Spring Lawn Care: Or When His (Or Her) Jobs Become Your Jobs

[This is the fifth installment of posts from Faith, AGE's CaregiverU Coordinator and personal expert on being a family caregiver - you'll continue hearing from her on a range of topics once a month.]

Lawn care.  Hmmm, not my expertise.  I do enjoy the sight of a well tended lawn, though.  Thick green grass, nicely edged, pretty stones in a ring around each tree, neatly trimmed trees, front flower bed blooming.  All very nice, but I am clueless as to how to create that, and probably not much better on knowing how to maintain it.  You see, I’ve been married close to 45 years and we’ve had a system called ‘his work’ and ‘her work’.  I took care of the inside of the house and he took care of the outside.  The work inside of the house and all my other responsibilities took up all of my time and then some, so I paid little attention to the work in our yard.  Seven years ago when we moved into our current house, I was eager to learn how to do yard work and hoped to work together with my spouse to plan the landscaping and share in the labor.  My dear husband was insulted by those plans—refer back to ‘his work’ and ‘her work’ above.  The yard was definitely his domain and I’d best remember that.  In the name of peace and harmony, I took my rightful place, and simply enjoyed the loveliness.

I enjoyed it until now.  Now my spouse is not so capable of planning and organizing the yard work.  He sometimes forgets how to start the lawn mower and claims it doesn’t work.   Our good neighbor comes over to get it going, and tells him the mower just needed an adjustment.  Helpful friends give him bedding plants for the flower beds, thinking he would enjoy digging in the dirt again.  He enjoys the digging and puttering, but then becomes very anxious because the plants aren’t thriving.  That’s when he asks me what to do, and, I’m –clueless.   He worries about the bald spots in the front lawn and then I worry.  Surely bald spots are not a good thing, but what does one do?

The solution would probably be to hire a lawn service.  Wouldn’t it be divine to turn the issue over to a professional? To do that, though, I’d need to work an extra job to pay for it, and then I’d need to pay for a caregiver to be with my dear spouse while I’m working that extra job, which would require more money.  I don’t think that’s a good solution.

When I talk with other caregivers I realize that this spring yard work problem is only one of many problems faced by my caregiver sisters that all fit under the general theme titled, ‘When His Work Becomes your Work’.  For some it’s paying the bills, for others it’s technology, and for still others it’s the cooking.  There always seems to be at least one area where caregivers are clueless.  I would imagine it’s very similar to the situation faced when a person dies, leaving behind a spouse to cope alone.  The only difference seems to be that in the case of death, the issue is more evident and support may be more forthcoming.  While the spouse is alive, it often is assumed that the job is getting done—until the bald spot in the front yard reveals otherwise.

In the Matter of Balance and Powerful tools for Caregivers classes that I teach through CaregiverU, the curriculum tells us to be assertive, communicating the need for help with good ‘I’ messages.  That would mean I should say, “I have some yard issues that I do not know how to tackle.  Could you please teach me what to do?”  Perfect verbage, but to whom do I say it?  The ‘to whom’ seems to be at the crux of my conundrum, but it may also be that asking for help from anyone is an unlearned skill.

I’ve never been good at asking for help.  It just seems to go against my independent grain.  Many participants in my classes seem to also have difficulty asking for help, and recently I visited with a friend struggling with that same issue.

This particular friend is currently experiencing some rather serious health challenges which make it difficult for her to do everything that she is accustomed to doing.  She expressed frustration with her eldest son, who seemingly doesn’t get the ‘Help Needed’ message.  As we talked, I realized that her son is probably living under a concept learned early in life and perpetuated to the present.  The concept he’s operating under seems to be that his mother is a strong woman who always handles difficulties with grace, multi-tasking with amazing capability, never needing assistance.  Perhaps it’s time for a very direct and honest communication session between the two.  My friend seems to have now granted herself permission to ask for help, but since it’s such a new concept, others around her may need a little help realizing this.

When I, too, finally granted myself permission to communicate that ‘Help Needed’ message, the ‘to whom’ became crystal clear.  I have a very good friend who delights in sharing her plant knowledge!  Teaching me about plants may become a very enjoyable way for us to spend time together.  Perhaps in the asking for help and then receiving it, I will be able to give more to others, enriching my life by the receiving and giving.  Wow–I just may have stumbled onto a large life lesson!

Making the Most of the Holidays: Helpful Tips for Caregivers

[This is the third installment of posts from Faith, AGE's CaregiverU Coordinator and expert on being a family caregiver - you'll continue hearing from her on a range of topics about once a month.]

We all carry visions of what the holidays should look like and often those visions don’t jibe very well with reality! At this time of year, many of us visualize a Norman Rockwell type scene with everybody gathered happily around a perfectly laid holiday table. Reality is often a bit different!  In addition to that image, I also carry around in my head visions of previous holidays when life was different.   That is, when the kids were younger and my spouse was cognitively able to partner with me in all the holiday preparation.  Today my husband has a cognitive disability and the children are young adults with spouses and responsibilities of their own.  Part of the holiday experience is traveling to their homes for visits and hosting them in our home, all the while helping my spouse cope and have a good time.  As a caregiver, managing the holidays has come to mean managing many different issues—disruptions in schedule and routine, traveling, adapting to new surroundings, decorating the home, shopping for gifts, and preparing food, to name a few.

When we need to stray from our well established regular routine, I find dry erase boards are a valuable resource.  We focus on one day at a time, so on a dry erase board I write down that day’s schedule.  As I write, we talk about what to expect and how to be prepared.  Then I leave the board out in a place that will be easily seen throughout the day.  Sometimes we need an additional board on which to write details or items to be brought with us.

On these ‘irregular’ days, it’s easy to forget about medications, or to not be home when they should be taken.  Keeping a regular medication schedule is important to well being, so I sometimes set the cell phone alarm as a reminder and keep the pills with me as we meander about.

My spouse does much better when he has appropriate activities to fill his time, and on regular days he has those.  During the holidays, especially when away from home, I have to create and provide.  My middle child, Christopher, has developed a wonderful resource for the days we are visiting the city in which he lives.  He puts together a resource bag for his father and gives it to him upon our arrival.  The bag has a variety of things Christopher has found at very little cost.  Usually there are a few books on adult themes with lots of funny pictures.  A delightful one was on the hundreds of uses for duct tape! Included also are usually some word game books and puzzles.  My daughter, Joy, often provides a craft activity for the two of them to do during the visit.  She also has a list of cleaning chores that need doing, all that her father is capable of doing with a little supervision.  That supervision is especially needed when selecting the right cleaning products—a few years back we had a memorable bleach incident!  Doing those chores not only fills his time, but also gives him a feeling of pride that he is able to contribute to the common good.

Safety must be a top priority during the holiday activities, safety for my husband and safety for those around him.  That sometimes means firmly setting some boundaries on activities and places, and following thru to be sure that the boundaries are kept.  It doesn’t make me popular but it does keep people safe!  For example, yes, he can hold the baby—but only when he is seated and secure.  Yes, he can go for a walk in this new neighborhood, but only if someone can go with him.  And on and on. . .

It’s very easy in the midst of all the chaos of a family gathering, to lose track of my hubby, and goodness knows, what he’s gotten into during that time!  Thus I’ve found the buddy system works well.  I recruit another family member or friend who is present at the event to help me keep watch.  Between the two of us we can usually maintain the right level of supervision.

A valuable resource I learned about from a good social work friend, is a tool that can be used to discretely communicate to strangers that my husband may behave differently than is expected.  That great tool is a set of business cards which simply say, “My dear husband has a cognitive difficulty.  Thank you for your understanding.”  It’s fairly easy to give out these cards when needed, and the recipient usually becomes my new helper in the situation!

While staying away from home for a few days, a careful decision needs to be made on where to stay.  My husband needs a certain amount of quiet time.   He also likes to go to bed early and rise early.  Thus staying in someone’s home may not be a good choice.  Perhaps a hotel will work better.  Careful thought about this will reap great dividends.  When hosting overnight guests at our home, I simply try to ensure that there is a quiet place for him somewhere in the house, and that there are appropriate activities at the ready.  My daughter-in-law, Leah, is great about gently guiding him into doing a puzzle when needed.

Attending events at any time of year is a challenge because the responsibility is all mine-to drive there, park, find seats, locate bathrooms, etc.  Usually it seems too daunting and I decide to stay home, but sometimes dear friends will invite us to attend with them and sharing that load makes it worth the effort to attend.  Occasionally, I’ll hire someone to stay with my husband, while I attend alone.  It’s expensive, though, to do that and finances are limited, so it’s a rarity.  To prevent extra stress, it’s important to evaluate carefully whether attending the event is worth the cost, including the effort.

Holiday times can still be very delightful for us, if we keep an easy pace, continue to provide what he needs, and share the care when the sharing is available.  It will never be like it was in the past, but today is a new day and we can still make it good!

 

For more thoughts on making the most of the holidays with a loved one who has dementia, click here.

How does Alzheimer’s affect the youngest among us?

My name is Emily, and I am the Development Associate and resident blogger at AGE. And I am a grandchild of Alzheimer’s Disease.

Or rather, I am a grandchild of a woman with dementia, likely caused by Alzheimer’s. It started when I was just 10 years old, and it has been over 15 years since my grandma started disappearing. It is no easier now than it was as a child.

First, she stopped cooking. It was how she showed her love and doted on us. I knew something was really wrong when my Grandpa, who had never really cooked, took over what had once been Grandma’s domain.

Then the more bizarre behaviors began- things that really mortified the kid I was at the time. Grandma would take out her dentures at the most inappropriate places to clean them, or she’d ask for ketchup at a Mexican restaurant because she couldn’t differentiate that from salsa, or she started to lose her ability to know when she should whisper in church or the movie theater instead of loudly observe things that you don’t say aloud in public.

And, of course, in crept the tell-tale sign of asking the same exact questions over and over and over again.

Grandma had an ‘angry’ period where she was occasionally physically and verbally violent, mostly towards my Grandpa. Then after a while, she became more and more juvenile- in the most joyful way. She became so affectionate, always reaching for a hand to hold.  And then, she became too affectionate, even with strangers. She has been known to sneak a kiss when a friend would try to just give her a hug, and since she’s in a wheelchair it’s quite easy for her hands to wrap around and give someone a little squeeze on the behind- it’s even happened to our pastor.

Mood swings and personality changes are common for those with dementia, but that was difficult to understand as child and even as a teenager. I sometimes felt annoyed at her behavior, angry at her outbursts, indifferent, confused, sometimes amused, and so very often deeply sad. Most of all, I felt beyond guilty for feeling anything but pure love and gratefulness for this woman.

As for the rest of the family, there have been stages of grief, denial, and bargaining for my parents and my aunt as they transitioned from being this woman’s children to being her caregivers. It has been an incredible journey of highs and lows, questions and transformations that have all fundamentally altered what my family looks like. Dementia changed my Grandmother, but it also changed us.

The irony is that she’s almost as fit physically now as she was five years ago. There’s no indication that she’s giving up yet, even if her mind has. The grandma I once knew has been almost completely devastated by whatever has taken residence in her brain. It has been a long progression. She hasn’t been able to walk for a few years now. She doesn’t really recognize any of us anymore. I don’t think I’ve heard a purposeful sentence from her in over a year. And these things can be hard for a child to witness and accept. “She looks fine, why won’t she talk to me? Why doesn’t she know you, Mom? How can she forget that she’s married?“

I know my experience is not special or unique:  1 in 8 older Americans have Alzheimer’s disease. And there are over 15 million Americans providing unpaid care for a person with Alzheimer’s or other form of dementia (Alzheimer’s Association). That is a massive amount of individuals, spouses, children, and grandchildren being dragged through the mud of this disease. You are not alone. We can learn from our shared experiences. It’s important to tell your story. And it’s important  to include the children of your family in discussions about what’s going on with your loved one with dementia.

For those of you who have a child facing the immediate reality of dementia in either a parent or grandparent, there are some lots of resources out there to help you talk about dementia or Alzheimer’s. This disease is a bit different from others in that Grandma, or your uncle, or your Mom may look perfectly healthy on the outside. Kids need some help understanding the mechanics of this disease and that you can’t always see that something is wrong when someone is sick in this way. The two resources listed below have great information ranging from how to make the conversation developmentally appropriate to concrete tips and talking points:

• From the Fisher Center for Alzheimer’s Research Foundation: “Talking to Children About Alzheimer’s“
• From Tam Cummings, experienced gerontologist: “The Do’s and Don’ts of Talking To Kids About Dementia”

Ultimately, I do not want to detract from unbelievably heartbreaking experience of those, like my Grandma, who are dealing with dementia themselves. Because it isn’t really about the pain of the rest of the family at all, it’s about allowing your loved one to experience the rest of their life with as much dignity and vitality as possible. Helping the children in your life understand what Alzheimer’s is doing to their loved one will make it easier for them to continue to see the person instead of the disease.

Reflecting back on the beginning years, Grandma never once talked about being aware of her diagnosis or what it was like for her. She sort of just slipped from the beginning stage where she was just ‘mildly’ forgetful to a place where she could no longer contemplate a question about her state of mind if she tried. I wish I knew what it was like for her. This journey has shown me that there many things I don’t know, and that there’s no ‘right’ way to be a supporter for someone with dementia. What I do know, Grandma, is that I will continue to love you wherever else this road takes us.

For those in the greater Austin area, AGE of Central Texas has a number of resources for caregivers and for those experiencing dementia. Click here to visit our website for more information.

Keeping Seniors Safe in the Texas Summer Heat

This summer may have started out kinder and gentler than last year, but we aren’t out of the woods yet. The heat makes summer a dangerous season for everyone, but seniors are at a higher risk of suffering complications from the heat. Many seniors take medications that could dehydrate them or make them more sensitive to the sun. For seniors who are not as mobile or depend on others to come by to care for them, they may not be able to move themselves to a cooler spot or help themselves if they start feeling heat-sick when they’re by themselves. And they may have trouble recognizing when they are experiencing symptoms of disorders caused by heat before it’s too late. There are two main kinds of heat conditions:

Heat stroke is a very serious heat-related illness. Symptoms include dizziness, weakness, nausea, spots before the eyes, ringing in the ears, bright red dry skin, rapid, strong pulse, and a body temperature of more than 103 degrees.

Heat exhaustion is a more mild heat-related illness, but should still absolutely be treated. Symptoms include cool and clammy skin, a body temperature of up to 103 degrees, weak and rapid pulse, and shallow and quiet respirations.

If you notice someone who has these symptom, get to a doctor immediately!

Below are a few ideas and suggestions to help keep older adults cool:

• wear light colored or loose clothing
• use sunscreen, even if going outside for just a short period of time
• wear a hat that is wide-brimmed to protect the face (but isn’t so tight as to prevent ventilation)
• stay hydrated with water or other non-alcoholic, non-caffeinated drinks
• keep a spray bottle with cool water nearby to lightly spritz the face and body
• a shady spot outdoors may be cooler than inside, so sitting on a covered porch with a portable or ceiling fan may be a good option
• if you are inside with no AC, stay on the lower floor of your residence (which is typically cooler)
• mobile seniors should try to spend a few hours each day in a place with A/C: either a mall, library, a movie, or restaurant

Unfortunately, many seniors either cannot afford or don’t have access to air conditioning to combat the severe Texas heat. Below are a few suggestions to help:

Tips to help cool your home:

1. When it is safe to do so, leave windows open (even at night) on both sides of your house to get a cross-breeze.
2. Utilize portable fans and ceiling fans to amplify your A/C’s reach, or help substitute when you don’t have one.
3. Close curtains or shades on sunny windows, or find a way to cover them if they don’t have draperies already.
4. Clean and replace air filters regularly to maximize your AC and vent systems.

AGE of Central Texas is a community partner in Family Eldercare’s Fan Drive, so we have box fans available for those who are over 55, disabled, or have children under the age of 18 living in their house. They must be at or below 200% of the federal poverty level ($22,340 annual income for one person or $30,260 for a couple), and be able to provide an ID and proof of income. Call us at 512.451.4611 for more information.

For more information on how heat affects the elderly, click here for resources from the CDC.

Meet Wilbur, A Client

“We all need assistance; we all need a helping hand. No person’s an island.”

Wise Words and a Personal Perspective:

‘Good Afternoon: My name is Wilbur.  I am a client at AGE’s Adult Day Care Center.  I am 87 years old and a World War II Army Combat Veteran.  I served in combat with the infantry in the European Theatre and in the Army of Occupation in Japan.  After my military service I was employed in the United States Postal Service from April 1946 until my retirement in January 1985.

He won a trophy today for ‘Best Dancer’ at the Carnival.

When my wife of 56 plus years of marriage passed away in November 2003, I, like so many elderly people had a decision to make.  To my good fortune my son and daughter-in-law gave me the opportunity to make my home with them in Austin.  Both my son and daughter-in law were still in the workforce.  Early in January 2004 my son and I visited Elderhaven (AGE’s Adult Day Health Center)- My first reaction was like most people.  Would I like Elderhaven and most of all would staff and clients accept me?  Not only was I accepted, but the clients voted me February King and my friend Queen.  I had not danced in years, so after we were crowned we danced like royalty.

The Activity Director at AGE’s Adult Day Health Center here in Austin is Theresa.  Theresa schedules our activities, and at the start of each month every client receives a calendar of daily activities for the month.  Every day we walk and we do exercise.  Some of our activities are arts and crafts, music, entertainment, games, trivia, sing-a-longs, dances, and a lot more.  All activities help the body, mind, and soul.  We have a snack in the morning and in the afternoon.

If you are considering someone who needs day care where you are treated with respect and all clients are treated equally, Elderhaven meets your needs.  Clients are from different ethnic, social, and economic backgrounds and we get along great.  At Elderhaven we have clients from 30 years of age to the mid 90’s.  We pray, laugh, and sometimes shed a tear.  I consider my fellow clients my second family.’

It is clients like Wilbur who remind us that community and compassion is so important in absolutely everything that AGE does. For those who don’t know, AGE’s funding (and that of several local non-profits) and ability to provide services to clients was severely damaged this week by the withdrawal of a major supporter. If you would like to join the AGE of Central Texas family by giving towards the direct services that benefit clients like Wilbur, please click here or send a check to AGE at 3710 Cedar St # 2 Austin, TX 78705. Feel free to reach us at www.ageofaustin.org or 512.451.4611.

 

Thank you for your love and support. And thank you for caring about the older adults of Austin and Central Texas.

Sandwich Generation: Old Story, New Problem

Boomers were the first to struggle en masse with both the financial needs of kids in college and retired parents outliving their nest egg. Now, the kids may be out of college—but moved back home. Meanwhile, mom or dad has not only run short on cash—but needs a daily caregiver too.

Some 35% of boomers have been responsible for the care of an elderly parent, according to an AARP survey. That is up from 26% in 1998. Meanwhile, half of boomers are raising a young child, including grandkids, or providing financial assistance to an adult child, according to Pew Research Center. Go ahead—just try to retire.

These obligations aren’t just expensive; they are time consuming and directly affect your ability to earn. According to a Hartford survey:

• 68% of boomers have missed work in the last six months or left early due to care-giving duties for either a young child or an elderly parent
• 50% of those who missed work for care-giving duties in the last six months missed between eight and 16 hours
• …….

Read the full article at Time Magazine.

How many of us get enough sleep?

Did you know that during sleep our brains consolidate and store our memory and learning? Sleep also helps us function more efficiently and effectively. Sleep helps us stay healthy and prevent additional health problems.

An adult needs 7 to 9 hours of sleep per night. How often do you meet that?

Sometimes we deprive ourselves of sleep by the lifestyle we have (or choose to have). Work, poor sleep habits, and other factors contribute to volitional sleep deprivation. This shows that many of us don’t take sleep as seriously as we should. But other things beyond your control also affect how we sleep: environmental disruptions and untreated sleep disorders fall into this category.

Being tired can interfere with your daily activities, such as being sleepy at work- which can causes errors or injuries. It also affects your driving. We may not like to admit it, but how many people have felt drowsy while driving? Or even more dangerous, dozed off while at the wheel? It’s more common than you may think.

Sleep Apnea is one serious sleep disorder, and it is when airflow stops during sleep. This causes frequent awakenings so the person can adjust and open their airway. In severe Apnea, some people stop breathing over 30 times each hour during their sleep. That does not sound very restful! If you think you might have an issue similar to this, you should contact your doctor, or look up the Central Texas Neurology Consultants of St. David’s Round Rock Medical Center, who provided this information.

Those with Alzheimer’s disease (or those who care for them) know that as the disease progresses, sleep patterns often change. They might experience confusion between night and day, causing them to sleep long periods at off hours. Often, it can causes restlessness or sleeplessness, which can lead to wandering. And, of course, for caregivers all of this can prevent or interfere from being able to get any real rest of their own.

There are a couple of things that caregivers can do to alleviate sleep issues:

• Check with your physician about medications that might be causing sleeplessness.
• Avoid caffeine or stimulants.
• Encourage your loved one to be active during the day, even exercise, but be wary of too much activity close to bed time.
• If they struggle sleeping at night, minimize daytime naps especially later in the day.
• And try exposing them to sunlight in the morning and earlier in the day.
• And of course, maintain consistency when possible in rising for the day and going to bed at night.

Moral of the story: take care of yourself, get enough sleep. The consequences can echo through every aspect of your life. And if you think you or your loved one need medical help with getting real, restful sleep, don’t hesitate to contact your doctor. And if there are other things in your life (such as issues with aging or getting older, or caregiver challenges) that are interfering with your ability to rest and take care of yourself, please contact AGE of Central Texas and let us figure out how to help you find what you need.

The Shingles Vaccine Returns

By PAULA SPAN

You may have seen a rugged-looking retired firefighter named Dennis Grogan in a TV commercial recently. “I have never encountered such a burning sensation,” he declares. “Like someone had set a bag of hot charcoal on my neck.” An announcer warns, “As you get older, there’s a greater chance shingles can happen to you.”

Let me explain why this ad actually represents an encouraging development.

The product never mentioned by Mr. Grogan is Zostavax, a vaccine against shingles approved by the Food and Drug Administration for people over age 60. Large clinical trials showed the vaccine reduces the risk of developing shingles by roughly half. Shingles occurs when the varicella zoster virus, which also causes chickenpox and can lie dormant in nerve cells for decades, reactivates to cause a painful rash. In some, the intense pain can persist for months after the rash clears, a complication called postherpetic neuralgia.

With more than a million cases annually and a high rate of serious complications in older patients, the development of a vaccine was a major public health advance. But you’ve never seen a broadcast ad for the vaccine before, or a public service campaign by the Centers for Disease Control and Prevention, because year after year Merck, the drug’s manufacturer, couldn’t produce enough of it.

Read the full article at The New York Times. 

The New Old Age: A Benefits Statement You Can Read

A Benefits Statement You Can Read

By SUSAN JAFFE

Belle Likover, a 92-year-old seniors advocate in Shaker Heights, Ohio, led the Ohio Department of Aging’s advisory council last year, and she is not easily deterred by government mumbo jumbo. Still, she struggled to understand the summary of payments she recently received from Medicare after a five-day hospital stay.

“I don’t understand these codes,” she said. “There are five different doctors listed, and I have no idea who some of them are.”

There’s good news for anyone who, like Mrs. Likover, has ever tried to decipher one of the inscrutable statements, called Medicare summary notices, mailed quarterly to roughly 36 million beneficiaries. Starting next year, officials will begin using a new consumer-friendly format; it’s already available online at www.mymedicare.gov. The mysterious procedure codes are still there, but an easy-to-understand explanation of each service in larger type replaces the descriptions containing baffling abbreviations and medical terms.

The change comes with an incentive for reading more carefully: Medicare will offer rewards of up to $1,000 for tips that lead to uncovering fraud. Last year, Medicare recovered a record $4 billion in fraudulent payments with help from people who reported questionable charges.

Medicare officials are betting that beneficiaries and their caregivers can be even better fraud detectives if only they understand what they’re reading. “They are on the front lines, and they can identify problems at the source,” said Julie Bataille, a spokeswoman for Medicare.

Read the full article here. 

Thousands of falls in elderly should be prevented: report

For more resources about preventing falls, check out Caregiver U, a program of AGE! : Caregiver Us online. 

Thousands of falls in elderly should be prevented: report

Thousands of deaths among the elderly could be prevented with action to prevent falls, NHS managers have said.

Falls in elderly people is one of the leading causes of death in the over 75s due to complications caused by fractures.

Well coordinated care between the NHS and social care, emergency services and GPs could prevent 30 per cent of falls, according to a report by the NHS Confederation.

There are 89,000 cases hip fracture in Britain, one of the highest rates in Europe, most of which are sustained during a fall.

The charity Age UK has estimated 7,000 lives could be saved in the over 65s each year if widespread exercise programmes were implemented to prevent hip fractures from falls.

The report highlights that the Department of Health has estimated that a falls prevention strategy could reduce the number of falls by 15 to 30 per cent

Read the full article here.