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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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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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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Detaching with love can help in toxic elder care relationships

One thing that can help is to realize that the little kid inside of us most likely still wants our parents' approval. When we can't get that, even as adult caregivers, it hurts. To cope with those needs, it often helps to learn the techniques of detachment.

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B12 should always be checked when Alzheimer’s symptoms are suspected

Decades ago, my grandmother received monthly vitamin B12 shots from the home health nurse. It was common knowledge, even then, that as people age they don't absorb vitamin B12 well. Low B12 levels can cause pernicious anemia, which was my grandmother's problem. However, low B12 levels can cause many other illnesses, as well.

Read more about Alzheimer's symptoms and vitamin B12 deficiency:

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Old movies, old music: bringing back memories isn’t just about nostalgia

Old movies via DVDs, as well as CDs of big band music or other favorites of our elders’ generation have long been used as a diversionary tactic. Now, Artists for Alzheimer’s (ARTZ) is spotlighting a new way that movies can be used to enhance the lives of people with Alzheimer’s disease. ARTZ is a nonprofit based in Woburn, Mass. that creates cultural opportunities for people with dementia and their caregivers.

Read more about old movies helping people with Alzheimer's remember:

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Open Enrollment: Time to check your parents' Medicare plans

If you handle Medicare for your parents, you are likely aware that we are now in the middle of what is called the open enrollment period. Even if your parents handle their own Medicare, you may want to discuss this with them. Since Thanksgiving is approaching, you may at least have time for a general chat about Medicare during the family gathering. You'll still have time to help them make changes in their Medicare choices if that's necessary.

Open enrollment is when people can make changes in their Medicare plans and the providers they've chosen for Medicare D prescription drug coverage. It's also the time to add or change a supplemental plan and/or Medicare Advantage.

Read more about open enrollment and your parents' Medicare plans:

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5 Reasons Why Assisted Living May Be the Best Solution for Your Loved One

Elders often say they want to stay in their own homes. They've lived there for decades and see no reason to move. However, many times their neighborhoods have changed so much that they are no longer safe. Even if the neighborhoods are safe, many of the old neighbors have died or moved away, and the elders become isolated. Many times a move to assisted living can give elders a new lease on life.

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Alzheimer’s Foundation of America schedules memory screening day

Since November is National Alzheimer’s Awareness Month, it makes sense that the Alzheimer’s Foundation of America (AFA) would schedule their memory screening during this high profile month. They’ve chosen November 15^th as the day for their national clinic.

Of course, if you or a loved one feel that memory screening is a must, scheduling an appointment with a qualified specialist may be the best thing to do. However, many people need just a little kick to get going. Or, they are just curious. Or they are, well, a little bothered by some forgetfulness, but not enough to lift up the phone and make an appointment with their doctor. This screening could help with the decision making process.

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Book on aging and ageism in our health system a gem

Dear Readers:  The book “Treat Me, Not My Age,” by Mark Lachs, M.D. is now out in paperback under the title “What Your Doctor Won’t Tell You About Growing Older: An Insider’s Survival Manual For Outsmarting the Heath-Care System.” Regardless of the title change – personally I preferred the original title – this book is a gem.

Lachs is the director of Cornell’s Center for Aging Research and Clinical Care, director of geriatrics for the New York-Presbyterian Healthcare System, chief of the Division of Geriatrics and Gerontology at Weill Medical College, and the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine.

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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.

Read more about in-home care and the flexibility it offers:

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Assisted living combines help and social life

Assisted living centers are attractive to many people who are isolated in older homes, with neighbors they no longer know and yards that are too much work. Not everyone wants to make this move, but many do it anyway, if only because they must have help at hand for emergencies. Often, once a period of adjustment has been endured, elders thrive in these communities.

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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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On Oct. 25, PBS will air Bill Moyers’ exploration of end-of –life issues “On Our Own Terms”

Emmy and Peabody Award-winning journalist Bill Moyers interviewed dozens of terminally ill patients to create a four-part exploration of end-of-life issues that span thoughts about everything from health care to cultural attitudes.

A press release that I received from PBS notes quotes of high praise:

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Families need to communicate to plan for aging loved one's eventual care

For me, caregiving was never a conscious decision. I grew up with regular family visits to my grandparents. Eventually, my paternal grandmother, who was severely crippled by rheumatoid arthritis, came to live with us in our home. My parents built a house specifically to accommodate her needs. My maternal grandparents were in good health until their mid-eighties. At that time, my mother, the geographically closest of the adult children, assumed the caregiving role for her parents, as well. As I've said, I never gave elder care a second thought. That was what people did.

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Should your parents to move closer to family?

I live on the Northern Plains, where winters are about as harsh as they get without going to Alaska. We are known to offer a good quality of life for families, with low crime, good schools, choices in higher education and neighborly people. We are also known to have deep snow, icy streets and howling winds a good portion of the time between Halloween and Easter. Not a pretty picture for a new retiree with aching joints and a hankering for warmth and sun.

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Bathing issues when a loved one has Alzhiemer's or other dementia

If your elder has dementia, then you may have a more difficult situation on your hands. People can think they have just showered, but in reality that was last week. Or, they can become confused when they begin the process, and rather than tell someone they are confused, they just avoid it. Or they can become afraid of the shower or bath because they don't know what it's all about or they think they will get hurt.

Read more about bathing problems with people who have dementia:

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Early on-set Alzheimer’s challenges people under 65

The news is everywhere. Pat Summitt, a virtual legend in women’s basketball who has won more games in her coaching career than any other college coach, has been diagnosed with early on-set Alzheimer’s disease. The news is rocking the college sports world because it seems so unbelievable. This active, healthy, intelligent woman, just 59-years-old, now has a brain disease that will forever change her life.

Read more about early on-set Alzheimer's and what to watch for:

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According to study, blood infection can affect elderly even after they “recover”

Most of us are aware that hospitalization of the elderly comes with risks. Of course, there are many times when there is little or no choice but to have someone hospitalized, no matter what their age.  This was brought to my attention, once more, by an article published by The National Institutes on Aging titled Severe sepsis associated with later cognitive, physical decline. Generally, we feel that if someone survives a serious illness such as sepsis, which is caused by the body’s overwhelming immune response to severe infection, the person will then fully recover.

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