Tag Archives: depression in the elderly

Nip Depression In The Bud: Warning Signs to Look For

By Mary Damiano

depressionWhile caregivers are defined as the people taking care of those needing help, they sometimes overlook the fact that caregiving responsibilities can take a toll on their own health.

In addition to physical ailments, caregivers are at risk for depression. Depression can strike anyone, at any age. Caregivers need to be especially aware of depression because of the great load they carry. Many caregivers work at a full-time job and take care of a family in addition to their caregiving responsibilities. They often sacrifice their own health, well-being and social life in order to do everything that needs to be done.

One common denominator among caregivers is the desire and the belief that they must do everything themselves. Often, caregivers do not ask for help, opting instead to inadvertently play the part of the martyr. This leads the caregiver to become overwhelmed and an overwhelmed person is fertile ground for depression to dig in and take root.

The great strain caregivers face on a daily basis can lead to depression. One way to stop depression before it strikes is to be aware of the warning signs. According to the Administration on Aging, here are some red flags that depression might be creeping in:

  • Sad, discouraged mood

  • Persistent pessimism about the present, future and the past

  • Loss of interest in work, hobbies, social life and sex

  • Difficulty in making decisions

  • Lack of energy and feeling slowed down

  • Restlessness and irritability

  • Loss of appetite and loss of weight

  • Disturbed sleep, especially early morning waking

  • Depressive, gloomy or desolate dreams

  • Suicidal thoughts

If you feel yourself exhibiting these behaviors, do not discount them. They should be taken as seriously as you might treat a fever that won’t go away or a persistent cough.

Below are some expert tips on what caregivers in particular can do to stop depression before it gets out of control:

Talk regularly with family, friends, or mental health professionals— it is very important that you do not isolate yourself. Join a local support group, or find one online. Share your feelings so they don’t build up and escalate into problems.

Set limits— this can be hard for caregivers, because they are used to taking on everything that needs to be done. It’s okay to say no to taking on more than you can handle.

Eat nutritiously, exercise regularly and get enough sleep— this can be difficult because of the irregular schedules caregivers must keep. But think of it this way: your body and mind are machines, and they must be properly maintained in order to function at their best. Nutritious food, exercise and sleep are the things that fuel these machines. Just as you would not let your car run out of gas, don’t let your body run out of its fuel.

Let go of unrealistic expectations— caregivers often have unrealistic expectations of themselves, and therefore push themselves to meet these goals. Accept the fact that you can’t do everything. Ask for and accept help, from friends, family and local agencies. Whatever you do, don’t be a martyr.

Keep a sense of humor— we all know that laughter is the best medicine, so go ahead and take a few spoonfuls daily. Relax with a funny movie or TV show. Put on a comedy tape to listen to while you do your chores. Find the humor in everyday things.

For a free 15 minute telephone consult addressing caregivers and their aging loved ones, call 919-803-8025.  Visit Raleigh Geriatric Care Management.

Advertisements

Leave a comment

Filed under adult children of aging parents, aging life care association, aging life care professional, Alzheimer's Disease, assessments, care giving, care planning, caregiver burnout, caregiving, Depression and the elderly, Geriatric Care Management

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

Leave a comment

Filed under adult children of aging parents, aging life care association, aging life care professional, Alzheimer's Disease, anxiety and the elderly, care giving, care planning, caregiver burnout, caregiving, dementia, Depression and the elderly, elder care raleigh nc, eldercare, family meetings, Geriatric Care Management, Having a conversation, humor, laughter in caregiving, NC, Nursing Homes, nursing homes and assisted living, pet therapy, pets, Raleigh, respite, Sandwich Generation, senior care, sibling relationships, support groups

MOST COMMON SYMPTOMS OF ALZHEIMER’S DISEASE

f3fb0b55f6c4ce997e1ff1597daa2268_garry-marshall-alzheimers-580x326_featuredImage

  1. Memory loss that disrupts daily life
  2. Difficulty completing familiar tasks
  3. Challenges with planning and problem solving
  4. Confusion with time and place
  5. Trouble understanding visual images and spatial relationships
  6. Misplacing things and losing the ability to retrace steps
  7. Decreased or poor judgment
  8. Withdrawal from work or social activities
  9. Changes in mood or personality
  10. Problems with speaking and writing

To learn more about reducing stress as a family caregiver, contact Raleigh Geriatric Care Management, http://www.rgcmgmt.com, or call 919-803-8025.  Call for your free 15 minute consultation. 

Leave a comment

Filed under Uncategorized

OCD in Elderly for Caregivers

By Cheryl Ellis, Staff Writer @ caregiver.com

Obsessive-compulsive disorder (OCD) is defined in part by the Merck Manual as “anxiety provoking thoughts and urges.” While the publication (a staple in the medical field for years) notes that symptoms are not often prominent in the elderly, caregivers may disagree.

Early stage Alzheimer’s patients may obsess about minor issues, such as the garbage being taken out. In some cases, it may become a “chicken or the egg” question as to which came first, the OCD or Alzheimer’s.
Since part of OCD involves performing repetitive tasks that balance the anxiety (using hand sanitizer repeatedly to avoid germs), it may not be immediately visible that there is an obsessive component to the elder’s thought process. Grandma may spend twenty minutes wiping out the bathroom sink after she has gone to the bathroom. Part of her extended cleaning out of the sink may be due to poor vision, or remembering something from a past not known by current family.

Elder folks who can identify “habits” begin to disassemble the cycle of worry that accompanies OCD. Dorothy, who is well into her seventies and a former nurse, mentions that she has several “habits” that have cropped up since her husband passed away. “I’ll just go right to the refrigerator in the middle of the night, not turning on the light. That’s a HABIT.” She’s noted others, such as waking up several times in the middle of the night. During family visits, she wakes hardly at all, and concludes she’s conditioned herself to associating being alone with needing to wake up.

A bright woman who applied much rational thought and association in her nursing career, she is still able to do so today. Dorothy emphasizes that recognizing a habit is one thing. “Doing something about it, well that’s another!”
It’s evident that the key to her dealing with these habits is making a connection; but more importantly, she has removed the anxiety component. Acceptance of these behaviors and the knowledge that she will break them when she chooses give her a sense of autonomy.

Caregivers can work toward helping their older family members retain a sense of self-control by remaining calm when “habit” strikes. When Grandma spends 20 minutes cleaning the sink, she can be asked “What makes you do such a good job?” This will open the door for her to make her own connection as to why. The caregiver may learn about the past (“My grandfather was in the military and we had to make sure it was clean and sparkling”). Or they may learn about a contemporary occurrence (“I heard my son say the place is a mess. I don’t want him to think I’m a burden”).

In either case, an artful question combined with a compliment may draw out information. It also allows caregivers to begin the process of reassurance which can decrease anxiety.

OCD is designated as an anxiety disorder, and any type of stress reduction technique that is agreeable to the person and caregiver can help tremendously. Aromatherapy, guided meditation, relaxing music and changes in diet (like reducing caffeine) are alternative methods of stress reduction that may have some impact.

Howard Hughes, famous eccentric billionaire, suffered from OCD. Those who have seen the movie “The Aviator” or who remember accounts from decades before have an idea of how bizarre this individual became. While most people live undocumented lives, we can look at the experiences of individuals in public power to relate to.

The Anxiety Disorders Association of America (http://www.adaa.org/) has a great deal of information to educate the layperson on anxiety in OCD, as well as other types of anxiety. Caregivers may find themselves developing a generalized anxiety disorder in response to the OCD disorder for those they are caring for.

Remember that when elders switch locations (moving in with a child, or to assisted living), they are going “out of the box” and stress factors increase. This increase in stress may turn Mom’s “habit” of cleaning when she is a little nervous into a full blown obsession over time. Work on the root cause, always.

(Page 3 of 3)
Compulsive hoarding or collecting may have developed from not having enough basic supplies during younger years. The cliché “salad days” may literally have meant that there were only vegetables from the garden to eat. A parent who always made sure there was plenty of food in the house may now not only have 65 cans of green beans (bought at scratch and dent warehouses), but stacks of newspaper coupons that are beyond the expiration date.

Instead of cleaning house in one fell swoop, try getting the elder to focus on the abundant stores they have, and how they can help others who are less fortunate. Some caregivers may have tremendous stress when it comes to dealing with the situation. At that point, calling in the “cavalry” of friends and associates who offer vague help is in order.

“I need you to help by going through Dad’s canned goods to find out which ones are expired or near expiration. Can you go with us to donate them to the local shelter?”

Any problems with compulsive hoarding require help. The Obsessive Compulsive Foundation has a website (http://www.ocfoundation.org/hoarding/) designed to guide caregivers. Support groups and other information can be found there. From that point, work on recruiting friends and family to help you with this issue. In the case of animal hoarding, the local Humane Society may be of help. Never, ever give any pet (hoarded or just a small excess) to anyone you do not know, or to any shelter that you do not know.

Even caregivers can have some obsessive compulsive traits develop with the day-to-day caregiving of an OCD elder. Look through information to see where you may have borderline events, too. By working through your own, smaller issues, you may silently be helping your loved one.

Raleigh Geriatric Care Management, http://www.rgcmgmt.com

Leave a comment

Filed under Uncategorized

What is an Aging Life Care Professional ™?

We are still the same, but our name has changed to better reflect what we do and who we are. Our national association, formerly known as National Association of Professional Care Managers (NAPGCM), is now  the Aging Life Care Association™ (ALCA) and care managers are now refered to as Aging Life Care Experts™.

Conflicting demands on your heart, time, and energy can make it hard to care for an aging relative. If this sounds familiar, you could benefit from the services of an aging life care expert.

An aging life care expert provides relief. They work with you and your family member to develop a realistic care plan. The goal of the plan is to maximize your loved one’s independence, safety, and quality of life. A solid care plan addresses family resources. This includes making sure you are not called upon to do more than you are able.

An aging life care expert is a guide and an advocate. These experts are typically trained in the health professions or social work. Many have specialties in elder care. They bring to their role an understanding of the

  • local healthcare system;
  • emotional and physical challenges of aging and/or disability;
  • difficulties of adult children juggling work and family;
  • common legal and financial issues that arise in later life;
  • local housing options and other senior or disabled services.

Aging life care experts use a holistic approach. They begin with a thorough assessment of needs and capabilities. They can often resolve uncertainties and dispel family disagreements. Their emotional support may help your loved one come to terms with this new phase of life.

An aging life care expert’s input may save you time and money. After looking at money and other family resources, they can recommend appropriate housing situations. They can identify veteran assistance and other benefits. They can avoid duplication of medical services and potentially catch problems before a crisis blooms. They can also monitor the quality of care.

An aging life care expert works independently as the client’s advocate.They are not paid through referral fees. Nor are they employees of hospitals or insurance companies. In some cases, their services can be reimbursed by long-term care insurance.

If you think you and your loved one could benefit from the services of an aging life care expert, give us a call at Raleigh Geriatric Care Management, 919-803-8025, http://www.rgcmgmt.com

Leave a comment

Filed under Uncategorized

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

Leave a comment

Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, aging life care association, aging life care professional, alcohol and seniors, Alzheimer's Disease, anxiety and the elderly, assessments, bathing and seniors, care giving, care planning, caregiver burnout, caregiving, caregiving and the holidays, clinical trial studies, dementia, Depression and the elderly, driving retirement, elder care raleigh nc, elder nutrition, eldercare, employee stress, family meetings, Geriatric Care Management, Having a conversation, humor, laughter in caregiving, Long Term Care Insurancee, long term care planning, medication reminders, moving in with family, NC, Nursing Homes, nursing homes and assisted living, paying for home care, Power of Attorney, Raleigh, respite, Sandwich Generation, senior care, senior driving, Seniors and driving, sibling relationships, support groups, tax tips for seniors, travel with seniors

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.


Leave a comment

Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, aging life care association, aging life care professional, alcohol and seniors, Alzheimer's Disease, anxiety and the elderly, assessments, bathing and seniors, care giving, care planning, caregiver burnout, caregiving, caregiving and the holidays, dementia, Depression and the elderly, driving retirement, elder care raleigh nc, elder nutrition, eldercare, employee stress, family meetings, Geriatric Care Management, Having a conversation, humor, laughter in caregiving, Long Term Care Insurancee, long term care planning, medication reminders, moving in with family, NC, Nursing Homes, nursing homes and assisted living, paying for home care, Power of Attorney, Raleigh, respite, Sandwich Generation, senior care, senior driving, Seniors and driving, sibling relationships, support groups, travel with seniors