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

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When You Say ‘Enough’ To Giving In Home Care

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

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

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

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

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

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

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

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

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

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

If Your Senior Goes to ER – Are YOU Ready?

by francy Dickinson

Mother in Hospital visit by her Pup

There I was standing in mother’s room in our home and she was not doing well. It was time to take her to the hospital. I had been through this before and I was running around her room trying to pack a bag. All of her meds in a plastic ziplock, slippers, her hearing aid case, her eye-glass case, her robe, on and on as I am zipping from one side of the room – pulling open drawers and grabbing what ever my mind said to grab, then darting back to check on her. My husband is coming in the room, getting her up and into her wheelchair and I am covering her with blankets so we can wrap her warm for the drive to the hospital.

Once there she is taken into the ER and I’m asked to fill out papers. I can hear her calling my name. Mother could not hear and she was frightened and needed me but I was filling out paperwork. It was horrible. I vowed not to repeat this mess again with any of us.
I put together a small plastic envelop filled with information that would answer all the questions that the hospital needed and allow me a quick in and out of the check-in with really just a signature. So I could be by the side of my loved one, not answering questions and pushing a pen around. Check and done…I know you will find this helpful. My mother passed at 100 yrs of age. But now my self, my friend Cheryl and my husband Georgie all have info packets that stay in the small desk in our kitchen. We are all ready for the ER and no matter how upset or scattered we are when we leave the house for the Emergency Room…we will now have all the required information in our hip pockets or in our purse.
YOUR EMERGENCY ROOM INFORMATION PACKET:
  1. First, I sat down with the bag of mother’s daily medications and read them over and divided them into morning, noon and night. I wrote down the name of the medication, the dose, the amount of daily dose pills, the time to take them and why she was taking them. If I did not know, I called the pharmacy and had them explain it for me. I would ask if it should be taken with food, or before food. Most medications absorb better on a stomach with at least a yogurt or apple sauce taken first, now it was on the paper for me to see and remember.
  2. Once they were all written down, I bought a new pill container that fit her schedule and was large enough for all of her meds and supplements. Yes, Mom took supplements. I studied what would help her, then asked the pharmacy person to make sure it would be OK with her prescriptions. Then I separated the supplements to compliment her medications throughout the day. I added the supplements to my listing of pills and the amount in the supplement.
    Example for you:  
    Vit D3 – 500 units -1 pill- morning – w/food  – (energy and emotional support)
  3. OK, I was now ready. I brought the paper to my computer and started to enter her list of pills and supplements. The top of the page had mothers full name and our phone number. The computer would put down the update date so I could keep it current and correct. I used the outline I had started and did the full listing. As we added or removed medications in times to come, I would just enter the new info into the computer and update the listing. It made the entry easy and fast from that point forward. Trust me so worth the effort when you consider you have to bring the big bag of pills to every doctor appt and now the listing on the paper is updated and easy for the doctor’s staff and you to read and understand. It’s a great thing. Not to mention perfect for travel even if the travel is to visit a close relative for an over night or weekend. 
  4. Now I started to think of the questions they asked at ER check in. Does she have allergies to medications? So I typed in the title and put down a list of medication and food allergies. She had no medication allergies, but she did have allergies to peanuts and rose oil. Believe me, even if it seems pointless to state this, you never know what is in medications, or lotions used for back rubs or veggie stir fry in peanut oil…this is big deal.
  5. They will ask about history: I put down a short history, 4 children, no miscarriages, eye operation to uncross her eyes, and cataract removal, no other medical history of hospital stays. No history of diabetes, blood pressure or confusion. Then I added the medical history of her family: Mother and dad passed with heart ailments, brother with cancer, brother with stroke, sister with Alzheimer’s. There you go – a quick and easy review for any new doctor to take a glance and see that there was clear relationship to her own heart problems.
  6. Now the emotional: Mother is clear of thought, reads even at her advanced age, watches TV and interacts with the news of the day. She does get very upset with her own frail abilities and can get angry in the late afternoons. See? It is stated matter of fact but you get the issues easy and so will the attending physician.
  7. Now her abilities: Mother does not hear well and her left ear is her best and has a hearing aid. Right ear is lost with no hearing aid. Her teeth are false and she has uppers and lower bridge. She walks with a walker at all times or she will fall. She has limited strength in her legs. NOTE: In order for mother to live with us she has to be mobile so she works hard to get around with her walker. She uses a bath chair and commode by her bed at night. She rings for me to come and assist her in transitions during the nite. But does them on her own in the day time.
  8. Food and Drink; Mother is not on any special diet, she eats well and prefers light food. She drinks one coffee per day and is not able to drink water, so juice mixed with water is her liquid for the day.
  9. Her TV habits are easy to understand news with captions or food shows that she can lightly watch and understand.

    Can you see the idea?  All the information that the ER needs, the nurse stations need, the new doctors that are assigned to her called “Hospitalists” need to know……in one place. Easy to read and understand

When I first presented this to the ER hospital check in person she took in a breath and said. “Wow, this is great, thanks I will make a copy and I think everything seems to be here.” KAZZZAMMMM – It worked!

NEXT PAGE: The next page is a listing of doctor and insurance information. I started by going to the copy shop and making a one page filed with mom’s driver lic, her social security, her medicare card and AARP supplement card. It was all there on one page. She could keep her ID in her wallet and I had it in my trusty ER Info Kit.

I then listed her doctors, their speciality, their office phone and fax numbers. I had a small explanation under them:

Dr Anna Kline, General Practice  o/555-222-1234  f/555-233-5678
Mother has been with Dr. Kline for three years and Dr. over sees and does all mother’s prescriptions. We use 90 day Rx and generics when ever possible. Dr. Kline works well with mother and is easy for her to hear and understand.  (Last seen June of 2009)

AT the end of the page: I put a — 

NOTE: I placed my name, relationship and emergency cell phone and stated my place as her Power of Attorney. Her medical information is to be discussed with me before any major change in medication or procedure given.

All of this is in my computer under Mother’s name. I updated it each doctor appointment and it’s printed and ready to go in a clear plastic envelop that I keep in the kitchen. I put a copy of the Power of Attorney in with the above information. That needs to always be presented at the check in for the doctor appointment or the hospital check in.

PLEASE NOTE: Power of Attorney can be done on your own computer. You can buy a great program called Family Lawyer or do a search and the information will be on the Internet. You can buy the paperwork at an office supply store. But the software is really nice to use. Then you sit next to your senior and together answer all the questions that will walk you through the Power of Attorney for Health. (You can also do full Power of Attorney) But the hospital needs this to include you in the informational and decision process for your senior or family member or close friend. By the way the Power of Attorney has to be notary stamped. You can do that free at most banks or real estate offices. This will also require two witnesses. So, I have done it and had mom sign and I wait for two people “unrelated” to come to the house or ask a neighbor. This is a no nothing thing that takes very little time and will pay off as your senior ages and their health diminishes and you are really needed to make decisions in their name. Just as you will need it for a spouse, friend or child. This is an important step in your family health, so taking the time to get this done will rest your mind and be appreciated greatly in times of crisis.

There you go…how cool is that…your packet is done:

 

Emergency Info Kit:

  • List of medications and the details of each and supplements
  • List of the person information
  • List of insurance and ID cards with contact  numbers
  • List of doctors and their contact information and how you use the doctors
  • Your Power of attorney (copy only needed)
  • Name of patient on each page and current date on material that could be unusable if out dated

All of the above are gathered folded and put into your plastic envelop. I used one that had come with an old insurance plan. It worked so handy I looked and found others like it. I slipped in business cards of the hospitals so I would have the call in phone numbers of the nurse’s station. That is it….Gold in an envelop.

OK… so it takes a little while to do the project, but once done you are in order and planned for any emergency. No matter what their age your family members will sooner or later need to go to the doctor or have an emergency. So, do this project and be prepared.You have the information for trips, and everyday crisis that do arise. Your Packet will relieve all the running around when you are in a state of high stress.

Would you like to have other tips to keep your life flowing a little easier? I have a step by step practical home care work book that is perfect for any family. It goes over all the things you ask yourself and wonder about when you’re caring for those that are unwell or elders that need assistance at their home or in yours. I have had such great feed back with my “Senior Care Workbook 101”  that I can say with confidence you will use it with ease.

Thanks for all you do for others…francy

Help My Parents Can Not Take Care of Each Other

by francy Dickinson                          www.seniorcarewithspirit.com

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

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

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

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

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

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

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

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

I’m Helping Him but He’s Mad-Senior Anger

by francy Dickinson              www.seniorcarewithspirit.com

Dear Francy; My Dad is in his early sixties, he has been divorced and on his own for years. He is now going through a stage that he calls and needs me to do all sorts of things for him. I’m trying to be there for him, I go over when ever he calls, but I’m busy with my own family. When I do go over he’s angry with me. I am his only child and I sadly dread the visits, what can I do?

I understand and I am sorry about this it’s a way with older folks, many times men especially, will display anger when they have frustrations in their life. So, lets begin with his age of sixty plus, that is young he should live into his eighties or nineties, so think of him as a person that needs to be healed and treated, not just old. Get your ducks in a row with the Health Care Directive signed and in place with your name as his partner in health. That is important so you can work with him on his health issues in years to come. Then schedule a good review of his health with a doctor. Write a letter to the doctor and drop it off or send it ahead of his appointment so you can tell him this issue of sudden needs and anger. The doctor needs to know to address emotional issues that might not surface in the exam if he is not notified.

There is a great issue of depression in men on their own. Not that depression does not effect women but men are especially hit with it and they rarely have the ability to talk it through. If he is newly retired, that is often a problem. He looked forward to many projects and kept busy until they were all in place and suddenly, he is faced with years of retirement and no where to go. There is also a problem after a spouse has passed, a year or so later, the realization that life is ahead with loneliness and no reason to be happy- hits. All of these things happen to many people single or in a relationship, that is why we have them checked and go to a support group, senior center or stay active with family to keep their emotional health up. If there is an on going problem, they will need medication and or counseling to get them healthy again. So you have to be pushy about getting a doctor’s opinion. Write down a few of the episodes of anger, so the doctor can see what stemmed the anger and if it might be body or emotional based. Once you have that diagnoses then you can help him with the treatment and go forward.

Tips on dealing with anger;

  1. You are the pivot point to anger – as the caregiver it is you that can start or end an angry session. So arrive up-  in energy and remove your emotions and just do what is needed and leave. It is very hard to do this, because you will think that the person hates you or you have done something wrong. But emotional anger has a base in the person not with you…so pivot that anger by being in charge of your own emotions.
  2. I deal with my husbands dementia all the time and I have learned to refocus him into a different project, idea, talking point or action. This will remove his frustration of the moment and get him thinking in a different direction. It takes practice, but I have learned how to avoid a lot of arguments by keeping him off a subject and onto another. I do this by interrupting a conversation and interject a whole new thought pattern.
    Example:George was up in arms about trimming our trees, had spent hours getting saws out in his work space and trying to do this task. I went out and told him my back was bothering me – could he come and help me move something in my office? He followed me into the house and the anger and frustration of his project was over the pattern broken. After he helps me, I praise him and get him a piece of pie and he then releases his day long project and returns to his TV or reading and the anger and frustration is over.
  3. If your dad has had a history of being involved in faith center or events, or if he has long ago given up a hobby –this is the time to reintroduce him to those events. Doing something he knows is easier for a senior than starting something new.
  4. Interaction with others. No one can be on their own for days at a time and stay happy. Little things start to become big things and small problems become a big mess. So, break this pattern by making sure he is doing a few weekly outings. Senior centers have card days or bowling teams, or any hobby he likes. Local libraries need volunteers as do teen centers and soup kitchens. Senior Universities are all over the place with weekly classes and lectures on fun subjects. These classes are just an evening or afternoon of information and it becomes an enjoyable routine. Your own family has weekly outings he could join, sports events, teen pick up from classes and school, school performances, bi monthly family picnics or dinners. There are ways for him to move into the world again and keep him with a weekly calendar of events that will fill his mind and spirit.
  5. Exercise is a great way to bring a senior back into good health. Joining you for a walk twice a week, or getting him into a senior bike program or golf game can improve his mind and his outlook.
  6. Talking to a support group or hobby group is great for a man’s interaction. You will find that Twitter and online support groups also provide a non evasive way to express feelings and interests. Woman usually have women to talk to, but if not, they too need to be attached to a group that will help them express their feelings among friends that understand.
  7. Eating well, can be a huge thing for men or women living alone. Days of empty food and no supplements can make a big difference in any ones life. So adding food from you or a service could be a big boost. He may have a neighbor that’s a senior and would be willing to provide 2-3 dinners a week, for a small charge. You then know that good food is on his plate and helping him feel well. Being creative with care is never easy, but it can make a big difference in his lifestyle and emotional wellbeing.
  8. Moving; many seniors try to keep their home forever. Nice if they can do it, but over burdened with yard, house, money or repairs is not a pretty picture for anyone. So, if he needs to relax and get yard or house cleaning help get that done. If he is not able to really do the work, then suggest a few visits to local townhouses where yard work is provided or retirement communities where everything is at hand for easy living. Moving early means a life of comfort in retirement, not worry over a huge move sometime in the future, usually when the senior is unwell. Keep them close to you, but find a place to tuck them in with a smile. The retirment communities are so diverse now, that you can find all price ranges in your search.
  9. Get him a pet to protect and care for at the local humane society. Often a furry pal will totally change a person. Instead of having a day ahead with nothing to do, you suddenly have to feed and walk the dog or change the cat box. It’s just this small chore, that keeps a senior busy and thinking of something other than their own problems.   
  10. Ask him to help you – what do you have around your home to fix or do? Men love to be of service, figure out different chores and ask him to come over and do them and then give him a good dinner and movie to share. Example: I would ask my mother to come over and make pie crusts. Then we would freeze them. She loved to make pie crusts, mine have always been horrid, so it was a nice way for her to do for me and I would get her talking and give her a nice day and dinner. Now that she is gone, I buy the frozen crusts which do not come close to the ones she made for me as well as miss our times together.
  11. Do not be a child, sit down and talk about anger issues. Tell him you are here to love him and have a nice visit to help him, but this anger is out of bounds. If there is something that bothers him about you, get it out and see if you can talk it through and leave the issue behind. Let him know, you will not be abused with words, they are hurtful and you do not want to have them in your life. Do not involve yourself with anger, this is a grown up talk between two adults, not a shouting match. But, remember, this conversation only works if he is not drinking, or in a depression or any altered state, those situations change the playing field and are why you need to have him checked out medically so you know what is what from the get go.
  12. Interaction during your day. Call him and ask if he is watching a news alert, or if he is going to watch a special program that night. Make things to talk about so you have more of a give and take talk during your week. Get your teen to teach him how to text message to them even if he does it on the computer. Set up a Twitter or Facebook account and get him used to it so he can enjoy it. This stuff is a perfect thing to do with grandchildren. Add an MP3 player with his favorite music and downloaded books from the library, a new digital camera or video for the kid’s sports events. Those are things that grandchildren will enjoy doing for him and give a boost to connections within the family.
  13. Don’t forget the geneology part of life, it can be very involved and fun to learn about heritage. To express an interest in wanting your kids to know about their past family history and ask if the family pictures could be organized for them. This is a project that can involve your dad, you,your kids and many other groups that do geneolgy in person or on the Internet.
  14. Know that as people age, the progress of health and mental health is not in stone. Dementia can set in early or late in life. Heart health can hit you in your thirties as well as in your sixties. Aches with arthitus can zap your energy and a simple addition of joint supplements can make a huge difference in pain control. So just take it step at a time, and read and learn because helping someone age means that you are helping yourself age well in the future.
  15. Reality is that most women are the organizers of events, food, doctor appointments and family for men. That is how our society works. So, if your dad does not have a gal in his life…you are the it girl. So, try to just let this sink in and add him to your list of boys to care for in your life…once you get this in place in your own mind, you can move your dad into a lifestyle that is good for him and for you. I know there are exceptions to this rule, but I have found very few in my care giving years.

I know that your creative mind will come up with other ideas. Once you get your mind in a direction to solve problems it becomes so much easier. Just remember anger does not mean they do not love and appreicate you. Seniors just have troublem expressing their feelings and dealing with their body changes. So be a sleuth and find out what is at the base of the anger, not what is on top of it.

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.

Senior Home from Hospital, I Need Help!

by francy Dickinson                 www.seniorcarewithspirit.com

Dear francy: Mother is home from a 8 day hospital stay – then she was in the care facility for 20 days. She was still too weak to go to her home so I have her here in our guest bedroom. I am not a nurse, I’m a crossing guard at our local school and I have no idea what to do now?

Well you have just joined the club of many children and spouses that are suddenly faced with care giving and no prior experience to guide them. First, try to stay calm and just know that a lot of things will hit you at once so you need to really stay organized and write things down as you go to make it easier. Keep a spiral notebook for your mom’s care and that will be your bible in the days ahead. I have written a how to book that will help you with the care giving but here is a list of things to do just to get started:

AFTER HOSPITAL CARE TIPS:

  1. Ask questions, the care facility will help you. Ask them if medicare will send in a home care nurse? This in home help is so wonderful. It will be someone to ask questions and to follow their lead with care ideas. Most cities have a few care companies that you can call and ask them if their services are covered with medicare and your mom’s insurance. Ask them what services they have for you and then pick what ever you can afford. Min. have a bath lady once a week, that gives you a break and keeps your mom clean. Your mom will be weak and hard to bath at first- so you will appreciate this service more than you know.
  2. Call the doctor’s office and “make” them talk to you. Ask them what state your mother is in? Ask them to review her needs and how long it will take to get her back to independence, or if she ever will be able to live on her own again? You need to know this. If you are going to take care of her for a month or for years, you need to know. You do not want to have your mother’s things in an apartment for months with rent being paid, if she will never return to the apartment. That money could be used with you to care for her.
  3. Get your mom’s health care directive and power of attorney in place so you can help her make decisions on her health. Plus you can pay her bills and care for her money in her time of confusion. You can get her home ready for sale or her apartment contract adjusted if she has to leave her residence permanently. You can then make a decision for her to be in a long term care facility, retirement community, etc. This is the legal part that has to be done so do not put it off. It may seem like caring for her is just nursing stuff, but it is not…it is all the business of her life that will need help. I have all of the business info in my workbook for you.
  4. Ask for help, if your mom does not have any money and you have very little yourself, get the state to come in and give you advice on how they could help her. She may be able to go on state care or Veterans care and get home help. That way she could return home sooner, or you could take a class and become the legal caregiver and the state would pay you to care for her. You will not know until you call Human Services for Elders and find out what is what in your local area.
  5. Make things easy for yourself; keep her room easy to walk around, remove small rugs and extra furniture. That way you’re able to move around with wheelchairs and walkers. You can set up a commode and a table for her medications and other care items.
  6. Get your mother tucked in when you leave the house. Get her a cell phone added onto your account and have her practice pressing a button that will call you. Make sure she goes to the toilet, is fed and has her meds before you leave the house. Leave her with a small lunch cooler with a protein drink, yogurt and water inside for her to have by her chair. Move her commode into the sitting room she will be using so her movements are limited.
  7. Ask family or neighbors to come and check on her when you are gone. Think in your mind about what could happen while you are gone and then cover all the basis. If you take time off from work, then know for how long. Maybe your mom will only need a good two weeks of care before she is up and moving around on her own. But if it is longer, then what will you do? No matter how hard it is, you have to have a couple of plans of actions so you are not losing your job and income just to help your mother. Make calls, get a couple of plans in place and find people to help you.
  8. Home nursing may not be your experience but it is a lot like caring for a young child. Keep things easy, very clean, and be solid on giving her medications and good food on time. She will have to move to be independent, so she needs to be walking with your help. Exercise, eating, medications on time…that is what will start to build her up again.
  9. Keep kids and long visits out of your mother’s life while she is trying to heal. You do not want her to get a cold or be so tired she gets weaker. Be strong with visits; no kids – 20 minutes- no smoking -only lite conversation-no one sick.  Keep it light and happy or no visits at all!
  10. Keep yourself eating and sleep even if it’s naps in the afternoon. Running to care for someone and adding that to your already busy life is very hard. So, say NO to everything else but the basics in your life and stick to it. Take one of those protein drinks and have it at lunch time for yourself, as well as your mother. Keep yourself strong – you will be living for two people for a while.
  11. Baby monitor, intercom, or remote door bell system, they will all serve you well so you know when your mother needs immediate care.
  12. Your mother may have a special diet to follow, but if not think easy. Think easy to chew, swallow, and digest with her food. Make soups in your crockpot & scrambled eggs before you leave for work. Give her jello, yogurt, puddings and fruit with cottage cheese. Soft foods and easy to digest foods. Her bowels will be off with all the medications and odd foods she has been having. If she has a strange food craving say NO if you feel it will be unwise, or give her a very small amount. No raw veggies or salads those are hard for her to process. Good fruit juices and smoothies are the ticket at first. Watch the dairy products do not over do those and if she is a coffee girl, get her some decaf and keep it an afternoon treat – once a day. She has to have water, so put a little fruit juice in her water so she will drink more than a few sips.
  13. Know and understand her drugs. What is this for, is it for long term or just for her recovery? Ask how to add stool softeners or yogurt for help with the side effects of antibiotics. Go over to the drug store with her medications and they will review them for you and you can write it down and get a weekly pill container that has morning and nite pills. This will make pill time easier.
  14. Remember that open wounds mean extra care, it could turn into a disaster MRSA probem. So, learn how to stay so clean you are squeaky. Wash your hands each time you enter and leave your mother’s care area. Use bleach wipes to go over all surfaces in care area. Keep the care products on a very clean surface so everything stays sterile. Keep the bathroom she is going to use clean to the point of exhaustion. Use a good cleaning solution like a bleach mixture and wipe off counters, toilets, bath, floor and keep it clean, clean, clean.
  15. Wash her clothing separately and in hot water with oxygen cleaner as well as soap. Do not throw her clothing on the floor, put the soiled clothes in a hamper or plastic bag to ready for wash. Do her wash at least twice a week – even if it’s a small wash. Make sure your things and her’s do not touch. You are now Miss Klean
  16. If she is not walking get her up. She can hold on to her walker and you can follow with the wheelchair behind her. Or you can get a waist band that helps the senior stand and walk by you putting it around their waste and then holding on to it, to give them extra steady help. Have her do the PBS- Sit and Stretch. It’s an easy exercise program that will help anyone recover muscles. You can get the program’s DVD’s at your local library.
  17. Swallowing, talking, transition, walking problems? Those need a physical therapy person trained in that area. Ask the doctor and he will write an Rx and those folks can come in to the home or you go to them. It will make a huge difference. They will show you how to help your mom. Good stuff, therapy sessions!
  18. If your mom is really weak and unable to stand without help. You need to learn how to transfer her from sitting to standing, to walking position. Ask for help, a nurse or therapist will instruct you how to do that without hurting your back. It is amazing how easy it can be if you know how. If your mother takes a fall, do not try to pick her up. Call 911 and tell them you need assistance with a fall and the fire department will send EMS services to transfer her and check to make sure she does not need hospital services.
  19. Are you ready if your mother is at the end of her life? Have you talked about her wishes and her health care wishes, and her funeral wishes? Can you sit down and have that talk? If not, ask a chaplain to come and ask her for you. Get it done, if she recovers you can file the information away for a future time.
  20. If you understand what is happening with your mother, what is wrong with her, what part of her mind or body is effected by her condition – you will be able to do research on the Internet and ask the doctor questions to get help with good care. Be strong with your voice and your questions. Understanding what your mother needs is number one, from there you, your family, your friends, your care giving professional can all work together to help put humpty dumpty back together again. If you do not ask, or demand answers you will suffer as much if not more than your mother during the recovery. Giving care is not hard, if you know what to expect – it is the unknown that bothers all of us, so ask questions and learn as much as you can when you are around any professional.

You are doing a service of love, thank you. Most of us will be there at one time or another. It is lonely and I would like to be here for you as you move through the care of your senior. Sharing your fears, frustrations, and hurt feelings will allow you to recover and give your mother good care and positive energy with your love.

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.

10 Tips to Keep Your Medications Working for You

By francy Dickinson www.seniorcarewithspirit.com

Dear Francy; I have no idea what medications my Uncle is taking on a daily basis or if he’s taking them properly. I have the pill bottles, do not know what they’re for and I have the daily box that is always filled when I arrive. He is 82 and seems well, just needs me for shopping and cleaning his small home. Do I need to push him for more information?

Yep! Here is the deal with medications for everyone – if you do not take them on time during the day and in repetitive days, then you are not really taking the medication that the doctor has prescribed. It may seem like blood pressure or even allergy meds show few signs of change, but inside the body there is a war going on and it needs to be put into a neutral state with medications. You can say, “Well I am old, I will stop medications and just let nature take its course.” That to sounds like a good idea; but you do not know what path nature will take you down. Do you want to NOT be able to walk or talk with a stroke? Do you want to be bed ridden or stuck in a coma for the rest of your life? Do you want to leave your home and be in a care center full time? Do you want to be on constant machines cleaning your blood or a machine in your chest to keep your heart going? Worst of all –is the diabetes side effects of blindness and losing limbs, not a pretty picture. So you can think that skipping pills or going off of a special diet for a day or just taking the pills that are easy to swallow is no big deal, but it can come back and bite you – badly.

Here is my over view of how to handle medications for yourself and seniors in your care:

  1. Know the medications. Either go into the doctor’s office and have them reviewed for you, or look them up on the Internet, or go to the drug store and ask for a print out of the pills and their reason and side effects. If your senior says something makes them dizzy, then you need to find out which pill does that and if that pill can be replaced with another Rx. (Note, when you find new medication ideas on the Internet, print them out and take them into the doctor on your next visit to review-they should always be open to this kind of discussion.)
  2. Always ask the doctor and the pharmacy if they could please use generics where ever possible. Even if the senior has a good drug insurance coverage. You save them the deductable. Plus the more money that is saved over all helps all of us when it comes to drug costs.
  3. Each doctor’s appointment- you are required to “bring in your medication bottles”. Since most seniors have more than one doctor this is how the medical offices keep track of the medications that can change since the patient was last in office. I found this way too overwhelming when my mother began to have over six meds and then went up to 27 a day before her passing. So I kept a list of the medications. I sat down in front of my computer and lined up the pill bottles with the information about each of them and put together a listing.
    Name of Drug/Reason/Strength/Times per day/with or without food/Dr that prescribed/
    I repeated this for each medication and I would add and remove as the prescriptions changed. Be sure to put the date on the paper so you know the last update. Now you have power. You can take this list into each doctor’s office, keep it in your kit for emergency trips to the hospital, check up on the pills and their purpose and most of all, you can fill the weekly pill container with morning and night pills properly divided.
  4. The medications all have reasons for time of day delivery. Some make you tired, some make you go to the bathroom, some make you dizzy, hungry or up energy. If you take them as the doctor advises then your body will respond in the proper manner at the right time. And if you have side effects with a new drug, it can be address from the get go.
  5. Side effects are nothing to ignore. They can really get a rolling start and change your life. People coming out of heart attacks can have big problems with their bladder control that means that their drugs need regulation and it is a hard thing to do. But it can be done. Some medications can make you feel more emotional than normal, dizzy or actually give you a rash or make you sick to your stomach. All of the side effects are listed on each new drug. But if you wonder about them, call into your pharmacist and they will review the problem with you and advise you on another drug to suggest to your doctor, or to assure you that the side effects usually go away in a couple of days or so. This information will keep your return visits to the doctor down to when you need to have the drug Rx changed or updated. Ask your doctor if all medications can be geared to twice a day, so memory is not challenged with seniors living on their own.
  6. Emotional drugs can be hard on those who take them. They can have very difficult side effects and the patient does not want to wade through the time to make changes. We all understand that feeling odd inside of our body or our heads is a terrible challenge, but taking drugs for high end emotional problems is paramount to wellness. So as a family care giver you need to keep on top of this and keep returning to the prescribing doctor with your list of the senior’s complaints until he can find a mixture of medications that fit their needs.
  7. Journal the drugs and the senior’s behavior and daily feelings. There should be a spiral notebook in the care area where you can check off the daily drugs, food, mood and physical ability of the senior on a daily basis. If you only do it every three days, that is better than nothing. This way the doctor will see that when pills were forgotten the breathing went down, the walk was staggered, or the emotions were more on edge. This is the stuff that is needed to keep anyone taking more than a couple of medications informed. This is how a doctor will treat and be thrilled at the information. They will thank you and give medication changes in a more effective way with this type of information.
  8. Cannot afford medications? There are ways around this with help. All drug companies have special services for those that are on a budget too tight for medication spending. Ask your doctor about this and they will hook you up with the different services available. You can turn to your own state human and senior services offices and get the senior on their program for financial or medical assistance. This is provided in each state, they have different rules for each state. But basically it can span a lot of things, it can give the senior food stamps only, or medical and drug coverage, or pay for care givers. It goes on and on and it is decided on the income of the senior and the spouse. Do not think you have to give up your home for this service that is not true. Veteran’s services are also there for those that have served. I am talking about served, not about retired only. My husband was in only three years and he is now receiving help from the Veteran’s for his dementia. Always check out the available services for all seniors it makes good care sense. Last is Medicare that has “D” coverage that will help with medication coverage. This is also inserted into your insurance coverage and you need to know that twice a year you can make Medicare supplemental insurance changes in the spring and fall. There is no problem changing during those times, but the rest of the year, you need to stay in the insurance that you currently have or pay a fee.
  9. The actual pill bottle can be coded to a color for couples that live together and have lots of meds. Hard to keep track so this is an easy solution. You can ask and sign for Easy Open bottles. Know that those bottles have to be kept away from your young grand children. I keep all of George’s medication bottles in a basket on a high shelf. Once a week I refill the medications into his weekly dispenser and then order whatever I need to keep the pills properly stocked. It is always less expensive to order three months of an Rx. So ask your doctor to write one month to try the medication and then ask him for a 90 days refill Rx if the medication is to be used over a long period of time.
  10. Do not be afraid to change your medications to another drug store. They have services now that ship pills out to you instead of having family pick them up at the store. They have computer services that automatically refill the drugs and call you when they are available. They have lots of nationwide services that will fill the order in any state if the senior visits family or travels. They also have services that provide breathing, diabetes and other ongoing conditions with all of their medications and services needed, by mail. You can also get many items ordered by your physician in prescription form that are not just pills. That would be bladder control products, special dietary supplements, breathing machines, oxygen, walking and bathing assistance products. This all depends on what Medicare, supplement or regular insurance companies will cover. So ASK – when the doctor says you need something to care for your health, ask him if you can get an Rx for that so it is covered by your insurance. They are there to help you, but they cannot guess at each patients needs.

My husband is a dementia/Alzheimer’s condition patient. He shows such a difference when he has his medication on time for four or more days in a row. It is like night and day. But with dementia it is hard for us both to keep on top of the pills. Sometimes we skip an intake for morning or night. We have learned to just ignore it and not take the night before pills with the morning of – pills. But this error means that my husband may get diarrhea, feel extra dizzy or have real memory or emotional challenges for a couple of days. That means that his brain cells are dropping and he is going backwards not forwards in his fight against Alzheimer’s continued attack on his brain. We try hard, but things happen. When they do we regroup and try harder – we feel lucky that there is medications that make his condition better and we are dedicated to keeping him alert and active as long as possible. It is the quality of life, not the length of life that we feel is important. That is why taking medications on time every day is paramount in elder care.

Thank you for your email please do send your questions to me. You will find the email button on my website at www.seniorcarewithspirit.com and you will also find my on demand radio shows talking about senior care issues. If you found these tips helpful, I have a workbook for those of you that are giving care to a senior called Senior Care Givers Workbook 101 – It is a step by step of how to give good care to seniors.

Blessings on your day, francy