A christmas wish for family caregivers

At my home town (Portland, Oregon) we’ve got more snow than ever recorded for this time of year. In fact, we’ve only had a white Christmas a few times in the last century. This year, we’ve got a foot of snow or more covering the ground.

But our family is among the lucky ones. We have no one ill or in the hospital; no one traveling from out of town that hasn’t already arrived and our aging parents are safely residing in communities that are devoted to their care and comfort.

This is the first Christmas that my in-laws (both in their 90s) are living in a retirement community after moving out of their home in the late summer. They’re happy, and they have no worries about frozen pipes, trees falling on the house, walking to the mailbox, or running out of groceries before they can safety travel to the store. They don’t need to worry about the roof or the gutters; the sidewalk or driveway.

My mother-in-law calls regularly to make sure we’re OK. In her voice, instead of the customary worries and concerns, I hear a lilt. She’s happy, warm and comfortable. She’s making new friends and enjoying the companionship. And she doesn’t even have to cook if she doesn’t want to.

I know that we’re lucky. Many families are just starting the process we began more than two years ago when we determined that the family home was no longer safe for the parents alone.

Some families are just now recognizing the problem. The solutions seem very far away. Christmas can heighten the anxiety about an aging loved one’s safety, as you see, maybe for the first time, how much the steady advancing of time has worn away at the person you love.

Holidays are a time that many families first notice their loved ones’ decline. That awareness can cast a pall over the entire holiday.

What should you say? What should you do?

Here may be a place to start: “Hey mom/dad. It looks like you could use a little help around here to make things a little easier for you. You certainly have worked hard all your life and deserve whatever help you can get now! Don’t worry; I’ll help you figure out what works for you, and you don’t have to do anything that you don’t want to do. Let’s just give it a try together, OK?”

If you think it’s time for your loved one to move to a retirement or assisted living community, ask them to simply give it a try with a temporary stay. Take them to visit and have a meal there (or 4 or 5). With my in-laws, it took several months and several visits. The last visit included all of their children and spouses – a group of about 10 of us – touring and sharing lunch. Finally, we got them committed to making a deposit and going back to prepare their home for sale.

We wondered if it would ever happen, but, at the same time, we were determined to let them take it at their own pace, as long as the pace kept moving forward.

Today, we’re convinced that it was the right move for them. It has given them a new sense of community; new friends; security and comfort. It has given us a tremendous gift of peace of mind, especially during the holidays and this cold, snowy winter.

My Christmas wish for you is that, no matter your situation, you find a way to peace of mind about your loved one. And patience, and persistence, and joy.

Caregiver Skills - How to videos teach needed skills

We've been developing our training videos for caregiver and nursing assistant training. One website, Howcast.com has great tools we've been using to build these training videos. Here's a sample: How to take a blood pressure (to learn more go to our website, CaringforMom):




Today I got their Holiday email with samples of How-to videos for the holidays and thought you'd like to see them. I know I'm going to check some of these out!



See more how-to videos on topics of all sorts at the Howcast website - it's a great site to know!

The family caregiver: should you feel guilty about moving mom or dad out of their home?

It’s been a cold, snowy week here in Oregon. The schools are closed and people are being advised to stay inside and off the roads if at all possible.

I called my mom first things to see how she was doing. She moved into a retirement center about a year ago – not entirely of her own free will. From time to time I wonder how much she misses her old home, set far out in the country surrounded by acres of pasture and woods.

She began our conversation this morning by telling me how no one wanted to walk outside in her village. The risks from a fall are simply too great at their age to take the chance.

My mom, of course, gets restless and starts calling her neighbors. “I have to get out to do laundry anyway,” she says. Her cottage is right next door to the laundry room; her closest neighbor is just one door further down.

By the end of the day yesterday she had joined one friend across the lawn for lunch (“she had made enough soup for an army!”) and spent the rest of the afternoon at her nearest neighbor’s place playing a 3-D version of Scrabble that’s her current favorite game.

I was, at that moment, so very thankful that my mom had moved into a close community of seniors. She’s not at home, alone, trying to stay warm and occupied.

She’s active, healthy and happy. Her mind and her heart are filled with activity and companionship.

We have much to be thankful for this holiday season!

Caregivers at the holidays - a brief word of advice

Holidays. The time of year when we’re all supposed to be jolly, worry-free and generous.

In reality, many families find it a time for stress. The pants fit too tightly; the calendar is jammed with way too little “down” time; and the relatives are coming.

Some families find holidays a time of discovery: mom or dad simply can’t function as in the past. Something needs to be done. Now, it’s a matter of who, when, what and how…and you know it won’t be easy.

Some families find holidays a time for renewed rivalry: you live closest to mom and run errands for her every week. Your sister, living worry-free (at least in your mind) on the other coast, cruises into town and is instantly the favored child.

It’s hard to get into the holiday spirit. It’s even harder to remember that, amidst all the noise, shopping and food, holidays are a time to celebrate life.

After all, whichever version of the holidays you celebrate, at the root is a celebration of life. The birth of a child who truly changed the world. The commemoration of an eternal flame and a new beginning.

You’ll find lots of tips, suggestions and ideas for getting through this holiday season in newspapers, magazines and online. But perhaps the best one of all is simply to remember why we celebrate, and to think, mindfully, every day, about the gifts of life that you’re thankful for.

And wear elastic-waist pants.

A Thanksgiving Story

Three thanksgivings ago we sat down at the extended table with our extended family and felt so incredibly blessed we could barely speak. My father had survived a small stroke; my husband’s father had survived a heart attack and bypass surgery. We didn’t expect to all be together that year, but we were.

A year later, my father was dead and my mother in the hospital, unable to join us for Thanksgiving dinner. We rushed, somewhat numbly, through dinner, avoiding the traditional recitation of blessings.

This year feels a little like that particular Thanksgiving, on a global scale. It’s hard to find things to be thankful for (if you actually open your investment reports). It can be frightening, as companies and individuals we have long looked up to for leadership are faltering – maybe even failing.

And yet. Today the sun shone through the piles of golden leaves. I walked to work the long way, savoring perhaps the last nice morning of the month, feeling healthy, alive and filled with thanks.

Today, we had a chance to help a whole group of individuals begin their journey to become caregivers and nursing assistants. We connected with business associates who are challenged but persevering; and several who are thriving.

My children are spread out all over the globe; one in India and one in Israel. They’re studying, volunteering, and traveling. They’re excited about their adventures and fully engaged in their work of growing into global citizens.

Our table will be a little lighter this year for Thanksgiving dinner. Our bank accounts and investment portfolios are certainly a lot lighter. But when I count my blessings this year – out loud – the list will be long.

Happy Thanksgiving.

On caregiving - Fall into winter

It’s a beautiful fall day – the sun is shining, the sky is that special kind of transparent blue, and the leaves are already starting to fall. Standing by the kitchen sink this morning, I could see a constant rain of leaves floating down – sort of an odd “sky-is-falling” sensation.

I think today how very lucky I am, heading into this fall with good health, a happy family and work that I love. This isn’t true for every family, however. Just yesterday as I was waiting to see my doctor for an annual check-up, I overheard the man who entered just before me sharing how difficult and stressful his life is right now.

He’s lost his job and worries about losing his home. He’s a little past middle age, making these losses hard to take, and harder to recover from. Clearly, he’s not alone in our society today. Many people are hurting and many people have no idea how they’ll recover.

When we were younger, it was easy to think, “I’ll just get another job.” I’d say to my family, “Money is a renewable resource, so let’s enjoy what we have. We can earn more.”

As I get older the renew-ability of money seems less of a given. I know if I had to change jobs or careers now, it would be much more challenging than it was in my younger days. Individuals who have retired, assuming their pensions were secure and adequate, and now experience rising costs or disappearing pensions face an uncertain and frightening future.

Fall is, inherently, a time of reflection; a time when the bright fresh colors of spring and summer fade and fall away, and the cold slumber of winter begins. Our economic cycle seems to mimic nature, with October being a month of dramatic financial and stock market drops, perhaps preparing us for a winter of less abundant prosperity – this year, at least.

As my team and I work hard to bring more training and resources to the people who struggle to continue to care for their loved ones, I believe, more deeply than ever, that together we can find the joy even in winter. We can, perhaps, cozy up to a warm fire, create new friendships that give us encouragement and laughter, and come out next spring richer for our experiences.

So bring on the winter – we’ll get through together.

What it means to be a family caregiver

A few days ago someone said to me, “My mom is in an assisted living community so I guess I’m not really a caregiver.”

As we talked, the person shared how he visited several times each week; how he interacted with staff on his mom’s behalf; how he took her to doctors’ appointments and other needs.

It didn’t take long to realize that he was, in fact, a caregiver.

This morning I read a story written by a daughter that made me feel incredibly sad. The daughter shared how she was never treated by her mom as a valued daughter and was always compared to her brother, the perfect child.

Now, with her mom elderly, falling, losing her ability to think, remember and reason, she was turning on this daughter who was investing hours of her day, every single day, to helping care for her mom. This daughter was feeling more angry, resentful and hurt with every passing day. She believes her mother’s behavior is intentional and is designed to hurt her – and she’s losing the quality of her own life quickly, as the result.

This daughter is a caregiver, too. She’s a caregiver in desperate need of better understanding of the aging process her mother is experiencing, however. The harder she tries to make her mother happy, the more defeated she feels.

I want to tell this daughter that what she is experiencing is the disease her mother has – not a personal attack. The memory loss, probably related to Alzheimer’s disease or another form of dementia, is causing her behavior. It may be making what has been a lifelong pattern even more pronounced. It is certainly causing both the mother and the daughter much anguish and distress.

Family caregivers, whether hands’ on or indirect, whether close or across the country, are an invaluable part of the caregiving network in our country.

If we can give them support and the training they need to make it a joyful experience rather than a gut-wrenching experience we’ll be doing exactly what we need to do.

Caregiver Training Resources

Caregiver Christmas gift ideas

National Caregiving Month - reasons to celebrate

The month of November has been proclaimed National Family Caregivers Month by President Bush. According to the proclamation, "National Family Caregivers Month is an opportunity to recognize those who serve a cause greater than self and contribute to the well-being of their loved ones."

As I read that I thought, "That's a great gesture, but will the real caregivers even know about it?" So many family caregivers trudge day to day with too little sleep, too little support, and too much hard, hard work.

In my recent meeting with a group of family caregivers, participants shared how they've come to turn to the internet for answers to many of their perplexing questions.

"Is it really Alzheimer's?"

"What are the side effects of the new medication?"

"How do I keep him safe during the day when I need to run to the store?"

For family caregivers the internet is a resource that they can turn to at 4 am or at 4 pm. They can do quick research while they keep an eye on their loved one at the same time.

My team at aQuire Training Solutions just added another resource for family caregivers: Caregiver Courses available 100% online.

Many family members want to keep providing care but have never been trained. They need to know how to help keep their loved ones joints moving (called range of motion); how to prevent bladder and bowel incontinence; how to keep providing care - and keep their sanity - when disease processes cause challenging behaviors.

These Caregiver Courses offer training in these subjects, and about 20 others. All combined, a caregiver can earn a Caregiver's Certification through this course, a good way to feel a sense of accomplishment while gaining new skills.

But here's the catch: sometimes caregivers are so exhausted from their 24 hours a day work that they miss these handy news releases.

This is the perfect opportunity for friends and family members at a distance to help. Maybe you can't provide the daily care for your loved one because of distance or time constraints, but you CAN help support those that do provide the daily care. With the holidays coming, it's the perfect time to give a caregiver in your life with the gift of support and education.

Let's give all caregivers a reason to celebrate during National Family Caregiving Month!

How to Stay Young

The following great list of things to do to stay young has been in my files for a long, long time. I lost the source, if I ever had it, so if you know who originated this, let me know, and please accept my apologies for not acknowledging you...

1. Throw out nonessential numbers. This includes age, weight and height (especially weight!). Let the doctor worry about them. That is why you pay him/her.

2. Keep only cheerful friends. The grouches pull you down.

3. Keep learning. Learn more about the computer, crafts, gardening, whatever. Never let the brain idle. " An idle mind is the devil's workshop." And the devil's name is Alzheimer's.

4. Enjoy the simple things. Walks in the fall leaves, a glass of wine or cider shared with friends, a warm fire and a rain-proof home; these are some of the best things of fall. Find someone and enjoy them together.

5. Laugh often, long and loud. Laugh until you gasp for breath. Call a friend who always makes you laugh, and make a plan to get together soon.

6. The tears happen. Endure, grieve, and move on. The only person who is with us our entire life, is ourselves. Be ALIVE while you are alive.

7. Surround yourself with what you love, whether it's family, pets, keepsakes, music, plants, hobbies, whatever. Your home is your refuge.

8. Cherish your health: If it is good, preserve it. If it is unstable, improve it. If it is beyond what you can improve, get help.

9. Don't take guilt trips. Take a trip to the mall, to the next county, to a foreign country, but NOT to where the guilt is.

10. Tell the people you love that you love them, at every opportunity.

Life is not measured by the number
of breaths we take,
but by the moments
that take our breath away.

-Anon.

Live Longer: Life Expectancy Can Vary as Much as 20 Years

A news story in last week's Baltimore Sun caught my attention with its headline: "20-year life gap separates city's poorest, weathy."

The story tells the difference in the life expectancy in West Baltimore's impoverished neighborhoods - 63 years, and the affluent Roland Park area - 83 years.

Clearly, there are lessons for us all in living longer, healthier lives. I'm not sure all of them have to do with money, either, although financial well-being is directly tied to longevity in nearly all studies. According to the story, for every increase in $10,000 in a neighborhood's median household income, residents lived 3.4 years longer. But even among neighborhood's not so financially divergent there may be lifespan differences of up to 10 years.

While homicides account for much of the inner-city's lowered life expectancy, other factors such as nutrition and exercise account for at least some of the difference. Of course when you are concerned with survival, you don't have much energy left to think about fresh fruits, vegetables and exercise.

For Americans, living in neither the wealthiest nor the poorest neighborhoods, we do have choices. It appears those choices can lead to significant differences in live span, too.

So like our mothers always said: "Eat your vegetables!" Eat some fresh fruit, too.

Go for a walk today.

Live longer and healthier.

Overcoming the Fear Factor for the Sandwich Generation

Franklin D. Roosevelt, in his first inaugural speech, used the phrase we are hearing echoed today: "...let me assert my firm belief that the only thing we have to fear is fear itself—nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance."

Today, we hear this phrase related to the economic uncertainties and fears.

But this weekend, as I talked with a friend who is sandwiched between her 25 year old daughter and her elderly father, I thought about this phrase in relation to the challenges we share as members of this sandwich generation.

She expressed great fear that her daughter is making choices today that will affect the rest of her life.

She fears for her father, who just found a frightening lump.

My own daughters are living on the other side of the world; one in India and one in Israel. I could be filled with fear for them, as I watch the news and know that these two areas of the world are filled with risk and unrest.

The fear and the worry can be consuming. These feelings can create a background level of stress that makes it harder to sleep; harder to eat healthy foods; harder to maintain our relationships.

Recently researchers found that our thoughts directly affect how our brain functions. We can, from all evidence, think ourselves happier by what we choose to focus on.

When we specifically think of things we're thankful for, the happiness centers of our brain become more active.

I assume that when we worry or focus on our fears, the opposite thing occurs: the parts of our brain that cause depression, unhappiness and despondency become more active.

This weekend, Karen and I made a choice to fight this natural tendency to obsess on the worry and fear. Surprisingly, some of the steps we chose to take really work:


1) Spend time with friends. Talk about what's worrying you, but then make a choice to talk about things that make you laugh or take your mind off your worries. We toured an historic old home in our community and talked about how much daily life has changed over the years - and how thankful we are to have today's comforts.


2) Take a walk. Exercise, combined with fresh air and sunshine has proven value in lifting our spirits and improving our feelings of well-being.


3) Do your "gratitudes." Every day, think of four things you're thankful for. Say them out loud. Try to be creative, and name new things each day. Many studies have found that this one step alone will improve your sense of happiness. Certainly focusing on the things that we are grateful for takes our focus away from our fears and our worries - in itself, a very positive step.

4) Take action. Where you can, take action to relieve your worries. If something is nagging at the back of your mind, let it come forward where you can deal with it. It might as simple as making a plan to visit a parent at a specific day and time. It may mean sending an email or writing a note and putting it in the mail. Action can defeat worry and fear. Do something.

5) Find simple joys. A warm wood fire, a glass of good wine, a book that makes you feel happy inside - these are simple pleasures that can create a feeling of well-being and happiness.


6) Get a pet. My dog Bella is a big furry mess this time of year. She brings in so many leaves when she rushes in that it can look like it's fall inside the house as well as outside in the yard. But Bella unfailingly greets us with a level of joy that is hard not to respond to. She is always excited to see us; always eager to be with us; always overjoyed with even the smallest measure of attention. Pet therapy is now an tested approach to healing and improving feelings of well-being.

Feelings of fear are probably not our greatest concern today. They can, however, as FDR said, result in paralysis that can negatively affect other areas of our lives. Taking simple steps to overcome fear and worry is one positive step we can all begin right now.

Life in the Retirement Center - it's all a big party

From time to time I've shared my experiences with both my mom and my in-laws. My mom lives in a retirement village made up of attached cottages. She loves her new friends there, and most of all she loves the ability to travel without worrying about her house, yard, garden and plants. Because her cottage doesn't come with many amenities, it's very affordable for her, leaving her enough each month to do what she loves - travel. So she's home from time to time between her trips to visit relative all over the US, her annual Hawaii get-aways, and her volunteer trips to places far across the world.

My in-laws, both in their 90s, just this past summer agreed to give up their home and move into a retirement community.

My father-in-law says, "We've moved to the Penthouse." He loves their 5th floor apartment overlooking the beautiful courtyard. He also loves Friday evening "wine tasting" which, last time we talked, he described as a "wine-drinking contest" for the old folks. "They just keep pouring and pouring," he explained. He laughs as he talks about how handy it is just to slide down the wall to the elevator and ride home.

For my mother-in-law, moving was a painful experience. She had determined to live out her life in her home of 57 years, even when it had clearly become a burden and a danger. Only after persistent, repeated family discussions did she finally relent and agree to move.

Last week they took the bus to a nearby casino (she loves to play the slots). She joined a knitting group. She marvels at how many nice, active people there are still alive in her age group (she had lost all of her long-time friends, and felt pretty lonely for peer companions).

Clearly, life isn't all a big party when you're 90+. Hearing is a challenge for her, and getting around is tough for my father-in-law. But living in the "penthouse" and going to weekly wine tastings isn't all bad. And smiling more, talking more, and enjoying what's left of their lives is truly quite wonderful - for them and for us.

Caregivers Need a Break

Family caregivers, especially adult children caring for aging parents, need a break.

We've known for years that caregivers have a higher rate of illness - even death - than the person in their care. We know that caregiving is stressful physically, emotionally and psychologically.

We know that high blood pressure, sleepless nights, colds and depression are common problems among caregivers.

Now, another study of baby boomer adults caring for parents reaffirms these impressions, finding that "helping a parent results in a downward trajectory of health and well-being for the child." ("Routine Caregiver Duties Create Overload," Times of the Internet, Sept. 26, 2008)

Among the issues are the challenges of balancing many roles. Most baby boomer generation family caregivers are also working, managing their own household and caring for kids or even grandkids. They have parent-teacher conferences with their children, and then rush to their parent's home for caregiver meetings.

They are sandwich generation people, pressed down and put on the grill.

Giving caregivers a break may be as simple as giving them access to tools to help them cope. It may be offering support in terms of training for their role, so that as they face caregiving issues with their aging parents they know how to respond.

Knowledge, after all, can be one of the greatest stress relievers of all. And providing support in the form of access to training is something that can be done by anyone, from anywhere.

If you know of family caregivers that need a break, consider ways to help them gain access to caregiver training and resources. Contact us - we'll help.

Preventing Memory Loss - It's Easier than you Think

Most people who have a loved one with memory loss from Alzheimer's or another disease affecting the brain have a fear running through the back of their minds:

"Will I lose my ability to remember and reason? Will I get Alzheimer's disease, too?"

We do know that many forms of Alzheimer's disease have a genetic component, but we also know another thing that is a little more of a secret:

You can take steps NOW to prevent your own memory loss. These simple steps are incredibly effective, and easy to incorporate into your daily life, starting right now.

Don't believe me? Consider this information, taken from the long-running Nun Study in Minnesota, where an entire group of nuns have committed to participating in a study of aging and memory loss, including autopsy after death. Among the nuns are women whose brains, upon autopsy, looked like typical Alzheimer's brains but whose functioning was essential normal throughout their lives. Their secret? They diligently incorporated some of the very steps you can take today.

1. Exercise. No doubt about it: exercise will preserve good health and improve poor or marginal health. Many instances of memory loss are caused by small strokes in the brain. Best prevention for stroke? Exercise. It doesn't have to be in the gym; it doesn't need to be intense. It just needs to be regular and of long enough intensity and duration to make your heart work a little harder and cause just a little glow of sweat. Good rule of thumb? 30 minutes every single day of vigorous walking, dancing, swimming or whatever you enjoy doing.
2. Eat Right. Again, nothing you're not hearing from many sources today. But something most of us could improve on. Two food choices can make a significant difference in your brain health: variety and color. Try for as broad a variety as possible in your meals, especially in the fruit and vegetable department, and go for foods that are intensely colored: beets, berries and peppers, for example. Make those two changes and you've done quite a lot for your future brain health.
3. Keep learning. Read the paper and news magazines. Listen to talk shows that are on the opposite spectrum as your usual way of thinking. Then find someone to talk to about what you're learning, hearing and thinking. If that's too argumentative for you, join a class. Learn to play the piano, speak Spanish, or cook vegetarian. Free or inexpensive classes for adults abound in this country. Consider volunteering in student tutoring or teach a class yourself. Keep learning and keep your brain active and healthy.
   
4. Nourish friendships and stay socially involved. Staying socially active is important for overall life happiness as well as brain health. That doesn't mean you need to have a circle of 50 friends; a few close friends who make you laugh and enjoy life are just as effective. But don't lose touch, and do reach out to make new friends from time to time.

Four easy things that you're probably already doing in one form or another. But focusing on these four vital areas can help you preserve your brain health as long as possible.

What's Happening to Mom? - Taking the First Step

Carrie has a full-time job and two kids still at home. When her dad became ill and passed away unexpectedly, Carrie spent a lot of time with her mother, talking to her about what she would be doing with her life now.

Carrie worried about depression becoming a problem for her mom, and her mother being alone, but what she discovered was that her mother seemed unable to manage even the simplest daily tasks. Cooking seemed to be completely beyond her; even daily dressing, bathing and grooming tasks seemed overwhelming.

In just a few days, Carrie began to suspect that her mother had been experiencing a decline in mental functioning for a long time – her father had been “filling in the blanks,” and no one in the family had even noticed her mother’s failing. Carrie needs to figure out what to do to be the most helpful to her mother right now – at the same time she’s coping with the loss of her father, as well as her own full-time work and family demands.


Figuring out how to face this challenge in addition to your own life demands is the first step you’ll need to take. Learning to cope with your loved one’s needs without losing your mind is your biggest challenge, however!

The First Step

Get a diagnosis. This is the first step you need to take, and the sooner you take it the better. You may wish to go directly to a research center that specializes in Alzheimer’s disease (most university hospitals have these kinds of programs). Or, you may need to start with a family doctor, and go from there for further tests, if necessary.

A visit to the doctor for a thorough check-up is the first important step.

You may hear, “There’s nothing wrong with me – I’m not going to the doctor.” Right off the mark, you need to learn some new skills.

Start with this one: Reassurance. “Dad, I’ll go with you, and I’ll stay with you the whole time – it’s no big deal.”

If that doesn’t work, try bargaining. “Mom, if you’ll just do this for me, we can go to lunch together afterward and have a nice, long chat at your favorite restaurant.”

If that still doesn’t work, try diversion: “Honey, I need you to go to the doctor so the kids will stop nagging me. I’m getting sick and tired of the nagging – it’s up to you to get those kids off my back.”

These are skills you’ll develop and learn to use like a pro over time. You’ll find that you need a whole new set of skills to be most helpful to your loved one, and keep your own sanity intact.

The least useful approach both now and in the future is argument. You might also call this debate, persuasion, or explanation. Whatever you call it, it won’t work! When the brain functioning is impaired, even slightly, a factual presentation is likely to be futile. Logic is frequently one of the first brain functions to diminish, so no matter how grounded in facts your arguments may be, you just won’t win. Try some of the other “tools” for accomplishing necessary goals.

Janice had tried every logical approach she could think of to get her husband Mac to agree to go to the doctor for testing. Each time she brought it up, Mac simply refused to go. “I’m perfectly fine,” he’d say.

Finally, at her wits end, Janice said, “I promised the kids that we’d both get to the doctor for a check-up. I’ll go first if you’ll go after me.” Reluctantly, Mac agreed to go. Janice got a same day appointment, and took Mac in before he was able to change his mind and refuse again.

Once you get an agreement to go to the doctor, you’ll want to consider the following things:

• Accompany your loved one to the doctor – all the way in. Don’t send him or her into the examining room alone.

• Make notes about what you’ve observed – details and facts, suspicions and observations. Take your notes with you, and don’t hesitate to read them to the doctor, or simply give them to the doctor. Can you do this in front of your loved one? Try it – you may be surprised how accepting your loved one is with the facts you present, especially if you word them as facts. For example, “Dad got lost coming home from the store last week. It was kind of scary for us both.” If you just can’t read your notes in front of your loved one, simply hand them to the doctor or nurse to read. Be prepared for your loved one to become suspicious about what you might have to say “behind my back,” and make an effort to include your loved one in your discussions with the doctor if at all possible. Most individuals with early stage memory loss are keenly aware of what they are losing, and this is distressing to them as well. Talking about it openly can actually be very freeing for both of you. Whispering about things tends to reinforce our society’s stigmatizing of diseases causing dementia. Choosing to openly discuss all of the facets of memory loss and dementia can help both you and your loved one face this disease rather than feel that it needs to stay “hidden.”

• Ask for tests. If your loved one has just suffered a significant loss – from a spouse to a beloved pet – be aware that depression could be the problem. Untreated, lingering depression can cause a person to act like they have dementia or another brain impairment. With appropriate medication and perhaps a “friendly visitor” program or brief talking therapy, your loved one may be able to work through the depression and re-gain complete mental functioning. Other physical problems like bladder infections, pneumonia, or vision or hearing losses can look on the surface like Alzheimer’s disease. These problems are generally completely treatable, and what looks like dementia can be totally reversed if the underlying health problems are addressed. Be aware that simple things like drug interactions, dehydration and malnutrition – fairly common problems for the elderly person living home alone – can cause the appearance of dementia. Ask the doctor to test for these and similar treatable physical ailments before you both assume that your loved one has dementia.
  

• Expect your loved one to be much more lucid at the doctor’s office than what you’ve observed. This can drive you nuts, especially if the doctor is not experienced in diagnosing dementia, and looks at you like you’re the one with the problem! This is so common that, fortunately, the medical community is beginning to catch on, and educate doctors to look beyond the “perfectly normal” presentation in the office. Be prepared that your loved one may even be able to ace the “mental status exam” that a physician can complete in 2 minutes during an office visit. If this happens, ask for a referral to a neurologist, or seek out an Alzheimer’s diagnostic center at a nearby University or teaching hospital. Don’t let this distress you. Take a deep breath, and know that what you’re going through is very common and normal. Keep at it until you find a doctor who is really able to see what you’ve been seeing, and help you find an appropriate treatment plan.

• Ask about medications. Once the physician has ruled out treatable problems, and has determined that your loved one likely has a disease like Alzheimer’s, ask about medications. The drugs currently available to “treat” Alzheimer’s disease and other dementias work best during the earliest stages of the disease. During this time, medications can be truly helpful, and can help your loved one regain some functioning, and, barring that, can delay significantly the progression of the disease. Imagine giving your loved one a year or two of extra independence, and what a difference that can make to him or her, both personally and financially. Ask about those medications!

What's Happening to Mom? - what to do when you first discover - or just suspect - your loved one has Alzheimer's disease

You’re reeling from the diagnosis the doctor gave you. Your loved one has dementia – what is that? What does it mean for him (or her) – and for you?

You’ve come to visit your loved one after being away for a while – and something clearly is not right. Is it Alzheimer’s disease? Is it something else – or just you?

You’ve just lost a parent, and the surviving parent seems to be totally unable to cope. You’re dealing with your own sense of loss, and struggling to make sense of what’s happening to your surviving parent at the same time. You need help!

You’re one of the millions of family members who is forced to face the daily consequences of the diseases causing memory loss and dementia, and figuring out what to do now is your first – and most important – challenge.

The Discovery

Typically, the discovery of a disease causing memory loss and dementia comes on slowly. You may be able to look back and realize that there were hints for months, maybe even years, before the moment when you came to the conclusion that Mom or Dad was not just become more and more “eccentric.” Some professionals refer to this period before the discovery as a period of “denial” when family members simply refuse to accept that something is really wrong.

More often, however, family members just don’t put all the clues together until something happens to bring the concerns to the forefront. That could be one pivotal event – Dad went out for a drive and got lost for hours before coming back home.

Or, even more commonly, the discovery comes on slowly, as, over time, you notice more and more signs of a change in your loved one.

Perhaps you realize that bills are not getting paid. Perhaps you notice that your obsessively neat parent forgot to shave for 2 or 3 days in a row, or neglected to change clothes for several days. Perhaps you notice a change in behavior – a use of language that seems out of character; a need for continual contact or reassurance that is unusual.

Perhaps your loved one looks at you with no recognition – or asks you why you never come to visit when you were just there yesterday.

Perhaps your loved one turns on you and threatens to call the police and report you for stealing money, wallets or possessions.

If you’re like millions of other family members facing this moment of discovery, your first reaction may be dismay, especially if you have other responsibilities in your life.

What now?

How on earth do I cope with this, in addition to my regular, busy, full-time life?

We'll explore these questions, and begin answering them, in future articles. Join us!

Families Need Support, too

This evening we're going to participate in the family support group sponsored by our local hospital.

We'll be talking about ways families can get support while they're busy providing care to their loved ones. One of the pieces we'll talk about is holding a family council or a family meeting. Based on our experiences we'll share ideas on when, where and how to get the whole family involved in the process of providing care - or at least supportive of those family members that do the direct work.

Families can be torn apart when caregiving decisions become difficult. When to get help ("Our Mom needs help? Are you sure?"); how to get help ("I hope you're not going to ask me to help pay for it!"); and heaven-forbid, the discussion about moving mom or dad out of the family home into a retirement center, assisted living community or nursing home ("I promised Mom she'd never have to leave home").

But you probably know exactly how this goes. The child living furthest away, doing the least amount of daily work, is still the saint, while the busiest child, helping every day with tasks big and small, is rarely the most valued and appreciated by the aging parent.

So tonight we'll go meet with some families who are right in the middle of this situation, and who come together, leaving their warm, cozy homes to venture out at night, for a little support and encouragement.

Sometimes all we can give is a little help. But sometimes that's all that's needed.

If you'd like a copy of our booklet titled "Holding a Family Council: A Guide to Family Decision-Making about Long Term Care Issues" email me at Sharon@aquiretraining.com.

Stuck in the Middle, but Still Smiling

Stuck in the Middle, but Still Smiling

Where it all began, May, 2005: After years of teaching about, counseling with and writing about them, I've become one. One of the people stuck in the middle - the "sandwich generation," we so fancifully call them.

In addition to the challenges we face raising three teenage daughters, my husband and I are now helping BOTH of our parents make a well-considered change in their living circumstances - hopefully before something happens that forces this change.

Both my husband's and my parents are getting to the point where if one little thing happens, staying in their own homes will not be an option. You know them - the people who, at age 92, are still "several years" away from needing to move from their home. We're encouraging them both to move into a retirement community that offers them all the benefits that they don't have in their isolated lives at home.

Of course, they've been balking - big time. We decided to use a little psychology – always a good thing when you’re the ones plastered in the middle – and we convinced each set of parents that we needed their help getting the other set of parents to agree to a move. Each set thinks the other “really needs to move!”

When we finally got both sets of folks to agree to tour – together - a beautiful, new retirement community close to our home, it took about a month to set a date convenient to all - and that's after two cancellations. Then, when we arrived, both my mother and mother-in-law stood there with jaw set, saying, "No way are we moving in here with these old people!"

By the end of the tour (three hours later), they had softened, and realized that this could actually be fun - a good thing!

Of course now they want to tour several other communities to comparison shop, and of course, they want us to come with them. We, who have SO much extra time in our lives!

Then there are the kids: our eldest away at college, still needing her mom and dad to help her through the challenges she's facing being away from home for the first time in her life. The middle daughter, who calmly cruises along - until the high school pressure builds up, at which point we have major DRAMA, as the girls like to say. And then there's the youngest one, who's determined to chart her own course in life, and not follow in her older sisters' footprints, no matter what it takes!

And we're stuck in the middle. No peanut butter and jelly on this "sandwich" - just lots of time-consuming, emotion-draining listening, coaching and guiding.

But last Mother's Day, as we made the round of the parents, we saw in their eyes a new energy, and an excitement for a new phase in their lives. They couldn't stop talking about what it's going to take to get their homes ready to sell, or what they should do with all their (tons and tons and tons) of belongings.

The Mother's Day cards I got brought tears to my eyes, and even had me sobbing out loud (thank-you again, daughter #1).

And just for a day, I thought what a blessing it is to be surrounded by family, even when the pressure is coming from both sides. Being "smushed in the middle" isn't such a bad thing after all.