All posts by Samantha Colaianni

Dementia & The Holidays: Tips for a Stress-Free Celebration

Celebrating the Holidays with Dementia

by Lisa Mayfield, MA, LMHC, GMHS, CMC, Principal, Fellow Certified Care Manager

The holidays can often be a time filled with high expectations, requiring lots of energy and engagement in non-stop activities. For the individuals and families living with Alzheimer’s or a related dementia, it can be challenging and a time of high anxiety. Festivities can agitate, confuse, and overstimulate persons living with Alzheimer’s disease and other dementias. Meanwhile, caregivers can feel anxious, frustrated, and lonely.

To minimize the anxiety and encourage a happy holiday season for the entire family, a little advanced thought and planning can go a long way in ensuring everyone has a wonderful time. Remembering that the holidays, at their best, are a time for enjoying one another’s company and sharing gratitude for each other can make some advanced planning go a long way.

Here are some stress busters that have worked for other families and might prove successful for your celebrations:

  1. Let guests know what to expect before they arrive. If your loved one is in the early stages of dementia, it’s likely family and friends won’t notice any changes. The person with middle or late stage dementia may have trouble following conversation or tend to repeat him- or herself. Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts. Make sure visitors understand that changes in behavior and memory are caused by the disability and not the person. Understanding, acceptance and patience go a long way.
  2. Adjust expectations. The challenges of caregiving responsibilities combined with holiday expectations can take a toll. Invite family and friends to a conversation ahead of time. Be honest about any limitations or needs, such as keeping a daily routine, or making modifications to plans to minimize holiday stress. The goal here is time together. Your loved one will enjoy the company of friends and family. Let their presence be their present!
  3. Be good to YOU! This is often the hardest step. But giving yourself permission to do only what you can reasonably manage is one of the most precious gifts you can give yourself. If you’ve always had a large group at your home, consider having only a few guests for a simple meal. Let others participate by having a potluck dinner or ask them to host at their home. This is the time to be especially gentle and kind with yourself. This is also a great time to practice saying “No” and pace yourself.
  4. Involve the person with dementia. Focus on activities, traditions and memories that are meaningful to the person with dementia. Your family member may find comfort in singing old holiday songs or looking through old photo albums. Involve the person in holiday preparation. As abilities allow, invite him or her to help you decorate, prepare food, set the table, wrap packages, or address holiday cards.
  5. Maintain a normal routine. Sticking to the person’s normal routine will help keep the holidays from becoming overly stressful or confusing. Plan time for breaks and rest. Make sure to have favorites at the ready: holiday music, movies, clothing and food. All these familiar favorites can bring comfort and build enjoyment into a holiday celebration.
  6. Use the buddy system. Plan ahead to have family and friends take turns being the buddy to your loved one. This is a great way to encourage one-on-one time as well as to shield the individual with dementia from distress. It also gives a break to the primary caregiver.
  7. Engage an Aging Life Care Professional®. Aging Life Care Professionals are the experts in aging well.  We understand dementia, aging, family systems, and the myriad of challenges and obstacles that families experience in caring for a loved one.  An Aging Life Care expert can help anticipate issues and address them before they happen, offering the options and wise counsel on how to navigate the holidays successfully. Our focus is on the well-being of the older adults in your life, while also helping you to care for yourself.  By engaging an Aging Life Care professional, you are working with someone who takes a holistic, client-centered approach to caring for older adults. Visit the Aging Life Care Association website to locate an expert near you.

By setting realistic expectations, involving others, maintaining a routine, and keeping activities and traditions to a select few, you can ensure yourself, your loved one, and family and friends a low stress, memorable, and successful holiday season.

Author Lisa Mayfield, MA, LMHC, GMHS, CMC, Principal, Fellow Certified Care Manager, founded Aging Wisdom® in 2003, recognizing early in her career that problem-solving and thoughtful, personalized care management were what most people needed, not therapy, to address the challenges and concerns of aging. When she discovered the Aging Life Care profession (AKA geriatric care management), she immersed her herself fully in the profession, and Aging Wisdom was born.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Home for the Holidays? Signs Your Older Loved One May Need Help

Home for the Holidays? Signs Your Older Loved One May Need Help

By Amanda Lewis, BA, CMC, Certified Care Manager, Aging Wisdom, LLC

 

In our work as Aging Life Care Managers®, a common story we hear around the holidays goes something like this: Debbie first noticed a difference in her mom at Thanksgiving. The traditional holiday family foods that Debbie’s mom always created from memory, not recipe cards, tasted and looked different. The usual care she took with place settings and decorations was noticeably different too. She also observed her mom struggling with day-to-day tasks and activities that used to be second nature to her. It was obvious something had changed, but Debbie wasn’t sure if she should be concerned or what she should do.

The holidays are busy, filled with activities, traditions, distractions, and visits with family and friends. It’s often the time when those who live apart geographically can spend extended, precious time together.  If you haven’t seen the older adults in your life over several months or years, it’s not unusual to notice changes when you are together for a few hours or days. You may observe uncharacteristic behavior, lifestyle changes, and routines, just as Debbie did with her mother.

The following are common signs that may signal a cause for concern and action. Use this Cause for Concern checklist for clues or changes that warrant attention:

Areas of Concern  

Cause for Concern

Yes /No

 

Concerned friends/

neighbors

They notice worrisome changes, step in to help when they can, but when the changes are such that they’re concerned for your loved one’s safety, it’s time to step in.  
Their home It’s not as clean or sanitary as you remember growing up. Routine maintenance, inside and outside, are neglected. You may notice hoarding tendencies, the trash not being taken out or the fridge filled with spoiled food.  
Finances Bills are unpaid or paid more than once; an unusual number of payments to telemarketers, charities, and television advertisements; utilities are at risk of being shut off; money is hidden; and/or the mail or newspapers are piling up.  
Eating habits Is there weight loss? No appetite or missing meals? You discover moldy, rotten food in the kitchen, or a burnt pan on the stove that your loved one can’t explain. Your parent says they just ate lunch but there is no evidence to support this.  
Medications/

health care

Medications are being taken incorrectly. Your parent doesn’t know why they are taking certain medications. They’re confused about their doctor’s advice, not filling their prescriptions, or missing medical appointments.  
Safety Your love one has difficulty using the stairs. They have had repeated falls. They seem less cautious about strangers and you are worried they may be vulnerable to abuse.  They lack the safety awareness they once had, and you wonder what they would do in an emergency.  
Hygiene Your parent’s clothing may not coordinate, it may be soiled, worn for days, or not appropriate for the weather. Are they bathing infrequently and not attending to oral hygiene? You may notice body odor, bad breath, neglected nails and teeth, and sores on their skin.  
Driving The car has new scratches or dents that can’t be explained. Regular car maintenance is being ignored. Your parent may mention they got lost while driving or ran out of gas. Or, they may seem too nervous to drive or don’t have insight that it’s time to give up the keys.  
“Mom is fine” So your father says. Mom agrees, though your gut tells you otherwise. They’ve learned to compensate for one another and may be afraid or embarrassed to share that they are struggling.  
Uncharacteristic behaviors Your parent is unusually loud or quiet, paranoid, agitated, making phone calls at all hours. Your loved one no longer initiates activities, is more withdrawn and isolated, and you wonder if sleeping all day is now the norm.  

 

The more items you answered YES to in the Cause for Concern checklist, the higher the likelihood your older loved one needs support. Even if you responded YES to just one question, you will benefit from being proactive and planning ahead.

What Next? Be Proactive

Whether you live near or far, there are steps you can take to ensure your loved one’s health and well-being and give yourself some peace of mind:

  • Talk with your parents/older loved ones. Start with a conversation and talk about your concerns. Consider including other people who care about your parent/s in the conversation, such as other loved ones, close friends, or clergy who may be able to come alongside your parents as they make these changes.

 

  • Regular checkups. If you’re worried about weight loss, depressed mood, memory loss or other signs and symptoms, such as those described above, encourage your older loved one to schedule a doctor’s visit. This can help to identify and address any possible causes of changes. Ask about follow-up visits as well. Offer to go with them and take notes. Remind them how nice it is to have an advocate.

 

  • Take care of safety issues. We can’t cover our parents in bubble wrap, but we can review any potential safety concerns with them. Start by prioritizing what needs to be addressed first. Then suggest small, manageable changes so they don’t become overwhelmed. Include your parent in the discussion and decisions. Go at a pace they can accept. Be patient.

 

  • Engage an Aging Life Care™ expert. Also known as a geriatric care manager, an Aging Life Care expert is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Visit the Aging Life Care Association website to locate an expert near you and/or your loved one.

 

  • Seek help from local agencies. The Eldercare Locator,a public service of the U.S. Administration on Aging, connects you to services for older adults and their families. You can also reach them at 1-800-677-1116.

It’s not always easy or comfortable talking with parents or other aging loved ones about concerns, as sometimes they won’t admit they need help, and other times they don’t realize they need support. Assure your parents that their health and well-being are a priority for you and that you are in this together. Fortunately, there are many options and resources for supporting them and you. You are not in this alone!

 

Amanda Lewis, BA, CMC, is a Certified Care Manager at Aging Wisdom with over 5 years of experience in care management. She assisted clients living with severe chronic medical conditions optimize their health and quality of life.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

communication memory loss

Aging in Place: Is It Time To Get 24 Hour Care?

By Alexa Graziani, ALCA Corporate Partner

24 hour care includes both day and overnight care, around-the-clock. Although every state has its own regulations, some of the common 24 hour care options include the following:

  1. A full day is worked by one caregiver, with breaks, and that is then followed 8 hours of rest in the client’s house.
  2. Two caregivers work 12 hour shifts, with the evening caregiver staying awake throughout the night.

24 Hour In-Home Care Benefits

When care is provided in the home, it enables a spouse or aging parents to be able to continue living where they are the most comfortable. Proper preparation can mean the difference between chaos and a calm transition. It can be very helpful to learn how to be an active care partner.

The following are some of the most important benefits that 24 hour care can provide your family:

  • Calm agitation in individuals who have lost their sense of place and time.
  • Reduce urinary tract infections and skin infections.
  • Reduce fall risk for individuals who need help getting out of bed.
  • Reduce risk of dehydration and fainting.
  • Avoid bathing and kitchen accidents.
  • Improve socialization by spending time with a companion.
  • Meet medical and personal needs during the night.

It can be difficult to make the decision to increase the level of care or get started with 24 hour home care.

As family members, none of us want to have to accept the limitations of our loved ones. Or, we live in complete denial about their illness or dementia. Don’t wait until a crisis arises. Be involved and aware. Whatever you learn as part of this process will be truly invaluable.

“Many adult children call us in crisis mode after a parent has had a fall or trip to the hospital,” says Jackie Summers, Sales Operations Manager for Home Care Assistance. “These kinds of situations, more times than not, could’ve been prevented if the senior would’ve had an in-home caregiver nearby to assist or notice a change in condition. Taking a close look at how well a parent is getting along on their own can make a big difference in their health and well being.”

The following signs might mean it’s time to switch to 24 hour care for your elderly parent, spouse, or friend:

  • Falls are occurring frequently.
  • Confusing nighttime and daytime, agitated while in the dark or waking up frequently during the middle of the night.
  • Staying at a rehabilitation facility or hospitalized recently after a heart attack, stroke, or hip fracture.
  • Fainting due to being dehydrated.
  • Difficulties with drinking or eating without help.
  • Wandering away from home, by vehicle or foot, and getting confused or lost.
  • Confused by brief absences of caregivers, friends, or family.
  • Increased or new bathroom accidents.
  • You are afraid about leaving the individual at night or aren’t getting enough sleep due to having to tend to their nightly needs.

Involve the Individual who is Receiving Care

With all of the planning, sometimes the individual receiving the care is lost! At first, it can be a shock having unfamiliar individuals coming into the house to provide intimate care.

Make the effort to respect and honor your spouse’s or aging parent’s needs and wishes.

When it comes to choosing caregivers, include them in the process as much as possible. After the caregiver starts working, respond to any ongoing concerns your loved one has.

Be patient and flexible throughout the process of getting 24 hour care set up. Work with the home care agency closely to provide quality, consistent, and safe care to your aging spouse or parent.

 

Alexa Graziani is a representative of Home Care Assistance, a Silver Corporate Partner of the Aging Life Care Association.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Support Groups: A Great Resource for Reassurance, Practical Advice and Humor

By Wendy Nathan, B.Sc., CMC

“Remember, we all stumble, every one of us. That’s why  it’s a comfort to go hand in hand.”

~Emily Kimbrough

November is National Family Caregiver Awareness Month. 

Family caregivers give it their all day in and day out, through the laughter and tears.  No matter the duties, they make it happen. Some tasks are large, others small. Some responsibilities are intimate, others mundane. It can be difficult (or even feel impossible) for families to find the time and energy to take care of themselves. As many family caregivers can attest, helping care for a loved one who has a chronic or progressive health condition can be physically, emotionally and mentally challenging. And isolating.

As Aging Life Care Professionals®, we recognize how caregiving can easily lead to caregiver burnout. We often help families identify and implement self-care strategies, which are indispensable in family caregiving. (To learn more about caregiver burnout and self-care, I encourage you to take the Caregiver Burnout quiz and read this e-book from my colleague Jullie Gray: Burnout Can Happen to Anyone: Take the Quiz to see if your Caregiver Flame is About to Fizzle. )

There are many ways to care for yourself, but I’ve found that attending a caregiver support group is an often-overlooked part of a healthy self-care plan.

Support groups can be essential self-care

Those who do eventually stumble into a group wonder why they waited so long to attend. Their preconceived ideas included notions that people just sit around complaining about things they can do nothing about. Or they assumed that talking about your troubles won’t help, so why bother when there are so many other things to do!

I facilitate a support group for the Alzheimer’s Association for young adults who have a parent living with Younger-Onset Alzheimer’s disease. Younger-Onset Alzheimer’s is diagnosed when symptoms occur before the age of 65. The challenges these families have are different since the disease often occurs while the person with the diagnosis is still working or raising kids. The group I facilitate may be unique in their situation, yet participants have experiences and emotions that are common to most family caregivers, such as:

  • feelings of being overwhelmed
  • struggles with problem solving
  • fatigue or tiredness
  • grief
  • sometimes, depression
  • financial worries
  • monotony
  • anger
  • disappointment
  • isolation

A support group becomes a safe place to share and work through these emotions in a healthy way, and find reassurance, comfort, practical advice and humor. Where a support group’s gifts become most evident is in the collective’s ability to understand your experiences as a caregiver. There’s validation, true empathy of the grief, loss and pain you may be experiencing. Most individuals in the group are either going through what you are or have been there themselves. You quickly discover you are not alone!

The culture of a support group is one of trust. The group is a safe place for participants to share fears, worries, frustrations, and sadness and to be completely understood by others experiencing similar feelings. It’s also a place to celebrate milestones, joys, awareness, achievements. The group can also help families prepare for what’s to come.

As a support group facilitator, I am amazed at how participants manage the complexities of their lives. I am in awe of how each have come to develop effective, healthy coping strategies, problem solving methods, as well as their willingness to listen and offer just the right advice at just the right moment. Even though I’m a certified care manager, I’m not the knowledge expert when we meet, the members of the group are. Their experiences are their teachers. They graciously and generously share insights, ideas, resources, and offer practical suggestions. It works!

We all need community, connection

In my work as an Aging Life Care Professional, I see how caregiving can be a lonely, isolating endeavor. Often, the friends and family of clients will fall away following a diagnosis or as a health condition becomes more complex. People who truly understand what you are experiencing can be found in a support group. Support group participation is something we encourage, and it’s a beautiful way to build a community of support.

A support group participant put it best when asked to reflect on her experiences:

“When my husband was first diagnosed with Alzheimer’s, we were both devastated. The physician who gave the diagnosis basically patted us on the hands, wrote a prescription for Namenda and said ‘I’ll see you back in my office in 6 months.’ That was it! No condolences. No resources. No referrals. It was the loneliest time in my life.

“I had no idea where to turn, what to do, how to move forward. It’s obvious now that my husband was in a progressive cognitive decline. He was retired, but now we needed to look at things like driving, financial decision-making, day-to-day concerns. Luckily, I found out about a support group through a friend whose husband also has Alzheimer’s.

“The group was a lifeline and a life-changer. I encourage everyone who is caring for a loved one to find a group. No one understands you like those in the group. And no one judges you. There is nothing but genuine concern, love and good counsel. If feels so good to know that I am not alone in this!

RESOURCES

  • Find an Aging Life Care Expert to help you navigate caring for a family member, friend or yourself and implementing a self-care plan
  • Support Groups: Make connections, get help – from Mayo Clinic staff
  • Find an In-person Alzheimer’s Support Group – from the Alzheimer’s Association
  • Check local hospitals and clinics, as they often have support groups for different health conditions
  • Senior and community centers often offer support groups as well. Find one in your neighborhood and inquire
  • Your faith community may offer support groups too
  • Recommendations from friends

 

Wendy Nathan, B.Sc., CMC, is a Certified Care Manager with Aging Wisdom, an Aging Life Care practice with offices in Seattle and Bellevue (WA) and has over two decades of experience in healthcare working in a variety of roles. She has been facilitating a support group for over four years and has witnessed firsthand its transformative benefits. She is also a volunteer for the West Seattle Momentia Mix, a monthly event for community members living with memory loss and their family and friends.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

8 Ways for Caregivers in the Sandwich Generation to Reduce Stress

America’s Sandwich Generation, men and women in their forties to sixties with both aging parents and children to care for, is one of the fastest growing populations. This group of people often find themselves stuck in the middle of trying to juggle a hectic schedule that includes caring for parents experiencing a decline in health, keeping up with adult children as they struggle to “make it on their own” and begin their families, and managing the financial and emotional stress that arise throughout these circumstances. This alone is a lot for one person to handle and often leaves little time for self-care and nurturing a relationship with your spouse. 

8 Things the Sandwich Generation Should Know to Help Ease the Stress of Managing the Care of Mom, Dad, the Kids…and Themselves

By Kim Miller, BSN, MSN, CMC – Aging Life Care Association® Member

How does one work a full-time job, raise a family, care for parents who are living with medical complications, maintain a healthy intimate relationship, and have time for stress management and stress relieving activities? The following 8 tips provide suggestions and information to help you cope with these demands and provide a way for you to move gracefully forward into your Golden Years.

TIP 1: It’s never too early to start planning.

The moment is now and the options are many. From making room in your budget now to prepare for the costs involved with aging parents and growing children to delaying the downsizing of your home to reviewing the benefits of long-term care insurance, there are many ways you can help yourself by planning now for what is in store. Rather than feeling suddenly overwhelmed in the face of difficult decisions, seek advice from financial, medical, and qualified professionals to help shore up your financial and physical resources. There are many professionals in the legal and financial sectors that specialize in elder care and long-term care planning.

TIP 2: Don’t make any assumptions and trust your instincts.

Recognizing when to seek advice is key. Early signs of feeling like you’re squeezed in the middle can be identified by simply noting if you have asked yourself the following questions:

  • How can I spend time with my children and help my parents every time they ask?
  • How many hours in a day are too many spent in the role of caregiver?
  • How do I fit in time for my marriage?
  • When was the last time I sat down?
  • Why do I feel so isolated?

It’s important to recognize when you begin to feel stretched too thin. Listen to that voice inside and seek the advice of a professional. This is especially important for women who often assume they should know about caring for the aging in the same way that they instinctually know about childcare. Everyone ages differently and every situation is unique. It’s impossible to know in advance how to handle the needs that will arise. It’s best to not assume anything.

TIP 3: Don’t try to go it alone. Seek expert advice and assistance.

Don’t be ashamed about feeling overwhelmed or ill-prepared. This is the case for most of us. There are a wide variety of services and professionals available to help you. A great place to start is to find an Aging Life Care Professional™. An Aging Life Care Professional is typically a nurse or social worker who has expertise in the aging process and the issues that may arise. An Aging Life Care Professional can assess all aspects of your unique situation and help you develop a plan that will meet your aging parent’s needs over time.

Ultimately, someone may need a geriatrician, psychiatrist, or lawyer. There may be a need to provide personal care by a professional. All of these individual providers are focused on a particular service while an Aging Life Care Professional can partner with you to coordinate the care your aging parent needs. Many people feel that this is a job for them to do on their own because they know their parent the best, however, this can be overwhelming. Partnering with an Aging Life Care Professional allows you to extend your reach in caring for you parent while remaining in balance with the other factors in your life.

You can find an Aging Life Care Professional™ by searching aginglifecare.org. You can also contact your local Area Agency on Aging, which can give you information about programs, services, and facilities available right in your community.

TIP 4: Bring them to the table and let them keep their seat at the head.

Talking with mom and/or dad about seeking assistance or advice about how to care for them can often feel daunting. It challenges the typical roles of parent and child. Even though they are aging, the need to be the parent and to feel in control does not fade away and can often become even more present. The first step is to recognize this fact, accept that it will be challenging and then move forward with respectful nurturing and loving care. The rest is artful conversation and psychology.

Here are some considerations when approaching your parents about needing help:

  • Give them the sense that they are the employer, even when they are not and that this is something that your parents will be managing. Try referring to them as a consultant. Find something in the home that they have been frustrated by and suggest that the person will help them make a plan to solve the problem.
  • Explain to your parents that this is someone who will be helping you (their child) by assuring your peace of mind that they are safe. This keeps you in the position of the child who needs help, and the sense that the parents are still needed to support you.
  • If the above are not successful, then it may be time to bring in an expert like a well-respected physician, lawyer or financial advisor who will then provide a prescription for the geriatric care manager.

TIP 5: Sharing is caring. Incorporate your family into the daily mix.

As corny as it may sound, a family meeting can be a great way to get everyone onto the same page about priorities and responsibilities. It provides the opportunity for everyone to share what they are going through and develop strategies to help meet everyone’s needs. It is an opportunity to discuss the caregiving needs, household chores and scheduled tasks to be accomplished on a daily and weekly basis. Bring a pad of paper and make a “to do” list for each person. Don’t forget that your close friends can also be a part of this meeting – the more, the merrier!

TIP 6: Anticipate and address the questions of children and grandchildren.

Even when they don’t ask, your children are likely wondering why their grandparents are more forgetful (especially about remembering their name, etc.), why they need assistance getting dressed, or why someone is coming to help them each day. It is important to educate your children, even at an early age, about these normal parts of life. You can also assure your children that grandma may not remember things but she still loves them. Explain that she can’t express herself but she is still thinking about them. There are many books available for children of all ages to help them better understand topics such as memory problems, feelings of sadness, death and so on. These books will allow them to acknowledge the sadness while also realizing the importance for grandma to have people around her who love her and can take good care of her. Additionally, the books can help you approach the delicate, difficult and sad parts of decline as well as finding the good parts worth celebrating about getting older.

There are many books available for children of all ages to help them better understand topics such as memory problems, feelings of sadness, death and so on. These books will allow them to acknowledge the sadness while also realizing the importance for grandma to have people around her who love her and can take good care of her. Additionally, the books can help you approach the delicate, difficult and sad parts of decline as well as finding the good parts worth celebrating about getting older.

TIP 7: Speak with your employer.

Many employers are familiar with or sympathize with the demands that are involved with being a part of the Sandwich Generation and are willing to work with you to keep you working for them. Since you never know until you ask, make an appointment to discuss the different ways your employer may be willing to accommodate you. Some companies allow you to work from home, adjust your hours or change the days of the week that you are in the office. It is also becoming more common for employers to offer brief periods of leave so you can attend to unexpected family matters. Your employer likely has an Employee Assistance Program (EAP) that may be able to help you access resources or provide you with support.

TIP 8: You are not the last or the least. Make time for number one.

Since we know stressors can contribute to and lead to health problems of a mental and physical nature, start out on the right foot and make time throughout the week for you. While it is essential to build important things like exercise, regular sleep, and healthy eating into your schedule, there is also no shame in giving yourself the opportunity to continue your hobbies, favorite pastimes, friendships and even alone time. Maybe you won’t have as much time for extracurricular activities as before, but just several hours a week can elevate your spirits and do a world of good for your health.

Here are some suggestions for keeping in touch with your sense of well-being:

  • Take 10 minutes a day to sit down, listen to music, meditate or even just close your eyes.
  • Keep your marriage on the priority list and add a weekly activity for just you and your spouse to enjoy.
  • Give laughter a chance and enjoy the funny moments that life brings along each day.
  • Try to set aside one hour a day for something you love to do like reading the paper, taking a walk during your lunch break or calling a friend.
  • Look for the ways that providing care enhances your relationships with your family and affords a sense of satisfaction.
  • Listen to your body and learn to recognize when it is telling you to slow down or that something is not right. It’s very important to immediately take action, take a break and seek medical attention when necessary.

No matter how much the above might seem like an indulgence, doing any or all of them can help save you from hitting the proverbial wall. Once you are at the point of burn out it is very easy to wind up sick which often happens when constantly being the caregiver and never the care recipient. To help avoid reaching that run down state, remember to check in with yourself on a daily basis.

In the end, it is good to remember that you are the most qualified person for taking care of yourself. By helping yourself stay strong and healthy, you are ultimately helping your family and parents by remaining available and capable for the challenges that live in the middle of that very tightly squeezed sandwich.

About the author: Kim Miller, BSN, MSN, CMC is a Certified Care Manager at SeniorBridge, a national health care company offering individually tailored care management and home care services. She has over 30 years of experience as a nurse, with 16 of those years as a nurse practitioner. Email Kim at kmiller@seniorbridge.com or follow SeniorBridge on FacebookTwitter, and LinkedIn.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Get a ‘Leg Up’ on Falls Prevention

Get a ‘Leg Up’ on Falls Prevention

By Nicole Amico Kane, MSW, LICSW, CMC

Photo Credit: National Council on Aging

To those of us who work with older adults, it comes as no surprise that falls are the leading cause of fatal and nonfatal injuries among adults 65 and older.1 Each year, more than one in four adults 65 and older will fall.

As Aging Life Care Professionals®, our role is to help clients manage their health, maintain a healthy lifestyle, and improve their quality of life. Our work often includes efforts to reduce falls.

Why is falls prevention so important? A fall is often life-changing. Falls, with or without injury, impact quality of life. Unfortunately, it can be the beginning of a loss of independence, increasing frailty and take a toll on an individual’s sense of self-worth.

Falls are the leading cause of the emergency room visits and nonfatal trauma-related hospitalizations for older adults, as well as long-term nursing home admissions. Fear of falling can also cause older adults to limit their mobility, activities and social engagements.

Don’t let this happen to you or an older adult in your life. It only takes a few easy lifestyle adjustments to reduce your risk of falling.

What can families and older adults do to prevent falls?

Falls are not a normal part of aging.  Falls are often preventable. You can lower your risk of falling with these effective approaches:

  • Talk with your healthcare provider
    • Be open and honest if you have had a fall, are worried about falling or have experienced some unsteadiness.
    • Have your provider or pharmacist review all medications, including current, expired, and over-the-counter.
    • Get an annual eye exam.
  • Exercise to improve balance and increase strength
    • Lack of exercise contributes to weakness and imbalance. Exercises that improve balance and strengthen your core and legs will lower your chances of falling.
    • Exercise also enhances mood, improves appetite, and can help with weight.
  • Hydration and nutrition
    • Make sure you are drinking plenty of water or other hydrating liquids.
    • Be careful about of how much alcohol you consume.
    • Eating a healthy diet also contributes to falls prevention.
  • Make your home safer – inside and out
    • Have a professional, such as a physical therapist or an Aging Life Care Professional, conduct a Home Assessment.
    • Reduce tripping hazards and remove clutter.
    • Add grab bars and railings on stairways and in bathrooms.
    • Proper lighting is essential.
    • Exterior pathways should be illuminated and clear. Repair exterior stairways and walkways that are cracked, uneven or broken.
  • Footwear
    • Shoes should be sturdy, comfortable, and fit well.
    • If you wear slippers, soft-soled slippers should be exchanged with hard-soled slippers.
  • Family and Friends
    • Family and friends can help make safety improvements in your home as well as their own homes, making visits safer.
    • Home modifications and safety improvements are not just supportive of older adults, they benefit all ages.

Who can help?

Start with your primary care provider for regular and ongoing healthcare assessments, monitoring, and referrals to other health professionals as necessary. For those who are more homebound and have had a fall or are at risk for falls, your physician can order Home Health services (Medicare covered) to provide in-home physical therapy and other services.

Aging Life Care Professionals are experienced, knowledgeable providers of home assessments, and can also connect you to appropriate community resources, services, and supports.

Certified Aging in Place Specialists (CAPS) are remodelers, general contractors, designers, architects, and health care consultants that can assist with home modifications.

Exercise programs are offered at most senior centers, your local parks and recreation departments, and through local Y.  Some evidence-based exercise programs for older adults include:

Falls prevention requires a multi-prong approach. By following the suggestions above, you can be confident that you are taking practical steps to stay healthy, minimize fall risk factors, and maximize your personal safety and independence.


Nicole Amico Kane, MSW, LICSW, CMC, is the care management supervisor at Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Nicole is a licensed clinical social worker and a certified care manager.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

 1.       Centers for Disease Control and Prevention. Falls and Fall Injuries Among Adults Aged ?65 Years — United States, 2014.

Grief & Dementia Care: Support for the Roller Coaster of Emotions

Grief & Dementia Care:  Support for the Roller Coaster of Emotions

By Linda Fodrini-Johnson, MA, MFT, CMC

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

When a parent or spouse can no longer do what they did yesterday, it becomes another transition for the primary caregiver and for the extended family.

These transitions catch us off guard and an overwhelming sense of loss and grief is experienced by the primary care provider.  They often don’t label this as a grief process, but it is about loss – however slow – still has the power to stop us in our tracks.

If you are caring for someone with progressive dementia, such as Alzheimer’s disease, you most probably have had a similar experience.  I think of a story of a spouse who called me one day in tears and said, “Linda, I thought I had accepted this disease and today my wife could not remember how to get toothpaste out of the tube. I could not even help her; I just had to go into the other room and cry.”

And that is what we need to do with this type of pain – express it, find someone to discuss it with and move on.   What this gentleman said to me a few weeks later is, “I just put the toothpaste on the brush and then she knows what to do and soon I’ll probably have to help her brush as well. And, when that happens, I’ll probably have those same feelings all over again. But, today we are enjoying our backyard and watching the birds at the feeders with great pleasure.”

The answer is yes if you can learn to have your feelings, express them, find a coping mechanism, preserve the dignity of the person with the dementia and then move on to what you can enjoy together to make this a less painful journey.

The moment is all each of us has.  However, we feel pain at little losses as well as big ones and it is essential to do the grief work and not let it eat at your inner soul.

Aging Life Care Professionals can assist spouses and other family members to move through these transitions with grace and empathy – one needs a coach and mentor in order to preserve one’s perspective.

To find an aging life care professional near you go to the Aging Life Care Association at www.aginglifecare.org.


About the Author: Linda Fodrini-Johnson, MA, MFT, CMC, is an Advanced Professional Member and Fellow of the Leadership Academy. You can find her at villageplan.com.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Before Turning on the Faucet: Alzheimer’s Disease and Bathing

By Miriam Zucker, LMSW, ACSW, C-ASWCM

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

It may be at the beginning when an Aging Life Care Manager® does an initial assessment of the person with Alzheimer’s disease; or it may come up as the dementia progresses; or it may never come up. The task is bathing, and for reasons discussed below, it is an undertaking that has its unique challenges.

For some, a bath or a shower is uneventful. But for others in the early stages of Alzheimer’s disease, he or she may be accustomed to bathing independently. Now that independence is disrupted. There may be an aide or family member standing in the bathroom or right outside the door. Privacy is compromised and the need for safety trumps a long history of modesty. It can be especially challenging when the aide is female and her client a male.  If this new bathing protocol were not enough, the cognitively impaired person may not recognize that anything is wrong, so she becomes verbally and physically abusive as she staves off the invasion of helpers and disruption to her customary routine.

With the progression of the dementia, the senses are the triggers for the challenge to bathing. Seeing the water rush out of the spout or shower head may be anxiety provoking; the sound of the water may illicit a similar response. Multiple mirrors in the bathroom may give a “house of mirrors” effect. Good in an amusement park, but not the bathroom. If it is a bath the person is taking, he may view the tub and water as bottomless and be afraid to enter it.

While the explanations are as varied as the person partaking of the bath or shower, the following five strategies can be helpful in reducing the stress for the caregiver and family member:

  1. Choose the right time of day. If a person is experiencing sundowning, a shower in the late afternoon or evening may not be the right time.
  2. Assess the level of help needed by the individual and then coach the person accordingly. A strength based approach will help the person to have a greater feeling of security and independence.
  3. As the caregiver, be aware of how you are feeling as you approach bathing. People with dementia are sensitive to the moods of others. If you are tired after a long day, put off the bath or shower for another time.
  4. If there is resistance, use a reward-based approach: “We’ll take a very short shower and then we’re going to have coffee and those chocolate chip cookies you like.”
  5. If these strategies prove unsuccessful, try a sponge bath or use a non-rinse body soap and shampoo. These items are available in drug stores and online.

As Aging Life Care Managers®, we suggest approaches that will insure minimum stress for the caregiver and the desired hygiene outcome for the cognitively impaired person. It is a customized approach that recognizes the unique needs of each family member.


MIRIAM ZUCKER, LMSW, ACSW, C-ASWCM is the founder of Directions in Aging, based in New Rochelle, New York. She previously worked as the Program Director for the Alzheimer’s Association of Westchester County, New York and has served on the faculty of the Brookdale Center for Healthy Aging of Hunter College.  Ms. Zucker can be reached at: mzucker@directionsinaging.com

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Engagement with the Arts Enhances Well-Being in Alzheimer’s Patients

Photo Credit: here:now art-making class. Photo by Lou Daprile

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

Engagement with the Arts Enhances Well-Being

By Lisa Mayfield, MA, LMHC, GMHS, CMC, Principal, Fellow Certified Care Manager

One recent afternoon in Seattle, a group of older adults gathered for iced tea, coffee and snacks in the café at the Frye Art Museum. Lively conversation ensued, like a gathering of old friends. Strummed on a guitar was a familiar tune. Carmen Ficarra, the musician and a teaching artist at the Frye, led them in song. It was joyful.

This gathering was of the Frye’s monthly Alzheimer’s Café, the newest of their Creative Aging Programs. Dementia-friendly programming at the museum is the innovation of Mary Jane Knecht, Manager, Creative Aging Programs, who along with her then-Director, Jill Rullkoetter. first proposed the concept nine years ago.

“Our goal from the beginning has been to reduce the feelings of isolation and stigma, which are often challenges for people who are living with dementia,” says Knecht. “We want the Frye to be a safe, supportive, and inspiring environment where participants can be social and feel welcome in a public place.

Creative Aging

The Frye’s first program — here:now — is an arts engagement program developed specifically for adults living with dementia and their care partners, where they can enjoy conversation, works of art, and artmaking in a supportive setting. The Frye also offers a quarterly film program – Meet Me at the Movies – where movie clips are shown, followed by facilitated audience discussion. Additionally, Knecht developed a program called Bridges, which brings art to the residences of individuals in the latter stages of dementia through one-on-one art discussion and art-making experiences.

The Museum is part of a larger collective of organizations known as Momentia Seattle, a “grassroots movement empowering persons with memory loss and their loved ones to remain connected and active in the community.” Momentia partners offer activities, programs and events including zoo and garden walks, talent shows, summer camps, field trips, improv, folk dancing, yoga, book clubs, and music, in addition to cafés and art classes.

The Arts are Transformative

In our work as Aging Life Care Professionals®, we believe in the transformative nature of arts and cultural engagement. We have seen this, when part of a care plan and tailored to each client, bring a new light through attendance at the theater, movies, concerts, and museums. An afternoon spent in an arts studio or getting social with new friends means someone is engaging socially, artistically, emotionally and mentally.

These arts and cultural experiences are an enriching, non-pharmacological approach that research shows can help improve mood, lessen anxiety and agitation, build relationships, make social connections, and improve overall quality of life for older adults living with Alzheimer’s or another dementia.

Most communities have some level of programming focused on arts for older adults, be it through senior or community centers, arts organizations, parks and recreation departments, churches, adult day centers, the Alzheimer’s Association or an Area Agency on Aging. There are also professionals such as recreational therapists and activities specialists who work directly with individuals.

How Can an Aging Life Care Professional® Help?

The responsibilities of taking care of your parent, spouse or family member can be very stressful. As Aging Life Care Professionals, we take a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. We help families navigate a path forward. Sometimes that path includes the arts and cultural engagement.

How do you know if you need an Aging Life Care Professional? Are you?:

  • Feeling both blessed and burdened helping your loved one?
  • At the end of your rope trying to balance the needs of your immediate family, a job and caring for an older loved one?
  • Concerned for your parents’ safety, well-being and independence, and it’s keeping you awake at night?
  • Noticing worrisome changes in your parent, contrary to what he or she tells you?
  • Living far from older family members and overwhelmed by caring for them long-distance?

Aging Life Care Professionals bring a positive outlook, years of experience, an objective perspective and responsive engagement to enable clarity, stability and a way ahead. Providing tools and resources to make informed choices, our guidance and expertise leads families to decisions and actions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers. We are well-acquainted with programs, services and supports in our service areas and can help match your loved one with activities and events that will be fulfilling and contribute to their health and well-being.

To find an Aging Life Care Professional in your community that can help connect you and your loved one to service, supports and programs, please visit the Aging Life Care Association website at http://aginglifecare.org.


Lisa Mayfield, MA, LMHC, GMHS, CMC, is the founder of Aging Wisdom, a care management and consulting practice in Seattle, an Aging Life Care™ consulting, care management and creative engagement practice that strives to bring peace of mind to families by both directly improving the quality of life for aging family members, and by providing consultation and coaching services for their families. She is president-elect of the Aging Life Care Association and a Fellow Certified Care Manager.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Planning for the Future: Long Term Care

Planning for the Future: Long Term Care

Andrea Zaite, MSSA, LMSW, CMC, C-ASWCM

How Will I Pay?

I want to introduce you to the web site run by the federal government called https://longtermcare.acl.gov/.  Long term care is defined as receiving assistance in the areas of daily living such as bathing, incontinence care, cooking, shopping, medication reminders, etc.  The website is courtesy of the U.S. Department of Health and Human Services.  This site covers some topics I think are important to those looking to plan for the future or to help pay for the care of a loved one recently in need, but without the financial means to write the check.

We know from experience that Medicare, Medicare replacement and commercial insurances do not pay for these services.  They are not considered medical care so they are not covered.  I agree that most chronically ill and elderly patients would benefit from these services as a part of care to prevent re-hospitalization, however Medicare doesn’t see it that way.  I have found many people wading through the myriad of services provided in the handbooks come across home care and assume this is the same.  The Medicare, Medicare replacement plans and commercial insurance are talking about medical home health ordered by a physician.  Home health is a medical service which includes a weekly nurse visit called skilled nursing care that may last 15-30 minutes to take vitals and deal with any medical problems and education; Occupational Therapy for upper body; and Physical Therapy for lower body and ambulation. Temporary bathing aid can be ordered for several visits to ensure patient can safely bathe. Home health is meant to be a bridge from illness to recovery; from hospital to home. There are restrictions as well; a patient must be home bound, and is usually time limited with the need to show improvement.

The next question and road block to obtaining this care is the cost. Long term care is expensive by the nature of the care required and location of services.  Most private duty home care can range from $12.00 – $25.00 an hour with some company’s requiring a 3-4 hour minimum.  Average monthly cost whether provided at home or in an assisted living, board and care home, or nursing home, can average as high as $5,000.00 to $6,000.00, with home care usually the least expensive if the home is in good condition and the home is owned outright.

OPTIONS FOR PAYING:

The options to pay for your long-term care have improved over the past 10 years because the need for this type of care has increase so dramatically.  These options include:

  • Long term care insurance
  • Combination Life/Long term care products
  • Accelerated death benefits
  • Life settlements
  • Viatical Settlements
  • Reverse Mortgages
  • Home equity loans
  • Annuities

Long Term Care Policies are generally obtained by those in the planning phase as they are less expensive the younger you are.  These policies can be activated once an individual is determined to have 3 deficits in the area of activities of daily living skills.  Most policies cover private duty home care, assisted living, and long-term nursing home care.  Policies have a 3-month waiting period and require an evaluation by a care manager that either works for the insurance company or is contracted by the recipient.  The evaluation is to determine the need for services and determine the 3 main deficits in the Activities of Daily Living Skills.  I have discovered that there are families and clients that don’t realize they may have these policies either because this was not discussed with the children or often the wife didn’t know her husband purchased the policy.  Many private duty home care companies and assisted living facilities will help you activate the policies if needed.  Some insurance policies will reimburse you for the cost incurred during the 3 month waiting period others consider that to be an out of pocket cost.

Combination Products are for those persons who would like a guaranteed return on their investment by combining life insurance with a long-term care plan so if you don’t use the long-term care component you can still collect on the life insurance or at least your beneficiaries can.  Many of the same rules apply as for long term care.

Accelerated death benefit feature of a policy allows you to receive a tax-free advance on your life insurance death benefit while you are still alive.  You may have to pay for the option to have this feature or it may be part of the policy.  There is the stipulation that you are terminally ill or have a life-threatening diagnosis or need long term care for an extended period of time verified by a physician.  This feature is usually capped at 50% of death benefit.  This type of policy is limited but can be a helpful in an emergent situation.

Life settlement option of a policy allows you to sell your insurance policy for its present value to raise cash for any reason.  This option is usually only available to women age 74 and older or to men 70 and older.  The down side is the income generated may be taxed as capital gains but the up side is you need not exam and no doctor statement.

Viatical settlements option allows you to sell your life insurance to a third party.  This option is like a life settlement but is only available to those who are terminally ill or have a life expectancy or 2 years or less.  The payments are based on life expectancy limitation due to illness or injury that must be verified by your physician.  The payment percentage is based on this number so for example someone with a life expectancy of 1 – 6 months may have a payout of 80% of benefit and someone with a life expectancy of 6 – 12 months would receive 70% of benefit and so on.

Reverse Mortgages are a good option if you have a home that is paid off.  You should go to a reputable mortgage company or bank to discuss this option.  Many reverse mortgages allow you to choose between a lump sum payment, a monthly payment, or a line of credit.  You continue t live in you home but you are responsible for up keep, taxes and insurance.  The stipulations to this option include being 62 years of age or older, and this must be your primary residence.  Your spouse can continue to live in the home after you die and there is an option to pay back the mortgage if your family decides they want the home.

Annuities seem like the least popular option as they can have an effect on your taxes and affect your eligibility for Medicaid.  There are 2 types of annuities; immediate and deferred long term care annuities.  Trust can be drawn up to help disperse the funds and protect them from Medicaid regulations.  This should be discussed with an elder care attorney.

The options discussed above and other related subjects can be found on the long-term care website.  I also recommend you visit another website called lifecarefunding.com.  This company has been doing business since 2007 in response to the Medicaid spend down for senior to qualify for long term care.  They help convert policies into living benefits.  Several agencies and assisted living facilities use and recommend them.

An Aging Life Care Professional® can help you to evaluate your circumstances and develop a plan that is right for you and your loved one.   They can also recommend and refer you to elder care attorneys, financial planners, ad insurance companies to help navigate the waters of long term care.


About the Author: Andrea Zaite, LMSW, C-ASWCM, CMC, is an Aging Life Care Association Advanced Professional member and a Board Member of the South Central Chapter.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.