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!

Join Me In Supporting Alzheimer's Research

More than 5.4 million Americans are living with Alzheimer's disease today, and that number is expected to grow to as many as 16 million by 2050. And that doesn’t even take into account the nearly 11 million people who care for a loved one with the disease.

Again this year I am participating in "2012 Walk to End Alzheimer's" in Lancaster, PA.  The Alzheimer's Association leads the way in research, development, and caregiver support.  Join me in supporting this worthy cause either by walking with me or donating to the cause.  Donating is easy and even small donations can make a big difference. Just go online to alz.org/walk. Click on “Donate” and search for my name, Christy Carpenter, as a walker.

Supporting efforts to find a treatment for Alzheimer's Disease and supporting their caregivers inspires Aging with Ease!

A Story - End of Life

The care of someone who is reaching the end of their life is a difficult process to undergo no matter what their age is.  It is a time of self doubt, constantly asking yourself if you are making the right decisions, wondering if this is what your loved one would want.

Most of us do not think about reaching the end of our lives on a regular basis and what we would want if that time came upon us.  I know that I would want to die with dignity, without pain or discomfort, and surrounded by the people that I love.  In my experiences with helping patients and their families through this stage of life, they all want those things also.

This truly became apparent to me when I needed to provide care for my father-in-law at the end of his life.  I really did not know specifically what he wanted to be done, what his wish was for this last portion of his journey through life.  I was very close to him and tried to put myself in his shoes to try to figure out what I would want if it was me that this was happening to.  Not an easy place to put yourself! 

My father-in-law passed away rather quickly from cancer that had spread from his lung to his liver and to his brain.  His final diagnosis was established in late October 2008 and he passed away in our home in February 2009.  When we were first told the results of his tests, it seemed to me that he was ready to fight to live, but as I look back now at that time, I realize that he knew before the diagnosis was even confirmed that he was in the last stages of his life.  Even with that being said, he agreed to the treatments and followed all the instructions to the letter.  I think he did those things to give the people he loved time to deal and accept the situation that was at hand.  He would have discussions with me and his son (my husband) about certain aspects of possessions he had and wishes for those closest to him, but we never talked about what he wanted for himself when he was no longer able to communicate with us.

In the end, we brought him to our home to be cared for until his last day.  I was constantly second guessing myself.  Is this the right thing to do?  Is this what is best for my family?  Can I do this?  Nothing can prepare you for providing end-of-life care for someone so close to you.  People think that because I am a nurse and have helped many families through this process that it would somehow be easier for me.  I can assure you that having had the experience I had in my work only made it harder.  Having been through this process so many times before with people that were not my family, I knew all the stages and what to expect.  This was the one time in my life when I wished I was more ignorant.  I knew what it meant when the confusion set in.  I knew what it meant to start giving the morphine to control the pain.  I knew what it meant when he could no longer respond to us.  I knew what it meant when that very distinct smell arrived.  I knew what it meant when his breathing changed.  Knowing all these things only made it harder but also reassured me that there was no other place that he should be than with us. 

My father-in-law died with dignity, without pain and surrounded by the people that loved him.  With the help of Hospice, we were able to give him those things in our home, a place that was his second home, a place that he knew well and felt he belonged.

Was it the right thing for my family?  YES!  Was it the right thing to do?  YES!  Is this what he would have wanted?  YES!  Did we make the right decision?  YES!

I only hope that when I find myself in the last stage of my life that I am surrounded by the people that I love the most, that I die with dignity and that my death is peaceful.

Let your wishes be known to those that love you!  Help your family with making these decisions when you can't.  You are never too young to think about these things.  My father-in-law died at the age of 56.  Having some kind of direction from him about his end of life care would have been priceless to us. 

Five Wishes is a great tool for you to use to write down these wishes for your family and take some of the burden off of them.  I would have valued this information in the care of my father-in-law had I known of it then.

Click image to view

Aging with Ease includes preparing for the end of life, not only for yourself but to help your family know your wishes!

Stay Young, Keep Learning!

“Anyone who stops learning is old, whether at twenty or eighty. Anyone who keeps learning stays young. The greatest thing in life is to keep your mind young.” Henry Ford

This is one of my favorite quotes.  Whenever I feel that there should be more to my life, I find that learning something new makes me feel inspired and young again.  One way you can continue to learn as you get up into those older years is to join groups that offer new learning experiences for you among your peers and at a reasonable cost.

If you live in my area, Southeastern Pennsylvania, then you should check out the Pathways Institute.  They offer many opportunities for older adults to continue to feel young by learning and having new experiences. Click on the below image to view their site and check out their fall schedule!

If you do not live in my area, not to worry.  There are groups like this all over the country, you just need to search for them.  If you are having trouble finding one in your area, send me a message and I will help you try to find one...

Learn something new everyday to maintain Aging with Ease!