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Alzheimer’s disease develops gradually over the years, usually going unnoticed at first but eventually becoming impossible to ignore. What signs should families be alert to? The key is to look for major changes that interfere with everyday life.
Some examples of actions that might be taken by a senior with Alzheimer’s include:
- Forgetting things that are part of a well-established routine, and were once done without fail.
- Repeating questions.
- Arriving somewhere without any idea how they got there.
- Losing their way on a familiar route they take every day.
- Forgetting to turn the stove off.
- Leaving doors open.
- Forgetting to eat meals.
- Unusually poor hygiene that the person is not aware of.
- Placing objects in unusual places.
- The inability to remember even basic words, or speaking in such a way that’s hard to follow.
- Sudden mood swings for no particular reason, or becoming uncharacteristically suspicious or trusting.
- Lack of awareness of strange behavior.
Unfortunately, more adult children live far away from their aging parents than ever before. When it becomes clear that mom or dad needs help, the thought of not being there for them can be very stressful. To make matters worse, they may not tell you the truth when you ask about their well-being. They are after all the parent, and they’ve spent your life worrying about you. They simply may not want to worry their child, especially one living far away.
If you have siblings who live close to your parent, they will probably by default end up as the primary care givers. Most siblings in this situation will appreciate it if you maintain frequent contact with them and make serious efforts to find ways to contribute. If they are raising their own family or their work leaves time at a premium, discussing the decisions to be made and supporting the decisions they make regarding your parent’s care will give them relief. It is a difficult and unfortunately common situation for the primary caregiver to feel abandoned by their siblings in this case. Ask your sibling what kind of support would be helpful. Often in these circumstances, family members who live at a distance contribute a larger share to any financial efforts, or sometimes come to pitch in for a week or two to give the primary caregiver a break.
If you don’t have siblings in the area, ask relatives who do live close by or your parent’s friends or former neighbors to visit them in assisted living. This will probably give mom or dad welcome company, and also give you a chance to hear from a third party how they’re doing. Talking to anyone who your parent knows, trusts, and speaks with regularly will help you sort through what they may actually need. People who can visit often will see potential health issues or other problems that your parent doesn’t want to discuss directly with you. ,
Get involved with, and stay involved with, your parent’s medical care. If your sibling is the primary caregiver, let them know you want to be a part of this. It’s important to understand the conditions your aging parent has, the medications used to treat them, as well as possible side effects.
It goes without saying that you will want to visit your aging parent as often as you can. The guilt often associated with living far away can be alleviated to a degree by maintaining contact. While it is not the same as being there, especially in the case of illness, these steps will give you the basis to be involved in your parent’s care and life.
Handling the needs of an aging parent is a task that requires teamwork, understanding, communication and cooperation among the senior’s grown children. The stress that comes with the situation can be overwhelming, making it difficult to get things done and work together. Conflict over many different issues—what kind of care is needed, who will do what, etc…—is common. But there are steps siblings can take to make this task easier.
First, conduct a group meeting with all siblings and any other affected parties. The meeting will give the opportunity to lay out the issues at hand, brainstorm solutions, and establish individual roles for each person. Come to an agreement on an agenda in advance and remember to take notes. Keep focused on the aging parent’s needs and wants. Try to find the best possible avenue for obtaining these things and assign tasks to each caregiver.
Be sure to establish roles among family members early in the process. These aren’t set in stone: it’s possible to redistribute roles later. It’s common for one sibling to become the primary caregiver. This can occur for many reasons, including living in an area close to mom or dad and having available time and resources. Unless siblings agree to this arrangement in advance, this can cause resentment, misunderstanding, and frustration.
Not every caregiver is going to have an equal responsibility. Acknowledge individual strengths and weaknesses and assign duties accordingly. Discuss what each person is willing and capable of doing.
Family crises can resurface old grudges and create resentments. Siblings can avoid this by setting up discussion rules. If possible, have regularly scheduled meetings with all caregivers, perhaps once a month or once a year, where everyone can discuss issues and concerns. Remember that working as a team is more productive and less hassle than working against each other. The aging parent and their needs are the primary focus, not settling family debates.
If arguments continue to block progress, seek out information on elder mediators. Mediators are third-person professionals who can handle sensitive family debates on aging parents in a fair, honest way.
It is essential to involve family members who appear to be in denial or unwilling to participate. Their assistance will help keep the amount of work from burdening the other caregivers and keep resentment at bay. The easiest way to get a family member involved is to ask them to do a specific task that is within their means. It is possible that this particular family member does not know how to help and is withdrawing because they aren’t sure what responsibilities they should take on.
If there is no progress on persuading the family member to contribute, continue trying by sending e-mails or letters and making phone calls. Share medical records revealing the reality of the aging parent’s health and the list of tasks that need to be completed. If denial continues to be an issue, involve a third party. This could be a doctor, a family friend, or a mediator. Keep trying, if not for the benefit of an extra helping hand, then to involve this sibling in the limited time left with the aging parent.
Managing the affairs of a dying parent is not an easy feat. To help things go smoothly and to keep family members on friendly terms, be proactive in maintaining the peace.
Photo used under Creative Commons from imarcc.
- Does the facility cover these plans with the residents and the staff on a frequent schedule? There should be regular reviews and drills that involve both the residents and the staff. What kind of emergency training do staff members have?
- Is someone who is well-versed in the plan and capable of leading staff in carrying it out on site at all times? Is there a plan to increase staff during a disaster? The number of people necessary to support a facility on a day to day basis may be insufficient during an emergency situation.
- Are there disaster kits on site? If so, what is included in these kits and how will they be distributed and used in the event of a disaster? A facility should have disaster kits on hand that provide each person with canned food and water for one week. The kit should also contain candles, matches, flashlights, batteries, and first aid and sanitation supplies.
- Even during an emergency, residents need to continue following their care plans. Ask the facility about their ability to continue without interruption during a disaster. Care plans should be easily accessible.
- How will essential medications be dispensed during and after a disaster? You will want to be sure your loved one can get their medication during disasters.
- Is there a plan for how to notify family members in an emergency?
- How often is the plan updated?
Photo used under Creative Commons from Casey Serin.
Deciding to enter hospice care is never easy. Everyone involved in the decision may find themselves experiencing regret, sorrow, and confusion about what to expect. While issues of death and dying are always extremely difficult, knowing what to expect can help make the process a little more bearable.
Most know hospice as a form of care for those who are suffering from terminal illness. It’s more than just medical care, however, as clergy and social workers may be part of the hospice team in addition to physicians and nurses. Hospice helps patients and their families come to terms with this difficult event. The main goal of hospice is to make the final days of a dying person’s life as painless and comfortable as possible, while helping to bring about a sense of resolution.
One of the main qualifications in order to be eligible for hospice is that the individual must be expected to live for no longer than six months. In most cases, if the person requires additional time, their physician can extend their care. Hospice can be discontinued if the person receiving it begins to recover.
One of the first steps in going about retaining hospice services is to consult with the loved one’s primary care physician. You can also contact a hospice group or a facility, such as Raya’s Paradise, that provides hospice care. Once a hospice team is assembled, all aspects of the patient’s care will be considered and a comprehensive plan will be developed. This would include the patient’s comfort level, finances, necessary medical care and medication, as well as religious beliefs.
When determining whether hospice is appropriate, physicians will usually use the Karnofsky Performance scale. This is a set of criteria to help evaluate the patient’s general health in order to determine life expectancy. Common diseases that usually resolve in hospice include cancer and Alzheimer’s disease.
Some may consider opting for hospice to be giving up. This couldn’t be further from the truth! In fact, it takes a very strong person to be willing to accept help and support when it’s needed. This is not a matter of giving up, but more of doing what’s necessary at that point in time. Furthermore, by choosing hospice, your loved one will receive increased comfort and support, leading to more fulfilling and meaningful final months of life.
Discussing hospice is never easy. Nobody wants to be the first person to bring up the topic of death and dying. If you or someone you love is considering hospice, it’s important to realize that not saying anything could in fact delay hospice and cause unnecessary pain. Hospice is all about making the last stage of life as comfortable as possible. There’s no point in prolonging discomfort. Take a moment to begin the conversation now and you may help ease the suffering of a loved one.
Photo used under Creative Commons from Bunches and Bits.
Today, seniors enjoy a wide range of options to choose from when it comes to finding a place to spend their later years. Things haven’t always been this way. In fact, not too long ago, assisted living wasn’t even an option. Prior to the advent of these facilities, older people could only choose between staying at home under the care of a family member or a hired caregiver, or going to a nursing home.
Going to a nursing home was not something one wanted to do, as it often meant forfeiting basic rights, such as the right to privacy. Many times, residents were not permitted to have locks on their doors and would have to share bathrooms. The institutionalized setting and communal bathing and showering areas created an environment all too reminiscent of some of the facilities used to care for the mentally ill. To make matters worse, nursing homes were gaining a reputation for being places where the elderly were frequently mistreated, neglected or even abused.
Dr. Keren Brown Wilson, whose own mother lived in a nursing home, made it her life’s work to develop alternative means to care for the elderly. She was integral in the inception of the first assisted living facility, which would serve as a model for such facilities all across the country. One of Dr. Wilson’s major priorities when developing the assisted living model was to restore the privacy and dignity that were missing in the institutionalized settings of nursing homes. In addition to this, Dr. Wilson made sure that these facilities were adequately staffed with round-the-clock supervision and a more individualized level of care with one-on-one support.
This prototype for a new and innovative way to provide care for the elderly drew attention from many other organizations that then helped turn assisted living into a viable alternative for older adults looking to make the transition to a living situation that provided more support.
The need for supportive living accommodations for seniors is greater than ever, and fortunately, there are a variety of desirable arrangements available. Today’s seniors can choose from different types of assisted living facilities depending on the specific care they need, their budget, and lifestyle choices. Their options, rather than demeaning them at the end of their lives, can help make these years a golden time to enjoy the sunset of their days with few worries.
The desire to stay in your own home and remain independent as long as possible is a strong one. Unfortunately, as we get older we eventually reach a point where this is no longer viable or safe. How can you convince a parent that it’s time to make a move to assisted living, where they can get the support they need, and help them see the transition as a positive one? Here are several tips for having this difficult conversation.
Enlist the help of a medical professional. If your parent is like most of us, he or she will have a sense of pride regarding the ability to care for him or herself. This is completely natural, and the idea that one can no longer do this is a severe blow. It is for this reason that seeking the opinion of their doctor or another healthcare provider they trust can help to add weight to your suggestions when discussing the potential move to an assisted living facility.
Avoid potentially condescending sympathy. It is important to realize that, despite any health complications that your parent may be experiencing, your sympathy is not what’s needed at this moment. Of course, it is always nice to have compassion for your parent. Yet discussing the move to an assisted living facility can elicit feelings of powerlessness, and providing heaping doses of sympathy could make matters worse.
Approach your parent with respect. Treat your parent as an independent person capable of making decisions and deserving of the same respect and considerations as anyone else. There are some situations where maintaining this tone could prove challenging. Diseases such as dementia can greatly impair your parent’s ability to process and understand what is happening, and may force you to take on a more guardian-like role in such cases. The underlying idea that you can still treat your parent with respect and value his or her preferences still applies more than ever.
Emphasize safety. The number one priority and guiding factor in all discussions and arrangements surrounding a parent’s move to an assisted living facility should be their health and well-being. The more that you can bring this point into focus, the better the transition process will likely be. If, for example, your parent has fallen several times while unsupervised, resulting in hospital stays and broken bones, reminding them of this in a gentle and understanding manner may help them see the logic in making this transition.
Above all, listen. Listening may be all you need to do to help your parent accept the idea of assisted living. It’s very possible that he or she will want to make the move, yet also feels a need to express all of his or her resentments and worries about doing so. By listening, you will help your parent feel more understood and will also help make him or her more receptive to your own feedback.
There is no simple and easy way to discuss assisted living care with a parent. The process can, however, be an opportunity for you two to grow closer as you share your thoughts and feelings about the matter in an open and non-judgmental atmosphere.