When & How to Choose In-Home Care

Choosing in-home care suggestions for caregivers.

 

When should we consider in-home care for my loved one? How do we find the right help and where do we start?

First, if your loved one is struggling to perform basic activities of daily living it’s probably time to get help. Part-time help to start might be the best way to go in the beginning.

Basic ADLs consist of self-care tasks that include, but are not limited to:

  • Bathing & showering
  • Personal hygiene & grooming (including brushing/combing/styling hair)
  • Dressing
  • Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
  • Functional mobility, often referred to as “transferring,” as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently.
  • Self-feeding (not including cooking or chewing and swallowing)

Asking why the owner is in the caregiving business is a great place to start. You can train people on caregiving but you can’t teach them how to care. The next place to look at is third party review sites.

Specific Questions to Consider

What specific services do you offer?  Some agencies do personal care as well as companion care but you may need nursing services. Caregivers can’t administer medications. Knowing exactly what you need in terms of help will help guide you to the right company.

Additionally, other questions to ask could be; ” What is the minimum number of hours of care provided?  Is there a daily minimum? What are the rates, are they different at night or on weekends?”  It’s helpful to know that the shorter number of hours makes it difficult to get a high-quality caregiver. Finding other chores they can do might be useful for you to have completed.

When you’re working with an agency it’s their responsibility to;

  • cover a shift if a caregiver is sick
  • provide insurance coverage for the caregiver
  • replace a caregiver if they aren’t a good fit
  • Conducting background checks, etc.

Even though you’re doing your best having in-home care allows you to maintain your relationship. As much as you want to be able to do as much as possible, getting help is likely to become necessary.

In-Home Care Self Assesment

Private Caregiver Site

Related Information (Long Term Care Insurance episode)

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Giving a Caregiver Help

Giving a caregiver help helps prevent burnout & disease.

Providing caregiver help isn’t easy. Asking for help is just one more task in a long list of tasks.  Learning how we can provide help is the topic of this podcast.

Because of their ever-increasing workload, 65% of caregivers are hospitalized or die before their loved one. For that reason, finding ways to provide help that works for them is crucial.  Many caregivers don’t ask for help for lots of reasons. Certainly, we can offer assistance without robbing them of their sense of self-reliance.

Help is frequently refused when adult children are offering. Although this is true, we can see that help is needed. Providing help in a way that will be accepted is our challenge to solve.

My conversation with Barbara Ivey was very insightful. Here are some of her tips.

  • Always make explicit, direct requests for help
  • Be reasonable
  • Take what you can get
  • Respect your potential helpers
  • ALWAYS let your helpers know how much you appreciate them
How To Offer Help

Finding ways to offer support starts with observing. Equally important would be listening. Hearing and seeing tasks we can help with should make acceptance easier. Many of the easiest ways you can help will mean the most to an exhausted caregiver.

Once an assessment of needs is made, make a list of who you can call on for help. You can find the right person for each task when you keep this list in mind. For example, I am not good at dealing with bureaucracy. Two minutes of “this is how it’s done” and I am ready for murder. Thankfully, my husband has much more patience than I do and can tackle bureaucratic phone calls for me.

Handling tasks that a caregiver isn’t good at can be a lifesaver. Certainly, it helps keep caregiver stress under control. Another method would be to find ways to allow a caregiver time to do what they enjoy. Barbara’s Dad liked to do yard work. Visiting her Mom while he worked in the yard solved two problems. Dad was able to tackle the yard work without the worry that Mom would have a problem.

If You Know a Caregiver that Needs Help

Call or stop by rather than sending an email. Bring along something that will jump-start the help, like a meal. Instead of saying “let me know what I can do” ask “what can I do right this minute to improve your day?”.

Set up a time to work with them on an exhaustive list of everything they do on a daily basis. Prioritize the list then ask if they know anyone who could tackle some of the tasks listed.

None of us plan ahead for the day we’ll become a caregiver. Many times this happens because of an emergency, leaving us unprepared.  Knowing ahead of time what services are available will make reaching out for help much easier.

When Your Parent’s Won’t Ask For Help (Article)

Reinforcements – How to Get People To Help You (book Barbara recommended)

It Takes A Village – (Senior Social Program with Kids)

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Bonus – Live Episode on Driver Safety!

Senior Driver Safety image

When is the lack of driver safety an issue?

When is it Time to Take Away the Car Keys?

Driver safety is important. When to take away the car keys is a difficult yet important decisions.  It’s not to do and should not be made lightly. Most seniors see giving up their cars as the total loss of their independence. Solving this concern will go a long way in aiding them in maintaining driver safety.

The ability to drive helps older adults stay active and independent. However, the risk of being hurt or hurting someone else in an accident increases dramatically as we age.  According to the National Highway Traffic Safety Administration, an average of 500 older adults are injured every day in crashes.

According to the NHTSA here are 20 signs we should watch out for.
  1. Drifting into other lanes.
  2. Straddling lanes.
  3. Making sudden lane changes for no reason.
  4. Ignoring or missing traffic signals or stop signs.
  5. Becoming confused in traffic.
  6. Braking or stopping abruptly without any reason.
  7. Hitting the accelerator suddenly without any cause.
  8. Coasting nearly to a complete stop in the midst of moving traffic.
  9. Presses on the brake and the accelerator at the same time while driving.
  10. Difficulty seeing pedestrians, objects, or even other vehicles.
  11. Getting more and more nervous when driving.
  12. Drives at a significantly slower speed than the posted speed or the general speed of surrounding vehicles.
  13. Backs up after missing an exit or road.
  14. Has difficulty reacting quickly as they process multiple images or sounds.
  15. Has problems with neck flexibility in turning to see traffic on the left or the right.
  16. She gets disoriented or lost easily, even if she is in familiar locations.
  17. Fails to use turn signals or even keeps the signal on without changing lanes.
  18. Has increased near misses on the road.
  19. Has been issued two or more traffic tickets or warnings in the past two years.
  20. There are dents or scrapes present on the car or on fences, mailboxes, garage doors, or even on curbs and very little understanding of how they got there.
How do we begin monitoring driving behavior?

Here are some questions you can ask your parent to help determine if they need to stop driving;

Can you read the street signs easily?

Do you have trouble looking over your shoulder?

Do you have difficulty moving your foot from the gas to the brakes?

How well do you see at night?

Are you comfortable with passengers or are they distracting?

Being honest with our loved ones goes a long way when determining if their driver’s safety is questionable. Services like Uber and Lyft will allow our loved ones to stay independent. Help them learn how to navigate these apps.

Sometimes, we have to be the “bad guy” and physically take away the car. If our loved one is determined to drive despite our serious concerns it may be necessary. Other options are to get a letter from their doctor stating that driving is no longer safe. You can also contact your local DMV and let them know a driver is unsafe.

My Dad told Mom one day that they were giving her car to my brother-in-law. For a long time, despite Alzheimer’s, Mom was still pretty angry over this “injustice”. Because of her Alzheimer’s she saw no logical reason she couldn’t drive anymore. It’s unfortunate that she was unable to enjoy the Karma when we took Dads’ car away.

Ensuring driver safety isn’t easy. A willingness to do all we can to aid in this transition is important. Having a discussion about their fears, struggles and how to address them might go a long way in getting compliance. Keeping in mind that losing even some independence is difficult is also important.

 

Assisted Living – Good Things To Know

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Walk To End Alzheimer’s – All About Fundraising & More

Each Walk to End Alzheimer’s flower color has a special meaning.

Walk to End Alzheimer’s is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. The walk is held annually in more than 600 communities nationwide, In talking to Ginny Roth, walk coordinator for a Northern California walk, I learned about the importance of the fundraising in helping find a cure.

In the United States, someone develops Alzheimer’s every 65 seconds. Currently, there are more than 5 million people living with the disease. Additionally, there are over 16 million unpaid family caregivers supporting them. In 2019, Alzheimer’s disease will cost the United States $290 billion. This number is projected to rise to more than $1.1 trillion in 2050.

Tune in to this conversation, you’ll learn exactly what is done with the money raised. Fundraising is important, checking out this podcast is even more important.

Getting involved with the Alzheimer’s Association started with joining one of their support groups. I had attended a grief support session after my Dad died but that group didn’t cover everything I was going through. A Google search for support groups led me to the Alzheimer’s Association.

After I started my podcast, I interviewed Pam Jarvie, one of the legislative advocates. She persuaded me to join her advocacy team and it’s been a whirlwind ever since. Attending my first state advocacy day this year (2-5-2019) was an interesting eye-opener.

Having very little interest in politics, I found it odd that I was now lobbying politicians on behalf of people like my Mom. Alzheimer’s is no way to live the last years of your life so I do all I can to help find a cure. Lobbying politicians for money is one of the most important activities we can do.

Why I’m Walking

However, not everyone can take the time to go to their state capital and spend the day telling their stories. For those that would rather do anything else, the Walk to End Alzheimer’s is an easy way to help. Early autumn is prime “walk season”. Most walks are easy enough that everyone can manage one. The walk I’ll be attending is flat, allows dogs, and has ample parking so even mobility challenged folks can easily attend.

After my talk with Ginny, I decided on a modest fundraising goal. I’m also going to do as much recording and live streaming for the podcast as possible.  Generating as much awareness as possible is part of the mission statement I have for my podcast.

Feeling ashamed with a diagnosis of Alzheimer’s is a stigma that needs to end. Interviewing guests living with Alzheimer’s or dementia allows me to knock down some of that shame. Showing the joy and camaraderie that people at the Walk experience will help grow my local walk.

We must find a cure for this disease. Alzheimer’s disproportionately affects women, and I’m sure women will find the cure.  Please make a donation to advance the care, support and research efforts of the Alzheimer’s Association. Thank you for joining the fight against Alzheimer’s!

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Be sure to tune in to our YouTube and Facebook pages for live streaming of this great event.

 

 

Learn more about the Alzheimer’s Association

Living With Alzheimer’s

Understanding Lewy-Body Dementia

Understanding how Lewy-Body is different than Alzheimer’s.

Lewy-Body dementia is very different than Alzheimer’s. While physical changes are similar, cognitive changes can be vastly different. Equally challenging, Lewy-Body dementia can present with a range of symptoms. These include problems with thinking, memory, moving, sleep and/or changes in behavior.

To better understand the unique challenges of LBD I spoke to Nance Tobar. Nance is caring for her father who has LBD. A misdiagnosis caused severe changes in his cognitive abilities due to the unique pathology of Lewy-Body.

Nance’s dad, Joe, fell and became hospitalized. As a result, his medications were changed. Notably, they took him off of one medication that was stabilizing his memory. Consequently, the family lost 2-3 good years with their Dad.

Early and accurate diagnosis is important because LBD patients may react to certain medications differently than other memory patients. A variety of drugs can worsen LBD symptoms. Joe was prescribed an anti-psychotic. Thankfully, Nance was warned of the danger before she gave him any. Anti-psychotics can be fatal to a person with LBD.

About Lewy-Body

Notably, LBD is the second most common form of dementia.  Generally, LBD can have three common presentations; movement issues, cognitive impairment or neuropsychiatric symptoms, which can include hallucinations. Joe had hallucinations.

Regardless of the initial symptom, over time all three presentations will develop very similar cognitive, physical, sleep and behavioral features.

The most common symptoms of LBD include:
    • Impaired thinking, such as loss of executive function (planning, processing information), memory, or the ability to understand visual information.
    • Fluctuations in attention or alertness;
    • Problems with movement such as stiffness, slowness, and difficulty walking
    • Visual hallucinations
    • Sleep disorders, like acting out one’s dreams while asleep
    • Depression, apathy, anxiety, agitation, delusions or paranoia
    • Changes in body functions, such as blood pressure control, temperature regulation, and bladder and bowel function.

 

To emphasize the lack of understandings of differences between LBD and Alzheimer’s I talked to Nance. Her story illustrates the struggles that can happen as a result of not having a proper diagnosis. Nance and I are in the same caregiver support group. During the time just after her Dads, hospitalization was a rough time for her.

The changes due to the medication trials make her feel very guilty. Caregiver guilt is common but Nance has nothing to feel guilty about. She’s caring for her father the best way she can. Sharing their stories is her way of helping other families.

Even if you are not caring for someone with Lewy-Body you’ll find this conversation insightful. Understanding all we can about senior health issues makes us all more compassionate. Realizing what challenges people are facing also makes it easier to provide help.

Podcast Housekeeping Notes

Some quick podcast housekeeping! Make sure to check out our new YouTube channel. We’re still creating it but take a look anyway. In addition to weekly video podcast episodes, there will be unique content specifically for YouTube.

Also, if you’re not following us on social media, please do! We’re on Facebook under Fading Memories podcast. Our Instagram account is Alzheimer’s podcast. Twitter is here. We post lots of interesting and fun content on all the channels. Can’t wait to see you there!

Want to suggest an episode topic? Go to our website and click on the voice memo icon. We wouldn’t mind it if you used this to send us some praise too! Don’t forget to rate & review us on Apple Podcasts. Reviews are how new listeners find us. Don’t keep us a secret! We’re here to help as many caregivers as we can.

Until next week, hang in there!

Learn More About LB

Other Insights on Dementia

Where Else To Find Fading Memories

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Could Cannabis be a Cure for Alzheimer’s?

 

Cure for Alzheimer's image

Could Cannabis be a cure for Alzheimer’s?

 

Not only have  200+ trials looking for a cure for Alzheimer’s failed, a cure in my life doesn’t look likely. What if we have had one all along? According to Dementia Care Central the dementia-related conditions that can be helped by CBD include; Alzheimer’s disease, Vascular Dementia, Lewy bodies dementia, Parkinson’s, Frontotemporal dementia and Huntington’s.

Additionally, according to researchers at California’s Salk Institute, their 2017 study has found evidence that cannabinoids such as CBD could help remove dementia from brain cells. At the same time, we’re looking for a cure for Alzheimer’s, we’re ignoring a potential natural ally. At the very least it could be a preventative treatment.

In the hope that we can avoid developing the disease, or at the very least reducing its effects, are we missing out?  Why are we afraid to investigate this option?

In light of this idea, I spoke to Chela of AlzNotes about her experience with her Mom and her use of medicinal cannabis. Coupled with her personal experience, Chela has done more than her share of research on this topic. Given that I have a family history of Alzheimer’s I thought it was important to learn more on this topic.

Has There Been Research Into Cannabis & Alzheimer’s?

Notably, there has been a lot of research on cannabis as medicine. A 2014 study published in the Journal of Alzheimer’s Disease showed that small amounts of THC can slow down the progression of Alzheimer’s in patients. Additionally, the right balance of CBD-THC can greatly reduce dementia induced anxiety or aggression.

Another key point is that THC is known to be a powerful antioxidant with neuroprotective properties. However, the 2014 study reported that the compound directly affects Alzheimer’s pathology by decreasing amyloid beta levels. Obviously, this is a mind-blowing result. Additionally, as you’ll hear, Cannabis has many other potential healing properties worth looking into. Natural cures come with far fewer side effects so they’re worth researching.

In short, I’m sure you’ll find this episode as fascinating as I did. Researching this topic further is definitely on my list! Don’t you owe it to yourself to do the same? Here are the links discussed during our chat.

PubMed.com

ProjectCBD.org

Past Episodes on Alzheimer’s Prevention

Move It or Lose It – Exercise & Brain Health

This Is Your Brain on Nutrition – Diet & Brain Health

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Alzheimer’s & The Birth of AlzAuthors

Jean Lee, founder of AlzAuthors & her book Alzheimer's Daughter

Jean Lee used her parents Alzheimer’s journey to start AlzAuthors.

 

Jean Lees parents were both diagnosed with Alzheimer’s on the same day. She was the hometown daughter, working full time. Her sister lived 1,000 miles away. What could have been a recipe for disaster became AlzAuthors.

Jeans sister suggested keeping a journal as part of caring for their parents . The result of this journal keeping was not to eventually write a book. Quite the contrary. The journal clearly described the health issues of their parents.

But keeping the journal, written words describing “private health information” made Jean feel profoundly guilty. In her own words, “Like a traitorous spy, I kept the journal for two years. It became an integral part of our parents’ diagnosis.”

Additionally, reading guided Jean through her Alzheimer’s caregiving journey. Each book, each voice, equally strengthened her for difficult times ahead. Uniquely, no story was exactly the same. Jean makes your caregiving journey easier by telling her story and adding her voice to the choir, .

How does someone go from documenting health issues to founding the largest collection of books on Alzheimer’s?  As most things, it happened in stages. As a consequence of being told by an agent that her book was loved but that Jean had no name recognition, she decided to self publish.

For example, Marianne Scuicco (a past guest) got started with Blue Hydrangeas through self publishing . Consequently, after her own publishing and receiving many positive reviews, Jean reached out to Marianne.  Jean felt she was reaching out to greatness and was shocked when she heard back.

About AlzAuthors

Connecting over a shared understanding of being Alzheimer’s caregivers is how AlzAuthors was born. Equally important to their connection was finding more like-minded authors with the same goal. Together with a shared goal in mind they reached out to more authors.

Making a difference in your dementia journey is the goal of AlzAuthors. Equally important the site is managed by six daughters who have experienced the loss of a loved one with dementia. Lifting the silence and stigma of Alzheimer’s and other dementias is their goal.

AlzAuthors write the words that serve as caregiver handbooks. In addition, they are guides through the disease process, or a catalyst for much needed conversation. A new author is featured each week and receive requests for inclusion from writers globally. Currently, they are 200 authors strong and growing.

The AlzAuthors Blog

Featuring a new author every week, the AlzAuthors blog is a fantastic resource to learning about other caregiver journeys. Together with authors and bloggers this site offers the widest range of advice in one place.

Regardless of what you’re looking for, you’re sure to find it on AlzAuthors site. Looking for books focused on advice? The memoir and non fiction titles available are sure to provide the advice you seek. Furthermore, if you’re looking for something different, there are many fiction titles available. Equally important are books for kids and teens. Young people have different questions about Alzheimer’s and AlzAuthors has many books that address their concerns.

As if books & blogs were not enough, there are opportunities to meet many the authors. By checking out their calendar of events you may find an opportunity for an in person meeting.

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Medication Management Made Easy!

Medication management made easy

Pill Map takes the worry out of medication management.

 

Staggering numbers of hospital readmissions are due to medication management errors made by the patient or caregiver.  Taking the right pill, at the right time, in the right amount sounds simple, right? Not so much.

Speaking with Kimber Westmore introduced me Pill Map. Pill Map is a medication management solution. What it’s not is a pill box. Pill Map takes the worry and confusion of managing your loved ones medications.

For example, when my Dad was released from the hospital my sister and I had to manage his medications for the paid caregivers. There was a long list of medications to discontinue, change as well as add. Many of his pills were white ovals in varying yet similar sizes. Worrying that we were not medicating him properly was overwhelming!

Ours was a common concern.  As a result, we looked up pills on the internet, a common way to manage new meds. Even that solution didn’t give us the peace of mind we were medicating him correctly.

Similarly, many families find themselves in this situation. Even spouses may not be unaware of their loved ones medications specifications. Consequently, if there is an emergency correctly informing the medical staff what is prescribed is a challenge.

As a result, there could be a delay in treatment until it’s clear what the patient is taking. This situation is definitely not ideal. However, Pill Map is an ideal solution to these situations.

After listening to Kimber’s story, check out their website. End the medication management nightmare by getting your own Pill Map. Caregiving is a tough journey. However, finding a solution to one of the biggest challenges is very rewarding.

Pill Map website

Pill Map Video

The Importance of Health Care Advocates

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Connected Horse- Healing for Dementia Patients & Caregivers

 

Connected Horse participant

Connected Horse – Equine therapy for people living with dementia.

 

Participating in a Connected Horse workshop provides unique opportunities for people living with early-stage dementia and their care partners. It’s time to be together and experience non-riding activities with horses. By experiencing the power of the human-horse connection participants feel relaxed, confident, and happy. Learning self-compassion, stress reduction strategies, communication and awareness practices is the goal.

Connected Horse was founded in 2015 by Nancy Schier Anzelmo and Paula Hertel. Both horse lovers and are professionals in senior and dementia care in addition to gerontology. Their nonprofit is committed to the belief that horses can provide humans with valuable insights into the healing process.

As a result, workshop attendees find a reconnection with the spouse they used to know, reawakened childhood memories or simply, exactly what the doctor ordered. Having a purpose is crucial for all people. But, providing that sense of purpose gets more difficult as our loved one progresses with their disease.

It’s also important to give both people a chance to reconnect. This program has utilized a lot of research to allow them to give the participants the best possible outcomes. For example, they’ve measured stress reduction and life indicators for those living with the disease. This research is ongoing with Stanford and UC Davis.

Speaking with Paula and Nancy was very eye-opening. I’d dare say almost inspiring. Watching the person I knew as my Mother disappear, unable to do even simplified activities is devastating. It’s too late for us to reconnect, she’s far from the early stages of her disease. However, I can see how she would have enjoyed a program like this. Getting her there may have been the biggest challenge, however.

Reducing Stigmas & Gaining Support

Most importantly is reducing the stigma attached to this disease. We’ve done it with others like cancer and Aids, now we need to do it for Alzheimer’s. As a result of reducing stigmas. more people will seek out programs that help them.

Above all, learning about the support and programs available will go a long way in helping.  Having Alzheimer’s is bad enough, consequently, we need to learn all we can.

Connected Horse website

Unconditional Love – Therapy Dogs in Action!

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Knowledge, Friendships & Memories

On an Alzheimer’s specific cruise you’ll gain valuable knowledge, friendships, and memories.

 

Offering something everyone on the Alzheimer’s path needs, knowledge, is one of the benefits of adding an Alzheimer’s cruise to your vacation list.  This one-of-a-kind cruise is a unique experience for people in the early stages of Alzheimer’s and their care partners. Cruising together you’ll gain valuable knowledge, important friendships, and happy memories.

In this podcast episode, I talk to Lisa Marie Chirco, the woman behind this cruise. With an extensive background in event planning as well as a history of caregiving.  Lisa put together a must take a cruise. For example, people newly diagnosed with Alzheimers have lots of questions. In addition, their care partner has questions and concerns unique to themselves.

On the inaugural cruise, attendees had daily opportunities to learn.  Many of the topics covered will make their journey together as easy as possible. During morning sessions on board, the topics covered included financial planning, safety, caregiving techniques and more.

Learning in a small group environment fosters a sense of camaraderie where friendships can blossom. As a result, you leave the cruise with the knowledge that you can handle what’s coming. In addition, you’ll have a group of people on the same journey to lean on when needed.

Give this episode a listen. I’m certain when you’re done, you’ll be adding this cruise to your must-do list.

Book Your Cruise Today

Hear from an Inaugural Attendee

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