Your Mom Just Now Needs More Care at Home-Great Ideas-

by francy Dickinson                     www.seniorcarewithspirit.com

Dear francy: After realizing that mom needed more care than a phone call each day things have changed. We just got through cleaning Mom’s home after years of her ignoring the mess. She had not hoarded she just did not clean. So rooms were filled with old things and now the family has cleaned it out and we are starting fresh. We had every room painted and the bath faucets updated and the kitchen got a new smaller stove and new microwave. We took your advice and got it ready for care givers. One of the bedrooms is now ready for an overnight guest or caregiver, the closets of old clothes in each room are clean too. Now it looks empty and mom is really feeling a cross between happy to have it clean and making it her own again. She is recovering from her stroke but I live two hours away and can only do so much with my weekly visits.

Well, lets start at the beginning, what a great job you and your three brothers did on the house. And how smart of you to clean and paint and ready the house for a sale if that has to happen in the near future. Since your mom is doing so much better and only needs her meals and a daily care visit of two hours, I think you have a great program going. The job now is to keep your mom busy and that might take some thinking.

Lets talk about depression its much more common than you can imagine. Strokes often effect the brain with sadness and so does the recovery from other health issues and of course the loss of a spouse. This whole house cleaning could also set off sadness in her daily routine. Even though your dad passed years ago, she is now just facing her own older and less able to do things lifestyles. I’m sure she thought that your dad would be there to help her at this time of life and the grieving can resurface. It can be treated with drugs that help so much, but so does therapy. Even though your mom is older it would not hurt to have her do a 4 session therapy round to give her a chance to express her personal feelings to someone other than family. She may smile when you are there but she may be very sad or teary on her own, so check this out. That way she can really close some personal issues and adjust to her new life of being less mobile and more home bound. It is not easy to make that change. So even though you are there for her and your love and support is strong…your mom needs some time talking things through and getting her new lifestyle started with healthy thoughts. What you dont want is for her to be upset or confused or just feeling lonely and no one really knowing about it because she is keeping quiet.

So, lets remake the home area that has been so well cleaned and updated.  Start with an area for her to write down things she needs on a listing by her chair. If she thinks of something she writes it down and when you come on Tuesdays she can give the list to you. You can review and try to handle what ever is on the list in a wise manner. That will keep her feeling that her inability to leave the house and drive is not stopping her from getting things and items in order in her life.

Put together a plan to decorate in a lovely way for each season so she can enjoy her home or any room she lives in as time passes.  Take older pictures of family and choose one or two and have them enlarged and put up on the wall like large art pieces. This removes the clutter of fifty small family frames, into a just a couple of stellar photos that reflect years ago and the current family picture. The older pictures can be scanned and put on a nice mp3 frame that will show a slide show when you touch the screen. Always put your father’s picture in a nice frame and have it where she can enjoy it..maybe one with them both as a couple but do not over do. Memories are to be cherished not overwhelming.

Add a little color with throw pillows and a good lap throw so she has color around her without changing wall color. If there is some money, recover  her better furniture It will be familiar but updated to a current nice color that reflects her personality. Add a grandchild corner with a big basket of toys for the visiting little ones. That way the kids enjoy the visit and she has a reminder of her lovely little ones around her. The house will remain clean, safe to walk around and yet feel updated with things that are currently special to her. Not things that have been there and forgotten for 30 years.   

Remember that when any person pulls their world back down into their own home or care center, their universe is smaller and therefore becomes more intense. So do not be alarmed if she gets upset with things that you feel are small and silly. The room temperature  may bother her to distraction, the way she feels sitting in her chair may be uncomfortable. What used to be a minor issue among many daily tasks is now the only issue. Deal with them as they come up and just allow her to vent until you arrive each week.

Here are some changes that you will have when your Senior is home bound:

  1. The TV may not be right for her. It becomes a big part of her life, so a new set that she can see and use the remote. Adding Dish or Comcast will give her more channels and a constant reminder of how to use the channels and the remote will be required for quite a while tell she understands the process. You might also try moving an old set in a closer position or get her headphones that plug into the TV so she hears without a high volume. History, sports and Military channel for the guys and food, home, mystery channels for the ladies…it makes a huge difference. Set the TV with text to run on the bottom of the screen if your senior is hard of hearing so they really enjoy the viewing time.
  2. Get her into a senior center and drop her off once a week to involve her with other seniors for as long as she can do this with her health issues. This can be cards, bingo, special exercise classes, lectures, lunches, food gifting, crafts and outings. You will find that the first visit needs you by her side and then they get drawn in and really enjoy this time. It will fill their mind with things during their week and help their emotional stability. It is worth having a care giver or senior in neighborhood driving them to and from and that could be a $10-$20 investment well made for the transportation. There are vans for seniors and you can try that too.
  3. Plan events in their homes for your active family members. OK so Thanksgiving is coming up. Did you know that around the holiday many local grocery stores do full turkey dinners? You can order one for a week before Thanksgiving. They will cook the whole meal and it only needs to be picked up, warmed and served. Then invite some family and old friends over for and early Thanksgiving. This will be a full month of getting ready and making plans without the worry over the cooking and lots of left overs to give away. Then the actual holiday comes and your senior can attend the family dinner or stay home without sadness because they had their own nice celebration the week before. Works well for many.
  4. Each visit you need to open the refrigerator and make sure the senior is eating food that is being delivered and prepared. Just because food is in the house does not mean the senior is eating it. So look through the refrigerator. If the senior gets into a special diet of potatoes or just canned chili or other items dont worry, it will work itself out. Just make sure they are eating and add a Boost dietary drink so they get plenty of protein. Tell dr about the eating if it gets bad and he will prescribe meds that increase the hunger issue.
  5. On your visit ck the cleanliness of the kitchen that is a care giver job and you want to make sure the staff you hire for your senior is doing their job. Clean counters, floors, and appliances are a must…check. If it is not clean, report the caregiver to the service and ask for another care giver or more time each week for a good cleaning.
  6. Check on the bathroom for the senior, it should be very clean, the caregiver also is responsible for that area. The bathchair should be in the tub the handheld shower should work and be clean. The towels should be in order. If your senior has old towels remove them. You will need four good bath towels and a stack of hand clothes to make sure your senior is able to get good care. I am sure you know that the most important person you can hire to care for your senior is a bath lady. They are well trained to do a great job and will report injuries, sickness, dizziness and any other problem with your senior. You always find professional at a “In home care service” they provide a variety of care people to hit the needs you might have. They are licensed and bonded but once you use them…all expensive jewelry and family things should be given away or put into the bank box…you dont want great grandma’s brooch to be lost to the family because you did not follow through with this.
  7. How is the mail box at your senior’s home. Is it on the porch and easy for them to use, or across the street? Maybe you need to buy a new one that is larger and easier to use. Or have the mail all forwarded to the home of the person caring for your seniors finances. Getting mail each day, can be a dangerous task for those that do not walk well. If they still want their daily mail, put the pick up on the care givers to do list. Or ask a long time neighbor to drop it off and put a box on the front porch for them to do so. Then  make sure you thank the neighbor often with cookies or a box of candy so they know they are appreciated. This daily ck in by a neighbor can save a life one day.
  8. Watch the charge cards of seniors, they tend to build up if they sit and order items from TV or the phone. You can stop unwanted calls by removing their names on phone lists. You can get a special service added to the phone that will filter calls from anyone but approved family and friends. You can also get a good easy to hear phone with special features for hearing disabled. You can add a cell phone to your own family plan and have your senior wear it on a holder around their neck or in a belt. Teach them how to call for help and call you…you can also add a home protection service that is a button for the senior to push if they are hurt or need help.
  9. If the senior looks out into the yard from their family or living area…get the grass cut and the bushes trimmed and load up the beds with bark. You dont have to make gardening a hobby at your mother’s place, but keeping it looking in order will relax her and help the home to re-sell in the near future. If you have teens in the family ask them to make the garden and grass their task and pay them a small amount. Taking care of the home and keeping it safe will allow your senior to relax and enjoy their life. Instead of them worrying over uncut grass and the house slowing breaking down around them.
  10. Make rules for your time…if your siblings want to visit great…but remember your mother is a part of your family…just a part. Make her needs work into your life with your calendar days not her’s. She is at home each day you are working and keeping another home. So be kind, but be strong about saying I will come down on Tuesdays and get what ever I can done that afternoon and evening…the rest will have to wait till my next visit. She will soon learn the routine and she will be happier knowing you give time to her but still have time for you and your own life.
  11. Care starts small…a day here, an hour there and soon it becomes overwhelming. Remember when you make any decision have an idea of what will happen in time to come. That way each step your mother takes in her recovery and her advancement with her declining health issues- is a step that fulfills her life but is in line with her future care. What I mean is do not spend a lot of her money on things for a home that will not repay, her money is limited and will be needed for care giving in the future. If she wants fancy clothes but she can not go out the door, try to adjust her thinking to clothing that is fresh and easy for at home comfort. It takes a mind change for you both…and that is what you now must make a change and realization that your mom is older and is declining in health.But her today and tomorrow can be happy and fun and filled with hope.

I appreciate your email and that my ideas have already helped you make solid decisions on your mom’s care. You are doing a great job and thank you for your care. Please do visit my web site and remember I have written a book on Senior Care Workbook 101 that really helps with all the decisions and care that will be happening as time goes on. You will find the workbook on my website www.seniorcarewithspirit.com

Blessings, francy

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Elders Need Cheer Sessions

by francy Dickinson                      www.seniorcarewithspirit.com

Dear Francy; My mother seems to be going into a deeper depression. She seems to be recovering physically well from her last small stroke, but she is just not herself. She feels down and not involved with everyday life. I am having a problem with her paying attention to what the day is or what food she wants to eat. How can I bring her around?

I am sure you have spoken with the doctor about her depression, that is a part of the brain that is also effected by the stroke and special medications can be prescribed to help her with her mental state. As the brain repairs it has to be exercised just like you are doing with her body. So you will have to make sure you participate in her emotional wellness as well as how well she walks or talks as she recovers. Even if you are talking to her over the phone each day, or in person, you will be doing a few things that will involve her mind and emotions so she gets back into life with her body and mind.

Here are some tips:

  1. Your interaction with a recovering stroke victim is in the morning or in the afternoon after food and a nap. So you get them fresh, it will be up to you to arrange your own schedule around that time frame.
  2. When speaking to the senior, use an up tone in your voice so they can see a difference in an everyday conversation, and an animated conversation. As you would a very young child of two or three, use words and facial expressions that include smiles, laugh, questions, and surprise.
  3. Prepare yourself with a list of things to talk about and always start with the day of the week. Endless days mean losing interest. “Hi Mom how is your Tuesday morning going?” That is a good way to begin, not to challenge her with a question that she can fail at the answer like “What day is today?” – Start with a positive statement that will inform her. Then go over what you know to be her usual Tuesday tasks. “I know you will be doing your wash this morning do you have it in the washer already? NO, well you can do that when we hang up and today is your day to see your friends for cards. What are you going to wear? –who is going to pick you up? OK, good well you’re going to have a busy day. I will let you go so you can finish your washing and getting dressed for the girls. I will call you this afternoon, when do you think you will be back home again?”
  4. Taking information you have and making sure it is restated and then adding questions that are easy for her to answer is how you begin. When you call back in the afternoon, you will ask about her food for that evening and suggest a TV show that is coming on that you want to watch and you will call her just before it begins to remind her so she doesn’t miss it. Ask if her wash is in the dryer and how the card party was with the girls, stretch her mind with asking about what she ate and who won at cards. Ask over anything new with the girls. Get her to talk about things that are up front in her brain. Bring out more than yes or no answers, with an upbeat voice again, ask about what the girls were wearing or where they went for lunch. Push her brain, push it in the direction that she has always had interest in, but know when to be calm and listen.
  5. When she does something more the normal daily tasks, make a big deal out of it. Let her know you are proud of her. “Wow, mom you did the wash this morning, had lunch out with the girls and then you came home and went over the floor in the kitchen? You are really on a roll, good job” – “You have gotten so much done and I have just been here at work all day, I’m impressed.”
  6. When you go over to visit and you see the house in a mess…remember her mind has to learn how to organize again. So roll up your sleeves and get one room done at a time. Find small clear plastic boxes that are easy to carry and fill them up with like items and then use a large print label maker to mark them. Just like you did for your toddlers when they had so many small toys, cars, crayons remember? Now it is your mother’s time to organize, vacuum bags, filters or parts in one box. Candles and matches in another. So when she is missing something and in a huff looking for it, she can open a cupboard and read the box. It helps her mind relearn how to stay organized and find things instead of being stuck inside a swirl of a mess.
  7. When the mind is healing from a stroke or other trauma, or in the middle of dementia the home needs to be clear and clean around the senior. If the front room or kitchen was covered with small items art or otherwise, pack them away for a while. Tell the senior you are clearing it to prepare for the room to be painted and we will go through the box and get things back in place after the painting. Then remove the box to a place  in the garage or storage area. Look around the room and see it with an eye that could get distracted. Look again, what needs to be in the room and what is just extra clutter for the brain?
  8. Example; lots of seniors have a full wall of photos of grandchildren and family members right by their TV chair so they can see it. If you look again at that wall, it becomes a maze of endless photos that have been added to over the years. So, how about picking out three or four pictures that the senior loves. Take down the older pictures, fill the holes in the wall and repaint and then put up the four larger photos in a row…so it is easy on the mind’s eye to focus on the pictures not to just see a jumble of frames. It will calm the senior’s eye and make it easier for them to rest while they are in their favorite chair.
  9. Asking your mom to help you, is a great way to help her recover her old self. What did you two always do together, maybe you cooked together, or sorted clothes in the kids room, played golf, walked, or painted walls, pictures, or worked in the yard together. Plan in your mind a task that is no longer than two hours and ask your senior to help you. Have the task all planned out so the beginning and end can happen in a short time. Together you work and together you get it done. You can stand back and admire the great result together, you can talk to others about how your mother helped you finish the task when you are so short on time. You become her cheer leader over a simple task, but it gives her such a feeling of accomplishment.
  10. Let go anything that no longer brings her pleasure. The brain in trauma, stroke recovery or dementia is simply changing, so if at one time your mother loved to bake cookies and now it is a chore. Let that part of your mother drop away. She will fill the void with a new enjoyment she has changed and changing is what we all do. This change was just more sudden than others.
  11. Anger is an emotion that will come to you and to your mother on her recovery. My husband has his dementia moments and out of those comes so much personal doubt that anger is his way to express the confusion of his brain not responding as he wants. Often stroke patients Even those with TIA’s or baby strokes- can find words are lost to them, actions are lost, rituals are no longer there, lifetimes of interest on certain subjects have faded…it will take your own personal patience to deal with this. You can see if you can easily move them back to the once loved interest or change it into a smaller and less stressful experience. My husband used to love WWII books and would read them endlessly, now he is unable to remember enough to read, so I have gotten him into the Military Channel on the TV. It’s the same information it just comes to him in a way he can absorb and enjoy it easier than reading.
  12. Even in days or times of anger…you have to stay calm. You have to back away and give them time to defuse and then re-enter and change the mood or the thought pattern so the day can go forward with joy, not stuck in anger. It takes a lot of creative thought on your part, but being there to cheer them on, will allow them to heal in a positive way instead of simply retreat on a daily basis.

I know you have had to do a lot to care for your mother. Stokes can happen in clusters, just as your mother gets well, she could be hit again. So make sure her meds, supplements and her food keeps her as protected and even in body chemistry as possible. You are the person that will give her life a guidance to calm and joy…you are giving her a gift of more than care, you are gifting her with true love. Thank you.

Please do go to my website at www.seniorcarewithspirit.com for more ideas. I have a great e-book called Care Giving 101 Workbook that will help you with giving care in your own home or in the senior’s home. It has all the basic home nursing tips and gives you ideas to support yourself as well as your spouse or loved one. These books are very popular with care givers and I encourage you to buy one so you can feel more in power of your situation as the care giver. It can be very lonely out there all alone when you are giving care – I want to make the experience more comforting for you.

I write these blogs to share information that I have gathered in my many years of care giving. I am now tending to my husband with Alzheimer’s and my books and services are how I’m able to stay at home and care for him. Thanks for all you are doing for your own loved one, blessings. francy

PS I am on Twitter @seniorcaretips and I would love to have you listen to my talk radio show on senior care issues just click the radio button on my home page. The show is on demand so you can listen whenever you have time.

How to Bring Grandma Into Your Home

by francy Dickinson                         www.seniorcarewithspirit.com

Dear Francy: I have decided that Mom just can not keep living on her own and in a state of worry each day. Her health is not ready for nursing care but I know she needs to be looked after more than a drop by each day. How do I tell my husband and kids and where will I put her? I live on a thin budget and I am worried.

Now this is a problem that I can help you with because I did the same thing and I have helped so many others do the transition smoothly. Here are my ideas and tips:

Moving Elders into Your Home Tips:

  1. After discussing it with your spouse and getting their approval, you call a family meeting. You will not be asking their approval, but informing them of the situation and letting them know a new arrival means there will be changes that might not be the most enjoyable. Depending on the age of your kids, let them live in the elders shoes, explain why the change, why the elder is no longer safe in their own home that way the family has a base of understanding that this decision is how we treat and care for family. You make room for children when they are born into the family, you make room for elders when they retire into advanced family care.
  2. Make it clear to your family and to YOU that this is a change that is not going to just go away or get old. This is a commitment on your part and your elders that life will be together through thick or thin. If money gets low, or someone gets unwell in the family, or a move has to be made- the elder is now a part of your family and will be with you for good or bad family times. That is life making room for an elder is a serious decision that once made is made, not changed because of an argument. You do not throw out babies or elders because they are extra work or a pain to live with…so think this step out very carefully and inform all; that this is a commitment of heart and honor on both sides.
  3. Set up some rules of the house so every one can work within a fair basis of comfort living. Kids do not invite friends for an overnight if Grandma is using the living area for her bedroom. Things will change, but the changes do not have to be huge, just considerate on all sides.
  4. Plan your elder’s living area. They need their own room, even if your children have to share a room, that is better than an elder sharing a child’s room. If no extra bedroom is there, then take an area that can be shared like the dining room. Put the big table in the kitchen, living area, or storage. Put up a day bed that can be used as a sitting area during the day. Always give privacy from public areas, you can hang a curtain or a bamboo shade to enclose the privacy for the senior.
  5. Try to bring the senior’s favorite things with them. A good sitting chair, a side table for bed and chair, a little desk or bookcase, favorite books, family memory photos, jewelry, special mementoes and art that can be incorporated into your home. This is the time for them to distribute family things to their children and grand children, not at their death. Do not rent a storage unit. If your elder is going to move in with you and it does not work, they will be in a care facility with little space, so there is no going back to an apartment living for the elder, this is a life change, not a try out.
  6. Paint the area to match the elder if you can. If your home is high energy color reflecting an action family….lower the tones for the elder so they can relax and rest in their space.
  7. Decide on the bathroom the elder will use. You might have them use a half bath and just take a weekly bath or shower in the kid’s bath. Always make room for their personal products.  A basket with their bathroom items tucked on a shelf makes their things private. Young kids do not understand false teeth or Depends. Make sure your family respects the privacy of the elder and no teasing takes place, bathroom humor is not appreciated by a person making a big change in their life.
  8. Keep elder drugs in a place in the kitchen or laundry area. That way it is away from the kids and in a place that can be sorted and the weekly pill try can be filled as well as meds reordered correctly.
  9. Use a closet in the hall or a rack in the laundry room for elder’s clothes, plastic drawers can be purchased for clothing. Sort over elders things and take clothes that fit the lifestyle they have now, not the clothes they wore ten years ago when they were active or working.
  10. Keep the elder with their friends as much as you can. If they go to a faith center away from you, take them back to the faith center once a month to connect. If they have a favorite Senior Center or exercise group try to keep them there or let them visit and replace those activities close to your home. Elders need to know their life has just moved, not changed or gotten lost. Emotional problems often stem from elders losing their friends, spouse, home and all connections…so work on keeping them as connected to their long established lifestyle.
  11. If your elder is into gardening and you are not, let them at it, get them started redoing your front yard and enjoy that the elder is giving back to the family. If the elder loves to cook, let them do a dinner during the week or make the lunches for everyone each day. Figure out how to use their talents with your needs and make room for change on your part as well as theirs.
  12. Hearing impaired does not mean shouting or loud TV. It means getting them a headphone remote for the TV so they can hear it, or putting on the text feature to run text on the bottom of the TV screen. It means turning down music to a normal range and take time to talk facing the elder not on the run.
  13. Careful walking with elders that may trip means removing scatter rugs and use double side carpet tape on larger rugs. It means making sure there are lights to see well in the public rooms and dogs that are trained to love not jump up on people. Think safety. If your kids are older you may have left those safety thoughts behind a long time ago, now get your mind going again on what your elder needs to be safe walking around the house.
  14. If the elder wants to make alot of calls, get them a cell phone and let them  learn how to use it. Then they can call on their own phone without worry about family phone time. Get them their own TV if they need it and a radio or MP3 player with a head phone for music and talk radio listening.
  15. Do not be afraid to ask the senior for money to add to the family income. They can give you a couple hundred dollars a month for food and utilities, even if they are on a small social security income. They can pay for their own personal needs and medication products, specialty foods and clothing, too. Just be fair, do not take all their money and think they will not reflect emotionally to it.
  16. If your senior is part of your family…then you can take them off as a tax deduction. Ask your tax person how to do this before you take that action, but it can help you financially to do this. You can also get help with their house sales investment of money, or reducing their bills. Get help so you do not have to worry about funds for their care, talk to senior care consultants and let them help you with the legal part of your relationship. Remember their home sales will have to pay for their care for a long time, so be wise with the money. It is hard when you are limited on funds to care for an elder, but it can be done with advise.
  17. If the senior is unable to pay for their own medications ask the DR for help with pharmacy company programs. If you need to put the senior on state medical do so, they will pay for the medications and pay you to care for your parent if they are in need of more than just light care. Get a review, be in the know, so the money you spend on your elder is wisely spent.
  18. Make sure your senior has someone to talk to about you and your family living. A faith center person, a neighbor or other family member, that is a third party, should make a monthly visit. Get the elder to talk about their life. They may be afraid to say what upsets them, or they may be filled with upset and anger and need to vent it to make their life easier with you. Emotional health is often not understood until you live with someone, a doctor can also medicate to calm an elder, if you explain your concerns in a letter to him before your elder’s next appointment.
  19. Everyone has odd behaviors even you…so learn to live and let live, small things you have always done may need to change, that is not the end of any one’s world, it is just a change to make life easier for all parties. That is what makes living as a family work, you all have to adjust and talk and love and make changes to make sure each of you can enjoy life together. But elders find change upseting and hard and younger folks can adjust to change much easier, so that should set the tone when making family decisions.

Perfection is not the goal with a senior living with their family. But kindness on both sides is a must. Do not be afraid to have someone come in and talk to the family about problems, questions, ideas or concerns. Talking things out helps everyone. There is your way or the highway is not the way with a multi-generation family. Every one has to make way for privacy and for kindness for each other. Often the experience of grand parents living with children changes the child into a more understanding and caring adult in years to come. That means when it is your turn to need help, your own children will be more open to giving you loving care in your own older age.

Please do go to my website at www.seniorcarewithspirit.com for more ideas. I have a great e-book called Care Giving 101 Workbook that will help you with giving care in your own home or in the senior’s home. It has all the basic home nursing tips and gives you ideas to support yourself as well as your spouse or loved one. These books are very popular with care givers and I encourage you to buy one so you can feel more in power of your situation as the care giver. It can be very lonely out there all alone when you are giving care – I want to make the experience more comforting for you.

I write these blogs to share information that I have gathered in my many years of care giving. I am now tending to my husband with Alzheimer’s and my books and services are how I’m able to stay at home and care for him. Thanks for all you are doing for your own loved one,

blessings. francy

PS I am on Twitter @seniorcaretips and I would love to have you listen to my talk radio show on senior care issues just click the radio button on my home page. The show is on demand so you can listen whenever you have time.

Trees a way to calm and heal

by Francy Dickinson                              www.seniorcarewithspirit.com

Dear Francy; I am going to share a little about my self today because trees came up again this weekend. We live in the northwest and our trees are deep green and tall, we have lots of Douglas Firs, cedar and pine so we have a green mantle around us all the time. You may have a small tree in your back yard or a park close by, take a walk – watch a tree – see what happens.

My people are Tree people:

In the middle of the summer of 1969 I was living in New York City, dancing with a ballet company. I had a curvature of the spine and as I danced professionally it effected the muscles. The pain would come and go, the muscles would act up now and then, but that summer – I was in very bad shape. I simply had to take a break and calm down the muscles and I flew back home for rest. I went from the busy high rise city to the quiet tree filled lanes of my home town.

Home was in Tacoma, Washington where my parents had a lovely turn of the century Queen Anne home in the North end. When I arrived I was shocked at the advancement of my father’s cancer. He had been fighting throat cancer for a few years with only radiation to help keep it at bay, in those days. He was now at home, no longer working, no longer walking well, no longer able to eat food- he had a feeding tube. Mother was working at the college as a cook and she got up very early to do the breakfast shift and came home in the afternoon. So she would put dad in the living room facing the large bay window and arrange all that he needed before she went off to work. He had a commode, water, pre-mixed food for him to administer through his feeding tube, Kleenex, and a book. She then hurried off to work and worried about him all through her working shift. Around 9am a nurse from the neighboring nursing home would arrive and let herself in and give him a morphine shot, she would check up on him and give him anything he needed and then leave. Mother knew the owner of the nursing home and as a neighbor, he sent one of his nursing staff over to help with daddy as a kindness. 

That was what greeted me on my arrival and the all too quiet house. A big house that had always been filled with noise from four daughters and now their grand children. But Dad was way to ill, no one was visiting Dad. He sat alone, quiet all day, unable to talk because of his throat cancer surgery. Dad was a man that was exceptionally bright and gifted as an artist. He made furniture and upholstered for a life long living, he had been one of the first home decorators in our city creating things all his life…now he just sat, quiet.

I took over the routine of caregiver, I was 19 that summer. I had to put aside the embarrassment of the commode and learned how to assist him out of his wing chair that he sat in all day long. I learned the recipe for his food mixture and knew how to clean out his trachea tube, it was not pleasant, but when you have someone you love that is sick – the details of care, simply go away and you concentrate on making them comfortable and giving them ways to find happiness – even if it’s in small moments.

It was a few days before we both settled into a routine and I soon would sit by him reading and writing letters to my NYC friends. I had the radio on some times, but most of the time it was quiet. Dad wrote notes all day…funny notes, sad notes, mad notes, help notes…it was an odd way of communicating. Just recently I found a box filled with his notes that mother had kept for over forty years – I have not read them, I just closed the top to the box and remembered how sad that time was for all of us.

I was feeding him one day when I first saw the trees. You see his eyes were that wonderful light grey-blue color that can reflect like a mirror. As I stood by his side holding up the feeder tube, he was looking outside as he always did and I saw the trees reflected in his eyes. I finished the feeding and cleaned the area and when I returned to sit back down I stared outside and saw the large trees across the street. Horse chestnut is what we called them, they were swaying in the wind and had a quite a rhythm going as I watched them. I looked over at Dad and he was still just involved with the trees. It was his meditation point. I asked him about it and he wrote a small note back to me, “I live with them, when I’m gone I will be with them.” He smiled and I excused myself to go and cry in the back yard.

I was there all that summer and into the fall as the tree’s leaves started to turn. It was the 19th of September that he passed that year. Every few years I drive by that house and look at the trees, they’re still beautiful, I think Dad is taking very good care of them.

I was forty when my sister found out she had cancer. It was a strange thing, she had called me on the phone and told me she was going to the doctor and there was something odd about her voice. I asked her if she wanted me to join her and we could have coffee afterwards, she said a reluctant OK and came and picked me up. After her appointment she returned to the reception area and sat next to me waiting for the doctor to instruct her on her next appointment and he came out and stood in front of us. In the middle of other patients he simply said; “You have cancer” and walked away. We bothjust sat there, not able to speak, not knowing what to do, not even feeling really- just like a scene in a movie we sat quietly together. Until I broke the silence and told her we needed to leave and we walked out the door to her car. I drove her home and we sat in her beautiful backyard and drank tea. No tears, no words- just shock. It was a horrible time for us both. She was alone with no one to care for her, I was married and worked with my husband. She needed someone to help her through the massive operation and home care…and the only person that could do it without paying for it, was me. It was the second time I gave care to someone who was terminal. It was such a sad time, she had so many needs and I had to learn so many skills to keep her comfortable. I tried so hard to make her laugh, I tried to think of funny things about the meds and the procedures and we tried to laugh all the time. But it got harder to laugh as you saw her go down in her body’s ability to function. One day I brought her a plate of crackers and cheese and put it on the table next to her. She was sitting in a favorite chair of hers and looking out the window into the back yard. I glanced at her eyes to give her a smile and there they were…the trees reflecting in her light grey-blue eyes that were so much like my father’s – all those years before. I asked her about the trees, “Do they make you feel good?” She smiled and told me that when she looked at the trees it was like they drew her in to them. She could just sit for a moment and they called to her and she instantly felt relaxed and had less pain. They made her feel comforted and left her feeling “not so alone”.

I remember going into the kitchen and crying again. The trees; they were pulling her in – that seemed to mean that we were all connected to each other. You hear about connection to all things on earth, but it’s a concept so hard to really grasp until you actually feel a kinship withsomething like a tree. My sister lasted from day of discovery of cancer to her death only five months. So much of her time in those months were in pain. There she sat, in the quiet watching the trees in her back yard, her face relaxed and eyes reflecting the leaves and branches. I came to understand the connection and respect it.

It was not until 2006 that I saw the trees reflected in my mother’s eyes. She had been living with me for a few years as I gave her full time care. She had had a series of little strokes. Her mind was still strong but her body just slowly failed her. I had taken two bedrooms in my home and given her one for her sleeping room and one for her sitting room. It was in that sitting room that mother would sit in her automatic lounger and stare out the window. Our home looks out into a ravine that was filled with Douglas firs. We see the upperparts of the trees so the view is wonderful. They’re filled with birds and the swinging of the branches in the breeze. Mother started to stare out the window about two months before she passed. She would forgo her favorite TV shows and her books and just stare out the window at the trees for hours at a time.

Mother’s eyes are like mine, green and yet the sea of green branches swinging in the wind reflected just as well in those eyes than it did in the grey-blue eyes of my dad and sister. I knew she was leaving me. I suppose it should have made me sad, angry or afraid that she was spending time with thetrees, but it didn’t. I knew she was finding calm and quiet thoughts with the trees. I knew she was sharing things that are hard to put into words and I just let her float there during the day. She passed just shy of her 100 birthday, but in her 100thyear. I was ready when it happened and both my husband and myself were by her side. The trees swooped down and took her away like in a book of fairy tales- off to be with Dad and my sister…

I use the trees myself now, I sit up on roof top deck and I just relax into the trees around me. It calms me and I feel it allows my mind to be more creative and at times I feel close to my family that has passed.

My husband, Georgie is now fighting Alzheimer’s. If he has a day that is filled with confusion, I take him up to my deck and we just sit and watch the trees. He calms down and starts to hold my hand and I feel the Georgie inside of him coming to the top again. I guess we are all Tree People…we just take time to know it.

I encourage you to spend some quiet time with trees to find a calm and safe place to go when you are in need. I wish you well and hope you will visit my web site and see the other services I offer www.seniorcarewithspirit.com

Thank you, 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