Archive for the ‘Love and Family’ Category

I have exercised all my life, but come from parents who considered breaking a sweat a waist of time.  So when I see my mother in so much pain due to back problems I think to myself (because I don’t want to push her) that it would be so helpful for her to strengthen her back and leg muscles.  She lays in bed all day either watching TV or reading and everyday she is in severe pain.  I know that if I don’t get moving everyday I get stiff and my moods aren’t the best.

Recently, while going through my Twitter account, I came across this blog post from the Alzheimer’s Reading Room, on what I see as getting things done to make you and your elders life easier and more enjoyable.   But a huge part of the article covers getting his mother to exercise even though she is mean to him on the way to the gym.  I’m thinking I need to get my own mother to the gym or have someone come to the house who can start working with her.

Has anyone starting something like this with their elderly parent?  Do you have any suggestions for a trainer or physical therapist in the Austin area?

My mom has always been a loner.  I don’t remember her being around much as I was growing up as she was always either at work or hiding in her room.  She still does those things (other than the work) while living with me.  She says she isolates herself because she doesn’t want to bother the family but it’s hard to know why she does it now when it’s been a life long pattern.

When she does emerge from her room, the kids love to visit with her and the dog absolutely adores her.  She unfortunately feeds him from her plate.  But she also pets him and lets him hide under her chair when the occasional Texas thunderstorm happens by.

Every year our family goes to Garner State Park to camp but this year we decided to visit a private camp ground called 7 bluffs.  We rented a big house so everyone, all 15 of us, could spend time together with Grandma, or Nona as she likes to be called.  Up to the last minute I thought she would change her mind but I kept encouraging her and she went.  I got her books to read and anything else that might keep her busy.  But after the first day she was ready to leave.  I think she missed her television which she leaves on 24/7 at home.  There was only one in the house and the kids had hijacked it for cartoons and tween shows.

She told one of my siblings she would never  come with us again.  She hasn’t told me that.  I guess she doesn’t want to hurt my feelings. I have to wonder though why she complains about not seeing her grandchildren more often and when she gets the opportunity to see all of them at once for 5 days she wants to high tail it out of there.  She did tell me the highlight of the trip was seeing the baby deer outside her window.  Sigh, I guess spending time with family will never be her thing.

Change is hard for anyone but especially older adults who have lived a lifetime doing things a certain way.  I shouldn’t have expected her to change her routines and become more social because I thought she would have a good time.  She knows what she likes and sticks to it.  I felt as though if I didn’t ask her to go her feelings would be hurt and she thought if she said no my feelings would be hurt.  I guess a little better communication would have been in order here but although she has  been living with me for over 6 months now I still can’t shake that mother/daughter role with every aspect of our relationship.

I think the lesson for caregivers is to find ways to socialize their parent(s) that follow their life long patterns.  Or at the very least introduce new activities in small doses.  Maybe 5 days was not such a good idea and maybe I should have brought her her own television.  I can’t help trying and I don’t think it’s right for caregivers to not try something.  Our parents did it for us when we where young and now it’s our time to change roles.

Parenting your parent(s) can be one of the hardest things to do.  Planning ahead is very important and necessary as a proactive approach to caring for aging parents.  Most children do not want to think about what happens when your parents age but when you look at the fact that 80 to 90% of all chronically ill older adults will need care at one time or another, you can’t ignore the statistics.  To make your job, or as we call it labor of love, easier you should ask your parents questions about their financial and medical status before a crisis occurs.

You never know when they may suddenly become ill and you are the one that has to provide information to a doctor or other health care professional.  While these questions are not easy to ask now, it won’t be any easier months or years from now.  I had to learn this piece of advice the hard way when I had to suddenly care for my ailing father.  It is far easier to talk to parents when they are healthy than when they’re incapacitated or hospitalized.  The object of these conversations is to get the information you need so that you can determine what kind of help your parents may need or wish.  Since their needs will change, you may have to have this conversation more than once or twice.

In addition to finding out about what they can do and what they need help with, you’ll want to understand what they want out of life, what their biggest concerns are, and what they cherish most.

Some general tips to use when talking with a parent are:

• Talk when you won’t be interrupted and when you are both relaxed.

• Don’t tackle everything in one conversation.

• Ask open ended questions such as “When you think about your future, what are you most concerned about” instead of “What about going to a nursing home”, something nobody wants to do.

• Do not be judgmental.  Your parents are competent adults.

• Don’t pepper them with questions.  Finding ways to have a conversation about the future rather than answering a quiz will cause less anger and stress.

• Involve others if it will help.  There are people out there who help manage later life decisions and issues for families.  In some cases, it’s easier to talk about these matters with an outsider than with a family member.  Call your local Area Agency on Aging, attorney, or doctor for assistance.

• Be open and clear about the facts.  Don’t whitewash problems.  Be straightforward about factual medical prognoses, for example.

• Actively listen to their concerns, don’t just convey your own.

26 QUESTIONS TO CONSIDER

1. Do you know the names and phone numbers of their doctors?
2. Do you know these physicians personally?
3. Are your parents enrolled in an HMO?  What do you know about their coverage and the quality of their HMO?
4. Are they covered by Medicare? Do they have supplemental insurance?
5. Do your parents’ have a lawyer? An Accountant? A financial planner? Do you know any of these people personally?
6. Do your parents have a will? (70% of Americans don’t) Do you know where it is kept?
7. Do you have health care power of attorney?  Do you have power of attorney?
8. How familiar are you with the “continuum of care”.  Do you know the difference between a retirement community (Sun City), an assisted living, a nursing home, skilled nursing facility, rehab, Alzheimer’s units, hospice care and home care services such as homemaker, personal attendant care, and skilled home health agencies.
9. Do you know how your parents feel about the possibility of leaving their home?
10. How much do you know about your parent’s finances?
11. Do you know what level of care they can afford?
12. Do you have other family members who might help serve as caregivers?
13. How honestly – and how recently – have you talked with your siblings and other family members about how you plan to care for your parents?
14. Is the family in agreement on what should be done?
15. Do you know who will be the primary caregiver or if it will be a shared responsibility?
16. If you will be the primary caregiver, how do you feel about that?  Are you willing to take on the responsibility?
17. How do your spouse and children feel about your commitment to your parents?
18. What is your current relationship with your parents?  Is it open and honest or are there a number of unresolved issues?
19. What can you do to resolve or ameliorate those issues?
20. Do your parents live nearby or will caring for them require a move?
21. Will they be moving near you or will you be moving near them?
22. How does your immediate family feel about either of those choices?
23. How candidly have you talked to your parents about their future?
24. Is there an “elephant” in your living room?  Are there on-going issues that have not been discussed such as alcoholism, prescription drug abuse, dangerous driving, memory loss, inadequate diet or self-imposed isolation?  Do you have the courage to discuss these issues?
25. Do your parents want extraordinary measures taken in case of medical emergency?  Do they have a living will?  Do they want to be organ donors?
26. Do you know what kind of funeral service they want, if any?  Do they want their service in a funeral home or a church?  Would they prefer an open casket or closed?  Do they want to be cremated?  Do you know a reputable funeral home?

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?

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.