Category Archives: anxiety and the elderly

Leaving Your Loved One Home Alone

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caregiver.com

If it has not already been debated, the possibility of leaving your loved one alone in your home is certainly bound to occur. You will no doubt have many questions to ponder as you decide upon the prospects of leaving them such as, will they attempt to go outside?, will they hurt themselves?, or will they need emergency assistance? This difficult question involves you the caregiver, and your loved one, who was once an independent person. The both of you will usually disagree with the situation, as it is normal for caregivers to feel their loved one cannot be alone, while they believe they are fine and healthy enough to be alone for how ever long. Asking other family members, health care professionals, and other caregivers for advice will go a long way to determining the likelihood of their safety being jeopardized when left alone. Some other important questions to consider before leaving them alone for the first time, or if you are questioning whether they are able to stay alone any longer include:

  • Are they capable of calling 911 or neighbors if an emergency occurs?

  • Can they distinguish friends and family from strangers if they are faced with answering the door or having someone enter the home?

  • If they are hungry, can they prepare and eat a meal without your assistance?

  • Is it easy for them to use the bathroom without your help, or do they require aid every time. Are there any other plans in place if they are not able to go to the bathroom without your help?

  • How does their behavior and temperament change from when you leave to when you return? Do they appear angered or scared at the first sign of you leaving the house?

  • In case of emergency are they able to leave the home and seek shelter outside?

  • Are they aware of smoke alarms and unusual noises, which may trigger danger, or are they likely to overlook all such noises?

  • Do they suffer from Alzheimer�s or dementia, and if so are they likely to wander off and get lost easily?

  • Are they routinely experiencing emergencies, which places their life in jeopardy? Do they suffer from epilepsy, or shortness of breath that may need to be monitored all the time?

  • Do they get lonely easily and feel deserted at the slightest moment of your absence?

  • Can they be destructive at times of stress and sickness and cause damage to themselves and your home in the process?

Depending on your answers to these questions, your decision on the possibility of leaving your loved one home alone should be clearer. If your answers gave you a sense of dissatisfaction, it is in your best interest to find assistance through a family member or home care aide who can stay with them while you are gone. But if the answers to the questions were comforting, you may still be able to leave your loved one alone, although you must regularly check up on their progress to ensure their safety in the future. This is certainly not an easy situation for all involved, but understand your own feelings and be strong-minded when making the most sensible and safe decision for all involved.

Contact Raleigh Geriatric Care Management to speak with a Certified Aging Life Care Professional™ for a no cost 15 minute telephonic consultation.    www.rgcmgmt.com

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Gift ideas for your senior loved one

As the holidays approach, purchasing a gift for an individual with hugs-079dementia can become difficult. Please be sure to keep in mind where the individual is living as to what type of gifts will be appropriate. If they are in a facility be sure to ask the staff there what is best. Below is a list of gift suggestions that can assist family members and friends with this task: Electric coffee or tea pots that turn off after a short period of time

  1. Large desk calendars to mount on the wall
  2. Medication holders—with timer to indicate time to take
  3. Photo albums with names and dates next to each picture
  4. Registration in the Medic Alert®/Safe Return Program®
  5. Simple-to-manage clothing (tube socks, easy on sweatshirts, tennis shoes with Velcro closings)
  6. Gift certificates for hair cuts and manicures
  7. Older music (especially music from the 30’s and 40’s)
  8. Tapes of sermons or church services
  9. Cuddly stuffed animals
  10. Tickets to take them to a musical event or circus
  11. Trip to a shopping mall and lunch
  12. Visit to the local senior center to participate in activities
  13. Bird feeders
  14. Tapes of bird songs
  15. Gift certificates to adult day services
  16. Hugs, Hugs, Hugs
  17. Short visits often

~Alz. Assoc.

Raleigh Geriatric Care Management, www.rgcmgmt.com, 919-803-8025

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Holiday Help: Relieving Caregivers’ Stress

by, Cheryl Smith, Caregiver.com

Who doesn’t feel overwhelmed sometimes by the bustle of the holiday season? Add to that the responsibility of caring for a frail elderly loved one, and burnout is simply a concept waiting to become reality. But wait. If you’re one of the 22 million households providing care for a family member or friend, there is hope. Stress doesn’t have to take the starring role in your family festivities this year.

If you’re like the increasing number of Americans who are trying to offer a sense of dignity to your parent(s), include them in seasonal events and help them stay in their own home, safety is your number one priority.

Most accidents happen at home in unsupervised situations. This season, enlist the help of older children or a spouse, playing games with (Great) Grandma and (Great) Grandpa while you change beds, do the laundry and other chores. Instead of decorating to the hilt, keep holiday décor simple. Eliminate the need for extension cords on the floor and “declutter” your notion of decoration: use colorful paper garlands strung high instead of breakable objects placed within reach. Remove anything a child or a frail elderly person may stumble over. Replace candles with bright centerpieces of fruit or flowers. Keep candy to an absolute minimum to prevent sugar highs and lows.

With the emphasis on “good cheer” during the month of December, the options are many. But don’t wear yourself out trying to make the holidays “happen” for everyone. If you don’t get yourself in a situation where you “overdo” you’ll be more alert to hazards—even emotional ones. Holidays bring emotions to the surface because they hold the most intense memories for your loved ones, and some may not be pleasant. You may find that tears fall for no apparent reason, or that a frail elderly parent suddenly seems gruff or annoyed just when you think everything is fine. Sometimes, the emotional stress of the season makes a frail aging parent seem distant, just when you want to draw them close. We never know what precipitates these reactions; we only have to deal with them. That’s not an easy task, but first and foremost, a caregiver must keep her own emotional balance.

Set a few guidelines as to what you expect from yourself. From the very start, set your intention to be positive during the holidays, and to respond with calmness to upsetting scenarios. Sure, things may come to the boiling point at times, but the resolve not to react in like manner will bring the most effective results. People don’t intend to be grumpy, distant or to give you a hard time. These behaviors may simply be a way of asking for help. The best way to give it is by remaining patient, offering consistent encouragement, and setting safe boundaries.

You cannot make everyone happy at all times, but you can take responsibility for your own emotional highs and lows. Preserve a few moments each day all for yourself. Take a half-hour break while your children entertain the frail elderly with Christmas music from the 30s, 40s and 50s or interview their grandparents about favorite holiday memories. You might enlist the services of a home-help organization to do some of the household chores while you go grocery shopping or simply take a walk. Professional caregivers can also help alert you to signs of stress or special needs that you might not recognize on a day-to-day basis, curtailing accidents or emotional spills.

Keep in mind that a frail person may tire more easily during the holiday season, need more sleep as the days grow shorter, and also need their own “space.” Ask for their help; ask them to let you know what they need and how they want to celebrate. Their answers may surprise you. Above all, an older frail person may crave our respect and our admiration. When we praise the good things they’ve accomplished in life, make certain they know that we appreciate their legacy, and tell them we’re happy they’re with us, things will be a lot easier. If they seem only to complain more, well, just grease the wheel with a little praise for yourself. Send positive messages to yourself out loud and mix in a few more affirmations for them.

The holidays are a great time to slow down instead of speed up. Think about all the things you can let remain undone instead of all the things you need to do. Give yourself a challenge to match the tempo of your frail elderly relatives or friends, and see if you don’t enjoy the season more. And after all, isn’t that what the holiday season is all about?

Contact Raleigh Geriatric Care Management for a 15 minute no cost telephonic consultation:  919-803-8025.  www.rgcmgmt.com

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Creating Fun for Caregivers and Frail Seniors

By Lynn Howe

_1571741_origYour confined-to-home (or assisted living or nursing home) parent, just wants to have fun! You are focused on their safety, finances, medical treatment, medications, privacy, nutrition and therapy. You busy yourself with monitoring their progress (or decline) and doing everything in your power to keep them comfortable. You worry about their reduced energy level, increasing fatigue, physical weakness and variable mental status. But do you know how important it is for them to just have fun? To laugh deeply, live in the moment, to briefly not be just old and frail, to forget pain?

OK, so what can you do? I know that you are thinking, well, they can’t do that much, but you might be surprised at all the options. Too often thoughtful families accommodate so much to their senior’s weakening state that they overlook how much they can do and enjoy! While it’s good to try to bring the world to them with visits, letters, phone calls and email, it’s also important and possible to keep bringing them out in the world. Of course, it may involve more work for you — transporting walker or wheelchair, assisting in/out of cars and doors, walking slowly, negotiating steps carefully, finding bathrooms, keeping him/her dry, warm (or cool) — so be prepared for a different pace and smaller goals. And some cajoling might be needed to just get going.

Mini-field trips

Seniors look forward to having a day out, but as they age, they don’t have the stamina or mobility for trips to fascinating museums, over-stimulating casinos, monster malls, giant sports stadiums, wooded parks, loud modern restaurants, etc. But they may be able to go out for an hour or two. My mom adored a simple trip to the supermarket — colorful flowers, fanciful balloons, acres of fresh, bright produce, bakery smells, energetic families with huge carts. She pushed her walker along, senses on overload, straying down enticing aisles. We didn’t buy a thing. But it was an hour that she talked about for days – a new topic of discussion with her nursing home buddies.
Another day we drove one short mile to a local antique shop. “I had those gold Fostoria glasses,” she pointed out. “Your dad and I would stop at the Fostoria factory store on trips to see my brother in Washington, DC.” Talk about the glassware led to reminiscing about her deceased brother, until she0interrupted herself; “Look at the quilts – just like Grandmother’s.” And so on, pushing her walker forward toward the next memory. After about an hour, she had had enough and home we went.

The first trip to a small local department store just before Christmas involved a little arm twisting. But once there, lights, perfume, soft velvety fashions and just ahead a decorated Christmas tree, worked their magic. She wheeled ahead, touching, smelling, exclaiming. Onward through silky lingerie, cute children’s clothes and glittering jewelry. At about the hour mark, like Cinderella, she was done. She relived it all week.

Recently she and I went to a small jewelry store 10 minutes from her home – she had favorite rings that needed resizing. Instead of just taking them for her, I invited her to come along. For the first time in a long time she became the customer, the center of attention. Soon she asked for a chair, her shopping done. But for her it was a big accomplishment, an errand, like in the old days she so misses.

My father-in-law loved an afternoon drive looking at properties we were considering purchasing. He was curious about these houses we described, their yards, their roofs, the neighborhoods. Since we didn’t even bring his wheelchair or get out of the car, it was like a guided tour. “I’ve been in that house” he’d say. “This was always a good neighborhood” he’d remember. “Let’s see what they are building on that hill.” Other mini trips for him were to the cemetery where his wife was buried, their first house in that area and a volunteer organization they founded. He remembered being a neighbor, a businessman, a father and a contributer to the community.
Other ideas might be a quilt shop for a former quilter, a hardware store for the ardent handyman, the library, bakery, family style restaurant, plant store or flower shop.

Fun at home

You don’t have to go out to have fun of course. Opportunities are right there in their home (or facility) to have fun and fight boredom.

  • Stage a sing-along to his/her favorite music. Play the music loud and clear.

  • Get all dressed up and take some photo portraits – use them for family gifts.

  • Rent/borrow movies for slow afternoons – old ones, funny ones, scary ones.

  • Have a deck of cards on hand and play the old familiar games – gin rummy, hearts, war.

  • Scrabble is great fun with grandkids.

  • Keep a puzzle going if you have a spare tabletop – people coming in always get engaged and stay to talk

  • Get out of the room – visit other residents, attend sing-alongs, presentations, craft sessions, chair exercises lunch groups.

  • Pull out a family album – get them to identify the older ones you may have forgotten and take notes or audiotape the stories you hear. Family photos trigger floods of memories.

  • Pick a theme for the week or month. Decorate his/her room and door. It will bring people in to check it out and or conversation.

  • Rearrange furniture and pictures – just for stimulation.

  • Order in or pick up some favorite foods that aren’t on the regular menu – hot dogs for my mom, milkshakes for my husband’s dad.

  • Manicures and pedicures are a special treat too. Have candy for drop-in guests and gifts for visitors – order online; think about birthday and holiday gifts and ‘shop’ on line.

  • Make up a Christmas, holiday or birthday wish list from the web – send it to family members. So think about what your loved one has always enjoyed, listen to what they talk about, look around your neighborhood and give it a try!

Call Raleigh Geriatric Care Management at 919-803-8025 for a FREE 15 minutes phone consultation. lwatral@rgcmgmt.com       www.rgcmgmt.com

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Considerations for Caregivers

By Arthur N. Gottlieb

Caregiving is not for everyone. Remember, it’s not about you. If the relationship is too emotionally charged or patience is not your best virtue, find someone else to take over the primary role of caregiver.

It is important to reflect upon your motivations for being a caregiver and to make an honest assessment of your limitations.

As a caregiver you may at times feel powerless and sad. But an experience laden with difficulty may also provide opportunities to strengthen relationships with loved ones, and for the development of one’s own personal and spiritual growth.

About Visits
Focus on the quality of interactions with a loved one, not on the quantity.

Consistency and predictability of visitations are important, especially for the homebound.

Communication Skills
Learn the healer’s art of “bearing witness.” This means listening empathically and suppressing the urge to intervene with solutions.

When speaking to someone in bed or in a wheelchair, sit down or otherwise lower yourself so that you are at the same eye level as they are. This will distinguish you from others who remain standing, essentially looking and speaking down to them with the unspoken but inherent power differential this implies.

Choose your battles wisely. Attempting to address an irrational situation with rationality is generally futile, and will increase conflict with no resolution

The hearing impaired are often too prideful to admit that they haven’t heard most of what you just said, and are hopeful that they can eventually figure it out.

Those with mild cognitive impairment are still quite capable of comprehension, but the thought process may have slowed down a little. Be patient and speak slowly.

Restoring Dignity
Asking for a senior’s opinion about a non-provocative issue may offer them an opportunity to feel respected and still relevant.

At the dinner table when others are present, if a person needs to have their food cut for them, discreetly take the plate back into the kitchen and cut it there. This will add an unspoken but important element of dignity for those being cared for.

Residential and Financial Concerns
The attitudes and behaviors of many seniors are oftentimes driven by an unspoken fear of abandonment.

When parents do not feel that their children have made wise decisions for themselves, they are naturally hesitant to turn over financial control to them.

It was not uncommon for senior women to have deferred to their husbands’ judgment when choices were being made about financial and property issues. If now widowed, they may feel more comfortable acting in accordance with someone else’s say-so for important decision-making.

It may be illuminating to discover what memories a senior has of his or her own parent’s convalescence. What would they, as caregivers, have done differently? Had they promised themselves they would never go to a “nursing home”?

When a senior is facing the prospect of moving to a continuing care or assisted living community, speak to them about what they think this will be like. Many will have a stark vision of facilities from many years ago when options were relatively limited.

About Moodiness
Seniors will experience good days and bad days due to effects of pain, adjustment to medications and or emotional issues.

Seniors who seem short-tempered may be responding to the frustrating lack of control of not being able to think as quickly, and remember as well, as they once had.

Psychology of Seniors
Understand and be prepared to recognize the issues that trigger depression and anxiety for seniors.

Be sensitive to anniversary depressions. Birthdays, anniversaries, and major holidays evoke memories of those who have passed, and independence lost.

For most, losing control of physical functioning is difficult. Experiencing the steady loss of friends and relatives leads to sadness and isolation. For those with dementia, witnessing the gradual loss of one’s own self can be the ultimate loneliness.

If a senior is grieving the loss of a loved one they think died yesterday, even if that person actually died years ago, their grief will be as deep and painful as though it just happened.  This is legitimate suffering and must be handled with empathy.

Oftentimes, a parent will have a set of expectations of how they deserve to be treated by their children based on the sacrifices they made on behalf of their own parents. When children do not meet these expectations, resentment, depression and various forms of acting out behavior are the result.

Some seniors harbor lifelong prejudices that were carefully concealed. It can be quite distressing for a caregiver to discover that their parent has “all of a sudden” developed a shocking taste for racial bias. The gradual loss of mental functioning allows one to become “dis-inhibited”; thoughts, formerly suppressed due to social constraints, are now out in the open. This applies for latent sexual desires as well, especially for men.

Denial
If the person you are caring for continually puts off medical diagnosis, they are using the defense of denial in the service of their fear. If they are never diagnosed, then they never have to face the reality of being sick.

For Senior Men
More often than not, senior men went along with the social arrangements made by their wives. If a man becomes a widower, he may feel out of place socializing with others on his own. Additionally, since women outnumber men of this age group, a man may feel he is betraying the memory of his wife when engaging in social situations involving mostly women.

Religion and Spirituality
It is important to understand what a person’s religious or spiritual beliefs are. Does he or she believe in an afterlife? Are they concerned over what is in store for them when their mortal life ends? Are they disillusioned  or angry with God?

Restore and Maintain Balance
It is essential for you, as a caregiver, to leave time for your own introspection and emotional balance. Engage in activities that serve to cleanse toxins and stress from the body and spirit.

Engage the help of others when necessary to de-stress and achieve perspective.

Rest and relaxation are critical in order to prevent “caregiver burnout.”

Raleigh Geriatric Care Management Aging Life Care Professional  www.rgcmgmt.com

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Geriatric Care Manager—>Aging Life Care Professional

WHAT IS AN AGING LIFE CARE PROFESSIONAL?

An Aging Life Care Professional, also known as a geriatric care manager, is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. The Aging Life Care Professional is educated and experienced in any of several fields related to aging life care / care management, including, but not limited to nursing, gerontology, social work, or psychology, with a specialized focus on issues related to aging and elder care.

The Aging Life Care Professional assists clients in attaining their maximum functional potential. The individual’s independence is encouraged, while safety and security concerns are also addressed. Aging Life Care Professionals are able to address a broad range of issues related to the well-being of their client. They also have extensive knowledge about the costs, quality, and availability of resources in their communities.

Aging Life Care Professionals become the “coach” and families or clients the “team captain,” giving families the time to focus on relationships rather than the stress. In Raleigh, Durham, and surrounding area, contact Raleigh Geriatric Care Management, an Aging Life Care member.


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Are You the Middle of a Triple Decker Sandwich?

Kathy Birkett, Senior Care Corner

Many baby boomers have grown to think of themselves as part of what has been termed the “sandwich generation”, caring for their aging parents or grandparents and their children at the same time. Calling that simply a sandwich overlooks a very important part of the equation, unfortunately the same part many boomers overlook — yourself.

Sharing information about the Triple Decker Sandwich Generation is an attempt to get boomer caregivers to realize the portion of the sandwich in the middle needs care as well. So often we find family caregivers putting their own needs on hold to address the sometime overwhelming needs of their children and senior loved ones.

No one in the multiple layers of the sandwich benefit when a caregiver ignores her or his own needs to focus totally on the needs of others. For some reason, though, we have been taught to feel like we’re being selfish when we think of ourselves. Just the opposite is true however.  When we take time to take care of ourselves, we put ourselves in a better position to give our best to others.

What happens when you shove your needs aside for too long? There are many reports of stress related disease and depression among boomer caregivers. Certainly being the middle “deck” of the sandwich can contribute to that. Focusing on the health care needs of others but ignoring your own can have serious consequences, especially for those entering a time in their lives where medical visits should be growing more – rather than less – frequent.

Being a Caregiver to Yourself

Taking care of that middle deck of the sandwich doesn’t mean simply looking after yourself, but those aspects of your life that are also necessary to your well being.

  • caring for a relationship with a spouse, partner or friends who help complete your life
  • putting appropriate focus on the job that provides the income needed to support the other aspects of your life (and hopefully some fulfillment)
  • hobbies, sports or other activities that let you get away from the rest of your life for a while
  • anything other aspect of your life that is important to you and allows you to decompress

The first step in caring for the middle deck of your family sandwich is to recognize that you and your needs are important and need to be met. Take some time for yourself and think about those needs putting plans in place to address them, just as you do to meet the needs of your children and senior loved ones for whom you care.

How do you care for yourself and your needs when it already feels like there are too few hours in each day? Can you substitute technology for some of the effort you put in already? There are a growing numbers of devices and programs that bright people have developed to meet the needs of people like you. There might just be an app for that!

In order to fully care for yourself to care for your family, you have to give yourself permission to put yourself in the sandwich instead of on the side of the plate. Some days will be harder than others to find time for your needs, but don’t give up. You will feel stronger when you have met your needs and be more able to be a loving and competent caregiver to the rest of the sandwich layers in your life.

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