Click here: "Romancing The Wind" - Ray Bethell - YouTube

The guy flying the 3 kites is in his 80s, and he's from Canada. He comes to the Washington State International Kite Festival every year. His skin is like leather as he normally flies with his shirt off. He is deaf, so when he flies we hold our hands up and wave them for applause. He flies 2 with his hands and the 3rd one is attached to his waist.

You must watch to the end to see the amazing landing of that last kite!  I would have those so tangled up, you could never get them separated again!  And of course, make sure the volume is turned up because the music is wonderful and totally reflects the soaring of the kites.  Beautiful.

Lewy Body Dementia

Lewy Body Dementia may be one of the most difficult types of dementia to deal with, for the patient and the family.  The person affected with this disease typically goes through extreme changes in mood and personality.  As it progresses, the family simply is not able to recognize the person that they used to know.  These changes tend to come on abruptly, leaving the patient paranoid and unable to trust others while leaving the family very confused about what is happening.

If someone close to you has been diagnosed with this disorder, it is imperative that you research what to expect as the disease progresses.  While every path of dementia is somewhat unique, there are basic stages that, let's say, Alzheimer's patients tend to follow.  With Lewy Body Dementia, the progression has more extreme changes and can arrive very suddenly.  Patients with Lewy Body Dementia will typically have hallucinations and delusions that are, in every way, very real to them.  Trying to explain to them that these things did not occur will only make them upset.  You may not be able to see or understand what they are experiencing, but, in my experience, it is as real to them as anything else that goes on around them.  By not listening and talking through what they are experiencing, you will only cause unnecessary agitation. As a result of trying to dismiss them, they will lose trust in you.  Patients that I have helped through this progression of Lewy Body Dementia are desperately trying to finding someone to believe them.   Someone to discuss what is going on in their mind.  Many times, in the earlier stages, as you talk through what they are experiencing, they can recognize on their own that it did not really happen.

Many times patients with Lewy Body Dementia will require assisted living or a long-term care facility to provide their care and safely manage their behaviors.  These patients have a tendency to become aggressive even if for their whole life they have never even raised a finger of anger toward any living thing.   They can have psychotic episodes that can arrive without notice or cause.  They can have episodes when they are not able to recall any of the recent events that brought them to where they are.  Their communication becomes very broken and hard to follow, which causes them frustration with their caregiver because they do not recognize that they are not speaking clearly - to them it is coming out clear as day.

I do not tell you this to incite fear for caregivers or patients dealing with this disorder.   I tell you this so that you can fully understand the extent of the changes that you should be prepared for.  Early preparation for their needs is vital as you prepare for this challenge.  Your best chances at keeping some of the behaviors from becoming aggressive is by understanding that what they see and feel is real to them.  Listen to them, talk to them, reassure them that you will do whatever you can to help them.

 
Today I had a 20-minute conversation with a client, diagnosed with Lewy Body Dementia, about the 20 men he saw on the roof this past weekend stealing internet signals from our company with a 9mm gun.  Sounds ridiculous right?  Of course it does, he even said as much when he started the conversation by saying, "I know you are going to think I am nuts but...".  He needed someone to talk to about what he saw and express his concerns to make sure that someone would follow up on it to keep things safe.  I was that person for him.  I reassured him that I would report it to our IT department and they would follow up.  He was happy and satisfied by that and was able to go about the rest of his day because he trusts that I will help him.  He felt heard and validated, which is what he needs more than anything.  Every time he comes to me with his concerns, I always listen and provide him a safe place to say whatever he needs to without feeling judged or looked at like he is crazy.  There are some conversations when I can say to him "Do you think that really happened or might it be from your condition?" At times he can recognize that he really has only pieces to a story and that it did not really happen.  Those occurrences are becoming less frequent.

I do not try very hard at all to help him see reality from his delusions because it serves no purpose for his quality of life.  If listening to him for 20 minutes and giving him reassurance allows him to enjoy the rest of his day, that serves to improve his quality of life to a much higher level.

Quality of Life serves Aging with Ease!

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Share Your Stories...

Today I went with my mother to visit my grandmother.  Not the same grandmother that I have mentioned in other posts.  This is my mother's mother and she is 90 years old.  She lived with my parents for more than 10 years and recently, due to health decline, has moved into a long-term care facility.  These last few months have been very difficult to watch as my grandmother began to fail both physically and mentally.

My grandmother has always been a very strong-willed person.  When things needed to get done, you could count on her to do it.  She always kept her word and could be depended on when you needed her.  She also was directly open about telling you what she thought about things.  Most times, she would express her opinions with love, but there were several moments that I can easily think of where she told you what she thought without any regard to what the reaction might be.  Don't get me wrong, my grandmother is a wonderful person.  From her I get my strength to keep moving forward, my stubbornness, my need to always be on time, my work ethic and my confidence.  From her I also inherited the family gene to worry.  She would worry endlessly about everything.  I also inherited from her the talent to keep personal struggles to myself.  Sometimes these two traits can be good things, but sometimes, as you can imagine, they are not.

I think that those last two traits are why, as her mind begins to fail, she spends a lot of her time now paranoid that people are talking about her, worrying that they are going to throw her out of her room and suspicious that they are out to get her.  It is very difficult some days to visit her.  You never know what you are going to be walking into.  One day, she is very pleasant and speaks very highly of the staff who help her.  The next time she spends the whole visit begging us to take her home.  The strain and guilt that this puts on my mother does not go unnoticed.  I know she wonders if things would be better for my grandmother if she did take her home again, but the fact is that my grandmother needs someone with her 24 hours a day.  Watching over her medications, her health and her hygiene.  These are not things that my mother is able to provide for her.

I am never sure what to say to my mother after a visit with my grandmother.  As a nurse in geriatrics, I understand the changes that are going on with my grandmother.  I have seen this progression so many times.  That does not mean that it makes it any easier to cope with it.  It makes you feel awful to see someone that you love, who was once so strong and vibrant, now look so sad and frail.  The only comfort I can give my mother is to reassure her that my grandmother is getting good care.  That she is in a good facility where people do really care about her.  Having worked in long-term care facilities before, I know the signs of quality care and they are all present at her facility.  My mother knows this as well and that does bring her some peace of mind.

My family is very blessed to have had my grandmother in our lives for so long.  Many families are not so lucky.  My hope for her is to find some peace in her own mind as she reaches the last stage of her life.  Perhaps the anxiety she feels is actually a result of exactly that - maybe she is afraid to die?  I don't know what the right answer is to this.  What the best course of action should be.  What we should say to her when she asks us to take her home.  I just answer her honestly about why she needs to be there and hope that some day soon she will accept this stage of her life.

If you are a caregiver who has gone through this transition with your loved one, I would love to hear your stories...

Sharing your stories helps the process of Aging with Ease!

 
I originally posted this in November 2011 on my first Aging with Ease blog, my grandmother passed away in February 2012 at peace with her family at her side.  Her passing would be the first of three close family members leaving me in 2012.  Let's just say this year has been very long, sad and unending.  As the year finally draws close to the final month all I can really say is that my family knows I love them.  Death is final and there is nothing you can do to change it.  All you can do is just love them...

I am working on finding a way to regain some motivation in my life, as my grandmothers and my father taught me to do.  It has been difficult since the three people I have lost were also the three people who motivated and inspired me the most.  I hope any followers that I have are patient with me as I try get back into it. 

Depression in Older Adults and the Elderly

Article: Depression in Older Adults and the Elderly

Depression is a very common occurrence in seniors for numerous reasons.  They have lost friends and loved ones; they become isolated due to physical losses; some suffer from health issues.  There are many factors that can lead to depression in older adults.  Anti-depressants are not always the best treatment for this problem.  As we age, our body is not able to metabolize medications as well and because of this the side effects of these medications are more commonly noted, which can do more harm than good.  Also medication alone, at any age, will not alleviate depression.  The reasons that are causing the sadness must also be addressed.  Click the image to read a very informative article regarding this issue.

Knowing the signs of depression in older adults improves your chances of Aging with Ease!

Navigating a Hospital Stay, Are You Getting the Help You Need?

Are you getting the help you need?  Navigating our health care system is, let's just say, nearly impossible.   Many people, especially older adults, don't even know if they are getting all the help they need or is available before, during or after a hospitalization.  Why is this such a well kept secret in our health care system?

Seems to me that the more knowledge and assistance you give someone the more likely it will be that they do not end up right back in the emergency room, constantly repeating the near same scenario over and over again.  It does not take a degree in economics to see that the system would be able to keep costs down considerably by giving more priority to this very simple element of health care.  Instead this system leads you to think that it is complete ignorance on our part that keeps costs so high when it appears to me that there is just entirely too many special interests involved in the treatment of sick people.

Every time that I experience, first hand, just how difficult moving through the labyrinth of our health care system is, I am left to wonder how in the world do families that do not have a medical professional as part of their family ever get anywhere.  The education of people should be of top priority, especially during a hospitalization, yet it always feels like the patient and family are left in the dark.   WHY?

As I write, my father lies in a hospital slowly recovering from a bowel obstruction. This is the 4th, yeah that is right, the 4th hospital that he has been over the last month.   Due to preexisting difficulties with advanced chronic obstructive pulmonary disease (COPD), the proper treatment for the bowel obstruction was delayed for far too long.  We started the first week at a local community hospital that either was not permitted to refer us to a larger hospital or just simply did not consider it.  Had it not been because of persistence of the family and a family member with a medical education, my father probably would not be with us at all.  After requesting that he be transferred to a larger teaching hospital with the ability to give him the help he needed we were told by the physician that he feels that would be the best plan and my father was moved within hours and just hours after being admitted to that larger facility with more advanced technology he received the surgery he needed.  He remained at this hospital for three weeks making slow improvements everyday with a few set backs.  He was finally strong enough to be transferred to a rehabilitation hospital at which he stayed for all of 12 hours before they sent him to yet another local community hospital because his oxygen levels were low.

The frustration the I feel about the systems within healthcare are mind blowing.  Many things run through my mind in the care of my father.

1. Why did the rehabilitation hospital not call a family member when his oxygen levels became low? To at least give us the option to say: "Please send him back to the facility he just came from".
2. Why did the current hospital that he is in right now not contact the previous hospital that he just spent 3 weeks at to obtain his records?
3. Did my father miss doses of his medications when he transferred from one facility to the next?  This very fact alone may have been what caused his oxygen levels to drop...
4. Where is he going to go from here?

The common denominator in every question that goes through my head is communication and why is it so poor in our healthcare system?  In this day and age there is no excuse for it!  If I can know with in seconds what my cousin on the other side of the country is eating for dinner right now and even see pictures of it through social media then we should be able to send communications just as quickly about things that truly matter in the care of a persons life.

Not only would some real attention to this aspect of healthcare improve the continuity of a patients' care but it would also help to keep the cost of health care down.  Blood test results, x-ray reports, CT scan reports, MRI reports, medication records, patient allergies, assessments, therapy notes, specialists reports, etc. all at your fingertips thus preventing unnecessary repeat testing.

I spend a portion of each day talking to someone at the hospital, whichever one he may be in, about the care of my father.  Whether it be his social worker, care coordinator, nurse, surgeon or physician I am constantly seeking information about what they are doing to help my father,  what the next steps are going to be and what he needs to be doing to get there.  If I would not be pursuing the information, we would be in the dark.  I hate the dark, don't you!

Learning how to navigate our health care system is essential to Aging with Ease!

Geriatric Care Management

So today I learned about a service that I have not had any experience with.  It is called Geriatric Care Management.  Some of you may already be familiar with this service, but it intrigued me because of my lack of knowledge about it.  So I did some research about it. This service offers support for families caring for older adults.  Many of people who are faced with caring for a spouse or parent who is declining in their health really have no idea where to begin to look for help.  Those difficulties are escalated when you are a child of an older adult and live miles away.   The day-to-day care that is needed can leave you exhausted and feeling depleted to even have the energy to look for help.

Geriatric Care Management offers care managers that specialize in social services. They assist in finding the help you need based on your individual situation.  Their goal is to help older adults find the best quality of life physically, mentally and socially.   If you are looking for help finding the right long-term care or assisted living facility, they can help you with that process.  If you need someone locally to check in regularly on a loved one, they can provide that service.  They will advocate for any needs that will assist in achieving an improved quality of life for the older adult as well as for the caregiver.

Geriatric Care Managers charge clients in a variety of ways, but typically their hourly rates are between $50-$200 an hour.   Medicare, Medicaid and private health insurance very rarely pay for these costs; long term care insurance might, but most often this is an out-of-pocket cost.  I know that sounds expensive, but when you consider the convenience and security they provide, the cost can seem worth it.  Actually, Care Managers usually save families money despite being an out-of-pocket cost because their needs assessments align an individual’s present condition with only those services that are necessary at that point in time.  This prevents unnecessary fees from home care providers and assisted living residences.

This service is worth checking out if you are struggling to decide the best way to provide care for an aging adult.  The first step is to locate one and simply have a phone conversation with them about different ways that they might be able to help your situation.  A simple Google search for Geriatric Care Management will help you easily locate one near you.  If you decide it is worth the investment, they will come to meet you and your loved one to perform a complete assessment; physically, mentally, financially and socially.  Together you create a plan to manage care.

Like I said before, I do not have any first hand experience with this service but it appears to be a very useful resource in assisting caregivers to manage care.  If you have ever used this service or know of someone who did, I would be very interested to hear what the experience was like.  Did they own up to what they offer?

Finding the right kind of help that is available for you is vital to Aging with Ease!

Fulfilling Activities in Adult Day Centers

Creating fulfilling activities for seniors can be challenging at times, especially if they are suffering from memory loss or physical ailments that limit their abilities to participate the way that others can.  I am blessed to work with some of the most creative people I have ever met.   They are constantly meeting this need for the seniors in our Adult Day Center.  They never cease to amaze me and I am constantly learning from them.

There are two main things that I have learned the most from my co-workers:
1. Try anything, no matter how odd it may seem;  you never know what might work.
2. If it failed once, that does not mean that it will fail again.

We offer a variety of different activities every month.  Sometimes certain activities are scheduled on specific days of the week with certain clients in mind.  For instance, for the lawyer who only comes in on Tuesdays and Thursdays, we schedule a game called "You Be The Judge."  This game engages this client extremely well and brings back to his life a chance to share his knowledge.   Then there is the retired English Professor who misses leading lectures in his classroom; he is given an opportunity to present a different topic each month to the other clients and staff.  By providing this activity for him, we are giving him a sense of purpose and a chance to perform.  There also is a client that spent her life raising her nine children - yes that is right 9 children -  she spent much of her time after her children were grown making quilts but because of memory loss she had stopped doing this.  My staff was able to find a way for her to continue this joy in her life.  It took several different approaches to find the best way for her to be successful at it, but she now comes into the center and gets right into it without hesitation.  I could go on and on with examples of these types of great things that happen in our Adult Day Center.

As clients remain at our center over time, their level of functioning will change.   Activities they once were successful at become difficult and frustrating for them.  Again, my staff observes this and quickly adapts to these changes. An example of this would be to remind you of the client that is a lawyer, that I spoke of in the paragraph above.  Since he started at our center, his condition has progressed and he no longer finds fulfillment in that game.  So the activity for this client was changed.  We looked for another opportunity for him to feel useful.  What we found was that he needed to be responsible for something in the center that made him feel useful.  So we gave him the task of helping with setup for activities and clean up when they are over.  He takes this responsibility very seriously and it is a huge help to our staff.  A win, win situation.

These activities are a direct product of my staff - by them constantly looking for ways for our clients to feel important and useful again.   There are also many activities that, in general, can be easily managed no matter what their losses may be.   We do use these activities regularly as well.  But who wants to do the same thing every day?  We all need variety in our lives no matter what age we are.

Adult Day Services can provide useful, fulfilling and satisfying activities for seniors.  They are designed to provide stimulation and socialization, which in the long run will keep older adults more active physically and mentally.  With all that to offer, it seems kind of silly not to check them out.  This kind of structure to a person's day will keep them living independently longer and can provide comfort to families that their loved one is being productive in a safe environment. 

Aging with Ease can be obtained by feeling useful as older adults!