Elder Care: 20 IMPORTANT Things to Locate and Keep

Many years ago, I started down the path of elder care.  My parents were in need of someone to help them.  I’m that person.  I wish I knew then what I know now, especially about organizing their important information.  It would have made my elder care road easier.

My parents aren’t organized people.  This led to many frustrations for me.  I would find bills and legal documents in the most unusual places, such as their life policy in a stack of newspapers, their power bill under their place mat at the table, etc.  When they started having services cut off, I decided I needed to step in.

First of all, we bought them a safe to keep their important documents in.  I organized it with file folders labeled for their easy understanding.  I went through stacks and stacks of papers and pitched what wasn’t necessary and filed the important documents.

I came up with a list of 20 important items I, absolutely, needed to know where they were.  Here’s a list of 20 items to know the information or have safely locked away where it’s accessible to the P.O.A (power of attorney) or potential P.O.A.

1.  Know where their wills are located.
2.  Where their Social Security cards are (the actual cards). Make sure these aren’t being carried in their wallets like my parents carried theirs.  Keeping them in their wallet is a possible identity theft situation.
3.  Know what their health insurances covers, where the cards are and the important numbers. My parents carried their cards in their wallets, so I made copies for the safe, front and back, in case the cards were misplaced.
4.  All bills should be in both of their names, if possible, in case of death.  Credit cards could be something different as having their name on the account may signify the debt being passed to the other person upon death.  In this case, #16 might be a better option.
5.  Have signed P.O.A.s, wills, health directives completed and know where they are kept, even if they haven’t been enacted.
6.  Know their social security numbers (or where to find out this information) and birth dates including year of their birth.
7.  Know where they were born.  For instance, my father was born at home, but I know which county registered the birth.
8.  Know where their birth certificates are located.
9.  If they are veterans of military service, know where the discharge papers are located. This is very important if you are dealing with the Veterans Administration.
10.  Know where they keep (should be in a secure location, not on them) codes and pin #s for all accounts.
11.  Copy of their Union cards.
12.  Know the benefits from their Union or Associations (such as burial plots, pensions, life policies, etc.)
13.  Be familiar with their life insurance policies; where the actual policy is, death benefit amounts, companies, companies’ address and phone numbers, and that the beneficiaries are up to date. Have they changed the death benefit amount?  If their beneficiary to their life insurance policy has preceded them in death it can lead to a probate situation and hold up the paying out of the death benefit.  This can be a sticky situation if those funds are needed to pay for their burial.
14.  Know where the titles for their vehicles, boats, toys, deed to home, deed to vacation properties, and the abstract to their home(s).
15.  Location of long term care policies.
16.  Have them put you down as person to talk to for credit card bill, life policies, other bills, etc.  If this isn’t done, you will have to file P.O.A.s with the companies, before you will get any help.  Most of the time, it is as easy as calling the company in the presence of your elder, who’s name is on the account, and having them talk with the customer service representative to let them know it is fine to talk with you, the elder care person.
17.  Know where they keep their bills before and after they are paid.  What system do they use for paying their bills?
18.  Know who the family treasures go to.  Is it written down?  Hearsay doesn’t always work.  It can lead to hard feelings later.  It helps to have it written down so everyone can see where these items go after the elder is gone.  Dealing with grief is hard enough, writing it down, in advance, cuts down on the unpleasant feelings later.
19.  Know where their lock boxes are kept.  If the lock box is at another locations, such as a bank, they may be locked down upon the death of the owner of the lock box.
20.  Keep a key or the numbers to the combination to their safe or important papers box.  My parents have dementia and it was very common for them to lose the key.  My back up key came in very handy.

Everyone’s situation is different.  The P.O.A. or potential P.O.A. needs to know this information.  Elders with dementia can be very unorganized and this can lead to a nightmare situation upon their death.  As the old saying goes, “an ounce of prevention can be worth a pound of cure”.

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5 Tips for Keeping Your Loved One with Alzheimer’s and Dementia from Wandering

Every year, in the news, we hear stories of an elderly person wandering away from home and dying from being lost outside.  It doesn’t take long for an old person to succumb to adverse weather.  There are other dangers out there such as water hazards, busy streets, industrial sites, etc.  For those of us who are caregivers to an elderly loved one who is dealing with Alzheimer’s or any form of dementia, this is a nightmare scenario.

How can we protect our loved one with dementia from having this happen to them?  First of all, we must recognize the ugly truth.  This is a potential risk.

My dad has always been a walker.  When he retired from his newspaper job, the hobby he adopted was taking walks.  His retirement goal was to walk 10,000 miles before he died.  He got a pedometer and proceed to go after his goal with gusto!  He would sometimes walk up to 6 miles a day.  In fact, he walk across Iowa on the bike paths, which we are fortunate to have.  He would park his car, walk 3 miles out and 3 miles back.  Being an old Iowa farm boy, he enjoyed walking in all kinds of weather.  He reached his goal by the time he was 72 years old.  Needless to say, he had a passion for his daily walks.

When he developed dementia, his passion for walking didn’t stop.  How could we keep him safe?  If you have a loved one with dementia, here’s a few ideas for reducing the risks.

1. Develop a a profile for them should they wander away.  In case of inclement weather when they wander, time will be working against us.  Being able to hand searchers a profile, immediately, can help them find them quicker.  This profile should include: their name, recent photo, date of birth, physical description, height, weight, other identifying characteristics such as moles, scares, tattoos, etc.  Knowing what clothes they were wearing when they left is very helpful.

2.  Keep a Alzheimer bracelet on them.  One with a G.P.S is very helpful.  The bracelet should have their name, address and your phone number.   The Alzheimer’s website has one they offer called Medic Alert and Safe Return.   In the case of my dad, he carried a cell phone.  Not because he could remember how to use it, but it was easy for him to fit it in his pocket and it came in handy for whoever found him.  The bonus of his phone was, it had G.P.S.  Once, on one of his “walks” he fell and hit his head.  A passerby stopped to help him and used Dad’s phone to call us to let us know where he was so we could pick him up.  Our number was listed as “emergency”.

3.  Inform the neighbors about your loved ones condition.  Keep a list of their names, addresses, and phone numbers.  Be sure they know your phone number and where you live.  I used to take walks with my dad.  Many of the neighbors knew my dad because of his friendly nature.  I would introduce myself to them, realizing they could be our first line of defense against losing him if he should ever wander away.  Many times, a neighbor will bring them home before they can get lost.

4.  Securing your home with deadbolts, slide bolts, or child safety knobs on all the exterior doors can help keep them inside.  These should be out of the line of sight if possible.  A electronic system such as an alarm system that reports “a door ajar” is helpful.  If there is a “dangerous for them” area in your home, keep it locked off from them, also.  This probably sound like a no brain-er, but never, ever lock a person with dementia in a home without supervision.

5.  Remember, people with dementia won’t just walk away from home, they could drive away.  Keep keys locked up away from them.  For our dementia patients who have enjoyed biking, this is another form of transportation which can take them away from their safe environment.

Alzheimer’s and dementia can progress very quickly.  Your loved one can seem very lucid one moment and an hour later they are in an alternate reality.  They can spend days in their alternate reality, not coherent, and then snap back for a time and be their old self.  This is why constant supervision is a must.

I know, first hand, how much of a relief it is to see my loved one sitting in the back of a police car as it pulls into the driveway!  Believe me, it only takes a minute of not watching them for them to wander away.  Preparation in advance can make all the difference in the world to their safety and your peace of mind.

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5 Tips to Make Your Elder’s Hospital Visit Less Traumatic

The last few days, I have been writing articles on hospital visits for the elderly.  What items to have available for an emergency room visit and what a care giver can do to be prepared for a hospital stay.  Today, I would like to tell you about how you can continue to help your loved one when they are in the hospital.

Aging senior citizens react completely different than other groups of adults to changing medications, new and unknown surroundings, and stressful events.  If your loved one is cognitively impaired or extremely ill, they can become very confused.  I have always tried to stay with my beloved old person for at least 24 hours when they first get to the hospital.  The hospital personnel understand how frightening and confusing it can be for an elderly person to be put in an unfamiliar place such as a hospital.  My staying with my elder has always been met with appreciation.

Hospital workers are very appreciative of having the main caregiver present because the main caregiver is the “go to person”.  We know our elderly loved one better than anyone.  A word of caution, I found out the hard way that turning over the first 24 hour period to someone who isn’t the main caregiver can be distressing for the elder, the stand in caregiver, and the hospital staff.  Why do I say such a strange thing?

My Mother-in-law was admitted to the hospital for a double mastectomy.  My sister-in-law who doesn’t usually participate in doctor visits with her insisted on staying with her in the hospital instead of me.  I am the “go to person” for my mother-in-law who I will refer to as Mom2.  I’m a laid back person and I don’t like to disagree with people.  I’m not Mom2’s daughter and I thought it would be fine for her to stay with her Mom.

The surgery went well.  The problems began afterwards.  My sister-in-law wasn’t familiar with Mom2’s medications.  She wasn’t prepared at all for after surgery delirium.  I have been with my parents through numerous hospital stays and I understood that delirium can happen even with those who aren’t cognitively challenged.

By the time I returned the next morning, my sister-in-law was in tears.  She hadn’t slept at all and she was worried sick about the delirium.  Mom2 was disoriented and combative.  She was saying things to her daughter that hurt her sensitive feelings.  The lack of sleep was making her even more sensitive to the remarks.  Knowing this wasn’t usual behavior for Mom2, we sat down and started to unravel the puzzle of the delirium.  The questions I asked were; What new medications were they giving her?  What pain medications was she on?  How much fluid were they dropping into her IV?

I, immediately, went to her nurse to get some questions answered.  In Mom2’s case, the delirium was being caused by the pain medication.  Talking with the doctor, we were able to substitute a different medication, and the delirium cleared up in a matter of a little over 24 hours.  Mom2 doesn’t remember any of this time in the hospital.
As an experienced caregiver, I put together five points which can help make your elder’s visit to the hospital a little less traumatic for them and you.

1.  Don’t be afraid to ask questions.  ANY TIME a medication is given ask what it is and WRITE IT DOWN!!  Remember the note pad and pen from the list of things to have on hand at the hospital….this is another reason why.  Even though you were very clear on allergies when your loved one was admitted to the hospital doesn’t mean accidents don’t happen.  Sometimes the doctor messes up and orders the wrong thing and the nurses don’t catch it.  You, the “go to person”, might be the one who catches it, only if you ask questions.  Even if you annoy the hospital staff, wouldn’t you rather annoy them then run the risk of having something preventable and bad happen to your elder?  Don’t think that could happen to you?  These statistics are mind boggling!

2.  ALWAYS read the bag on the IV bag.  Mom2 is very allergic to penicillin.  I want to make sure she isn’t receiving penicillin in her IV drip as that would be life threatening to her.  Make sure your elder’s name is written on the bag.  Wouldn’t it be a disaster if your loved one got John Q Public’s bag of Chemotherapy and your loved one was in the hospital for something completely different than cancer?  Yikes!  But, things like that do happen.

3.  When test are being done, ask questions!!!  What is the test for?  What are the side effects?  If surgery is going to be preformed, why is it being done?  When they take them away for a needed surgery, is the area marked on their body?  Are the records correct on their chart?  A surgery to remove a right big toe wouldn’t be a success if they removed a leg instead, especially if it’s the left leg!

4.  Pay very close attention to what the doctor and the nurses are telling you.  Again, WRITE IT DOWN!  I have a very good memory, but hospitals can be stressful places.  I don’t want to forget anything that has been told to me.  I don’t want my memory to have to sort out what’s important and what’s not.  I write it all down.  Be sure you understand before the doctor leaves the room what was said to you.  If you’re having difficulty understanding a doctor’s accent, ask someone to stay in the room with you and help you translate it.  Nurses are very good at this because they deal with the doctor every day.    If you don’t understand a term they are using, ask what it means. Don’t be afraid to ask them to explain more or repeat it.  It doesn’t matter what they think about you, it’s your loved one that is important.  It can all done civilly.  It’s important to be polite.

5.  It’s important to be patient and don’t lose your cool.  The wheels in a hospital move slowly.  Especially in a hospital’s ER.  Your elder may be sitting there longer waiting for help than someone who comes in from a bad car accident or is near death.  But, don’t confuse patience with accepting things that aren’t right.  If you believe you are getting bad service ask for a supervisor.  The squeaky wheel does get the grease.

I believe it is important for the main caregiver to stay with the elder for at least 24 hours, especially if a cognitive issues such as dementia and Alzheimer’s is involved. It is, also, important for the caregiver to take care of themselves.  It’s easy to get worn out staying in a hospital for days on end.  Go home after the first 24 hours and rest.  If it’s important for someone to be with your senior at the hospital, let someone else be there.  After all, that’s another reason you have written everything down and have all your important documents in place.

When I first started taking an active role in my parents care it was the early 1990’s.  The Internet wasn’t as evolved as it is now.  I didn’t even have a personal computer at home.  I would have loved to have someone to point the way for me with helpful information. Thankfully, the Internet exists!  Now, we can get helpful hints from all over the globe.  Let’s help each other.  If you have more helpful hints about this subject, leave a comment.  We’ll all benefit from it.

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14 Stress Relieving Tips for a Care Giver to Survive an Elder Loved One’s Hospital Stay

Hospital visits can be very stressful for care givers.  When our loved one must spend time in the hospital, they are in need of all of our attention and there are many questions to be answered.  How can we keep our stress levels down?  I’ve found being prepared ahead of time helps me stay focused on them and their needs, not overwhelmed with the extra stress of being uncomfortable because every thing I need is at home.

My parents are both dealing with different forms of dementia.  Emergency visits were common place for them before they moved to the Veterans Home.  Keeping information ready for emergency room visits was a must.  The list can be found here.

Before they moved to the Veterans Home, they had many trips to the hospital for extended stays.  Because of the dementia they became confused and slipped into delirium easily.  It is important for someone who is close to them to stay for at least a night or two for them to orientate to their hospital stay.  Doctors always seem to make their rounds very early in the morning.  I felt like I always missed the doctor’s rounds if I wasn’t there all night.  With so many trips to the hospital for both of them, I needed to be like a fireman who is always ready to jump into action mode.  I found a back pack to be very handy.  Packed with things I would need to spend a few nights at the hospital with them.  Here’s a few suggestions for this handy item.

1.  Extra undies, socks, toothbrush with tooth paste, mouthwash, hair brush, nail file, and face cleaner and lotion.

2.  Lip balm.  Hospitals are kept with very low humidity to hinder the growth of germs and bacteria.  The low humidity dries lips and skin out quickly.  Not only did I use my lip balm often, but it was a comfort for my loved one to have lip balm put on their dry lips.

3.  Feminine items.  Sometimes, stress can upset even the most regular ladies.  It’s best to be prepared.

4.  Portable Kleenex.  Hospitals are usually very good about leaving Kleenex in family conference rooms and waiting rooms, but a small portable Kleenex carrier can be tucked in a pocket and pulled out for those impromptu emotional moments.

5.  Small notebook or steno pad and a pen.  This is important for documenting the information you get from the doctors.  It’s handy to write questions you want to ask next time you see the doctor, etc.  Notes about what you are observing about your loved one to relay to the nurses and doctors.

6.  Your medications, prescription and over the counter drugs.  I found the dryness in the hospital gave me sinus headaches and headache medication is a must.  Added stress can turn a stomach into a raging acid producing machine.  Antacids helped me with this.

7.  Distractions from the boredom of a hospital stay.  Books, magazines, crossword puzzles, needlepoint, hand held games, or anything you enjoy to keep you and your loved one entertained.

8.  Most of us always have our cell phone handy, but the charger seems to get left at home.  Chargers seem to be universal and cheap anymore.  It may be worth the extra money to buy one to keep in the bag.

9.  Hospitals are no smoking zones.  Where I live, there’s a no smoking policy on the entire campus.  I’m not a smoker, but my husband is.  Finding a place to partake is next to impossible without getting in the car and going out of the hospital campus.  Nicolette gum or the patch is an easier fix.

10.  Comfortable shoes.  I can’t put enough emphasis on this.  Stress is bad enough, but suffering stress in a bad pair of shoes is horrible.  There can be a lot of walking, I suggest a comfy pair of tennis shoes.  In the evening, slippers can be a life saver for the tired feet.

11.  Dollar bills and quarters are wonderful for use in the vending machines.  Is always easier to have your own stash of dollars and not have to worry about getting larger bills broken in the middle of the night.

12.  A warm comfortable sweat suit or sweat pants and sweat shirt.  Hospitals are kept cooler because it inhibits the growth of germs and bacteria.  Even in the summer months it can get chilly.

13.  Simple snacks such as granola bars, apples, bananas.  Anything easily transportable that can help keep your blood sugar up when the cafeteria is closed.  Obviously, fruit will spoil if it’s kept in a bag pack for days, but granola bars last for weeks.  I always keep a bowl of fruit handy and it’s easy to slip a few in the bag on the way out the door.  I try to stay away from high sugar snacks as they spike my blood sugar and I can get into a cycle of up and down blood sugar which adds to emotional stress.

14.  I’m a freak about my pillow.  I’ve had neck issues in the past and my pillow is a must.  I always travel with my pillow when ever I know I’ll be staying over night.  I put it in a flowered pillow case that won’t get mistaken for one from the hospital.  It doesn’t fit in the back pack, but I grab it on my way out.

Hospitals are very stressful for care givers.  Having things in one spot or at least a list of things to take is very helpful. It’s easy to be stressed and feel overwhelmed.  When this happens our brains struggle to juggle everything.  That increases the stress.

When my father had a stroke, I was so stressed out I didn’t feel like I should be behind the wheel of a car.  Thankfully, I had my husband to take me.  If you are with your loved one when an emergency arises if you can’t hitch a ride with the ambulance, and there isn’t anyone to drive you, call a cab!  It’s cheaper to take a cab then having an auto accident.

There isn’t any way to completely alleviate the stress of being with your loved one in the hospital.  We’re concerned for them.  Obviously, they are quite ill for them to be there.  Hospitals can be a life or death situation.  It’s natural to feel stressed out when they are there.  Being prepared ahead of time won’t cure the stress, but it won’t add more to it.  It might even give a feeling of having something in control in an out of our control situation.

Do you having any more tips on what to have in our readiness pack?  Please feel free to leave a comment for all of us to learn from.

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Care Givers for Elders – What Do I Need to Have for An Emergency Room Visit?

I have been a care giver for several aging seniors over the years.  One of the things I had to “grow into” was the knowledge about what to do when emergency visits happen.  As my elders aged, hospital visits seem to increase.  The first few times, my husband and I only had the presence of mind to fly into action and make sure our elder got to the hospital in time.  As we became more seasoned in our roles, we learned a few things about advanced preparation.

I found out when I was more prepared for the unexpected hospital emergency room visit, the stress wasn’t quite as bad as when I was flying by the seat of my pants.  Here are a few things I found to be very necessary, kept altogether, in a special spot so it won’t be forgotten for these visits.  All these things should be prepared ahead of time.

1.  A file folder with copies of:
a. the DPOA (durable power of attorney),
b. copies of their living will if they have one.
c. copies of the front and back of all their insurance cards (including supplemental insurance), medicare card, veterans identification card (if they have one), copy of their drivers license or picture ID of some kind.

2.  Keep up to date and in their file folder all medications (including medications for skin such as cortisone, etc.), prescription and over the counter medications (including vitamin and supplements), that your elder is taking, with the dosages and frequency they take them.  Be sure to know when they took the last dose of each medication and when they are due to take the next.

3.  Also, in their folder, keep a list of all their hospitalizations and surgeries they have gone through.  It is important to keep track of the dates and what each hospitalization was for.  A brief medical history is important also.  Questions like age of parents when they passed, what they passed from, and the same for their siblings.

4.  If they are on oxygen, note this and how many liters per hour they are on and how long they have been using it.  If the are taking an ambulance ride, let the paramedic or ems know this information and leave your elder’s equipment at home.  The paramedics will use their own oxygen equipment for the transport and the hospital will use theirs once your loved one has arrived.  This is, also, true for wheel chairs, walkers, etc.  This equipment is expensive and can get lost or misplaced in a hospital setting.

5.  A list of their special dietary needs, allergies, and sensitivities.

6.  Are you keeping a journal about your elder’s health?  It’s a good idea to take your journal with you when you go.

7.  A list of important phone numbers; doctors, loved ones, relatives, neighbors, home health care providers, pharmacy they use, pet sitter, etc.  The phone number of those who need to be notified about the trip to the ER or notified if there will be a hospital stay.  I keep the numbers in my phone, but if you aren’t a cell phone user, make sure there is an up to date list in your folder with all the other information.

I found my stress level decreased substantially when I had this information readily available.  It helps the hospital professionals do their job which equates to our senior getting better care.

Do you have an emergency room visit story you’d like to share?  Is there anything else you’ve found which should go with us on our ER trip? Would you like more information like this? Click here!

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Elder Care – What If You’re the Only Sibling Near By or Willing to Help?

Years ago, taking care of our elderly Mom and Dad was a different situation.  Many families had a maiden sister or aunt who stayed home with the parents and took care of them until they passed.  The maiden care giver didn’t have another job and was supported by the family members who married and moved away.The families who didn’t have the spinster sister or aunt, moved their elderly parents into their home.  There was usually a stay at home Mom who was available for elder care responsibilities.  Lifestyles have changed dramatically in our country.  Most families have two working adults.  Children go to school or daycare.  There are many after school activities.  People are going every which way and most of the time the only one left at home is the family pets.

What hasn’t changed, is that one sibling is usually on tap to care for the aging parents.  This may be due to proximity to the elderly parents or they just “step up to the plate” and do what needs done.  It’s been my experience in my family and also in the families of my friends that rarely is it where siblings switch off and more than one accepts the responsibility of the elder care.  If your family is different and more than one, or everyone, is taking joint responsibility, consider yourself lucky.  It doesn’t happen often.

There are as many family dynamics as there are families.  Family politics flourish in all families.  When it comes to decisions about Mom and Dad, either everyone is together, or no one can come together, or, sadly, they don’t care.  In my family, I am the one who does the elder care for both sides of the family.  I’ve been blessed with a flexible schedule in which I can take time away from my career to take them to the doctors, emergency room visits, and be on call for any thing they may need in the way of care.

I’ve found, dealing with elderly parents can be a stressful thing, especially if dementia is involved.  Even without family politics, stress and pressure can build up.  When parents have dementia, that adds to the stress levels due to the nature of the affliction.

As their health declines, there are frequent trips to the hospital.  If you have ever waited in a hospital emergency room, you know it is a test of patience.  The wait is long, even when traffic is light.  If he caregiver has a job outside of the home, frequent hospital visits can mean a loss of income and careers came be compromised.  Some companies aren’t understanding about time away from work because of elder care giving responsibilities.

It’s sad to admit, but I don’t have a cure all pill for taking care of them or the stress involved.  I can tell you, from experience, we need to care for ourselves first.  Sounds selfish doesn’t it?

Have you ever taken a flight on an airline?  If you are familiar with flying, you know about the speech the flight attendants give everyone before taking off.  They point to where the exits are.  They show you the air mask and explain the procedure of putting YOUR mask on before you help children and the elderly.  Why is that?  Our first reaction is to make sure our children and those who can’t help themselves have their mask on first.  So, why would they tell us the contrary?  If we are busy taking care of others and don’t take care of ourselves, first, we won’t be able to breath for long.  Then, no one gets cared for and we all could perish.  Child or Elder care can be the same way.  If we don’t stop and de-stress, we won’t be worth anything to those we love.  We need to take care of ourselves first.  When we are always dipping into the well and never replacing the water, we will run dry.  Find something which relaxes you and takes you, mentally, away;  a bubble bath, read a book, take a walk, go window shopping, sit and relax with your pet on your lap, whatever makes your heart sing with joy.

If our lives become so wrapped up in elder care that our wells run dry, we will soon resent those we are caring for.  After awhile we will be burned out and that serves no one.  Our health suffers right along with our attitudes.  I found this out the hard way.

If you need help, don’t be afraid to ask.  Talk to their doctors about additional help.  They can refer you to agencies that can help.  Agencies who specialize in elder care know so much more than we do.  They can point us in the right direction.  They can talk to us about helping us cope.  They can arrange for services to help us take care of our elder better with less stress to ourselves. And, they can help us find funding for those services.

Talk to a neighbor or someone else who might be interested in coming in to visit your elderly parent while you get out and about.  Placing our elder in an adult daycare for a couple of days a week can free us up to pursue some stress free time off.  Adult daycare can be a stimulating place for our older person.  They have activities to participate in and, most of all, our elder gets a chance to interact with other people in their age group.  For instance, my Dad loved talking to all the other WWII and Korean War veterans about his time in the military. When they can talk to others in their peer group, they feel less cut off from the world.

Most of all, stop with the guilt.  Guilt is a killer.  It kills our health and our relationships. It makes us feel bad and attacks our self esteem.  It can make us resent the people we love the most.  Believe me, I know how pervasive guilt can be.  If we don’t keep it in check it will annihilate us.  We will not be a help to anyone at that point.

If you are the only sibling who can or is willing to help care for your beloved old people remember there are so many loving rewards. It isn’t easy, especially when they are very ill or suffering from some form of dementia.  But, you will be in a position to make a huge difference in someone else’s life.  As Helen Keller said, “When we do the best that we can, we never know what miracle is wrought in our life, or in the life of another.”

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What has worked for you?  Do you have some tips to pass on to the rest of us?  Please leave a comment and share your experiences with us.

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Alzheimer’s – A Daughter’s Thoughts About Love and Mom

Alzheimer’s is a cruel dictator.  It robs its subjects of their memories, their lifestyle and eventually their lives.  It doesn’t care who it rules, only chooses its victim and then becomes relentless as it steals a piece of their life day after day.

My Mother has this terrible affliction.  We have had to move her to a full care facility.  I’m fortunate that she still recognizes me and my husband, but the grand kids aren’t so lucky.  I have 3 sisters and we all have children.  It’s very confusing for her when the grand children visit.  She knows they are a grand child, but she doesn’t know who they are.

One of my sons made a family calendar for her and my Dad.  It turned out beautifully!  Every month has a pictures of the family members who have a birthday in each month.  The birthdays are listed.  My son put each person’s name under their picture.

My husband and I took the calendar to her on Mother’s Day.  She was thrilled to get it.  As we were going through it month by month, I realized she didn’t know which grand child belonged to which daughter.  The great grand children were even more baffling to her.  It was then I realized he should have put the relationship down with the name.  Which child and grandchild belonged to each of their daughters.

My Mother’s family has always meant so much to her.  I have always lived close by and she has had more contact with my children over the years.  Most often, she doesn’t remember them or know their names now.  It was sad to see how much she has forgotten.  Don’t get me wrong.  I feel very blessed that she still remembers my husband and me.  I know this won’t always be the case.

I, also, realized on this visit she was having difficulty comprehending the Mother’s Day card when she was reading it.  She understood it more when I read it to her.

I have only one grandchild.  He is a boy who now 5 months old.  He has been up to see her and my father.  She remembers seeing him but she doesn’t remember who he belongs to.  She had it in her mind that he belongs to my oldest sister’s son.  She must have asked me 10 times in a hour visit who he was and how many grand children I have.

It saddens me to see her declining so quickly.  There isn’t anything I can do about it.  It is what it is.  I have witnessed other people who’s parent is slipping into dementia and Alzheimer’s.  They are annoyed with the repeat questions and feel it is their duty to be short and cross with their parent.  They act as though their parent is doing it, deliberately, to annoy them.

I realize some people don’t have much patience.  I know my Mother isn’t asking over and over again because she wants to upset me.  She doesn’t realize she has asked the question before.  It doesn’t do any good to get short with her or treat her badly.  She isn’t going to remember any better if I correct her every time.  She would love to have her whole memory back.  She wants to feel connected to her family.

What harm does it do to the person being asked to answer with patience as if they had never heard the question before?  Why do some people feel as though they need to raise their parent as if they were a small child?  With a small child they would have more patience.

This article isn’t an information laden piece.  An idea to glean from this piece is the calendar.  It was a good idea for her.  She enjoyed it so much.  I hope that as she looks at it sitting on her wall she will feel more connected to her family.  I wrote this article to remind those who have a loved one with this issue to stop and think about how they are treating their elder.  This is the time to bust out the golden rule and think about how they would like to be treated.  Because as the old saying goes, “but by the grace of God go I.”

In parting I would like to share something I received on Facebook. It is a letter from an aging mother to her daughter.  I don’t know who wrote it, but it spoke to my heart and I hope it speaks to yours.

“My dear girl, the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If when we talk, I repeat the same thing a thousand times, don’t interrupt to say: “You said the same thing a minute ago”… Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep.

When I don’t want to take a bath, don’t be mad and don’t embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl?

When you see how ignorant I am when it comes to new technology, give me the time to learn and don’t look at me that way… remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life’s issues every day… the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through.

If I occasionally lose track of what we’re talking about, give me the time to remember, and if I can’t, don’t be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you. And when my old, tired legs don’t let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don’t feel sad… just be with me, and understand me while I get to the end of my life with love. I’ll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I’ve always had for you, I just want to say, I love you… my darling daughter. “

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Prescription Medications, The Elderly and Pill Boxes – What Do I Do When They Don’t Mix?

The elderly and prescription medications go hand in hand.  As our bodies age many elderly find the number of their prescription medications rise in direct proportion.  Many of the prescriptions they take are life threatening if they are taken incorrectly, take to many, or not enough.  A crucial time in our elderly lives is when they have trouble filling their own pill boxes.

In the article on this site entitled; Danger! Prescription Medications and Our Elderly, we discussed how it is vital to our elderly that we stay on top of what is being prescribed and how they interact with other drugs. The New York Times article titled; Wide Medication Misuse Is Found Among Elderly reported the in many ways prescription medications weren’t being taken correctly including “… misuse of drugs by elderly patients themselves.”  We can be vigilant on the what medications their doctors are giving them and what combinations they are taking their pills,  but if they have gotten to a point where they are having trouble filling their pill boxes every week, we have a dangerous situation brewing.

How do we know if they are taking the medications as directed?  Being informed as to what drugs they are taking and how they should be taken is vital.  A simple check of their pill box will show whether they are taking all their pills every day, but if they can’t seem to fill them correctly, you may notice changes in their behavior.  Symptoms such as more confusion, dehydration, retaining too much fluid, unsteady on their feet, etc.  Most of all, what is you gut instinct telling you?

If you discover your senior citizen isn’t taking their medication because they aren’t able to fill their pill boxes correctly anymore, but they can still function in their independent environment, what can you do?  Sometimes, if we live in another city, or have a time consuming career, or if our elderly loved one won’t take the help from us it can feel very frustrating and down right scary.

Where can you go to find help and information?  Here are 2 resources I found very helpful:

In the case of my Dad, he was a veteran of World War II.  My parents retirement income was limited and it was mostly Social Security.  They weren’t able to pay for expensive health care in their home.  Therefore, I found the Veterans Administration as an excellent resource.  They were very willing to help with education and skilled in home care.  Their philosophy was to keep the veteran in their home as long as it is safe for the elderly veteran.

My Dad was going to them for his health care and I would accompany him.  When I expressed my concerns on this issue, they immediately set up an in home social worker who came to the home and asset his situation.  She was a great help.  She filled out the paperwork to get the services started. She became a friend and ally.  She set up a health care professional to come out and fill my father’s pill case and some nursing care.  At the same time, my Dad was have issues with not being able to get out of the bath tub after his bath.  She set up an in home care professional to come out and give my Dad baths a few times a week.  A good online resource is the Federal Benefits for Veterans and Dependents Book.

When my Mom, who wasn’t a veteran, began to have issues with her medications, I turned to her doctor.  Her doctor was a internal medicine doctor and treated many geriatrics.  She was familiar with medicare and the services they provided.  The doctor put in a “referral” for an aging advocate service professional to come to the home.  She performed a similar service as the VA Social Worker and her fee was paid by Medicare.

As we watch our loved ones age, or we are the one who is getting to those “golden years” it is important to stay informed and know our options.  I applaud you for doing your research and hitting it head on with information at hand.  It isn’t easy to traverse the field of elder care, but knowing where to go for the info is half the battle.

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Many of you who are reading this article are health care professionals or are experienced informal caregivers.  It benefits all of us if you leave a comment about what works for you.  If you have found any other resources that would be a help to us, let us know.  Many thanks in advance!



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Should I Go to the Doctor Visits with My Elderly Parent?

Elder care can be a very rewarding endeavor.  If you are an Informal Caregiver, (A family member, friend, or any other person who provides elder care without pay) you may not have professional training in caring for the elderly.  This was my case.  I was thrown into the role without any formal training.  I’m the only one of my parent’s children who lives close by.  I had to learn by trial and error.

I developed a philosophy of;  “I don’t want to take away from them something they are still able to do.  Taking away things from them when they are still able to do them creates a dependency on me.  Soon, they become unable to do them at all.  Every time I take over something, it erodes their self esteem regarding their ability to take care of themselves.”  You may not agree with my philosophy, but it has worked well for me.

One of the first areas our senior citizens needs help with is doctor visits.  Obviously, we don’t want them to feel as though we think they are incompetent to deal with the doctor.  But, it’s imperative to their health and well being to stay up to date and properly informed on their health care visits.  By having a second set of ears at these visits gives our beloved elder a better sense of security and helps the doctor give better care.

How do we know when it’s time to tag alone on their doctor visits?  One of the first signs to watch for is their inability to recall what the doctor said on their appointment.  I’m not suggesting a Spanish Inquisition when they get home, but I found that if I asked some pointed questions about the appointment it gave me a gauge to know how well they were comprehending what’s going on at these visits.

Another sign which let me know it was time to go with them was when they started missing appointments.  They had forgotten to write the appointment down and completely missed the appointment.  When I went with them, it gave us both an opportunity to write it in our appointment books and calendars.  A gentle reminder a few days in advance of the appointment seemed to give my parents a better sense of security.

For me, not having special training, I relied on my gut, or instinct.  By using my gut feelings, it was evident when it was time to start going with them.  My parents were relieved to have me accompany them.  It proved to be imperative to have my eyes and ears at the visits.

I kept a notebook/journal in my purse dedicated to their health care.  By having it my purse, I always had it with me wherever I went.  I could add questions as we thought of them.  I had all the professional caregivers’ phone numbers and information in it.  Some people might find it easier to use their phone or PDA.  I think it’s important to use something you can keep with you at all times.  If you decide to use an electronic device, be sure to back it up often.  I found out the hard way about back ups!

I had each page labeled with their name, date, and list of medications with dosages.  I would write down any questions we wished to ask the doctor.  I would record their blood pressure that day and whether they had any blood drawn.  I left a blank section on the page for doctor’s comments and concerns. This was very helpful for me in staying organized.  Later, I expanded it for different health care people such as the in home nurse who stopped in to do their medications and take their blood pressure etc.  As my parents’ health continued to erode, I counted on my notes more and more every day.

As time moved on, I became the “go to person” for my mother-in-law and a dear friend who’s children passed before him.  If I hadn’t had “my system”, I would have gone bonkers trying to keep everyone’s health issues straight in my mind. It could have been disastrous to get them mixed up!

Elder care can be very fulfilling.  When we participate in their health care we are providing a gift of love which makes a huge difference in their lives.  It is easier for us if we can do it with love, compassion, and organization.  After all, they gave so much to us as we grew and matured.  Competent elder care is a life changing gift we can give back.

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What are the 11 Signs of Dementia?

We are very fortunate to live in a time of medical advancements, especially in regards to elder care.  People are living longer lives.  The dark side of an increased life span is the many adverse effects of the aging brain.  If you have known very many elderly people, the chances are high that you have known someone with dementia.

Not everyone who has the opportunity to become elderly gets dementia.  Many people stay mentally clear all of their life.  For those who suffer from some form of dementia, there are many causes.  I’m not a medical doctor or research scientist.  My experience with dementia has been up front and personal.  Both of my parents have dementia.  My mother has Alzheimer’s and my father has another form of dementia.

Dementia is a puzzling thing.  It can come on slow.  In the case of my Mom’s Alzheimer’s, it took years to progress to the stage where she couldn’t live independently and needed constant care.  My Dad’s case of dementia was also a slow process.  But, for a dear friend of ours who has the same type of dementia as my father, the loss of cognitive abilities was rapid and crippling to his ability to function.

When we see our elderly loved ones often, we may not notice the changes as clearly as someone who doesn’t see them on a day to day basis.  We may notice small changes and chock it up to their advancement in age.  How do we recognize the signs of dementia?

Here are 11 signs to watch out for:

1.  Recent memory loss.  Everyone forgets things, but remembers it later.  Dementia patients often forget things and never remember them.  They might ask the same question over and over again, forgetting they had asked before.  Memory loss is more severe than just forgetting where the keys were left or where they left the mail.

2.  Difficulty performing familiar tasks.  They may forget how to do something they have done many times before.  They may, also, do something familiar, but forget in the middle of doing the task that they are doing it and walk away and start something else.  For example, cooking a meal.  They could walk away in the middle of it and it burns , or they could forget to put it on the table to serve it.

3.  Problems with language.  People with dementia may forget simple words or use the wrong words, making it hard to understand what they want.  My Dad has his own language at times.  He uses words that don’t fit in the concept he is trying to communicate.  By listening very carefully, I can discern what he is trying to say.

4.  Time and place disorientation.  Someone suffering from dementia may bet lost in familiar settings.  They could go for a walk or a drive and become disoriented and forget how to get home.  This, also, applies to time.  They can become disoriented on time and forget that a person has passed on.  They talk about the person as if they are still living.  They may even wonder where their deceased person has gone, or get angry because they feel the person has gone away from them and aren’t where they think they should be.  Sometimes, they can seem to be lost in another time period of their life.

5.  Problems with abstract thinking.  Any body could have trouble, as they age, in balancing their check book.  Dementia patients can forget what numbers are and how to use them.  They can forget how to pay their bills, screw in a light bulb, how to open a package of crackers, etc.

6.  Misplacing things.  Someone with dementia may put things in the wrong places – an iron in the freezer or a wristwatch in the sugar bowl.  They can’t find them later when they are looking for them. They may even feel like these items have been hidden from them by others.

7.  Changes in moods and mood swings.  Most people get moody occasionally, but someone with dementia may have rapid mood swings, going from calm, to tears, to anger, in just minutes.

8.  Personality changes.  People with dementia may have drastic changes in personality, often becoming irritable, suspicious, fearful, or paranoid.  A person who is usually friendly and amiable can become angry and cranky.  Someone who has always been chronically crabby can change and get nice and amiable.

9.  Loss of initiative.  Someone with dementia can become passive and withdrawn.  They may not want to go places and interact with people.  Often times, they may seem to walled off from others.  Some of the things they liked to do in the past don’t appeal to them anymore.  Activities they enjoyed in the past no longer have any draw for them.

10.  Poor judgement.  They don’t have the ability to decide what is a good thing to do and what is not.  They make poor judgement decisions.  This is critical when they are behind the wheel or any other potentially dangerous activity. For example, my Dad’s poor judgement led him to standing in a rocking chair in the dark trying to change a light bulb.  Before dementia, he would not have done something that unsafe.

11.  Inappropriate behavior.  This can also translate to inappropriate sexual behavior.  Many times, a dementia patient will do things which are so foreign to their usual behavior.  They don’t know the are acting in a way that is social unacceptable.

Dementia can be a very upsetting thing for the patient and their families.  It’s important to stay loving and understanding with them as they can be confused by their behavior also.  It is important to be vigilant and know when it’s time to bring in extra help for them, or they may not be able to stay in an independent living situation.

My advice is to seek out help from their physician.  The doctor will be able to help with your questions.  The doctor can also give them a cognitive test and refer them to a neurologist for further testing.

Many senior citizens fear this change in their aging brain.  It’s important for the caregivers and family to handle this with love and understanding and not judgement or condemnation. As Betty Davis said, “Old age is no place for sissies.” 

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