Age Related Issues

Aging Families: Dilemmas, Concerns and Solutions

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on April 19, 2013

Working adults in the “autumn” of their careers find that they are juggling work and aging family dilemmas — causing loss of pay or employer dissatisfaction with their performance or absence. Baby Boomers facing retirement also face the realities of still having to care for parents or other older relatives — this “care” duty can detour their dreams of the envisioned “retirement”.

Linda will talk about major issues facing families locally or at a distance. She will give Rotarians a list of resources to help them navigate the maze of resources available in order to find help that will respect the dignity of the elder and bring peace to the adult child. Linda will also talk about the realities of living longer lives and statistics that will affect all of us as we age.

Linda Fodrini-Johnson is a Licensed Family Therapist and a certified, Professional Care Manager. She founded Eldercare Services in 1989 — the first full service Geriatric Care Management and Home Care company in the East Bay. She has been guiding, coaching and counseling families in the Bay Area for 30 years. Linda is the recent past President of the National Association of Professional Geriatric Care Managers (NAPGCM).

The Elephant in the Room – Difficult Talks We All Should Have

Posted in adult children, Age Related Issues, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life, home care, Mental Health, Moving an Aging Adult, Relationships on April 19, 2013

Linda Fodrini-Johnson, MA, MFT, CMC, Founder and Executive Director of Eldercare Services discusses and give solutions on effective communication with family members about the issues of aging.

These issues might be:

Who would make medical decisions for you? And, do they know your wishes?
Remarriage
Memory loss — possible dementia
Forgiveness — Needing it and granting it
Moving
Can someone take over your financial affairs?
How do I face not driving?
Who inherits what of my possessions and assets?

Pickled Grapes – A Lesson in “Being in the Moment”

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Dementia and Memory Loss on March 15, 2013

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

Visiting a small group home this past weekend, I arrived when three seniors were just finishing their lunch meal, so I joined the conversation. The first one (a new resident) asked me if this was a “boarding house” and I answered in the affirmative about everyone having their own rooms. One of the ladies answered, “They give us good food, too.” The conversation then went to their memories not being as good as they used to be, but it really didn’t matter now.

The oldest, age 95, asked the youngest, 85, how old she is and the 85 year old, a retired teacher and graduate of a very prestigious university, asked the staff for paperwork that would show her age; she was pleased and surprised to know that she is 85. She was neither embarrassed about having to ask nor did any of the residents question her for not knowing her age.

Somehow the conversation went to growing up on a California ranch. The 95 year old asked the 85 year old what they grew on the ranch and the answer was horses and grapes. She was then asked if she raced horses and she answered, “No” she just rode them, but not in “shows.”

A few minutes later this fractured, yet serious conversation, focused on those grapes, with the eldest asking, what color the grapes were, “Purple, burgundy?” “No”, the 85 year old answered, “Just plain grapes that were tied to wires.” She continued and said that when the grapes were ready to be picked, men would come pick them, put them in a big pot, add sugar and we would have “pickled grapes”.

I joined in some of the conversation and could not keep from smiling and being pleased that they were able to have a

Pickled Grapes

conversation, despite the memory deficits and/or dementia. Even though at times the conversation was disjointed, and sometimes they were not able to find the “correct words,” they were all very respectful, yet curious, with all of them willing to ask questions without questioning the answer. It was actually very uplifting and I was honored with the spirit, authenticity and just being in the moment with this trio of souls.

Being in the moment for the sake of the moment is just something we don’t take the time to do as often as we should. We all get caught up in the “to do” lists of our lives.

Have a glass of “pickled grapes” and savor the moment.

Dementia and Glasses/Hearing Aids

Posted in Age Related Issues, Blog, Dementia and Memory Loss, Technology, Uncategorized on February 15, 2013

Director of Client Services, Chris Rose-Franks, PTA, MPA, CMC

Glasses and hearing aids: The unheralded quality of life features that, all too often, are taken for granted. My client recently had the unfortunate experience of having her glasses break – more specifically the frames. She has a dementia diagnosis and it was a very sudden and distinct change in her reaction to her surroundings and to her caregivers that was most striking. Since this frame breakage has happened before, I quickly got them repaired so her “world” could return to her “normal”. A person with dementia is so used to things in their environment maintaining a certain way that when any aspect of that equilibrium is disrupted it can have a very significant impact.

Vision and hearing are such simple yet very vital senses that must not be overlooked. Clearly labeling eyeglasses with a white out product so your permanent marker can show up is one trick. The same goes for taking a photo (so easy these days with smart phones) of the glasses on the person’s face so if they are ever lost in a hospital transition or misplaced in a congregate living environment you have an easy way to identify them. This trick was helpful with another client when her hearing aids went missing. Taking a photo (as well as keeping the model and style number handy) of those small devices made the search in Lost and Found a bit easier to rule out from the collection of hearing aids the nursing home had amassed.

Speaking of hearing aids – this is another area that, new batteries and plenty of them, can be so vital in assisting the person with dementia to really enjoy and participate in their surroundings. Like glasses, when a person can’t hear adequately, it adds to their confusion or desire to be reclusive and withdraw. Ensuring hearing aid batteries are unplugged at night and reinserted properly in the morning can be such a simple step and so necessary to ensure your loved one’s quality of life is maintained to the highest degree possible.

Mom is Gone

Posted in adult children, Age Related Issues, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life, Relationships on January 31, 2013

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

You know the time will come. You have been through many big and small health care dilemmas. You have prepared for her final care and found caring and loving people to be with her. You wish you could have done more but know you did your best with the information and support of professionals and family. Yet, when the time comes, it still hits your heart and soul like having the wind knocked out of you.

“This is the day that the Lord has made, let us rejoice and be glad in it.” Psalm 118:24. I can’t tell you why this scripture rings in me when I feel so much loss. But, it is a glorious sunny January day and though it began with her leaving, I think this Psalm is mom telling me, “I am at peace, dear family. Be glad in your life, rejoice with one another for I will always be part of each of you.” “Smile, joke, be positive and find the bright light in every day.”

We have been gifted by a mother who lit the way and guided each of her four children to be themselves, honor family, honor God and care for others. She has imprinted her hand on the hearts of us all.

So, the Academy Award and the Nobel Peace Medal for “Wonderful Mother” goes to Bernice Bidwell born on April 8, 1922 in San Francisco and died at peace, on January 30, 2013 in Walnut Creek.

Mothers’ Gifts for all Seasons

Posted in adult children, Age Related Issues, Blog, Care Management, Caregiving, Dementia and Memory Loss, Holidays, Relationships on December 21, 2012

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

I am posting this picture of my mother for all of you to know that the end of life can be filled with dignity. Yes, she is in the very last phase of her life and on hospice but she has quality, despite her deficits.

Our mothers gave us life by birth or love and sometimes both. At this season of giving, I am so thankful for the gift of a loving mother who never put me down and always encouraged me to just do my best, to love God, country and family.

I am fortunate to have taken a professional path that enabled me to secure the very best at the end of life for my mother (and many of your parents as well). Seeing her smile lights my heart and will stay with me all the days of my life.

To paraphrase a line in a song, “fathers be good to your daughters, they will grow up to be mothers”. Love is what nurtures us all – love those close to you, respect them for who they are with all their imperfections – because we are all imperfect but love is not.

Merry Christmas and Happy Holidays!

Taking Me Home?

Posted in adult children, Age Related Issues, Blog, Caregiving, Dementia and Memory Loss, End of Life, Moving an Aging Adult, Relationships on December 18, 2012

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

I moved my mother to a small residential care home that gives great care, at the same time I was scheduled to take a week’s vacation. When I returned six days later, I went to see how she was doing and the first thing she said, “How did you know I was here?” I explained I had picked out the home and she said it was a very good one (nice for me to hear).

She has vascular dementia so her short-term memory is impaired but she was very aware that she had not seen me in six days. We chatted for a few minutes with the other five residents before it was time to eat and then I accompanied her to the dinner table to continue chatting with her and all the residents.

As she finished her meal, she gave the caregiver a kiss and then a hug and thanked her for everything she had done for her and then turned to me and said, “Taking me home now?” Wow, I didn’t expect that. I said, “No, you need to stay here.” And she said, “What about my home?” Well, thinking she was talking about her home of 58 years I explained that her grandson was taking care of that house. She said, “No, the other house” and I responded with the name of the Assisted Living she had resided in for 18 months prior to two months in skilled care and she said, “Yes!”

I had to tell her we gave that up because we can’t pay for two places. She has always understood money and that was ok with her – while again telling me that this new home was a good home. I told her if she gets well, she could return to Assisted Living and she said, “Am I sick?”

Needless to say, I drove home in tears but, once I synthesized her comment, I was thinking how wonderful that she has no idea she is nearing the end of her life and that her sweet, tender heart is failing her.

Gracious, appreciative mom – I am privileged to be your daughter.

Life-giving and Integrity vs. Despair

Posted in adult children, Age Related Issues, Blog, Caregiving, Dementia and Memory Loss, End of Life, Relationships on December 11, 2012

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

What is “life-giving?” We are aware that in order to be a living creature, we all need air and substance (food and water) but the third and fourth elements will differ for each of us and, I believe, become more important as we age.

One is a belief in a higher power or a resolve in whatever one believes is the circle of life. This is inline with Erickson’s stages of life when he says, the last stage of development for us is to resolve the integrity vs. despair step. In simpler words, making peace with the whole of your life vs. longing for something that wasn’t or could never be for a myriad of reasons.

As I look at my mother’s life though, on Hospice, I see it was a simple life but she did accomplish that last Erickson task – and there is great integrity to the life she lived. I believe this is why she does not complain and is appreciative of every interaction – with “thanks” being expressed frequently.

The fourth element, which differs in each of us, is the environment we need to thrive. I mean both relational as well as the physical environments. I need times of complete quiet in my day. Days that are overfilled with “to-do’s” stress me and leave me anxious and actually interfere with sleep. However, I also long for the intimacy of spending quality time with my spouse, family and friends.

In my physical environment, I need nature but more specifically trees. And out of every window in my office and my home you can see trees. Why trees? I have no idea other than the fact that they are actually oxygen producing and stand tall during any weather. I also know that trees need to bend in order to be strong and over supporting them makes their trunk weak – just like people!

You each will need differing elements to be life-giving and, as you age, it will be important for you to keep that which gives your life meaning and importance in your everyday life.

Also when making decisions for others, remember to keep these four elements in the forefront and base your actions on what has been life-giving to this individual, not you – often they can be the same but, not necessarily.

Advocacy vs. Complacency

Posted in Age Related Issues, Future Trends on November 6, 2012

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

Having just returned from Washington D.C., attending and presenting at The American Society on Aging Conference, I realized the importance of those of us aging, caring for frail family members and those with careers in the field of aging to stand up and be heard.

We cannot afford the luxury of denial or being complacent. No matter what side of the political spectrum you find yourself on or if you care about “care”, now is the time to let your representatives, both local and national, know that we cannot reduce discretionary line items in our national budget. These are the funds for services that actually keep elders in their homes and out of the expensive health care and long term care Medicaid settings. It is spending a dime to save $10,000.

Yes, there are ways to reduce the overspending in Medicare but it isn’t reducing payments to physicians. I think if we brought about 25 people with common sense together – good organization skills, some understanding of the levels of medical care and criteria for each level, they could look at what we do spend money on and find ways to cut spending without compromising the health of seniors or to demoralize physicians. We need to remove politicians (sorry) from these decisions.

The proposed budget change and plan to transform Medicare using a voucher system will only add another expensive, cumbersome system of bureaucracy. I don’t have answers; I only seek those of you with common sense to be creative in ensuring a health system that cares when necessary and doesn’t inflate any one pocket in the health care delivery system. Did my mother really need to be seen by 10 different specialists on her last hospitalization? What if the hospital had resident Geriatricians instead of hospitalists who come from a variety of specializations? I think I just saved a few thousand right there…and the story continues.

We also need to revisit the “Class Act”. It sounded to me like a common sense start at getting us to save for our own care (of course we can’t add another burden onto the current deficit – but I trust some creative people to come up with a replacement or another like idea). My–oh-my, doesn’t it make you shake your head.

Our representatives want to hear from us and I found them willing to listen (or at least their staff). So, please for your future and that of our parents, stand up and be heard – be part of the positive change. Fight for good medical care and community services that allow the frailest among us to stay in their own homes and/or the community of their choosing.

Mom is 88 and says she wants to have a baby?

Posted in adult children, Age Related Issues, Blog, Dementia and Memory Loss, Relationships on September 21, 2012

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

Can you imagine your mother saying that? Well, it is not uncommon for someone with dementia to see themselves as much younger and yearn for the joys of holding and loving a new born baby.

The family that heard this did all they could not to laugh but respected their mom with a lovely response. I think that is the lesson – listen and respond nicely and then change the subject.

But, I wanted to talk about what “baby” might mean to someone with dementia. It could be the need to care for something – try to give Mom pets or plants that she needs to care for and nurture daily.

Sometimes “baby” can represent “new”. What can you add or do that is new? Ideas: paint a wall, buy some new colorful shoes, bring in a child to visit if all your little ones have grown up. The honesty and freshness of children can be a great joy to those with dementia – but be sure this is time limited for both the visitor and mom or dad with a dementia.

The lesson here is that all requests are not concrete – but are often metaphors for something you can respond to in a creative way!