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4 Characteristics of a Senior Caregiver

It takes a special person to provide seniors with excellent at-home care. Some people excel in playing the role of senior caregiver, while others simply aren’t cut out for the job. For anyone considering a new career in the field of elder care, a certain set of characteristics must be present.

Successful senior caregivers proudly possess the following traits:

The ability to show empathy is likely the most important characteristic of a senior caregiver. While some can empathize more than others, all caregivers should be able to step back from a situation and look at things from the senior’s point of view. For those who provide care, taking a moment to ask “If it were me lying in this bed, how would I want to be treated and cared for?”

Senior caregivers have a lot of pressure on them. Their patients have suffered a loss of total independence, which puts them in a rather vulnerable position. They’re forced to rely on caregivers to complete daily tasks that used to be simple. For example, many seniors are unable to prepare a meal, bathe properly, get dressed each morning, or go to the bathroom without assistance.

When someone’s job is to provide in-home care, the caregiver must be dependable. That part is non-negotiable. In short, never promise to do something and fail to follow through; a senior’s life might depend on it.

In-home caregivers must have both mental and physical strength. There will be days that completely test personal limits. The caregiver might be having a rough day, the senior may be extremely agitated, or a bit of both. Personal strength is the only thing that will keep someone going forward, refusing to give up and admit defeat.

When charged with the task of caring for a senior loved one, flexibility is critical. Life happens when we least expect it and situations can change in the blink of an eye. As an adult child providing in-home care to an elderly parent, be prepared to rearrange schedules, should the need ever arise (and it will).

Caregiving is a good fit for people that adapt quickly and embrace change. It’s important to come to grips with the fact that, once plans are made, something is sure to change. For schedule and routine sticklers, the role of senior caregiver could quite possibly be maddening.

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Can’t We Talk About Something More Pleasant?

Cartoonist Roz Chast Takes on her Aging Parents

I expected a book of cartoons to be laugh-out-loud funny. But I didn’t expect that a story told in sketches would also make me cringe at its honesty or break my heart.

In Can’t We Talk About Something More Pleasant?, Roz Chast bares the painful decisions adult children often have to make as their parents’ health declines. She offers an unsparing look at how she handles—and mishandles—their falls, forgetfulness, stubbornness, dementia, abhorrence of nursing homes and dependence. I know it sounds grim, but leave it to Chast, a longtime New Yorker cartoonist, to mine the humor in their decline and her efforts to help.

She offers a rare and unsparing look at the grist of aging: health-care directives, money, care and trust. I was touched by her frankness about how hard “those conversations” are. And as a financial advisor, I was pleased that she didn’t shrink from those topics, though her parents—who uttered the lament that became the book’s title—clearly would have preferred to talk about anything else.

Chast, an only child who lives in Connecticut with her husband and kids, simultaneously resents being responsible for her parents in Brooklyn and feels guilty about feeling resentful. It doesn’t help that her parents stubbornly resist help, even as they become increasingly frail.

Chast’s father, George, is a gentle, extremely anxious retired teacher who has a tendency to break everything he touched. Her mother, Elizabeth, a retired assistant principal, has a sharp tongue and volatile temper, bragging that she fires “a blast from Chast” at anyone who crosses her.

Their daughter knows she’s outgunned by their collective resistance to change. So she gets help. She arranges for an Elder Lawyer to visit her 93-year-old parents in their increasingly cluttered and grimy apartment. “I learned about their pensions. I learned about their taxes,” she writes. “… I learned about incredibly boring stuff like some account they opened up in 1979 where every month, they got a check for $53.17. We all did wills and filled out health-care proxy forms and power of attorney forms. It was all stuff I never wanted to know about, but that’s what an Elder Lawyer was for: to help you learn about it.”

As difficult as this was for the Chast, they made a wise decision to share their financial situation and their end-of-life wishes. And giving their daughter power of attorney—and the ability to make financial decisions for them—enabled her to follow their request and safeguard their assets.

That’s not to say it’s easy. Chast constantly worries about running out of money for her parents’ care. Two years after her father’s death, her mother, who’s living in a nursing home, begins to decline and needs around-the-clock nursing. “We were blowing through my parents’ scrimpings at breakneck speed: about $14,000 a month, none of which was covered by insurance,” Chast writes.

But there is a bright spot: Elizabeth bonds with a private nurse, a Jamaican woman named Goodie. Goodie is “smart and strong-willed and a good match for my mother,” which is clearly no mean feat. And though Chast feels guilty not “doing the dirty work,” she’s relieved that her mom is so well cared for, grateful to Goodie for her hard work and not a little jealous of their camaraderie.

Of course, Can’t We Talk About Something More Pleasant? doesn’t have a happy ending. Anyone who picks up the book knows that. How can grief, frustration, senility, death and wrenching decisions about money and health be upbeat?

Yet strangely enough, this isn’t a grim book. I think that’s because it’s a tale told with extreme honesty. Chast acknowledges how she struggles to parent her aging parents, trying to remain respectful and compassionate as she loosens their stranglehold on independence. It’s tough to turn that parent-child dynamic on its head, especially when health and finances are involved. But Chast navigates this rocky territory with empathy and, ultimately, humor.

Emilie Goldman is a financial planner and the owner of Tamarind Financial Planning in San Mateo, Calif. Contact her at Emilie@tamarindfinancial.com.

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Aging in Place: Common Dental Concerns Among Seniors

Oral health is an important, but often overlooked, component of a senior’s health and well-being. Since oral infections have the potential to spread to other parts of the body, proper dental hygiene becomes even more important. Unfortunately, as seniors continue aging in place, they face a unique set of dental issues.

Here’s a look at some of the oral complications that are unique to seniors:

Gum (periodontal) Disease
There are two types of gum disease: gingivitis and periodontitis. With gingivitis, the gums become red, swollen, and can bleed easily. In periodontitis, gums pull away from the teeth and form pockets of infection.

No matter which form of gum disease is present, seniors are in danger of losing natural teeth and healthy bone density. While it’s true that gum disease affects people of all ages, experts agree it grows worse with age. During the early stages, gum disease is painless. Without pain or warning signals, most seniors don’t even know they have it. When the disease advances, however, seniors face serious adverse effects.

Gum disease is usually caused by poor brushing and flossing habits. Without proper care, dental plaque builds up on the teeth. When the plaque isn’t removed, it hardens and forms tartar – something that brushing is not able to clean.

Eating Difficulties
Oral damage above or below the gum line can make it nearly impossible for seniors to eat. With problems like missing teeth, cavities and ill-fitting dentures/bridges, eating difficulties can force seniors to modify their chewing habits or adjust the quality, consistency, and balance of their diet.

Dry Mouth
Bouts of dry mouth – called xerostomia – are common among seniors. Saliva plays a crucial role in preventing tooth decay. Without it, the mouth is no longer able to decrease bacteria or prevent cavities.

Many seniors take daily medications to treat or manage illness. Unfortunately, a number of those medications cause dry mouth. Examples include decongestants, antihistamines, blood pressure medications, narcotic pain medications, incontinence medications, antidepressants, diuretics, muscle relaxers, and Parkinson’s disease medications. To prevent dry mouth, seniors should drink an adequate amount of water and regular dental checkups.

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Anxiety Issues Among Seniors

While a certain amount of anxiety is considered normal, excessive amounts can pose serious health risks, especially among seniors. High anxieties can quickly lead to an irrational sense of dread for everyday situations. These feelings sometimes morph into a disabling disorder.

Left untreated, stress and worry can lead to:

Anxiety among older adults frequently occurs alongside other illnesses such as depression, diabetes and heart disease. In a cruel twist, depression also increases a senior’s risk of developing an anxiety disorder. Combined with cognition difficulties and life changes, matters can get highly complicated. Late-life anxiety is more common in females than males; both genders tend to have chronic medical disorders. For these reasons, accurately diagnosing a senior’s anxiety disorder can be tricky.

Seniors with obsessive compulsive disorder (OCD) experience persistent upsetting thoughts or obsessions. To ease the anxiety, older adults perform rituals. Let’s say a senior is obsessed with germs; he may spend hours on end cleaning with bleach or washing his hands. Even when prolonged exposure to cleaning chemicals forms hand sores, seniors with OCD continue performing the very rituals that caused the sores to develop.

To be clear, agonizing over something like germs and performing constant rituals is not pleasurable for seniors with OCD. Instead, the rituals are more like putting a band-aid on a festering wound. Older adults who suffer anxiety disorders are often mistaken for Alzheimer’s disease or dementia.

Seniors who suffer from compulsive hoarding will exhibit some clear-cut behaviors. First and foremost, they bring home excessive and unexplainable collections of items. Once they have these items in hand, seniors cannot bear the thought of throwing them away.

Compulsive hoarding is another disorder that’s associated with anxiety and OCD. With a never ending collection of items that most people would see as trash, seniors tend to ignore the fact that junk has taken over. Some hoarding seniors are perfectly willing to let the clutter build, ignoring the fact that their living spaces are rapidly declining. The home of a hoarder can quickly be identified by cramped living conditions, dilapidated homes swimming in germs, and narrow walkways carved out through the mountains of clutter.

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Understanding Restless Legs Syndrome

As the name suggests, restless legs syndrome (RLS) is a condition that makes your legs feel extremely uncomfortable. It can begin at any age and grows progressively worse as you age. For most people, the legs are at their worst in the evenings, particularly while sitting or lying in bed. The “restless” feelings associated with the condition make most people get up and walk around. Moving is the one activity that offers temporary relief of RLS symptoms.

In many cases, there is no known cause for RLS. Modern researchers tend to believe the condition is brought on by an imbalance of dopamine, a neurotransmitter chemical found in the brain. Other cases, however, can be traced back to a specific cause. Those include:
  • Heredity
  • Pregnancy
  • Related Medical Conditions

Dual Diagnosis
RLS is sometimes diagnosed with additional conditions, such as:
  • Peripheral neuropathy: Nerve damage in the hands and feet can be caused by chronic diseases like diabetes and alcoholism.
  • Iron deficiency: When the body is deprived of enough iron, the resulting iron deficiency can cause or worsen RLS.
  • Kidney failure: Iron deficiency and kidney failure often go hand-in-hand. When the kidneys are unable to function properly, iron in the blood decreases. The resulting changes in body chemistry can cause or worsen the symptoms of RLS.

Commonly Described Sensations
What does restless legs syndrome feel like? Most people describe the symptoms as abnormal, unpleasant sensations that are localized to the calf muscles. Other descriptive RLS sensations include:
  • Crawling
  • Creeping
  • Pulling
  • Throbbing
  • Itching
  • Pain
  • Tugging
  • Gnawing
  • Burning

Commonly Reported Patterns
Common RLS indicators are:
  • Triggers: Onset of uncomfortable sensations begins after periods of inactivity, such as sitting in a car or traveling by airplane.
  • Timing: During the day, leg symptoms are either non-existent or extremely mild. At night, however, symptoms and discomfort peaks.
  • Secondary conditions: The presence of another associated condition called periodic limb movement disorder (PLMD) is fairly common among RLS patients. PLMD causes the legs to involuntarily flex and contract, then extend and retract. All this movement goes on while you are sleeping. Many seniors experience hundreds of twitching and kicking movements throughout the night. PLMD is common in older adults, even without RLS, and doesn’t always disrupt sleep.

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Sometimes You Have To Find The Funny

Being a caregiver is definitely not for the weak at heart. I’ve been a caregiver to my legally blind mom for almost five years, and my sister, who has been developmentally disabled since 2008.

When you’re a caregiver, everyone wants to give you advice on how you should best handle your situation. But, I find that most of the people offering advice have never had the opportunity to take care of a loved one while managing a life, career, family, and caregiving responsibilities. It’s those moments where I find that you have to live by one of my mottos, finding the funny.

You have to learn how to “find the funny” in every situation. It’s not obvious most of the time. It always appears at an unexpected moment, and that’s what makes it wonderful. You can be at a point where insanity is making a dash toward you because you have just realized that you have to go pickup your sister from work at 7:30 pm; after rushing across town to make dinner for your mom, after leaving your downtown office that you’ve been at since that morning. In that one moment you have gone from breadwinner, cook, and chauffer all in the span of two hours.

The humor reminds me that all of the stresses of the day mean little compared to these moments. Those moments are rare and these memories will last a lifetime. It’s funny when you’re a caregiver, you feel like this is the most permanent decision of your life. But, in reality it’s temporary. Remember, nothing lasts forever.

When you find the funny, you create a memory that will last past this situation. You forget about the stress, and remember the things that make you want to give up your life for this person. That’s what sustains me. Of course, I get frustrated, and want to give up. We all do. But, when I do, I remember that beautiful glint in her eyes and everything is right in my world. Make it a point to find the funny. It will free you, and give you laughs and a lifetime of memories.

About the Author
Pamela Davis is one of the “2 Chicks” of “2Chicks and 1 Old Lady”. “2 Chicks and 1 Old Lady,” is a blog that Pamela started to share the adventures that she and her developmentally disabled sister are experiencing on their quest to live life and find love while taking care of their legally blind mother. Her blog can be enjoyed at www.2chicksand1oldlady.com

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5 Steps to Help Seniors Develop an Emergency Response Plan

In honor of disaster education and awareness month, why not take the time to sit down and formulate a plan for emergency preparedness? Friends, family members and senior caregivers can help tailor an age-appropriate response, keeping in mind that, as people age, their needs and physical capabilities change.

Ready to develop a plan with your senior loved one? Here’s how you can get started:

1. Identify risks that are specific to your area
Common natural disasters to consider will mainly depend on a senior’s location. Find out if the region is known for hurricanes, earthquakes, tornadoes, blizzards, floods, forest fires or other natural disasters. The type of disaster will dictate the reaction and response.

2. Come up with a plan
Make the planning process super simple. Utilize the free family emergency plan form on Ready.gov to record contact information, Social Security numbers, medications, health conditions and health insurance information.

3. Decide who’s in the network
For seniors with special needs or those requiring in-home eldercare, a solid support network is vital. Great ideas include family, friends, neighbors, doctors, organizations or place of worship. Be sure to include contacts that are both local and out-of-town residents.

4. Have an emergency kit on hand at all times
Remember the saying “better safe than sorry”? This is one adage that certainly rings true during an emergency or natural disaster. Seniors and their caregivers should pack the kit with:

  • Three days of water and non-perishable food items
  • A one week supply of daily medications
  • Batteries for hearing aids
  • Hard copies of identifying documents, including birth certificates, Medicare cards, Social Security cards and banking information

  • 5. Store adequate survival items safely within the home
    When storing survival supplies, try to put everything in containers that are easy to reach and easy to transport. For seniors, it’s a good idea to store survival items in containers that come with rolling wheels. Remember to label each bag or container, thoroughly documenting what’s inside each one. It’s also a good idea to label durable medical equipment, including the senior’s name, address and phone number.

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    3 Sure-Fire Ways to Keep Seniors Socially Healthy

    Having a life full of loving family members and loyal friends is a blessing for most seniors. Frequent social contact is the best way to prevent depression and loneliness. Studies show that socialization even has a positive effect on seniors and their cognitive abilities, helping to fight off Alzheimer’s disease and other forms of dementia.

    Let’s take a look at three actions that are sure to keep seniors feeling upbeat and mentally sharp.

    Joining Community Programs
    Local community centers are often the best places for seniors to take part in age-appropriate social clubs. They commonly offer free (or inexpensive) classes, activities and day trips. The centers offer a wide variety of services. Some even offer transportation to and from the center; the complementary commute ensures that homebound seniors have an opportunity to socialize with their peers.

    Giving back to the community not only creates a sense of pride among seniors, it’s also a great way to meet new people and make positive changes. A few of the most common volunteer opportunities for older adults are:

    • Working for local literacy programs to help children improve reading levels
    • Joining foster grandparent programs and serving as a source of inspiration for at-risk youth
    • Helping in the local soup kitchen
    • Donating or working at community thrift shops
    • For seniors looking to broaden their horizons, consider joining the Peace Corps – a group that welcomes retirees

    Live it Up
    Post-retirement, most seniors have a lot of free time. Why not spend it by taking up a new hobby or diving back into a previously enjoyed activity? Thousands of older adults spend their time scrapbooking, painting or pursuing photography.

    Retirement is also the perfect time for seniors to get out and see the world. By conducting some research, older adults will find Elderhostel programs that offer travel and educational opportunities. Cruise lines offer hundreds of packages that give seniors a hefty discount. RV owners can hit the road with communities of like-minded seniors, crossing the country at a leisurely pace and taking in the sights.

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    July is Eye Injury Prevention Month

    Though July is normally associated with Independence Day, the month is also designated as Eye Injury Prevention Month. For older adults, poor eyesight is often a problem that requires prescription glasses and an eye injury has the potential to cause serious, life-altering trauma. In honor of Eye Injury Prevention Month, let’s spend some time focusing on protection and prevention.

    Every day, an estimated 2,000 Americans suffer eye injuries. According to the Bureau of Labor Statistics (BLS), almost 70% of those eye injuries are caused by falling or flying objects, or foreign objects striking the eye.

    Protection is Key
    The best way to prevent eye injury is to practice prevention and use protection. Some of the best protection tips for seniors are:

    Invest in Protective Eyewear
    Protective eye goggles or glasses are the single most effective tool to help seniors avoid eye injury. Though adults over the age of 65 are likely retired from the workplace, protective eyewear is just as important around the house. Mowing the lawn, for example, is a household chore that requires eye protection. Sticks, rocks and other lawn debris are commonly flung from underneath the lawnmower and straight into the eyes of an operator.

    Shield Harmful UV Light
    Did you know that the human eye can suffer sunburn? The sun’s UV rays are extremely harmful to the eyes. If the eyes are sunburned, seniors suffer an increased risk of developing cataracts or, in extreme cases, blindness can occur. In order to protect the eyes, seniors should always wear sunglasses that are made to provide UV protection.

    In the Event of an Eye Injury
    For older adults or senior caregivers, time is of the essence when dealing with an eye injury. Should an eye (or both eyes) become injured, seek immediate medical attention.

    Symptoms of a serious eye injury include:

    • Isolated pain and/or vision problems
    • A visible cut on the eyelid
    • One eye no longer moves like the other
    • One eye protrudes or sticks out further than the other
    • Pupil shape and/or size is abnormal
    • Specks of blood seen in the whites of the eye
    • A foreign body can be seen imbedded in the eye
    • A foreign body under the eyelid that cannot be wiped away or flushed out

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    The Need to Alter Our Communication Techniques

    By Karen Love

    communicationDid you know that spoken words only account for 7% of communication?  The remaining 93% of communication is conveyed through body language, vocal tone and pitch.  If you are surprised by this information you are in good company – most people don’t realize this.  Human brains process communication in milliseconds so we aren’t aware this process is even occurring.

    Communication style becomes especially important when there is someone in your life that is living with dementia.  Communication often becomes one of the most challenging aspects because we try to use the same communication technique with someone living with dementia as for those who don’t have this brain impairment.  Understanding a few basic elements of communication can make a positive difference.

    1. Remember that 93% of communication is non-verbal.  Use this dynamic effectively to help the person with dementia be better able to process what you are saying.  Here are some tips:
    • Stand at eye level in front of them so they benefit from seeing your body language and facial expressions.  People likely don’t realize how often they speak behind or besides someone.  If that person has dementia the lack of visual cues hampers their ability to process information.
    • Slow your speech down because their brains process information more slowly.
    • Phone calls are especially challenging for someone who has dementia because the only communication cues they receive are words (7%) and vocal tone and pitch (38%).  Limit phone conversations to a minute or so and say something positive like, “I was thinking of you and just wanted to call and say hello.”  The expectation of being able to have a meaningful two-way phone conversation is not realistic.
    • Consider using Skype or another one of the visual software methods on a computer, tablet or iPad to communicate.  This provides the opportunity to see the person speaking, which greatly enhances their ability to process what is being communicated.
    1. Take time to listen to the person’s response giving them enough time to respond.  Don’t interrupt them while they are speaking.  If they are especially stuck on a word, kindly supply the word and see how the individual reacts.  If they don’t appear to want the help, let them manage on their own.
    1. Ask one question at a time and ask questions that require simple or yes or no answers.   For instance, “Do you want scrambled or fried eggs this morning?” instead of “How would you like your eggs this morning?”
    1. Where possible, give visual cues about what you are communicating about.
    1. Use touch as a way to communicate.  Touch is a powerful communicator.  When used positively touch can convey caring and warm feelings.  It only takes a moment for a light touch or pat on the shoulder, a kiss on top of the head of someone sitting, or a gentle hand squeeze.
    1. Smile often, not only because it conveys warmth and caring, but also because smiling can make you feel better too.
    1. Spend time together in companionable silence.  It can be exhausting for someone living with dementia to continually process communication.  Sit across from the person or at 90 degrees so they can easily see you.
    1. Lastly, the most important action you can take is to be aware of how you are communicating and whether it is having desirable results such as smiles, nodding, and looking contented, happy, or relaxed.   If not, review how you were communicating to see if you should adjust an aspect of your technique.

    Karen Love is a former speech therapist and long-term care administrator with more than 30 years of experience advancing person-centered practices in long-term service and support settings.  She has been a co-investigator of numerous research projects funded by the National Institute on Aging and the U.S. Administration on Aging. She is the Co-Founder of FIT Interactive, which researched and developed FIT Kits. FIT Kits are engagement kits that help family and care partners improve the quality of life of people living with dementia. For more information please go to their website www.fitkits.org

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