Category Archives: Caregiver

Communicating with Aphasia

If your loved one suddenly developed difficulty with speaking, he or she probably has aphasia, typically from a stroke or traumatic brain injury. Slow or garbled speech can be frustrating for everyone.

Recovery is enhanced by following the advice of speech and occupational therapists. There are even apps to help! Your support is invaluable in terms of bolstering self-worth and confidence.

Try these aphasia communication tips:

  • Remove distractions. Turn off the TV or radio. Move to a room that is quiet.
  • Allow time. It takes more effort to organize thoughts and form words.
  • Let them find the right words. Filling in and guessing what is meant may seem helpful. It actually undermines self-esteem.
  • Listen patiently. Communication is more than an exchange of facts. It’s a way to express personality and competence. As a listener, relate as if you have all the time in the world.
  • Confirm your understanding. Repeat back what you think was said.
  • Keep it simple. Speak in short sentences. Avoid a long string of ideas or requests.
  • Consider apps. There are many mobile- and tablet-based apps for aphasia. Some provide assistance with speech exercises. Others offer symbols your relative can point to instead of speaking. Some even help your loved one stay engaged with others by sending emails and texts based on the symbols!

Create a Communication Card
To help your relative stay engaged and be independent, create a “business card” he or she can pass to waiters, receptionists, merchants, or service providers. Personalize it appropriately:

  • I have aphasia: I have trouble speaking.
  • No need to shout: I am not deaf.
  • I do not have dementia: I think very clearly.
  • Please be patient: Give me time to find my words.

 

 

Getting out of the mental spin cycle

Do you find yourself in a repetitive cycle of reliving an exchange over and over? Reflecting on experiences gone badly is one way we learn. We think about what happened and look for insights that might promote a positive outcome in a similar situation next time.

But sometimes reflection can be unhealthy. If you find yourself in a memory loop continuously going over a negative experience, it may be more rumination than reflection. Instead of finding a way toward closure, it can be more like picking an emotional scab and not letting the wound heal.

Research suggests that a process of self-distancing can help us gather useful insights without getting stuck in a quagmire of replays. Try this:

  • Describe the event in the third person. Imagine you are an observer of the situation. If you were someone watching the dynamic, what events occurred? Write the “story” from this perspective.
  • Avoid the words “I” and “you.” Instead, use the names of the individuals involved. “Sarah told Bob she thought their dad was not taking all his medicines. Bob, who orders their father’s medicines through the pharmacy, got angry about her comments.”
  • Answer the question “Why?” and list many possible answers. In your description, address why the people did what they did. Then ask yourself, “Do I know for sure that’s the reason?” Think of several alternate explanations. For instance, Bob might find himself exploring whether Sarah brought up the issue because she thinks he’s incompetent, or because she’s noticing something different about their dad’s memory.
  • Describe the event from the future. Project yourself a week or a month down the road. Maybe a year down the road. How are you likely to tell the story? This perspective can reduce the emotional punch of the event and help you distill it down to its salient features.

What is an Occupational Therapist?

Eating, dressing, getting in and out of a chair. In the course of daily life, we use many skills to accomplish even “simple” tasks. Walking or using a fork is surprisingly complex. Nerve signals and muscles have to coordinate in a very specific order. A healthy body is a marvel!

We take these skills for granted until something interrupts our abilities. Arthritis, for instance, can make it hard to grasp a fork. A stroke may require a right-handed person to learn to do things with the left hand. The tremor of Parkinson’s can make dressing a challenge.

Occupational therapy can be used to help your loved one

  • remain at home despite a chronic condition;
  • recover from a surgery or other health event;
  • improve the ability to accomplish specific tasks or activities.

Occupational therapists have special training to help people overcome new challenges with the daily tasks of living. A therapist might show your loved one some exercises for better coordination. They might recommend special equipment or supplies. Maybe all that’s needed is a rearrangement of furniture in the house. Or a slightly different approach to doing the same thing.

Occupational therapy can be provided at home or in an outpatient clinic. It usually starts with a home visit. The therapist will

  • watch your loved one perform various tasks;
  • evaluate the home for safety and convenience;
  • recommend exercises and/or home modifications;
  • consider best options for transportation;
  • develop goals based on your relative’s abilities, interest, and budget.

Participate in the visit if you can. That way you learn what might help your family member live to the fullest in spite of limitations.

Ask the doctor for a referral

If you think your loved one would benefit from knowledgeable guidance, ask the doctor for a referral. Occupational therapy is covered by Medicare. Also by Medicaid and most private insurances.

Does life seem harder than it was?

If you notice your loved one struggling to do things that used to be a simple part of daily life, he or she might benefit from the services of an occupational therapist. As the Orange County expert in family caregiving, we at Senior Life Management have seen firsthand how much a simple device or a change in approach can transform an elder’s self-sufficiency. If you are concerned about a loved one, give us a call at 949-716-1266.

When Language Falls Apart

 

One common outcome of a stroke or other brain injury is the sudden loss of ability to process language. This disability is called “aphasia” (ah-FAY-zya).

Depending on which part of the brain has been damaged, the affected person may have trouble speaking or trouble understanding. Or may have difficulty with reading or writing.

Needless to say, this is frustrating—for the injured person and family members too!

Aphasia does not change intelligence

People often assume that someone with aphasia can no longer think clearly. Or that hearing is affected. As a result, those with aphasia frequently have others yelling at them. Or acting as if they have dementia. Not true! Hearing remains the same. And unless the stroke or trauma affected the logical thinking portion of the brain, your loved one is just as “smart” as they ever were.

Aphasia does affect relationships and self-esteem

Talking is how we express our personality. It’s also how we interact with those we love. Without full language capabilities, your relative may feel “less than” and withdraw. This can lead to isolation and depression.

Work with the rehab team

It’s important to engage speech and occupational therapists soon after the stroke or trauma to better understand the full impact. They will identify strengths and weaknesses and develop exercises and strategies to help your relative live fully. Don’t get discouraged! Therapy takes practice and time, but it makes a big difference.

Stay engaged

When a loved one struggles with speaking, it’s tempting to want to “help” by doing things for him or her. Help your loved one stay involved with friends, hobbies, and activities, as well as with family discussions and decision making. You may need to get creative and be patient. But staying engaged will help the person you care for regain as much language ability as possible.

Does aphasia have you down?

We at Senior Life Management notice that aphasia is one of the more challenging outcomes of a stroke or brain injury. It affects family relationships and your loved one’s feelings of self-worth. As the Orange County experts in family caregiving, we can help you find optimal strategies. Give us a call at 949-716-1266.

Aging and the self-fulfilling prophecy

 

“Whether you think you can, or you think you can’t—you’re right.”

—Henry Ford

It turns out this truism applies to the ways we perceive the aging process itself. Research shows that older adults who view aging as a time of continued learning and development are physically more resilient. They seem to weather a setback and regain their mobility and independence more readily. They stay healthier and live longer than their peers who view aging primarily as a time of decline.

As a society we tend to hold aging in a negative light. But studies have found that advanced years do indeed bring many benefits. When compared to younger generations, for instance, older adults generally are more able to

  • focus on the positives
  • tune out the negatives
  • relax and accept who they are

The wisdom of aging may be that older adults recognize life is too short to “sweat the small stuff.” And with accumulated years, they have developed more coping skills for life’s inevitable rough spots.

Get this self-fulfilling prophecy working in your loved one’s favor! Try asking some of these questions to help him or her identify the special strengths of aging:

  • If you were suddenly 20 again, what skills or wisdom would you miss?
  • What has helped you through hard times in the past? Look for ways to emphasize these skills or resources.
  • What people, activities, or situations tend to leave you feeling positive? Consider ways to emphasize these resources. For many older adults, family and social interactions bring the greatest joy.
  • What is the ‘gift’ in your situation right now? With aging, we frequently come to realize that in every situation the good coexists with the bad. Even people with incurable diseases can usually identify something positive they have learned as a result of their condition.

Is the glass looking half empty?

Let our strengths-based approach give everyone a fresh perspective. As the Orange County experts in family caregiving, we at Senior Life Management can help with a realistic picture of the glass-half-full side of the equation. Give us a call at 949-716-1266.

Fighting Parkinson’s with Exercise

If your loved one has Parkinson’s disease, you have likely observed physical symptoms such as tremors, slowed movement, and poor balance. In addition to treatment with medication, evidence is mounting that exercise itself can reduce or delay progression of these symptoms. Even as little as 2.5 hours of physical activity a week.

Benefits and types of exercise

The benefits of exercise include smoother and quicker movements and improved balance and coordination. Plus, exercise can ease depression, which is so common in Parkinson’s. It’s not a cure for Parkinson’s. But overall your relative will simply feel better.

There is no one “best” exercise for Parkinson’s. The goal is to get going on some kind of activity and keep going over the long term. Have your relative talk with his or her doctor and get a referral to a physical therapist specializing in Parkinson’s. The therapist can suggest exercises best suited to your loved one’s likes and needs, such as

  • boxing. Punching a bag reinforces confidence and fast, coordinated movements. No hitting of others!
  • dance. Allows for creativity while also promoting agility.
  • rowing or tandem cycling. Doing it with others can help ensure a pace that builds stamina. A stationary bike with a forced pace may work as well.
  • tai chi, qi gong, and yoga. These activities support better balance.

Reach a bit, push a bit

Your loved one may prefer to start with something more familiar, such as walking or swimming. The key is to get moving! With Parkinson’s, movements gradually become more restricted. Research indicates that a “forced-pace” activity that feels to the person a little harder than they can do is more likely to extend ease of motion. A physical therapist can design and monitor a program that strikes the balance between too much and too little.

Trouble getting your loved one to exercise?

You are not alone. And nagging won’t help! As the Orange County experts in family caregiving, we at Senior Life Management can help you navigate the balance between pushing and support. Give us a call at 949-716-1266.

Spiritual Advance Directive

Spiritual advance directive

 

Every adult needs to complete an advance directive (and that means you, too!). It is the health care planning document that medical professionals follow if a patient becomes too ill to speak for him or herself. It gives your loved one the option to name someone as decision maker. And it is the place he or she can state preferences regarding life-sustaining treatment.

More than medicine

Death and dying is more than a medical event, however. Like birth, a family member’s death is a profound part of a family’s life journey. Just as an expectant mom might contemplate where to give birth and the emotional tone of the environment, your loved one may have thoughts about where to die and those surroundings. This may involve his or her religious or spiritual beliefs and preferences. Or may simply reflect personal rituals and symbols. The advance directive is a vehicle for your relative to describe these wishes, but you might need to start the conversation.

Some questions you might ask:

  • Is there anything you would like us to do that is rooted in your faith? Tell us everything you can about what you might like. Any faith leader you would like us to call?
  • Where would you prefer to pass? At home? Somewhere else?
  • How do you envision the room? Special photos or prayers? Poems or music?
  • To provide a sense of who you are, how shall we describe you to the doctors, nurses, or other helpers who may not have met you before? “Above all, he/she was a person who _____.”

A final gift

Capture your relative’s wishes on paper. Have him or her sign the document and attach it to the advance directive. Knowing your loved one’s spiritual wishes enables you to give him or her a final gift of comfort and dignity.

Is this an uncomfortable topic?

We at Senior Life Management understand this is not always an easy discussion. As the Orange County experts in family caregiving, we can help you and your loved one get started on an advance directive and even explore these more personal, very meaningful aspects—”spiritual planning.” Give us a call at 949-716-1266.

When the worrying won’t stop

stop worrying

 

Worry is useful when it calls us to action. But it’s a problem when it becomes an ongoing state of mind. It can become a habit, bringing tension and stress.

If you’re a worrier, you may have mixed feelings. It may seem that worry

  • keeps you on your toes, yet it
  • makes you edgy and distracted, interfering with your sleep and peace of mind.

Relieving the stress of worry doesn’t mean you have to stop worrying. Here are some strategies to harness the positives of worry and keep the rest in balance:

  • Don’t try to give it up. Instead, do it consciously and take notes! Schedule a 45-minute “worry time” for yourself every day. If a worry pops up at another time, write it down for review during your next worry period.
  • Clarify what is fact and what is emotion. Hint: Facts are in the present tense. (“Dad seems tired and is coughing a lot.”) Emotional concerns often have a “future” component involving a problem that might happen (“What if it’s lung cancer?”).
  • Create a strategy for action. Unproductive fears are usually based in uncertainty. Create a list of action steps to answer the unknowns. (“Look up the symptoms of lung cancer. Find out how many risk factors he has. Make an appointment with the doctor.”)
  • Write out a balanced perspective. While completing the action steps, your mind is unlikely to just “let go” of the worries. For each worry, write down evidence in its support and evidence against it. For instance, “Dad spent the afternoon in bed today. Then again, just last week he played a full round of golf with his buddies, and no coughing.” When the worry reappears, you can respond to it with this alternative, fact-based thought.

Seek professional help if your worrying feels unmanageable.

Want help with the source of your worries?

You may be worried because there is simply more to do than you can handle by yourself. Or you don’t know the spectrum of normal aging, so you don’t know whether a situation is dire or not. You don’t need to do this alone. As the Orange County experts in family caregiving, we at Senior Life Management can provide that perspective. Give us a call at 949-716-1266.

Managing Chronic Pain

chronic pain

“Chronic pain” is pain that lasts for 12 weeks or more. The cause is usually nervous system misfiring, like a faulty car alarm system. Often there is no specific trigger, which makes treatment difficult.

Chronic pain is common, affecting 50%–66% of adults age 50 and older. Opioid drugs are recommended for pain control in life-threatening illnesses such as cancer. For those with chronic pain, however, a mix of pain relief strategies is better.

With chronic pain, a full recovery to “no pain” may not be realistic. Instead, it’s a matter of finding ways to help your loved one adjust so he or she can continue activities that bring meaning to life despite the pain.

Pain is physical, and the experience of pain can be reduced with physical changes. Pain is also highly affected by mental perception. In other words, how negatively we think about it. These two qualities open the door for many nondrug strategies of pain management. For instance:

  • Physical therapy. Exercises to gain strength and flexibility can improve overall comfort.
  • Occupational therapy. Learning new ways to accomplish daily tasks may reduce pain.
  • Exercise. Low-impact physical activity—walking, swimming—releases endorphins, the body’s natural pain killer.
  • Quality sleep. Lack of sleep makes pain worse. Good rest supports resilient coping with pain.
  • Relaxation techniques. Special techniques can train the mind and body to interrupt the pain cycle (in which pain triggers fear and tension, which brings more pain).
  • Meditation. Mindfulness practice can help your loved cope by “seeing” the pain from a new perspective.
  • Counseling. Counseling can help your relative identify and change the thoughts, feelings, and actions that amplify pain. Cognitive behavioral therapy is often the most helpful. It can also address depression and anxiety, which then lowers pain.

Looking for pain management strategies?

Of course the first step is to talk with a doctor to get a diagnosis and find out about nonnarcotic, nonaddictive sources of relief. At Senior Life Management we have seen that a combination of therapies works best. As the Orange County experts in family caregiving, we know how difficult it is to care for a loved one in pain. We also understand your concerns about opioids and other drugs. Give us a call at 949-716-1266. You don’t have to navigate this alone.

Smartwatches for Seniors

age friendly smartwatches

 

The makers of smartwatches are now designing products for older adults. And they just may have come up with an acceptable alternative to the standard “I’ve fallen and I can’t get up” pendant. Perhaps you’ve tried to get your loved one to wear a personal emergency response system (PERS) pendant—only to hear, “No. I don’t like it.” Many older adults consider the pendants ugly and stigmatizing.

The new smartwatches offer advantages:

  • Unlike home-based emergency response systems, they work anywhere there is a cell signal.
  • They are easy and natural to wear.
  • GPS features enable using the watch as a locator device for persons with dementia.
  • They can do dual duty as fitness trackers, measuring heart rate, number of steps, etc.
  • They send and receive text messages. Some even handle phone calls.
  • Apps are available for things like setting a timer for pill reminders, or scheduling appointments. Soon even EKGs for heart monitoring.
  • They tell time!

On the downside:

  • Will your loved one use all these features? Or will the apps just be confusing? The options are likely too much for those with memory problems.
  • How useful is the watch in an emergency? Screens are small and several steps may be required. Practice may be necessary ahead of time.
  • So far, the automatic fall detection apps still have a few bugs to work out.
  • Not all smartwatches offer a companion service for 24/7 connection to a trained professional who can triage the need for help.
  • Those with hearing loss may have difficulty hearing a respondent if the device isn’t held close to the ear.
  • While smartwatches are definitely more stylish, they are still big. They seem to appeal more to men than to women.
  • These devices need to be regularly charged.

Meeting resistance to a PERS device?

Many family members find their loved one simply won’t wear the device. A smartwatch may be the solution, but they aren’t for everyone. As the Orange County experts in family caregiving, we at Senior Life Management can help you determine the best ways to protect your relative in the case of a fall. Give us a call at 949-716-1266.

Age Friendly Kitchen

Age Friendly Kitchen

Aging creates so many “new normals.” Even routine activities such as cooking may become challenging for your loved one. Balance issues can make reaching, bending, or lifting a problem. Arthritis often makes it difficult to maneuver pans and tools, turn on a faucet, or twist off lids. Extreme fatigue may sap overall motivation. And problems with memory increase the risk of a kitchen fire.

Consider these revisions to create an age-friendly kitchen.

  • Stoves. Choose a stove with continuous grates (for gas) or a flat surface so that pots can be moved off the burner without lifting. And look for stove controls that face the front so your loved one is not reaching over hot pots to change settings. If memory is a concern, add an automatic stove shut-off sensor. (If there is no movement around the stove for 15 minutes or so, the device shuts off all burners.)
  • Microwaves. Countertop rather than overhead placement makes access safe and easy.
  • Sinks and faucets. Install a single-handle faucet to make it easier for those with arthritis. You might even consider a faucet with sensors at its base to turn the water on and off. If possible, position a sink with a hose sprayer near the cooking area so a pot can be filled in place on the stove with no need for lifting.
  • Cabinets. Place frequently used items and heavy items within comfortable reach to reduce bending. Install lazy susans and pullout shelving for easier access. Use “loop” pulls or long “D-shaped” handles rather than knobs for cabinet doors.
  • Countertops. Include lighting under cabinets to compensate for shadows cast by overhead fixtures. Create countertops at several heights with knee space underneath to permit use as a seated workstation if need be.
  • Freezer/refrigerator. Look for a side-by-side model rather than top-and-bottom. Include pullout drawers and shelves to minimize reaching and bending.

Does a remodel seem in order?

If the person you care for wants to continue living independently, a kitchen remodel might be a wise choice. As the Orange County experts in family caregiving, we at Senior Life Management have seen that sometimes even simple changes or rearrangements can make a world of difference. If you follow principles of “universal design,” the layout will be easier for everyone, not just a person with physical challenges. Give us a call at 949-716-1266 to discuss a home assessment.

 

 

Conserving Energy in the Face of Fatigue

Conserving Energy

People with congestive heart failure (CHF) often tire easily, especially if they exert themselves. In CHF, the heart is swollen with fluids and cannot beat efficiently. The body’s cells then become hungry for oxygen. If your loved one has CHF, you witness this in his or her fatigue, shortness of breath, and frequent naps.

Even with CHF, however, your relative needs to be physically active. Physical activity helps the heart muscle gain strength. It improves circulation. It helps with weight control, and, oddly, with reducing fatigue. Exercise also helps with depression, which is common in CHF.

Pacing is the key. Talk with the doctor about optimal forms of physical activity. Initially, walking, swimming, or biking may be recommended. As CHF progresses, simple tasks, such as taking a shower or cooking a meal, may qualify as exercise. Ask the doctor for a prescription to work with a cardiac rehab team to create an activity plan tailored to your loved one’s needs.

Conserving energy. Think of personal energy as a tank of gas. With CHF, your relative has a small tank and needs to be “fuel efficient.” Conserving energy when doing chores leaves more “in the tank” for doing things that bring joy and meaning.

  • Alternate periods of activity with periods of rest. Divide large chores into smaller tasks throughout the day or across the week.
  • Avoid rushing. It wastes energy.
  • Work smarter. Minimize trips up or down stairs. Cook large quantities of food and freeze for heating later. Instead of towel drying, slip on a terry cloth bathrobe after bathing.
  • Get help for mundane tasks. Have groceries and prescriptions delivered.
  • Create workstations that permit cooking, grooming, dressing, bathing while seated.
  • Use a cart or walker with a basket for carrying things from place to place.
  • Avoid bending or reaching. Use extenders.

Looking for ways to ease fatigue?

Give us a call at 949-716-1266. As the Orange County experts in aging well, we at Senior Life Management understand that quality of life is based on how much time your loved one can spend doing things he or she truly enjoys. Let us help you identify ways to conserve on chores so your relative can go full throttle on pleasant activities.

Bathing and Dementia

bathing discomfort

Bathing brings many discomforts. Bathrooms can feel cold and drafty when a person is wet. And running water can be noisy. Nudity makes bathing very intimate, which can be distressing when a modest person needs help and may not recognize the helper.

Plus, bathing is a complicated process with many steps in a specific order. People with dementia may become confused and frustrated. They also may forget about the purpose of cleanliness.

Here are some tips to ease bath time:

  • Guard the senses. Sometimes people with dementia are hypersensitive. Heat the bathroom ahead of time. Be gentle and avoid scrubbing. Check the water for temperature—too hot?—and the water pressure from the shower—too hard?
  • Promote independence. Encourage your loved one to do things themselves. If you do need to take over, tell them what you are going to do before you do it. And give them a role so they can participate, such as holding the soap.
  • Preserve modesty. Even if you are helping a spouse, have a towel at the ready for undressing and dressing.
  • Maintain a routine. Most families notice that certain times of day are better than others. Bathing at the same time each day may make it easier.

Sponge baths work just as well. In terms of hygiene, all that’s needed is a twice a week wash, and even that can be just the highlights: armpits, folds of skin (under the breast, on the belly), groin, genitals, feet. Remember to keep the rest of the body covered with warm towels to minimize any chill.

Get creative

  • Try singing together. Or play music or old radio shows for distraction.
  • Consider using bath wipes. Warm by putting an open package in the microwave for 10 seconds. Find out How to keep the bathroom dry.
  • Call it “spa time.” Use no-rinse soap on moist, warm midsize towels and massage in gently. Wipe off with warm, moist washcloths.

Tired of the bathroom battlefield?

As the Orange County experts in family caregiving, we at Senior Life Management have developed many strategies and insights that can help you make bath time more pleasant. Make a vote for peace in the household and give us a call at 949-716-1266.