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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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Guide to Buying Medication Online

guide to online pharmaciesMany of us are doing more and more online shopping, and so inevitably we wonder if we should buy medication online too. Beyond the simple convenience, the cost savings are certainly tempting, especially when dealing with an expensive chronic condition. However, the world of online prescription drugs is one that needs to be navigated with caution. Counterfeit medicine is abundant, and the old saying that “if it seems too good to be true, it probably is” was never more apt. There are both legitimate and illegitimate online pharmacies, and the trick to buying medicine online successfully is to be able to tell the difference. By taking the time to gain a little knowledge, you too can be an informed consumer and avoid getting burned. Here are signs of a reputable and safe online pharmacy:
  • They require that you submit a prescription from your doctor. Usually they will ask for this by mail. If they allow you to send a fax or a scanned copy, they should then check with your doctor to make sure that the prescription is legitimate. Avoid sites that will send you medicine just on the basis of a questionnaire, without requiring you to visit your doctor.
  • They should also require that you fill out a detailed profile that includes your medical history.
  • You should be able to speak to a licensed pharmacist who can answer any questions you might have.
  • The pharmacy should be located in the United States. Many online pharmcies are located abroad. The prices may be cheap, but as much as 40% of the medicine in these countries is counterfeit, so you’re much more likely to not get what you paid for, or even something that’s safe to consume.
  • You can easily find and understand the website’s various policies regarding privacy, shipping, and payment.
Officials recommend that you only use sites that have accreditation from an organization called Verified Internet Pharmacy Practice Sites (VIPPS). This insures that the company has gone through a rigorous review process and on-site inspection. You can find a list of pharmacies that have achieved this accreditation at the National Association of Boards of Pharmacy. When your order arrives, make sure that all the information on the label is correct, including your name and the name of the medication. Make sure that the dosage you’ve been given matches what the doctor ordered. Also keep an eye out for packaging that seems to be tampered with. If this is a medication you’ve taken before, compare its color, shape, and size with what you’ve taken previously. Do you see, taste, or smell any differences? You should also be able to easily verify that the medicine has not expired. If you have any doubt about what you’ve received, don’t take the medication until you’ve spoken with your doctor or pharmacist. This may be a hassle that negates the convenience of online shopping, but it’s much easier than making a mistake that could be costly or lead to further health problems.
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Should Your Parent See a Geriatric Specialist?

should you see geriatric specialistYour loved one has multiple doctors already. Do they really need to add one more to the list? This post is designed to help you decide whether your loved one should consider seeing a geriatric specialist. A geriatric specialist provides comprehensive care for the elderly. They’ve completed their residency in Family or Internal Medicine, and have one or two years additional training in the various issues – physical, mental, and social – that affect this age group. There are several benefits to seeing a geriatric specialist. Seniors sometimes experience illnesses differently than younger adults, and so it helps for them to work with a doctor who understands their specific situation. Geriatric specialists are especially well-equipped to understand the particular complexity of senior health issues, which are typically caused by multiple factors. For example, they can examine a senior’s prescription drug regimine and make sure that they’re not over-medicated. They will also be familiar with the particular resources available to help your loved one in your specific local area. Whether or not a senior should see a geriatric specialist depends on their particular situation. After all, seniors themselves are different: one 80 year-old may be active with minimal health problems, while another may be struggling with serious health conditions. Geriatric specialists tend to step in when an individual’s health problems become complicated. It’s recommended that all seniors consider a visit when they turn 65, and highly recommended for those seniors who are in some way impaired, who have multiple medical problems, who are experiencing cognitive decline or dementia, or whose family members are struggling with caregiving. If you do decide to take your loved one to see a geriatric specialist, the initial assessment will take several hours. You’ll be given a detailed questionairre to fill out that your loved one will most likely need help with. Make sure you bring a list of all medications, hearing aids and dentures, eyeglass prescriptions, and information about other doctors your loved on is seeing or has seen recently. The following elements make up a typical assessment:
  • Complete physical exam
  • Detailed medical history
  • List of medications and their purpose
  • Dental exam
  • Hearing and vision tests
  • Pain level analysis
  • Cognitive evaluation
  • Osteoporosis screening
  • Dietary analysis and advice
  • Meeting with a social worker
  • Discussion with family members
Rather than being “just another doctor” a geriatric specialist can help you with managing the extensive medical care your loved one is already receiving. Many seniors and their caregivers find these physician’s particular expertise helpful.
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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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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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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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How to Tell When a Loved One with Dementia Is Sick

dementia and illnessDementia can make it difficult to tell when a loved one has come down with a cold or another illness. They may not be able to tell you how they’re feeling in an intelligible way. By being observant and keeping an eye out for certain signs, you can spot when they may need a little extra TLC, medication, or a trip to the doctor. Here are some tips.
  • A runny nose or sneezing by itself may not be a cold or flu–it might be just allergies instead. Try to determine if your loved one has additional symptoms, like fever or tiredness. If they do have a cold, make sure that they stay well-hydrated.
  • Those with dementia or Alzheimer’s are unfortunately susceptible to urinary tract infections. Due to the intimate nature of the task, keeping these areas clean isn’t always easy for caregivers. If their urine has a strong sour smell, they likely have an infection and need treatment. Urine may also be darker or even contain blood, and your loved one will have to use the bathroom more frequently than usual. Finally, urinary tract infections can cause behavior changes in seniors and even bring on dementia symptoms. If you notice any of these signs, be sure to treat the infection right away. A neglected urinary tract infection can land a senior in the hospital.
  • Look for signs that your loved one is paying attention to or favoring one part of the body over others. That could indicate that they’re experiencing pain. Do a thorough check of the area to see if there are any bruises or other abnormalities.
  • Watch for changes in bowel movements and abnormal stool. If problems don’t respond to over-the-counter medication, seek the advice of your loved one’s doctor.
  • Changes in speaking patterns or behavior is another important sign. If a loved one’s demenaor suddenly changes without obvious explanation, and attempts to distract or calm them down don’t work, illness or injury is often the cause. They may also attempt to “speak” to you using gibberish. Even though your loved one cannot express themselves properly, they’re trying to give you information.
Your best tool as your loved one’s primary caregiver is intimate knowledge of their usual habits and behavior. Once you notice variations from what’s typical, you should begin to suspect that problems are afoot. If you have any concerns about your loved one’s health, be sure to get in touch with their physician.
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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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Advice for New Caregivers

advice for new caregiversTaking charge of mom or dad’s affairs and becoming the one responsible for their well-being may have happened suddenly with a crisis event, or it may have snuck up on you over time. However you ended up here, you likely feel like you need some advice. Here are some things to keep in mind as you navigate this new world. Set Good Boundaries Setting good boundaries can be difficult when it comes to the loved ones who are closest to us, like our parents. They sacrificed so much for us, right? However, if you drop everything for mom and dad it will cause much larger problems, and you’ll be so burned out you won’t be able to be there for them. If mom is calling you from assisted living mulitple times throughout the workday, you need to be clear that this is preventing you from fulfilling your obligations to your employer or clients. This may seem harsh, but if you career begins to suffer you won’t be as effective when it comes to caring for her. Understand that Needs Change If you’ve been thrust into your new role by a stroke, accident, or other crisis event, there will be a time when life begins to settle into a routine again. But don’t get too set in your ways: there may be another crisis that’s somewhere around the bend. It’s simply part of the unpredictability of life, and you will need to adapt if you’re going to keep up with your parent’s needs. What worked before may not work now. Don’t be afraid to ask for help or to look into adding new care. Reach Out to Others in Your Situation You’ll get a great deal of support from those whose loved ones have more advanced Alzheimer’s or dementia. You can find a caregiver support group somewhere near you, or you can seek out others online. This may in fact be better since you and other caregivers probably don’t have much time for face-to-face meetings. Try the Alzheimer’s Association or your local hospital for recommendations. Notice that a lot of this advice has to do with taking care of yourself, your physical well-being, and your own mental state. The old cliche of helping yourself before you can help others has never been more applicable than when it comes to caregiving. Your loved one is counting on your health for their own wellbeing.
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Five Steps to Convince Your Parent to Move to Memory Care

convince parent to move to memory careMaking the decision to enter memory care is difficult for seniors, and it’s a process to get them to accept that this is the right choice. They of course want to remain on their own as long as possible. A big decision like this can’t be forced. Your best chances of success lie in helping your parent own the decision, so that they have the feeling that this is something they’re choosing for themselves. Here’s a step-by-step plan for how to get your parent to accept a move to memory care. 1. Help mom or dad begin to get used to the idea. Identify problems that would be solved by a move to memory care and how that move would improve quality of life. For example: “You know, mom, you wouldn’t have to worry about hiring someone to take care of the lawn if you were in memory care.” Or, “Dad, wouldn’t it be nice if you lived somewhere with people your own age around?” 2. Offer to help them tour some nearby memory care facilities on a no-strings-attached basis. Try to seek out activity times when they can notice the residents having fun. However, it may still be too soon for them. Be prepared to just drop it if they show resistance to the idea. 3. Help them see the signs that it’s the right time for this sort of care by connecting this need to things that happen. For example, when mom leaves the stove on, gently but tactfully use the opportunity to point out that both of you would be less worried about these incidents if she were in memory care. Be careful not to be too pushy here, unless there really is a crisis brewing that would necessitate moving quickly. 4. See if anyone your parent knows has made a move to memory care, assisted living, or a similar facility who is happy with their choice. Or see if the relatives of any of your own friends are enjoying senior living. Take your parent to visit that person, or at least set up a phone call. This will help make the idea more real to them, and may make moving to the same facility more appealing. Even having one friend in a new place can help. 5. When you go on tours, point out all the positive aspects of the facility. Be as excited as you would be about renting a new apartment or buying a new home: focus on the possibilities. Would mom’s favorite antique chair look good in the rooms of a particular facility? Does the activity room have a piano so that dad could still play? Once you’ve gone through this process, wait for all that you have seen and discussed to sink in. Don’t expect that they’ll have that “Aha!” moment right away: unfortunately, it often takes some sort of accident or crisis for a move to seem necessary. They are making a huge life decision, and that needs to be respected. If you are feeling the need to move your parent along in this process, however, the most effective argument would be to say that you and other family members would have much greater peace of mind if they were in a memory care facility. Remind them how much their safety means to you. This will hopefully help them to see the importance of making the move.
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