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Archive for the ‘senior care’ Category

Last week I was asked as a Caring.com senior expert to speak on NBC Miami Live show and talk to folks in South Florida about how to choose a senior care facility for your aging loved one. Sometimes no matter how much we want to keep our loved one in their own home, or with us, it’s jut not possible. Working caregivers, frequent falls, severe dementia or other round the clock care needs can make it impossible for your loved one to remain with family. If, or when that time comes, it helps to have a plan and to already know your area and what it has to offer for families.

Here is a link to Caring.com’s YouTube channel to view the NBC Miami Live interview:

http://www.youtube.com/user/caringcom#p/u/0/u_8LHy-Cjto

It’s such a big decision and you want to make sure your loved one adjusts and is safe and well cared for. Are there specific points to help guide you through the search? It’s so overwhelming I thought I’d just bring up three key points to help guide you.

3 Tips to Consider When Searching for a Senior Care Facility:

  • Look past the fancy “storefront” and notice how folks are being treated. More and more facilities are beginning to look like country clubs, and that’s great but real care is what you’re after. Look past the golf carts that whiz you in and out, look past the luscious garden-like entrance, past the swanky lobby and even ask to see something other than the staged guest room all decked out with new pictures on the wall and a great view of the courtyard. Ask to have lunch with the residents. Stroll to the community center or gathering room. See if you can go down the hall where your loved one might be placed and see who their neighbors will be.
  • Don’t just take the tour–branch off–ask the residents (and their family members) who live there. Ask the residents if they like the food, if they get their medications on time. Ask their family members if they’ve ever had a bed sore or have problems with any of the staff or other residents. Even if they say the right words, notice how they hesitate, get antsy, or look around as if they’ll be heard. If your loved one has dementia ask to see that ward. Make sure there are safety measures for them not wandering away, and also make sure they are spoken to in a firm but kind manner. Look in their faces and see if they have that hazy drug look. Notice if they’re dressed, if their rooms are tidy, and if there’s a smell of urine in the air.
  • Ask how concerns will be handled, and what you can do if you need to change care facilities. Face it, you’re going to have certain questions and concerns. You’re going to have to ask them if they’ll change something to accommodate your loved one’s needs–that’s just normal adjustments. Find out how that’s handled up front. Talk to not only the day staff, but the night and weekend staff. Ask how they do their background checks and if they’re updated. Ask how you handle serious issues and what happens if you choose to move your loved one to a different facility.

Don’t think that once you move them in that your job as a caregiver is over. It’s not. You’re their care advocate. Visit often and not at the same time. Be cordial with the staff, get to know them and genuinely care about them. Bring in a treat or send them a thank you card if they’ve done something thoughtful or helpful. People respond to positive reenforcement and caring for a (sometimes) cantankerous, sick person who isn’t always jolly is more than a job, it’s a calling. It’s to your benefit to reach out. People who are visited often receive better care, and besides, it’s just the right thing to do.

There’s so much more I could talk about, but this is enough for now. In the end, follow your gut instinct. Stay involved and do all you can to surround your aging loved one with good care–no matter where that might be.

~Carol O’Dell

Author of Mothering Mother, available on Kindle

Got a caregiving question: Send it to me, Carol O’Dell, Caring.com’s Family Advisor at Carol@caring.com

(NBC Miami Live interview is now on Caring.com’s YouTube channel (click on link below):

http://www.youtube.com/user/caringcom#p/u/0/u_8LHy-Cjto

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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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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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I opened my front door Thanksgiving morning and called “Here kitty, kitty, kitty.”

My 14-year-old cat, FatBoy had been missing 18 hours. I was up late in the night looking for him. He never went far, hanging around our shady front porch, but most eating (thus his name) and sleeping in various windows, beds, and closet corners throughout the house. No answer. No meow. I was in full worry mode. I’m no stranger to death. I know that losing  a pet isn’t like losing a parent or spouse, or child but nothing in me wanted to go through this again. Not today. Not Thanksgiving.

My husband and I took our bikes and began to ride around the neighborhood calling him.

And then I saw him.

My husband threw down his bike and got to FatBoy before I did. His hands went to his heart. He ran half way to me, turned and back to FatBoy, then back to me–not knowing what to do.

And then he held his arms open and I folded into his chest and cried.

We’ve been through so much together. He held me when my adoptive Daddy died, the big teddy-bear hero who gave me a home and made the world right again. I held him when his brother-in-law died in a head-on car crash. Bill swerved the car and spared the life of his wife and daughter. My husband identified the body. I held him at four in the morning when he returned from the morgue and collapsed in my arms. He held me when my mother died after years of Parkinson’s and Alzheimer’s, when exhaustion gave way to release gave way to void. He sat beside me on a sailboat as we helped to scatter a dear friend’s ashes into the sea, feeling our own mortality. We’ve stood side-by-side as we witnessed the death of friends, family, and yes, our beloved pets and remembered their lives in that bitter-sweet time of letting go. I can barely grasp what it would be like to lose him. I can’t even let myself glimpse into that sorrow.

Who would hold me?  Who would I hold?

I’ve learned a thing or two about death. I’ve learned to not stop the pain, the tears. I’ve learned to accept the love, the support.

I stayed with FatBoy while Phillip went back and got a blanket. He was in a garden behind a small white picket fence. I call this particular neighbor’s house the Thomas Kincaid house. His paintings are warm cottages with trees and shade, and dappled sunlight. It was quiet, a little cool. I could sit with him. Be with him. I wasn’t afraid or nervous. It was just him and me.

My husband dug a hole in the backyard and we decided to bury FatBoy under my Buddha statue. I bought the laughing buddha for my birthday last May–did I somehow know? I laid my sweet, chubby, always there for me kitty into the earth and sprinkled the first handful of cool, moist dirt on top. I wanted to do this.I was fully alert and present. It wasn’t like Daddy’s funeral. I was 23, so young, so scared. I turned away when they lowered him into the ground. Today, I don’t need to turn away.

It felt right–for him to die in a garden and be buried in a garden. In the spring he’ll be surrounded by cannas and irises and calla lillies. There’s a windchime in a Live Oak nearby.

Our youngest daughter joined us. She hugged me–full body. We held  on to each other, neither of us in a hurry to let go. Our middle daughter arrived for the day’s festivities. She’s the director of a massage therapy school and could charge for her hugs, they’re so good.  I felt my muscles give way, and then her husband–a former wrestler with a wide chest and strong biceps curl around the two of us. My friend, Laura arrived and ran to me. She has four cats, and we cried and cried.

I’m tired of holding it all in. Tired of trying to be strong. Tired of keeping it all together. Each person, their arms, shoulders, necks and kisses comforted me. I allowed each of them to minister to me, feed me, be my strength.

We all pulled the meal together, sat down at the table and took hands. And I realized that it was good day for a death–I was surrounded by people I loved and who loved me.

The love that surrounds a death is healing. It’s comes in time. You’re ready when you’re ready, when life has brought you here. It will come.

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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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Caregivers are often told to take care of themselves, and sometimes this advice is a little annoying.

Exactly how am I supposed to take care of me? Not give my mom her pills in the morning? Go to the gym instead?  Not take her to physical therapy? Not help my kids with their homework or fix dinner? Just soak in the bathtub all day? Right…

Yes, the stress builds and you can’t sleep, you’ve gained 40 pounds and you’re pretty sure you’re depressed but you don’t care to go to the trouble it would take to find out. Self care sounds like a fairy tale most days, but don’t think that the self-help movement is some new-age 70s feel good way of thinking. It’s not. In fact, it’s as old as Socrates…

One of my favorite books is Eye Witness to History, edited by John Carey. It’s first hand accounts recorded throughout history, and as a memoirist and writer, I love having a front row seat to the most stunning and scary historical moments man has ever witnessed.

The first account is written by Plato and recounts the death of Socrates. The year was 399 B.C., and for those of you (us) who might be a bit fuzzy about Greek history, Socrates was a philosopher and teacher, (and he’s still widely debated today–both as an individual and for his teachings). He got in a bit of trouble with the Atenian government and was considered a “gadfly”  (a fly who stings the horse into action). He wound up in prison and was proved guilty of corrupting the minds of the youth of Athens (political minds, that is) and was  ordered to drink a deadly mix of hemlock poison, which killed him.

On the last day of Socrates life, his friends, including Plato came to visit him and asked,  “Do you wish to leave any directions with us about your children, or anything else. What can we do to serve you?” 

Socrates replied: “Nothing new. If you take care of yourselves , you will serve me and mine and yourselves.” 

So this idea of caring for yourself first is the best way to care for another isn’t new. It just makes sense and that’s why it’s been around for so long. When we “sacrifice” ourselves for too long, we lose ourselves, we deplete who we are. Sometimes it’s needed–giving all you have–but it isn’t a sustainable long-term model.

During the last couple of years of my mom’s life (she had Parkinson’s, heart disease and Alzheimer’s), I can tell you, there wasn’t a whole lot of self-care going on. I had to pull it out–long hours, lifting my mom, hospital stay after hospital stay. I rested when I could–napped in the middle of the day–or any other time for that matter, took long showers. when my family members could take over “mom duty.”

I simplified my life–letting go of work, friends, saying goodbye to many activities–but I held onto a few lifelines. I journaled every day. Not a lot, but when the tears or screams built inside, I’d anchor them onto a page. I slipped  outside to pray and think, allowing nature to nurture me. I returned to take a college class one night a week–up until the last six months of my mom’s life. I got a new puppy to bring us all joy and laughter and remind us that life does indeed go on. Other aspects of my life were put on hold. That’s just part of it–for a season.

Self-care isn’t always a bubble bath and candles. It isn’t impractical nor is it selfish. The only way for a caregiver to do it is to incorporate small amounts of self-care throughout the day. Read a line or two of a poem. Buy your favorite coffee and refuse to get up off that couch and take care of anyone until you drink that first cup. Put a lock on your bedroom door and use it. Take short five-minute walks in your yard. That may be all the self-care you get to, but those few snatched moments here and there add up.  You’ll find a sense of calm comes over you when you’ve honored your own soul.

Take care of you and yours and you will serve me well. Good advice. No wonder Socrates is still remembered today.

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It’s not what you think. Caregivers don’t dread the work, giving up aspects of their lives, or even the inevitable moment of death that’s to come.

I recently spoke at a caregiving event (sponsored by my friends at Community Hospice of North Florida) and I asked caregivers what they feared…and a quiet, thoughtful gentleman shared:

“I fear that something will happen to me and I won’t be able to continue to care for my wife.”

That’s one of the biggest fears–that our loved ones won’t be cared for.

I’m sure it’s different for each person, but there are a few fears that most caregivers have in common.

What’s your biggest caregiving fear?

By asking yourself this question, you can then face it and then begin to explore solutions.

I knew the second this gentleman said it, that it’s a big fear, especially for those caring for spouses. 

And yet, most caregivers don’t take proper care of themselves. They put off their own doctor appointments, forget their own medications, and go dangerously  low on sleep and rest. Most caregivers are generous, kind-hearted, and conscientious–with others, but forget to give themselves the same respect and attention.

Spouses worry about their ability to care for their husband or wife more than any other group. They’re typically close to the same age, which means they probably have health issues of their own. They want to keep their partner at home, with them, and make sure that every need, every inkling of a desire is met–but they can’t if they’re not here.

Adult children, sons, daughters, and other family caregivers fear burning out, giving up, or the onset of some disability/illness that will cause them to be unable to stand up to the unrelenting workload and emotional load that comes with caring for others.

Caregiver stress is a real problem in the care community and that concern takes on a physical manifestation in the form of heart disease, cancer, depression, or arthritis.

Caregiver Fears:

  • What if I die before my loved one? Who will care for them?
  • What if my back goes out?
  • What if I have a stroke or my cancer comes back?
  • What if I can no longer lift or move my loved one?
  • What if I lose my temperand do something I’ll regret? 
  • What if my depression gets worse?  
  •  What if I start forgetting important things like medication or if I left the stove on? 

The bad thing about fear is that it’s paralyzing.

We don’t run or yell or scream like we should (Ever watch a horror movie? The girl just cowers in fear). That’s our first reaction, but then we need to realize we’re in the grips of fear and make a plan–face the fear and decide our course of action.

My gentleman was still reeling from admitting his deepest fear, so it was important to give him the time and space to process his revelation. I asked him, and other audience members if they had a plan–a back up plan, and then I led him to some community resources who could help him figure out what would be “Plan B.”

Ask yourself: What can I do to give myself a sense of peace that my loved one will continue to be cared for?

Do you need to change your will? Ask someone to be his/her guardian and care advocate? Check into care facilities or purchase long-term care insurance? There are no easy answers, but doing something is better than doing nothing. Start small. Make a call. Ask someone.

My gentleman friend needed to know he had choices–agencies such as the Council on Aging, Urban Jax (in our area) and the Alzheimer’s Association who could help now, offer respite, home health care assitance–and later, he needed to consider small care home, memory disorder care home nearby (his wife had Alzeimer’s), information on Medicare.

By the end of the day, he said he felt better. He needed to face it, to say it out loud. He went home with the beginnings of a plan.

We tend to fear the unknown, and in the “caregiving world,” there are lots of unknowns. We turn our fears into monsters and we hide, deny, and ignore in order not to look at them. Their shadows loom above us, but when we turn on the light, admit our deepest fears and take a look around, we realize  we’re not alone.

The best way to defeat a monster is with the help of a few friends.

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