such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult day care or other community services.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. 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.

Lastly: it is important to take care of yourself first in order to give effective and loving care.

Stephen Covey tells a story in his book The Seven Habits of Highly Effective People about a man who is sawing a tree. A woman approaches and asks the obviously exhausted man how long he has been sawing the tree. He tells her that he has been there for hours.

She says “Well, I see that your saw is dull, if you would just sharpen your saw you would be able to saw it much faster and with less effort.”

He replies, “I don’t have time to stop and sharpen my saw, I need to chop this tree down now!”

It seems pretty silly that the man just doesn’t stop for a few minutes to make the work easier. It is common for caregivers to do the same thing. They focus on caring for their loved one and run themselves down instead of stopping to “sharpen their saw”.

Covey states that “sharpening the saw” is to take care of yourself by keeping your physical, mental, emotional and spiritual self balanced. There is joy and respite in balancing all of these areas in our life. This is what makes us efficient and happy. Here are some ways for you as a caregiver to sharpen your own saw:

• Maintain a positive attitude. Take time to be grateful for everything that is good in your life. There is always something. Adjust your expectations for the holiday season. If you aren’t expecting that perfect holiday family picture, then you won’t be angry and frustrated that it isn’t something you have right now. It is always possible to change your attitude and perceptions, but it is not always possible to change your circumstances.

• Eat healthy food and be sure to get some exercise. Do this in small increments if it is too overwhelming to plan menus. Drink more water, cut down on sugary snacks, pick up some vegetables and fruit to grab. Walk or do marching in place. Run or walk up and down stairs if that is all the time you have right now.

• Forgive and let go of frustrations, anger, resentment and guilt. These are common feelings for caregivers. The best thing a caregiver can do for their own emotional health is to clear out these negative thoughts and feelings. Get counseling, talk to a friend or family member or simply write down the negative feelings to get them out of your system. Never take your anger and frustrations out on those you care for.

• Take time to do something you enjoy and give yourself a little bit of rejuvenation everyday. Laughter is a great stress reliever. Find something funny to read or get on the internet and find a funny video to watch.

• During the holidays, be easy on yourself. If you enjoy holiday activities, then get out there and do them. Ask someone to help with your caregiving duties even if it is just for an hour or two to shop or to see a concert or movie. There are day care facilities or home care services available for short term care. See www.longtermcarelink.net for a service in your area.

Being a “perfect” caregiver during the holidays does not have to look like the perfect on-screen holiday family. How you handle your circumstance will be the key to creating your own peace, happiness and cheer during the holiday season. The holidays can be a time of reflection on good things. Your attitude and a little care for yourself can make a big difference in the care that you give in the coming year.

Safer Travel for Those with Dementia

December is a time when many families are planning to travel to visit family and friends. Whether you're considering a weekend getaway or an extended stay, traveling with an individual who has Alzheimer's requires additional thought and preparation. 

Additionally, as Alzheimer's progresses, negotiating changes in environment will become increasingly challenging. Be prepared for the individual with the disease to experience some confusion or disorientation. Exercise caution, as wandering and getting lost are more likely during transitional times. The checklist below will help you plan for the trip and make it successful and safe.

Before going persons with Alzheimer's and their caregivers need to be prepared for a change in schedule and environment. Even if it is a trip you have taken before, it may feel new for the person with the disease. 

• Call the Alzheimer's Association chapter in the area you will be visiting. Let them know you will be staying in the area and ask about available resources. You can locate any chapter by calling 1.800.272.3900 or visiting www.alz.org/apps/findus.asp.
• Enroll the person in MedicAlert^® + Alzheimer's Association Safe Return^®, a 24-hour nationwide emergency response service for individuals with Alzheimer's or a related dementia who wander or have a medical emergency. You may also want to consider the Alzheimer's Association Comfort Zone^TM, powered by Omnilink, a Web-based GPS location management service.
• If you are already enrolled in MedicAlert, update your records with temporary contact information (call 1.888.572.8566).

Upon arrival

• Let the neighbors know a person with Alzheimer's is staying next door and ask them to keep their eye out for wandering or other unsafe behavior.
• During the first few days after arrival, keep your schedule light with lots of down time.
• Create opportunities to re-acclimate the person to the new environment.
• Keep familiar things around.
• Limit access to money and credit cards.
• Limit access to driving.
• Be aware that the change can be chaotic for the person.
• Recognize the warning signs of anxiety and agitation.

For more tips on safety for people living with Alzheimer's disease and related dementias, including concerns about wandering, disaster preparedness, home  and medication safety, visit the Alzheimer's Association Safety Center at www.alz.org/safetycenter  or call 1.800.272.3900 to find the Alzheimer's Association chapter closest to you.