2010

What Empowers Family Caregivers to Provide Care?

Posted in Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on December 21, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Most of us would say love, duty or obligation is what empowers family caregivers to provide care. All true, but more than what is most evident truly empowers and fuels us who are family caregivers . Knowledge of community services and benefits allows us to share the care – and then there is the acceptance of needing to have down time and use outside care options in order to renew and re-energize ourselves.

The knowledge that you are not alone keeps you from being isolated and that is why it is important to join a support group, attend community classes on family caregiving or to work with a professional who will help you with those boundaries. Eldercare offers monthly support groups and classes free to the public – because this is our way of giving back to the community.

A sense of humor is most needed when providing hours and hours of care to another. It is good to laugh together – find funny programs to watch or simply start the day off by reading the comics – you might read some aloud to someone you are caring for if they are appropriate. “Pickles” is always a good one!

Spiritual resources can strengthen your core and get you through those tense or tough times. It can come from being connected to religious practice or it can come by being in touch with nature. Everything, from prayer and meditation to a walk in the woods, can give you that peace you just can’t find in any other venue. We need down time so we can continue to care from a place of love and not just from obligation.

Struggling to find this empowerment? Consult with a Professional Geriatric Care Manager who can work with you in finding ways that re-energize your heart and soul – your health will also be benefited.

Eldercare Services Makes 14 Blankets for Trevor’s Eagle Blanket Foundation on Trevor’s Birthday

Posted in Blog, Holidays, Relationships on December 17, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

On Monday, December 13^th, the day that Trevor Tonsing would have turned 17, 18 staff members at Eldercare Services worked hard to make as many blankets as they could to donate to Trevor’s foundation, Trevor’s Eagle Blanket Foundation. Trevor was born with a congenital heart defect that took his life last year shortly after his 16^th birthday. As part of his requirements to attain the rank of Eagle Scout, his project was to make these blankets. Now his foundation works hard to collect fleece tie blankets to donate to the children at the Oakland Children’s Hospital, the very place he had several heart surgeries over the years.

We continue in his project with joy and love and are honored to carry out Trevor’s dream to make these beautiful, warm blankets to give to the children at Oakland Children’s Hospital in the name of his foundation, Trevor’s Eagle Blanket Foundation.

The festive blankets, made by 18 generous staff members at Eldercare Services, will be presented to the foundation on Wednesday, December 29^th, 2010. The blankets will then be presented to the children at the Oakland Children’s Hospital. The foundation has already received over 1,000 blankets.

For a video of the staff making these much needed blankets, please click here.

For more information on Trevor’s Eagle Blanket Foundation, visit the Facebook page.

When the Assisted-Living Bill Balloons by Patrick Egan of The New York Times

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on December 10, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

I was quoted in the below article posted on December 7, 2010 in the New York Times in the New Old Age portion of the Health section. It is important information to have when deciding what is best for your aging loved one…

This fall, my father sat down for a semi-annual assessment with staff members at his assisted living facility in Tinton Falls, N.J. They decided his condition — at 72, he has advancing Parkinson’s disease — necessitated an upgrade to the next level of care.

The meeting yielded an upgraded bill, too: a nearly 18 percent bump, about $12,000 a year.

Most assisted living residents foot the bill on their own or with help from family. Cost increases typically come in two forms: annual upticks to cover rising expenses, and more significant hikes accompanying a move to the next tier of care, such as help with bathing or dressing.

The annual rises can be daunting enough. The MetLife Mature Market Institute recently reported that assisted-living costs climbed 5.2 percent from 2009 to 2010, to a national monthly average of $3,293, outpacing both inflation and the interest earned on savings and bonds — a problem for the elderly on fixed incomes.

Mom Needs Assisted Living?

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on December 7, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Watch the video blog here!

Often an adult child will call and tell us that a parent needs to move to Assisted Living and they want some help on the choice. The first question from me is, “Is mom in agreement with this need?” The second question is always, “What have you done to try to keep her in her home?”

Once I am clear that the need is real and the family has tried all the community support systems and mom is either ready for a move or at risk to continue to live alone, I begin the journey of working with a family in selecting the right “Assisted Living” community for mom.

Families should:

1) Project what type of care mom might need in the future. A professional Geriatric Care Manager can help with that, depending on diagnosis and family history.

2) Take an inventory of what has given Mom’s life value and meaning so the new community can continue to be a place where she feels valued.

3) Realize that apartments are small – know how much space she will really need and ask, will she be able to have her most treasured piece of furniture or art with her?

4) Ask: Is the new community close to medical providers, friends and you?

5) Ask: Will this community be able to meet mom’s changing needs?

6) Ask good questions when you tour the communities, such as rate increases, level of care increases, care conferences and finally, have a meal there. Then go a second time, without an appointment, and see if you can talk to residents that live in the community to get their opinion.

7) Check with the State Department of Licensing to be sure this isn’t an AL that has problems.

8) Ask how long it has been under the current ownership and if the community is up for sale.

9) Ask about guests, pets, emergency plans and transportation.

Having the guidance of a professional who doesn’t take referral fees for helping you with this choice could save you lots of time and dollars in making a wrong choice. But, if you do, we can work with you on the second go around. Geriatric Care Managers guide and support families in making choices based on “reality” of needs and “values” of the client. The goal is Peace of Mind for everyone in the family.

Medication Errors – Helpful Hints

Posted in adult children, Age Related Issues, Alzheimer's, Care Management, Caregiving, Dementia and Memory Loss on November 30, 2010

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

As a Geriatric Care Manager, I have heard many stories regarding medication errors. Early on in my career I was amazed to learn how many errors happen in medical facilities where everyone is well trained in dispensing medications.

Practically speaking, however, it is not hard to imagine how medication errors can occur. Bottles can be mislabeled or can be filled with the wrong medication – I have had this happen. Patients don’t always read the label for directions and may take the medication incorrectly. Language can also be an issue.

Here are some helpful hints. First always carry a current list of medications with you. Check it with your doctor and with your pharmacist whenever a visit is made and if there is a change in medication. If you take more than 2 medications more than once a day, it is safer to use a medication box. They come in all shapes and sizes and you will certainly find a type that works for you. I like ones with big boxes that fit prescriptions as well as vitamins and ones with big letters that are easy to see.

In our oversight of client’s care, we arrange for all medications to be packaged by the pharmacy. This reduces the opportunity for error. The more times the meds change hands, the more room for error. With this system, the pharmacist places the medications on a card and bubble packs them into time slots. The card replaces the medication box. It is a similar concept yet filled by the pharmacist.

If you are filling a medication box yourself, make sure you pick a quiet time with little distraction. This sounds like simple advice, but this is where many errors occur. Long ago, when I was training as a Medical Assistant, the rule was to check the label on a bottle of medication 3 times before dispensing; the dosage and time should be correct and, of course, you should have the right patient!

If you are caring for someone else who may misread their box, forget what day it is or just be curious and move things around, make sure you or someone close looks over the medication box regularly to make sure things look right.

There are also automatic medication dispensers that dispense at designated times of day. For some people these work well. It is important that we think about the system that is most appropriate and holds the least chance of error for ourselves or the persons we are caring for. Then we can all breathe a little easier!

“In-Law” Adult Children of Aging Parents More Effective in Interventions

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on November 23, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Adult children of aging parents are often disregarded when they make successions about services, care choices or other support systems. This seems to be because the parent still sees that daughter, who might even be a physician, as a 12 year old.

So, when the daughter’s husband makes a suggestion, they listen. When the in-law asks questions about the parent’s finances, they share information. When the in-law approaches the older family members with suggestions about moving to Assisted Living, they are open to explore. These findings came about from a study done by Fidelity Investments and conducted by Harris Interactive in April 2009.

I find this confirming and interesting because this is a strategy I have recommended for years on “who” should approach mom or dad with concerns that might be received with resistance. Again, all families are different but especially with Alzheimer’s disease, this study shows how the “in-law” is usually more successful.

So, if Mom or Dad just won’t listen to you have your spouse or partner do the talking – you might just need to stay away for these more sensitive discussions.

If this causes you distress, go to a support group and know we all do whatever it takes to secure the best for our parents. And, sometimes it’s best to have anyone other than you ask the questions and make those suggestions!

Best of luck to all of you on this often painful journey of “Parent Care”.

Help My Spouse is Losing His Memory!

Posted in Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on November 19, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Many of us have trouble with our spouse remembering what we just said let alone what we did yesterday! When this becomes problematic and starts to affect your relationship and your day-to-day life, it needs to be addressed differently. It could be a more serious illness and will need a comprehensive workup to find a diagnosis and help the family make decisions.

A dementia diagnosis is more than just the forgetting we all do when we’re not paying attention or multi-tasking. It is more than just repeating the same story over and over again – it interferes with judgment, self-care, sequencing, planning and relationships.

Most spouses have a hard time facing the “elephant in the room” because it means they have to move out of denial and into a reality that most of us never imagined will happen to us, let alone want to face head on.

Spousal caregivers, as well as those dealing with the diagnosis of a progressive dementia such as Alzheimer’s disease, report that, after given this shocking and scary news, they then can move forward more honestly with one another. They can have more realistic expectations of each other and, for the person who has the diagnosis, they often no longer feel like they are “crazy” or “dumb”. So, after their own grieving period, they can move onto being in the present and enjoying the here and now.

The caregiving spouse needs to get support early in this long journey of love and care because, without it, the possibility of the well spouse’s health being negatively affected is high.

My recommendations are to find a support group in your area and consult with a professional Geriatric Care Manager who can be your coach – even if is once every 3 months. What you want to do is have a mirror for your emotions and also a resource to help you cope with the changing needs of your partner. I highly recommend that spousal caregivers stay engaged with whatever gave their life meaning and purpose outside the relationship. Balance will be the key to successful spousal caregiving.

Lots of Help at No Cost!

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on November 16, 2010

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

As a Geriatric Care Manager, I am constantly impressed with the many things family caregivers do to help themselves help someone else. One thing that really tops the list in terms of bang for your buck in my opinion is attending a support group. Please keep reading!

Support groups are usually free and family caregivers who attend them seem to “hear” things differently. What is it that keeps some people away from support groups? I think some level of fear or misunderstanding and just plain being too tired to do one more thing.

Fear of what? Fear of being judged, fear of being bored, fear of being subject to lots of crying and wondering how does sharing with others help me?

These groups are the foxholes of caregiving. You will find camaraderie, someone with knowledge you may not have, someone who understands what you are going through in a common situation in time. In addition, you will hear first hand information regarding resources – who, where and why they might be helpful. This comes from other people who are also on the front lines of the struggle. In addition to receiving a huge amount of help you will also feel empathy and heartfelt sympathy for what you and the person you are caring for are going through. Interestingly, this often happens with a minimal amount of cathartic tears, although tissue boxes are kept at the ready!

If you decide to stick your toe in this pool, commit to giving yourself three meetings before deciding if its for you or not. As in most relationships in life, it can take time to meld into a comfort zone with others. If you continue to try, you will feel informed, lighter and just a bit more energetic.

One final thought – there are very specialized support groups. Some are disease specific such as ALS, Alzheimer’s disease and Parkinson’s disease for example. Others are more encompassing – caring for a spouse or an aging parent. To find out more about groups in your area, feel free to call our office at (866) 760-1808 or check the resource chapter of our website. Local hospitals and the Alzheimer’s Association are also good resources.

How Do I Get My 88 Year Old Dad to Move?

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on November 12, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Watch the video blog!

Dad’s vision is failing, we notice he has lost weight since Mom died last year and he just doesn’t have much interest in maintaining the family home. He doesn’t want to move because we all grew up in that house. The neighborhood has changed and all his old friends have died or moved to retirement living.

He could be grieving or depressed but his children also mention that Mom was trying to get him to move to a new Assisted Living community closer to us kids before she got sick. Mom had become concerned with his memory and vision loss and thought it would be good for both of them because Dad has always been so outgoing and so many of their old friends had died.

Since, in this case, the wife had already picked out a community she thought would meet their needs and values, the adult children don’t have to pick out a community they just need to convince Dad.

It is sometimes good to enlist the help of the family physician in prescribing a “move”. But, what works best is to have a family meeting and express your concerns as “I” messages. Such as, “I worry about your weight loss, Dad.” Or, “It is hard to maintain a big yard and I worry about you falling when trying to keep it up”. Then as a family or child of an aging parent, you ask them to try “Assisted Living” for a few months – usually three.

It is important for the adult children to pull back somewhat and let relationships blossom in the new community so that at that 3 month mark Dad says, “I like it here I think I’ll stay”. And if his memory is impaired the 3 months don’t have to be calendar months – but you, as a family, say he can move back home when the doctor gives the “go”.

Geriatric Care Managers specialize in working with families that need to have a strategy to get mom or dad the care they need.

I Need to Know My Mother’s Getting Good Care!

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on November 9, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

A statement that I hear whenever I speak and a concern for families at a distance is, “I need to know she is getting good care”. For example, if you breeze into town ,set up a plan of care and put resources into place for your aging family member, then once you leave they cancel everything you get the “pulling out the hair” stage of family caregiving.

We can have the best of intentions, but if you don’t have oversight, things will either revert back to what they were or take a downward direction. The result is often seeing the older family member having an accident or medical crisis – and you don’t want that middle of the night call just when you have an important meeting or event the next day!

How do you find that needed help? Do you use the Internet, the new Yellow Pages of our time (especially if you are at a distance)? How do you evaluate the site you are on and the credentials of those offering up a service? No matter how attractive the information is – look for years in business. Most importantly, look to see that they have “Professional Geriatric Care Managers” (PGCM) to oversee the plan of care. Yes, there is an added cost to this peace of mind, but it is the only way you can have the checks and balances to keep the individual care designed for mom or dad. In the long run, the cost may even be lower due to pro-active involvement that prevents or reduces a crisis.

When reviewing the GCM option, be sure to “read between the lines” as to what is being offered to you. Are they experienced, highly trained professionals who oversee all aspects of the older family member’s care as needed? Or, are they one person who is using the term “care manager” to imply the necessary (and possibly minimal) supervision that one of the agency’s caregivers need?

A care plan that is pro-active in keeping mom or dad healthy and as independent as possible is what you need to prevent that “hair pulling reaction” once you return home!