Author Archive

I just finished reading Dr. Barry Jacobs’ book “The Emotional Survival Guide for Caregivers; looking after yourself and your family while helping an aging parent” and found it to be very insightful. It was easy to read which means I could put it down and come back to it without getting lost or having to backtrack. I loved the way the book followed a caregiver and the family through the whole caregiving process and pointed out issues that could occur, or did occur in this case, and then gave suggestions for everyone on both sides of the issue. The suggestions where very pragmatic and I believe helpful to any caregiving situation.

Here’s are a few excerpt I especially liked:
page 62 “Or, as I’ve heard many primary caregivers put it over the years, “No one else knows how to take care of our sick family member as well as I do since I’m the one with her all the time.” But as a long-term plan, concentrating the caregiving in few hands courts disaster. If you do the vast majority of the work, you’ll likely suffer the brunt of the cumulative physical and emotional toll that caregiving usually causes over months and years. If you give up the pursuits of your own life, you probably will grow gradually more resentful of the family members who still have the luxury of pursuing theirs. The danger is, without consistent logistical support, you’ll burn out and then not be able to take care of your ill relative well at all”

page 63 “Information, empathy, and hands-on help are the kinds of support that could bolster you to handle any caregiving situation. But there’s one proviso: You have to be willing to use the available supports. That brings us to the third common problem of many family members caring for loved ones. They don’t take full advantage of the help they’re offered. They say things like “God only give you as much to carry a you can bear” and then tell other family members they don’t need assistance.

Page 70 has several ideas for family members to use to encourage the primary caregiver to accept help. They include gently persuasion, recruiting the doctor, giving permission, asking instead of telling, and enlisting the help of the person receiving care.

The book is a great read for families who are working through the caregiving process. It’s not easy and it’s always helpful to have your thoughts validated. Whether you get validation through a book or in a support group it’s always helpful.  I get frustrated with my mother often but reading through the book let me know that other folks feel the same way and it’s OK.  My mother and I have actually gotten along better since reading the book.

I highly recommend Dr. Jacobs book.  The caregiving process can be a wonderful experience but not at the expense of your own health.  I personally try really hard to keep up with my kids and care for my mother.  She deserves to be well cared for but I need to keep up my relationships with my kids and other family members so that when I get old and need help they will be there for me.  Plus I don’t want the stress to kill me before my grand kids arrive.

In January of 2010 the American College of Physicians (ACP) published a position paper which recognized the pivotal role family caregivers play in the health and welfare of millions of those with chronic illness such as Alzheimer’s.

The National Family Caregivers Association posted the main points and recommendations in their Spring 2010 newsletter  of TAKE CARE!  They are:

“The physician should strive to ensure that the patient, family caregiver and other family members
have a common, accurate understanding of the patient’s condition and prognosis”

“Physicians should routinely validate the family caregiver’s role and be sensitive to specific
commitments the caregiver may have made regarding how her or she will manage the patient’s care.”

“Physicians should develop care plans that are patient-specific and caregiver-specific and provide
information, training and referrals to support those plans.”

“The physician should be alert for signs of distress in the family caregiver and suggest
appropriate referrals.”

“Physicians should recognize that geographically distant caregivers may face unique challenges.”

“The physician should define a palliative care plan that focuses on maximizing patient
and caregiver quality of life.”

Wow is this exciting or what! Family caregivers can be a huge asset for doctors and hospitals who see their patients returning to their offices or hospitals for issues that could have been prevented with a little thought and effort.  We just need to give these family members a little bit of help and understanding to get huge results.

Because I am in the  elder care business I  know what and how to get services for my mother but what do all those millions of caregivers who are totally unprepared do?  I will say that I take charge in my own life and health and have never had a problem talking to or getting what I need from a doctor and if I don’t I keep looking for one that will help.  Most stressed out caregivers won’t.  They don’t have the strength or will to do what it takes to get answers and many of these caregivers are usually elderly women caring for even older husbands.  They need their children or someone they trust to step in a say “hey what does that mean and how will this affect everyone concerned?”

What has been your experience with doctors?  Have you as a family member been treated badly or have you had great experiences with your doctor and his office?

If you are interested in getting a list of resources that where published online at the ACP website Click Here

I struggle everyday with my mothers depression which she has had all her life.  Most of the time she is upbeat and a lot of fun to be around but there are other times when she sleeps for days at a time and just wants to stay in her room.  She says it’s because she doesn’t want to bother the rest of the family but I think she’s hiding out. 

A lot of things I have to deal with at work have similarities with the issues I have at home.  My mothers depression is one of those.  It relates directly to my employees morale of late.  I only just realized the correlation while developing a new employee performance appraisal system.  I, like most people, used to hate doing annual reviews.  They were uncomfortable and to my way of thinking had no real purpose.  But after doing some research and getting some pointers from my TAB Board facilitator I have come to realize that they are powerful tools for myself and the employees.  They now have a sense of purpose!  We evaluated their work performance but more than that we set goals and I had fun setting them.  I can’t wait to see my employees develop there goals and after just a few days I have noticed a huge jump in employee morale!  The future looks very bright for Practical Care now that it’s employees are working on not just in the company.  They have purpose.

My mothers depression, I believe, has the same characteristics of an employee with low morale.  What is her purpose?  At this point she is just hanging out with me waiting to die.  She doesn’t go to work or volunteer, most of her friends have already passed away and the few she does have all live out of town.  Her health also prohibits her from getting out and that includes her depression which just makes it that much harder to get the get up and go to go anywhere.  She can’t drive anymore, well she can but we sold her car, so she couldn’t if she wanted too.  Although she has threatened to rent a car.  Sigh! 

Just as I sat down with my employees I am going to sit down with my mother and set goals for her.  Some of the goals I’d love to see for her are:  Goal #1  Plan and cook a meal for the family once a week, including grocery shopping with the help of her caregiver.  A stretch goal would be to plan and cook two meals a week.  Goal #2  Set up her sewing machine and make clothes for the kids or fix their torn jeans or hem my work pants.  Wow this would be great for me.  Too come home to a meal already planned and cooked,  to have mended clothes without waiting months whereas before I would wait until I had a healthy pile to take to the cleaners for cleaning and repair.  This is sounding more and more like it benefits me more than her but I know that’s not the case.  She will have a purpose in life and not one that includes waiting to die!

Have any of you come across this issue with your parents?  What have you done to help them?

A recent New York Times article, A Graying Population, a Graying Work Force, talks about older workers comprising at least 30% of the elder care workforce by 2018.

At least 20% of Practical Care’s current employees are over the age of 55 and we hope to add more as our new homemaker program grows. In the past we have concentrated on caring for folks who need heavier care such as assistance with personal care but due to recent requests we are restarting our homemaker program to help those who just need a little bit of help to remain independent. This is the perfect job for a retiree as the hours are flexible and short.

And I can tell you from past experience that caregivers over 55 tend to have better work ethics. Not that I all my caregivers aren’t brilliant in their own way, older workers just seem to have more sympathy for elders. They go to work even on days when their joints hurt and they seem to develop friendships with their clients faster.

There are exceptions from the clients mentioned in the article though! My mother loves her younger caregiver. They talk about kids and school and life. The challenge of being a mother doesn’t change all that much over the years and my mother had lots of experience after having seven kids. I have thought of cutting back the caregivers hours but my mother looks forward to her visits so much that I don’t have the heart to cut her off from someone who has become a friend.

The are pluses and minuses to every generation but all elder caregivers tend to be caring and dedicated individuals who always work hard to help their clients remain independent and motivate them to find meaning in life.

Hello my name is Samantha and my 82 year old mother is addicted to pain killers! As I write this I imagine myself in a room full of  caregivers who are going around the room saying the same thing. I know I’m not the only family caregiver out there that has had to handle this issue.

It’s just one of the many issues I’ve had to deal with since my mother moved in with us in February. She tells me she is not addicted and that she knows they are bad but hides them in her room, searches my house for where I hid the rest and tries to get more than one doctor to write her prescriptions for her drug of choice.

Oh and now since I have taken control of those drugs she has developed migraines which require another pain killer! I got so frustrated last week that I told her to handle the bottles herself. Childish I know but dang it I’m tired of being her drug pusher. Well you can guess what happened, she took 6 migraine pills in an 8 hour period. That brought me back to my senses and I have taken those away from her as well. She now has to ask for them, which humiliates her, but I’ll be damned if I’ll let her “accidentally” kill herself.

The really frustrating part of this whole issue, other than having to police my mother, is the reaction of the medical community and her peers.    Every doctor I have talked too about this gives me the same line “She’s 82 let her take whatever she wants”. BULL! I won’t accept that. She has people that love her and her health such as it is. Would they have said the same thing to someone in their 20′s or 30′s. I sure as heck hope not. People are living quality lives into their 90′s now and there’s no reason why she shouldn’t.

I do think she has seen the light somewhat though due to her 11 year old grandson, Michael. He loves spending time with her. She has the most amazing long term memory and the funniest stories to tell. She remembers all of my fathers stories about WWII and Vietnam and loves to talk about her 7 children. Michael is constantly begging for war stories about his grandfather and has now insisted we work on her genealogy on www.ancestory.com. The other day he came to her and asked very quietly if she would come with us to a WWII war reenactment that a nearby Army Base was putting on. She told him not this time as she was too tired. She told me he looked at her with sad eyes and pleaded with her to come. He really wanted her to spend time with us. Ever since then she has been a more engaged person.

While she is still on enough pain meds to kill a horse she isn’t taking the migraine pills (although the caregiver secretly substituted some of them for aspirin). We are all looking forward to wild stories of the 40s and spending more time with our family.  My mother isn’t perfect but she’s the only one I have and I selfishly want to keep her around for as long as possible.

Wouldn’t that be lovely!  Someone you could call to help out on a moments notice.  You could call them to ask “Can you run over and drop off books for my mother”?  or “Can you run to the drug store for candy this afternoon”?  Just helping out with the little things is HUGE.

Well I have that.  I own my own home care company, Practical Care Continuum,  and I have a wonderful nanny for my kids that helps out with my mother too.  I could never be a caregiver without them and still work.  No wonder daughters are leaving the workforce to care for their parent(s).  How in the world can anyone keep down a full time job and cater to their parent(s).  I would go insane trying to keep up with her needs.

The big issues are not the problem because I can get home care help for those issues but the little things such as making sure her medications are set out properly and ordered in a timely manner consume a lot of my time.  The woman is on 12 medications umpteen times a day.  If I have a problem keeping up imagine my 82 year old frail mother keeping up with them.  Not to mention the 4 different doctors she has.  I don’t even have one (pretty typical for a caregiver to have no physician.  It’s not in our plan to get sick)

I think family members take on too much when caring for their parents and don’t think about the little things a home care company can do for them.  I have an advantage in that I own the company but even if I didn’t I would still hire one to handle the little things because my family time is precious to me.  My kids are growing up way to fast.  My 11 year old is graduating to middle school in two months and will no longer want to hang out with mom.  I want to grab all the time I can with him and running errands for my mother (much as I love her) is not my idea of family time.  So I give myself a break and ask (pay) for help.

Corny as it sounds I don’t want to be remembered for all the hard work I did when I go I want to be remembered for all the love and shared time I had with my family.

Bottom Line:  I am so lucky to have the help I do and if you don’t get your own you are missing out on life so get your own Concierge Service any way you can!

I spend a lot of money on management books each year trying to improve my leadership style but just the other day I realized that I had forgotten one of the basics.  Tell someone what a great job they did!

My week started out very hectic as usual.  Between the kids, my mother, her caregivers, and the business I really needed a Calgon moment and I got it from an email sent to me that included a testimonial from a client of mine.  It was wonderful to receive the pat on the back and the acknowledgment of all the hard work I put into my company.  That simple note made me realize that we all should give more kudos and if we do it will make us feel better which will in turn lower our stress level.

I emailed a kudos yesterday for the great service I received while ordering a pizza from CraigO’s.   I noticed that CraigO’s has gluten free pizza so I called to order for both myself and my kids who can eat anything.  The young girl who took my order was cheerful, patient and knowledgeable about her product.  You don’t find that everyday in the food service arena so I dropped a quick email to her boss about how impressed I was with her service.  They sent a note back thanking me but what I noticed was the fact that my email was forwarded on to her boss and the owner.  The whole process only took a minute, made me feel good, and hopefully put a smile on that young woman’s face. Who knows maybe that simple acknowledgment brought her to the attention of the higher ups which in turn will lead to her one day being the CEO.  A simple pat on the back can do wonders.

Which brings me to my point about caregivers.  Don’t forget to acknowledge all the hard work they do. The stress can be overwhelming but well worth it if someone says “Good Job” and Thank You for all you do.  Caregivers put up with a lot from their clients/family members/loved ones and it’s even worse for those caring for someone with dementia.  Those folks become isolated and forgotten all to often so take a moment to send a card or flowers to brighten up their day.  As an added bonus it will make you feel great too!

At Grace and Laughter I have decided to invite guests to blog for us.  I have met many wonderful people in my career and want to pass on their information/wisdom/opinions to my readers.  My first guest blogger is Sue Ronnenkamp of AgeFullLiving.com.  I think you’ll enjoy her blog!

An Easier Approach to Change

At the beginning of each month, my calendar prompter reminds me that it’s time to update my Change Journal.   This is a ritual I started in June 2008 after spending a lot of time reading about making changes – including great information I found on Ariane de Bonvoisin’s web site called First 30 Days.   I thought – why not take change just 30 days at a time?   Would this work better than strategies I’d tried in the past?

The answer to this last question is a resounding YES!   It’s now been over a year and a half since I started my Change Journal (a simple Composition Book I picked up for $1 at Walgreens).  At the beginning of each month, I list the changes I want to try or work on for that month (2-5 items is normal for me). When I reach the end of the month, I review my list and write briefly about the results – what worked and what didn’t.    And then I create a new list for the new month.   Some changes stay on my list for a few months until they are fully cemented in my life.  Some things get tabled and tried later.  Some changes get knocked off the list – “tried that, didn’t work, try something else.”   Bottom line, I never beat myself up over the things that don’t work.   I just focus on what DID work for me and move forward with keeping change active in my life.

What kind of changes have I made since I started this practice?  Here are some notable ones from my change list:

• Started doing crossword puzzles – something I had shied away from my whole life because my dad and sister are such crossword puzzle wizards.
• Did my first REAL push-ups at exercise class (something I’d always said I couldn’t do).
• Switched health clubs which led to trying aqua classes for the first time – exercise that gives my aging joints a break, is surprisingly effective and fun, and that has provided a nice change of pace in my weekly routine.
• Took baby steps toward being more energy conscious – starting with using cloth bags for groceries one month, turning off unneeded lights around the house another.
• Followed my dad’s advice and got back into the stock market and investing money again.
• FINALLY lost the extra unwanted pounds I had gained by trying a new diet that now allows me to eat more and weigh less.
• Cut down on salt and started using salt substitutes like Mrs. Dash at most meals.

As you can see, some of these changes are pretty minor.     But as I see it, EVERY POSITIVE CHANGE COUNTS – no matter how big or how small    I’ve also learned that once I find a change that feels right for me, then I need to work on making it STICK so it becomes a natural part of my life – even if it takes several months to accomplish this.   Changes that stick are how progress is made and how rewards can be reaped for your efforts.   And once a change is cemented in your life, then you can move on to the next thing and keep building on your change successes.

So, what do you think?   How does approaching change just 30 days at a time sound to you?   Is this something worth trying this year?    To learn more about this, go to www.first30days.com and give change a more reasonable try.   Who knows – it may just stick like it did for me.   Good luck!

Sue Ronnenkamp is the creator and founder of Age-Full Living, an aging education and consulting firm that focuses on the positive aspects, opportunities, and gifts of growing older.   Sue calls herself an “Age Changent” for Baby Boomers and beyond – her made- up and catchy version of the term “change agent” that encompasses both changing the way we think about aging AND embracing changing with our own aging.   For more information, visit Sue’s website at www.AgeFullLiving.com.

I was recently invited to attend a dinner in which Eva Church of Austin Groups for the Elderly was one of several older adults recognized for their volunteer efforts. Eva was being recognized for her efforts on the AGE board of directors.  And as everyone knows Eva is an icon in the Austin elder care scene.  Although it was a stormy evening in Austin the table was full of Eva’s cheerleaders. The meal was amazing, of course you would expect that from the Querencia at Barton Creek, and if the food is anything to go by this place is outstanding.

Eva now runs the Caregiver Resource Center at AGE. They are a great resource for those folks looking for information on elder care issues. The resource center, which is located at 38th & Cedar Street,  also boasts a loan closet for durable medical equipment and a lending library. The lending library is a great idea for those of us who don’t know what books are available and would rather not spend a lot of money on books that may not apply to your specific situation.

If you see Eva around congratulate her on her accomplishment!

I wanted to take a moment to let everyone know about the wonderful care my mother is receiving at the Summit at Westlake Hills in South Austin.    But first a little bit of background on my mothers situation.

• My 82 year old mother has been independent until a recent cold which has really brought her down.
• I wanted her to stay in her apartment an hour and a half from me because I thought she would have more interaction with people.  She staying in her room all the time.
• She has been depressed for years but never more so than after my fathers death 9 years ago.
• She was hospitalized for a week and then discharged to a Rehab unit next to her apartment which after less than 24 hours I pulled her out of due to complete incompetence.

Ok this is my experience with the Summit.  I called on Friday morning to see if they had an opening for her and their Admissions Coordinator, Tammy, said sure! and she would handle it all for me.  And did she ever.  She kept in contact with me throughout the day while I retrieved my mother from the “other” facility and she met my mother at the door with flowers.  As a caregiver who was stressed out and very upset at the poor decision I had originally made it was such a relief to know my mother was finally in good hands.  The nurse and the therapist saw her in the first hour, they had everything ready for her and I could finally relax.

I have never seen my mother so happy.  She actually got her hair set.  I haven’t seen her do that since before my father passed away.  She loves the staff there.  They have been kind to her and patient with me.  I have run nursing homes in my past and have always had to force myself back into them.  But this place doesn’t give me the willies.  I think it’s a combination of everything from the staff to the ambiance.

I wanted to use my blog to express my appreciation of their care of both my mother and myself. I don’t know if this is the thing to do but as it’s my blog I’m guessing I can.   If you live in South Austin and need to place your family member in a facility for care I highly recommend The Summit at Westlake!