Tag Archives: elderly

Rethinking treatment for seniors with depression

Mom is depressed. I know this. She knows this. Admitted it to the doctor when he asked.

But she remains very resistant to the idea of talk therapy.

This, from the woman who can, and does, talk to everyone! She’s never met a stranger, and she’s collected the life stories from hundreds of strangers while riding the bus or waiting in line at the grocery store. Mom is not shy at all about discussing depressing personal subjects, like Dad’s Alzheimer’s or her own battle with cancer.

The woman who admits she is lonely and just wants someone to talk to, still refuses to go talk to a therapist once or twice a week. There is a special program in her town designed to deal with geriatric mental health issues.

Mom says it’s because they won’t come to the house. The doctor wants to encourage my mom to stay active and get out of the house. The personal care service can and does drive her to any appointments.

Perhaps it is more of a generational issue. Mom comes from a generation that quietly bore their burdens, versus jumping on the therapist’s couch. Psychoanalysis was more of an upper-class pastime than something the average person engaged in. Now, therapy is recommended for just about anyone, even children.

But maybe we need to rethink senior therapy to encourage more people like my mom to participate. Perhaps an initial home visit/assessment, then subsequent office visits. When you physically feel lousy, you are going to feel even more depressed but may not feel like getting dressed and leaving the house.

Once my mom connects with someone, it lifts her spirits and she is willing to be more flexible with her routine. For example, sometimes the personal care attendant can only come at 10am, which is early for my mom. Guess what? Mom has adjusted just fine.

This is probably a short-term issue, as I have a feeling baby boomers will have no problem with therapy, but it does make me feel for all of those lonely, depressed seniors isolated in their homes right now. I wish we could reach out to them effectively. (Mom refuses to go to the Senior Center as well!)

Are there programs in your community that are designed to help seniors battle depression or loneliness?

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A simple act of kindness is often greatly appreciated

Recently, I visited my mom. It was the first time I would be meeting her personal caregiver. I’ll call her Debbie (not her real name.) Mom had raved about how wonderful Debbie was and how much she liked her.

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We’ve all heard horror stories about the other kind of caregivers, those who steal from clients or abuse them. I was relieved that Mom was happy with her caregiver. I think the service has lifted her spirits and helped take the burden off of her when it comes to housekeeping and grocery shopping. In short, personal attendants can help my mom live independently longer.

Debbie made me comfortable immediately. She is warm and kind and doesn’t let Mom get down on herself. But she also isn’t fake in her positive thinking, instead she is encouraging. She is an ideal match with my mom, who is set in her ways and finds changes in routine stressful. Debbie knows how to keep my mom on the right track.

I thought the least I could do was get Debbie a thank you card, to let her know I appreciated her taking good care of my mom. Apparently it’s a struggle to keep gas in the car on her wages, and she doesn’t get reimbursed for mileage. She was one of the few people who was almost looking forward to jury duty, because it would pay the same/better than what she earns normally!

So I gave Debbie the card and she told my mom later that she was so touched that she cried after reading it.

Caregiving is a job where you may not receive much thanks or positive feedback. Showing a bit of appreciation can go a long way.

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Caregiving tip: Change isn’t easy for seniors

I’m sure we’ve all heard of the saying, “She is set in her ways.” This tends to become more true as one ages. Our elderly loved ones have a certain schedule, or a certain way of doing things, and a disruption of that schedule can cause them great stress.

I’m a little like this already and I’m only 40!

But what made this clear to me was spending time with Mom this past week. We still have not figured out what is wrong with her, but we finally were able to see the specialist. He wants to rule out the return of cancer, so he has ordered a colonoscopy (ugh) and an EGD. Mom wasn’t thrilled with the idea of more testing and the preparation involved for it but knows it is necessary.

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If there is no cancer, her abdomen muscles can be surgically repaired so her stomach doesn’t protrude, which seems to cause her constant discomfort. But first, we have to increase Mom’s weight and strength. She is down to 100 pounds (has lost a shocking 30 pounds in 8 months.)

The specialist is a young guy that is into natural supplements in addition to medicine. While I truly embrace this approach, when he recommend my 77-year-old Mom start juicing, I had to force myself not to laugh. While I don’t doubt the benefits of fresh juice (though I do think the benefits are overstated and the high sugar and low fiber in juice is a concern), the doctor clearly needs to consider a patient’s age and situation when making care recommendations.

He knows Mom lives alone, and to ask a frail old lady to go buy a bunch of produce, wash it and process it through a juicer, and then go through the tedious clean up progress is totally overwhelming. I purchased her some pricey but convenient organic juice mixes instead.

The doctor also recommended spirulina supplements. After researching I’m on the fence about the benefits, but at least this is an easy step for Mom to take (comes in capsule form.)

He also recommended upping her daily Ensure drinks. I found a Boost very high calorie variety that has 530 calories. Also I got her a flavorlees calorie supplement that you mix into food. These are small steps that Mom can handle on her own.

Still, when I called her after returning home, she was overwhelmed by the new medications ordered by the doctor and the supplements I had sent. She said she knows everyone is trying to help her, but it is a lot to process.

And so it is. Just something to keep in mind when we introduce change to our loved one’s routine. Try to make it as simple and smooth as possible, and take time to explain why the change has to occur. Change can be hard for anyone, but as caregivers we can try to soften the blow.

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Another heart-stopping false alarm

So I finally was able to set my mom up with a personal care service, in addition to the home nurse visits. The personal care attendant was supposed to take my mom grocery shopping yesterday afternoon. Around noon, I was at work and received a call from a number that I did not recognize but with the same area code as where my mom lives.

I answered and it was the woman who runs the personal care agency. She said the attendant going to see my mom finished up a bit early with her previous call and she headed over to my mother’s house a bit early. But she knocked on the door multiple times and there was no response.

alarm bell

So of course I go into immediate panic mode in my head. Just like in those commercials, Mom’s fallen and she can’t get up!

I told the woman I would try calling her phone number and if she didn’t respond, there is a house key in a lockbox on the property.

I could feel my heart pounding with every ring on my mom’s line. Finally, Mom picked up. She sounded a little frazzled.

Turns out Mom was getting ready in the bathroom which has a loud heat vent. She couldn’t hear the knocking.

So Mom was okay, just a bit annoyed that the attendant was early … don’t mess with elderly people’s schedule! This is true also for those with dementia, any change of plans or a schedule can really upset them. It’s something many of us caregivers have learned the hard way.

It took a while for my heart rate to return to normal, but so grateful that it turned out to be a false alarm.

What kinds of false alarms have you experienced as a caregiver?

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Let’s talk about guns and dementia

Here’s an important topic for family members to discuss: gun ownership and seniors, especially those who have been diagnosed with dementia. While there is quite a bit of awareness of the need to take the car keys away from those with dementia when their driving skills become impaired, there is little discussion about another deadly weapon found in many households. As part of the “caring for our aging parents” #Blog4Care blog carnival, please spread awareness about this topic so that families can have discussions about the proper precautions needed in their homes. Perhaps we can help prevent injuries and save lives.

If you’ve been following the news in America recently, there has been a slew of tragic shootings that have once again ignited the gun debate. The issues surrounding gun ownership and gun violence are being passionately debated right now. But one angle of this issue I never thought about before involves seniors and guns.

gun

An intriguing post on Alzheimer’s and Dementia Weekly made the point that more seniors own guns than any other age group. With the increased risk of dementia as one ages, this could create a dangerous situation. The article quotes Dr. Ellen Pinholt, who wrote in the Journal of the American Geriatrics Society that as family members, we should think about seniors and guns the same we do about seniors and driving. While there is no maximum age limit for owning a gun or driving, mental health status should be taken into consideration for both situations.

Dr. Pinholt recommends asking “the 5 L’s” when it comes to gun ownership and seniors. The questions include if the gun is locked, if it is loaded, if there are children present where the gun is located, whether the senior is depressed, and whether the senior has been diagnosed with dementia.

Sounds like simple and sane advice for an issue that is so complex and controversial. Still, I think it is just as important to consider the issue of having a gun in the house as it is allowing a person to drive once they’ve been diagnosed with dementia. It is yet another question to add to the all-important discussion with your elderly parents and the rest of your family.

While stereotypically, these random mass shootings tend to be perpetuated by young men, anyone who has a condition that impairs the brain and impacts judgement and emotions should probably have their access to a gun restricted, to protect themselves and others. I’m not a fan of legislative restrictions on personal liberties, but when someone’s safety and society’s safety is at risk, smart and limited restrictions may be appropriate.

While there is not a good substitute to driving a car, seniors with dementia may be able to handle a replica gun that either shoots a safe-type pellet or even better, a replica gun without ammunition. Of course, immediate supervision would be necessary. As caregivers, we should try to allow our loved ones with dementia to enjoy their hobbies as long as possible, if safety measures can be taken.

What do you think about the issue of gun ownership and seniors, especially those with dementia? Should guns be immediately removed from the household upon a diagnosis of dementia or are there alternative and less drastic solutions to consider?

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Landmines for dementia patients

Until you spend a good deal of time with a dementia patient, you can easily overlook potential triggers that will create an explosion of confusion, fear and anger in certain people with dementia.

Take for instance, the simple act of getting on and riding in an elevator. I’ve heard that a way to keep dementia patients from crossing a door’s threshold is by putting a black strip of tape on the floor, or painting a black strip on the floor. Dementia patients see this as a black void and are afraid they will fall into it. I think this is what Dad experienced as we ventured towards the elevator. As we coaxed him to join us in the elevator, he jumped back as if he had been shocked. We finally were able to get him safely in the elevator, and had him hang on to the railing at the back for support. He was very unsteady and I could feel his anxiety level rise.

Fortunately, we only had to go a few floors up so the frightening incident for Dad didn’t last very long. He forgot it as soon as he exited the elevator. The trip back down was uneventful. But I remember that “scared out of your wits” gleam in Dad’s eye. It’s not something you ever want to see on a loved one’s face, but with dementia, it becomes an expression that one sees all too often.

What the experience has taught me is to be even more aware of my surroundings, and other’s special needs. What may seem like a routine, mundane task for me may be a journey of terror for someone else.

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Driving into the ditch

I’ve passed the ditch Dad drove into almost every day since I’ve been staying with Mom in Ruidoso. It’s not very deep, but enough to give one a bit of a scare.

It was the beginning of the end for Dad behind the wheel. Families dealing with dementia often have a big struggle over getting their afflicted loved one to “hand over the keys.” In America especially, the car is such a symbol of independence. For those with Alzheimer’s, having to give up such a huge part of their independence is soul-crushing. While mental and physical faculties are usually quickly fading during the mid-stages of Alzheimer’s, people are usually still self-aware enough at this point to grasp the loss, and what the disease has claimed from them. It’s a heartbreaking moment.

For Dad, that shallow ditch was the beginning of the end of his driving career. Always a slow, careful driver, the big boat of a car he drove gently went off the road and settled into the lower ground. Mom and Dad were physically fine, but mentally and emotionally, they were wrecked.

The car set next to their condo for many months, until someone mentioned how long it had been sitting there. It went to the junkyard. Now the only memories of the car is a set of car keys and some old oil and brake fluid sitting in the storage closet outside.

The ditch represented more than just a minor car accident involving a man struggling in the mid-stages of dementia. My parents’ independence also took a hit, and sank along with the spinning wheels into the ground. They would manage, thanks to the small but very efficient public transit system in their small town, but that unplanned meeting with the ditch transformed their lives forever.

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