Archive for the ‘Be Proactive’ Category

Preparing To Get Alzheimer’s

Posted on January 25th, 2016 by karen

Karen's Origami Crane

by Kim Keller

I was watching a TED Talk by global health consultant and writer Alanna Shaikh when she suddenly announced, “I’m preparing to get Alzheimer’s disease.”

What? Why on earth would you consign yourself to such a future? And how do you possibly prepare for such a cruel disease? I was definitely taken aback but also intrigued, so I decided to keep watching to find out more.

Alanna’s belief, it seems, stems from her father’s AD diagnosis back in 2005. He had been showing signs for about five years, and now he’s deep in the embrace of the disease, needing help to do everyday simple tasks like eating and dressing. Alanna reports that her father “doesn’t really know where he is or when it is” any longer.

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Five Wishes: The Aging With Dignity Guide

Posted on January 15th, 2016 by kim

Rosey landscape

by Kim Keller

The decisions we made still haunt me. And I suppose they always will.

It’s not that I think we made the wrong choices. In fact, I’m certain we made the right ones. What I can’t shake is the belief that my father should have been leading the discussion about his own healthcare choices.

Instead, he wasn’t even a participant.

My dad had a living will. So my parents thought they were covered when it came to the recommendation, “Have a discussion with your family about end-of-life issues.”

But missing from that recommendation was the word “thorough” — as in, “have a thorough discussion about end-of-life issues.”

The living will only told us that Dad didn’t want to be kept alive by artificial means. What the document never anticipated were all of the other more likely scenarios that could develop. When some of those unforeseen events did ultimately play out, it was too late to secure his input and guidance.

Making these critical decisions for someone we loved so much, such as stopping aggressive medical treatments or starting hospice care, was a major impetus in the creation of In Care of Dad. My sister Karen and I wanted to spread the word: Have those end-of-life discussions before it’s too late, and make them meaningful!

Which often prompts people to ask us, “So how do I do that?”

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To Drive Or Not To Drive, That Is The Question

Posted on December 12th, 2015 by karen

by Joan Blumenfeld, MS, LPC

Driving with my dear old friend, Sarah, was becoming scary!

One evening, Sarah picked me up to go out for dinner. On the way, as we approached a red light, she was chatting with me and not paying attention to the road and we bumped right into the rear of the car in front of us. Thankfully no one was hurt, and neither car was damaged. The scariest part was that Sarah seemed to have no idea of the danger into which she had put herself, me and the occupants of the other car.

Her car was taking on an increasing number of small scrapes and dents. She was getting lost on her way home on familiar roads that she had been driving for years. The police were called four times in six weeks to locate her.

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Breaking The Alzheimer’s Code: One Hundred Hankies For Joe

Posted on November 6th, 2015 by karen

alzheimer's providing security

We are happy to re-post this very special blog from August of 2014.


by Karen Keller Capuciati

I’m at the Alzheimer’s Association’s Annual Education Conference, held a few months ago in Cromwell, Connecticut. Jolene Brackey, the keynote speaker, is what you might call an Alzheimer’s visionary. After graduating from Iowa State University, Jolene began working as an interior designer but soon came to realize that she was more interested working with the people at the Alzheimer’s special care unit across the street from her design firm. She enjoyed the interaction with older people and began formulating her own unique ideas for helping people with dementia live in the moment.

She walks out into the audience and chooses a gentleman entirely at random. She asks him for his wallet and keys.

As the man dutifully hands over the items, Jolene declares, “I’m just going to place them up there behind my podium for a few hours. Okay? So that you don’t lose them.”

The man seems a bit confused but willing to play along.

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Caregiver Salvation: A Delicate Balance

Posted on October 29th, 2015 by karen

Caregiver Stress

by James McGinn, LPC, NCC

“My mom had always been fiercely independent and self-sufficient all of her life,” said Deborah, who, like many of my clients, was struggling with the increasing dependence of her elderly parent. Deborah’s mom, Helen, had been a proofreader for Springfield’s Republican newspaper for decades. Although her retirement in 1986 was bittersweet, Helen was at least partially comforted by her lifelong passion for reading, which brought her to the local library several times each week. As Helen grew older and less mobile, her library sojourns became less frequent, but, fortunately, the librarian with whom she’d built a friendship would drop books off at Helen’s home on her way to or from work.

Sometime around the year 2000, when Helen was in her early 70s, she began to experience distortions in her vision that was eventually diagnosed as macular degeneration, a progressive worsening of the eyesight due to retinal damage that accompanies old age. Macular degeneration can be slowed with vitamins and supplements but has no medical or surgical cure — blindness is the unfortunate prognosis. It’s a disease that regularly impacts millions of people around the world, but it hit Helen particularly hard. Reading had always been her refuge: she’d been able to compensate for the deterioration of other abilities and functions by maintaining an active mind through her love of books, as well as by completing the crossword puzzles in the newspaper everyday. Now, however, with her sight degrading, Helen was at a loss as to how she would cope with her steadily increasing limitations and maintain what little independence she had left.

Deborah had been an active support for her mom for some time, assisting her with errands and transportation needs, but she decided it was time to take on more responsibility for Helen’s daily care. While the obvious solution in cases like this is for the child, or children, to step in as the primary caregiver, it’s a complex and stressful arrangement to say the least. In addition to handling a multitude of duties on behalf of an aging loved one, a caregiver must also contend with the reversal of the parent-child dynamic, as well as the parent’s emotional response to losing their independence and stature. In other words, aside from supervising Helen’s finances, medical treatment, and daily routine, Deborah also had to face Helen’s injured psyche, which the older woman often expressed as criticism and displeasure with her daughter’s decisions.

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Meal Train: The Best Thing Since Chicken Soup

Posted on October 15th, 2015 by karen

Chicken Tortilla soup from Rosie in New Canaan CT

by Karen Keller Capuciati

When you have a sick friend and you want to help out, sometimes you don’t know what to do. Offers to help — Don’t hesitate to call me! — seem perfunctory. You don’t want to be intrusive or force your sick friend to assign you a job, but you’d really like to show your love and concern . . .

Helping can get complicated.

Well, it just got less complicated. Meal Train is an interactive online service that allows family, friends and neighbors to sign up for delivering meals to friends and loved ones going through difficult times and/or significant life events, whether it’s surgery, cancer treatments, grieving a recent loss, arrival of a new baby, or just to ease the strain of everyday caregiving.

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The Nine Secrets To A Long Vibrant Life

Posted on September 3rd, 2015 by karen

Blue Zone healthy habits

by Kim Keller

If you were told you could live into your 100s, with good health of both mind and body, would you be interested?

If the answer is yes, then you might want to read this article, and maybe even take notes!

According to the findings of a joint investigation by the National Institute on Aging (NIA), the National Geographic Society, and bestselling author Dan Buettner, the key to longevity — what these social scientists have labeled as “Blue Zones,” meaning communities around the globe where lifestyle choices have led to unusually long and healthy lives — is a combination of diet, exercise, family bonds, spirituality and personal fulfillment. The study explored places throughout the world where indigenous populations live vigorous and dynamic lives into their ninth and tenth decades. The researchers have examined the societal habits of these communities and noted what they have in common in the hopes of helping us all live longer and healthier lives.

The formula for longevity comprises these nine common features:

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Facility Living: Empowering Ideas For Better Care

Posted on August 20th, 2015 by karen

How to get better care in facility

by Karen Keller Capuciati

“Feeling of defeat: When you realize the place where you have moved your loved one gives less than desirable care and there is no place better to go to. I had to accept that this was as good as it gets.”

This comment was written by Martha in a recent post to In Care of Dad.  She had done her due diligence, checking all the memory-care facilities in a 50-mile radius surrounding her home, eventually locating the very best place for her father. But she is frustrated because the care her father is receiving doesn’t match up with her expectations for the facility.

Martha explained that all the personalized care details that she communicated at intake — her father’s food likes and dislikes, his special skin care needs, etc. — are not being communicated to the folks who are caring for him. Furthermore, the activities provided by the facility are not engaging.

So Martha’s question is, what can be done?

I asked some professionals in the field of geriatric care for ways to help a person in Martha’s situation. Here are some of their suggestions:

Joan Blumenfeld, a geriatric care manager:
I’d like to have some help with this myself. Even “good” places often fall short of our expectations and their promises. Sometimes our expectations do not jibe with reality and that’s frustrating. So we have to make some adjustments to our expectations.

Consider the following:

  • Pick your battles and set priorities. Not everything is worth a confrontation.
  • If there is an issue of health or safety, speak to nursing or administration, not to the aides. Facilities are hierarchical. Power to fix, change or adjust comes from the top.
  • Visit regularly and randomly, so you can see what is really going on.
  • If you can afford it, a part-time private duty aide might be of service, though it may create conflict between staff and the private aide.
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20 Simple Ideas To Regain Mental Focus

Posted on August 13th, 2015 by karen

Tips for Regaining Focus

by Kim Keller

Stress and anxiety chip away at our ability to concentrate. Left unchecked, we can become paralyzed, virtually unable to move forward effectively in our lives.

Here are 20 simple actions you can take to reduce stress and regain your mental focus:

  1. Stay Hydrated — Water transports oxygen throughout your body, which in turn boosts your energy level and helps keep you alert.
  2. Wiggle Your Toes — Sounds silly, I know, but this great little “mindfulness” trick brings you back to the present moment and helps you refocus. Olivia Fox Cabane recommends this tip in her book, The Charisma Myth. Try it sometime.
  3. Create a Routine — Having a regular daily schedule simplifies life, which consequently eases stress by removing a major issue (laying out your itinerary for the day) that used to occupy your brain.
  4. Use the Mind Dump Exercise — When my brain is flooded, this exercise gives me comfort: I take 10 or 15 minutes to write down, as fast as I can, anything — anything at all — that comes to mind. It often starts with something like this: Why am I feeling SO stressed out?! I need to stop saying yes to everything! I need to get more sleep. All I want to eat is junk food! And on it goes. While the pages I create tend to be jumbled and chaotic, the exercise helps relieve anxiety and produce a sense of mental clarity.
  5. Don’t Worry AloneNed Hallowell, M.D., a bestselling author and world-renowned expert on ADHD, offers these next four tips, starting with Don’t worry alone. “Worrying alone tends to become toxic,” writes Hallowell, “because in isolation we lose perspective.” The benefit of sharing your fears and concerns is that “when you worry with someone else, you usually end up problem solving, as you feel more empowered and less alone.” So find someone to talk with and get the worries out of your own head.
  6. Get the Facts — “Toxic worry is rooted in wrong information, lack of information, or both,” explains Hallowell. Spend the time you’d normally waste on worry by getting the facts and learning what is true.
  7. Make a Plan — Use your energy to create a plan that helps you work through the problem, instead of using your energy to worry and fret. A plan will make you feel more confident and in control of your life.
  8. Think Happy Thoughts — “Thinking of things that promote warmth, connection, and happiness reduces the hormones associated with stress, fear, and anger that can impede concentration,” says Dr. Hallowell.
  9. Create a To-Do List — Trying to remember all of the little tasks on your plate takes too much mental effort. Instead, keep a list of everything you need to do, no matter how big or small, all in one place. I find it useful to review the list each night and make a smaller list that separates the items based on the tasks that must be completed the following day and those that I’d like to complete but aren’t quite as urgent. A to-do list is a great way to reduce anxiety.
  10. Use All of Your Senses — Make a point of practicing mindfulness by engaging all your senses. Next time you look at a tomato, for example, smell it, touch the skin, appreciate the shade of red, and, of course, taste it. Apply your senses whenever you can, and not just the most obvious ones. Take a moment to listen to the sounds of the day. Touch and smell things you normally just look at. Bring your entire sensory arsenal to bear on your everyday encounters.
  11. Noise-Canceling Headphone — To protect myself from distractions, I take breaks from phones, email, texting, etc., by wearing noise-canceling headphones and listening to music without words. This amplifies my focus and helps me fixate on whatever I’m trying to accomplish.
  12. Schedule Time to Worry — To avoid continual, uncontrolled worry, I find it helpful to allow myself actual worry time: I’m not going to worry about this tonight, I’m going to sleep, and I’ll make time in the morning to stress about this. It only works, though, if I make a pact with myself to devote equal time to reflect on what’s good in my life. This combination of scheduling worry time and giving equal attention to gratitude never fails to give me perspective. And comfort.
  13. Work in Small Doses — Whenever I’m overwhelmed, yet eager to be productive, I set a timer for, say, 10 minutes and then force myself to concentrate fully throughout the short time frame. When the timer goes off, I take a quick break, then I start again. At the 45-minute point, I take a longer break — 15 or 20 minutes. I’ve used this timer technique for years, and I just recently found out that there is an actual name for this approach: it’s called the Pomodoro Technique.
  14. Know Thyself — We all have times during the day when we can best focus; mine is in the morning. I try to organize my day so that anything requiring a lot of concentration and brainpower happens in the morning.
  15. Move —  Take a walk, dance, run up and down the stairs, anything to wake up your body and your brain.
  16. Get Rest — The converse to number 15 is also true. Sleep is a great healer. For the longest time I just accepted the notion that I wasn’t a good sleeper, that I wasn’t blessed with that particular gift. But in recent years I’ve come to realize that my inability to sleep well was just another bad habit I needed to break. So I’ve put a lot of thought and effort into the subject, and that prompted a number of In Care of Dad articles. These, in particular, I found helpful. Take a look. Sleep Strategies Part One and Part Two.
  17. Clean a Closet — Removing clutter and getting organized gives you a sense of accomplishment and a great lift. It creates momentum to tackle even larger problems.
  18. Memorize Something — Memorization keeps your mind sharp. Try a poem or the US state capitals. If that gets too easy, learn the lines to your favorite play.
  19. Eat Well — Reduce your sugar and caffeine intake. Eat foods that will give you natural energy, like fruits and veggies. Create a diet for yourself that reflects excellent nutritional balance.
  20. Take Time to Meditate — I know, I know, when you’re stressed out and overwhelmed, who has time to meditate? But trust me, finding 10 minutes a day to focus on your breathing and your inner calm will set the tone for you. Just get started. First thing in the morning, before your coffee, set your timer for 10 minutes, find a quiet spot to sit comfortably, close your eyes, and take in a deep long breath. Hold it for a moment and then release a long slow exhale. To get me in the proper frame of mind, I say “in” as I take that deep breath, and then I say “out” as I let go and exhale.
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It’s All About The Meds

Posted on July 22nd, 2015 by karen

Prevent Medication Errors

by Kim Keller

If you were to listen in on some of the conversations I’ve had with my sister Karen during the last 10 years, you might very well hear us talking about medications, and it would probably not be in a positive light.

The disenchantment began with our dad. As a result of having so many doctors contributing to his care, he was saddled with too many meds, some of which were ineffective and even unhealthy. Duplicative prescriptions, improper substances for patients over 65, too many adverse side effects, confusing dosage instructions . . . The list goes on and on.

Then, after Dad passed away, our mom’s health suffered (no surprise there, since she was Dad’s primary caregiver for so long) and the same kind of medication problems started cropping up. The lesson? Be ever vigilant about medication regimens.

Our latest concern is trying to limit the escalation of Mom’s prescription-drug intake. It’s a challenge to find the balance between the meds she really needs and the meds that are being casually prescribed to her.

In general, there are thirteen points we focus on:

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