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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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Forgiving Your Elderly Parent

Even if your parent has hurt you badly, you can forgive.Every parent-child relationship has at least a little hurt that’s developed over the years, and many of us hold resentment and anger towards our parents for past wrongs. Some have unfortunately had to deal with a parent’s addiction, neglect, or abuse. When the time comes when your parent needs more day to day help and assistance with managing their affairs, these emotions can prevent you from stepping in to help. How can you manage this situation when your emotions make it difficult to meet your parent’s needs? If you are willing to forgive but are unsure how, take hope: healing the rift is possible. First, stay focused on the present. The past is over and nothing can be done to change it now; you have nothing but pain to gain if you hang onto it. Remember that by clinging to your resentment, you are only making yourself feel bad. There are even studies that show that people who are able to forgive lead longer and healthier lives. Recognize that the wrong you were done has helped make you who you are today, and may have caused you to develop some of your strengths. For example, struggling with an abusive parent may have resulted in you becoming stronger and better able to stand up for yourself and protect your boundaries. It may also mean that you are kinder and more able to keep yourself from lashing out in ways that are harmful to others. Consider looking at your history with your parent from a different angle. Were they doing the best they could do at the time? Were they struggling with circumstances beyond their control? Put yourself in your parent’s shoes, and while you shouldn’t excuse bad behavior, you may find yourself more able to understand how it could happen. Finally, seek out stories about those who have forgiven people who hurt them. Hearing the experiences of others can help inspire you or give you a guide for how you yourself might forgive. There are many story collections out there on this topic – your local library is sure to have at least a few. You can also look for movies that address the theme of forgiveness. Remember, forgiving someone doesn’t mean that the wrong they did is now OK. But try to separate the person from their behavior. We all make mistakes and behave badly at times, but that doesn’t mean that at our core we don’t deserve love and a second chance.
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Seniors and Proper Nutrition

Our Los Angeles Alzheimer care facilities offer healthy meal options.While eating healthy is vital for any person, regardless of age, the senior population tends to be especially susceptible to poor nutrition or malnutrition. Studies have revealed that a whopping 15 – 50 percent of elderly people in the US suffer from malnutrition, but detection has sometimes proved difficult. Symptoms such as lethargy, light-headedness and loss of appetite are often mistaken for other illnesses. However, as a caregiver, you can help to combat this challenge. Often more important than attempting to alleviate the nutritional deficiency, getting to the root of why your aging loved one is not eating (or eating well) is essential. Some common causes for poor nutrition in seniors includes the following:
  • Medication. The side effects of certain drugs can lead to nausea, poor appetite, and altered taste buds. It doesn’t matter whether the medication is prescription or over-the-counter – feeling bad often leads to reduced food intake.
  • Poor Dental Health. Some seniors have difficulty with their dentures, broken or missing teeth, or pain in the jaw area that can make the consumption of some foods exceptionally difficult.
  • Lack of Transportation. Ours is no longer a society which harvests its own food, so we depend heavily on routine trips to the grocery store or market to get healthy, fresh foods. Seniors have often scaled back on driving due to the hassle of heavy traffic or other challenges; some have stopped driving altogether. This can make getting the foods you need difficult or nearly impossible.
  • Cognitive Decline. Memory loss (caused by dementia, Alzheimer’s, or other diseases) can disrupt the very idea of maintaining a routine of any sort. The brain’s reaction to these diseases can sometimes make a senior forget very simple things you take for granted (such as when they ate their last meal). Further, some seniors suffering with cognitive decline will buy large amounts of the same items (which can, and often does, reduce their intake of certain nutrients).
  • Depression. A person suffering from depression will often simply feel too “blue” to concern themselves with their diet. Depression tends to take a toll on an individual’s appetite, as feelings of loneliness and/or unhappiness mount. While depression is manageable, this shouldn’t be left untreated.
  • Health Challenges: Some health challenges can make simple kitchen tasks unbearable. Arthritis, vertigo, joint or other pains, and overall weakness can lead seniors to settle for something quick and easy, but less healthy.
The best way to pinpoint signs that these challenges may be leading to nutritional deficiency is to simply observe and have open conversations with your loved one, especially when or if you suspect that he or she isn’t eating enough or enough of the right things. Speaking of right things, the types of foods taken in is important. Whole grains, fresh fruits and vegetables, protein-rich beans or other legumes, and lean meat and dairy should be the norm in a senior’s diet. The combination of these items helps assure that seniors are getting essential vitamins, minerals, and other nutrients. Other ways to encourage your senior to get better nutrition include: dining as a group, especially with other seniors (to introduce the social factor); maintaining food storage for them; grocery shopping with them; and addressing contributing health concerns that are obstacles to eating well.  
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Dealing with Cranky Elderly Parents

Our Los Angeles assisted living staff are friendly towards all moods.

Photo used under Creative Commons from becstarr.

Has dealing with your elderly parent become an encounter with Oscar the Grouch? If so, you certainly are not alone. However, as their child, it can help to view these encounters from an entirely different perspective. For a person who has always been independent, athletic, and able to recall many details, losing these faculties brings many underlying fears to the surface. Feelings of both helplessness and hopelessness can overtake their thought processes. It is important to remember that anger is often an outward expression of inner fears, and that while the complaints may seem to be hurled in your direction, it often has little if anything to do with you. Be patient, be kind, and reassure your loved one that he or she can talk to you. Understand though that no matter your age, parents generally do not want to place excess burden on their children. If your mother or father is uncomfortable expressing their innermost feelings with you, perhaps arranging sessions with a professional counselor will help your parent to truly process those raging emotions. It’s important for adult children to really assess the situation thoroughly–and honestly. For instance, some individuals always see the glass half empty, regardless of the circumstance. If your aging parent was always negative, illness will not bring out the best in them. Complaining personalities generally remain negative, complaining personalities… and sometimes you, as the caregiver, must be honest with yourself about this. Also, most people are more irritable when they do not feel well. But, there are some elderly individuals who feel that by virtue of their years on this earth, they have somehow earned the right to “not hold back”… and some will use it with a vengeance! In this case, there may be a glimmer of hope for change in circumstance. When your loved one begins taking a new medication, it often can wreak havoc on the body. This is further exaggerated by negative interactions between multiple drugs used to treat symptoms. If you notice a recent change in behavior or attitude that seems to coincide with a new prescription, a pharmacist or your loved one’s doctor can often help you get to the root of the issue. Personality changes can come on quickly and strongly in these scenarios. Bladder infections can also cause severe shifts in mood and personality. Cognitive decline (such as that found in Alzheimer’s disease, dementia and Pick’s Disease) can trigger severe levels of frustration. That is due, in part, to the inability to perform certain tasks that have been routine for years. These disorders cause a person to lose the ability to recognize objects or to remember things and people that are very familiar. It’s a tough time for both the individual as well as their family members; the frustration can spark the types of personality changes that surprise even those closest to the individual. Addressing personality changes brought on by medical challenges is easiest to deal with; simply get your loved one to a physician for treatment. These types of personality changes can disappear very quickly with medical attention or a change in prescription. However, if your parent was always the “Debbie Downer” type, or if he or she had tendencies toward verbal abuse (or worse) in the past, you have to establish reasonable boundaries so that you, as the adult child and caregiver, do not walk away hurt, frustrated, and disrespected constantly. If that still doesn’t work, you may also have to distance yourself from your parent, assisting on a limited basis. If you cannot find a workable solution on your own, you may need to speak with your local Social Services office to find a reasonable solution for everyone involved.  
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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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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

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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Signs of Alzheimer’s Disease

Our LA home for the aging is skilled at helping loved ones aflicted by Alzhiemer'sAlzheimer’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.
Such behavior is serious and not to be confused with typical signs of aging, such as momentarily forgetting a piece of information or a name. Even otherwise healthy seniors may take longer to remember things than they used to. We all misplace items or forget important things from time to time—this is normal. Alzheimer’s is marked by the extreme frequency of these sort of incidents. It’s important to compare a loved one’s current behavior to how they were in the past. If someone has been on the more careless side throughout their life, a few odd forgetful incidents is less of a concern than if someone who was always highly conscientious shows the same behavior. If you suspect a loved one has Alzheimer’s, have them evaluated by a competent specialist. The problem may turn out to be simple forgetfulness or even a lack of sleep, but get the input of an expert.  The earlier the diagnosis, the better position you’ll be in to take steps to prevent a situation where your loved one or someone else gets hurt. You’ll also have the opportunity to get finances in order, obtain power of attorney, and plan for the care of your loved one. It’s not easy to accept that a once vibrant and active person may have Alzheimer’s, but it happens to families every day. In fact, half of those over 85 have the disease. The progression of Alzheimer’s can be heartbreaking, but it is more manageable for seniors and their families with counseling and treatment.
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How to Care for a Loved One in Assisted Living From Afar

Our assisted living facility California makes our residents feel at home.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.
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