Open Wide and Say Ha! Three medical jokes for your week.

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FIRST JOKE:

A woman accompanied her husband when he went for his annual checkup.  While the patient was getting dressed, the doctor came out and said to the wife, “I don’t like the way he looks.”

“Neither do I,” she said, “but he’s handy around the house.”

SECOND JOKE:

Three doctors were on their way to a convention when their car had a flat.  They got out and examined the tire.  The first doctor said, “I think it’s flat.”

The second doctor examined it closely and said, “It sure looks flat.”

The third doctor felt the tire and said, “It feels like it’s flat.”

All three nodded their heads in agreement.  “We’d better run some tests.”

In this Blogger’s humble opinion, I guess that’s a hint at why the health-care system is broken.  Yes?  No?  Probably.  Which leads us to the LAST JOKE of the week:

A physician went to heaven and met God, who granted him one question.  So the physician asked, “Will health-care reform ever occur?”

“I have good news and bad news,” God replied.  “The answer is yes, but not in my lifetime.”

Honesty is NOT always the best policy.

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Bear with me – don’t judge me quite yet.

You are not destined for Alcatraz just because of a little well-placed dishonesty.

If you are primarily responsible for a loved one with Alzheimer’s or other dementia, or perhaps you assist an elderly relative who relies on you for help, do you find yourself telling little white lies?  Do you stretch the truth a bit in order to keep the peace?  Without doing any harm to your loved one or anyone else, do those little white lies help you accomplish tasks on behalf of your loved one, thus improving their life?  Congratulations – you understand that honesty isn’t always the best route to take and you’re in good company.

How do you jump over the hurdles of negotiating with a loved one for whom you provide care?  Here are a few examples that come to mind.

Scenario one: the need to get creative in order to leave the house for personal business.  For example, if telling your wife that you’re going to a caregiver support group meeting makes her mad, sad, or distrustful of your intentions, (“I’m sure you’re going to say bad things about me!”), why not tell your spouse that you’re going out with the guys, and you promise you will be back in two hours.  Then make sure you’re back on time!  If you’re not comfortable with that lie, by all means, every month you can continue to explain how helpful this caregiver support group is to you and how much it helps you be a better husband; and month after month your wife will not understand your rationale and will feel ashamed.  Knowing that you’re going to a support group only confirms how miserable she’s made your life. Read the rest of this entry »

Life can turn on a dime.

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If ever there is an example of how life can turn on a dime, it’s Congresswoman Gabrielle Giffords’ tragic experience.  January 8, 2012 marks one year since Ms. Giffords was shot in the head while meeting with her constituents in Tucson, Arizona.

The bullet traveled 1000 feet per second into her brain and not only did she survive, even her neurosurgeons termed her recovery a miracle.  Is Ms. Giffords back to 100%?  No.  Will she be?  There is a strong hope that she will.  As her husband said to Diane Sawyer when asked if he’s holding out too much hope: “You can’t have too much hope!  That’s not practical!”  In her ABC special on 20/20 chronicling Congressman Giffords’ and her husband, Astronaut Mark Kelly’s journey, Diane Sawyer characterized their endeavors in this manner:

 The courage & love you bring when the life you live, is not the life you planned.

Life turns on a dime in many ways: in relationships; in difficult financial times; and in sickness and in health, to name just a few.

Some of you reading this Blog are in the midst of a life trauma that you certainly didn’t plan, and from which you wish you were released.  What challenge do you face?  Did you see it coming?

One story of life’s changes. I volunteer as a Facilitator for an Alzheimer’s Association caregiver support group.  Every member of our group has a loved one with some sort of dementia diagnosis.  Some are in the early stages, some are in the middle stages, and three in particular recently experienced the end stage.

RRRING!  A telephone rings in the middle of the night and life changes for caregivers gearing up for the Holidays with their family.

In the wink of an eye, life as they knew it took a sharp turn.  It’s the Holiday season and suddenly one set of caregivers hires in-home hospice care for their parent and another caregiver rides in an ambulance with her spouse to a local hospice center because of a terminal change in health.   Within days both sets of caregivers arrange memorial services for which they hadn’t planned at this stage of their loved one’s life.

BANG!  Six lives are lost, and Gabrielle Giffords’ and Mark Kelly’s lives change forever.

Congresswoman Giffords loved spending time with her constituents.  The night before she was shot, she took a long bike ride with a friend and was eager for the next day to begin.  A week later she and her husband were to undergo in vitro fertilization so they could start planning the birth of their first child together.  And those attending this gathering, both staff and general citizenry, hoped for a successful and enjoyable experience.  The bottom line is that you can’t plan for what you can’t see coming.

Oftentimes when we hear of tragedies such as those mentioned above, we naively say to ourselves, “Those are the types of things that happen to other people; not us.”  Well, the truth of the matter is, those types of things happen to people, and that’s us.

Congresswoman Giffords’ neurosurgeons stated that they don’t know where in the brain one finds charm, optimism, humor or charisma.  Certainly no where in the brain can one find sufficient prescience that allows us to see what’s coming around the corner.

No matter how hard we try; no matter how careful we are; life turns on a dime.  And sometimes, the life we live becomes the life we did not plan.

I received inspiration for this article from the caregiver heroes with whom I am acquainted, and from Gabrielle Giffords and Mark Kelly in their book: Gabby: A Story of Courage and Hope.

Living long enough to put your foot in your mouth.

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Many years ago I attended a very large wedding at my church.  Big bridal party; all dressed to-the-nines.  While mingling after the wedding prior to walking into the church reception hall, I chatted with a couple who would be getting married a couple months hence.

“Weren’t those groomsmen’s shiny gray tuxedos atrocious?” I said.   “What were they thinking when they decided on those colors?!!!”  To which the future bride and groom then stated, “Uh – those are the exact same tuxedos we chose for our upcoming wedding!”    Oops.

I give you the above real-life example as a lead-in to the following wedding joke humor:

“How lovely you look, my dear!”  gushed a wedding guest to the bride.  The guest then whispered to the bride, “Whatever happened to that dizzy blonde your groom used to date?”

“I dyed my hair, ” replied the bride.

Oops!

What would your loved one want?

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More frequently than I can tolerate, I have visited long-term care (LTC) facilities during Holiday celebrations: July 4th, Christmas, New Years Eve, etc., and I find residents in the dementia wing with accoutrements, e.g., July 4th hats, reindeer horns, festive party hats, that the resident with Alzheimer’s or other dementia would NEVER consider wearing if they had a choice.

My suggestion: before you allow anyone to adorn your parent, spouse, grandma/grandpa, aunt/uncle with a party adornment, ask yourself this question:

What would ______ want?

 Why do facility employees feel obligated to dress up their residents with what can only be described as hideous garments/accessories during Holiday seasons?  It’s demeaning.  It’s borderline abusive.  It’s just not right unless the resident himself has chosen to wear such accessories.

Becoming a clown does not equate to living a dignified existence.

My father, on the right, with his brother. My dad was in the Canadian artillery during World War II.

Prior to living in long-term care facilities, these senior citizens lead distinguished lives, fought in wars, managed households and families, and most likely survived tough financial times.  These men and women just happen to be older now, but no less important; no less dignified. In one of my earlier articles, Be an advocate for your aging loved one, I stated, “If your loved one no longer has a voice in which to defend or advocate for herself, who better to do so than you?”  Chances are in these costumed situations during the Holidays, your loved one doesn’t even see themselves in a mirror, and if they do see themselves, the image they’re seeing may not be comprehensible to them.  Would they want to look like a child wearing a season-appropriate party hat?  Would they have worn that hat in public prior to the advancement of dementia?

This brings to mind another article, Senior citizens are NOT children!  In that article, I broached the topic of talking down to Senior Citizens by using cutesy names: caregivers do it, customer service employees do it, DON’T YOU DO IT!  We have to get out of the mindset that our older population is somehow less worthy of respect simply because of their advancing age.  If anything, the opposite should be occurring.  All of us should honor the lives that were – and the lives that still remain.  This station in life, these circumstances, are not who they are.  They are simply where they are right now.  Use the memories that you retain of your loved one to promote the true person they are.  Don’t let others – caregivers or well-meaning friends – define your parent/spouse/family member.  It is my firm belief that regardless of the severity of a person’s Alzheimer’s or other dementia, the essence of the person remains in tact.   Make it your responsibility to enhance other people’s understanding of your loved one by correctly defining their true essence.

Dignity and quality of life are a right, not a privilege.

Secret letters – no longer a secret.

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Grandma was preparing dinner when her grandson Bradley came into the kitchen.

“What has grandma’s darling been doing all day?”

“I’ve been playing mailman,” replied Bradley.

“Mailman?” asked grandma.  “How could you do that when you had no letters?”

“I had a whole bunch of letters,” said Bradley.  “I found them in that old trunk up in the attic, all tied up with ribbon. I put one in every mailbox on your street!”

Negotiating to Yes

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Negotiating to Yes.

I really appreciate this article by Lark Elizabeth Kirkwood because teamwork is a theme/process that is applicable to so many areas of our lives.  Employed in a small or large company? Applicable.  Volunteer for non-profits?  Applicable.  Family members trying to play on their strengths in a caregiving situation?  Applicable.

Thank you Lark for showing us that teamwork isn’t just for sports teams any more.

A granddaughter’s first wedding.

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Attending a wedding for the first time a little girl whispered to her grandmother, “Why is the bride dressed in white?”

“Because traditionally, white is the color of happiness,” her grandmother explained.  “Today is the happiest day of her life!”

Her granddaughter thought about this for a moment.

“So why is the groom wearing black?”

Optimism amongst the chaos.

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In the book, Gabby, by Gabrielle Giffords and Mark Kelly, Congresswoman Giffords’ husband, Mark, provides statements about optimism that have greatly encouraged me.  Here are just a few:

  • “I saw how optimism is a form of therapy and hope is a form of love.”
  • “Doctors at TIRR, the rehab hospital, told us that our optimism and encouragement could make a great difference in Gabby’s recovery…”
  • “To be of help to a brain-injury patient, we were told, families need to find a way to balance pragmatism and optimism.”

In a Time Magazine article published December 13, 2011, Congresswoman Giffords addresses the struggles she and her husband have endured as they continue to adjust to the “new normal” brought about as a result of a bullet that pierced her brain on January 8, 2011 when she was reaching out to her Congressional district in Arizona.  So many of us have new normals as we walk, or fall, head first into Baby Boomerism.  This normal may involve a loved one who has a fatal or debilitating illness.  This new normal may be characterized as our own bodily/physical struggles inherent with our age.  Each of us have some sort of chronic something-or-other that inhibits our ability to function at 100%.

What is the chronic something-or-other that inhibits your ability to function at 100%?

The above question is a rhetorical one.  Neither myself nor the public need to know the specifics – but you know the specifics and you’re the one making long-term adjustments as a result.

What processes do you follow to unearth the optimism that exists somewhere in your psyche? How do you overcome your personal challenges so that you end most days victorious, rather than defeated?

My wonderful sister, on my left, and I at a Napa winery - tasting wine of course! Cheers!

For me, it’s acceptance.  For me, acceptance doesn’t mean giving in or giving up; rather, acceptance means being o.k. with how things currently are and finding ways to succeed within that new normal.  This mentality or attitude is more optimistic than you may think.  Again, for me, I  decided to allow optimism to nurture the hope that oftentimes is buried deep within me.  Things could very well change for the better –  which doesn’t have to be defined as being 100% problem-free.  Nope.  If I garner optimism at the start of each day, I’m making a conscious and aware decision to acknowledge and celebrate even the smallest of victories that might occur in the next 24-hours.  If I wait for a humongous, star-spangled mega-victory, I may wait forever.  Instead, I attempt to be aware of even the smallest improvements/goodnesses in my day so that my life is filled with many victories to celebrate.  The previous sentence says that “I attempt” to garner optimism throughout my day.  I don’t always succeed – but I try.

What small victory can you celebrate today?

What works for you? The rest of us would love to celebrate that victory with you.

Granddaughter and Grandma humor

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A granddaughter watched, fascinated, as her grandmother smoothed cold cream on her face.

“Why do you do that?” she asked.

“To make myself beautiful,” said the grandmother, who then began removing the cream with a tissue.

“What’s the matter?” asked the granddaughter?  “Giving up?”

Some late, late in life humor.

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The judge was trying to change the mind of a woman filing for divorce.  “You’re 92,” he said.  “Your husband is 94.  You’ve been married for 73 years.  Why give up now?”

“Our marriage has been on the rocks for quite a while,” the woman explained, “but we decided to wait until the children died.”

Visiting a loved one at a long-term care facility.

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Your Dad lives in a long-term care (LTC) facility and you’ve found that these visits really take a lot out of you and your Dad.  You’re bored, your Dad is bored, and you’re beginning to wonder if these visits are even worth it.  Do you want some encouraging ideas to make your visits beneficial to everyone involved?  Here are some suggestions that might take the hurt out of the equation.

ACKNOWLEDGE THAT THE LTC FACILITY IS NOW YOUR DAD’S HOME.

Southern Oregon CCRC where my Dad lived.

The longer your Dad lives in this LTC facility, the more it will feel like his home.  That’s a hard pill to swallow when you’re accustomed to visiting him on his home turf.  His new normal is his 200 square foot (if he’s lucky) LTC apartment.  Remember how painful it was for your Dad to move away from the family home to his apartment in the facility?  One can not minimize the difficulty of downsizing a lifetime of emotional attachment to a household of personal objects to a mere few that will fit in his small living space.  Respect for the remaining space allotted to him will go a long way towards making him more comfortable when you invade that space.

HOW I ADJUSTED TO MY DAD’S LTC LIVING SITUATION.

My distingushed Dad in the 1980's.

I would never attempt to offer any advice if I too hadn’t been through what you’re going through.  At the age of 84 my father was diagnosed with Alzheimer’s.  Dad lived in a Continuing Care Retirement Community (CCRC) in Oregon state.  At the time of his diagnosis he was living in a decently sized one-bedroom apartment “on campus” and for a few years was able to function quite well in that space.  When I visited from Seattle, it was pretty challenging coming up with ways in which to engage him and make my visit a valuable time for him.  He was still active, however, so we went on picnics, took walks, shopped for needed personal items, and our days were filled with purposeful activities.  As his disease progressed, however, he moved to the dementia unit of the CCRC and shared a room with another gentleman who also had dementia.  Now what?  I certainly can’t visit him in his room, and the common areas were populated with other residents who presented challenges to creating a valuable visiting experience for both my father and me.  Visits outside the CCRC campus became more and more difficult as my dad’s ability to function outside of his routine rapidly decreased.  How could just sitting with him in the dementia  unit’s living room make any difference in his day?

IT’S NOT ABOUT YOU – IT’S ABOUT YOUR LOVED ONE.

Well, it is about you, to be sure, but if your loved one’s experience is a good one, chances are your experience will be equally as satisfying.  Depending upon your loved one’s executive function, your activity options may not be limited at first.  You’re still able to take your loved one to movies and museums.  You’re able to go out to dinner and attend family gatherings.  You pick your Dad up, he’s happy to go with you, and your time with him is about as normal as it gets.  If Dad is physically or cognitively impaired, however, your activity options decrease considerably.

BEING PRESENT WHEN YOU’RE PRESENT.

I think you’ll be amazed at how far a smile and a pleasant attitude will go when visiting your parent or other loved one.  You’re of the opinion that you have to be doing, doing, doing to have a successful LTC visit.  If being active is a thing of the past, I encourage you to simply be present when you’re visiting Mom, Dad or your spouse.  Does he still like to read or watch TV?  There’s no reason why he can’t continue to do that while you sit nearby and use your laptop or read a good book.  When was the last time you had nothing but time in which to do so?  Consider this down-time as some sort of blessing in disguise.  Does Dad like certain types of movies – or one in particular – that you can put in the DVD player for his entertainment?  Watch that movie with him even though it’s the 100th time you’ve done so.  It’s difficult for us to define the movie-watching experience as quality time spent with Dad, but for him it may be just what he needs that day.  I know very well how slowly time passes when visiting a loved one whose world has been significantly diminished.  But imagine, if you can, being your Dad’s age and unable to come and go as you please.  When you visit him, you bring the outside world to him and give the day a whole new meaning.

WHY VISIT DAD IF HE DOESN’T RECOGNIZE ME ANYMORE?

This is one of the most challenging times for a son, daughter (or spouse) to go through when our loved one’s cognitive levels continue to decline.  (Please check out other articles on this subject under this Blog’s “Alzheimer’s/Dementia” tab for additional encouragement.) You’ll be doing yourself and your loved one a favor by not trying to force him to recognize you.  The Alzheimer’s Association suggests that it is far easier for you to walk into his or her world than it is for him to be present in yours.  When you walk into his room for a visit, simply announce yourself, “Hi Dad, Irene is here for a visit.”  You don’t even need to qualify your name by saying, “your daughter, Irene.”  Your title is not as important as who you are when you visit him.  Smile.  Speak in a lively tone – not loud, just lively – and let him feel your friendliness and your love.  Caregivers can’t give your loved one the love that you have for him – only you can.  As difficult as it is to seemingly have lost your identity with him – and it truly is difficult – the fact remains that you are his/her daughter/son/spouse and only you can love him like a family member can.

I sure don’t own the franchise on ideas to employ when visiting at a LTC facility.  What has worked for you?  What do you suggest?  Your ideas may be just the thing that helps someone else weather this difficult time.

Baby Boomer Dating: a pick-up line that backfired

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A divorced man in his 50’s finally felt that after 3 years, he was ready to put himself out there again. It didn’t go so well. “I went to a singles bar,” he told a friend, “walked over to this 30-something year old woman and asked, “Where have you been all my life?”

She said, “Teething.”

Alzheimer’s Heartache: young family members adjusting to a grandparent or parent with dementia.

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The 7-year-old child says, “I don’t want to visit Grammy anymore.  She doesn’t remember me and she scares me!”

My daughter in 1st grade. Would she have been able to handle visits with her Grandpa at that age?

This is a major dilemma with adult children whose parent has dementia.  It’s difficult for the adult to reconcile their parent’s disease progression – and they have a fairly comprehensive understanding of the disease that is robbing them of their parent.  Now imagine a child’s inability to comprehend the disease.  All they know is that Grandma seems upset when the child visits and on top of that, no longer recognizes him.  When one considers that adult children sometimes dread visits with their mother or father with Alzheimer’s or other dementia, it seems easier to just let those visits slide for the younger members of the family.  My daughter was an adult when her Grandpa was diagnosed with Alzheimer’s.  I can only proffer a guess at what I might have tried in order to make her visits with him a comfortable experience.

Should parents force their children to visit the person whom the child has started to fear?

Forcing anyone to do anything isn’t always the best strategy to follow.  In these circumstances, it could almost be considered cruel.  My grandparents lived in a different country than my family.  Us three kids saw our grandparents maybe six times before they died.  Having the opportunity to live near an older relative would have been a novelty for me as I’ve always envied those who grew up with Grandma and Grandpa nearby.  With that said, however, I acknowledge that close proximity alone in this situation is not a sufficient motivator.

How can grandchildren still maintain a relationship with their Grandma and Grandpa?

The distracted visit – visiting but doing his own thing as well.  If the parents are able to provide some sort of distracting activity while visiting Grandma, the child might get more accustomed to their grandparent’s behavior.   The child casually observes how mom and dad interact with Grandma – while still being able to watch their favorite video or play with their hand-held electronic game – and gradually feels more secure being there.  Over time, but certainly not immediately, he may realize that Grandma is no longer someone to be feared and may attempt his own interaction with her.

Parents visit without the child and provide engaging updates to their child when they get home.  Parents can keep their child connected by telling him the funny/cute thing Grandma said that day when they visited and also making the child aware of the positive things that are happening in Grandma’s life to balance out the overwhelming negative that pervades it.  Who knows, this reporting tactic might actually lead to the child’s “distracted visit” next week.  Curiosity may be just the ticket that gives the child the desire to see Grandma.

There’s SO much more that needs to be said on this topic.

I haven’t even addressed the issue of early-onset dementia that thrusts young children and teens into an extremely challenging relationship with a parent whose disease robs their children of the guidance that their parent might normally provide during their adolescence. What can you, the Baby Boomers and More Blog audience, contribute to that very unfortunate, and ever-increasing reality, in today’s world?

I’m very much looking forward to what you can add – successes and failures – that will benefit those of us searching for advice and guidance.

Baby Boomers: what topics interest you?

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Irene writing on lanaiWhat do you want to read and comment on?  I thoroughly enjoy this blogging experience but it’s not satisfying enough for me to have a one-way written conversation.  My family would be the first to say that once I get going, it’s hard to shut me up.  (As of March 2016, I’ve posted 700 articles.)

But I want to enhance my own Baby Boomer experience with your wisdom, advice, successes, even failures.  It’s in those practical experiences that we grow the most.

So I sincerely covet your input as to what would draw you to my “Baby Boomers and More” Blog more frequently.  What topics interest you enough that you would provide comments and even contribute your own articles that I’ll press/link to my own Blog site?

Truth be told?  This is not just my site – it’s out there for everyone.  I hope you’ll be candid and honest with your input.  Bring it on – I’m good and ready for your Baby Boomer Blog ideas.

Preserving your loved one’s dignity.

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The more a person becomes dependent on others, the more protection he needs.  A person with dementia needing the assistance of others is considered a vulnerable adult.  He can’t defend himself or speak up for himself.  He can’t demand exceptional care, courtesy, and respect.  As his advocate – that’s where you come in.  When he doesn’t have a voice – you step in to be that voice.  Your reward will be great if you succeed in doing so.

Part of what I do in my working life is to advocate for vulnerable adults by doing what I can to promote dignity and quality of life for those I have the privilege to serve.  As a family member, or good friend, to an adult with dementia, your task is a monumental one because along with your caregiving role, you must also excel at the task of advocacy.   In my blog article, “Be an Advocate for your Loved One” posted on this blog November 14, 2011, I discuss the various ways in which you can advocate for your loved one.  This current article is the last article in my “Understanding Alzheimer’s and other dementia” series and it addresses the issue of dignity and privacy.

My dad in the 1960's; a former Marathon runner

As those of us who have, or have had, loved ones with dementia we know without a shadow of doubt, that our loved one’s current condition does not reflect the pre-Alzheimer’s/dementia person.  A grandmother who previously never spoke the “F-word” now speaks it as though it were just another word in her vocabulary.  A previously modest and distinguished gentleman now routinely removes his clothes in front of others, and/or may be inclined to grope his caregivers or other residents.  A former globally recognized businessman, sought after for his abundant knowledge in his field, now needs others to feed him and has lost the ability to string a meaningful sentence together.  Our loved one’s new normal is shocking to those of us who are close to the person with dementia, and completely foreign to those who are not.

Keeping people informed about your loved one’s condition.

Those who definitely have an attachment to your loved one: friends, coworkers, close neighbors, and of course family members, will probably appreciate knowing what’s going on with him.  It’s important to use discernment when deciding who needs to know – and who doesn’t.  And thanks to e-mail and texting, we can update people immediately and thoroughly with no need to pick up the phone.  That’s truly a bonus, isn’t it?  You’re already stressed and emotionally drained by your situation so having to conduct numerous telephone calls and provide the same update to several people would be prohibitive at best.

But with the ease of e-mail comes the temptation to be too thorough in the e-mail missive.  You’ve already discerned who needs to be kept updated; now you need to use judgment on how much you say and how you say it.  Does your neighbor really need to know about your husband’s incontinence?  How would it benefit your mother’s former coworkers to learn that their former Marketing Executive now drools throughout the day and can no longer feed herself?  More to the point – ask yourself this question: How would my spouse/parent/partner/sibling/friend feel if they knew I was providing all the gory details of their dementia progression to those near and dear to them?  The answer, I believe, is obvious.  If they could, your loved one would say, “Please don’t let everyone know what I’ve been reduced to.”  Showing respect for your loved one includes protecting her privacy, and thereby her dignity.  And I’ll tell you from experience – those on the receiving end of the information would rather you be brief and not overly descriptive.

Celebrate the uniqueness of your loved one.

My dad in the 1960's "fixing" the toilet. He always was a jokester!!!

Your loved one is not just some generic living and breathing person in the Early, Middle or Late stage of Alzheimer’s.  He may not be able to do everything he previously could – maybe he’s not even able to speak – but you can still celebrate him as a human being.  Everyone mourns what’s been lost; hardly any one celebrates their loved one’s remaining attributes.  I learned a lesson from my father during the middle stages of his dementia.  I was quick to finish his sentences, or rush him along by answering people’s questions for him.  My dad didn’t have to use words to express his displeasure when I did that.  He slumped in his chair, looked at me, and let out an exasperated sigh.  I stopped right then and there and made no further attempts to rush him as he conversed.  Doing so would take away one of the abilities he still had – talking and getting his point across.  It may have taken him a long time to complete his thought, but he still had the ability to do so.  Please don’t take away the remaining vestiges of your loved one’s independence and abilities.  If you feel compelled to feed your loved one just because they take a long time to eat their meal, you’re training them to rely on you for that assistance when they could have been doing it on their own.  Who cares if it takes 60 minutes instead of 15 to finish a plate of food?  If they’re still able to feed themselves – celebrate that ability.  Don’t take it away for your own convenience.

Walk into their reality – don’t force them to enter into yours.

We’ve all experienced conversations with our loved one wherein he or she talks about things that didn’t really happen, although they are convinced that they did.  What’s the harm in agreeing with them and going along with their story.  Your wife says, “Didn’t you enjoy that trip to the Grand Canyon we took with the kids a few years ago?”  O.K. – first of all you don’t have any children, and second of all, you’ve never been to the Grand Canyon.  Instead of trying to convince her of what’s real – and making her feel bad/ashamed in the process – talk about the great view, or how all the kids fell asleep in the car and missed the entire gorgeous spectacle.  I can guarantee that if you change your paradigm regarding this development, both you and your loved one will be better off.  The Alzheimer’s Association has a great adage that they offer us caregivers to help us along the way.  If you don’t insist – they can’t resist.  I challenge you to go with the flow instead of trying to paddle upstream.  Don’t cause contention.  A little make-believe goes a long way and harms no one.

AARP magazine reviewed the book Dancing with Rose: Finding Life in the Land of Alzheimer’s by Lauren Kessler. This memoir by Ms. Kessler is portrayed as “an  Alzheimer’s tale that’s warm, uplifting, even hopeful – qualities not normally associated with the illness.  This odd dichotomy – joy atop a ravaging disease – makes this book a refreshing standout.”  Alzheimer’s and other dementia have the ability to peel away a person’s former mask to allow what’s underneath to surface – pleasant or not.  What Ms. Kessler learned in her journey with her mother is that “if viewed from a different perspective, Alzheimer’s is not the end of personhood.”

Yes – dementia changes who your loved one is.  It oftentimes reduces him or her to childish, and then infantile behavior.  But they are still a person.  They are no less worthy of your respect and your compassion.  This hardest task of your life will end some day.  In the interim, may you be merciful to your loved one and may those with whom you are associated support you along the way.

Long distance caregiving: Part II

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Whether your aging parent lives in a long-term care (LTC) facility or in his or her own home, if you live more than an hour away from them, you’re their long distance caregiver.  What are you doing to protect them, and yourself, during this trying time?

As I mentioned in Part I of this article, published December 3, 2011, bridging the gap between you and your parent can be a difficult task.  Being able to monitor your parent’s day-to-day  life from a distance, especially when a parent has dementia, is a frightening task, and it’s one for which you need suitable support.  What follows are suggestions gleaned from my experiences with my father.

If your parent lives in a long-term facility:

  1. If you haven’t done so already, meet all the department heads entrusted with your parent’s care.  Do what you can to be on record as the go-to person.  If you are your parent’s health care representative and/or financial representative, make sure that the facility has the appropriate legal documents in your parent’s file.  Whether a crisis arises or you simply need to discuss your parent’s condition, making sure the staff know of your legal authority to discuss care will make your, and their, job a smoother one.  If you don’t have those specific legal documents in place, and if your parent is still able to designate you as the approved contact regarding care, do so as soon as possible.
  2. When it’s time for your parent’s care conference, a time when the resident – if able – and care staff discuss the resident’s plan of care, be present by phone.  This is a more common occurrence than you may think.  Share your observations of your parent’s behavior, phone abilities – or lack thereof – and don’t be shy about asking detailed questions about your parent’s care, regardless of how intimate the details.  As your parent’s advocate, you have the right to question the staff’s care plan – and you should.
  3. Meet your parent’s primary care physician.  Be sure that he/she has it on record that you are your parent’s health care representative.  Being able to talk to my father’s doctor to discuss all of his medical conditions, as well as all treatments, including medications, kept me in-the-know and enabled me to keep my siblings informed.  My brother and sister were also a big part of my dad’s life and they were also long distance caregivers.  They told me time and again how appreciative they were that I was on top of dad’s care, and that I was able to keep them informed at all times.

If your parent lives at home and is in the early stages of dementia:

  1. Follow point 3 above because even if both of your parents live in the home, you probably can not rely on them to be on top of their own care.  The parent without dementia is the on-site caregiver, and at his or her advanced age, might not be able to adequately function on his own behalf, forget trying to do so for his spouse with dementia.  If your parent is living alone without the presence of a family member, you have no choice but to nurture a relationship with his/her medical team so that you know what treatment your parent is receiving; what medications have been prescribed; and what long-range care goals should be addressed.
  2. Engaging the help of trusted friends, church members, and neighbors might provide some sort of care continuity as they do drop-in wellness checks of your parent.  If you have people who are able to provide this type of observational visiting, I suggest you utilize web services, such as the following, that can help get you organized: Lotsa Helping Hands, which is “Free, private, web-based communities for organizing friends, family, and colleagues – your circles of community – during times of need.  Easily coordinate activities and manage volunteers with our intuitive group calendar”; or Caring Bridge which is “Free, personal and private websites that connect people experiencing a significant health challenge to family and friends, making each health journey easier.”  Additionally, Caring From a Distance provides resources that are available in your parent’s local area: “Whether you live across-the-world or an hour away, you and your family face special challenges.  Where can you find the local resources they require?  How can you, your family, and friends communicate in an emergency?”

What if the burden is too much for you to bear?

You’re in good company.  If I had been familiar with the services listed above I think my caregiving journey would have been a smoother one.  But believe it or not, this type of caregiving challenge is one that is relatively new in the grand scheme of things.  If you’re losing ground as your parent’s long distance caregiver, it might be time to consider the services of a Geriatric Care Manager.  The National Association of Professional Care Managers is a non-profit resource that can put you in touch with someone who might be able to provide the bridge you’re looking for.

Consider the cost of managing your parent’s care from a distance:

  • time off from work;
  • driving and flying time to your parent’s location;
  • hotel accommodations, food and other travel expenses; and
  • the emotional and physical toll on yourself.

Paying a Geriatric Care Manager to manage your parent’s care, whether he lives at a long-term care facility or in his own home, may greatly pay off in the long run.

Whatever you choose, and which ever direction you take, I hope you will carefully consider the best option for your particular situation.  As I’ve said in past articles, only you know what is the best fit for your family.  Consider all the alternatives and move forward confidently.

Long Distance Caregiving: Part I

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Numerous authority figures are entrusted with your loved one’s care – most of them a fraction of their age.  If you can’t be a physical presence for your loved one what will you do to bridge the gap between physical absence and an effective long distance presence?

My mother and my daughter, circa 1976.

My father was diagnosed with Alzheimer’s at the age of 84 and died in 2007 at the age of 89.  By the time of his diagnosis he had been living in a Continuing Care Retirement Community (CCRC) for seven years.  His wife, my mother, died a month before they both were to move to this CCRC located in Oregon state.  My mother was truly looking forward to the move with my dad but on September 24, 1994, she was granted the wish that she had thrown into the universe many years earlier – that when her time came, she wanted to die in her sleep.  My father still moved to the Oregon CCRC because at the age of 77, he knew he still had a valid reason to move there.  Both he and mom didn’t want to be a burden to us three children, so moving into a retirement community that would meet all the needs of his aging body and mind was dad’s gift to us.

Dad, myself, and his wife Barbara on his 87th birthday.

A few years after my mother’s death, dad married a resident of the CCRC and they had a wonderful late-in-life marriage.  Dad’s wife, Barbara, died from complications of Parkinson’s in 2003 so once again, dad became a widower, but this time his biggest challenge was that he was in the early stages of Alzheimer’s disease.  He was still able to live semi-independently in an assisted living apartment at the complex and he was able to perform his activities of daily living (ADLs.)  Of us three adult children, the job of being dad’s caregiving team leader quite naturally fell to me.  I had worked in the senior care industry for several years so I was quite familiar with caregiving lingo and body frailties, not the least of which was Alzheimer’s and other dementia.

Dining room at my father's facility.

Initially, the miles that separated us wasn’t all that challenging.  He was still active, was fully capable of getting himself up in the morning, taking his medications, getting to the dining room, etc.  Us children would call dad frequently – and he still had the ability to call us – and we continued our visits throughout the year and although his dementia was obvious to us, we knew he was in good hands and that he was functioning quite well.  The staff was very attentive to him and if they had concerns, as his health care representative and financial power of attorney, they kept me abreast of the latest, the greatest, and the ever-increasing not-so-greatest.

The not-so-greatest happened one frightful evening.  Dad called me telling me that he felt very agitated and he couldn’t stop walking around his apartment; he couldn’t settle down; he didn’t know what was going on.  I asked him if he had recently taken any medication and he replied, “Just some cough syrup.”  “How much did you take?”  “I don’t know.”  So while I had my father on my home phone line, I called the front desk of the facility on my cell phone and told them that my father was having an emergency in apartment #94 and a nurse needed to get there immediately.  I kept my dad on the phone and told him that a nurse was on the way to see him and that he would be taken care of very soon.  The nurse arrived quickly, and the emergency was averted.

Bottom line?  We now knew that dad was no longer capable of managing his own medications.  He took way too much cough syrup that evening and it caused his heart to race, resulting in extreme agitation.  This precipitating event was the start of his noticeable decline and medication management became the first ADL for which my dad needed assistance.

The above example barely scratches the surface of what many of you are dealing with.  Your long distance eyes and ears seem thoroughly ineffective and you’re concerned about your loved one’s well-being.  There is hope for the long distance caregiver.  It’s not the same as being there, but this hope somewhat bridges the long distance caregiving gap.  Part II of this article, published December 4, 2011, addresses some practical steps you can take to help in your caregiving journey.

Driving with dementia: the dangers of denial.

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As family members, we are desperate to believe that dad’s driving is absolutely fine.  We try to convince ourselves that even with dementia, dad presents no hazard to himself or others and we even trick ourselves into believing it.  When a precipitating, oftentimes, climactic event occurs, our best-case-scenario dream becomes a nightmare.

My family was one of the lucky ones – those in the very small minority whose loved ones come to their own decision to retire their automobile keys.  My dad decided that he wasn’t comfortable driving anymore and stopped driving cold turkey.  Boy did we dodge a bullet!  I know, however, that more often than not- male or female – your loved one will be very resistant to any suggestion that their driving experience come to an end.  And it’s not always a case of dementia causing the questionable driving behavior.  Declining hearing and/or vision, combined with slow response times, can render just about anyone a hazard to humanity behind the wheel.

Be supportive, not argumentative.

Whatever you do, acknowledge that this function of your loved one’s life equates to independence – going wherever you please, whenever you please.  Imagine being told that you have to give up that freedom.  How would you feel?  Very carefully consider what steps will be most successful in addressing this issue with your loved one.

  • Make serious efforts to preserve the dignity and pride of the person while protecting the safety of that person and others;
  • Involve your loved one in the discussion; by doing so you emphasize that person’s ability to be a part of the solution which might bring about a more successful outcome;
  • Be realistic and honest with yourselves.  Don’t take comfort in the fact that the person with dementia “only drives to the store and back” or “only drives in her immediate residential area.”  Many accidents occur during the shortest and most mundane trips;
  • If you’re the primary point person for your loved one, enlist the help of other family members and friends, and/or a respected professional – such as a doctor or lawyer – to support you in your efforts.

What does the law have to say on the matter?

Just about every state in the Nation has driving restrictions for those who exhibit questionable driving aptitude.  I’m about to provide some links to laws that are applicable in the State of Washington but I’m certain that similar statutes exist in most states.  In Washington Sate, the Revised Code of Washington, RCW 46.20.207 states that the Department of Licensing can cancel any license wherein the driver is not competent to operate a motor vehicle under RCW 46.20.031 which addresses a person’s inability to safely operate a vehicle due to physical or mental disability or disease.  RCW 46.20.305 further details the reexamination process for those who fall within this category.  This is not a laughing matter to be sure.  Not only is your loved one at risk, but everyone within sight of his vehicle is unknowingly being subjected to your loved one’s dangerous driving.  Imagine how you will feel if an innocent person dies or becomes disabled as a result of your family member’s driving.  And there are liability issues to consider.

Who shares liability in these types of circumstances?

The Western and Central Washington State Chapter of the Alzheimer’s Association has much to say on this matter.  You can request and receive, free of charge, their booklet, At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia & Driving.  In a separate article, Seattle elder law attorney, Janet L. Smith outlines our legal obligations as family members of those who drive with dementia.  Are you letting your wife or husband drive with diminished abilities?  According to this article by Ms. Smith, because Washington is a community property state, the marital community is generally responsible for any injury or damage caused by either spouse.  This article further states that an attorney-in-fact, acting under a Durable Power of Attorney, opens himself up for possible legal action should the impaired driver cause significant damage to another.  In both of these circumstances you simply need to ask yourself if you feel comfortable enough to take that risk, knowing that the driver is unfit but taking no action to prevent that person from driving.  It all boils down to a matter of conscience, and a matter of moral obligation.  Only you can decide what type of risks you’re willing to take and/or the degree of responsibility you’re willing to shoulder.

Consider the frequency and severity of these signs and symptoms of dementia-impaired driving:

  • inability to locate familiar places;
  • failure to observe traffic signs, perhaps because they may no longer understand what they mean;
  • making slow or poor decisions in traffic, such as slow response times, and making incorrect responses to traffic conditions;
  • driving at an inappropriate speed – usually too slow;
  • becoming angry or confused while driving.

Soft ways to eliminate driving opportunities.

  • Arrange an independent driving evaluation through the local AARP or your State Department of Licensing;
  • With the help of your loved one, assign driving responsibilities to family members, neighbors, and church friends;
  • Take your loved one on errands that she needs fulfilled and make a date of it – grabbing a cup of tea somewhere, or combining the errand with a lunch opportunity;
  • Plan alternative transportation such as public transportation organizations similar to those found in Washington State: Access VansCatholic Community Services, National Volunteer Caregiving Network, and Senior Services, to name a few.

Drastic ways to eliminate driving opportunities that should only be employed as a last resort:

  • gain control over access to the car keys;
  • disable the car by removing the distributor cap, a battery cable, or the starter wire;
  • arrange to sell or donate the car;
  • secure a letter from a physician declaring the person incapable of safe operation of a vehicle and present it to the Dept. of Motor Vehicles/Department of Licensing.

I can not emphasize enough how important it is to make sure that you’ve assembled a team of well-intended friends and family members to fill in the transportation gaps.  Helping Mom and Dad, or your spouse, maintain an acceptable level of independence will go a long way toward softening the blow of losing the ability to get behind the wheel on their own.

Denial: Roadblock to better health and better care.

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STATEMENT:  Carol’s having a little problem with her memory.
Initially this might be an accurate statement.  Two years later, it’s a euphemism that doesn’t benefit anyone, the least of which is Carol.

Imagine denying a person’s cancer diagnosis.  There’s no need to treat it.  I just have an uncontrolled division of abnormal cells in my body.  It’s not that bad.  It’s early in the diagnosis anyway and I’m not even experiencing any major symptoms.  I’ll do something about it when it really gets bad.  Ill-advised, right?  Most people would not follow that path.  But Alzheimer’s disease, and other dementia, are no less serious.  As a matter of fact, cancer isn’t always fatal, but Alzheimer’s is.  There is no cure and no potential for one at this time.

Most people would spring into action upon receiving a cancer diagnosis: learning as much as possible about it; taking measures to curtail  the cancer’s effects on their lives.  The sooner one does something about it, the better the chances of successful treatment.  For some reason, when a person receives an Alzheimer’s diagnosis there’s a self-inflicted stigma attached to it; as if the afflicted person brought the condition on themselves.  This is an unfortunate perception and one that should be put to rest.  Whereas clinical depression or mental illness used to be a taboo subject, those conditions are now more readily accepted in the public eye.  Alzheimer’s must be brought out into the open, especially as it affects you or a loved one.

THREE MAJOR REASONS WHY ONE SHOULD ACT ON AN ALZHEIMER’S DIAGNOSIS:

  • The window of opportunity to start early drug therapy can be a very narrow one.

The time to seek medical assistance is when symptoms become fairly consistent and more than just a “senior moment.”  A thorough medical exam should be conducted to rule out any cause other than dementia.  Some medical conditions and/or medication usage can mimic cognitive decline.  All the more reason to act early to rule out what might be a readily fixable temporary condition.

If after the thorough medical exam a cognitive workup is warranted, you’ll have a defined cognitive baseline and can start treatments and/or make adjustments in the household that will minimize the disease’s impact on your lives.  Now you’re in the driver’s seat, regaining some amount of control over the disease.

  • Those close to you need to be informed.

As mentioned in an earlier post, “Caregiving: The Ultimate Team Sport” (article located in the “Caregiving” tab) you can’t assemble a care team if you’re ignoring the needs and challenges facing you and your loved one.  You’ll be amazed at the relief you’ll feel knowing that you’re not battling this disease on your own.  Let your family and close friends know early on what you need from them.  Partner with them to become a formidable force upon which you can rely.  You need support and it’s available from several resources.

  • Join a local Alzheimer’s Association support group.

The Alzheimer’s Association lists support groups in most geographical regions that should prove extremely helpful to you.  Type in your zip code in the “Find Us Anywhere” upper right area of their website and you’ll be connected with the Chapter located nearest to you.  Within that local Chapter you’ll then be able to search for a support group by typing in your city, county,  or zip code.   You’ll find groups for family members who are attempting to support their loved one who has received a dementia diagnosis.  You might also find support groups for patients who are in the earliest stages of their illness.  Both groups can do much towards providing you with confidence and hope when none can be found.  These groups become a practical resource into which you can tap to benefit from others’ experiences in managing the disease.  If by chance there is no nearby Alzheimer’s Association Chapter, check with your local hospitals, community colleges, senior centers, and the like as they oftentimes hold groups that are facilitated by trained professionals.  These alternative groups are very adequate options when no other groups are available.

If you or a loved one has received an Alzheimer’s/dementia diagnosis, you’ve just entered one of the most difficult chapters of your life.  You deserve all the support and medical attention you can get.  Ignoring the condition doesn’t make it any less real so please take the steps needed to manage this stage of your life effectively.

The next article in this “Understanding Alzheimer’s & other dementia” series is : “Driving with dementia: the dangers of denial.”

Understanding Alzheimer’s & other dementia

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There are diagnostic tools in place that try to make sense of the symptoms of Alzheimer’s and other dementia; some are conclusive, while others are simply an educated guess because knowledge of this disease is evolving day by day in the medical and scientific fields.  And for certain, no two people with the disease have the same manifestation thereof.

Whether or not an actual diagnosis is presented, you as family members, or perhaps as the patient, are struggling with this new reality and are attempting to carry on as normally as possible.

In the days ahead I am going to submit four articles addressing some of the challenges inherent with this disease.  I am not an expert – I have no PhDs and no medical degrees – but what I do offer is advice gleaned from my own practical experience and from that of those with whom I have been fortunate to be acquainted.

The four articles will be as follows:

  1. Denial: Roadblock to better health and better care.
  2. Driving with dementia: the dangers of denial.
  3. Long distance caregiving (provided in two parts.)
  4. Preserving your loved one’s dignity.
My wonderful brother Don, and our dad in June 2005, a year after dad's Alzheimer's diagnosis.

As Charles Darwin once said: “It is not the strongest of the species that survive, nor the most intelligent.  It is the one that is the most adaptable to change.”

I hope that ALL of us will have something to offer as these four articles are presented.  I covet your input and hope that you feel free to provide it.

Old Age Golf.

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Bob is old.  He’s played golf every day since his retirement in March.

One day he arrives home looking very downcast.  “That’s it,” he tells his wife.  “I’m giving up golf.  My eyesight has gotten so bad that once I’ve hit the ball, I can’t see where it lands!”

His wife sympathizes.  As they sit down for dinner she makes a suggestion:  “Why don’t you take my brother with you and give it one more try.”  “That’s no good, ” sighs Bob, “your brother is a 103 years old!”  “He may be 103,” says the wife, “but his eyesight is perfect.”

So the next day, Bob heads off to the golf course with his brother-in-law.  He tees up, takes an almighty swing and squints down the fairway.  He turns to his brother-in-law.  “Did you see the ball?”  “Of course I did!  I have perfect eyesight,” says the brother-in-law.

“Well, where did it go?” asks Bob.

“Can’t remember.”

Transportation challenges with Mom and Dad.

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Because of your flexible work schedule, you are the designated driver when it comes to taking Mom and/or Dad to doctor appointments.  Well, the older your parents get, the more feeble their bodies, and the more potential for aggravating factors such as cognitive decline.  What should have been a 2-hour outing has become an all-day event.

Remember the good ol'days? Neither do I.

I’m quite certain that many of you reading this article have struggled in your efforts to drive Mom or Dad to their many doctor appointments.  Getting Dad into the car is one thing, but getting him out?  My goodness – through no fault of his own, he’s forgotten the process and you don’t have the strength to lift him out.  With Dad’s cognitive decline, his understanding of what it means to sit or stand on command has decreased.  The ol’ “Ally Oop!’ maneuver or the “1-2-3 Stand!” command just won’t work any more.  What’s a person to do when you are not able to exert the strength to facilitate such an action on your father’s behalf?

Dad and I on a picnic, Spring 2005.

When I visited my father in the long-term care (LTC) facility in which he lived, my goal was to get him out of the facility as frequently as possible.  I took him on picnics, on walks around a park’s perimeter, up and down the aisles of a supermarket – anything to provide a change of scenery for him.

As my father’s dementia increased, however, these outings became less and less practicable.  I was not blessed with a strong back so my attempts to lift him out of the car or onto a park bench were met with horrendous failure.  I grieved the cessation of these activities but I just couldn’t manage my father’s body any more.  And not being able to go on these outings really curtailed the enjoyment of our visits together.

Had I lived in the same town as my father, another person could have accompanied me who was capable of assisting with the transfer of my father in and out of the vehicle.  Unfortunately, my father lived in Southern Oregon and I live in the Seattle, Washington area so calling upon a friend to go along on these outings was not an option for me.  If you, however, live near your loved one, do yourself, and your loved one, a favor by bringing another family member or a friend who has the ability to assist with the mechanics of transporting Dad on outings.  Not only will the physical assistance help, but you’ll have someone else with whom to visit when the conversation with Mom or Dad lags due to cognitive decline – or hearing difficulties.

Another benefit of having an additional person with you is that you are introducing your friend to the unavoidable process of aging.  This may sound like a negative benefit, but truly, it is not.  You will open your friend’s eyes to the future that awaits us all while also providing him with a lesson on how to enhance the life of someone whose world has been drastically reduced in size.

See?  It’s a win-win-win situation!  You receive the help you need, your parent gets a change of scenery, and your friend learns a valuable lesson.

I want to encourage you to check into local resources that provide suggestions on how to be the best caregiver you can be.  For example, your local chapter of the Alzheimer’s Association is a very valuable resource. They have numerous articles within their website and a 24-hour Helpline 1-800-272-3900 to ease you through this process.  There’s one thing on which all of us caregivers can agree – we can’t do it all by ourselves.  Reach out to receive the assistance that you so richly deserve, and that others are willing to provide.

Adult children: taking care of an abusive parent.

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When an adult child’s earlier relationship with a parent has been wrought by abuse, how does the child manage to provide care to this parent who reigned verbal, physical, and/or sexual abuse upon him/her?

  • Is it possible?  Yes.
  • Is caregiving required of an adult child in this circumstance?  No.
  • Is the child wrong to turn his or her back on a parent requiring care and attention?  Absolutely not.

Every individual’s situation is unique due to the extreme nature of this type of family dysfunction.  There truly is no textbook answer that fits each circumstance.  Not only is the situation unique but we’re talking about emotions – and how one deals with those emotions.  We’re talking about the balance of how the previous harm has been handled and whether or not contact of a caregiving nature may prove newly damaging to the adult child/victim.  For the purposes of this article, we will assume that the adult child has decided to participate in her abusive parent’s caregiving.  CAVEAT: Anything I offer in this article is not based on personal experience, but rather, experiences that have been relayed to me through my work with adults who are also caregivers for their parent.  I’m not an expert, I’m only an observer.  I covet any input that my readers may be able to offer.

The caregiving well is shallow.

More likely than not, the well from which the child can draw may be very shallow.  If the adult child has chosen to keep her distance from the abusive parent for many years, being suddenly thrust into one of the most difficult jobs she will ever perform could be a next to impossible task.   Let’s say that she has decided to give it a try but she has been wise enough to set up an escape route that she will follow when the going gets tough.  I don’t necessarily mean an actual, physical escape route.  Rather, she has established the upper limit that she will bear should matters get out of hand emotionally or physically.  She makes a commitment to herself that sets a comfortable threshold after which she will walk away, guilt free, knowing she made a valiant effort.  She is strong enough to acknowledge that at some point she may need to cease all caregiving efforts.

As I mentioned in a September 2011 Blog entry, “Deathbed promises and how to fulfill them,”  (found in the Caregiving category of this site) even adult children with a fabulous relationship with their parent struggle greatly in their caregiving efforts.  Whether you end up being a hands-on caregiver (providing the care in your parent’s home or yours) or you find yourself as the primary family contact with the staff caring for your parent at a long-term care (LTC) facility, you are pulled into the intimate aspects of a parent’s life and it is not an easy role in which to function.

Feeling obligated vs protecting oneself.

Too often, we do things out of a feeling of obligation rather than heartfelt compassion.  In the situations outlined above, obligation will either be the only thing that places you in the caregiver role, or it will convince you that you’re not emotionally available to walk down that rut-filled path.  I am an advocate for vulnerable adults – I live by that mantra – but in this situation I feel that the person needing the most advocacy is the adult child who still struggles with the effects of a past abusive relationship with a parent.  If you are not able to provide the caregiving, please know that there are others who can do so in your place.  You don’t have to be “it” ‘in this situation, and having someone else step in could very well be the best caregiving scenario for you, and your parent.  If you ever find yourself in this role, please do not act alone.  The community around you: churches, local government health service organizations (such as that found in Washington State), organizations that protect the abused, are an absolute required tool in your toolbox to be an effective caregiver, and an emotionally protected adult child.

Anyone out there who has been in this role or is currently in this role of taking care of an abusive parent?

Your input is very valuable and could very well help those struggling with this scenario.  If you feel strong enough to share your story you have my thanks for opening up on this Blog.

Don’t you hate it when you get hiccups?

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A man runs into the ER and asks the doctor if he knows a way to stop the hiccups.

Without any warning, the doctor slaps the man in the face.  Amazed and angry, the man demands an explanation.

“Well,” says the doctor, “you don’t have the hiccups anymore, do you?”

“No,” the man answers, “but my wife, who’s in the car, still does.”

Thanks to my sister-in-law, Tricia (a nurse), I’m able to add this joke to my Blog.

On being grateful….

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On being grateful…..

I’m truly grateful for this posting by Morris in his  Musings from Third Base blog.   My mother always told me that you don’t have to look very far to locate someone worse off than yourself.  That doesn’t mean you ignore the valid feelings of desperation or frustration that one feels from time to time – especially as we become more and more of a Baby Boomer.  But what it does mean is that we can probably honestly say that we also have a few reasons to celebrate during this stage in our lives.  I don’t wait for the grandiose, huge reasons to celebrate – I don’t want to wait THAT long.  Instead I celebrate even the smallest of accomplishments, or good times; that way I have far more celebratory moments in my life.  Forget about not SWEATING the small stuff.  Let’s CELEBRATE the small stuff that give us reasons to be grateful.

When it comes to logic, this Senior Citizen excels.

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A class of approximately 25 Senior Citizens enrolled in a Logic class at the local community college.  This class proved to be very interesting but also VERY challenging.

A week before the final exam, their Professor sympathized with their concerns about what was sure to be a difficult Final Exam, especially given the fact that the Senior Citizens in the class hadn’t sat in a classroom or been faced with this type of exam process in quite some time.  The Professor gave each student permission to fill an 8.5 x 11 sheet of white paper with what they felt would help them correctly answer the exam questions.

On the day of the exam, student by student filed into the classroom with their white pieces of paper filled with notations that they felt would help them through the exam.  The last student to enter brought in a blank piece of white paper and placed it on the floor to the left of him in the aisle.  Shortly thereafter a more traditionally aged college student walked in and stood within the confines of the piece of paper.  Wow – now that’s weird.

Turns out the student that stood on the white piece of paper had a Masters Degree in Logic and provided all the answers to the Senior Citizen who invited him to participate in the exam with him. This Senior Citizen student got all the answers right because he followed the guidelines suggested by the Professor: fill the 8.5 x 11 sheet of paper with what he felt would help him correctly answer the exam questions.

Seems logical to me – wish I had thought of that when I took my college Logic exam so many years ago.

Caregiver: put on your oxygen mask first.

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passenger-362169_640The airline flight attendant gives pre-flight safety instructions:

“In case of a loss of airplane pressure, oxygen masks will drop from the overhead compartments.  Put mask on yourself first before assisting children or those not able to help themselves.”

Why?  Unless the able-bodied person is fed oxygen, he won’t be able to help any one else.

Whether you are actively providing care to your loved one or you are the point-person managing that care, you are stretched thin.

Your reserves are low.

Your tank is nearing empty.

You’re on the path to caregiver burnout – or you’ve already arrived.

You love to think that you can do it all:

  • have a full-time job, and a full-time family;
  • have numerous duties in your own household that obliterate any “idle” time during your day;
  • you’re on the community board or other volunteer activity; and, oh yah
  • you’re responsible for your aging parent’s, or spouse’s, day-to-day maintenance.

Not only are you burning the midnight oil; you’re burning the candle at both ends and about to self-destruct.

“But I have to do this.  I have a lot of people counting on me to take care of dad.  If I don’t do it, who will?  I won’t be a dutiful son/daughter, if I walk away from all my responsibilities!”

Oftentimes what happens in these situations is a person ends up being of no good to anyone.

  • You’re taking more and more time off from work either due to your own illnesses or to attend to the needs of others;
  • Your spouse and children are suffering from the constant stress that your over-extension of commitments places on the household;
  • The project for which you volunteered at the PTA or Boy Scouts, or FILL IN THE BLANK, is dead in the water because you don’t have the time or energy to devote to the cause; but
  • Your loved one for which you provide care is doing just fine because he/she is receiving all of your attention.

Keep this up and you’ll be no good to anyone because a vehicle doesn’t run on an empty tank and neither can you.  It’s time for you to attend your own “care conference” to come up with a realistic plan of how to direct your own health and well-being.

The “To Do” List vs the “Don’t Do” List:

You weren’t put on this earth to help everyone and despite your well-meaning belief that you can do it all – you can’t, and you’ll never be able to do so.

  • Write a list of everything you currently feel obligated to do each week.  Now cross out a third of that obligation list.  Do what you can to delegate duties and/or designate other willing people to carry a third of your burden.  You should already start feeling better.
  • Now eliminate – or temporarily withdraw from – another third of your obligations. You won’t offend others by doing so if they know you well enough to understand your reasons for stepping back a bit.  I’m certain they know that they will be able to count on you later when your life situation isn’t so acute.  You’re not dropping out, you’re just putting yourself on pause.
  • Reconnect with the family in your household. Don’t risk losing your family.  You need them on your team and they need you.  They will be around long after the loved one for whom you’re providing care passes away.  You want your family with you now, and you’ll want their support later.
  • Assemble a caregiving team. In my blog entries: Caregiving: The Ultimate Team Sport and Solo Caregiving I address the importance of reaching out to others and tapping into resources that will help you stay sane and healthy while on this caregiving path.

You owe it to yourself, and your loved one, to start taking care of yourself.  So place your own well-being at the top of your priority list.  I can pretty much guarantee that you won’t regret it.

I sang for my Dad today … January 30, 2011

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I sang for my Dad today … January 30, 2011.

I am so pleased that I FINALLY figured out how to post someone else’s blog entry and I do so with this one by Lark Elizabeth Kirkwood.  How wonderful that Lark was able to have that musical connection with her father at that time in his disease.  One of the last songs I sang to my father, a couple hours before he died, was “Aloha Oe” which is a good-bye song in Hawaiian.  I know he heard the song as he rode on the wave of departure from this Earth. Reading Lark’s many posts about the positive effects of music on those with dementia or brain injuries is so timely as I am still reeling from the positiveness of Diane Sawyer’s 20/20 program on ABC that was broadcast earlier this week.  Her story of Gabrielle Giffords and Mark Kelly was  inspirational on so many levels.  Music had, and continues to have, an AMAZING healing effect on Congresswomen Giffords recovery from that horrific gun shot injury on January 8th, 2011.

8 Rules for New Caregivers

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8 Rules for New Caregivers.

Caregiving is one of the hardest jobs any of us will ever undertake. Please take time to read this article that I have added to my Blog that originally came from an AARP posting.