Minding Our Elders®

Adult grandchildren caring for their aging grandparents: how to cope?

Whatever the reason that caregiving begins, I hear from a number of young adults who are trying to care for one or more grandparents. Most of them love their grandparent dearly, but they often come up against obstacles that are quite overwhelming for people so young.

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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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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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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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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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How to prepare when a parent or grandparent comes to live with you

These days, having grandma move in with the family is still an option for some families, but it has become more complicated. First of all, there are fewer families with a stay-at-home adult in the home. This is where a great deal depends on Grandma's health. I know of one family where the dad is single. He has custody of his two young sons most of the time, and his mother has moved in. For the most part, Grandma is actually a help with the boys. Yes, she has her issues, and there has been some adjusting on all sides. But with Dad's odd hours and Grandma still fairly capable, it's a situation that works well for all.

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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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How much could someone with advanced Alzheimer's understand?

Loving family members, and others who care for and about people with dementia, would like an answer to their question about how much a person understands. My non-medical viewpoint is that it varies. No, I'm not "copping out." The dementia I've witnessed, some of it Alzheimer's and some of it other types, has suggested to me that people likely do understand their surroundings on some level, even if it's just the body language or mood of his or her caregiver. Also, some people with dementia will have inexplicable moments of clarity where they seemingly come out of the walled-off state and momentarily return to a state that is indicative of their pre-dementia personality.

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Getting outside help with eldercare isn't failing

Taking care of your loved ones means giving them the best care you can provide. Often, during the early years, that typically means your own loving, hands-on care. However, as their needs grow, the best care sometimes means you need to hire help to come into the home or arrange adult day care while you work. Perhaps it means they need to move to assisted living or even a nursing home.

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Start early talking about parents' views on care

If your family is among the many that gather during the holidays, this time of celebration can give you the opportunity to jumpstart a conversation of this kind.

You are likely aware that bursting through the door Christmas Eve and thrusting this brochure into your parents' hands as you deliver your holiday hug isn't a good idea. However, tucking a few copies of the brochure into your suitcase could be a good plan. Then after the celebrating is over and everyone is reacquainted and mellow, you can start this important conversation with as little stress as possible. It's very likely that your parents would like to share their wishes with you, but aging and the attendant decline are often difficult topics to approach. Often, all that's really needed is a nudge in the right direction.

Read more about starting that essential conversation with your parents:

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Talk to parent about care preferences and legal documents

Dear Carol: My mom is 90-years-old, lives alone and does quite well. She’s always been very independent, and has never been willing to talk about her preferences if she needs care. My siblings and I want to do the best we can for her, but she doesn’t even have a living will or Power Of Attorney. We feel like our hands are tied since she won’t discuss finances or the kind of care she’d like when she needs help. Whenever we bring up the issue, she says “she’ll get to it.” - Franny

Dear Franny: Your mom has likely outlived most of her friends, and those who are left are probably battling illness or frailty. 

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You can help reduce loneliness of elders during the holidays

Elders can have an especially hard time with the holiday season. While aging and maturity can bring the wisdom of years for many people, there are inevitable losses that come to even the most healthy individuals. Many of these losses are emotional and social in nature. Spouses become ill or die. Other aging relatives and friends become seriously ill, or die. Neighborhoods change, often leaving even those well enough to remain in their own homes feeling friendless and isolated. The holidays can bring this isolation and a feeling of loneliness to a head.

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Read contracts before signing on for assisted living

When adult children or others are suddenly thrown into helping their elderly loved ones, they often see the need for outside help. Because the responsibility of personally providing care or finding good paid care is emotional, we often dive into the task with our brains disengaged. Then, down the road, we find we have moved our loved one into assisted living while we expected the skilled care a nursing home offers. We can be angry, but we need to be realistic. Did we read the contract to see what the home provides?

Read contracts before signing on for assisted living:

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In-home care a flexible option

Prior to my need to find care for my elderly neighbor, Joe, after he dislocated his shoulder, the closest thing I'd seen to "in-home care" was the public health nurse who used to come to our home to give my grandmother her vitamin B-12 shot. That was decades before I became Joe's caregiver. I simply hadn't had a need to keep up with care trends.

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Loneliness can cause some elders to turn to alcohol

Many an elder who only drank socially, or with a spouse, finds that a nice glass of wine at the end of the day helps ease loneliness. The once concrete rule that only alcoholics drink alone is rationalized away. When aren't they alone? The death of a long-time spouse leaves a huge hole in an elder's life. Could your elder be filling that hole with alcohol? If so, how much? What can you do to help?

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When insurance stops physical therapy what are the options?

Supporting information:

"Problems with medical billing and insurance can present huge difficulties for elderly patients and their families. It may seem like a major obstacle but there is help out there."

 

Dear Carol: What can you do when insurance discontinues physical therapy because a patient is not making enough progress? My 66-year-old sister suffered a massive stroke and was in physical therapy for several weeks. Because she was not making enough progress in her physical therapy, they discontinued her sessions. The insurance company states that there is no point in continuing the discomfort, effort, and expense of physical therapy if it is not helping, but her husband thinks she could benefit from more. Amelia

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Tips on initiating the talk about end-of-life issues

I've found in my experience that it isn't always the elders who shy away from end-of-life talks. Some do, of course, but many would like to discuss the arrangements they've made for finances, as well as their opinions about what measures they would want taken if they needed someone to make their decisions if they can't, however the adult children often find excuses to put off that particular "talk."

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