Tag Archives: transitioning
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
When caregivers take on the responsibility of caring for a loved one, we expect our lives to change. What is unexpected, and often goes unnoticed, is the forfeiting of our own well-being in order to become a primary caregiver.
Ask yourself the following questions. If you answer, “Yes,” to any of them, you need assistance. Support groups, your loved one’s social worker, your physician, counseling or therapeutic centers and a number of other community resources can help you in providing greater balance between your caregiving responsibilities and your well-being.
Have you stopped communicating with friends you had before you became a caregiver?
Do you lack time to participate in activities that make you feel good?
Is your caregiving role negatively affecting your personal relationships?
Have you failed to have a check-up lately or find you do not follow the doctor’s recommendation for you own health?
Does your loved one need, but not have, a monitoring device?
Has your loved one become abusive towards you?
Have you noticed you are becoming verbally, physically or emotionally abusive to your loved one?
Are you drinking or taking drugs to cope with stress or distress?
Has your sleeping pattern changed since becoming a caregiver?
Do you feel you are not getting enough sleep?
Do you refuse to let others assist you, or give your respite, for fear something will happen if you leave you loved one in another’s care?
By Estee Bienstock, R.N.
Depression affects more than 20 percent of our elderly population, aged 65 and older (U.S. Department of Health and Human Services, 2009). For many, depression presents initially late in life. Depression in older persons is closely associated with illness or injury and can cause great suffering for the individual and the family.
Feeling down from time to time, due to life struggles, is normal. Depression, on the other hand, is a REAL medical condition in which a person has feelings of sadness, loss of motivation, and lack of self-confidence. The feelings of hopelessness and helplessness prevent one from enjoying everyday life and affects overall daily functioning. There is a loss of interest, even in one’s family, friends, work or social activities. Depression is often described as “living in a black hole.” Getting through the day can be overwhelming.
There are many reasons why our treasured elderly family members experience depression. These include:
- Loss of a close family member (spouse) or friend
- Chronic pain or illness
- Difficulty with mobilization
- Frustration with memory loss
- Difficulty adapting to life changes (i.e., moving residence)
- Reaction to an illness
- Side effects of medication
Depression varies from person to person and the symptoms are varied. Women have a greater risk of depression than men. Women tend to have feelings of guilt. Deprivation of sleep is frequently a problem. Women tend to either lose weight or gain weight. When men suffer from depression, they often see it as a sign of weakness. They tend to be more aggressive, angry, violent and reckless. Men have a higher suicide rate. (U.S. Department of Health and Human Services, 2009)
Other symptoms people may have when suffering from depression include:
- Loss of interest in activities of daily living such as social interactions, work, family gatherings
- Disturbed sleep patterns
- Irritability, agitation, and restlessness; loss of energy, feelings of fatigue
- Self loathing, feelings of worthlessness; frequent crying
- Decreased concentration, difficulty focusing, unable to make decisions,
- Headaches, gastrointestinal disturbances, muscle aches, and weakness
- Abnormal thoughts about death
Depression can be difficult to identify in the elderly and is often untreated because many people think that depression symptoms are a normal part of aging or a natural reaction to chronic illness, loss, or dramatic changes in social transition. Contrary to popular belief, depression is not part of the normal aging process. Many elderly people and their families do not recognize the symptoms of depression, are not aware that it is a medical illness, and are not familiar with treatments. It is natural to feel grief in the face of major life changes, such as leaving a home of many years or losing a loved one. Sadness and anguish, natural responses to major life changes, are normal, temporary reactions to the inevitable losses and hardships of life. However, depression is a medical disorder that continues for prolonged periods. Depression requires professional treatment to reduce the intensity and duration of the condition.
Deteriorating health, a sense of isolation and hopelessness, and difficulty adjusting to new life circumstances often combine to create untenable living situations for the elderly. Suicide in our elderly population far exceeds the general population as a whole.
Fortunately, the treatment prognosis for depression is good. Once diagnosed, 80 percent of clinically depressed individuals can be effectively treated. Medication is effective for a majority of people with depression and the elderly respond the same way. (Adams et al, 2007) Medications can be combined with supportive psychotherapy or cognitive behavioral therapy to improve effectiveness. Psychosocial treatment plays an essential role in the care of older patients who lack social support or lack coping skills to deal with their life situations.
Suggestions for activities for skill building with the elderly patient with depression include:
- Utilize music as a distraction from worries and an assist for relaxation; try it as a sleep aid before bedtime
- Organize interactions with pets as a relief from loneliness; ask friends or neighbors to visit with their pets regularly
- As a focus for new growth, assist the patient with nurturing a seedling
- Select readings as a stimulant for conversations about feelings
- Encourage reminiscence and sharing of recollections for posterity to increase feelings of self-worth
Caregiver skills that are important to nurturing our elderly patients with depression include:
- Be patient
- Acknowledge the sadness
- Resist giving advice, but hone your listening skills
- Do not pass judgment
- Promote realistic expectations
Deteriorating health and advancing age present problems for the patient and their loved ones. Issues associated with depression can lead to family conflicts, even more isolation, financial strain, abuse of drugs or alcohol, and thoughts of suicide. Depression, left untreated, prevents elderly loved ones from enjoying life as they have in the past.
A strong support system is often helpful to both the caregiver and the senior person’s well being. Find sources of help for caregiver tasks. Contact family, friends, neighbors, church/synagogue, workplace, Area Agency on Aging or other organizations. Keep looking!
Family physicians can have a significant impact on the health and well-being of the elderly and their caregivers. Family physicians can educate caregivers on behavioral management techniques and coping strategies. By providing the holistic approach to care for patients and caregivers, family physicians can help prepare families for the many phases of this challenging role and allow the patients to feel safe with their dignity left intact.
Raleigh Geriatric Care Management, www.rgcmgmt.com
By Hilary Wright
Abuse isn’t happening just to toddlers and young children, but is becoming more common among the senior citizens in this country. Unable to take care of themselves, they must rely on a professional or family caregiver to help them from day to day. If you have a loved one who must depend on care from someone other than yourself, you may want to know the tell-tale signs of the many forms of abuse that they may be afflicted with.
Sometimes, an elder may report an incident of physical abuse; however, they often won’t, so you’ll need to look for other behavioral and emotional signs, like depression or withdrawal from family and friends, changes in behavior, i.e., mood swings or appearing frightened and teary eyed. Sometimes, the abusers themselves will give clues to possible abuse by their refusal to take the elder to the doctor when needed, by not allowing family and friends to see the abused person alone, by giving explanations which are found to be inconsistent with the abuse symptoms. They may have bite marks and scratches themselves, from an elder fighting back.
Signs of physical abuse:
Cuts, lacerations, welt marks (a possible sign of using restraints)
Burn marks from cigarettes
Malnutrition or dehydration
Hair loss from someone grabbing/pulling hair
Sores on the body, open wounds
Weight gain or weight loss
Poor skin conditions
Unexplained injuries, such as fractures and breaks
Bruises, scratches, bite marks, finger prints
Frequent trips to the emergency room
Black eyes, broken fingernails
Over or under medicated
As much as people don’t want to think about it, sexual abuse does occur among the elderly. It’s considered sexual abuse when something happens either without their consent or when an elderly person is incapable of making such a decision on their own. Physical signs of sexual abuse may include:
Bruises around the breast or genital area
Cuts or lacerations around the breast or genital area
Clothes with blood stains or tear marks
Soreness around breast, genital, or anal areas
Difficulty with walking or sitting
Some older people may report sexual assault, while others may withdraw from family and friends, flinch at certain quick movements, or be frightened by the opposite gender. The abuser will usually have a story that will not match the physical or emotional evidence noted by family members, and they will generally not allow family or friends into the home or to be around the abused person alone.
Not all abuse can be seen with the naked eye. There’s also emotional and psychological abuse that occurs when a person is demeaning and dehumanizing to another person. Psychological and emotional abuse can also make someone withdraw into depression or even deny that anything bad is actually taking place. You may catch the abuser talking down to the person, calling them hurtful names, and begin to withdraw the elder from visiting with family and friends.
Behavioral signs of psychological abuse:
Continuously emotionally upset or disturbed
Nervous behavior and a repetition to their actions
Agitation or anger
Rocking back and forth, sucking their thumb, or even biting (themselves or others)
Financial abuse occurs when a caregiver takes advantage of an elderly person financially, either through stealing money, lying about how much the elder needs for certain care, or cashing the elder’s checks without permission.
Signs of financial abuse:
Caregiver withholds money from the elder
Checks are cashed without permission of the elder
Personal belongings begin to disappear
Power of Attorney begins to be misused
Caregiver isn’t actually providing the services that are needed
Elders aren’t taken to the doctor when needed
You notice unusual items being charged on a credit card
You notice the elderly person requesting a transfer of assets or funds
There’s sudden and abrupt changes in a will
They are not aware of where all their money has gone
Suddenly, they are unable to pay their bills
They are unable to buy clothes, food, and other necessities
You notice withdrawals of a lot of money at the same time or within the same week
Another form of abuse is neglect and abandonment, occurring when an elderly person isn’t being cared for properly, like not being fed, bathed, or properly medicated. Ignoring an elder is also considered a form of neglect and abandonment, because the caregiver refuses to give them any sort of care. The signs of neglect and abandonment can sometimes be noticed with a simple inspection of a loved one, where you may see things like untreated sores or bed sores, malnutrition and/or dehydration, unsanitary living conditions, or dirty bed linens and clothes. You may also notice a strong odor coming from a loved one, due to the lack of continual hygiene, or obvious weight loss or weight gain. Sometimes an elder will actually begin begging you for food, or tell you they have some medical or dental need that hasn’t been tended to.
Although it’s no excuse, caregiver abuse, either by a family member or by a professional, often occurs due to caregiver burnout, caregiver stress, substance abuse, emotional and mental issues of their own, economic conditions or living arrangements. This doesn’t mean that all caregivers are abusers, because very few are; but it’s better to be informed and educated for the safety of your loved one. If it’s a family member who is a caregiver for someone disabled or elderly, you can take some preventative measures in order to prevent it from occurring, or to at least notice it at the very earliest stages. Educate yourself on the signs and symptoms of caregiver stress; make sure the caregiver is receiving help from others, so they don’t have to do everything on their own, which can quickly lead to caregiver burnout; and investigate other living arrangements, in order to take an elderly loved one out of a toxic, ultimately unsafe environment. Elderly people don’t have to be a target for others, especially by those who are supposed to care for them. Older people can also take some important steps on their own in order to make sure they remain safe from abuse of all kinds:
Don’t live with a family member who is or has been abusive in the past.
Speak to friends often, especially when you feel as though you are being taken advantage of.
Review your will. If changes are made, be sure it is because you want them to take place, not because of pressure from family members.
Have friends and/or neighbors visit you often.
Seek legal advice when making decisions.
Have your Social Security or pension check deposited directly into your account.
Speak directly to your attorney first before signing a Power of Attorney.
Don’t sign anything until you’ve read it. If you have difficulty understanding the legal terms, make sure to seek out an attorney and have them explain it to you.
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
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.