Category Archives: News

Distraction Techniques

If the person you care for has a problem with memory loss (dementia), you may find that he or she gets agitated about things that don’t make sense. Your long-retired dad, for instance, may wake up in the mornings and insist, “I have to go to work!” It can be confusing for you. And frustrating!

Disregarding these comments will only make your relative more determined. And it’s pointless to try to reason. The disease has robbed that ability. Instead, spend some time connecting with your loved one in “their reality,” and then distract them.

Compose yourself. Your body language, face, and tone of voice speak volumes. People with dementia still perceive respect versus dismissal. If you need time to calm yourself, make an excuse to get something from the car or to go to the bathroom, so you can return refreshed.

Validate their concern. “Gosh, Dad, I see you are ready to go. I wish I had your enthusiasm about work! Is there something special at work today?” By joining in their emotional reality, you are not telling them they are wrong. They feel reassured you understand.

Distract. Engage them in a fond memory of something related. “Remember your first client back when the business was new? What was it they had you do?” As you reminisce, consider walking together into another room to shift their attention. Once in the other room, draw on their forgetfulness and eventually offer an alternative activity: “I’m hungry. Let’s have breakfast” or “Oh look at that messy walkway! Would you sweep it? That would really help.”

Reflect. If your relative obsesses on things that don’t make sense, look for triggers or the underlying meaning. If Dad associates morning with time to go to work, have a task for him to do that addresses that need—in this case, to feel productive.

Does your loved one get agitated often?

It can be very wearing when a relative gets stuck, especially about things that aren’t real to us. We at Senior Life Management have a lot of experience with dementia. As the Orange County experts in family caregiving, we can help you learn validation and distraction techniques. Give us a call at 949-716-1266.

What to do with their stuff?

stuff

Perhaps your loved one is downsizing. Or maybe planning a move to assisted living or a nursing home. He or she may even have passed away… If you find yourself needing to pack up a relative’s belongings, start by sorting them into five categories:

  • items to keep
  • items to sell
  • items to donate to charity
  • items to shred
  • items to throw away/recycle

Items to keep and to throw away/recycle have obvious action steps. If you have a lot to dispose of, ask the local waste hauler to drop a debris box at the curb.

Items to sell. There are a variety of options for professional help with reselling.

  • Estate liquidators do on-site sales. They review, organize, and price the goods and host a sale in the home. They typically take a percentage fee on what they sell, plus hourly charges. You can find a local referral through the American Society of Estate Liquidators.
  • Auctioneers take a fee for selling items off site.
  • Consignment shops offer items for a set period of time, such as 30 days. They take a commission on sales. Find out what happens if your items don’t sell.
  • Consider selling them on eBay or to an eBay reseller.

Items to donate. You can claim a tax deduction for the fair-market value of items in good condition. Get a dated, itemized receipt from the charity.

Items to shred. If you are going through old bank statements, tax records, or any documents with important financial information—social security numbers, bank account numbers—you will want to shred them to prevent identity theft. Certainly you can shred them at home, but this is time consuming. There are companies that can deliver a container they will pick up later and shred the contents. You may also find a local merchant, such as a photocopy store, that has a shredding container you can put your documents in for a per-pound fee.

Want help with all of it?

A senior move manager. They charge an hourly fee and will do everything from packing to coordinating with resellers to taking leftovers to charity. Check with the National Association of Senior Move Managers.

  • A junk removal service. These companies can remove everything. Get a cost estimate first (ask if there’s a fee for the estimate). They resell items, recycle them, or dispose of them at the local landfill. A nice plus: they finish with a thorough cleanup!

Daunted by the prospect?

Moving or distributing a loved one’s belongings has an emotional component in addition to practical realities. We understand. As the Orange County expert in family caregiving, we at Senior Life Management have helped many families through this process. Give us a call at 949-716-1266.

Plan Ahead when Downsizing

downsizing

 

Moving into a smaller living situation is a big decision. More emotionally challenging, however, are the many little decisions your loved one must make about what to keep and what to let go.

  • Possessions, from knickknacks to garden tools, hold many dear memories. Letting go of them is like discarding the people or events they are associated with.
  • When boxing up the possessions of decades, it’s not a big jump to realize that one day—after dying—these possessions will be boxed up and permanently disbursed. Downsizing can feel like a little death, at the least the death of their younger self.

Allow plenty of time

Senior move experts recommend a minimum of three months’ lead time. A less hurried approach will allow your loved one to ease into the project and savor memories before saying goodbye. Consider these steps:

  • Talk with your family member. Approach the topic carefully: “While we have the luxury of time, Mom, let’s begin to plan how things will fit in your new space. Only you know what’s most important to have with you.”
  • Know what space is available. Obtain measurements or, better yet, visit the new residence and measure the floor space (and the closet space!). Create a layout drawn to scale to help your relative visualize what furniture will fit. Likewise, plot space for books, clothing, hobby materials, and other personal items.
  • Be sensitive. That set of books may never have captured your interest, but they may hold beloved memories for Dad. This is your opportunity to learn the history of treasured possessions. Such sharing helps your loved one say goodbye, and it provides a way to “pay last respects” to parts of his or her past. What you hear may also change your mind about what to keep!
  • Take time. Go at your parent’s pace, even if it seems tortoise-slow to you. If you rush, you’re likely to run into resistance or exhaustion.

Is downsizing on your radar?

We at Senior Life Management have helped many families go through the process of moving to a smaller household. Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we can help you support your loved one in making this transition as smoothly and sensitively as possible.

Researching Treatments Online

online treatment

For those facing a serious—or even incurable—condition, the Internet can seem to be the last refuge of hope. But how can you distinguish a trustworthy website from that of a huckster? “Follow the money” is an important key for deciding if a website is truly unbiased. Start by asking yourself who, what, and why.

Who: Whose site is it? Websites cost money to create. Who is paying? Check the “About Us” page. If the source of money is not obvious, use “Contact Us” to ask, “Who are you and how do you get your funding?” Keep that funding in mind as a possible source of bias.

What: What kind of information is provided?

  • Is it a research-based news article? Does it cite research done in university or government studies? Is there mention of “randomized clinical trials”? These are the gold standard of science.
  • Is it a blog? Is it one person’s opinion, or are other sources included? What are the author’s credentials? Are they reliable?
  • Is it a forum (or “chat room”)? Anyone can speak in a forum. Chat rooms offer a wealth of practical tips for day-to-day coping with side effects. But they are not reliable sources for evaluating the success rate of treatments.
  • Is it really just a sales piece? Does it make claims about a treatment sold by the sponsor? If so, review multiple sources and look for promises that are backed by credible research as described above.

Why: Does the website identify its purpose? Government and university websites typically have a mission to educate. The websites of nonprofit organizations usually weave education with advocacy. A for-profit company is not automatically suspect. Many generously share their expertise through educational articles. Simply use caution if they ask for your personal information or if the talk turns to specific treatments that they themselves sell.

Confused about where to turn?

As the Orange County experts in family caregiving, we at Senior Life Management can help you determine your confidence level in the various options you are considering. 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.

 

 

2019 Medicare Improvements

Medicare Advantage

Here’s some good news to start the year! In 2019, we’ll see improvements in coverage across the major Medicare plans.

About two-thirds of people on Medicare use “original Medicare.” Patients with original Medicare can go to any health care provider that accepts Medicare. Original Medicare pays for 80% of costs after a yearly deductible. The remaining 20% is paid out of pocket. In addition, your loved one may have a supplemental insurance. Sometimes this is called “Medi-Gap.” Medi-Gap policies pay the deductible and that 20%.

There is also a “Medicare Advantage” plan. If your family member has this coverage, he or she must go to providers who are part of the plan’s network. Medicare Advantage programs usually cost less than a combined original Medicare and Medi-Gap policy.

Starting in 2019

“Donut hole” is closing early

Medicare Part D has been paying roughly 75% of medication costs up to a set amount per year. Patients paid the balance of 25%. If costs were higher, the patient had to pay a greater percentage out of pocket (35-44%). If your relative’s drug costs reached a second threshold, additional medicines were then covered 95% by Medicare, 5% by the patient. In 2019, that “donut hole” gap in coverage is “closing,” meaning it is getting smaller. And a year earlier than planned. This year Medicare will extend coverage of brand name drugs at 75% up to the second threshold. Then 95% coverage will kick in. Generics will have a 63% coverage rate after the first threshold. The following year, generics will be covered at the 75% rate as well.

Nonmedical support services

Some Medicare Advantage Plans have been given permission to expand coverage beyond traditional medical care. With a doctor’s orders, for instance, they have the option to offer policies that provide for things like the installation of grab bars or a wheelchair ramp. Check your loved one’s plan to see if it includes this type of coverage.

Want to switch policies?

Wish your loved one had a different plan? As of 2019, those with an existing Medicare Advantage plan may switch to a different plan within the first three months.

Do you find Medicare confusing?

You aren’t alone! As the Orange County experts in family caregiving, we at Senior Life Management can help you decide if there’s a plan that would be better. Give us a call at 949-716-1266.

 

 

Stress or Burnout?

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.

Exercise and COPD: an oxymoron?

COPD

Does Mom say she feels too weak to exercise? Does Dad run out of breath just walking down the street? People dealing with COPD often believe that exercise will make things worse. Actually, in moderation, quite the opposite is true.

Very real benefits. Even people with severe COPD can become more physical. Something as simple as arm lifts or singing can improve breathing and reduce fatigue. Exercise also helps with the fuzzy thinking many older adults experience with their COPD—because it gets more oxygen to the brain. Plus, people who engage in physical activity even just three times a week have been able to reduce the severity of COPD flares. If they have to be hospitalized, they get home sooner. Best of all, it’s not that hard to achieve these improvements.

Talk with the doctor first. Don’t challenge your loved one to a mile starting out! A balanced approach is required with COPD. The goal is to stretch breathing capability and stamina a little bit at a time without getting overly tired. Your family member’s doctor can give guidelines about when to stop and when to push past that initial feeling of “today is not a good day.”

Ask for pulmonary rehabilitation. The doctor may be able to prescribe a special exercise class for people with COPD. Exercising under supervision supports your loved one to feel safe. A class also presents the chance to talk with others who face the same challenges, which helps combat the isolation and depression that are common with COPD.

Tips for making it easier. Have your loved one

  • pick an activity that is pleasurable;
  • start small and increase gradually;
  • find an exercise buddy. This adds fun and supports commitment;
  • ask to be trained on “pursed lips breathing.” This technique makes it easier to exhale deeply and bring in enough oxygen.

Does better breathing feel impossible?

At Senior Life Management we have seen how people with COPD who didn’t think they could exercise can actually improve their breathing with very light, supervised activities. Even a physical therapist coming to the home a few times can guide your relative to exercises that will reduce that scary feeling of air hunger. Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we can help you get the support needed to make each day the best it can be.

Savoring Good Experiences

positive experiences

Sharing positive experiences is like sharing a good meal, warms and strengthens friendships and family bonds. There are other benefits to savoring positive experiences. Even in the privacy of your own thoughts, reflecting on pleasant memories is an easy and effective way to increase your overall happiness.

Hard wired to focus on the negative

Have you noticed that even a small negative event can grab your attention repeatedly over the day? Positive events, by contrast, rarely come back to mind. That’s human. Our brains are hard wired to pay attention to threats.

Retraining our brains

As a family caregiver, you may find yourself focused on the things that aren’t going well. This zaps your energy. It also sets you up for depression, a common occurrence when caregiving. Fortunately, as humans we can retrain our brains to notice the positive for a more-balanced assessment of our days.

Try this exercise

  • Before bed, write down three good things that happened over the day. They don’t have to be big events. Just things that felt positive. Maybe a good conversation or a leisurely walk. Include as much detail as you can.
  • For each one, also write down “why” it was positive. Knowing what uplifts you tunes you into future opportunities for positive activities.
  • Take 30 seconds to relive or savor each memory. Close your eyes. Were there particular smells at the time? Sounds? Thoughts? Immerse yourself in the full memory of the event.
  • If possible, tell others about the event over the next few days. The recounting of it helps seal it in your awareness.

Why it works

Neurons that fire together wire together.” The more memory traces you create of positive experiences, the more adept your brain will become at recognizing the positives. You won’t lose your ability to identify threats. But you will form more-accurate assessments of your life and increase your overall sense of happiness.

Does the positive elude you?

If finding the positive experiences is difficult, it may be a sign that you could use some caregiving help. As the Orange County experts in family caregiving, we at Senior Life Managementunderstand that it’s a lot to shoulder. Give us a call at 949-716-1266. Let’s talk and see what we can do together to bring more positives to your day.

When your Parent Drinks Too Much

parent drinks

Alcohol is a sensitive subject. Consider asking your parent’s doctor or a respected friend to initially bring up the subject. Tell them the reasons for your concern: slurred speech, unexplained falls or bruises. Be specific in your examples. Your parent will have less face to save with a trusted friend or professional than with their own child.

If you do talk, don’t say “alcoholic.” Even if it’s applicable, this is a loaded term. Tread lightly. A confrontation will just make your relative defensive and could jeopardize your relationship long term.

Instead, clear yourself of judgments about what he or she “should” do. Your relative is an adult and has the right to make unwise or unhealthy choices. He or she is doing the best they can, using the coping strategies that are readily available to them.

Open the door. Let them know that you notice some things aren’t working well and that you care. Rather than preach, create an invitation: “I notice you’ve been falling” (or losing weight, or seeming kind of withdrawn). “Are you concerned? Want to talk?” If yes, great. If no, just make it clear you’re available any time.

Casual help. Rediscovering meaning, purpose, and connection is one route to recovery. Separate from a conversation about alcohol, help your loved one explore ways to feel engaged with life, perhaps through involvement with others. Maybe you can go together to a social activity to make the first time easier. Or you might help remove barriers by providing transportation or covering costs.

Formal programs. Older adults also respond well to short-term interventions that address the specific isolation and loneliness of late life. If your loved one shows interest, help him or her find a recovery program that is geared to the needs and concerns of aging.

Is alcohol a problem?

Alcohol use is surprisingly common in late life. At Senior Life Management we see it frequently. As the Orange County experts in family caregiving, we can help you strategize about optimal ways to approach the situation. Give us a call at 949-716-1266.

Signature Strength: Courage

courage

In the tradition of “positive psychology,” we encourage family caregivers to know and use their signature strengths. These personality traits can become reliable tools. Courage, for example, has many faces beyond bravado and derring-do. See if you recognize yourself in these descriptions.

Honesty and integrity are facets of courage. Are you a person who insists on living by your values? Do you prize authenticity? Courage is at the root of what it takes to

  • know your limits and take respite breaks when you need to;
  • talk compassionately with a family member about behaviors that are not healthy;
  • ask a sibling to participate more in helping out with Mom or Dad.

Steadfastness. Another aspect of courage is the willingness to continue even if the going gets tough. Think about ways you advocate for your parent with the healthcare system. Or perhaps you’ve found yourself calmly handling once-unimaginable tasks in personal care or wound care.

Maintaining focus. Courage also involves feeling several things at once, yet staying focused. A courageous person may feel fear. But they steady themselves with a belief that they can have an impact. The thoughtfully courageous assess situations with eyes wide open. They see the risks. Rather than run, they look for ways to reduce the chance of a negative outcome.

Tempering qualities. The roar of a lion—a blustery manner or righteous indignation—may look like strength. But that type of courage is not usually constructive in family dynamics. Better to remember that lions can be tender too, and they work for the overall good of the pride.

Courage may not be something you think of as your signature strength. This fresh look at the many sides of courage may help you see the daily bravery you exhibit as a family caregiver.

Are there days when you don’t feel like a lion?

We all feel that way from time to time. Usually it’s when there is more to be done than we think we can accomplish. As the Orange County experts in family caregiving, we at Senior Life Management can help you look authentically at the situation, and find your courage to take the next step. Give us a call at 949-716-1266.

Does Mom have a Drinking Problem?

drinking problem

 

Alcohol use is on the rise among older adults. And it’s not easy to spot. Many of the signs resemble common problems of aging drinking problem. And who wants to think that when Mom stumbles, for instance, it might be because of drinking problem?! There’s a lot of shame associated with drinking, so older adults—especially older women—often hide the activity of drinking problem.

Chronic drinking

About two-thirds of older adults with drinking problems have been drinking much of their lives. They’ve been “getting away with it.” Or they may have stopped in middle age, and then relapse in late life.

Late-life triggers

The remaining one-third of older adult drinkers with a problem are people who may even have been teetotalers in their youth. Keep your eyes open! Even if Dad never seemed interested before, alcohol could be his “comfort” now.

Loss makes elders particularly susceptible, for instance after the death of a spouse or a move to a new living situation. Pain or failing health are other common triggers. Even something as happy as retirement can pull the rug out, removing friendships, identity, and daily routines. With so much idle time, it’s easy to fall into a drinking habit without realizing it. When one drink becomes two or three, it can lead to dependence.

Loss of meaning and purpose are huge culprits

Loneliness and isolation lead to depression and anxiety. Without social contacts, it’s just too easy to “self-medicate” the emotional pain with alcohol. Older women generally, and men who have lost their partners, are especially vulnerable to drinking in later life.

Signs of a drinking problem

  • Unexplained falls and bruises
  • Moodiness, irritability
  • Poor sleep
  • Weight loss
  • Forgetfulness
  • Changes in appearance and hygiene
  • Increased secrecy, hiding bottles

In a follow-up article, we will describe constructive ways to raise this sensitive subject with your loved one, as well as things you can do to help him or her.

Are you worried?

Maybe this is a new issue. Or maybe your relative has been a lifelong drinker at no small expense to the family. As the Orange County experts in family caregiving, we at Senior Life Management know how delicate this issue can be. And sometimes even painful. Give us a call at 949-716-1266 to talk about the options. You don’t have to face this alone.

 

Preparing for Joint Replacement

joint surgery

If your loved one is slated for joint surgery, don’t underestimate the impact. Expect that he or she will have reduced energy and greater needs.

Limited mobility will create surprising challenges. Things you take for granted will need extra care and attention for joint surgery.

Plus, the body simply needs time and energy to rebuild bone, muscle, and nerve connections after joint surgery.

There is much you can do ahead of time to help prepare a smooth path for recovery.

Support physical preparation for success

Please Note: Senior Life Management does not specifically endorse the activities of these organizations, but offers their information as a sample of the kinds of materials and services that are available.