Wednesday, December 31, 2014

Happy New Year 2015

As this year comes to a close, we often reflect back and make resolutions for the new year. Being the caregiver in a sandwich generation will probably be one of the hardest roles you will encounter in a lifetime. Take a deep breath and keep going! Remember to take time for YOU!

Make new memories with loved ones and set in motion plans for your own future to make the burden on your children less as you age. Take time to smell the roses every day and enjoy life. Remember this is not a dress rehearsal; it's the real deal. Enjoy. Happy 2015!

Thursday, September 11, 2014

Never Forget

In September, 2004 we visited NY and I shot this picture. There was nothing quite so sobering as standing at Ground Zero and surveying the damage and feeling the impact this heinous act has imposed on all of us for a lifetime.

Never Forget.

Thursday, July 10, 2014

Need to Have a Realistic Discussion About the Consequences of Falling?

Dealing with an elderly parent or other loved one is a challenge to say the least.  Sometimes it seems like you're dealing with a toddler or small child with an old soul. They want to do things they can no longer safely do and they can get cantankerous and downright obstinate. It's like dealing with a teenager who thinks he is invincible. They want to remain independent and are argumentative about almost everything! It can be most frustrating to deal with.

Safety is one huge issue as balance and gait changes begin to set in with the normal aging process. Chronic diseases such as arthritis, and Parkinson's can complicate the situation because they severely limit joint mobility and cause the gait to shuffle and scissor almost uncontrollably. Dizziness and vertigo play havoc when trying to ambulate and not feel like you're drunk or impaired.

The Fear of Falling
old woman on stairs
Google Images
A fear of falling can cause a person to tense and to make sudden sharp movements as they gain seconds of confidence. Ask your loved one if s/he is afraid of falling and the answer is likely YES! Yet where is that assistive device? The walker is probably back in the bedroom. The cane is next to the door so s/he might remember to take it if s/he ventures outside. And the lifeline device? Oh it's hanging on the lampshade or a doorknob.

Falling is the leading cause of death due to injury among seniors. This is due to complications such as head injury, fractures and immobility related pneumonia. Sometimes if your loved one falls and can't get up it could be considerable time before anyone discovers they are down. This can lead to all sorts of complications such as muscle breakdown that begin in 30-60 minutes, dehydration and hypothermia which can be life threatening or even fatal.

Fifty Percent of Seniors Will Fall Annually
So how do you get this proud, determined, elderly person to actually USE their assistive device and keep that lifeline around their neck?!!  By age 80, 50% of seniors will fall at least once a year. One fall can be too many.  Once a person falls they are more likely to fall again.

Sometimes you have to use the same type of reality scare tactics they used on you when you were that invincible young person. It's also important to remember your job is not to become the parent although it seems like that's what is happening. This makes your job incredibly more difficult and challenging!

These elderly loved ones, no matter how childlike they become, are still our parents, aunts, uncles, grand parents and friends. We need to be respectful while guiding them in the direction of making safe and sane decisions on their own if they are capable of doing so. Alzheimer's and other dementia can take this option off the table quickly.

Discuss Care Options if They Do Fall
But as long as your elder is capable of making decisions, try to have a hypothetical or logical and harshly realistic discussion about what they would want done in case they were injured in a fall. Do they really want to do something to jeopardize their current lifestyle? A typical fall for an elderly person doesn't just result in a skinned knee or bruises. All too often these falls result in broken bones (hips, wrists, shoulders), major skin tears requiring sutures, or head injury.

Would they want surgery to repair a broken hip, wrist, or other joint? Or would they prefer to spend weeks in bed hoping for the fracture to heal so they could eventually be pivoted to a chair or commode for a few hours each day? Would they want to be intubated if they ended up with a very bad case of pneumonia and couldn't breathe?

What if they hit their head and ended up with a brain injury? Would they want to have a feeding tube inserted and possibly need to be sustained on life support devices?

How would they feel about a long rehabilitation process? With a broken wrist for instance they will probably find themselves in need of assistance to dress, bathe, eat and even wipe their own bottom for several weeks! Who would they like to have helping them?

In the course of this conversation, you'll hopefully plant the seed to help them take stock in their own safety and actually use the devices, but you'll also gain some insight into their feelings about general end-of-life desires. It might just open the door to having that conversation soon too.

What Would Help Make the Device More Effective?
Meanwhile, help them to decide which devices they will use. Perhaps a cane needs some sprucing up or decoration to fit their lighthearted personality. Or the walker needs to be outfitted with a basket or tray so they can carry their clothes to the bathroom or bring their coffee cup and cereal bowl to the easy chair.

The device may not feel like it's the right height or doesn't give them the same feeling of stability that hugging the walls or furniture does. Perhaps it's too heavy, or feels flimsy. Maybe they need something different. Sometimes there's a completely logical explanation for leaving the device behind.And sometimes it's just a change they need to vent about and begin to accept.

Be gentle, be kind and be supportive. Change is NEVER easy. And growing old is not fun! But this is for their own good, and your piece of mind. Ahh you are giving them back all the same reasons they gave you growing up for worrying about your safety. Life is a circle and someday you'll be having these conversations with your adult children over your care and safety.  Start making plans to decorate your cane now!

Thursday, January 16, 2014

When the Best Plans Fall Apart....

We plan and we think we are ready for anything and then life happens…. Even with the best laid plans, expect that you are going to be knocked for a loop and totally discombobulated, if only for a little while.

In my observances and my experience, the best possible scenario for caring for aging parents doesn't always just happen. How many times I've heard, "Mom's the one in bad health and she'll die first….." And how many times it just doesn't happen that way.

Dad is a very young 80 and perfectly healthy as well as a good caregiver to Mom, but he needs a little assistance to make things easier. So you hire someone to help with Mom's personal care and a little housekeeping. Things should be OK for a while. Then suddenly Dad has a fatal heart attack and everything is turned upside down.

Mom has lived alone for 20 years and then she had to stop driving. She almost hit someone in her shared driveway and she surrendered the keys. Your friends are envious because it was so easy. You work out ways to assist her and help her stay in her own home. Then suddenly Mom has a small stroke and can no longer live alone. She has no savings. Her income is fixed and low. Her house has a reverse mortgage and the equity was eaten up long ago. Now what?

Suddenly you need to make decisions on a dime that will become permanent and impact your own life more than you ever expected. You thought this was in the bag and you would know what to do when more care was necessary. But life took cruel turns and you aren't prepared for what has to happen.

It will be overwhelming. You will have anger and fear and confusion and be somewhat paralyzed in trying to find solutions. You will want your life back more than you can imagine! And you will find yourself wanting to SCREAM!

My best advice: SCREAM!! Find somewhere where you can do so without scaring a neighbor or summoning the police. A train track can be ideal when the freight train passes by. Or a deserted beach. If all fails, turn on the shower, raise the volume on the TV or stereo, smother yourself into your pillow, and let go!

You will feel better. And you may find that over the course of the next months and years you need to do this regularly. It will help to save your sanity and your marriage. Teach your spouse your tricks and tips.

Prioritize and Delegate
Then you make lists and determine what you can and must do right away and then how you will sort through and find ways to make things work. Enlist your siblings and children to help with necessary tasks. They may not be willing or able to provide any direct care but they CAN help with other tasks so that you can do what has to be done. Don't let them off the hook and stop trying to do it all. It isn't easier to do it yourself now. And your sister won't do things exactly as you would, but she can do it and you can relax a bit. Learn to give up control and delegate.

Learn to Take Care of You
Slowly your wits will come back and your brain will begin to function again. You will find a semblance of routine and settle in to a new life. It won't be the one you had, but it won't be as awful as you recently imagined, at least not every day. You will see new options and make new plans.

Most of all take time for YOU! Don't lose yourself completely. Hang on and climb away from that knot at the end of your rope. Say NO to caregiver fatigue. Reward yourself with a few minutes of "me time" and take advantage every chance you get.