Sunday, July 6, 2014

How To Care For Two Parents With Dementia

My mom and dad both have dementia. I am all alone taking care of them since my sister passed away I have no one to help me. I get sad and frustrated with them both. How do I deal with my feelings?
These are powerful words. It's a "cry from the wild" which will touch the heart of most caregivers. Many of us feel alone when we are trying to care for our aging parents and there are no siblings to help, or if siblings won't help with caregiving. When we have one parent who has dementia, it is hard. When we have two, it is often nearly unbearable.

My dad had dementia from surgery. There are many kinds of dementia. Mom developed a more subtle type of dementia, the type they used to call "senile dementia." Now it's called "organic brain disease." Whatever the type – Alzheimer's disease, vascular dementia, Pick's disease, dementia due to Parkinson's or just plain "organic brain disease," which sort of applies to them all - it's painful for the caregiver. Sometimes the pain is so raw and isolating that the caregivers become more ill than those they are caring for.

Statistics vary, but upward of thirty percent of caregivers die before those they are caring for. Some of those are adult children, lonely and depressed, isolated and frustrated, often torn by guilt. These caregivers can develop cancer, commit suicide, or have heart problems and other ill health that can likely be traced to the stress of caring for their loved ones.

For awhile, my mom's dementia was just some minor memory loss and she was able to be a fairly active part of my dad's care team after his brain surgery left him demented. However, her dementia worsened and I was soon coping with both of my parents' demented behavior.

One scenario: Their wedding anniversary was the day after Christmas. I would always bring to the nursing home tiny bottles of champagne and their 25th Anniversary champagne glasses. I'd also bring other treats and we'd have a party. Oh, yeah. I'd also bring cards for them to give to each other.

I would sign Dad's card to Mom, as he couldn't and didn't really know what it was. Mom would sign her card to him, but soon after would generally forget what it was for. I would then pile the things into Mom's walker bag and take her down the nursing home hallway to Dad's room (they each had a private room on the same floor).

Generally, I'd have to drag Dad out of foggy sleep, sit him up and - big smile on my face - give them each their cards for the other, explain what they were for, read them with gusto, pour champagne, explain again what they were doing, let Dad fall back to sleep in his chair, then bring Mom back to her room. Like a puppeteer, I'd arranged bodies, moved limbs, orchestrate a production. I'd go home exhausted.

Why did I do this, you ask? Because I didn't want to have to lie a week later when Mom become aware that their anniversary had passed, because she happened to be looking at her new calendar I brought for her wall.

I knew I'd hear, "We missed our anniversary! Why didn't you….?" I'd hear this whether we "celebrated," or not. So I did it. It felt like a sham, but I did it. How did I cope? After I got home, I cried. I cried for them. I cried for me. Pain, frustration, anger, exhaustion, pity – for them and my self, sorry to say, it was all there. The seeming futility of the production was more draining than the actual activity.

So, my friend, you ask how do you cope with your frustration? You are a better person than I if you don't have times when you wonder why you do a lot of the things you do. Much of your frustration is grief, and even anger. Yes, anger. It's okay to say that. Your sister died and she left you with two demented parents. You are all alone. Logic tells you your sister didn't do this "to you" on purpose. But this isn't about logic. It's about your feelings and your feelings are human, painful and justified.

How do you cope with caregiving? Get support from people like those on this site. Get support from caregivers who feel what you are feeling and won't judge you for it. Get professional help, both with the care of your parents, by calling your Alzheimer's Association, and going online to your state's Web site. On the site, under "aging services" or some such phrasing, you will find "The Family Caregivers Support Program." They may have another name for it in your state, but they will have a form of the program because it's federally funded. They will help you find support. Lastly, please see a doctor for yourself. Emotional support from a professional may be needed. Medication may be needed.

You don't want to be a statistic. You need a life. Know that you aren't alone and seek out these resources. And please keep coming back to talk with us. Sometimes everything we do for those who can't remember what we did can seem worthless. But it's not. Other caregivers understand this. In the end, you be glad you did your best, whatever that is. And that's all you can do.

Dementia Signage for the Home

Tuesday, July 1, 2014

Top Summer Tips for Retirees

Summer is a wonderful time to be outdoors and to be active. It is the vacation season for millions. But summer can be a very dangerous time as well. And, like it or not, once we reach the age of 65 or we develop heart disease or high blood pressure, we are at greater risk of suffering a heat-related illness during the summer. Here, then, are my top summer health and safety tips for retirees.

1. Know the symptoms of heat-related illnesses. The greatest risk, of course if heat stroke. But other problems can also occur due to summer heat. Thirst and less frequent urination are signs of dehydration. Prickly heat bumps are a really irritating skin rash. Some people experience cramps and swelling of the hands and feet. It is also possible to experience heat exhaustion (clammy skin, paleness, dizziness, nausea, fever, and headache). Heat stroke symptoms include: sluggishness, rapid heart rate and breathing, confusion and irritability, high body temperature, intense muscle aches, fever, diarrhea or nausea and even fainting and convulsions. Heat stroke is a life-threatening situation. People suffering heat stroke need to get to a hospital immediately.
2. Drink lots of water throughout the day. Water cools and prevents dehydration. Be sure to drink lots of water throughout the day, not just with meals. Sports drinks are also helpful. But avoid drinks with a lot of caffeine, lots of sugar, or alcohol because they can cause you to lose more body fluids.
3. Be smart about physical exertion. It is best to limit exercise to moderate activity. Plan to engage in any activities that require great physical exertion either early in the day (before it gets really hot) or late at night (after the sun goes down and it cools off). You will find that you have more energy at these times and that you place yourself at less risk for heat-related problems.
4. Protect your skin. Protecting your skin with either a hat, clothing or sun screen will not only prevent an uncomfortable sun burn, but it will protect your skin against the damaging UV rays of the sun and protect you from potential skin cancer. Sun Protection Factor (SPF) 30+ or higher is the best choice. If you plan to be in the water, it is important to use a water resistant sunscreen. You can also protect your face, neck and ears by wearing a hat with a wide brim.
5. Think about your clothing. Most of us dress for the occasion or the purpose. But as we grow older and our skin becomes more sensitive and our bodies are more likely to feel the effects of heat, we also need to think about what we wear a bid differently in summer. Of course, we want to wear cool clothing. Lightweight clothing is best, but with a tight weave, if possible to keep off the sun. Remember that natural fabrics breathe better than synthetics. And don't forget that black clothing tends to absorb heat while white clothing tends to reflect it.
6. Know how heat and sun interact with your medications. Some medicines make us more sensitive to the sun (increased photosensitivity), more sensitive to heat, or more likely to become dehydrated. A quick conversation with your physician or pharmacist will alert you to problems that could arise due to your medications.
7. Pay attention to Air Quality Warnings. Breathing difficulties are more common as we grow older. Smog, pollutants, allergens and humidity can make it difficult to breathe. Check your television weather information or check online to see what the air quality is before engaging in strenuous activities or before deciding to spend time outdoors.
8. Don't forget to protect your eyes. The UV rays of the sun can also damage your eyes, and will be uncomfortable, especially if you are developing cataracts. Always protect your eyes when outdoors by wearing tinted lenses, a hat with a wide brim, or sunglasses.
9. Stay as cool as you can. Staying indoors in an air conditioned place is the best way to protect yourself from the summer heat. Electric fans might be helpful, up to a point, but once the temperature passes the 90 degree mark, they really don't do enough. If you don't have air conditioning, you might want to visit a friend or family member, go to a public place, like a library, shopping mall, etc. or a "cooling center" to spend time in cooler air. Even a few hours in a cool environment can help you prevent heat-related illness. The best time to go to a cooling center is always during the hottest part of the day.
10. Rest. Try to space out your activities so you have time to rest between them. If you begin to feel the effects of summer heat, stop what you are doing and rest for a bit before continuing. The less active we are the less our bodies are stressed by heat.
In addition, be safe by paying attention to normal safety tips. When traveling, pull over to eat snacks. This year, we should all be particularly careful where we swim and especially where we dive since many lakes and ponds have been affected by this year's droughts and have significantly lower water levels. And, be very careful with fire of any kind.

Dementia Signage for the Home

Bookworm Notepad

Monday, June 30, 2014

Life Diagrams

StumbleUpon featured 21 Incredibly Important Diagrams to Help You get through Life and I was so impressed I saved them as a link on my desktop.

But what good would they do for YOU on my desktop? For a FUN diversion, I am sharing them.

Diagram Highlights:

  • 29 ways to stay creative
  • How to tie a scarf or bow tie
  • How long does food last?
  • How much to serve at a party
  • When is an avocado perfectly ripe? (I need to test this.)
  • How to brew a perfect cup of tea
  • Dining Etiquette 101 (How do I let my server know when I’m finished eating?)
  • How dehydrated are you? (We tend to neglect our thirst. Many of us need to drink more water.)

Click on:

Sunday, June 29, 2014

How To Help Your Caregiver Cook Healthier Meals

When someone's cooking for you, it's easy to get trapped by politeness and gratitude. You're thankful to have their help, and you're afraid to rock the boat by making suggestions that might be taken as criticism. That's natural, but it's not going to pay off in the long run. After all, it's you -- or your loved one -- who's eating the food. And you're paying a caregiver to cook these meals for you. (As well as paying for the ingredients, of course.) So how do you take control of the situation so that the meals you're served are ones you actually want to eat? Try these six tactics.

1. Compliment the meals you like.
Remember the old saying, "You catch more flies with honey than with vinegar"? And remember the number-one rule of so-called positive parenting, "Catch them being good"? It's much easier to explain to your caregiver what you want her to do if you set the stage by praising the healthy cooking choices she already makes. Note when she cooks chicken or fish rather than red meat, and tell her how much you like them. Compliment specific cooking styles as well -- if she grills the meat one night, you might say "Grilled meat is my favorite -- it brings out the flavors."

2. Buy healthy ingredients.
If there's fresh salmon in the refrigerator, you're halfway to a healthy meal before you start. Same goes for fresh vegetables, which can be quickly steamed to balance out the unhealthiest main dish. Stock the cupboards with whole wheat pasta, brown rice, and other whole-grain staples, and toss out the unhealthier varieties so there's no confusion.

3. Keep it simple.
While we'd all love to have a professional private chef, that level of expertise is a lot to expect from a caregiver who has a million other duties in addition to meal preparation. Streamline and de-stress the cooking process and you're likely to get much better -- and healthier -- results. Chicken breasts, pork chops, and fish are delicious seasoned and cooked very simply. Vegetables taste great sautéed in olive oil and garlic. Pasta doesn't need fancy sauces; a simple marinara or combination of olive oil and parmesan is all it takes. Make a sample menu for your caregiver that features simple examples from each food group. Emphasize whole grains, lean meats, and plenty of fruits and vegetables.

4. Show rather than tell.
Your caregiver comes to you with her own cooking habits and traditions, and she may be reluctant to take the risk of trying something new that might result in a disaster. Build her confidence by offering hands-on guidance at least once, if possible. Show her how to put together your favorite salad and whip up a simple dressing. Pick a couple of simple recipes and walk her through them. If there's a mistake she commonly makes, such as overcooking vegetables, make a pot together and introduce her to your preferred methods. If you're a long-distance caregiver and can't do an in-person cooking session, send her a few simple recipes with tips on how you prepare them.

5. Make small changes gradually.
If your caregiver is cooking for a loved one who's a picky eater or set in her ways, try to steer the meals in a healthier direction without making drastic changes. For example, if fried chicken is your loved one's favorite meal, with French fries a close second, it's not going to work to banish fried foods altogether. Instead, talk to the caregiver about substituting other cooking methods when possible, but letting a few key dishes stay in the menu. Keep the fried chicken once a week, but switch to stewed okra and baked fish for other meals. (And switch to a healthier cooking oil like canola oil, if you haven't already.) If your loved one hates salad, there's no point in insisting. Instead, teach your caregiver to slip greens and other vegetables into meals like soups and stews, where they won't be as noticeable, and serve meat dishes accompanied by tasty vegetable sides.

6. Cook in bulk.
It takes a long time to make a good, healthy vegetarian lasagna or a hearty chicken stew. But if you make a lot of it, you can have one meal a week ready to go for the next two months. Let your caregiver know that every meal does not have to be freshly cooked and that it's more practical to prepare some dishes, especially soups, stews, casseroles, and some egg dishes and pasta sauces, in larger quantities. Ask her to double recipes when possible, and package the unused portions in single-serving packets. On nights when she's serving a precooked main dish, she'll have more time to prepare a salad, side dish, or dessert.

Dementia Signage for the Home

Saturday, June 28, 2014

How To Deal With A Clingy Elder or Patient

One of the most frequent concerns I hear from caregivers is how to deal with a care recipient who never wants his or her caregiver out of sight. This can be a real challenge for caregivers who need to work, take care of other family members, or just have a little time to him or herself. It is also often hard for caregivers to tell the difference between helping and enabling a loved one.

Most family caregivers have two main questions: What is the root cause of an elder's clingy behavior? and, What's a caregiver to do about it?
First, it is important to sort out which of the following 5 situations best describes the dynamic you face:
  • Puppy: This individual is perfectly safe and has no behavioral disorder which causes him or her to become overly anxious when left alone (or with another friend, family member or paid caregiver), but prefers that you be around all the time. If you're dealing with a puppy, the best technique is training—also known as behavior modification. Try to have a reasonable conversation with your loved one and explain why you can't be with them every minute. You can negotiate and offer rewards for desired behavior. It sounds simple, but as with a puppy, it is helpful to give choices and let your loved one pick from among different alternatives that you're okay with. Sometimes, you will just need to go and do your thing. Try to stop feeling guilty about leaving them alone. If they protest, just know that they'll get over it eventually.
  • Nervous: This person is safe but tends to panic when they are left alone (or with another caregiver). Sometimes this is due to behavioral issues which may or may not be related to their main conditions. If your loved one is nervous, the situation is more complicated, especially if they suffer from an anxiety disorder. In this case, it may be best to seek help from a mental health professional. These providers can offer techniques, such as cognitive behavioral therapy, to help alleviate an elder's anxiety. Your care recipient's need to have you close is very real to them and no amount of reasoning will change their experience of the fear of not having you close. In this case, it is important to find ways to help your loved one feel safe when you can't be around, but don't expect them to just deal with the situation on their own. Unlike the puppy who will bark, the nervous care recipient may have a full blown panic attack and hurt someone.
  • Learned: This individual has had a real life bad experience in the past when you weren't around. They are clingy because they are afraid it will happen again. For a loved one who has learned that when you're not around bad things can happen, you have to acknowledge the reality of their fear that it could happen again. If you can help them to understand that they are clinging to you because of past experience, it may be possible to create safety nets that allow them to relax and let you go. For example, an emergency alert system might do the trick, or phone calls at agreed upon intervals.
  • Oblivious: This person is unaware that they are clingy and thus can't change their behavior or expectations. Perhaps the saddest situation is a loved one who is oblivious to the fact that they are constantly clinging and demanding your presence. This is often the result of dementia or other neurological or psychiatric disorders, but can occur with any type of serious illness. This loved one has either lost the cognitive ability to recognize that their behavior and expectations are unreasonable, or they are so wrapped up in their own pain and suffering that the result is the same. In this situation, your best bet is to grit your teeth and do what you need to do, without taking anything your loved one says or does too personally.
  • Manipulative: This individual is well aware that they are not at risk, but they simulate a panic reaction or some related tactic to keep you close at hand. The manipulative family member is the toughest customer of all. In this case, your loved one knows exactly how to push your buttons and does so for his or her own gain. A caution: try not to be too quick to conclude that this is the explanation for your situation – make sure that you consider all of the other reasons first. Certain dementia behaviors can seem like manipulation, but there is often a simple way to handle a clingy loved one situation, either by working with them, or wrapping your own mind around the circumstances and changing your understanding of what's going on. So many caregivers become frustrated and assume that their loved one is being manipulative when in fact it is really one of the other scenarios. If you are convinced that you are being manipulated, then it is up to you to decide that you're not going to fall into the trap anymore. You're unlikely to be able to change the manipulator's behavior, so your only option is to change how you allow yourself to react.

Dementia Signage for the Home