A national 2008 survey found that about 40 percent of adults ages 65 and older drink alcohol. Older adults can experience a variety of problems from drinking alcohol, especially those who:
• Take certain medications
There are special considerations facing older adults who drink, including:
Increased Sensitivity to Alcohol
Increased Health Problems
Bad Interactions with Medications
Drinking Guidelines for Older Adults
• 3 drinks on a given day
Drinking more than these amounts puts people at risk of serious alcohol problems.
If you have a health problem or take certain medications, you may need to drink less or not at all.
Source: NIH National Institute on Alcohol Abuse and Alcoholism
Tag Archives: home care assistance
By Michael Plontz
Your loved one has been diagnosed with Alzheimer’s. The first thing you want to do is find out all you can about the disease, and all about what you can do to take care of your loved one. It’s a bitter pill to swallow, but, at least you’re an adult and you can understand what’s happening. What about your children? How can you help them cope?
The way in which Alzheimer’s may affect children has to do largely with their relationship with the person before. If they are close to the loved one, the mentally debilitating illness could cause fear, anger, sadness, and confusion. If the loved one is living in the home of the caregiver, it can cause these feelings to intensify.
Fear is usually the first emotion to surface. From the fear of their grandparent or other loved one arises feelings of anger, guilt, and jealousy. All of these feelings can lead to sadness and even depression. Also, feelings of despair and helplessness may result from the loss of the loving relationship between child and loved one.
The best thing you can do for your child or teenager is to be completely honest and keep the lines of communication open. If children don’t understand, they could act out by doing badly in school or withdrawing or becoming impatient with their loved one. Physical or psychosomatic ailments such as stomachaches or headaches may manifest themselves as well. They may have to be reminded several times that Alzheimer’s is a disease, and that the disease is what’s affecting grandma or grandpa.
It is helpful to have answers ready for an inquisitive child’s difficult questions. The following questions are just the tip of the iceberg, but it’s a start.
Q – Is grandma crazy?
A – No. Alzheimer’s is a disease. Older adults are prone to illnesses that may make them forget things or act differently.
Q – Is it my fault?
A – Certainly not. If grandma told you that, it is just the disease talking.
Q – Can I, or my mom or dad catch Alzheimer’s disease?
A – Alzheimer’s is not contagious, so, no, you can’t catch it like you would a cold.
Q – What will happen next?
A – Here the parent must judge how much information the child can handle. The best thing to do is reassure them that you love them mo matter what happens.
With teenagers the questions will probably be a bit more complicated. They can see things from different perspectives. The best thing to do is to inquire about how they’re feeling, and what can be done to make them feel better. Regardless of the age of the child, open communication is the key to success in weathering the Alzheimer’s storm.
~Paula Spencer Scott
Does caregiving actually cause stress? Some surprising new research says no, the real source of the stress lies within the person, not the situation.
After looking at more than 1,200 female caregiving twins, Peter Vitaliano, professor of psychiatry and psychology at the University of Washington, concluded that how stressful caregiving is for you psychologically is more a matter of your genes and your upbringing. Caregiving itself does not cause stress, he says. This new study appears in the Annals of Behavioral Medicine.
Who’s most at risk, according to this research? People who:
- Have a history of depression. “Like putting salt in a wound,” says Vitaliano.
- Grew up with parents who showed a lot of avoidance and fear in response to big stressors (like losing a job).
- Lack resources to help them cope, like social support and finances.
The study also found that caregiving can cause anxiety, which is in turn linked to depression.
This all may sound like splitting hairs. Though this research confirms Vitaliano’s earlier work debunking a causal connection between caregiving and stress, it flies a bit in the face of many, many other studies that link them. There’s even a name for it: caregiver stress syndrome.
This study didn’t specifically look at Alzheimer’s caregiving, whose duration and unique challenges can wear down even the best-adjusted family member. I wonder, would the results look different?
Bottom line: It doesn’t strike me as terribly helpful to be told your stress is the fault of your genes or your family history. If you’re feeling it, you’re feeling it. It’s nobody’s fault — the real question is what to do about it.
File this info in the nice-to-know category. Then go hide in the bathroom for a little deep breathing, a few bites of dark chocolate, and a wish for some respite time to come your way this week.
By Paula Tchirkow, MSW, LSW, ACSW
Not again? You’ve heard that story about Sunday trips in the big black Studebaker at least 100 times. But you sit politely as your elderly mother recalls her grandfather’s rumble seat, running boards, chrome grill and overflowing picnic basket.
It’s likely that your mother has not forgotten that she told you the story before. And she’s not just shooting the breeze or living in the past. Your elderly parent is bolstering her self esteem by reminiscing. Like many older adults, she is engaging in an important psychological process called “life cycle review,” and it’s healthy.
Encouraging an older adult to reminisce is one of the easiest and most effective techniques you can use to boost their confidence and brighten their mood. In fact, it’s virtually foolproof as a method of combating mild depression or loneliness.
Go ahead, give it a try. Next time the Studebaker story comes up, engage your mother. Ask her how many people fit in the car? Did it have a rag top? How fast did it go? What were the roads like back then? And what exactly was in that picnic basket?
The vivid connection to a time when your mother or father felt more alive, happier, successful, and useful reassures them that they weren’t always in their current physical and mental state. Reminiscing helps older adults review past accomplishments and activities, thereby giving them a renewed sense of fulfillment about their life.
Although most people tend to focus on good memories, life cycle review can also help older family members become comfortable with the past. That is, the technique gives older adults an opportunity to admit and accept the parts of their lives that didn’t go as well as expected.
Both the reckoning process, and the acknowledgement of happier times, clears up minor depression, reverses feelings of isolation, and helps parents get back into a rhythm of positive reinforcement that boosts physical and mental well being. To be sure, the benefits of storytelling and review are greatly underestimated.
To discover how valuable life cycle review can be for older adults, here are 10 tips to help you get the process started:
BY BONNIE LAWRENCE
Caring for an aging parent alone is complicated. When your brothers and sisters are also involved, and when care, medical and financial decisions must be arrived at together as a team, caregiving can become even more complex. Your siblings can be enormously helpful and your best support. But in many families, they can also be a source of stress. No two families are ever alike.
In this column, we’ll talk about how to identify the family dynamics that can impact shared caregiving, ways your siblings can help, how to increase your chances of getting that help, and how to deal with emotions that arise.
A visit home. Often, around this time of year, adult children returning home for a visit realize for the first time that their parents are far more frail than they expected. Although Mom or Dad always report they are “just fine” when you make those weekly phone calls, during a visit, you realize that this is not the case. Your parents suddenly seem much older, and you see the memory lapses, or shortness of breath, wavering balance, multiple prescription containers, or other signals of waning health.
Reactions differ among your siblings. Perhaps your sister, who lives two hours away, is angry that her mother is not the source of emotional support she used to be and doesn’t want to accept what she sees; your brother, who lives across the country and only gets home once a year, is stunned by changes he didn’t expect.
You and your siblings talk in whispers about what should to be done to ensure Mom’s safety and care. There is no money for assisted living, even if your mother would agree to it. Someone needs to step up, to see what can be done, to make decisions, to find some help, or even to live with your Mom to keep her as safe and healthy as possible. And it’s determined, often by default, that one person — perhaps the one who lives the closest, or doesn’t have kids, or is the oldest — will take on the role of primary caregiver.
Why sibling tensions can surface as parents need care
People are living longer — but not necessarily in good health. Their adult children may be caring for them for years or even a decade or more. Siblings or step-siblings are coping with a major emotional passage that stirs up childhood feelings and conflicts. But it’s made more challenging when there’s no model for working together as a team to handle the practical, emotional and financial issues that go with caring for someone who is no longer able to be independent. Some families are able to work out differences; many others struggle.
Consciously or unconsciously, needs arise for love, approval, or being seen as important or competent as a sibling. The disagreements now are over care for your parent: who does or doesn’t do it; how much; who’s in charge. At the same time, your parent is very aware — and most likely not happy — that he or she has become so dependent on you.
To help your family navigate through this situation, we offer this advice:
1. Think about, and talk about, family history and dynamics, and how they might affect caregiving. When we get together with our families, many of us tend to slip into our old roles. Maybe one person was the “responsible” one, one was the “social” one, one was the “helpless” one. But do those roles define you today? And more importantly, can you take a fresh look at who your siblings are now in the context of how these roles and assumptions can affect care for your parents?
2. Consider that care for a parent is a shared responsibility. A key concern is who will be the primary care provider(s) and what support other family members can provide. Since this is a role that can progress to more than a full-time job, this is an important decision. Rather than letting assumptions become default decisions (e.g., Barbara is oldest so she will be in charge, or Max needs a place to stay, so he’ll take care of mom), really consider who is most able, willing, skilled, and emotionally prepared to fill this role. Then consider what other family members can contribute in time or money.
3. To help reach the goal of effective shared decision-making, hold a family meeting. Family meetings are a way for siblings, parents and other concerned relatives or friends to try to clarify the situation, work out conflicts and set up a care plan that, ideally, all can agree upon. If the meeting is likely to be contentious, or if you want an experienced, objective voice to guide it, involve a facilitator such as a social worker, counselor, geriatric care manager or trusted outside party who will ensure that all participants have a chance to be heard. You may need more than one meeting. And although emotions might run high, it’s possible to conduct a productive meeting by following a few guidelines:
- Set an agenda for the meeting and keep to it.
- Focus on the here and now. Try not to bring up past or unrelated issues.
- Share your feelings with siblings instead of making accusations.
- Listen and respect the opinions of all participants. Give everyone time to speak.
- Share all information. If possible, get a professional assessment of your parent’s condition from a doctor, social worker or geriatric care manager and send the report to all participants before the meeting.
- As time goes by, use email, online care-sharing tools, conference calling and/or in-person family meetings to help keep everyone abreast of care issues and information.4. Understand and respect that your brothers and sisters might have different ideas about the care your parent needs. It’s hard to accept that your parent now need your help. Unless there’s a sudden crisis like a stroke, adjusting to this new reality takes time. Some adult children have to work through their denial that anything serious is wrong. Others might feel reluctant to get involved, fearing they are “meddling” in their parent’s life.
Yet, to the primary caregiver, the person who is present day-to-day, it’s clear that his or her parent is less and less able to handle everyday needs. They see that Mom requires assistance with grocery shopping and cooking, that transportation and bill paying are problems, or advancing memory loss or fading eyesight or painful joints keep her from normal activities. Her needs are evident and most likely will become more intense.
Working through differences: communication plays a critical role.
- If you’ve held family meetings, everyone concerned should have a clear idea of the medical status of your parent. Focus on the facts.
- REALLY listen to what your siblings have to say. Be willing to compromise and to try new solutions, as long as no one’s safety is jeopardized.
- For the doubters, it may be helpful for them to spend a weekend or even a day as a sole caregiver, to get a first-hand view of the issues.
- Be straightforward about financial issues. Finances are a key component in long-term caregiving, affecting where your parent lives, whether paid outside help is available, whether placement in a facility is a suitable or desirable option, or whether home care is manageable with family support. Overseeing bill-paying and dealing with Medicare and other health care bills is a job in itself, and can be delegated as such.
- Let your siblings know that their help is needed and wanted (if, in fact, it is — see below). Be direct and specific about what tasks you need help with. Even if they live far away, siblings can help with finances, can provide virtual companionship to your parent with frequent phone calls and Skype, or can provide occasional respite or substitute care.
- Keep communication lines open.
Tips for gaining the support of your siblings
- Accept your siblings for who they are. Not everyone thinks, feels or acts the same way, especially when a situation is this emotionally charged. Try to keep your own expectations and expressions of “should” in check, and instead, strive to accept and work with your siblings’ personalities and abilities.
- Be aware of how you ask for help. If you’re angry and frustrated when you’re talking with your siblings, it will come through in your voice. Their reaction will be defensiveness or anger. Likewise, making siblings feel guilty may lead to resentment and tension that will not be productive in solving the problems at hand.
- Figure out what you really expect from your siblings. Do you think they should provide more hands-on care? Help with errands? Visits? A day or week of respite? Financial support? Help with decision-making? Analyze whether you’re able to give up control to allow a sibling to help you, or if you’re unconsciously communicating that you don’t trust the care that someone else provides.Some caregivers really don’t want help, or can’t rely on help from siblings who are undependable or unavailable. If you’re in this situation, admit it to yourself, accept that you’re on your own, and work to make the care as efficient as possible while still attending to your own health and well-being. If other relatives or friends are willing, ask for help from them or from religious communities your parent might have been involved in. Check for resources in your community. When people offer to help, say yes.
- If what you really want is recognition and appreciation from your siblings for all that you do, you can ask for that. (You also need to express your own gratitude when you do get some help.)
- Seek advice from someone outside the family. A mediator, social worker or geriatric care manager may help get past long-standing emotional roadblocks, family competition, controlling behavior, denial, or other issues interfering with successful resolutions.
Conflicts over legal, financial and inheritance issues.
With Durable Powers of Attorney or an Advance Health Care Directive, your parents can designate who will be in charge if they become incapacitated. Sometimes this creates tension among the adult children. If at all possible, this should be discussed at a family meeting and clarified for everyone concerned. An advance directive will outline the types of care that your parent desires at end of life. With this information in writing, a difficult situation is made a little more tolerable.
Some families compensate the primary caregiver for their work, particularly if he or she has cut back on employment to care for their parent. How much the compensation is and who pays it can be covered in a Personal Care Agreement, which is a written contract. This can be reviewed periodically to ensure it reflects any changes in care.
If an inheritance is in question, or if someone feels they should get a larger portion of an inheritance because of their caregiving duties or other reasons, this is another source of potential conflict. Be aware that your parent’s will is his or hers to direct as they like, and is not necessarily representative of who was the “good” son or daughter or who did more or less for their parents.
Sharing care among siblings is a reality that millions of Americans manage on a daily basis. By taking steps to foster positive communication and support one another as much as possible, the challenging role of providing care for elderly parents can be a fulfilling, rewarding experience, which ultimately can bring siblings closer together.
While everyone else is enjoying the hustle and bustle and the joy of the holiday season, there are many caregivers out there who just want the whole thing over with. Caregiving creates a level of stress unmatched by most endeavors. Add to that the extra stress of family gatherings, gift buying, cooking, and other obligations and it is almost unbearable. How can caregivers better cope with this stress on top of stress?
The following tips may help you weather the holidays much better:
Start your own tradition. Often we feel bound by past holiday traditions, but it doesn’t have to be that way. Instead of having 20 family members and guests in your home, and cooking for all of them, try a different approach. Suggest that someone else host Passover or Easter dinner. Or, if your home is the only appropriate one, enlist the help of friends and relatives for everything from cleaning to preparing food. A potluck is a great idea—you can even assign specific dishes to ensure that a complete dinner is provided.
There are great ways to shop non-traditionally as well. The Internet is a fantastic way to shop for food and gifts without leaving home. Another way to shop from home is using catalogs (many people feel uncomfortable about putting credit card numbers out in cyberspace). If you would rather go out, use the catalogs to make lists of specific gifts for each person. That way you know exactly where to go and exactly what to get.
Make sure you leave enough time to enjoy the holidays. It shouldn’t be all about the hustle and bustle.
The motto “Everything in moderation” should be your guide through the holidays. There are many temptations abundant throughout the season—alcohol, sweets and rich food. Go ahead. Have some. Just don’t over-indulge. It may make you sick or uncomfortable even through the following day.
Be prepared for unexpected circumstances. Something may come up, and probably will, so what can you do? If you can, change the situation. If you can’t, accept it and move on. You cannot control life no matter how planned out you believe you have things. Laugh a lot…
Try to keep up on your regular exercise routine, or start one, during the holidays. Walking five times a week is a great way to stay in shape. There is also something about pounding the pavement that helps release frustrations and clears your head. If your looking out your window and the snow is flurrying and drifting, find an alternative. Many health clubs have indoor tracks. If that doesn’t appeal to you, check with the nearest shopping mall. Some open early just for walkers.
Ideally caregivers should have a daily, weekly, monthly and yearly break.
Daily-Half an hour of yoga, meditation, needlepoint, reading, etc.
Weekly-A couple of hours spent away from the house at the mall, library, coffeehouse, etc.
Monthly-An evening out with your friends, a play, a concert, etc.
Yearly-A well-planned (and well-deserved) vacation.
Planning ahead for these breaks is imperative. You may need to arrange for respite care for your loved one.
It can be done. You can care for your loved one, attend to your daily activities, and enjoy the holidays. We all do what we can, and nobody should expect more than that from us. Especially us. Happy Holidays.
In Raleigh, NC contact Raleigh Geriatric Care Management, www.rgcmgmt.com
by Terry Weaver
As an adult, balancing work and elder care can be a challenge whether your parent lives next door or out of state. Add children to this, and the situation becomes compounded. Legal, financial and long-term planning for elder care is crucial, and long distance caregivers need to prepare for travel and time off from work. Face the facts, most older adults want to stay right where they are. They do not want to relocate, even if it means being closer to family. If this is what the elder wishes, as the child, you must respect their wishes.
For people who work and care for an aged family member, (particularly when that family member lives far away), one solution is to hire a professional geriatric care manager. A geriatric care manager is a professional who specializes in assisting older people and their families with long-term care arrangements. Care managers have a minimum of a bachelor’s degree or substantial equivalent training in gerontology, social work, nursing, counseling, psychology or a related field.
Prolonged illness, disability or simply the challenges of aging can significantly alter the lifestyle of older adults. Daily responsibilities can become difficult. Efficient coordination of medical, personal and social service resources can enhance the quality of life for older adults and their caregivers.
Geriatric care mangers assist older adults in maintaining their independence at home and can ease the transition to a new setting, if needed. Geriatric care managers also help:
Conduct care planning assessments to identify problems, eligibility for assistance, and need for services.
Review financial, legal, or medical issues and offer referrals to geriatric specialists to avoid future problems and conserve assets.
Act as a liaison to families at a distance, making sure things are going well and alerting families to problems.
Assist with moving an older person to or from a retirement complex, assisted living facility, or nursing home.
Offer counseling and support.
How do you know when it is time to call a professional? Look for these signs.
Is your loved one losing weight for no known reason? Do they fall?
Is the home unkempt and becoming unsafe? How are meals made? Who pays the bills?
Are they able to(and do they) maintain a neat appearance? Has drinking become a problem?
Is it safe for your parents to drive? If not, who does the driving for them?
Has there been a sudden memory loss or increased confusion?
Of course in order to answer these questions, you’ll have to pay a visit to your long distance loved one, or rely on information from a relative or friend who is close to that loved one. There is no reason to feel guilty about being far away as long as you are doing everything that you can to help. In Raleigh, NC, visit Raleigh Geriatric Care Management, www.rgcmgmt.com