Lots of Helping Hands


This FREE website allows you to set up a community of acapturessistance 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


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Have Parents?

plan aheadPlan 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.

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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.

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Aging Care Solutions logo-no typeJanuarys 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.


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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.”


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.


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hearingMy 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.

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