Staying Alert Means NO Silver Alert / Protecting Elders

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Protecting Elders by francy Dickinson

young-francy-01-50

Mom kept me safe…then, I kept her safe – f.

Dear Francy: This is my own family story. In the 1970’s my Aunt was baby-sitting her two grandchildren. They stayed overnight and she made them lunches and drove them to their elementary school, the next morning. She was never seen alive again. One year later her car was found off an old logging road and her remains found deep in the woods. She had somehow gotten confused and lost. How could that happen? Did her children miss seeing that she was getting older and more stressful and having children over-night was just a step too far? Or did she have a sudden attack of dementia? Did no one notice any warning signs? We were all heart sick. She was a dear lady and did not deserve that life-ending no matter what had happened.

8 TIPS TO HELP KEEP YOUR SENIOR ~SAFE

  1. Take note of sudden change in personality. Example; if a person was shy and they now just push their needs onto everyone. Or, if they were chatty and now are very quiet. Change in personal moods are important and you need to write a few notes of examples and give it to the doctor’s office check-in person and ask them to “attach your letter” to the chart. That way the doctor will read it and take note of its significance.
  2. Constant anger over small things. If you are losing power in your body or mind it is frightening. You want to be in charge of your mind…so you automatically push yourself to be right. You make your point, you debate, you push and push until others do what you feel is right. That is what “taking power back” is all about. But this is also a sign that there is something going on in that mind and needs to be checked. A memory test, a talk about early signs of dementia or other mental issues. Ask your health care team to schedule a memory test for the elder and make sure you are all on the same page.
  3. Your elder has slight memory problems but they speak well and still drive. They do chores around the house and they “seem” OK. Yes, they are slowing down and Yes, their projects take longer to finish than they used to…but you do not see any danger in them staying independent. Next thing you know; your dad is taking a left turn. His driving timing is off and he turns right into my car, while I was driving in the opposite direction. Head on crash.
    I was really hurt, when that happened to me. The lady that did that to me had Parkinson’s. She told me she was on medication…as I limped around and checked on a young man with children in the other car she had hit…she was shaking and very upset. Now, I was kind to her…but it upset me that her husband (that came to the scene to bring her home) just protected her. He was telling her not to worry, they had another car at home for her to drive!!! Hello, do not tell yourself lies. If someone is suffering from high pressure of life changes, taking medications that are strong or are mentally confused…they cannot drive. You can write a letter to the driver’s department and tell them to demand that she takes another test to keep her driver’s license. Or, you can make sure no car is available for them to use. Period, subject closed. It is not fair to others and I could have lost my life. My injuries were very upsetting, because I had my Georgie at home, to care for at that time.
  4. Post Alerts in the house. If you worry about dad out in the garage, or mom walking out the front door…take note of new helper tools. There are cameras that can be put on the door bell or inside of the house. There are alarms that ring loudly when a door opens so you can dash to the door and way-lay the elder back to the living room. There are so many things that are new and exciting that I ask you to simply talk to the techie in your family to help you find just what you need.
  5. Can someone help your elder if they are upset or confused? OK, so George would have a drop in mental ability when he was under pressure so I knew I had to get him an ID bracelet early on. Just in case he was to walk away from me in a store or while I was gardening. If someone stopped him…would he know my phone number or my name under pressure? So, I looked and the ID’s were so expensive. Now that has changed. You can get a locator on their own cell phone…or on their fit watch. Tech stuff has really done well for all of us seniors…look it up on the Internet.  I got a simple RoadIDTag that was very inexpensive and has room for their name, your name and phone number – plus I ordered a health tag and added dementia to a line. Go, take a look…get one for yourself, this stuff is important!
  6. When you send your elder to another member of the family…tell them the rules. This happened to me: George had his kids in California. They sent him a plane ticket to come and visit and although he had early dementia, he had showed no signs of getting lost. So, off he went. While there he borrowed a truck to drive while his son was off at work. He drove the truck into town and then got lost. He was clear enough to call his daughter and she came right away to get him and have him follow her home. But it was an eye opener for me, when I had lost my Aunt so long ago. And he was so upset he never drove again.
    I then made sure where ever George went with friends or family…I gave them the “keep him close” talk. Then off he went with two old friends to a Mariner’s game. They had a great time, then he went to the bathroom and never came back. They went into a panic and took most of the ballgame to search for him in the huge ballpark facility. So, that was the end of going away without me telling the person about the need to keep him close. Not to mention; it was really me deciding he could only go if I was with him…because I’m a ninny. But it never happened again. That was long before Silver Alert system…and tech locators. Be smart…be ready…plan ahead. There are so many choices available now…go do home work to be prepared.
  7. Stress can really take a toll on anyone, with or without dementia. So if your elder is under stress keep an extra strong eye on their behavior. Do they have to move? Have they lost a dear friend or loving anipal? Have they taken a fall? Have they started a new medication? Have they had a small procedure like cataract removal, or colon cleaning? If so, be sure you spend time with them. Call them a few times a day, bring them into your home for a short stay…allow them to calm down and get their normal daily routine back into place. If you ignore it all…if you think, its no big deal – YOU ARE WRONG. Stress will pull many elders into a semi-dementia state or a lightly confused state. They could take a fall, take medication incorrectly, get very depressed and send them into other health issues. You have to do some planning and take note of the changes. Share change with health care team and let them inform you of things to look for to give them protected caring.
    I went through a horrible time after I moved from my long time home. Dear friends took me into their home and kept me safe while I calmed down, got feeling stronger, recovered from my grief and was ready to go forward. I was blessed with their kindness. So age is not a barrier from high emotional stress. I needed to be cared for…does your senior need that extra care?
  8. A big fall, a bad burn, the flu, heavy cough, bad allergy season, over doing resulting in sore limbs or excitement over a positive or negative event or visit. All of this can actually take brain cells away from a person. You have a stress kill of brain cells and it takes time to build it all back. Now as a young person, you recover from stress or injury quite fast…but as we all age and then go into advanced age we take longer for those brain cells to reproduce. The doctor told me that George would have six months of extra confusion until his brain could grow the cell structure back and perform at a high level with his dementia. He had had pneumonia and was acting strange. The doctor was so right. George’s over-all brain abilities dipped strongly and I was so worried he would not come back…but he did. Just a few months later he was showing signs of recovery in his abilities. If you know something has happened to your elder…then take note. Maybe extra visits to check on them…or bring them into your house on the weekends, or phone checks more often. You might even want your teen to stay with Grandma for a couple of months and check on her. Think it over…be protective and share it with your health care team.

What is a Silver Alert?

A silver alert is a public notification system in the United States to broadcast information about missing persons – especially senior citizens with Alzheimer’s disease, dementia or other mental disabilities in order to aid in their being found. You can call your local police department and report your senior missing and they decide to issue the Alert. It will go out to cell phones, highway signs, radio and TV station alerts and your senior will able to be quickly located.

Be Honest with yourself and your family and long time neighbors. When George was diagnosed we had our private time to grieve and then we took action. He wrote a beautiful letter to his dear friends thanking them for their friendship and telling them he was slowly going to slide. He talked to his kids and tried to let them understand it might take years, but he would be different from that time forward. I went around our neighborhood and told them that if they saw George walking alone in front of their home to please go out and get him to come home. Face it…you have to be honest to be safe. George lasted a long time in his slide…we knew what was coming. But we celebrated life as much as we could and I kept him safe. Its pointless to be private with dementia…it is not to be ashamed of…its to be honored, as with the elder’s life’s accomplishments.

Thank you for all you do for your senior. You are a blessing in their life and even if no one else is saying “thank you” – hear it from me. You are walking the walk with an elder so they are not alone in their journey…that is a loving act. Blessings, francy

Death, How To Cope When You Are The Caregiver

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Death and Dying issues to help caregivers by Francy Dickinson

Geo n francy oilMy Georgie has been gone for three months and I am adjusting to life again. I wanted to continue to share things with you. As you know, I began this blog to help myself and other spouse/caregivers with the issues that come up in daily care giving. I still want to be a voice in the wilderness for those that are giving their love, time, effort and attention to a loved one. Helping someone on their life’s journey is a very special and loving job…I hope you will find my words help you along the way. 

If you have been reading my blog over the years ~ you will remember I have always asked everyone to use hospice services when your senior is nearing death. You never have to be worried about it. The Hospice Services comes into your home and does an assessment of the senior and they share their ideas of how to help you. Their services are paid by a Medicare type of services…it then becomes a special Hospice Service expense and the medications and services are then no longer billed to you. So, financially, mentally and physically Hospice is the way to face the end of life issues with your loved one. It will help you overcome the worry and they will help you step by step…question after question.

That said; Georgie and I did not know he was at the point to call on Hospice. The doctors did not know what was wrong with George. He had a lot of tests and the diagnosis was not known. We had made another appointment for the next Tuesday to see the main doctor and talk to him about placing George in a care facility to review his health issues. In the mean time…we were home alone together. I was trying to understand how to use the oxygen, medications, catheter and take care of his physical needs. I was going on five days without real sleep and the situation was not good and we both knew it.  He was weakening by the minute and it was becoming very hard for me to do transfers and be strong enough to help him. We were ready for his “in hospital” care. I told George that after his stay at the care center I would be asking Hospice to come and help us and he understood that…but his end came before we could move through our plans.

Early on Saturday morning…George was taking his Albuterol breathing session. At the end of the session I went to remove the breathing mask and found he had passed. His eyes closed and he had stopped breathing. It was quiet and fast and I was heartbroken.

What I am going to talk about today is the process that followed. But once again, IF I had had the services of Hospice..all the following steps would have been taken care of for me. I would have been able to sit and be calmed by loving professionals and they would have taken over the different steps that come with a death while in their care. This is why I want you to NOT follow my lead…to avoid the sadness I had to walk through have the Hospice professionals by your side…caring for you and your loved one.

What to do when your spouse, or senior, passes and you are all alone:

  1. When George passed I went into shock. Lucky for me, I had my family and friends on my cell phone and I kept the phone close to me. I knew I was very tired and I had been afraid of my falling and needing help. So I was able to pull out my phone and call family and selected friends and our dear minister – to come and help me.
  2. Everyone arrived within minutes and each of them comforted me in their own way. They were not totally in the know…of what to do…but they worked together to decide on the immediate steps to take. I was in such shock, shaking and crying and just out of it…so they were gentle, loving and moved me through the process.
  3. We all knew we did not have to report the death the minute it happened. I had looked at the clock and knew he passed at 7:10AM but that was not really needed. I was just so struck with sorrow, I had no real knowledge of what was happening around me. That is why Hospice would have been so helpful…but my own support group did their best.
  4. Our minister asked everyone to come and circle around George and say a prayer and when we did that…each of us were then able to feel we had settled the tension and brought the love into a protective circle.
  5. If you have a faith that requires immediate burial, I suggest that you start today to make plans for the end of life. You will need to know the process and have numbers to call. In my situation, I knew that George wanted to be cremated, but we had no time frame to worry about. So we just took our time and did not call 911 until all the family members that wanted to view him, did so and at that time we made our call.
  6. Our local paramedics arrived and asked if they could inspect the body alone.So we cleared out of the room and they looked over things taking note that everything looked like a “natural death”. They wrote down the death and they made calls to the medical examiner and logged it in to the official book as a death with time and place written down. Then they alerted the police.
  7. A while later, the police arrived and they questioned all of us and asked questions about George’s health care and asked me to review the last couple of days. It was very hard for me to do this interview. I was still in shock and my mind was not able to connect properly with their questions. If I had had Hospice…that step would not have happened. Hospice is a legal service and the medical examiner takes their word for it. The police were very kind, but they had a job to do and they did it. Once again, they needed us to clear out and let them be with the body. When they were done…we were released to remove the body.
  8. We did not hurry…once again, we gathered together to say another prayer and wish George a loving passing. Then we called the mortuary services and they arrived to remove the body. I did not have to do anything personally. They simply enclosed the body and took it away. They were very kind and my family was very loving.
  9. My sister felt I needed to be taken home with her. I was still in shock and she wanted me to try to sleep and process the death away from the house.
  10. When I left my home, my friend and daughter-in-law cleared out the bedroom. They disposed of the sheets, pillows and medical things in the bedroom and master bathroom. They tried their best to clean the area so I could return to the house and not be upset. They did a loving job, that I am sure was very difficult for them.
  11. I returned to the house in two days. At that time, we had to go to the mortuary to review the details and pay for the services. They applied for the social security and veteran’s death benefit for me. So the basic paperwork was done.
  12. Now, this is where I will caution you. From that day forward, everyone I knew tried to help me. They gave me advice on social security, insurance, returning medical supplies, my own health, my mental health and so on. It was a constant barrage of information and suggestions to follow their opinions. This was the hardest time for me. I did not want to be rude…I listened and tried to understand what they were saying. But really, it became total overload.
  13. I will ask you to simply, sit and be quiet. Write down things and numbers and make your notes very complete…this is no time for shorthand. Then just take it easy. There is no time frame of getting services and help, insurance, social security and such done. Just do it on your own time.
  14. As usual…others try to take over and care for you. But you have to do it all on your own. It is best of you ask someone to drive you here or there. When we are upset the world does not need us behind the wheel of a car. But just write down a list of to do’s and slowly work through them.
  15. George and I had already talked through end of life issues. I knew he wanted no memorial and wanted a cremation. So, that made it easy for me. What does your loved one want? This is the time to talk and get it out in the open.
  16. The doctor had us fill out the no resuscitate papers and post them up on the kitchen door so the EMS could see them.  We talked about the issues of care at the end of life. So we were in place when his death happened. But what about you?  Do you have your end of life issues down on paper? Please do it for you and for your loved ones. Don’t make more work and worry for the loved ones left behind.

Lessons learned. I am still working on paperwork and details of my husbands death. I am still trying to learn to sleep and eat properly again after so many months of 24/7 care giving. It’s a hard road and I am walking it slowly, alone, but not afraid. I have support of friends, family and my small dogs. I am still working on my feelings of loss and I am still raw with my emotions. But I am taking care of myself now.

I gave care to my mother and my husband until their deaths. Now, its time for me to care for myself. Its hard to do…but I am trying day by day to form ideas of what my future is going to be. I so miss my Georgie’s smile and I can not imagine how I will live my whole life forward without him. But day by day…I learn and do.

I hope this helps you to prepare and take the fear out of a passing in your home. I cleared the house with love and blessed George on his way. I am sleeping soundly in our bedroom. I got new bedding, I brightened up the bathroom and I cleaned and cleared away the sadness of care giving in my surroundings. I now find my bedroom a place of comfort for me and I enjoy spending time there.

I will say…having my family and friends as well as my community of loving friends on Facebook, Twitter and through the group that follows my blog was totally positive and loving for me. I also had a #WritersThatChat group that continues to support me through the long grief process. I am a lucky girl to have had such a dear, as George, with me for over 30+ years. As I walk down my own path of life…I do not do it alone…I am surrounded with love.

Blessings on all that you do for your own loved one. francy

PS/ I find a little reminder of George is so healing for me. I blew up a picture of him and have it in my bedroom with a candle to light. I can have a good chat with him each day…kiss his picture and feel his love any time I am in need. Grief takes its own path…some move through it fast and strong…others have more up and down days. There are no rules for missing someone that you loved…but being ready for the hard time of passing helps.

Where to Go When You Need a Hospital for Dad?

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How to choose hospitals that fit the needs of your senior in care. by francy Dickinson

HospitalDear Francy; We just got through with a horrible experience at our local hospital. We live in a bedroom community and my dad had been having trouble with pain in his stomach area. He had trouble going to the bathroom and his back hurt. So, we finally took him to the ER at our larger local hospital. We have two hospitals in the area; one is smaller and other is a big trauma hospital with a big ER. We went to the larger hospital thinking they would have a better ER to treat him. When we arrived the ER was packed and we had to wait and wait.  Then when he was in the ER room…there was no room for him! So he was on a gurney in the outer area while a police officer was patrolling the ER. There had been gang trouble and they were trying to keep two rival gang members separated while they treated them. Poor dad, was confused, in pain and totally unable to process why the police were there. It was a nightmare. Why do they let seniors take back seats to these horrible gang people?

I can understand your distress and I assure you they did not take the gang members over your dad. They do Triage and the gang members were in more high risk condition, than your dad so they went first. The problem was that the hospital itself is a haven for high stress when it is a trauma center. So, lets talk about hospitals and get the idea of how to choose them in your mind. Next time when an emergency comes up…you will be prepared and be able to guide the ambulance driver to the right place for your special care.

Triage Means:
noun(in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or  casualties. verb to assign degrees of urgency to (wounded or ill patients)

I will assume your dad had prostate or blocked bowel, correct? Those are conditions that older men have and they are very painful. Elders often do not talk about their private bathroom problems with their care givers or family…until the situation gets painful. I understand that and I’m sorry you all had to go through that sad emergency experience. But lets roll back the clock and see how it could have gone differently.

Both elder men and women need to have a verbal check each day. Care giving is part immediate and part prevention. So everyday( I usually do it while I am picking up their breakfast tray) talk to them. “Dad how was breakfast, I see you did not eat very much of your cereal. How is your stomach feeling?” Dad says; “Oh, fine, I was just not very hungry.” You say; “Oh, well lets talk about it. Are you feeling OK..when did you last go to the bathroom?”

Then you go down the list; are you in pain…if so 1-10 how does the pain feel? When did you have your last bowel movement, or – you are going to the bathroom more often..why is that?” It may not be a hit parade topic for a father-daughter subject…but it pays off. You do this day after day and then he will get used to it. The conversation and your voice tone stay quiet and you sound calm…so your senior feels the conversation is normal. Pretty soon, you learn to take note of changes and you can make a quick doctor or nurse practitioner appointment. When you do that, remember to write down the symptoms your senior has been showing or talking about. As you arrive to the appointment, hand the paper over to the office person checking you in and ask them to attach it to the file for the doctor’s review. It will make the appointment go faster and easier for everyone.

As one older, very experienced in-home nurse said to me…”Francy, stay out of the ER as much as you can. It will usually mean more trouble than it is worth for an elder senior.” So, I try hard to catch problems before they get out of hand…but falls and extreme illness do happen and we all have to face them and learn to use the hospital system and keep as informed as we can.

Now, what I found after years of hospital visits is how to choose a hospital in advance to a problem. The smaller hospitals are perfect for ER visits when you have non heart related issues. So, if the senior falls, or has bowel or urinary problems, even stomach pains…that is something a small hospital does best. ERs are always busy…but less stressful in smaller hospitals because the “trauma'” issues are brought to bigger specially designed Trauma Centers…so car accidents, gun violence or heart problems that require loads of equipment and team efforts to solve a problem are their specialty. This huge effort for big care issues is much different then the smaller hospital ERs. Not that smaller hospitals do not carry heart issue equipment, but its nothing like the big Trauma Centers.

Heart issues are always brought to the larger hospital centers that have special heart teams on staff, at all times. So, you know if you have a senior with any heart, stroke or related issues with blood thinning medications…you have a clear path to that large Trauma Hospital. When you get all of this in your mind ahead of time…when the emergency hits…you are prepared.

Share your choices with anyone that will be caring for your senior …so this is all figured out and runs smooth. Every emergency is stressful…so to know the direction to go for help is really a step toward faster care.

Now if your senior is having small elective surgery…you want to once again take on that smaller hospital. But here is where that changes. If your senior is in a questionable situation…or diagnosed with something complicated…you want to find a “teaching or specialty hospital”. Yes, this could mean a drive to a larger city…but the specialty hospitals are simply a godsend when you have a complicated diagnosis from a doctor. When you face a long-term battle like cancer…having a full service cancer center to go to is a super smart way to treat the issue.

So the example would be this. Your senior goes to the smaller local hospital ER and is treated for a blocked prostate. They come back and say that the prostate is showing cancer, what to do?

There are a lot of decisions to be made in case of a complicated diagnosis. Prostate has many different treatment options. My young niece was just diagnosed with leukemia. That was a two-week ride of trying to figure out what kind of leukemia she had, so they could treat it well. If she was in a small town, with a small hospital – I would have asked them to transfer her to a children’s hospital in a larger city. That specialty hospital is trained in children issues, has specialists that deal with leukemia on a daily basis..not every once in a while. She was lucky because she had a children’s hospital close. She is safe and getting a complicated treatment schedule that the “Hospitalists” are well-trained for and she is getting stronger.

Something to know: Hospitality are now the treating physicians in the hospitals. You   will be using a general Hospital, not your own regular doctor  when your senior goes into the hospital. This is what I found for meaning: A Hospitality is a doctor who basically does nothing except take care of in-hospital patients. They do not have private    practices, they strictly do hospital work.

A senior with the prostate blockage and possible cancer would be best at a large hospital with a specialty of cancer or a teaching hospital. That way all the newer treatments are available for the senior and they can give you a full understanding of your choices in treatments. What I have found is that town doctors may be specialists, but in emergencies they stick to what they have done for years. They stay close to treatments and drugs that are comfortable within their experience. I do not want a complicated situation to be handled in an out of date or common way. I want a complicated issue to be handled with a group of specialists that are on the cutting edge and will use different services to make you and the senior informed of the options of care. I also like the idea that a “group” of doctors will be reviewing the situation and debating treatment for your senior patient.

If you are reading this and say…WOW, my dad is older and does not want to have fancy extended care. He wants to pass naturally and easily.

 That is called Palliative Care. Here is what I found on the meaning: With palliative  care, there is a focus on relieving pain and other troubling  symptoms and meeting your emotional, spiritual, and practical needs. In short, this new medical specialty aims  to improve your senior's quality of life -- however you define that for yourself.

What I feel is that the word Palliative Care is an important word for you and your elder/senior in care need to talk about. That is why everyone needs a Living Will/Medical Care Directive. As you make out this form, you will go through the different options of care giving with the senior. You will then know how to make a decision in the middle of a medical emergency. Do they want to be on long-term care? Do they want to have CPR…there are many different questions on the form and the senior will be able to design their own life care. If those decisions mean that they do not want to extend their lives you need to talk to a doctor and get a special paper that says “NO MEDICAL LIFE SAVING SERVICES”. This paper will be signed by the doctor and the senior. So when you call for help and the EMT team arrives they know the rule and the paper is posted and they then do not have to do “any or all to save a life”. This is important to have when your senior is in the last journey of their life. Lots of families do not understand this rule and do not take that extra step. When the EMT or ER people respond to the senior’s needs they can not…just let the senior go…they are legally bound to treat the senior. But if you have the paper that the doctor and senior have signed (its different – in different states) you can show it and the medical team can relax and make the passing comfortable.

Inform yourself on the forms to keep your senior from extreme life saving treatments. Its a form here is what I have found on it: What are “Medical Orders for Life-Sustaining Treatment” (MOLST)?
The MOLST form is a standardized document containing valid medical orders about life-sustaining treatment. It stays with the patient and is honored by health professionals across all health care settings.

My mother had the MOLST paper posted…but when she started to bleed from her mouth..I still took her into the hospital and they found she had an ulcer from her medications. They did a small procedure to stop the bleeding and changed her meds. I did not think we should have let her life go, under the situation. It was a small mend and she lived on another two years. You see I knew how to make that decision because we had talked about her care when we did her care directive and I got my name on the paper as her Power of Attorney for Medical issues. I know it sounds complicated…but I assure you…during the care process for a senior these issues will come up. Life is not always “passing away in your sleep”. It can get very complicated. So with my mother…she did not want any fancy testing or complicated or major procedures to extend her life. I knew that and my choices for her care were easier for me because of our talking over her wishes.

To download your state’s health care directive forms FREE click here. 

I have put the hospital phone numbers of my city on my cell phone. I have also thought about when I drive or when I call 911 for help. When my husband George had pneumonia I called a friend to come and help me drive him to the hospital. When he had symptoms of a heart attack I called 911 for immediate help. If you take a few minutes to think over the idea of when to call for help or when to do take action on your own…you will find that you are prepared in your mind…when and if an emergency pops up.

I also have just done a review of how to make sure that you are prepared for the ER hospital trip and possible stay. Here is a link to that blog so you can pack and have your Emergency Kit all ready to go.

George on a rare out and about with me ;)

George on a rare out and about with me 😉

I want to take time to thank you for the care giving you are doing for your senior. I know what a struggle it is to be a care giver and I appreciate all you are doing. Would you do me a favor and click on the “sign up” button on the right side of your screen. I am so busy with care giving for my Georgie (with Alzheimer’s and Parkinson’s) that my blogs are random…this way you will get an email with my new blog info. Blessings, francy

PS Thank you to all of you that are constantly supporting me during my care giving for George. He is getting much weaker with his Parkinson’s issues. So the care giving is more complicated and extended. But we did get out for dinner on Good Friday…to celebrate Easter. We met George’s son and his wife at a local restaurant and had a nice dinner. I picked a place that I could park and walk in on one level. George just wheeled up to the table and I did the running around the buffet to fill his plate. He had such a good time, but it took about three days for him to recover from the extended activity from the out and about. I think of our journey as “creative problem solving’ on a daily basis. I want George’s life to be as joy filled as possible. So, we make most quiet days into little celebrations of current events. He is happy and the care giving needed, is still within my range. Thanks again, francy

Are You Ready to Take Your Senior to ER?

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How to be ready for emergencies so you and your senior can get to the hospital and be comfortable while you deal with the Emergency Room or extended stay. by francy Dickinson

GrabnGo ER Kit 4 You!

Grab n Go Ready ER Kit – Just 4 You!

Dear Francy; I live in a small community and my dad lives with us. He had issues last week, his heart was in a race and he was fainting…on the floor…I was in a panic. I called the doctor, because dad was on a lot of heart meds and they said take him to hospital. A neighbor helped me get him in the car and off we went for a 28 minute drive to the hospital. Once there…they took over…but I just lost my head. I had none of his information with me, we start in ER and then were there for two more days while his drugs were adjusted and watched.  I was exhausted, worried and still dressed for work. It was an all around horrible situation. I remembered you talking about being prepared…I failed on that end…would you review the ideas for stress and emergency room trips. Thanks..Cindy, New Mexico

Thank you Cindy…don’t feel bad…I’ve been there too. You sit in that hospital and are uncomfortable…and can not just race home to change or get your things….so what I suggest is that if you are caring for a senior….YOU NEED A BAG FOR THE ER!

I have heard the stories for years…a spouse, family member or dear friend goes into a serious backward spiral and you know that you have to call 911 or take them to the hospital yourself. You are caught up in the moment of panic, worry and actual action of caring for the senior. Out the door you fly…to drive behind the ambulance or drive to the emergency care place yourself. The last thing on your mind is comfort..your mind is racing and your heart is in a high state of worry. But once at the hospital…everyone starts to ask you questions…social security numbers, health card information, does the senior have allergies, what are the medications that they are taking…you stand there in stunned silence…just wanting to be in the ER with your spouse or parent…and there you are – stuck with answering questions that you are not prepared to answer. After that nasty 15-20 minutes…you try to find your senior and they have started treatments. They are telling you things and you wish you could write them down…new ideas for treatment, interactions of medications and you are just trying to breath and tell your senior that they are OK…just hang in there. Then the ER puts the senior in a side area and they have to wait…wait for tests, wait for doctors to arrive, wait for ER or CAT scans…and the minutes stretch into hours and hours…then they say they will put the senior in a room for a couple of days…they want to keep them on close watch. Close watch? That means you don’t leave your senior’s side.

You are tired…your phone is on the last few minutes of energy…you have no phone numbers with you to use the hospital room line. You need to drink some water, have a snack but its the middle of the night and the cafeteria is not open yet and no change for the snack machines. You have now been at the hospital for 4-6 hours and you are looking at an over-night stay…sitting in a chair in the room. Nasty….and all of us…have gone through all of this and there is no reason to do that to ourselves….we do enough just loving and caring for our seniors. We need to be prepared for these fast, unscheduled emergencies….so we all need to put a kit together for our own use.

“ER Grab n Go Bag” 

If you have not experienced this yet, please believe me…it happens…your senior can fall or become unwell in an instant…and you will be faced with all this drama…and wind up feeling like a fool that you did not plan ahead to make the trip so much easier for your self. REMEMBER: the hospital is going to give full care to the senior in the emergency…YOU are the one that is not going to be cared for…you are simply in their way…so you stay quiet and try to stay close to your senior so you can give them calm and love. BE PREPARED!

ER Info Kit for your Senior

ER Info Kit for your Senior

START WITH ER INFO KIT FOR YOUR SENIOR

I keep an ER info Kit for George in my handbag…and one in the kitchen. I have given one to my sister and his kids know where I keep another copy. I have all the info that the ER entry office person is going to ask me. There is a good copy of all his cards, front and back. There is a review of what he is allergic to and his personal needs for check-in. There is a very detailed medical prescription and doctor listing and there is Power Of Attorney or a letter signed…that allows you to give and get medical information. I also tuck in the driving instructions so if I get too nervous or stressed…I can still get to the hospital. This is a must…and you have to take time to type it up and make copies…and then you are set to go. I update my medication listing…and you will find a whole blog on the details on April 21, 2010 called “If your senior goes to ER, are you ready” Please put that in the search bar on the top of the page and read over that blog…it has all the details for the paperwork to get you in the out of the check-in process of hospital or doctor visits. I can not tell you how many health care professionals tell me how they love my kit…you will too.

Just remember this information is all of the personal ID on the senior and it has to be kept private and safe…so keep it protected...I use a plastic envelope and I also have a whole booklet that I use for his medical information. If you do put together the “Grab n Go Ready Kit” you will also have a spiral notebook n pen to take notes. Trust me…I have given care to my mum and my husband for over 10 years now…you need these items when you go to the doctor and the hospital. I know you may think they have all the patient’s information in their computer system…but you are wrong…info is rarely updated and they often lose the patient in the computer files. Be ready to give them any thing they need to help the senior get well in the middle of a crisis. Do not count on your mind…even ss# can be forgotten or mis-stated when you see someone you love in peril! (NOTE: What I remember is wasting time at the check-in window when I wanted so badly to be with my frightened 95 yr old mother in the ER room…to keep her calm. I did all of this so I would never have to repeat that.) The next time we were at the ER…the check in lady…just took my paperwork and told me she would enter it all and bring it to me in the ER…it was perfect. I have been thanked by nurses, doctors and admin-people for having the information so well-organized and it only took the time for me to enter it into the computer the first time. I update the info every six months or on medication changes. Easy -peasy for no stress check-in’s.

 NOW LETS TALK YOU…HOW ARE YOU GOING TO COPE WITH HOURS IN THE ER– IF NOT DAYS IN THE HOSPITAL? JUST LIKE SCOUTS….”BE PREPARED”

hospital sleeping chair

Well this is the chair you get to live in for a couple of days. As you can see it is not pretty, but it does recline and you can stay in the senior’s room…by their side and be part of their healing team. Even a First lady, does not get anything better than a sleeping chair in most hospitals. But trust me…its a lonely place if you don’t have anything with you.

So, out comes your ER GRAB n GO READY BAG…and you have a few things to make yourself feel comforted and rest as you help your senior do the same.

  1. Comfort and Warmth; I put an old pair of sweats and a warm top in the bag…with cozy warm slipper socks…that way my clothes are presentable to the public…but totally comfortable for me to sit and sleep. I also have a throw…or you could put in a hoodie so at night you can be extra warm…the hospital rooms are always cold to me. They often give you a blanket…but its never enough for me. As you see the chair it does have a lift so your feet will be up and the back will tilt. I have a pillow collar that I can tuck under my head or put on my lower back to ease the comfort level. You can get blow up neck pillows in the travel department. They are honestly the best gift to yourself in this situation. (I would rather use my things instead of hospital things…its a germ thing with me…my things make me feel safe, not worried about catching something)
  2. A small water bottle is in my bag…you can refill it in the hall with the drinking fountains. This is just a must…I don’t want to be buying soda all day…and swell up…the hospital can have dry air…so stay hydrated. I also have a couple of snack bars…to get me through. Usually the emergency is through the night and when I am able to take a few minutes to eat…the cafeteria is not open and you are faced with only snack machines. So, I have my snack bars and I tuck a few dollars in an envelope and keep in my bag. Often times, I am out of cash in my purse so this makes it easy to get anything I want out of the machines…and then I can also go to the cafeteria for a sandwich or soup during the day. I also tuck in a few tea bags and sweeteners…you can always get hot water from the nurse’s station…and it tastes so good to relax and calm yourself with tea. You can also ask them if there is a snack fridge for family….the VA has a nice area for us to go and get hot coffee, yogurt, or pudding etc – any time, when we are with our loved ones. Don’t be afraid to ask…it maybe there for you, just steps away from the room.
  3.  Keep clean…wash your hands until you drop when you are in the hospital…and I have a small hand cleaner in my bag with Kleenex if I get snuffy. Plus…you will never find me wo/ my Advil. I have a bad back and I tend to get pressure headaches…so my little package of Advil that I got at the Dollar Store is heaven-sent when I’m in need. If I was taking medications…I would have a couple of ziplock baggies with a couple of days of those in my Ready Bag too. Nothing worse than going without your bladder or blood pressure med for a day or two…add in the stress and your body will really complain.
  4. Bored? Remember…people that are unwell…sleep. The hospital will give them drugs to keep them calm…but what about you? I bring a book to read. I use a Kindle but you don’t want to depend on remembering that….as you run out the door. A good old fashion paperback book and a pair of readers can be tucked in and ready for you to dive into and remove your stress in a good story. An older Mp3 player is also a great tuck in…yes, TV’s are in the rooms…but often they are on a channel that you don’t like or you can not hear them…so I make sure I have my own things to keep me calm. If you are a knitter…just tuck in an old project you have never finished…in a zip lock bag and its there for you. Think what it is that you enjoy…and make that happen in your Ready Kit.
  5. Calling the family? You need to have a re-charger in your bag…buy one that will recharge all your devises and if you tuck in your reader or tablet as you run out the door…you will be able to keep them going with your charger. Your mobile phone is your lifeline to the family…but many times the hospitals…block the cell phone signals. What then? You have to walk all the way to the front of the building and make your calls…not an easy thing to do. I had that happen to me and it was exhausting. So, write down a few of the key family phone numbers to keep posted. You can always ask them to send the information out to others. This way you can use the in-room telephone for local calling. I have my number in the front of my spiral notebook and I’m ready to go.
  6. Pets left behind…what about the mail? After a long stay in the ER and then you find out you maybe in the hospital for a day or two longer….have a neighbor or friend that has a key to your home and will take care of your pets. They can also pick up the mail and put it in the kitchen for you and just keep the lights out and everything in order while you are gone. I always put a key ring with my name on it…so the neighbor can keep it and knows who it belongs to — it could be a couple of years before the call could come for them to help….once you have this info in place…you can relax and know that all is well without you leaving your loved one to run home.
  7. A Ziplock baggie with little things that mean something to you…to keep you calm. Maybe you need cough drops…or lip balm. A new toothbrush and small toothpaste. Hand cream and face cream…Glasses and a glass cleaning cloth. Maybe you are a person that needs a few peanuts to keep you going or hand wipes to feel clean. If you are in need…you can tuck in a few Poise/Depend pads. Think comfort. NO the bag does not have to be a huge case…its just a big tote…but keep it full of things that bring you comfort…so when you are stressed and worried…you can keep yourself calm.
  8. If you forget your tote…then you call a friend to retrieve it from your hall closet and everything is in the tote..instead of the friend wandering around your home for a “few things”.

I suppose you read this and think…Oh, I will get on this pretty soon….please do not do that. Go right now and just put a few things in a bag and tuck it in the hall closet. You can make it fancy or expanded later..but get the ER senior’s information kit, in order and a few things in your own Ready Kit–RIGHT NOW. Its like giving yourself a gift…and you will rejoice in it if and when the day comes that an emergency hits your home…and you can just open a door grab your Ready Kit and walk out the door caring for your senior in need.

I always want to thank you for caring for your senior. Would you do me a favor and “sign up” up for the blog. That way it will come to you via the email and you will not miss any of the tips…and if you know someone that is a care giver…please share my blog with them…thank you.

As a spouse of a Alzheimer’s/Parkinson’s senior…I find the care giving can be so overwhelming and it represents such love. The gift of care is the dearest thing you can give to a person that has become unwell, unsteady or confused.

My Georgie has been declining a great deal lately. Falls and safety issues are a daily challenge for me to handle now. I am not blogging as much as I would like…but know I’m here for you to send me a message if you have a question or need help.

I am pleased to say I have a dear friend that helps me with my care giving….and I want to thank you for just “being there” for me in this journey I am taking with George….Friends are the best. I hope you feel I am on your friend list and you will feel free to ask questions that you may have at any time….Blessings…francy

Me with my friend Cheryl who is always helping me with George and supporting me as a loving friend...Thank you Cheryl!

Me with my friend Cheryl who is always helping me with George and supporting me as a loving friend…Thank you Cheryl!

Walk, don’t Fall! How to Buy Medical Equipment

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How to buy medical equipment for seniors at home by francy Dickinson

Say NO to using surfaces as Table Top walking...

Say NO to using surfaces as Table Top walking…

Dear Francy: Mother will not use her cane…she falls…I know because she has bruises – but her pride is over the moon and she will not use them. She is also having night problems with her bladder…I have to change the bed each time I visit…but no mention of it from her. How can I get over this pride issue and keep her safe and clean and feeling good about herself?

TALK ! There comes a time when seniors have to sit down and listen to their children. It is a hard thing for both fathers and mothers to do- but the transition from being their ‘little girl’ to their care giver simply has to happen. I get it. I have talked about medical equipment and how to acquire it and when to use it before…but just when I think everyone knows…I get four emails in a row about problems with seniors and a need for help. So, I am going to review the different things you need to use as a senior progresses in their life’s journey.

Use a gel cushion in the car and on your favorite TV chair…save that bottom and your back…it feels great!

Start with a gel cushion: When you age, your bottom and your feet start to change and you need to use a little gel cushioning. I am in my early sixties and I have both gel in soles in my shoes and a get cushion on my bottom when I rest…I am a happy girl…get one and enjoy pain free life again!

Age and how a senior feels and their personal challenges are always different. That is why its good to know what is out there for you to help anyone that has ups and downs in their health. Heart problems can come and go and so can arthritis–so if you have some of these helpful tools on hand. You can use them when needed.

Toilet Support Rails r easy to install

Toilet Support Rails are easy to install

This unit simply screws on to any toilet under the seat..then you screw the seat on top of it…it gives you adjustable handles. This has helped George so much…but guess what? After my car accident I had great pain in my foot..and this helped me too! I will not be taking it off when George leaves the house…it is now something I count on myself 😉

To carry this idea out…we need to talk about a commode. These are like portable toilets. When a man is up 2-3-4-5 times a night with prostate issues…or when Parkinson’s has you extremely unsteady…a portable toilet, called a commode, is the ticket to ease of use and relaxed worries of accidents and falls. This commode has a bucket you fill with a bit of water and I hit it with a small amount of Pinesol type product. Then you keep it by the bed…so it is just a few feet away. I put a plastic sheet (black bag) down under it and have toilet paper ready. It is used at night..then during the day you take out the bucket and dump it in the toilet and put the unit over the toilet in the bathroom so the senior can use it with it’s handles for sturdy up and downs. REMEMBER:You always have to ask your doctor for the different products to help you. The doctor will write a prescription for the item and the medical rental house will get your product ready and it will then be able to be all or partially covered by Medicare/Supplement. If you are lucky, like we are, and have Veteran’s…they will give you a review and provide the equipment. If you do not have coverage and need medical products…then it’s time to check out local charities and ask them for help. They often are giving things after someone passes. They clean it up and get it ready for you to use without a big investment. Be creative…do not be embarrassed to ask for help from friends and local charities…they are working hard to provide things for your use…use them.

–> NOTE:Women need to use pad or pants that are designed for urinary problems. Not pads for menstruation. This is very important because the wrong pad for the wrong situation can lead to nasty UrinaryTrackInfections. UTI’s are one the main health risks of both men and women when they begin to lose their strength. UTI’s can take a senior down and change their future living alone abilities… in no time. We can not stress enough to “talk” to your senior about their bathroom issues. Then talk to the doctor. Stool problems can lead to real problems; and the use of stool softeners and/or Imodium products to harden stools can reduce those terrible battles in the bathroom.Medications has nasty side effects for all of us…but especially seniors find them embarrassing and often to do not mention the problems.  Men have to relax and let a pad or “Depend”  under short type product reduce their need to hurry to the bathroom everywhere they go. Doctors can and will give you a prescription for urinary pills that will reduce the ‘urge’ feeling that requires so many bathroom visits. This ‘hurry up’ is the cause of many seniors falling in the middle of the night. A good mattress cover is required. Most seniors need to update their bedding after years of use anyway. So, get a new mattress cover that will protect the mattress and give a little cushion to the older bed. Add two new sets of easy to wash sheets and pillow cases so they can be easily washed and changed. Most seniors like the feel of flannel sheets almost all year round…so keep that in mind when you are buying the new bedding. Update the pillows so the senior has two new pillows for head. Use the older pillows and put one for between their legs to cushion the legs and one to tuck under their upper arm to put them into a womb-curling posture as they sleep. This wrapping them in comfort will allow them to sleep soundly. Adding a night-pad or Depends type of pant…will let them know they are OK, if they have an accident. Then adding in the commode or toilet handles will be a winning ticket for seniors with night time worries and accidents.

—-> Tip//how a lady wipes her bottom after a bowel movement — is going to stop a lot of UTI infections. I had mother re-learn this process…she also used a femine wipe..or child’s diaper cleaning wipe and put it into the special (with swinging lid) trash bin…not down the toilet. These products will clog your sewer system! So teach them to have a trash bin close to the toilet to use for the wipes and a place to put their Depends type products. Then you line the trash bin with a light plastic liner and empty it twice a week to keep the smell out of the bathroom. I use a disinfectant spray inside the trash bin and then re-line it with another tall plastic bin bag. (I get mine at the dollar store) This makes this whole process easy for the senior and the care giver to use and keep really clean. I also have a container of cleaner-wipes (w bleach) under the sink and I use them to wipe off the toilet area and the sink and other handles and light switches- each time I clean the bathroom. This keeps down the germs and the odor. Seniors often lose their sense of smell so you have to help them keeping clean.

I have never been so proud that I could not use a cane with my back. I have had a bad back long before I became a senior. The pain was too much to worry about pride. Even as a younger woman, I had a cane hanging in the closet. It helped me through the three days of pain until the back would relax and let me go back to my regular walking.

Cane and Handle helps George w balance

Cane and Handle helps George w balance.

Just as you prep your house for little children or dogs…its time to do it for seniors that will be aging into health challenges. The senior may only need a few of these items as they move downhill in their health. But actually, at the first signs of stability problems, its time to make changes. Stair lifts are such a lovely thing for those that can afford them. They allow the senior to stay in their two story home, so much longer. And electric chairs are great too. But they are for seniors that have all their thought processes working. Since my George suffers with his Alzheimer’s and Parkinson’s he is unable to remember how to use the electric chair or cart.

This new small wheelchair is proving to be a hit with us

This new small wheelchair is proving to be a hit with us

George started using his walker quite a while ago. But it only worked as a walker. It did have a seat for him to use when he got tired…but now he has days that he is too weak to walk at all. So, what to do? We asked for a Physical Therapy appointment and the PT gave us a very small, light weight, wheel chair with small wheels. It now is used as a walker for George when he is feeling strong. The chair is light and easy for me to fold and put into my smaller car. (not everyone uses an SUV) and it works well when George walks. I am going to look around for a larger bag that can hang off the back of the chair so he can grab a few things to take from room to room. I also have to figure out how he can have his cane on the back of it too…so maybe a velcro connection there??

Walking w his legs instead of me pushing is Great!

Walking w his legs instead of me pushing is Great!

The new wheelchair also allows him to sit and walk with his own legs. The older walker was not designed for this move. Now, George is able to move around on his own with his own leg power, without me pushing him all the time. NICE – he is able to walk it out to the front porch where we have a container garden and he helps me water the tomatoes and catches some sun rays each morning.

Now what do you do when you wake up and your spouse is not able to even get out of bed to begin their day? You learn how to use a ‘gait belt’ – the Physical Therapist will show you how to use this. Its an easy tool…you put it around the mid section of the senior and then you can help guide him up and walk with him supporting his legs from the middle of his body.

Example of Bed Rail

Example of Bed Rail

Or you can add a support bar for the side of your bed and the senior can use it to get up on their own. It will depend on if the senior has strong arms and is able to use them.

That is why I keep George exercising three times a week. I have a routine I put him through to keep those legs strong enough for him to make transitions and get up and down from chairs and bed. As he goes up and down in his abilities…we stay with exercise. I use the elastic exercise bands to give him some pressure to stretch and keep his arms strong. Look for them at the sports department or ask the PT the next time you go.

Thank you for all you are doing for your senior…you have no idea how kind and dear it is for you to give your time and love to another and let them age with grace. I have been giving George more and more of my time each day as his Parkinson’s is taking over…poor guy is losing his abilities so fast. So, what I try to do is take each day as a new day. If a day is bad…we work through it. But the next day we start a new…so if his strength is better he does more. If you start to put the senior into a pattern of you doing more and more for them and never checking if they can do some of those things on their own…its just a downhill slide for both of you.

Enjoy the fall…no more hot hot days…things will cool down. George has already asked for Pumpkin pie or pumpkin cream in his coffee…so he gets what time of year it is. I also make sure I change the decor and the calendar in the house. Seniors have no daily change of pace…so pointing out the seasonal changes makes their days into days…not endless time with no change. Quality of care, depends on you as a care giver…so make fall a good time for you…and it will translate onto the senior you are caring for.

Blessings…francy
Oh, would you please sign up for my blog listing. With the care giving getting more and more I try to do the blog, but often miss my weekly update. When you sign up for the blog it will notify you of the new post and you can keep on top of the info. Also…please, please share this blog. You have no idea how lonely care giving can be…and if I can help a few people along my own path of caregiving it helps me feel my own life has meaning…Thank you!

Help, Dad Fell Twice this Week

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Tips to help elders/seniors from falling – by francy Dickinson

George was an avid golfer, skier, ran and played tennis. Is there memory in those muscles still?

My dear Georgie was an avid golfer and skier. He ran, cycled and played tennis. Is there memory in those muscles still? Alzheimer’s and Parkinson’s is robbing him of his mobility, how I am fighting to keep him moving.

 Dear Francy: Dad fell twice this week alone. He has a bruise on his upper thigh and his ribs are sore. I took him in to the doctor to check it out after the second fall, but this is so frightening. His Parkinson’s is just turning his legs into jelly. What can we do to keep him safe? 

I am right there with you. My Georgie is falling all the time and I worry so about a broken hip. How do you keep someone that is aging and losing their strength from taking tumbles? Well there are things you can do to lessen the problem. So, lets go through the list together and see what pertains to us and if we can use the ideas to keep our guys standing and walking safely.

  1. Start with clearing space. No matter where you live…look over the pattern that the senior is using to go to the bathroom, the kitchen, the bedroom and back to their favorite chair. Is there obstructions? Remove throw rugs, extra furniture and any clutter. Keep the area clean and clear…so the cane, walker or wheelchair is easy to use. If you have to re-arrange furniture so the senior is safer…do it. Life does not have to be pretty…it just has to work for the senior.
  2. Take note of the time of day that the senior takes their falls. If it’s at night they may need a better path to the bathroom or a portable commode. These commodes are easy to use and you tell the senior it’s just for night-time. Set it up right by the bed so there is only a couple of steps and then put in a good night light so the commode can be seen and used. When I had mom, I would use the commode by the bed at night and then take out the bucket, clean it and move the commode part over the toilet during the day. This provided handles for the senior to use when getting up and down off the toilet.
  3. “Table top walking” is a favorite with women. They do not want to break down and use that cane. So they move through their home by grabbing onto a chair back, a table top and counter. This is so dangerous and you simply have to draw a line and refuse to allow the senior to keep this habit. Get them a cane or a walker. The rule is a cane is for pain. Used for recovery from an operation, a break, or a arthritis type of continual pain. The walker is for steady and support-always get a walker with a seat, so the senior can rest if they feel weak. The wheelchair comes when the falls are simply so often that you can not depend on the senior to be safe alone. Physical Therapy should be ordered and they will review your senior and help them make the choice of what is right for them. If it is a walker or wheelchair, you will have to go through the living area and prepare space for the senior to move. Doors may have to be taken off hinges, kitchen areas cleared and a basket to carry food and drinks has to be added to the walker or wheelchair for convenience.
  4. Exercise. Physical Therapy can be the key to success to getting any senior walking stronger again. After stroke care, Parkinson’s, severe arthritis – it all has a lot of recovery to keep the body in movement and the PT will give special exercises to help the senior regain strength. I found it surprising that doing the exercises even three times a week made a big change for George.
  5. Recovery. Mom was a girl that had a series of tiny strokes. She was in her nineties
    Mother on the go in her wheelchair at 98 with our dear Kathy who helped me with care giving

    Mother on the go in her wheelchair at 98 with our dear Kathy who helped me with care giving

    and each TIA took away her muscle abilities. I told her in order for her to remain with me, in my home…she simply had to be mobile. I could not lift or transfer her all day with my bad back. So she was such a trooper. Each time she lost her balance and could not walk…she would pull her self up and use her walker inch by inch. With me following her with the wheelchair in case her legs gave out. She recovered over and over again. I know; first hand…that muscles do have memory and you can recover it with patience and continued practice. But there is always a line in the sand when wheelchairs have to be used and transfer help from a care giver is the only way a weak body is able to keep safe.

  6. Eating to stay fit. Protein is really important to re-build your muscles. Add a protein drink to the senior’s morning exercise routine. It will help give them a boost. Go over their food and make sure they have plenty of small ziplocks filled with treats. Carrots, celery, peanut butter on crackers, a cookie, fruit slices etc. Keep them handy so the senior can munch and crunch every few hours. If they are living alone, you will call them for a short reminder for pills and snacks – four times a day…this will keep their energy up. Often seniors forget to eat and drink..they lose their energy and that reflects in their ability to safely walk. My trick is that they keep a cooler by their TV chair and it is filled each morning with drinks, food, treats and the senior then does not have to go anywhere for their daily food. This is perfect when a senior is checked in the morning and evening by a care giver or family member.
  7. Rules: setting rules is no joke. You set rules for children when they are growing…so you need to set rules for seniors. They may break them…but they need to know they are there. George is not allowed to walk without his cane or walker. I spend my day finding a cane in one room and bringing it back to him and keeping the walker close. But his dementia does not help him remember. So, its my job to keep his tools of support around him close, so he uses them. George can not overload his hands…I now transport anything he needs in a basket so he walks with hands free and balance in check.
  8. Medications can be a big problem with falls. Talk to the doctor about his falls and tell him they are worrying you. Ask if he can review the prescription list and see if any of the medications could make the senior dizzy, tired or forgetful. So when you are giving the senior their morning pills – you can adjust their routine to allow them to rest for a while after they take their meds. Make sure the senior is sleeping in their bed at night and resting their brain and body. Many elders sleep in their chairs and nap all day. This confuses the body and does not help the senior stay strong.
  9. Talk to your senior. Just sit down and tell them your concerns. “Dad, I want you to live with us. But if you fall and break your hip – you will have to have more care in a facility. This is why we are all trying to keep you safe. I know that the walker is not fun, I know you don’t like to be bothered with me hovering. But I am doing this to keep you safe and at home (or with us).” When seniors hear your concern, when they understand your fuss is in love – they take note of their own care. Life gets easier. I often ask George; “What do you think we can do to fix this?” And through his dementia he usually has a come back. Some times its funny…sometimes its way to hopeful…but he feels involved in the conversation. A senior’s personal honor has to be kept in place for them to work with you on solving problems.
  10. NO SHAME _ NO BLAME I work very hard to deal with emergencies, not yell about them. Even though I get mad and exasperated when my Georgie does something silly and causes a big issue of a fall. I take the moment new. I use a calming voice. i tell him to relax and just stay still till he can catch his breath. I inspect his body and make sure he is in one piece. I ask him about pain level. (1-10) I keep him still untill he can recover his mind and review his own body. When I feel it is safe I assist him in getting up again, using a straight chair. I bring the chair to the site of the fall. I get George turned around and on his hands and knees. Then he puts his hands on the straight chair’s seat and I assist him to slowly stand. If he is dead weight and not thinking straight – I do not try to move him alone. I call for help. I have a neighbor that comes over and if he did not respond to my call – I would call 911 and ask for assistance with a fall. The EMS (fire fighters) come and get him up and into a chair or bed. They check him out and would then help me transfer him to ER in my car or by ambulance if it was needed. I force myself to stay calm and thinking.
  11. After a fall: I have George drink water while he sits calmly in his chair. I turn off the TV and put on music to help him relax. I bring him something that has sugar, like a cookie and make him tea. I sit with him and we talk about something totally unrelated. That allows his mind to rest back into place. The shock of a fall is hard for anyone. Letting the senior absorb the shock and relax again…then rest for a while before they go to the bathroom (or back to their day activity) is best. I always cover George with a light throw when he is in his chair…keeping him warm, rested, fed and calmed with music and talk…brings life back to him. I save my fears and upset for another room…away from him. Often the fall worries me – more than George. So I try to calm myself down with a little tea and maybe a walk around the yard or a chat with a friend on the phone. It’s OK to cry out frustrations, but its not OK to do it in front of the senior. They will feel nothing but guilt over your upset.
  12. Pain. If the fall causes bruising or pain. Its best to make a call to the doctor’s office and ask to talk to the nurse. Tell her what you have done and what the senior complaints have been. They will tell you what to look for that would require the senior to come into the office. The rule I live by…is the ER and doctor’s office are there for real emergencies and I take that seriously. Just like a new mother…it takes experience to tell when a baby is in need of rest and love or a trip to the doctor. So it goes for seniors in care.

Just the fact that you care about your dad and his falls..tells me that you are a kind person there to help your dad through his elder challenges.

George is now waiting for his PT appointment to get a wheelchair. I am concerned what that will mean to our household routine. Will he not want to even try to walk or exercise when he gets in that chair? Will his dementia and Parkinson’s really start to take a dive when he is no longer moving on his own? I worry about change…

I know what it takes to give care on a full time basis. Its lonely. I thank you for your love and kindness to your father. I hope these ideas have helped. Blessings, francy

What if someone said you were going to die soon…then what?

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How to handle the journey to the end of life by francy Dickinson

My little Annie and her never ending love.

My little Annie and her never ending love.

Dear Francy; I am 47, I live alone and work in a doctor’s office. I have an adult son that is now in France with his own family and his dad. I am alone, no one in my family is left but me and a distant cousin. I have not been well for quite some time so I have very few friends and no one that checks on me or is a close confidant. When the doctor told me – my time was close…I just came home and sat down on my patio and wanted it to end right there and then. I was given your name by a friend, she said you ‘knew about things’. I wish I knew about things…I was wondering what you think I should be doing? I just don’t have the energy to think lately…and yet, I want the end of my life to be joyful. Do you have any ideas for me?

Yes! First, a Friend told me one day…that you should think of death as the beginning of a new life. Think how happy everyone is here…when a new baby is born into our family or community…we all give showers and gifts and stand in line to hold the child with great hope. What if your death here…is like a new child’s birth on the other side? What if when you enter that realm or dimension…you are the star…you are the one everyone is waiting for? Your family that has passed on, dear old friends…anipals that have passed – all standing in line for hugs. What if you are the center of attention? Just a thought to throw around in your mind.

I sent you a personal note and asked if I could share some information on the blog and you granted me that right. So, I will talk about the idea of death that bursts forth when anyone is faced with it. The recent tragic news about people dying in terrible fires and storms, children being shot in their schools and cars dropping off of bridges without any notice. You can be faced with end of life situations at any age…but for you and many, its health issues that take over the body and cause an end to life. You are still young, but a person’s age does not matter, death is death.

I was faced with 4th stage cancer in my twenties. So I know the pain and trials of thinking about death. I know the feeling that just making it through a day to day situation seems overwhelming. But the truth, as I know it…is that life enfolds and I lived on. I lived through the procedures, the pain, the confusion, the trauma and thirty years later — I am still here. So timing of our death can be very tricky and I would not get caught up in dates, times or places of your own demise…it may be tomorrow…or it may be a very long way, away.

Since you are alone, you have the privacy to be emotional when you need to be. You don’t have to be brave or polite for your family or older parents…you can just be who you are and that is a gift. That means that you have the ability to sit on your patio and enjoy the air, the noise of life and the sunshine….its a good place to be. I happen to be a great believer in trees. My family has a history of staring at the beauty of trees, as they made the last part of their life’s journey. It gave them all a feeling of calm, peace and they often talked about things they saw in the trees after hours of staring at the limbs swaying and leaves shimmering. Being with nature when you are tense and worried…is always a great calming effect. You get into the feelings of the day…the noise of the morning, afternoon and evening…and the quiet of the night. Some times…you just need to connect to that and I think its a good thing.

I know your son seems like a lifetime away. But one day he, his children or grandchildren will want to know about you. Its time to prepare for that. When you are fresh in the morning…start to pack a box for your son. Put everything in protective sleeves or ziplock bags and add notes to them. Example: Your wedding ring…tuck in a note about when you got it and how much you loved to wear it. I did this with my sister when she was passing with cancer…those little gifts and notes to family and a few friends…were held like gold when they received them.

Go to Ancestry.com and do a simple search and get your immediate family members in place. Then scan in a few pictures and things..so when someone does research on your family…they will find your smiling face and a small outline of your life. They will read a few things about your own father and mother and maybe you knew your grand parents. That is like a gift to your great, great grandchildren…please give it to them.

Call Hospice. They will come and talk to you and talk you through what has to be done to keep you safe and well and at home, if you choose to be at home… through your end days. They are trained for all sorts of situations…so you will be surprised at how much they will do for you. They will clean your home, help you with a pet, find a home for your gold fish…they do what you need to make a life transition without worry. Its a wonderful group and is free to all of us.

Ask someone you know, to be your health care directorship. Maybe it will be a friend at work, or the doctor you work with or anyone that you enjoy talking to and understands your true voice. When you fill out the paperwork, you will see it will ask you what you want to do about your decisions…like would you want to be on prolonged life support? Think on it and then answer. Do you want to be buried or cremated? These questions are not there to upset you…they are there for you to make the decisions before you get so ill that someone else makes those decisions for you.

Let people know you are on a limited time frame. My husband has long talked about an incident that happened in his life. He was married with children and his father was suffering with Parkinson’s. His dad went into the hospital and his mother called and gave him an upbeat talk about it and told him not to worry to come and visit the next day. My husband was going to do just that and he had in mind what he was going to bring to his dad and some special treats he was going to include in his gift.  Then early that morning a call came that his dad had passed. My husband was so upset that he never forgot about the missed chance to see his dad…and he has always been stuck on why his mother did that to him?
Give your son a call and let him know the situation. If he wants to come and see you…let him. If he is fine with it and just wants to chat and send you love over the phone…then you can deal with that too. But do not take away the choice of your son to express his feelings for you before you are no longer there. Gift him, the choice. Being brave and not wanting to rock a boat, is really being selfish and taking the power away from your loved ones – to give to you.

Ask what or how the end will come. A lot of people do not want to know this..but Hospice will explain to you what is ahead. When I have worked with them…I have found that this information takes the worry and fright out of what is happening to you when your body is weak and you are no longer able to understand or do for yourself.

Do what pleases you. If you like hamburgers eat them…if you like chocolate eat it, if you like to drink martinis ~ this is your moment. No diet is going to change your health when you are in the final stages of health decline. Be good to yourself…do as you please…if you want to take off your bra…or wear your hair on top of your head. Do it!

Do not spend energy on things that have no meaning. I try to explain to anyone in your place…that your body only has so much energy…so how you use it each day is very important. Think of your body as a laptop on a plane trip. You have an hour or two of battery time, before it has to be recharged…so what are you going to do with that laptop?

Say NO…if you are asked to do something that you do not want to do…you now say, NO.

Do not push away people. You know I have gone through a strange life of care giving. Not because I wanted to…I am not a nurse type person, but because I was in the right spot at the right time to help a few of my family members, friends and others. I could have said NO. I could have gotten someone else to do the care giving..but somehow I was put there to learn and to do. Its just how life unfolds. But from caring for my dad in his last days…he shared some stories and ideas with me, that I would never have known. Being with my sister in her last days gave me a clear appreciation for her helping my mother to raise me. When I took mom into our home, in her last days…showed me that I was strong and could keep my mind working even in crisis. All of those actions and care giving…now allowed me to be here for my dear Georgie, as I am now caring for him during his Alzheimer’s/Parkinson’s journey. It has not been a bad thing, or a sad thing, but a journey and a gift that they gave to me. I always was a very self-centered person that only worried about my own life…I have now been shown how important it is to do for others and to give them your love when they really need it. I have learned that my sense of humor has as much power as my care giving…because nasty health issues are not fun…and if you can not laugh in the midst of chaos…there is a big problem in your world. The care giving was not a burden, but an awakening for me as a person. The care giving turned out to be how I was meant to give back and I am pleased that my family members gave me the chance to learn that…I am not mad about being ‘put out’ over the work. I am honored. So do not think that you are asking to much when you ask care givers to help you…they are there to be next to you during this time. Maybe something you say or do, will enrich their lives in a way that never would have happened without you.

If it is true that giving is blessed…then you have to remember than someone has to be the receiver in that process. So you have given all through your life…now, its time to be the receiver and let others be blessed on their kindness and giving to you.

Last…there is nothing to be afraid of — if the end of life has nothing. I mean if those that believe in an after life of some kind…are wrong…so what? Nothing is nothing, you don’t have to worry over nothing. But if we are right about the end of life being a beginning of another experience…then being prepared and thinking of what you would want in that new experience is worth your energy. Pushing through the fear…and knowing that you will be swept up into love…is so important.

There is no being with someone when you die. We are all going to be alone. Even if we have a big family around us…the experience is ours alone. All you have done will stand for its own value. Today, think and do what feels right. You said you like to do watercolor…so paint! Do not care what it looks like, if it’s shaky or the colors are not perfect…just open up and paint. Feel the inner you coming out and allow it to talk to you. Maybe it will be sad and dark…or maybe it will be beautiful and light colors, or maybe it will be joyous and just shine. .Allow that inside of you…to spill out. There are no more rules…you are on your own ride.

Know that you and your life had meaning as all lives do. I think of my sweet little wire haired fox terrier, Annie. She passed years ago. She gave me so much joy and love and I still think of her as being by my side. She is dead, she is gone…and yet I feel her close. I remember how she expressed her love to me and it still makes me feel special. She was with me only nine years, such a short time on earth and yet…she gave me a lasting feeling of love and being a good dog mom. Since I have not had any children of my own…those feelings of motherhood were expressed with her and she – in return, left her love behind.

You are loved…and I am honored to have met you and that you have shared your feelings with me. Blessings, francy