Anyone caring for a loved one with Alzheimer’s knows that angry, aggressive outbursts are one of the disease’s greatest challenges. Often, caregivers think in terms of managing these episodes once they occur. How can I redirect their attention elsewhere? Is there medication mom or dad can take? These solutions can be helpful, but it’s even more effective to find the cause of the outburst, in order to prevent such incidents before they even occur.
There are five common reasons why someone with Alzheimer’s disease may become upset. The problem could be one specific thing, or a combination of factors.
Their Surroundings: Is there something about the environment that’s making your loved one uncomfortable? Are they too hot? Is there some noise that’s bothering them? Are there too many people around? Frustration with being unable to control what’s happening or even communicate that they have a problem with it may make them upset.
Physical Difficulties: Your loved one’s agitation may be caused by some kind of a physical impairment. Check to see what might be wrong. Is there some kind of irritation or pain that’s bothering them? Are they having digestive problems or are they tired? These kind of problems may cause your loved one to lash out with a tantrum.
Psychological Issues: It’s common for Alzheimer’s patients to develop mental health problems such as depression, anxiety, or delusions. If you suspect this might be the case with your loved one, take them to the doctor. Medication can make an enormous difference in these situations.
Interpersonal Problems: Alzheimer’s patients are very sensitive to the tone you set, and thus are likely to react strongly to feeling rushed, forced, or otherwise rudely treated. Be gentle and calming in your approach and try not to talk down to them. Be alert for your own frustration and do your best to keep it in check. Ask them to do things rather than issue commands.
Disappointed Expectations: Because you know what your loved one used to be capable of, it’s easy for you to ask them to take on a task that might be too difficult for them. When they realize that they are not able to carry out the assignment that you gave them, they’re likely to have an outburst. Be careful to keep in mind what they’re capable of, and remember that rather than learning and growing, as we normally expect from people, they are instead in decline. What was possible a few months ago may no longer be.
If you’re finding that your loved one is frequently aggressive or agitated, consider these root causes when trying to address the problem. If you can prevent such incidents from happening in the first place, you’ll both be better off.
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Three important legal documents that every adult should have are a will, a living trust, and a living will. Each document defines your decisions for the different areas of your estate and will save your loved ones time, money and stress when you are gone. These documents are easy to draw up, or you could have a lawyer prepare the documents for a nominal fee.
A WILL dictates how your estate and property is to be distributed after your death and can also designate guardians for children and self should you become incapable or pass away. A regular will must pass through probate court in most states before your estate can be passed on to your heirs. Most state laws do not require that you use a lawyer to prepare your will; you can use a will kit at home. Probate court can take some time if there are any disputes, so make sure your wishes are clear when writing your will. A LIVING WILL defines your wish to be kept or not kept alive by artificial life support in the event of terminal illness or injury. A living will also give you the ability to set limits on your hospital, medical and funeral costs that can easily drain your estate and leave your loved ones with the bills. If you express your wishes beforehand, it will make the process much less stressful for those involved in your care and the execution of your final wishes. A LIVING TRUST is quite similar to a regular will, but they are different at the core. Unlike a regular will that cannot be changed after it is written, a living trust can be amended at any time. A living trust takes effect while you are alive, whereas a will takes effect after you pass. You can put property into your living trust at any time before your death and afterward your estate goes directly to your heirs without passing through probate court. If you ever change your mind about the definitions of your will, you can change or revoke how your estate will be divided at any time by using a living trust. A living trust will also save money and time later on because your loved ones won’t have to go through probate first.With everything going on in December, taxes are the last thing we want to think about. But this is a crucial time if you’re looking to save some money when you send in returns in a few months. You probably already know to make sure you’ve used up your flexible spending account or to contribute to your IRA, but here are a few other things you can do during the year-end crunch.
- Decide whether or not you (or your parents) will itemize deductions. Run the numbers to decide whether you’re better off taking the standard deduction (which is $5,950 for single filers or $11,900 for those who are married filing jointly). If you are going to itemize, look for opportunities to increase the amount of deductions before the year is over, since all deductions will lower your tax bill. For example, if you make a larger-than-usual donation to charity you’ll reap extra benefits. This may motivate you to do a little holiday cleaning, and take unused clothing or furniture to The Salvation Army or Goodwill. These organizations will provide you with a receipt, and you’ll be able to claim the item’s fair value as a deduction.
- Make large gifts now. If you or your parents want to give someone a large cash gift, write the check and make sure it’s cashed before January 1. You can give as much as $13,000 to an individual without being required to pay gift tax.
- Make an extra house payment. Here’s a trick for maximizing your deductions if you’ll be itemizing next year. Make your January mortgage payment early. As long as you mail it by December 31, the payment will qualify for this tax year.
- Review medical expenses. How much have you and your parents paid for medical care out-of-pocket? If your medical expenses are greater than 7.5 percent of your adjusted gross income, you can deduct them on your tax return. If you are close, you may be able to find ways to get care or purchase supplies that will put you over the edge.
- Consider claiming your parent as a dependent. If you pay more than 50% of your parent’s expenses, and their gross income is less than $3,800 (not counting disability payments, tax-exempt income, or Social Security), you can claim them as a dependent. Again, if you’re just shy of qualifying, see if you can make up the gaps in the last few weeks of the year.
There comes a point when you are caring for a loved one, when you have to ask yourself what is the best decision for me as well as for the person I am caring for. Whether you decide to continue to care for your loved one or start to explore other options such as a professional care home, take the time to insure your own personal health and well being. There is a reason that during the safety briefing on a plane they tell you to put your oxygen mask on first, then help your love ones. If you don’t take care of yourself you have no way to care for someone else. “There is a cost to caring,” states Charles Figley, an expert in trauma and researcher in the field of burnout; he comments that compassion fatigue is something that can occur when caring for someone long term. Take a moment to examine how you feel and see if you may be experiencing any level of burnout or even compassion fatigue and then take the time to explore ways to best care for yourself as well as those you love.
Before we go much further, let’s briefly explore the difference between burnout vs. compassion fatigue. Figley describes burnout as the end result of a gradual process of wearing down. It is the long-term consequences of unaddressed compassion fatigue, resulting in emotional exhaustion and a diminished sense of personal accomplishment and achievement. Recovering from burnout is often a more lengthy process.Compassion fatigue is often a result of the daily care we do, and is a more immediate specific response. It is often characterized by emotional and physical exhaustion; symptoms resembling depression; and usually a shift in a person’s sense of hope and optimism about the future value of the care they are offering. This may not be a constant feeling, but it something that comes and goes. The recovery from compassion fatigue is often less lengthy then burnout.
Are you isolating yourself, bottling up your emotions, having nightmares or even physical ailments? Do you suffer from compulsive behaviors such as over eating or over spending or have difficulty concentrating. Do you feel stressed out or depressed? These are symptoms of compassion fatigue. There is no cure for compassion fatigue but by practicing good self care techniques daily can help you to be physically and emotionally healthy and decrease these symptoms.
A self-care plan begins with you. It begins with being kind to yourself, becoming aware of how things are effecting you (both physically and emotionally), setting boundaries, expressing your needs, taking actions to aide yourself, surrounding yourself with individuals that listen and support you and being able to listen and support others around you. Although when you care for someone it seems like you have no time, you need to take the time to have healthy eating and exercise habits. Get plenty of rest and hydrate yourself. Develop good time and self management skills even if it means saying no. Have a support system, take breaks and try to enjoy a balance in your life. Do not give up all of your friends and hobbies. Pick your battles and even though it is hard, consider professional care givers, if not on a regular basis then consider short term help. You can sometimes schedule breaks, where you use a professional care giver in the home or facility for a few weeks a year, allowing yourself to have time to decompress and feel better before you can no longer care for your loved one.The biggest travel day of the year, the day before Thanksgiving, is almost here. For families with an aging loved one, that brings up the question of how to get that person to the feast. Whether travel means just a few hours by car or a plane ride, here are some tips for making sure your voyage goes as smoothly as possible.
1. Talk to your loved one’s doctor. Make sure that it’s OK for them to travel before you take off, and that the place where you’re headed is somewhere they can handle. Your doctor will let you know if there’s any special preparations you need to make in advance, and can also give you advice on medication to take if problems with anxiety or other issues arise. Make sure that you fill your loved one’s prescriptions before you go.
2. Do some advance planning. Think through your trip with your loved one’s limitations in mind. Are you renting a car? Then make sure you’ve requested a minivan or other vehicle that will be easy for them to get into and out of. Make sure you can fit their wheelchair and any other bulky equipment. If you’re flying, put in a request for seats meant for the disabled and notify the airline of any dietary restrictions. Also request a wheelchair so that you have some help navigating the airport. Contact both your hotel and airline to make sure they are able to handle any medical equipment that your loved one needs. Request a hotel room at ground level.
3. Be realistic. You may need to scale down on your usual travel routine. Keep things simple. For example, consider renting a cabin in the woods that’s just a two-hour drive away, rather than going to Europe or planning anything that will require a lot of walking (such as visiting an amusement park). Do your research in advance to make sure the location is properly equipped to have your loved one as a guest. Put plenty of padding in your schedule and don’t overload on the activities: it will likely take much more time to do things than normal.
4. Make sure you have necessary supplies. Special stockings can help if your loved one will be sitting for long periods, so that their extremities don’t go numb or a blood clot forms. Make sure you have protective gear for the sun, and especially that you have enough water since seniors are more susceptible to dehydration. Make sure medical information is with you at all times in case there’s an emergency.
At the final stage, Alzheimer’s disease begins to affect a person’s physical as well as their mental capacity. At this point, the person will require intensive, round-the-clock caregiving: assistance with dressing, eating, using the bathroom, and other ordinary tasks. The goal at this point is to make sure your loved one is comfortable and that they maintain as much dignity as possible.
At this stage, communication becomes difficult, and the person loses the ability to have a conversation. They might need assistance in order to walk, and their muscles might become rigid or possess abnormal reflexes. As the disease progresses they will likely also become unable to control their bladder or to swallow. At this stage, it is important to watch for infections; there is an especially high chance of pneumonia.
Due to the extent of your loved one’s needs now, this is the time when you’re most likely to need to move the person to a facility where they can receive the proper care. This is a decision that will require lots of research and education to make sure you’re making the right choice. On this website, we have many different resources to help you find the right Alzheimer’s care solution.
Though they have trouble speaking, your loved one is still “there.” They feel emotions such as calmness, fear, and love. They can also still use their senses to perceive you and the world around them – this is their primary way of interacting. Your main focus will be on providing for their physical well-being, but try to find ways to connect with them. You might read to them, look at old photographs, play music they might like, give them some potpourri to smell, or make them a meal they would enjoy. Think about the basic life pleasures that many of us take for granted – these are the kind of things your loved one can take pleasure in at this point.
This stage of the disease is one that is difficult for caregivers, both on an emotional level and on a physical level too. As the end of your loved one’s life approaches, you might be feeling sad, relieved, or numb to any feeling at all. These reactions are all normal. Receiving guidance from a bereavement specialist, therapist, clergy member, or other support can help you address these feelings in a healthy way. It is important to confront your grief.
For seniors in delicate health, forgetting to take medication or taking it improperly can have more dire consequences than one might think. The federal government estimates that 10% of hospital admissions are due to taking medication incorrectly, and over 125,000 people die each year as a result of this problem. Almost a quarter of nursing home admissions might be due to seniors having trouble with taking their medication. Unfortunately, this is an alarmingly common problem, with over half of all seniors taking medication incorrectly. Half of those, in turn, make the kind of mistakes that could have serious ramifications! When we consider this information in light of the challenges of seniors with dementia, it’s clear that this is a problem caregivers and family members need to be alert about.
There are many devices and solutions available to help keep loved ones on track. One simple remedy is buying a pill dispenser or a similar device. Your local drug store probably carries basic versions that will both organize pills and sound some kind of alarm or another reminder. There are also more elaborate and expensive systems that might, for example, call a designated caregiver if the senior has missed a dose. There are even smartphone apps for this issue. Drug companies themselves are also trying to help, with phone calls to seniors who are taking their products.
However, studies have shown that these methods don’t solve the problem. Sometimes this is because the devices are too complicated for seniors to use, or because they are not equipped to handle the typical senior’s complex medication regimen. And these systems often require input from a senior who may no longer be organized or independent enough to do what’s needed. Even if a loved one sets up the system initially, snafus like dead batteries or a malfunction could cause that effort to be useless.
For this reason, the best solution is to have a family member or other caregiver help the seniors with managing their prescriptions. A human helper can also address when forgetfulness is not the issue so much as unwillingness or lack of understanding about why a particular medication is important. This can be a particular concern for dementia sufferers who are determined to hang on to control and demonstrate their independence. Ideally, there would be some kind of gadget or gizmo to make this problem go away, but this is one issue that requires a human touch.
Many caregivers are proud of the fact that they’re helping their loved one and doing what they can to keep that person home with the family. But no one claims that caring for a loved one with Alzheimer’s disease is easy. Taking on this heroic task is without a doubt exhausting: mentally, physically, emotionally, and financially. Most caregivers report feeling high levels of emotional stress, and many are just simply worn out physically.
For this reason, all caregivers should consider the option of respite care. Respite care is offered at assisted living and similar facilities. A loved one can check into the facility temporarily and there get the expert care they need, allowing caregivers some time to recharge. This can be for as long as a week or two, or as short as an afternoon, giving you the chance to get some important errands done.
Rather than frantically doing a search for a respite care facility when you’re at the end of your rope and in a panic, it’s best to start your research before you think you need it, while caregiving still seems manageable. Talk to senior homes and adult daycare programs in your area to learn about the different options available.
Respite care might be a good change not just for you, but for your loved one as well. They may enjoy the chance to interact with the other seniors that they meet in their temporary home. Many facilities will hold entertaining events, or run fun activities that are specially designed for their particular ability level.
Some Alzheimer’s patients may have some trouble with being in a new environment. However, they do have the capability to get used to being in a new place if you make taking a break a regular routine.
How do you know when making use of respite care might be a good idea? Pay attention to your emotions and your body to recognize burnout. These include having trouble sleeping, exhaustion, anxiety, depression, social withdrawal, and anger. Your body will often warn you when you’re getting in over your head, so be mindful of any health problems that crop up.
Respite care is not a cop-out, and you are not abandoning your loved one. Rather, you are taking a break to prevent your own burnout. By taking advantage of the respite care option, you are strengthening your ability to provide the best possible care for your loved one. Consider that if you ignore your stress, you may create bigger problems down the line that will result in you giving up caregiving permanently. You can always run much further if you start and stop, rather than push through past the point of exhaustion.
Contact us for more information about the respite care options at Raya’s Paradise.
A study in ‘The Gerontologist’ states that, “approximately one-third of 65-year-olds are single.” That’s a 50% increase since 1980 according to the U.S. Census.
Aging with family and friends has been shown to result in improved health of seniors, including lower chances of cognitive impairment, and hospitalization. Research shows that socialization, companionship and hobby-building has great benefits for seniors: older adults who are surrounded by others are at a decreased risk of both cardiovascular and cognitive decline.
For some seniors, moving into an Assisted Living Community is the first step they can take to help maintain or increase the quality of life as they grow older. In reputable communities, experts in the field of long-term care help coordinate between activities to create communities where older adults are able to create new memories with one another. Residents take on scheduled group hobbies such as yoga, cooking, and artistry while pursing passions both new and old. Assisted Living Communities can act as a hub for seniors to connect and make new friends.
Our advice for making friends in a community? Participate and try out all the opportunities that are available. The goal is to foster an natural feeling of community with residents similar in age and circumstances.
Let’s say that your mother has granted you power of attorney over her finances, and she has recently become unable to manage her own affairs due to dementia. Upon looking into her accounts, you discover that she has several thousand dollars worth of debt. Can the creditors come after you personally for this money?
No, they cannot. This holds true even if you have power of attorney. The only way you can be responsible for your parent’s debt is if you were also a co-signer on the loan. But, those of us who feel duty-bound to do the right thing may want to make sure that the bill gets paid anyway. Here are some things to consider before you proceed.
What type of debt does your loved one have? Depending on who the creditor is and the conditions of the loan, the rules for paying back the debt or your sense of obligation might be different. A bank loan is going to be relatively impersonal. The bank will be business-like if there’s a problem with the account, and if everything’s in order will probably not hassle you to repay the whole loan quickly. However, if your mother owes money to a contractor who also happens to be a family friend, and he needs the money, the debt will be much harder to ignore.
Is there a way to contest or renegotiate the debt? For example, was your mother taken advantage of by an unethical salesperson? Did she put a doctor’s bill on a credit card rather than working out a payment plan directly with the office? Can items be returned or recurring services canceled?
Explore different ways of addressing the problem. It’s always worth calling the creditors to see if more favorable arrangements can be negotiated, and the Consumer Credit Counseling Service can help you with working things out fairly. Also, examine your parent’s finances carefully to determine if a source of funding is available. For example, they may qualify for a reverse mortgage that can help you get the debt taken care of quickly. And if your parent has passed away, the matter is as simple as using whatever funds remain in the estate to pay what you can, and then notifiying whoever has not been paid that there are no more assets.
If there’s no money available to pay the creditor and your parent is still alive, you can simply try asking them to forgive the debt (though they may not buy that there are no assets unless your parent is on Medicaid). Your parent can also declare bankruptcy. You’ll of course want to speak with a lawyer before considering this step.
Few of us are comfortable leaving debts unpaid, but if you follow the steps above you will have done your due diligence to get creditors what they are owed.