What to Look for When You Visit Your Senior Parents This Holiday Season

What to Look for When You Visit Your Senior Parents This Holiday Season

It can be hard to tell how your senior parents are really doing at home when you don’t live near them. It’s one thing to talk on the phone or video chat, but going home for the holidays gives you a chance to check in on their well-being while you catch up with everyone.

Is Your Senior Loved One in Need of Assistance? Things to Look For While You’re Home for the Holidays

It can be difficult to determine when your loved one is no longer able to live independently. This can be particularly hard if you don’t live close enough to your parents to drop by often and see how they’re doing.

The holidays are a great time to reassess your loved one’s functional status. If you plan on attending a family get together or are going home for the holidays, it’s important to know what to look for. At the very least, you can assess any help they may need that can be provided in their home and if concerns are more urgent, help your parents find the best possible living solution going forward.

The following are some subtle — and not-so-subtle — signs that your parents may need some extra help to stay healthy and safe.

1. Do they have piles of unopened mail?
If your folks have always been organized but now you see stacks of unopened bills and letters sitting around, try to find out why. Maybe they’ve just been busy getting ready for the holidays. But unopened mail, especially if it dates back more than a few days, can also be a sign of cognitive impairment, financial problems your folks may not know how to handle, or simply vision loss.

Possible solutions: If Dad or Mom have trouble reading the mail, an eye exam is in order. If financial or memory issues are to blame, it’s time to talk to your parents about having another family member or a professional daily money manager help them manage their bills and mail.

2. Do you see damage to your parents’ garage or vehicles?
New dents on their cars or scrapes on the garage walls can be signs that your parents’ driving skills are declining. Try to ride with your parents during your stay to see how they are currently driving. Drifting across lanes, driving much more slowly than normal, and not using the back up camera or turning around to look while backing up are signs that it is no longer safe for them to drive. No one looks forward to the “driving conversation” with a parent, however, there are ways to make it less stressful and more productive.

Possible solutions: Research alternative transportation options and discuss their effectiveness with other relatives. You should be prepared to have more than one conversation with your loved one about scaling back or stopping driving altogether.

3. How do your parents look?
Your senior parents’ grooming standards should be about the same during this visit as the last time you saw them in person. Cognitive impairment or physical limitations may be the cause of noticeable changes in their appearance. Changes to look for include dirty clothing, dirty hair, and significant weight loss.

Possible solutions: These changes are signs that a visit to the doctor is needed. Memory loss may be causing your parents to forget to bathe, change clothes, or eat. Mobility issues like arthritis and neuropathy can make some activities of daily living too painful for your parents to handle on their own. Depending on what their doctor recommends, your parents may need an in-home aide or a move to assisted living.

4. How is your parents’ pet?
Pets can be a great source of companionship, but caring for pets can get tougher as we age. Your parents may be having some challenges with pet care if you notice long claws and matted fur on Fido, a birdcage that’s long overdue for a cleaning, or an overflowing litter box. It is probably time to get some help for the sake of your loved one and their pets.

Possible solutions: Dog-walking services, mobile pet groomers and vets who make house calls can take care of the checkups and chores. This leaves your parents free to enjoy their pet’s company.

5. Is your parents’ home about as clean as the last time you visited?
Your parents don’t have to have a spotless house, especially when they’ve been getting ready to host company. However, if their housekeeping has noticeably slipped since your last visit, they may need some help maintaining their home. Not so nice signs of neglect like mildew and mold, pantry pests and spoiled food are indicators that your folks need another set of hands and eyes to keep their home clean and safe.

Possible solutions: If there’s not a family member nearby who’s able and willing to help out, consider hiring a cleaning service or an in-home aide to clean regularly. Help your parents contact pest control, mold remediation, and other services as needed to make their home a healthy environment to be in.

6. Is the refrigerator and pantry stocked?
Does your parents’ refrigerator resemble that of a financially unstable college student who just moved away from home? If so, it’s possible that they are struggling with grocery shopping or putting their meals together. It is also very common for seniors to experience a loss of appetite due to a decrease in activity and resting metabolic rate, medical problems, smell and taste changes, or even depression. If you notice your parents have lost a lot of weight or appear fatigued, it is possible they are not maintaining a nutritious diet.

Possible solutions: For parents struggling to make their meals, there are many meal delivery services available (e.g. Meals on Wheels) to bring healthy, cooked meals straight to your loved one’s door. If your parent seems malnourished, you might need to consult a medical professional to try and determine the cause of any appetite changes. In some cases, prescription appetite stimulants or liquid dietary supplements can help your parents meet their nutritional needs.

7. Are your parents taking their medications?
While you might feel strange snooping in your parents’ medicine cabinet, it is a good idea to familiarize yourself with their medications and any potential side effects or drug interactions between them. If you notice expired medications, unopened prescription bottles, or past due refills, your parents may be forgetting or choosing to not take their medicine.

Possible solutions: Take time to sit with your parents and ask how they are doing with taking their medicine. Make a medicine list and review the medicine label with your loved one. Create a medication schedule for your parents. Pillboxes labeled for each day of the week can help them manage multiple prescriptions.

8. Do your parents have any unexplained bruises or other injuries?
If your parent has scratches or bruises they are unwilling to explain, this can be a cause for concern. It is possible that injuries are due to accidental falls or tripping into furniture. While everyone has moments of clumsiness from time to time, a significant number of injuries can indicate your parent is struggling with mobility. This can be due to aging or may even a side effect of some medicines.

Possible solutions: Inspect your parents’ home and take note of any potential slipping hazards. Work with your parents to make their home more accommodating to their current needs. Non-slip flooring, entry ramps, stair rails, and non-skid mats can help decrease the chance of falling. Ensure there is plenty of lighting to help your parents see at night and help increase accessibility in pantries and closets. Grab bars should be strategically placed in the bathroom. Consider adding a shower chair or bench. Get the help of family members or hire someone to help your parents with tasks that can cause injuries such as changing a light bulb, vacuuming, mopping, and landscaping.

9. Do you notice any mood swings or personality changes?
In addition to examining your parents’ physical health, pay attention to your parents’ mood. Do they seem more down than normal or are they detached? Are they cheerful one moment and angry the next? Depression and anxiety are common in seniors, especially during the holiday season. Additionally, mood swings and personality changes can be a sign of dementia.

Possible solutions: Don’t ignore any concerns you might have about your parents’ mental health. Don’t be afraid to consult a professional, especially if you suspect your parent might be depressed or suicidal. If you are suspecting that your parent has dementia, attend a medical evaluation with your parents and mention any symptoms you’ve noticed. Help your parents connect with a community or center that offers opportunities for socialization and engaging activities they can engage in.

If you notice any of the aforementioned signs or…others that concern you, remember that your family’s holiday gathering is not the best setting to hash out a solution. It may be more productive to talk things over with your parents and other family members when there are fewer distractions and you have more time to research options.

How to Tell Family Members That Mom or Dad Have Alzheimer’s Disease

How to Tell Family Members That Mom or Dad Have Alzheimer’s Disease

When a senior loved one is diagnosed with Alzheimer’s disease, it doesn’t only affect the person receiving the news. It very much affects the lives of family members, friends, and especially the person who will be caring for the loved one. If this person is your parent, life is definitely going to drastically change for that person and for you as well.

As a caregiver, once you educate yourself about the behaviors, side effects, challenges, and changes that will occur in your elderly parent, the burden might fall on you to tell family and friends.

Caregivers must realize that family friends may not necessarily be prepared for this kind of news and might not be educated about the disease. Lack of knowledge can lead to them staying away, not wanting to about it, or other behaviors that can cause stress for the caregiver.

After you process and deal with the Alzheimer’s diagnosis, here are some tips for telling family that your elderly mother or father has Alzheimer’s disease.

When to Tell Family and Friends

When soon-to-be caregivers learn that an elderly parent has Alzheimer’s, they may wonder when and how to tell family and friends. Some concerns about sharing the news include:

  • How will others react to the news?
  • Will they treat your elderly parent differently?
  • Is there a right way to talk about it?

Alzheimer’s disease is hard to keep secret. Realize that family and friends often sense that something is wrong before they are told. Think about the following questions:

  • Are others already wondering what is going on?
  • Do you want to keep this information to yourself?
  • Are you embarrassed?
  • Do you want to tell others so that you can get support from family members and friends?
  • Are you afraid that you will burden others?
  • Does keeping this information secret take too much of your energy?
  • Are you afraid others won’t understand?

When the time seems right, be honest with family, friends, and others. While there is no single right way to tell others, here are some approaches to think about.

In society, there is a stigma about Alzheimer’s. Some people feel stigmatized and ashamed by having a family member with Alzheimer’s disease. Others are afraid their own time will come and may see your situation as a foreshadowing of their future. As a caregiver, here are some effective ways to communicate to family and friends:

Be honest. Explain the behaviors and symptoms that your elderly parent had been exhibiting and how the diagnosis was made by the doctor.

Educate. Explain that Alzheimer’s is a brain disease, not a psychological or emotional disorder. Share any educational materials that you have compiled. The more that people learn about the disease, the more comfortable they may feel around the person.

Focus on the positive. Help them realize what your elder can still do and how much he or she can still understand.

Suggest interaction. When confronted with the news, often the biggest concern for family is how they should act around the person with Alzheimer’s disease. They wonder if they should act differently and how they will interact. Explain to them that they can still have a normal relationship with the elder. They also shouldn’t be condescending or act differently, or avoid contact. Help them understand to avoid correcting the person if he or she makes a mistake or forgets something. Help them plan fun activities with the person, such as going to family reunions, church, community activities, or visiting old friends.

Help kids understand. Alzheimer’s disease can also impact children and teens. Just as with any family member, be honest about the person’s diagnosis with the young people in your life. Encourage them to ask questions.

After all is said and done, and the news is communicated, caregivers must expect a harsh reality that accompanies Alzheimer’s disease. No matter how well you communicate the diagnosis, realize that some people may drift out of your life, as they may feel uncomfortable around the person or may not want to provide care. At the end of the day, you can only do your best, and you cannot control how others will react.

Does My Parent Have Alzheimer’s Disease or Dementia?

Does My Parent Have Alzheimer’s Disease or Dementia?

If you have concerns about an aging parent’s behavior or memory, you’ve probably wondered if they have Alzheimer’s disease or another dementia. What should you do about your worries? First and foremost, tell the doctor!

If you’d like to share your concerns with your parent’s doctor but are worried about upsetting your parent, send the doctor your concerns in writing. No HIPAA authorization is needed for you to share your thoughts with parent’s health professional.

However, if you, your parent, and your parent’s doctor truly want to get to the bottom of things, you can take a simple approach that is incredibly effective: start taking notes on the behaviors known to correspond with Alzheimer’s.

By doing so, you’ll be gathering the kind of detailed information that doctors need in order to confirm cognitive issues and likely detect the disease.

Eight Alzheimer’s Behaviors to Track

Research shows that there are eight primary Alzheimer’s behaviors to track and for each of the behaviors, it’s important to take down the following:

  • What kinds of problems you see your parent having now
  • When you — or another person — first noticed problems, and what you observed
  • Whether there’s been a change or decline compared to the way your parent used to be
  • Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities

Note: If you don’t notice a problem in any of the following areas, be specific in documenting this. (e.g. “no such problem noted.”) That way, you and your family will know you didn’t forget to consider that behavior.

1. Daily Struggles with Memory or Thinking
It’s normal for older adults to have a lapse here and there. But if your parent seems to experience a memory or thinking problem every day, make a note of this. It’s a good idea to add specific examples describing what you — or another person — observed.

2. Difficulty Learning to Use Something New
Any difficulty learning to use a new appliance or new gadget, such as a smartphone? Make note of what your parent has difficulty adapting to and how he or she tried to manage.

3. Difficulty Managing Finances
Have you noticed any problems managing bills, expenses or taxes? You might have to ask your parents about this if you aren’t usually involved in their finances.

4. Forgetting the Month or Year
Any difficulty keeping track of the current year or month? If it happens more than once, make a note of the especially.

5. Poor Judgment
Have you noticed any behaviors or situations that seem to indicate bad decisions? Any excessive or unusual spending? Or perhaps a poor understanding of safety concerns that everyone else is worried about? Write down anything you or another person close to your parents has observed.

6. Problems With Appointments and Commitments
Has your parent missed any appointments or forgotten about a get-together that you’d planned? Everyone forgets something occasionally, but if this happened repeatedly, be sure to document when it started and how bad it’s gotten.

7. Reduced Interest in Leisure Activities
Have you noticed that your parent no longer seems as interested or involved in his/her hobbies? Did your mother read voraciously but now hardly picks up a book? Any change in hobbies or leisure activities should be noted, especially if such a change doesn’t seem to be related to a problem with physical health.

8. Repeating Oneself
Any repeating of stories? Any asking the same questions repeatedly? Has your parent been declaring the same thing, e.g. “I really love those roses you gave me!”, over and over again? If so, write that down.

How to Detect Alzheimer’s Disease

The eight behaviors listed above correspond to the brain’s ability to learn or manage memory or judgment. To diagnose Alzheimer’s or another dementia, your parent’s doctors must document that your parent has been having persistent difficulties in two or more areas of brain function. (This is necessary but not sufficient for diagnosis as the doctors must also rule out other causes for thinking problems).

While doctors can assess the different aspects of brain function through certain office-based thinking tests, research has found that asking family members about the behaviors previously listed can be just as effective when it comes to spotting probable dementia, including Alzheimer’s disease.

Getting this type of observational information from family members helps doctors determine whether the behavior is a persisting, and maybe even worsening problem. This matters because a single office-based test only provides a snapshot of how your parent’s brain is doing that particular day.

Last but not least, geriatric doctors very much appreciate getting these kinds of behavioral observations from families as its practical information related to people’s daily lives. By knowing more about what kinds of problems an older person has been experiencing, physicians can make useful recommendations right away to help families with family conflicts, independence, and safety.

Ways to Help Your Parents Get the Right Care

Doctors who knowledgeable about dementia will ask a family about problems related to the eight behaviors previously mentioned. Unfortunately, many primary care doctors aren’t experienced in evaluating dementia. It’s not unusual for doctors to wave off a family’s concerns or have them be told that this is just what happens when people age. Such a scenario can happen partly because families are often a bit vague when they voice concerns. This means the doctor has to do more work in investigating the concern and in documenting specific problems that can help diagnose Alzheimer’s. Some doctors will do this work, but since office visits are often rushed, many of them won’t get around to it.

Unless you are proactive and bring detailed information to help the doctors take further action. The more specifics you can share regarding what you have observed, the more likely you’ll get the help your parent and your family need. Plus, whether or not Alzheimer’s caused these behaviors, they often cause anxiety and frustration within families. So it’s important to bring them up to a doctor so that you can get help understanding the cause and learn what to do next.

Don’t go on for too long with the worrying and the wondering. Take notes so that you can take better action.

With the Holidays Around the Corner, Plan Now to Have Conversations about Senior Living with Loved Ones

With the Holidays Around the Corner, Plan Now to Have Conversations about Senior Living with Loved Ones

Many families head home for the holidays, gathering together and reconnecting with loved ones who they may have not seen in a while. Many times, these gatherings are the first settings where family members notice age-related decline, as well as cognitive and health or safety issues facing older loved ones.

Maybe a family member is having mobility issues or seem to need more help with the activities associated with daily living. Perhaps there is nothing wrong but you just feel like it’s important to discuss options surrounding topics such as senior living, finances, or even end-of-life wishes.

Whatever the reason, The Classic wants to help families learn how to recognize problems and provide advice on having tough conversations with them this holiday season.

Prepare for the Talk

Before your family arrives for the holidays, create a list of all the things you want to cover. There are certain topics that should probably be discussed, including:

  • Any perceived age-related decline and/or cognitive ability
  • Financial planning
  • Health and safety
  • Legal planning
  • General well-being

If moving to a senior living community is definitely off the table, you and your family members may want to discuss who would take over as a caregiver(s) if it becomes necessary.

Discussing Health and Safety Issues

Physical decline is a natural part of the aging process, but it can be difficult for both you and your family member to discuss. Despite this, families are encouraged to open a dialogue regarding health and safety issues.

The first elements to ask about are the activities of daily living, which includes tasks such as:

  • Dressing themselves
  • Cooking/feeding themselves
  • Proper grooming and hygiene
  • Using the restroom
  • Housekeeping and basic home maintenance
  • Shopping for groceries and other essentials
  • Walking around and general mobility

If your family member has any difficulty performing these basic necessities of life, it can lead to major issues, and it may be an indicator of other possible health issues.

Discussing Financial Planning with Your Aging Loved Ones

Bringing up the subject of finances with your parents or another relative can often be a sensitive subject, but as loved ones get older it becomes increasingly important. Modern medicine is helping us live longer than ever before, and while that is generally a good thing, it can cause problems down the road if you don’t adequately prepare yourself financially.

Being prepared for any potential future costs requires a thorough conversation regarding your loved one’s current and future financial position, expenses, lifestyle, medical needs, and other sensitive topics.

Approach the conversation with care, and make sure to:

  • Ask your parents about their goals
  • Practice what you want to say
  • Talk in a comfortable setting

Speak to a financial professional, preferably one with experience in retirement planning, and be sure to stay involved as your loved one will let you. Use caution, as there are unscrupulous financial advisors out there who could try to take advantage of senior clients.

Discuss Legal Planning with Your Loved One

Legal planning is an important aspect of retirement planning. The main goal of any legal plans should be to ensure that your loved one’s wishes are carried out while also protecting you and your family. For these reasons, we recommend discussing legal matters with them candidly.

Everyone, regardless of their age or status, should have both a will and a living will, but this is especially true for older adults. It’s also important that they have (and you are aware of) the following legal items:

  • A life insurance policy
  • An end-of-life wishes letter (for things not covered by a will)
  • Authorization to release health care information
  • Health insurance
  • Health care proxy (durable healthcare power-of-attorney (POA)
  • Insurance cards
  • Lists of current medication and health conditions
  • Organ donor information

Assessing and Discussing Age-Related Cognitive Decline

Cognitive (mental) decline can be one of the most intimidating facets of aging for many older adults and their children. During the holiday season, you should keep an eye out for the following warning signs:

  • Repeatedly asking the same questions
  • Changes in normal behavior
  • Difficulty holding a conversation
  • Difficulty with short-term memory
  • Forgetting names

Some older adults learn to develop coping mechanisms to deal with one or more of these issues, so you may have to pay close attention to notice if they are having any difficulties or displaying any of the aforementioned warning signs.

When and How to Talk About Senior Living Options

It’s recommended that you discuss the topic of your loved one’s situation with other family members before you bring it up during the holidays. Consider waiting until everyone has arrived and settled in before broaching the topic. Many times, people are worn out from traveling and fatigue can be a major contributor to frustration. The last thing you want is a big “blow-up” at the start of your holiday celebration.

If at any point you feel these topics are upsetting your loved one, take a break for a while. Making the situation seem urgent will just further contribute to frustration. Many people associate making the move to a senior living community with a loss of independence or usefulness, which is why, when, and how you discuss these topics is so important.

Other tips to help this conversation go more smoothly include:

  • Be sure the person understands that the move will make them more comfortable and keep them safe.
  • Reassure them that this their choice and the decision is entirely up to them.
  • If you or your loved one know someone who lives in a senior living community, invite them to come and talk about their experiences with you.
  • Make sure the whole family is on the same page. You don’t want others offering conflicting opinions or advice.
  • Reassure them this is just a change of address and that you will visit regularly.

Having these conversations may not always be easy. It’s important for you to be your loved one’s health advocate, especially if they are experiencing physical or mental decline. While their opinion and wishes are important, it’s also critical for you to know when to be compassionate but firm in explaining what you believe is best for their overall welfare.

November is Alzheimer’s Awareness Month

November is Alzheimer’s Awareness Month

Since 1983, Alzheimer’s Awareness Month has been observed in November, thanks to a presidential proclamation from President Ronald Reagan. According to the Alzheimer’s Association, the number of U.S. citizens dealing with this disease has now grown to more than five million.

What is Alzheimer’s Disease?

Alzheimer’s disease is a type of dementia that leads to memory, thinking, and behavior problems. It is the most common form of dementia, accounting for 60-80 percent of all cases. It is also the sixth leading cause of death in the United States.

Alzheimer’s disease gets worse over time and eventually comes to a point where a person can no longer accomplish daily tasks. In the beginning, memory problems are mild, but as the disease progresses, patients become unaware of their environment and may no longer be able to carry on a conversation. Once their symptoms become noticeable, Alzheimer’s patients typically live an average of eight years, but can survive for as many as 20 years—depending on other health factors. Although those ages 65 and older are more likely to develop Alzheimer’s disease, there are thousands of others under the age of 65 who have early-onset Alzheimer’s.

Is there a Cure for Alzheimer’s Disease?

There are no drugs or treatments to cure Alzheimer’s disease, but there are treatments that can slow down its progression. Researchers are constantly looking for new treatments as they search for a cure for this mind-robbing disease.

Alzheimer’s Disease Symptoms

Part of Alzheimer’s disease awareness is knowing the symptoms so you can know whether a loved one may be developing it. Symptoms include:

  • Memory Loss – People may forget things they’ve learned as well as dates and events. They may also ask for the same information over and over again.
  • Trouble Planning or Solving Problems – You may notice a loved one taking longer to complete tasks they used to be able to do much quicker. You may also notice they have trouble following directions, even a simple recipe becomes complex.
  • Confusion with Time or Place – People with Alzheimer’s often lose track of time. They also forget where they are and even how they got there.
  • Misplacing Things & Unable to Retrace Steps – As people forget dates and events they may also start to misplace objects. Although they would be able to retrace their steps in the past and find what they are looking for, that is no longer the case. This may lead them to accuse others of stealing because they can no longer find what’s theirs.
  • Mood & Personality Changes – Because of the changes that are going on in their mind, you may notice major shifts in mood and personality. They may become confused, suspicious, and even depressed.

Helping People with Alzheimer’s Disease

Although there is no cure Alzheimer’s disease, there are things you can do to help a loved one, especially if the disease is still in its early stages.

  • Keep a Daily Routine – This helps to avoid confusion and lets the person know what can be expected. Alzheimer’s patients like routines.
  • Don’t Overstimulate – Keep things simple. Say one thing at a time. Present only one idea so that the person can understand it the best they can.
  • Be Reassuring – Always try to make the person feel safe and comfortable. Sometimes even saying the words, “You are safe with me” is enough to make the person feel at ease.
  • Don’t Yell or Argue – As frustrated as you may get, imagine how your loved one feels. They can no longer grasp what is going on inside their own heads. Don’t yell or argue out of frustration. Be the calming voice they need.

While you may be able to care for a person with Alzheimer’s in the early stages of the disease, doing so as it progresses can become more challenging. Many times the patient can present a danger to themselves by wandering off or forgetting to turn off the stove. If this is the case, it may be time to consider a memory care community than can monitor and manage the care of your loved one.

For those living with the challenges of Alzheimer’s disease, The Classic at Hillcrest Greens provides an optimal balance of security, independence, empowerment, and honor.

Our highly trained, licensed professionals ensure 24-hour individualized care, while our Life Enrichment staff is trained in the concept of generating daily moments of success by offering opportunities for residents to find happiness and meaning along with supporting their unique needs. This overall approach to interaction with our residents focuses on creating feelings of belonging and purpose while seeking to preserve their identity and sense of self.

When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

As the pool of seniors in American becomes increasingly greater with each passing year, a frequent question more and more families are faced with is: “How do I know when it’s time to place my loved one with dementia in a long-term care community?”

Most long-term care experts will agree that every scenario can be unique and different. The general rule of thumb however is that there is really no downside to placing a loved one in community too soon. However, there are many drawbacks in waiting too long.

If your loved one requires a higher level of care, and for whatever reason(s) you decide to wait, the number of things than can potentially go wrong are endless.

Medication Management
In a facility like a memory care unit, all medications are carefully regulated. They are administered on a strict schedule, the nursing and care staff look for any indications that a resident’s regimen should be changed, and they can usually implement these changes quickly once the doctor has approved them.

When your loved one is living at home, all of the medication oversight falls to you. While many family caregivers learn a great deal while caring for their loved ones with dementia, there are certain signs and issues that only medical professionals can pick up on and address. Even if you do notice a problem, getting them to the doctor for an evaluation to change their meds can be a struggle.

Mobility Issues
Toward the end stages of dementia and Alzheimer’s disease, patients have extremely limited mobility. This is a serious hazard for both the patient and their caregiver. For example, a petite 70-year old woman could easily get hurt trying to get her 180-pound husband to the bathroom two or three times each night. Continuing to care for him at home puts them both in danger of falling.

Bathing, toileting, dressing, and other activities of daily living all come with risks, but a facility is far better equipped to safely handle any of these concerns. They have the proper equipment, training, and manpower to assist residents and prevent accidents.

Wandering
A loved one can easily get out of the house without their caregiver realizing, and this can be a life-threatening situation. Wandering can (and does) happen in facilities, but the residents are limited to spaces within the building and, in some cases, a secure area outside. This is why supervised memory care is so valuable for dementia patients and their family members. The residents are able to move about, but the premises are heavily monitored and often feature special security measures to prevent them from wandering away from the facility and getting lost or injured. The response time when someone does wander is greatly increased as well, due to the number of employees available to look for them.

Caregiver Stress
It doesn’t matter if you are in your thirties or in your seventies, the stress that dementia puts on a caregiver is the same. If you are in your thirties, chances are you are in reasonably good health, but older caregivers are more likely to have medical conditions of their own to contend with. Stress can quickly manifest itself in people of any age, and is known to exacerbate even minor ailments. Be honest with yourself about your emotional and physical limits while caregiving. Sometimes placement in a facility is best for both the caregiver and the loved one’s overall health and well-being.

Long-Distance Caregiving
Caregiving from afar rarely works, especially for loved ones with progressive illnesses like dementia. How could it? Some local family members can provide intermittent support, but they still struggle to stay on top of the level of care and assistance that their loved one requires. Adequate supervision and care can’t be provided from afar. The patient’s needs will continue to increase, and it will only put more strain on the caregiver and leave the person with dementia more vulnerable.

In a long-term care facility, yes, there are more residents, but there are also more caregivers. Unlike family member who lives across town or across the country, nurses and aides are on duty around the clock to ensure residents are safe and their needs are met.

Rely on a Plan, Not a Promise
The most important reason to have a plan way before it is time to even think about placement is because you probably make a promise years ago that you would handle a loved one’s care yourself. It is common for people to promise to take care of their parents, spouse, siblings, whomever and pledge to never place a loved one in a nursing home for any reason.

There is the fact however that as a patient, a person deserves and should demand to be taken care of to the best of one’s ability. A dementia patient’s daily care should not be substandard simply because of a promise their family member made some 20 or 30 years ago. We all have made promises we haven’t kept for one reason or another. This thing about, “I promised my mom I would never put her in a facility,” is noble, but that’s about it.

Sometimes it can simply be a matter of pride for caregivers. A caregiver doesn’t want their family to know that he/she is struggling with Dad, so they do the best they can, not even realizing that the care they are trying to provide is substandard. Every person deserves to be taken care of. A loved one may not be able to communicate or have any idea what is going on around them, but they deserve to have their dignity intact.

Placing your loved one in a long-term care community doesn’t have to be as dramatic as it is often portrayed to be. Communities that offer Memory Care are nothing like the nursing home setting of 30 years ago. It’s highly likely that neither the potential resident nor the caregiver has ever been in a specialized facility that cares for individuals with dementia, because most people don’t have a plan in place for that scenario.

There is research involved, a medical assessment of your loved one must be conducted, and there needs to be a financial plan in place to cover the costs of professional care. When you take your time to prepare, there is less drama and fewer surprises.

Do yourself and your loved one a favor and be prepared. Placing a loved one is one of the most loving things you will ever do for them. You are doing something your heart tells you not to, but you are doing something that your mind knows is the right thing to do. At the end of the day, this is exactly what you said you would do all those years ago….take care of them. When you can no longer manage, you seek out placement. This is, in fact, taking care of them.

My Parents Need Assisted Living. Where Do I Start?

My Parents Need Assisted Living. Where Do I Start?

It can be difficult to realize that dad or mom need more care in a setting like assisted living. Just as your parents kept us safe and secure when we needed it, there comes a time when we’re called upon to return this same caring concern with our parents.

Steps to Take When Your Parents Need Assisted Living

Some of us will provide care to our parents or senior loved ones in our own home for a period of time, but this scenario is not always possible for all families, or…always desired by the children or parents themselves. Many families will in turn, find themselves searching for an assisted living community. These communities provide an intermediate level of residential care for seniors who aren’t safe living by themselves.

Ideally, your parents can be full participants in the search, but if your loved one is impaired by Alzheimer’s disease or dementia, you may to proactively take more control of the decision making.

If you see that your parent(s) need assisted living, here are some steps that can help you find them the right care:

1. Determine what you can afford.
Like it or not, money is going to be a factor in many families’ searches. Look at what your family can afford on a monthly basis. You may be need to look into creative ways to pay for care, like social security, veterans benefits, or long-term care insurance if your parents have that available to them. Some families may have to consider difficult options such as pooling resources from the adult children, selling a family home, or even cashing in a life insurance policy.

2. Research assisted living communities in the area you are planning to have your parents live.
Make a list of needs and preferences and research which communities can meet those criteria while being in your price range. For those families who ultimately cannot afford private-pay senior care and will require state assistance in the form of Medicaid, an appropriate resource is your county’s Aging & Disability Resource Center (ADRC).

3. Visit a number of assisted living communities.
No amount of time viewing brochures, floor plans, photos, or reviews can substitute for an in-person visit to an assisted living community. Schedule visits for you and your parent at a minimum of three communities on your short list. If you and your parent have the time and stamina, it may be helpful to visit more communities as you narrow the search. A good time to tour is during a meal, such as lunch, so potential residents can try the food and get a good sense of the community’s culture; as many residents will be out and about during a mealtime. Based on these initial tours, narrow down your search to two or three favorites. Perform follow-up tours…perhaps even unannounced…to get a good sense for the community you and your parent are considering.

4. Include your parent or senior loved one.
The more involved your parents are in the search, the better. Of course, you can do much of the legwork for them, but have discussions with your parents about their desires and preferences and, ideally, present them with a range of options.

5. Prepare to move.
If you’ve come this far in the process, there’s no sense in delaying the move. It’s risky to procrastinate when a parent needs care, as the delay can lead to avoidable accidents and medical problems.

6. Work together towards a decision.
Whether your parent is choosing the community themselves or you need to make that decision for parents impaired by Alzheimer’s or dementia, try to make sure that everyone in your family feels good about the choice. When possible, have conversations with your parents discussing the pros and cons of each option and try to find consensus about the right option.

Solutions for Families Who Disagree About Senior Care for Their Parents

Solutions for Families Who Disagree About Senior Care for Their Parents

Caring for aging loved one can be one of the most stressful family milestones. The sheer difficulty of the task, its high cost, as well as underlying family issues can collide to create a perfect storm of discontent.

If families can put aside their differences and work together as a team for the best interest of their elderly loved one, they are often able to overcome this challenge and assure that their parent’s last years aren’t marred by bickering and strife.

Reasons Families Fight about Senior Care and Possible Solutions to Avoid Conflict

1. Siblings View Parent’s Need Differently
Adult siblings don’t always see care needs the same way. One child may have the impression that mom is doing fine at home while another feels that care must be put in place immediately.

Possible Solution: When siblings disagree about how much care a parent needs, or about whether the parent needs care at all, the conflict can often be resolved by seeking expert guidance. Arrange for a visiting nurse with a background in elder care assessments to see your older loved one at home and gauge the level of safety. Also seek information and guidance from the senior’s primary physician so that the assessment process is as thorough as possible. Clarification from healthcare professionals can help answer this question definitively instead of allowing it to become a point of contention that prevents progress from being made.

2. Parents Resist Care
Sometimes the whole family is on board and agrees that mom or dad needs care, but the parent resists any change tooth and nail. It’s understandable; people value their independence highly, and are loathe to give up any of it.

Possible Solution: When you’re trying to persuade a parent to accept a move to a senior community, make it clear that you’re not trying to “put them away.” Help your parent understand your concerns and that they come from love. Also educate your parent about the senior care options that are available in your area. Your parent may imagine moving to some dreadful institutional situation while you have something much different in mind. Today’s assisted living communities are attractive and comfortable may contrast sharply with what your parent is imagining. If your parent has advanced Alzheimer’s or dementia, you may be able to initiate proceedings if you have an activated Power of Attorney (POA) or you can go the route of obtaining guardianship (pretty much as a last resort), but you can’t force an elderly parent of sound mind to receive care.

3. Family Members Regress to Earlier Roles or Past Issues Resurface
When the immediate family comes together to care for mom or dad, they often can revert to dysfunctional and unhealthy roles of the past. Sibling rivalry that has been dormant during adulthood may suddenly rear its head again during the stressful process of caring for an aging parent.

Possible Solution: It’s not realistic to get along splendidly with everyone in your family, or for your parents needs to suddenly unite a family that was formerly divided. But recognize that you won’t always see the best behavior from your loved ones or agree with them on every issue. Encourage them to be caring and dignified during this process by setting a good example yourself. Be the “big person in the room” and avoid being sucked into feuds or bickering that feel as if they are a flashback to a disastrous family road trip of our childhood. Practice active listening, as family members who feel like their voice isn’t being heard are most likely to become frustrated.

4. One Child Does All the Heavy Lifting
Often the child who lives closest to mom or dad will be the one that assumes the role of the main caregiver. When other family members don’t offer to help, the “lucky” child who is giving all the care can come to resent the siblings who have gotten off without having to help.

Possible Solution: Caregivers who have found themselves shouldering an inordinate portion of the burden from caregiving shouldn’t be afraid to ask other family members for help. Sometimes it is necessary to spell out your specific needs to your siblings rather than presuming that the needs are already understood. Outline to your siblings the challenges that you’re having, and any areas that they may be able to help with. While they may not be close enough to physically offer a hand, they may be able to contribute in other areas, such as paying for caregiving relate bills. They may also be able to host your parent in their home for short periods so that you can have a break.

5. One Child in Control Excludes Others from Decision Making
A scenario almost opposite of the previous example occurs when one child takes over the caregiving role and leaves their siblings or other family members in the dark, perhaps even limiting access to their parent.

Possible Solution: It hurts to feel left out, but if your parent’s care needs are being met and they seem safe and happy, it might not be necessary to intervene further right now. If your relationship with the caregiving loved one is strained and you’re less involved then you’d like to be, strive to maintain an ongoing relationship with your parent nonetheless. If your parent doesn’t have a memory disorder like Alzheimer’s, you should be able to maintain a relationship by contacting your parent on the phone. If your sibling is acting as a gatekeeper and prevents you from reaching your parents this way, write emails or letters to show that you care, learn about the situation, and stay in touch.

6. How to Pay for Senior Care
For many families, the most challenging part of arranging care is the question of how to pay for it, particularly when our parents don’t have the funds to pay themselves. This scenario is increasingly common as many seniors’ retirement accounts still haven’t recovered from the 2008 global economic meltdown and subsequent recession. Unless funding for care is found through government assistance like Medicaid or veteran’s aid, the adult children will have to look to their own pockets to pay for care…or they may look to one another. Should a sibling with a big income contribute more than a sibling who earns less? Should a family member who has been providing unpaid personal care be exempted from having to contribute? These questions, and others like them, have frequently kindled fiery conflicts.

Possible Solution: Open communication is essential to preventing conflict. We shouldn’t presume that siblings will necessarily be able to contribute as much as we hope. If the cost of your parent’s care will require the grown children or other family members to help pay for the care, call a family meeting with all the people involved right away. Realistically establish the cost of care, and determine how much money needs to be raised between all the involved parties. Start by determining how much each person believes they can contribute, and if funds are still short, dig deeper as a group, talking about what each person might be able to sacrifice to make arrangements work. When these decisions are made in the open, with everyone at the table, future conflict is less likely. It’s only natural that the process should be as fair as possible, and that a sibling with a low income should not be expected to contribute as much as a sibling with a high income, but not all families agree on what’s fair and what isn’t. In these cases, the voice of a neutral but knowledgeable outsider can be beneficial. Other professionals, such as elder care mediators, can also help iron out areas of disagreement and help families build consensus.

7. Balancing Caregiving with Raising a Family
According to data from the National Center on Caregiving, 60% to 70% of family caregivers are women. Very often, the same woman is raising children of her own (a “sandwich generation” caregiver) and balancing the demands of a career to boot. It’s understandable that someone juggling these demanding roles, each of which could be considered a “full-time job,” might get burned out and irritable.

Possible Solution: Understand that your caregiving loved ones have limits and are not superheroes. Do what you can to ease the burden. Offer to help care for mom or dad, or your loved ones children, so she can have some time for herself. On the other hand, if you are the “sandwiched” family member and feel like you’re hanging on by a thread, don’t be afraid to ask for help. Consider arranging a family meeting to reorganize care for your older loved one in such a way that burden is shared more evenly.

8. Caring for Both Parents at Once
While it’s great that your parents have been able to grow old together, caring for two parents simultaneously is doubly challenging. When both parents need advanced care, the physical and financial strain is immense. But it’s also challenging when the level of care needed is imbalanced, or the two parents need different kinds of care. For example, one parent might need Alzheimer’s care while another needs skilled nursing. The heart wrenching prospect of having to separate your parents can cause tempers to flare, and the physical, financial, and logistic complexities of arranging care for two loved ones at once can raise stress levels to an all-time high.

Possible Solution: Try to talk with representatives from agencies like your local Aging & Disability Resource Center (ADRC) or another local expert to learn about care options for your parents that you might not even be aware of. Many communities offer multiple levels of care, or even different kinds of care, which allows married couples to remain together when they wouldn’t ordinarily have been able to do so. Hold family meetings to ensure that everyone understands each other’s concerns, and work to define a mutually agreed upon strategy for caregiving.

9. End of Life Care
Loved ones often battle fiercely about end of life care. One child may want to arrange hospice care for a terminally ill parent, while another may advocate that every day lived is a victory. In both cases, family members want what is best for their older loved one, but disagree about what that means. This type of conflict can be avoided when seniors, well before a medical crisis, write a living will (also known as a healthcare directive) that specifies end of life wishes while also appointing a health care proxy to help implement the specified plans.

Possible Solution: Make sure that your parent has drafted a living will (or healthcare directive) and has designated a healthcare proxy. These documents are easily available online or by checking with your parents’ primary healthcare provider.

10. Estates and Inheritances
It’s incredibly sad to see families fight over an inheritance, but it happens all too often. Whether the dispute is over a treasured family heirloom or a large sum of cash, it can get ugly fast. These unfortunate battles frequently occur when a will hasn’t been written or has become out of date, but they can even occur in cases when reasonable and appropriate estate planning measures have been taken.

Possible Solution: Disputes about inheritances can be ideal cases for family mediators. A family mediator’s job is to analyze these situations fairly and objectively, while helping families find areas of common ground. While a perfect compromise may not be found through meditation, it’s almost always preferable to suing a close family member over an inheritance.

Are You Putting Off a Move to Assisted Living?

Are You Putting Off a Move to Assisted Living?

A move to an assisted living or senior living community may be one of the best decisions a family can make for a parent or senior loved one’s happiness, health and safety, particularly when they need more care than we can provide or they’re suffering from social isolation.

Lots of families delay this all-important decision, however, feeling helpless as their parent’s needs escalate and their own caregiving stress increases.

Five Reasons That Families Put Off a Move to Assisted Living

Making a decision about assisted living is not easy or straightforward and there are a variety of reasons why families and seniors may try to avoid discussing this difficult topic. The following are five of the most common reasons families might delay a move to senior living, along with some possible solutions for tackling each obstacle:

1. “I live too far away to make a decision.”
Geographic distance — living at a distance or in another state from their loved one — is often cited by family members as a reason for delaying a move of their loved one to an assisted living community. A recent study by AARP and the National Alliance for Caregiving showed that 15% of family caregivers live one or more hours away from their care recipient. Living at a distance poses extra challenges to those searching for assisted living, adding stress and making logistics and timing difficult.

Possible Solution: If you are looking at the possibility of managing your loved one’s care at a distance, you are not alone. To make the process easier, schedule family meetings with other involved loved ones to discuss decisions ahead of time. Make sure to organize all the important documents and paperwork you might need, so everything is in place in case your loved one’s health situation changes unexpectedly. Seek help from online and offline resources and referral services in order to determine what will fit your loved one’s needs and your family’s budget.

2. “I need to talk with my loved ones about assisted living care.”
Many folks will say that they have delayed their loved one’s move to assisted living because they haven’t had the opportunity to talk with family and friends about it first. It’s human nature to put off the decision because it is difficult to coordinate with other family members, or because we want to talk with experienced or trusted friends before figuring out what to do. Of course, it is painful to think about an aging loved one’s declining mental or physical health, which makes it easy to delay having those tough conversations. But doing nothing about it may put our loved one’s health at greater risk. It’s important to discuss issues such as health, logistics, and scheduling before they become real concerns.

Possible Solutions: First, be honest with yourself about your own feelings and why the delay is occurring. Think realistically about what will happen if you do nothing about their situation versus what will happen if they move to assisted living. Don’t be afraid to seek help from a counselor, friend, or support group and…don’t forget to involve your loved ones when it’s time to make a decision. Just don’t put it off forever. If it’s pre-existing family conflicts getting in the way, remember that the focus should be on the welfare of your loved one and set a good example by trying your best to rise above sibling rivalries and making sure everyone’s viewpoints are heard.

3. “I want to do more research.”
In the aforementioned study, the greatest number (27%) said that their top reason for putting off the move to assisted living was to allow them to do more research — from calling communities to driving by the property to looking at websites. Families often worry about the ratings of the community and about what the community offers residents.

Possible Solutions: Researching assisted living care can seem daunting, but there are numerous resources available for families to utilize in evaluating specific communities as well as different types of care. In the Eau Claire area, a very helpful resource is the Eau Claire County Aging & Disability Resource Center (ADRC). Their counselors can provide you with excellent advice and insight into the various assisted living communities available nearby. The key is taking that first step toward seeking out help.

4. “I’m concerned about assisted living costs.”
With the media monthly cost of assisted living rising, (typically $4,000 to $5,000 per month on average in the Eau Claire area) it’s no surprise that sticker shock is one of the reasons families and seniors delay the move to assisted living. Again, in the same survey, 13% of respondents cited budget uncertainties or high expenses as a delaying factor.

Possible Solution: An important fact to remember is to check what is included in the monthly cost of assisted living. In many cases, amenities such as housekeeping, meals, utilities, etc. are included. The key is understanding what the costs mean and what value you are getting for your money.

5. “My mom/dad/parents are not ready to leave their home.”
There are a number of specific reasons why a loved one might be reluctant or even afraid to move into senior living. They may worry about losing their independence, they may fear that others won’t care for them properly, or they may worry about being bored. They may not feel they need to be in a “nursing home,” or they may be attached to their current home or pets and be understandably reluctant to consider the idea of parting with treasured possessions and memories in order to move into a smaller space.

Possible Solution: Get informed about the most common fears associated with assisted living and other retirement housing options and learn what you can do to openly acknowledge and discuss these fears rather than letting them derail the conversation. Once your loved one can articulate his or her worries and feel like they are being heard, you can take steps to alleviate their fears. Then you can work together to discuss senior living options that value residents’ dignity, independence and privacy. Talking to a loved one about downsizing their possessions can be difficult, but once the conversation is open, you can encourage them to enlist trusted family and friends or even a professional move manager.

While these aren’t the only reasons families delay a move to assisted living, they are definitely some of the most common. Being prepared and having realistic expectations will help you avoid potential roadblocks.

Tracking Possible Alzheimer’s Behaviors in Your Parents

Tracking Possible Alzheimer’s Behaviors in Your Parents

An Aging Parent’s Behavior

Are you concerned about an aging parent’s cognitive skills? If you have concerns about an aging parent’s behavior or memory, you’ve probably wondered if they have Alzheimer’s or another dementia. What should you do about your worries? Tell the doctor.

If you’d like to share your concerns with your parent’s doctor but are worried about upsetting your parent, send the doctor your concerns in writing. No HIPAA authorization is needed for you to share your concerns with a parent’s health professional.

However, if you, your parent and your parent’s doctor truly want to get to the bottom of things, you take a simple approach that is incredibly effective: start taking notes on the behaviors known to correspond with Alzheimer’s.

By doing so, you’ll be gathering the kind of detailed information that doctors need in order to confirm cognitive issues and likely detect the disease.

Eight Alzheimer’s Behaviors to Track

• There are eight Alzheimer’s behaviors to track and for each of the behaviors, it’s important to take down the following:
• What kinds of problems you see your parent having now
• When you — or another person — first noticed problems, and what you observed
• Whether there’s been a change or decline compared to the way your parent used to be
• Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath, or physical disabilities

Note: If you don’t notice a problem in any of the following areas, be specific in documenting this, e.g. “no problem detected.” That way, you and your family will know you didn’t forget to consider that behavior.

1. Daily Struggles with Memory or Thinking
It’s normal for older adults to have a lapse here and there. But if your parent seems to experience a memory or thinking problem every day, make a note of this. It’s a good idea to add specific examples describing what you or another person observed.

2. Difficulty Learning to Use Something New
Any difficulty learning to use a new appliance or new gadget, such as a smartphone? Make note of what your parent has difficulty adapting to and how he or she tried to manage.

3. Difficulty Managing Finances
Have you noticed any problems managing bills, expenses, or taxes? You might have to ask your parents about this if you aren’t usually involved in their finances.

4. Forgetting the Month or Year
Any difficulty keeping track of the current year or month? If it happens more than once, make a note of that especially.

5. Poor Judgment
Have you noticed any behaviors or situations that seem to indicate bad decisions? Any excessive or unusual spending? Or perhaps a poor understanding of safety concerns that everyone else is worried about? Write down anything you or another person close to your parents has observed.

6. Problems With Appointments and Commitments
Has your parent missed any appointments or forgotten about a get-together that you’d planned? Everyone forgets something occasionally, but if this happened repeatedly, be sure to document when it started and how bad it’s gotten.

7. Reduced Interest in Leisure Activities
Have you noticed that your parent no longer seems interested or involved in any hobbies? For example, did your mother read voraciously but now seems disinterested in even picking up a book? Any change in hobbies or leisure activities should be noted, especially if such a change doesn’t seem to be related to a problem with physical health.

8. Repeating Oneself
Any repeating of stories? Any asking the same questions repeatedly? Has your parent been declaring the same thing, e.g. “I really love those roses you gave me!” over and over again? If so, write it down.

How to Detect Alzheimer’s Disease

The eight behaviors previously mentioned correspond to the brain’s ability to learn or manage memory and judgment. To diagnose Alzheimer’s or another dementia, your parent’s doctors must document that your parent has been having persistent difficulties in two or more areas related to brain function. (This is necessary but not sufficient for diagnosis as doctors must also rule out other causes for thinking problems).

Now, doctors can assess the different aspects of brain function through certain office-based thinking tests. However, research has found that asking family members about the behaviors above can be just as effective when it comes to spotting probable dementia, including Alzheimer’s disease.

Getting this type of observational information from family members helps doctors determine whether the behavior is a persisting, and maybe even worsening, problem. This matters because a single office-based test only provides a snapshot of how your parent’s brain is doing on that particular day.

As a rule, most doctors appreciate getting these kinds of behavioral observations from families because it provides very practical information related to people’s daily lives. By knowing more about what kinds of problems an older person has been experiencing, doctors can make useful recommendations right away to help families with family conflicts, independence, and safety.

Ways to Help Your Parents Get the Right Care

Doctors who are knowledgeable about dementia will ask a family about problems related to the eight behaviors above. Unfortunately, many primary care doctors aren’t experienced in evaluating dementia. It’s not unusual for a physician to wave off concerns or tell the family that this is just what happens when people age. This can often easily happen partly because families are often a bit vague when they voice concerns. This means the doctor has to do more work in investigating the concern and in documenting specific problems that can help diagnose Alzheimer’s. Some doctors will do this work, but since office visits are often rushed, many of them won’t get around to it.

Unless that is, you bring detailed information to help the doctors take further action. The more specifics you can share regarding what you’ve observed, the more likely you’ll get the help your parent and your family need. Plus, whether or not Alzheimer’s caused these behaviors, they often cause anxiety and frustration within families. So it’s important to bring them up to a doctor so that you can get help understanding the cause and learn what to do next.

Don’t go on for too long with the worrying and the wondering. Take notes so that you can then take better action.