Wednesday, July 30, 2008

New Book Notice: A Family Caregiver Speaks Up

A Family Caregiver Speaks Up: It Doesn’t Have to Be This Hard

by Suzanne Mintz, President, and Co-Founder of the National Family of Caregivers Association has a new book available now on the NFCA website.

The blurb reads:

“Full of advice for family caregivers, this one of a kind book written by a family caregiver provides lessons from family caregivers across the country, tips for interacting with the healthcare system to better meet the needs of families dealing with chronic illness, and a cogent presentation of how public policy has a profound effect on even the most intimate details of life in caregiving families.”

Having just finished Love, Honor, & Value, I would strongly recommend this follow-up book. Although some of the information will likely repeat from the last book, it is now six years later and Mrs. Mintz continues as caregiver to her husband.

A Family Caregiver Speaks Up will enhance any caregivers’ library.

Book Review: Love, Honor, & Value

Book Review: Love, Honor, & Value. A Family Caregiver Speaks Out about the Choices and Challenges of Caregiving

By Suzanne Geffen Mintz
President and Co-Founder, National Family Caregivers Association

This book explores the meaning of love, honor, and value in the everyday lives of family caregivers. It discusses why care giving is different today and what role society should play to integrate care giving into the fabric of our health care system.

Caregivers are an element of the health care team and deserve acceptance as such. They bring inside knowledge of the loved one’s condition to the table. Their day-to-day experience merits respect.

Love, Honor, & Value is part memoir, part philosophical treatise, and shows a new way of looking at life. Mrs. Mintz shares insights and ideas meant to ease a caregiver’s journey learned first hand from her own experience.

The common thread interwoven through all caregiver’s lives is the emotional impact of care giving. Common emotions include feeling overwhelmed, grieving the loss of personal time, sadness, and stress.

Caregivers should examine, accept, and experience their emotions. It is okay to be angry, to cry, to let go in a healthy way.

Although published in 2002, I just discovered this wonderful book. Mrs. Mintz shares her personal story as a caregiver drawing the reader in as if everyone were sitting in the family room sharing his or her story around a warm, inviting fire.

She writes with a comfortable conversational style and the reader knows she truly understands. She understands the isolation, the frustration, and the fear.

Because of her experience, she knows first hand just what to say to provide comfort.

The book explores what the everyday life of a caregiver is all about, and what part the words of the title play in that life.

Ultimately, it is important the caregiver understands she or he needs to take control of their life. Reading this book will reinforce that lesson.

Love, Honor, & Value is as pertinent today as it was the day it was written, and should be at the top of every caregivers reading list.

Monday, July 28, 2008

Surgery and the Very Old - How Far Should You Go?

1. The New York Times has an article dated July 18, 2008, discussing how far the medical community should go in treating the very old.

The question seems to hover around such surgeries as knee and hip replacement, cataract surgery, heart valve replacement, bypass operations, pacemaker implants, and treatment for slow-growing cancers.

When seniors arrive at the ripe-old age of 98 or 99 or above, are such surgeries necessary, helpful or cruel and painful?

2. A study conducted by Simon Forstmeier and colleagues at the University of Zurich in Switzerland found that seniors with a can-do attitude did better on memory and thinking tests given at the time of the study.

Forstmeier believes people can be trained to be more optimistic, helping to keep the aging brain in shape, and in the long run, helping build a brain resistant to Alzheimer's.

3. The Alzheimer's Association and the Centers for Disease Control and Prevention said in a report out Sunday, that all adults can take the following steps to improve or maintain cognition.

+ Follow a low-fat diet rich in fruits and vegetables.
+ Get out and move most days of the week.
+ Play games, do crosswords or take a class.
+ Reduce high blood pressure or high cholesterol.
+ Adopt an optimistic approach to life.

There's that word optimistic again. Must be something in the attitude that can help people fight Alzheimer's and related diseases. That is sometimes difficult to do in this day and age, but I believe following the above steps will help combat the disease.

What do you think? Let me know in the comments below.

Saturday, July 26, 2008

Seniors Who Wander

We lost another area senior citizen this week. A seventy-eight-year-old diagnosed with Alzheimer's in 2002 wandered away from his home in the middle of the night and was missing for about a week.

Unfortunately, he was not found in time.

Following are several statistics according to the Alzheimer's Association, Michigan Great Lakes Chapter:

+ 6 to 10 - Number of people with Alzheimer's disease who wander.

+ 170,000 - Michigan residents over the age of sixty-five with Alzheimer's as of the year 2000.

+ 10 million - Baby boomers who will develop Alzheimer's in the United States.

There are several ways family members can help protect their loved one who wanders:

1. Consider registering the person with the Medic Alert + Safe Return program. The person is given a bracelet for identification if he or she wanders. To register call (888) 572-8566 between 6:00 a.m. and 7:00 p.m., Monday through Friday.

2. Place special locks on the doors.

3. Place warning bells above the doors.

4. Avoid leaving the person with Alzheimer's alone, either in the house or car.

Many times elderly people are living in the past and when they leave the house, they are searching for something they remember years ago. Unfortunately, it's part of the disease.

This information was first published in the Lansing State Journal, July 22, 2008.

Have you had experience with a loved one who wanders? If you have any ideas to share, please leave them in the comment section.

Online Support for Caregivers

Previously I mentioned caregivers and their need for some type of emotional support. Recently I joined two online forums, both providing an opportunity to communicate with other caregivers.

The first is AARP's online community. I have had several conversations with other caregivers, plus I joined a joke of the day group. That should be interesting. You can reach AARP at

The second is on the National Family Caregivers Association (NFCA) website. They have a wonderful message board with numerous topic threads. They are located at

Both of these websites also have good information for the babyboomer set. NFCA was created for caregivers and provides a lot of info and support specific to that topic.

Of course, there may be support groups in your area where you can have one-on-one contact, including hugs, but the on-line forums are available 24/7 and can be another handy resource in the caregivers arsenal.

Let me know if you find any others. I'm getting to be quite the joiner.

Friday, July 25, 2008

When Living Alone Is No Longer An Option

Most seniors, at some point in their life, must make the painful decision to leave their home. They find that living alone is no longer an option.

If for some reason they are incapacitated and unable to make their own decisions, a family member or close friend must step in to make arrangements for their care.

These three tips can ease an aging person's transition:

1. Discuss the future as early as possible. By the time people enter their fifties, they are beginning to discuss the future, often because they have helped their own parents. That is a good time for boomers to let their own children know their thoughts and concerns for their future.

2. Deal with the reality of the situation. Many times what we want to do in the future and what we are physically or financially able are two different things. We need to be honest with ourselves and our families as we head into the future.

3. Develop a tentative plan ahead of time. Write your desires down and keep them in a safe place. What do you really want if you become incapacitated? Does your spouse or children know your wishes?

As parents age, it is vitally important that trusted individuals have access to necessary papers such as wills or end of life choices. By keeping all family members apprised of a seniors wishes, concerns, and needs, conflicts will less likely occur.

This blog contains just a portion of the article Elder Care: When Living Alone is no Longer an Option. See the complete article at

Wednesday, July 23, 2008

Family Treasures

The June/July issue of AARP has an interesting story about PBS’s Antique Roadhouse. I’ve watched the show numerous times and have often thought of childhood items such as old lunch pails I wish I had saved.

But, my family has in our possession items that would never pass muster at Antique Roadshow.

My mother was an artist, writer, and poet. Numerous short stores and poems written in notebooks or typed for posterity remind us of her active imagination; drawings and paintings remind us of her skill as an artist.

She was left-handed yet her script was perfect, identical to the writing seen atop old chalkboards at school. After all, she took penmanship class in college. For years I tried to emulate her penmanship with little success.

Several photo albums hold pictures of the many cakes she decorated for birthdays, weddings and other special occasions. Not to mentioned the untold number of photographs and slides she took as she recorded our family history.

Many of us have in our homes the bed quilts, baby quilts, Christmas tree skirts, or doll dresses she sewed or crocheted, and the ceramic tile coasters she painted adorn our end tables.

And then there is Dad. He built wooden headboards and bookcases, webbed lounge chairs with our initial or name embedded on the back, and caned the numerous chairs sitting around our dining room and kitchen tables. He even caned the headboard of his bed.

Dad attended the School for the Blind in Lansing during the mid to late 1930’s where he learned how to cane. He later taught a caning class through the local community center.

Throughout our homes, we see on a daily basis the priceless family treasures no amount of money could buy. And I don’t think any of us would trade these personal items and the memory of how they came to be for anything we could have appraised at the Roadshow.

What family treasure do you have? What story does it hold? Better yet, what legacy are you passing on to your family members?

Monday, July 21, 2008

How to Prevent In-Home Falls

Approximately half of all accidents happen at home. As people age, they often become unsteady as they walk or move around. Sometimes medications may cause weakness or dizziness, or these conditions may be due to illness or disease.

The elderly often have a fear of falling. Because their feet can become painful or numb and their joints stiff, they can easily lose their balance.

Falls are a serious health risk and can lead to further medical problems. The following steps can help reduce the risk of injury and help your loved one feel safer.

1. Review medications for possible side effects. Have a doctor or pharmacist examine medications for harmful interactions.

2. Have the doctor evaluate your loved one for leg strength and function. Check their heart rate and blood pressure.

3. Begin or continue an exercise program to build strength. Regular exercise improves balance and coordination. They will soon begin to feel better and more secure as they walk. Ask the doctor for the best exercise for your loved one.

There are a number of things you can do in the home to help prevent sudden falls.

1. Review their home environment for potential hazards.

+ Make sure all chairs in the home are sturdy. Remove those that are not.
+ Make sure all rooms and hallways are properly lighted.
+ Simplify traffic patterns.
+ Remove or secure all area rugs.
+ Clear pathways of furniture or other obstacles.
+ Remove possible hazards from floors and stairs.

2. Review use of walking aids and devices.

+ Make sure canes and walkers are non-skid and in good working order.
+ Wear non-skid shoes and slippers.
+ Don’t walk round in socks on bare floors. Beware of waxed floors.
+ Use stable objects for support when walking or standing up.

3. Many accidents occur in the bathroom. The following ideas can help prevent injury.

+ Use a nightlight in the bathroom and hallway.
+ Install and use grab bars in the bathroom and shower.
+ Use a bath chair or stool in the shower.
+ Use a hand-held hose to control water flow and for ease while bathing.
+ Use only two or three inches of water in the tub.
+ Use no-skid decals or a mat on the bottom of the tub or shower.
+ Use non-skid bathmats on the floor.
+ Install carpet in the bathroom or beware of puddles of water on the floor.
+ Install a raised toilet and handrails.

Depending on the age and health of your loved one, consider not leaving them alone in the house or while bathing. Although accidents can happen at any time, taking precautions will reduce the possibility of serious injury.

I hope the above lists will give you a few ideas to help your aging senior live a long and accident-free life.

If you have other ideas to add to the lists above, feel free to do so in the comments.

Friday, July 18, 2008

Return of the Cleaning Lady

Yesterday, after a one-year absence, our cleaning lady returned.

Last year, as a cost cutting measure, we decided I would clean the house. It’s a good-sized three-bedroom house with a loft at the top of the stairs and huge walk-in closets.

At first, I was okay. The cleaning lady only came in every two weeks but I liked to clean the house once a week. The more my freelance writing business picked up and Dad’s needs increased, the less time I could devote to taking care of the house. Because I appreciate a clean and orderly home, I was not okay with letting anything go.

Therefore, she’s back!

I recently read an article by copywriting guru Bob Bly. He discussed outsourcing as much as possible to increase production. I would add outsource to increase quality of life for those who are in need of assistance or would like to add more hours to their day.

As this relates to elder care, my dad used to mow his own lawn in the summer and clear snow from the driveway and sidewalks during the winter months. After several accidents with his riding lawn mower and as his health declined, we knew we needed to make a few changes.

A local man and his son have a yard care business. Once a week our lawn receives a trim with riding mower and hedge trimmer. In the winter, when the snowfall reaches at least three inches, we hear the magical sound of their pickup with attached snowplow. What a relief when these men show up, do their thing, and leave.

The cost? Between thirty and forty dollars for each occurrence. Obviously, the snow and lawn mowing are at different times of the year and the cleaning lady shows up every other week. As these tasks are routine, we can usually enter them as a budget line item. Some years we have a heavier snowfall than others, so it’s a little difficult to plan. However, most of the time we can anticipate how much we need for these services on a monthly basis.

The assistance we receive from these wonderful people makes a huge difference in our quality of life. Caregivers, or even those who aren’t, should consider outsourcing. Remove another task from your daily or weekly to-do list.

What are you able to outsource? Where can you reduce the workload in your life? Make a list of jobs that cause you anxiety and see where you can ease the burden and increase your quality of life.

Wednesday, July 16, 2008

Seniors Return to School

Several years ago I was listening to the radio show Parent Talk as I was driving home from work. An interesting conversation caught my attention - the hosts were interviewing a seventy-year-old (plus) woman who attended classes at the local community college.

One of the questions they ask was, "What do you wear to class?"

"Sweats and tennis shoes," was her answer.

Immediately I thought, "When I get her age, I hope I'm still willing to learn."

Well, I have a ways to go to reach seventy, but I still enjoy taking classes. Now they are usually on-line.

It's mid-July and time to think about the offerings in your community, either through the local adult education office or nearest community college. Don't forget there are many on-line classes through such schools as Virtual University.

Watch for the catalogs or search online and find something interesting that will stimulate your mind. Whether you enjoy crafts, computers, art history, world religions, or something in the personal enrichment category, sign-up and have a great time.

You'll meet new people and learn at the same time. You will get out of the house, if not on the computer, and will have great new information to share during conversations with friends and family.

Let me know what classes you are interested in, especially those that are unusual. And enjoy every second of your learning experience.

Monday, July 14, 2008

Amber Alert for Elderly

An article in today’s Lansing State Journal (LSJ) grabbed my attention. Rep. Mark Meadows, D-East Lansing introduced legislation requiring police to issue missing persons reports on seniors as soon as possible after receiving the information, much like the Amber Alert for missing children.

Several years after her dementia diagnosis, my mother would occasionally leave the house and head down the street and through neighbors yards.

Thankfully, my parents have lived on this street since 1962 and many of the neighbors recognized Mom. While Dad was trying to locate her, they would stop her from going further and then get a hold of Dad or start walking her back home.

Numerous stories in recent years have not turned out as well as ours.

According to Eric Hall, president and CEO of the Alzheimer’s Foundation of America, about 16 million people will develop Alzheimer’s disease or other forms of dementia by 2050.

Meadows’ bill, called the Mozelle Senior Medial Alert Act, passed the Michigan House this spring, and is pending in the Senate according to the LSJ. The bill is similar to the national Amber Alert program and drawing federal attention.

According to the LSJ, others supporting the notification system include the Michigan State Police and AARP.

Due to the growing number of seniors and the rise in Alzheimer’s-related diseases, this bill needs to pass the senate and become law in Michigan. An alert system for missing seniors could prevent needless deaths.

Sunday, July 13, 2008

Seniors and Spirituality

People have their own opinion of religion and spirituality. As they age, their spiritual focus tends to change.

When they are young, they are busy living life; going to school, raising a family, working on their career. By the time people reach senior citizen status, they have usually determined what they believe.

Many churches not equipped. Pastors are finding they are not equipped to deal with the spiritual aspects of their aging population. Sure, some churches may have activities for seniors, maybe a bible study, bingo, or some other type of get together, but many struggle with such in-depth issues as death and dying or the end-of-life issues that are a growing concern to many. Most spiritual leaders lack training in the area of geriatrics.

Beginning steps. Churches moving toward services that are more contemporary sometimes throw in an occasional hymn to pacify the seniors, and larger churches may have a separate service for the more conservative attendee. However, for the most part these moves are cosmetic compared to the real needs of the older church population.

Better yet. The more progressive churches now provide transportation, listening aids for the hard of hearing, larger print for easier reading, and services broadcast on a local TV channel for those who are home bound.

As the baby boomer swell enters their early sixties, to stay relevant more churches will need to address the concerns of their aging population.

Baby boomers as a group tend toward independent thinking and activism. It will be interesting to see how the church handles its current senior population plus the growing number of aging boomers filling their pews every Sunday.

Thursday, July 10, 2008

Dental Care and the Elderly - How Far Should We Go?

This is an off-the-cuff personal observation about dental care and the elderly. No research done, no statistical information sought, and no expert comment from others included - just my own raw opinion.

Dad visited the dentist last week for his scheduled cleaning and I believe that’s important to his health. He will be eighty-six-years-old in a few months, and has numerous health problems including diabetes and an arrhythmic heart. I know from years working in the health care industry, preventing bacteria from making its way to his heart through his blood stream could avert a serious health event.

The dentist wanted to do some work around a tooth near the front, then place a crown on the tooth. As an alternative, she could pull the tooth and leave the space empty. Of course, the former was labor intensive, far more expensive, and included additional painful visits. She mentioned other dental work he needed, but this was the most pressing.

Last year he and I discussed this very subject and it was his strong opinion he wanted no more dental work other than routine cleaning, as he did not want the pain or the expense other work would require.

This time as I was sitting in the waiting room, I heard him say, “You better ask my daughter. She makes all the decisions.”

Oh, really? And this started when?

What is the best for Dad? Considering his age, at what point do we stop preventative or cosmetic care? Because of the location of the tooth, the real question was, should we pull the tooth and leave a space or place a permanent crown.

Dad’s comment that I should decide led me to believe he was thinking he should have this work done, but didn’t want to make the decision himself. Otherwise, he probably would have said no upfront.

As a team, we discussed our options including the amount insurance was likely to pay, and I decided that we should proceed with the crown. I made an administrative decision, there were smiles all around, and Dad seemed okay with that, even a bit relieved.

Because my nature is to look to the future, how can I deny Dad the same opportunity? Rather than say to him by my actions, if not specifically in words, it’s time to give up, lets not do anything more, what I am saying is “you have a future and we need to prepare you for that future”.

I’m not ready to make decisions based on thinking it’s time for him to let go and die, and at the end of the day, neither is he.

Tuesday, July 8, 2008

The Elderly and Their Medications

As symptoms of aging or disease increase, it is likely the number of doctors and prescriptions will increase. Therefore, incidents of over or under medicating can become a serious problem in an elderly persons life. A main concern is the interaction of medications to the detriment of your loved one.

When my father visits his primary physician every three months, he places all medications in a plastic bag to take with him. The nurse always makes note of the medications and the dosage he is currently taking. That way if another physician has made any changes, Dad's primary physician is aware and can make any necessary adjustments.

Caregivers should play a vital role in monitoring their loved ones medications. Note what they are taking along with the amount and frequency. Work with their pharmacist or doctor regarding side effects and know what symptoms to watch for.

Pharmacists are highly trained in the interaction and effects of drugs. An especially good resource if you have any questions regarding possible side effects are those pharmacists specifically trained in geriatrics.

These key tips may help you in caring for your loved one.

1. Make sure all physicians are aware of current medications, including prescriptions, over the counter medications such as cold medications and aspirin, daily multivitamins, and herbal remedies.

The cumulative effect of medicine can cause side effects to show up a month or so after starting a new drug. Talk to your physician about what to watch for so that you understand when you see a new symptom.

2. With newly prescribed drugs, find out:

+ Can another drug be removed?
+ Should the drug be listed on an ID bracelet?
+ What side effects should you watch for?
+ Which side effects should you immediately report?

3. Watch dosage amounts, how often to take the medication, and whether to take prior to or after a meal. Also helpful:

+ Plastic dosage containers with the day of the week or time of day
+ Request large type on prescription labels
+ Double check the label to insure correct medication is taken
+ Keep medication in a dedicated storage area to prevent over or under usage

Physicians cannot always eliminate side effects when they are trying to address a patient’s symptoms. They will try to maintain the correct balance if they are aware of all current medications.

Use drugs with extreme caution and only for specific symptoms. Watch for symptoms such as dizziness, blurred vision, drowsiness, increased confusion, increased agitation, falling, or the appearance of a rash. Immediately notify your elder’s physician of any disturbing reactions.

When you keep informed as to what your loved one is taking, seek further information from their physician or pharmacy when necessary, and oversee their daily dosage requirements and regimen, you play a huge role in helping your loved one live a better quality of life.

Saturday, July 5, 2008

Saturday Morning Musings

Dad and I had a quiet 4th of July. Until after dark, that is. For about two hours the pops and sparks and sounds of fireworks filled the air. But it was expected and ginger ale and vanilla ice cream floats took care of any angst we may have felt.

Hope everyone had a good day. We are so thankful for the freedom we enjoy living in the United States. Although at times we may know things could be better, as we look at the problems and situations in other countries, we can't help but feel blessed to live in the land of the free.

I know this blog is still in its infancy and I'm not sure exactly where it's going. Should it be a strictly formal venue for all things elder care related, or should there be an informality that allows one to swing between the heavy and the lighter fare?

I spent a good deal of time yesterday researching and writing about elder care and thought I had a post ready, but just couldn't quite bring it together. This website can get into some heavy topics, and living with an elderly man, who happens to be my father, and trying to write about caring for the caregiver and other topics can get a bit dicey.

Humor has always been a fallback for me whenever life has put in a more somber appearance than I would like. Stepping back from the situation and placing my focus on other interests also helps to lift a sometimes listless mood. Fortunately, several telephone calls from family members yesterday evening also provided a welcome distraction.

Therefore, after all was said and done, no post was entered and today I am looking at other blogs regarding writing and/or elder care. I'm looking forward to a productive, yet relaxing, day as I peruse other sites.

What are you doing to lighten the caregiving load? What pleasant distractions do you enjoy? Are pleasant distractions and guilty pleasures related?

Hope everyone has a wonderful weekend. Is it really the 4th already?

Wednesday, July 2, 2008

Three Keys to Aging in Place

A growing number of aging senior citizens consider staying in their homes a priority. In the last few years a new term as emerged identifying those who desire to stay put.

The term? Aging in place.

Recent studies show approximately twenty-five million U.S. households are headed by someone over sixty-five. That number will grow as the leading wave of aging boomers arrives on the scene. With eighty-five percent wanting to remain in their homes, the challenge to do so will increase.

The following three factors are key in making that happen.

1. Physical and mental health. To age in place, seniors must be able to care for themselves. Families can prepare ahead of time by obtaining physical and mental examinations to determine what needs may arise and what services are required, if any.

Assess what community services are available. Often nearby family and friends are able to lend a hand. Public transportation, senior citizen centers, and programs such as Meals-on-Wheels quite often are available. Paid or unpaid caregivers can provide much needed assistance.

2. Financial Health. Especially vulnerable to forced moves are the low to moderate-income elders. Unable to pay for upkeep or expensive repairs on a house, many people must move in with other family members or make other less desirable living arrangements.

Experts say mortgages should be paid off prior to leaving the work place in order to reduce the likelihood of future financial stress. Some may consider an alternative course of action such as a reverse mortgage. Make sure to discuss options with a trusted financial advisor.

3. Physical condition of the home. If possible, make sure the senior’s home has been properly maintained. Homes are in constant need of upkeep and as people age, they will not be able to do the work themselves. Addressing as many needs as possible will assure a pleasant living experience.

Sometimes people know their needs ahead of time and are able to remodel. For example, removing steps and adding a ramp will make the home wheelchair accessible if health concerns warrant. Widening doors and adding grab bars to the bathroom will help the handicapped senior live alone. Remodeling a home to make it handicap accessible should be a priority.

Many people desire to remain where they feel a sense of warmth and comfort. They are familiar with the neighborhood and may still be active in the community. Their home is comfortable, convenient and feels safe. Strong memories and traditions are difficult to leave.

Helping people age in place will contribute to healthier, safer, and happier lives for millions of older Americans. Using wisdom and preplanning may allow many more of our aging population to remain in their homes.