Tag Archives: elderly

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.

question mark box

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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A loyal companion gone

Mom has been missing Dad a lot lately. Now that she’s back home, she misses his presence even more than before. 40 years of daily contact is not easy to replace with something or someone new.

Over the past year, when Dad was in the nursing home, she learned to craft a new life for herself. It wasn’t easy or ideal, but she had her health then. Now that her health is in jeopardy, I think she is relying more on the good memories, before Dad’s dementia, when they had their boring yet comforting life together.

Of course, Mom had to live with a different version of Dad, the one with Alzheimer’s, for a few years. Even though that was very difficult, she had someone to take care of and protect, which made her feel needed.

Even though Mom and Dad were opposites in many ways, it is clear to me now how they fit together like puzzle pieces. Now that Dad is gone, Mom is finding it difficult to feel complete and whole again.

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“No more hugs!”

Mom is getting a bit weary of being under the wing of a caregiver (me) and the home health care agency. She’s at that point where she’s feeling well enough to want her old life back, but she also knows that she has new limitations on her that prevent her from fully embracing her previous life.

Dad’s dementia created many limitations, both mentally and physically. But despite how he regressed partially into childhood, he still tried to maintain a sliver of independence. When Mom would go visit him at the nursing home, and she would try to hug him repeatedly when she was departing, Dad would pull away and loudly command, “No more hugs!”

At first it bothered Mom but then she interpreted it as Dad trying to hold on to a piece of himself. She relates the memory fondly now. Of course, little did she know that a year later she would be the one fighting to hold on to her independence.

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When the caregiver becomes the patient

Mom almost had forgotten how she had taken care of a “bag” before she was stuck with her colostomy bag. Dad had a catheter inserted temporarily at one point when he was still living at home and he had to “pee into a bag” that was attached to his leg.

Mom handled the extra duty with ease. Dad was already starting to drift mentally a bit by that point, but even if he had been mentally sharp, I think he would have wanted Mom to take care of it.

Now Mom is having to deal with her own “bag” issues, in this case a colostomy and it looks like it may be a permanent thing for her to deal with. Mom mainly has a good attitude about it, but she does get down sometimes, especially when there are accidents, like today.

I have also surprised myself by stepping up and being able to manage a medical issue with some level of competence. If someone had told me a year ago I would be able to change a colostomy bag successfully, I would have told them they were crazy.

I think what I have learned so far through the illnesses of my father and my mother is that we humans can more easily adapt to change than we give ourselves credit for.

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A slow walk, a small gain

Today Mom and I went for a short walk after a doctor’s appointment. Mom did quite well, as I hovered around her like a mother hen, scanning the sidewalk for cracks and gravel that could cause her problems.

It reminded me of last summer, when I held on to Dad’s arm and walked around the nursing home. There was an outdoor area that he liked to spend time in. I was constantly worried he would go down on the pavement, and Mom and I would not be able to support his frail frame. Even though he was skinny, he was still more than Mom and I could manage easily.

He would also try to take off without us by his side, and had a hard time getting in and out of chairs on his own. I remember those slow, painful walks, with Dad on a search for something he could never find.

The walk with Mom was also painfully slow, but she finished with a boost in self-confidence, and an increased hope that she could return to independent living in the near future.

A simple little walk can reveal more than meets the eye.

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Tests and more tests

Dad refused to have most of the medical tests that were ordered for him before his dementia set in. I remember begging him to go have the prostate exam done, as he showed multiple symptoms and at the time I thought for sure he had prostate cancer.

I sent cards, I begged him on the phone, all to no avail.

Of course, my diagnosis turned out to be wrong. Cancer would not kill my dad, despite his almost lifelong smoking habit.

The last test I ever saw performed on him was the swallow test at the hospital in Albuquerque. It was about a month before his death. He failed the test miserably. Then came the dreaded feeding tube question. We declined. He was hand fed instead, but I don’t think he actually ate much that last month of his life.

Now Mom is the one that faces test after test after test, to keep track of her cancer. It is daunting, keeping all of the doctor’s appointments straight. There are people out there, too many poor souls no doubt, that have to manage all of this on their own. No one should have to do that, while trying to recover from surgery and get stronger.

The trepidation behind the tests are two-fold. Not only is there fear and anxiety of taking so many tests, but there is the fear of the results of the tests.

All a caregiver can do is to try to be a supportive secretary, by setting the appointments, helping to navigate the logistics and offering moral support.

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