Stress or Burnout?

Most of us know it when we’re stressed. We talk about it, and we talk about needing to do something about it…when we have the time.

But we might not be aware when we reach the point of burnout. That’s because going numb is the nature of burnout. To be so worn out that you are beyond caring.

Put simply, burnout is stress that has gone on too long. It is an important distinction to understand. Burnout has more serious, long-term consequences for your physical health and for your emotional well-being.

Take a moment for self-reflection and assess yourself.

If you are stressed, you are

  • constantly on the go, urgently trying to get things done.
  • emotionally brittle, tending toward irritability and anxiety. Your thinking might be a bit scattered.
  • tired and not sleeping well, rushing through leisure activities.

If you are a stressed family caregiver, you are scrambling to keep up with the demands of your role. But you believe that you eventually can get everything under control, and doing so feels important to you. Getting stress relief is a goal.

If you are burned out, you are

  • doing less and less and still feeling exhausted.
  • emotionally dull and hopeless, feeling there’s no point in making an effort at anything because nothing ever changes.
  • frequently physically ill, catching every cold that comes around.
  • withdrawing from friends and activities and often overconsuming food, alcohol, tobacco, etc.

To put this in perspective, consider stress to be a blinking yellow light: Yield. Slow down. Find a way to weave in more breaks. Consider burnout to be a red light: Stop. You have given too much for too long. Change is needed immediately before burnout undermines your health and your ability to provide appropriate care for your loved one.

Do you recognize the signs of burnout?

At Senior Life Management we see dedicated family members who, frankly, are fried! They are beyond stress and are dangerously in the realm of burnout. As the Orange County experts in family caregiving, we know it doesn’t have to be this hard. There are options. Give us a call and let’s start the conversation: 949-716-1266.

Gifts for Older Adults

What to get for the “chronologically gifted?” The age-friendly ideas below address the special interests or concerns of persons in their later years.

Providing an experience. Don’t add to household clutter—give an activity! This way, you give the fun of anticipation as well as countless hours of enjoyment afterwards, remembering. Ideally, arrange the gift as something your loved one can do with someone—you or a friend. After all, “a joy shared is twice a joy.”

  • A gift card for a favorite restaurant.
  • A book of movie passes.
  • Tickets to a theater or musical performance.

Supporting connection. If your family member has been outrun by the pace of technology, a simple device might be fun. But only if you can be the tech advisor to set it up and maintain it! Or can provide for in-person tech help as part of the gift. Consider:

  • Fax-to-email converters. Your relative can write a note and put it in the machine to be emailed out to others. Conversely, a converter fax can receive emails to print out on paper. No computer or Internet required!
  • Simplified phones and tablets. These come with a special interface that has large buttons and limited options. Without the whiz-bang features older adults don’t need, these devices let non-techies enjoy the connective opportunities of the Internet.

Honoring cherished memories. Over time, your loved one has doubtless accumulated many fond memories of people and events. Reminiscing is fun, even if your relative has memory problems. Help your loved one savor recollections of beloved people and experiences with:

  • A puzzle made from family photos. Another, similar option is to have a blanket printed with photos of your choosing.
  • A digital photo frame. Connect a “smart frame” to Wi-Fi and you can even upload new pictures remotely. (Again, be sure to include tech assistance as part of the gift!)

Looking for distinctly practical gifts?

Perhaps your loved one needs help getting around. Or he or she may need a grab bar or other safety device. If you are concerned, give us a call at 949-716-1266. As the Orange County experts in family caregiving, we at Senior Life Management can do an assessment to give you a sense of the most appropriate device or services.

When family comes visiting

family

If you have family coming to visit this season, you may be feeling both excited and concerned—excited about brightening your loved one’s life with family gatherings and holiday events, and concerned that your loved one may become tired or anxious with the extra activity.

It is wise to think ahead about factors that could add stress and undermine the pleasure. These tips can help ensure fond memories of the season.

  • Set expectations. Update visiting family members about changes in your loved one’s health. Avoid awkward moments by having them adjust their expectations in advance. Let them know, for example, if Mom is no longer cooking, or Dad now dresses only in sweats.
  • Maintain routine. You’ve created useful routines for caring for your family member. Don’t give them up! Instead, make your regular schedule known and ask others to plan around it. Your loved one will fare better for this stability.
  • Avoid doing “business.” The season is stressful enough without heavy conversations about the “what ifs” of the future. If you and your siblings need to talk, schedule a conference call for later.
  • Plan simple activities. Keep it low key and flexible. Although togetherness sounds good, your loved one may do better with short visits with one or two people at a time. Ensure that the day’s pace allows for naps.
  • Provide tips. Especially where memory loss or dementia is involved, provide visiting family members with ideas on how to respond to behaviors, such as confusion or repetitive questioning.
  • Take a break. This is your holiday, too! If your loved one needs ongoing care, ask another family member to take over for a while. Or, especially on a party night, hire someone for the evening so that you can enjoy the fun.

Concerned about family visits?

If you notice you have LOTS you want to discuss with your siblings, it might be wise to connect beforehand. As the Orange County experts in family caregiving, we at Senior Life Management understand the pressures you are under. We also know that family visits are delicate. Let us help you strategize about what kinds of help you need and how best to communicate that. Give us a call at 949-716-1266.

Preventing flare-ups of COPD

Preventing flare-ups of COPD

Chronic obstructive pulmonary disease (COPD) thickens airways, making it harder to breathe in and get enough oxygen. Damage to the lungs also makes it harder to exhale and get rid of waste gas (carbon dioxide).

COPD is characterized by flare-ups that rather suddenly make breathing much more difficult. Often the patient needs to go to the emergency room. Every flare-up has the potential to make the disease get worse at a faster rate.

Here’s what you can do to prevent a flare:

Aim for quality air.

  • No smoking. If your loved one smokes, he or she has already been told to quit. Ask visitors and other family members not to smoke in the house.
  • Reduce exposure to common irritants. Keep the house well ventilated and free of dust, animal hair, and other allergens. Strong fumes, such as those in cleansers and paints, should also be avoided.
  • Limit exposure to outdoor pollution. Check for local air quality at epa.gov/airnow. Stay indoors when the pollution level is high.

Beware of infections. Any cold or respiratory infection can cause a flare.

  • Stay current on vaccinations. Make sure your relative keeps up with flu and pneumonia vaccines.
  • Avoid crowds. During flu season, your loved one should avoid public places. Ask friends to be mindful of their own health before visiting.
  • Wash hands frequently. Fingers and hands collect bacteria from everything! Have your relative avoid touching his or her eyes, mouth, and nose. Bring a personal pen for use in stores, at the doctor’s, etc. Carry hand sanitizer or wipes.
  • See the dentist regularly. Good dental hygiene helps protect against infection.

Promote overall health. Getting adequate sleep is important for a person with COPD. So is getting enough exercise. Walking is recommended. But talk with the doctor first. There are special lung-friendly activities designed for persons with COPD.

Frequent ER visits wearing you out?

They may not be completely preventable, but as the Orange County experts in family caregiving, we at Senior Life Management can support you in doing what can be done to reduce the likelihood of a COPD dash to the ER. To find out how we can help, give us a call at 949-716-1266.

Red flags for COPD

red flags

Chronic obstructive pulmonary disease (COPD) is a lung condition that gets steadily worse over time. It is often characterized by “flares,” or “exacerbations,” periods when breathing suddenly becomes more difficult. It can be very frightening and often results in a dash to the emergency room.

It’s important to know the early signs of a flare and to have an action plan. If you know the signs and what to do, chances are good for managing the condition at home. Skip the stress and cost of trips to the emergency room!

Develop a personalized action plan with your relative’s health care provider. They may even have classes or nurse educators to help. Ask what you should do if your family member suddenly shows symptoms such as these:

  • Feeling more breathless than usual
  • Extreme fatigue
  • More coughing, with thicker phlegm or mucus
  • Needing to use a quick-relief “rescue” inhaler or nebulizer more often
  • Weight gain of three pounds or more in a day’s time. This may be due to fluid build-up. Check for increased swelling around the ankles.
  • Inability to sleep well because of breathing or coughing difficulties
  • Lack of appetite

Plan with the doctor what steps to take to address these symptoms. Among other things, the doctor may suggest

  • special medications
  • special breathing exercises
  • increased oxygen

Have these on hand and ready for use at the first sign of a flare. Call the doctor immediately if these treatments don’t help and the condition seems to be getting worse.

Does the person you care for have COPD?

We at Senior Life Management understand how frightening it can be to see a loved one struggling so hard to breathe. As the Orange County experts in family caregiving, we can help you do what you can do at home to keep things stable. Give us a call at 949-716-1266.

Sing a Song for COPD!

COPD

If you know someone with COPD (chronic obstructive pulmonary disease), you are familiar with the ever-present wheezing, coughing, fatigue, and anxiety that come with the disease. It’s difficult to breathe! The lack of oxygen leads to persistent “air hunger,” which can be both frightening and exhausting.

At Senior Life Management, we find that people with COPD are often so tired, they have trouble leaving the house. Such isolation leads to depression in 50% of the cases. Plus it can be very wearing for partners and family caregivers.

Music Therapy

Several studies have recently confirmed that singing and playing light wind instruments, such as penny whistles, can greatly improve lung function, fatigue and even depression.

The Louis Armstrong Center for Music and Medicine

Funded by the foundation of our country’s “Wonderful World” jazz great, Louis Armstrong, a team of music therapists at Mount Sinai Beth Israel is investigating an integrated approach to the management of chronic illnesses. In particular, the focus is on improving quality of life and daily life activities through music and culture.

Sing-a-Lung Choir

Participants in the Music for AIR study engaged in music-assisted relaxation and guided imagery. They also learned greater breath control by playing penny whistles together and singing in the Sing-A-Lung chorus. Study participants got to pick the music from a wide range of styles. Some even wrote tunes for the group to play! The goal was to enhance voice and spirit, as well as breathing ability.

COPD is serious

COPD is the fourth leading cause of death, after heart disease, cancer, and stroke. There is no cure. But this study did shine a light on fun ways to manage the condition and combat the depression, fatigue, and breathlessness.

Learn more in this month’s issue of our newsletter, Kari’s Communication Korner.

If you have questions about ways to juggle the care needs of someone you know with COPD, give us a call at 949-716-1266. We can help. We are the experts in aging well in Orange County.

Is a reverse mortgage appropriate?

reverse mortgage

If your loved one is worried about having enough money, he or she may be considering a reverse mortgage.

A reverse mortgage enables a homeowner to turn some of the equity in a home into cash. You might think of it as an advance payment on the accrued value of the home.

An approved lender will give your loved one money once a month, or in a lump sum. Interest is charged as the money is drawn against the house. When the borrower is no longer living in the house, the loan generally must be repaid. Usually this happens by selling the house.

A reverse mortgage may sound appealing, but it is a very complicated loan that should be considered carefully. Be sure you understand:

  • The reason for getting the loan. Counselors strongly advise against using it for living expenses. If the money is to pay for care—at home or in a facility—you should consult with a financial or legal professional to explore all payment options.
  • Cost of the loan. The loan origination fee on a reverse mortgage is high—usually 10% of the loan amount.
  • Taxes, insurance, and maintenance.  Some lenders require that money be borrowed—with interest charged—and “set aside” to cover these expenses.
  • Surviving spouse.  Once the primary borrower dies, or moves out—to a nursing home, for instance—the house may need to be sold to repay the mortgage. A surviving spouse may have to leave.
  • Inheritance.  The mortgage must be paid back when the borrower dies. This may require that the heirs sell the house. Depending on how much is owed, there may be no money left from the sale.

Before your relative takes out a reverse mortgage, talk with a HUD-approved reverse mortgage (HECM) counselor. These professionals are free, or very low cost. Call 800-569-4287 for a referral.

Concerned about finances?

As the Orange County experts in family caregiving, we at Senior Life Management understand the many demands involved in elder care. As you consider the financial side, give us a call at 949-716-1266. We make it our business to understand the local resources for our clients.

When Dad Resists a Walker

Walker

For many older adults, use of a walker carries great stigma. It’s a symbol of disability and often of isolation. In actual fact, a walker can be the key to staying actively engaged with favorite activities.

The benefits of a walker

  • It can bear up to 50% of a person’s weight. (A cane holds only 25%.)
  • It supports good posture. A walker keeps a person upright by reinforcing both sides of the body. (A cane steadies only one side.)
  • It is designed for people with moderate to severe balance problems or those with generalized weakness and arthritis. (A cane is best for only minor balance problems or injuries.)
  • It may act as a chair when needed. Many walkers with wheels have a bench. Great for “standing” in line or when your loved one is suddenly tired or dizzy.
  • It can be rather stylish, with modern accessories, such as a smartphone clamp, a coffee cup holder and a basket for carrying things.
  • It stays where you put it! Canes seem to have a mind of their own, scooting out of reach when you least expect it.

If you have had the “walker talk” with no success, make an appointment with the doctor and directly ask, “What’s your experience with patients who fall? How careful should we be?”

Also get the doctor’s input about the type of walker that is best for your loved one. Perhaps he or she will do a mobility assessment. Or make a referral to a physical or occupational therapist to create a plan for safe walking.

Empathize with Dad’s frustration that his body has given out on him in this way. Remind him that with a walker, he can still get around on his own to do what he pleases. It’s often the most effective choice for maintaining independence.

Is mobility a struggle?

As the Orange County experts in family caregiving, we understand. At Senior Life Management we have helped many older adults come to terms with the need for a walker. You don’t have to do this alone. Give us a call at 949-716-1266.

Care of the Feet

care feet

Did you know that our two feet together have 52 bones and 66 joints? And that doesn’t count all the muscles and tendons needed to carry our weight upright and in balance. It’s a lot to ask of two little feet!

Natural changes of the feet

With advancing years, the padding of the feet gets thinner, joints get stiffer, and arches flatten out. These are normal changes of aging. Since the feet are the basis for walking, and problems with the feet contribute greatly to falls, it’s important to be sure that your relative’s feet get the attention they deserve.

At Senior Life Management, we notice that in the hubbub of all the other elder care issues, foot care often goes by the wayside. On the one hand, it’s easy to take feet for granted. On the other, making foot care a weekly routine can be a very tender and caring exchange with your relative.

To maintain foot health,

  • do a weekly soak. Begin by soaking the feet in warm water softened with Epsom salts. Afterward, dry the feet thoroughly. Then massage in skin cream or lotion.
  • inspect for problems. Check for ingrown nails, cuts, hot spots, redness, or swelling once a week. If your relative has diabetes, check daily! Put a hand mirror on the floor to readily check the soles of the feet. Diabetics often lose sensation in their feet and can develop sores and infections without realizing it. These infections can lead to the need for amputation, which is why it’s so critical to check every day.
  • be sure socks and shoes fit well. Be careful that socks don’t bunch up in shoes. Are socks so tight they leave dents in the calf? Have shoe size checked by a podiatrist or in the store. Try new shoes on at the end of the day, when feet are apt to be swollen. There should be a half-inch of space between the longest toe and the end of the shoe’s toe box. Don’t assume new shoes will stretch out.
  • avoid walking barefoot. With the thinning of the foot pads, it’s hard on the bones to walk without shoes. Keep cushy, nonslippery shoes for wearing around the house.
  • seek professional support. Have a podiatrist or other trained healthcare professional evaluate your relative’s feet, especially if there is pain. Treatment may be as simple as a new pair of shoes.

Nails are also a concern

Nails are the archeological record of foot health. And even nutritional health. Check out our article about nail care in this month’s issue of our newsletter for family caregivers.

Not sure what to do?

There’s certainly a lot to do when caring for an aging loved one. As the Orange County experts in aging well, we can help guide you through all the areas that need attention. Give us a call at 949-716-1266. You don’t have to do this alone!

 

Balance exercises to prevent falls

balance exercises

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

All it takes is short but consistent focus for Mom or Dad to significantly reduce the chance of a fall. In one study, two 15-minute sessions of balance exercises over a six-month period was enough to make a difference. That’s only 30 minutes a week. Depending on your situation, this may even be something you can do together.

Routines are simple. Mom won’t be daunted by the balance activities recommended by the National Institute on Aging. Standing on one foot and heal-to-toe walking are easy to do at home.
No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. Dad can even hold on to a table or chair until he feels more stable.
Tai-chi

It turns out the most effective exercise for preventing falls is tai chi. This gentle activity has been practiced in China for centuries. Tai-chi involves slow, graceful movements combined with controlled breathing and awareness of the body’s position.

Research has shown that people who practiced an hour of tai-chi three times a week for three months experienced a 43% reduction in falls. They also had a 50% reduction in injuries from a fall.

Tai chi is best done with a teacher and in a class. But if that’s not an option, there are DVDs that teach tai chi. The local library may even have some to lend out.

Get the doctor’s okay first

There are many reasons a person might have poor balance. Just to be safe, ask for a fall risk assessment before starting an exercise program. You want to be sure your loved one has all the bases covered.

Does your Mom or Dad need help with balance?

The exercises aren’t difficult, but they do take time. And it’s much easier to stick with them if they can be done with others. Let us help you explore the options. As the Orange County experts in aging well, we at Senior Life Management are quite adept at helping older adults become more physical and focus more positively on their bodies. Give us a call at 949-716-1266.

Balance exercises to prevent falls

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

All it takes is short but consistent focus for Mom or Dad to significantly reduce the chance of a fall. In one study, two 15-minute sessions of balance exercises over a six-month period was enough to make a difference. That’s only 30 minutes a week. Depending on your situation, this may even be something you can do together.

  • Routines are simple. Mom won’t be daunted by the balance activities recommended by the National Institute on Aging. Standing on one foot and heal-to-toe walking are easy to do at home.
  • No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. Dad can even hold on to a table or chair until he feels more stable.

Tai-chi

It turns out the most effective exercise for preventing falls is tai chi. This gentle activity has been practiced in China for centuries. Tai-chi involves slow, graceful movements combined with controlled breathing and awareness of the body’s position.

Research has shown that people who practiced an hour of tai-chi three times a week for three months experienced a 43% reduction in falls. They also had a 50% reduction in injuries from a fall.

Tai chi is best done with a teacher and in a class. But if that’s not an option, there are DVDs that teach tai chi. The local library may even have some to lend out.

Get the doctor’s okay first

There are many reasons a person might have poor balance. Just to be safe, ask for a fall risk assessment before starting an exercise program. You want to be sure your loved one has all the bases covered.

Does your Mom or Dad need help with balance?

The exercises aren’t difficult, but they do take time. And it’s much easier to stick with them if they can be done with others. Let us help you explore the options. As the Orange County experts in aging well, we at Senior Life Management are quite adept at helping older adults become more physical and focus more positively on their bodies. Give us a call at 949-716-1266.

 

What is MCI?

 

“Senior moments” are a normal part of aging. They happen to everyone. We just don’t process things as quickly as we did in younger years.

Some people develop significant memory and thinking problems. These people are eventually unable to live safely on their own. Typically, they have a stroke or develop Alzheimer’s or Parkinson’s disease.

And some people function at a level in between. They can live independently and lead normal lives. But they just aren’t thinking as well as they used to. These people may have mild cognitive impairment (MCI). About 15%-20% of adults over age 65 have MCI.

Signs of MCI include greater than usual difficulty with

  • remembering recent events or scheduled appointments
  • following the thread of a conversation or movie
  • making decisions or following instructions
  • finding familiar locations
  • making well-reasoned choices

People with MCI are at greater risk for dementia. Every year, 10%-15% of people with MCI will go on to develop dementia as compared with 1%-3% of the entire group of adults over age 65. Some people with MCI simply stay at this mild level of memory and thinking difficulty. Some even improve over time!

If you think your loved one may have MCI, schedule an appointment for a full examination. It may be MCI. Or the explanation could be as simple as a medication side effect or even sleep apnea or alcohol overuse. Follow up every six months to track changes.

If your relative has MCI, there is no treatment. Research shows, however, that strong circulation of blood and ongoing mental stimulation are very supportive of a healthy brain:

  • Manage blood pressure and heart health.
  • Increase physical activity.
  • Increase social and mental activity. People who are socially engaged or who have a hobby tend to keep their mental functions longer. Passive activities, such as watching TV, aren’t as helpful.

Are you concerned about a loved one’s memory changes?

Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we at Senior Life Management can help you get your relative the assistance that is needed.

If Mom is Afraid of Falling Again

Many older adults who have fallen believe it is best to “stay safe” and avoid falling again by restricting their activities. Unfortunately, that’s the worst thing they can do! Inactivity is a path to reduced strength and mobility, which increases the risk of a fall and injury.

One of the most important things you can do is encourage your worried relative to stay up and moving. Here are some tips:

Talk about the fear

Although you don’t want to push, it’s important to talk with your relative about the risks of inactivity. This can pave the way to discussion of how to work with his or her (understandable) fear. Putting things in terms of your own concerns may be helpful. It sounds less blaming or demanding. For example:

“I’m concerned, Mom, that the fall you took in December has made you extra fearful. For sure, no one would want to go through that again! But I’ve done some reading and learned that being inactive actually makes you more likely to fall a second time. What can we do to build your strength and confidence?”

Offer strategies for change

Suggest ways that you can help your relative overcome his or her fear.

  • “Let’s talk with your doctor about what’s worked for other patients in this situation.”
  • “Let’s practice balance exercises together. Take a few laps down the hall. I’ll be here so you don’t have to worry.”
  • “Let’s ask for a referral to a physical therapist. They can give you tips about walking, how to better catch yourself, and how to get up safely if you did fall again.”
  • “Let’s take stock of what’s different now than when you fell. You were sick then.” (Or, “You’re no longer on that medication that made you dizzy.”).

Does fear of falling loom large?

As the Orange County experts in family caregiving, we understand both sides! At Senior Life Management we can help you negotiate a graduated activity program that starts small to boost confidence and then builds upon success. Give us a call at 949-716-1266.