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How Children Can Help with Caregiving

children help with caring for seniorsMost people have fond memories of at least one of their grandparents. These are some of our most cherished relationships. It’s important to both your children and your parents that they make the most of this relationship while they still can. During this difficult time when the family struggles with dementia or the poor health of your parent, strong grandparent-grandchild relationships are vital and can be very nurturing to them both. Often people leave children out during times of illness, but if this happens they can miss out on the chance to help a relative who needs them. As adults, we want to feel that we are valuable and that we’re making a contribution to our world. That’s what makes old age so tough – we can begin to feel that we’re no longer relevant and that we no longer matter. Kids, on the other hand, want to be recognized for what they do well, especially when they’re teenagers. Kids today often don’t know much about history, and this is where a good relationship with their grandparents can really benefit them. They have much to learn about where they come from, and about things that happened before they were born. Even if your parent thinks your family history is unremarkable, your kids are likely to be curious and glad to know where they came from. And kids, in turn, know quite a few things that grandparents don’t. They may be able to set up your mom’s new DVD player faster than you can say “Gone with the Wind” or they are pros at doing that cool new dance everyone’s talking about. Even a sullen teenager may be more receptive to assisted living visits if you find some way to incorporate their talents. Maybe they can build an online photo album with treasured images to share with their grandparent. Or, if they were just in a school play, maybe your child and their classmates will agree to volunteer to perform a few scenes to entertain the assisted living residents. (Won’t mom be proud!) Make sure that both grandchild and grandparent know what they can contribute to the other, and ask each of them privately to help you by contributing their knowledge and spending time together. By each of them sharing what they know and what they’re good at, grandparents and grandchildren can meet each other’s emotional needs. So getting them to spend time together can be good for your parent, good for your kids, and ultimately, good for you because everyone’s happier and a little less stressed.
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Senior Day Trip Idea: Visit the Zoo

senior day trip to the zooWe think of zoos as a classic class trip for children–but seniors can enjoy them too! Taking your loved one to visit a zoo, possibly with the extended family in tow, can be a great way to create togetherness and provide a stimulating activity for your loved one. In southern California we have some of the best zoos and aquariums in the nation, so this can make a great local day trip. Interaction with animals is beneficial both for seniors and their stressed caregivers. Research has shown that this activity contributes to lower blood pressure and makes people feel happier. The increased chance of social interaction that happens during a zoo visit, whether the senior is part of a group or just visiting with one caregiver, also has positive effects such as reducing the chance of depression. Your loved one will even get more exercise than they do when they stay at home. For various reasons, seniors are often not able to have pets. This can be a difficult restriction to live with for those who are lifelong animal lovers. But regular zoo visits allow these seniors to experience the benefits of animal interaction. Those who have Alzheimer’s disease or other forms of dementia can specifically benefit from zoo visits, as this environment can trigger happy childhood memories. Be sure to plan your trip carefully, as that will help the day go smoothly and minimize stress for both of you. Schedule your trip for a day when the weather will be good. You’ll want to arrive close to opening time, when the zoo will be less crowded. Discuss with your loved one what exhibits they want to see, and get a map of the zoo beforehand so that you can plan the best route for seeing everything on your list. That way you won’t get lost or waste time backtracking once you’re there. When you’re at the zoo, don’t be afraid to ask for help. The staff regularly deal with various people with disabilities and know ways to help your loved one get the most out of their visit. Zoos often offer priority seating during events for those with mobility or vision issues. Special audio assistance devices can also be arranged. And be aware that many zoos offer senior discounts or other special deals for the elderly. A trip to the zoo can be a fun diversion for both seniors and caregivers, breaking up the monotony of the day-to-day.
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Dealing with a Loved One Who Wants to Go Home

seniors who want to go homeThere are many seniors who make the transition to assisted living or memory care comfortably. But unfortunately, due to the nature of the disease, sometimes loved ones are faced with an uncomfortable request: “I want to go home.” Such a plea is heartbreaking, and when you hear it every time you visit it can leave you quite distressed. The first thing to know is that when your loved one says “home,” they probably don’t mean their previous residence. Remember that due to Alzheimer’s and dementia, they’re living in their earlier years. Home is most likely their childhood home, and that place and the people they lived with may be long gone. So before you beat yourself up with guilt, know that they are requesting something impossible that you couldn’t give them no matter how hard you tried. The best way to deal with this request is with gentleness and a little bit of subterfuge. This is one of those moments where enabling your loved one’s denial may be the better course. Avoid correcting or arguing with your loved one, as this will only cause distress without really aiding them in recognizing the truth. First, use positive body language such as nodding your head. Then try to change the subject. Look for something interesting going on in the immediate environment. Maybe there’s a bird outside the window, or a colorful painting nearby. Point this out to them and shift the conversation. It may also be helpful if you can move them physically: guide them to the object of interest or turn them to face a different direction. You are trying to get them out of an unproductive rut. From there, seguey into your loved one’s memories. Get them to talk about what “home” was. This will help them pay this cherished place a visit, if only in their minds. A photo album might be helpful here if you have one. Your discussion may give you some clues about how you can bring home to them in their new living space. Perhaps there are beloved objects or furniture that will help their new surroundings feel more familiar. Your loved one will likely not completely stop talking about home, and you’ll likely continue to feel the pangs of heartbreak. However, some knowledge about where the request is coming from can help you accept it. This is a case where you may not be able to change external circumstances, but you can change how you react to them.
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Helping Teens Cope with a Grandparent’s Alzheimer’s Disease

teens and Alzheimer'sAn Alzheimer’s diagnosis challenges everyone in the patient’s family. Teenagers may sometimes seem to be wrapped up in their own worlds, but a grandparent who has Alzheimer’s disease can be very troubling for them and significantly affect their lives. Of course, it goes without saying that when a teenager’s parent is diagnosed with Alzheimer’s, it is all the more devastating. Teenagers are likely to need some help from older members of the family in understanding the disease and what they can do to cope. First, reassure your teenager that the emotions that they’re going through – which may include fear, regret, confusion, and anger as well as sadness – are all normal responses. It may be helpful for them to hear that this will be a difficult time in the family, and for you to acknowledge that this experience is a hard one for them specifically. And of course, it may be good for them to know that they are far from being the only teen in the world dealing with a grandparent with Alzheimer’s, even if none of their friends have any experience with the disease. If there’s no support group in your area that they can turn to, you may want to point them to the website of AFA Teens, a branch of the Alzheimer’s Foundation of America. There they can find articles written just for them, a community message board where they can connect with other teens, and numerous other resources. One of the most useful things you can do is to explain to your teenager how to communicate with their grandparent. The following are some tips you can pass along to them:
  • Approach a person with Alzheimer’s from the front, so that they are aware someone is coming.
  • Use their name to get their attention.
  • Ask questions one by one, rather than giving them too much to think about at once.
  • Maintain eye contact.
  • Speak clearly and not too fast.
  • Remember that if they forget your name, it says nothing about how much they love you. Just be patient and tell them who you are.
  • Use a voice that is gentle and kind.
  • Smile and use hand gestures and other body language. This sets a positive tone and makes you easier to understand.
One aspect of the disease that teens have trouble with is how to spend time with their grandparent. How do you connect with someone who doesn’t even remember you? Let them know that their grandparent will be glad to have someone come visit them and pay attention to them, even if they don’t know who that someone is. Here are some tips for visits:
  • Help grandparents do some basic, manageable chores. The feeling of getting something done and being useful can be very therapeutic.
  • Ask them questions about the distant past, for example: “What was your life like when you were my age?”
  • Listen to your grandparent’s favorite music. This may also get them talking about the past.
  • Go through family photo albums, especially older ones.
  • Play a game together or work on a puzzle.
  • Read them something that they might enjoy.
It can be easy to forget the needs of teenagers during this difficult time, especially for a parent who is scrambling just to take care of their aging mom or dad. But remember that teens can be very sensitive to what’s going on around them. Spending just a little time to help them adjust to what’s going on can make all the difference.
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Activities to Do with a Loved One Who Has Dementia

With some creative thinking, you can come up with activities to do with a person who has dementia

Photo used under Creative Commons from Marg S.

It’s difficult to think of things to do with a parent or other loved one who has dementia. Your options may seem quite limited. However, it’s important to make the effort to find ways to spend quality time together: this will improve your loved one’s happiness and their health. Below are some tips to get you started: once you begin to think about it, you may realize that there’s more that you can do than you think. 1. Come up with activities that incorporate their interests. All of us thrive and are much happier when we’re doing things we enjoy. But what if your loved one is no longer capable of taking part in the activity in the same way they once did? The answer is to think of ways to modify their hobby. For example, if they once loved to read but their eyesight has deteriorated to the point where they can longer read even large-print books, you can get them audio books and a good set of headphones. If they once loved to play baseball, make sure they have a radio or TV that they can use to catch the game, or even take them to a day at the ballpark. 2. Don’t just try to pass the time. Ideally, the activity you do together will have a lot of meaning to both of you. Don’t plan to do something that neither of you would have enjoyed twenty years ago. Sometimes people rationalize not putting much thought into the time they spend with loved ones with dementia by telling themselves that the person won’t remember the activity anyway. It’s true, they may not remember, but they can enjoy the present when they’re in the moment. 3. Do something that involves social interaction. We all need to feel connected to others, even those of us with dementia. We make an effort to visit with a loved one in assisted living for this very reason. But try to add variety as much as you can. Consider taking your loved one with you on outings – even just a simple trip to the mall or to a park can be interesting and different for them. (Do try to avoid very hectic places, though, as that could make your loved one anxious.) Even if they’re not able to leave home, try to make sure they see new faces. Ask visiting relatives to come to their care home with you when they’re in town, or bring one of your loved one’s former neighbors by to say hello. 4. Do something that involves exercise. Does your loved one tend to wander, as many dementia patients do? The underlying cause of this behavior may be a lack of exercise. Try going for a walk with them around the neighborhood, or get them an exercise bike if they’re still limber enough to use it. This can be a solution for boredom and anxiety.
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Understanding Parkinson’s Disease

Parkinson's disease becomes more severe over time.Parkinson’s disease is something that develops slowly over time. In the beginning, symptoms may be mild, but will eventually become more severe. This is due to the gradual decrease of the neurotransmitter dopamine. Nerve cells that use dopamine to send messages to control muscles can no longer do so if the brain cannot supply them with sufficient amounts of the chemical messenger. Recognizing Parkinson’s The common conception of a person with Parkinson’s is that they suffer from uncontrollable tremors and muscle movements, but this doesn’t occur in the early onset of the disease, nor is it universal in all sufferers. Researchers have isolated four pre-motor symptoms:
  1. Body movements occurring during REM sleep when only the eyes should be moving
  2. History of constipation
  3. History of depression and anxiety
  4. Diminished sense of smell
Since early treatment can keep the disease under control, it is vital that you be aware of the above warning signs in loved ones as well as:
  • Changes in speech patterns such as slurring, hesitation, low volume, a monotonous voice, and difficulty in choosing words
  • Increased sweating or urination
  • Changes in personality
  • Low blood pressure when standing
  • Foot cramps
  • Drooling
As the disease continues to progress, the following areas may be affected:
  • The face: this manifests itself as “Parkinson’s Mask,” or the loss of ability to smile, blink, or alter facial expressions
  • Fine motor skills: handwriting may be unusually small
  • Muscle coordination: there may be difficulty with walking, rising from a seated position, and swallowing
  • Cognition: watch for memory problems, the degeneration of problem-solving skills, attention deficit, confusion, and the inability to make decisions,
  • Mental health: the person may experience depression, hallucinations, or signs of dementia
Diagnosis The importance of early diagnosis and treatment cannot be overstated since Parkinson’s often makes an insidious entry into a victim’s life, establishing itself before he or she realizes something is wrong. So if you notice even one of the above symptoms in a loved one, pursue immediate medical evaluation. There is no definitive diagnostic tool for Parkinson’s. Blood testing rarely uncovers abnormalities, nor do MRIs, EEGs, and CAT Scans spot any brain change. Therefore a doctor must make a clinical diagnosis (one based on his or her own judgment). It is crucial you seek a neurologist with a thorough knowledge of Parkinson’s disease to evaluate your loved one. Evaluation After taking a family history and performing a physical examination, the doctor will ask you and the patient about observed symptoms, then watch him or her stand up, turn around, walk around the room, etc… all in an effort to judge movement, balance, and coordination. Treatment The Doctor will prescribe drugs to alleviate symptoms, the most common of which is Sinemet (Levodopa/Carbodopa).
  • Levodopa, also known as L-Dopa, travels to the nerve cells of the brain that should be producing dopamine, where it is converted to dopamine for use as a neurotransmitter.
  • Carbidopa increases Levodopa’s effectiveness and decreases possible side effects like nausea, vomiting, and occasional heartbeat disturbances.
If medications have minimal effects, or cease to be effective, depending on age and overall physical condition you may want to pursue alternate treatments as Deep Brain Stimulation or Stem Cell Treatment. Care A Parkinson’s patient needs individual care and constant observation. In a perfect world he or she could remain in their own home, but this is often not possible. An excellent alternative is a board and care home, like Raya’s Paradise, where staff keep a watchful eye and make sure medication is taken. There is no cure for Parkinson’s, but we can buy time and make that time as pleasant as possible.
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How to Address the Effects of Vision Loss

Vision loss is more than simply loss of sight.The loss of your loved one’s vision is a loss of their independence and a battle with their quality of life. The decline in their depth, central, and peripheral perception has a negative effect on mobility, communication skills, safety, and emotional health. It’s very important to come up with a plan to help them cope. Impact of Vision Loss The easiest way to think of how your loved one feels is to think of someone who is hearing impaired. They communicate by sight, with their hands, and read lips. They are able to pick up facial expressions, head nods, and gestures. You may already have to speak louder to a loved one because of hearing loss. The loss of two senses is heartbreaking and leads to a lack of social interest and activity, a poor quality of life, anxiety, and even depression. There are also safety issues associated with vision loss. Your loved one is in danger of falling doing normal activities, slipping on spilled oils, lotions, or food. They could trip over cords that were previously tucked away, or miss stepping over something because of poor judgment of the height of an object. Loss of vision impairs driving ability and increases the chances of vehicle accidents. The worst safety concern is that your loved one might not be able to effectively communicate what is wrong because they’re in a state of panic and not able to see their surroundings properly. Living in assisted living can mitigate some of these risks because the environment is designed for senior safety, but it’s impossible to completely prevent accidents from happening, especially if a senior miscalculates what they can handle. Helping Your Loved Ones Cope With Vision Loss There are many things you can do to help your loved one cope with vision loss.
  • Color code medicine bottles or purchase pill containers to help with medication management
  • Make standardized arrangements of household items
  • Add safety features to household items such as table edge guards and gates around stairs, and place non–slip mats around slippery areas such as the kitchen
  • Decrease glare from the sun or other light sources in the home; add motion sensors and plenty of lighting
  • Minimize clutter and bulky furniture
  • Attend eye doctor appointments with your loved one; discuss all medication because drug reactions can have side effects on vision as well
Your loved one may feel they are a burden and keep important issues away from you. It’s important to let them know you are there for them. Set up a caregiver treatment plan. Help them connect with community resources for assistance such as transportation services and support groups. Provide self-help aids such as magnification devices, various eyewear, tinted lenses, closed-circuit television, large print books and telephones with dials. If they enjoy sewing, have a needle threader and plenty of thimbles. If they love novels, get them a subscription to an audio book of the month club. By being mindful of what loss of vision means and showing compassion and support, you can ease the negative effects of this health condition.  
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Notice the Seniors Around You

Noticing the seniors around you can bring rewards.When you visit your loved one, do you ever take a look at any other residents? I mean really take a look. Or have these elders become part of the background of the facility? How about that tiny woman with the thick glasses who’s always in the main lounge, shading her eyes from the light; or the frail man with the gray hair who nods at you from his wheelchair whenever you pass by? And that Asian man who likes to sit by the window watching the traffic outside, have you ever wondered about him? Your mom or dad’s new neighbors all have a piece of history attached to them. Some struggled in school, while others triumphed. Some worked with numbers while some pursued their creative abilities. Some individuals worked at exciting or prestigious jobs, others at boring repetitious ones. They lived, loved, and laughed, just like your mother or father. Why not take the time to learn a bit about them, too? When you’re spending time in the lounge with your mom or dad, choose a seat within speaking distance of another resident. Start with a smile. You never know where a casual comment may lead. We all crave conversation. In most cases, it doesn’t diminish with age. In sharing their stories, a senior has a chance to relive their experiences here and now, rather than in the recesses of their memory. They matter to someone who wants to know who they are. As for your mom or dad, perhaps they will gain a new friend out of your simple outreach. Maybe your dad was a pharmaceutical salesman, too. Maybe your mom was an I Love Lucy fan, too. Common experiences can serve as a firm foundation for a friendship. You’ll feel better knowing she’ll have someone to “hang out with.” You might benefit in other ways too. Widening your circle of older acquaintances might result in practical advice you can put in place in your own life. And when you least expect it! Take that lady mentioned above, the one with the glasses. A woman visiting her father, who was a writer experiencing a string of rejections, struck up what she thought was a casual conversation with the unassuming senior. As she wheeled her father toward the elevator, she offered her arm to the old lady hobbling beside her. She learned that the woman had been an accomplished illustrator of children’s books in the 1960s and ‘70s. “Oh, I tried writing children’s books,” our visitor replied. “And what happened?” asked the woman. “I gave up.” “Well, you must start again,” was the advice offered. And so she did. So, look around. At the very least you’ll break up the monotony of another human’s life. You never know, you might hear about a life of accomplishment. That Asian gentleman by the window, he was the youngest in a family that emigrated from China. Inspired by parents who believed in education and excellence, he went on to medical school and opened his own neighborhood practice, holding off retirement until the age of 82. And the friendly gentleman in the wheelchair — after a career as a cameraman in Hollywood studios, he opened a successful store specializing in nuts and fine candies. It flourished for years. Notice someone, because you never know where it will lead.  
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Caregiving and Anxiety

These three tips can help ease caregivers' anxiety.We probably don’t have to tell you that those with elderly parents are more prone to anxiety. The root of anxiety is unexpected changes, and the health of seniors can change suddenly. Caregivers are also working hard to balance multiple priorities, and often feel stretched to the max. Addressing severe anxiety will require help from a doctor or therapist, but the tips below will give you some tools that you can use on your own to get to a more relaxed, peaceful state. 1. Do something you enjoy. Yes, we know you don’t have a lot of spare time. But there’s much you can do to make life more pleasant in the bits of time you do have. A ten minute walk on a nice day can work wonders, especially if you make a point of being in the moment and enjoying it. Another thing to do that adds virtually no extra time is to listen to your favorite music while you’re in the car, at your desk, or doing chores. Also, try to squeeze in time for your hobbies. Even spending just an hour a week, or one day a month, can help lift your mood and give you an outlet. 2. Try meditation or breathing exercises. Simply taking a few minutes to focus on your breathing has more of an effect than you might think. If you find your anxiety rising, stop and take some slow, deliberate, deep breaths. This basic technique should help, but you can search online for more breathing exercises to get further benefits. Meditation or prayer can have similar advantages. Don’t worry if you think you don’t know how: meditation can be as simple as taking the time to pay attention to your breath and the present moment. You don’t have to be an expert. 3. Focus on nutrition and exercise. When we’re busy, taking care of ourselves can be one of the first things to go. But sticking to healthy routines goes a long way to staying on track in life. If you find that in your stress it’s hard to say no to fatty or sugary comfort foods, start not by cutting back on the things you crave but by adding healthier options into the mix. Have a piece of fruit as a snack or a salad along with your dinner. You’ll likely find yourself wanting less as these additions help curb your hunger, and as you develop a taste for healthy choices you’ll pick them more often. As for exercise, even a walk and a quick stretching routine can make a difference. Addressing your anxiety is not just about helping you feel more calm and peaceful, but about helping your loved one as well. Your parent is probably picking up on your stress, even if you think you’re hiding it, and they themselves feel more stressed in turn. Taking a little time for yourself to follow these steps will benefit not just you, but everyone around you. For additional tips, check out our post on caregiver stress.
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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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