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Archive for the ‘emotional’ Category

You weren’t born a caregiver, although it might feel like it. This morning, I noticed that a bright orange Crepe Myrtyle leaf lying on the grass. Fall is on its way. Yes, I live in Florida, and yes, it’s still hot–but it feels different than a few weeks ago. The click in the gear has already begun. The seasons are changing. Caregiving is like that leaf. It comes in seasons, and you can’t fight the seasons life gives you no more than I can glue that leaf back on its branch, paint it green and declare it Spring. 

Some people seem to care for someone most of their life–a sibling, their alcoholic parent, their co-dependent spouse. It’s not that we mean to attract it, but for some, caregiving is a recurrent theme. For most, caregiving is something we’ll do more than once in our lifetime. But I do know this: You won’t always be in your caregiving role.

You weren’t always a caregiver, were you? You were a child, a teenager, a young person–in college or with a new job-career. You fell in love. You traveled. You birthed children, raised them. Maybe you got a divorce, remarried, changed careers. Even though caring for others may have been a part of your life many times over, it didn’t completely sideline you.

So why should caregiving sideline you now? Yes. There comes a time, particularly in elder-care, chronic illnesses, or at the end of life, you need to stop everything else and just be with your loved one. There are times when another person’s care is all-consuming–time, emotions, finances…you name it and it takes it all. But that needs to be the rare occasion and for the least amount of time possible. Why? It’s not a healthy way to live. If you’re not careful, you’ll find that you’re living for and maybe even through someone else, and that’s not good if you do it for too long at a time.  

Think of it this way: Humans are capable of running marathons. We can exert great physical and emotional energy and do amazing things–for a short period of time. Our bodies have great reserves (and I believe our spirits do as well). They say we only use 10% of our brains and 20% of our body’s capabilities in everyday life. We have enormous reserves. We have to. When we need to tap into that deep well of energy, thought, and focus, it drains it very quickly.

Stress is like jet fuel–it takes a huge amount, so our stockpile has to stay stocked. Intense caregiving is a lot like a marathon–you really can’t expect your body to run 26 miles a day, every day.

I fought full-time caregving in the beginning. I was a sandwich generation mom. I already had a full-plate life. But my mom needed me–I worried about her falling, not eating, not taking her meds–that other people were having to do my load.

Even after we moved her into our home–I avoided her/caregiving. I’m not proud of that, but I just couldn’t be with her all the time. She got on my nerves, made me nervous, however you want to put it. It took time–I felt judged, watched, consumed by an all-present mother-figure. She certainly had no qualms about stating that she was in charge. It took time, but we learned how to live together again.

Caregiving allowed me to dance around, dip into, and even avoid it for a season, and then the seasons changed. I couldn’t leave my mom with my husband or children (they were teens and quite competent). She was too emotionally volatile and her medications and needs were too intricate to explain. One by one, my activities dwindled. Death was like an intrusive relative who moved in with way too many bags and set up housekeeping.

The last year of my mother’s life was a series of secessions, and from March until June, I did nothing but watch my mother die. Each week got quieter. Each week I gave up a little more of the outside world. At first, I was angry and scared–death is an unwelcome and rude guest. As time went on, I learned how to let my family go on about the business of living–jobs, school, boyfriends, and part-time jobs. I became comfortable with the fact that I was supposed to spend these last months by my mother’s side. Like a circle that kept growing tighter and tighter, I drew close to her.

It felt like she’d never die–only continue dying. The last few weeks were grueling, and now I know the meaning of that word. It’s not that I wanted her to, it was just so painful, so quiet, so intense…

And then it was over. The funeral home people came, took her body, and I walked back in her room, her empty room. I’d never felt so lost, so unhinged, so exhausted and depleted in every way.

Getting used to that space in my life–that caregiving space that was now an empty room with empty hours with empty purpose–it was such a void and it took time and being tender with myself. I’d lost my mom. Who was I now? What was I if I wasn’t a caregiver?

New seasons came. I returned to college. Helped one daughter get married, two off to college. I wrote a book. I now travel and speak and teach. More seasons to come.

If you’re just starting caregiving and wondering where this will take you, how long you’ll be caregiving, try not to jump too far ahead–there’s just too many what if’s out there. If you’re coming to the end of your caregiving journey, hang on–it won’t last forever–and that’s a good and not good thing.

Currently, I’m not a caregiver, but I know that one day, that season will come back into my life. I’ll be out walking one day–I’ll look down, and there will be a crisp autumn leaf reminding me that a change is about to come.

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Move over, Michelle Obama, cause Mama’s in the house.

That’s right, Michelle Obama’s mother is moving into the White House.

Marian Robinson quit her job 22 months ago to help care for the Obama girls while Michelle and Barack started campaigning. She’s now 71 and a retired secretary and she’s moving into the White House on a “trial basis” before giving up her home in Chicago. While the presidential campaign was underway, Ms. Robinson cooked the girl’s meals, shuffled them to their various activities, helped with homework and kissed them goodnight. That’s a big job, but it was for a big reason.

That’s something I admire–a family that figures out how to care for one another and when it’s the appropriate time to do so. I’m not too worried how she’ll be treated a few years from now when she needs elder-care or caregiving. She’s invested in her family, and love is almost always returned.

The White House will be full again, with a father, mother, two children, a grandmother, and a dog. I like the idea of those old rooms bustling with the sound of feet running up and down the halls, of a grandmother’s stern call to order and the yelp of a dog.

Multigenerational families aren’t new. People used to live together under one roof out of necessity–to run the farm, to continue the family business. In fact, it’s on the rise.

More than 3.6 million parents lived with adult children in 2007, according to census data. That number is up 67 percent from 2000. And in the new economic light, more and more families are choosing to “bunk up” to save on expenses, and as a necessity for those who have lost their jobs.

Somehow, we got away from that in my generation. We got independent, perhaps too independent thinking that money would be enough–or as my southern daddy would say, “We got too big for our britches.”

My adoptive mother grew up in a multigenerational house. She was surrounded by aunts and uncles (her mother was divorced and raising two children on her own in the 1910’s). My mother’s memories are good ones. A large table with lots of food and conversation. She said she felt as if she had many mothers, not just one–and it helped that her mother could work full time and her two children had someone at home.

Times haven’t changed that much. Marian Robinson is an example of millions of grandmother’s who are either raising or helping to raise grandchildren. We need each other. We need our mothers and fathers to be a part of their grandchidren’s lives. That’s how values and stories get passed down.

From all I’ve read, Marian Robinson is going to be a busy woman. She’s noted for her independence and will only stay if she’s needed. She may even purchase a home nearby just so she has some privacy and doesn’t have to deal with the day to day fuss life in politics entails. She’s no where near slowing down and has recentlycompeted in the Senior Games running the 50 and 100 yard dash. No matter where she chooses to sleep, she’ll be an active part of the Obama household and everyone will benefit from that.

It’s not that her value as a grandmother is in throwing in a load of laundry or chauffeuring the girls around, it’s that the children will be influenced by her wisdom and will have that sense of family and continuity that’s so important. It’s easy to caught up in the “doing” and not the “being.”  The most valuable gift our elders have to offer is simply who they are–a part of us. Their life, their experiences, their stories shape and define future generations.

I have seen families take advantage of their elders–used them as free babysitters–and that’s not healthy for anyone. Sometimes we have to say, “No, not tonight, I have plans.”

As my mother moved in with my husband, our daughters and myself, I knew I had to strike a balance. My mother had to fit into our home, and in return, I (we) needed to treat her with respect and privacy. These are the concerns multigenerational families face. You don’t know exactly what your issues are going to be until you’re there, all living together. One person becomes needy, another bossy–someone needs more privacy than another, and…somebody always gets jealous. It’s just human nature and no matter how old we are, we still get jealous or needy at times.

My mother was always a part of our lives, and I’m so grateful that even though she was an older grandmother (she was 74 when her first granddaughter was born), she got right to being an active grandmother. She used to come over and get our girls and take them for an overnight stay as soon as they were out of diapers. They remember going to eat breakfast at Shoney’s with my mom and how proud she was showing them off to anyone who walked by, and then going to K Mart to hold the dolls. She’d buy them something small and even though these times weren’t fancy, they were just enough to begin to build a relationship–and memories. Our daughters remember my mother’s songs, her prayers and Bible stories, her stories–and even her quirks, her humor, her fears–everything that made her a whole person. So when it came time for my mother to move in with us, they expected it. In many ways, she was already a part of our lives.

Just the other day, our 21 year old daughter said she was glad her grandmother lived with us. That’s saying a lot, because she was there through it all, the Alzheimer’s, the heart attacks, and the end of life. She’s now able to measure the whole of the experience and not just focus on a particularly dark time.

What I wish for the Obama’s is that everyone will be patient and understanding with one another during this time of change. My advice, if I may offer a little–be quick to forgive, laugh at your mistakes, value your togetherness, and respect each other’s differences.

Getting used to living together and under such scrutiny is bound to cause some nerves to be razzled. Just as with any family, it takes time to learn to live together. But it’s worth it. There are times when we need each other, and that’s the best definition of what makes a family that I can think of.

In the end, the Obama girls will be surrounded by family, by legacy, and by love.

I wish them (and all of us) the best.

~Carol O’Dell, author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir

Familly advisor at Caring.com

 

 

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I wrote these words during the early weeks after my mother moved in with us. It captures the concern, guilt, and trepidation we all felt on this new venture.

 

I didn’t feel I had a choice–about insisting my mother move in with my family and me. My mother’s Parkinson’s and early signs of dementia had grown to the point that I didn’t feel she was safe living alone, or that her care was something I could continue to farm out to paid care, extended family, church members and neighbors. She needed consistency. She needed me.

 

 

But it wasn’t easy on either of us.

 

 

Here’s an excerpt from my journals, and what later would become my book, Mothering Mother.

 

 

“I think Mother would just like to sit down and cry. She can’t figure out the layout of the house and says she doesn’t want to sleep downstairs. I explain that there isn’t a downstairs, but her apartment is on the opposite end of the house from my bedroom. It’s so far away that she must feel like it’s on a separate floor. She keeps saying she wants to sleep next to me. Not in the next room, but next to me. She walks around touching the walls as if they could collapse on her if she were to let her hands down. She sits in my dining room chair with nothing to do. I’ve made her breakfast, given her the paper and told her I need to unpack the kitchen, which she can see me do from where she’s sitting.

I feel as if I’ve taken everything from her, which she enjoys announcing to everyone, from the bank teller to the podiatrist. She makes sure to note that she’s selling her house, moving in with us, and giving up everything—her church, her friends, and her home. I stand beside her as she regales them with her sob story, wishing I could add what I am giving up—my freedom, my privacy, my mind, and that I’m not doing this to hurt her. I’m trying to help. Instead, I smile and pat her hand, hoping she’s receiving the sympathy and attention I can’t give.”

It took some time for all of us to get used to living together. I still had two teenage daughters at home. Along with “mother issues,” I had to contend with boyfriends, curfews, teen drivers, and the ever threatening emotional outburst from any of them–at any time. Mother was usually the first to blow.

 

“Mother, I want you, we all want you. Relax. You’re here now, and we’re all at home. This is our home. Please give us time to adjust.” I think of my own mother angst. I spent the first half of my life trying to get away from her and the second half trying to get back.

The cat walks by and rubs against her leg. I don’t know why that cat insists on cuddling up to the only person in the house who would like to throw it across the river. Mother pushes it away with her foot, gentler this time because she knows I’m watching. She looks disgusted. I try not to laugh.

“Go on now, scat!”

Great. Now I have to play referee between her, the kids and the pets.

 

 

 

 

For me, being an adult, a daughter, a wife, and a mother at the same time was challenging to say the least.

 

“We’re having to figure out how to stand next to one another in the kitchen, how to maneuver past each other in the hall, not just physically but even in our thoughts. No one fits every groove of our psyche, habits, or beliefs, and those knots and bumps rub us raw before we develop calluses. As hard as this is, I’m not in a hurry to get to the dying part. I want to face each day and glean whatever sweetness there may be, to truly be here, open my eyes wide and learn to stand next to her, neither one of us shoved to the side, each with a decent amount of space.”

 

 

 

 

I think women are particularly vulnerable into morphing into whatever and whoever someone needs them to be–to the point of losing a piece of themselves. We are the ultimate super-hero, we lose our identities in order to care for others.

 

 

Caregiving takes it even one step further. Your loved needs more. You are their protector, their provider. You are their lifeline.

 

My mother’s apartment was next to my kitchen and laundry room and was the parallel opposite to my bedroom.

 

I can remember evenings of helping my mother change into her gown, giving her the last of her medication, tucking her into bed, kissing her goodnight…and then walking through the kitchen and feeling myself “stripping” that caregiving/daughterly clothes and having to change into the next person I was to be–to help a daughter study for her SAT’s, or become a wife, my husband’s lover. All within moments…a new identity.

 

 

How do you keep your head and heart intact?

 

  • Believe you can do this. You were meant to do this–wife, mother, daughter, friend, co-worker. You have lots of experience already. Life never comes to us orderly. You have to be able to unload the dishwasher, talk to your best friend, pack your kid’s lunch, kiss your hubby goodbye for the day, and hand your mother a bowl of oatmeal–oh, and don’t forget to feed the cat.

 

  • Having your mother move in with you–or you with her–isn’t the worst thing in the world. Not having a mother is far worse. Yes, you’ll have a few squabbles, at least I hope you will. Your mother will teach your more about yourself than ten shrinks ever will.
  • Becoming your parent’s parent is the hardest, fastest, best way to really grow up. Whatever residual crap you had left over about your childhood (or adulthood) issues, you will finally either forgive or give up. It just gets too hard to stay angry and do everything else you’ve got to do.
  • Put yourself in your mother’s place. One day, you will–so take a moment to consider how vulnerable they feel. Their bossiness, negativeness, or fussiness is just a cover up. It helps to remember that it’s much easier to be the one in charge than the one in need.
  • Speak up. Set boundaries. Don’t give anyone–your kids, your husband, or your mother all your time and energy. Save some for you. Be alone every day–for ten minutes. I don’t care if you have to lock yourself in the closet, go to the mailbox and stand by it for ten minutes pretending to read the mail–be alone. Take long baths. Drink your coffee on the back porch. You do not have to be at anyone’s beck and call every second of the day. It’s not good for you. It’s not good for them.
  • If you don’t pray or meditate–start. You’ll need it. Find your center of strength. Ask for help, guidance, and wisdom.
  • You might not like it, but you’re probably a lot like your mother. The quicker you learn how to love her, the quicker you’ll love you.
  • Don’t let every little comment get to you. So what if she thinks you’re a slob, wear your shorts too short and can’t cook. There’s no better way to get over what people think of you than to practicce with your own relatives. Smile and be content with being just who, and just how you are.
  • Our minds, bodies and spirits are meant to love a lot of people. You can do it. You can find the patience and perserverance to do this. You will surprise yourself with how much you can love.
  • Caregiving is stressful, I won’t try to water it down in the least. You will have to be on your game almost all of the time. You will lose your cool, cry, curse, and at times, fall apart. But you are resilient. You will rebound.
  • This won’t last forever. I promise. It won’t. Parents die and kids grow up. My mother’s gone now–and what seemed like an eternity is now a memory. And I miss her.
  • Being a part of a family and caring for someone intimately is a priviledge. It’s messy, heartbreaking, hair tearing, and scary–but the alternative is orderly loneliness.

When it’s over, let go.

You will most likely grieve, feel secretly relieved, guilty, resentful, and scared all the way through and especially after it’s over. But this will pass. Your parent will become a part of you–in a cosmic, spiritual, and even on a biological level.

It will then be time to recreate who you are again.

Trust that all you need to know you already know.

You will find your way.

 

 

~Carol O’Dell

Family Advisor at Caring.com

Mothering Mother is available at Amazon

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Do you feel this is the last Christmas with your spouse or parent?

Perhaps you’re looking at a  cancer diagnosis, or you’re at the end stages of Alzheimer’s or heart disease.

This can put a cloud over the festivities. Everything drips with meaning. You’re standing in Wal Mart and feel weepy.

Or…you can’t seem to wedge your butt off the couch. Flipping channels has somehow become  your life.

 

You don’t know it, but this is the face of grief.

We start grieving long before death enters the picture.

The word grief means Deep mental anguish, as that arising from bereavement.

 

So what do you do if you feel like this is your last Christmas together?
Do exactly what you feel like doing. Trust your gut, your heart, your intuition, your spirit…whatever you want to call it.
If you need to flip channels, then give in and flip. Are you missing something significant?
Could you really grasp “significant” right now? Even if it hit you on the side of the head?
I really do believe that after about 3 days, either you’d get sick of the same old “As Seen on TV” merchandise–or, you’d get carpel tunnel and you’d have to quit anyway. Be willing to give in and see where it takes you. I’ve learned that the best way to get over something  is sometimes to give in.
Even scientists have observed  this–they find that if a child is exposed to copious amounts of pizza, chips, cookies, and apples–they’ll eventually get the junk food crave out of their system and willingly choose the apple.
Grief isn’t something you can fight. Nor should you.
It’s natural, and for the most part, healthy.
But if you can, try not to jump time–don’t go to the future–to the time your loved one dies. Be present. That season isn’t here yet.
Also realize  that if you’ve been caregiving for several years, you may have hit the caregiver’swall–you may feel numb, exhausted, and zombie-llike.
Trust the process. If you go too far, you’ll know it–everyone else will know it.
If you do have the ability to rationalize and feel, then cherish this season. Don’t dread it or push it away.
Don’t make everything drip with meaning. That can get exhausting and annoying.
Your loved one won’t appreciate being inthe spotlight every second. Follow the moment.
When something touching, seweet, or poignant happens, you have a better  chance of recognizing it if you are ‘gently” alert.
If you get a few photographs or can jot down a few thoughts, then you’ll have something you can treasure for years.
If you can’t–or don’t–then let it go. I promise you, all you need is one moment–one glance, one gentle touch of the hand, one brush of the hair–somethig will rise to the top. You will have your moment. You will find the sweetness in the season. Just let it happen.
Our relationships–and the holidays–aren’t to be forced. 
Trust that this holiday will give you a gift–at the most unexpected turn.
~Carol O’Dell, and hope you’ll check out my book, Mothering Mother

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Every day, a child’s mother, father, grandmother, grandfather or sibling dies.

Experiencing death while still a child is common, but that in no way makes it less difficult.

There are ways to help a child deal with grief.

When a child loses a loved one to death, that loss can have a profound effect that can even last a lifetime.

Emotional, psychological and physical trauma can occur and effect how a child views the world.

If grief is talked about and a child is given the proper coping tools, is surrounded by love and support, then the negative impact can be lessened.

But too often, adults are at a loss. They’re grieving themselves, and they don’t know what to say or do to comfort a child.

They don’t know how to tell a child that someone they love has died.

They don’t know how much to share with them–they either tell too much or too little.

Adults can simply “freeze” and stop communicating, and the child is left to grapple with their sorrow alone.

They can also insist that the child be happy and move on–because it makes them feel less guilty. They try to live life through their child–but children also have their ups and downs when it comes to grief. They can’t be puppets that we demand to be “okay,” because we need them to be.

Many people expect and demand that children are expected to go on with their lives.

They want them to hurry and go back to school. They don’t want them to get behind. How sad. Something as profound as a parent, sibling, or grandparent dying is so much more significant than an A in algebra.

Just days or even hours after a grandparent dies, many children are expected to return to school, sports and activities. Adults someone need the child to be busy so that they can deal with “adult” matters of business and details, but the child has his own grieving process to go through.

Children have so many issues to deal with–growing up, adolescence, fitting in, weight issues, pressure to smoke or smoke pot, divorce, family issues, academic and social issues–and it starts at a very young age.

When are they supposed to feel safe and free to open up and talk?

When can they express how much their miss their grandad?

How Do You Tell a Child That a Loved One Has Died?

Keep it simple. Use “died”, not “He is sleeping.”

Allow your child to express raw feelings freely or ask questions.

Answer questions honestly and simply. Do not go into detail, unless asked.

If the death was due to a violent crime, explain that they are safe now, nd you will do all you can to make sure they stay safe. 

Offer a comfort object–blanket, doll, teddy bear. Even if they’re “older,” something cuddly can reduce anxiety.

If the body is suitable for viewing, allow the child to see your deceased loved one, if requested. Prepare the child for what he or she will see.

Tell your child what will be happening in the next few days.

Give your child choices in what to do. Some children want to go to school the day of the death–it’s comforting and feels “normal.” Give them a choice. Whenever they return, inform the school of the death before your child returns.This makes their teachers and classmates more sensitive. Most schools have a school counselor that can also assist and be made aware of the situation.

Reassure your child that he or she will be cared for and explain the plan.

Children sometimes open up easier if they’re doing something with their hands–playing cars or helping bake cookies–it can take awhile for them to feel safe–and they feel less on the spot if they don’t have to look at you but can pretend to be “busy” with their hands.

 Don’t Know How to Talk To Your Child: Here’s some Easy Conversation Starters: 

 I’m sorry your grandmother/papa/mom/dad/sister died.

 What was your dad/mom/brother like?

Tell me about your__________. 

What was his favorite food/book/thing you did together?

 What do you miss the most? What is the hardest time of day for you?

I cannot know how you feel, but I remember how I felt when my __________ died.

 Whenever you want to talk about it, I’m here.

I’m thinking about you especially today because I’m aware that today is your mother’s birthday (anniversary of the death, your birthday, etc). 

If you don’t want to talk, we can still spend time together.

 

WORDS THAT CAN HURT:

I know just how you feel. I know just how you feel…my dog died last year. Lick your wounds and move on. You’ll get over it. It will be okay. Don’t think about it. You are better off without him. Don’t cry. It’s your fault. God took him so he wouldn’t be in pain. Tears won’t bring her back. Be strong. Forget about it. You are the man/woman of the house now. You should feel ….(proud, relieved, happy, sad, etc.)

Children May Express Grief Differently Tnan Adults:

Their emotions may experience highs and lows. They may laugh inappropriately–even at the memorial service. Don’t think this is because they don’t care. It’s difficult for a child to figure out how to handle their emotions. They may avoid sleep–or a teen may sleep all the time. They may zone out and not seem to hear anyone talking to them.

Become clingy and panic if you’re not home on time or don’t pick them up on time. Act rough or violent toward a sibling or friend. Defiantly disobey.

Teens may become daredevils–drive fast, extreme sports, breaking and entering–anything to feel “alive”

They may even try to “test” your love.

When Do You Seek Professional Help?

When the symptoms (lack of sleep, depression, agression) continue for weeks or months and grow in intensity.

When they can no longer function in school or around other people

When they isolate themselves for too long

When they become dangerous to themselves or others

They fixate on death, experiment on animals, or are exhibiting cruel behavoir

What do you do if you suspect your child or teen is not handling grief well?

Talk to the school counselor, your pediatrician, or clergy

Get a recommendation for a therapist who has helped children through grief.

Don’t settle for just a prescription. Talking and expressing their emotions is crucial to the healing process.

Don’t go just one or two times and think your child is “better.” Follow through and be consistent.

The Best Advice?

Be patient. Expect some some highs and lows. Share your own grief journey. Listen. Reassure. Be there. Provide help if or when it’s needed. Let them know it’s okay not to be able to handle this all by yourself–we all need each other. 

 

In the United States, approximately 4.8 million children under 18

are grieving the death loss of a parent.

~Carol D. O’Dell

Author of Mothering Mother, available in hardback or on Kindle

www.caroldodell.com

Helpful sites:

www.opentohopefoundation.com

www.beyondindigo.com/children

www.griefnet.org

www.childrensgriefnet.org

www.kidsaid.com

I’m Carol O’Dell, author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir, available on Amazon. I hope you’ll visit my blog again.

www.mothering-mother.com

 

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Most people, in fact 85% don’t want to go into a nursing home–that’s what they used to call them.

Many of our seniors cringe at the word and imagine long, dark halls, people screaming, sitting in soiled diapers, horrible food, and being abused. Thank goodness, this is not the norm–and there’s more vigilance to report elder abuse and substandard care today.

According to surveys done by AARP, most of us would prefer to Age in Place–meaning, stay in our homes  and augment care as needed–a mix of family caregiving, professional caregiving services, adult day cares, and other elder-care community based resources.

I highly recommend staying at home, including various elements of family caregiving, paid care, and community care–but I do know that there are times and circumstances when this just isn’t enough.

What Are the Different Kinds of Care Facilities–and Which One Is Right For my Loved One?

Contining Care or Graduated Care is when you buy into a community in which you can choose your living condition (small home or condo at first), and then “trade” it in when/if your care needs increase. Within one “complex” you might see homes or duplexes, condos or apartments, a building (care facility) that houses many units of care, and all these may be near a hospital or hospice facility. These are usually a large development and can offer meals, hired care workers, transportation, activities, and other amenities.

Assisted Living is similar and can be a part of graduated care. Assisted living can be houses/duplex, condos/care facility where the person has their own apartment but has access to additional help. There may be a place for meals, a van for transportation, and non-skilled care workers can be hired to do various needs and levels of care. Some assited living and care facilities are individually owned while others are a part of a larger corporation.

Care Facility or Skilled Nursing Care is considered a full-care facility and is what people think of when they say, “nursing home.” They can be a part of other facilities, such as the continuing care, or assisted living home, but they have the added component of a skilled nursing staff (RN’s–registered nurses) as well as non-skilled care, usually called CNA’s (Clinical Nurse’s Assistant). Care facilities are for people who have medical needs, have severe mobility issues (can’t walk, falls), and need supervision as well as medical care. They often have a staff of doctors and other care workers who will come to visit them, prescribe medications, and offer in-house treatments such as physical therapy.

Memory Disorder Facility or Center can be a part of an assisted living or care facility and focuses on the needs and care of people with neurological disorders such as brain injuries, advanced Parkinson’s or Lewy Body, Alzheimer’s and dementia.This facility has the feature of secured doors and exits so that people who tend to wander can’t leave. They specialize in dealing with the behavoiral, psychological and physical issues that come with neurological disorders. Since this is an area that overlaps, many of their clients need medical care/skilled nursing care/visiting doctors, etc.

Rehabilitation Facility is usually a short term facility that focuses on people recovering from surgeries, accidents, and for those who need various care treatments such as physical or occupational rehabilitation therapies. They are a “half way” facility people go to when they’re not quite ready to go home, or need more care than a graduated or assisted living facility offers. Most rehabilitation facilities are corporate owned and work closely with hospitals and doctors. 

How Do I Assess If My Loved One Should Go Into a Care Facility?

  1. They choose a graduated/continual care or assisted living on their own.
  2. They have no family nearby and no one can or will coordinate their care (don’t forget how helpful geriatric care managers can be in figuring out various stage of care and evaluating care facilities)
  3. They need full-time care, perhaps with needs of skilled nursing care as well–and this has become too much to manage for a loved one to deal with.
  4. Their dementia/Alzheimer’s has increased to a level to where they’re not manageable at home–violent, escapes, can’t be managed by one care helper–needs more supervision, medication, and physical control than the family/and caregivers can provide.
  5. Are at the late stages of various diseases/aren’t mobile/and the family can’t manage their care–perhaps hospice is involved and there are end of life and palliative care needs (pain management).
  6. You, the family caregiver simply can’t do it anymore–your own health or finances are falling apart and you’ve done all you can.

There are valid reasons for your loved one to enter a care facility.

You have not failed as a caregiver–nor are you “done” when your loved one enters a care center/facility.

Your loved one needs you more than ever to oversee their care and make sure they are safe, respected, and receiving all the care they need and deserve.

Also know that the first care facility may not be your last one–it may not be a good fit, you may have to change and try a different one. Also, as time goes on and their care increases, you may have to move them again.

Don’t forget that hospice and palliative care is still needed (and must be asked for) to supplement their care at the end of life.

You may also consider letting them come “home” to die.

You  have many options.

Helpful Links:

Great article:

newoldage.blogs.nytimes.com/2008/07/14/faced-with-caregiving-even-experts-struggle/  

~Carol O’Dell, Author of Mothering Mother–an Amazon Bestseller in Alzeimer’s and Aging Parents.

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The first month after your loved one dies is perhaps one of the scariest,

most dreaded times in a person’s life.

Losing a spouse, a parent, a child is devastating. But somehow, you will get through.

I know you don’t think you will.

But there’s this little thing called breathing. Your body does it whether you want it to or not.

Your heart can be breaking, your gut wrenched, and you can feel as if you will truly lose your mind–and your body will continue to take its next breath. There will be times when you don’t want to breathe. You don’t want to live–the pain is so intense. Just let your body get your through for now.

It’s a divine design–to keep our heart and lungs on automatic.

I’m sure I would have either forgotten or opted not to breathe, not to allow my heart to pump if I had any say in the matter. But this sheer involuntary response is the only way to go on during those early days of grief.

Death comes in many forms–by way of an accident, or after a long agonizing illness–it’s never easy.

Even when you’ve been caregiving for years and you know your loved one is no longer suffering, almost everyone has a difficult time letting go.

Why? Why is it so difficult to watch death take those we love–even after pain and suffering, and even old age?

I believe because there’s something in us that deeply believes in the eternal.

Our brains do not compute that life is simply cut off. I’m not basing this on any particular religion or theology–I’m basing this on biology–we cannot comprehend that someone we know and love was here yesterday–and is not here today. Those who look at this purely scientific would say that it’s mere habit–but something in me feels that it’s more.

Why, after practicing a lifetime of faith, and believing with all our hearts that we will see our loved one again–is it still so hard to stand next to their lifeless, breathless body and kiss them goodbye?

The same reason a toddler cries for his/her mother. We don’t like separation.

And those early days of separation are very, very difficult.

What’s it like? That first month?

Experiencing a death of someone we love–at any age, and for any reason, usually means that we go into shock. Not only have I experienced the death of several loved ones, like you, I have many family and friends who have also experience grief and loss.

By looking at these first few days and weeks, we can begin to see a pattern–in ourselves and others. It’s less scary to know that we’re not alone, and that our bizarre thoughts and actions are something others experience as well.

What is shock?

It’s our body’s response to trauma or pain.

Physically, speaking, shock is when the body isn’t getting enough oxygen. It can occur after an injury when the body shuts down (the blood stays close to the heart to preserve life at its core level–or it can occur after a severe emotional trauma.

WebMD desribes shock as this:

  1. A sudden physical or biochemical disturbance that results in inadequate blood flow and oxygenation of an animal’s vital organs.
  2. A state of profound mental and physical depression consequent to severe physical injury or to emotional disturbance.

If you’ve ever experienced shock (yourself or by witnessing it in another person), one of its prime characteristics is that you’re probably not reacting to pain (physically or emotionally) as you would expect.

Car accident victims can walk around with a head wound or internal injury–and only after minutes or even hours does the body “compute” the damage and begin to react. This may give the person time to rescue a child or get out of a fire.

Emotional trauma shock can present with similar symptoms–the person may talk or act rather normal, even when you would expect them to cry or scream or fall apart. They might eventually do all those things–but it may be weeks or months later. The mind has the ability to stay “in shock” much longer than the body–and it will usually only allow the person to really feel and experience the deepest levels of grief when it’s safe.

The movie, Reign Over Me is a great example of emotional shock.

Adam Sandlerplays a man who lost his wife and children during 9/11. He spends years in “shock,” and the exploration of how this man deals with grief in an unconventional way–and the arguments that the social and mental health community make to try to “fix” him, is interesting.

Every person’s journey with grief and loss is different. Honor yours.

Trust your gut, your shock will get you through.

During the first month you might: (no two people are the same)

  • Be able to plan an elaborate funeral or memorial service
  • Hold yourself together–be courteous, thoughtful and polite
  • Look healthy and strong
  • Go back to work days or weeks after your loved one passes
  • Feel euphoric–an urgency to get on with life
  • Plan a trip, go shopping, or other ordinary things
  • Go off with friends and do things you haven’t been able to do in a long time

But…if you observe grief and shock a little closer, you’ll notice things aren’t quite what they appear on the surface.

You might also:

  • Feel high strung, nervous, agitated
  • Can’t pay attention, get bored or antsy with people
  • Suffer from insomnia
  • Have a panic or anxiety attack when you’re out in public
  • Zone out and not remember where you are
  • Feel guilty and think you caused your loved one to die (by taking them to the hospital, or not taking them, or a myriad of other decisions you had to make)
  • Forget things–your keys locked in the car, your wallet at the gas station
  • Avoid falling apart or crying because you may feel like once you start, you won’t be able to stop
  • Have nightmares, even scary dreams of your loved one coming back alive–but not alive
  • Become obsessed with something–putting your affairs in order, doing something your loved one nagged you about but you put off–but now you’re doing it to excess
  • Do something, anything to feel alive–gamble, go to Vegas, visit online chat rooms, shop too much, eat too much
  • You may start to snap at people–or cling–can’t let yourself be alone
  • Your emotional pendulum keeps swinging wider and wider

Practical Things You Typically Do The First Month:

  • File for and receive the death certificate (that’s tough)
  • Contact your life insurance
  • Decide when or if to go back to work
  • Comfort others around you–children, friends, even when you don’t feel like it
  • Cancel credit cards and put your house or car in your name only
  • Pay the bills associated with your loved one’s passing–funeral expenses, etc.
  • Decide to buy or sell certain items
  • Figure out how to pay the bills or deal with repairs–whatever your spouse/loved one did that you now must do
  • Catch up with your lfe–if your loved one was ill, there may be many things that need your attention now
  • Write thank you notes and figure out how to handle your relationships with this new change

Emotionally You’ll Have To:

  • Make calls and let businesses know your loved one has passed
  • Talk to many family and friends–and some of them will be awkward and say the “wrong” thing
  • Walk back in your house, your bedroom, drive his car–feel his/her presence and be faced with your loss
  • Sleep in the bed he’s/she’s no longer in
  • Deal with clothes, cars and other personal items–even if you don’t start sorting and deciding what you keep, they are with you–in your house and your life
  • Allow your brain and heart to assimilate that your loved one’s not here for you to call–to talk to
  • Wake up and think he’s/she’s still there
  • Feel alone and lost even when you’re busy
  • Figure out who you are now and what to do with your time and energy
  • Think about that “first” that is to come–first birthday without him, holiday without her–and make a plan
  • Literally survive the best you can

For most people, the first month is a blur.

At times, you’re in bone crushing grief alternting with an odd euphoric gotta-get-out feeling.

You can bite someone’s head off or not even care if the shoes on your feet were on fire.

There’s a lot to do, and that list of wrapping things up and starting anew at least keeps your keep moving. The good news is: you probably won’t remember most of this.

Shock does a whammy on the brain. You may feel like you’ve put your skin on inside out–and your nerve endings are exploding–but later, there will be many things you can’t recall.

Your body is protecting you. Let it. J

As crazy, lost, alone, scattered, numb, and frantic as you feel in those first months, know that as hard as it is to believe, it won’t last forever.

Just breathe.

Carol D. O’Dell

Author of Mothering Mother, available on Kindle

www.caroldodell.com

Carol is a family advisor at www.Caring.com

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