Caregiving and the Holidays

It is always interesting this time of year in the "caregiving" business. We will usually get more phone calls after Thanksgiving and Christmas from the adult children who just visited their parents. They are often surprised by how their parents have changed since the last visit. They are often concerned for their parents safety. If you or someone you know is in this type of situation, it is a good idea to bring the matter up while you are together and face to face. Make sure your loved one knows that you want to work together to solve what issues you are concerned about. It also makes sense to ease into a solution rather than jump in with both feet. If you feel in home care may be needed but the senior is a little reluctant, propose 3-4 hours 3 times a week. They not only get comfortable with the help but actually look forward to it! Then if you feel the need to increase the care, it will be a lot easier.
Perhaps meals are an issue. Work together for a solution. Throw out several options and let your parent decide. Offer an in home personal chef, ready made meals delivered from a grocery store or meals on wheels, if they qualify. Always include your loved one as much as possible in finding an answer to a problem. Have them take "ownership". The last thing you want to do is for them to feel that you are taking away their independence.
We have found that the more you include your parents in the decision making, the easier the situation becomes! Always ask questions and work things through out loud. You may think you have the perfect solution but you may be unaware of a concern because you didn't ask a specific question. Ask, ask and ask again.
And of course, relax and enjoy the family time!

Met Life AiP2.0 Report

Please take a moment and read this fantastic report from Met Life and Louis Tenenbaum. It is quite the interesting report for ALL Baby Boomers!


http://www.metlife.com/mmi/research/aging-in-place.html#methodology




(You may need to copy and paste the above link)

Click "download report"

Medicare Watch Newsletter

Here is some interesting advise from the Medicare Watch Newsletter regarding a person's rights upon admission when a skilled nursing facility says that Original Medicare will not pay for your care will depend on whether the facility will agree to admit you anyway.

If the facility will NOT admit you because it believes that Medicare will NOT pay, you MUST find another facility.

If the facility will admit you but believes that you do not qualify for Medicare coverage, you do have the right to ask the facility to bill Medicare anyway. This is called DEMAND BILLING.

When the facility believes that Medicare will not cover your care because your health doesn't require the need for the skilled facility or you only need custodial care or non medical care, the facility must give you either a "Skilled Nursing Facility Advance Beneficiary Notice" or a form attached to a denial letter.

For more useful info go to
www.medicareinteractive.com

Medicare Counselor

The current Medicare Counselor is available at
http://www.medicarerights.org/pdf/thecounselor.pdf

This is a great newsletter filled with usable information. One of the issues discussed in this issue is regarding Home Health Care. The newsletter details what is covered and when.

Take a look!

Fall Prevention Tips

Tips from the American Academy of Orthopaedic Surgeons

1. Make sure your home has good lighting and that light switches are easily accessible. Motion sensor lights are also a good idea.
2. Install grip bars. For example, put handrails in the bathtub and toilet areas.
3. Repair any loose carpet or boards in your home and secure any rugs.
4. Keep your furniture at a height that is not too low or too high. For example, make sure your bed is high enough so that you don’t have trouble getting in and out.
5. Always buy chairs and sofas that are easy to get up from.
6. Make sure your floors aren’t slippery. Use nonskid floor wax, slip-resistant rugs and nonskid adhesive textured strips. Clean up any spills right away.
7. Try to keep your home clutter-free

Foe more tips go to: http://orthoinfo.aaos.org/topic.cfm?topic=A00123

Coping With Caregiving Radio Show

Please check out this internet radio show...Coping With Caregiving. Listen to the archived programs. It offers great advise and you can hear about some very interesting companies that are in business to help caregivers and seniors!
Of course, please listen to my archived interview from May 16th:

http://www.wsradio.com/internet-talk-radio.cfm/shows/Coping-with-Caregiving/archives/date/selected/05-16-2009.html

(You may need to copy and paste the above link)

Sleep Position To help Stiff Joints

Do you or your parents wake up with stiff and achy joints? Here are a couple of quick tips from RealAge.com to do before you fall asleep to help prevent that morning pain:

1. If you sleep on your back, place a small pillow under your knees.
2. If you sleep on your side, avoid tucking your neck and chin in the fetal position.
3. If you sleep on your stomach, put a pillow under one side of your body so your head and neck aren't strained.

Waiting List for Assisted Living

Do you know of a senior who can't move into the assisted living facility because they can't sell their house in these tough economic times? It can turn into an unsafe situation rather quickly but in home care can help. Home care agencies can come into their home for several hours a day or more if needed. The caregivers can do all of the tasks that the senior will get when they move into the assisted living facility.
Apple Care and Companion can come in and work on whatever schedule the senior needs until they can sell their house and move into the facility. Our caregivers will help with meal prep and cleanup, bathing and dressing, companionship, transportation, light housekeeping and more. Our caregivers can also help ease the transition of moving from their 30 year old home into the assisted living facility, which can be quite traumatic!
Don't wait to sell the house to get eldercare assistance...call us today!
www.AppleCareAndCompanion.com

Top 10 Ways To Improve Your Diet

10 Ways for Seniors to Improve Their Diet
10. Eat breakfast every day
9. Choose whole grains
8. Have 3 servings of calcium/Vit D daily
7. Grocery shop with a friend
6. Add herbs and spices
5. Remove skin from chicken and choose lean meats
4. Serve meals attractively
3. Have a variety of colors of veggies
2. Try new foods
AND
1. Eat meals with someone you enjoy!!!!

These are easy ways for seniors to improve their diet. If you are an adult child of a senior, encourage them to make a few changes. Eat healthy today, fell better tomorrow!

Why Seniors Don't Have A Nutritious Diet

Top 10 Reasons Seniors Don't Have A Nutritious Diet

10. Difficulty chewing and swallowing
9. Digestion issues
8.Loss of taste and smell
7. Financial Reasons
6. Loneliness/Isolation
5. Difficulty shopping
4. Loss of appetite due to medications
3. Living alone
2. Difficulty cooking
AND
1. Been eating this way for 75 years!!!!!!

If any of these reasons seem to effect your loved one, there are people who can help! Our caregivers can do the shopping, help with meal prep and clean up as well as provide companionship so people won't have to eat alone.
Look into your loved one's teeth and/or dentures...that could be a quick fix if there is irritation and dentures are ill fitting.
Look into Meals On Wheels...there are a lot of options once the problems are identified!

Top 10 Reasons To Start Eating Healthy...NOW

10. Reduce mood swings

9. Sleep better at night

8. Have softer skin

7. Lose weight

6. Have more energy

5. Able to fight illness better

4. Reduce medications

3. Less gastrointestinal problems

2. Prevent/postpone/help manage major chronic diseases

AND

1. Eat better today, feel better tomorrow

Happy New Year

Welcome to the New Year...2009! This last year has been quite a tough one for me personally but I have also learned a lot about family, life, death, and the things that really matter in this world. The most important thing that I have learned is about attitude. You can't change the world but you can change how you see the world! One's attitude can keep a person sane and even alive or if it is a bad attitude, can make a person sink into depression or even take one's life. The good thing about your attitude is that it can change on a dime. One minute it may be lousy but you can hear a song on the radio and your entire attitude and outlook can change. I have witnessed how a positive attitude kept someone alive when the charts and doctors said otherwise. I also saw a depressed attitude take someone's life way too early. If nothing else, make sure your attitude is flexible! Also, do random acts of niceness because just maybe, you will change a lousy attitude to a positive one just with a smile and a thank you. You can make a difference!

The 3 most "germiest" places

I heard a report on the radio the other day about the three most germiest places. If you can't stay away from these places, then wash your hands or use antibacterial gel asap after you visit one of these places.
Number one: the kids playground
Number two: public transit
Number three: the handle on the shopping cart! Use the wipes that stores now provide or start to carry your own. Yechhhhh.
Remember to get your flu shot this year...If you are a current care giver or happen to visit folks in the hospital or senior facility, it is only the right thing to do. It is not only for yourself, but also for all of the other people that you come into contact with throughout the day.
When you are caregiving or under stress, it is easier to catch a cold.
Take care of yourself first, so you can take care of your loved ones!

Experiment

Sometimes we all fall into the trap of parenting our parent. It is stressful and unproductive for all involved. In order to see how it feels to age, try this experiment.
Put some marbles in your shoes and walk around the grocery store. Put some cotton in your ears and nose and experience the feeling of not being able to hear or smell like you once could. Put on some rubber gloves and tape a few fingers together. Try and dial a phone or open the OJ carton and pour a glass and see how frustrating it feels to not be able to do everyday things that used to be so easy.
Hopefully, this experiment will help you have an insight to what your parents may be feeling. You should be able to identify with the loss of control going on in their bodies: a loss of hearing, mobility, and even a feeling of a loss of self worth.
It is so powerful when you realize that you can help empower your mom or dad. Not only will it make them feel better, but your relationship will improve as well. Take the time to ask them their opinion. I'm sure they have some thoughts on the economy! Ask what they did during the Great Depression...maybe we can learn some money saving tips! Ask them child rearing questions or recipe questions. Ask their opinion on a problem you are having at work. It will make your parent feel like they still have something to offer.
Elder care can be tough!
Try not to be the parent to your parent but rather a helping daughter or son who only wants to see their mom or dad feel respected!

Forgotten Cookies

My mom was not known for her cooking or rather known for her good cooking. She is more "infamous" in that area. I was thinking about this because I am about to make her "forgotten" cookies.
A little background....Our family joke is that Mom's recipe for pork chops is this: heat the oven and cook the chops until they curl and then serve with apple sauce to rehydrate! When we were first married, my Mom would invite my husband and I over for dinner . We went once and then every other time Mark would insist on taking her out to a "nice steak" dinner. Mom always that it was just so nice and thoughtful of Mark...little did she know that Mark just couldn't stand her cooking!
There were a couple of things that Mom did do great. One, was my Grandmother's fudge. Everyone loved it and it really was great. She taught my daughter to make it, too.
The other item was her "Forgotten" cookies. These are basic meringues...whipped egg whites and sugar left in the oven over night, hence "Forgotten" cookies. For the last 15 or 20 years, she made a couple batches for every holiday because everyone loved them. When my nephew, who really loved the cookies, went into the Air Force, Mom would make an extra batch for Cathy to send to him. She so enjoyed the feeling of making people happy. She made these cookies with a broken oven but that just didn't seem to matter.
While she was in the hospital this past Thanksgiving, I felt a desire to try and make a batch for the holidays...it just seemed the right thing to do. I looked for her recipes and I found two...both with the same ingredients but with different measurements. I picked the bigger recipe because she always made so much. Boy, did I fail!!! They were either gummy and sticky or the wrong color...yech, they were just awful. I told her what had happened and she gave me some pointers but I think she was happy that she still held the secret to make the best Forgotten cookies.
Just like her, I won't give up....I am going to make them again this week but this time they'll be great! I've learned her secret ingredients: love and patience!

Write Details Down

When you are in the midst and knee deep in care giving, it is so easy to get overwhelmed! A quick tip: write details down! Whether it is on a calendar or loose paper, write dates and other information down. Store it in your Blackberry or on your computer but get the information down. When you or your loved one is ill, it is too difficult to remember the little things that you very well may need at a later date.
My family and I are going through this now. We are having to go back to the hospitals and rehabs to get discharge paperwork for an insurance policy. We noticed that the hospital had missed about 3 weeks of time! I knew the date Mom went into the hospital but I can't recall the date she left the ICU for the main floor and we can't remember the date she went from the LTAC back into the ICU! There were too many trips back and forth to the ICU to recall the specific dates. At the time, we were too upset and distraught with our Mom's condition to keep notes. Looking back, I realize we should have kept a little journal or log to keep this type of information.
It is very easy to get overwhelmed when dealing with eldercare issues. Always write down dates or any other information that can get lost with the passage of time.

Reduce Stress-Start Walking

It has been proven that walking does more than help you lose weight. Here are just a few good reasons from Realage.com to put on your shoes and get out there....

1. Creates a feeling of more energy

2. Improves your perspective-because of the circulation benefit, walking can help clear your head and improve cognitive brain function which can help you deal with a stressful situation.

3. Reduce the impact of disease-walking can reduce cardiovascular disease, decrease osteoarthritis pain, reduce the risk of colon cancer, protect against diabetes, and lower blood pressure.

4. Makes you happier-due to less stress, you can feel happier.

5. It's FREE

Anything that you can do to reduce stress in your life, will make you a better person. You will be a nicer spouse, a more pleasant daughter, and a more productive worker. Of course, less stress will make you a better care giver. It will help give you the strength to continue day after day.
If you don't have time for a full workout, park a little farther away at the grocery store. Walk up and down every aisle at the store whether you need an item or not! Take a 10 minute break and take a brisk walk where ever you are: hospital, at work, it doesn't matter.
Remember: the good effects of walking are accumulative throughout the day. A 10 minute walk, a quick walk with the dog, the few extra steps at the store...it does add up.

Aging IQ Quiz

This is an excerpt from the Aging IQ quiz prepared by the National Institute on Aging to get people more aware and in tune with the senior population.

These are true or false statements...answer in your head before reading the explanation!

1. American families have by and large abandoned their older members.
2. Depression is a serious problem for older people.
3. The numbers of older people are growing.
4. The vast majority of older people are self sufficient.
5. Intelligence declines with age.
6. If a person has been smoking for 30 years, it does no good to quit.
7. Extremes of heat and cold can be particularly dangerous to old people.
8. Snake oil salesman are as common today as they were on the frontier.
9. Personality changes with age, just like hair color or skin texture.
10. Many older people are hurt in accidents that could have been prevented.



1. False. The American family is still the number one caretaker of older adults.
2. True. Depression, loss of self esteem, loneliness, and anxiety can become more common as older people face retirement, the deaths of relatives and friends, and other such crises. Fortunately, depression is treatable.
3. True. Today, 12% of the U.S. population is 65 or older. By 2030, one in five people will be over 65 years of age.
4. True. Only 5% of the older population lives in nursing homes; the rest are basically healthy and self sufficient.
5. False. Intelligence per se does not decline without reason. Most people maintain their intellect or improve as they grow older.
6. False. Stopping smoking at any age not only reduces the risk of cancer and heart disease, it also leads to healthier lungs.
7. True. The body's thermostat tends to function less efficiently with age.
8. True. Medical quackery is a $10 billion business in the U.S. People of all ages are commonly duped into "quick cures" for aging, arthritis, and cancer.
9. False. Personality does not change with age. As we age, we just care less about what others think about us.
10. True. Falls are the most common cause of injuries among the elderly. Good safety habits, including proper lighting, nonskid carpets, and keeping living areas free of obstacles, can help prevent serious accidents.

So, how did you do? Did you learn anything new? Did the quiz help you identify any issues in your own family?

You can find the entire quiz and a whole lot more, on a fabulous caregiver website: www.FamilyCaregiversOnline.net

Parenting Your Parent

I have noticed lately that the chief complaint from my clients is regarding their adult children. The kids mean well but they are not asking first. The kids think they are doing the right thing and they may go out of their way to help, but they are not asking their parents what they would like. It is very easy to fall into the trap of role reversal and parenting your parent. No one really wants that situation...the adult children don't like it and the parents don't like it either.
You have to remember that the aging parent is losing control throughout their lives: vision, hearing, driving, memory, etc. They need to have a sense of control in the areas that they can still manage. Whether it is talking about not living alone anymore or not cooking for oneself, the parent must feel like the decision is theirs and that their children are not telling them what to do.
Perhaps the senior is a fall risk and they should not live alone in their house. Instead of telling them that you are going to move them into a beautiful assisted living facility, you should discuss the options that are available. Maybe you and your parent interview a couple of in home care agencies and then let your parent decide which one to go with...of course, you would have already done the leg work. While now she is not alone anymore (which is what you wanted in the first place) , the plan feels like it was the parent's idea and everyone is happy!
Even if you still would like to explore the assisted living idea, make it seem like it is their idea. Ask open ended questions and not yes or no questions. ie: "Would you like to visit A place or B place today?" Just remember that you are still their child and they are still the parent and they deserve that respect even if their health and or mind is failing. It will make for a more pleasant time and a lot less stress, I guarantee it!

Tips For A Doctor's Appointment

Going on a doctor's appointment can be very stressful as a caregiver or a patient. Plan ahead and discuss issues with your loved one. If the appointment is for yourself, set some time aside and think about your own issues before you step in the exam room.

Here are some tips to help:

Before The Appointment
1. Make a list of all of the symptoms that have been experience or reported. How long do they last and how frequent are they?

2. Make a list of all recent significant illnesses. (Over the past 2-3 years)

3. Make a list of any allergic reactions and sources.

4. Make a list of all drugs that are being used.

5. Make a list of all health care professionals who are providing treatment. (Including any home care professionals)

During The Appointment
6. Write down information about what the problem appears to be. (A description is more important than a diagnostic name)

7. Make a list of any medications that are being prescribed, an explanation of why, and what effect they should have. Ask about the generic form-is it safe and available?

8. Write down information about when to take the meds, how much and how long.

9. Write down information about the side effects of each medication or interaction with foods or other meds.

10. Write down if there needs to be any changes in diet or lifestyle. Take the meds before a meal, after a meal, etc?

11. Make an appointment for a follow up visit or phone check up, not more than one week later. (Medicines can have strange effects on the older patient)

12. Ask the pharmacist to give regular capped bottles, if the senior can be in charge of their own medicines.

13. If there are any advers reactions to the new meds, call the doctor immediately!

It can be overwhelming at the doctor. Plan ahead and take paper. Remember, it is okay to ask the doctor to explain things again and it is okay to ask the doctor to repeat themselves.