LIFE ACCORDING TO ROSE

Rose started her college education at age eighty-seven. She said that she was there to meet a rich husband, get married, have a couple of children, and then retire and travel. In a more serious moment she admitted that she had “always wanted a college education and now I’m getting one!”

At the end of the semester Rose was invited to speak at a banquet. As she began to deliver her prepared speech, she dropped her three by five cards on the floor. Frustrated and a little embarrassed she leaned into the microphone and simply said, “I’m sorry I’m so jittery. I gave up beer for Lent and this whiskey is killing me! I’ll never get my speech back in order so let me just tell you what I know.”

As we laughed, she cleared her throat and began: “We do not stop playing because we are old; we grow old because we stop playing. I’ve learned a few secrets to staying young, being happy, and achieving success. You have to laugh and find humor every day. You’ve got to have a dream. When you lose your dreams, you die. We have so many people walking around who are dead and don’t even know it!”

“There is a huge difference between growing older and growing up. If you are nineteen years old and lie in bed for one full year and don’t do one productive thing, you will turn twenty years old. If I am eighty-seven years old and stay in bed for a year and never do anything I will turn eighty-eight. Anybody can grow older. That doesn’t take any talent or ability.”

“The idea is to grow up by always finding the opportunity in change. Have no regrets. The elderly usually don’t have regrets for what we did, but rather for things we did not do. The only people who fear death are those with regrets.”

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REDUCING CAREGIVER STRESS

Here is a quick survey to determine your level of stress. Fill out the questionnaire on the first page and score it on the second.

https://www.healthinaging.org/files/documents/caregiver.self_assessment.pdf

What are ways to reduce stress?

• One of my favorites is to throw your Tupperware (or other plastic storage items) at the fence. This makes a satisfying sound and doesn’t hurt anyone, not even the Tupperware.
• I find working a jigsaw puzzle helpful. It distracts me from other thoughts because it requires my total focus.
• Talk to your friends. That’s what they are for! You don’t need to discuss your stressors with them, just have a pleasant conversation, and you may feel less stressed for a while afterward.
• Use humor. Find a funny movie or book or podcast or whatever and laugh. Laughter truly is the best medicine. Your brain cannot focus on two things at once; if you are laughing about something, it’s difficult to be focused on your stress. My favorite is ‘Who’s on first’ by Abbott & Costello. A humorous book is ‘My Middle-Aged Baby Book’ by Mary-Lou Weisman.

Ways to Reduce Caregiver Stress

-Prioritize – make a list of what must be done and focus on how to accomplish only these.

-Delegate – Use your list of tasks and decide who else besides you can do those things.

-Set realistic goals – What can you accomplish Today? Maybe just preparing meals, and let the laundry go to tomorrow.

-Ask for help. Be willing to accept that you can’t do it all, and ask your church, your friends, the community for assistance.

-Join a support group. You will be surprised at how helpful these groups are. People who came to my support groups often told me that listening to other participants’ situations made their own feel lighter. And you make get tips on how to cope with your situation make listening to others in the same situation.

-Give yourself one night a week off. Hire and ask a friend to stay with your care receiver while you go to a book club or the library or a movie or get a pedicure, or whatever relaxes you.  Just for a couple of hours give yourself time away and don’t allow yourself to think about your stressors during this time.

-Take your care receiver out. Plan a simple brief trip to an ice cream parlor or a nail salon or shopping or whatever the care receiver used to enjoy. There are many free places in our area to go. Getting ready to get out of the house may be stressful but often it will be worth the effort.

-Pace yourself. You have to last as long as your care receiver. Don’t allow yourself to ‘burnout’ or become so overwhelmed that you cannot provide for your care receiver. Take advantage of these suggestions, or find others that work for you.

Call Kay at 972-839-0065, and let’s talk about solutions for you and your situation.

 

 

Caretaking versus Caring for

1.     When I caretake, I assume responsibility for meeting the needs of others – even those needs which they should be able to meet without my assistance.
When I care for, I encourage my care receivers to do for themselves whatever they can and applaud them for their accomplishments.

2.     When I caretake, I feel responsible for the feelings of others; I work hard to make my care receiver(s) happy.  If they are happy, I take credit; if they are sad, I feel guilty because it must be my fault.
When I care for, I recognize that my behavior affects others. But I know it is their reaction to my behavior, or other factors in their life, that produces their negative feelings; therefore, I do not assume responsibility for their emotions.

3.     When I caretake, I expect others to live up to my expectations. If their expectations are different, I am disappointed and get upset.
When I care for, I make few demands of others; if their behavior goes against my expectations, I am not upset.

4.     When I caretake, I try to manipulate others into doing things my way. If it turns out right I take credit. If it turns out badly, I feel guilty.
When I care for, I give others freedom to make their own mistakes, and feel no blame when they do make mistakes.

5.     When I caretake, I focus so much on the needs of others that I neglect my own needs – maybe even lose a healthy sense of what my needs are.
When I care for, I am aware of my needs and plan ways to get my needs met.

6.     When I caretake, I see others as an extension of myself, not as they really are. The boundaries between my issues and theirs are blurred.
When I care for, I recognize my boundaries and can see their needs and feelings as separate from mine, and see others for themselves.

7.     When I caretake, I often feel tired, burdened, and resentful because so much of my energy is tied up in the welfare of others.
When I care for, I have more energy for myself.

I highly recommend the book, Boundaries, by Cloud and Townsend. It is written from a Christian point of view but the advice is excellent. The book explains the concept of boundaries and how we can confuse our needs with those of the people we love, and then become frustrated when their needs are not met. When our boundaries are blurred, we confuse their pain as our pain. This excellent book is in most libraries and can be ordered online.

Lots of Helping Hands

https://lotsahelpinghands.com

This FREE website allows you to set up a community of assistance for you and your loved one who needs extra care. This community can last for the duration of an illness or hospitalization, or it could provide help for the remain of your care receiver’s life.

A Painless Way to Organize Help

The way it works is simple. The website has a calendar where you post requests for support. You can request meals for your family, rides to medical appointments or rehabilitation, or just friendly visits. Set visits for times when your care receiver has the most energy or the least discomfort. Rather than leaving your friends, family, and neighbors to guess the best time to visit, or guess what they can do to help, you post it on the Calendar.

Lotsa sends reminders to the members of your community to help coordinate.

You begin by logging in and name yourself as the Community Leader. You can invite those who have offered to help; they find your community online either by its name or your zip code.  You can also post progress reports or test results and share good news.

The website hosts webinars that focus on specific caregiving topics and highlights nonprofit partners and their caregiving resources.  Each webinar reviews tips and features of Lotsa. An archive of webinar recordings is maintained so you can go back and listen to those you have missed.

This is a wonderful way for you to give others the gift of doing some good deeds

 

Have Parents?

Plan Ahead!

A caregiver called with a disturbing request. His very elderly mother with increasing cognitive decline has been living in an assisted living community. He has now spent all her assets and she can no longer afford to live there.  The caregiver wanted me to help him find a less expensive place for her to live.

The call was disturbing because clearly the caregiver had not planned ahead. Her community is not one of the posh, expensive ones; there are not any that are less expensive. The sad fact is that once the older person’s assets are exhausted the only alternative is Medicaid. Texas Medicaid is far from adequate and it takes time to enroll. There are very few assisted living communities that accept Medicaid reimbursement, which means the caller’s mother will probably have to go into a nursing home that accepts Medicaid, if one can be found that will accept an otherwise healthy resident. Most nursing homes require several months of private pay before they allow a new resident to go into one of their Medicaid rooms. There is a program called ‘Medicaid Pending’ in which the nursing home will take the resident immediately while the family applies for Medicaid, will be reimbursed for the care when Medicaid is approved. These nursing homes are rare, and often have a waiting list.

If the caregiver had called me or another Geriatric Care Manager a year ago, he would have been advised of the situation in TX and encouraged to begin the Medicaid approval process at that time. Care Managers, or Aging Life Care professionals, are easy to work with. Most of us will speak with caregivers on the phone for several minutes before going ‘on the clock.’  If he had gotten professional advice, he would not now be in a panic, and his mother would be ready (financially) to go into a care community that her son had selected earlier.

Can he now find a place for his mother, who has no assets, and has not been approved for Medicaid?

The caution here is to Plan Ahead! If you have living parents that are not wealthy, contact an Aging Life Care professional and start a conversation.

Holidays, Post Holidays, and Grief

No matter the season, there are many losses that cause us to grieve. The impending death or  recent death or someone you love, dementia and memory loss in family or friend, and one’s own loss of lifestyle are only a few.

When the rest of the world is Ho-Ho-Ho-ing, grieving is difficult. It’s like swimming upstream; you feel apart from the general mood. When the death of a loved one  is near, caregivers and friends hurt with preparatory grief. It is nearly impossible to hide, even though you want to pretend to be happy and appear cheerful along with everyone else.

Sharing your grief by talking to your friends is always helpful. But Holidays may not be the best time to share your sad emotions, unless you are asked. Even then, it is probably wise to tell the short version.

Surviving Death over and after the Holidays

When you are providing care for someone who is dying, or a loved person has recently died, celebrating during the holiday season is difficult. So many things evoke memories of traditions that were, but are no more. ‘Mother used to make shortbread cookies;’ Dad always sang off-key during Christmas Eve church service;’ ‘Our family enjoyed reading “the night before Christmas” together but now Mom is too sick to read with us.’

Unfortunately, you cannot skip the holidays. December will come, whether welcome or not. How can you cope?

• Attend services at a different church, or sit in a different place at church.
• Shop in different stores, or online.
• Bake different recipes.
• Instead of a family pot luck at your parents’, try a meal at a sister’s home.

These involve doing the same traditions but doing them differently.

Try starting new traditions, such as going to a movie the day after Christmas instead of your usual Boxing Day activity.

Get out old photographs and let them remind you of happy times in years past. Maybe start a holiday album with these former holidays pictures; add to it next year.

Set a place for Dad at the Holiday dinner, and fill it with someone else, such as a lonely widower, a bachelor uncle, and gawky teenager, an unmarried school teacher, or someone from your church with no local family.

Keep in mind,  no matter how unbelievable, that this will pass.

POST HOLIDAY DECISIONS

Januarys are the month that Geriatric Care Managers receive the most calls from concerned family members. This is due to holiday visits. Aging parents that sound fine during long distance telephone conversations may not appear to be so fine in person. Parents that function well in short visits during the year may not function so well over longer visits. Anxious family members contact Geriatric Care Managers (Aging Life Care Professionals) to assess the situation professionally and assist them as they make decisions about the future care for their family’s older adults.

In addition to assessing the parent’s functional level, we Geriatric Care Managers like to look at the home environment and check on medications, so we do an in-home visit. What we see is usually differs from the family’s concerns because we look at the situation from a different viewpoint. When the elder takes daily meds directly from  pill bottles, that can lead to problems; we recommend loading pill boxes weekly, sometimes with a friend or relative watching to be sure it is correct. We check labels on pill bottles to see if the medications are current, and to see what physician prescribed them, and whether there are refills available. We also check in the bathroom cabinets to see what over-the-counter medications are there and ask how often they are taken.  OTC meds can interfere with prescription medications, as do herbals.

Environmental factors play a big part in maintaining function. How far does the older person need to walk to take the trash out? Are curtains or bedclothes laying on the floor a trip hazard? Is there enough light, especially at night, to get to the bathroom? Are there telephones near the bed? Are there guns in the house? What safety equipment is in use in the bathrooms? There may be a need for raised toilet seats, a long shower hose, and hand rails in the shower and near the toilet. Medicare does not reimburse for the costs of this equipment but Care Managers can often find them at “nurses’ closets” for free.

Geriatric Care Managers also assess mood and cognition. Changed cognition is often the red flag that causes family members to call us. Frequent memory lapses signal possible problems. Is telling the same story three times due to cognitive loss, or is the elder very lonely and needs someone to listen to them? Is sitting quietly and dozing during family activities a sign of depression or hearing  loss?

Depending on what we find during our in-home visit, we make recommendations for improving both the elder’s situation and relieving the family’s concerns. Yes,  Care Managers are expensive! If we save you the cost of moving into the wrong facility or prevent an impending fall, we have saved you the cost of our assessment.

• Find a local care manager at www.AgingLifeCare.org  by clicking on ‘Find a Care Manager’ and putting in your zip code. Or visit my website, www.AgingCareSolutions.com. I am an emeritus member of the Aging Life Care Assn, so my name does not come up in a search. I have been in private practice since 1993, and am a trained ElderCare Mediator. Please visit my website, call or email me, and we can discuss the changes in your older family members.