Archive for Care Tips
Common Sense Caregiving by Gary Joseph LeBlanc: A must read for anyone caring for a loved one with Alzheimer’s
A columnist and book dealer from Spring Hill Florida Gary Joseph LeBlanc offers a personal and down to earth account of his experience caring for his father who suffered from Alzheimer’s disease. This common sense account of is a must read for anyone caring for a loved one with Alzheimer’s disease. Written as a completion of sixty-five articles from his column, LeBlanc gives an encouraging and enlightening guide for anyone navigating the turbulent waters of caring for a loved one with Alzheimer’s disease.
Discussing End of Life Care (Part 2)
In part one of this two part series, we looked at the different types of advance directives people can establish to ensure that their end-of-life care is in line with their wishes. Today, we look at how to talk to your loved ones and encourage them to express their wishes so that as they approach the end of their life, you as the caregiver know exactly how to proceed.
Although there are always different techniques for approaching this conversation, there does seem to be one common opinion: the time to do it is now. “Everyone over the age of 18 should have a health care proxy form filled out and should be discussing what they would want done with a person that would be making decisions for them in the event that they are not able to make these decisions for themselves,” said Fern Wasserman, Founder of New York Legal Nurse Consultants. New York Legal Nurse Consultants helps facilitate conversations between the individual filling out their health care proxy form and the people who will need to carry out these wishes in the event this person is unable to make their wishes known.
Colleen Reynolds, President of Edge Communications and former admissions and marketing coordinator of a skilled nursing facility in Fort Myers, Fla., also emphasizes that time is of the essence. “I’d suggest that the Healthcare POA/Surrogate be discussed well in advance of needing it. A DNR should be gently discussed, but discussed again when the decision is imminent,” she said. “I watched so many people struggle with this decision and family members who wished desperately that loved ones asked for a DNR after they had been resuscitated and then left to suffer brain damage and broken ribs.”
In Reynolds’s work, she had to have these conversations with patients who did not have any advance directives on file. “Because the conversations didn’t happen earlier, it was often left up to me to talk to someone who was admitted, if they were not declared legally incompetent, to see if they wanted to be resuscitated in the event of heart failure. Strangers should not have to do this.”
Medication Log
Use this tool to monitor changes made to your loved one’s medications over time. The type, date and effects of these changes can be recorded and monitored between doctor visits. This log can then be brought to future doctor appointments to track the negative and positive side affects to further alter dosages to ensure the right use of each medication individually as well as the effects of all the medications taken together as a group.
Sample Log ↓
| Start Date: | 12/10/08 |
| Medications For: | Joe Walker, Sr. |
| Log Prepared By: | Joe Walker, Jr. |
| Brand Name: | Seroquel |
| Generic Name: | Quetiapine fumarate |
| Date Prescribed (mo/yr): | January, 2009 |
| Doctor: | Dr. Ryan Smith |
| Pharmacy: | CVS – Boston |
| Monthly Cost: | $50 |
| Reason: | Dementia – Delusions |
| Date | Dosage | Doses Daily | Times of Day | Observations | ||||||||
| 1/13/09 | 50 MG | 2 |
|
Seems to be doing better, a little tired mid-day. |
||||||||
| 5/20/09 | 100 MG | 2 |
|
Dosage increased by Dr. Smith at appointment on 4/15/09. Increased dosage is managing delusions better. Still somewhat tired after taking morning dosage. |
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Caring and Traveling with an Elderly Parent
Dr. Alexander Fiuza's Family
By Alexander Fiuza, PhD
For many of us summer vacation means traveling with spouses and children, but for some of us it means traveling with our elderly parents. That’s what this year’s vacation was all about for me.
My father, Serafin Fiuza, now eighty-one years of age, dreamed about the day that he could return to his native Orense, in Galicia Spain. On many occasions he mentioned to me his desire to see his homeland one more time. Thoughts of his childhood, family life and friends left behind during the European Civil Wars brought back feelings of nostalgia. And, he faced his own immortality with the loss of his own family members over the years, leaving him to be the only family member living in the United States. This only fueled his desire to return at least one more time to visit his only living relative, Ramona Fiuza, his younger sister.
The siblings were separated at a young age and put onto ships that were destined to arrive to Cuba in hopes for a better life. My grandfather and his eleven brothers and sisters set sail in December of 1931 destined for this new life. Together with his wife and two of their four children, one of which was my father, they arrived in Havana, Cuba. His two other siblings went aboard another ship which arrived in Buenos Aires, Argentina. These two siblings, Generoso Fiuza and Dolores Fiuza, would not see my father and his other siblings until the early 1970’s, when they all came to gather in Miami, Florida for a family reunion. I still remember the emotions displayed and shared by all of our family members. Although I was young at the time, I still get emotional over the memories.
Study: Palliative Care Extends Life Expectancy
It is well known that palliative care aims to reduce the severity of suffering in terminally ill patients, but a recent study conducted at Mass. General Hospital finds that palliative care can also extend life expectancy as well, reports The Boston Globe.
The research team at MGH found that patients with advanced lung cancer who began receiving palliative care soon after they were diagnosed lived almost three months longer than patients who did not receive palliative care. Patients who did receive the additional care lived longer despite being less inclined to opt for aggressive techniques to extend their lives in the final stages of their illness.
Palliative care, which aims to comfort ill individuals both physically, emotionally, and spiritually, also resulted in patients being half as likely to report being depressed than those who only received the standard level of care.
Mindful Caregiving Thought Tools for Resilience (Part 5)
Setting Life-Serving Limits & Boundaries
By Holly Whittelsey Whiteside
This series of articles teaches ways to strengthen your resilience.
Article #1, Utilizing Your Emotions introduced tools for managing self-talk and learning from anger.
Article #2, Conserve Your Energy, offered tools for recouping energy.
Article #3, Building Well-being helped you to scale down your activities and take care of yourself.
Article #4, Survival: Managing Your Emotions helped you fine-tuning your emotional accessibility and adjusting your shifting caregiving role
This article, Setting Life-Serving Limits & Boundaries concludes the series of articles that teach ways to strengthen resilience as a caregiver.
Setting Life-Serving Limits & Boundaries
(Harmony) is when…”Yes” is tempered by a gentle “No,” and “No” is expanded with measured compassion. – Mrs. Chana Rachel Schusterman
While times for silence in caregiving are often a rare gift, opportunities for speaking out abound, offering you practice in setting boundaries. As your loved one ages, your role can shift before your eyes. Within a given day, you may function as child, nurse, entertainment committee, adult friend, healthcare advocate, and sibling, each role requiring a somewhat different voice. Notice that most of these roles are in response to others. (How easily we forget ourselves!)
While dancing with your various and mutable roles, you can remain effective by staying centered in yourself. To stay centered in yourself during caregiving, develop the habit of protecting and asserting your own boundaries. Notice where your responsibility stops and another’s begins. Notice what is yours to do, and what could or should be done by others. Notice what you need in order to be effective. If what you need must come from someone else but is not forthcoming, ask for it. Setting your bounds and limits in your relationships and in your life is an art of balancing controlling with allowing. Here are some guidelines for promoting healthy limits and boundaries:
Top Five Questions to Ask an Assisted Living Facility (#2)
All this week we are taking a look at what the five essential questions to ask when evaluating an assisted living facility are. Today, we address question number two: What services does the facility offer?
The services your loved one will need at a facility vary depending on their level of current ability, as well as how quickly they might need more help as their abilities weaken.
“Level of care needs is determined by how well an individual can carry out his or her Activities of Daily Living (ADLs); the more help they need with ADLs, the higher the level of care required,” said Robert F. Bornstein, PhD, Professor of Psychology at the Derner Institute of Advanced Psychological Studies at Adelphi University and co-author of When Someone You Love Needs Nursing Home, Assisted Living, or In-Home Care: The Complete Guide. The easiest way to evaluate what the future resident might need is to look at what you, as the adult child, are already providing. Does your mother take her medication at the prescribed times and dosages, or do you need to call and remind her? Is your father able to shower on his own, or do you go to his house every other day to help him? “Once a person can no longer carry out basic ADLs, they may require skilled nursing, nursing home, care,” said Bornstein, so be sure to factor in the possibility of a higher level of care depending on how quickly your loved one’s ability is deteriorating.
Discussing End of Life Care (Part 1)
Erin had been caring for her aging mother for the past four years as her body slowly succumbed to cancer. She had read every book and article she could find to teach her what to do throughout the various stages of care. As she stood face to face with an intensive care unit doctor, who wanted to know at what point they switch from attempts to prolong her mother’s life to giving her only palliative care to make her comfortable as she neared her final days, she became unsure of what to do. Over the past months, the exhaustion from battling the illness had gotten extreme; her mother was only awake for about an hour a day – and barely cognizant of her surroundings for that hour. Erin could not remember the last time she had gotten out of bed. Erin was faced with a tough decision… “If only I had talked to my mother about what she would have wanted,” Erin thought, recalling so many times over the past years where they had pretended that an end would never come. Instead of trying to enjoy every moment left in her mother’s life, she is spending it instead worrying whether her decision is really the one that her mother would be comfortable with.
Although Erin’s story is fictional, it is a reality for many caregivers – a situation that could be avoided with one conversation. While discussing end of life care may sound like a daunting encounter, it does not always need to be.
Before having the conversation, it helps to become familiar with what the different options are, and what is legally recognized in each state. This way, the adult child can be more confident in the information they are bringing to their parents, which will help comfort them and allow there to be fewer “what if’s” that may prevent the parents from opting to make a decision.
As We Age: The Five Senses
By Nicole M. Farmer, MD
The five senses work together to help us find our way through the world. Ironically as we move throughout life, the five senses change as almost as much as we age. Ask any person approaching fifty and they can tell you at least a few minor changes they may have noted while trying to focus on objects more while driving or while trying to concentrate harder on words said from across the room.
As common as the complaints are about how the senses change with age, the reasons behind the changes and the total impact on the lives of older people are less known to most people.
In this article we will look into the changes that occur with each of the five senses: hearing, vision, touch, taste, and smell.
Hearing
One of the most important senses is hearing. It is thought to be the only sense that can invoke other senses. Not only does our ability to hear affect our ability to appreciate wonderful things in life, such as a favorite song, once our hearing is impaired there may also be balance issues that ensue. Thus making understanding how and when to recognize hearing loss changes all the more important.
Over one-third of those over 65 and half of those over 85 have some hearing loss. The ability to have sharp, clear hearing may start to decline at the age of 50. Age related hearing loss is caused presbycusis.
Loss of hearing can lead to social isolation and depression. Changes with hearing can also cause falls because hearing contributes to balance.
Unfortunately, hearing is often under diagnosed and undertreated. This may be because assessment of hearing and hearing aids has not been covered under Medicare or most other health plans. Another potential reason for under diagnosis is that hearing loss occurs gradually and we may be unaware of subtle changes. One way to help determine if you or a family member is starting to experience age related hearing changes is the whisper test- done by whispering in the ears. Other signs to look for are frustration with talking to family members, problems understanding conversations in noisy rooms, difficulty watching television. With presbycusis, consonants become a major problem in conversation. The subtle sounds made by the letters z,s,f,p,g,t are difficult to understand for someone with hearing loss. An important note to remember is that when raising your voice, consonant sounds become harder to hear. So speaking louder makes it harder for those with hearing loss to actually understand.
While hearing loss from presbycusis is helped by hearing aids, sometimes hearing changes are from problems due to the ability to conduct sound through the ear. For example, impacted ear wax is common in the elderly due to increased water loss and can cause severe hearing impairment. Ironically, those with hearing aids may experience an increased amount of impacted ear wax.
Read more
Medication Chart
This medication chart can be used to track the doses and times for each medication that you or your loved one takes. Along with being able to fill pill organizers, this chart can also be used to track and schedule non-pill medications (injections, powder supplements, etc.). This is an easy way to see at a glance the medications your loved ones need to take each day.
Download: PDF version or DOC version
Sample Chart ↓
| Medication | Location | Morning | Noon | Evening | Bed |
| Seroquel | Pill Box | x | x | ||
| Insulin | Refrigerator | x | x | ||
| Benefiber | Kitchen Counter | x |