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ElderCare Solutions of MI

Tag: Adult Children

 

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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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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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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When caring for an older adult, there can be many different areas where they need attention and support.  If your family is like most families, the most critical needs get addressed first.  But after that’s done, usually people forget to get back to those less urgent issues, which often include bill paying assistance.

Now I’m not talking about financial need, but rather help with the physical task of sitting down a few times a month to pay bills, keeping an accurate balance in a checkbook, and avoiding finance charges.   Sometimes an older adult’s cognitive functioning can really limit their ability to pay their bills on their own.  We often see people who pay the same bill twice, or mistake a solicitation for a bill.  After all, fundraisers are getting savvy…they put a return address envelope and tear-off pledge sheet right in the envelope so, in fact, it looks like a bill!  Often times an older adult may be paying for a service they don’t even use, such as high speed internet bundled in with their cable tv.

That’s the not so great news.  However, help is available.  If family members want to help by setting critical bills up for auto pay by the bank, that’s a good first step.  But for those who need a little more help, there are services that can step in and take over this responsibility.  The Fiscal Concierge is a company that puts an individual’s bills on a secure web page, viewable by family with an older adult’s permission.  They will check balances, contact the family if a bill is due and there are insufficient funds available thereby avoiding bank fees, and pay bills on time.  For those who prefer a more hands on approach, Daily Money Managers and retired accountants often offer in-home bill paying assistance.  They can set up files and stop in 2-3 times per month to go through the mail and help write checks.  Obviously, security is a number one priority when dealing with finances, so be sure to go with a personal recommendation from a trusted source.

Grabbing my checkbook,

Lynn

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Living in a time where celebrating your 100th birthday is no longer uncommon, the cost of long term care is often on the minds of older adults, their families, and senior service professionals.  How will we pay for it, should the need arise?  Next week, the Elder Care Chat debuts, and may have an answer for you.

Hosted by Christopher J. Berry, Certified Elder Law Attorney and Veterans Accredited Attorney, the Elder Care Chat is a weekly call and webcast Mondays at 2:00pm, that addresses topics of interest to both those who need elder care services, such as caregivers, as well as those who provide them, such as home care providers, social workers, elder care communities and other senior service professionals.  Chris will  lead the calls each week and will also occasionally feature other experts who work with older adults and their families.  You can join him on the web at http://InstantTeleseminar.com,  using the event ID 42786354, or dial (206) 402-0100, and enter ID 670087#.
This Monday, June 24th at 2:00PM,  Chris will give an overview of the 6 ways to pay for long term care, followed by a brief Q & A.  As he is fond of saying, “This is the cheapest time you’ll ever spend with an attorney”!
Putting it on my calendar,
Lynn
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Now that spring has arrived and summer is around the corner, I often find myself refilling my water bottle several times throughout the day.  And unlike me, my clients usually don’t have a water blottle with them when we’re out and about.  As we get older we become less aware of thirst, so I thought this beautiful weather week would be a great time for a quick dehydration reminder.  Many times dehydration is caused by inadequate water intake, but that’s not the only cause.  Other culprits include medication side effects, sweating or diarrhea.  

If you’re not sure of the signs of dehydration, here is a list from The Mayo Clinic:

  • Dry, sticky mouth with thick saliva
  • Sleepiness, weakness or a general feeling of being unwell
  • Decreased urine output with a dark or deep yellow color
  • Dry skin
  • Headaches
  • Constipation
  • Feelings of dizziness or lightheadedness
  • Sunken eyes
  • Cramping in the limbs
  • Breathing faster than normal
  • Low blood pressure
  • Acute confusion

While water is the best option for hydration, here are other ways to increase fluids in the body:

  • Fruits and vegetables
  • Flavored gelatin
  • Watered down juices
  • Sparkling or flavored water
  • Soups
  • Ice pops
  • Limit salt intake
  • Avoid alcohol
  • Minimize the number of beverages with caffeine.

The goal is not to change your loved one’s behavior, but to be creative in finding ways to keep them hydrated.  As they say, timing is everything.  It is best to drink often instead of in large amounts.  After a trip outdoors, during meals and with snacks are all good times to offer a beverage.  While most older adults may not think to  ask for a drink, if you offer them one while getting one for yourself they’ll most likely agree, and remember, every sip counts! 

Don’t forget, if you have questions, concerns or suspect dehydration be sure to check with their doctor.

Refilling already,

Lynn

Contributing author Christie Schoenwald

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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.