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When Should Your Parent Stop Driving?

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

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

Los Angeles Demetia care understands, we can help.Of all the diseases that can affect our loved ones, dementia is one of the most difficult. Your loved one may have been an intelligent individual who you enjoyed interacting with, but the effects of the disease on the brain may cause that person to become an almost distant stranger you barely know. People facing the early stages of dementia generally understand that something is awry. They may become forgetful, have difficulty remembering names or performing ordinary tasks. Initially, your loved one may attempt to hide the challenges they face by offering a myriad of excuses. Eventually, though, as the disease progresses, your loved one’s frustration is likely to mount as he or she realizes things are getting worse and not better. The loss of independence and often the lack of understanding about what is actually happening becomes very frightening. Anger is sometimes an expression of fear, and as the closest individual to your loved one, you may bear the brunt of the angry outbursts often associated with dementia patients. It is also important for family caregivers to recognize that dementia patients often lose the ability to reason, so what makes perfect sense to them can seem outrageous to others. Sometimes wanting to prove their abilities to maintain their own independence, a dementia patient can, and will sometimes, defy the instructions given by family and physicians. In these moments, it’s important to remember that your loved one does not have the full control or understanding of their actions that they did ten or twenty years ago. So how do you, as a family caregiver, maintain a peaceful, positive relationship with your loved one? First, patience. Yes, mom or dad may ask the same question 25 times a day. Yes, they may tell stories so off-base you’re tempted to lose it. Don’t. Your loved one sees the world through an entirely different filter, and losing your temper benefits no one. So, answer the questions repeatedly. Change the subject. Refocus your loved one on the flowers or animals in the backyard or on music. If those tactics are ineffective, remove yourself temporarily by taking a 10 minute walk or enjoying a calming cup of tea. Praying or venting with a friend (far away from your loved one, of course) can also help reel you back in and shift your perspective. Second, do your best to avoid arguments. Your loved one’s stories may be driving you crazy, but arguments fuel tension at a time when your loved one needs reassurance that you will actually be there for them. Further, dementia patients can be quite stubborn, so they are less likely to back down in the face of conflict. Third, do not take things personally. Dementia patients often lash out at the very loved ones who are attempting to help. Harsh statements can be hurtful coming from anyone, but absolutely devastating when said by your loved one. This is when it is critical to understand the effects of the disease on a person’s behavior and memory. Blame it on the disease, not the person, to reduce your stress and enable you to maximize your time with your loved one. Fourth, get help. Your parent’s doctor can often prescribe medication to reduce their anxiety, so discuss the challenging behavior with them. They may have solutions you are not yet aware of. Also, your emotional and physical health is vital, too, so join a support group to connect with others going through similar experiences. Take care of yourself and see your doctor regularly.
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What to Do When Your Parent Refuses to See the Doctor

Los Angeles Alzheimer care has healthy options.Among the challenges you may face as a caregiver for an aging parent is the refusal to see a doctor. Most people assume a person who has the financial means to get medical care will do so  – just simple scheduling, right? Not always. So what do you do? First, go for backup. While it may sound silly, if you have been a caregiver (or in contact with other caregivers) for any length of time, you understand that family dynamics can often come into play in these situations. Your parent took you to the doctor as a child, and in your adulthood has been offering you advice over the years. Having those tables begin to turn – even if it is ever so slightly – can cause some resistance. As their loved one, the caregiver often thinks their advice is first to be considered, but the nature of family dynamics sometimes proves otherwise. Often, you can enlist the help of an objective third party, such as a doctor or nurse. Preferably, this person is already known to and trusted by your parent. He or she is likely to be viewed very differently since they’ll be seen as a professional and not subject to the parent-child power struggle. If possible, a geriatric physician is even better, because he or she deals with patients in their age range every day and can often hint at possibilities that others (loved ones or not) may miss. They can often be your best advocate. Second, if the objective third party doesn’t work, or if you cannot secure one easily, getting one of your parent’s friends on board may work wonders. The friend may have already seen a geriatric physician or know someone who has similar symptoms who sought medical attention. Cast your net to include relatives (perhaps your parent’s sibling) to weigh in on the subject as well. Though the friend or sibling definitely has an interest in the matter, they also have more life experience and can relate to your parent on an entirely different level. Third, create a positive reward. As a person ages, the “stuff” of life becomes less important than the experiences of life. So, perhaps the two of you can have breakfast or lunch at their favorite diner after the appointment. It becomes a positive memory for your parent and it creates a convenient focal point should another doctor’s visit be necessary. Fourth, be aware of the time span between appointments. Often, when we are scheduling appointments at the front desk, the scheduler may offer you the very first appointment available. If there is no medical emergency, some time between appointments may make the experience seem less invasive and unpleasant. As a caregiver, you will often need to gain a greater level of perspective in order to relieve frustration. For example, your parent may give you what you deem an absolutely ridiculous reason for not wanting to go to the doctor. For some people, aging brings with it a fear (albeit sometimes irrational) of doctors or hospitals. It may create a very unpleasant association – for example: it may conjure up memories of time spent with their loved ones following an illness or it may bring to the surface fears of hearing that he or she may need to have a surgical procedure. For an elderly person who has been relatively healthy and independent all their lives, the thought of losing that independence can be extremely bothersome. Though younger generations have embraced pharmaceuticals, many older adults have relied heavily on the home remedies and tinctures their mothers and grandmothers used on them. Certainly, a level of distrust can exist toward these “newer” treatment options (and their side effects). Either way, try to assure the discussion (and the trip) is as pleasant as possible… but do schedule that appointment at the first sign of an okay…. okay?
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How to Talk with Someone Who Has Alzheimer’s

Our assisted living facility in California has items to comfort.

Photo used under Creative Commons from Karen Roe.

As human beings, we are created for meaningful relationship with one another. Healthy communication is a vital part of remaining connected in any relationship – even when the person you’re communicating with has been diagnosed with Alzheimer’s disease. While cognitive decline puts a tremendous toll on your loved one’s ability to remember significant people, places, and things, it can also severely impact your ability to communicate with them. There are, however, a few important tips to bear in mind as you are working to maintain healthy communication with your loved one. It is also vitally important that you remember no matter what stage your loved one is in, human connection is essential to his or her overall well-being. That said, the following are some suggestions to make this challenge a bit easier for the both of you.
  • Create A Distraction-Free Zone: Background noises can distract anyone – even those with no cognitive challenges at all. But for a loved one suffering from Alzheimer’s disease, the television, radio, or other device can easily compete with your conversation. Give your loved one’s conversation your full – and undivided – attention in a peaceful environment.
  • One-On-One Conversation: While it may sound silly, having multiple individuals gathered together for conversation can create an overwhelming and highly confusing environment for your loved one. After all, the more individuals who are present, the more apt each party is to contribute to the conversation. It can prove to be extremely agitating to your loved one, whose brain may still be trying to process what has been said as well as who has offered the input. Keep the conversations simple – one person at a time.
  • Simple, Lighthearted Conversation: There’s always something to be said for small talk, but especially so when your loved one is experiencing cognitive decline. Most of us are taught to converse with others using open-ended questions to spark conversation. However, for an Alzheimer’s patient, this leaves entirely too many choices. Remember, your loved one may not remember the significance of certain titles, such as “nurse.” Therefore, he or she may ask questions like, “What’s a nurse?” Combat these challenges by simply referring to your loved one by name, and referring to yourself (or another person) by name. It helps the Alzheimer’s patient to orient themselves. If you’re speaking to your loved one about an animal, address the animal either by name (if it’s a pet) or by species (for example, “cat”) instead of saying “it.” Again, it helps your loved one keep track within the conversation.
  • Be Patient and Non-Combative: It is easy to understand how difficult it becomes for you, as the loved one of a person suffering from such a debilitating disease, to repeat yourself or explain the who-what-and-where’s of very familiar things. But engaging in arguments will most likely end in one result – agitation for yourself and your loved one. Stay calm and repeat yourself if necessary. If your loved one seems to be having difficulty in making a request, do your best to state the question you feel he or she is attempting to ask. For example, if your loved one is fumbling around for something on a table nearby, you may say, “Are you looking for a tissue? Are you looking for your glasses?”
  • Watch Yourself! Everyone understands that non-verbal communication is as important as, if not more than, verbal cues. Cognitive decline, especially as it progresses, will undermine a person’s confidence as simple, routine tasks become increasingly more difficult. Thus, your loved one is likely to be highly sensitive to everything you say and do. The tone of your voice and your body language is important. Expressing your acceptance with friendly eye contact and kind facial expressions is important. After all, the goal is to maintain positive communication with your loved one and to minimize feelings of confusion or distress which may lead to negative, hostile reactions or to your loved one “shutting down” due to feelings of isolation.
 
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Signs of Caregiver Burnout

Our Los Angeles Dementia care staff helps ease your stress.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, etc… 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 (haircuts, manicures, etc…) become 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.
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5 Steps for Taking Responsibility for a Parent’s Finances

Board care for elderly can be expensive, help them manage their finances.

Photo used under Creative Commons from Images_of_Money.

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. 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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Reducing Caregiver Stress

In our Los Angeles Alzheimer care facilites we understand caring for your parents can be stressful. Let us help.

Photo used under Creative Commons from jenny downing.

Being the caregiver to an aging parent may be one of the toughest family roles imaginable. The task can be as demanding as watching a small child, with the added heartbreak of seeing mom or dad decline…plus the challenge of navigating the changing parent-child dynamic. But there is hope: stress can always be managed. Here are a few tips to use during those times when you feel like it’s all too much. First, do not attempt to become a lone ranger. One of the greatest areas of stress comes from the feeling of taking on more than we can handle, and that is as true in the caregiving role as it is in other areas of our lives. Other relatives may be both willing and able to help. You may also be surprised to find that those outside the family, such as family friends or neighbors, may also be there to lend a hand. It is important to remember that aside from the task of caring for your aging loved one, there are necessary tasks related to caregiving, and having someone else shoulder those for a while may help you build in some much needed time for yourself. Second, schedule in your “me” time. One of the greatest challenges family caregivers have is the overwhelming tendency to neglect their own needs in favor of their loved one. It is critical for caregivers to schedule some non-negotiable time to participate in activities that stimulate and interest them, because caregiving can (and often does) demand a significant amount of time and can deplete an individual both physically and emotionally. Schedule such activities as an exercise class, a movie, date night with a significant other, a massage, dinner with friends, taking classes on a subject of interest, etc… By doing so, the caregiver remains in touch with his or her own life. Third, pay attention to your body. While most caregivers begin their roles in an overall state of good health, statistics show that they are more likely to develop symptoms of depression, anxiety, obesity, and weaker immune response as time goes on. Exercise is a particularly effective method of de-stressing the body, with the added bonus of boosting overall energy levels. Getting outside for fresh air can also be highly invigorating. All the great advice we give our loved ones — about eating balanced meals, drinking plenty of water and getting adequate rest — are just great rules of thumb for everyone to live by… including caregivers. Fourth, building in a support system can be very beneficial. Providing care for an aging loved one brings forth a flood of emotions. After all, it is during this time that the caregiver witnesses the frailty and physical decline of the person whom they have always looked to for their own care. Seeking the services of a psychotherapist or joining a support group (through a church, synagogue, or local agency on aging), caregivers can often receive sound advice on how to cope during this emotionally taxing period. It is important also for the caregiver to not place unrealistic demands upon themselves but to simply do the very best they can. Finally, cherish every moment. Glean the wisdom of these years and forgive any past disappointments you may be harboring against your loved one. Resolve any issues that may still linger, and commit to enjoying each precious moment available. Remember to be kind to others, understanding that each person operates the best they can with the knowledge they have. Be gentle even when expectations go unfulfilled. With a slight shift in perspective, you may find — as others have — much greater enjoyment of life’s simplest gifts as an unexpected bonus from caregiving.
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