GETTING CAREGIVERS THROUGH THE HOLIDAYS

Most people know at least one person who is assisting an elderly or frail relative or friends. Being good friends, you often ask if there is anything you can do to help them. This is especially nice of you during the holidays when you are already busy with additional holiday activities. Most of these caregivers will respond with something like, “No, thanks” or “I’m fine,” or “We’re getting along well, thanks.”

That is a socially acceptable falsehood. Most caregivers are not fine, and they do need all the help they can get. But they find it awkward to ask. And when they are given an open-ended offer, “Is there anything I can do to help?”  they say no.

If you honestly want to help, phrase your offer differently, and be specific. Try, “I’m free Thursday afternoon. Could I stay with ____ so you can get out?” Or, “I grocery shop on Monday  mornings. What can I get  you, or please make a list of things you would like to have; you can pay me when I get back.” Or, I know you need to see your physician. When is your appointment? I’d like to stay with _____ while you are away.”

Caregivers 

Many of your relatives and friends and neighbors do want to help you get through the holidays. My favorite suggestion is Post-Its notes! When you need to go to the cleaners, write it on a Post It and stick it to your refrigerator. When you need to go to the pharmacy to pick up prescriptions, put it on a Post It on the refrigerator, or somewhere near your phone. When people ask if there is anything they can do to help, say YES! And give them a Post It.

This makes them feel good about themselves and makes your tasks a little easier.

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Holidays with Dementia

Holidays with Dementia by Kay Paggi, CMC and Angela Thomas, CMC, http://www.caringwithgrace.com The memory loss that accompanies dementia can make the holidays a nightmare. This is probably the most frustrating part of caring for someone with dementia, the constant repetitive questions and the surprising forgetting of what was just done or said. People with dementia may forget that the Christmas tree is up and be startled every time they see it. They wonder why the caregiver is changing their environment by adding decorations or cooking different foods. Unfortunately, this seasonal changing of the environment and altering of familiar daily routine presents a difficult challenge to the person with dementia. They are most comfortable with everything being the same; the daily structure helps them feel secure cope with their cognitive losses. There are several stages of dementia; discomfort with change is part of most of them. During the holiday season the caregiver wants to put up decorations, go to holiday events, go shopping, wrap gifts, address cards and participate in familiar traditional holiday activities. These tasks represent change from the routine and can be threatening to the person with dementia. Adjust your expectations of your care receiver and yourself, what  you are able and willing to do. Let family members know that some traditions may have to be altered. Understand that some friends and/or family will avoid seeing your care receiver because they don’t understand or are angry. Some sort of holiday truce needs to be negotiated between care giver, the care receiver, and the family. Explanations should be offered to your care receiver only once. When the same question is asked repetitively, it indicates the dementia patient cannot cope with the answer; it doesn’t make sense to them.  After the first answer, the practical caregiver might switch to a different type of response. One is to ask the care receiver something, such as ‘Which bow do you like best?’ or ‘Should this ornament go here or there?’ Another is to engage the care receiver in an activity. Ask them to help replace ribbon on a bolt or put stamps on cards. One of my favorite leisure activities is coloring. Dover Publications has color books printed on see-through paper (like thick tissue). Once colored, these can be placed on windows for a stained glass effect. In fact, they are called Stained Glass Coloring Books. Dover Stained Glass Coloring Books. They have several different books with holiday themes, including Christmas, Easter and Halloween, plus trains and fashion and mandalas. This elevates a childhood familiar activity to an adult activity that can be displayed along with other decorations or mailed to friends as gifts. I have some that are more than 25 years old, carefully saved from year to year. Plan for contingencies! Holiday season is also the flu season. If you or others are ill, cancel the event. If the weather looks bad, don’t go out. Shorten the amount of time usually spent in eating the holiday feast, so your care receiver will have plenty of patience to enjoy the meal. You should, also,  designate someone to take your care receiver “home” (whether it is their home, assisted living or memory care) when they are “ready to go.” While people with dementia have memory loss, they do not lose their capacity for emotions. They are particularly sensitive to the caregiver’s emotions. They may not appreciate the effort expended in decorations and baking, but they will definitely react negatively to their caregiver’s stress. The best gift you can give your care receiver, and the best for the caregiver, may be to eliminate many of the holiday-must-do’s, keep your stress level low, and enjoy hot chocolate and holiday music with your loved one. Let the primary emotion your care receiver experiences this holiday season be Joy.

HEARING THE HOLIDAY FEAST

My mother was very ‘hard of hearing.’ She was also a very strong  person, determined to have her own way; she absolutely refused to wear her hearing aids. On one of her final Thanksgivings, we agreed to bring our family and the feast food to her house. Keeping things hot was tricky. As the dishes were passed around, everyone who tasted the sweet potato casserole said something like “Oh! That’s Hot.” It got to be a joke because everyone’s startled reaction was spontaneous. Finally, Mother tasted the potatoes and exclaimed, ‘Wow! That’s Hot!’ And everyone burst into laughter. Mother had not heard other people’s comments, and thought everyone was laughing at her.

Most older adults have some hearing loss. This loss makes hearing what is being said at the feast table challenging. There is the clanking of silverware, the background music, the chatter of children, all in addition to the conversation. The conversation is probably more important than the food to the older family members, who may not see family often and are somewhat isolated. To mom’s defense, hearing aids amplify everything and might not have helped her hear other diner’s comments.

What can you do to improve the holiday experience for your aging family members/friends? Try seating her/him with his back to a wall that may act as a sounding board. Turn off holiday music. Ask the children to sit elsewhere; maybe they can have their own table where they can chatter. Remind your family to speak a bit louder.

Even more effective may be having multiple seatings, each with fewer people. Have just a few for the main meal and everyone for dessert. Or invite friends for a morning brunch and family for dinner. Try getting an inexpensive ‘pocket talker’ to amplify conversation. https://www.agingcaresolutions.com/Resources#Hearing

 

To  find out more about ElderCare, visit www.AgingCareSolutions.com  Kay Paggi’s website has been created to help educate caregivers about ElderCare; it has pages of resources as well as articles she has written. Kay is a professional geriatric care manager in private practice since 1993.

Adapt Your Holiday Traditions

When you are a caregiver you do not have time to do everything you did before you started on this journey. This is especially true during holiday seasons when the number of extra traditional activities increases your normal tasks. Take stock of those traditions that are really important, and which you can do without, or adapt to be less time and energy consuming. This is a great time to establish new traditions, too.

• What traditions ‘make the holiday bright’ for you? Make a list-
• What are your personal traditions that you could do without? Scratch them off your list.
• What would you like to do that is different this holiday season? If you add something new, something old has got to go!
• Discuss proposed family traditions that could be changed with your family. You and your family should discuss which traditions need to be kept. Going to your parents’ home may not be feasible this year; discuss an acceptable compromise. Some traditions can be adapted and still be meaningful or provide holiday happiness. Adult children must recognize that holidays may be different now that parents need extra help.
• Discuss with proposed changes with your care receiver. What is most important to them, and what can they omit without regret?
• Create new traditions such as driving to see nighttime holiday lights, watching television specials or old holiday movies, visit shopping malls to see holiday decorations, or shop at craft stores to see what they have created. Spend time listening to holiday music.
• Accept help from family and friends. They will enjoy your company far more if you are not exhausted! You need time to re-energize, away from your care receiver.
• Ask friends and family to email you their photos of  past holidays. With your care receiver, make a holiday album. You can work on this all year long!
• Scents evoke memories. Get scented incense cones, candles, potpourri, or put cinnamon sticks in a jar.
• Maximize what your care receiver CAN do – Ask what they would enjoy doing.
• Set limits. Learn to say no!
• Slow the pace – Holidays tend to be frantic, which causes stress, which is not helpful.

Adapting the Holiday Feast

Most older adults have sensory deficits. If you prepare a family recipe, be prepared for a comment like, ‘This doesn’t taste like it used to’.  This is probably not intended as a commentary on your culinary skill. It is a recognition that food doesn’t taste the same way it did when he/she was younger. People start with about 100,000 taste buds but by age 65 they may have lost up to ½ of them. The loss of sweet and salt taste buds makes their food taste bland and less appealing.

Rather than responding to this comment defensively, say something that indicates your awareness of the issue, i.e, ‘It may not taste exactly the same, but I hope it still tastes good.’  or, ‘I can’t make it like mom did.’  Try cooking with more or different spices to liven up the food for your older guests.  Add a couple of tablespoons of dried sage, rosemary, thyme, and a sprinkle of garlic powder. Or be adventurous with

• Mint – Taste: A bright and refreshing herb that works in sweet and savory dishes. ..
• Nutmeg – Taste: Sweet and pungent flavor. …
• Basil – Taste: Sweet and peppery. …
• Cardamon – Taste: A warm, aromatic spice. …
• Chilli/Cayenne. … Hot!
• Cinnamon
• Chives

Or try preparing your feast with new, different recipes instead of traditional foods. Also have new condiments on your table, such as A1 sauce, Mrs. Dash, onion powder, or Tobasco. Your goal is to make the holiday feast a happy experience for everyone present, including you, the Cook!

Happy Feasting to you, and please forward this blog to all your friends!

Adapting the Holiday Feast

Most older adults have sensory deficits. If you prepare a family recipe, be prepared for a comment like, ‘This doesn’t taste like it used to’.  This is probably not intended as a commentary on your culinary skill. It is a recognition that food doesn’t taste the same way it did when he/she was younger. People start with about 100,000 taste buds but by age 65 they may have lost up to ½ of them. The loss of sweet and salt taste buds makes their food taste bland and less appealing.

Rather than responding to this comment defensively, say something that indicates your awareness of the issue, i.e, ‘It may not taste exactly the same, but I hope it still tastes good.’  or, ‘I can’t make it like mom did.’  Try cooking with more or different spices to liven up the food for your older guests.  Add a couple of tablespoons of dried sage, rosemary, thyme, or a sprinkle of garlic powder. Or be adventurous with

• Mint – Taste: A bright and refreshing herb that works in sweet and savory dishes. ..
• Nutmeg – Taste: Sweet and pungent flavor. …
• Basil – Taste: Sweet and peppery. …
• Cardamon – Taste: A warm, aromatic spice. …
• Chilli/Cayenne. … Hot!
• Cinnamon
• Chives

Try preparing your feast with new, different recipes instead of your family’s traditional foods. Have different condiments on your table, such as A1 sauce, Mrs. Dash, onion powder, or Tobasco. Your goal is to make the holiday feast a happy experience for everyone present, including you, the Cook!

Sleep Aids

Most over-the-counter (OTC) sleep aids contain diphenhydramine. This drug often causes constipation, confusion, dizziness, and next-day drowsiness. These are particularly bad side effects for older adults. OTC sleep aids also lead to impaired balance, poor coordination and poor driving performance the next day. The long time use of these drugs is linked to an increased risk of dementia.

The packaging says it is not ‘habit forming.’ But long term use of diphenhydramine can create psychological dependence. Psychological dependence is what happens on the night you do not take it and lie there for hours trying to sleep; your mind is convinced that you have to take a pill in order to sleep. How else are you to get to sleep?

Sedative-hypnotics are prescribed by physicians for sleep disorders. One-half of all sedative-hypnotics are prescribed for older adults. All have side effects that include falls, confusion, depression, and dependence. Best to avoid these medications.

A geriatric psychiatrist recently recommended playing yoga tapes at bedtime. At the end of most yoga sessions, there is a cool down period in which you consciously relax. Counting sheep and reading the phone book are substitutes, of course. But listening to relaxation tapes is safe and effective.