How Often Should You Visit Your Parent in Assisted Living?

How often should you visit your parent in assisted living?When a parent first enters assisted living, their children often feel wracked with guilt. Does your loved one feel abandoned to a strange place? Could you have made in-home care or another arrangement that would allow them to live with family work? First, think about yourself. This may seem like the wrong advice right now – my parent needs me! – but we’ve all heard that we need to take care of ourselves before we can take can of anyone else. You most likely have other obligations that you cannot let go: work commitments, caring for children, maintaining a good relationship with your spouse. Your parent is important, but so are these other parts of your life. You need to make sure that the time you spend with your parent doesn’t result in neglecting other vital relationships and needs. Second, think hard about what your parent really wants. Some seniors get comfortable in their new home, sometimes sooner rather than later, and are so busy enjoying new friends and what the facility has to offer that they don’t need or want you to visit everyday. Have a conversation with your parent about visiting if you think they still have the mental capacity for a productive discussion, or observe them carefully to get a sense of how much they really want you there. Even if they’re not social butterflies and seem to spend a lot of time in their room, they may prefer the alone time, and it’s possible that too frequent visits may make them feel less independent. Especially when a senior is experiencing cognitive decline, you may need to separate what they say from what they really want and need. If mom calls to ask why you never visit her three hours after you were there, it’s likely that this has nothing to do with how dutiful a child you are. She may have simply forgotten how often you’ve been coming to see her! Be careful about taking her remarks personally. A final consideration in deciding how often to visit is how you will feel about your efforts as a caregiver after your parent has passed away. If, after considering what’s possible and the other things in your life, you think you will be comfortable with how much time you spent with your parent, you have probably found a good balance. However, if you think you may have regrets, increase your visiting schedule now while you still can.
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Choosing Assisted Living for Senior Couples

There are options for senior couples moving to assisted living.For aging adults, the move to an assisted living facility is a major life change, but even more so for a couple who has lived together for many years. It is comforting for families to know that while the selection process is still challenging in this situation, there are a growing number of facilities offering accommodations for couples. For a couple whose health needs are very different (i.e., one is in excellent health and the other is experiencing cognitive decline), you as the caregiver may be able to find a facility well able to accommodate the needs of both individuals. However, because their needs are vastly different, some facilities may house one in a particular area suitable for them, and then do the same for the spouse. In situations like this, while the couple does not live in the same room, they are still able to visit with one another often and share meals and other activities. This is often quite beneficial for the spouse in better health, because while their spouse’s health needs are too great for them to handle, they can still live and socialize under the same roof. When both spouses are experiencing similar levels of health challenges, arranging for common living space is much easier. For these couples, privacy may become a major hurdle and developing social relationships with others in the assisted living facility can become more difficult (as it becomes much easier to simply keep to themselves). The rule of thumb, though, for the caregiver and assisted living staff, is to focus your selection options on the spouse whose health needs are greater (or the spouse who is older). Discuss this with your loved one’s healthcare professionals before coming to a final decision. Living together in an assisted living facility can come with tremendous cost benefits as well. Generally speaking, in situations where one spouse is very healthy and the other requires higher level care, the spouse with good health simply pays for room and boarding expenses, while an additional fee is assessed for the care of the other spouse. In short, they are paying for only one room. Many assisted living facilities offer a pricing tier, with the lowest care needs at the bottom of the tier, while others provide services using a la carte, fee-for-service or all-inclusive pricing packages. The truth is, cohabitation with a loving spouse or partner translates into increased happiness and overall better health generally. These benefits would most certainly apply if the couple moves together into an assisted living facility. It may, in fact, strengthen the bond each has with the other, because in this type of environment, each individual’s needs are met in a friendly, healthy manner. Therefore, this gives the couple the freedom to reconnect with one another in a manner often lost over the years in the midst of health problems and other concerns. By consulting the staff, touring the facility and discussing your loved one’s health needs, you as a caregiver will certainly be capable of supporting your loved ones’ housing choices…together.
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Where to Start with Power of Attorney

Part of planning for a senior's future includes making power of attorney arrangements.Please note that this website is not able to provide legal advice. The article below is for informational purposes only and designed to help you get started on researching this issue further. We strongly recommend that you speak with a lawyer or other legal authority to understand how the law applies to your specific situation. When planning for your aging loved one’s future, one of the most important conversations to have is about granting power of attorney (POA). Someone who has power of attorney for an individual is legally able to make important decisions for them. To hold power of attorney both you and the individual must be 18 or older and of sound mind. Here are the basic steps for acquiring this important legal document. Discuss with Your Loved One the Type of POA You Want to Have. In California, there are four different versions of power of attorney, and each has a different function. Durable power of attorney will give you the power to make financial decisions for your loved one. Limited power of attorney will give you the right to carry out a specific duty, and once you fulfill that duty your power will end. Medical power of attorney allows you to make medical decisions for your loved one. General power of attorney is similar to Durable, but your power ends if your loved one becomes incapacitated. Decide Who Will Hold Power of Attorney. Your loved one may have several relatives and trusted friends who they might choose to act on their behalf. Choose someone who will be available to complete the specified duties and who has the most expertise depending on the type of power of attorney desired. A family member who is an accountant, for example, would likely make a great choice for holding durable power of attorney, but may not be the best person for making medical decisions. Your loved one’s comfort with that particular person is an important consideration as well. Complete the Paperwork. In California, Power of Attorney can only be granted in writing. Your loved one can create the document themselves, or someone else (often a lawyer) can create it for them. The document must contain the signatures of the person granting the POA and the person receiving the POA, what powers are being granted, and what date the POA will take effect (if not intended to start immediately, in which case no date is needed). Get the Document Notarized. The POA document will need to be notarized in order to be valid. Any bank branch can provide this service for you. Once these steps have been completed, make sure the form is somewhere where it can be easily accessed when it will be needed. The advantages of preparing in advance will be lost if the document is not available when important financial steps or medical actions need to be taken!
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When Should Your Parent Stop Driving?

steering wheelMany children of aging parents face a challenging decision: is it time to demand that your parent no longer get behind the wheel, or are you being overly cautious and wrongly limiting their mobility? The is one of the most crucial moments you’ll experience as a caregiver: it may be the first time you have to step in and request that your parent make a major life change for their safety (and that of others). While there is no pre-defined age threshold that signifies it’s time to hand over the car keys, there are warning signs that may prompt you to initiate the often difficult but necessary discussion about other transportation options for your aging parent:
  • Challenges with Vision: If your aging parent has been diagnosed with conditions such as macular degeneration, diabetic retinopathy or glaucoma, you will understand right away that your loved one’s vision is severely impaired. However, in cases where there is no diagnosis, but you observe such challenges as difficulty in maintaining their lane or in responding to road signs or traffic lights, this may indicate a decline in vision.
  • Memory Challenges: Because the memory decline associated with dementia or Alzheimer’s disease is often misunderstood, it’s important to understand that these diseases cause those affected to lose orientation and become confused at a moment’s notice. If your loved one has not been formally diagnosed but you notice such challenges as getting lost in familiar places, becoming very confused or being easily distracted behind the wheel, be sure to set an appointment to discuss these concerns.
  • Dents and Scrapes: If you begin to notice a number of scratches, scrapes and dents on the vehicle, fence, garage or several close calls, your loved one may be a danger to themselves or others while driving.
  • Physical Decline: Pain or stiffness in the back, neck, arm or leg areas can create real problems while driving. After all, drivers must still look over the shoulder or use the rearview mirror while behind the wheel, so a lack of dexterity can be especially detrimental while attempting to drive.
  • Side Effects of Medication: While medications are prescribed by doctors to effectively treat certain illnesses, these medications can produce side effects within the individuals taking them. Often, the list of known possible side effects is addressed briefly at the time the medication is being prescribed. However, if your loved one takes a number of medications, there is also a risk that certain medications taken together may produce an undesirable response within the body. Your loved one’s pharmacist can often research this information for you. Some side effects impair an individual’s ability to drive, so pay attention to this and respond appropriately if your loved one seems to be having trouble.
While an active and independent senior adult may find the change especially difficult, feeling that increasingly more aspects of their lives are outside their control, there are other viable options you can offer to help your loved one maintain a sense of independence:
  • Community or Senior Transit Systems: Your local area Agency on Aging can usually coordinate trips for senior transit to places like the doctor’s office or grocery store. Certain places of worship also have a system for transporting individuals who cannot drive themselves to different places within the community. Some medical facilities have also expanded their service offerings to include transport to and from appointments for patients unable to drive themselves.
  • Public Transportation: Depending on where you live, the public transit system may be  developed enough for your loved one to get around to different areas. Lower fares are usually offered for senior adults.
  • Create a Ride Sharing Program with Neighbors: This is a great way to increase the sense of community, build up social relationships and barter with others in your network. For example, your loved one may not be capable of driving, but might be able to help with other domestic tasks. Plus, the camaraderie formed is tremendous for older adults.
  • Get Around the Good Old Fashioned Way: Walking or cycling is a great form of exercise and helps reduce the risk of certain diseases. It’s an excellent way to get around on a warm, sunny day. Just remember that while some seniors can still walk or bike when they shouldn’t drive, there are safety considerations even for these simpler forms of transportation too.
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Helping a Child Better Understand Dementia and Alzheimer’s Disease

Children can have a tough time understanding the challenges of dementia.While it is incredibly difficult for adults to adjust to the progressive challenges that come along with caring for a loved one with dementia, the pain and frustration a child (or teen) might feel can become almost overwhelming. Imagine, for a moment, the difficulties in comprehending why their grandparent or other loved one no longer recognizes them or behaves in a manner inconsistent with previous experiences. It can be tough, but being aware of your child’s feelings and helping them learn to cope can reduce frustration on the part of both your child and your loved one. Dealing with dementia can be frightening as you watch your loved one’s memory and behavior fade into unknown territory. However, children are often curious and as they begin to notice changes, you might help to ward off anxiety by both anticipating questions and by quickly addressing their questions in an age-appropriate manner. For example, depending on the emotional closeness the child has enjoyed with the loved one, the fact that grandma can no longer remember them or seems to be acting bizarre in your child’s presence may suggest the loving, special bond once shared is now lost. Feelings of rejection can ensue. However, you can always do your best to reassure your child that the disease causes difficulty in remembering things. Remind them that Grandma does, however, still love them and regards them as a special part of her life. Young children may develop a concern that you, too, may begin to develop similar symptoms and that they might “lose” you, too. Educate them; dementia is not a contagious disease and it is not a part of the normal aging process. Questions regarding what happens next will have to be addressed gingerly. Young children thrive upon routine; therefore, you will do well to explain to young children how their normal routine may change a bit in the face of the illness. Combat feelings of jealousy by assuring them that although your loved one will need time and attention, they are still an important part of your family unit. Signs that dementia and Alzheimer’s disease is affecting your child may come in indirect manners, such as substandard grades or withdrawal from friends. In instances where your loved one is being cared for in the home, emotional expressions may become more exaggerated or more frequent. For example, your child or teen may become exceptionally frustrated at having to repeat themselves again and again, or from being subjected to seemingly silly accounts given by your loved one. He or she may feel that the loved one with cognitive decline gets all the attention and may lash out in the moment. While it is likely that both you and your child will be learning – and coping – with the effects of the disease at the same time, gently remind them that all people (even those who are forgetful and sometimes difficult) have the capacity to feel and receive the outpouring of love in the moment. Encourage your child to talk about feelings and observations; your child may reveal things you haven’t previously addressed that could be an underlying cause for concern. As much as you can, help them to comprehend that you, too, can empathize with their feelings. Further, help them understand that their grandparent or other relative with cognitive decline did not choose the disease and that the changes happening inside their brain is what is causing the memory and behavior problems. For you as a parent, read over related materials to help with these discussions. Try involving your child with the loved one with dementia or Alzheimer’s by engaging them in simple activities like listening to music, setting the table, or creating memory boxes. Above all, you and your child can come together to devise ways of showing your love and support which helps you both to keep an open line of communication available for everyone involved.  
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The Pros and Cons of Dementia Care Support Groups

Dementia caregivers should consider joining a support group.Being a caregiver is tough – from a physical and emotional standpoint, among other considerations. However, for caregivers of a loved one with dementia, the experience can be rather unique. After all, the person’s cognitive decline can incite a number of challenges, including how to deal with unpredictable changes in behavior, the fear of maintaining the strength to deal with ever-increasing responsibilities, the increasing difficulty in communicating with your loved one, and the isolation a caregiver may begin to feel as friends and family sometimes begin distancing themselves from this often uncomfortable situation. It is in times like these you may consider joining a dementia care support group. There are usually a number of support groups available in your local area, most guided by experienced professionals who have been trained to assist caregivers in dealing with the difficulties associated with this disease. Some groups have even broken down into smaller subsets, such as dementia care support for spouses, adult children, caregivers of  patients in later stages of cognitive decline, etc. While joining a support group gives the family caregiver a “safe place” to discuss the challenges, here we will discuss both the pros and cons of joining a Dementia Care Support Group. This way, you can evaluate this option ahead of time. If you feel a support group can help, you should always attend at least one meeting to see if the group you’ve chosen is right for your individual needs. If you have been the family caregiver for a patient with dementia for any length of time, you are bound to have dealt with friends or family members who are absolutely certain that the individual you are caring for has no problem at all. In fact, they probably felt that you were the problem instead. Often, in the earlier stages of decline, the condition is not easily detected, so your gripes may fall on deaf ears. It is a difficult time that can often leave you feeling misunderstood and rejected as others see your claims as unwarranted. A dementia care support group can give you the much-needed empathy you may be looking for, because the room will be filled with others who are currently dealing with, or who have dealt in the past, with the very challenges you face. This part alone can be quite liberating. Second, the professional guidance you will receive from the support group leader will often educate and encourage you throughout the process. Behaviors you regard as bizarre are often common to the disease, and you will hear that through your group leader or from others within the group. Third, if you are in need of individual counseling outside the group, your support group leader can often give you some direction about reputable services in the area. At times, the conflicts you face as you deal with caring for your loved one can bring up old, unresolved issues you’ve suppressed for years. If this is the case, counseling may be a good fit, but you will not want to open these issues to a counselor who may not understand the space you’re standing in. Now to the cons of joining a dementia care support group. First, the liberating feeling you’ll get by being surrounded by others who “share your pain” can lead you to rehearse feelings of helplessness and victimization. Even in the face of the caregiving challenge, you will always want to remain positive and focus on the good; thus, you will want to be aware and to follow the guidance of a strong support group leader so you will not fall into the “forever victim” trap. Second, you will want to build strong, healthy relationships which focus on other areas of your life. In other words, don’t spend all your time away from your loved one rehashing what he/she did and how you feel. You will want to put avenues in place to support a balanced lifestyle, including friends and activities which support your interests and goals. These are things to think about as you consider joining a support group. The decision is not for everyone, but some caregivers find such groups useful for getting through a difficult period.
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Setting Limits as a Caregiver

Setting healthy limits is the key to keeping your sanity as a caregiver.As a family caregiver, you probably are finding your life sandwiched between your career responsibilities, raising children, nurturing a marriage and yes, caring for mom or dad. Though you feel the pressure to perform well in each role, being a caregiver can be especially time-consuming and emotionally draining, even more so when you approach the situation as the ever-ready hero. The experience, however, doesn’t have to be that difficult. Most of our encounters in life involve the early establishment of boundaries, and we’re generally content if we do it well from the start. But family situations get sticky. In the role of primary caregiver, we tend (as much as we hate to admit it) to fail in this area. The reason is actually a simple one – regardless of whether you are 18 or 78, you will always be the “child” in the relationship. As children, we learn to respect our parents and see telling them no as being inappropriate, so the role-reversal can become quite touchy for the both of you. If these feelings have made you anxious and caused you to avoid setting limits, take heart. Having reasonable, lovingly presented limits established for the relationship can not only benefit you but can also benefit your loved one. As you release the responsibility to do, and be, everything for your parent, he or she will learn a sense of independence which significantly raises self-esteem. So, how do you, as a family caregiver, go about setting limits you and your loved one can live with? The following are a few tips for getting started on this journey. First, have an honest, evaluative dialogue with yourself. Outside of accidents or sudden, debilitating illness that a loved one might recover from, the role of caregiving usually plays an increasingly more significant role in our lives over time as the end of life nears. When it reaches the point where a great deal of time is spent caring for your loved one, you must take an inventory of your needs as well as theirs. This is the moment you determine what you can reasonably commit to, what needs to be delegated to others, and what you’ll have to decline. Truthfully, it’s much better if you are able to establish a team before crisis time… ideally in the form of a family meeting involving your parent, siblings and other relatives who might be able to assist. You must know that caregiving is NOT a solo operation, and being clear about this from the start can save you from physical and emotional burnout. Second, get clear on your priorities. Often, caregivers rush onto the scene believing they will somehow come in to save the day, but often at the expense of time spent with their spouse, children, and friends. It has been said that we all make time for the things which matter most to us in life, and the caregiving experience (which can be lengthy) is but one component in the rich, well-rounded life you’ve created for yourself. Your parent is important, but don’t neglect others you hold near and dear, who of course will be your support network during the rough spots of your journey. If your career aspirations are high on your priority list, you will also have to build in time to achieve the standards of success you’ve defined for yourself. Third, understand that your loved one can become quite demanding in the face of illness and loss of independence. You will find that some elderly individuals will become increasingly more self-absorbed as their illness lingers, and as the primary caregiver you will likely be targeted to meet those needs, right then, no matter how reasonable they are (or are not). Sometimes, you just have to make the words “no” or “not right now” your close companions – and then stick to your guns. In closing, taking on too much can be detrimental to you, making you of little help to your loved one who needs you. If you need help, ask for it, and don’t rule out hiring professionals and turning to long-term care. It may seem counter-intuitive, but doing so can create a better, more loving experience for everyone involved.
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Choosing a Hearing Aid

Purchasing a hearing aid requires some research.Currently, about 37 million Americans are affected by some form of hearing loss – from slight impairment to complete deafness. Of that staggering number, only about one-fourth of those individuals actually utilize hearing aids to overcome this challenge. Among the top reasons for not choosing a hearing aid: the unwillingness to admit the disability and the high cost associated with the devices. The costs for a hearing aid range from $1400 to $5000 each, according to the Hearing Loss Association (a consumer advocacy group). The market is now made up of almost all digital hearing devices which receive sound via a small microphone, process the sounds digitally using a microchip, then amplify the sound, sending it to the recipient’s ear. These are a far cry from the analog hearing aids of old, which did little more for the recipient than amplify the sound and allow him/her to adjust the volume. Overcoming hearing loss is such an individual process that the newer, digital devices allow manufacturers to adjust the devices to suit the particular needs of the buyer… and that’s great news. That is due largely to the fact that two people with the exact same level of hearing loss can process sounds entirely differently, making the selection of a hearing aid a very individualized matter. Most hearing loss evaluations are performed by audiologists or by ear, nose and throat specialists. These professionals can often also sell you devices, or recommend you to reputable vendors. If you are having trouble locating an audiologist, the American Academy of Audiologists can connect you with a list of qualified providers. A basic hearing test includes the following:
  • Speech audiometry: The patient repeats words (in silence and noisy backgrounds) to determine how the hearing loss is affecting him or her.
  • Pure tone bone conduction audiometry: This test detects where  in the ear the hearing loss has occurred, and thus how best to treat the problem.
  • Tympanogram: This test determines how well the middle ear hearing system, as well as the eardrum, is working.
  • Pure tone air conduction audiometry: This test determines how well the patient actually hears the beeps and tones given.
Once the level of hearing loss is accurately assessed, the hearing specialist should also work to determine your lifestyle, so that the hearing aid chosen will actually fit into your normal daily routine. Your specialist may want to know if you live alone or with others, in a large or small space, if you dine out regularly, if you are often in noisy environments (movies, theater, religious services, etc.), or if you’re a heavy user of your telephone or television. Before you look into the types of devices available, it is important to note that most medical insurance plans will readily cover the cost of testing, but most will cover little (if any) of the cost for the actual device. If you served in the military, be sure to start with your local Veteran’s Administration’s office, as they have some programs to address hearing loss for vets. Medicare, along with most private insurers and Medicare Advantage plans, exclude the cost of the device with some exceptions for cochlear implants designed to address the most severe of hearing loss concerns. Financial help is available through programs with Lions Club International, the Hearing Loss Association, as well as the Better Hearing Institute. Hearing aids and their capabilities have come a long way, so ask your vendor about the number of options available (as well as warranties and extra fitting fees, if any). Open fit hearing aids eliminate distractions and echoes, as do the devices outfitted with noise reduction technology. Devices with directional microphones reduce outside distractions and the Bluetooth option allows calls from your cell phone to ring directly to the hearing aid. Of course, today’s digital technology provides all types of options to accommodate your lifestyle.  
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