Dear Carol: My mother has been in a nursing home for two years because of strokes and vascular dementia combined with Alzheimer’s. It’s obvious that she’ll never go home. Dad died years ago, but Mom stayed in the family home where we kids grew up. While my siblings and I know that this house must be sold to pay for the nursing home, Mom talks about the house and going back to it. Do we tell her that we have to sell it or do we just pretend that it’s still hers? I hate being dishonest with her, but I know that she’ll be talking about the house and she’ll be terribly upset if we tell her we’re selling it. How do we handle this? - Dave
According to an AARP survey, the vast majority of boomers have stated that they want to stay in their current homes rather than move to another setting for their later years. This attitude has been the springboard for many aging in place advocates as well as businesses like contractors and high tech companies. It’s not hard to understand why 60-year-olds would say that they want to remain in their home for life rather than move to assisted living or a nursing home. These are generally people who are relatively healthy and feel that they can hire help for whatever they need down the road.
Alzheimer's and dementia caregivers had $9.3 billion in additional health care costs of their own in the same year. Nearly 60 percent of Alzheimer's and dementia caregivers rate the emotional stress of caregiving as high or very high, and more than one-third report symptoms of depression. Remember, this is just the cost for caregivers.
Dear Carol: I’m a single woman who was forced into early retirement because of multiple sclerosis. My mother has been a widow for years and I’m her only living child so we’re very close. She recently had two strokes and has residual issues so I had her move in with me. We get along well, but I’m finding that I can’t take care of her needs without worsening my own health. We’ve been looking at different options for care and Mom is fine with whatever we need to do. I know that I'm being irrational, but I feel guilty that I can’t take care of her by myself. Where do I start to make changes? M.L.B.
...with our current tendency to follow trends and label them, sociologists would call what my family did decades ago "intergenerational living," and Grandma's special living area would be considered an "in-law suite." In this era of supersizing, some intergenerational living arrangements even involve detached smaller homes on the same lot as the family abode.
Dementia aside, significant research has shown that having a supportive social network is linked with positive health outcomes, both psychological and physical, while lacking such support can be harmful. Previous studies have also suggested that loneliness itself can kill people, generally by raising blood pressure and increasing risk for stroke or heart disease.
The Milken Institute School of Public Health at the George Washington University has published a piece called "The Cost of Aging in America," which explores the serious financial burdens faced by aging individuals, their loved ones, and industry professionals -- as well as steps our health care system might take to counteract this trend. I wanted to share this infographic with the readers of Minding Our Elders.
Dear Readers: Although most information on this blog is written by me, I felt that this information was important enough to share as presented. I hope that you agree. Carol
Not every person struggling with dementia lives in a nursing home or assisted-living facility.
In fact, more than 15 million Americans – usually family members or friends – provide unpaid caregiving to people with Alzheimer’s disease and other forms of dementia, according to a 2014 report by the Alzheimer’s Association.
Although it’s wonderful so many are willing to assume that responsibility, it’s also important they take steps to make sure the home is a safe place, says Kerry Mills, co-author with Jennifer Brush of the book “I Care: A Handbook for Care Partners of People With Dementia.” (www.engagingalzheimers.com)
Part of that is to focus on potential hazards. The concept is not unlike new parents making a house “childproof.” Many of the concerns are similar, such as stairs, electrical sockets, sharp objects and swimming pools.
At the same time, it’s easy to go too far, Mills said. Ideally, the environment for the person with dementia should be as unrestricted as possible.
“For example, if your loved one enjoys cooking for a hobby and can safely cut and peel vegetables, then by all means, encourage it,” Mills says. Mills suggests several ways to make a home safer for someone with dementia.
• For the front and back doors. Use bells on the doors, motion sensors that turn on lights or alerts, or other notifications that make the care partner aware when someone has gone out. Add lamps or motion-activated lighting so people can see where they are going when they are entering or leaving the house.
“Another way to discourage someone from wanting to leave the house is to make sure that he or she gets plenty of outside exercise whenever possible,” Mills says.
• For stairways and hallways. Add reflective tape strips to stair edges to make stairs more visible. Remove obstacles, such as mats and flowerpots, to minimize risks of falls on or by the stairs.
Also, install handrails in hallways and stairways to provide stability, and install a gate on the stairway to prevent falls. Improve the lighting around hallways and stairs by installing more ceiling fixtures or wall sconces.
• For the bathroom. Install grab bars and a raised toilet seat to help both the individual with dementia and the care partners so they don’t have to lift the person on and off the toilet.
Add grab bars inside and outside the tub, and a non-skid surface in the tub to reduce risks of falls. You can also add colored tape on the edge of the tub or shower curb to increase contrast and make the tub edge more visible.
Lower the water temperature or install an anti-scald valve to prevent burns, and remove drain plugs from sinks or tubs to avoid flooding.
• For the possibility the person becomes lost. Provide your loved one with an identification or GPS bracelet in case he or she wanders. Label clothes with the person’s name, and place an identification card in his or her wallet with a description of the person’s condition. Notify police and neighbors of the person’s dementia and tendency to wander.
For caregivers who are constantly on the run trying to meet the needs of their vulnerable loved one, paperwork can become what seems like an insurmountable burden. But paperwork comes with the job, especially if you have Power Of Attorney.
Dear Carol: My father-in-law has a poor heart as well as early to mid-stage Alzheimer’s disease. My husband is an only child who is very responsible. We live 200 miles away from his dad so it’s hard to keep as close an eye on him as we’d like. Dad’s 82 and has been in his own home with in-home care. Even though he’s happy and everything is familiar to him, we know that eventually he will need more help. We’d like to move him to our community before he gets much worse, but I’ve read where moving someone with Alzheimer’s can be bad for them.