Advanced Alzheimer’s/Dementia Help for Care Givers

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Tips for families caring for advanced Alzheimer’s seniors. by francy Dickinson

When your senior is confused…Tips to help with care giving.

Dear Francy: Mother does not remember me any longer. I can hardly go into her room without crying. That makes her confused and she cries…I want her close to me, I want to care for her…but my heart is broken. 

Living life “in the now” is a very hard thing to do, so here are some tips to help you through this awful time in both of your lives. First, would you do me a favor and just trust me that your mother has not really forgotten you…she remembers in her inner mind and heart that you represent love and caring for her. So you just have to try hard to work with that thought.

Ideas for caring for Elders with Dementia:

  1. If you took a nap and woke up to a world around you that was not familiar to you, can you imagine the fear you would have? That is what is happening to your senior when they wake…or go a few minutes without input…they get caught in a world of no memory. They become frightened, angry, upset, totally overwhelmed with fear–their mind running 24/7 with nerves. You must keep your senior connected to your neurologist. Even if the appointments are only every few months…you want to check in with the memory clinic for help. They may take the senior off the heavy brain drugs because they are no longer working. Usually, the drugs are given in a combination to treat the patient for as long as they get a response. Once off those meds the mind of the senior regresses fast. But we are talking about treating the signs of the regression…the fear, the anger, the upset, the nerves. So you need to keep a running note of your care giving days so the doctor can see where they can prescribe different meds to calm and give the senior an underlining feeling of peace in their mind.
  2. You must accept the “living in the now” concept because this is how the senior is living their day. They wake up to confusion – to a life that is out-of-place and they try to cope. Your job is to help them. No longer address them as mom, dad or auntie…call them by their given name. Remember the farther they regress they may recall a family nickname that they were called as a child. “Sissy, Sonny, Toots, Cutie, Sweetie, Kittens” Families often give young children nicknames and the senior may find comfort in that name once again. Always smile when you talk to them…remember they will react as a child does to a face…if you are angry or upset…they will reflect your emotions…that is what a child or dementia patient does. So force yourself to stay “in the now” and “act” calm and happy…that way your elder will be calm and happy.
  3. Take breaks…overwhelmed with sorrow means you need a break. Ask your neighbor to come over a couple of times a week for two hours and sit with your senior…you can take a walk, go for a ride or do the grocery shopping. Ask a cousin or family member that is older and retired to come and give you a couple of hours a week. Ask your children and grand children to come and visit for a couple of hours each week. Yes, you have to arrange the time…no one looks forward to this task..but they will respond with love “if you ask”. So write down a few names of people who will help you just for a short visit. Then call two or three each week to fill your week with breaks here and there.
  4. Deep breath. You will find when you are upset you hold your breath.I do not know why this happens, but we tend to tense up and hold on to our breathing. So, begin a program of taking in a breath with your nose and holding it a moment and then very slowly let it go. Like a balloon deflating…It will release the tension and the stress on your body as you force yourself to breath. I do it in a series of three as many times as I can during the day…just this simple trick will allow your body to relax.
  5. Smile…remember the rule of smiling through tears. Smiles allow others to read your face as calm and in-charge. When you are in-charge the senior in care will feel relaxed and know you have their back. It may sound silly…but it is so true that I implore you to smile.
  6. Set a repeated pace to the day. It is a proven fact that when children are raised with a structured daily routine they are found to be more emotionally stable. So if your senior is constantly trying to remember who, what and where they are…this underlying feeling of a routine…keeps their inner mind relaxed. Plan the day around you, not your senior. Up at a certain time, eat, do exercise, then rest. Quiet time, TV or radio time and then a nap. Up again to cleaning up time, teeth, face, more walking or exercise in the chair. A puzzle on a table to work,a game of cards, a craft project and then a rest for the afternoon…usually a nap in their chair. At 4PM there is always tea and cookies to keep the blood sugar high for the evening and keep the senior from a “Sundowner crash”. Then TV news to keep their mind thinking and you talking about your day. Rest time…dinner time. Then talk time…right after dinner while you are cleaning up the kitchen you have the senior sit quietly and you talk to them about the day. Who called, whose birthday is coming up…what time of year it is and tell them of your own day. Just use a sing-song voice tone and matter of fact talk through things of the day. The senior may or may not respond. If they do respond – listen to them and go with their mind. If they talk of years past, or a fear, or hover on something fearful. Take note of that and do not go to that part of their brain with your conversation again. Maybe a kidnapping or violent event on the news got them thinking they would be hurt…you just change that around and take note not to mention that again.
  7. Find an in-home nurse practitioner to come and check-in on your senior. There is no reason to constantly worry the senior over the big trip to the doctor. Just keep medications that are palliative or for the seniors comfort. The rest of it can all just drift away and their body can adjust to the natural way of their journey.
  8. TV game shows are very good for dementia. They have excitement in the people –clapping, laughing and the senior will respond with pleasure. Radio shows are very good for seniors. Many elders were raised on radio…they like their own childhood music styles and NPR or local radio stations that feature music of their era are great to have playing in the background to “Ground” the senior’s very busy mind.
  9. Just because they no longer talk…does not mean they no longer think. They have just lost the part of the brain that allows them to speak. So you have to talk to them as though they are speaking. You have to look at them and learn their cues to tell you their needs. Or if you are in the black over their needs…you just say to yourself…”what would I want to be doing right now?” You do as much as you can and then release your own worry. You are doing what your heart is telling you to do…that is all that is needed.
  10. Remember, smile…speak in a strong tone…so the senior can hear your voice. Face the senior and talk so they can see and read your face and don’t be afraid of making mistakes…we all do that every day. Just do your best to care for your senior with love. Then tell yourself…what do I need today? Keeping yourself well fed, exercised and calm is the key to your own health and that will reflect onto your senior in positive ways.

Thank you so for giving your love to your family…you are doing a job that no one else will do. You are loving and caring for your loved one. I so appreciate your time, love and the years that you are gifting to that senior. Taking their hand and helping them down the path of their last days is a very hard thing to do…you are doing fine. I trust your judgement.
Blessings, francy

What Do You Do When Your Mom Stops Loving You?

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How to handle the anger and pain of emotional discourse between parents and caregivers. by francy Dickinson

Francy w her mom, Toots and dear little Mac

Francy w her mom, Toots and dear little Mac

Dear Francy; This is a review of many folks that write to me…that have had very painful experiences with their parents. It could be their mom or dad…or grandmother. Someone that raised the caregiver and had a solid relationship and then it was broken. The pain is not a small issue…it is felt long and deep.

I suppose it starts with me. My mother and I were very close. I was the ‘late in life’ baby that arrived after mother had raised three other daughters. She was older and going into mid-life issues and I really gave her a run for her money. But over the years, I was her escort, I took her to doctor visits, cared for her and her home…included her in vacations with my husband and really felt I was her friend. When she started having small strokes and could no longer live alone, she moved in with us and lived on the lower floor of our home. Her care was long and hard for me. She was with us for five years…and it was in the last few months of her life she began to talk through her personal history…and the more she talked…day by day…the more she decided I had been the pivot point of her life. She told me she could have gone back to work and made a better life for herself if I had not been born. One day, she spent the whole day telling me how she just never really liked me and it was so hard for her to be in my house. I understood that a woman of almost 100 years was working through things. But when your own parent tells you…they really just never cared for you, as a person…it hurts. I am a fully grown woman and I understand the pain of someone facing death with health issues. I understand the dementia that slowly changes the way an older person sees the world….but it still hurt. I also know that mother loved me…she was a caring person. But loving and liking a person are two different things. I am still working with those words she spoke. In little ways I think…that I did all I could to make her life rich and happy in the end. But I know that inside of me, I was just not the right type of person for her. I was outgoing…she was shy. I was independent and she was a person that needed her family around her. I was not afraid of life…she was cautious. But we never had an argument, or bad words, we would laugh and enjoy our friendship all through my adult life. So, those words…those feelings…they are still with me. Mother died at 100 years after living with us for her last five. She has now been gone since 2006 and yet…I am still mulling over her words.

What do you do…when someone that has been a life-long parent or parent figure decides that you are not the person they need or want in their life? Well its very hard. So I am going to use three examples of family caregivers that have sent me emails about their situations that brought them to a place of feeling deep sadness.

Mary was in her late forties with a great job. She had been divorced for three years and her son had just graduated from college when her father died. She had always been close to her parents and so she really stepped up and traveled to her mother’s side. Those trips to help her mother increased and within a year…Mary sold her small home, left her job, friends and son and moved two states away to be close to her mother. Mary found a small apartment, she got a lesser job and she began the three-year care giving of her mother. Her mother was suffering with kidney problems and they became very serious. Mary tried to keep her mom busy with things that brought her joy. They would shop, go to activities, do a bit of travel and gardening together. Mary would constantly think of how to help her mom over the pain of her health issues. Mary quit her job and moved in with her mother in the last year of her life. Mary was her mother’s sole caregiver. She tried to make each day include something happy to talk about and give her mom food she enjoyed and was constantly arranging friends and family to come and visit. As an only child, Mary was really shocked that on the death of her mother…everything that her mother owned, family pieces, property, money and personal items…were all left to the Humane Society. (Who promptly arrived on the door step two days after the funeral to ask Mary to be out of the house within 48 hours.) Mary has moved back to be by her friends and son, who is now married. She started her own business and is busy, busy, busy. But, she still harbors the pain of her mother rejecting her after her death. Never telling her that she was not going to receive things that belonged to her dad and her family history items. She has no idea why her mother made those decisions…but the pain of them haunt Mary. Mary and I have talked about it many times…she has gone on with her life, she is happy and comfortable…but she is wounded.

Roger lost his mother when he was 10 and his dad did his best raising he and his brother. His dad was a professional man and spent very little time around the boys…but hired care givers. As Roger went through life, graduating from college, marriage and success with wonderful children of his own and a great business career…his dad often told him how proud of him he was so Roger always felt loved. It was when his dad had aged and lived alone a long time.. that things started to crack. His dad told Roger that his brother had been helping him more than Roger and he was disappointed in him. He would call and tell him that the brother was there when he fell or went into the hospital. Roger was really upset. He called his dad every other day. He lived about an hour’s drive away and would come if his dad needed him. But his dad never told Roger of his health issues or of any need…even when Roger asked and came over to check on him. Suddenly…it was like his dad was using Roger and his brother as bouncing balls. His brother always coming out ahead. This tension went on for five years…constant worry over his dad and his dad’s care…upsets between he and his brother…upset with what his dad wanted and needed. Then when his dad had his final heart attack and Roger raced to the hospital…his dad had put his name down as “blocked from visits”. When his dad died…he was even asked not to come to the memorial. Roger, a man with a family, grand children, money and friendly disposition…is suddenly out of favor. His own father rejecting him from his life and death. Roger has talked to me about this for many years…those actions of his dad…have caused Roger so much heart ache and feelings of failure.

Anne was the 8th child and the beloved baby of her family. They were all close and caring people and often gathered together in their parents large home for holidays. Family gatherings were filled with jokes, laughs and love. Stories of the family history, grandchildren running around and simple joy of being together. So when her mother died…it was not only hard to be without her…but the family gatherings stopped. No one really stepped up to take them over…the family slipped apart. Soon her dad was alone in a large house and none of the other siblings, but Anne, were coming to visit or give him care. No matter how often Anne would talk to the family members…they were busy and had their own lives. So she and her dad just forged ahead. At first Anne tried to keep the house and garden up like her mother did. But Anne had her own family and she simply could not do two homes. As the house became overwhelming…her dad started to get quiet and sad. Finally, his health was not good enough for him to be alone…so Anne and her husband had him come and live with them. Her dad sold his house and remodeled a garage at Anne’s place so he could have a place of his own, but be close. Then Anne began the high pressure care giving of someone with health issues and the running back and forth to deliver food and care from her house to the back garden cottage. Anne had three boys who had spent their life adoring their grandfather but now he wanted quiet and was always complaining about them. Her husband would go over and watch TV with her dad and then the complaining began that he did not have privacy. A lifetime of a quiet, loving dad had started to turn into a man who was mad and his own anger was directed at Anne. The rest of his kids rarely came to visit…no matter how much Anne tried to get them to come…so the dad felt it was Anne keeping them away. The situation was not just hard, but hurtful and three days before her dad passed…he had called a retirement center and told him he was being abused and needed to move in with them. Anne was too busy to think about the sadness when her dad passed…but now that her own kids are grown and out of the house she has more time. Anne cut ties to her siblings…she just could not deal with the thoughts that people she loved were not there for her when she needed them. She has worked through the anger over what her dad had done…at the end of his life…but the reporting abuse has left her feeling such pain. She still does not understand why her dad would say things so hurtful about her.

So, that is the review of issues between parents and their children…who have grown into adults and gave their love back to their parents. What to do? How to heal? I have talked this over with so many family members that I know that just saying it meant nothing…the hurtful words, actions or times…are just forgotten. But the hurt does not go away. You can tell yourself that an older person has fear of dying issues…but hurtful words and deeds take their toll.

What most of us have decided is that talking about our pain helps…even if we have to repeat the story a few times with a few different people…it helps hearing it in your mind and through your ears. Making a personal pledge that we will not do anything like this to our own family caregivers when the time has come is also helpful. But the most we can do…is to simply put the experience down as a sad life story…and try to move on through our lives.

Care giving is a gift…and just like any other gift…it can be accepted with grace and a thank you…or it can be taken and put aside and not appreciated. When you take a step back you see the bigger picture..but you can not step back far enough not to wonder why…the one person you loved and tried to help…took advantage of you. Just know you are not alone…and your own moral compass gave you the ability to help and love your family member at a time in their life when they needed to have someone to help them. That knowledge means you tried your best…and nothing more needs to be said. Even thou your mind and heart will never forget the slight from someone so loved by you.

I want to once again, thank you for all you have done and or are doing for your senior in care. They need you, even if the journey is not pleasant…they need your love. Blessings, francy

Summer Garden Squash Lasagna for Seniors

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Seniors love their gardens.Here is how to use your early zucchini and summer squash
for a delightful Italian meal for your senior. by francy Dickinson

Dear Francy; Mom is so sad that she no longer has her garden…she talks about it all the time. I just wish I could gift her a day in the dirt…any ideas for a gal stuck in a wheelchair?

George enjoying his tomatoes on the front porch

George enjoying his tomatoes on the front porch

Yes….get her out the door on your front or back porch and put some veggies in a container. Even if it’s just some herbs…she will feel a part of it again if you hand her the hose and let her water each morning or evening. Here is a fun recipe from our garden…George loves to sit on the porch and watch his garden grow and so when we cut our first squash today — we had to bring it in and make it into a meal!

What I love about cooking these days is I cook for four or six…then I freeze a couple of the left overs as meal size portions. When I have a day that is stress filled and I’m tired. I am able to go and get one of the home-made dinners and George can enjoy the moment all over again. I served this meal with a French roll. I find buying a couple of French rolls is so much easier than trying to finish off a big loaf of French bread. I know both you and your senior will enjoy this meal…its fun to use your own (or local) summer squash and this is a hit with George.

Summer Squash & Zucchini Lasagna

Our first summer squash and zucchini from our container garden

Our first summer squash and zucchini from our container garden

1 med summer squash and 1 med zucchini( chopped)
1/4 pound hamburger (room temp)
1/2 medium sweet onion (chopped)
1 tsp of house seasoning
1tsp Italian seasoning
1 tsp fennel
1 can chopped Italian- stewed tomatoes
1  small can or 1 cup of tomato sauce

Turn the oven on to 350 and get a 9 x13 pan greased and sitting aside.

Layering the veggies with cheese

Layering the veggies with cheese

Start the hamburger browning on medium, on the stove. Break it apart so it is in small pieces as it cooks. Add the seasoning combo of salt, pepper and garlic..then when it’s brown…mix in the small chopped onion pieces and the fennel. Let it all brown together. (drain off the excess oil) Add in the squash pieces – that are cut in inch cube size – and the can of stewed tomatoes. Stir for two minutes to bring the flavor of the mix together than take off the burner and let set while you make the cheese layer.
Cheese Layer: 1 Small carton of small curd cottage cheese – 1 beaten egg – a few fresh  leaves of basil cut with scissors into small strips- a large sprig of parsley from your container, cut with scissors. 1/4 cup of Parmesan cheese. Mix all of this together and add pepper and salt.
Layer 1/2 the veggie and meat mixture in the greased pan. Top that with the cheese layer dotted all over the first layer and then spread out. Layer the rest of the veggie and meat mixture and top it with the 1 cup of tomato sauce (or canned spaghetti sauce) and sprinkle that with the Italian Seasoning.
Top it with shredded mozzarella cheese and if you have some shredded fresh Parmesan you can mix that in with the other cheese. Sit the pan in a baking pan to prevent dripping (the squash really adds moisture to this dish, so you do not want to have it dripping in the oven as it bakes.) Bake for 45 minutes on 350 –watching the cheese so it browns but does not burn. Take it out and let it set for about 5-10 minutes so it will cool and set so it is easier to serve.
Italian casseroleI take the French roll – butter it and sprinkle with garlic, Parmesan cheese and Johnny’s Seasoning…and wrap in foil…put in the last 10 minutes so it can be warm and toasty…YUMM.

I usually serve George at his chair in the living room. I have a good tray that I use and I always line it with a towel or napkin and make it look as nice as I can. Eating when you are a senior..is a hard chore…many times seniors lose their ability to taste…so this is a great Italian seasoning meal that is tasty and fun for the senior to eat. Since it’s made of veggies I do not make a side salad..and because its quite rich…I let George eat…rest and then have his coffee with a couple of cookies later. I always put his pills, on the tray…so he can see them and remember to take them after the meal.

I like to give George a nice tray to encourage him to eat the meal

I like to give George a nice tray to encourage him to eat the meal

Italian is a fun way to mix up dinners for seniors that get so tired of everyday meals. Plus the use of the veggies that they helped raise…with their daily watering…and love…makes the dinner even better.

I understand that as the senior advances in his medical complications…eating spicy foods can be hard on the stomach. I did not use many spices in this and you could always leave out the garlic completely. Just work around it and then remember the dinner is fresh and the left overs are perfect frozen dinners for next week.

I always want to thank you for your loving gift of time and attention to your senior. Care giving is a very lonely way of life. So when you and your senior can share a little chore of watering a small container garden…and then enjoy the taste — it gives your daily life a boost…Blessings, francy

10 Tips for Great Doctor Appointments 4 Your Senior

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Info on how to prepare for doctor appointments for you or your senior. by francy Dickinson

George on his weekly out and about.

George on his weekly out and about.

Dear Francy: Mother was complaining for two weeks on how she was having bowel problems and a soreness in her rib cage…I made the doctor appointment. We go…then she says nothing! He asks her how she is and she says; “FINE”  I am so frustrated and mad that I wasted a day off work for an empty doctor appointment. HELP!

Hello!  Are you sure you are not living my life? I have been there and done that so many times that I sat down and went over all the steps that would give me quality time with busy doctors. We all can get scattered and forget, or not really ‘think’ about our body and what to ask the doctor. So here is a listing to help you never again feel cheated at a doctor’s office.

George is going to his memory clinic on Friday. We have had three appointments that have had to be cancelled, due to all sorts of things, so this time…we need to really go and hit the nail on the head. I am taking time to do all of these steps this week with George. I know this will help you. It has made my time at doctor’s offices go smooth and easy.I have even had doctors “thank me” for being so informative.

10 TIPS TO HELP YOU MAKE THAT DOCTOR APPOINTMENT INFORMATIVE:

  1. Quiet yourself and think about you/or your senior’s body. What has changed since the last time you were at the doctor’s office? Even if the doctor you are seeing is a foot specialist…write down your whole body changes. Doctors diagnose with detailed information. They are best when they know the most. Give them a list: slightly dizzy when I get up to go to the bathroom at night – gained 10 pounds and feel like candy is my best friend – allergy headaches that really bother me – my mouth is dry all the time, lately – my nails are breaking a lot – my hair is getting thinner. Go ahead. Sit and think about this, talk it over with your senior or spouse and write it down. Do not be afraid or embarrassed to share the information…this list could save a life.
  2. Write a letter to the doctor about your care giving elder. Just let the doctor know. I have written my letter for my husband’s friday memory clinic appointment. I have taken time to be quiet with myself and just write down his changes with his Alzheimer’s. I have had to insist on him getting out of bed, he only feels safe there. I have forced him to walk 10 min. in the hall – twice a day. His shuffling is so bad that I am very worried over him not walking at all and I would lose the ability to care for him. I even did a short video to show him on our tablet. I am not sleeping (see I talk about me too) I find my temper is getting short over the silly things he does. Now you go ahead do your letter and let it all flow out. Let the doctor know the things your senior has told you during the last couple of months. Write it down and give it to the check-in desk and ask the doctor to read it before he comes into the appointment. The doctor will be so grateful.
  3. Keep a list of things you hear on the radio, from friends or read online about the special medical problems you or your senior may have at this time. Maybe you heard a tip on supplements to help diabetes, or a special test on a new drug, or a place to go and join an experimental test. Write it down, so you can remember to ask the opinion of your own doctor before you proceed. Use his opinion to help you make your “own informed decision”  about treatment.
  4. Walk in the doctor’s office with an updated list of your medications. Keep this list on the computer or ask the doctor to print if off for you. You need to know each name of the medication, the amount, the time to take it, if it is taken with or without food, and what the medication is doing in your body. If you don’t know those things take a trip to the pharmacy and talk to them. You need to take pills that make sense to you and understand the reason you take them. That way you will be taking them on time, in a a daily manner. Many medications simply stop working if you take them 2 -5 times a week. So you may “pay” for a medication and then not take them properly or not understand that one medication may assist another. This is serious stuff. If you do not take your medications…then open your mouth and tell your doctor. He is assuming that you are taking it. So each time you walk in the door, he is trying to diagnosis you and if you do not have his prescriptions in your body chemistry…he is unknowingly making a mistake.
    This is important. KNOW YOUR MEDICATIONS AND TAKE THEM PROPERLY. If you forget to take them…find a way to remind yourself. There are cell phone apps that will do just that, or ask your care giver or family to call you…but take your medications!
  5. Be informed. I often go to the doctor with my sister because she tends to blank out when she is faced with the doctor’s answers to her questions or diagnosis.  I go and take notes. But now, we all have cell phones with recording buttons. When the doctor is starting to tell you what is wrong with you or how to treat it…have your record button ready…let the doctor know you are taping and push the button. Then you can play the information back for yourself or your family to review.
  6. Dress for success. OK you are going to the doctor, wear something that is easy to remove and put back on. Wear shoes that are not the heaviest you own because you will be weighted-in. Take off your coat before you get weighed and take note of your weight at the doctor’s office so you can go home and adjust your own scale. Also write down your blood pressure, if it is high you can then take it a few times at home to make sure that it does not stay in a high range. Blood pressure is best taken at lunch time…relaxed and repeated so the doctor can see the time frame of the numbers. Same with weight…weigh in the morning, twice a week and write it down in a notebook. When you go to the doctor you can show him your progress up or down over a time period so he can look for glues.
  7. Seasonal issues. Keep a green marker for your calendar journal to mark seasonal problems. Maybe you gain weight around the holidays…write it down. Maybe you have spring or fall allergies, write it down. So the next year…you can look at it and know that it is repeated and needs to be talked about with your doctor. Allergy medications have changed a lot in the last few years. Ask for help, runny noses may not be life threats, but they do keep you from going on walks for your health. Medications change and update…always ‘ask’ the doctor about new medications and if you can drop some that you are taking. All medications are changed just one at a time…so the doctor and you actually know what the reactions are for that one drug. Then you can make another change…so be patient. Maybe your weight has gone down and your diabetes pills or water pills are no longer needed. Do not marry your medications…think of them as fluid and up-datable. There is always a doctor that will give out medications just to keep you quiet…so make sure you “ask” why you are getting a medication and then do a little homework online to make sure it is something that you need and you are prepared for the side effects if they show.
  8. Can you relate to your doctor? If you are going to a doctor that does not talk to you, or you do not understand. Tell him, or change doctors. Your own, or your senior’s health is what life is about. You need to understand..that exercise is needed to help your knee or maybe you need to stay off of it…or cold not hot must be used. If you do not understand then you are not healing and it could effect the way you walk for the rest of your life. Its a big deal! Do not be afraid to make a change of a doctor, or to speak up!
  9. Use a calendar on the wall to remind you of all medical appointments. I like to cluster them. I have George do his appointments in the spring and the fall. So, in one month we see all his specialist doctors. Then the rest of the time…we only go to the doctor if he is unwell and needs extra help. This way I am not trying to take him around to appointments every month…or twice a week. My mother got too weak for doctor appointments…so I found a local doctor that would come and visit her at home. Working with a nurse practitioner is also a wonderful way to check-in quick with questions and not have to wait for appointments with a busy doctor.
    REMEMBER: ER visits are to be avoided. You can catch germs, get overly tired and they are expensive.  Make appointments and keep them. That way the flow of your life will be calmer.
  10. If you have come to a point in your life, or your senior’s life — that fighting a physical or extreme dementia condition- is simply too overwhelming. Then you need to tell your doctor that too. The doctor will discuss palliative care. That is where you are treated to keep you pain free and comfortable. You will be assigned a Hospice Care Team that will come to you and allow you to relax and adjust to the end of life journey. There is no reason to drag elders around to doctor appointments if they have issues that are beyond a medical cure. No matter what your income..Hospice is there for you. You or your senior deserves to have a wonderful team of caring nurses and helpers come to you…to keep your needs met and the pain or worry level down. It is always hard to make that decision, but once made the Hospice team really knows how to take over and keep the elder in-care…comforted and given good palliative care.
    NOTE: Medicare and insurance bill either your regular doctor or Hospice. So you do have to make an appointment and have a good truthful decision with your doctor for this change of care situation. You need to also remember to ask for a disability sticker for your car and understand the doctor needs to sign a ‘Do Not Resuscitate’ agreement. I always try to remind you to get a Health Care Directive Form, signed and agreed on right away while the senior understands the issues.

I hope this will all be of help to you. Since I have kept my medication listing and added in the allergies that George has and his needs if he is put into the hospital on that same page….the doctor visits have been great. I express myself before the appointment and then the information is turned into the nurse at the check-in desk to attach to the file. The doctor then walks in the door, knowing what is going on and directs his attention and knowledge to help me and George make changes for the good in our daily lives. Some times there is no change, some times there is a medication change — other times there is just advice in how to make changes in our daily life to keep George as strong as he can be. Maybe we go to the Physical Therapist to help him get strong, maybe we have a respite to give me a break. All of the information that I share with the doctor, helps him make sound decisions that are based on our reality of life. I once told the doctor that a medication he prescribed was to hard for me to give four times a day. George has no memory and I can do morning and evening meds…but to add a few more during the day…means I have to remember things for me and for him. It was too much. The doctor said that was fine, he would change the medication to one that had a time release. You see how being honest helps everyone?

REVIEW:
*  Take time to review the body functions of yourself or your senior
*  Write down the information or changes
*  Be prepared with a list of medications that is complied from all the different doctors that prescribe to you
*  Be honest with yourself and the doctor

Thank you again for giving your time and love to your senior. Its a lonely world out there for care-givers. I appreciate you taking your time to share with me. I am here for you. Send me your questions and I will do my best to help. OH, I would really appreciate you signing up for this blog post…it will email it to you. I am doing less blogging because George’s Alzheimer’s is getting in advance stages and he needs more care. So the ups and down of my writing is easier for you if you just recieve the update in your email. Please add your email to the side bar and you will hear from me each time I write a posting….Thank you…and Blessings, francy

If you are saying, “Oh, I forgot” then get an Alzheimer’s Check!

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How to fight Alzheimer’s before it hits hard. by francy Dickinson

Dear Francy; It’s  me this week…I wanted to ask you all to really take note of your forgetfulness. If you find you are simply having more than simple ‘senior moments’ then get a memory check. Get a ‘Monty’ test from your doctor or memory clinic. This will give you a baseline of your memory and mind skills…so, as you go forward your doctor can see what changes are taking place. Everyone has moments of memory loss….but when it is more than a few…get checked!

If you think forgetting means “Alzheimer’s” and you are afraid to have anyone know, or to even know yourself ~ if you do have dementia in your life….re-think that decision!!!

Alzheimer’s is a combination of memory, cognitive skills, conversational skills, emotional responses and normal age changes…all rolled together. So, thinking that simple forgetfulness is your problem is only a tiny part of the Alzheimer’s family.

Low blood sugar and high blood sugar can really work on memory loss and confusion. So easy to control with proper diet routines, your blood sugar level is a quiet rumble in your life. You could be living with it everyday and not know….so get a blood sugar test…be in the know about your body. What if; just the way you eat….could change your mind’s health for the best? How easy is that fix?

Thyroid, boy, this is a problem that so many people have and so many people live without knowing it’s out-of-order. The thyroid can be low or high and your body will react in really nasty ways. Like gaining weight or causing other health problems to break-out as a result of faulty thyroid. To check your Thyroid you take your temp as you wake –in bed…in a resting position for three days in a row. If your temp is below the normal level let’s say 96 degrees…then you want to go into your doctor and talk about the thyroid. You will need to do a good deal of study about Thyroid if it is out of kilter…because ‘natural’ thyroid medications are essential to treating this condition properly. The thyroid can and will affect your emotions and your memory…so you need to check it if you find the signs are there. Do a few hours of work on the Internet and read about all the treatments around thyroid and get knowledgeable. Then write down your questions and go into the doctor with your questions in hand. That way…you are in-charge of your treatment and your lifestyle changes. The medication is not the only change you make with thyroid disorder, you have to make nutrition changes too…so be in the know.

Then there is stress…that will take your memory away from you for short or long periods of time. There is the low but constant stress…like what you would have if you were a teacher. You have the daily stress of children, class energy, noise and such…most teachers tune it out and do not think they are suffering from stress…but they are…and they often show it. Then there is the high stress…that is what I find I have giving care to my Georgie…never knowing when I will find him on the floor from a fall…or acting out in a highly emotional way. My day will be quiet and then the ultra stress hits. Stress is really important…so if you find that you are the middle of this type of lifestyle, you need to know that breathing in oxygen is your ticket. You simply have to train yourself to take deep breathing time a few times a day. I do it in the morning right after I get up, I repeat it at 11AM–1PM–3PM–6PM–then before bed. Or if I am in the middle of an ‘event’ with George I will do my breathing as I am helping him cope and have him do the breathing to re-oxygenation his brain.

Stress has a lot of side issues that can be high blood pressure and such. So once again, getting those check-ups for simple signs of body changes are the answer to change your stress into controlled life issues. Meditation, yoga, just resting with feet lifted above the heart…you name it…it will make a difference on both the stress and your memory.

Food. Choosing a life style of eating…vegetarian, vegan, low carb, low sugar, low salt, low fat…they are all choices we go through in our lives. But that does not mean our bodies work well on those choices. That is why you need to keep up with your simple testing of protein levels, sugar levels and blood pressure –not to mention cholesterol. Those tests are a once a year thing…they are done with a blood draw and urine test. They are no big deal. If you are 30 or 70 you need to know what is happening with your own body. To say; ” I only eat vegetarian” and think that means you are healthy is a dangerous road to follow. Your body responds to food intake on its own terms and you need to make sure you are choosing the right nutrition for your body, your age, and your activity level. Protein intake has to be high as you age. I have already added a nutritional drink to my diet every day. I take it in the morning and it starts my day with a boost of protein so I can get through what ever awaits me with my care giving. I am 62 and according to my tests I’m in good and even health. But, I know my care giving stress is taking its toll so I am trying hard to be good about my nutritional needs.

Exercise. It’s hard to believe just because we spend our day in an office and walk around the house and do chores that we could be ‘in bad shape’. The truth is in your own daily movement. If you are not walking more than around your home…more like walking each day around the block or doing some sort of ‘extra’ exercise your body is going downhill. It may be a slow or fast slide…but you have to control it. I know that I have gained way to much weight being at home and eating through stress. I now have to move and watch my eating with a low carb diet. I can tell the difference, not the way I look…but how I feel. When I am on my low carb I have energy and can think and be creative. If I start to munch too much, I just start to feel aches and pains and get emotional and forgetful. I feel the change in my body. Do you?

Supplements. I know so many people who do not take any nutritional supplements. There is no law about it…but in my mind, it’s nuts. We all live such busy lives…to not take at least added minerals or vitamins is living on the edge. Eating well and healthy enough to give us good nutrition takes time and money…do you prepare all your food and eat healthy each day? If not, think of adding supplements that will enhance what you already do in your daily food intake.

I live without health insurance. I simply do not have the means to pay for it. So, I just have to live with the idea that I need to keep my body as strong as I can. It makes me crazy worrying that I might have a big health issue…and my doctor visits are $200+ but I still go in once a year.  I am so aware of it, that I have done a lot of study about my own personal needs. I take supplements and minerals and so does George.

I have interacted with so many dementia/ senior and Alzheimer’s care givers that we all share different supplements that help our seniors in-care. So George has quite the list of things he takes each day along with his Alzheimer’s medication. I feel they help him. I encourage you to do your own study. I know this is all time, time to study, time to look things up, time to find a good price on supplements and such. But it is an investment in your own physical and mental health. If you are worried about your memory…the place to start is with at least reading about good food, supplements, movement, breathing and taking these simple medical tests each year.

I wish you all health and good brain power. I also wish you the courage to face your health with honesty and listen to what your body is telling you. There is no reason to ignore memory loss or any other feeling you have about your own mind or body. Face it, today there are answers and solutions…be active, don’t wait till there is no answer and no way to make a change.

Thank you for all you do for your seniors. Giving Care is a lonely and hard journey for us all… it takes love and a kind spirit to stand by the side of a senior facing a difficult health journey. Just being there is a gift…Blessings, francy

SENIORS And HEAT – IT’S DEADLY

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Visist your seniors today and check for heat stroke signs

Ideas for keeping seniors cool in the warmer weather months…by francy Dickinson

When I began caring for my mother in her 90’s with heart problems, I was shocked at the extent of her feeling ‘of being cold’. She wore layers of clothing all year long…she had her space heater on in the summer and wanted me to give her heating pads. Why? I would be so confused and wanted her to be outside in the sunshine…but she was too cold there.

I talked to the doctor about this and he said, it was her medications. Many medications fool the body into believing that it is cold. Even though the seniors temperature is normal, they ‘feel cold’ . So, that made sense to me and I tried to help her with year round flannel sheets and a good electric blanket on her bed. I would serve her tea warm not cold in the summer and I would give her a hat and sweater when we sat outside in the middle of a heat wave. Lucky for us, we live in the Seattle area and our summers are very moderate. But, all along…I would push her drinking juice and water.

ELDERS DO NOT DRINK WATER….LIKE WE DO!

I don’t know when we all started to drink so much water. But older folks did not grow up with water bottles. They had drinking fountains and drank when they were thirsty…so it is very hard for them to drink water, on our demand. Mother and my husband George…would drink water with pills –but just enough to take the pills. So, I have learned to give  fruits like grapes and watermelon, fruit drinks watered down…and as much decaf tea and coffee as I can get in them during the day.

Water is not only important for reduction of heat stroke, but also for good bowel movements and kidney functions. It’s not just water for thirst, its water for a body to function well and stay healthy and working. Many seniors take water pills to help their hearts clear out the water in the body….that alone will drain the system of liquids. So the seniors have to keep intake of water up…and up…and they have to do it in the summer even more.

WHAT DO YOU DO WHEN IT IS HOT AND THE SENIOR THINKS THEY ARE COLD?

This is so important. You simply have to ‘remind’ them over and over again to drink…to keep the room cool with a fan or AC and if not — you have to take them to a ‘Cool Center’ in hot weather. Each summer we have waves of extra hot weather..and with it waves of seniors that lose their lives to heat stroke and dehydration. As neighbors, family, spouses and simply caring people…we have to be as observant of our elders as we are of our small babies.

If you know a senior that is alone during this heat wave…please check on them over and over again. Seniors do not want others to fuss over them…so they will say; “Oh, I’m fine here -everything is OK at my place.” Do not take that as an answer…go and check…see if they have the temperature in order and there are signs of drinking liquids.

IDEAS FOR KEEPING SENIORS COOL:

  1. Cooling Centers are set up all over your area. They can be at high schools, churches, senior centers. Just ask, call your local library and ask them to locate a senior cooling center for your own senior. Those librarians are always a wonderful source of information…please use them!
  2. Time for a movie…or a walk over at the mall. If you just want to get your senior out and about…find a movie they will enjoy and know they will have a couple of hours in a cool spot. If their apartment is extra hot, call the local fire department (on their business line, not the 911) and ask them if an air conditioner is available for a senior that is bed bound. If the senior is on Hospice, ask Hospice to check on the temperature in their home. There are many avenues of community help out there…get creative and find someone who will step forward and give you help.
  3. Not only can you give your senior liquids, but fruits such as watermelon, grapes, apples and always bananas for their potassium. Ice cream is a senior favorite, but Popsicle are golden. Sherbet and Popsicle are really easy for seniors to have two to three times a day. You can buy a big bunch of Popsicle at any box store for very little price. If you are going to check on a senior that you do not know well…arrive with a box of Popsicle and ask them to enjoy them a few times a day to stay cool and keep their body hydrated.
  4. Bed clothes are way to warm at night. Add flannel sheets to keep the senior feeling warm — but remove the electric blanket and layers of heavy blankets during the summer heat.
  5. Change the senior’s clothes. Layers are fine, but make it layers of underwear, tee-shirt type of material and then a sweater or shawl. They do not get to wear winter warm clothing in summer. I actually change the closet in the hot and cold weather to make the dressing choices easier for the senior. So flannel shirts go out the door to the storage closet and the polo shirts and short sleeve shirts hang in the closet. Adding a light jacket, sweater or sweat shirt is fine…but keep the selection of clothing tilting towards the cool side in the summer. Remember: Mumu’s were invented for one reason…comfort in the heat 😉
  6. Most seniors shower. As you age using a tub for a bath becomes harder and the risk of falls increases. Showers are the best way to cool down each day…a moderate temp shower on the cooler than normal side will reduce the body temp and ease the skin. ALWAYS HAVE A BENCH OR SEAT IN THE SHOWER AREA WITH A GOOD WALL MOUNT HANDLE FOR SAFETY!! You know; senior skin gets thinner and it makes it very sensitive. So you will have to keep moisturizer handy for the senior to use in the summer. A Spitzer bottle of water will also provide the skin and face with moisture in the heat.
  7. PERSONAL: (Cover your ears.) Body parts are body parts…so women that are older have hot spots under their breasts, on the high thigh or hips where the stomach skin slouches down and other personal spots. Men are the same with even their penis effected with the skin shrinking down and the area becoming moist. So, ask your doctor 4 help here…or just get some cream that you would use on baby bottoms to fight diaper rash. That cream will go on, in those sensitive areas and keep them from rash and infection in extreme heat. (OK, you can uncover your ears now)
  8. Cool clothes or small zip lock bags with ice inside held under the arm pits –on the neck, or lower back, will cool the body fast. NOTE TO SELF: Check to see that the senior has ice available.
  9. Fans should be kept on in the sleeping area…maybe the senior can sleep in a back bedroom instead of their usual bedroom…check the house for the coolest spots and keep the air flowing or the AC on in those areas. Check the internet for less expensive portable AC units. Do your home work and know the investment is always well worth it, when the heat hits.
  10. Be creative. I know seniors get stuck in their ways…but take a look at their home or apartment…you can work things out. Then if all else fails…I sit down and get serious. I told my mom– that I loved her and wanted her to be with me as long as possible. Her health was simply the most important thing to me, so how could we keep her body cool and healthy? I made it a joint venture…don’t lose your family, friend, neighbor or spouse in a heat wave…it can be prevented!!
  11. My tip for seniors alone…get them a small ice chest to have by their feet, at their favorite chair. Then you can fill it with Boost, water, fruits and sugar treats etc and they only have to reach down and open the lid to get refreshed!

Once again, I thank you for caring for your loved one. Because of you, their life is richer and you have to focus on that. I know that getting thanks from seniors in care is rare. So, take it from me…YOU ARE SPECIAL…francy

PS I have been going through hard times with my husband Georgie, so I have not kept the blog up to date. I am sorry for that…I will try harder. Georgie has Alzheimer’s and is forgetting how to walk. I have had to re teach him to walk on a weekly basis, lately. He also had so many accidents that he is now using Depends….it was a hard thing  for him to do, he was so sad over it. Life is never easy with care giving but, I do want to be here for you and I know you support me. It’s a lonely road when your spouse is failing in their health. Let’s work together to make the road as smooth as it can be for us all…f.

Answers for a Depressed Spouse Care-Giver

Ideas to help those feeling low and helpless with depression over giving care to their spouse 24/7. by francy Dickinson

Family friend, Kathy, giving me a break and caring for mom

Dear Francy; My wife is in late stages of Parkinson’s. She now sleeps a lot and her speech is very impaired. I can not really understand her or what she wants from me. Her ability to be mobile is gone and I have to stay by her side when she moves. She does not eat anything but cookies and drinks only soda pop. The house is a mess, I am tired and mad most days. I know you help others with ideas, but what can you do for me…I’m just angry.

Anger, yes…who would not be angry when the person you have given your heart to for so many years…suddenly needs you the most, but you are unable to really help?

You just have to trust me this frustration and anger is called depression. If you have never had anymore than a few blue days in your life…depression may seem a fussy word for you. But you described just the situation that brings a person down.

See if this fits?

  1. You try so hard to care for your spouse that you actually can ‘feel’ their needs. You know when they need to go to the toilet, eat, or what they say when they mumble. You try to think ahead to things that will keep them calm. This is very what mothers do with small infants; the ability to talk, does not mean there is no way to interact with another person.
    But/ if you go to the bathroom yourself, take a step out of a room or just fall asleep in your chair you miss the clue. You then feel like you have let them down. They’re in need, they have fallen, they have had an accident, they are crying from frustration…it feels like your fault.
  2. You find that you are sleeping at the top of your sleep…any small noise wakes you up and you feel you have to go and check your spouse. This light sleep makes you feel out of sorts all day.
    Result/ you get very little sleep at all and almost no deep rejuvenating sleep. Therefore, you are just running on fumes most days and your frustration turns to anger towards yourself.
  3. You try to  think of things to feed your spouse. As they lose their sense of taste they turn to sweet or sour foods. They eat less, so they are not hungry. They forget how to swallow well and you have to be right by them at all times to keep them from choking. They need water for flushing their pills and the toxins in their body, but they will not drink water. You try but they resist every road you go down.
    Result/ you don’t eat well yourself. You do not want to make a dinner for one, it feels like to much trouble so you grab easy choices to eat. Toast, sandwich, cookies, chips and other easy to eat food. They simply give you sugar highs and lows, upset stomach, weight gain or loss and you counter with more and more caffeine to keep you going.
  4. You need to be there to move your spouse from point A to point B. Too unsteady to walk on their own, that means you have to jump up each time your spouse needs to move.
    Result/you have no time to your own self. You get pulled away from doing the washing, making beds, cleaning the house. You can not take time to walk out the door even to retrieve something from the garage. You feel almost trapped in the room with your spouse and your world gets smaller and smaller.
  5. People tell you to get out and about. But preparing your spouse is so time-consuming. You have to clean them up, get them dressed, struggle with the upset they have on any change of pace to their day. Then you have to get yourself clean, dressed and ready to go.
    Result/ you forget your grocery store list, you lose your keys, you are late for doctor appointments or if you do go out to eat…the process is so upsetting, you simply find staying at home is safe and easier. Plus; one trip out the door, means 2-3 days of bed rest for your spouse and more work for yourself.
  6. TV becomes the focus of the household. It will calm your spouse and give you that ‘white-noise’ in the background to rest your mind.
    Result/ you nod off during the shows and that reduces your night-sleeping ability. You sit in a chair and do not get real exercise so when you jump up to help your spouse you find you have a sore back, or achy feet.
  7. When any moment of intimate talk with your spouse does take place, or even quiet time–you look at your spouse and remember old times, memories of places you have gone together, things you used to say to each other. You miss the little jokes you once shared, the songs you sang, the silly talk between you. You start to hate holidays, anniversaries, birthdays and you avoid the thoughts that bring out the pain.
    Result/ you get upset and emotional, then you get mad at yourself for being silly and you get angry. You walk around the house just thinking of what you can do to change things and yet, come up with no answers.
  8. You wake up with an idea for your day; maybe you have a household repair that has to be done or a chore that has to be attended too. You have it in your mind, how you will go about the repair, or what tool or part you have to buy to make the repair. Then you start to care for your spouse. The morning personal cleaning of them, their breakfast, their pills, adjusting their chair or couch area, the whole process and then you realize that the day is half over. You have had no time to do the chore or to leave the house to get the tool needed.
    Result/ you get upset with yourself that you are getting nothing done around the house. The place looks messy, dirty, and it is over-whelming.  You start to pull back and force yourself  not to look at the mess, not even think of the repair. You just protect yourself from disappointment by ignoring your surroundings.
  9. You have had a stomach upset for a few days, you know you do not feel right. You get so busy helping your spouse and dealing with anyone coming over to help with the house that your own health is coming second.
    Result/you slowly become weaker in your own body. You start to have more problems. You feel allergies, problems with your bathroom habits, your own cleanliness. Everything seems to go downhill. You would go and get yourself checked-up with a doctor but the ability to be free to leave the house is so limited you just put it all on the back burner.
  10. Your family or children come over and when they do your spouse rallies up and looks so much better. They see a person that is doing well, maybe in a good mood and wonder what all the fuss is about when you call them.
    Result / your relationship with the family and old friends starts to go down. You call them less, you rarely ask them to help you. You know they are busy and so you simply cope. You feel upset towards others that don’t understand

All of the above things equal a care giver that is burnt out, tired, feeling helpless, angry, upset and that all twirls together into high stress and depression. It does not mean you are a bad person, or that you are not strong, or that you are not doing your best. It means that you need help.

HELP – HOW CAN I GET SOME OF THAT?

  • March your bottom into your doctor’s office and tell the doctor you need help. Let them know you are tired, upset, worried and simply have emptied out your energy pool. Let them look you over. Let them see if your weight, blood pressure, sugar levels, energy, strength and emotional issues are understood and treated. That way you can continue to care for your spouse with a renewal of energy and creative ideas to help them. You get strong, so you can be stronger for your spouse.
  • Call a ‘family and close friends’ meeting. Explain you need to have some time to breath away from the house. You need help with a few hours here and there to take your mind and body out the door and away from care giving to ‘just be you’. Let them come up with ideas; maybe they will offer to come and help, maybe they will offer to pay for in-home care. No one knows what you are going through until you share. I had to share and when I did I was shocked at how kind and loving my family and friends were to me.
  • Call a professional. There are companies that your doctor or friends can recommend to come into your home and help with different chores. If you are on a strict budget, do not worry…the companies that do this work, know all the ways to get paid. They will know how to bill you personally, through your insurance, through a local or state funding, or other means. Give them a call; it will cost nothing for them to come and give you an evaluation. They will tell you what you need and work within your budget. If nothing else get a bath lady to bathe your spouse so that chore can be done fast, professionally and allows you the rest while they do so.
  • Ask the doctor to advise you of an elder care social service. This is really nice. They are trained people who know how to find different services in your area that are free. They will help you get things done. They can advise you and you can alway say NO…but to know that there are people out there that will help you is so important. I have personally gone to the local hospital and worked with the social worker there. Hospitals are very community oriented and they want to advise you on services. There is no cost to go and talk to an Elder social worker.
  • Call your local Elder social services in your area. They will hook you into things that your state can provide for you. Often there is food, care, energy bill relief and medication money available from your state. It is a wonderful service and your tax money, all the years of your working life, have paid for these services. You are not talking anything from anyone – the state wants their residents to be safe and well cared.
  • Let neighbors and your faith community know that things have now gone into over load…do not be quiet. No one can help, if you don’t tell them your efforts and challenges. The help will be for you and your spouse…so speak up. Veteran’s, service organizations like Elks, local community services, fraternal and union orders, there are so many people who are waiting to give you a hand. Reach out…talk – tell them you have needs.
  • Hospice is a free service for those who are on a life ending journey. They will come to your home and make an evaluation and give you ideas of how to use their services. If it is not time yet, they will check-in with you every couple of months, if it is they will ease in the door and take over and give you so much more time to yourself. This service is so important and most people call them way to late. When you call they will come and offer food prep, cleaning services, medication, nurse services and the list goes on and on. Know that it is there…to allow you to return to the job you really have…the loving spouse. So you can have quality time during the journey’s end for your loved one.

The key to your situation is being brave enough to reach out for help. To talk, interact with others and to understand your personal strength is the key to good care for your spouse. You need to stay healthy and in a place of peace with your emotions. No one will take away the sadness of your situation, but they will honor it and help you find ways to work through the journey. I thank you for your loving care given to your wife. Blessings, francy

francy Dickinson with Missy

PS I am working on a care giving book for all of you…I’m excited to say it is scheduled for publishing in the next month. Yeah.

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