elder

“Taking Me Home?” Redirecting the Conversation

Posted in adult children, Blog, Caregiving, Dementia and Memory Loss, Moving an Aging Adult, Relationships on January 9, 2013

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

Many individuals, with different forms of dementia, ask from time to time or sometimes on every visit, “Are you taking me home now?”

My advice has been most of the time to these family members to say, “When the doctor says you can leave” or “When the plumbing at your house is fixed”. And then I suggest using distraction to redirect the individual from being fixated on the thoughts of home.

As family members, we need to remember that our loved one with a dementia associates us with whatever that memory of “home” is and however hard it may be, we need to answer quickly and simply – and then use redirection.

My mother is doing so much better but since she has moved into her small residential care home she has asked me on the last three visits, “Have you come to take me home?” Interesting, she even whispered this to me the last time so as not to let the care workers or the other residents know what she was asking. I am able to say, “When you no longer need the oxygen”. And, in the moment, she understands and we just chat about recipes or gardening – me asking her advice – which gives me a reason to “thank her” instead of her always thanking me for my visit.

The dance of “elder care” has it smiles, grief, tears and is full of creative opportunities to protect dignity.

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.

85 Years Old and Love at First Sight

Posted in Blog, Relationships on November 30, 2012

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

Last night, I watched a lovely short film, “Love at First Sight” on public television by ImageMakers. I was touched to the heart of my soul because this story is about someone who has significant memory loss living in an Assisted Living community who falls in love.

We all remember the adrenalin and that rush of positive emotions when we fall in love for the first or even second time. Falling in love is one of the human emotions with the most visceral of all feelings. You want to shout for joy, you can hardly eat and your thoughts are only of the other – you desire for nothing other than being with the object of this love.

This short film can’t be downloaded or purchased – but you can search your local channels to view. (If you subscribe to Comcast, you can watch it on On Demand.) It should be an educational film shown to every caregiver, both professional and family caregivers, of someone with a memory disorder.

The lesson is that when you don’t have a memory for a period of time due to a progressive disease, you can still be in the moment and what a joy to be able to re-live falling in love everyday. The gift in this movie is that the object of his love is able to be in the moment and enjoy the feelings of falling in love with her spouse everyday. She doesn’t correct him, she just lavishes in the moments with him. You know her heart longs for what was lost, but she doesn’t let her grief interfere with her ability to enjoy the shear pleasure she sees in the man who is falling in love with her over and over again!

Emergency Response Systems Save Lives and Medicare Big Dollars

Posted in adult children, Blog, Relationships, Technology on November 27, 2012

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

Needless trips to the ER are stressful to older adults and their families and take the time of emergency room medical providers. These needless trips will cost individuals, hospitals and Medicare thousands of dollars.

My mother, who lives in Assisted Living, uses oxygen and can have episodes of forgetting how to adjust her oxygen and all its cords, buttons and dials. When she does she becomes short of breath, she tends to call 911 and in the last 30 days she has had three trips to the ER.

So, I decided to install an emergency response system in her apartment, which she was familiar with because she had used it when she lived alone in her home. She is aware that pushing it will get her help. She can’t remember to call the front desk when she feels ill – so the necklace works for her.

On Saturday morning, less than 24 hours after installing the “button”, she pushed it requesting transport to the hospital. The Emergency Response company called me first (should have been the front desk but since cleared that protocol up) and I was able to direct them to the front desk who sent the medical technician and nurse to check on her – sure enough her oxygen tube was pinched and once corrected, she was fine and walking down to breakfast within minutes and not on her way to a hospital!

This monthly cost of $30 saved Medicare thousands of dollars and Mom and me hours of stress.

If you are looking for an emergency response system for a family member, never sign contracts that have high costs. Installation should run under $50 at the most and monthly fees from $29-60, depending on all the enhancements. You should have the ability to stop service whenever it is no longer needed and not be billed any fees for discontinuing.

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.

“Soul connecting” – the honor of my work!

Posted in Blog, Care Management, Relationships on October 26, 2012

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

Since I am the Executive Director of Eldercare Services, I do get to meet with a few families from time to time, mostly the adult children of aging parents. I have two older clients I have worked with for many years but I just don’t get the opportunity to meet many other older adults at this time in my career.

Today, I went to see an 89 year old client and was so touched by his history, his strength and wisdom that I just feel blessed by the work I do. This work allows me the opportunity to communicate, not only cognitively but, with the soul and heart. Of course, I was keeping professional boundaries however, hearing the story of a life with my heart and not just looking for past strengths for which to base my recommendations.

It was not the concrete fixing of a problem, it was listening and responding from the heart – hearing the truth from a deep place of the soul. It is so important for us all to listen to the wisdom of the elders in our community or family. Their life trials, successes and adventures have many a lesson for each of us.

I thank all who have contributed to a better world and encourage everyone to listen for those life stories of “strength” from the elders in their communities.

Aging Experts

Posted in Blog, Care Management on October 16, 2012

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

After watching a home repair program about fixing the messes that non-expert contractors (and I would guess not licensed) cause homeowners great headaches and expense, I could only think about families who hear, “We do free Care Management” and think they are receiving expert guidance. I guess you get what you pay for!

Professional Care Managers who belong to the National Association of Professional Geriatric Care Managers (NAPGCM) and whom are certified as Care Managers are experts and they have fees that represent the years of experience, education and supervision you would expect to see in any profession. They usually bill by the hour or fraction of.

When you trust a non-expert to guide you, it could cost you dollars and time but, most important, quality of life could be compromised when you don’t have a professional advocate.

I encourage you to hire experts to not only build your fences and fix your plumbing but to write legal documents, guide you in making challenging decisions or find care for an aging family member.

Singing in the Rain…

Posted in Blog, Dementia and Memory Loss on October 12, 2012

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

When visiting a small residential care home to see a client I came at coffee hour and they were doing a sing along. One of the residents is very impaired with a dementia and can’t talk in complete sentences. Since I had prior experience running a day program for those with dementia years ago, I am very comfortable talking with her and responding to facial expressions and some of the words.

This woman, who is not my client, seems to always want to talk with me – I guess “dementia” is the one foreign language I have mastered! And, since she is not a family member, I have no history with her and we just have the moment of connecting words, facial expressions and feelings.

What truly surprised me on this most recent visit is this woman who can’t speak in a complete sentence or hold a thought very long knew every word to the tunes of our “grandparents” – she didn’t miss a verse of “You are my Sweetheart” or “Take me out to the Ball Game.”

The memory for music is held in a different part of our brain than memory and language. I have been thinking maybe we all need to put the names of those we love to a tune so we can sing it all our days.

Without a memory, you might not have words but you can still connect in ways that lift the spirit. Try “old” tunes to pass the time with those you love that might have a dementia like “Alzheimer’s”.