How to Help Aging Parents.+Add.Feed Info1000FOLLOWERS
The How to Help Aging Parents ebook provides clear, easy to navigate information on how to know what type of assistance is needed for your aging parents and what services are available in the growing world of elder care ranging from home delivered meals to moving into an assisted living facility.
Seniors are the target of criminals who are willing to use every avenue possible to scam them out of money. Scammers prey on victims through intimidation, fear and exploiting a person’s loneliness.
Some common scams include: the Grandparent Scam where a caller will pretend to be a stranded grandchild in need of cash; a caller claiming to be from the IRS demanding immediate payment on tax debt to avoid arrest; a caller claiming to be from the local police department with a warrant for arrest unless immediate payment is given; and a caller claiming there is a problem with the persons computer and they require access and payment to fix. Con artists use voice calls over and Internet connection to alter caller ID and could be calling from anywhere in the world, regardless of the area code victims see when they pick up the phone. Callers are rude and scary and there are too many scams to list! A September 2016 article in the Huffington Post “The Top Scams Targeting Seniors and What To Do About Them” at http://www.huffingtonpost.com/anthony-cirillo/senior-scams_b_11766650.html provides more information.
You can cut down the number of telemarketing calls received by registering a number on the Federal Trade Commission’s Do Not Call Registry using https://www.donotcall.gov/ You can also report unwanted calls on this website.
Researchers at the Department of Kinesiology at McMaster University in Canada have published the results of a study which suggests that the risk of dementia may be just as high for seniors exhibiting sedentary lifestyle behaviors as for those who possess one copy of the APOEe4 gene. Those who possess one copy of this gene are three time more likely to develop Alzheimer’s disease than those without the gene.
On the flip side, the study also suggests that physical activity can also decrease the risk of dementia. Arthritis, pain, fear of falling and isolation can all be barriers to older adults adding physical activity into their lifestyle. Just the sheer force of habit may keep them in their favorite chair. To help an aging parent become more active, consider movement they can accomplish while sitting. Some examples are leg lifts or stretches, arm movements or lifting even a can of soup to start. Helping a person ease into change through encouragement is the best approach with those who are experiencing the physical limitations of aging.
A results of a study led by University of California – Los Angeles Department of Psychiatry were recently published in the Journal of Alzheimer’s Disease (http://www.j-alz.com/) and suggest that yoga and meditation may reduce older adults’ risk of mild cognitive impairment. Mild cognitive impairment, or MCI, presents in older adults as changes in memory or thinking. Although these changes may be noticeable, they do not interfere with a person’s day-to-day activities. However, MCI is considered a precursor for the development of Alzheimer’s disease (http://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/basics/complications/con-20026392).
The results of the UCLA study are encouraging and exciting! The study included 25 participants aged 55 and older. At the beginning and the end of the study, participants’ cognitive function and brain activity were measured through MRI imaging and the completion of memory tests. Then for 12 weeks, 14 of the participants took part in a 1-hour Kundalini yoga class once a week and practiced Kirtan Kriya meditation for 20 minutes a day. The practice of Kundalini yoga uses breathing techniques, meditation and chanting. Kirtan Kriya meditation is regularly practiced in India to maintain cognitive functioning and uses chanting, hand movements, and light visualization.
The remaining study group participated in 1 hour of memory enhancement training through activities such as crossword puzzles and computer games once a week for 12 weeks, and spent 20 minutes a day completing memory exercises.
At the conclusion of the 12 weeks, the researchers found that both groups showed improvements in verbal memory skills – ability to remember names and lists of words. But greater improvements in visual-spatial memory skills – the ability to navigate and remember locations – were shown in the group which practiced yoga and meditation. The improvements in verbal and visual-spatial memory correlated with changes in brain connectivity.
Additionally, results found that, the yoga-meditation group did better in terms of levels of anxiety and depression and coping skills. As those who care for the elderly know, people can become anxious and depressed when they recognize that their memory and cognitive functioning is changing. This study indicate that yoga and meditation may be an effective strategy to combat these symptoms and to slow the progression of MCI. An alternative to adding medication to address anxiety and depression is refreshing. Also, yoga and meditation does not require physical exertion – it is available to all.
Most of us have heard a concern about aching joints from aging parents and can often see changes in joints such as knobby knuckles or swollen knees. Arthritis may be the cause. Arthritis is the leading cause of disability in America, effecting more than 50 million adults. It is most common among women and occurs more frequently as people get older (http://www.arthritis.org/).
The symptoms of arthritis may include swelling, pain and stiffness. Symptoms can be severe enough to change a person’s ability to do daily activities such as bathing and dressing. Although some changes caused by arthritis can be visible, often the damage can only be seen on X-ray. There are many types of arthritis and some types also affect the heart, eyes, lungs, kidneys and skin as well as the joints. Osteoarthritis is the most common type that effects the elderly and occurs when cartilage, the tissue that cushions the ends of the bones within the joints, breaks down and wears away http://nihseniorhealth.gov/osteoarthritis/whatisosteoarthritis/01.html).
Symptoms can be managed by using hot and cold therapies, using assistive devices like a cane, walker or a reacher, and taking over-the-counter pain relievers. The pain is real and more movement is probably the last thing on a person’s mind when there is a flare up, but research has shown that exercise is the most effective non-medication way to manage the symptoms of osteoarthritis. Strengthening the muscles around the joint add support to the joint. The Arthritis Foundation is a helpful resource and have arthritis friendly exercise videos available at http://www.arthritis.org/living-with-arthritis/exercise/videos/.
Remember to keep your parent’s doctor involved in their care. Talk to their doctor about symptoms of arthritis and any exercise or other interventions they are using to manage the pain. Ask about a referral to a rheumatologist to further diagnosis and manage arthritis.
My mother reads a lot, I mean like devouring a book at day is normal for her. So my siblings and I know that to give her books as gifts is a pretty safe bet. When I visited her at the beginning of the year, I saw the books piling up and she was using a book reading light in addition to a mega-watt reading lamp so we arranged for an eye exam. The doctor diagnosed her with cataracts in both eyes.
Cataracts cause more vision problems internationally than any other eye condition. They are cloudy areas in the lens of the eye which is normally clear. They can develop in one or both eyes and, if both, one will be worse than the other. The cloudy lens blocks light from passing through to the back of the eye, which allows us to see well-defined images. Seeing through a cataract is like looking fog. It’s frustrating and scary to think of living with impaired vision, especially when you’ve had good vision your entire life. In addition, vision impairment increases the risk of falling and accidents. Falls can be devastating for older adults. If they break a bone, especially a hip, or hit their head, the injury can change the trajectory of their life and severely impair the quality of life.
Here are some tips that can help improve vision in the short-term, if the cataracts are not too advanced:
Make sure your parent’s glasses are the accurate prescription;
Provide a stand-alone magnifying glass for reading;
Get brighter lights for the house, especially around stairs;
If your parent is still driving, ask them to refrain from driving at night, or stop all together until the cataract is removed.
However, these are only temporary measures – the cataracts will continue developing and will impair eyesight more. Fortunately, surgery can remove cataracts and restore vision; it is routine and usually safe. After care requires an eye guard and frequent eye drops. Usually, the surgery will be for one eye at a time. Eyesight in the treated eye will be clear right away.
Be aware that alpha-blockers, which are commonly used for urinary problems and hyper tension, may increase the difficulty of cataract surgery. Examples of an alpha-blockers are Flomax and Doxazosin. Make sure your parent’s doctor has an accurate medication list to be aware of any risks.
When you are a long distance caregiver you hope that when your parent says they’re “doing fine” that everything really is just fine. The fact is that seniors usually under report concerns and problems; even serious problems. Why do most aging parents keep the truth under wraps? Thoughts that come to mind are pride, independence, not wanting to feel like a burden. There is also societal pressure to live independently in your home for as long as possible. We’re all familiar with the plea to promise an aging parent that you won’t put them in a nursing home (we may have even asked a spouse for the same promise) or the declaration that the only way they’ll leave their home is “feet first”. If your anxiety level rockets when the phone rings, this is a sure sign that you know things may not be what they seem.
There is a tipping point when it’s clear that an elderly parent can no longer live alone or that hired help is needed to fill gaps in self-care. To get a clear picture of where your parent’s risk level is and what changes may be necessary to mitigate those risks, check out the assessments available in the How to Help Aging Parents e-book available on this site (http://howtohelpagingparents.com/). The situations that usually bring everything to the forefront are a crisis hospitalization or a visit home. Hopefully, you can help your parent make changes before a crisis hits and a visit home give you an opportunity to take a good look around at how your parent is functioning. But what exactly are you looking for? Here’s a quick list:
Changes in hygiene – stained clothing, not bathing regularly;
Piled up mail, laundry and/or dishes;
Notes to self all over the house reveal memory concerns;
Expired food in the refrigerator;
Charred pots or burn marks on stove or in microwave;
Housekeeping and yard care slipping;
New scrapes and dings on the car.
Talking to a parent about these changes can be a delicate matter – they’re the parent and they don’t need their pesky child telling them what to do! Reaching out to their doctor for assistance with this difficult conversation may help as older adults usually will respect their doctor’s input. Considering hiring an eldercare professional such as a Geriatric Care Manager who has specialized training in eldercare and can provide expert advice to aging individuals and their families. You can learn more at https://www.aginglifecare.org
Caring for aging parents is stressful, but caring long distance adds a new twist. A phone call or even a Skype conversation (if your parent is computer savvy) doesn’t tell the whole story and can keep you up at night with worry. Assurances that everything is okay, and that they are managing and that dad is only a little forgetful are found to be the tip of the iceberg when a visit home reveals that more care is needed. Long distance caregivers cannot be on hand to see changes has they happen and the challenge of gathering information and coordinating care is daunting and frustrating.
You are not alone. It is estimated that out of the approximately 34 million caregivers 15% live one or more hours away from the person to whom they provide the care (2004 MetLife/National Alliance for Caregiving report). In many situations a sibling or relative living locally are available to support their aging parent, but this can cause family drama and stress. The people providing the day-to-day support can make the long distance caregiver feel that they are not pulling their weight in caring for mom or dad. Although it is not always easy, it’s best to talk it out and come up with a plan that may make things more equal. One example is contributing money to pay for a caregiver once a week to give local caregivers a break. If money is a concern, researching and coordinating services can save local caregivers time and frustration.
For those caregivers who are the primary person providing care, it is even more imperative to hold a family meeting to discuss the following:
Your parent’s wishes regarding end of life (DNR, resuscitation, etc.);
Is there a Power of Attorney of health care and finances? Where is the paperwork?;
All banking information;
Where important documents are kept (Power of Attorney, Living Will, Last Will etc.);
Current Primary Care Physician and all specialists; and
Current medication list.
Juggling a family, career and caring for a parent’s needs long-distance is a recipe for stress. Consider reaching out to community organizations and Agencies on Aging in your parent’s area for available services and advice. Look into programs such as an Adult Day Care program for extra socialization and support. Consider hiring a Geriatric Care Manager who can help coordinate care and provide a clear picture of your parent’s needs. Bottom line is don’t be shy about creating a support network for yourself and giving yourself some peace of mind.
Daytime hours can be the hardest to cope with when you are caring for an elderly parent. Making sure they are safe, getting to the bathroom without falling, that they are eating and that they are not sitting in the same spot all day feeling lonely. Caregivers might think their choices to address this problem are limited to either quitting their job to stay with their parent or placing them in a nursing home or assisted living. The first thing to do is assess the situation. Is your parent safe to stay at home with minimal support? How much supervision do they actually need? If they are able to stay in their home safely but need minimal supervision and engagement consider the option of an adult day care center.
Adult day care centers, also known as social day care, provide a comprehensive program of supervision, structured activities, minimal assistance with toileting, and light meals. Adding this option as part of the care plan for your elderly parent can provide you with peace of mind and your parent with social engagement which is vital to the quality of life.
There is also a program called Adult Day Health Care program which is Medicare funded program and is appropriate for elders who are more impaired. This level of program is more appropriate for elderly who are need more direction, are incontinent, or wheelchair bound. Nursing, rehabilitative and social services are offered to participants based on an initial assessment. Unlike adult day care centers, these programs are licensed through state agencies.
The fee for adult day care centers is private pay. Most centers offer a pro-rated fee for half-day enrollment. Transportation is available, usually at an extra charge. If your parent has long term care insurance, check with the policy to see if this service is covered. If you choose this option, meet with the center manager to go over the plan of care and how things work. It is also important to get to know the staff who will care for your loved one. Visit this resource to learn more; http://nadsa.org
If your elderly parent has been recently discharged from the hospital, they are at a high risk of being readmitted. One in five elderly are readmitted within 30 days of discharge for reasons varying from congestive heart failure, pneumonia, and infection. The elderly are also more likely to experience falls after a hospital stay due to weakness and confusion which often result in readmission. The best prevention against these health conditions is careful monitoring and setting realistic expectations. The elderly take longer to “bounce back” from a hospital stay. The loss of routine, stress of being in a medical setting, change in diet, and fear can take a toll on their overall well-being – physical, mental, spiritual and psychological.
The care that is provided during the transition period from hospital to home is important and various models and strategies have been developed and researched. Some strategies include forwarding the discharge summary to your parent’s primary care physician right away to keep them in the loop, scheduling follow-up appointments before the discharge even occurs, inquiring about follow up nursing care through home health services with the hospital discharge planner and arranging for someone (family or home care agency) to be in the home at least for the first 72 hours after discharge (http://news.yale.edu/2013/07/16/six-strategies-reducing-hospital-readmissions-among-elderly).
The Affordable Care Act (ACA) has focused on this problem by imposing penalties on hospitals with high readmission rates with the theory that this will prevent the elderly from being discharged prematurely. The ACA also created the Community-based Care Transitions Program in which hospitals partner with community organizations to provide oversight and services to newly discharge patients covered by Medicare as they transition from hospital to home. The Centers for Medicare and Medicaid Services will oversee this program. The goals of the Community-based Care Transitions Program are:
To improve transitions of the elderly from the inpatient hospital setting to home or other care settings
To improve quality of care
To reduce readmissions for high risk elderly patients
To document measurable savings to the Medicare program
Ask your hospital discharge planner about this Medicare program and if there is a provider authorized by the Centers for Medicare and Medicaid Services to administer the Community-based Care Transitions Program in your county.
Becoming a full time caregiver to an elderly parent is taking on a role that can deplete your emotional, physical and mental health. This is especially true when caring for a parent that has dementia as it is very difficult to separate the person from the disease when hurtful things are said or they strike out physically. Old wounds and pain from the parent/child relationship are often revisited as resentment builds over the time and energy depleted by caregiving. Many people go the caregiving journey alone, wondering how they would find the time or energy to join a support group. But one of the most often-repeated pieces of advice heard from caregivers is to make the time to take advantage of the many resources for caregivers that are available. Seek assistance from family, friends, support groups, and community organizations to help you through the difficult times.
Build a support system of alternative care options to cut down on stress and provide much needed replenishment of your emotional and mental resources. Research adult day care programs and home care programs in your area to build in hours during the week of free time for you and engagement for your elderly parent. Local churches or high schools may have service clubs specifically for helping the elderly and their caregivers with grocery shopping or other chores. If other family member are not pulling their weight, it may be time to have a family meeting and review the realities of what it takes to care for mom or dad. If time is not available from family members than money to pay for services can be substituted.
No one is really prepared for the potential changes that occur in life when caring for an elderly parent. It’s wise to recognize that the journey is a unique and difficult one and give yourself permission to ask for help.
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