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On Dementia: Care, Community and Creativity

Conversations of hope, joy, and better ways to care for and support individuals living with dementia and their care partners

More than 5 million Americans live with Alzheimer’s disease and over 15 million family members, friends and volunteers serve as care partners, according to the Alzheimer’s Association. Individuals with Alzheimer’s and other dementias do not stop living because of a diagnosis. They are still people—needing and deserving joy, engagement, community, and purpose. Their care partners also benefit from support.

So, how can others help to make an impact, address stigma, and enable people living with dementia to become integral parts of their communities and create opportunities for inclusion?

This spring, the Frye Art Museum Creative Aging Program, Aging Wisdom, and the University of Washington Memory and Brain Wellness Center are collaborating on a three-part series of enriching conversations with pioneers in dementia care, support, community building, creative engagement, and artistic exploration.

Each dementia care expert is also an author of engaging books that challenge, even disrupt, our assumptions about dementia, providing new perspectives and a deeper understanding of care, community, and creativity. Their books also offer practical suggestions on how to implement what they have put into evidence-based practice in support of individuals living with dementia, their care partners, and those who support them.

Author discussions will be offered as virtual programs through Zoom. The series is listed below. Pre-registration is required. There is no fee. To register, visit the Frye Art Museum at https://fryemuseum.org/program/creative_aging_workshops

  • Each program is scheduled on a Thursday at 12 noon Pacific Time.

March 11, 2021: Lynn Casteel Harper, On Vanishing: Mortality, Dementia, and What It Means to Disappear

Lynn Casteel Harper will expand our understanding of dementia beyond the typical fear-driven and tragedy narrative, On Vanishing provides encouragement and meaningful examples of better ways of caring for, and thinking about, our fellow beings.

April 8, 2021: Susan H. McFadden, Dementia-Friendly Communities: Why We Need Them and How We Can Create Them

Susan H. McFadden, PhD will discuss how intentional, thoughtfully engaged dementia-friendly communities can give people with dementia the opportunity to continue living with purpose, reciprocal personal relationships, and enrichment.

May 13, 2021: Anne Basting, Creative Care: A Revolutionary Approach to Dementia and Elder Care

Anne Basting, PhD is a MacArthur Genius Grant recipient who pioneers a radical change in how we interact with people who struggle with dementia. Basting’s proven methods use storytelling and active listening to stimulate the brain and awaken imagination.

About the Author: Keri Pollock directs marketing and communications for Aging Wisdom, an Aging Life Care practice based in Seattle, WA. She serves on the Frye Art Museum’s Creative Aging Advisory Committee as well as the Aging Life Care Association’s PR Committee.

Black and Brown Aging Life Care Managers® Changing The World, One Client at a Time

For over 400 years, black and brown communities have experienced systemic racism and intergenerational trauma (Gibbs et al., 2020). In 2020 and 2021, we continued to experience these traumatizing events portrayed through violence, dehumanization, and oppression. The disparities among black and brown communities have been marginalized and minimized by many for so long that some have given up hope and no longer recognize “I have a Dream.” As a result, historically, black and brown people learned to trust only within their circles and question all others’ motives. Because of this inner-circle trust level and distrust of others, black and brown individuals continue to suffer. We unconsciously deprive ourselves of a level of resilience. We mistrust the system, so we do not seek appropriate help or support from experts, such as mental health counselors and professional care managers.

As a Black Aging Life Care Manager® and Psychotherapist, it is my responsibility to foster resilience and hope for change again. While on the cusp of this change, it is essential to help my colleagues better understand why many black and brown individuals are resistant to hiring a care manager or seeking mental health support. The list below is not inclusive.

    1. Lack of understanding of the culture and environment: Historically, black and brown families developed inter-family systems where family members take turns caring for their elder loved ones. For example, as a kid (age 12), my siblings and I had to learn how to feed my grandmother through a feeding tube. During this time, you used a syringe to push the pureed food through the tube. Sending my grandmother to a nursing home was not an option. Also-just because there is a health care surrogate (HCS) or power of attorney (POA), that does not always mean that people always make independent decisions. Often, there are conversations between family members before the POA or HCS makes a decision.
    2. Fear and distrust: Fear and distrust of “the system” creates barriers for black and brown families to engage an outside expert (care manager or mental health therapist) to assist with their elder family member’s needs. Many do not see it as a value and will not invest in services. As a care manager, you must work closely with family members and the elders to gain their trust and dispel their perception. For example, do not pretend or say you understand their challenges without exploring their experiences (such as with medical providers, mental health therapists, or insurance case managers). Remind black or brown clients that they are the expert of themselves and that you view the relationship as a partnership.
    3. Miseducated or uneducated: Many individuals are miseducated or uneducated about their medical insurance benefits. As an experienced Medical Social Worker, I worked in the hospital for over ten years and encountered many patients who were informed by a neighbor or another family member that their insurance covers custodial care needs or that their medical insurance benefits include a care manager. Educating individuals about the differences in services is essential. Keep in mind, you must spell out the word V-A-L-U-E as a conversation. Increase their knowledge of Viable options; Advocacy; giving meaning to their quality of Life; Understanding their differences and how they view the world, and showing how much more Effective and Efficient actions are taken when an experienced Aging Life Care Manager is involved.
    4. Value of spending money on care management services: When you compare the socioeconomics between black and brown families and their counterparts, black and brown families have an extensive history of poverty and often limited access to financial resources. It is not that black and brown families do not value money or other financial resources; they usually do not see the value of spending money on care managers’ services.
    5. Lack of self-reflection and acknowledging your “stuff”: Many of us are comfortable in our role as a care manager, which can be somewhat dangerous when engaging black and brown elders and their family members. Words or phrases we use; or our body language can be offensive. Phrases like “when you people,” “my black friend,” or “I had a black supervisor that was great,” or “these people are nice” are not productive or effective rapport builder conversations. Before you take a referral or engage in discussion with black or brown families, dispel all your assumptions and cancel judgment.


V- to increase Viable options that family members may not be aware of. (As a care manager, our role is to ensure our clients know they have viable options and that the one a medical provider suggested it just only one).

A-show how your experience will help Advocate for them. Even as we get older it takes a village to care for someone. As a care manager, we aid in advocating for clients and family members. No person should ever feel like he or she is in this alone.

L-giving meaning to the quality of Life is important. As a care manager, our role is to be honest and meet the family and clients where they are. Explore what quality of Life looks like to them because changing their diet is not a measure of their quality of life.

U- showing your client that you want to Understand their differences and how they see the world is a great way to start a partnership.  For example, explore whether your black or brown client prefers to have medical providers that look like them or if that is not an issue.

E-emphasizing and showing how much more Effective and Efficient actions are when an experienced Aging Life Care Manager is involved.


About the Author: Kizzy Chambers MSW, LCSW, CMC, Aging Life Care Association Member. Kizzy is in her fifth year of providing Aging Life Care Management services and is the Founder of RR Care Management, LLC in Orlando, Florida.  She is a Professional CareManager and a Licensed Clinical Social Worker with much of her experience as a Medical Social Worker. You can contact Kizzy through her website at www.rrcaremanagement.com.


Sex, Money, & Your Parents: Conversations you never wanted to have

Annie and her two siblings have been helping their elderly parents in a growing number of ways over the past several years. Assisting with the care and upkeep of the family home, making needed grocery runs, preparing meals, attending occasional medical appointments, and in general — ensuring things are going OK.  Their mom was diagnosed with MCI (Mild Cognitive Impairment) or early stages of Alzheimer’s about a year ago and their dad has had several heart-related issues over the years but remains strong, active, and on “top of his game” as he likes to say.

Annie and one of her brothers are willing and continue to step in and help in a variety of ways. The real challenge now is planning and preparing for the future. The reality of their parents’ changing needs is becoming clearer. Annie and her brother realize they do not have a clear understanding of their parents’ finances. Their dad retired from a long successful career with NASA and always talked about the importance of saving for retirement. As far as Annie and her brothers are concerned, money never seemed to be an issue, nor was it talked about. Their parents always seemed comfortable. They have a nice, modest home, sent two of three children to college, drove nice cars, went on the occasional vacation, and as far as Annie and her brother knew they seemed to be financially secure.

The challenge now is talking to their parents about the future including their finances.  Just as Annie and her brothers never wanted to talk to their parents about sex when they were growing up, their parents do not want to talk to them about finances. Both can be uncomfortable conversations to have, but it is important to understand the need to have such conversations, and the potential outcomes if they are ignored.

Just as Annie and her brother work toward understanding their parents’ finances, many adult children with aging parents are challenged to recognize the importance of the topic.  Being prepared will allow families the ability to assist with realistic future financial costs and the ability to readily step in should there be a potential emergency.

Why is this topic so difficult to talk about? 

  • Generational – certain age groups kept personal matters such as money private. It was considered good, respectful manners to keep personal information private.
  • Shame, guilt – parents may feel embarrassed about their finances. They did not budget, plan, and/or save.
  • Fear – the fear of running out of money. Having to depend on, or be a burden to, their children.
  • Once a parent always a parent – parents want to stay in control – after all, they are the parent. They watched us succeed and fail many times, and they witnessed all kinds of mistakes along the way. They are not going to sit by and watch us make mistakes with their money.
  • Mortality – The reality of nearing the end of life.
  • Scams – potential scams both from within and outside of the family.

Strategies and tips to help begin the money conversation:  

  • Accept and acknowledge the conversation may be uncomfortable.
  • Share a story of a friend/colleague who had no idea about their parents’ financial situation and the difficulties this created.
  • Timing – be conscious of when, who, and where. Do not rush; there will likely be many small conversations, each one allowing both you and the parent to get comfortable with sharing information. (A holiday meal may not be the best time.)
  • Respect – avoid criticizing your parents’ record keeping and/or explanations of their choices. Remember they have been managing things their entire life, including raising you.
  • Do not go at it alone – recognize your own skillset and the value of working with professionals.

A CFP (Certified Financial Professional), Elder Law Attorney, or Certified Aging Life Care Professional may be valuable expert resources for their helping maximize their financial futures.

Many of us did a good job avoiding our parents’ unsolicited, awkward conversations about the birds and the bees when we were growing up, but we should not avoid the tough money conversations with them now.

  • Jennifer Beach wrote this article for the December blog post for Northeast Ohio Boomer and Beyond.

About the Author:  Jennifer Beach, LSW, MA, C-SWCM established Advocate for Elders in Rocky River in 2010. Jennifer has 25 years of experience in working with and advocating for older adults and their families. Jennifer is a licensed, insured Social Worker and an Advanced Aging Life Care® Professional. She has served as the Midwest Chapter President of the Aging Life Care Association and additionally served 7 years on the Board of Directors. In 2018, Jennifer was honored as the recipient of the ALCA Midwest Chapter Outstanding Member of the Year Award. Learn more at advocate4elders.com.

Jennifer is also a monthly contributor and author of Caregiver Corner for Northeast Ohio Boomer and Beyond blog and magazine.

 

A Portable Living Solution & Protection – For The Ones You Love

 

Bob and his father, John, in front of the newly delivered Wheel Pad! Brattleboro, VT

What does a family do about an aging parent who lives far away on his own? This dilemma faced Bob and his wife Jennifer Jacobs. Bob’s father, John, had always been independent. Once a professor of Histology at the University of Illinois at Chicago’s dental school, John, now 87, was living on his own in Chicago. Bob, a busy tree arborist from Brattleboro, Vermont, found himself flying to Chicago frequently to check up on his father. 

When a friend called to say John had fallen and was in the hospital, and after another trip to Chicago to see his father out of the hospital and into a rehabilitation facility, Bob knew that his father needed to be closer by.  With some planning, the rehab facility in Chicago released John to a rehab facility in Brattleboro. Because John was not yet ready for a nursing home, Bob looked at assisted living facilities in the area. John, however, was using a catheter, and assisted living places would not take him. With no place to go and no apparent options, John remained in what was meant to be temporary rehab. Adding to the dilemma the family faced, the coronavirus pandemic was starting to take hold in early March 2020; a rehab center was no place for an aging parent to be. Although John sometimes used a walker, he was increasingly reliant on his wheelchair for mobility. Bob and Jennifer’s home lacked space for another, nor was it wheelchair accessible. They were at a crossroads. 

While worrying about how they could possibly navigate having John live with them, Jennifer had an idea. She had been involved in organizing a Tiny House Festival in Brattleboro, where she met Julie Lineberger, the owner of Wheel Pad, the most unusual house on display at the festival. It was not an ordinary tiny house, it was a wheelchair accessible module that could attach to Bob and Jennifer’s home via a connector! It seemed to be the perfect solution to freeing John from the rehab limbo he was in. Jennifer’s plan was confirmed when she called Julie. After a bit of advance sitework, installation took place over a weekend.

As a regular process for all of our clients, Wheel Pad creates a rendering of what your home will look like after installation. Here’s an example of what we showed Jennifer, Bob, and John.

Far left, John’s grandson with his dog, Olive. Behind them, the family who previously leased this Wheel Pad. Sean suffered a Traumatic Brain Injury as a result of a motorcycle accident. The family insisted on helping to deliver and install the unit for Bob, John, and Jennifer. 

John has been living in his Wheel Pad for a couple of months now, and he expressed the wonderfully positive impact it has had. He feels like a part of the family, yet has his own private space with control over his climate. When he sometimes feels colder than other family members, he can go off into his own domain and turn up the heat. John noted how well-designed the unit is. His one suggestion was to move the heater controls from the floor to a spot more easily reachable from a wheelchair. 

 

The view from Wheel Pad into the main house via a connector.

 

 

 

 

 

 

It turns out, John is leasing an early model Wheel Pad, and all current Wheel Pads have heating controls at wheelchair height! He can easily transfer himself to the bed and the bathroom and down the ramp to get outside. He gets the benefits of rehab with a visiting nurse and physical therapist who come and work with him in the privacy of his own space without entering his son’s home and disrupting the family. The visiting nurse has been most impressed with John’s Wheel Pad and reflected that it could help many others in his situation. 

The fully installed Wheel Pad connector as seen from the outside.

Bob and Jennifer now breathe a collective sigh of relief at having Dad at home with them and safe from the ravages of the pandemic. They take meals together, enjoying both social time and privacy. John manages many of his own needs such as organizing and taking his medications, and, when he feels like it, he can still beat anyone at Scrabble!  

 

John in his new Wheel Pad!

 

 

 

 

 

With the help of Wheel Pad, John, Bob, and Jennifer are all partners in navigating this stage of John’s life with dignity, as much independence as is safe, with the security of family nearby. . . a gift for all!

About the Author: RJ Adler is the Business Development Director at Wheel Pad. Based in Vermont, he likes market-based solutions and building businesses. He spent his early career as a teacher, then switched to the solar energy industry, before moving into housing. He finds that the issues creating the energy and climate crises are similar to those facing the housing shortage, and they are fun problems to solve. Most often you’ll find him skiing, in a canoe, or dreaming about tinkering around the house. He’s always happy to have a conversation at rj@wheelpad.com.

Radon Awareness Month: Aging Life Care Specialists® go Underground

Among other events, January is officially declared as Radon Awareness Month.

We Aging Life Care Specialists® ask a lot of questions – most pertain to the medical, social, and emotional conditions of an older adult, and the home environment. Now, in recognition of January’s theme, we are going even deeper in the home and descending to the basement.

Why the basement you ask?  Because in some homes, across all fifty states, evil may be leaking from the ground. It’s colorless, odorless, invisible and can only be detected by testing.  This mysterious element is called radon. It is a radioactive gas that comes from the decay of uranium found in the soil one’s house might be built on.

It typically moves up through the foundation to the air and enters one’s home through cracks, walls, construction joints or gaps in the foundation around pipes. A home traps radon inside, where it can build up. The ventilation and the air flow patterns in a house will affect how much radon will be pulled into different areas of the house. The age of the home does not make a difference.

According to the United States Environmental Protection Agency radon is the leading cause of lung cancer in non-smokers in the United States. The higher the radon level in a house, and the longer the exposure period, the greater the risk to the occupants.

Apologies for the scare, but the good news is that radon levels can be measured and if remediation is necessary, there are solutions. The place to start is with A Citizen’s Guide to Radon, published by the EPA. In a nutshell, the average radon concentration for homes in the United States is 1.3. It is when the radon levels, goes beyond 2 picoCuries per liter (the EPA will explain the jargon) that thought should be given to resolving the potential problem.

While you can hire a professional tester to determine the radon level, you can easily start with buying a do it yourself test kit available in hardware stores or online. You can also call 1-800-SOS-RADON (part of the EPA). This testing method consists of a small charcoal canister. The radon in the air is absorbed on the charcoal and the decay products can then be measured by a laboratory. The laboratory cost is usually incorporated in the cost of the canister. There may be some variations by state; for example, it is suggested by the New York State Department of Health, that two separate charcoal canister measurements be used before deciding to correct the situation. If mitigation is necessary the most common method is to have a vent pipe system and fan installed, which pulls radon from beneath the house and vents it to the outside. More information is available from the EPA at 1-800-55RADON.

So, why this article on radon?  January is officially declared as Radon Awareness month. But beyond this, often, as Aging Life Care Specialists, we turn to our personal experiences when they can enhance the lives of those we help. Some years ago, with great excitement we closed on our dream weekend home in the woods. Surrounded by nature, deer leaping thru the woods beyond, a welcoming lake for rowing and swimming, what could be better? The answer would have been a tent for camping had we not taken care of the high radon level that was noted in the inspection report. As Aging Life Care Specialists, it is our goal to keep our clients safe at home. Checking for radon is another step to ensure their safety.

About the AuthorMiriam Zucker, LMSW, ACSW, C-ASWCM, is the founder of Directions in Aging based in Westchester County, New York. For over two decades she has assisted families in customizing plans of care and developing effective strategies to meet the needs of senior adults.

Mentors in the “Aging Space”

ALCPMentoringPerhaps you are recently retired and have some skills you would like to share or maybe you find yourself in a role that you are not prepared for, possibly “family caregiver.”   These are two examples where mentoring could benefit you in your later years.

Mentoring is a win-win relationship between two people that is usually intended to assist the mentee to become more proficient in a new role, job, or even a craft.  Mentoring is more development-driven, not just the “Job Function:” it goes beyond, taking a more holistic approach to the goal and its impact on all of life.

A coach is someone who is more performance-driven; there are circumstances where that might be the better choice.   There are many crossovers between mentoring and coaching.

The mentor guides a less experienced person by building trust and modeling positive behaviors.  Mentors are dependable, engaged, authentic, and tuned into the needs of the mentee.  They respect confidentiality, manage time well, and also become your consultant and cheerleader.

As Aging Life Care Professionals®, we work closely with families who are experiencing caregiving and are often overwhelmed with the tasks at hand.  In our mentoring, which is sometimes looked at as consulting, we help the new caregiver prioritize tasks and learn how to manage difficult behaviors brought on by dementia or other illnesses.

Once a trusting relationship has been established and the mentee or client has learned some skills that help them find a balance in their lives and deliver care without burn out, we then move to a relationship of consultant and are called in only when there are changes or stressors that need some guidance and/or modeling.

Those newly retired with skills to share can approach their professional organization and look for opportunities to mentor younger people coming into a new profession.  There are also opportunities to mentor children in a variety of capacities – from reading to dealing with feelings, emotions, and life adjustments.  Many religious organizations, as well as community groups, use mentors with those who are homebound and just need a cheerleader or someone who is a good listener.  This is a great way to stay engaged in your later years and often an Aging Life Care Professional can help you find a place to share your skills at the same time as keeping you healthy and giving you a link for aging resources in the future.

To find an Aging Life Care Professional® near you or a parent, go to our new website AgingLifeCare.org.

About the Author: Linda Fodrini-Johnson, MA, MFT, CMC is a Fellow Advance Level Aging Life Care member.  She is a licensed family therapist as well as a certified care manager.  She is the past president of ALCA as well as a past president of the Western Chapter of ALCA.  She has been honored with many awards for her leadership and mentorship in the organization as well as in her community.   She owned a full-service care management business for 30 years, sold it in 2019, and now continues to do mentoring, consulting, coaching, and teaching in the San Francisco Bay Area.   She can be reached at LindaFJ620@outlook.com

Financially Helping Clients Fund Their Care Needs: Real Life Examples

financially helping clientsAging Life Care Professionals® are called upon to assist clients with resources to handle their particular situations, including evaluating the financial resources necessary to help clients ensure quality care and an optimal life.

Did you know that 500,000 seniors walk away from their life insurance policies each year?  This happens because they no longer want the policy, need the policy, or can afford the policy any longer.  The reason a policy was purchased 10, 20 or even 30 years ago is no longer a concern.  The house is paid off, perhaps a spouse has passed away, the kids are grown and have their own lives, etc.  They do not know there is another option that can have dramatic impact on the ability of people to pay for their care needs.

A life insurance settlement is that option, and is the ability for a client to sell their unwanted/unneeded life insurance policy for cash.  The investor groups who purchase these policies become the new owner, pay the premiums, and become the beneficiary.  The client receives cash today, and the buyer receives an investment with a future return.  The amount a policy could we worth is very specific to each client, but policies can be worth tens of thousands or hundreds of thousands of dollars…all from an asset a client was going to walk away from.  All different types of policies can be sold, including term policies.

Here are some real-life stories of some of our clients whose lives were changed through a life insurance settlement:

*A 66 year old woman with MS had a $150,000 term life insurance policy.  Her beneficiary was her ex-husband.   There were no children, and no one she wanted to leave the money to.  This policy was no longer needed or wanted.  She did not know a life insurance policy was an asset that could be sold.  Since she didn’t need it anymore, she decided selling the policy made sense, in order to give her money for the care needs she knew she would need in the future.   We marketed the policy and she sold it for $25,000, giving her the financial cushion she wanted.

*A 78 year old gentleman with cancer had a $250,000 term policy.  He purchased the policy for his wife, so she would be protected and could pay off the house, if something should happen to him.  The house had long been paid off, and his wife had passed away 4 years ago.  His daughters were the beneficiaries.  They had successful careers and their families did not need the money.  He decided that he wanted to sell the policy to make his life more comfortable while he was still here.  The opening offer on his policy was $15,000.  By the time we were done, he sold it for $128,500.  That will go a long way to helping him stay comfortable for the rest of his life.

*A 58 year old gentleman with significant heart issues had a $1.6 million universal life policy.  He was a successful businessman, and his family was well cared for.  He had a dream of living on a ranch for the rest of his life.   So, he sold his business, sold his house, and sold his policy for $350,000 (the opening offer was $125,000).  Now, he has the resources to live the rest of his life the way he wants.

About the Author:  Lisa Rehburg is President of Rehburg Life Insurance Settlements, a life insurance settlements broker, and a Bronze-level Corporate Partner for ALCA. Lisa has been in the health and life insurance industries for over 30 years. She has held executive roles at carriers, general agencies and TPAs. Ms. Rehburg is energized by helping care professionals and their clients benefit from unwanted or unneeded life insurance policies. By having access to many investor groups, Rehburg Life Insurance Settlements can place more policies and realize a better return for clients. She holds a Bachelor of Arts degree in Finance and a Master of Arts degree in Organizational Development. She can be reached at (714) 349-7981, lrehburg@aol.com or www.rehburglifesettlements.com.

Sibling Relationships and Older Parents

As adult children age many unresolved conflicts are swept under the carpet and avoided.  Often with parents as buffers, and contact limited, relationships remain stable. All this can change when adult children must share the task of caring for an aging parent. When the focus becomes their own unresolved conflicts, this can interfere with the task at hand and further destroy family relationships.

 

Here are a few tips that can help resolve these pitfalls:

  1. Focus on parent’s needs –- If siblings are spending time and energy arguing with one another it takes away the focus from the aging parent.  Unresolved issues that exist can be reduced by making parent’s needs a priority.  If siblings disagree then an evaluation and plan by an objective third party can be very instrumental. An Aging Life Care Manager can assist (aginglifecare.org)
  2. Avoid childhood roles — Reliving past roles that siblings played in their childhood can often lead to competing issues including favoritism, controlling behavior, and decision making. Identifying childhood reactions so siblings can move forward as adults can make a difference. Identifying may not be enough.  The engagement of a licensed mental health professional with backgrounds in Marriage, Family, Clinical Social Work or Aging Life Care, who is experienced in dealing with family conflict, as it relates to aging, can assist.
  3. Put gender stereotypes aside — The role that men and women play in both the workplace and family has changed dramatically in the last generations. By eliminating these stenotypes and focusing on each sibling’s specific situation and attributes can lead to better outcomes when it involves caring for an aging parent.
  4. Avoid keeping score — Siblings often differ in geographic distances, financial situation, personality, relationships with parents, outside responsibilities, and other factors. Any of these inequalities, once recognized, can lead to a more efficient care plan for parents and reduce conflict. Regular family communication or the formal use of a family therapist can help set up a realistic distribution of tasks.
  5. Acknowledge another — Dealing with the complex issues associated with aging is often stressful for all involved. This is particularly true when parents are resistant, difficult, or their feelings are ambivalent.  Siblings can recognize that there might not be anyone more able to understand the situation than themselves. Being able to vent and express frustrations can make a difference.  A counselor or other mental health professional can be that ear if more support is needed. Hiring an Aging Life Care Manager to share the burden and understand the challenges can make all the difference.
  6. You may not be able to do it alone — Families are different. For those that need a more formal process, elder mediation can assist. In addition to the aforementioned issues, hiring an elder mediator to resolve conflicts involving potential neglect, undue influence, medical treatment, trust, and inheritance issues can be vital in not only resolving family issues but avoid costly and stressful legal proceedings.

About the Author: 

Bunni Dybnis, MA, MFT, CMC, President of Aging Life Matters, has over 30 years’ experience as Aging Life Care Manager, Family Therapist, and trained mediator working exclusively with aging adults and their families. She is a proud Fellow in the Leadership Academy of the Aging Life Care Association.  She has served on the National Board and Western Board of ALCA, holding several leadership roles including past president of the Western Regional Chapter. Contact her on LinkedIn or at www.aginglifematters.com or at bdybnis @aginglifematters.com

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

ALCM Help With Virtual Assessment
This year the holidays and holiday gatherings will look a bit different for most of us because of the pandemic. Experts advise us to stay home and limit our in-person celebrations to those living in our immediate household.

Observing the holidays with loved ones outside our household will likely take place virtually or physically distanced. You may observe, during this time of distanced or virtual gathering with your older loved ones, uncharacteristic behavior, or lifestyle changes and routines that may prompt concern.

The following are some common signs that could signal a cause for concern and action. Use this list for clues or changes that warrant attention:

  1. Concerned friends and neighbors. They are noticing worrisome changes and step in to provide help, but when the changes are such that they are concerned for your loved one’s safety, it’s time to step in.
  2. Their home. It does not seem as clean or sanitary as before. Routine home care and maintenance, inside and outside, is being neglected. You may start to notice hoarding tendencies, or perhaps see trash isn’t being taken out – maybe you notice food that seems old.
  3. Finances. Bills are unpaid or paid more than once; you notice 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.
  4. Eating habits. Has your loved one lost weight? Does he/she have no appetite or missing meals? Your parent tells you that they just ate lunch but there is no sign of plates, pans or cups to support this statement. Or perhaps a friend or neighbor has commented the refrigerator has a strong odor or there’s molding, rotten food in the kitchen, or a burnt pan on the stove that your loved one can’t explain.
  5. Medications. Medications are being taken incorrectly. Your parent doesn’t know why they are taking certain medications and they can’t tell you what they are taking them for. They are confused about their doctor’s advice, not filling their prescriptions, or missing medical appointments.
  6. Safety. Your parent is having difficulty getting up and down their stairs, or they have had repeated falls in their home. Your parent seems less cautious about strangers and you are worried that they may be vulnerable to individuals with bad intentions. They do not seem to have the same safety awareness that they once had, and you wonder what they would do in an emergent situation.
  7. Hygiene. Your parent’s clothing may be soiled, worn for several days (or video calls), not appropriate for the weather, or may not coordinate like usual. They may be bathing infrequently and not attending to oral hygiene. You may notice neglected nails and teeth, sores on the skin, or your neighbor of friend may report of body odor or bad breath.
  8. Driving. The car has new scratches or dents that can’t be explained, and regular car maintenance is being ignored. Your parent may have mentioned that they got lost while out driving or ran out of gas. Or, they may seem too nervous to drive, have trouble purchasing groceries, or don’t have insight that it’s time to give up the keys.
  9. “Dad is fine,” your mother says. Dad agrees, though your gut tells you otherwise. They have learned to compensate for one another or may be afraid or embarrassed to share that they are struggling.
  10. Uncharacteristic behaviors. You notice your parent is being unusually loud or quiet, paranoid, agitated, making phone calls at all hours. Your parent no longer seems to initiate activities, is more withdrawn and isolated, and you wonder if sleeping all day is now the norm.

What next? Be proactive!

Whether you live close by or at a distance, there are steps you can take to support your loved one’s health and well-being:

  • Start with a conversation. Talk about your concerns. Consider including other people they trust and who care about your loved ones in the conversation, such as family, close friends, or clergy who may be able to come alongside your loved one 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 loved one to schedule a doctor’s visit. This can help 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 loved ones in bubble wrap to protect them, 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 loved one in the discussion and decisions. Go at a pace they can accept.
  • 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. Aging Life Care experts know the ins and outs of the various resources in your area and can connect you to appropriate resources, provide education and advocate for your loved ones needs. 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.

It’s not always easy or comfortable talking with parents or other older loved ones about concerns. Sometimes they won’t admit they need help, and other times they don’t realize they need support. Assure your loved ones 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.

About the Author: Wendy Nathan, BSc, CMC is a Certified Care Manager with Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Wendy also facilitates a family caregiver support group for the Alzheimer’s Association.

Eldercare as Art and Ministry – combining life’s passions

Aging Life Care Association® members are distinguished for their high qualifications, adherence to standards of practice, and a drive to care for older adults. And it is this distinction as an Aging Life Care Manager® that separates them from people who are geriatric care managers.

And one such notable member is Irene V. Jackson-Brown, Ph.D., CSA, CMC, CDP who has published her book Eldercare as Art and Ministry. Irene is an author, speaker, consultant, caregiver’s coach, and educator.

Focusing on eldercare as an art, with ministry, is a unique angle where someone like Irene has special insight.

After earning a Ph.D. in cultural anthropology, Irene held several academic appointments and then moved to the not-for-profit sector. When her father grew ill, she juggled work, her family and personal life, along with responsibilities as a hands-on family caregiver.

About two years into her father’s illness, Irene learned about geriatric care management through a newspaper article. Without hesitation, she made an appointment with one of the few nearby care managers. “With her guidance, I got through one of the most tortuous, but satisfying, periods of my life,” Irene admitted.

It was soon after her father’s death, in 2005, that Irene created Jackson-Brown Associates, LLC, d/b/a “The Art of Eldercare” as an applied gerontology practice. This is where Irene’s unique twist on eldercare comes in: her practice (and book) benefit from the partnership with Enrique R. Brown, her husband of forty-six years. As an Episcopal priest (retired) with extensive pastoral experience, administration, and program development, Irene acknowledges how her husband helps her, “Enrique offers care and helps steady me in this work. He is my caregiver.”

Irene holds several certifications as a senior-servicing professional — CMC (Care Manager Certified) from the Association of Aging Life Care Professionals (ALCA); CSA (Certified Senior Advisor) from the Society of Certified Senior Advisors; and a CDP (Certified Dementia Practitioner) from the National Council of Certified Dementia Practitioners.

Like her counterparts at ALCA, Irene has a wealth of continuing education experiences, including a multi-year, post-graduate certificate from the Washington School of Psychiatry’s program entitled, “The Study of Aging and Clinical Application.” She was also a Fellow in a year-long program on clinical-related topics in psychanalysis at the Washington Baltimore Center for Psychoanalysis. And she has a certificate of completion from the Georgetown University Medical Center’s Herbert B. Hercowitz Mini-Medical School Program.

Irene earned credits from The George Washington University’s School of Business and Public Management’s Project Management Program to enhance already notable communication and successful goal achievement skills.

The book is a guide to navigate the challenges of eldercare and to find meaning in this important work through stories, lessons, and poignant vignettes. Jackson-Brown calls each one of us whether young or older, ordained or laity, fortunate or less fortunate, prepared or not, to serve and care for an aging loved one.

Dr. Kumea Shorter-Gooden, Ph.D., a psychologist with a consulting practice spoke at Jackson-Brown’s virtual book launch on November 17, 2020. Dr. Shorter-Gooden has known Irene for more than 44 years, starting when Irene was first caring for her newborn son and pursuing life as an academic in Ethno-musicology, through now, as an Applied Gerontologist and an expert on eldercare.

Dr. Shorter-Gooden stated:

Eldercare as Art and Ministry

Eldercare as Art and Ministry brings to the fore Irene’s knowledge and wisdom — to help us navigate in this complicated arena – caring for our mothers and partners and loved ones.  And, frankly, wondering about our own care as we age — what it will look like, and how we can shape it and make it what we want!

Irene’s deep well of experience and expertise comes from her training as a cultural anthropologist, her work as an educator, her service on behalf of the Episcopal Church, and her lived experience as a caregiver of aging, ailing parents. That experience in particular taught her that we, as a society, can do better, and led to her pursuit of education and practice in this arena.

Eldercare as Art and Ministry is a beautifully written resource that combines important facts and little-known information with stories that resonate. It normalizes the challenges and struggles of caring for elders, while broadening our perspective on the interplay of art and ministry and the meaning of this life-supporting work.

Over the years, Jackson-Brown Associates, LLC, located in Washington, D.C., has served clients along the East Coast and as far away as California through consultations and guidance. With two divisions, Care Management and Project Management, Jackson-Brown Associates centers on issues and projects that impact the lives of seniors and their loved ones.

Living in Washington, D.C. with her husband, a retired Episcopal priest, Irene has an adult son and a partner, Irene’s “daughter-in-love.” At the time of publication, she has grand-dogs but is now expecting her first grandchild, a girl!