Minding Our Elders®

How do we address Valentine’s Day for a surviving parent?

Dear Carol: My father died a month ago and I’m worried about how to handle Valentine’s Day for my mother. My parents had a good marriage and had always made Valentine’s Day special for each other. I’ve thought about just ignoring it, and sometimes I think Mom would prefer that. However, other times I think that maybe we should do something to honor Dad’s memory and their marriage. How do people handle these times? – Jennifer

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Deciding whether surgery is a good option for an elder can be tricky

This is a subject close to my heart, as my dad had surgery to relieve pressure from fluid on the brain due to an old World War II injury. A shunt was put into dad's brain to drain excess fluid. This type of surgery is not uncommon and is generally successful. Dad went into surgery a little fuzzy from the fluid, but still very much himself. A day after the surgery, he fell into a hellish dementia from which he never recovered until death took him a decade later.

Read more about deciding whether surgery for an elder is worth the risk:

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When siblings don't agree on parent care

Even in seemingly harmonious families, the person who slowly became a default caregiver can start to feel resentful. The out-of-town siblings can conveniently slide into denial. They aren't around to see how much help is needed. They see Mom and Dad occasionally, talk to them on the phone, and all seems well. The fact that you, the in-town sibling, are the reason everything is going so smoothly doesn't really register with them.

Read more about siblings and how to settle disagreements:

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Getting a handle on caregiver guilt

Guilt has a purpose in life. If we are mean, we should feel guilty. If we owe someone an apology, we should be big enough to do so. But guilt is a complicated emotion. We take on the expectations of our culture, our religion, our family. And then we take on the expectations of our toughest critic – ourselves. That committee that meets in our head tells us we are not doing this caregiving thing well enough. If we were "good" people, we'd just keep answering the phone endlessly until Mom found something else to do.

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Help your kids cope with grandparent's dementia

Children can be frightened by the changes in the grandparent who was once gentle and loving, but could now have become cranky and occasionally downright mean and abusive. How we, as parents, handle the changes in our own parents can affect how well our children handle the changes. But each child is different and each set of circumstances is different. So where to you start when it's time to explain?

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Nursing homes are changing to accommodate two generations of elders

The young seniors who are now edging their way into the nursing homes are a generation who just missed being baby boomers (some are actually boomers, but may need nursing care at a younger age because of a stroke, MS or other ill health). This generation remembers sitting around a giant radio, often the centerpiece of the living room, listening to The Lone Ranger. Then later actually viewing the show in their homes on a huge television set with a small, round screen.

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Wife struggles to care for husband with early on-set Alzheimer’s

Dear Carol: My husband developed Alzheimer’s disease at 46. I’ve cared for him on my own for three years, while also running the business we started years ago. I can’t leave my husband at home for long so I frequently have to leave work to check on him. This is affecting my ability to do my work well. I’ve tried hiring in-home care and that helped, but I still worry if they will show up, or if someone is late in the morning, then I will be late to my business. I also don’t feel he gets much mental stimulation at home. I’m exhausted when I do get home, since I need to get up very early to take care of his needs, and when I get home he needs more care. I love my husband dearly and don’t want to feel like I’m giving up on him, but I can’t continue this way, either. What are my options?  - Emma

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Geriatric care managers boon to distance caregivers

The profession of geriatric care coordinator or manager - they go by various names - is a profession that has evolved out of an obvious need. There are legions of harried caregivers, social workers and nurses have a front row view into what a caregiver's life is like. Some of these professionals came to believe that maybe they could make a profession out of helping these caregivers. These entrepreneurs hung out their shingles and a profession was born.

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What to do if you are worried about the care in a nursing home

...That is something I still regret. I don't regret my vigilance. I do regret not going through proper channels. As it worked out, this man became one of the best aides in the home, and I can't tell you what his care for my mother meant to me after Dad died and I had to handle all of the logistics, plus the emotions, and my mother's upset. 

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Dr. Travis Stork from “The Doctors” talks about heart health, with tips for caregivers

February is Heart Health Month. With this in mind, Dr. Travis Stork, co-host of the award winning talk show The Doctors, generously donated some time for a small conference call that allowed four writers to ask specific questions about heart health. Dr. Stork is a practicing ER doctor and faculty physician in the emergency department at Vanderbilt University Medical Center in Nashville, Tenn.

Read more about Dr. Travis Stork's advice on heart health for caregivers and their elders: 

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Trying to prevent falls in elderly a challenge to family caregivers and professionals

I've joked (actually, it's thinly veiled seriousness) with care agency people, and our city leaders, that every city needs one person available day and night to just sit and wait for a call to pick someone up off the floor. Caregivers have a dreadful time with this problem and often they don't know who to call for help.

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Study shows nicotine patch could help some with mild cognitive impairment (MCI)

Smoking is bad for our health. Nothing has changed that often proven fact. Also, nicotine is part of the addictive element in smoking. However, nicotine as administered through a medical patch, rather than a tobacco product, was shown in a recent study to have some benefit for nonsmokers with mild cognitive impairment (MCI). Not everyone with MCI goes on to develop Alzheimer’s disease, but many people do. Therefore, the interest in studying MCI is intense.

Read more about the nicotine patch for MCI:

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When both parents have dementia

Statistics vary, but upward of thirty percent of caregivers die before those they are caring for. Some of those are adult children, lonely and depressed, isolated and frustrated, often torn by guilt. These caregivers can develop cancer, commit suicide, or have heart problems and other ill health that can likely be traced to the stress of caring for their loved ones.

How do caregivers cope when they have two parents with dementia?:

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UK reporter chronicles dementia awareness course: calls it a “taste of hell”

The saying that we can’t really understand another person’s experience until we’ve “walked in their shoes,” has always felt right to me. Intelligent people can be educated to the brim and be able to give excellent “book” advice. However, it frequently takes someone who has endured an experience similar to ours in order to make us feel thoroughly understood. This is where real "hands on" advice differs from advice in the abstract.

Read more about dementia sensitivity training:

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When an ill parent turns on the charm with the doctor

 A friend of mine took her mother to the doctor because she suspected her mom was in the early stages of Alzheimer's. My friend sat dumbfounded as her mom charmed the socks off the doctor and seemed as sharp as she was ten years ago. The mother denied any health issues, especially those associated with memory. The doctor, too busy to run tests on someone who seemed "so good for her age," signed off of some prescriptions and sent them off. My friend felt like banging her head against the wall.

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Handling the pain when your loved one no longer recognizes you

I recall asking one of the nurses at the nursing home if my mother-in-law knew who I was. I was aware she couldn't have told anyone my name or my exact purpose in her life. That much was evident. However, I wondered if she knew that I was there to see her. The nurse assured me that my mother-in-law's seeing me step off the elevator as she sat in the common room was a highlight of her day. I was glad of that. I felt my visiting her was important no matter what she "knew," but it was nice to hear those words from the nurse just the same.

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Time management for caregivers

For me, the need to be prepared for anything is mandatory. During my heaviest caregiving years, I cared for two children, one with multiple health problems, plus multiple elders. During their last years, several of my elders lived in a nearby nursing home, while I worked full time, so that care was a blessing. I could visit daily, but still know they were cared for while I worked at my "real world" job.

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Alzheimer’s Foundation of America stands up against antipsychotic use for people with Alzheimer’s

We’ve addressed the inappropriate use of antipsychotic drugs for dementia patients a number of times on these pages. In one article, I wrote about my dad’s terrifying experience after he was given one of those antipsychotic drugs after failed brain surgery, and my fight to get him off the drug.

Read more about standing before Congress to fight against non-essential use of antipsychotics:

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Improving elder health care transitions

Fortunately for me and my family, I was able to make myself available to help each of my elders after their many hospitalizations. Typically, however, many families simply don’t have anyone in a position to help, and elders go home only to return quickly to the hospital setting because they didn’t have the community support needed for recovering.

Billions of dollars are spent annually by elders returning home from hospital stays. According to the US Administration on Aging, almost one out of every five Medicare patients ends up back in the hospital within 30 days. Most of these readmissions are due to poor transitions due to poor communication and medical mismanagement. The Centers for Medicare and Medicaid Services (CMS) have been trying to address this problem.

Read more about getting the information download from CMS on reducing hospitalization of elders:

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Doctor may help when it’s time for a care facility

Dear Carol: I want Mom to go to a nursing home because I’m burned out. She insists on my undivided attention every minute that I’m home. I work full time, have a handicapped husband at home as well, and don't have a minute for myself. I have a wonderful marriage that I have sadly neglected since Mom moved in a year ago. However, I’m paralyzed with guilt when I consider making the decision to Mom to a facility.

I also suffer from depression and anxiety. Listening to Mom complain all the time doesn't help. I have a brother who hasn't called for six months and doesn’t answer his phone or email. There’s no other family to help. I find myself hoping Mom gets just sick enough to go into the hospital

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