Archive for the ‘In-Home Care’ Category

Reframing Negative Emotions When Life Throws You A Curve

Posted on February 10th, 2016 by karen

Help When Life Throws You A Curve

by Alana Pietrantuono, LMSW

When a loved one falls seriously ill, family members are faced with an unexpected turn of events, one that likely alters the plans they had spent their entire lives constructing. Accepting these changes is a challenge for anyone — they can leave you feeling as though your life has come to a screeching halt.

Joyce, a 35-year-old nurse, was on the verge of purchasing her first home. She had worked hard for many years and finally saved enough money to realize the dream of owning her own place. But when the health of her father, Charles, a 74-year-old Parkinson’s sufferer, took a turn for the worse, Joyce was forced to put her plans of home ownership on hold.

You see, Joyce had been her dad’s primary caregiver ever since her stepmother, Janet, passed away two years before, and it became clear to her that some serious sacrifices would have to be made in order to help her dad. She felt she had two choices: she could either quit her job and move in with her father to take care of him full-time, or continue working and spend the money she had saved for her condo to pay for his around-the-clock care at home. Charles would not consider moving to a nursing home, as he insisted he was still grieving the loss of wife and didn’t want to leave the house where he and Janet had lived together.

Joyce, for her part, was utterly destroyed by the loss of her home-owning dream. And while she felt guilty about this overwhelming emotion, she still couldn’t deny feeling angry and cheated. “I never thought that this is what my life would become,” she said at our first meeting. “I can’t even cope! But I can’t imagine leaving my father either. I would be a terrible daughter.”

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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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Water, Water, Everywhere: Preventing Dehydration

Posted on May 6th, 2015 by kim

dehydration tips

by Kim Keller

I never fully appreciated how important drinking water was until my dad needed to be hospitalized — twice! — as a result of severe dehydration. He first complained about feeling extremely tired, and then he suddenly became completely confused, seemingly out of the blue. It scared us! Dad was so weak and disoriented that we needed to call an ambulance to get him safely to the hospital.

And as it turned out, the fuss was all about water.

It seems so simple. Water. Yet, severe dehydration is a serious health concern for aging adults. Medications can be dehydrating. The ability to signal thirst doesn’t work quite as well anymore. The ability to store fluids diminishes. Those with dementia can no longer keep track of their water intake. And, for many, the dismay of incontinence makes all fluid intake extremely undesirable.

My sister Karen and I became relentless reminders with our dad, and now with our mom, to drink more water! Talking with friends, we’ve discovered that we aren’t alone. Many of them have experience with this issue as well.

So we asked for some of their tips, and here’s what they told us:

“I am always trying to get my mom to drink more water. Part of the problem is not knowing how much she drank. I always suggest that she put water in a quart bottle and I tell her she needs 2 bottles a day. That way she always knows how much she had.”

~ Mindy, art restorer, Weston, CT

“Most older adults, I have found, if they drink water at all, handle it better in small doses — meaning a small glass, but fairly consistently throughout the day. Encourage drinking a full (small) glass when taking meds, which is usually at least twice daily. I encourage clients to drink about half the small glass before taking the meds, so they go down easier. I try to get them to also drink a full glass (even if it’s small) with every meal. Make it a routine.

“I think water can be boring and uninteresting for many older adults, so we put it “on the rocks,” or we add a splash of OJ, grapefruit juice, cranberry, etc., to mix things up. (Be sure to check if there are any issues with medication interactions here.) We’ve even added a maraschino cherry for fun.”

~ Kathy, a gerontologist and eldercare manager, Hartford, CT

“I recently bought something called a citrus zinger water bottle. It has a juicer on the bottom for lemons, limes and oranges but can also be used for fruit of all kinds. It flavors the water, which sometimes is what’s missing for people: raspberries and lime, blackberries and lemon, melon and mint, etc.”

~ Karla, Darien, CT

“What is their favorite drink? Coffee? Then put liquids in their favorite coffee cup and make sure it’s hot. Whiskey? Then pour apple juice in a favorite whiskey bottle and warm it up in the microwave. Juice? Then pour water in a red-pebbled glass so that it looks like juice. Martini? Pour water in a martini glass and add olives. When it looks like their favorite drink, they are more likely to drink it.”

~ Jolene Brackey, author of Creating Moments of Joy for the Person with Alzheimer’s or Dementia.

“In the last couple of years of my father’s life, he would get so dehydrated that he’d have these episodes. He’d lose contact with reality, start calling out, and become incoherent or delusional. It was always a big emergency, involving ambulances and rushed visits to the hospital. One time they almost had to turn a plane around on the way to Florida. We did everything we could think of to entice him to drink. There was always a water bottle, fruit juice, his favorite drinks like Cel-Ray soda (we had to get it from NYC; soda that actually tastes like celery), non-alcoholic beer or soup at hand. It seemed like we asked him to take a sip of water at the beginning of every other sentence.

“The only time he requested water was one time that he came out of a coma. He was “nothing by mouth” at the time. He asked me for water, and it was quite the moment because we had been told he was not going to wake up, that he was going to die that night. So I had to refuse him. His eyes flew open. He thought it was so funny after all the times that I had asked him to take a drink. He said, ‘WHY? WHY??’ and then asked for the nurse. When she came, he said, ‘Tell her what you just told me.’ I repeated my refusal about the water. The nurse confirmed the medical orders and then went and called his doctor at 1 a.m. to have the orders reversed. When she came back in, she asked him what he wanted. ‘I want what I can’t have,’ he said, meaning Scotch. But he finally agreed to some water.

“I tell this story because I would have to say that, while we were very committed and resourceful in taking care of my dad, I always felt embarrassed when he had these episodes, as if I hadn’t been taking good enough care of him, as if it should have been so easy to simply give him water. So that would be my first piece of advice: to hope that people won’t feel embarrassed when this happens. The other things we learned to look for was his skin tenting or his tongue being wrinkled, but we really could have used a better way to anticipate these episodes.

“It would have been better if we could have made an arrangement to bring him in for an IV drip or, better yet, to have it available at the house, rather than wait until we had to call an ambulance because, by that point, it was very difficult to move my dad around. There were many times, taking care of Dad, that I felt like simple remedies were not available to us. These things would have made our lives easier at such a difficult time, but there was no place for simple solutions in a system that had a rule and a procedure for everything.”

~Grace, photographer, Block Island, RI

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The Flu. Who Knew? A Daughter’s Journal

Posted on April 22nd, 2015 by karen
Elderly Flu Considerations

Arthur Whitman takes a sip.

by Beth Whitman

Dad got the flu this winter. Funny thing was, it didn’t look like the flu. I thought he was just more tired than usual, or that maybe he had the mid-winter blues.

What I discovered, though, is that the flu looks and acts differently in older folks than it does in the rest of us. Dad showed none of the symptoms that we normally associate with influenza, at least not until AFTER he was admitted to the hospital.

Here is what his flu looked like: For three days, I noticed Dad getting weaker and weaker. He started out just lying in bed all day. He had no interest in activity, and he didn’t seem to have much of an appetite. To get him up and moving around, which seemed like a good idea, I had to walk with him the 20 steps out to his living-room chair. He didn’t have the energy to button or even zip up his pants. I asked him if he was okay.

“Yes” was all he said, but it wasn’t convincing.

He soon became incontinent because he didn’t have the energy to get to the bathroom in time, and then not even the energy to stand up and pee in his portable urinal. He had also lost all interest in consuming fluids.

By the third evening, when it was time for him to head into his bedroom, I went over to help him stand up. He was slouched in his big stuffed chair by the window, and seemed unusually extra-tired. I asked him if he wanted to be wheeled into the bedroom. He nodded, and then coughed a little. So I brought a wheelchair over to where he was sitting, and put my arm around his back and gave him my arm to lean on, but he was just dead weight. He couldn’t stand up — even with my help.

I called my neighbor, Steve, and asked him to come over to help me transfer my father into his wheelchair. The two of us were able, with considerable difficulty, to move him into the chair.

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A Roadmap For Finding Excellent In-Home Help

Posted on April 15th, 2015 by karen

Home is where the heart is concept card

by Karen Keller Capuciati

For most of us, the prospect of hiring in-home help can be overwhelming. I remember the first time our parents needed in-home care, back in 2006. Dad was very ill and required round-the-clock assistance. We needed someone to help out at night so that Mom could get some sleep.

We had no idea where to even look for help, let alone how to find the right person. There were so many variables to resolve, like convincing Mom that she needed help in the first place, and then deciding whether to hire from a licensed agency or find an independent contractor, like a friend-of-a-friend from church, for example (referred to as “the grey market”). Most of all, we weren’t sure how to find someone our parents would feel comfortable having in their house at night, or how to make sure that person would be reputable and qualified. I remember thinking there were endless problems to overcome.

Eldercare professionals, like the ones I meet with every month, often help their clients find the best in-home-care candidates. They do some interviewing and checking of references, qualifications and backgrounds, and then provide a couple of recommendations. And after years of doing this, and observing the results in various situations, these professionals have learned what works, what doesn’t and which pitfalls to avoid.

So I asked my group to give us some tips on finding excellent in-home help. Here is some of the solid advice they offered:

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Postcards From Florida

Posted on January 8th, 2015 by karen

Postcards from Florida

December 29, 2014
Here’s the latest: Mom’s been in rehab for the past five weeks, recovering from hip surgery. Just before Thanksgiving, she was having dinner with her girlfriends, and she fell when leaving the restaurant and fractured her left hip. This certainly hasn’t been the holiday season we imagined! But the good news is, she’s doing well and I’m bringing her home in the morning. She’s pretty excited!

December 30, 2014
Phew! Mom’s friend Debbie cleaned out the refrigerator at home, and then went grocery shopping to refill it with essentials. I’m so grateful because it’s been just crazy busy moving Mom home!

December 31, 2014
Well, transitioning Mom back home from rehab has been a lot harder than we anticipated. We expected it to be “all good” when she finally made it home, but it’s not. No call button. No aides. Her daily routine is off. Everything feels different than in rehab: Mom says that the furniture at home feels too low, while her bed feels too high. It’s like Alice In Wonderland, when she drank the potion that made her so teeny that she could fit through the miniature door — and then she grew too big to fit in the room.

Note to self: When the dust settles, let’s find a better chair for Mom to get in and out of.

Morning, January 1, 2015
Mom’s been weaning herself off the pain medication way too fast! It’s causing lots of distress. We should’ve asked for more guidance to manage this one. Oy!

Evening, January 1, 2015
Mom’s overwhelmed by all the things that need to be done — bills, laundry, necessary correspondence, that kind of stuff — and her anxiety is exacerbated by the withdrawal from the pain meds. Plus, there’s a whole new group of people for her to become familiar with: the visiting nurse, the nurse’s aide, the physical therapists. This is not easy for Mom under the best of circumstances, and right now it’s even more complicated.

She’s still not fully recovered from the surgery, and needs to use a walker to get around (not sure how much longer). Her limited mobility is frustrating her, and her lack of control makes her feel even more anxious. We need to establish a routine to help her address all those tasks that are floating out there, unnerving her. A little structure goes a long way in making life feel more manageable.

During dinner tonight I’ll try to help her create a schedule and a master to-do list. We’ll take a few simple items from the list each day and put them on the schedule, things that Mom can realistically accomplish. That way, things get done and she starts to feel a little more confident and in control each day. We need to do this every night and stick to it.

Morning, January 2, 2015
I’m feeling the stress. I need to create my own schedule with a little “me” time each day. Before Mom wakes up in the morning, I’ll meditate from 8 to 8:30, and then, after she goes to bed, I’ll have time to read from 9:30-10. Then it’s lights out!

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Caregiver Tools: Top Five Resources

Posted on June 18th, 2014 by karen

Caregiver Tools

by Karen Keller Capuciati

Here is a Top Five list I simply had to share — my favorite caregiver resources that I put together for Mary Underwood, Vice President of Memory Care and Resident Experience at the beautifully appointed Maplewood Senior Living in Westport, CT. Mary is putting together a resource library — books, CDs, DVDs, and websites — for professional and family caregivers alike.

It’s a thoughtful gesture on Mary’s part that will no doubt be highly useful. Knowing what resources are available is the first step in making one’s arduous caregiving duties go a little smoother.

It was not easy narrowing down the extensive list to only five resources, so stay tuned for more top picks.

  1. Eldercare Locator is a nationwide public service that connects aging Americans and their caregivers with community resources. Whether you’re looking for home-delivered meals, help dispensing medications, transportation to various appointments, adult day-care or respite programs, Eldercare Locator will help you find the resources available in your ZIP code. Visit eldercare.gov or call 800-677-1116.
  2. Health Journeys is a guided-meditation clearinghouse, offering CDs or downloadable meditations to assist with many of life’s health challenges. Fight Cancer, Healthy Heart, Successful Surgery, Ease Pain, Healthful Sleep are just a few of the available titles. These meditations provide the kind of supplemental support that we need to actively participate in our own health and recovery.
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Meals On Wheels: Two Squares And One Smile

Posted on April 16th, 2014 by karen

Meals On Wheels dinner. Photo credit: Kathleen DiGiovanna

by Karen Keller Capuciati

Gloria is a 90-year-old woman healthy enough to still live alone. But it is no longer safe for her to drive, and making meals has become problematic. Kathryn is only 65 but just had hip replacement surgery. She also lives alone, but is having trouble getting around and cannot cook for herself. She’ll be able to resume cooking once she has recovered from the surgery, but, for the time being, meal preparation is a challenge.

Meal on Wheels Association of America is a tremendous resource for people like these two women. All told, there are some 5,000 local senior nutrition programs in the United States, providing more than one million meals to needy seniors each and every day.

But the largely volunteer staff of MOW does more than just deliver food – they also provide a safety check and a friendly smile that often serves as a lifeline to homebound seniors. Many of those who receive Meals on Wheels may have just come home from the hospital, have limited mobility, impaired vision or cognitive difficulties. A meal, and the fact that someone is dropping by to deliver it, is an indispensable assist for those of us whose loved ones want to stay home rather than moving into a supervised facility.

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Bright Ideas: Improving Safety And Accessibility

Posted on May 9th, 2013 by karen

Intense Burst of Light

by Karen Keller Capuciati

I came across a terrific idea the other day while scanning through Parkinson’s Disease: 300 Tips For Making Life Easier, by Shelley Peterman Schwarz: “Purchase touch-sensitive lamps if manipulating the small turn-screw on most lamps is difficult. Touch any metal on the lamp base and the light goes on; touch it a second time and the light goes off.”

A good tip, I thought. Not only can the switch itself be difficult to turn, but getting to it often requires bending down to reach under the lampshade, which could throw an unsteady person off balance and possibly cause a fall.

This is also a good idea for people with arthritis, vision impairment, cognitive disabilities or anyone assessed as a fall risk. Our dad, for example, had rheumatoid arthritis and this would have been a nice convenience for him.

But instead of buying new touch-sensitive lamps, I set out to  find out how easy it would be to adjust the lamps in our home in a similar fashion, and I discovered it couldn’t be simpler. Here are three small, low-cost options to make your own lamps easier to operate.

 

Touch Adaptor

This gadget allows you to turn on, off, brighten or dim a metal lamp by a simple touch. It’s inexpensive and easy to install. A couple of considerations: it only works with a metal lamp, and the addition of the 2-inch adaptor reduces the bulb space created by a traditional lampshade bracket. A lampshade that clips onto the bulb, or a bracket that sits at the base of the light bulb, as shown below, eliminates that issue.

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A Daughter’s Mission: VeteranAid.org

Posted on February 26th, 2013 by karen
Debbie Burak with Marine, Washington DC 2012

Debbie Burak with Marine, Washington DC 2012

by Karen Keller Capuciati

If medical expenses are straining your finances and your parent is a veteran, 65 years or older, then this is one blog you should definitely read.

Debbie Burak was in this very situation. When her elderly parents, already in poor health, lost their house to a fire, they moved into an assisted living facility rather than attempting to rebuild their lost home. Her parents, however, were not financially prepared to handle the cost of long-term care.

“We were overwhelmed by the expense of facility living,” Debbie explained in a telephone interview. “Our parents were living off of Social Security, which wasn’t nearly enough to cover their expenses. So we pulled from their small nest egg, and my aunt and my sister and I collectively chipped in to help each month, but it was exhausting to always be needing something extra, on top of just getting by with our own immediate family’s needs.

“New expenses would always come up,” she added, “be it a new medication for Mom’s kidney condition or a root canal for Dad. The financial stress kept us all on edge.”

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