Activities for People With Alzheimer’s Disease

It is universally recognized that elderly people with dementia lose their short term memory first and their long term memory last. For example, they often remember people and events from their earlier years, but have difficulty remembering what they ate for breakfast the day before. A short summary of some activities include the following:

1. Reminisce! Everything you do together lends itself to reminiscing. If the person can still speak fairly well, say, “Tell me about…” If his vocabulary is more limited, you may have to facilitate the story. “Do you remember when…” As you bake cookies together you can talk about residents’ favorite cookies, meals, etc.
2. Read aloud and use visual aids such as memory poems, family pictures, or stories about “the days gone by” stimulate reminiscences. Ideas include Chicken Soup for the Soul series and Yesterdays by NaDezan, and other short stories
3. Make music. Sing, hum, whistle, dance. Singing brings oxygen to the brain to help you think more clearly. Dancing exercises other parts of the body. Both increase your own sense of well-being as well as the well-being of the residents! Have music activities and entertainers visit. Choose the residents’ favorite cassettes.

4.  Sensory stimulation activities could include the following:

• Making lap quilts.
• Painting.
• Talking books.
• Scrap books.
• Walking!
• Flower arranging.
• Tutoring, or visiting with children.
• Baking.
• Happy hour with non-alcoholic drinks.
• Ice cream party.
• Brushing & fixing a resident’s hair.
• Manicures.
• Ladies luncheons.
• Building with wood (include sanding).

Although these activities are written for residents of a retirement community or a nursing home, they certainly could be utilized for private use as well. Keeping the mind and body active are important for everyone, but especially your loved one with dementia. Do something that is enjoyable for both of you, and it makes it that much easier. Raleigh Geriatric Care Management assists adult children of aging parents. caregiver.com

Is it time for Assisted Living?

by Paula Spencer Scott

The decision to help an aging adult move out of a current home is a complex one — both emotionally and practically. Above all, you want the person to be safe and well. How can you all feel more confident about whether circumstances suggest that your loved one should no longer be living alone?

1. Big-picture signs it might be time for assisted living

Keep the big red flags in mind. Certain situations make it more obvious that it’s wise to start thinking about alternate living arrangements.

Look for:

• Recent accidents or close calls. Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.
• A slow recovery. How did the person you’re caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter’s cold develop into untreated bronchitis?
• A chronic health condition that’s worsening. Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or precipitously, but either way, their presence means your loved one will increasingly need help.
• Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs and IADLs are the skills needed to live independently — dressing, shopping, cooking, doing laundry, managing medications, and so on. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert’s view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

2. Up-close signs it might be time for assisted living

Give your loved one a big hug. Clues aren’t always visible from a distance; especially when you don’t see the person every day, you might learn more through touch.

Look for:

• Noticeable weight loss. Does the person feel thinner? Are clothes loose, or has he added notches to his belt? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight; check the fridge and watch meal-prep skills.
• Seeming more frail. Do you feel anything “different” about the person’s strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.
• Noticeable weight gain. Common causes include an injury slowing the person down,diabetes, and dementia (when someone doesn’t remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.
• Strange body odor. Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.
• Changes in appearance. Does the person’s hair and makeup look all right? Are clothes clean? Someone known for crisply ironed shirts who’s now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

3. Social signs it might be time for assisted living

Think realistically about the person’s social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

• Signs of active friendships. Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or moved away, moving to a place where other people are around could be lifesaving.
• Signs that your loved one has cut back on activities and interests. Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing interest in almost nothing is a red flag for depression.
• Days spent without leaving the house. This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being “locked away” in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.
• Someone who checks in on a regular basis. If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system, or a daily calling service?
• A plan for a worst-case scenario. If there’s a fire, earthquake, flood, or other disaster, is someone on standby to assist? Does your loved one understand the plan?

4. Money signs it might be time for assisted living

Riffle through the mail. Your loved one’s mail can offer an often-overlooked clue to how he or she is managing money, a common early warning sign of cognitive trouble.

Look for:

• Snowdrifts of mail in various places. Finding lots of mail scattered around raises concern about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential tripping hazard.)
• Unopened personal mail. Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.
• Unopened bills. This can indicate that your loved one is having difficulty managing finances — one of the most common first signs of dementia.
• Letters from banks, creditors, or insurers. Routine business letters aren’t worrisome. But it’s alarming if they’re referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.
• Thank-you messages from charities. Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease). Some charities hit up givers over and over, and your loved one may not remember having donating the first time.
• Lots of crisp, unread magazines. The person may unknowingly have repeat-renewal subscriptions he or she doesn’t need.

5. Driving signs it might be time for assisted living

Take a drive — with your loved one behind the wheel, if he or she is still driving. Living independently in our culture often depends on the ability to drive (or the arrangement of alternate transportation options).

Look for:

• Nicks or dents on the car. Notice the car body as you get in and out. Damage marks can be signs of careless driving.
• Whether the person promptly fastens his or her seatbelt. Even people with mild dementia usually follow the rote basics of driving. It’s worrisome if he or she is forgetting this step.
• • Tension, preoccupation, or being easily distracted. The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain — a safe kind of self-policing but also signals of changing ability.
• Signs of dangerous driving. People whose driving ability is impaired are more likely to tailgate, drift from their lane, go below the speed limit, react slowly to lights or other cars, and mix up gas and brake pedals. See 8 ways to assess someone’s driving.
• Warning lights. Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?

6. Kitchen signs it might be signs for assisted living

Go through the kitchen, from fridge to cupboards to oven. Because people spend so much time in this room, you can learn a lot.

Look for:

• Stale or expired foods. We all buy more than we need. Look for signs that food is not only old but that this is unnoticed — mold, sour milk that’s still used, or expiration dates well past due, for example.
• Multiples of the same item. Ten bottles of ketchup? More cereal than can be eaten in a year? Multiples often reveal that the shopper can’t remember from one store trip to the next what’s in stock at home.
• A freezer full of TV dinners. Your loved one may buy them for convenience sake, but frozen dinners tend not to make healthy diet. If there’s not much fresh food in the house (because it’s too hard to for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.
• Broken appliances. Check them all: microwave, coffeemaker, toaster, washer, and dryer — any device you know your loved one uses (or used to use) routinely.
• Signs of fire. Are stove knobs charred? Pot bottoms singed badly (or thrown out)? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen; ask for the story behind what you see. Accidental fires are a common home danger for older adults.
• Increased use of takeout or simpler cooking. A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

7. Around-the-house signs it might be time for assisted living

Look around the living areas. Sometimes the most obvious sign is hard to see because we become so used to it.

Look for:

• Lots of clutter. An inability to throw anything away may be a sign of a neurological or physical issue. Obviously it’s more worrisome in a neatnik than in a chronic slob. Papers or pet toys all over the floor represent a tripping hazard.
• Signs of lax housekeeping. Spills that haven’t been cleaned up are a common sign of dementia — the person lacks the follow-through to tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.
• Bathroom grime and clutter. A common scenario: Your loved one makes an effort to tidy up living areas but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time (the one off a bedroom, for example). Here you may see a truer picture of how your loved one is keeping up.

8. Pet-care and plant-care signs it might be time for assisted living

Be sure to check out how the other living things are faring. An ability to take care of pets and plants goes along with self-care.

Look for:

• Plants that are dying, dead, or just gone. Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect, especially in a former plant-lover’s home.
• Animals that don’t seem well tended. Common problems: dogs with long nails, cat litter boxes that haven’t been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.

9. Home-maintenance signs it might be time for assisted living

Walk around the yard. Yard maintenance — or lack of it — can yield clues that your loved one isn’t faring as well at home alone anymore.

Look for:

• Signs of neglect. Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.
• Newspapers in the bushes. Are papers being delivered but ignored? Sometimes people pick up those they can see on a driveway but not those that go off into the yard.
• Mail piled up in the mailbox. Go out and check — it’s an indication that your loved one doesn’t even retrieve it regularly.

10. Get help looking for signs it might be time for assisted living

Get the input of others who know your loved one in order to collect a fuller picture of reality. Gently probing about what others think isn’t nosy; you’re being loving, concerned, and proactive.

Look for:

• Input from those in your loved one’s circle. Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn’t get out much (“She doesn’t come over anymore.” “She quit book club.”). Pay attention to comments that indicate ongoing concerns (“Has he had that heart test yet?” “We were worried the day the ambulance came.”).
• Medical insight. With appropriate permission, your loved one’s primary doctor may share your concerns about his or her patient’s safety at home — or may be able to alleviate those concerns or suggest where to get a home assessment.
• A second opinion. A social worker or professional geriatric care manager visits older adults’ homes and does informal evaluations. While your loved one may initially resist the notion of a “total stranger” checking on them, try pitching it as a professional (and neutral) second opinion, or ask the doctor to “prescribe” it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they’re loathe to admit to their own children or family.

11. Caregivers’ signs it might be time for assisted living

Finally, realize that some of the information you collect is intangible — it has to do with feelings and emotions, and the stress levels of everyone involved.

Look for:

• How you’re doing. While this decision to remain in one’s home is not primarily about you — the son, daughter, grandchild, caregiver — your own exhaustion can be a good gauge of a decline in older adults’ ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one’s need for care is just plain wearing you out, or if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it’s time to start looking at other options.
• Your loved one’s emotional state. Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons.

If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it’s worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.

If, on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.

How to Handle An Aging Crisis

Unfortunately, life isn’t a smooth, straight road as you grow older.

Your husband could break a hip without a second’s warning or your Mom might simply forget to eat one week. Events that throw you into crisis mode happen more and more frequently as you age. But by taking the proper steps and leveraging the best resources, you can prepare yourself to deal with crisis when it strikes and get your loved one’s life back on track.

Below we have compiled some of the more common crisis situations you might encounter and given you the best game plan to resolve these issues:

1) A neighbor found your mother a mile away from her home. She didn’t know where she was, how she got there or how to find her way back.

Now’s the time to get Mom evaluated for dementia. She may need the security of a dementia unit at a skilled nursing facility or a retirement community.

2) When you visit your 90-year-old aunt, who lives alone, you noticed that she hasn’t bathed and her clothes are dirty. The food in her refrigerator is going bad. She may even be forgetting to take her medication.

Home care or an assisted living facility could help your aunt take care of the important activities of daily living that she’s having trouble with on her own. This interaction could also provide socialization she may be missing.

3) Your husband fell and shattered his pelvis. After he’s released from the hospital, he needs regular physical and occupational therapy, but driving him every day will be a hardship for you as well as cause him undue pain.

With a two or three-week stay in a short-term rehabilitation facility, your husband can receive the concentrated therapy and specialized care he needs and return to his regular activities more quickly. This also gives you the time to prepare your home for his return.

4) You live with your Dad, but worry about whether he’s eating right or mobile enough when you have to go to work during the day.

While you’re away, home care can fill your shoes, if your Dad prefers to remain at home, or if he needs the socialization, adult day care may be the right fit.

5) Your children want to take you on a cruise, but your wife, who suffered a stroke, needs your round-the-clock care.

You can feel confident that a respite care facility will take good care of your wife during the 10 days you are gone and you can enjoy a much-needed vacation!

—

There are a variety of crises that seniors can encounter that will require your immediate and informed response. By checking out the local resources available to you and your loved ones, including geriatric care management (in Raleigh, NC,  Raleigh Geriatric Care Management  home care, skilled nursing facilities, assisted living, hospice, adult day care and respite care, you’ll have solutions—rather than anxiety—should a crisis be around the corner. ~Senior’s Guide

What are the benefits of hiring a geriatric care manager?

• Help meet goals of older adult and all involved.
• A care manager’s knowledge, education, training, and experience can objectively help set realistic expectations while addressing obstacles that might be present.
• Often families are overwhelmed with the many options presented. A care manager can efficiently streamline decision making.
• As a neutral third party with knowledge of issues of older adults, a care manager can often help resolve conflicts that a more emotionally involved party can’t.
• A care manager can often be a cost-effective alternative to families doing it themselves. Knowledge of entitlement programs, the elimination of often hours of research, reduction of time off from work and crisis-based travel can prove to not only provide positive outcomes but save time and valuable financial resources.
• Avoid problems. The proactive nature of care management can help avoid many of the unfortunate problems that face older adults. Supervising caregivers, home safety precautions, and safe financial management can be vital parts of a care manager’s role.
• Avoid family conflicts. Having a facilitator to assist with difficult decisions can maintain family stability. Difficult decisions including end of life, driving, and relocation can be addressed in a positive manner.

~~excerpt from caring.com, Brad Prescott

In Raleigh, NC, Contact: Raleigh Geriatric Care Management, http://www.rgcmgmt.com, lwatral@rgcmgmt.com

Tips and Techniques for Dealing with Stress

by Dr. Rita Gugel   Change is an expected part of our daily lives today. Dealing with it so that YOU control IT rather than vice versa is an important and positive force in controlling your life. Try a few of these tips. 1. Accept what you cannot change. Take a tip from AA. Change what you can, if it bothers you. But, if you cannot change it, learn to live with it. 2. Face up to your problems. Sort them out, and see which ones are real and which are simply imagined. Deal with them as they are, and not what you think they are. 3. Deal with one problem at a time. Sort out your priorities, and deal with them in the order of their importance to you. 4. Be flexible. Give in once and a while. If you do, others will too. 5. Don’t hold all of your worries inside yourself—talk it out. Frequently we swallow our unhappiness (along with candy, cake, ice cream, etc.) because we can’t let the problems out. Talk to someone. A burden shared is much less of a burden. 6. Work off Stress. Physical outlets for stress help your body to fight off many of the negative results of stress. 7. Get enough rest/relaxation/sleep. Give your body a chance to recover from day to day. Lack of sleep and rest will only make matters worse for you. 8. Avoid “self medication.” A “spoonful of sugar” may make the “medicine go down,” but it does your body no good. Sugar, alcohol, nicotine, and ice cream may all feel good going down, but they make matters worse—from the inside. They add to your body’s physical stresses, thus making dealing with external stresses much harder. 9. “Take time to smell the roses.” Have some fun. Relax. 10. Think about and do something for others. A little altruism never hurt. It even makes people feel better about themselves. 11. Be the “captain of your ship.” If you are not happy with your life, think about what’s wrong or missing, and then plan the necessary actions to change it to coincide with your needs and desires for your life. 12. Work on your relationships with those who share your life. Don’t hold back your feelings. Share them with your family and friends and co-workers. It can help to decrease tensions.

Five Myths About Medicaid’s Long-Term Care Coverage

While Medicare gets most of the news coverage, Medicaid still remains a bit of mystery to many people. The fact is that Medicaid is the largest source for funding nursing home care, but there are many myths about exactly who qualifies for it and what coverage it provides.  Here are five myths followed by the real story.

1. Medicare will cover my nursing home expenses. Medicare’s coverage of nursing home care is quite limited. Medicare covers only up to 100 days of “skilled nursing care” per illness. To qualify, you must enter a Medicare-approved “skilled nursing facility” or nursing home within 30 days of a hospital stay that lasted at least three days. The care in the nursing home must be for the same condition as the hospital stay.
   
2. You need to be broke to qualify for Medicaid. Medicaid helps needy individuals pay for long-term care, but you do not need to be completely destitute to qualify. While in general a Medicaid applicant can have no more than $2,000 in assets to in order to qualify, this figure is higher in some states and there are many assets that don’t count toward this limit. For example, the applicant’s home will not be considered a countable asset for eligibility purposes to the extent the equity in the home is less than $536,000, with the states having the option of raising this limit to $802,000 (in 2013). In all states, the house may be kept with no equity limit if the Medicaid applicant’s spouse or another dependent relative lives there. In addition the spouse of a nursing home resident may keep one half of the couple’s joint assets up to $115,920 (in 2013).
3. To qualify for Medicaid, you should transfer your money to your children. Medicaid law imposes a penalty on people who transfer assets without receiving fair value in return. This penalty is a period of time during which the person transferring the assets will be ineligible for Medicaid, and the length of the penalty period is determined, in part, by the amount of money transferred. The state will look at all transfers made within five years before the application for Medicaid. That doesn’t mean that you can’t transfer assets at all — there are exceptions (for example, applicants can transfer money to their spouses without incurring a penalty). However, before transferring any assets, you should talk to an elder law attorney. 
   
4. A prenuptial agreement will protect my assets from being counted if my spouse needs Medicaid. A prenuptial agreement only works to keep property separate in the event of death or divorce. It does not keep your property separate for purposes of Medicaid eligibility.
5. I can give away up to $14,000 a year under Medicaid rules. You can give away up to $14,000 a year without incurring a gift tax. Under Medicaid law, a gift of $14,000 or any other significant amount could trigger a penalty period if it was made within the five-year look-back period.

Elderlaw News, Mary Markovich

Family Money Fights

 

by Carolyn Rosenblatt

Let’s imagine that you have an aging loved one who has cognitive impairment. You are aware that your loved one is “slipping.” You tell yourself it’s OK. You do nothing more than try to pay closer attention. You may ignore the fact that if your loved one has dementia, it’s not going to get better. You ignore the reality that if a person develops dementia, he or she is not going to be able to manage money for very long and that alternatives must be in place. Then something happens that brings you to a crisis.

It may be loss of money to a scammer. It could be huge mistakes in careless spending. It could be that bills aren’t paid and the utilities are cut off. Whatever the event, it brings you and your family to the boiling point. Some are angry. Others may still be in denial. A family fight breaks out. Siblings accuse each other of wrongdoing. The elder accuses you of plotting against him. It’s a nightmare.

If there is one recurring theme we see in working with families who have aging parent issues, it’s conflict about finances.

Whether siblings are arguing with each other over how to pay for a parent’s care, or it’s about Dad mishandling the checkbook after being diagnosed with dementia, it’s a source of enormous distress. Part of the problem is that when an aging parent’s mental capacity begins to decline, it is subtle, uneven, and can be hidden for a time. Most families are in denial about cognitive impairment. It’s just too painful for so many to accept and take in.

Adding to the stress of a parent’s cognitive impairment is the consequence of denial: Money issues arise and no one is prepared to deal with them.

Here are some suggestions for avoiding those nightmare fights over money that can be prevented by planning ahead.

1. If you have a loved one with cognitive impairment, whether officially diagnosed as dementia or not, be sure you have the critical legal documents you need properly prepared and signed. You need a durable power of attorney for finances and an advance healthcare directive. Do not wait. Eventually, your loved one may be unable to sign any legal document. Lack of signed legal documents can force you into court for a guardianship (conservatorship in California) and cost time and money you don’t need to spend.
2. Educate yourself. You need to know what assets your aging parent has, what debts exist, and whether any arrangements, such as long-term care insurance, are available to help with the cost of care. You need to know what income your parent receives and how that income is being spent. If you or your family members are able to contribute to the cost of caring for an aging loved one, including providing some care yourselves, be sure you write down the agreements as to who will do what. Strive for equity. Most of us can do something to help, even from a distance.
3. Seek advice from a qualified financial advisor to use any assets you have in the best way possible to care for your loved one. He or she may seem fine now, and able to manage independently. With cognitive impairment, this independence will not last. It is typically, with any form of dementia, a progressive and deteriorating condition. Not everyone is ready to handle the behavior changes, the need for constant supervision, and the need for helping with activities of daily living that dementia causes. It costs a lot to hire help and give family relief from the often burdensome responsibilities of long-term dementia care.
4. Have a family meeting to discuss the need for care and the sharing of responsibilities. Someone needs to take leadership and develop an agenda for topics that should be discussed. Identify them and be sure everyone has the same information well before the meeting. Everyone should be allowed the chance to speak and give his or her views. If there is no one in your family who is good at leading a discussion, get outside help from an experienced mediator,  geriatric care manager, or social worker. The cost of help is well worth it in guiding your family to good decision making.
5. Include your aging loved one, even with cognitive impairment, in the planning process as much as possible. This does not mean that you allow an impaired person whose judgment is not intact to make all the decisions. Ask your loved one for his or her preferences. Respect your parent’s values as much as possible. And use your own good judgment to keep your elder safe. He may not be able to see or understand his own cognitive problems and may think he is fine to manage money, drive, live alone, etc. If he can’t see the problem, step in and assume the necessary role of parenting your parent.

No one needs to experience the heartache of family fights over aging parent finances. With smart planning, you and your family can weather the storm of a parent’s cognitive decline with dignity. And you can know that you’ve done everything possible to make this part of your aging parent’s life the best it can be.

The New Female Problem

by Patricia Grace

In the halls of the nation’s businesses, the hushed whispers which were once reserved for gossip and Monday morning quarterbacking now echo the despair stressed out women are feeling in their role as caregivers. While men do represent a growing percentage of today’s caregivers, the role is still largely filled by women. In what could be considered the new “female problem” in the workplace, male management does not have the tools to adequately discuss and remedy this female ailment.

Caregiver Stress Defined

An individual’s face may not readily give away clues that they are suffering from caregiver stress, but a quick look at their employee attendance record will reveal absenteeism due to their work as a caregiver for an aging loved one. The fact that this individual has a higher utilization of the healthcare benefits and increased prescription plan participation for stress-related disorders may also warrant their classification as a caregiver.

Stressed out caregivers are susceptible to a whole host of problems as their immune system becomes compromised under the weight and associated guilt of caregiving. Migraine headaches and GI disorders are just the tip of the iceberg when it comes to the impact caregiver stress has on individuals. Caregivers overwhelmed by stress are also highly susceptible to depression. Individuals need to learn to recognize when their caregiving duties are getting the best of them.  Identifying community resources that offer services to caregivers and their loved ones can be just the prescription needed to bounce back.

Businesses and the overall economy are negatively impacted by caregivers who are emotionally drained by the burden of their role. The financial component of caregiver stress is far more reaching than that individual’s wallet. The trickle down effect of the disorder hurts all of our pockets as it robs employers of nearly $ 33.6 billion.

The Role of a Geriatric Care Manager

A GCM is a professional with expertise in geriatric or aging issues. They are a local resource with firsthand knowledge of the services available in your community.  Boomers living at a great distance who are concerned if their parent is safe in their own home can avail themselves of geriatric care management services for peace of mind with ease. Often the task of navigating the maze of senior housing and financial options associated with eldercare can put a strain on the parent-child relationship. A GCM can bridge the gap and facilitate discussion that leads to decision-making.

Geriatric care managers can assess, facilitate and
coordinate placement while providing family members the education they need to make informed decisions.  This education not only gives individuals a better understanding of the process, but it enables them to overcome the guilt and stress they may be carrying. Professional geriatric care managers consult with the family members and take into consideration their psycho-social and clinical needs, financial concerns and geographical desires.

Focus on Funding

Gaining an understanding of the finances associated with eldercare can cause a caregiver’s stress to reach an all- time high level.  Working with a geriatric care manager can put the funding solution you were looking for right at your fingertips. Aging specialists are experts on the VA Aid and Attendance bill as well as astute in Medicare and Medicaid issues.  Certified geriatric care managers can dispel any funding myth you may have heard and give you an indication of your eligibility for assistance.

 

In Raleigh , NC, Geriatric Care Management is provided by Raleigh Geriatric Care Management

How to Share Caregiving Cost

4 Ways to Figure Out Who Pays for What

By Paula Spencer Scott, Caring.com senior editor, and Carol O’Dell, Caring.com contributing editor

Figuring out household finances can become a real sore point for family caregivers. After all, having someone living in your home raises the cost of basics, like food and utilities. And if multiple family members help care for a loved one, it can be challenging to track who paid for what. Here are some ideas that can help:

1. Call a family meeting to establish big-picture principles.

When it comes to money issues, it’s important to lay the cards — including the credit cards — on the table, with all the relevant parties involved. Work out a general approach to spending that everyone can get on board with. Once a year, hold a special meeting to address big expenses coming up, such as a new roof or a faltering washing machine.

2. Keep a receipt box.

If multiple caregivers are involved, tracking expenses is critical so that nobody later complains of spending more than his or her fair share. Have a clearinghouse system in which all receipts — for medication and drugstore supplies, medical co-pays, hairdresser appointments, and so on — are deposited in one place, with the payer’s name indicated. Some families find it useful for one member to track individual spending on a spreadsheet.

3. Work out a single rent check.

Track bills for a month or two and compare them to life before your loved one moved in. Come up with a single figure that includes proportional amounts for electricity, heat, food, and other basics. This eliminates dickering over individual bills every month, while allowing your loved one to feel as if he or she is contributing. (It works in reverse if younger family members move in with an older generation.)

4. Set up payment systems.

Another approach is to decide together on a general system for how bills are to be paid. Some families choose to use one credit card for medication, another for supplies or food, and so on. If your loved one insists on writing checks, look into having another family member’s name on the account. In the event the person becomes too ill or disabled to physically write checks, access to this account won’t be lost.

Convincing a Loved One to Go to a Nursing Home

By Marie Marley

Virtually no one wants to either live in a nursing home or place a loved one in such a facility. However, according to Linda Breytspraak, Center on Aging Studies, University of Missouri-Kansas City, “Today, people over the age of 65 have about a one-in-four chance of spending time in a nursing home.”

Most elderly people who have a clear and compelling need to be in a long-term care facility desperately want to remain in their own homes. They want to be in a familiar setting and be close to their family members.

Family members are often adamantly opposed to the idea as well, even when a nursing home is clearly what is needed. It may be that a spouse previously promised to never put them in a nursing home. It could also be that a child made the same promise to a parent. In many cases, it’s even more difficult because a loved one’s objections usually make the family member(s) feel guilty about the very idea of institutionalizing them.

The decision to place a loved one can be agonizing, but caregivers need to consider the following:

Long-term care placement can be the most loving choice when absolutely needed to ensure the person receives all the necessary care, is around others for social stimulation, and is in a safe environment.
Their promises (if any) were made years earlier when no one could have foreseen the current conditions that are urgently requiring the kind of care that a nursing home provides.
Caring for a loved one is probably seriously affecting their own physical and mental health and wellbeing. No one can be a good caregiver if they are exhausted and burned out all the time.
“I often work to convince reluctant spouses to change from being a ‘caregiver’ to being a ‘care advocate,’” says William G. Hammond, founder of the Elder and Disability law firm in Overland Park, Kansas. “They can then be vigilant to ensure their loved one is receiving appropriate treatment in the facility while preserving their own health.”

Many people, however, flat out refuse to go. In such cases, you can try to convince them that it’s best for their own health and wellbeing. If that doesn’t work, you may enlist the help of another family member or even the person’s physician to talk with them. People will sometimes pay more attention to the advice of someone other than the primary caregiver. However, if the person is mentally competent and continues refusing, there may be very little you can do about it unless their health is in imminent danger.

If your loved one has dementia and is resisting placement, it can be more complicated, but there are several strategies you can use. First of all, try those listed above for loved ones who don’t have dementia. You may also obtain the services of a geriatric care manager, who can often guide you through the process.

Another approach is to use what is referred to as “compassionate deception.” You can convince the person to go for a limited period of time, such as a week. Then you stretch it out to two weeks, then three, and eventually they will probably adjust to being there full time. If a loved one is significantly impaired, he or she may even forget they were supposed to go back home. Or they may not be aware they aren’t at home.

You may also make arrangements for a facility to allow you to take the person there, saying you’re going to visit someone there or you have dinner reservations there (or some other reason for visiting). Then when you leave, don’t take them with you. You will probably feel terribly guilty, but the person will almost certainly adjust. This may take a few days or, in rare cases, a few weeks, but your loved one will probably come to know the facility as ‘home,’ and they are not likely to remain angry with you.

If none of the above suggestions work and you have power of attorney, you may have to enlist the help of law enforcement. According to Hammond, “You should do this only as a last resort. It’s only for the most severely impaired people and the most dire circumstances – such as if the person becomes a danger to him or herself or others.” Law enforcement typically takes the person to a hospital geriatric psychiatry unit for evaluation and treatment, from where they may be released to a nursing home.

“If all else fails and you don’t have power of attorney,” says Hammond, “you may face costly and potentially embarrassing court action in order to be appointed the person’s guardian or conservator. You can then make all decisions for them about where they will live.”

When you must take a demented person against their will and/or go to court to get guardianship, however, consult a local elder law attorney for advice because laws vary from state to state. You can call your local bar association to get a referral.