Barbara's Blog

A common problem that speeds Alzheimer’s decline, and how to avoid it

Guest Expert Blogger:
Leslie Kernisan, MD MPH

Earlier this week, while I was listening to a social work colleague (Mary Hulme of Moonstone Geriatrics) give a talk on dementia at the public library, the following question came up:

“How can one keep Alzheimer’s from getting worse?”

Now, Alzheimer’s disease — the most common underlying cause of dementia symptoms — does slowly get worse no matter what. (Given enough years, it will eventually damage the brain to the point of causing a slow death, which is why Alzheimer’s is a terminal disease.)

But on the other hand, we do know that some things tend to slow the progression of brain decline, whereas other things seem to speed up the decline. In other words, the actions we take — and don’t take — can influence a person’s dementia journey.

In my experience, people often have heard about things that might slow down decline (exercise is one of my favorites).

But it seems to me that people are often much less well-informed about the things that can speed up Alzheimer’s decline. This is too bad, because often it is possible to take actions to avoid or minimize things that might cause dementia to get worse faster.

So today I’m going to write about what I think is the most important of these potentially dementia-accelerating problems: delirium.

Delirium: What it is, why it matters

Delirium is a state of worse-than-usual confusion brought on by illness or some kind of stress on the body or mind. It is especially common during hospitalization.

Although the extra confusion of delirium does tend to get better with time (and of course with the treatment of whatever illness or stress brought on the delirium), it’s very important to know the following facts:

  • Some people with dementia who experience delirium never recover all the way back to their previous level of thinking ability. Instead, they settle at a new, lower level of mental ability.
  • People who’ve experienced delirium tend to mentally decline more quickly during the following years than people who haven’t had delirium. In this study, having had delirium was linked to thinking abilities declining twice as fast in the year after a hospitalization.
  • Hospital delirium is very common in people with dementiaThis study found that delirium affected 32% of patients with dementia during hospitalization.

In other words, experiencing delirium is common, and can really speed the decline of Alzheimer’s or another dementia.

This can be scary for patients and caregivers to realize. Fortunately, although it’s not possible to avoid all delirium (people get sick after all, or do need to have surgery sometimes), it ispossible to take steps that have been proven to reduce the chance that an older person will experience delirium while hospitalized.

To learn more about how you can help prevent delirium during an older person’s hospital stay, I recommend this resource for patients and caregivers on the Hospital Elder Life Program website.

What caregivers can do about delirium

If you are caring for someone with dementia, here are three things you can do to avoid mental decline due to delirium:

  1. Educate yourself about delirium. For instance, you can learn more about what brings it on, how to have it managed, and how to prevent it. Much of this information is presented in the Dementia and Delirium Solution Center, which I wrote while at Caring.com a few years ago.
  2. Be careful about surgery and hospitalizations. If you are considering a surgery that is elective or otherwise not completely mandatory, be very mindful of the risks of accelerating the decline of Alzheimer’s or another dementia. For a sad story of how a family came to regret agreeing to a heart valve repair for an older woman with dementia, read this New York magazine story.
  3. Learn to spot delirium in the hospital. If you are a caregiver and your loved one with dementia has to be hospitalized, try to help hospital staff monitor for delirium. Yes, it’s their job to do, but studies have shown that busy hospital workers often don’t notice delirium in older adults. Families can help their loved ones get better care by watching for delirium and getting doctors to promptly address it if it develops.

 


Leslie Kernisan, MD MPH, is a practicing geriatrician with a special interest in educating and empowering family caregivers. For tips on better healthcare for aging adults, and information about upcoming caregiver education events, visit her website at www.drkernisan.net.

She will be leading free Q & A calls for caregivers on Tuesday, June 24th 3:30 p.m. EST. Please check her website for more details.

Caregivers may live longer…

I often quote studies done by Dr. Glaser at Ohio State Medical center that looked at the impact on family caregivers who care for their elderly parents.  The stress of care giving often negatively affects longevity, the immune system, and mental outlook.

So when I read a new study which states that caregivers may live longer, I was doubtful.  First of all they only looked at family members who were caring for stroke victims.  The research showed that the survival advantages were due to enhanced self-esteem when they received gratitude from the care recipients.  “…when care giving is done willingly, at manageable levels, and they are thanked.”

The last line of the article stated “more research is needed particularly on those caring for aging parents”.  If you are taking care of elderly parents, you know for certain that this needs MORE study!

CAR KEYS- funny story

Because caregiving can sometimes be sad or depressing, I decided to share with you a “forward” I received. Both my husband and I laughed out loud. However, I think my husband might have laughed the loudest!

Several days ago as I left a meeting at a hotel, I desperately gave myself a personal TSA pat-down.

I was looking for my keys. They were not in my pockets.

A quick search in the meeting room revealed nothing.

Suddenly I realized I must have left them in the car.

Frantically, I headed for the parking lot.

My husband has scolded me many times for leaving the keys in the ignition.

My theory is the ignition is the best place not to lose them.

His theory is that the car will be stolen.

As I burst through the door, I came to a terrifying conclusion.

His theory was right.

The parking lot was empty.

I immediately called the police. I gave them my location, confessed that I had left my keys in the car, and that it had been stolen.

Then I made the most difficult call of all,”Honey,” I stammered; ( I always call him “honey” in times like these.) “I left my keys in the car and it’s been stolen.”

There was a period of silence. I thought the call had been dropped, but then I heard his voice.

Are you kidding’ me,” he barked, “I dropped you off!!!

Now it was my time to be silent. Embarrassed, I said,”Well, come and get me.”

He retorted, “I will, as soon as I convince this cop I didn’t steal your car.”

Yep, it’s the golden years……………..

Dementias

I had the honor of interviewing Dr.  Scharre from The Ohio State Medical Center as one of the 3 experts for my PBS-TV special.  He is at the end of the Special.  What he emphasized over and over was to get a good diagnosis. There are many diagnoses other than dementia but look like a cognitive problem… UTI, mourning, B-12, dehydration, and many more.  Many of these other health problems are curable or have great interventions available.

Dr. Scharre and other physicians have developed an on-line test (SAGE) which can help people decide if it is time to contact a specialist to get a diagnosis.  Early detection is as important for the whole family as it is for the elderly.  Please read more below and also follow the link.

 

Advantages of Early Detection

Early diagnosis of Alzheimer’s and other types of dementia is important and has numerous benefits. While today’s treatments for Alzheimer’s disease arelimited in their effectiveness, they have the best chance of helping when they begin early.

• An opportunity for the senior to build better relationships with physicians and caregivers

• Ability to participate in clinical trials

• Time for the senior to make decisions about future care, financial and legal matters

Early warning of cognitive problems also allows the senior’s loved ones to remain more vigilant. Dr. Douglas Scharre, who helped develop SAGE notes, “The results can be a signal that caregivers may need to begin closer monitoring of the patient to ensure their safety and good health is not compromised and that they are protected from financial predators.”

The SAGE Test – one of the questions -

 

Read more       http://www.aplaceformom.com/blog/2-15-14-online-alzheimers-test/

Driving Tests

My staff and I laughed out loud when we read the responses to a recent article in a Virginia newspaper. The newspaper published an OP ED about an elderly lady who hit a 7 year old girl. The little girl ran out in the street to retrieve a ball, was hit by an elderly driver, and later the girl died. The editorial said that it was time to discuss administering drivers test every 2 years for people over a certain age.

The following were some of the irate responses the newspaper received.
—“I am 93 years old and I’m a defensive driver. I drive below the speed limit in the right lane. I drive with my right foot on the accelerator and my left foot on the brake.”
—“I am senior driver. If a child were to run into the street, he and his parents had better hope and pray that the care that hits him belongs to a watchful, slower-moving senior and not to my 30-year old son who can’t take his foot off the gas”.
—“I am fuming about the essay. He did not mention the thousands who are killed by pot-smoking, texting, daydreaming and drunk adults of all ages. I am 90 years old. Take my driving away from me, and they may as well wrap me up completely. I will know when I am endangering myself and others.”

I have told my kids that I will willingly hand over my car keys when they ask me to. I am hopeful that day is 20+ years in the future, and I am not certain if at that point I might get angry and insulted. Check back with me in a couple of decades!

How to identify risky medications for older adults

Guest Expert Blogger: 
Leslie Kernisan, MD MPH

Many family caregivers know that medications can cause side-effects in older people, and may worry that perhaps their loved ones are being affected by medications.

It’s a very reasonable concern to have. Studies have shown that older adults, especially those taking multiple prescription medications, often experience potentially serious side-effects from their medications.

Today, as I was giving a talk on geriatrics at a Family Caregiver Alliance retreat, the topic of medication side effects came up.

This was a terrific group of fairly experienced caregivers, almost all of whom had been caring for one (or sometimes more than one!) loved one for years. So many in the group had already identified several useful online resources for health information and support.

But most of them didn’t realize that the American Geriatrics Society’s Beer’s Criteria list is available online.

What is the Beer’s Criteria? It’s a carefully reviewed list of medications that are “potentially inappropriate” for older adults, and includes many of the medications that we geriatricians tend to stop or reduce in our patients. (Seriously, identifying and reducing these medications is a big part of my clinical practice!)

Although mainly meant to be used as a reference by clinicians, the American Geriatrics Society(AGS)  also provides the information in an easier-to-read format here.

What to do if you realize that you or a loved one is taking a potentially risky medication? Conveniently, AGS addresses this very issue and provides a handy online guide on “What to Do and What to Ask Your Healthcare Provider if a Medication You Take is Listed in the Beers Criteria for Potentially Inappropriate Medications to Use in Older Adults.”

If you’re a caregiver: Have you ever used the Beer’s list as a resource? Other ideas for how caregivers can be empowered to check on their loved one’s medications?


Leslie Kernisan, MD MPH, is a practicing geriatrician with a special interest in educating and empowering family caregivers. For tips on better healthcare for aging adults, and information about upcoming caregiver education events, visit her website at www.drkernisan.net.

She will be leading free Q & A calls for caregivers. Her next Q & A call will be January 28. Please check her website for more details.

PEW Study

Caregiving elderly parents is a national issue that will overwhelm us in the near future. A PEW Study discussed some of the issues that impact the rising need for family members to care for their aging parents. “As more people are able to be saved by medical advances, their lives are being extended, but they are also being sent home medically fragile.” Most caregivers are not trained to handle the very complicated regiment that newly discharged parents need.

Baby Boomers will need to have RN or MD degrees to keep their parents healthy. They will also need to figure out how to pay for their own retirement while also giving up to 10% of their pay checks to support their elderly parents. Boomers wonder if they will ever be able to retire. The slowing economy is squeezing all generations. There are more 3 generations living together than ever before. The graying of America will stress all of our institutions.

Caregiving is a marathon

Too often we underestimate the time obligation of caregiving.  Adult children step up to be the primary hands-on caregiver having no idea that they may spend as much time caring for their parents as they spent raising their children. Read…

Isolation

Isolation in the general public has huge ramifications, but is even more escalated in the elderly. Being lonely can impact the brain, heart and even cause death. Almost ½ of women over 75 are living alone. Neglect and abandonment is a health issue that we can design communities and institutions to effectively deal with. The question is when will this happen?

It is remarkable that China has had to institute “Protection of Rights and Interests of the Aged” law that states adult children should visit their elderly parents every 1-2 months. Many of us caregivers try to help our parents age in place. Yet, the isolation of being alone may not be the best choice. Moving to a retirement facility may improve verbal skills, increase nutrition, decrease loneliness, increase mental acuity, and increase physical interactions and exercise. Adult children need to stay involved in their parents’ lives, know housing options, and help parents make good choices.

Law of Protection of Rights and Interests of the Aged

China has a law that requires grown children to look after their parents who are 60 years or older. Grown children must visit at least every 1-2 months and on holidays. The wording of “frequently” visit written into law is to make certain children see that their elderly parent’s financial and spiritual needs are met.

All countries going forward will have difficulties caring for the elderly. We balance health care on the backs of families caring for each other. In the US 85% of care is done for free by family. That cannot be sustained with more single women, both spouses working, dispersed families, very complicated care regiments, economic stresses, living longer, declining birth rates, and the impact of factors that we have not even begun to imagine.

The questions are: What will we do as a nation to have the elderly age with grace and support? What are we going to do to support the Baby Boomers who are overwhelmed and stuck in the middle of kids, career, and taking care of aging parents?

Elderly Depression

Depression affects approximately 20% of people over the age of sixty-five, yet only about one in six is treated appropriately.  Depression is a treatable medical condition, not a natural part of the aging process. To further complicate the issue, 80% of those over 65 have at least one chronic condition, and 50% have 2 or more.  The burden of living with a chronic condition, particularly one not well managed can increase the liklihood of experiencing depression.  As you care for your parents, report any of these symptoms to your parents’ doctor: Read…

Healthy Aging Through Food

We all know that a low salt, low fat diet with plenty of fruits, vegetables, and fiber can reduce the risk of age related risks of heart disease, diabetes, stroke, osteoporosis, and other chronic diseases.  However, there are lots of other foods out there.  Can you eat those other foods and still experience healthy aging?  Yes! Read…

Prevention is the Best Medicine

While we all know this, we don’t always follow it.  Unfortunately, neither do our parents.  Not only do heathy people experience a better quality of life, they are also easier to care for.For people over 65 years of age there are eight indicators that signal the appropriate amount of prevention is occurring.  Those are: Read…

How to talk so they can listen…

Caregiving requires many conversations that may be uncomfortable for your elderly parent or loved one. As a caregiver, you can facilitate conversations with less friction by keeping some key points in mind.

Stay on Topic – First don’t take anything personally. Your loved one may not be completely receptive to everything you have to say, so keep the tone calm and gentle. Don’t argue. It will just lead the conversation off topic. Remember to pick your battles carefully.

Listen – Next you must listen and give the elderly ample time to speak. They need time to gather their thoughts and reflect on your ideas. Bring up a crucial topic several times in a low key manner. Be prepared to listen to their point of view, and look for matters of agreement.

Control – Let mom know that you want to help her retain control for as long as possible. By having open discussions, her wishes can be known and documented. Out of love and safety, all topics from finances to end-of-life should be addressed for the benefit of the whole family. The cost of putting off these conversations is too high to ignore.

Conversation Starters -You can start the conversation with, “I am starting to put together my financial plan… what does yours look like? Come with me to visit a financial planner.” Use other people’s stories to illustrate you points. Share with them a friend’s financial story or share a story from Stuck in the Middle. Sometimes elderly people can hear someone else’s problem more easily than their own. Assure them that you only want to help and honor their wishes.

Practical caregiving tips to advocate for your hospitalized patient – Part 3

Guest Expert Blogger:
Marie Gibson

This article is part three of a three part series that will help you step into an advocacy role, feel more confident about your role as a caregiver, and communicate effectively with medical professionals. These tips and actions are practical and provide real life advice to help you navigate through the countless tests, doctors, nurses, therapists, medicines and other medical professionals and new terminology. Moving forward, accept that you have a steep learning curve and apply yourself persistently.

Part 3: Tips for Control and Confidence of one’s own emotions

You can make a huge difference in the healing of your family member and you must recognize this fact early in the hospitalization process. It may be a time of great stress, confusion and frustration for you and the patient. By taking action in specific, concrete steps like those below you’ll find that you are assisting in the patient’s healing, and you will have more confidence and feel more in control of your own emotions during this time.

  • Remember the five ‘Rules of Medicine’ —Right patient, right drug, right amount, right time, and in the right manner. Although accidents are infrequent in hospitals, the staff can get overworked and tired; they are only human. An extra set of eyes to double-check every administration of medicine keeps everyone well and healthy.
  • Feel confident to look at any chart, record, table, or billing records if you are the agent of choice in the patient’s recorded Medical Power of Attorney Form. Staying informed is important in your role as an advocate for the patient. It’s your right and it’s your patient’s health.
  • Adopt the motto “Cleanliness is the route to healthiness!” Hospital-acquired bacterial infections are a serious risk to your patient. Anything you can do to keep the bacteria minimized is exceptionally important.
  • Screen all visitors and guests for colds and illness. Prevent those that are ill from visiting your patient. Patients’ resistance and immune system are compromised after surgery. You must protect them from outside illnesses.
  • Watch for bedsores not just on the bums, but also on elbows, knees, ankles, hips and backbones. Have nurses treat them immediately to prevent infections.
  • Realize that some patients have very fragile skin and that sores are quick to develop. They might begin as small red irritated spots, and can grow quickly without the medical professionals noticing. They can rapidly become serious infections endangering the health of your patient and must be treated as soon as possible.
  • Keep track of medications being started and stopped, changes in dosages, and changes the patient experiences in mental or physical reactions. Drug interactions can occur even though the patient has been using the medicine for a long time.

Marie Gibson is an author and speaker who advises caregivers on how family members can become crucial advocates for their hospitalized family member, and who also leads employee training at health care institutions. She is author of The Caregiver’s Journal and Peace of Mind for Caring Hearts and Helping Hands.
Using an organizational tracking tool like The Caregiver’s Journal will provide greater clarity in comforting your patient, communicating and collaborating for their health with the medical professionals and you will have more confidence and control of your own emotions. If you find these tips valuable, you’ll find more at www.The-Caregivers-Journal.com.

Practical caregiving tips to advocate for your hospitalized patient – Part 2

Guest Expert Blogger:

Marie Gibson


Practical caregiving tips to advocate for your hospitalized patient
This article is part two of a three part series that will help you step into an advocacy role, feel more confident about your role as a caregiver, and communicate effectively with medical professionals. These tips and actions are practical and provide real life advice to help you navigate through the countless tests, doctors, nurses, therapists, medicines and other medical professionals and new terminology. Moving forward, accept that you have a steep learning curve and apply yourself persistently.

Part 2:Communication and Collaboration with other caregivers; professional staff

  • Express confidence when advocating for yourself or your loved one. Now is not the time to be shy. You will need to make yourself heard when speaking to the medical practitioners. Speak up when you feel there is an issue you’d like to discuss with the doctors or nurses.
  • Ask questions. Learn as much as you can about the diagnosis, any procedures, recommended medications, and the prognosis or expected outcome. Medical terminology and hospitals are foreign to many people. You must learn new terminology and new concepts.
  • Keep track of the name, title, and contact information for the health professionals that are treating the patient. You will meet many new physicians, therapists, and nurses.
  • Write their names and contact information in a journal, such as The Caregiver’s Journal, or simply a notepad. This gives you a way to contact them if needed or if another medical professional asks. It’s also easier to track and share details of specific conversations when you know the person’s name and title.
  • Realize it’s always best to have an extra set of hands, a pair of eyes and a loving heart in the room with the patient. This is true whether it’s due to emotional or physical reasons.
  • Be aware that occasionally a doctor who did not request a certain test procedure will overlook vital information regarding the patient’s condition. The numerous doctors must have all the information to diagnose properly. Mentioning results of a new test or procedure to a doctor who may not be aware of it is entirely appropriate.

Stay tuned for our next article: Tips for control and confidence of one’s own emotions

Marie Gibson is an author and speaker who advises caregivers on how family members can become crucial advocates for their hospitalized family member, and who also leads employee training at health care institutions. She is author of The Caregiver’s Journal and Peace of Mind for Caring Hearts and Helping Hands.
Using an organizational tracking tool like The Caregiver’s Journal will provide greater clarity in comforting your patient, communicating and collaborating for their health with the medical professionals and you will have more confidence and control of your own emotions. If you find these tips valuable, you’ll find more at www.The-Caregivers-Journal.com.

Practical caregiving tips to advocate for your hospitalized patient

Guest Expert Blogger:

Marie Gibson

If you have a family member or loved one in a hospital or rehab facility, your life needs simplification–immediately!   With these simple tips you’ll make the stay easier and maintain control of your emotions better.  You’ll also learn to coordinate communications among multiple caregivers and collaborate with medical professionals in an advocacy role for your patient.

This article is part one of a three part series that will help you step into an advocacy role, feel more confident about your role as a caregiver, and communicate effectively with medical professionals. These tips and actions are practical and provide real life advice to help you navigate through the countless tests, doctors, nurses, therapists, medicines and other medical professionals and new terminology. Moving forward, accept that you have a steep learning curve and apply yourself persistently.

Part 1. Compassion and comfort for your patient

  • Stay with your loved one, as a caregiver advocate, as much as possible and as much as is allowed by hospital policy. It’s almost impossible for patients to become their best advocate.
  • Understand that being alone in the hospital room can be scary or at least disconcerting. It’s important to provide extra emotional support and encouragement.
  • Show patience when your loved one is having difficulty understanding what’s happening to them. Patients may be incoherent, forgetful or unable to comprehend simple requests due to fatigue, surgery, medication, or a combination of all.
  • Hand-feed your patient if necessary. Patients are tired, and their appetite may be affected by medicines so they don’t feel like eating. Caregivers must arrange their schedules around meal time to ensure adequate and proper nutrition.
  • Realize that patients can get discouraged by the change in their bodies. You’ll want to coach them to perform the activities assigned by the therapists.
  • Become the cheerleader when your patient becomes discouraged. They may lose strength, balance, or mobility during the illness. It’s important that you remind them that they can rebuild their muscles and movement.
  • Keep up the positive encouragement without being annoying or bossy. Emotions can run a little high. Your expectations may be too high for the patient—it’s a fine-line between pushing to recover and pushing too much.

Stay tuned for our next article: Tips for communication and collaboration with medical staff and others.

Read…

Family Responsibilities Discrimination

A new article in the New York Times, shines a light on the problems employed caregivers jobs can encounter. It suggests that it may be easier to take time off to care of your children than to care for your parents. Thanks to FMLA you can take time away from your job to care for your family. The trouble for caregivers in the workplace stems from trying to accommodate alternative work arrangements. Companies are often wary to make the adjustments that would allow employees to do their jobs, as well as care for their aging parents.

We can anticipate the need for childcare and know about how long it is going to last. The need for eldercare is often sudden and the length of time is unpredictable. These differences call for a change in the language used for constructing family leave laws. The law that allows parents to care for children, when more inclusive language is applied, could also allow the Baby Boomers to effectively take care of their elderly parents.

Should your elderly parent stop driving?

Approaching the subject of driving should be taken in very strategic steps. The first step should be to ride along with your elderly parent. The more obvious signs that your parent shouldn’t be driving are getting lost and diminished vision. If theses signs aren’t apparent, check for slowed reaction times and a safe distance. Be sure to take note of appropriate speed and their ability to complete complicated maneuvers.

If you don’t quite have a clear case for suggesting that you parent not drive start setting parameters. Asking them to drive only during the day, in good weather, in familiar places and staying off interstates are good ways to keep everyone safe and still allow them freedom.

If your parent really should not be driving consider asking a third party to help take the keys. Asking a doctor, AAA course, the DMV, insurance agent, or friend to help may make the difference. Remember when taking something away, have solutions ready and in place. Some options are public transportation, riding with friends, Share-a-Ride and your Local Area on Aging may even be helpful.

Caregiving: Maybe it’s Time to Ask for Help!

As caregivers to our elderly parents, we think that everyone should see that we are drowning. If you really feel like you are drowning, it’s time to ask for help. That small piece of advice can sometimes be the hardest to accept. Caregivers are horrible at asking for help. We also think that we are the only ones who can get the job done correctly. Or that asking for help somehow diminishes the work we have been doing.

Getting help can sometimes be as simple as saying “Yes” when you are asked “Is there anything I can do?”. Make a “job jar” that is filled with the tasks that other people can do for you. You could also try emailing your sister right now to tell her what days next month you will be gone and need her to take care of Mom and Dad. It could be that you end up pleasantly surprised by her response that she is happy to help. Another alternative is to find out how much it would cost to hire in help for those days. Ask her if she would rather pay for the in-home care agency if she is unavailable.

With that free time, you may find yourself coming back to your tasks refreshed and ready to tackle all the stress of being a caregiver. Sometimes the best way to take care of others is to take care of ourselves.

World Alzheimer’s Month

Alzheimer’s is a type of dementia that affects the brain’s comprehension. It is a progressive and terminal disease that can last 2-20 years (average 8 years). 1 in 8 people over the age of 65 have Alzheimer’s Disease. By age 85, it increases to 50%. It is the fourth leading cause of death in older adults (seventh overall), and all by itself, it will bankrupt the Medicare system.

Early diagnosis of AD is critical. There are several disorders that can look like Alzheimer’s. Before concluding that a person has AD, rule out the following reversible and treatable diagnoses: depression, drug interactions, thyroid disturbance, malnourishment, dehydration, fluctuating blood sugars, chronic infections (including Urinary Tract Infection and Pneumonia), and brain tumor or head trauma.

There are some early symptoms: personality change, decreased executive functioning (balancing a checkbook), getting lost in familiar places, impaired judgment, decline in language and verbal skills, and social withdrawal. I know most of us are panicked that we will someday have memory problems. I once heard someone say that forgetting where you put your car keys is normal. Forgetting what the car keys are for, might be a major dementia.

The National Institute on Aging has released a free guide for caregivers of those with Alzheimer’s Disease. I have provided a link here to that guide.

CWRU Care Giving Study

CWRU just published a study on the impact of caregiving on the adult child. This study was conducted by nurse researchers at Case Western Reserve University. If you are or have been a caregiver you are well aware the problems caregivers face such as back problems, fatigue, and depression. The study supports this and especially focuses on the higher levels of depression.

Previous studies done at The Ohio State University focused on the physical impact. They found that the caregiver actually shortened their life expectancy for 3 years. The caregiver is often called the “hidden patient”. The primary caregiver of an Alzheimer’s patient, often dies before the patient. This probably just documents what you are already feeling!

As a caregiver it is important to find time to take care of yourself. Take 1 hour per day to revive with a good book, gardening, and meeting friends for coffee. Try eating a well-balanced diet and exercising most days. Keep your stress levels as low as possible by prioritizing, making lists, establishing routines, and delegating tasks to other people. Find a support group online or better yet, locally. Most importantly ask for and accept help.

Boomer Greatest Fear … not to have learned anything

As an eldercare expert, I speak all across the country. In listening to my audiences, I have discovered some universal themes that are common to all caregivers. Over the next couple of months, I will share all 10 themes.

The greatest Boomer fear is to have taken care of aging parents for 10 years, and not have learned a thing about how to age better. We are panicked that we will repeat the same things our parents have done. That we will be a burden to our kids and present the same challenges. We will not have cleaned the clutter out of our house. We will not have our entire financial, medical and legal papers assembled and signed. We will not have planned ahead. We will not give up our care keys with a smile and loving heart.

My book Stuck in the Middle…shared stories and tips for caregiving your elderly parents started as a list on my computer. It was a list of all the things I was going to do better than my parents. I titled it “I’ll be darned if I’m going to do this to MY kids!” All my friends wanted to add their thoughts to my list. Once it was compiled, I signed the list and gave a copy to each of my two young adult children. We will all see if I am compliant when I am elderly.

Stay tuned!

Top 10 Tips for the Caregiver

There are 75 million adults taking care of their elderly parents. Of that number, 2/3 are in the workforce … stuck in the middle of kids, career, and aging parents. Many provide 40 hours of unpaid hands-on care with little or no outside support.

At some point YOU will be a caregiver. Definitely start preparing sooner than later. Don’t wait for a crisis to start to get organized. The following 10 tips can be helpful to you and your whole family. Please visit www.BarbaraMcVicker.com for more information.

1. Assess the health and safety of Mom and Dad. This is the only way you and your siblings will know where you are on the continuum of caregiving. There is a list of the 9 areas you need to be aware of on my website.

2. Hold a Family Meeting. Bring together the whole family to discuss ways to support your aging parents. Have an agenda and a list of needed tasks.

3. Amass the Essential Documents. Gather the important medical and legal documents that are listed on my website.

4. Build a Team. Start to gather a group of professionals who can support you, provide information, and advice. Consider a financial planner, geriatric care manager, elder law attorney, healthcare professionals, in-home care agency, and more.

5. Information is Powerful. Start to get educated about this topic and find resources that are available in your parents’ city. There are many great books, websites, webinars, and government resources.

6. Even Good Families become Dysfunctional. All of the conflicts and emotions involved in taking care of Mom and Dad, make for arguments in even normal families.

7. Sibling Conflicts. Usually caregiving falls to 1 adult child. Only 10% of primary caregivers feel that the burden of caregiving is evenly distributed. All siblings need to share in the care.

8. Support the Caregiver. The primary caregiver is often called “the hidden patient” because the job is so stressful. The other siblings need to say “thank you”, provide respite care, lend a sympatric ear, and send tokens of appreciation.

9. Financial Impact. The latest statistic states that most adult children caregivers are helping to support their parents with $2500/month. We may all have to work longer just to support our parents.

10. Boomers Greatest Fear. We are panicked that we will repeat the same mistakes as our elderly parents and be as demanding to our kids when we get old. Afraid that we have not learned a thing about growing old gracefully!

2 Factors impacting Elderly Caregiving

I just read an article out of the UK titled “The Forgotten Age”. We have known for a long time that the issue of caring for aging parents impacts the caregiver’s emotional, physical and financial well being. Going forward the factors that complicate this “informal” caregiving will be unusual sociological issues.

There will be a huge struggle going forward between the demands in social care and government spending constrains funding, and the downturn in everyone’s economic well-being. In the United States, most adult children caregivers help financially support aging parents with over $6000/years. How to fund care for our parents is being completely ignored in the health care debate.

Another factor is the increase in the breakdown in the family unit. The divorce rate is rising. Older females have no family members. There are fewer family members available to care of the aging. Communal bonds are deteriorating because of urbanization and disruption of family across the country. Who will care for our parents? Who will care for us?

Rewarding the Caregiver

I remember driving home from taking care of my 86 year old parents, and thinking that I needed to reward myself for all that I did for them. Since a rarely got a “thank you” and often was in the middle of their bitter arguments, I really need something.

I ruminated about ice cream or chocolate, but that meant I would need to go exercise to work off the calories. I considered clothes shopping, but shopping always depleted my energy, and what I need now was to be energized. My next idea was a great specialty coffee from Starbucks. The problem was all of the caffeine and sugar. What I finally decided on was a decaf coffee. Reality is awful!

Here are some suggestions that I think might be of more help.
Get a mentor or support group
Don’t do everything yourself. Learn to delegate.
Assess Mom and Dad’s situation.
Get all of the documents amassed
Explore options for health, housing, meals, and transportation
Take care of your own nuclear family. Caregiving stresses marriages.
Take care of yourself…walk, read, soak, and socialize

Productivity and Help for the Caregiver

 

Expert Guest Blogger:

Productivity Coach Meggin McIntosh

 

  1. Tip more than is expected.  Significantly more.  Whenever you get great service provided by someone you know will be surprised by your gesture, provide a generous tip.
  2. Treat yourself as if you’re worth it.  You are.  What do you need to do to care for yourself?  Do it.  Read…

An Apple a Day Keeps the Aging Away

An apple peel that is!  Muscle atrophy (the weakening and breaking down of muscle tissue) impacts most people at some time in their life due to illness or aging.  Unfortunately, there is no medication available to treat muscle atrophy.
Read…

Physical fitness and aging

The age of the body is defined by the flexibility of the spine
~ Maya Fiennes, yoga master

We all want our parents to remain as active and independent as possible, and we want the same thing for ourselves! Regular exercise is pivotal for seniors. Seniors are at greater risk for disease, lost mobility, and falls than any other age group. Conversely, they often realize the positive effects of exercise more quickly than other age groups. If your parent hasn’t been exercising, it can be difficult to get started. Read…

The Invisible Family Caregiver

“This is what you need to do.  Please sign here.”

Too often, caregivers, already reeling from a parent’s recent health crisis, are simply handed written medical instructions, new prescriptions, a car load of medical equipment, and sent on their way.  They are offered no training, no one asks if they are prepared for their new assignment, or how they are doing emotionally.  Read…

Valuing the Invaluable

Whether you give care to a friend or family member, or receive care from a friend or family member, you know that such care is so valuable, it is truly invaluable.  The world is just beginning to catch up with that understanding.  Read…

The emotions of caregiving

I always ask my audiences to shout out the emotions associated with caregiving.  ‘Sad’, ‘overwhelmed’, ‘denial’, and ‘angry’ are typically the first responses.  Mentioned less frequently, but perhaps even more important are ‘resentment’, ‘isolation’, and ‘burdened’. Yet, no matter where in the country I speak, the one emotion that always bubbles to the top of the list is ‘guilt’. Read…

Caregiving Tips for the Holidays

Help a Caregiver You Know

  • Offer to help clean and cook, wrap presents, go shopping, pick up the kids.
  • If your family is caregiving, suggest a potluck holiday meal or secret Santa gift exchange to save time and money.
  • The best gift you could give a caregiver is help. Give them the day off!
  • Remember to say “thank you” to a caregiver and let them know they are appreciated!
  • If a member of your family is caregiving for a relative this holiday season, send a thank you gift! Read…

Seniorhomes.com announces its Caregiver Recognition Award winners

Angela Diaz-Burris began caregiving as a young teenager as a volunteer working with kids who had developmental disabilities.  She regularly cared for a little boy with cerebral palsy and was devastated when he passed away under her care.  As a young girl, most of us would have been too traumatized to continue caregiving, and too scared to experience that loss again.  However, Angela was different, and her passion for caregiving gave her strength and allowed her to continue to help people. Read…

Share your caregiving story

Every caregiver has a story, and every story needs to be told.

I am so excited to share with you that I have been selected to participate on a panel of leading senior care experts to judge the SeniorHomes.com Caregiver Recognition Awards program, co-sponsored by Emeritus Senior Living.  The Caregiver Recognition Awards program aims to recognize the millions of Americans serving as caregivers; be it as a professional caregiver, or as a caregiver to a loved one or friend. Read…

Understanding aging services

The world of Aging Services is large, complicated, and can be overwhelming.  It is difficult to understand where to go, what agency does what, and how to access assistance for your parents.

Here’s a bird’s eye view of what’s what:

Read…

Traveling with your aging parents

With so many of us now living with and caring for our parents, we are constantly searching for ways to incorporate that care into our daily lives…and our vacations.
Remember back when our travel plans required that we consider feedings, strollers, diaper changing, and play grounds? Read…

End of Life Plan

Funeral planning is never a picnic, and this is likely why we are so often unprepared when the time comes.  Our failure to plan our own funerals forces our grief-stricken loved one to plan our funerals for us, at a time when they are working to process their own pain. It is no different for our parents.  As a caregiver to your parents, you are in the unique position of working with them to develop such a plan and avoid later pitfalls.  Read…

How parents hide dementia

Is your mom doing more things for your dad than she used to? She may be covering for his dementia.

But isn’t it normal to become more forgetful as we age? Not according to Carolyn Rosenblatt, RN, Attorney, and Mediator for aging related conflicts. Rosenblatt stresses that problems with memory are signs of underlying medical issues. Read…

Does increased activity decrease the risk of dementia?

Dementia is nearly the four letter word of aging.  No one wants to watch their parents or partners fade away into a loss of memories and recognition.  For so long it seemed that all we could do was sit back and hope the “d-word” didn’t come along.  That is until now. Read…

Public Event

If you are in the Columbus area on June 15, 2011 it would be a pleasure to meet you at my upcoming event: Read…

Cities are ramping up for the elderly

Cities across America are finally realizing their populations are aging at a rapid rate. Unfortunately, their architecture is designed for the young.

In New York City seniors will soon outnumber school children. New York Deputy Mayor Linda Gibbs says, “It’s about changing the way we think about the we’re growing old in our community.”
Read…

The Importance of Family Caregiving Meetings

The importance of family caregiving meeting

Caring for your parents is a big responsibility.  We all know it is very important that siblings share in that responsibility as much as possible, but what exactly does that mean? Read…

Medicare Scams

The United States loses billions each year in Medicare and Medicaid fraud scams targeted at the elderly.  Knowledge is power, and by educating your parents on the scams that exist, you can protect your loved ones and their needed benefits. Read…

Two Factors Impacting Elderly Caregiving

I just read an article out of the UK titled “The Forgotten Age”. We have known for a long time that the issue of caring for aging parents impacts the caregiver’s emotional, physical and financial well being. Going forward the factors that complicate this “informal” caregiving will be unusual sociological issues. Read…

The Cost of Caregiving

The costs and time of caregiving will impact government and personal resources in ways that are just now emerging.

Family caregivers save society billions of dollars each year. With the elderly now being the fastest growing segment of the population, programs to meet the needs of the elderly will have to expand and consume more of the gross national product. Read…

November is National Family Caregiver’s Month

Take a Minute and Thank a Caregiver

Recognized by President Clinton when he signed the first proclamation in 1997, National Family Caregiver’s Month has been proclaimed by an American President annually ever since. Many states, and dozens of local municipalities have also proclaimed November, NFC Month. Read…

Caregiving and Eldercare News 10-19-10

Key 4 Women luncheon sponsored by KeyBank being held TODAY at the Blackwell Center – speaker Cindy Solomon. Fundraiser for Breast Cancer.

For more information about other caregiving events, visit Barbara McVicker’s Upcoming Events page.

The Sandwich Generation

Caregiving for Yourself and Your Whole Family

It is estimated that 75 million Americans are caring for an elderly parent, many while working full time and caring for a family. This is the definition of the Sandwich Generation – sandwiched between taking care of 2 generations. Read…

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