- Moving tables and furniture out of high traffic areas to keep travel areas free of obstructions.
- Securing throw rugs or taking them up if that’s not possible.
- Making sure walkways are properly lit (this will especially help those with vision impairments).
- Adding non-skid mats to bathrooms and bathtubs, along with hand rails.
- Buying a raised toilet seat with hand rails.
- Installing grip rails where they’re needed.
- Insuring that there is room for the use of mobility aids such as a walker.
As parents age, adult children gradually find familiar roles shifting. More and more, their elders turn to them for help, rather than the other way around.
The individual circumstances will vary. A fall and broken hip can incapacitate a parent, requiring temporary assistance at the least. Degenerative diseases can reduce mobility or vision, making it harder for a senior to drive or even venture far from home on foot. For even basic needs such as groceries or meeting with friends, they’re dependent on others. Alzheimer’s Disease or dementia can also create a need for consistent monitoring and care.
When these changes take place, there’s a greater chance of family conflict. Older parents resist the idea of slowly losing their independence and having to rely on others for help. They often will still try to assert a sense of parental authority when in fact it doesn’t exist at all anymore. Their children themselves are already middle-aged or older, well-experienced in life. Acting out of concern, they may try to take control of the situation, sometimes creating hurt feelings as they make difficult decisions for the best care of an older parent.
Much of the problem in conflict usually occurs with faulty communication or a lack of it altogether. Parents can feel downright offended being relegated to a dependent status where they are guided or restricted in decision-making. That emotion can make it hard for an older parent to see reason. At the same time, the older child is balancing a new demand for parent care with everything else in life including raising his or her own kids, holding down a full-time job, paying the bills, and perhaps mid-life relationship issues. Their spouse’s parents may need help too, bringing another set of problems to the mix.
Under these circumstances, an adult child’s need or choice to bring up the subject of assisted living can come across to the parent as a rash decision. There is no question that most older parents would love to retain and keep their independence for as long as possible. However, as mobility and mental faculties begin to falter, the need for monitored care begins to increase. Assisted living can serve a real benefit for everyone involved, especially when adult children live a significant distance from their parents.
Regular and constant communication between an older parent and caring adult child towards each other is the key. Granted, someone usually has to make a final decision, but as long as they’re able to participate the parent should play a prominent role in the planning for their care. If adult children maintain communication and actively seek the parent’s input, they will generally feel more at ease with the transition to assisted living. But acceptance takes time. Adult children have to be patient and work with their parents as they grapple with the changes that take place during the aging process.
/by Moti Gamburd
Has dealing with your elderly parent become an encounter with Oscar the Grouch? If so, you certainly are not alone. However, as their child, it can help to view these encounters from an entirely different perspective.
For a person who has always been independent, athletic, and able to recall many details, losing these faculties brings many underlying fears to the surface. Feelings of both helplessness and hopelessness can overtake their thought processes. It is important to remember that anger is often an outward expression of inner fears, and that while the complaints may seem to be hurled in your direction, it often has little if anything to do with you. Be patient, be kind, and reassure your loved one that he or she can talk to you. Understand though that no matter your age, parents generally do not want to place excess burden on their children. If your mother or father is uncomfortable expressing their innermost feelings with you, perhaps arranging sessions with a professional counselor will help your parent to truly process those raging emotions.
It’s important for adult children to really assess the situation thoroughly–and honestly. For instance, some individuals always see the glass half empty, regardless of the circumstance. If your aging parent was always negative, illness will not bring out the best in them. Complaining personalities generally remain negative, complaining personalities… and sometimes you, as the caregiver, must be honest with yourself about this. Also, most people are more irritable when they do not feel well.
But, there are some elderly individuals who feel that by virtue of their years on this earth, they have somehow earned the right to “not hold back”… and some will use it with a vengeance! In this case, there may be a glimmer of hope for change in circumstance.
When your loved one begins taking a new medication, it often can wreak havoc on the body. This is further exaggerated by negative interactions between multiple drugs used to treat symptoms. If you notice a recent change in behavior or attitude that seems to coincide with a new prescription, a pharmacist or your loved one’s doctor can often help you get to the root of the issue. Personality changes can come on quickly and strongly in these scenarios. Bladder infections can also cause severe shifts in mood and personality.
Cognitive decline (such as that found in Alzheimer’s disease, dementia and Pick’s Disease) can trigger severe levels of frustration. That is due, in part, to the inability to perform certain tasks that have been routine for years. These disorders cause a person to lose the ability to recognize objects or to remember things and people that are very familiar. It’s a tough time for both the individual as well as their family members; the frustration can spark the types of personality changes that surprise even those closest to the individual.
Addressing personality changes brought on by medical challenges is easiest to deal with; simply get your loved one to a physician for treatment. These types of personality changes can disappear very quickly with medical attention or a change in prescription.
However, if your parent was always the “Debbie Downer” type, or if he or she had tendencies toward verbal abuse (or worse) in the past, you have to establish reasonable boundaries so that you, as the adult child and caregiver, do not walk away hurt, frustrated, and disrespected constantly. If that still doesn’t work, you may also have to distance yourself from your parent, assisting on a limited basis. If you cannot find a workable solution on your own, you may need to speak with your local Social Services office to find a reasonable solution for everyone involved.
/by Moti Gamburd
Caring for an ailing loved one is demanding, time-consuming, and quite stressful. Often, caregivers spend a great deal of time making sure their loved one’s needs are met and their affairs are on track. What often goes quickly out the window? The caregiver’s own needs. The following are ways to detect if you, as a caregiver, have neglected yourself to the point of burnout.
Isolation. As human beings, we thrive upon healthy relationships. When you find yourself regularly failing to engage in healthy social interaction–even with your own friends and family–this may be a huge signal that caregiving has begun draining you. Avoiding calls from people you enjoy, making excuses for not going out, etc… can indicate you may be well on your way to isolating yourself from others, which is never good.
Feeling Overwhelmed. Caregiving can be an emotional rollercoaster for sure. There is the physical toll of spending so much time attending to the needs of your loved one. Further, there’s an emotional toll that comes with facing the shift in relational roles, seeing both physical and emotional decline in your loved one, and having to face day-to-day tasks which reinforce that life as you have known it has changed.
It is natural to grieve, especially at the beginning of your caregiving experience. Frustration can arise. Anxiety and exhaustion can arise. But over time and left untreated, those feelings can lead straight into depression. If you become angry to the point of wanting to hurt your loved one or even yourself, get help fast. Your doctor should be able to diagnose whether there is a medical condition driving these symptoms. If medical challenges have been eliminated as a probability, you may have reached the point of extreme burnout and may possibly be experiencing depression.
It is important to remember that while you serve as a support system for your loved one, you will also need to create a team of others who can step in to help. Being kind to your loved one is important, but it is also important for you to be kind to–and eliminate excess pressure on–yourself.
Loss of Interest. One of the biggest warning signs of depression is loss of interest, especially in things that were once a huge source of happiness and enjoyment. When your hobbies, big and small, no longer inspire you… you may need help.
Significant Changes in Your Sleeping or Eating Patterns. Can’t sleep at night? Can’t get enough sleep, no matter how long you’ve been in bed? Binge eating or hardly eating at all? Major shifts in your habits generally indicate huge shifts in your stress levels and turmoil in your emotions.
Ceasing Your Exercise Routine Despite Enjoying It Before. Exercise is one of the best stress-busters available. It leaves a person invigorated and energized. So, when you used to enjoy exercise and suddenly stop, start again! The endorphins released while you’re exercising will relieve tension and help elevate your mood, plus you will get a better night’s sleep.
Failing To Keep Up Your Appearance. Unfortunately, many caregivers fall into the mode of caring for a loved one so much that simple grooming (haircuts, manicures, etc…) become neglected. Some who once were fashion-conscious and took particular efforts to care for their appearance can suddenly become apathetic in this area. Generally, your outward appearance reflects what’s happening inside. This challenge may require some input from others you trust–close confidants, social workers, or healthcare therapists can help you sort things out to decide if you’re experiencing burnout and if additional help is necessary.
Frequently Susceptible To Illness. If you catch every cold or flu that comes your way, and especially if you cannot shake the cold once you get it, your immune system is likely compromised. Our bodies are not created to handle excessive stress for long periods of time. If this is you, caregiving could be getting to you.
Take these symptoms seriously. You can only be a good caregiver for your loved one if you yourself are healthy and happy.
/by Moti GamburdMany of us know that living wills are a smart decision, but even with this document in place many find that making medical choices for a loved one is still complicated in practice. This post discusses some of the common problems with living wills and steps that you might be able to take to make sure that your wishes are followed.
The living will document was designed to give the patient the right to determine–ahead of time–the type of medical care desired in the event he or she is unable to communicate those wishes. However, the language commonly used within a living will (which is also referred to as a substantive or instructional advanced directive) tends to be rather vague, often lending itself to interpretation. For example, in this age of advanced medical technology and cutting edge treatments, verbiage such as “little to no chance of recovery” is becoming obsolete.
Some living wills, indeed, spell out possible scenarios and the patient’s desired outcomes for each scenario. While this is helpful, with medical technology evolving at its current rate, listing every alternative is virtually impossible, which then forces medical professionals and/or family members to then determine what’s best for the patient. Making matters even more difficult is the fact that for many what they want changes following an illness or hospitalization. One research study on medical decision-making revealed that three of every 10 patients change their minds about the type of care they desire, but those changes are not often reflected as quickly on the living will.
So then, we’re back to the challenge of interpretation. It’s important to note that even when the patient’s wishes have been clearly written out, family members are still faced with making these decisions at a very emotional time. Arguments often arise between family members in the midst of the crisis about what their loved one really wanted, when their energies would often be better utilized in coming together to support one another as well as the patient.
According to a February 2001 study published in the Archives of Internal Medicine, family members presented with various health crisis scenarios were about 70% accurate in predicting their loved one’s desires if faced with the scenarios given (whether the patient had a living will or not). That’s good news because three out of five patients who have living wills in the first place never give them to their doctors or to family members.
While that fact is baffling to most, it leads directly into the necessity for medical doctors to exercise their professional opinions regarding care that is in the best interest of the patient. Family members must often draw from their knowledge of their loved one’s lifestyle and wishes, perhaps even going back to conversations that happened before a crisis ever arose. Sometimes, though, the decisions made can go directly against the wishes of the patient.
Having a living will does not always negate a medical team’s decision to perform invasive procedures on the terminally ill. And again, family members who are facing difficult decisions are often reluctant to accept a diagnosis of imminent death and will, in some cases, fail to follow the instructions in a living will (hoping for a turnaround).
A number of legal and health care professionals who once championed the idea of each patient having a living will are now suggesting that patients designate a health care advocate. Generally this would be a family member or perhaps a close friend who would exercise what the legal community calls “substituted judgment.” In short, the health care advocate is responsible for making the decision you would make if you were able to. To protect that individual, a patient may even record verbally or write out their wishes, to confirm that the decision made–no matter how difficult–was in accordance with the patient’s desire.
There’s really no way to guarantee that what actually happens during a serious medical situation is what you would have chosen for yourself. But you can increase the chance of receiving the care you desire by communicating with your loved ones, with your doctor, and in writing the outcome you would want.
/by Moti Gamburd
As parents become older, there comes a point where you realize that you need to step in and help them with their finances. The red flag may be a bounced check or noticing that some bills are past due, or you could discover much more serious problems like the fact that mom or dad has been taken in by a telemarketing scammer. The steps below are your roadmap to getting your loved one back on track.
1. Know Your Parent’s Finances
The first thing every adult child needs to know is the condition of your parent’s finances. This means that you need to know what debts they have (credit cards, loans, mortgages, etc…), as well as what their living expenses are. Familiarize yourself with utilities, credit cards, and any bills they have and make sure you start paying them right away. You also need to know if there are any safe deposit boxes, and if you parents already have a financial advisor. It may be beneficial to take a look at your parent’s tax returns to get an idea of their financial situation.
2. Learn About Your Parent’s Income and Insurance Situation
Find out what sources of income your parent has. Find out of if your parent is receiving income from social security, what Medicare options they’ve chosen, and whether they receive Medicaid. Also find out if they have purchased long-term care insurance or other forms of insurance to make sure any premiums are kept up to date and policies are still in order.
3. Establish Who Has Legal Authority Over Your Parent’s Finances
When a parent becomes unable to care for their finances, it is especially important for adult children to know who has legal authority to manage the estate. Find out if your parents have already established legal guardianship with a relative, financial advisor, or with an executor. Pre-planning in this area can be especially important as it‘s more difficult to establish power of attorney if your parent develops dementia or Alzheimer’s. If you parents haven’t established a legal guardian before they become incapacitated, you’ll need to seek guardianship through the court system. A judge must agree that your parent is not legally competent to handle their own finances and that you are, which may take time.
4. Contact a Financial Advisor
A financial advisor or accountant can help you not only sort out your parent’s current finances, but also help you plan for the future. Depending on how you parent’s have invested, there may be other ways to maximize their assets to help finance their transition to assisted living. A financial advisor can help you navigate the options and ensure the best possible course for your parent’s financial future.
5. Get Everything in Writing
In order to safeguard both your parent’s and your own financial future, it’s best to make sure you have written documentation of everything related to their finances. Make sure you have legal authorization to act on their behalf. Any access to funds should be documented and any decisions with a financial advisor should be copied into a written document so there is a paper trail to help protect you and your parent legally. Having written records will also help if conflict or concern arises among siblings or other relatives.
Watching a parent age can be a difficult process emotionally for adult children, but it doesn’t have to be difficult financially. By following these steps, adult children can help ease the transition for their parents, ensuring a brighter and more secure financial future./by Moti Gamburd
Being the caregiver to an aging parent may be one of the toughest family roles imaginable. The task can be as demanding as watching a small child, with the added heartbreak of seeing mom or dad decline…plus the challenge of navigating the changing parent-child dynamic. But there is hope: stress can always be managed. Here are a few tips to use during those times when you feel like it’s all too much.
First, do not attempt to become a lone ranger. One of the greatest areas of stress comes from the feeling of taking on more than we can handle, and that is as true in the caregiving role as it is in other areas of our lives. Other relatives may be both willing and able to help. You may also be surprised to find that those outside the family, such as family friends or neighbors, may also be there to lend a hand. It is important to remember that aside from the task of caring for your aging loved one, there are necessary tasks related to caregiving, and having someone else shoulder those for a while may help you build in some much needed time for yourself.
Second, schedule in your “me” time. One of the greatest challenges family caregivers have is the overwhelming tendency to neglect their own needs in favor of their loved one. It is critical for caregivers to schedule some non-negotiable time to participate in activities that stimulate and interest them, because caregiving can (and often does) demand a significant amount of time and can deplete an individual both physically and emotionally. Schedule such activities as an exercise class, a movie, date night with a significant other, a massage, dinner with friends, taking classes on a subject of interest, etc… By doing so, the caregiver remains in touch with his or her own life.
Third, pay attention to your body. While most caregivers begin their roles in an overall state of good health, statistics show that they are more likely to develop symptoms of depression, anxiety, obesity, and weaker immune response as time goes on. Exercise is a particularly effective method of de-stressing the body, with the added bonus of boosting overall energy levels. Getting outside for fresh air can also be highly invigorating. All the great advice we give our loved ones — about eating balanced meals, drinking plenty of water and getting adequate rest — are just great rules of thumb for everyone to live by… including caregivers.
Fourth, building in a support system can be very beneficial. Providing care for an aging loved one brings forth a flood of emotions. After all, it is during this time that the caregiver witnesses the frailty and physical decline of the person whom they have always looked to for their own care. Seeking the services of a psychotherapist or joining a support group (through a church, synagogue, or local agency on aging), caregivers can often receive sound advice on how to cope during this emotionally taxing period. It is important also for the caregiver to not place unrealistic demands upon themselves but to simply do the very best they can.
Finally, cherish every moment. Glean the wisdom of these years and forgive any past disappointments you may be harboring against your loved one. Resolve any issues that may still linger, and commit to enjoying each precious moment available. Remember to be kind to others, understanding that each person operates the best they can with the knowledge they have. Be gentle even when expectations go unfulfilled. With a slight shift in perspective, you may find — as others have — much greater enjoyment of life’s simplest gifts as an unexpected bonus from caregiving./by Moti Gamburd
Alzheimer’s disease develops gradually over the years, usually going unnoticed at first but eventually becoming impossible to ignore. What signs should families be alert to? The key is to look for major changes that interfere with everyday life.
Some examples of actions that might be taken by a senior with Alzheimer’s include:
/by Moti Gamburd- Forgetting things that are part of a well-established routine, and were once done without fail.
- Repeating questions.
- Arriving somewhere without any idea how they got there.
- Losing their way on a familiar route they take every day.
- Forgetting to turn the stove off.
- Leaving doors open.
- Forgetting to eat meals.
- Unusually poor hygiene that the person is not aware of.
- Placing objects in unusual places.
- The inability to remember even basic words, or speaking in such a way that’s hard to follow.
- Sudden mood swings for no particular reason, or becoming uncharacteristically suspicious or trusting.
- Lack of awareness of strange behavior.
Unfortunately, more adult children live far away from their aging parents than ever before. When it becomes clear that mom or dad needs help, the thought of not being there for them can be very stressful. To make matters worse, they may not tell you the truth when you ask about their well-being. They are after all the parent, and they’ve spent your life worrying about you. They simply may not want to worry their child, especially one living far away.
If you have siblings who live close to your parent, they will probably by default end up as the primary care givers. Most siblings in this situation will appreciate it if you maintain frequent contact with them and make serious efforts to find ways to contribute. If they are raising their own family or their work leaves time at a premium, discussing the decisions to be made and supporting the decisions they make regarding your parent’s care will give them relief. It is a difficult and unfortunately common situation for the primary caregiver to feel abandoned by their siblings in this case. Ask your sibling what kind of support would be helpful. Often in these circumstances, family members who live at a distance contribute a larger share to any financial efforts, or sometimes come to pitch in for a week or two to give the primary caregiver a break.
If you don’t have siblings in the area, ask relatives who do live close by or your parent’s friends or former neighbors to visit them in assisted living. This will probably give mom or dad welcome company, and also give you a chance to hear from a third party how they’re doing. Talking to anyone who your parent knows, trusts, and speaks with regularly will help you sort through what they may actually need. People who can visit often will see potential health issues or other problems that your parent doesn’t want to discuss directly with you. ,
Get involved with, and stay involved with, your parent’s medical care. If your sibling is the primary caregiver, let them know you want to be a part of this. It’s important to understand the conditions your aging parent has, the medications used to treat them, as well as possible side effects.
It goes without saying that you will want to visit your aging parent as often as you can. The guilt often associated with living far away can be alleviated to a degree by maintaining contact. While it is not the same as being there, especially in the case of illness, these steps will give you the basis to be involved in your parent’s care and life.
/by Moti GamburdSeniors sometimes have trouble finding ways to occupy their time, but there are many hobbies that they can still enjoy. Below are some suggestions.
Art
Art, especially painting, is a popular hobby for people of any age. Seniors can take great satisfaction from having created something. Even those with no artistic training or who have trouble holding a brush steady can still have fun expressing themselves with more abstract works.
Needlecraft
Seniors are often able to enjoy different kinds of needlecraft. Knitting is especially popular with older adults, in part because even people with limited dexterity can still complete projects. Many people who have arthritis in their hands also find that it helps them to improve dexterity.
Games
Games of all kinds make great activities for seniors and help to keep the mind active. Games also provide a way to socialize and help keep seniors from feeling lonely. Popular games among assisted living residents include chess, checkers, backgammon, and bridge. Other seniors enjoy putting together puzzles, both alone and with others, or doing word games and crossword puzzles. No matter what their interests and abilities, almost all seniors enjoy games of one form or another.
Collecting
Some people enjoy collecting things as a hobby. Objects related to a favorite animal, stamps, and coins are all popular items to collect. A collection can be a great way for a senior to have something to talk about with visitors, and also keeps them busy by having something to research and think about. Collections can help seniors keep in touch with their past: for example, someone who was a big fan of 1950s sitcoms might collect memorabilia related to their favorite shows.
Writing
For some seniors writing can be the perfect hobby, allowing them to reflect on and reminisce about their experiences. Sometimes they may need assistance and ask for someone to help them with transcribing their thoughts onto paper, which can also provide an opportunity for socialization. Other seniors may choose to write to friends and family. Sending and receiving mail is an enjoyable and comforting ritual for some people. They can tell friends and family about what they are thinking at that moment, rather than waiting until the next time they talk to them.
Photography
These days photography requires little in the way of initial costs and expertise, but there is still plenty to learn as one gains more experience. Seniors can always find something they would like to take pictures of, and this hobby can help them document their lives and then share what they’ve noticed with others. Some people have been shutter bugs their entire lives, and photography is a hobby they can continue to enjoy as they get older.
Scrapbooking
Scrapbooking can be a great hobby because it doesn’t require a large amount of effort or concentration. It’s also an excellent way for seniors to be creative, as well as to reminisce about good times and preserve memories for the future.
These are just a few possible ways to keep busy in assisted living. With a little ingenuity and help, seniors can keep on doing the things that they love. This will not only give them ways to occupy their time, but also boost their spirits and even their health!
/by Moti GamburdCorporate Office / General Information
Raya’s Paradise, Inc.
1156 N Gardner St.
West Hollywood, CA 90046
Tel: (310) 289-8834
Fax: (323) 851-0375
E-mail:Info@RayasParadise.com