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How to Talk to Someone Who is Dying

how to talk to someone who is dyingWhen someone has received a terminal diagnosis, it’s a sensitive and traumatic time for them. Our words and actions at this point carry great weight. While it would be nice to believe that there’s no wrong thing to say and it’s the thought that counts, those close to the dying can make the experience easier or harder for them depending on what they say. If your loved one has recently received the bad news, look to them for clues about what to say and do. Don’t be surprised if they in fact don’t want to talk at all. People facing their own passing are often relieved to not have others say anything – though they are also glad to know that they can reach out if they choose to do so. Do your best to respect what they want, but find ways to make it clear that you’re willing to offer a listening ear when they need it. Rather than fretting about what to say and whether it’s the “right thing,” put your energy into listening to and observing your loved one. Whatever you do, avoid grand platitudes about fate or God’s will. These won’t make the person feel better, and may even make them feel that they are at fault for their illness in some way. Don’t tell your loved one that they’ll be OK – both you and they know that this isn’t really true. Don’t try to praise them by telling them how strong they are – at this time they may not feel very strong. Instead, they need to be allowed to acknowledge their fears. Find ways to emphasize that you love them and that you’re there to help them in the way they need. Do your best to make this time pleasant and comfortable for them. This is one exception to the advice to let your loved one guide you – as far as comfort goes you should take the lead. This is the time for random acts of kindness like making them breakfast or doing their laundry for them. They may be too preoccupied to ask for help with these everyday tasks. Make sure that you follow through on any offers you make. What gift do you give someone who doesn’t have many days left in the physical world? The gift of your time. Even sitting quietly with your loved one can be valuable to them. It sends the message that you’re there for them and that you’re willing to support them in their struggles.
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Caring for Aging In-Laws

caregiving for in-lawsYou expect to have to care for your own parents in their old age, but often times we find ourselves caring for our in-laws too. For many this isn’t a problem, as they’re your spouse’s parents and part of your family. But sometimes, this situation presents issues when we have conflicts with our in-laws. It’s also not unheard of for someone to be caring for their former spouse’s parents, even when they’re no longer married to that person. Then things become a little more complicated. Though gender roles are changing in contemporary life, it’s often women who find themselves in this situation. Sometimes their partner is helpful and supportive, but too often this isn’t the case. Men aren’t used to taking on nurturing roles like this and tending to someone physically. They may manage their parents’ finances or help with more manly tasks like mowing the lawn if his parents still live in their own home. And of course he calls the shots for the big decisions. But the women in his life end up taking on the responsibility for tasks like preparing meals and bathing – and this role is not always welcome on the part of the woman. If you find yourself in this situation, try appealing to your spouse’s desire to be a good caretaker. Once their parents have passed away, many children regret not doing more for them while they were still alive. Remind him that he’ll want to be proud of what he’s done for them. You’ll also want to remind him that doing so-called “feminine” tasks doesn’t make him less of a man – he’s getting hung up on stereotypes. If you work, you can also make it clear that you have just as much of a right to spend time on your career as he does. You have your other obligations too. In the end, you need to decide how much care you’re willing to take on, and then leave it to your spouse to handle things from there. Set strong, clear boundaries: ultimately his parents are his responsibility. Of course, if you’re married, you’ll need to take the health of your relationship into account with any decision you make. However, if you’re divorced, you have no obligation, though some women feel they should care for their former in-laws because they are, after all, their children’s grandparents. But the key point to remember is that you are in charge of your contribution.
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How to Maintain a Positive Attitude

caregiving positive attitudeThrough our communication with others and with ourselves, we create reality. Does that sound a little new age to you? Think about it. Everyone has a friend whose negative attitude makes them difficult to be around because you in turn start to feel more pessimistic. Or, on the other end of the scale, there are enthusiastic people who leave us feeling more energized. It’s a basic fact that the people around us influence what we think and feel. And this is true not just for our friends and family, but for ourselves as well. What we think and say to ourselves can change our lives. Examine your own thoughts about caring for your loved one. If you say to yourself, “This is a hard situation” you’ll experience it as being unpleasant. Try telling yourself, “This situation is a challenge” instead. Can you see how that might change how you look at things a little? Challenge implies that this is something you can overcome, and that will make you stronger as you deal with it. Watch how you discuss the events in your life, both what you tell others and what you tell yourself. Our words not only describe our feelings, but also create what we feel. Here are a few other tips for keeping a positive attitude:
  • Express thanks at the end of each day. Take some time to look back over your day and think about the things that went right. Even if you had a truly lousy day, you probably still have a roof over your head, food to eat, friends and family members you love, and a life in one of the wealthiest countries in the world. You can always find something to be grateful for.
  • Commit a random act of kindness. This can be one of the best ways to make yourself feel better and adjust your mood. Try bringing your mother flowers, giving a neighbor a small present, or paying for the person behind you in the drive-through. We usually think that to feel good we need to do things for ourselves, but doing things for others can have a powerful impact.
  • Take a minute to appreciate nature. Even if it’s just a small park or your backyard garden, there’s probably some place close by where you can go for a few minutes to clear your head and be in the moment. You don’t need to hike out into the wilderness. Just take a few minutes to admire the beauty of the world around you. Consider it a mini-vacation.
All of the above isn’t to say that you should never complain – to keep your frustrations bottled up inside clearly isn’t healthy. But be careful not to get carried away when you do indulge in venting. You may want to set a time limit for airing your greivances, and then when you’re done make a point of reminding yourself of the big picture. Caring for your loved one can be aggravating, but you are doing your best to make sure that they’re healthy and comfortable. Revisit your reasons for taking on these responsibilities in the first place. In this way you can connect to the deeper meaning of caring for someone you love, which is a deeper happiness that goes beyond day-to-day annoyances.
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Telling Your Loved One They Have Alzheimer’s

Telling someone they have alzheimer'sMany caregivers wonder whether or not they should tell their loved one about their Alzheimer’s diagnosis. This is not an easy decision to make. Often the best course of action is to let your loved one determine what you should say and not say. At the time of initial diagnosis, early on in the disease, your loved one may know that they have some kind of problem and will have a lot of questions about what’s wrong. At this time, during the moments when they’re asking you directly, you should tell them that they have Alzheimer’s in an honest and straightforward manner. Your loved one’s doctor should help you with this task when breaking the news for the first time. However, you will likely notice that over time your loved one forgets about the disease. Should you remind them? In most cases, no. Constant reminders and explanations can irritate them and often make situations worse. Even if they ask what is wrong, try to say just enough to put them at ease and try to be calm and gentle. For example, if dad tells you he needs to go to work, don’t tell him he quit once he was diagnosed with Alzheimer’s. Instead, simply remind him that he’s retired without going into the details why. Try to get them to refocus on positive memories or employ some other distraction to bring their mind someplace else. This point may be challenging at times, but eventually your loved one will stop asking questions and become more accepting of their current situation. Trial and error will help you find the right approach for you and teach you ways to keep your loved one happy. Don’t let them feel frightened and alone, but don’t reopen old wounds about the diagnosis either. Consider using their own words for describing what’s happening. If they talk about “losing their memory,” use that as an explanation. Be flexible–if something’s not working, try something else. Watch your loved one’s reactions as you look for what gets results. Know that what works may change over time. There is little to be gained from discussing the diagnosis: it is painful and confusing information. What matters more is how life is lived every day and the way forward. Sadly, there is nothing that can be done to reverse the disease. Focus instead on enjoying the remaining time with your loved one and on making them comfortable. As hard as it is to not be honest, kindness is important too.
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Helping a Loved One with Alzheimer’s Bathe

bath alzheimersEven with normal aging, bathing becomes more difficult as we get older. However, the particular challenges of Alzheimer’s disease make this everyday ritual all the more nerve-wracking. If you’re finding it almost impossible to get mom or dad squeaky clean, read on for some advice. First, consider why bathing has become more difficult. Does mom think she just showered an hour ago when in reality it’s been a couple days? Does dad not know what to do once he’s in the tub, and thus gets frustrated? Does your loved one not know what’s happening and become fearful once they’re all wet? Once you’ve figured out why they’re avoiding this activity, you can better address the problem. If memory-related issues are the challenge, try to make taking a bath fun. For example, let mom know that you’ve planned an enjoyable outing where she’ll need to get dressed up, so that’s the reason why she needs to take a bath “again.” If your loved one is fearful or uncomfortable when taking a bath, see what you can do to correct this. Turn up the heat if the room is too cold, or install grab bars so that your loved one can support themselves. Stools for the tub and hand-held shower heads are also popular with the elderly. As you help your loved one, go slowly and explain what you’re doing. The bath will be much less frightening for them if they know what’s coming next. If your loved one is very frightened at bath time, sponge baths may be your best bet. You may also want to purchase some dry shampoo so that you don’t have to get them in the bath as frequently. Finally, consider whether your own expectations of cleanliness are part of the problem. Though the norm now in 2013 is to wash up daily, when your loved one was younger this wasn’t always the case. For example, in rural areas 75 years ago running water was a luxury, and many farm families took baths once per week. So keep in mind that your loved one may not be used to taking baths as often as you think they should, and that a bath every few days may make them a lot less stressed without causing much real harm. Making bath time a comfortable and welcome experience for seniors with Alzheimer’s is a challenge, but with some adjustments it can become a manageable task.
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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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Talking to Your Parent’s Doctor About Alzheimer’s

Talk with your parent's doctor about Alzheimer'sIf your parent has just been diagnosed with Alzheimer’s disease, it’s a confusing time for your family. One important item to add to your to-do list is to plan to have a talk with your parent’s doctor about their condition. Below are four important questions you’ll want to make sure you include. Keep in mind that in order to have this conversation, your parent will need to let the doctor’s office know that you have permission to discuss their health matters. 1. Why have you chosen a diagnosis of Alzheimer’s, rather than another disease? This question will help you better understand your parent’s illness. It can also be valuable in cases where family members or your parent wants to deny that they have the disease. Find out what signs demonstrate to the doctor that this is Alzheimer’s and not another disease or another form of dementia. You’ll also want to ask how your parent’s symptoms differ from the normal forgetfulness and confusion that can come with aging. 2. What medication is available that might help? Prescription medication is available that can help slow the progress of the disease or alleviate symptoms. However, not all patients respond to these aids, and the doctor may not think any of them are appropriate for your parent’s particular situation. Also know that at this point there is nothing that can be done to reverse the progress of the disease or to cure your parent. If the doctor does recommend medication, ask how it works and how it treats particular symptoms. Also make sure you understand the side effects, and what to do if your parent takes the medicine incorrectly or misses a dose. The doctor may be able to offer suggestions about how to make it easier for your parent to keep track of their drug regimine. If you or your parent is thinking about trying herbal remedies, be sure to include these in the conversation as well. The doctor may be able to share information with you that you haven’t previously considered, such as the latest research. He or she can also let you know if herbal remedies would be wise for your parent’s individual situation. For example, there may be harmful interactions with the medicine your parent is currently taking. 3. Are there clinical trials we can participate in? By participating in research studies on new treatments, your parent may be able to receive cutting-edge care for free. However, these arrangements are not without risks. Your parent’s doctor can help you determine whether volunteering in clinical trials would be a good idea. 4. How can I reach you if I need you? This may be the first time you’ve had any conversation with your parent’s doctor. Make sure you know the office’s procedures for getting in touch with the doctor. Does he or she take questions over email? What should you do if your parent is having a medical emergency and the office is closed? Having the answers to these questions can ease your mind greatly and help you prepare for the unexpected.
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Signs of Caregiver Burnout

Caring for an ailing loved one is demanding, time-consuming, and quite stressful. Often, caregivers spend a great deal of time making sure their loved one’s needs are met and their affairs are on track. What often goes quickly out the window? The caregiver’s own needs. The following are ways to detect if you, as a caregiver, have neglected yourself to the point of burnout.

Isolation

As human beings, we thrive upon healthy relationships. When you find yourself regularly failing to engage in healthy social interaction, even with your own friends and family, this may be a huge signal that caregiving has begun draining you. Avoiding calls from people you enjoy, making excuses for not going out, can indicate you may be well on your way to isolating yourself from others, which is never good.

Feeling Overwhelmed

Caregiving can be an emotional rollercoaster for sure. There is the physical toll of spending so much time attending to the needs of your loved one. Further, there’s an emotional toll that comes with facing the shift in relational roles, seeing both physical and emotional decline in your loved one, and having to face day-to-day tasks which reinforce that life as you have known it has changed. It is natural to grieve, especially at the beginning of your caregiving experience. Frustration can arise. Anxiety and exhaustion can arise. But over time and left untreated, those feelings can lead straight into depression. If you become angry to the point of wanting to hurt your loved one or even yourself, get help fast. Your doctor should be able to diagnose whether there is a medical condition driving these symptoms. If medical challenges have been eliminated as a probability, you may have reached the point of extreme burnout and may possibly be experiencing depression. It is important to remember that while you serve as a support system for your loved one, you will also need to create a team of others who can step in to help. Being kind to your loved one is important, but it is also important for you to be kind to, and eliminate excess pressure on, yourself.

Loss of Interest

One of the biggest warning signs of depression is loss of interest, especially in things that were once a huge source of happiness and enjoyment. When your hobbies, big and small, no longer inspire you, you may need help.

Significant Changes in Your Sleeping or Eating Patterns

Can’t sleep at night? Can’t get enough sleep, no matter how long you’ve been in bed? Binge eating or hardly eating at all? Major shifts in your habits generally indicate huge shifts in your stress levels and turmoil in your emotions.

Ceasing Your Exercise Routine Despite Enjoying It Before

Exercise is one of the best stress-busters available. It leaves a person invigorated and energized. So, when you used to enjoy exercise and suddenly stop, start again. The endorphins released while you’re exercising will relieve tension and help elevate your mood, plus you will get a better night’s sleep.

Failing to Keep Up Your Appearance

Unfortunately, many caregivers fall into the mode of caring for a loved one so much that simple grooming becomes neglected. Some who once were fashion-conscious and took particular efforts to care for their appearance can suddenly become apathetic in this area. Generally, your outward appearance reflects what’s happening inside. This challenge may require some input from others you trust. Close confidants, social workers, or healthcare therapists can help you sort things out to decide if you’re experiencing burnout and if additional help is necessary.

Frequently Susceptible to Illness

If you catch every cold or flu that comes your way, and especially if you cannot shake the cold once you get it, your immune system is likely compromised. Our bodies are not created to handle excessive stress for long periods of time. If this is you, caregiving could be getting to you. Take these symptoms seriously. You can only be a good caregiver for your loved one if you yourself are healthy and happy. If checking these boxes feels familiar, it may also be worth asking whether the level of care your loved one needs has grown beyond what one person can manage alone. The Orange County assisted living readiness checklist can help your family assess whether additional support is the right next step. After a move, an Orange County first month in assisted living checklist can also help families track care updates, routines, communication, visits, and early adjustment concerns.
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Problems with Living Wills

Our LA home for the aging is there to guide your way.Many of us know that living wills are a smart decision, but even with this document in place many find that making medical choices for a loved one is still complicated in practice. This post discusses some of the common problems with living wills and steps that you might be able to take to make sure that your wishes are followed. The living will document was designed to give the patient the right to determine–ahead of time–the type of medical care desired in the event he or she is unable to communicate those wishes. However, the language commonly used within a living will (which is also referred to as a substantive or instructional advanced directive) tends to be rather vague, often lending itself to interpretation. For example, in this age of advanced medical technology and cutting edge treatments, verbiage such as “little to no chance of recovery” is becoming obsolete. Some living wills, indeed, spell out possible scenarios and the patient’s desired outcomes for each scenario. While this is helpful, with medical technology evolving at its current rate, listing every alternative is virtually impossible, which then forces medical professionals and/or family members to then determine what’s best for the patient. Making matters even more difficult is the fact that for many what they want changes following an illness or hospitalization. One research study on medical decision-making revealed that three of every 10 patients change their minds about the type of care they desire, but those changes are not often reflected as quickly on the living will. So then, we’re back to the challenge of interpretation. It’s important to note that even when the patient’s wishes have been clearly written out, family members are still faced with making these decisions at a very emotional time. Arguments often arise between family members in the midst of the crisis about what their loved one really wanted, when their energies would often be better utilized in coming together to support one another as well as the patient. According to a February 2001 study published in the Archives of Internal Medicine, family members presented with various health crisis scenarios were about 70% accurate in predicting their loved one’s desires if faced with the scenarios given (whether the patient had a living will or not). That’s good news because three out of five patients who have living wills in the first place never give them to their doctors or to family members. While that fact is baffling to most, it leads directly into the necessity for medical doctors to exercise their professional opinions regarding care that is in the best interest of the patient. Family members must often draw from their knowledge of their loved one’s lifestyle and wishes, perhaps even going back to conversations that happened before a crisis ever arose. Sometimes, though, the decisions made can go directly against the wishes of the patient. Having a living will does not always negate a medical team’s decision to perform invasive procedures on the terminally ill. And again, family members who are facing difficult decisions are often reluctant to accept a diagnosis of imminent death and will, in some cases, fail to follow the instructions in a living will (hoping for a turnaround). A number of legal and health care professionals who once championed the idea of each patient having a living will are now suggesting that patients designate a health care advocate. Generally this would be a family member or perhaps a close friend who would exercise what the legal community calls “substituted judgment.” In short, the health care advocate is responsible for making the decision you would make if you were able to. To protect that individual, a patient may even record verbally or write out their wishes, to confirm that the decision made–no matter how difficult–was in accordance with the patient’s desire. There’s really no way to guarantee that what actually happens during a serious medical situation is what you would have chosen for yourself. But you can increase the chance of receiving the care you desire by communicating with your loved ones, with your doctor, and in writing the outcome you would want.
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5 Steps for Taking Responsibility for a Parent’s Finances

As parents become older, there comes a point where you realize that you need to step in and help them with their finances. The red flag may be a bounced check or noticing that some bills are past due, or you could discover much more serious problems like the fact that mom or dad has been taken in by a telemarketing scammer. The steps below are your roadmap to getting your loved one back on track.

1. Know Your Parent’s Finances

The first thing every adult child needs to know is the condition of your parent’s finances. This means that you need to know what debts they have (credit cards, loans, mortgages, etc…), as well as what their living expenses are. Familiarize yourself with utilities, credit cards, and any bills they have and make sure you start paying them right away. You also need to know if there are any safe deposit boxes, and if you parents already have a financial advisor. It may be beneficial to take a look at your parent’s tax returns to get an idea of their financial situation.

2. Learn About Your Parent’s Income and Insurance Situation

Find out what sources of income your parent has. Find out of if your parent is receiving income from social security, what Medicare options they’ve chosen, and whether they receive Medicaid. Also find out if they have purchased long-term care insurance or other forms of insurance to make sure any premiums are kept up to date and policies are still in order.

3. Establish Who Has Legal Authority Over Your Parent’s Finances

When a parent becomes unable to care for their finances, it is especially important for adult children to know who has legal authority to manage the estate. Find out if your parents have already established legal guardianship with a relative, financial advisor, or with an executor. Pre-planning in this area can be especially important as it‘s more difficult to establish power of attorney if your parent develops dementia or Alzheimer’s. If you parents haven’t established a legal guardian before they become incapacitated, you’ll need to seek guardianship through the court system. A judge must agree that your parent is not legally competent to handle their own finances and that you are, which may take time.

4. Contact a Financial Advisor

A financial advisor or accountant can help you not only sort out your parent’s current finances, but also help you plan for the future. Depending on how you parent’s have invested, there may be other ways to maximize their assets to help finance their transition to assisted living. Families comparing local care costs can also use an Orange County assisted living cost checklist to track monthly rates, care fees, insurance considerations, and projected expenses. A financial advisor can help you navigate the options and ensure the best possible course for your parent’s financial future.

5. Get Everything in Writing

In order to safeguard both your parent’s and your own financial future, it’s best to make sure you have written documentation of everything related to their finances. Make sure you have legal authorization to act on their behalf. Any access to funds should be documented and any decisions with a financial advisor should be copied into a written document so there is a paper trail to help protect you and your parent legally. Having written records will also help if conflict or concern arises among siblings or other relatives. Watching a parent age can be a difficult process emotionally for adult children, but it doesn’t have to be difficult financially. By following these steps, adult children can help ease the transition for their parents, ensuring a brighter and more secure financial future.
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