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ElderCare Solutions of MI

 

The older we get, the more doctor appointments we seem to need.  It is not uncommon for the average baby boomer or older adult to see a cardiologist, a neurologist, perhaps even a rheumatologist, pulmonologist or gynecologist!  But amidst these many appointments there is one that often gets forgotten…an annual physical with a primary care physician.

Why is it important to keep up with your primary care doctor if you’re seeing all these specialists?  That’s a frequently asked question among our clients.  And the answer is a timeless metaphor…to be sure the right hand knows what the left hand is doing, and vice versa! Most specialists will only diagnose, treat, and prescribe medications for illnesses that fall under their own area of specialization.  So problems that come up may not be addressed outside of a primary care physician’s office.  For example, you’ll routinely have your blood pressure checked as part of an office visit with a pulmonologist, rheumatologist, or gynecologist, but it will not likely be addressed or treated, even if it is elevated. That’s also true if your labs show elevated cholesterol levels.  Instead you’ll be referred to primary care.  Also, routine general preventive care and screening will not be done by specialists, who need to use the appointment time to focus in-depth on the condition they are treating.

So, as much as you would love to eliminate another appointment, call your primary care doc, and schedule your annual appointment.

Getting out my calendar,

Lynn

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I can’t believe that Thanksgiving has come and gone, Hanukkah is almost over, and Christmas and New Years are right around the corner!  The best part of any holiday celebration is visiting with family from out of town.  While it’s always fun for everyone to catch up with each other, all too often my phone rings the following week because  people get an unexpected surprise…their parents do not seem to be doing as well as they were last year, or as well as they seemed over the phone.  Changes can happen suddenly if someone has a fall or other serious illness, but most often changes happen very gradually, with cumulative effects that become more pronounced over time.  And while they may go unnoticed from week to week, if it’s been several months since your last visit, the difference can be very surprising.

But how do you know when your parents might need a little help?  Here are a few clues that you might see on your visit:

  1. Stacks of unopened mail
  2. Old, expired or moldy fruits, veggies, milk and yogurt in the fridge
  3. Unanswered messages on the answering machine
  4. Difficulty walking or precarious balance
  5. Fatigue and lethargy
  6. Confusion or forgetfulness
  7. Misplaced or lost items

The tricky part is knowing what to explain away and what to consider concerning.  Any one of these signs by itself  may not be worrisome, but if you’re seeing more than one, it may be time to talk with your parents and other family members about getting some support.  If you’re not sure,  meeting with a geriatric care manager can help you decide, and arm you with recommendations to put in place before you leave or have at the ready.  Although this may be a conversation you’re dreading, it’ll make getting on the plane to go home much easier.

Feeling thankful,

Lynn

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Dementia…that single word carries with it a tremendous amount of stigma.  But it is the second most common diagnosis given to older adults. And perhaps the most difficult to accept.  Once that label has been given, people never forget it. As this happened to several of our client this week, I wanted to address two of the questions we are asked most often after someone receives a Dementia diagnosis starting with “What exactly is Dementia and how is it diagnosed?” 

Dementia is an umbrella category that serves as a catch all for different types of cognitive disorders, ranging from simple short or long term memory loss to more specific diagnoses including Alzheimer’s disease.  Dementia diagnoses are usually made by combining someone’s history and experiences with some type of testing, so that objective evidence and observed functioning together form the basis for the diagnosis.  MRIs or other brain scans are helpful to identify vascular dementia and rule out physical causes for cognitive difficulties such as brain tumors.  More extensive neurological and psychological testing are available and can provide objective measures of cognitive abilities and identify specific areas of strengths as well as deficits.

Cognitive screening tools however, are available to anyone regardless of history of symptoms, and are very low cost.  Screening tools are designed to help people identify whether or not a more thorough evaluation is necessary, and scores are broken down into three distinct categories of “Normal, Mild Cognitive Impairment (MCI), or Dementia”.  Cognitive screening is a great place to start, but it is important to remember that the results may not be conclusive.  For example, if someone’s score results in a determination of MCI, it would be important to follow up with more in-depth testing.  There have been many instances of people who are highly intelligent testing as MCI when further testing indicates Alzheimer’s disease. Their intelligence allows them to compensate for their cognitive deficits on the screening tool, but cannot be sustained through more extensive testing.

Which brings us to another frequently asked question: “Why is it important to be screened or tested?”  That’s an individual decision, but unfortunately at this time there is no cure for Dementia.  However, there are several medications that are believed to slow down the progression of the disease and help keep people living with more mild to moderate forms rather than severe.  If that is the case then starting treatment as early as possible is important to help preserve cognitive functioning.  The decision to use medication is of course an individual one, and needs to be made in consultation with a doctor who can explain the benefits as well as possible side effects.

Counting my blessings while I still can,

Lynn

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Fall is in the air…even if the temperature will be 92 degrees here in Michigan tomorrow!  And many of us have favorite fall activities that we like to participate in.  Missing out on many of those activities can cause older adults to feel isolated.  Here are a few ways to incorporate the seniors in your life into your family’s fall festivities:

Take a trip to the local cider mill - there’s nothing like hot donuts and cold cider to welcome in the change of season.  If the trip is too physically taxing, bring a jug of cider and a bag of donuts with you the next time you visit an older adult.

Take a drive to look at the leaves – whether just a few miles away, or taking a trip up north,  driving to look at the fall colors is a favorite past time for older adults, and is usually comfortable for people with mobility issues.

Take in a football game – while getting into the stadium and climbing bleachers may be a thing of the past, today’s big screen HD TVs make watching at home almost as good as being there…and the seats are much more comfortable!  Make popcorn and hot chocolate and cheer for your favorite team as a family.

Stroll (or wheel) through an art fair – the last fairs of the season will be happening over the next few months.  For a listing of art and craft fairs visit http://www.artscraftsshowbusiness.com/shows.aspx?state=MI

Create multi-generational fall art projects – When you get ready to rake those leaves in your yard, have your children select the prettiest ones and set them aside.  On your next visit to Grandma and Grandpa’s, bring the leaves, construction paper and a glue stick and create some seasonal decorations.

However you choose to spend your fall family time, I hope you enjoy, and make memories to last a lifetime!

Going to the cider mill,

Lynn

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Long distance caregiving…that phrase certainly sums up my week!  It seems as though everyone I spoke with this week lives out of town, but is coming in for the holidays and is worried about their parents. I am very fortunate because both my in-laws live locally.  and unlike my sister-in-law, I don’t have to get on a plane every time there’s a problem.

When that dreaded role reversal happens and our parents begin to need help, it’s hard under any circumstances.  All of us deal with the uncertainty of wanting to help, but not wanting to step on our parents’ toes.  But the emotional stress takes on another dimension when you’re not there to check on your parents yourself.  This week I spoke to daughters who feel guilty about not being more available, and to sons who feel helpless…both feel anxious and burdened by worry.

As difficult as these first few conversations can be, I’m always so uplifted when I get off the phone.  People’s relief at having found someone, willing and able to be there for their parents long term, is almost tangible.  Someone who can not only help put supports in place but will be there to follow up as their needs change over time.  At those times, I’m grateful to be a Geriatric Care Manager!

Talk to you next week,

Lynn

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The Woodward Dream Cruise was last week. For many native Detroiters that conjures up images of elegant antique cars leisurely making their way down Woodward Avenue, to the delight of the many spectators who line the road.  As I fought the crowds vying for a parking space, I wondered why so many of us flock to watch this motor parade every summer.

The answer is simple.  We come because it brings back memories.  It is a reminder of a simpler time, when lemonade came from lemons, water, sugar and ice instead of the powdered packets I pour in my water bottle.  Of a time when going for a car ride was a family outing.  A time my children would call “The Olden Days”.

I’m not old enough to have memories of antique cars, but I do have hundreds of loving memories of my grandparents, and of being a child playing jump rope on the patio with my friends. And as I sat there, transported back in time to those sunny days of my past, I thought “this is why we come”.   So in the midst of our very busy lives, take the time to explore your old memories, to dig out the old yearbooks and family albums.  It’s time very well spent.

I hope you enjoy your own personal Dream Cruise!

Lynn

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Spending time together as a family can sometimes be challenging if you’re trying to make the activities older adult friendly.  But spending quality time together is so important, for the youngest family members up to the oldest generation.  Those memories of happy times spent together become priceless once those opportunities for togetherness are no longer possible.  If you feel like you need a few new ideas for activities, here is a list to help jump start your imagination:

  • Movie Day (or Night) – This works well for family members of all ages, especially those with mobility concerns.  Whether watching a movie at home or going to the theater, switch off who gets to pick the movie, grandchildren, parents or grandparents!
  • Family Dinner Date – Everyone has to eat! Whether it is pouring over old recipes, choosing a new one, going to a restaurant or bringing in take out, the opportunities to share memories and stories are endless.  If cooking at home, there’s usually a way for everyone to help out.  Have a picnic at a park or bring the picnic inside if that’s more comfortable.
  • Game night – Take turns picking out the games, and be sure to vary them from creative choices like Charades and Pictionary, to more structured board games.  Grandparents can teach games that were popular during their childhood like marbles or jacks, and kids can teach them all about the latest craze.
  • A Trip Down Memory Lane – Most children enjoy hearing stories about when they were young, and when their parents were young.  And older adults have stories to tell!  Even those with memory loss usually have memories from years ago they can share.  Looking at old photo albums together often can spark a memory.
  • Visit Extended Family – Whether on a short road trip or a virtual one via web cam, try to stay in touch regularly with loved ones who live elsewhere.

The following websites offer more suggestions of family activities and games that include older adults.  Hope you find them helpful.

Planning a Movie Night,

Lynn

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Have you ever walked out of a parking lot and had to think for a moment because you weren’t sure where you had parked your car?  Or searched the house because you couldn’t find your keys? I know most of us have.  And for a second we usually joke about losing our memories or getting older, but the reality is that most of us lead very busy lives, and we don’t always pay enough attention to the routine tasks we do each day, and occasionally have difficulty remembering where we left our keys (or car).  And that’s perfectly normal, especially as we age.  So how do you distinguish when your level of forgetting is no longer what would be considered normal?  And how difficult must it be to accept that?

Generally speaking, when memory loss or confusion is severe enough to interfere with someone’s ability to work and maintain a social life, it is no longer considered normal age related cognitive changes.  Instead that’s probably the time to consult a neurologist or geriatrician for a closer look.  But the fact that some of these things occasionally happen to all of us, ironically feeds denial, both on the part of the person living with dementia, and their family members.  Luckily, education and support are available, both one -on-one and support groups.  Support groups are offered through the Alzheimer’s Association, as well as through many memory care communities and adult day treatment programs.

In the meantime, if you would like to better understand how it feels to be someone living with dementia, pick up a copy of Still Alice, by Lisa Genova.  It is a really quick read that paints quite a vivid picture.

Pulling out my copy,

Lynn

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While many of you were hopefully enjoying some fun in the sun on this 4th of July weekend, my family’s weekend was bustling with indoor activity because my much loved niece got married on Saturday.  The festivities spilled over into the entire weekend.  It was absolutely heartwarming to see so many familiar faces again, all in one room.  And as we made our way from table to table, gathering snippets of conversation as we went, I think we were all experiencing a myriad of thoughts and feelings.  Some heartwarming, “Where has the time gone?”, others silly “Look who asked who to dance…”, but I was surprised at the direction my own thoughts were taking.

I was struck by something altogether unexpected, namely the fact that there were many older adults in the room from both the bride and groom’s sides of the family, and absolutely none of them appeared to have any type of dementia!  Given the work that I do, all too often I see the way dementia robs older adults of their independence, their relationships, and often their peace of mind.  I see it so often that somewhere along the line a part of me began to accept it as a consequence of growing older.  But seeing this vital, thriving group of seniors actively engaged and enjoying this phase of life, reminded me that it doesn’t have to be that way.  Whether the causes are due to genes, lifestyle, luck or a combination of factors, clearly the quality of life implications are impossible to overstate, and deserve our time and attention, as well as ways to prevent and treat this challenging disease.

Relishing my memories,

Lynn

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The 4th of July is just a few days away, and families across the country are planning picnics, barbeques, and other celebrations.   If you are having an older adult join you and your family this year, here are a few things to consider in order to help them have as much fun at the outing as you do.

Heat: If you’re planning an outdoor function remember that older adults are more sensitive to heat, and because of that are more susceptible to heat stroke.  If possible, choose an area with some shade, or if that’s not possible, bring a canopy or sun umbrella from home.

Dehydration: Be sure to have a selection of non-carbonated cold drinks available to help ward off dehydration.  Water, lemonade, and Gatorade are great choices.  Popsicles work well this time of year too.

Balance: Because the ground outdoors is often uneven, and patio chairs can be slightly unsteady, balance issues can become a concern.  In order to reduce the risk of a fall, pick a level spot to put your sturdiest chair, and save that seat for the older adult in your life.  It’s helpful to minimize the amount of walking to get to the food as well.

Dementia:  If one of your loved ones has dementia, an afternoon celebration might be easier for them than an evening one.  Often times people with dementia can become more confused during the evening hours.  A smaller crowd is also less overwhelming for people with dementia.  For more tips on how to customize family gatherings for relatives with dementia, please refer to my former blogs on the topic.

A little bit of thought up front can lead to a great time for all!  Happy 4th everyone!

Firing up the grill,

Lynn

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ElderCare Solutions of Michigan is a division of Jewish Family Service of Metropolitan Detroit, a non-sectarian not-for-profit organization that has served the metro Detroit area for more than 80 years.