A Visit With My Grandmother

This weekend I was visiting my grandmother who now, at the age of 95, has recently moved into a skilled care setting.  I was sitting there talking with her and bringing her up to date on the happenings in our family as I frequently have to do when I go see her and it occurred to me that my grandmother is the essence of Aging with Ease.  She is the true inspiration for why I began writing and trying to help others.  She is the reason that I care and respect older adults the way that I do.  I have watched her progress from the vibrant person who would always be ready for play to the old woman who now mostly sits in her chair, content with her life and herself the whole way through.  It is her attitude toward life that has aided her the most in gracefully going through the aging process.

I can remember when I was 12 years old and my grandfather became ill with cancer.  I can clearly recall the way in which my grandmother cared for him with respect, love and laughter.  Never changing the way she loved him or how they communicated with each other.  It always stayed with me how she faced the reality of the situation head on, would tell you what she thought about it and then just simply do what needed to be done.  There was never a doubt in her mind, at least not that I saw, of what she should do, care for and love him.  Of course, she would be sad sometimes, but it never held her back; she seemed, to me, to gain strength from the hard times.

Not long after my grandfather passed away is when she decided it was time to sell her house and move to a retirement community, there was no changing her mind.  She knew she could no longer care for the house any longer and the memories that she shared with grandfather in the house that he built for her was just too much.  It was time to move on!  Our family would discuss with her other possible options besides living in a retirement community but her mind was set.  She would say: "This is what I want to do, I don't want to live with my children."  So everything was packed up and the house was sold.

My grandmother transitioned through every level of care within this retirement community over a span of about 18 years.  With every move, she accepted it with ease and trust that she would be taken of even though with every move she was slowly losing her sight, her hearing and eventually her mobility.  She never once doubted her faith or her family.  She would find laughter in the situation and was always so very grateful that we were there for her.   So thankful we were there to make sure that everything would be done the way she would want it and that the things that were most important to her stayed with her.

Now, as she sits in her favorite recliner, unable to see anymore and hardly able to move with out help, all she prays for is a peaceful end to her life.  Not because she is sad or depressed.  If you would meet my grandmother, you would know that she certainly is none of those things.  My grandmother even at the age of 95 could still be the life of a party.  She hopes for the end because she has lived her life to the fullest.  She has no regrets.  She has lead a happy and full life by having fun and helping others.  She is simply just tired, her body aches and she cannot do the things that she once did.

She has gone through the aging process with grace.  I can only hope to follow in her footsteps, even just a little.  In my work I have seen the direct result of negative attitudes on a person's health.  The mind is the most powerful tool you have in overcoming challenges in your life.  She showed me how to always look for something to laugh about, especially if it is about yourself.  She showed me to just let it go.  She showed me that if you can't change what is happening, then find a way to handle it but keep moving forward.

I am truly blessed to have had a person like this in my life.  I think there are probably many people that don't.  All you can do is be responsible for yourself and your own attitude.  You cannot change the way other people think or behave.  The most you can do is maybe make them laugh, which sometimes is all that they may need to improve their attitude, at least for a while...

Finding joy in your life is the essence of Aging with Ease!

• When I originally made this post in November 2011, little did I know at the time that a few short months later my grandmother would get exactly what she was praying for.  She passed away on May 1, 2012.  Thanks to the wonderful nursing staff where she lived she died peacefully with a photo of my grandfather right beside her and her music playing, just the way she wanted it.  I miss her everyday!

It Might Be Time to Step In...

As a child of aging parents, it can be difficult to know when your parents can no longer manage on their own.  Your mother or father will become very adept at keeping it looking good.  You will become very good at looking the other way.  It is not easy to look at your parent as someone who needs help with their activities of daily living.  Parents are the people you turn to for support, advice and strength - not the other way around.  On top of that, your parent will most likely become upset with you if you even suggest that they cannot manage on their own anymore.  No one enjoys confrontation, especially with our parents.

Some of the sure signs that someone may need to step in are easy to spot, if you are looking for them.

• Things in the house are out of order from the normal (laundry piling up, dirty dishes, messy floors, etc.)

• Mail piling up and bills not being paid

• Body odor/ Poor hygiene

• Frequently losing or misplacing things

• Forgetting to go to appointments

• Spoiled foods in the refrigerator

If you notice some of these signs, you need to take a closer look.  There are numerous reason that these things could be occurring.  Pain, fatigue, or memory loss just to name a few.   As uncomfortable as this discussion may be, it needs to be done.  Avoiding it until the situation becomes a crisis will decrease your family's control of the decisions that need to be made.

If you have siblings, you need to involve them in these discussions.  This is a family matter; it should not completely fall on the shoulders of one child.  Typically one child will become the primary care taker for your parents but that does not mean that all the decisions fall to you. 

If you are an only child, seek advice and guidance from other family members.  If you feel like you have no one to help you with this problem, you can look for support online, your parent's physician, your pastor or your local Area Office of Aging. 

Expect confrontation when you approach your parent about these concerns.  Try to keep your cool.  Continue to talk with them calmly and respectfully.  It may need to be brought up more than once until you are able to have on honest conversation with them about the changes that you are seeing.

Knowing when to step in aides older adults' ability to experience Aging with Ease!

Time to Hang Up the Keys?

What do you do when your parent or spouse is unsafe to drive a car any longer?  This is a delicate problem.  Of all the things that you lose as you age, not being able to drive a vehicle any more can be one of the most difficult to face.  It is one of the biggest losses of independence an older adult can encounter.

Some signs that it may be time to stop driving:
1. Slowed motor reflexes
2. Decline in vision
3. Impaired hearing
4. Decline in attention span
5. Physical limitations (neck, arms and/or legs)
6. A few "Close Calls"- almost hitting someone, dents or scratches on your car

If your loved one is experiencing one or more of these difficulties, it may mean that it is time to look at their driving safety.  Being forthcoming about these limitations can help to understand the risk that they may be taking by driving a vehicle.  It would be horrible for them to be responsible for a terrible accident by avoiding these questions.  The last thing anyone wants is to hurt themselves or somebody else.  The risk for fatal motor accidents rises significantly after the age of 70.

Another important point is for them to know their limitations.  If they don't see well at night, then don't drive at night.  If they get nervous driving to certain areas because of traffic congestion, then don't drive to those areas.  If they have pain in their neck when they try to look back over their shoulder, have it checked by a physician.

Tips to staying healthy behind the wheel:
1. Stay active
2. Have regular eye and hearing exams
3. Manage any chronic conditions
4. Know your limitations
5. Plan ahead for trips
6. Drive when weather is good

If you feel that it is time to hang up the keys, you do not have to face this obstacle alone.  Ask your physician for support in this and ask that he recommend this for your loved one. You can request to discuss it with him at an appointment.  There are driving courses available for older adults that you can enroll in to have them evaluated by a professional.

Click Here to visit the AARP link to their Driver Safety Program.

Being safe behind the wheel contributes to Aging with Ease!

Choose Your Battles Wisely

When you are the caregiver for someone, it is essential that you choose your battles wisely.  Caring for someone suffering from dementia, brings times when you will find yourself having the same frustrations with them over and over again.  This is not something they can change.  This is something you must change about yourself and how you handle the situation.

For example, a frequent concern my client's families come to me about is their loved one's refusal to bathe.  Most of us probably shower on a daily basis.  Prior to their diagnosis of dementia, so did your loved one.  It comes as a shock that this very basic activity of daily living is something that they no longer want to or are able to do. 

This can be very frustrating for some caregivers.  I try to help the caregiver realize that this is an issue they have to get over.  If you look at your loved one's current level of activity, it is probably significantly less than it once was so a bath every day is really not necessary.  They probably hardly ever break a sweat.  Unless there are incontinence problems, they have an odor or they have sores, the need for daily bathing is a routine that can be changed.  This is a daily argument or frustration that you could avoid.  Another thing to consider is home health care; in my experience, people are more likely to listen to a stranger that they recognize as a care taker than their own family when it comes to personal hygiene.  If you try to look at it from the patients point of view, it would feel degrading to some degree to need help from your spouse or your children to bathe. 

Another example, which is also a chronic problem that I hear, is difficulty having your loved one with dementia change their clothes.  How many of us wear the same outfit two days in a row?  Not anyone that I know.   So why do so many dementia patients develop this habit?  I don't have the answer to that question but it occurs none the less.

Rather than arguing with them about having worn that outfit yesterday or repeatedly trying to explain that their clothes need to be washed, a simpler solution might be to just remove the clothes they had on that day from their site when they get ready for bed at night and to lay out a new outfit for the next day the night before.  Seems like an obvious solution but you would be surprised at how many caregivers have never thought to do that.  Especially if it is a husband and wife dealing with this situation, they have lifelong habits and routines that have always worked for them and because of the progression of dementia those routines must all change.   Again this is also an area where home health care could offer relief for you in the daily care of your loved one.

I could go on and on with examples of ways that you could try different approaches to the ever-changing challenges of dementia.  The point I want to make the most is that you choose you battles wisely.   Attempting to argue with someone with dementia or trying to make them understand something that they are no longer able to understand or remember is a losing battle that will only make you, the caregiver, feel bad in the end.  The progression of dementia cannot be stopped or controlled not matter how hard you try.  Remember to try to enjoy each moment that you can no matter how brief they may be.  Spending your time trying to get them to understand something when they are no longer able to is a waste of your precious energy.


Choosing you battles wisely promotes Aging  with Ease!

The Value of a Quality Movie!

Ahhh, the movies!  Who doesn't love a good movie?  They can entice your senses.  They can make you dream of another life.  They can give you hope.  They can scare you to death.  They can make you feel warm and fuzzy.  They can open your eyes to the world.   They can make you laugh and cry.  They can educate you.  So many ways that a good movie can satisfy the senses...  The value of a movie is one thing that does not change as we age.  Movies can satisfy your senses at any age!

 However, in this day and age as an older adult, it can be hard to find a good movie to go see.   So many of the current movies don't seem to offer a whole lot of value.  Let's face it, many of them are just plain raunchy!  They seem to just be trying to shock you by just how inappropriate the content can get.  I was thinking about this during the past week as I searched for an appropriate movie to take a group of clients to from the Adult Day Center that I work in.  There were very few choices and really nothing with any value to them. 

I feel that mainstream movie-makers are missing a fairly large group of potential moviegoers by not having more options of movies available for the older population.  As I looked over the listings at our local movie theater, they were showing 12 different movies and only one of them was one that I would even consider taking a group of older adults to.  HELLO, baby boomers are now the largest group of people over 60 years old that has ever occurred!   They should have more options for satisfying their senses when they want to see a movie.

We routinely show movies at the Adult Day Center that I work at.  They are mostly older movies that they have requested to see.  Movies are a great way for them to remember their past.  The movies we show tend to spark memories in our clients, which induce conversations in the center.  I view that as a successful activity.   Any activity that gets people talking to each other and reminiscing about their lives should be viewed as a good thing.  I love hearing these conversations.  It helps me learn more about who these people really were in their life.  It also makes me realize that everybody essentially wants the same things in life.  To be happy, loved and secure. 

The selection of older movies that can be shown  are endless but try to find a list of current movies that fits the criteria, the list does not form so quickly.   I suggest that this is because our society just simply does not value our older adults as they should.   The majority of movies today are driven to attract the young.  Don't get me wrong, I love the movies.  All types of movies.  I am simply suggesting that more quality movies be made more often.  By "quality movies" I mean movies with substance that inspire hope, real life and give a connection to life.  Movies such as: The Help, Moneyball, The Notebook, Blindside and The Greenmile come too far and few between. 

Satisfying your senses keeps a person on the path to Aging with Ease.

Exploring Personal Care

Today I would like to explore Personal Care Living, formally known as Assisted Living.  This level of care is the in-between stage that comes after independently living in your home or apartment but before the need for skilled long-term care.

Personal Care settings offer 24-hour nursing staff, prepared meals, laundry services, housekeeping services, medication administration, health monitoring and activities.  Sounds kind of like long-term care living, but there is a big difference.  Residents at this level of care are still able to mostly perform their own activities of daily living like bathing, dressing, using the bathroom, things like that.  The nursing staff that is on duty are mostly certified nursing assistants and medication technicians who are all overseen by a registered nurse.  The ratios of patients to staff are less than that of a long-term care setting.  These ratios are less because the demand for one-on-one care is significantly less in Personal Care.  That is not to say that additional help will not be provided by staff.

Typically, there are three level-of-care tiers to determine the costs of living in Personal Care.  Residents who are only requiring meals, laundry services, housekeeping services and medication administration will be less expensive than a resident in this setting that needs more assistance with their care.  A resident that is already using all the first-tier options but in addition needs assistance throughout the day to manage problems with incontinence will bump them up to the next tier.  If a resident is using all of the previously mentioned services but in addition to that needs assistance with bathing and dressing each day, that will put them in the highest-tier level.  You need to examine the different tier levels at whatever facility you are looking at to determine which one you would fall into.  The cost of Assisted Living across the country ranges from $1,500 to $5,000/monthly with the average probably somewhere around $2,500-$3,500 per month.

In my opinion, if you are considering looking at admission for Personal Care and you are already at that highest-tier level of care, you should seriously consider a long-term care setting.  Most residents that reach the third-tier level are not able to stay in Personal Care for much longer.  Typically their condition is deteriorating and more extensive care is needed than can be provided in Personal Care.   In addition to this, a move to a new setting can be very difficult and confusing for older adults.  It can cause increased confusion, agitation and depression.  It can take as long as 1-2 months for them to adjust to their new setting.  The last thing you want to do is move them twice in a short period of time.  Some older adults never recover from something like that.  They feel unsettled, unwanted and almost punished in some way for having to be moved again.  As a result of that, the family then feels as though they have not done what is best for their loved one.

This decision should not be taken lightly nor should it be made alone.  This should be a discussion for you along with the people closest to you.  Talk openly about why this could be the best course to take, discuss why the move is needed and explore other possible options that might be available.

If you are a child trying to figure out what is best for Mom or Dad, make sure you are including them in your discussions.  If you have concerns about their living arrangements, express those concerns openly, honestly and respectfully.  Unless you are dealing with an advanced stage of dementia where communication will have no positive outcome, these conversations need to take place no matter how uncomfortable it may be.  Always try to put yourself in the other person's shoes and try to figure out how you would want to be treated.  Trying to find a solution to problems together as a family will increase your chances for success significantly.

Communication is key to Aging with Ease!