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A House is Not a Home (Part 3)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 18, 2017
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A House is not a Home (Unless You’re There)
At CCM, home and safety are as important to us as to you, so it’s no surprise that it’s...
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June 5, 2017
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In the Caregiver's Words

Recent Client Praise

The discussion about whether home is still the right or safe place for an aging parent should start with whether an older adult wishes to stay in their lifelong home or not. Some older adults are ready for a move, whether it is just to downsize the responsibilities of home ownership or to move to a warmer climate. But if they really want to stay where they are, the next conversation can then focus on what can be done to allow that to happen, but only if the choice is to stay and age in place. This is going to be the first in a two-part series about helping an older parent maintain independent living within their own homes. I have talked about some of the hardware-related issues in earlier posts, but this is more about lifestyle changes.
Emergencies Just Happen. There are a lot of options to make an elder’s home safer from falls. But, a fall or some other medical emergency can occur no matter how hard we try to prevent one. Make sure you have copies of all the important phone numbers in case of a medical emergency, especially if you live in another town away from your parents’ home. And be sure that this includes the local hospital, the primary care physician, any medical specialists and even the phone number of a neighbor or two who can step up if called upon. Also, keep current with any diagnoses or medications that your older parent currently takes.

Unheard of Problems. Hearing loss is typically a slow process of degradation. It may not be noticeable to those whom your parent sees everyday. But you take care of a Chicago senior living some distance away, note any change you may notice since your last visit. It is not just that you want your parent to benefit from optimal hearing – when one loses hearing, it is harder to even talk on the phone. Add up the difficulties in social situations and the inability to reach out with phone calls, and an older adult is at risk for becoming isolated which ultimately fuels melancholy and depression.

Vision Too. Older adults who have progressively lost visual acuity also are at risk for the same isolation that deafness can produce. If it is hard to see the buttons on a telephone it becomes just as hard to reach out to others as when one loses hearing. But if your older parent does have a decline in seeing or hearing, it does not mean that they cannot be socially active, but you may have to get help in the way of transportation, organization social venues and the like.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com. Visit our For The Caregiver page for more information and resources.
There are those who have not seen any changes in their lives in the midst of this pandemic and quarantine. They’re our older family members with Alzheimer’s disease or some other form of dementia that has robbed them of the ability to even comprehend the restrictions of this pandemic. They have been isolated as protection against COVID, but their quarantine experiences are not the same as ours. I bring this up because as more of us are able to be vaccinated and resume some semblance of life before the pandemic we also will likely be able once again to visit Mom or dad who have been under strict quarantine and may have some questions for us. How you answer their questions and engage in conversations in general is necessarily going to be more about them than it will be about you and the rest of the world that has been upended. Honesty is going to be the first casualty of the pandemic when we encounter a loved one who has Alzheimer’s or dementia, but I am not talking about lying. At its core dementia is a progressive decline of the brain’s ability to process what has happened in “their world.” You ought not view your initial reunions with older loved ones with dementia as a “chance to catchup.” We have to be prepared to join their reality using a technique health care professionals call “therapeutic fibbing.” You will need to learn to “go along” with the reality they know by first asking them about themselves, their recent experiences, and what’s going on. This may go against how we all were raised, but telling the truth may be cruel to someone who is not processing reality in the same way we are. An example helps. Picture you’re talking once again with your mother who asks where your Dad is. He had told her, she recounts, that he was going to get the car and come by to pick her up for an outing. The unfortunate truth is that dad died last year, but she keeps coming back to scenarios in which he is just temporarily gone, and understandably is looking for his return. You don’t tell her he died, because she will experience the awful loss all over again, she’ll cry hysterically and become agitated. And since she has short term memory issues she will forget again so she will be primed for experiencing the grief anew the next time you correct her. Instead you might say that Dad suggested he would be delayed a bit and that he had asked you to offer her a snack until he can make it back. She agrees that a snack is a good idea and you get into another conversation. Or, your father with dementia tells you that he is going to go get the car and take mom for a ride. They like their Sunday afternoon drives…it does not have to even be Sunday. So, maybe you can ask how the car is running and suggest it would be nice to have a snack with him for their ride. While you prepare the snack perhaps look out the window and remark on the sunshine or the birds or anything. Then start talking about the view and ask him questions. Share the snack with him and get into a new conversation. My clients with parents or spouses with dementia talk about their “therapeutic fibbing” as really hard at first until they can see their loved one actually brightening with the diversions. And once they both have a brighter conversation, they both have now had a better day. And tomorrow will be another chance to brighten both of their days…and tomorrow…and tomorrow. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
As I look to the close of November which has been National Alzheimer’s Awareness month, I thought it would be helpful to allow someone who was diagnosed with has Alzheimer’s to give this devastating disease a voice. Richard Taylor, Ph.D., a psychologist from Houston, Texas, died in 2015 from cancer, but he also died with dementia. Early in the progression of his condition, he committed to writing about his experience so that others with a loved one who has dementia might gain some personal understanding of what dementia is like. When he was seven years into his diagnosis, at age 65, Richard Taylor wrote Alzheimer’s from the Inside Out, and he followed this with a monthly newsletter on the subject. The following is an excerpt from an edition of his newsletter in 2011: “I am Richard, an individual living with the symptoms of dementia, probably (maybe) of the Alzheimer's type. This is my monthly newsletter for February, the month of my birth (Chicago, Illinois/Jackson Park Hospital 4:30 PM), at least that is what my Mom told me. This really isn't a newsletter; it's more like a report of what's happened to me in the past 30 or so days. It is sort of like my book, Alzheimer's From the Inside Out, except this newsletter is free and without charge (at least for now). It will soon be published in five languages - the newsletter that is. Through it, I have made and maintained friends with kindred spirits all over the world. We all share more than a failing memory and slipping cognitive skills. We all want to know as much about what we "have" as possible. We all want to understand the research that is going on. We all to a greater or less degree are hoping for a cure - whatever the hell that means to each of us- within our lifetime, affordable to our families, with side effects that are significantly less than the symptoms of dementia with which we now live, and oh, by the way, could it reverse at least some of the more intrusive symptoms of this or that form of dementia. I have spent a lot of time this month thinking and writing about this. I am not a researcher; I am not a physician or a pharmacist. I am just, Richard, a tall guy with a beard who is living with the more and more intrusive and more insoluble symptoms of dementia with which I have to cope if I want to live a purpose full, joy filled, love filled, and complete life. Most times this is much harder than I want it to be. It's not fair, it's not right, it just is. So I most times try to cheerfully embrace today, live in it as fully as I can by myself, and live in it more fully as a result of the enabling support of my family and those who love/like me. Welcome to my inner and outer world more and more defined by dementia, probably (maybe) of the Alzheimer's type.” Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
It ended with almost uncontrollable laughing. That’s how one of our team describes his conversation with his mother about making her funeral plans one day not long ago. Yes, you heard that right…they talked about her memorial service and had a great laugh together. My take on that is that once the incredible stress around a topic that no one wants to talk about is addressed, the relief is almost giddy. We laughed too when he relayed the part about Googling funeral hymns and singing along with his mom the ones she particularly liked. Trust me; this is not a unique story, and it is only one of the “difficult conversations” families can have. According to AARP, 70 percent of Americans say they feel that it is important to have an end of life conversation with their family members, but only 30 percent have had that conversation. The younger generation in the family may not hear the conversations that older adults have among themselves about death and dying, and parents may not want to “burden” their adult children with talk of end of life. But that will not change the fact that death is a universal event for all of us. If you are that adult child who would like to help your parent with the conversation, there are some ways to “break the ice” in order to have a productive conversation. First, you don’t have to start with end of life questions; you can start with some of the more mundane issues about health or medical issues. Every professional painter will tell you that there is a whole lot of prep work before they even put the brush to the paint. Start with mentioning perhaps a friend whose parent had a medical episode, and the adult children were not even aware that their parent had a problem with their (fill in the blank…heart, lungs, etc.). So those same children could not even supply their parent’s physician’s name or the medications they were taking or any of the other details that the paramedics or emergency room personnel had asked. Or you may even point out that your significant other has all the details on your medical health “just in case.” Would your parent also wish to have you in the know about their health…just in case? And there may be certain circumstances…
- Mom, if your medical professional makes any kind of new diagnosis, do you want to know every detail, treatment options, prognosis, or just the big picture stuff?
- Dad, if the doctors have treatment options for a condition, do you want to know all the details, or just what your doctor recommends?
And there are some issues that can be clearly laid out in documents for the medical record. Called POLST in Illinois (Practitioner Orders for Life Sustaining Treatment), it is considered a legal document that becomes part of a patient’s permanent record which states what kind of measures they wish to have applied in emergency situations. It is more than a Do Not Resuscitate (DNR) order; it covers the extent to which medical professionals should work to sustain them in an emergency. The Illinois site for this legal document also has suggestions for how to have the conversation. Obviously, the conversation can get into details like the one I started this post with, but it may not be the first conversation. We as Geriatric Care Managers also get the call to help families cover these kinds of issues, and we have made this into a form called the Life Span Care Plan(SM). Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
You’re fortunate that you haven’t contracted COVID, and you may even have received your first dose of a vaccine, but you likely have been laid low by the other scourge: the quarantine. I’ve talked about the ill effects – particularly among older adults – of the enforced isolation to tamp down the spread of COVID-19. Yet, there are active steps all of us can embrace to not just survive this pandemic, but to thrive. Here are Six Simple Steps you can take daily to help body, mind and soul get from lethargy to energy:
1. Sunshine – It’s particularly challenging this week to get outside, but sunshine boosts the mood; try a SAD (seasonal affective disorder) lamp, if you can’t get to the real thing.
2. Steps – I know that 10,000 steps a day is the often recommended dose of walking, but even 5 or 6,000 can boost your mood and burn carbohydrates.
3. Speaking – It doesn’t have to be a ZOOM call, but reach out regularly to people in your orbit; a number of Clubs who are not meeting these days are working phone trees, because human connection is important.
4. Social – But not social media and news is what you need; limit the time you take in the news or scroll on your FB page – they have made it addictive, so don’t get hooked.
5. Share – We get through crises, because we know how to give and also to receive. If you have an older neighbor or loved one, recognize they may not ask for help…so don’t wait for the request…offer.
6. Slack – Cut yourself some. We all set goals and we all have high expectations of ourselves, but you need to show grace to yourself just as you would with others.
As you can probably tell, this list could go on and on. Most of these revolve around having a heightened sense of what is good for you and also a sense of what would be beneficial for others, especially older loved ones with cognitive issues like dementia. We are social creatures who benefit from the good will of others and from giving to others. Please pass it on; you’ll be better for having done so. Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.

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Creative Care Management, LLC.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

855.455.5118 tel

info@creativecaremanagement.com

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A House is Not a Home (Part 3)

A House is not a Home (Unless You’re There)

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