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Archive for the ‘healthcare’ Category

It’s not that most caregiving families want to, but there may come a time when your spouse’s or elder-parent’s care becomes more than you can physically or emotionally manage at home. Caregivers need to look past the initial bells and whistles of a care facility to make sure that your loved one is receiving the very best care at all hours of the day and night.

How to Choose a Care  Facility For a Loved One:

  • Plan early—don’t wait until it’s an emergency. The highest rated
    care homes usually have a waiting list.
  • Don’t pay for more than you need. Know that cost rises with care needs, so don’t pay for services your loved one doesn’t need–yet. Ask if they have a graduated care situation or whether your loved one will have to find another home if their care needs increase.
  • Consider smaller care facilities or even a group home. Bigger isn’t always better.
  • Don’t get razzle-dazzled by fancy entrances/amenities. Look past all that and notice how the staff interacts with their residents–are they caring, engaged, friendly, and prompt?
  • Visit several times/and several shifts before making your
    decision–and eat the food for yourself–and if you can, talk to a resident or family member of someone who’s already living there
  • Consider visiting with a friend or someone who is impartial and can notice things you don’t want to–or can’t see.
  • Ask other caregivers if they know about this facility and
    “what’s the word on the street?” Check out a care home rating site such as the ones listed at: http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=268
  • Check online for more facility information and reviews–Caring.com lists care homes, facilities and hospices in your area–along with helpful checklists and other info to assist you http://www.caring.com/local
  • Does the facility offer family support services, such as caregiver support
    groups and family event days?
  • Discuss how client and family concerns are handled, what is the
    protocol for disputes? Also find out the procedure for how to move your loved one to another facility if that becomes a necessity.
  • Ask about turnover rate of employees and residents. If people are happy–they stay.
  •  Ask how they screen their employees and how often this is
    updated (know that some care facilities allow employees to have misdemeanors, etc. on their record)
  • Ask to view the ACA survey. It will list the facility’s records on everything from safety records, employee issues, MRSA and other infections, bed sores, accident/fall rates.
  • How is orientation handled and what efforts are made to
    integrate your loved one with the staff and other clients?
  • Find out if your spouse/parent’s doctors/hospital serve this
    care facility or if you will have to find all new doctors. (Many physicians or their assistants visit care homes, which can make it easier than your family member having to make a trip into the doctor’s office.
  • Consider location and how often you–and others–can visit.
  • Consider other location factors–should your loved one stay in their own community where they have friends, doctors, and religious support?
  • Never forget that you are your loved one’s care advocate. Stay involved, hang out, and continue to be aware of their physical, financial, and emotional needs.
  • Visit often and make sure it’s not a “to do” session. Caregiving can strip you of your most important role–to be the spouse, partner, daughter or son. Once your loved one settles in, then it’s time to make an effort to be their emotional support–brighten their day by wearing a smile, bringing small presents, taking them outside (if possible) or bringing them home for a few days around the holidays.

~Carol O’Dell

Author of Mothering Mother, available on Kindle

Other great care facility information can be found at:

http://www.caring.com/articles/caring-checklist-evaluating-an-assisted-living-facility

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I’m heading to France this summer and I’m taking a small photo of my dad standing in front of the Eiffel Tower during World War II. This Memorial Day we honor those who have served in war. We remember what they did. How they defended us. How they stood up for the helpless, the defeated. And now, many who have fought for our country are our elders. Their bodies are failing–and it’s our job to care for them and to give them the honor they deserve. Caregiving is more than meeting someone’s physical needs. It’s about remembering–all they are and have ever been.

Our fathers and grandfathers, brothers and mothers helped to stop Hitler–among others intent on destroying life. That’s amazing–and there are still atrocities going on in the world. People are still not free, and as flawed as we are, we still stand for justice. Maybe our government has mixed motives, but the men and women who serve in our Armed Forces have some pretty high ideals. We don’t want tyrants to take over, to kill and destroy, to obliterate the simple opportunity to live and work, marry and have families, eat and make a life for themselves and those they love.

So this weekend, look someone who has served our country right in the eye–and say thank you.

Ask them what it was like–to be “over there,” to be scared, to liberate a country, to ride in a tank. Give them the chance to tell their stories. Give them the opportunity to talk about it, for their chest to fill with pride. For them to relive their glory days. Get out those albums. Hang a flag. We’re far less patriotic than previous generations, and yet we are the ones reeping the benefits of their valiant efforts. Forget politics. Thank the men and women who protect us–who gave their time and for many, their limbs for something bigger than themselves.

I’m taking that photo of my dad to Paris with me. He was a sharpshooter and he helped to liberate France and Germany. He fought at the Battle of the Bulge. He stayed two more years to rebuild Paris. He absolutely loved serving our country–and now, he’s gone–but I won’t forget. I’ll tell his stories. I’ll visit Paris and Normandy. I’ll wear his dog tags.

~Carol O’Dell

Author of Mothering Mother, available on Kindle

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All of us worry about aging. Perhaps we should worry less–and learn from a pro. So, who’s the oldest person who ever lived?

The oldest woman (that can be documented) is Jeanne Louise Calment. She lived to the age of 122.

Born in Arles, France, February 21, 1875, and left this earth on August 4, 1997. Now, that’s impressive–but what’ more impressive is her mindset, her ability to embrace challenges and change. If anything is the key to longevity–with quality–it’s embracing challenges and changes with a measure of wit and grace.

What attributes do you need to live a long, healthy, and meaningful life? Living past 100 isn’t just about longevity–it’s about quality. Being a caregiver, I got to see “old age” close up. My mom lived to the age of 92 and it was only the last two years that were extremely difficult. ( My mom had Parkinson’s, Alzheimer’s and heart disease). There isn’t always rhyme or reason why one person makes it well past 100 with a sharp mind and a spry body while another person seems to hit one health problem after another.

Many centenarians have eaten what they wanted, smoked, drank (usually in moderation)–while someone else who tries to follow all the rules finds a not so pleasant diagnosis. Life isn’t fair. That’s a mantra we must embrace–and not in a negative way–but by choosing to love what is kind of way, and knowing the only thing we can change is our attitude.  Life’s a crap shoot, so let’s play some craps.

Highlights of Jeanne’s Louise Calment’s Amazing Life:

  •  Born the year Tolstoy published Anna Karennina
  • Born one year after Alexander Graham Bell invented the telephone.
  • She met Vincent Van Gogh in Arles, her home town, when she was just 14. She wasn’t impressed.
  • In the end Calment was blind and almost deaf, but she kept her spunk and sharp wit to the end.
  • At age 121, she released her two CDs, one in French and another in English titled, Maitresse du Temps (Time’s Mistress). the CD features a rap and other songs. She wrote or contributed to five books.
  • Her husband died of a dessert tainted with spoiled cherries–she was a widow for more than half a century.
  • She outlived her only daughter who died of pneumonia at the age of 36. She raised her grandson who became a medical doctor and  lived him as well (he died in a car accident in 1963).
  • Calment took up fencing at the age of 80, and rode her bike until 100.
  • Calment enjoyed port wine and a diet rich in olive oil–and chocolate–two pounds a day.
  • At the age of 119 she finally agreed to give up sweets and smoking–because she could no longer see to light up.
  • Calment enjoyed a life of relative ease–from a bourgeois family, she always had enough money–not wealthy mind you, but enough.
  • She was active–and enjoyed tennis, bicycling, swimming, roller skating, piano and even opera. In her later years she sold some of her real estate and lived comfortably in a nursing home in Arles until her passing. She was affectionately known in France as “Jeanne D’Arles.”

Calment’s attitude and longevity s attributed to her decision not to worry: “She never did anything special to stay in good health,” said French researcher Jean-Marie Robine.  She once said “ If  you can’t do anything about it, don’t worry about it.”
Calment recommended laughter as a recipe for longevity and jokes that “God must have forgotten about me.” ( L’Oubliee de Dieu?) as her reason for her long life.

For skin care, she recommended olive oil and a dab of make-up.  “All my life I’ve put olive oil on my skin and then just a puff of powder.  I could never wear mascara, I cried too often when I laughed.”

Calment’s Quotes:

“I’ve waited 110 years to be famous, I count on taking advantage of it,” she quipped at her 120th birthday party.

Also on her 120th  birthday, when asked what kind of  future did she expect, she replied “A very short one.”

Getting used to growing media attention with every year that passes, she quips:  “I wait for death… and journalists.”

“When you’re 117, you see if you remember everything!”   She rebuked an interviewer once.

On her 120th birthday, a man in town said, “Until next year, perhaps.”

“I don’t see why not,” she replied. ” You don’t look so bad to me.”

Clement’s Best Quote:

“I’ve never had but one wrinkle, and I’m sitting on it.”

I don’t know about you, but aging like this doesn’t sound too bad. It sounds like a good life.

Enjoy life, learn to let go–even of those you love, crack a good joke, eat what you love, and don’t worry about the rest.

***

Mothering Mother is now available as an e-book! (click here to order for your Kindle)

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After a decade of caring for my mother who had Parkinson’s, Alzheimer’s and heart disease, then brought her into our home the last 2+ years of her life, this is the distilled version of what caregiving taught me. I am profoundly grateful for these lessons.

  1. To stand up for myself, and caregiving will give me plenty of opportunities to do so.
  2. There is a time in life in which you sacrifice for someone you love–and a time to stop sacrificing.  
  3. It takes humor to tackle the big scary things in life, like caregiving, disease, and death.
  4. Caregiving will inevitably bring out the worst–and the best in me.
  5. Caregiving will change me, but it’s up to me to determine how.
  6. I can’t stop death.
  7. I can decide how I will live the next moment of my life. One moment at a time.
  8. My emotions are my body’s barometers. I need to listen to these cues, feel them, use them as a catalyst, but know that no one emotion will last forever.
  9. To pace myself. Burnout is very real and very dangerous.
  10. I can’t meet all the needs of another human being. I can’t take the place of my care partner’s spouse, career, friends, or health.
  11. Caregiving is about integrity. I have to choose what is right–for me–and for all the others in my life. No one person gets to be the “only one ” 
  12. When I start to give too much to caregiving, it means I’m avoiding some aspect of my own life’s journey.
  13. Caregiving  isn’t just about caregiving. It unearths every emotional weak spot I have–not to destroy me–but to give me a chance to look at, and even heal that area.
  14. I have to stop being nice and pleasing people. “They” will never be satisfied or think it’s enough. What’s best for me–truly, deeply best–is best for those around me.
  15. Learning to stand up to relatives, authority figures, to my parent or spouse, and even a disease teaches me to be brave, a quality we need.
  16. Give up perfect. Go for decent. Do more of what I’m good at–and ask for help on the rest.
  17. Don’t isolate myself. Being alone, depressed, and negative is easy. Fighting to stay in the game of life–that’s tough, but worth it.
  18. If or when my care partner needs more care than I can provide, or even dies, that doesn’t mean I’ve failed. It means I’ve done all I could and it’s time for change.
  19. You will go the distance. You will live at hospitals, stay up night after night, weep in the deepest part of your soul, question everything you’re doing…and barely come out alive. Caregiving asks, takes this from you. Through this process, you will transform. You will see who you are–the whole of you. You will survive.
  20. Choose to care-give–then do with heart and guts.

To love makes us brave. To be loved gives us courage.

                                                                                                                                       –Lao Tzo, Chinese Philosopher

Carol O’Dell

Author of Mothering Mother

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Dr. Christiane Northrup did a PBS talk on the Wisdom of Menopause in which she reminds me that nothing–not caregiving–not menopause is brought into my life to destroy me. It’s to make me pay attention. To love and accept myself more–not less. Over-caregiving is more common than you think. I’m guilty of it myself–at times. I had to learn that I couldn’t fix my mother–I couldn’t take the place of her beloved husband after Daddy died. I couldn’t stop Alzheimer’s. I couldn’t be her all in all. And I had to stop trying.

Dr. Northrup used the excellent model of breastfeeding to correlate how we should care-give. Being a young mother is another time of extreme care. We physically and emotionally give our all to birth a new life. In order to breast feed, you have to feed yourself. You use up 600-1000 calories a day breastfeeding. What you eat, how you sleep, how stressed you are–all effects your ability to produce milk. If you go for even a few days without eating healthy and sleeping well, your milk production will begin to wane. What a great example. You can’t give out, unless you give in. Your body–and your spirit just won’t do it.

She also mentioned that a doctor friend of hers wrote on his prescription pad to a woman “See your mother ONLY 2 times a week.” Doctor’s orders. Sometimes we need others in authority to give us permission to take better care of ourselves.

I remember one day when my mother shuffled into my kitchen with a scowl on face. She slammed her hand down on the counter and announced,

“I”m not happy!”

She had a “and what are you gonna do about it look on her face.”

I started to smile. Revelation.

I realized in that moment that the only person I could make happy–was me.

We can never fill up another human being. We can’t make up for aging and disease–or for their lack of caring for their lives and health all along. Our best way to give is to know what ways ive best.

How do you know when you’re over-caregiving?

When you have zero time for your own health and relationships. But, but…you argue. If you are getting less than 6 hours sleep, are spending all your time taking care of someone else’s physical and emotional needs, feel like your stress levels are above an 8 almost all the time, then yes, you’re over-caregiving.

How to stop over-caregiving?

Care-give  ala’ carte style. Pick and choose and don’t even try to do it all.

What are you good at?

What does your mom–or dad–or spouse value?

What seems to be working?

What isn’t working?

So, if you’re a great cook and they eat for you, then cook and fill their tummies with homemade soup and decadent brownies.

If they like for you to be at their doctor’s appointments, then build that into your schedule.

If you tend to fight every time you start trying to organize their house–then quit.

But I dont’ have a choice. If I don’t do it, it won’t get done.

Then it won’t get done. Be willing to live with it.

For example, I stopped going to re-check appointments. My mom had Parkinson’s and Alzheimer’s, as well as heart disease. I took her in for her six month check-ups, but no follow-ups. I got her meds and created a structure we could live with. I dealt as best as I could with the emergencies that came up.

I also said no to hospitalizations. They wanted to try exploratory surgery. Really? On a 90 year old with all these conditions? I said no. The medical profession looked at me as if I were a bad daughter, but I didn’t care.

Ask yourself: Does it need to get done? Will it improve the quality of life enough to warrant the work/commitment?

Yeah, some things do. But do the minimum in the area you’re not good at or don’t think it will pay off. Or ask someone to help.

If you have to choose–choose to meet your needs first.

What?

Yep, that’s what I said.

You can’t reverse Alzheimer’s once it’s started.

But you can prevent heart disease (the number one killer in the US) in your own heart!. Go for a walk. De-process food your house. Sign up for yoga. Rent all your favorite funny movies and invite a friend over for a laugh fest.

Sounds too simple? It’s because it is simple. Choose health CARE over health-care. Do what you can, but know that you can’t undo another person’s diseases or problems. Love them, make life comfortable, and give up over-caregiving.

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Who is an invisible caregiver?

Millions of spouses, adult children and friends who are caring for someone they love–but having to “do it on the sly.” It’s a tough transition, to admit you need care. After decades of being the strong one, the provider, the professional, the hub of the family, admitting that you need help in and out of the bed, in and out of the car, or down the stairs because of a chronic illness, disease, or after surgery can feel like a blow to the ego.  And it’s not who they are. Call is pride, but there’s a time in a person’s life when they aren’t ready to admit they need care. Their worth goes far beyond their need for help.

I met a gal last week who is caring for her husband, but it’s not a label she gives to herself. He has MS and is in a wheelchair. He’s on disability and yet he strives to see himself as he always was–a competent businessman, father, friend and spouse. He is–all those things–but he needs a little help now and then.

They married last year and their devotion and honeymoon love is obvious. They look at each other with such tenderness. She walked into this relationship eyes open. His disability isn’t what she fell in love with–it’s his charm, his wit, and his generous spirit. But his disability is something they have to work around.

She helps him dress–on difficult days. She makes sure his meds are delivered on time and she helps him sort them and reminds him occasionally (wives tend to do that–some people call it nagging but it’s all in the interpretation). She washes his hair. She works her schedule around his so she can accompany him to doctor visits so she can help manage his care. And since he’s prone to infection, she takes extra care to keep their environment germ-free–and keeps masks available for when they’re out in public during flu season.

The other night, he had a fever and decided to sleep downstairs on the couch. He just didn’t have the strength to head upstairs, change clothes and do his normal bedtime routine. She slept in the recliner next to him and checked on him several times that night–to make sure his fever didn’t spike.

Yes, technically she’s a caregiver. But her husband is a young 50 years old,  and his disease takes such a toll on his life and health that she doesn’t want to see him as needing care. He wants to be seen first as a man. That’s how she chooses to see him as well.

There are times when naming something brings a sense of relief–so that’s what it is. The definition helps define us. And then there are times, as in this gal’s case when it changes the relationship. She’d rather be an “invisible caregiver.” She’d rather consider herself his wife, his companion, his confidant.

Caring for a spouse isn’t a role. It comes with “I do.” All the invisible caregivers out there–spouses, children or friends do it out of love and loyalty. They choose to camouflage the care they give in order to keep the emphasis on the relationship–to give their loved one the dignity and respect they deserve.

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“You want to see my new girlfriend?” My friend’s husband teased his wife one day as I was visiting her in the hospital. He is her caregiver, her husband, her lover, her muse and mentor  of 40 years, and her illness had put a real strain on their relationship. 

He pulls out his wallet, takes out a picture and shows it to her. I can tell it’s a joke because he’s grinning from ear-to-ear. She breaks out in laughter despite her pain. They show me the picture.

It was a picture he had taken of his hand!

My friend was in the hospital–that time for close to three weeks. She has a chronic disease that has attacked her intestines. Her husband had sold his business and they had rearranged their life to accommodate this hostile addition to their family–illness.

Both of them had visions of their golden years–traveling in their RV, grandchildren, financial security, and lots and lots of leisure and fun. Hospitals, drugs, and pain was not what either had in mind.

To say that their sex life diminished is an understatement.

To say that sex doesn’t matter in the face of disease and pain is to not look at the whole situation. Sex does matter. It’s the one thing couples do together that they don’t “do” with anyone else. It’s a glue, a bond, a secret language, a healer of life’s wounds…to simply and biologically state it, sex is a needed release.

More magazine has an interesting article in September 09’s issue on this very subject. They state that 75% of all marriages that are dealing with chronic illness long-term end in divorce.

These aren’t shallow people. This isn’t Jon and Kate splashing their news on the headlines (not that they’re shallow, marriage is tough and I hurt for them and their children). These are quiet, hard working, family oriented people who  face surmounting, mind-boggling stress, heartbreak, financial ruin, unbelievable and unrelenting pain. And the one thing that can combat all this–their marriage and the healing powers of sex and intimacy–are taken from them.

How do couples get through caregiving and the strains it places on their marriage?

I observed my couple friends and this is what I’ve gathered.

You readjust.

You let go of what you thought life would be.

You dig deep to find your integrity.

 You find joy in the smallest of things. You find purpose as a caregiver.

You use your anger not at each other like weapons of mass destruction, but together, to get things done, to let off steam, to keep from going crazy…and you turn that anger into humor–maybe a little sick and twisted–but it keeps it from turning toxic inside you.

You do what you have to do to get by–and it’s nobody’s business. How you define sex may be different than other couples, and how and when you’re intimate may not fit the national average.

You get strong and tough and tender and real all at the same time.

I have no big answers here. It’s too complex and too gritty to give you bullet points–as if you could fire them on target and make it all instantly go away. What I have gathered from my friends and others I’ve seen going through years of what illness can do to a relationship is that the ones that make it create this circle of energy around themselves. They are one.

Couples who face caregiving challenges together have come through the fire, and on the surface, no, life didn’t turn out like they thought it would–but in many ways, it’s better. I witnessed it in my parent’s marriage.  The unity, the simplicity, the bond they have, they earned. You can see it in their eyes, they familiar gestures of thoughtfulness, the resolve in their voice. They have something profound.

~Carol O’Dell

Author, Mothering Mother

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