alzheimer

When Our Parents Become Sexual Beings on Our Watch

Posted in Blog on January 4, 2013

Eileen Zagelow, BA, CMC | Professional Geriatric Care Manager/Director of Care Management Services

Many jokes have been shared over the years regarding the idea of parents having sex. Everyone knows they must have but no one wants to think about it! And then one day there it is bigger than life!

I spoke with a daughter recently who received a call from a facility stating that her father was being sexually inappropriate with the caregivers. He was getting” overly friendly” in his words and in his touch. It was also reported that he now had a girlfriend and the staff had found them lying on the bed in his room on more than one occasion.

The daughter who was aghast upon hearing this, immediately shared the news with her brothers who were surprised, although not as anxious as she was about the report. And then she called me.

“Susan’s” father has dementia. He has been diagnosed with mid-stage Alzheimer’s disease and has always been completely socially appropriate. He never dated after his wife passed away 8 years ago. They were like “two peas in a pod” and this daughter was so taken aback that this was occurring and at this time in his life. She was saddened as she felt that the depth needed to engage in a “meaningful” relationship was lacking. The family had legal concerns as well.

It is so difficult and yet important to remember that sexual attraction is an innate part of our humanness. Unfortunately, loss of social inhibition can be a very large part of dementia. In addition, the need for partnership can be very strong for a person who is having much difficulty navigating through their memory loss and/or judgment issues, especially when the person has had a meaningful relationship previously.

As family members, we have to try to step back and view this piece of the process through a clinical eye or at least speak with someone who can assist in framing this picture more clearly. Most facilities are equipped to deal with such behaviors and have appropriately trained their staff. However, as with life, each situation is unique and may require a special care plan and/or oversight.

As a Certified Care Manager, I was able to assist Susan with her father’s journey and, by extension, with her own as well. Dementia can exhibit in many ways and is inconsistent from person to person. It is so important to digest and listen with a trained ear when sexual behavior presents itself. As with most behaviors, appropriate communication and environmental support are key factors in a successful care plan.

Is Mom’s Home Making Her Alzheimer’s Worse?

Posted in adult children, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on December 23, 2011

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

Many individuals experience great anxiety when they see items in a home that they once used and operated but no longer can due to the advancing ravages of a progressive dementia.

Most families and professionals feel home is the greatest place of comfort – and for many that is true. In fact, for some individuals with a dementia, a trip away from the home causes great anxiety and challenging behaviors.

However, it has been my experience with some individuals who see a bank statement or a cooking utensil, that they once used but now don’t know what to do with that item, become very anxious. Sometimes they can become angry thinking someone or something made the items not usable and this anger gets projected on the spouse or family caregiver. This is because they are constantly reminded by the familiar of what they can’t do and that causes great frustration.

Those individuals, who experienced a high level of anxiety and frustration in the home, often settle down in a “dementia designed” care facility. This is because they are not presented with any activity or request that reminds them of what they once did.

One of my clients became extremely angry whenever she saw her husband start to cook (in 60 years he had never boiled water). She would yell at him to leave the kitchen – yet not be able to make a meal. He learned to gently get her in the den with a cup of tea and then he would quickly prepare a frozen meal, put it on the table and tell her the dinner she made was done. This worked for him, but for others it might not.

The environment can be the problem, as can be our communication style. Learning new tools to live each day with a family member with a dementia, such as Alzheimer’s, is critically important to preventing caregiver burn out.

If you are unsure of what is best for your parent find a Professional Geriatric Care Manager to give you an objective assessment of what would be best for all family members based on values as well as needs.

When A Caregiver Needs Help — When Exactly?

Posted in adult children, Age Related Issues, Alzheimer's, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on March 8, 2011

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

Like most things in life this varies by person and situation. Those of us who have worked in this field for a while, though, recognize some common signs.

If you are thinking about it – needing help that is, chances are your instincts are leading you to fulfill a need. As a caregiver, if you find yourself feeling edgy, tired, anxious or short of temper while caring for someone, it is time to check into care options.

It is never too early to investigate care options. Knowing about services before you need to use them is very wise indeed.

Like many things in life, we often wait until we truly feel and understand our need for something before we go after it. We want to be absolutely sure!! By then we are usually pretty sure, however we are often quite behind in the planning process.

These guidelines might be helpful to you.

1. Do you find yourself lacking joy in your life? Depression can be an insidious process and moves in comfortably without a person being any the wiser.

2. Do you find yourself becoming angry with the person you are caring for? Are their behaviors or constant questions becoming quite annoying?

3. Are you feeling exhausted or having trouble sleeping? Are you feeling anxious?

4. Do your friends or colleagues notice a difference in you?

5. Is your health suffering? Does your immune system seem suppressed?

6. Are you having trouble organizing and getting things done?

7. Are you feeling stressed regularly?

8. Are your relationships suffering?

These are a few signs that you are in need of support. Support groups are in abundance and a place where you can find understanding, camaraderie and much needed resources.

Day programs are a wonderful resource. You can bring the person you care for to such a program so that you can both enjoy a bit of respite. It very often means that it is time to hire help in the home. Sometimes this can be a small amount of help with a lot of benefit. Other times more attendant help is needed.

A Geriatric Care Manager can help you navigate the steps in reducing and/or eliminating the warning signs in your life. He/She can help you figure out whether the time has come to utilize some caregiving support and how much that may be. Remember, that making an inquiring phone call is not a commitment; it is just a phone call. However, it is a very important step to take – it can’t hurt and can only help.

Mom Needs Care and I’m Not Ready!

Posted in adult children, Care Management, Caregiving, Dementia and Memory Loss, Relationships on February 11, 2011

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

After 27 years of helping families understand and cope with dementia and/or memory loss, I find myself riding the same wave. What I notice sitting on this end of my career colliding with my family life is a feeling of denial and grief.

Seeing this resilient and very social mother of mine lose her ability to make sound decisions is actually worse than just memory loss. This weekend I took her shopping to a favorite small discount store and she came home very happy and proud of her purchases. She told me she bought a computer, a Blackberry for $3.99. When I looked at the package it was a cover for a Blackberry! I used all my professional skills and made excuses for her about the lighting in the store being bad and how easy that it would be to think this was a phone. Then she showed me two blouses she bought for $1.00 (what a bargain). However, the tag did say 2 for 1 – but the price on the back was $11.99!

What concerned me is she didn’t realize her total bill was nowhere near what it should have been if the blouses were $1! This is the information I didn’t want – it tells me she is at great risk for exploitation trying to live and manage on her own.

My brothers will call and help her to remember to take her medications, her personal assistant helps with the bill paying and I will now visit once a week and set up those medications. But, to tell you the truth, I know it won’t be long when we will need to move her out of that big house and I fear (and know from experience) such a move will bring more changes that I don’t want to see or experience.

Life is full of “pot holes” that we didn’t see coming and find it hard to get out of. I just didn’t want to feel as if I ever had to take control from my mother – but it looks like I will have no other options.

I pray I do what I need to do to preserve her dignity and give her some semblance of control over her life. I am losing my mother and it hurts.

Fear & the Aging Process

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on February 4, 2011

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

Sometimes fear keeps us stuck in old routines even if they don’t work for us anymore. The fear of falling could keep someone from exercising, the fear of loss of control could keep us in a home that doesn’t meet our needs and the fear of rejection could keep us from speaking from our heart and having a full life.

Recently, I heard the Rabbi Harold Kushner talk about fear and his new book, Conquering Fear.

One comment he made that resonates for me is, that “rejection destroys a person and is worse than fear. It can destroy a person’s soul”. How we deal with rejection will protect us from having our “soul destroyed”. Rabbi Kushner said, “We need to remember that even the smartest people make mistakes and most important when dealing with rejection, don’t deal with this yourself – get professional help”.

Don’t let fear or rejection keep you or an aging family member stuck, talk it through with a Licensed Therapist and if you are an elder, a Professional Geriatric Care Manager who is also a licensed therapist is your best guide to assist you with some “re-framing” so you can live life to its fullest. We have but one life and each of us should have a life of quality not just quantity.

Choosing Skilled Nursing

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on January 18, 2011

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

“Help – Mom’s diabetes is out of control, she can’t manage it and we can’t be there for her. Her memory is failing and it looks to us she is losing weight.” “Dad should be on oxygen and now they are talking about a gastric feeding tube because of his Parkinson’s disease.”

Older Adults who have complex medical issues that can’t be managed by themselves or their family need another level of care. Quite often this is “skilled nursing” because no other level of care can provide the medical attention they need on a 24/7 basis.

Not everyone will need “skilled nursing” care and I highly recommend that families work with a Professional, Certified Geriatric Care Manager before making this decision – for options that might have been overlooked.

If the care manager, the family physician and the family think it is time to look for a skilled nursing facility it is best to start back with that Professional Care Manager who has experience with all the skilled care communities in the location you want your family member. The reason I say to start with this person is, because they know all the facilities and their strengths and weaknesses. One might be better with dementia, diabetes or stroke patients than the other. Some will take Medicaid/Medi-Cal when resources are limited and others will not. Some excel at physical therapy and others are not as strong in that service. So, the answer is: choose the right facility for the needs of the client, not necessarily how it looks or how close it is to you (even though that is important).

You will want to check on-line evaluations of the skilled nursing facilities as provided on the Medicare website or in Northern California the California Advocates for Nursing Home Reform site (www.canhr.org). You could also call your local Ombudsman Office for this information and a list of facilities in your area (800-510-2020 in California).

When you visit, you will want to look for the calendar of activities, the menu and have a tour. If possible, chat with residents. You don’t want to see a lot of residents lined up outside the nurse’s station. You’ll want to see people in their rooms engaged in activities that interest them or in group activities. Inquire about bringing in some personal favorites such as a favorite chair or other piece of furniture and, can the beloved cat or dog visit?

If this is to be the “home” of your family member, you want all the family to visit. Look for rooms where you could gather as a family. And, would your 6year-old grandson be ok visiting Great Grandma in this environment? Believe it or not the opinion of a 6year-old can be great information.

So – if possible have a Geriatric Care Manager help you with the decision and if not, ask that 6year-old to give you their opinion. Out of the mouths of babes often comes the most honest truth.

Electric Blankets & Seniors

Posted in Age Related Issues, Blog, Environment, Technology on January 11, 2011

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

“85 year old active senior dies in a house fire on December 28, 2010 in Walnut Creek, CA.” This is news none of us likes to hear.

Many of us love to get into a warm bed and since many seniors run cold, having an electric blanket is something many enjoy. However, it can be very dangerous for those with diabetes, paralysis from stroke, Parkinson’s disease or a dementia.

One issue is that many of these individuals have an impaired or delayed ability to receive information from the brain that they are overheated, thus they can be easily burned.

The other issue is that electric blankets that are folded over can cause the wires to become bent and to short out causing a fire that could start with smoke (a reason why seniors should all have smoke alarms in their bedrooms). When smoke inhalation starts, it can put an individual in a state of unconscious even before the flames of a fire break out. Those who have mobility issues would be more at risk and should avoid electric blankets.

It is suggested that those who are incontinent do not use electric blankets.

Two safe ways to have a warm bed are to use flannel sheets and down comforters – these can be light weight yet very warm. There is nothing wrong with the old fashioned warm water bag that Grandma used to warm her feet – as it cools naturally.

Do your older family member a favor and replace that electric blanket with down comforters and flannel sheets.

Read the source articles here: Contra Costa Times and eHow.