How to Prevent Theft by Caregivers Part 2

How to Prevent Theft by Caregivers Part 2

 

 Read Part 1 Here

 

 

 

 

 

 

 

Don’t Use Cash

 

If your hired caregiver is responsible for running errands or buying groceries, don’t give them cash. Instead, use prepaid debit cards or gift cards along with asking for receipts for all purchases.

 

That way, all purchases can be tracked and verified. Plus, if the hired caregiver steals those cards, they’re only getting a limited amount.

 

Though the vast majority of senior caregivers are reputable and honest, occasionally someone comes along who takes advantage of an elderly client.

 

According to Sally Hurme, coordinator of AARP’s Financial Protection Outreach & Service, there are at least 5 million financial abuse victims each year in the U.S., and only one in 25 of them are reported to authorities.

 

Hurme cites many reasons why elder financial abuse is a “particularly pernicious crime.”

 

“Studies point to specific cracks in victims’ defenses against exploitation: trust, financial niavete, cognitive impairments, social isolation, dependency, fear, and embarrassment.”

 

Hurme goes on to explain that elder financial abuse is unique because “there is a very real chance that the victim has no idea that she has been … victimized. The victim may have no awareness that anything is amiss with his finances.”

 

There are many ways of combating and preventing financial abuse of elders, one of which is using a reputable caregiving agency. Many of these agencies not only screen their employees, but also do background checks to ensure the safety and security of their elderly clients.

 

Some such agencies have also begun a gift card program. Gift cards are a convenient and easily accessible solution to preventing certain financial abuses. Agencies issue the gift card to the caregiver, who can then buy groceries and other essentials for their clients. Since the gift card is purchased through a bank, the agency can track purchases online and know when transactions take place. All risk, which is limited to the amount of money put into the gift card, is borne entirely by the agency. The caregiver never needs to use the senior’s cash or credit cards as all purchases must be made using the gift card. Receipts are kept and purchases are then billed to the client with their regular invoice.

 

Though financial abuse of elders is a reality, measures can be taken to minimize the damages and the possibility of elderly clients being victimized.

 

As Hurme points out, “Even though there are no broken bones, the effect is devastating financially and emotionally.”

 

Being aware, taking steps to prevent theft, and utilizing reputable In-Home Care Agencies are the first defenses against elder financial abuse.

 

 

 

Watch for Over Attachment

 

Hired caregivers who are planning to steal might start out by creating an unusually close relationship with your senior. Through this tight bond, they may be able to get your older adult to voluntarily give them money, valuables, or extravagant gifts like cars!

 

That’s not to say that you should be suspicious a little suspicious and look into things, especially if you see any of the signs outlined below.

 

An heirloom bracelet goes missing, electronic gadgets can’t be found, a wallet or bank account seems to be bleeding cash. Talk to anyone who’s hired someone to help care for an older loved one, and theft is almost always a major worry. Bringing a paid caregiver into the home — whether through an agency or privately — can come as welcome relief to all, but it can also feel like a risky decision. Stories abound about vulnerable people who’ve been taken advantage of.

 

The solution? Be careful, proactive, and alert. Here, some of the key warning signs that a caregiver is on the take.

 

Receipts that don’t add up

If grocery shopping and other errands are among a caregiver’s responsibilities, it’s pretty easy for “mix-ups” to occur. You might notice items listed on a receipt that seem out of character for your loved one, or certain supplies that seem to run out — and be replaced — with surprising frequency. If the caregiver takes your loved one out to shop or dine, you may notice purchases from stores that he or she doesn’t typically frequent or restaurant meals that are out of your family’s typical price range.

Why it’s worth worrying about:

A few dollars here, five dollars there may not seem worth making a fuss over. After all, caregivers aren’t usually well paid, so is it worth rocking the boat over a little bit of paycheck padding?

Yes, says Carolyn Rosenblatt, author of The Boomer’s Guide to Aging Parents. “You may see $6.50 for a lipstick, knowing Grandma doesn’t wear lipstick, but if you let it slide you’re sending a signal that no one’s minding the store.” Typically, these first purchases are tests, Rosenblatt says. “The caregiver is saying, ‘Let’s see if I can get away with it.’ If you don’t respond by confronting her, you’re saying, ‘Yes, you can.'”

 

What to do:

For starters, avoid cash. Supply the caregiver with debit gift cards preloaded with a limited balance. This way, if fraud is occurring, you can limit the amount of liability your family is exposed to. Also, use online banking to monitor card transactions, so you can see how much is being spent at each store. Ask the caregiver to supply receipts for each shopping trip, and keep an eye out for any purchase that seems unnecessary or for quantities that seem overlarge.

If you find yourself hesitating over a questionable purchase in case it’s an honest mistake, bring it up in that spirit, keeping it light and nonconfrontational. Explain that you noticed a purchase that didn’t seem to be something intended for your family member, and you’d like to keep those kinds of purchases separate in the future so it’s easy for you to keep track.

 

Phone Use and Friendships

 

Frequent cell phone use on the job

Texting or taking calls on the job is discourteous and distracting — but it could also be a sign of something more serious.

 

Why it’s worth worrying about:

While there are legitimate reasons a caregiver may need to make an occasional call, if someone’s on the phone all the time, it’s a signal that some outside relationship or network of relationships is more important than caregiving. It may even be that some outsider is calling the shots, says Rosenblatt.

 

What to do:

If you — or the agency you’re working with — haven’t already done so, run a thorough background check on the person you’ve hired. While some agencies do an in-depth background check on all employees, including requiring drug testing, others are much less thorough. It’s important to make sure good research was done, says Rosenblatt, because all too often records of crimes committed in other states or counties may not come up during a simple records search in your area.

Next, make sure you’ve securely protected your family member’s finances from potential fraud. The best way to do this is by having your family member sign a durable power of attorney for finances, which authorizes you or another trusted person to oversee financial transactions. A power of attorney is just a piece of paper, though, unless it’s recognized by the financial institutions that handle your loved one’s money. The safest strategy is to inform the banks and other financial institutions that you’re the proper legal agent for your loved one’s finances and that no one else is authorized to act. To do this, you’ll probably be asked to show a copy of the power of attorney document and may need to fill out additional forms.

 

 

Cultivating a Personal Connection

 

For many older adults, a caregiver quickly becomes a trusted friend, often the only person they see from day to day. With such consistent and intimate contact, close bonds are common. But keep your eyes open for anything that seems to step over the boundaries of professionalism. Watch and listen for signs that your loved one is becoming emotionally involved with or dependent on his or her caregiver, such as talking about the caregiver all the time or seeming to consider that relationship more important than friendships or family ties.

 

Why it’s worth worrying about:

Typically, thieves planning a scam will gradually “prime the pump,” seducing an elderly target with greater and greater shows of affection until he or she becomes emotionally dependent on the caregiver. “It can start very subtly: touches on the arm, little gifts, shows of affection,” says caregiving author Carolyn Rosenblatt. Hugs, compliments, and attention become stepping stones to building a connection that’s overly intimate. Some concerned family members have found themselves in situations in which their loved ones bought their caregivers cars or gave other expensive gifts, paid their rent, or “loaned” them money that was never repaid.

 

What to do:

Prevention is worth a pound of cure, experts say. Loneliness and isolation leave many older adults susceptible to all manner of exploitation, from relatively small expenditures to outright fraud and identity theft. To protect your loved one, you’ll want to act on two fronts.

First, the psychological: Think about your loved one’s day-to-day interactions. Does he have opportunities for companionship other than his caregiver’s visits? Can you find a day program or other activity for him to attend, or are there others who might visit from time to time to liven up his routine?

Next, the practical: Focus on safeguarding against his caregiver gaining access to his finances. Experts recommend setting up online banking for checking, credit cards, and any other accounts, so you can monitor all activity in real time. (Most transactions post within a few days.)

If you check credit card records and discover charges that you or your loved one didn’t authorize, act quickly to protect yourselves from identity theft, says Caring.com legal expert Barbara Kate Repa. Close the account and immediately alert the company holding the account that you believe it’s been used without your authorization. Then alert one of the three major consumer credit reporting agencies and request a fraud alert. If your loved one hasn’t already signed a durable power of attorney for finances so someone trusted has authorization to access financial accounts, encourage him or her to do it now.

 

Manipulation and Missing Work

 

Bids for sympathy

Personal tales of woe are a common danger sign. If your loved one begins expressing worry and concern for a situation his caregiver has told him about, that’s your cue to get involved — and quickly. “A sister with cancer who can’t afford medical care, a child who needs dental work, a family member in another country who’s being persecuted and desperately needs to come to the U.S. — these are the kinds of scenarios we hear all the time,” says caregiving author Carolyn Rosenblatt. “The next thing you know, your loved one’s writing checks and that money’s gone.”

 

Why it’s worth worrying about:

The caregiver relationship is a professional service. If it becomes personal enough for your loved one to become involved in the caregiver’s private life, the caregiver has clearly crossed a line. Best-case scenario: The caregiver is manipulating your family member. Worst-case scenario: An outright fraud is in progress.

 

What to do:

Act quickly. You may hesitate to question your loved one’s judgment, but the caregiver, if he or she is a practiced scammer, will be counting on that. Call a family meeting and discuss the situation with all family members, including siblings who don’t live nearby. Make sure everyone is on the same page, so you don’t end up in the all-too-common situation in which family members are divided against one another or undermine one another. As many of you as possible should talk to your parent or other loved one together, explaining how concerned you are and why you need to take steps to protect him or her.

If the caregiver was hired through an agency, it’s a good idea to alert the agency to your concerns and ask them to double-check the records of the searches performed and make certain this caregiver hasn’t been accused or convicted of exploitation or fraud in the past. If the caregiver was hired independently and a thorough background check was not performed at the time, now would be the time to do some digging.

Depending on how your loved one reacts, you may wish to terminate the caregiver’s employment or set up a more careful monitoring situation in which you limit access to funds. If possible, consult a family lawyer to make sure all possible legal protections are in place, says Caring.com legal expert Barbara Kate Repa. If your loved one’s judgment appears to be seriously impaired and you’re not able to convince him or her to grant you power of attorney, you may need to consider trying to obtain legal guardianship, also called conservatorship.

 

Missing Work on Mondays

 

Some days your loved one’s caregiver seems responsible and reliable; other days — particularly Mondays or the first day back after time off — he or she goes AWOL.

 

Why it’s worth worrying about:

“This is a classic sign of alcoholism or substance abuse; people go on a bender over the weekend and then can’t make it into work on Mondays,” says caregiving author Carolyn Rosenblatt. “Unfortunately, alcoholism and chemical dependency often go hand in hand, and they frequently lead people to steal to meet their need for drugs.”

 

What to do:

Be on the alert for other signs of alcohol and substance abuse. Check the liquor cabinet and make a note of liquid levels in each bottle; you might even taste the contents to see if they’ve been watered down. Go through bathroom and kitchen cabinets and empty them of any prescription and over-the-counter medicines that might tempt an abuser. For prescriptions in current use, count the pills so you can check if doses go missing. Hide medications in a safe place or — if your loved one doesn’t need them right now — take them home with you. Keep prescription receipts and labels in a safe place, so the caregiver can’t call in refills without your knowledge.

If your caregiver was hired through an agency, report all unexplained absences and discuss the situation with the agency. If the caregiver has a history of this type of behavior with previous clients, the agency should be proactive about assigning you a new caregiver. If the caregiver was hired independently, have a frank discussion and set boundaries. Explain that you require 24 hours advance notice if he or she has to miss work, and another unplanned absence is going to be grounds for dismissal. Then stand firm. The caregiver will almost certainly use illness as the excuse and protest that illnesses come on suddenly, but don’t get sucked into that debate.

While this is happening, take all necessary precautions to protect your loved one’s cash and financial records, since a caregiver with a drinking or drug problem is a risk and a disgruntled former caregiver can be a threat.

 

By using common sense and due diligence, you can both reduce the risk of caregiver theft and minimize it’s scope.  Always pay attention and trust your feelings.

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

Suggested Security Camera System:

Arlo Security System – 4 Wire-Free HD Cameras, Indoor/Outdoor, Night Vision

 

 

 

 

 

 

 

 

 

 

 

 

 

Recommended Reading: 

How to Care for Aging Parents (3rd Edition);  A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues

by Virginia Morris

 

 

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How to Prevent Theft by Caregivers

How to Prevent Theft by Caregivers Part 1

 

 

 

 

One of the most common worries about hiring in-home help is that the caregiver could take advantage of your older adult. Even though the relationship between a hired caregiver and the family should be based on trust, it’s smart to take steps to prevent theft or fraud.

 

 

 

Prepare Your House First

 

Protect your senior from theft or fraud by removing or taking inventory of valuables, not keeping cash around, and watching bank and credit card statements carefully.

 

Keep an inventory of valuables in the home. Compile a list and take pictures to document your parent’s valuables, put them under lock and key, or remove them from the home.

 

Don’t forget about hidden jewelry or valuables, and think about removing any valuable memorabilia displayed in the house. There’s no need to put temptation in front of anyone.

 

 

 

Don’t invite petty theft. Your parent should keep only a small amount of cash at home. Don’t leave money in obvious places, such as the nightstand next to the bed. Make sure your loved one keeps any checkbook, ATM and credit cards, and computer passwords in a secure place.

 

 

 

Pay Attention

 

After spending some time with the hired caregiver, pay attention to how you feel about them in your gut. Most people work hard to make a great impression at the start of a new job. But later, you might start to see a different personality show through.

 

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If you start to feel uneasy, trust your gut and talk with their agency. If it’s a private hire, you might want to investigate for theft and (secretly) observe them carefully for a while.

 

If they continue to make you feel suspicious or uneasy, look for a new caregiver.

 

 

 

 

 

 

 

 

 

Do Your Homework

 

 

Whether using a home care agency or hiring an independent caregiver, it’s important to do your research to make sure that you’re getting a reliable person.

 

Of course, no one knows better than me that this isn’t a foolproof method — but due diligence is still required on your part.

 

Home care agencies are responsible for fingerprinting and screening to make sure potential aides don’t have criminal records or other complaints against them.

 

When selecting a home care agency, ask how they screen potential caregivers, how many theft accusations they’ve had in the past and how they’ve handled them. Will they replace stolen items?

 

Amy Nelson, founder and CEO of Accurate Home Care in Otsego, Minn., says that her agency reports theft accusations to the authorities and cooperates however possible. The caregiver is suspended until the investigation is over. If found guilty of theft, the caregiver is fired and reported to the Department of Human Services.

 

After you’ve picked an agency, it’s still wise to interview caregivers they assign to the job. If you don’t feel comfortable — at any time that the person is working for you — tell the agency that this person is not the right match for you.

 

When hiring an aide without going through an agency, spend the time and money to check them out, advises Lisa A. Lieberman, a licensed clinical social worker, family counselor and author of A ‘Stranger’ Among Us: Hiring In-Home Support for a Child with Autism Spectrum Disorders or Other Neurological Differences.

 

She stresses checking references, especially ones from previous employers, and scheduling a face-to-face interview before making a decision.

 

A criminal background check is one way to make sure that applicants are who they say they are. For example, SentryLink will conduct a background check on an individual and send the results via email for around $20.

 

Unfortunately, these precautions aren’t enough to guarantee you won’t get ripped off. Detective Mike Cruce of the Oro Valley, Ariz., police department, who solved the case of my missing laptop, warned that just because the prospective caregiver doesn’t have a criminal record doesn’t mean that you still can’t be victimized by them.

Just ask my caregiver, who had no criminal record when she stole my laptop.

 

 

 

 

Trust Your Instincts

 

 

Most people try to make a good first impression, so keep in mind that caregivers need to earn your trust and maintain it by being reliable over time. If you develop an uneasy feeling about a caregiver and aren’t quite sure they can be trusted, you could be right.

 

 

 

Everyone in the household should be comfortable with the caregiver. If you live alone, ask visiting family members and friends for their opinions of the caregiver and how she/he interacts with you.

 

In my case, my caregiver the laptop thief was shy but likable at the beginning — but after a few weekends with her, I began to wonder if I could trust her. It wasn’t one particular thing she did but a strange feeling that entered the room along with her. I began to secretly look after my wallet. She started showing up late, or not coming at all, and her excuses were hard to believe.

 

At that time, I should have called the agency and requested another caregiver. But I figured I was stuck with her, because the agency had been having trouble finding a caregiver to work in my part of town. This is a very real issue for people with disabilities nationwide; many people accept personal care attendants who are abusive because there is no one else to fill the gap.

 

Next time, I will make any uneasy feelings known to the agency.

 

 

 

Don’t Be So Darn Nice

 

The trick is to be comfortable with the caregiver, but not too comfortable, says Nelson. The same goes for caregivers: They need to feel comfortable in your home, but not so comfortable that personal boundaries are crossed. For instance, most agencies have rules against caregivers accepting loaned money, whether it’s solicited or not. Even if you don’t use an agency, it’s always wise not to let caregivers borrow money or important items.  

 

When James Kelley, who has facioscapulohumeral muscular dystrophy (FSHD), loaned one of his caregivers his very expensive leather-bound King James Master Study Bible, he never imagined he’d have a problem getting it back, because “who’s going to steal a Bible?”

 

The caregiver in this case asked to borrow his Bible for a couple of days, but after weeks went by and she still hadn’t returned it, Kelley, 44, confronted her. She assured him that she would bring it back. After a month passed and still no Bible, he called the home health agency, which contacted the caregiver — but she still didn’t bring it back.

 

That’s when Kelley, who lives in Cincinnati, Ohio, contacted his case manager, who advised him to call the police and file a report. He felt strange about filing a report over a Bible, but the detective assured him that, “If you don’t get some of these people when they’re taking small amounts, then they continue to push the envelope and see what else they can get away with.”

 

Kelley eventually got his Bible back after the detective told his caregiver that Kelley would press charges against her if she didn’t return it. The detective warned that she didn’t want it on her record, especially since she’s a health care worker.

 

Kelley ended up asking the caregiver not to come back.

 

Even trustworthy caregivers can forget they borrowed something. Consider this scenario: You lend your paid caregiver a book and, for practical reasons, keys to your house, but then due to everyday circumstances — a move, a career change, etc. — the caregiver stops working with you before the items are returned.

 

 

 

Caregivers and House Keys

 

In the case of the house keys, the best way to prevent that scenario is to never give the caregiver a permanent set. Instead, buy a key lockbox, like those used by real estate agents, and hang it on your front door handle with a key or keys inside.

 

 

Master Lock 5400D Select Access Key Storage Box with Set-Your-Own Combination Lock, 13/32-Diameter Shackle, 1-Pack

 

When a caregiver arrives at your home for work, he or she just punches in the code to the lockbox (like this Master Lock Select Access Key Storage Box pictured above) and retrieves the key — and then returns it to the lockbox after opening the door. The lockbox code is easily changed, meaning you don’t need to change your locks every time you change caregivers.

 

 

 

Protect Your Stuff

 

Detective Cruce says it’s especially important for those with multiple caregivers, or with a “revolving door” of caregivers who are new each time, to secure their valuables. Having multiple caregivers definitely complicates theft investigations, making it difficult to pinpoint who’s responsible for missing items.

 

When she started using a home care agency in 2006 due to her amyotrophic lateral sclerosis (ALS), Fern Cohen, of Rego Park, N.Y., was sent different caregivers every day. When her brand-new digital camera was stolen, the agency wouldn’t do anything because she couldn’t prove who stole it, even though Cohen knew who was working the day she found it missing.

 

“[The revolving door] was my main reason for switching from agency care to self-directed care,” says Cohen, 58. She now has a handpicked staff of four trustworthy caregivers.

 

(Self-directed care means that people with disabilities have decision-making authority over certain services, and take direct responsibility in managing their services, including personal care aides. Self-directed services may not be available in every state and may vary from state to state. Check with your state’s Medicaid program or your personal insurance for more details.)

 

After the digital camera incident, Cohen also realized she could take measures herself to avoid enabling theft in her home. So to safeguard her valuables — from otherwise trusted eyes as well as the hands of strangers — she bought a safe.

 

But theft is not limited to physical possessions. Be sure to monitor bank accounts and credit card charges and look for anything unusual. Staying aware of your financial situation and transactions may help detect a theft. Also, hide important documents and consider storing duplicate copies in a safe place with family members or friends.

 

For example, Kelley learned the hard way that it’s wise to always request a receipt when the caregiver returns from shopping for you. He gave one of his caregivers his food stamp card to go to the store for him one afternoon, and she didn’t bring back a receipt.

 

“It was a red flag when she didn’t bring back a receipt, so I waited until she left and went back over to the store with my food stamp card, and I told them that I needed them to run an audit on the card,” Kelley says.

 

Within a few days, the store provided an itemized computer printout that showed his caregiver had purchased $10 worth of items for herself.

 

Even if people take the precautions mentioned here, some may find it comforting to also monitor caregivers with nanny cams or webcams. This option can be very expensive and time-consuming, so research this technology and its associated costs before deciding if it’s right for you. (Also, consult an attorney, or familiarize yourself with state laws governing video surveillance and speech before recording anything.)

 

 

 

 

Break the Cycle

 

As for my stolen work laptop, I didn’t even know it was missing until I received a phone call from the support coordinator at the agency where my caregiver worked asking: “Are you missing a laptop computer?”

 

I went to check under my bed (not a good hiding spot), all the while thinking, “If it’s missing, she stole it.”

 

My support coordinator said that the whereabouts of my laptop were still unknown but that my caregiver’s ride had called the agency and reported that she had bragged about stealing it from beneath my bed. My support coordinator also told me that my caregiver had quit the day before.

 

I decided to press charges against my caregiver thief because I didn’t want this happening to anyone else. Later, I heard from the prosecutor that she had similar charges before, which were dropped by the client. The fact that she already had a second chance and blew it made me feel a little better about pressing charges.

 

A few days later, Detective Cruce returned my work laptop after convincing my now former caregiver that the judge would go much easier on her if she relinquished it.

 

“Theft is not uncommon for people who are vulnerable,” says Cruce, adding that every state has laws to help protect people who are vulnerable to abuse due to their age or disability. “Theft from a vulnerable adult is a crime by itself,” he continues. “So not only do you get charged with theft, but you also get charged with theft from a vulnerable adult; therefore, the consequences could be doubled.”

 

As of this writing, my former caregiver had received a $25 fine and was sentenced to 36 months of probation, during which she’s not allowed to have any contact with me. Theft from a vulnerable adult will appear on her record.

 

 

 

Be Prepared — Just in Case

 

It’s impossible to avoid getting ripped off. It happens to everyone, but it’s even more upsetting when you have a disability and you’re paying and relying on the culprit to help you live more independently. People with disabilities face the additional difficulty of having to get rid of a vital caregiver often without having another qualified person to instantly replace him or her.  

 

We love our caregivers. They are, literally, the reason we can get out of bed every morning. Most of them are dedicated to their caregiving jobs and are totally trustworthy.

 

But it’s smart to be prepared in case one of them decides to pull a fast one.   

 

 

 

Minimizing Stranger Danger

 

Allowing a “stranger,” even a professional caregiver with good references, into your home can be a scary proposition. But deciding when and how to work with outside caregivers is far less daunting if you assess your options and perform due diligence to evaluate candidates for the position.

Lisa A. Lieberman’s A ‘Stranger’ Among Us: Hiring In-Home Support for a Child with Autism Spectrum Disorders or Other Neurological Differences offers readers, especially parents, tips on how to do just that.

Lieberman, of Oswego, Ore., is a licensed clinical social worker and family counselor as well as an author and speaker.

 

 

 

Read:  How to Prevent Theft by Caregivers Part 2

 

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

Recommended Reading: 

How to Care for Aging Parents (3rd Edition)A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues

by Virginia Morris

 

 

 

 

 

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The Angry Dementia Patient

The Angry Dementia Patient

 

 

 

Seniors With Dementia are Easily Frustrated and Stressed

 

 

 

 

Sometimes it seems like seniors with Alzheimer’s or dementia get angry at the drop of a hat. What’s most likely happening is that they suddenly reach a breaking point because of frustrations that build up.  Here are some ways to make everyday life easier and less stressful for seniors with dementia.

 

 

Why Dementia Patients Get Angry

 

When someone has dementia, their ability to function well in the world declines.

Tasks that we consider simple, like brushing teeth, are actually quite complex. To a person with dementia, it can be difficult to remember all the steps and sequence them properly.

 

 

For example, these are the major steps they need to take to brush their teeth:

 

  1. Enter the correct bathroom (the one with their toothbrush)
  2. Find switch and turn on light
  3. Locate correct toothbrush (theirs)
  4. Locate toothpaste
  5. Take cap off toothpaste
  6. Put an appropriate amount of toothpaste on toothbrush
  7. Put toothbrush (with toothpaste still on) in mouth and gently brush every tooth surface
  8. Spit out toothpaste
  9. Rinse mouth thoroughly with water – spit, don’t swallow

 

Once we break it down, brushing our teeth is far less simple than we might think. And, someone with dementia may also have trouble with the smaller steps that make up many of these major steps.

 

 

When even the most basic parts of the day are so difficult and overwhelming, it’s easy for the frustration to build up. When they’re expected to do yet another “simple” thing, they may erupt in anger.

For example, when you’ve had an extremely stressful day, someone coming to you with even a simple request can cause you to lose your temper – it’s the last straw, right?

That’s often what’s happening to seniors with dementia. Because their world is becoming more confusing and difficult to navigate, it doesn’t take much for them to reach that “last straw” feeling and react with anger.

 

 

Taking Steps to Reduce Anger in Dementia Patients

 

 

Accept Their Limitations

Avoid pushing seniors with dementia beyond their limits by expecting them to do things they’ve been struggling with. They aren’t refusing to do things because they’re lazy or refuse to remember.

Their brains are failing and they’re losing the knowledge and abilities they need to accomplish those once-easy tasks. Accept where they are now and work with the skills they have today.

 

 

Reduce Complex Decisions

Making choices about every part of their day isn’t necessary, but there are some decisions your older adult may still want to make.

The goal isn’t to take away their right to choose, but to simplify so making choices is easier – too many options are confusing and overwhelming.

For example, when changing, lay out all the clothes they need, but offer a choice between two shirts – the red shirt or the blue shirt? That way, they are still participating in the process. But they won’t have to find and select all the other clothing items they need.

Similarly, for lunch you could offer a choice between two entrees you know they enjoy – a ham sandwich or split pea soup? That decision is much easier to deal with than a broad question like “What do you want for lunch?”

 

 

Slow Down

We’re used to moving at a “normal” pace, but that’s because our brains are fully functional and can quickly process information and thoughts.

When someone has dementia, those cognitive processes slow down significantly. That’s why your older adult needs more time when thinking, speaking, or taking action.

To reduce stress and allow them to feel successful, don’t rush them through daily life. Take the pressure off and let them move at their own pace – even if it seems really slow.

 

 

Keep the Environment Calm and Quiet

Being in a noisy, bustling environment can overwhelm the senses and make it hard to think, especially when someone has dementia.

Have you noticed that we all need calm and quiet when we’re trying to think? For example, if you’re driving to an unfamiliar location, you automatically turn down the radio so you can concentrate. And, most students seek out quiet places like libraries when they need to learn complex new concepts.

For someone with Alzheimer’s or dementia, everyday tasks have become difficult and require extra thought and concentration. When you add loud noise or lots of people, it’s natural for them to feel frustrated and stressed.

 

 

Treat Them With Respect

Everyone, no matter their age or abilities, wants to be treated with respect. Seniors with dementia are no different. Even if they struggle with decisions or everyday tasks, there are many ways to make things easier while still showing respect.

A good way to do this is to offer simplified choices, like with the red or blue shirt mentioned above. That way, you’re not giving orders and expecting them to follow. You’re helping your older adult make decisions in a way that suits their current abilities.

 

 

Rely on Routine

Routines reduce the amount of thinking and number of decisions that need to be made on a daily basis. We don’t have to remember what time to eat breakfast because we always eat around 9am, after getting up and brushing our teeth.

Routines are especially helpful for seniors with dementia because they reduce the number of things they need to remember or think about.

Having a steady, constant routine is comforting and far less stressful than if each day was unpredictable and they had to go hunting for their toothbrush every time they needed it. Putting objects in the same places and doing the same activities at the same time of day means they know where things are and what will be happening.

 

 

Speak Simply

Alzheimer’s and dementia affect the brain’s ability to process and retrieve information. Short, direct sentences with only one thought per sentence are easier for your senior to understand.

The goal is to give your older adult less to think about and less to remember. If you’re giving instructions, make it one step. If you’re sharing information, keep it to one thought.

Using fewer words and a warm and positive tone will be far less frustrating for your senior.

 

Recommended:

The Validation Breakthrough – Simple Techniques for Communicating with People with Alzheimer’s and Other Dementias

 

 

 

Avoid Fatigue

Getting overtired isn’t good for anyone’s mood, but it can put even more pressure on an already frazzled senior with dementia.

 

 

Just like you’re more likely to snap when you’re exhausted, someone with dementia is more likely to have an angry outburst when they’re fatigued.

 

 

 

 

 

Modify Tasks to Help Them be Successful

When a task is too difficult, it’s frustrating and stressful. The answer isn’t to have your older adult stop doing things for themselves. That will only make them feel worse. Instead, find ways to modify activities so they will be successful.

For example, if they’re having trouble cutting meat at dinner, consider serving more foods where the meat is already in smaller pieces or getting a specialized knife that’s easier to use (like this one).

Or, if your older adult struggles to zip their pants, consider switching to elastic waist athletic-style pants or specialized pants with velcro fastening in place of a zipper (like these). Another idea is to switch to easy, slip-on shoes if they have trouble tying their shoes.

 

For further information, see

 

Bathing is another good example. Similar to brushing teeth, there are many steps involved in taking a bath or shower. It’s much easier to be successful if you help by laying out a towel, comb, and fresh clothes. Then, turn on a heater in the bathroom and start the water running at a comfortable temperature. Now there are less steps for your older adult to manage and bathing will be easier.

 

 

Recommended: The 36-Hour Day, 5th Edition

by Nancy L. Mace, M.A. and Peter V. Rabins, M.D., M.P.H.

 

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

 

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Choosing a Medical Walker

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Find the Right Power Wheelchair

About Me

Create Your Own Blog

 

 

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Important Tips For Stroke Patient Caregivers

Important Tips For Stroke Patient Caregivers

 

 

 

 

Life for the Jack Meadows family changed forever in December 1989 when this husband and father suffered a stroke. The massive incident in his brain left him with no use of his right side.

 

Months of rehabilitation restored strength and balance but could not return him independence in daily routines of self-care. He has a strong left arm and weak left leg to provide limited mobility. In addition, frustrating his life even greater is the lack of communication. He definitely has cognitive processes as is evident when following conversations and watching television quiz shows. But, thoughts have difficulty connecting to words and words in the brain do not translate to speech. 

His family has chosen to assist him at home. While visiting nurses and aides have contributed valuable services over the years, the major day-to day attention to his needs has been and continues to be given by his wife. A son, daughter and a few good friends frequently assist.

We (his family) have learned tremendous lessons about the skills our stroke patient has retained or developed. We have also acquired extensive knowledge and mastered many competencies in our twenty-four hour a day, seven days a week responsibility.

Over the years Mr. Meadows has required services in several hospitals and many doctors’ offices. Our experience has been that doctors and nurses do not know readily how to meet his needs. We can only surmise that they learned about stroke patients and other handicapped individuals in their schooling and on-the-job training but have not had the amount of direct experience as when a family provides care at home.

Our intention is to share the wisdom we have attained and to contribute to the quality of care accorded to all persons with physical restrictions.

 

 

Communication With a Stroke Patient

 

 

First, be sure you have the full attention of your patient.

 

While eye contact is important the individual who has had a stroke may look you square in the eyes but not have focus on the conversation.

Position yourself in front of your patient and tune out all other sights and sounds in the room. Turn down the volume of the television, radio and block the talk of any other people in the area. Make contact by touching the hand, chin or cheek, an area not affected by the stroke. Sometimes our family member is helped by directing him to look at the speaker. Saying, “look at my face,” does not offend him and gains his concentration. Use a normal volume and speak clearly.

Express one idea at a time in simple terms and repeat if needed to assure yourself that the two of you understood each other. For example, “do you want coffee?” and then follow up with “coffee?” More complex thoughts can also be conveyed in this manner. Ask, “were you on Omaha Beach?”… “Omaha Beach?”… “you were there during World War II?”

 

 

Hand gestures can assist with clarification.

 

Both the care giver and the stroke patient can benefit. Ask your client to point to what he wants or needs. He will develop a repertoire of pointing for such daily items as the television remote, newspaper, eyeglasses, radio, drapes, an uncomfortable foot or arm or headache. When going through complicated maneuvers such as using the mechanical lift to get in and out of bed the patient can work in coordination with the attendant. Instruct him to place his hand on the release lever of the lift and push in. Point to the lever or guide his hand to the lever. Demonstrate a pushing motion at the same time as saying, “push.”

 

 

Recommended: Pictures and Words Communication Flip Chart

 

 

At times when communication is not working, give it a rest.

 

Take time out and try again later. Sometimes the family or friend has exhausted the twenty questions and both parties are becoming frustrated. Tell the patient, “we will think about it,” or “we can try again later.”

 

 

 

Daily Care and Activities for Stroke  Patients

 

Have the person who had a stroke do as much routine self care as possible.

 

This may seem very little with one good arm but we have discovered many surprising tasks that our husband and father can do well. Every task he found he could do for himself raised his pride and confidence.

 

 

He can operate a television remote, secure a towel around his neck before eating, use a spoon to eat most anything, pick up food morsels he has dropped, use a cordless razor to shave and put a cassette in a tape player.

 

His more complicated skills include leafing through a magazine or newspaper, folding towels from the laundry and using the overhead bar to slide himself up in bed.

 

 

 

 

 

 

Vary the day but follow a routine.

 

This piece of advice may seem contradictory but really is no different for the person who lives with a stroke than the family around him. To make the most of the day a schedule provides security and comfort for both the stroke client and the caregiver.

For instance, a schedule of getting dressed in the morning, eating breakfast, moving into a comfortable chair and watching favorite television programs gives the patient peace of mind. He also can feel he has some control over his day as he watches the clock knowing certain activities will occur at specific times.

Additionally, within the day, activities could be varied so that the person who can not move himself does stay in one place, one position for such a length of time that the body and mind become numb. Thus, the assistant must move the client from the bed to the wheel chair to the easy chair and so forth several times in the course of the ordinary day. Staying in one place for hours at a time is neither comfortable physically or mentally.

 

 

The Routine

 

The routine for our stroke patient includes sitting in a recliner in the morning to watch television, moving to the wheel chair and into the kitchen for lunch, return to the bed after lunch for a nap or listening to music. In the afternoon he moves to the recliner again and enjoys watching children coming from school or birds dining at the feeder. Again he moves to the wheelchair and the kitchen for his supper. In the evening he may sit in the recliner again or sit in bed to watch television, read the newspaper or listen to the radio.

 

 

Recommended: Easy Comfort Lift Chair Recliner

 

 

 

 

 

A mechanical ‘lift’ (such as one manufactured by Hoyer) is a necessity. With practice it is easy to use and makes possible the mobility of a person weighing over two hundred pounds by the helper who is five feet tall.

 

A lift could be available in every wing of a nursing home, rehabilitation center, doctor’s office and hospital department. The lift seldom breaks down and takes wear and tear over the years.

 

Every care giver should learn to use this invaluable tool.

 

 

 

Use the stroke patient’s good side.

 

Place a tray or table where the mobile hand can easily reach. Items the patient wants at his access include tissues, cup, spoon, pills and cough drops. The television remote or the nurse call button must be on the side where the patient can handle them. 

 

 

Recommended: Carex Overbed Table

 

 

Carex Overbed Table

 

 

 

 

Be prepared for normal body functions at all times.

 

If the stroke patient uses a bedpan or underpads, a supply could be kept at the bedside. The patient can’t wait until a nurse or aide walks down the hall and back with the needed items. The same is true for saliva and nasal mucus. Tissues kept at the patient’s hand usually prevent a mess and embarrassment.

 

 

Stroke Patient Needs and Wants

 

 

Find those special traits that each person maintained in spite of the stroke or developed afterward.

For example, our patient can read a clock and point out directions when riding in the car. We also discovered that he can sing and his words are correct for the song and intelligible. At times he will try to sing a word that when spoken is not making sense to his listeners.

 

 

The member of the family who has had a stroke can be involved in everyday decisions.

This is accomplished by offering choices. The easy tasks such as what to have for dinner can be accommodated by asking, “what do you want, chicken or fish?” More difficult choices can also work in this manner. “What should we give our granddaughter for a wedding gift, money or a clock?”

 

 

Be patient and willing to try innovative approaches.

One great frustration is learning to eat with one hand, the opposite of the dominant hand. Our patient required many trials before being able to get more food in his mouth than on the tablecloth but eventually his persistence won.

 

 

In the process we found that a flat dinner plate did not work well. When a pie plate with sides was substituted he could scoop food into a spoon instead of pushing it over the edge.

He occasionally requires assistance with cutting food and picking up the last morsels. The person who sits to his right can assist by using his or her fork to push the food onto the spoon. This method allows him to master cleaning up well liked but difficult foods such as peas.

 

 

 

 

 

Special ‘treats’ rouse the spirits of everybody involved with the stroke patient.

We can’t take for granted the common events such as going for a ride in the car or giving a biscuit to the dog. The stroke patient who has difficulty getting around thrives on getting a change of scenery or visiting places he used to frequent. For our patient going past the plant where he worked for thirty-five years boosts his mood for days at a time. Other special treats include visits from friends and cards from school children. 

 

 

Include the stroke patient in as many events as possible.

Although he may not communicate easily, including him in conversations is good for his positive mental outlook. Moving him around is a difficult task for the family but one which must be undertaken to maintain his emotional well-being. For our patient the trip to his granddaughter’s wedding and reception was a huge undertaking but one worth the effort when the joy was shared by all. Other times to include him are more easily accomplished. For example, we arrange gifts for him to give at Christmas and birthdays. He participates in the selection and wrapping. 

Living with the stroke patient at home is not for every family. One member of the family needs to become the driving force behind the effort. In the Meadows family that person is the patient’s wife. Medications must be closely monitored. Services of doctors, nurses, aides and therapists must be scheduled. Doctors, hospital and pharmacy bills and Medicare and insurance payments are accurately watched and recorded. 

Overall, our family experience has been rewarding. The little triumphs from day to day far outweigh the effort and frustrations. Taking time, being composed and possessing boundless energy are necessary but not easy. Employing innovative thinking and maintaining focus on the solution to daily obstacles to the patient’s comfort and happiness is a challenge to family, friends and caregivers. 

 

Based on an article by Nancy Meadows

 

 

Recommended Reading:  Stronger After Stroke Your Roadmap to Recovery, Second Ed.

by Peter G. Levine

 

Stronger After Stroke puts the power of recovery in the reader’s hands by providing simple-to-follow instructions for reaching the highest possible level of recovery. Basic concepts covered include repetition of task-specific practice, proper scheduling of practice, setting goals and measuring recovery.

Sections new to the second edition cover the latest research from neuroscience, treatments for recovering sensation as well as recovery strategies for the young stroke survivor. Also included is a breakdown of the phases of recovery and how these phases can provide structure to efforts towards recovery.

 

 

 

Stronger After Stroke promotes:

  • Repetition of task-specific movements
  • Proper scheduling of practice
  • Challenges at each stage of recovery
  • Setting goals and recognizing when they have been achieved

The second edition is completely revised throughout incorporating feedback from readers and the latest research data. Peter has written a new chapter on “recovery core concepts” that defines the stages of recovery and explains how these stages can structure efforts toward recovery. There is also a new Question and Answer section culled from the talks Peter regularly gives on the subject.

Read reviews.

 

 

Thoughts, questions, tips?  Feel free to comment below.

 

 

 

 

 

 

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About Me

Create Your Own Blog

 

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Planning a Family Meeting to Discuss Caregiving

 

Planning a Family Meeting to Discuss Caregiving

 

 

 

When taking care of an elderly parent or another relative, family members need to work cooperatively. The more people participating in care, the less alone a caregiver feels in his/her role. Books and articles about caregiving often mention the family meeting as a way to facilitate this process.

 

But how does one go about having such a meeting?

 

 

Each family is different. In some families, only a husband/wife and their children are considered “family.” In other families, aunts, uncles, cousins, current and ex-in laws and close friends may be included in the definition of family. When planning a family meeting, it is important to include everyone who is or will be part of the caregiving team, and this may include a family friend, neighbor or paid caregiver.

 

 

 

It is also sometimes helpful to engage the help of an outside facilitator, such as a social worker or minister to help the family communicate about difficult subjects during the meeting. (This is discussed in more detail below.)

 

A decision must also be made about whether or not to include the ill family member in the meeting. Family members usually do not want to be excluded from family events and their preferences for care must be considered. However, if someone has dementia or another condition where he/she might misunderstand the purpose of the meeting, it might be appropriate to hold at least the first meeting without him/her present. Also, other family members may need to share with each other thoughts or feelings that would be painful for the ill person to hear. Consider holding one meeting to focus on those matters, and holding a second meeting with the ill person present.

 

Communication is the key to working successfully with a group of people. If it’s difficult for some family members to travel to the location of the meeting, technology can help: a conference call or the use of a speaker phone can make it easier for them to participate. A videotape or an audiotape of the meeting can also be sent out to all family members who are unable to attend. With the use of email, even those who are not nearby can also be kept up to date on how things are going.

 

Prior to a meeting, you’ll find it helpful to prepare an agenda. Someone in the family will generally introduce the idea of a meeting and arrange the date and location. That person can also create an agenda for the meeting and send it out to all the family members ahead of time. Family members can then share their ideas and suggest other items to include.

 

 

 

An agenda might include topics such as:

 

 

  • The latest report from the physician
  • Sharing of feelings about the illness/caregiving

 

Fears: 

  • About death and dying 
  • About being overwhelmed 
  • About what will happen to family members after the death 

 

 

  • Sadness, confusion, anger, guilt, shame 
  • What does the person who is ill want and need? 

 

 

Daily caregiving needs:

 

  • Should the sick person move in with us? 
  • Does she/he need to be in an assisted living facility or nursing home? 
  • How much time does each family member have to visit? 
  • Other ways each person can help? What other help might be available? 

 

 

 

http://www.navigatepanc.com/wp-content/uploads/2015/09/iStock_000044814800_Medium-01.jpg

 

Financial concerns:

 

  • How much will it cost? 
  • How much work can family members afford to miss? 
  • What financial help might be available from outside? 
  • Who will make decisions (e.g., financial, medical, hiring a caregiver, etc.) and how will they be made? 

 

 

  • What support role does each person want to play? 
  • What sort of support does the primary caregiver need? 
  • Need for respite (a break from caregiving)
  • Help with meals, shopping, cleaning, laundry, etc. 
  • Emotional support by telephone or email 
  • Help with chores—i.e., taking the care recipient to doctor’s appointments 
  • How will the caregiving and support needs change as the illness progresses? 
  • Problem Solving 
  • List of tasks that need doing 
  • Summary of meeting and schedule for next meeting 
  • Written summary of what each person has agreed to 
  • Email or telephone tree for regular updates

 

It will probably be difficult to cover all these issues in one meeting, so additional meetings will be helpful. Each ensuing meeting should have a clear time table and a definite beginning and ending time. Be sure to stick to the time table; if meetings get to be too long, fatigue sets in, minds will wander, and people may resist coming to future meetings.

 

As with all high-level negotiations, deciding where to hold the meeting is as potentially controversial as the meeting itself. Whether you hold it in an office, a restaurant or someone’s home, keep in mind that you want a setting that the majority of the participants will find comfortable and convenient and that presents as few distractions as possible (e.g. noise, small children who need attention, etc.).

 

 

A successful family meeting gives everyone a chance to be heard. All feelings are appropriate and need to be expressed and acknowledged. People will be more willing to talk about their feelings regarding the situation if they feel safe. For example, the brother who is never present may reveal that he is unable to stand seeing someone sick, and the sister who is doing all the work may not realize how she pushes others away when they offer to help. Another sibling may be having marital problems which he or she has not yet shared with the family, and yet another sibling might be worried about losing a job. Each person needs to balance his/her own fears, concern, love and desire to help with available time, strengths, weaknesses and hopes.

 

Until the depth and breadth of the issues concerning the ill family member are explored, it is important to not try to solve the problems. Recording the problems in a list as they are shared, however, will be useful during the problem-solving portion of the meeting.

 

 

It is important for each family member to learn to use “I” messages, as well to say “I need…” rather than “You should…” Even when disagreeing, try to find the part of what is said that you can agree with. The goal of the meeting is to work as a team in caring for the person who is ill, even if there is conflict among family members in other areas.

 

At the conclusion of the meeting, make sure everyone has a clear understanding of the issues and considerations discussed. When the solutions to issues have been established, make sure that each person understands what he/she has agreed to do.

 

The most important thing for family members to remember is that the meeting is not a one-time event. Family meetings need to take place regularly. It is helpful to schedule them at a given time, perhaps at the same time each month. However, if this is not possible, they at least need to take place when the caregiving situation or other situations in family members lives change. Holding regular meetings puts less pressure on family members to get everything resolved in just one meeting, and allows more time for processing of information and decision-making. When a family member is unable to attend a meeting, keep in touch with them by phone, mail or email.

 

Families come with history: a history of how each person relates to the others, a history of what role each person has played and currently plays within the family, a history of how each person feels toward the person who is sick, and a history of how each person deals with illness and adversity. And in each family there are rules about what can and cannot be said, what emotions are okay and not okay to express. These factors can make family meetings difficult. This is why a third party facilitator can be helpful.

 

Family members play roles based on position in the family, relationship to the person who is ill, special talents, etc. The person who is the caregiver may be different from the one who handles the money, who may be different from the person who is the information gatherer, who is different from the one who is the decision maker or the one who has some medical background. One person might play several roles. Also, often someone is the “blamer,” and someone else the “blamed.” One person may try to make peace, and another may try to sabotage the process. There will be secrets, old family rivalries, guilt, unequal burdens, differing investments, values and interests. Some will worry about past promises and about someone else not pulling his/her own weight. Everyone will need attention, power, love, control, and appreciation. It can help to acknowledge that there is probably no fair distribution of work and trying to make it even will fail.

 

A narrow focus for each meeting can help alleviate some of the pitfalls. Still, you will have to deal with some of the difficult issues when they get in the way of cooperation. Remember that you can’t resolve long-standing family issues with one such meeting. The task is not to “fix” the family, but rather to have everyone on the same team, as much as possible, in caring for someone who is ill.

 

If alcohol will detract from the main focus of the meeting or will lead to conflict, it is better not to offer it. However, each family has different ways of communicating, and in some families a drink may make everyone more comfortable and more able to talk. In any case, over-consumption should be avoided.

 

 

Consensus

 

http://opengov.newschallenge.org/open/open-government/submission/consensus-based-governance/gallery/consensus.jpg/

 

Not all the issues inherent in caregiving and decision-making can be solved; sometimes it is important to accept approximations of a good solution. Try to work toward consensus building. Change happens slowly, but when families meet regularly, the seeds that are planted can grow into more productive solutions. Often things do not change until there is a crisis, but the work that has been done during the family meeting will make decision-making easier when the crisis does come. Agreements can be made on a time-limited basis to see if the agreed-upon action will work. Future meetings can be used to evaluate these trials and revise them as necessary.

 

Respecting each person’s individuality and situation helps to create an atmosphere of acceptance and allows for creative solutions to problems. For example, Carol finds it difficult to be around sick people, so when her brother got lung cancer, she knew she couldn’t take care of him. However, she was more than willing to make the pastas of their native Italy and take them to him to comfort him during his illness. Jesse lives a thousand miles away, but can get time off from work to be with her mother while her brother and his family take a vacation. When Ed’s mother had surgery, Ed arranged to take care of his father with Alzheimer’s, while his sister worked full time and helped with the expenses. Gina takes her parents to medical appointments while her sister makes sure they get their medicines properly every night.

 

 

Compromise

 

http://peoplemastery.com/wp-content/uploads/Compromise.jpg

 

In order for these solutions to work, people have to learn to compromise. By being open to alternatives, you might get part—although maybe not all—of what you want or need. We often hold out for only one solution to a problem, we don’t consider other possibilities that could assist us. Asking for help is one of the hardest things to do. Learning to graciously receive help offered can also be a struggle, not only for the person who is sick, but also for the person who is the primary caregiver. Being appreciative is the best reward you can give someone who is trying to help you, even if the type of help he/she is offering isn’t exactly what you wanted. When you make someone feel good about helping, he/she will want to help again. “Thank you” will take you a long way in working together. In creating the caregiving team, think about how each person should be acknowledged.

 

 

Put it in writing:

 

 

A written agreement capturing the decisions and agreements made at the end of the meeting can be a helpful reminder for family members. Distributing a calendar with different days marked with responsibilities and commitments can also help each person honor the agreements made.

 

Although family meetings can be powerful and effective ways to connect and work with family members, they cannot magically solve all the problems of caring for an ill family member. When families have trouble working together or coming to agreements or when the family is divided on a big issue, it often helps to invite a neutral outside facilitator to attend. Sometimes a crisis precipitates the need for a meeting—perhaps someone is in the hospital and major life and death decisions need to be made. Time can be of the essence. Whatever work you have done together earlier will help you at these times of extreme stress.

 

Social workers from local caregiver organizations (such as Caregiver Resource Centers in California), as well as ministers, private case managers, social workers in home health or hospice, physicians, discharge planners in hospitals and nursing homes can help facilitate a family meeting or refer you to someone who can. Psychotherapists in private practice are trained in family counseling. If you find yourself in a difficult position, you might also want to see a psychotherapist privately. Don’t forget the support you can find with friends, colleagues and support groups. Sharing experiences with other caregivers can help ease the feelings and frustrations often involved in being a caregiver.

 

Sources:

Share the Care, Cappy Capossela, Sheila Warnock, Simon and Schuster, 1995.

I’ll Take Care of You, Joseph Ilardo, Carole Rothman, New Harbinger Publications, Inc., 1999.

Taking Care of Aging Family Members, Wendy Lustbader, Nancy Hooyman, The Free Press, 1994.

The Caregiver Helpbook, Vicki Schmall, Marilyn Cleland, Marilynn Sturdevant, Legacy Health System, 2000.

How to Care for Aging Parents, Virginia Morris, Workman Publishing, 1996.

 

 

Recommended:

How to Care for Aging Parents – A One-Stop Resource for All Your Medical, Financial, Housing and Emotional Issues

 

How to Care for Aging Parents, 3rd Edition: A One-Stop Resource for All Your Medical, Financial, Housing, and Emotional Issues by [Morris, Virginia]

 

 

 

Also Very Helpful:

The Caregiver’s Toolbox – Checklists, Forms, Resources, Mobile Apps and Straight Talk to Help You Provide Compassionate Care

 

The Caregiver's Toolbox: Checklists, Forms, Resources, Mobile Apps, and Straight Talk to Help You Provide Compassionate Care by [Hartley, Carolyn P., Wong, Peter]

 

 

 

 

 

 

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Please help others by sharing this post. Share on Google+Tweet about this on TwitterShare on LinkedInDigg thisPin on Pinterest

Book Review of “Our Dementia Diary”

 

Book Review of

“Our Dementia Diary”

 

 

 

Rachael and Irene were supposed to live a long and happy life, retire and travel the world. But a thief called Alzheimer’s visited in 2004 and began tearing apart the lives they had carefully built for a quarter century.

This is a remarkably honest story of the enduring love between two people coping with uncertainty and the eventual loneliness of losing a spouse.

The author, Rachael Dixey, professor at Leeds Beckett University copes by keeping a journal—a way to release her feelings. She ties these entries with “interpolations” to make sense of it all. She wonders if a more appropriate title might be Fifty Shades of Dementia.

 

 

Dixey manages to find strength amidst the tears to take care of herself and find the humor. She hires in-home caregivers for Irene while she works (for sanity). When Irene is hospitalized and then placed in a care home, she visits almost every day and soon realizes the toll it takes when Irene recognizes her and says, “I love you” and the next day, forgets and walks past her in the corridor.

During the nine-years, from Irene’s diagnosis to her passing, Rachael writes of the full range of emotions—from the love she and Irene shared to missing Irene, feeling lonely as a singleton, dating (nothing lasts but gives her strength to be stronger for Irene), and even contemplating Irene’s death. Through it all, she visits Irene regularly, cares for her, feeds her, and feels Irene in every room of their house.

She recounts with humor the folly of dealing with social services. Irene attends adult day services in a county that only covers healthcare and receives healthcare in a county that covers social services such as adult day care. After almost a year, they work it out where she feels assured of not losing their home. Meanwhile, she takes time off periodically. The time away gives her greater appreciation for what she and Irene had despite some funny (in hindsight) foibles during her travels.

She recounts the good times they had going on “epic walks,” camping, exploring the mountains, trees, and sunsets. She misses those quiet mornings together. She struggles to remember the bad unusual behaviors for five years before Irene’s diagnosis at age 57. Home movies help her see the beginnings of Irene’s inexplicable behaviors. She’s able to piece together those embarrassing outbursts when Irene would storm out of restaurants after finding something wrong with her meal. She recalls the desperate cries at home when Irene couldn’t find a piece of clothing she had worn for several days in a row (likely because Rachael removed it for washing). And yet, Irene’s heart-wrenching cry early on returns to her from time to time, “I don’t know who I am anymore. Please help me.”

Written by an author based in the UK gives us Americans a refreshing expression of care between partners. Her writing is characterized as informed humility. We gain greater awareness and knowledge of what it’s like to live with Alzheimer’s while feeling the angst and pain of losing her soulmate. Written by one of a gay couple gives us an endearing portrait of how love among LGBTs is no different than love among (dare I say, traditional?) male-female partners. Oftentimes, because of ongoing discrimination, the bond of their love seems stronger.

I’m glad she chose to write, Our Dementia Diary – Irene, Alzheimer’s and Me and that her and Irene’s story is being shared. The LGBT caregiver’s voice is one that needs to be heard.

 

Based on a review by Brenda Avadian, MA,  who serves as President of The Caregiver’s Voice.

 

 

More information from Amazon:

 

This is a love story from start to finish, Irene and Rachael’s. Based on the diaries of Rachael Dixey who looked after her civil partner Irene after she developed early onset Alzheimer’s disease, the book opens with the lines: Irene, Alzheimer’s and me – Alzheimer’s came between us. It does that, drives you and the love of your life apart, going your separate ways because you cannot follow.

That’s the story really, that’s it. The end. But it is also the beginning of the story, which shows how life can still be lived despite losing a life partner to dementia, and how to cope emotionally and practically with a disease that robs you of your loved one a thousand times before they die.

 

 

The story charts the daily decline and inexorable loss of Irene to dementia. With the dramatic deterioration in Irene’s health Rachael turns from lover and soul mate to career and, finally, single woman. Eventually, no longer able to cope with Irene at home, she makes the agonizing decision to allow Irene to be put in a care home. There she spent her last six years. When she died aged 66, the couple had spent half their life together.

This book is a powerful and moving account of the progression of dementia, and raises serious questions about how our society cares for those who develop the disease, especially at a young age and in the gay, lesbian community. It also deals with loss and grief, during the illness and afterwards. Their memoir will be invaluable for anyone affected by dementia, those working in mental health and those caring for a loved one with a life-changing and incurable illness.

Our Dementia Diary tells with brutal honesty of love, loss and life with Alzheimer’s and opens up discussion of how dementia can be handled better.

 

 

 

Also Recommended:

The 36-Hour Day, 5th Edition A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss

This best seller is the definitive guide for people caring for someone with dementia. Now in a new and updated edition, this best-selling book features thoroughly revised chapters on the causes of dementia, managing the early stages of dementia, the prevention of dementia, and finding appropriate living arrangements for the person who has dementia when home care is no longer an option.

 

 

 

The author, Nancy L. Mace, M.A., is currently teaching dementia care internationally. She has been a consultant to the Office of Technology Assessment, U.S. Congress, and to the Alzheimer’s Association, and she was an assistant in psychiatry and coordinator of the T. Rowe and Eleanor Price Teaching Service at the Department of Psychiatry and Behavioral Sciences of the Johns Hopkins University School of Medicine.  

 

 

 

 

 

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Book Review of “Can’t We Talk About Something More Pleasant?”

 

A Caregiving Memoir You’ll Really Identify With

 

 

 

Roz Chast is a professional cartoonist and illustrator who captured her personal story about caring for her parents as they grew older and sicker. It’s titled Can’t We Talk About Something More Pleasant? and was one of the New York Times’ 10 Best Books of 2014.

 

Chast was an only child, living in Connecticut, but cared for her parents who lived in Brooklyn. Her journey started in 2001 and ends with her mother’s death in 2009. Her father passed away in 2007.

Why this book is different

 

There are many books written by former caregivers and they’re each wonderful in their own way. What makes Roz Chast’s memoir stand out are her cartoon-style drawings.

They transmit her feelings so well, we can feel her annoyance when her father’s incessant chatter drives her up the wall. The pictures bring her anxiety-filled childhood to life and explains her (still) complicated relationship with her overbearing mother.

She perfectly captures the funny and crazy moments

 

While there is sadness, this book is far from depressing. It’s a real-life view of Chast’s caregiving journey. She remembers the funny things and crazy stories and captures them all in hilarious drawings.

 

roz chast

Image: The New Yorker

My favorite caregiving scenarios from the book

 

Chast is an excellent storyteller and entertains us with scenes that we’re all too familiar with:

 

  • Living an hour or two away, having her own children and husband, and just really not wanting to deal with her parents and their increasing needs.
  • Hating the ever-worsening grime and clutter in their apartment.
  • Trying to convince them (unsuccessfully) that they need more help in the house.
  • That first horrific episode of incontinence (the really messy kind)!
  • Those middle of the night phone calls when something happens…

 


I love this book and recommend it to any current or former caregiver as well as any family members. It doesn’t matter if you’re caring for a parent, spouse, relative, or friend, this book is beautifully illustrated, well-written, and a lighter way to get acquainted with caregiving and aging.

Check out the customer reviews of Can’t We Talk about Something More Pleasant? at Amazon

Excerpts From Can’t We Talk about Something More Pleasant?

 

 

 

Check out the customer reviews of Can’t We Talk about Something More Pleasant? at Amazon.

 

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Overcommitted and Burned Out

 

 

 

 

We in the ‘civilized’ Western world have way more to do than is doable.

 

Does the term “overcommitted” fit you?  If you are a caregiver, likely it does.  

 

You probably don’t have time to read this, but I am glad you are.

 

 

 

 

Defining and Studying Overcommitment

 

According to a German study , the term ‘overcommitted’ refers to people who are doing way too much. And more specifically, we also have a high need for approval for the things that we do.

 

We are talking about a type A behavior personality where a person has a lot of ambition, likes to control things, and needs approval too.

 

People who are overcommitted generally try to do much more than is humanly possible, and they use up their all energy in the process, to the point that they can get sick to the point of exhaustion and poor health. In some natural medicine circles, this will lead to what is called ‘adrenal fatigue’, a condition where the adrenal system is working sub optimally.

 

 

Why Overcommitment Is Not Good For You

 

Overcommitment has been shown to lead to a number of issues including:

 

  • depression
  • diabetes
  • sleep problems
  • inflammatory disease (like autoimmune illness) and
  • cardiovascular disease.

 

When you are temporarily overcommitted, and in an anxious state, your body tries to help you cope, by making many more stress hormones and also chemicals that can raise inflammation in your body. In the short term, these will help you muster the energy to cope with the stressor and get through.  It is like when you are running from a bear, you want those stress hormones to kick up your speed and make you stronger. And you want those inflammation molecules just in case there is a fight, so you can fight the infection from any injury that might happen.

 

Unfortunately, overcommitted people run hot like this all the time. They are always running from the “bear.”  In the long term, these stress hormones and inflammatory chemicals tend to start doing more damage than good: they beat up the brain, the linings of the blood vessels. They deposit fat in places they shouldn’t and there’s often poor blood sugar control. This is why so many diseases become more likely when we are overcommitted.

 

When you are chronically running from a bear, you will notice your resilience to stress starts to buckle too. Your sleep can be affected, and for women, hormonal issues start cropping up, including difficult periods with pain and emotional challenges, fertility issues and sufferable menopause symptoms too. For men, libido and sexual performance will go way down, fatigue takes over, and anxiety and depression can hit as well. For those genetically prone, they may end up with allergies, headaches, migraines, chronic fatigue, digestive problems, high blood pressure, or the opposite postural hypotension (a condition where blood pressure drops easily).

 

The German study from 2008 looked at 53 teachers (20 men and 22 women).  Teachers are a group notoriously known to overcommit despite the fact that they are given little appreciation.  They tested each person to find out who were over-committers, and who were not. What they found was the people who were demonstrated to be overcommitted in their lives had a tough time creating the stress response needed to keep up with the demands of life. Like in the case of adrenal fatigue, these people were running from the bear for so long, they couldn’t even make the hormones they needed to keep it up.

 

This makes these teachers and all of us over committers especially vulnerable to the burnout.

 

 

How To Protect Yourself and Heal from Overcommitment

 

Overcommitment syndrome as a very common underlying cause of illness. While most people can’t just completely stop their lives,there are a few ways to rethink and support your mind and body:

 

 

 

 

1 – Sleep a little more

Sleep is the best way to rejuvenate the body and the stress system. Trying to get to bed early (by 10 or 11 PM) goes a long way to lower inflammation and heal. Don’t exercise if you are not getting enough sleep, for you may deplete yourself more.

 

 

 

 

2 – Remember that ‘no’ is a sentence: it’s okay to say no sometimes.

 

Realize that you do not have to go to everything. You also don’t have to be the volunteer for that church or community project, because you feel guilty. You may not need to check all those emails or answer every facebook comment at night. You can also opt out of extra work – it won’t kill your career. It’s okay to let someone else do it;  delegate when you can.

 

 

 

 

 

3 – Meditation: even one minute twice a day will help shift your body from “I’m running from a bear” stress mode to “I can be in the present” mode.

 

 

This will open up your digestive tract and lower inflammation in the body, as well as allow your brain to repair from all the stress hormones. Overcommitters live in the future – visiting the present can help break the cycle.

 

 

 

 

 

e-factor-diet-cover

 

4 – Eat a High Energy Diet, and Lose Weight if Necessary

Being well-nourished and at a healthy weight will increase your resilience.  Read about the diet I recommend for weight loss and energy.

 

 

 

 

 

5 – Take some Supplements:

 

Supplements for general health and mood, as supported by research, are a high quality multivitamin/mineral supplement , a fish oil supplement  and a probiotic.  These can help gently support systems that are constantly under siege.

 

 

Recommended: MegaFood One Daily, Dr. Tobias Optimum Omega 3 Fish Oil and Naturewise Time Release Probiotics

 

 

 

 

6 – Find places for support: look towards friends, family, and other overcommiters to share the burden.

 

http://www.thelifeofsingleparents.com/wp-content/uploads/2015/03/bigstock-Priorities-List-65174149-704x454.jpg

 

 

7 – Prioritize: going along with #2, know that you can’t do everything… so sit down in a quiet place and pick what is most important and make that the focus.

 

 

 

8 – Adrenal Testing and Support: There’s a test called a saliva adrenal test or saliva stress test, and it can show function of your adrenal system.

There are correlations between non-optimal adrenal function (aka “adrenal fatigue”) associated with orthostatic hypotension, POTS Syndrome (postural orthostatic tachycardia), chronic fatigue and fibromyalgia, as well as inflammatory issues like lupus and other autoimmune diseases. 

Once you have the information from this test, you can pick the right herbs and supplements as well as lifestyle choices to boost your adrenals. 

Recommended: Adrenal Home (Saliva) Stress Test from ZRT Laboratory

 

For some people, an adrenal supportive supplement can help gently nourish the adrenal glands when they are not responding as well as possible.
 

For adrenal help, use a combination that includes ashwanganda, B vitamins and mushrooms. There are many quality supplements out there for this purpose.

I like NutraBorn Optimal Adrenal Support.  Talk to your holistic doctor to learn which might be best for you.

Remember, supplements themselves do not fix the problem, but they can help support the body to avoid exhaustion.  When used with a proper regimen of sleep, lifestyle and dietary changes like mentioned above, you can gain your strength and vitality back.

 

 

 

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The Drunk Caregiver

 

For some, the burden of caregiving can seem unbearable – whether you’re caring for an elderly parent with Alzheimer’s or parenting a child with cerebral palsy. It is, without question, a challenging way to live: attending to your loved one’s personal hygiene, going back and forth to doctor’s appointments, preparing meals and ensuring he or she eats, and so on.

 


 

 

The stress is serious enough that it causes some caregivers to turn to alcohol or drugs in a desperate attempt to cope.  This can turn the tables on a caregiver – putting them in the position to need care in the form of alcohol or drug rehab.

 

 

The stress is serious enough that it causes some caregivers to turn to alcohol or drugs in a desperate attempt to cope.  This can turn the tables on a caregiver – putting them in the position to need care in the form of alcohol or drug rehab.

 

The Impact of Caregiving

 

Caring for the needs of another can be rewarding. Caregivers often feel that the responsibility adds meaning to their lives or peace of mind that they are strengthening their relationship with a loved one.

 

However, there are many downsides to taking on such a daunting task. For example, the responsibilities of caregiving often take a significant physical toll. It’s not uncommon for those who must constantly tend to the needs of others to suffer from headaches, insomnia and weight loss or gain.

 

They often begin to feel the physical strain that comes from helping a loved one use the restroom, washing their hair regularly, or lifting them in and out of a wheelchair. Perhaps you can relate – you may be dealing with similar issues or have even suffered injuries related to your role as a caregiver.

 

 

 

The physical effects are just part of the picture. There are emotional and financial costs to caregiving as well. Caregivers report high levels of depressive symptoms. Dementia caregivers have been found to be particularly vulnerable to higher rates of depression and stress, as well as lower rates of general well-being.

 

Overall, caregivers report a lower quality of life [3].  As a caregiver, you may struggle with anxiety or social isolation. You might be frustrated or angry that you’re the one who has to be responsible for a family member’s care.  Additionally, you may suffer financial strain if you lose time from work or need to take on additional expenses.

 

 

 

Feeling the burden of caregiving doesn’t necessarily end when an ill loved one is placed in long-term care. One study found that caregiver depression and anxiety did not decrease when a relative, especially a spouse, was moved to a care facility [4]. Your duty may have ended, but the emotional impact still lingers.

 

When the negative effects of caregiving are combined, they may actually increase mortality rates in those doing the caregiving.  For example, a study of individuals between the ages of 66 and 96 who cared for their spouses and who also reported caregiver strain found that their mortality risk was 63% higher than those in a non-caregiving control group [5].

 

Recommended: Free PDF Report – Why You Need to Stop Drinking … and how to get started TODAY!

 

 

 

Caregiving and Substance Abuse

 

 

The high stress of caregiving can make you vulnerable to substance abuse, which can lead to a serious problem that requires alcohol or drug rehab. As a caregiver, perhaps you began with a glass of wine every night to relax; now you drink until you pass out. Or maybe you’ve started dipping into your loved one’s pain medication.  Before you know it, you have an addiction that is interfering with every aspect of your life.

 

 

Whether it’s alcohol or drugs, an addiction puts your health at risk. It negatively affects your body in a variety of ways, including the potential for serious damage to your liver and other organs. Alcohol and drugs affect the brain as well, altering how you think and interfering with your ability to make good decisions – for yourself as well as for the person in your care.  You may also suffer financially, by lost income due to missed work days (for example, because you’re hungover) or from losing your job altogether.

 

Your substance abuse also puts the person in your care at risk. You’re less likely to be able to respond to his or her needs, including dispensing medications properly, caring for his or her personal hygiene, or calling for help if there is a medical emergency. In addition, studies have shown that caregivers who use are more likely to abuse the person in their care [6]. If you’re intoxicated or high, you may do something you’ll regret like strike the person in your care if he or she is uncooperative or fussy.

 

As you can see, if you’re using substances to cope as a caregiver, the potential risks and costs can be extremely high.  Not only are you putting yourself at risk for a variety of problems, you’re also endangering the person who’s been entrusted to your care.

 

Treatment for Caregiver Substance Abuse

 

You can’t adequately care for a loved one if you’re not healthy — and abusing substances is not a healthy way to cope with the stress. Substance abuse is a mental health condition that requires professional alcohol or drug rehab treatment. An addiction therapist or counselor will help you determine the type of treatment you need.  If you’re substance abuse issue is serious, you may need inpatient treatment. If you get help sooner than later, outpatient treatment may be sufficient.  But you won’t know until you have an assessment.

 

If you are the primary caregiver, you may need assistance finding a person or organization able to care for your loved one while you’re in treatment. A family member or close friend of the patient may be able to step into the caregiving role.  You may find that they were already aware of the substance abuse issue (or at least suspected it) and are more willing to help than you might expect. Don’t let pride get in the way of asking for help.

 

In situations where others cannot or will not step in to assume the caregiving role, reach out for assistance. Your addiction counselor or team may be able to provide some helpful resources. Also, consider contacting local agencies, such as social services, for recommendations for skilled daycare or other care options. It’s critical to check out every available option. Please don’t give up on treatment because it is a challenge to find care for your loved one.

 

Once you begin alcohol or drug rehab treatment, your job is to focus on getting yourself well. As you work toward your sobriety, talk to your treatment center team to determine if or when you can return to your caregiving role.

 

If you do return, it will be essential to continue to care for yourself by making lifestyle changes that support your recovery. To stay healthy and abstinent, you’ll need to take time every day to step away from your responsibilities and take care of yourself.  This might include things like taking a walk around the block, having coffee with a friend, or working on a project that relaxes you.

 

Finding support is another critical tool for long-term recovery -– especially for caregivers who often struggle with isolation. Consider joining a self-help group that can provide support and guidance for those living with an addiction. Regular meetings will allow you to connect with other addicts so you can learn and share experiences.

 

In addition to support for your addiction, it’s also important to find support in your role as a caregiver. Locate a local support group with members who are going through the same experiences as you. For example, you might find it beneficial to connect with similar caregivers, such as other mothers of kids with autism or spouses who care for partners with dementia.

 

Substance abuse hurts not only you, but also the person you’re caring for. Alcohol or drug rehab can help you overcome it. The journey may not be easy – in fact, you can expect some setbacks -but you will learn healthy coping strategies so you can get well and, if possible, continue in your role as caregiver. You and your loved one don’t deserve any less.

 

 

How Strong is Your Addiction?

 

Working out the extent of a problem is not simple. Countless drug users refuse treatment on the basis that they aren’t “really” addicts, and in the process they allow their use to spiral out of control.

 

Many people only seek treatment when they hit rock bottom, they might find themselves lying in a pool of their own vomit in a dive bar, losing their job, or utterly destroying their personal relationships before they realize they need help. The reason they let it get this far is because being honest with yourself about your problem isn’t easy.

 

 

Adopting the Right Mindset

 

The first thing you have to do if you want to truly understand the extent of your problem is to drop any pretenses you hold. Rationalizations for your use might have been growing and gaining power since you started using, and you need to forget these in order to make an accurate assessment.

 

Telling yourself that you only use to reward yourself after a tough day or that you’re only “experimenting” with drugs is a good way to completely ignore a problem. Discard any of these notions you’ve picked up along the way.

 

In order to really understand how serious your problem is, you have to temporarily ignore the emotional part of your mind. This is easier said than done, but receiving any form of criticism from anybody isn’t easy, so you have to ensure you won’t ditch a train of thought because of the potential consequences of it.

 

You might not want to realize that you have to use every single day, otherwise you get tense and irritable, but the weight of that knowledge pales in comparison to the damage you’ll do to yourself if you don’t acknowledge it. You essentially have to become a third party, observing and analyzing your own behavior through the microscope of rationality.

 

Recommended: Free PDF Report – Why You Need to Stop Drinking … and how to get started TODAY!

 

Thinking About Your Use

 

The simplest way to start appraising your problem is to think about your relationship with your drug of choice. Think about the pattern of your drug use. How often do you use on an ordinary day, and when do you use? Do you need to take drugs to feel “normal” for the day? How much do you spend per day on drugs? How about per week? Asking yourself searching questions like this starts to paint an important picture. Remember, you need to treat this information as if it’s coming from somebody else; don’t spare your feelings, just think about the information objectively and draw what conclusions you will.

 

One of the most important things to think about is the degree to which your life revolves around your drug use. Do you find yourself planning your day around taking drugs? Are you unable to stick to limits you’ve set yourself for the day? When you don’t use, do you experience withdrawal symptoms? If you find yourself getting irritable, having trouble sleeping or experiencing general flu-like symptoms, you might be going through withdrawal. Taking more drugs to alleviate these symptoms is also a clear indicator of a problem, as is taking drugs instead of participating in activities you used to enjoy.

 

 

Thinking About Your Life

 

The other major impact of drug use is the one it has on your life outside of drugs. You might find you’ve been dodging your responsibilities, calling in sick for work, or even neglecting your children as you’ve started to use more and more. Have you been having trouble with your relationships? Even if it doesn’t seem related to drugs, it’s important to think about. The psychological impact of drugs can have wide-ranging consequences, and it could be placing your relationships under strain indirectly.

 

 

Putting it All Together

 

The pieces of information you’ve been gathering should be starting to form a picture. You might be faced with somebody who takes drugs every day and at every opportunity, who takes days off work to dose up to oblivion and whose closest relationships are crumbling by the day. It might not be nice to admit things like this, but if you were presented this information about somebody you’d never met or a fictional character in a book, what conclusion would you come to? Is the person a casual or experimental user, or is he or she suffering from addiction?

 

Remember, you don’t have to be ashamed of your actions; it could happen to anybody and it might be the result of a genetic pre-disposition to addiction. Even if it isn’t, there is no shame in having made some mistakes in your life. We are all human, and as a result we are all flawed. No matter how hard you try to get along the right way in life, it’s easy to stray off the path. It takes wisdom to realize that you’re heading in the wrong direction, and it takes strength to turn yourself around and do things right.

 

The fact that you’re reading this means that you acknowledge that your drug use is negatively impacting your life, but thinking honestly about the full extent of the issue can help you realize how severe the problem is. If you don’t appreciate the impact that your addiction is having on your life, relapse is much more likely. Those little rationalizations and denials we use to protect our egos will mount up and convince you that starting to use again wouldn’t be that bad. Stay objective, and you’ll see why starting treatment is absolutely essential.

 

Recommended: Free PDF Report: Why You Need to Stop Drinking

… and how to get started TODAY!

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Plan Some Summer Outings With Your Senior

Many aging adults spend the bulk of their time just managing to get through the day. They take care of life’s basics but often don’t leave their home, assisted living center or nursing home, except for doctor appointments and an occasional holiday.

 

 

Enjoying a breezy spring day or the warm summer temperatures don’t have to be a distant memory for elders and caregivers.

After being cooped up in the house for possibly months at a time, senior adults can breathe in the fresh air, even if they are experiencing mobility problems.

It takes some advance planning and choosing an activity that won’t seem like a chore, but it’s worth getting out of the house, for you and your elderly parent.

 

The benefits of getting outside

 

A main advantage of heading outdoors, even for a short period of time, is being able to soak up the sunlight, which generates Vitamin D – necessary for the brain, bones and muscle function, says Dr. Michael Raab, a geriatrician with Lee Memorial Health System in Fort Myers, Fla.

 

 

Some doctors even prescribe sunlight as a source of Vitamin D, which research also finds can improve cognitive function.

See Vitamin D and Diabetes

Another key benefit is that being outside enables elders to socialize and interact with caregivers as well as other adults, children and animals.

Those activities can give people an extra spring in their step and rejuvenate them, says Christina Chartrand, vice president of training and staff development for Senior Helpers, an in-home senior care agency with offices in 40 states.

Raab adds: “Whatever you can do, it’s going to be mentally uplifting.”

Although caregivers may be aware of the benefits, sometimes it seems as if the obstacles, such as wheelchair access, bathroom access, frailty and fatigue, are too great to overcome the great outdoors.

Caregivers can start to prepare elders with mobility problems to take the steps to head outside. Your physician can suggest chair exercises to make them more stable and build their muscles, for example.

Even though the temperatures may be pleasant, Raab says it’s also important to make sure an elderly family member stays well hydrated; if not, it can impact muscle function and blood pressure and lead to a dangerous situation.

Families and friends might like to take a senior out for some fun but they don’t know how to go about it.

 

Even seasoned caregivers can be stumped for ideas, so here are a few to get started:

 

Take a Sunday drive.

Back in the “olden days,” driving around the community to check out home town activity was a Sunday afternoon ritual for many adults.

While life is more complicated now, many elders still enjoy watching new construction or being shown how the town that they’ve lived in for decades is changing.

For those who live near flood prone bodies of water, spring is a terrific time to take a drive to see how this year’s water levels compare to other years.

A twist on this approach is to pick a prime time when cherry trees, crab apple trees or other ornamentals are at their peak and do a flower tour. Getting out of the car is optional, based on your elder’s abilities and wishes.

 

Go to the zoo.

Who doesn’t like baby animals? Spring is birth time for most species. Rent or borrow a wheelchair if one is needed for longer walks. Not only will your elders see baby animals, they will see young children reacting to the animals.

See Choosing a Transport Chair

As with everything suggested, watch your loved one for signs of fatigue, thirst, too much sun or other issues that could signal that it’s time to leave, perhaps with a promise to return at another time should they wish to do so.

 

Go to a restaurant.

When was the last time you took your elder to a restaurant that he or she has enjoyed over the years? Now that snow isn’t a problem, it’s easier to navigate such adventures.

Keep in mind that going for a meal at off-peak times is a good idea. That usually means less stress for everyone. Also, elders who are hard of hearing won’t feel as isolated if there’s less background noise.

 

Visit an Ice Cream Place.

Ice cream treats are a favorite of many a senior. I suggest encouraging your loved ones to sit outside if the weather’s nice and they are able.

 

Enjoy children at play.

Watch children swim or play on playground equipment. Spring brings young children out in throngs. People who enjoy children often like hearing their laughter and watching the seeming innocence of this type of play.

 

Summer programs.

Take your elder to the spring programs that most schools sponsor. This is particularly nice if a grandchild or great-grandchild is involved, but that’s not necessary. If your elder doesn’t know any of the children, then I’d suggest focusing on the younger ones. They tend to be “cuter.”

If grandchildren are involved, take your elder to watch them perform in their concerts, plays or other activities. You may have to arrange for a spouse or friend to be available to take Grandma home if she gets tired or uncomfortable.

A twist on this idea is to attend one of the concerts in the park that many communities have during the spring and summer.

 

Have a picnic.

Whether you go to a park, stay in your own backyard or use the grounds of the nursing home, a picnic is often possible. If your loved one is able, going to a park would be nice, however many nursing homes have gorgeous grounds and nice areas with tables that accommodate wheel chairs. If all else fails—and I’m aware that this isn’t an outing but sometimes we have to punt—bring a picnic to your loved one in the care home.

 

Check out the crops.

 

If your elder has an agricultural background or is interested in wildflowers, try taking a country drive. Even if your loved one didn’t have any first-hand agricultural experience, but they will probably still enjoy driving in the country to see new crops being planted and wild flowers blooming.

Tailor this outing to your area of the country and your elder’s preferences. Maybe you can pick up some fresh fruit and vegetables from a farm stand.

 

Go fishing.

A friend told me that his community sponsors events where elders are taken out on pontoons—wheelchairs and all—to fish. Volunteers are there to help with anything the elder can’t do.

Just being out on the water and holding a rod can be a thrill for someone who has enjoyed fishing in the past. Again, this can be adjusted to accommodate other pastimes.

 

Visit a friend.

Many elders lose touch with their peers. Sickness, the death of a spouse and/or difficulty getting around can mean they haven’t seen a dear friend for months or even years. See if you can set up a lunch or just a visit with someone your loved one has enjoyed through the years. Perhaps you can take them both to a park or a restaurant.

 

 

Use these ideas as springboards. You know your loved one. What did his or she enjoy in their earlier, healthier days? Don’t be afraid to ask what they miss doing or what they’d like to do. They may not hear those questions very often these days.

If you get a shoulder shrug or an “I don’t know,” then be ready to say, “Sunday looks nice so we’ll go for a picnic.” You may get some resistance but if it seems like simple inertia, just say with a smile that it would make you very happy if they’d do this for you. If a loved one truly doesn’t want to be part of an activity, try whittling down your expectations and suggesting something less strenuous.

As mentioned above, during any of these activities monitor your loved one for dehydration and heat issues if the weather is warm, or chilliness if it’s cool. Older bodies don’t adjust to temperature changes as well as younger ones. Be prepared with sun hats and hooded windbreakers. Also, bring water to drink and watch for fatigue.

And remember, you are doing this for pleasure, so don’t overdo anything.

 

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Suggested:

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Sun Protection

A Final note – caregivers do need to be sure that before they head outdoors, they have protected both themselves and their elderly loved ones against the damaging effects of the sun, which can lead to melanoma.

New York dermatologist Arielle Kauvar told AgingCare.com that most people don’t do enough to protect aging skin. For instance, instead of a dollop of sunscreen smeared on the face as you’re heading out the door, you should be applying a shot-glass size amount about 30 minutes before you leave. If you’re swimming or sweating, you should reapply the sunscreen every two hours.

The sunscreen should be a water-resistant, broad-spectrum product that protects against both UVA (ultraviolet short-wave) and UVB (ultraviolet long-wave) rays, with an SPF or sun protection factor of 30 or higher. It should be applied before you get dressed, so you can be sure that you haven’t missed any spots.

Dr. Kauvar says it’s important to pay special attention to the hands and feet, as well as any bald spots on an elderly person’s head. Lip balm with an SPF at least 30 should also be used, and reapplied after eating.

 

Recommended:

Aquaphor Lip Repair + Protect UVA/UVB, SPF 30, 0.35 Ounce
 
Aquaphor Lip Protectant + Sunscreen is the #1 dermatologist recommended therapeutic lip brand. 
This product contains a broad spectrum SPF 30. It is formulated with shea butter and vitamin E for extra conditioning of sensitive, dry chapped lips. This lip protectant is fragrance-free and dye-free.
 

 

 
 

For a general use sunscreen, I like Coppertone Sensitive Skin Broad Spectrum SPF 50. 

Coppertone Sensitive Skin SPF 50 Lotion, 6 Fluid Ounce

This product provides protection against UVA/UVB rays, won’t sting eyes, and keeps skin moisturized with Vitamin E.

 

Fallene Cotz Plus SPF 58 Water Resistant UVB/UVA Sunscreen for Sensitive Skin, 2.5-Ounce Tube
If your activities will require a water-resistant sunscreen, pick up Cotz Plus; this is an excellent broad spectrum SPF 58 sunscreen which will stand up to water activities without any chemicals to irritate sensitive skin.

Dark clothing with a tight weave can also protect the skin, but may not be the best choice for seniors, since they get hotter than loosely woven, lighter-colored clothes.

For this reason, Dr. Kauvar suggests buying special clothing that protects against ultraviolet rays. Made for gardening, swimming and leisure wear, the clothing should have a UPF or ultraviolet protection factor above 30 (by comparison, she says, an ordinary tee shirt only has a UPF factor of 6).

 

I like the UPF sun protection garment choices from Coolibar. They have a good variety of clothing items for men and women which are perfect for keeping skin protected during outdoor activities.

This versatile sun protective shirt below, for example, has a UPF of 50+ and comes in 6 colors.

Coolibar UPF 50+ Women's Beach Shirt - Sun Protection (X-Small - Mainsail White)

Coolibar UPF 50+ Men's Plaid Sun Shirt - Sun Protective (Small - Green/White Plaid)

 

 

 

This men’s sun protective shirt (also available in blue plaid) also has a UPF of 50+ and is a great choice for a day of activities in the sun.

 

 

 

 

Top the outfit off with a broad-brimmed hat and dark sunglasses, and you’re ready for your place in the sun.

Please share your tips for warm weather activities with your senior in the comments section below.

 

Related:

Important Tips to Keep Your Senior Hydrated

Practical Shoes for the Elderly

Keep Your Elder Safe in Hot Weather

Review of Kite Shield Mosquito Repellent

Choosing a Transport Chair

Choosing a Walking Cane

Choosing a Medical Walker

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