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ElderCare Solutions of MI

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If we were compiling a Top Ten list of things we put off, discussing our wishes for end of life care would probably be number one on the list.  Whether it is the expense involved with having legal documents drawn up or our own sincere desire to believe we have no need to think about it yet, too many of us have not put our wishes in writing.  That leaves our loved ones in the unenviable position of having to decide what types of treatment they think we would want.

However, the 5 Wishes program takes some of the sting out of this most important topic.  According to the Aging with Dignity website, the 5 Wishes program lets you notify your doctor and hospital:

  • Who you empower to make health care decisions for you if you are unable to do so yourself
  • What kinds of medical treatment you do or don’t want
  • What comfort measures you want
  • What information you want shared with your loved ones

The form is free, can be completed online and then printed out, or a soft-bound version can be ordered.  It is currently recognized as a legal document in 42 states including Michigan, and is written in plain, easy to understand language. 

For more information visit http://www.agingwithdignity.org/five-wishes.php.

 Downloading as we speak,

Lynn

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A new year…a time for new beginnings and resolutions…anything seems possible!  As you make those New Year’s resolutions be sure to include ways to not only care for the older adults in your life, but to be sure you care for yourself as well.  In addition to all the old standbys like “Lose those extra 10 pounds”, you might also consider some of the following:

  • Be honest with yourself
  • Create resolutions that are realistic
  • Vow to make time for a little fun each week
  • Be sure you laugh, loudly and often
  • Ask for help when you need it
  • Be proactive whenever possible

None of us can escape the complexities of aging, whether we’re experiencing difficulties ourselves, or with someone that we love.  But the one thing we can control is how we react to those changes.  Are you being proactive or reactive?  Let’s all plan to age well and live well in 2013.    

 Ringing in the New Year,

 Lynn

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The holidays are a much anticipated time of year for most of us.  Seeing family and friends, exchanging presents etc. make it a very exciting time.  However, for some the holidays bring unexpected surprises if they live out of town and haven’t seen the older adults in their life for some time.

An older adult’s level of functioning can change significantly over the course of a few months, even more so if it’s been longer since you were last together.  Here are some potential red flags that might indicate more support is needed:

  • Stacks of unopened mail
  • A fridge full of old, expired or moldy fruits, veggies, milk and yogurt
  • Unanswered messages on the answering machine
  • An older adult seems to:
    • have more difficulty walking
    • have precarious balance
    • have less energy
    • tire easily
    • be confused or forgetful

It can feel overwhelming when you first realize that all is not well, but there’s no need to handle it on your own.  Their physician might be a resource, and a Geriatric Care Manager can help you identify and put in place local resources that will make it easier for you to board that plane for your return flight. 

Happy Holidays,

Lynn

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The cliché is that life begins with parents as caregivers and ultimately the tables turn, with children becoming the caregivers of their parents. The reality is much more complicated.

My siblings and I have been very fortunate in that our parents are pretty healthy and have been pro-active in dealing with the changes that inevitably come with age. A couple of years ago, my parents decided to downsize to a smaller home “in town” rather than remain where they’d been living in the country. Since then, they’ve discussed what their next respective living arrangements should be, depending upon who survives the other. As a result, my siblings and I have been spared difficult future conversations about changes that will need to happen, although the conversations about what they’ve decided are often difficult in their own way. With these actions, even at 84 years of age, my parents continue to “give care” to us, their children.

So it was a new experience when, about a month ago, I found myself for the first time taking the position of telling them that I didn’t think they should do something, specifically drive to Florida on their own. I was very worried, yet also respectful of the fact that it was their choice. I reminded them that several years ago they’d made the decision not to take any more long driving trips. Fact acknowledged, no change in plans. I slept on it and then called again the next morning, this time explicitly saying that I didn’t think they should do it. Still no change. I continued to gently voice my concerns and insisted that they at least agree to call me each night when they checked into a hotel. Ultimately, they decided not to make the trip alone (I think mostly because Mom had concerns of her own in the first place and somehow that finally prevailed).

Today, they are each other’s primary caregivers, but I know the day will come all too soon when one of them will be left alone or need help caring for the other.  While this is close to impossible to even visualize, I hope that I can be as good a caregiver as I see them being for each other. In the meantime, as I’ve done throughout my life, I watch and listen for the lessons they offer. They’ve always been my best teachers through the way they’ve lived their lives. Here are a few of the lessons I’ve learned from them about caregiving:

  • Be a partner to the one for whom you care and talk through important decisions, but also have others with whom you can vent and share concerns privately. At times, we all have things that need to be expressed but are best not said to each other.
  • Have conversations about preferences for important decisions while everyone is healthy. Don’t hesitate to raise concerns or reservations about choices. Cry during the conversations if you have to, but have them.
  • Face the fact as courageously as you can that you will one day lose the one for whom you are caring.  It will make it easier to respect their decisions and wishes during that time period when health and abilities are declining.
  • When the day comes that you must accept care (and make no mistake, that day will arrive for the majority of us), accept that care graciously and express gratitude.

Throughout life, we are each other’s caregivers. This is one of the many blessings to be grateful for each and every day.

Shari-Beth Goldman

 
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I said good-bye to my beloved grandmother, Nannie, as I called her, in late November 2008. Alzheimer’s disease had ravaged her brain and taken away the grandmother I knew as a child. She was diagnosed in 2001 and steadily began to decline. Gone was the vibrant, eccentric gourmet cook, artist, and world-traveler, among other talents. She no longer helped me make cookies, sent me hand-drawn cards, or went on safari in Africa. She now needed to be reminded who I was, what food she was eating, how to get dressed.

She moved in with us and I watched as my mother had to essentially care for a second child. It must have been difficult, having one child going off to college and not getting an empty nest as she had been expecting. It was challenging for all four of us (My parents, my grandmother, and I) as we all had our roles constantly redefined, changed, and renamed. I was no longer granddaughter, I was big sister. My mother was no longer a daughter; she was a mother to her mother. My father was just a visitor. Even the dog played along: he was now the cat.

Within these roles, our responsibilities and expectations also changed. We no longer ventured far from home. I would have to “baby-sit” my grandmother and make sure she didn’t try and walk down the stairs for fear of a fall. My grandmother would set the table; someone else would reset it with the proper dishes and silverware for each setting. We all learned patience and creativity as we tried to keep her occupied and happy. We repeated ourselves often. The dog learned that he would have to go outside to do his business every 15 minutes because Nannie would forget she had already let him out.

As her disease progressed, it became obvious that she was no longer safe in our home. My parents woke up in the middle of the night to find her outside in her nightgown in December waiting for the bus to “go home.” With much pain and regret, my mother made the decision to place her into an assisted living unit. Faithfully, she visited my grandmother nearly every day. For over three years, my grandmother was in this facility before she went into hospice.

A few days before she was moved to hospice, she was having a particularly good day. I had taken a leave of absence from work so that I could be with my family and spend time with my grandmother, so I was sitting with her in the common room when she had a completely lucid moment, looked right at me and said, “I love you, Jennie.”

I think about this moment often. It is something I hold onto, for in all those grey, dark days where Alzheimer’s had taken over, this is a memory that shines like sunlight. It chases away all those negative thoughts and is how I like to remember Nannie in those last few weeks leading up to her death.

Jennifer Simms-Coffey

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Caregiving…It’s the job none of us apply for, but most of us will end up having at one time or another.  Caring for an older adult that you love is truly an honor, but it also can be one of the hardest jobs we’ll ever have. 

As a geriatric care manager I have worked to help support spouses who are caring for each other, grown sons and daughters who are caring for their parents, even brothers and sisters caring for one another, and have been touched by their love, compassion and dedication.

Because November is National Caregiver Month, I would like to highlight family caregivers.  For the rest of the month, this blog will feature a different guest each week, sharing their stories…the struggles and the successes.

 Waiting for their posts,

 Lynn

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Change…I don’t know about you but I’ve never really been a fan of it!  But on a serious note, change is difficult and older adults seem to constantly have to adjust to more and more changes.  Changes in their health, changes in their living arrangements, changes in their circle of friends, just to name a few.

 And generally the type of changes I’m talking about truly mean adjusting not only to change but to loss.  Loss of their independence, their home, their ability to drive, and in some cases their cognitive abilities.  Is it any wonder then that we hear so much about depression and anxiety in older adults? 

 I know we all lead busy lives, and many people live far away from their parents and can’t just drop in once a week.  The good news however, is that there are many ways to make a difference for the older adults in your life, from around the corner or around the globe.  Here are a few suggestions:

  • Call for no reason at all, just to let them know you are thinking about them
  • Plan outings together whenever possible
  • Send cards when you can’t be there in person
  • An I Pad or kindle can bring back the pleasure of reading due to adjustable font sizes
  • If loneliness is a problem arrange for a caregiver or volunteer to pay weekly visits

 If you suspect a more serious concern, consult with a physician or geriatric care manager to see what other resources may be available.

 Going card shopping,

 

Lynn

 

 

 

 

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I had several calls last week from family members, asking how to talk to their parents about whether or not it was time to stop driving.  Since the topic seems timely, I decided to repost this blog.  Hope it helps…

One of the toughest conversations to have with an older adult has got to be the dreaded discussion about driving, the keys and the car.  Whether it’s a spouse who has concerns or an adult child, undeniably, that’s a sticky topic.  But, what can make it a little harder, or a little easier is how we phrase the question.  It really isn’t a question of whether or not an older adult needs to stop driving; the conversation is really about whether or not they are still able to drive safely.

One thing to keep in mind in your approach is that age alone isn’t really a determining factor.  There are people in their late 80′s who still have the functional capacity to be really good drivers, where someone 10 years younger may not.  Vision, cognition, reaction time, as well as back and neck mobility may change as we age, and are really the topic of discussion.

So how do you start the conversation?  There are a few different ways to go.  You can commiserate with new technology by saying something like “Boy, driving sure isn’t what it used to be!  Between these new blind spot mirrors on my car, and the round-abouts that have popped up, I don’t feel as confident as I used to.”  Or you may use current events to break the ice for you by saying “Did you hear about that car accident on the news?”  If neither of those approached works, you can try taking the subject back a generation by saying “I remember when Grandma gave me her car when I was a teenager.  What made her decide to stop driving?”  Hopefully one of these will let you start talking.

But the decision to stop driving threatens our very independence.  An older adult who no longer drives may fear becoming isolated and dependent on others.  So be armed with a list of alternatives including local transportation services as well as activities that provide their own transportation.  If you’re not sure what resources there are in your community, contact a local geriatric care manager or social service agency for resources.

 Grabbing my keys,

Lynn

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Most of us accumulate a lot of stuff throughout our lifetimes.  Even though I diligently clean out clothes closets each year, and have my kids pare down their collection of books and games, I know I’ll have to do it all again next year.   But for some people, this process of weeding out what to keep from what to throw out, sell or give away is more than just a chore; it’s an emotionally threatening task.  Those people are called hoarders.

Hoarding is not just a label made popular by the television show, neither is it just a sign of laziness.  Psychologists describe it as a condition that results from deep rooted trauma or loneliness.  Living in a home environment with stacks of belongings covering most of the floor, with only a winding trail to walk through is dangerous for anyone, including paramedics and fire fighters who need swift access in order to be able to help in an emergency.  But older adults, who may already have precarious balance, are particularly at risk. 

Often isolated and without frequent visitors, older adults may be hoarders and no one knows until that person has a crisis, usually a fall where they are unable to get up.  If you suddenly become aware that someone you care about is a hoarder, here are a few tips to keep in mind:

  • Resist the impulse to help by cleaning everything out for them while they are in the hospital or away.  Experts believe that the accumulated belongings offer a sense of security and protection, and that an abrupt clean out will likely be traumatic.
  • Contact a therapist who specializes in hoarding issues.
  • Involve the hoarder in the clean out process, empowering them to make some of the decisions about what to get rid of in order to make their home safe, while you’re there to help.

Getting ready to tackle the basement,

Lynn

 

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Many older adults end up downsizing at one point or another, moving from their home to a smaller apartment or senior living community.  Usually their family members help with that process.   But after choosing the furniture and other mementos people want to take with them, it is easy to become overwhelmed by all that’s left.  We sure do accumulate a lot of stuff!

If this happens to you, it might be worthwhile to look into selling the items that you cannot take with you. There are a few ways you can go about doing this; you can sell your items yourself or you could have an estate sale.  Estate sales are often held after someone passes away, but that’s not the only time they’re held.   The difference between having a garage sale and holding an estate sale is the logistics behind the event.

For an estate sale, a company will come in and do the marketing, advertising, pricing, and display of your items for sale.  Estate sale companies have the expertise to know an item’s worth and will price your items at fair market value to get you the most money possible. The downside is that most estate sale companies operate on a percentage basis which can range from 20%-40% of the total sales.

If you have the time and the inclination, you may prefer to sell your items on your own at a garage sale or the internet, but then all of the nitty-gritty work (pricing, advertising, displaying, etc.) is done by you (and maybe friends and family if they are willing to help).  Either way works, but one caveat:  If you are disposing of possessions not because of a move but after the death of a loved one, it can be very difficult emotionally.  If it’s financially feasible, it might be helpful to choose the things you want as mementos and then leave the rest for professionals to handle.

 Clearing out my junk,

 Lynn

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  • Does an older adult's family live out of town?
  • Are local family members overwhelmed and need help?
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  • Do family members have differences of opinion regarding a senior's care?
  • Is a senior living in an environment that needs aging-in-place modifications?

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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.