Saturday, June 29, 2013

Personalizing a Funeral By Planning in Advance

Most people can recognize the benefit of advance funeral planning when it comes to sparing loved ones the burden of making difficult decisions at an already difficult time. But many may not realize that advance planning also allows you to personalize your funeral and cemetery services in ways that reflect your specific wishes.

As more and more Baby Boomers plan their own final arrangements, traditional funeral services are being enhanced with highly personalized life celebrations.

Decoration of the visitation room is one way to personalize your service.

Items related to your work or favorite hobbies, such as fishing, hunting, sewing, gardening or photography, can be displayed to reflect your interests or personality. Personal photographs of important events and people in your life can also create a very personal environment for the visitation or funeral service.

In addition to decorations and displays of personal items, many people choose to personalize various elements of the service itself with significant music and readings.

Baby Boomers have increasingly begun to leave their creative mark on these elements as well, by departing from the traditional in favor of selections that reflect their generation's spirit of individuality.

The procession from chapel to cemetery also can reflect your personal uniqueness.
An avid cyclist, for example, might wish for riding club friends to escort the procession, while a musician might choose a band to lead the way.

Consider also the flowers ordered or sent for the service. Do you have a favorite flower? Instead of flowers, would you prefer people to make charitable gifts in your honor? Are there other requests of your guests, such as attire, or activity, that you wish to include in your plans?

After the service, receptions are more the norm than the exception these days. The reception might be held at the funeral home, a relative's home or another venue.

Again, as Baby Boomers increasingly plan their final arrangements in advance, many ask friends and family to gather in a place of significance, such as a beloved restaurant or lake house, to share memories and celebrate a life lived.

By arranging their funeral and cemetery services ahead of time, Baby Boomers not only can help relieve family and friends of the stress of planning their funeral but also can create a highly personalized service unique to the spirit and passions with which they lived their life.


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Caregiving at a Cookout: 14 Tips to Ensure a Good Time

Almost everyone looks forward to gathering with family and friends for a backyard barbecue. But if you've been dreading going to one because of your responsibilities as a caregiver, never fear: Both you and your elderly loved one can have a fine time, if you plan ahead.

But first, make sure that your relative is in good enough health to attend a party where there will be heat, bugs, noise, smoke from the grill and possibly rambunctious children. Also, check with your hosts to ensure that they understand and can accommodate your loved one's limitations. If not, find another caregiver to look after your relative while you attend alone; it's important for you to socialize and recharge.

However, if your hosts are amenable and your loved one is up to it, don't leave him or her behind. Joan Wright, a certified geriatric manager at NVNA and Hospice in Norwell, Mass., told AgingCare that you should remember that every elderly person was once young, mobile and eager to socialize. "Those desires are still there even if their physical capacity to fulfill them is not."

Here are some tips from Ms. Wright and others to ensure that everyone has a good time:

Before the barbecue

--Talk to the host or hostess about dietary limitations your elderly relative may have. If the menu is too spicy, fatty or hard to chew, plan to bring some food that the senior can eat, and request that the meal be served at the same time as everyone else's.

--Find out what sort of seating the hosts will have for guests. If they just have backless picnic benches, which can be difficult for an elderly person to sit on and provide no back support, ask if you can bring a folding chair or stackable plastic chair.

--If your relative is in a wheelchair, find out in advance if your hosts' gates are wide enough and slopes gentle enough to maneuver it into the back yard.

--Ask if there's any shade in the backyard; if not, ask if you can also bring a portable beach umbrella.
--Lay out comfortable clothes that include layers, since some seniors feel cold even when it's warm out. Include sturdy shoes to prevent trips and falls.

--Before you go, make sure that the senior has put on some sunscreen.

At the barbecue

--Set up a spot for your relative away from the hot grill and any areas where children are likely to be throwing balls or rough-housing.

--Find out the location of the closest bathroom, and if accidents could be a problem, seat the senior near it. If your relative needs assistance using the restroom, you might want to arrange a discreet hand sign or code word between you so you can excuse yourself to help without embarrassing him or her.
--If your relative can't get around much but is sociable, bring other partygoers over for brief chats.

--Since dehydration can be a problem with elderly people, make sure that a glass of water is always at hand. Avoid alcoholic beverages, which are not only dehydrating but also can conflict with medications.

--If you must cut some meat off a bone or corn off of a cob, do it in the kitchen and then bring the plate to the senior. Cutting up food in front of other partygoers puts the senior in an embarrassing, child-like position.

--If your relative can't get around much but is sociable, bring other partygoers over for brief chats. And ask other family members or friends to sit down with the senior from time to time so you can mingle, too.

--If your loved one can't communicate well, bring headphones, a CD player and some music. He or she will be able to enjoy being around others without being under pressure to talk.

--Watch your loved one for signs of restlessness, overheating or other distress, and be prepared to leave before the festivities end.

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Friday, June 28, 2013

Before Your Parent Moves, Pack a "First-Night" Box

When your parent first arrives in her new living quarters -- whether it's a smaller home or apartment, an assisted living facility, or a nursing home -- there are a few key things she'll need from the get-go. Here's what to put in a suitcase (or a box that goes in your car rather than the moving van) for easy first-night access:
  1. Sheets, pillows, and other bedding
  2. Paper towels and toilet paper
  3. Coffee maker or tea kettle (plus coffee or tea)
  4. Toiletry kit with toothbrush, toothpaste, deodorant, soap, hair products, and other essentials
  5. Prescription and over-the-counter medications your parent takes regularly
  6. Checkbook
  7. Pajamas and a change of underwear
  8. Bedside clock
  9. The book your parent is reading
  10. Address book or list of key phone numbers
  11. A framed photo or other memento -- to make the new place feel a little more like home right away


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6 Steps to Organizing Your Parent's Move (Without Getting Disowned)

Step 1: Get the whole family on board

Moving an older relative from his family home to a new -- and usually smaller -- residence is labor intensive for you and emotionally disruptive for him. Tempting though it may be, it's not a good idea to "surprise" a family member by sorting through his stuff when he's not around. If you try to make an executive decision about his belongings, chances are, you're headed for a run-in with him or others in your family.

To help prevent emotional flare-ups and ensure a smooth process, schedule a meeting with the whole family, if possible, to discuss the plan of attack well ahead of the move-out date. (If you can't get together, do it by phone.) Hash out some guidelines: Under what circumstances will you call each other on "keep or discard" decisions? When will you consult the person who's moving? What key possessions would you and your other family members like to keep in the family?
Encourage the person who's moving to actively participate in decisions. For example, adult children often want to throw away old furniture and buy newer, more attractive pieces for their parent's new home. But the parent should be able to pick what comes with him, says Dollar. "Let them take their own furniture if they want to -- they know what will make them most comfortable in their new home, and sentimental value often counts for more than aesthetics."

Step 2: Work slowly when packing up -- think months, not days

Your relative's home is more than just a roof over his head: It's the place where he feels most comfortable, a museum of his memories and life stories.

Complicating matters, if he lived through the lean Depression years, chances are he's spent a lifetime saving and collecting. Decades of squirreling away can add up to a house that's packed floorboard to rafter with stuff. As you begin organizing for a move, keep in mind that seemingly worthless belongings may have huge sentimental value for him, and he'll need time to sort through his things on his own terms. Try to resist the urge to execute the move as quickly as possible.
"It really needs to be a three- to four-month process. You need to give an older adult time to go through the love letters, the report cards, and the photographs from the Grand Canyon," says Jacqueline Dollar, a geriatric care manager in Des Moines, Iowa. "It's a wonderful chance to go back and reaffirm the full, productive life that he's had."

Step 3: Get real about the size of your older relative's new place

"In almost every case I've been involved with, people take more stuff than will fit in their new space," says Gayle Grace, a moving coordinator in Oakland, California. "Many times I've been called back in to help do more weeding out after the move."

Avoid this situation by first getting a sense of how much square footage and storage your relative will have in his new home. What he can keep will depend on how much room you have to work with. Getting realistic about space constraints up front -- even sitting down with him to sketch out what can go where -- will help force some of the harder decisions about what to get rid of.

Step 4: Work room by room when organizing the move

Take on one room -- even one drawer -- at a time. Evaluate the items one by one and sort them into piles located in separate rooms in your relative's house: one for items to move to his new home, one for those you and other family members might be interested in keeping, one for those to keep in storage, one for those to donate, one for those to sell, and one for those to throw away.
If your thrifty relative is uneasy about tossing anything, donation may be the way to go. Many organizations will arrange a pickup at his home; check your local charities (salvationarmyusa.org, redcross.org, goodwill.org) for pickup policies. Tip: Be sure to get a receipt so he can deduct the value of the donation on his next tax return.

Furniture and belongings that will go with your relative to his new home should be labeled with their specific new location (living room, kitchen, bedroom) and mapped out on a floor plan of the new home so that the movers know exactly where each item goes.

Step 5: Accept your relative's choices about what to keep

"It can be difficult for a child to understand why her father wants to take a bowling ball with him when he's not in any condition to bowl again," says Dollar. "But clearly that bowling ball means something to him, and he should be able to take it with him."

Obviously, you'll have to make some hard choices about what will and won't fit into his new home. If he insists upon keeping more than will fit, you can try to find storage in another relative's home to ease your his anxiety. However, there are limits. "If your mother wants to keep her antique spoon collection, she may have to relent on other nonessential items," says gerontologist and home sale expert Cathie Ramey of Walnut Creek, California.

When push comes to shove and your relative is still unwilling to get rid of something, it can help to suggest an alternate route. Taking a photo of the item, keeping a few pieces of a large collection, or finding a good home for a beloved chessboard are some ways to do this. No one wants to see their belongings tossed into a dumpster.

The bottom line is that you'll need to be patient with your family member and allow him to adjust to the changes. If the tension between you has stalled the project, consider calling in a professional to assist you. Professional move managers specialize in assisting older adults and their families with the emotional, physical, and organizational aspects of relocation. You can find a professional in your area on the National Association of Senior Move Managers website.

Step 6: When all else fails, move first and purge later

For any aging person, moving is a loss, says Dollar. "It's a loss of familiarity and personal things -- and it's really tough emotionally." If your family member is showing his anxiety by clinging to every last Tupperware lid, you may need to get him moved first and worry about purging the nonessential household items later. "After he's been in his new home for six to eight weeks and he's settled in and removed himself from the old environment, it's much easier to get rid of things."

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How the Montessori Method Can Help With Dementia Care

Educators Tom and Karen Brenner have a long-standing interest in the principles of Maria Montessori, the Italian doctor and teacher who used practical, sensory-based materials in a prepared environment to foster better learning for children. The Brenners' consulting company, Brenner Pathways, teaches Montessori-based memory-support principles to professionals and family caregivers. They're also the coauthors of You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care (Brenner Pathways, 2013).

How did you come to apply Montessori techniques, which have been mainly used with preschoolers and older children, to people with Alzheimer's?

Tom and Karen Brenner: When we were working with elders in person-centered care programs and teaching young children in Montessori schools, it occurred to us that there was a lot of overlap in our work. For example, the prepared environment is very important to both populations. The environment should fit the needs of the people using it. Montessori also teaches us to use natural materials and to bring nature (plants and animals) into the classroom and the care home.

Dr. Montessori also believed in finding and building on the strengths of each person. This is vital when working with elders who are losing cognitive and physical abilities: We find the spared abilities and remaining strengths of each person living with dementia and build a care program around this information.

What's the goal of this work?

T&KB: We have three major goals in our work:
The first goal is to change the conversation about dementia from despair to hope.
Our second goal is share the stories and wisdom that we have found in the elders living with dementia.

The third goal is to help caregivers learn how to communicate and stay engaged with the people they care for by using the Montessori principles and techniques that we teach.

How does your work compare with that of Cameron Camp, the psychologist who has pioneered Montessori-based interventions for people with dementia?

T&KB: Our memory-support program dovetails with most person-centered approaches. We use many of the Montessori materials as prototypes to teach care staff and family members the principles and important aspects of the Montessori Method in positive dementia care. We nurture creativity and imagination in people who are living with dementia and their caregivers. We do this by incorporating art, music, poetry, and short stories from life into our Montessori approach to caregiving.

Explain "muscle memory," a Montessori concept, and how it applies to people with Alzheimer's.

T&KB: Muscle memory is sometimes called procedural memory. This is the memory system that is based on repetitive muscle movement: the sort of memory that helps us remember how to ride a bike, play the piano, and read. Because muscle or procedural memory is often less affected by dementia, we have found that using this memory system is very helpful in reaching and engaging people who have dementia.

Can you give some examples of Montessori Method activities that a caregiver might use at home?

T&KB: One of the best things about using the Montessori Method for positive dementia care is that it can be easily understood and applied in any number of care settings, including the family home. An example of a Montessori exercise that could be used at home would be baking bread together. Using the Montessori principle of task breakdown, the person with dementia could be asked to participate in all of the steps to bread baking or only one or two steps (depending on the remaining strengths and abilities of the person with dementia).

There are many examples of how best to apply the Montessori Method to dementia care in our recently published book: You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care.

Can this work foster better communication with a loved one who has Alzheimer's?

T&KB: As stated earlier, one of our main goals is to help caregivers reach and stay engaged with the people they care for. The Montessori Method gives us many helpful strategies and techniques to accomplish this goal. Here is an example of the Montessori Method helping a person with dementia find a way to communicate in a deep and profound way:

We discovered that Sam, a man in his fifties, diagnosed with early-onset Alzheimer's, had been a collector of vintage cars in his earlier life. Knowing this, we found a number of interesting vintage hubcaps in a local junkyard. We brought these hubcaps, some nontoxic metal polish, and polishing cloths to the locked dementia unit where Sam was living.

As we polished the hubcaps together, we thought that Sam would start to discuss his car collection. We were shocked when he began to talk about his experiences as a soldier in Vietnam. As we quietly polished hubcaps, Sam opened up about his memories of the war. We think that the simple act of polishing was the key that unlocked some deeply felt emotions and memories for Sam. Without this Montessori activity, we doubt that Sam would have volunteered such profound information.




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