Does Your Senior Know Fall is Coming?

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How to note changing seasons for seniors in care by francy Dickinson

fall door decor

Dear Francy; Mom is hot, she is usually, always cold and now she is hot. She is wondering if I can take her to the old family cabin. We sold it years ago — So, she is just sitting in front of the TV and does not want to go outside at all. She fussed with her bath lady and she is a grump.. Ideas? 

Labor Day is change of season for me. I always make changes. Even though I live on my own now and no one will see my decor I do the change for myself to honor the season changing. I change the Garden Banner into one that has pumpkins on it so when you are sitting outside you see the fall decor. I bring out some of my fall things for the house and go around and just place things here and there that represent fall. I buy small pots of mums and put them out on the front porch. (A perfect thing for the senior to do!)

Sit your man, or woman senior at kitchen table and bring in some plastic bags to protect the table. Have your pots of small mums on the table and help them put the small pots into a larger basket or pot for decor by the front door or the small patio. The actual hands in dirt is very relaxing for the senior. The potting then tells them the season is changing. They need to take note of seasons so their every days don’t blur.

If they are not able to help you with potting, then bring out the throws and give them a good wash and have the senior help you fold them and decide to put them on the backs of chairs or couch. Talk about the weather changing and let them know the hot late summer will soon be gone.

late fall 09 017Make a pumpkin pie…most of us are very deeply connected with food. Pumpkin pies tells us we are close to fall and gives us a great treat on top of it.

Pick up Pumpkin Pie lattes at the coffee shop and make a big deal about them. The senior will enjoy the treat and get the picture of fall coming.

If your senior is in a care facility…go over and sort through their summer clothes and bring a big plastic bin with fall clothes. Make your change. Leave them a few cool tops, but slip in longer sleeve shirts and sweaters. Get their closet cleaned out and let them see and feel the change in what they are wearing. I love the vacuum bags you can buy for clothes. It makes storage of your senior’s wardrobe all compressed down and easy to wash and store in the garage or closet of your home without taking up much room. You do not have to take a closet from your own house to hold Grandma’s clothes…you can just put them into the bag and vacuum it down into a nice thin storage bag that you can see thru to locate anything you need. Its a winner and they are reusable. Click here for bags. 

Make a big deal about fall outings. Don’t just watch football, make the football game a celebration, with your senior. My dear friend Bob, gave me a Seahawks throw, I get a kick out of having it…even though it does not change the world…it changes my feeling of fall and involvement in the team. Drive to the park and sit and look at the leaves changing color, go to the local market and let the senior see the pile of pumpkins. Change your seniors purse, or tech bag that they use by their chair.

Seniors love candy…so change the candy dish to some fall looking candy….it all starts to combine the season in their minds. They may forget it the next day…but it goes into their mind and will calm them and show them that seasons are moving. Life is important everyday, it does not just become days rolling into days.

Don’t forget that fall is flu shot season. There are newer over 65 flu shots this season…make a trip to your local Walgreen’s for a flu shot. No appointment needed. You do not have to go all the way into the doctor’s office. Walgreen’s take insurance and the shot is of no cost with medicare and supplement combo. If you are a primary caregiver to little ones or seniors…get your flu shot too! We do not need to have a horrible ending to a sweet life over the flu going into complications and changing the abilities of any senior in care. I just got mine and it was easy as pie.

Why am I hungry for a pumpkin pie now? Blessings, francy

 

 

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When You Say ‘Enough’ To Giving In Home Care

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How to make the decision to end the ‘in your home care’ of an elder. by francy Dickinson

Toots w Kathy, Merrilee n Francy at mother's downstairs area

Toots w Kathy, Merrilee n Francy at mother’s downstairs area in our home

Dear Francy: I don’t know what to do…I am in trouble and too tired to make a decision. My husband has MS and he is still functioning on his own. He is in a wheelchair but he has a good life at home, as a writer. We have three children ages 10-15 years and they are in the swirl of life. I have been a part-time cook at the local cafe. My husband’s aunt is all alone in the world and very dear to us. We have a mother-in-law outbuilding in our backyard and we have fixed it up and moved the Auntie in, to be close to us. She is a quiet and kind person that was doing for herself but she needed a lot of our help. It all seemed great for the first three months she was here. Then she got the flu and complications and she became more frail. Now, I have to care for her…running back and forth over the path to what the kids call “the cottage”. I am getting so tired and the house is beginning to feel the pressures. I don’t know what to do. Our Aunt has done nothing to upset us…she is just getting older and needs more care. Do you think this is just a bump? Or is this going to spiral down and take more of my time?

I can not tell you that, I am not a professional medical person. I am just a person that has years of giving in home care to my family and elders. So, what I will do is write down a list of things to help care givers with ‘in home care’ situations and you can pick and choose what might help you. Just remember there is no guilt when you try to give help and love to another…life changes and things often have to change. You are really in a situation that many others are…you are sandwiched in between job and family vs the care of a senior. Just the kindness of your heart, to make room for your beloved Aunt, is very dear to me. Thank you.

IDEAS OF HOW TO DECIDE, WHEN TO GIVE ELDER CARE IN YOUR HOME:

  1. YOU  have to save yourself first! My dear friend Cheryl, was a flight attendant for 25 years and they were taught to be the first to grab the oxygen when it dropped down! So they could stay clear headed and help others. Its a lesson for all of us to remember when we face situations that require so much of us as care givers.
  2. START SMALL. If you just take time to sit with your spouse and go over the needs list for your aunt and decide who will do what. Do not forget your children, they are all old enough to do little things and be in charge of this or that. Maybe they will take over more of the “in your house or yard chores” so you can go and take care of your Auntie. Be honest…this time can be an amazing learning lesson for your children and you. Giving up some of your own wants and doing for others…is what characters are built on. But this organization meeting will show you how much time you are spending. I don’t want to be out of place saying this…but a business meeting is like a “Come to Jesus”. You finally see what is in front of you.
  3. ASKING FOR HELP: If your Auntie has money then you have to be honest with her and get her to allow you to hire help. It could be a cleaning lady for both places that allows you to forget the little things a bit. The one help I insist on is a bath lady. I have said this a million times. They are worth their weight in gold and they should be the first on a sparse budget. They will take that pressure away and get the bath and hair all clean in a ‘faster than light’ action. Plus, they are another friendly face for the senior.  NO MONEY? Then you simply have to go down to the social services and get your Aunt signed up. They will do a review of her income and your care giving and they will provide help to make it easier for you. They will pay for her medications, they will provide food stamps for her food, they will pay – you – for care you are giving. (they do not pay for a spouse but they will pay for a family member or friend) Yes, in return they will make demands. You have to keep a clean area for the senior and do a few hours of nursing classes to teach you how to give healthy and wise care. But it was a life saver for me when mother’s care went into overdrive and I was not able to work any longer.
  4. BE HONEST: If you pretend life is fine, you are signing your own health decline order. This is not easy stuff…you simply have to say…I NEED REST. You can ask other family members to come one day a week, so you can ease your strain or simply sleep. You can ask your employer if you could just work two days instead of four days. Your income from the state should cover this change. You will find an increase in your expenses. Seniors require expensive food, protein drinks, Depends, extra electric bills with the increased clothes washing and heat bills. (seniors need heat all year round) Talk, the more you talk and ask for help…the more your family and community services will hear you and add you to their listing.
  5. COMMUNITY SERVICES AND FAITH BASED HELP: Even if you do not belong to a faith group, your local church, temple, etc is there for you. You are a part of their extended community and they will reach out to you. You may find that they have a list of retirees that are willing to come and just visit or sit with your senior so you can leave the house and shop. Or the senior can get a good laugh with a person of their own generation. You may find they have a food bank to help with extra items, they also have visiting lay-ministry people that will come and just talk with the senior. Do not get uppity about community help. Those services are made up of others that have gone through what you are going through and decided to put a group together to help others. Take advantage of their ideas and service time available.
  6. RELEASE ANGER: I have a list of families that are angry with their relatives because they did not help with giving care to their elder. If you can ask family to help you…to come and visit when you need to be at school for the kids…or to buy your elder a pair of slippers or new housecoat…then do it. But if they don’t…let it go. Just do not spend your already low energy on anyone that is not willing to reach out and give you a hug and help in your time of high stress. Those folks are not worth it. Let it be…
  7. GET A POWER OF ATTORNEY AND HEALTH CARE DIRECTIVE: I am afraid I often say this, so if you read my blog…its a repeat. But there is nothing, and I mean nothing more frustrating — than to give care to an elder on a daily basis and then have some punk realitive walk in the door and tell you that another anxiety medication is not really needed for your elder. Like they know! No one knows more than the “in home care giver” so you need to insist that you can make the decisions on the behalf of the elder. Then it will be your moral duty to make them in the best way you can, for the elder. Trust me, each time I talk about this…people think…OH my sister is better with forms and she will do it. NOT 
  8. GATHER A HEALTH TEAM: Add your senior’s family doctor, get a specialist to at least see the elder once and review things. Get a nurse to talk to or just get a nurse practitioner to be your main care giver reference. Now lets talk real. Doctors diagnose they do not treat you. A nurse or care giver treats. So you need to learn how to ask the doctor questions and understand the chemistry of the elder’s health problems. The better your questions are, the easier the care giving will be. Then you need to know what will happen at home…and what that means you will be doing about the care. If you go through a bump, ask the doctor for in home nurse care, he can order that and the nurse will show you how to treat the elder. Bring in a nurse contact or help line to help you decide how to care for the elder at home and a pharmacist to explain the medications needed. The doctor will give you drugs and what is called an Rx for things like physical therapy, wheelchairs, in home help of an occupational therapist, message, therapy sessions, supplements etc. This is important; anything your senior needs should be written as a prescription so the insurance and medicare will accept it and help pay for it. Always ask the doctor to prescribe something and to give you generic medications so you are not going down a big hole when free services and medications are available to you.
    YES> THIS MEANS YOU NEED TO BE ORGANIZED. So don’t be a baby…the more you write down, the more questions you ask, the more you get clarified…the easier the care giving will be.
    Remember; talk to a nurse about home care tips…read my blog and learn home care tips. Use the Internet for extra advise and read it all…then make your own decisions. Talk about supplements that will help the elder and special ways to use food and exercise to increase the abilities of any senior in any stage of decline. Understand bowel movement difficulty, side effects of medications, dizziness, avoiding falls, eating difficulties, hydration challenges. All these things will come up so you need to write them down and have doctor or nurse show you how to treat the problems at home. It is not scary if you understand and are prepared.
  9. NO< NO< NO: I just do not want to clean a bottom, or smell blood, give a shot, or lift the elder up out of a chair. OK…see, that is being honest with who you are. It does not make you a bad person. You need to draw a line in the sand and when you come to that line the elder is going to be placed in a care facility. Everyone has a line, yours maybe closer than mine…but that does not make me a better person. I have a disposition to give care. I never knew I did…I was never a girl that said I wanted to be Nurse Francy. Now I know, that I can turn off my mind and just give the care without getting sick or too involved in the immediate yucky situation. Some can, some cannot. Know yourself and draw your line. I have a line. I drew it with my mother and now it is firmly in place with my husband and his decline with Alzheimer’s. They have to walk or at least be transferable. I have a very bad back and I simply can not lift a huge person and walk around without a great deal of pain. What is your line in the sand? 
  10. HAVE A PLAN: Is there respite services you can use or senior day care services? Ask and find out how the local community is prepared to help you with rest. There needs to be a plan, where would you take your elder if they need to leave you? Some where close so you can visit and keep an eye on their care.  Have the place in your mind. Go and visit, tell them what you are doing and ask if they take medicare patients, if they have a long waiting list, if you could be on a secondary list of placement in case of emergency, etc. Once this is done, you will then be able to relax and know a quick transfer to a facility will not end up in you moving the senior again because the facility was not up to your standards of care. Call Hospice and ask them when you are to use their services…ask them how to judge the situation and they will walk you through a review of how to use them. So, if the senior is sinking down and wants to die at home…you can get help. Hospice also has facilities for end of life care…so find out the best way to use their services, now. Lastly, know what would happen if your elder passed in their sleep. Who do you call, is there money for a funeral, do they want a funeral. Do they want to be buried or cremated? Get it done early in the time you take the elder into your house. So as care accelerates you do not have to add another layer of upset to your own life. Get all this over and done. Then you can turn your attention to today…and making it a day of joy for you and your senior.

You may think no one cares about you being tired, upset and stressed over senior care. You may think that no one has ever been where you are today…but you are wrong. Generations have faced the same problems and found solutions that worked for them. One step at a time…give it time. A senior may have a big dip…and then in a week or two they will regroup, re energize and come back up in strength and life will go on again. Give it  all time. You take time to get over the flu…a senior takes more time. But encourage them to get well….keep them moving, drinking, eating and laughing. Let them know you want them to live…to the end of their life. Not just make it through to end. Keep your heart in the race and it will work out. Care giving is just a short part of your life time. The gift of your giving your heart…will come back to you in so many rich ways…year after year.

Blessings on all that you do for your family and your dear elder. francy

NOTE: Will you sign up to receive notice of my blogs please? You will find the button on the right side of the screen towards the top. I do not write as often now that my Georgie is in need of more and more of my own time. But I am here to do all I can to help. So send me an email if you need help. f.

Dealing with a Life Crisis n Alzheimer’s Too! HELP!

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How to get through a life crisis and still give care to an Alzheimer’s senior…by francy Dickinson

My Georgie with his great grand daughter, Claire and little Missy

Dear Francy; My mother died 3 months ago and I have a very big problem. My dad has early stages of Alzheimer’s and his emotions and memory loss have blown-up since mother has passed. I am a single mom of three and have no place or money to keep dad and my brother’s wife does not want him in her home. He has his home, paid for and he makes a small income each month, but his life is going down fast and I don’t know how to help him?

Friends are doing a big Auction with lots of items to help us in our move…TY francy
Auction 2 help 

Yes, we have some work to do. First, let’s just have a quick review of the brain for Alzheimer’s from a lay-person. Any person, with any kind of a jolt to their lives is going to have a loss of brain power. If you have a bad fever, a fall, a big argument or a death within your close circle of loved ones – the brain takes a hit. A person that is younger and has full function of their brain, will grow back the brain functions over a short period of time…and although they may feel a little loopy or tired, or experience some feelings of being ‘out of focus’, the repair takes place and the brain will once again function. For a person that is older the brain repair is on ‘slow’, and it will take a few months time to recover all of the brain functions up to par and then move forward. For a person with dementia/Alzheimer’s it really sets them into a ‘swim of things’ and takes a great deal of time for the brain to even  ‘try’ to recover.

Auction 2 help bit.ly/QEY6j0 I experienced this early in the Alzheimer’s process with my husband, George. He had pneumonia and it was not diagnosed. So he went in and out of hospital within a one month time frame losing his body’s ability to fight the infection and finally just having a mental check-out. When they found out his problem and gave him medications he was able to  return home from hospital…it took another six months for his mind/brain to recover. Even after that time, he never came back like he was before the onset of pneumonia…it put a quicker movement into his Alzheimer’s decline and it was such a sad thing to have happen.

It took a long talk with George’s neurologist to get an understanding of what was happening to him. So, you need to know that even on a good day of your dad’s Alzheimer’s he is not functioning like he would…he is grieving both the loss of his wife, life partner and friend. He is in the midst of that and that pressure is going to cause him to express his own thoughts in a confused way.

As always; a trip to his neurologist that specializes in Alzheimer’s care should be done right away. The doctors that give this care specialty are very savvy and will be able to help you understand where your dad stands in his Alzheimer’s progression. He can adjust his medications and help him with diets, exercise and social interaction suggestions for you to follow.

I would suggest that you try to keep him in his own home. He can not be alone and be safe…so my suggestion is that you either hire someone to come in during the day to keep him eating and moving and establishing his own routine again. Or you get someone to come in and live, in the house. This is a very common thing to do in the senior care field. You could find an adult student that needs a place to live and is willing to provide simple services for your dad; in return for free rent and food.

Or you could go into the community and look for another senior that would like to be in the home. I would go to the nearest senior community center or faith facility and ask if they know of a senior that needs a place to live and would be open to giving your dad his meals and making sure he takes his medications and gets to his doctor appointments. To be there for him so he can have six months to a year to move through his grieving and re-establish his life. It is worth your time to find just the right person. That will give you and your dad time to adjust and then face a move into an Adult Family Home.

I like the Adult Family Home…they are usually a house that has a few bedrooms that have other folks with Alzheimer’s in each room. The owner is a trained health care professional and provides a more family type of atmosphere for the patients. This place may be their forever home, or a place to stay for a few years and then transition into a care center that will provide more advanced care.

What I like about the live-in help is way to give you and your brother  time to heal and adjust to the huge change in your family dynamics. You can both stay close to keep an eye on things and still afford his care by exchanging a place for the person to live and eat…in turn for their time giving attention and ‘light’ care to your dad. Usually the house work is left to you or an outside person to do once a month. Then, when your dad has the time to repair from his grief and adjust to his mental loss…it will be time to give him more care and protection with an Adult Family Care Facility.

You can hire daily in-home care that is done by professional services…or you can go the private live-in help, which will give you less trained people. If you do this, you will have to set the rules and outline the chores to be done each day to help your dad.

The professional in-home services have their routines all down on paper. The company comes in and does an assessment and then puts a plan of care together with you. It is a very well run organization, but it is pricey. You can often set your budget and then pick and choose the care services he needs the most. The care that is given from the service is bonded and done according to a pre-agreed on program of care.

The private hiring of an in-home resident can also be very pleasing for all around, if they are interviewed and required to provide a reference and any one younger would have a drug test. That way you can know your dad is safe. The point here is – your dad can no longer live safely on his own. He needs to be cared for and if you can not do it…you will have to get someone to step-in. Keeping your dad in a stable situation is what will allow him to extend his mental abilities as long as possible without a big drop in his functions. If you allow him to just be on his own, and he is unable to remember his medications, eat well or interact or exercise…he will be in a downward spiral that will not be able to be repaired. His mind is not going to heal it will only go downhill…so this is a must..you have to keep him as calm and comforted as you can — as soon as you can…or he will take a dip.

The sale of your father’s home will pay for care in an Adult Family home…so I would keep that in your mind. As you go forward this next year…be sure to make improvements to his home to get it ready to sell in the near future. You can lay out the landscaping so it can be taken care of with bark and a lawn mowing. If your brother goes over a couple times a month to mow the lawn it will look tidy. The inside of the house will need new paint and cleaning and maybe updates to small things to give the house a good sale position on the market. It is best to do a little of this prep work each month…so the expenses can be budgeted during the year. Then when the time comes that your dad is in need of more care, the sale of the house will go easier.

You do need to take over his doctor visits. You need to be in the office with your dad to hear the doctors and understand the medications, food and exercise needed to keep your dad’s brain functioning at its peak performance. That performance will be a slow dip but good care can keep your dad in a bubble of calm and love for a long time.

Once again, if you can not do any care for him…then an Adult Family Home from day one is your goal. But I think with the help of you and your brother, hiring a service or a live-in help would be the best answer. This could keep your dad in his home and allow him to adjust to a new type of life for a year or so…then as he changes his routine’s a move into an Adult Family Home would be easier for him to make and not cause him a total melt down.

I understand the upset that a big change can make to an Alzheimer’s senior. We have to move out of our family home. We have lost it and will need to find a new place to live. I am really trying hard to absorb all the sadness and fuss myself…to keep my husband in a protected bubble. My husband’s Alzheimer’s is moving ahead and I do not want him to go into a severe decline over the move. So, this is a very hard time on me. I am asking friends to help and making plans to keep him calm and protected with a family member during the move. It takes a lot of planning to keep the pressures away from my husband, but in the end…we will be in a new place and he will have his things around him and he will feel safe.

I appreciate all you are doing for your dad…I know how hard it is to make these decisions for your parent. It’s an odd thing to be a child/daughter one day and a comforting care giving daughter the next. You have my appreciation for your love and time that you are giving to your dad. I understand that being a single parent on top of it all…is quite the undertaking…but you can do it! Blessings, francy

Worried About Grandma Back Home?

Help for seniors that are left alone in cities without family to care for them. Ideas and tips by francy Dickinson

Keep Seniors safe at home

Living Safe and Living Long

Dear Francy; My Grandmother and Aunt live in my old home town- two states away from me. I have a family of my own and very little time or money to spend on their care. They do not live together but they talk each day. I am getting very worried about their welfare. Their homes need help, their gardens need help and they need help. Both are in their early 80’s and are able to be on their own, but they need an extra eye to look over them. Ideas?

YES! This is a subject that I am asked so often. It’s so hard on family these days with all the travel we do, the jobs and families that we have established away from our old home towns. I understand the worry, I understand your fears and I have a few ideas to help.

  1. Try to plan a trip back home once a year or every other year. Do not go home at holiday time…do it in the spring or fall, when life is not so busy. That will allow you to really spend a few days with your older relatives and get a feeling for their health and ability for self-care.
  2. If you can not go than ask a relative or old friend from your home town to do a security check. You can reconnect with a highschool chum that would stop in once a month and you send her a thank you note with a Starbucks card inside. Be creative; older folks tend to say; “I’m just fine” when they are not just fine.
  3. Get the legal stuff out-of-the-way right from the get go. You need a power of attorney for health issues and they can have each of their names on the POA as back up. That way if they’re in trouble you can call long distance to the hospital and get information. The world and laws have changed, privacy means, NO information will be given out without permission of the patient. If the patient is unable to give permission…you are stuck.
  4. Make sure even if you are far away you can call and talk without worry. Add a MagicJack to your computer. That will give you unlimited long distance through the Internet for $25 a year. That way there is no worry about multi calls each day or long calls to them or others in the town to make appointments.
  5. Add them both to your family cell phone plan. They will not use many minutes and its a safe way for them to call 911. If you are all on the same cell phone company then your calls to each other are usually free. So they can talk to each other and to you and no minutes show on your billing. Call your service and ask them what a good plan would be for all of you, then make the change. Keep updating your cell services, some companies have special senior plans and it really helps to have that phone in their pocket ( or in their bra- LOL) all day long so they are secure in case of a fall.
  6. Think like you would if you were close. Call their doctor and make appointments, they do not care where you live. You make the appointments and keep up with the information as it comes up. If you have lived well into your 80’s and you have low health issues, then keeping life simple and having check ups is the way to keep your seniors living on their own for an extended time. Every year they need to see eye, skin, family doctor, and any specialist that they need for their extra care. Don’t forget teeth, they will start to eat less if they have teeth that are missing or hurt. 
  7. If they begin to have health issues; ask them if they would consider living together. They could both sell their homes and put the money in a fund. Then move in together in a retirement situation that would provide care as they age. They would have a community around them and be more involved in their lives – instead of alone.
  8. If they want to be where they are for as long as they can….start to set up a group of people who will help them. Get a listing of repair people from the community colleges and tech schools that are inexpensive and help seniors. Get yard people from garden clubs or faith organizations that do a yearly clean up for free.
  9. Add on a care service or hire an occasional cleaning person. Even once a month, or every other month. Add a bath person once a week this is really a good way to check their health. The bath person is trained to see if they are losing weight, have bruises from falls, or other medical complaints. I think this should be #1 on your list.
  10.  Connect with someone who will pick them up once a week and take them both to the grocery store, get their hair done, and get a pedicure (every 5 wks). They can visit together get a lunch after the shopping and have an enjoyable day. Someone from a faith center will do the job if you simply give a gift to the program. Be creative.
  11. Food, if they need help with food then do the local ‘Meals on Wheels’ they will send out food for the week and little treats can be purchased on the side. Do not allow them to go one day without a protein drink. This drink can be covered on their health program if you ask the doctor to give them a prescription for it. Boost and other protein drinks give them vitamins and protein that they may not get each day with small or unbalanced meals.
  12. Call the local Senior Center and get them on their mailing list…get them involved with day trips to local sites, card days, lite exercise, movie nites. Senior Centers have lots of extra services and so do the YMCA’s in the area. Tech college that are training in-home care givers also can send students for safety checks and so can the local Red Cross and Senior Care Services.
  13. Professional in home services can be done by the hour and you can get a review of what is needed when you call a Senior Care Service in the area. I always find them online and check out the references. These services are varied like bath people, cleaning, food prep, care giving and nursing. You can figure out the amount of money you have in the budget and use them each week or only on occasion. Its good just to talk to them and have an evaluation so they are ready to go when you are in need. Remember Medicare will pay for one month of in-home care after a patient has been in hospital for three days or more. Or Medicare will provide a 30 day stay in a care center to recover from a hospital stay before the senior returns to their own home. Your insurance and local senior services will review what your area covers for in-home care so call and get the idea in your mind and written down, in case you need it.
  14. If you feel they are in need of help financially..with food or other things you need a social worker. The best place to begin is with a  trained person that is there for you…you can call the local hospital that is close to them. Ask for the senior social worker and start with that person. They are always in the know and it is a hospital community outreach to help the public.

It will require you to make calls and get your lists ready to go, but once you do. It will be like you are living right next door. Do not depend on relatives, they often say they will do things and then do not follow through. It’s better to have a service help you, pay for it if your seniors have money and/or search for local charity services if you don’t have funds. Once again, the key word is being creative. Think about how you can ask others to help you to give your seniors the best care…even if you are not able to be there for hands on help.

Thank you for being so kind to your seniors. Many elders find their lives closed in to just their own home. They lose their spouses, friends pass, children are out-of-town and who do they have to help them? So good to know that you care enough to be on the other end of the phone. Blessings, francy

Help My Parents Can Not Take Care of Each Other

by francy Dickinson                          www.seniorcarewithspirit.com

Dear Francy; My dad is 82 with mild dementia and osteoporosis and my mother is 80 with heart problems and weakness. They simply can no longer care for their own needs without my help. I have increased my time with them up to 2 hrs a day but I am at the end of my ability to care for them. We have no money for a retirement home and I do not know what to do? I have three siblings, all male and unable to give care and so I am on my own here.

OK, if there is simply no money (I understand they are in a smaller and older home) Here are some steps to help you out:

  1. Make sure you have your name on the Health Care Directive for both of them. This is a form that is filled out and it then goes to the notary so you can make decisions legally for your parents.
  2. Remove your attachment to your parent’s home and look at it with an eye if you were going to sell the home tomorrow. Walk through the house and mark down what has to be done to ready for sale. Heavy cleaning with older folks living there unable to see dirt or move furniture or refrigerators to get things cleaned. Walls need paint, wall paper needs to be removed, bathrooms need painting and new faucets, updating and kitchen needs declutter? Write it all down in a notebook. Edit down their things no longer used as much as you can and still keep your parents feeling safe and cozy in their home. Changes are hard for elders so make them with ease and in a quiet manner.
  3. Now, think about getting a reverse mortgage, that’s a way a lot of families are dealing with monthly income. Call a reverse mortgage place and have them come and look at the home and explain all the benefits and downfalls. That is what they will do. They will make a flat fee for doing the paperwork on the mortgage and it is done through the government, so you can feel free to take their time and ask questions. It means it is a way for your parents to get the money they have invested in their home out each month. Then when they pass the home is sold and if there is anything left it goes to their heirs on their will.
  4. Call a local real estate person and ask them to simply come and view the home and evaluate it for you. They will do this with the hope that you will use them as an agent when you choose to see the home. Also ask them if the home is rentable as an income instead of selling, they will know the area and give you guidance.
  5. Call the Veterans Association, if one of your parents has served in the military and see where they are on the health care coverage. You will find it’s a sliding scale according to the time and type of service they served. If the Vets will help with care you can enjoy their services and save some money on care.
  6. Call their Medicare supplement insurance company and tell them you need them to send you a booklet on the outline of what care their plans are providing. Then you know where you stand with money for services for your parents. Twice a year you can change Medicare supplement insurance companies, you may find that now that your parents are in a higher need of care, there is other insurance policies that will cover more of the costs. Make some calls and study the Internet on this issue, it can make a big difference in money spent.
  7. If they have attended a faith center call and ask what type of community care they provide. Often large faith centers have seniors that will give you an hour or two a week, a dinner program, or in home visiting program. It all helps.
  8. Ask about Meals on Wheels in your parent’s area, this program is delightful for seniors that no longer cook. You can supplement the extra pie or cookies, take them extras on the bigger meals you cook at home and still have the meals in the freezer for your parents to microwave. If they no longer can cook or reheat, then that option will not be there for you.
  9. Call the state welfare and ask for a booklet on what type of care they provide for seniors with small incomes and they will send you information on that form of help. This is really important, because once you know what money you have to work with you can then move on and hire help accordingly. Lets say the state will only give you food coupons, that means a couple hundred a month on their income that can be spent on care givers not food. It is a good thing to ask for help, it is there for elders and it has been paid for by your parents in their taxes for years. The state may also pay you to care for your parents so your own time with them could be increased with an income or other care services could be added.

Now that you know about their money income it is time to add to your in home care assistance or to a more traditional adult care home, or assisted living facility.

  1. It is not easy to keep a couple together in assisted living if they have different types of care required. Dementia has a staff trained to handle emotional problems and health side problems. Health care for mom takes care givers that are trained for challenging medications- those are two different care giving situations and it may take time and extra looking to find a facility or home that will fulfill both care issues. So start to call today, if you think your parents will need a spot to go to in the next few months. There are waiting lists in many facilities and you want to be prepared not stunned when the time comes to take that step. Even if you think it will be another year, talk and get on waiting lists.( This is what I do for my income, I help families find those facilities and make their senior’s transition into them. I do not charge the family a fee.)
  2. If you are going to be staying on as their care giver you have to know it will be a more time consuming effort than what you are giving now. You will sit down with your brothers and have a talk. It is no joke, this has to be an adult conversation about your parents, without your parents in the room. So you can be free to speak of their health challenges and let them all know that things are heating up and growing out of control for you personally to care for them. Many family members respond to money rather than time. So explain it will take a min of $10 up to $25 dollars an hour for in home care. If they need only 4-5 hrs a day that is $100 a day…that can add up fast and then show them your parent’s income. This is how people look at problems. To sit down and say, I need help is not enough —  show them, the needs, the time,and the money needed — that is what will shake them into understanding the problem.
  3. Tell them your options, you have now done your home work so show them the different ways that care can be given and afforded. Then ask for their support, not their help. If they have not helped in the past, they will not help now. But ask them to support you with additional money each month, even if they give you $35 a month that could buy the Ensure that your parents drink everyday, or the Depends they use, or help with a bath lady each week. Every small amount is appreciated and the commitment has to be long term. The bath lady has to be paid each week if they give the money or not. Make decisions on reality not promises.
  4. If the house is going to be sold to pay for your parents care, then you ask the family to help you ready it for sale. You may not be able to remodel or update, but you can clean. Just take one room at a time, clean out closets, give things to family and good will, do not put yourself through big yard sales, they are to hard on you. Giving time and care is overwhelming, do it with thought about your own health.
  5. Paint as many rooms as you can to give it a low key color update. Use colors that are popular in your area. Update little things like lite fixtures in the bathroom and new faucets in the kitchen. Use the inexpensive vinyl tiles that you can easily put down over old vinyl floors, remove carpets if the house has wood floors and polish the floors. If you plan your actions over the next two months with help from your brothers on room by room, the house will look fresh and clean and update the yard to make it have nothing junky outside and just a clean lawn and some bark on the flower beds. Then you will be able to get the most for the house without remodel prices.
  6. You will need to keep your parents calm while you are doing this so if the project is big ask a brother to take one or both of your parents for a weekend so you can do the work without them worrying over it all.
  7. If you are not going to sell the home right away, still do as much of work as you can as you go along. The day of selling the home will be close in the future and work has to be done now or then.
  8. You will need to call an in home health care service. They have trained nurses, PT, OT, nutrition and bath ladies. They also handle the care giving with light housekeeping, cooking and tending care givers. All trained, bonded and ready to help you with chores for your parents. What you can not do, they fill in. This is easiest way to get help. You can add a few hours a week at first, a bath lady is my favorite pick and then increase as the need and finances are there for extra help. They are also ready to be your back up if you are unwell and unable to attend to your parents needs. They will come to your home and do a review and then you set up a plan of needs.
  9. If you choose to directly hire someone to cover for you each day, make sure you do a background check and call the references, you want a quality person to care for people you love. Horror stories can be avoided with doing a good check on the person’s prior job abilities and people skills. No smoking, drinking or drugs are allowed by any care giver so let them know that from the get go. Ask your Tax Person how to make the payment to the person you hire on your own. A service takes care of all taxes and pays your caregiver for you. I you hire a person on your own, payment for the person is up to you. Remember to ask if the care givers are a tax deduction for your parent’s taxes too. Remember if your parent or parents are in your home, they can be your own tax deduction for their care.

Now, I have a workbook that was designed for family members to read and use if they have never had any training in caring for a seniors. You will find my book under Products page of my website www.caregivingwithspirit.com. Its called Care Giving 101 Workbook and you can download it as an E-book or as a printed workbook sent to you via mail. That will detail the basic care giving needs and how to handle them for you as time goes on. I have both health and Alzheimer’s tips in the workbook. Its been a great help for many who are facing giving care to parents and or spouses.

Hope this all helped you – you can find me on Twitter @seniorcaretips and this wordpress site has many older blog entries that you will find helpful as you add giving care to an already busy life with your own family and job. I also have a talk radio site that is fun to give a listen – its an easy click from my website…thank you for your time and blessings on your giving care.

Please do send me emails if you have a question on care, I am happy to help. francy

Seniors in Care Facilities – Tips for Visits and Safety

By francy Dickinson www.seniorcarewithspirit.com

Dear Francy: Mom in-law is in care facility and we’re visiting twice a week. It’s clean and she seems well fed but angry. Her dementia is still raging and she took a fall out of her bed and hit her head two days ago. How can I help keep her safe and sound in the care facility?

Here are a few tips:

  • Visiting twice a week is very good. Change your days and your times, so you’re there, but not on a routine. That way you can see the progression of the daily care staff, as the weeks go by.
  • Check the facility for being clean, the patient room, the eating facility and the public rooms are easy to see. But a walk down the hall will show you how the storage closets are kept orderly, the shower area clean, how the kitchen is run and the pill dispensing cart is being used. You just observe, even if you know nothing about care giving – you will see that organization is the key to good care, and cleanliness is right behind. If you have a question – ask the management about the staff, not the staff. It keeps the resentment from the questioning from reflecting on your senior’s care.
  • Do not be afraid to ask for a review of a fall. It should be logged in and reviewed by the staff. If it’s a staff problem you need them to make adjustments to the procedures in the facility and make sure they adjust the monthly payment to reflect any incident that caused harm to the patient. If it’s the patient that is being unwise in their movements or manners, then review how the care staff can make changes to avoid a repeat of the problem.
  • Take treats into the staff. This is open to what you like to do yourself. But once a month, I would bake brownies or cookies, or stop off at a special candy store and gather together some treats. You could buy some expensive coffee beans for the lounge or bring root beer and ice cream for a treat in the summer. Be creative, but be smart. Drop them off at the nursing lounge with a thank you card that has the patient’s name and your name. This goes along way for the staff to know you care about them and in turn they will care about you and your senior patient.
  • If the patient has dementia/Alzheimer’s let the staff know the real patient as you do. Take in pictures of the patient when they were young and first married, have a little label with names of spouse and family in the picture. Make a copy of a college degree or service certificate, so others visiting for the first time see that a very valuable person is inside of that patient. Honoring who a person is, inside, makes the current situation more understandable to strangers.
  • See if you can surround the senior with things that bring a feeling of home. A favored piece of art on the wall and a small shelf with bits and bobs from their collection. A throw that was crocheted by the senior or a book that has always been a favorite. Things from the past will surround a person and give them a feeling of safety. Ask about the rules of the facility and then make the creative side of you bring just the right stuff in to the room to perk it up!
  • Always ask the senior what they did yesterday?? Have them tell you what ever they remember. It’s important to take note. If they are abused or do not like things, it will come up in one of these conversations if you keep asking. You can hear what is bubbling inside of them, what bothers them or makes them happy. You do not need to worry about the details; just the feelings you get from the senior.
  • Food treats for seniors. If a senior does not have a food restriction, then do bring along something special for them. They may love some chocolate, cracker jacks, or a dinner of food from your family heritage. Heritage food is lost in care centers and still is so important to the senior.
  • A small covered jar of wrapped hard candy for visitors or care staff is always a nice lure to get them into the room to check up on the senior
  • Take a container of those cleaning wipes and each time you visit. Take them out and go over public surfaces around the senior’s room. A double protection against germs is always good.
  • Make sure the senior has a way to call home. If you need to put a large printed sign with your phone number taped to their room phone, do it. If they want a cell phone and are able to use it wisely, do it. They need to have a way to feel connected, not dumped. If that is hard to do, then make a quiet evening time call each night. Set a time that is good for you both and just make it an evening call each evening. The repeat of the calls is what the senior will feel – they can count on you is what they will think. Those are good things.
  • Check the senior for signs of red marks on their skin and ask each week if any skin irradiation has shown itself during the week. That is a very important point. Hot spots on older skin are hard to heal, if you catch them before they happen it makes life easier. The skin will show if the staff is not moving the patient around, bathing them carefully, or changing their bladder control products on time. Each time they do a bath, they will make note of the skin problems, you can ask to see that chart and take note that there are none. If they have them, then ask how they are being treated and stay on top of it until it is healed. If it repeats often, there is a care giving problem to be addressed.
  • Bladder infections or UTI’s are very common in seniors in care. You want to make sure they have cranberry pills added to their daily intake and you want to know that the infection is being treated, but the cause is researched and addressed.
  • Just because the senior is in care, does not mean they cannot add supplements. You can talk to their doctor and supply the supplements for daily dispensing. Turmeric is very popular for dementia and infection treatment…our doctor just added it to the OK list and mom was able to enjoy the supplement each day.
  • Remember, the facility wants to have you in charge and up to date, they want you to be involved, so do speak up. Read about your senior’s care and bring up the ideas you gather during the family meetings at the care center. You can have a monthly meeting at the care center if you like. I love them, you keep up with their ideas and how things are going – good stuff.

Hope these ideas help you with your care for your senior in a care center. It is always a hard choice to make when you place them in care. I have a free service for families called Loving Memories it helps family place seniors in good care facilities. We review the senior and their needs and then find a care facility that meets those needs. I also have care tips, workbooks, on demand talk show information and just all around good stuff on my website. Please do visit www.seniorcarewithspirit.com

Thanks, francy

Panic-Dad has a cold and not able to walk!

by francy Dickinson                       www.seniorcarewithspirit.com

Dear Francy; Dad has had a cold for a week and today he is so weak he is unable to walk. He refuses to go to the hospital. I am unable to lift him and I have called a cousin that will take an over night flight to come and help me. What should I do?

OK, first Panic is not a word to use that does not get attached to calling his doctor for help and/or taking him into the ER. So remember, if you are that scared you need to be calm and take care of the situation with a call to a medical adviser and get him help.

Now, the options: One he has a mecial directive that says no hospital or resusitation. This is your honor to protect, but a cold never says I am dying to me- (it says; I’m sick, tired and weak – I need some meds to make me better. I may need some fluids and I may need some physical therapy to recover my legs)but I think that dying is low on the list of what will happen with a cold unless you ignor it and it goes into pneumonia. So, if I were in the house, I would call the doctor’s office. (who would probably just tell me to send him to ER)

I would take him to ER and they would give him fluids, check his vitals, and put him on a program to recover his legs again.  The least I would do is call the local Fire Department and have the medics check him out. I would not wait by the door for a relative, I would take action now. You are the care giver, your dad is too sick to make calls or decisions. So, use your intuition and react in a safe and appropriate way to give him care.

After that has been addressed; I want to assure you that many older seniors with different health challenges have problems with their legs and the slightest infection can take their energy down fast and that will keep them from walking. As they get fluids and meds and recover, they get their legs back again. So, do not immediately think he is off his feet for any permanent time period. It may just be a passing side effect of the body fighting an infection or other conditions in the body.

DO NOT ALLOW ANYONE TO STAY IN BED WITHOUT WALKING FOR MORE THAN A DAY! If someone is on doctor’s orders to be in bed and the doctor understands they are in the bed full time and can not get up – that is the exception. If they are simply unable to walk or stand without falling, they need to be treated by a physician and not you. They need to address what ever is bothering the senior that has produced this weakness.

Let’s go forward. Your dad has gotten some meds and has gotten his fluids and oxygen levels up. He has his sugar level in order, he has seen a doctor or nurse practitioner and he is back home. But he is still really unsteady and needs you to help him move around. You have a bad back or are very tiny and you are worried about caring for him in this state. Then you have to have him placed in a care center until he gets strong enough to meet the standards of your own home care. It maybe a week or a month in the care center but the doctor will write a prescription for it, just like a medication so the insurance can cover the cost. The care center will give him Physical Therapy to walk, monitor his vitals and get him strong again. If they can not do that, then he has moved into a new stage of care and you have to decide on the next step.

If the doctor or nurse has him back home and he is simply wobbly and can stand but not without you next to him, walk but not more than a few steps. This would mean that he has been examined and is on medication to take down his infection or handle his health challenge and he is on the mend. You will be asked to help him stand up and move him to the commode that will be placed in his room. You will have to help him up from the commode and get him back in his chair. An in-home nurse can be sent via the doctor to help you learn how to do the assisting so it will not harm you. Very small people, can handle larger bodies if they are taught how to move them.

He will have to do all the exercises that the Physical Therapy person has given to you. They usually have a sheet with the exercises printed on it. You and your Father will have to do those exercises a couple of times a day for his legs to get strong again. Older people lose muscle strength really fast and they need to re-gain it right away so it is not a permanent situation. Even if he is very ill with heart problems or cancer, he needs to move for as long as he can. So he will have to do the exercises that the professional PT person designs for him. You will have to assist him until he gets strong enough to be on his own.

If he falls on the ground – do not even try to pick him up. Call 911 and the fire department will come and lift him to his chair or bed and check him out. If they think he has injured his body they will transport him to the hospital. If you do not want him transported or given resuscitation you have to have a piece of paper posted on the wall that releases the medics from their duty of rescuing the patient and doing all they can to save him. This paper is called A Do Not Resuscitate Order/Agreement (or DNRO form). This is not his living will, it is a special piece of paper that has to be from his doctor. It would be signed by the patient, or his Power of Attorney and the primary doctor that you use for his care. It’s usually a green piece of paper and I posted mother’s in her bathroom door, so I could easily show it to a medic crew. If mother went into the hospital I took it with me in my hospital pack. (You will find my hospital emergency workbook package on the products page of my website www.seniorcarewithspirit.com  it is a beauty and will really help you go step by step through Emergency Room visits.)

If your dad knows he is facing a life transition it is time to call Hospice. That is a terrific service that will come into your home and help you as well as your dad through the process of dying. It is used in the last six months of someones life and is paid for via medicare and all you have to do is ask your doctor or look up Hospice in the phone book. They will come and do an assessment of your dad and then give you an outline of all the things they can do for you. So you can be released from some of the stress and just be his daughter, instead of a care giver.

Remember, older people get weak. But they also recover. So be really clear on what your dad needs to do around the house for you to give care. I told mother she just had to walk, I could not lift her for any length of time. So, she was very good about walking after each of her little strokes and illnesses. She knew I could help her for a few days, but not on a permanent basis, so she responded with lots of exercise to keep her legs working.

Thank you for all you do for your dad, I hope you will go to my website and read about my Care-Givers Workbook 101, it has helped so many family members give top notch care to their seniors. Thanks francy