Minding Our Elders®

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.

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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?

Read more about helping kids understand grandparents' dementia:

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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.

Read more about nursing homes changing to accommodate two generations of elders:

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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.

Read more about geriatric care managers or coordinators: 

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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. 

Read full article about handling questions of nursing home treatment:

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Celebrating Valentine's Day when loved one can't understand

During their last years, my parents' special days would be considered by some to be a fiasco, if the celebrations were judged by traditional standards. Yet, I'll never regret trying my best to simulate the kind of celebration my parents had always had. Celebrations give life some texture. And if anyone needs something to make one day different than all of the others, it's people who are already coping with the indignities the aging process can bring.

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Use compassion with Mom to help her move

Dear Carol: My dad died suddenly about a year ago. Mom is 73 and quite frail for her age. She’s also slipping cognitively. She can’t keep up the house they’ve lived in for decades. She seems afraid to live there alone, so I’d like to see her move to assisted living. She actually wants to make the move, but she seems frozen when it comes to getting rid of anything in the house so she can move. How can I get her going with this project? - Amanda

Dear Amanda:  Your mom has decades of memories attached to the home, most of which likely include your dad. She probably feels she’s leaving a part of him behind if she moves out. At the same time, she’s rightly concerned about living alone. Remind her that Dad would want her to be safe.

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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.

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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.

Read more about how an ill parent can fool the doctor:

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How do we keep our elders safe and still maintain their sense of dignity?

How do we get elders to stop doing "handyman" tasks, doing yard work that should be hired out or even extensive kitchen work? Everyone needs a reason to get out of bed in the morning. If a person has no purpose in life, why go on living? For elders whose bodies – and sometimes minds – seem to betray them more each day, this becomes an issue.

Read more about keeping our elders safe while preserving their dignity:

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When your parent repeats "I want to go home"

A tip, here, for people who still have their elder at home, but the elder still asks to "go home." Understand what the person wants and then try the same distraction or relearning technique. Some people go as far as taking the person in the car and driving around the block, then re-entering the house. This can work for awhile, but not likely that long. No matter what you do, you will hear it again: "I want to go home." The point here is that no matter what you do or say, likely you will continue to hear the plea to "go home."

Read more about how to handle the plea "I want to go home":

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Vision and hearing checkups tough for people with dementia

You are helped into a chair and the doctor covers one of your eyes and asks what letters you see. What is a letter, you think, and why is he covering my face? You start to squirm and then push him away. You get more confused and frightened because you don't know what they want with you.

Read more about helping your loved on through vison and hearing checkups - or whether to have them done:

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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.

Read more about preparing for a live-in parent:

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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.

Read more about when a loved one no longer recognizes you:

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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.

Read more about managing time when caring for aging parents:

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Sundowning with Alzheimer’s common and difficult behavior

Dear Carol: My husband has Alzheimer’s. We get by fairly well for most of the day, but he gets agitated late in the afternoon and acts as if he’s searching for something or someone. The doctor said he’s “sundowning.” He says it’s common with AD, but he hasn’t helped much other than label it. I’d like to know if there’s anything I can do.  - Betty

Dear Betty: "Sundowning" refers to an increased state of anxiety and confusion at the end of the day that often occurs in people with Alzheimer's. There have been many theories about the behavior. Some professionals think the person is used to a normal work day, therefore as the day ends, he or she is trying to go home from work or accomplish something that is related to wrapping up the day. Other’s think

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Why distance siblings are often in denial about parents' health

What the distance sibling doesn't see is the intense decline of the parent once the visit is over. The elder sinks back into reality. Often, they've forgotten the visitor even came. That happened after my brother and his wife visited us when our mom was getting very ill. She had looked forward to the visit for weeks.

Read about sibling denial and problems with relating real issues to distance siblings:

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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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