You Have Been Diagnosed Now What? Dementia Notes

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How to handle the time when you first get a diagnosis of dementia or another life changing situation..by francy Dickinson

senior walkingDear Francy: My dad just got a diagnosis of dementia and my mom has just found out she has cancer. I know they are both depressed and upset…what should I do now?

First its the shock. No matter what your age or how long you have felt out of sorts…when a doctor looks at you and tells you, your body is not functioning — it is a big change to your life. There will be depression, sadness and worry…there is no getting over that…but how you deal with it all, is the key.

Mental processes have to follow through with it all and talking it out to a few friends, family or a faith adviser is really the best start. Then its time to roll up your sleeves and find out what all this means.

Here is your list:

  1. Actively talk about the diagnosis and let the senior feel the pain, worry and fear. They have to accept and process through it. After that time has passed and they can get out their feelings progress onward. Its always OK to be sad, its just as important to try to end the conversation with an up tone.
  2. To heal, or to live on with tough medical news the mind needs to know what that diagnosis means. No matter if the age is 6 or 86 the person needs to understand the name of the diagnosis and be able to visualize what it is. So, you need to go online and read about it…find out the main points and bring those points down to understandable language. The idea that you can “save” a person from the stress of knowing a serious life condition is long gone…now we face truth and work through it.
  3. Talk about the options that are now on the table. If the doctor has not done this…you can make another appointment for a consultation or go to the net and find the answers yourself. To know the different procedures, medications, surgeries, or other options is something that makes the problem into a “situation to solve” instead of a “dread to face”.
  4. Get a second diagnosis from a professional in the line of specialty- for the problem. A family doctor can tell you there are dementia problems…but a neurologist will tell you more specific details and explain the process of treatment. The family doctor can say you have cancer but a specialist in that type of cancer can give you ideas for treatment and prognosis. This way…you have a firm understanding of what is really wrong. When this is done the mind will be calmer…knowing is very important.
  5. Record doctor appointments on your cell or with a little recorder. Many times we are tired or nervous and we forget what the doctor has said. Tell the doctor you want to share the information with your family and get it down on tape. This way you do not forget or over emotionalize the consultations. Some times the mind will zero in on one word and the rest of the conversation is lost. This recording keeps you clear of mind.
  6. Always ask what this new condition will do to the other things that the senior already is dealing with in their life. If they have a heart problem and now dementia…does that mean medication changes, treatment changes etc. If they are a smoker, drinker, or even on heavy medications, does that mean a different type of treatment for the problems? If they now have cancer does that mean that their special “diabetes diet and drugs” can continue or is there a conflict with the chemical interactions? The specialist will know these things…and you will find support groups online that will share their journey with you so you can make changes. When you understand all these details…your own mind will be calmer.
  7. Understand that the body has to fight the invaders of what ever diagnosis that has been given. So a sincere re-think of diet and supplements has to be made right away. Keep in mind you have to boost the body’s ability to fight the new problem. So new supplements and new ways of eating and exercising will simply boost the ability to fight the invading problems. This step is not in place of medication…it is in addition to medication that will help the body absorb and heal faster. As everyone ages…we all need a boost of help with quicker healing. To ignore this step is many times to hasten the end of life issues.
  8. Talk and talk again. There are lots of things to talk about. There are business things…home, care, money, investments, insurance, and care giving. It will all be needed in the future. So talking about it right now…gets it out in the open and you can seek help from local services of needed. Do not delay in this important part. A person who is extremely ill or under mental/emotional stress does not make choices well. So do it now.
  9. Talking about end of life issues is always hard to do. To make sure a Health Care Directive is agreed on and understood by the family – will mean you can set that hard part aside and deal with the healing and everyday issues. Find out if the person, wants to extend their life, relax and let things take their course, be tube feed, resuscitated, or in the end – cremated. Once again…this is what you do as soon as you can so the ideas are set, papers signed and then it is put aside and you don’t dwell on it.
  10. Is there something an older person wanted to do before they are really unwell? A bucket list type of thing? Maybe they always wanted to visit a family member or see a special place, or return to their home town. Ask the elder what they had hoped to do and make sure you can try to make arrangements for this to happen or something like it. A brother can come to your town…instead of a big trip to his town…or a place can be seen via the web cams instead of a big car trip. But allowing the senior to dot the i’s and cross the t’s of their life, is very important.
  11. Make sure the family knows about the medical conditions. If a child has not spoken to the parent in years…this is the time to write them a letter to let them know the situation. This way they can make a decision to come and visit and let the hurt and years of upset – lay to rest before the senior is no longer with them. You may not care for the family member…but the senior loves each child and each family member and its not for us to judge.
  12. Take pictures of the senior and make video or audios of the senior and their childhood stories and family knowledge. It helps the senior sort through their life choices and leaves you with a remembrance that is very dear. This is a ritual that will really help the senior in their life journey.
  13. Put together what you will know as the dream team of health care. A good specialty doctor that you can talk to, a nurse practitioner that will help with the everyday things, your senior and you and any other person that will give care. Then make a pact that you will all work together to keep the energy and emotional levels up and support each other through the journey.
  14. If end of life issues are being spoken about…call Hospice…do not wait. Too many families wait and do not get all the benefits that Hospice gives. They will come to you and make an evaluation…if they feel it is not time for them…they will put you on hold and check in with you every month. If it is time, they will assist you in ways that really allow you to be with your family member, not only be the 24 hour care giver.
  15. Hurtful family history should be put aside. Thinking about how to make the senior as strong as possible in their mind, heart, and body is the key. Remove guilt and anger. Try very hard to just be in a settled and joy filled mind set each time you visit the senior. Things that happened years ago…are now gone…today has time for joy.
  16. Medic-alert systems are a must if the senior is starting on a downward journey and living alone. These systems will allow you and the senior to be assured that someone will come to their aid in an emergency.
  17. Since both of your parents may need health care…here is advice on how to deal with partners in care together. Click Here for information if your parents can not care for each other.

I hope this list will be of help…I know that all the things on it have happened to me over and over again…and when you tick them off the list…your mind and heart feel free. I thank you for caring for your senior and I wish you well on the journey…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

Routine gives Alzheimer’s n Elders Good Home Care

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George’s Routine -Daily exercise with me ;O

Ideas to give Elders and Dementia/Alzheimer’s seniors good care with routines..by francy Dickinson

Dear Francy; Dad moved in two months ago and stays in bed all day. What can I do to get him up and out? 

Good Care Secret? ROUTINE

Many people lose their routines when they retire or suffer a loss of a spouse or a health change. It is a normal for them to react…they just cope. So, if you are unable to get them professional care…then YOU have to be the care giver with the mostest….and that means YOU return the senior to ‘a routine’. You might remember back to when you were raising or helping others raise their children…children respond to life so much stronger with a routine in place….well…this is just like that…the more you pre-program the day with activities that are repeated…the more secure the senior feels and the more they respond in kind.

I say this with love…because it means that YOUR own life is changed…you, have to live for another and it is very challenging…trust me — I live it. But here are the rules:

RULES FOR DAILY ROUTINE:

  1. You will do the routine for two days and then take a break. So we have two days on and one day off. That off day means you can sleep in or do your own morning routine. 
  2. You will have an up attitude, even when you are down, sick or tired. That is what it means when you ‘give care’ You are giving not taking.
  3. You will think through a routine and write it down and then make it your own.

FRANCY’S ROUTINE WITH GEORGE:

George hates to get up in the morning. So I do not pressure that…I allow him to rest. He has Alzheimer’s and Parkinson’s so there are loads of issues for him. But what to remember is that everyday…is a new day in his mind…so it has to be a new day in my mind too.

I bring him breakfast and tell him that he has to get up in 1/2 hour and then I take note of the time. I either rest, or go and get things done in the house while he is eating and then return at the set time for him to get up. I make sure he has taken his meds then I get him up and bring him into the bathroom. Usually, he has already gone to the toilet…so I begin with him sitting on his bath bench facing out into the bathroom – or facing me standing right next to him. It is a good height and easy for him to get up and down from this sitting position.

I start him by asking him to remove his upper clothes and as he does that I go and get his clean clothes for the day. I always put out an under shirt and a thermo-shirt and then a flannel shirt or nice sweat shirt (sometimes with an added vest.) <Why so much? Seniors often have a problem with feeling cold and to keep the house temp in order…I layer his clothing>

Once he is undressed on top: I then get warm water and give him a wash cloth and he does his personal wash up, then deodorant  Twice a week we do a bath; the other days it is this procedure instead. <Many elders become worried about water and a bath is hard to get them to do…so this is a short clean, if the problem with the bath continues, then hire a bath person to come once a week and you do the clean up ea day in-between>

Then I help him dress with his undershirt, his thermo-shirt and have him stay seated.(I do not add the rest of the tops until he is done with all of his clean up and ready to exit the bathroom) Still in his sitting position: I then have him do his leg exercises that keep his calves strong. <This exercise keeps the falling down to a min. The calves are the point that helps us stay up and balanced> He will sit and lift one leg out straight and then do flex and point of his foot for a 20 count. Keeping the leg out and straight the whole time. Then we change to the other leg. I do the flex and point with a slow (one-and two- and three…so the point is on the number and the flex is on the and count– up to 20) You can do this a round of one or two…depending on how strong the legs are and if they have fallen within the last month. If so, repeat the 20 count routine on both sides.

He stays in a sitting position and we take off his socks. I let him do it and he bends down and then takes off his pajamas and his Depends…he then cleans up with a fresh wash cloth, just like we did with his torso and then sits back down. I make sure his feet are done and I help him with this so he can be steady. I then apply a moisturizer for his legs and feet and he has to rub it in. It will require him to bend over; so I stay close and hold his shoulders so he does not fall while he rubs in the moisturizer all over his lower leg & feet. If there is fungus on his toes we do the drops at this time. The skin there gets very flaky and we want it healthy, clean and moist. <This is when you notice if there are any sore spots or red spots. If so you talk to the doctor right away by phone and get guidance  Any sores on legs or feet are serious and hard to heal…get help —fast>

I then (while in a sitting position) have him put on his new Depends to the knees and add his sweatpants to his knees and then he stands and we pull them up. He sits down and we add his socks and slippers. He then gets up and goes to the sink and I have him do his shaving on his own. Then I remind him of his mouthwash, his floss and then he sits back down to do his Sonicare. Now you may or may not have a Sonicare…but I feel they have saved our teeth. They are an investment, but they do such a good job when you are unable to move your arms well to do your teeth. <Obviously if using false teeth you would have them soaking while you did the body clean and rinse and put the teeth in fresh and ready to go. You never brush false teeth they are made of material that is to be cleaned with a Polident-type of soaking once a day to keep the mouth fresh and you would  have your senior rinse their mouth with mouthwash before the teeth are put in again.>

Now he is back standing at the sink:  I have him use a wash cloth and get it very warm water and let George go over his face. Then I use a sugar scrub…it is designed for the face. Or you can use a cleanser for the face with beads in it to remove the dead skin on the face and leave it looking fresh and healthy. George moves and scrubs the scub all over his face up into his brow and hairline and his eye brows. Then he takes the hot wet wash cloth and cleans it off the scrub…rinsing and cleaning until the scrub is gone. Then he puts on Oil of Olay. <Any moisturizer is good, this one is easy for a guy to use and It is designed as a nice face moisturizer and it goes all over the skin of the face and ears and chin. it has SPF in it so the sun will be kept away from delicate facial skin and ears.  Now he is clean and ready to leave the bathroom.

I remove all his clothing that has to be washed and put it in the closet in a large clothes hamper and do a load twice a week of his clothes alone. < It is “SO-OOO” important to keep the bathroom and clothes clean, the bed linens and towels clean too! The ability to have bed sores and infections in small cuts and scraps are very high – when a person is older and their body is not as healthy as it used to be. Clean everything…be a freak…or hire it done. Its your choice.>

George then goes out to the living room. Where I have a straight back chair. I put a small pillow on the chair for his comfort and he sits down. From here he does his exercises. He will first do a stand – squat – stand and slowly sit. This is an exercise that allows his thighs and bum to learn how to sit and stand from a chair, again. I use the term stand as (solider with his straight arms down to his side – I say squat and he does and I move my arms to the front so he remembers that he has to balance his body with his arms. Then I say solider again and he goes into the straight standing position with his arms straight down to his side and then I use my voice “Slowly down” for him to sit in a slow motion….then it is repeated for at least 10 times. If we do this 4 times a week…his body responds well…if we do it less…he forgets the routine and his muscles get weak again. That is when he begins to fall and it goes down from there…

I have learned that his routine is really ‘my routine’ and the more we are able to stick to it..the better his body and muscles respond.  

From there I do arm exercises and I will do a little video for you to use if you like. I will add it in to this blog when I get it done.

After we are through I help him back into his chair and have him do 3 really deep breaths to load up his brain with oxygen. Breathing-in with the nose and out with the mouth. The is the beginning of his day…from here he rests and we do what ever our day holds. But I do this as often as I can. YES…it is a pain — NO he is not always nice to me while we do it — YES I have to push him each time — NO he does not remember the exercises or the toilet routine —YES it does make a difference in the quality of his day forward.

It’s a routine that takes about 1 hour and 30 minutes because he is slow. But it sets the tone for a full day of healthy, happier emotions and the attention makes him feel wanted and I always give him a full cheer-leading routine as he is going through is paces.

I know you can do it. It would be done like this at a professional care facility…so I think doing it at home makes the ability of the senior to stay in good health and strong all the longer. I feel that Alzheimer’s is going to take over George…but we can hold it off by keeping him fit and clean and happy in his day

Blessings on all that you do each day for your senior. 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.

Never Too Old for New Year’s Start-Overs

Ideas to re-boot and review the care for your elder in the New Year. How to get a boost in the care giving routine. by francy Dickinson

Adding Mobility in the New Year

Dear Francy; My dad has had a hard holiday caring for my mother. He feels like his life is fading as fast as my mother’s life. He is worn out and simply feels frustrated with the doctors and medications that have been given to mother. I have asked him to get a new doctor, but he says it’s best not to rock the boat. How do you feel about changing doctors in mid-stream for a Parkinson’s patient?

I feel like you all deserve the best care you can get. If the family doctor is no longer making head way with your mother…then it’s time for a change. If you do not have a neurologist you need to do some research and get one. Get your mother in the door and ask for a review of her symtoms and a re-assestment of all her medications.

The world changes so fast and every year there are new medications. As a patient moves forward in their care they may need to change their general health medications or limit them down. Neurologists are like the geeks of the care world. They love to research the different meds and do an in-depth review of all the chemical compounds in the medications.

Let’s take another step; let’s get your dad thinking positive about his health and his own future. As a care-giver; the emotions of the spouse do make a difference in the quality of care. Depression is very real for those facing the onslaught of a constant down swing in the health of their life-long partners. Here are a few tips I use:

  1. Get his own health check-up. Many times women are the ones that keep their husband’s health on track. If she is no longer able to do that sort of thing…it is up to him to make an appointment and get a full check-up in the New Year. Knowing his body is strong, or if a problem is beginning for him….he can add medication or a proceedure to deal with it and give him a feeling of well-being.
  2. Depression is not a light issue. I talk about it so often because so many care-givers suffer with depression in silence. The family is concentrating on the care of the sick spouse and the other spouse just seems to slip under the radar. Pay attention to him and make sure he is taking his own medications, that he is eating well and he gets breaks from the 24/7 of care.
  3. Freshen up the surroundings. If a home becomes a care place, it often gets very disorganized. That clutter of pills containers, bills, pillows, and care giving things can really get over whelming. Try to help him calm the place down. Many elders use their dining table as a place to put bills…get them into a spot that is sorted and easy to review. Get a spiral notebook so your mother’s care and notes can be kept in one place, not on little pieces of paper. Get the dining table free to be clean and tidy, get the living areas calmed down so the care giving and the patient can feel comforted not distracted.
  4. Do phone checks. If you have other siblings have them call in the morning and you call at night. That constant check-in for just a couple of minutes will keep your dad feeling he is not alone and you can judge if he is in a good place day by day.
  5.  Get your dad into watching a TV show, or radio program each day. Many times if one has a focus on something simple but distracting it can really lift spirits. It might take you to do a search to find a sports show, and interview show or a game show that your dad would get a kick out of viewing or listening to on a continued basis. This repetitive action gives the days a basis. When you are care giving around the clock…you tend to lose your daily clock. If you can replace that with something enjoyed by your dad…he will look forward to it each day.
  6. Exercise for them both. No matter what stage your mother is in her journey, she needs to move. If she can still walk…she needs to do so, if she can only do transfers she can do hand and feet circles and lift small weights. Your dad can take a walk in the back yard for 10 minutes while your mother is napping. That way he is close, but still feels the fresh air and moves his body back and forth. I do this on a daily basis. It may not be a fancy walk in the woods, but it gets me moving, breathing and rests my mind with the quiet of the outdoors in my own backyard.
  7. Have your dad change his daily drinking of coffee to one cup a day and then switch to tea. Most older men have problems with prostate issues. They do not understand the way that coffee pulls on their body and if they make this change it will help them. Running back and forth to the bathroom is very exhausting when you are busy giving care. Keeping an eye on this issue is important there are medications that can help and it should be talked about.
  8. Watching skin care. Lots of elders tend to stop bathing as much as they used to. It means that the skin can break down and so they need to set a ritual. I have an every other day shower rule for my Georgie. He gets his shower and his legs and arms get a good moisturizer so the skin stays healthy. Then he has the next day off.  Take note of the bathing in the home. If your dad has trouble with bathing your mom…get a ‘Bath-lady’. This in home service is worth its weight in gold, they will come once or twice a week and bath your mother. They are trained to bath and check for any sore spots on the skin. They interact with the elder and do their hair and moisture treatments. They are a great choice of added ‘in-home’ care.
  9. Ask family to give your dad an afternoon or evening off each week. Make sure he has plans. No staying home; kick him out the door to go to the store, have coffee, visit a friend or do a hobby. This simple rest from the care giving can save the mental, emotional and physical health of a spouse giving care.
  10. Make sure your dad is wearing comfortable, clean and new clothes. Lots of elders tend to stop shopping for new things. All of our minds need to have new things in our lives to keep us feeling good about our self. We need to get our hair done, our face and teeth clean and our clothes looking good. Just because they are in their home most of the time, does not mean they get to ignore their personal appearance. Men often do this and it will affect their emotions.

I think that the beginning of the year is a perfect time for anyone to review what has been working in the past and what has not been working. To share it with family and the health care team they work with and make changes. Your mother deserves quality care; new medications, new supplements, new food intake, more water and other fluids and movement…could change the stage of her health.

Your dad deserves some space to be his own person. Encouraging him to do a hobby or see friends is just as important as his giving care to your mom. He needs to keep his own life pattern so when your mother passes…he will have a reason to live on in peace.

It’s never too late and no one is ever too old to make decisions to empower and improve their lives. Encourage your dad to make some changes this month. Often, the thought of change itself; is hard for someone in the middle of giving care. Help him with your spirit and love…it will make a difference for both of your parents.

Blessings on all you do for your mom and dad…thank you for your care, francy

Francy with her Bichon, Missy

PS My new book on senior care is coming out this winter…I’m excited to start sharing it with you and help with more care giving tips.

Oh, please do me a favor and click on the “Sign-up” button on the right hand side of the webpage…you will be notified when I post a new blog. And please do share my work with anyone that is giving care to their family or loved one.

I am on twitter @SeniorCareTips

HELP – Senior Parents Need Part-Time Care

How to juggle care giving and your own family life for senior parent care…by francy Dickinson

George carefully stepping down into our living room

Dear Francy; My mom and dad have hit the age that they both need care. Dad is younger than mom but he took a fall and has a very bad back. Mother is suffering from heart condition that really limits her ability to do around the house and go out. She is on oxygen most of the time and is so tired she is unable to care for dad. I have been trying to do things for them, but I have 3 teens at home and I am almost sick from exhaustion. What can I do now?

Well the secret is always in the money isn’t it? If you have money to hire in help or even a limited amount you would be wise to get a house cleaner. At least the house itself would be tidy and you would not have to do that part yourself. Alternatives are getting family members to come and clean for less. We have a young mother with her baby that cleans for my sister. She is her grand-daughter so she pays her a little bit and the cleaning and visiting with grandma is all done together. If your parents have a faith-based life with a community attached, call and see if they have a retired lady or young mother that would be willing to clean each week for a small amount that you can afford. Just remember; it has to be clean. So when you get someone in…tell them what you want them to do. Make a check off list and make sure it is done to your liking. If not explain and see if they can improve or get rid of them. You can not afford to pay someone to sit and talk and have a sandwich instead of washing down the shower and tub. Be strong on any help you bring into your parent’s home.

The next thing, that makes all the difference in the world, is a bath lady. Every single senior will get ticked-off at the thought of having one. But when they come; they will spend hours telling you how wonderful the bath lady is – I can not explain it. But I have seen it so many times. If they come and help your mom with a shower it is done so fast that its like a miracle. The heart patients are so receptive to this because it is exhausting; showering on their own. You find well trained bath ladies at a professional in-home care service. They will come and do a free review of the home and needs…and talk to you about their services. You can use as many services as often as you can afford; but even if you are low on funds…make a bath lady a priority she will add quality to the care being given. (PS she also reports any mark or problem with your parent’s body as she washes them. It helps to know if they have a bad skin spot where they are sitting…or a bruise or an open wound.)

Walk through their home with a good friend of yours. Tell your friend, it has to be a safe and practical for your parents. As you

Putting up handles anywhere that a fall may happen

walk through the family home…think of how to add handles to places that need support if they have to bend down or step up. Take away throw rugs or things on the floor. Remove clutter of newspapers and stacked books or hobby things. Clean it up, make it safe. How are they getting out of bed? Do they need a shower bench or handles in the bathroom? Does their kitchen need to be sorted so the everyday things are at a closer reach. Be strong…make good, wise changes and let your friend use her eyes that are not clouded by years of loving the home and it being ‘your parents’ place’.

Talk to your own family and tell them you need help. What could they do each week? Could they all come over on a Friday after school and get the yard cleaned, the garbage out, the wash carried up or down stairs, the bed changed….you know if you figure out that every Friday…you have a storm of duties and you all work. In two hours you will be free as a bird for the weekend.

Go and fix meals for the week in one night ! Don’t tell me this can not be done, I do it all the time. It just takes planning and saves you so much energy. Stay there for dinner that night and have the family over for dinner. Make it easier for you to be in one place, at one time. Then buy nice Rubbermaid dinner containers and store the dinners for the week. You can freeze a few left over dinners. This way your parents just microwave the meals and eat good home cooking each night. A big soup, a nice slow cooker meal, pasta, a pre-cooked roasted chicken for a couple of meals. Come on, you can do it! They add their fruit and salads, cookies and treats. You get it all done in a swoop of one evening. It may take some thinking, but you will see it is doable and easier than coming over every day.

No matter how smart and bright and gifted your parents are at this time. Take over the care of their medications. This one item could extend their lives. You simply have to gather up all their meds and find out what they are and why they are taking them. You write it all down and take it to the pharmacy where they will explain the medications. Then you list what is needed every day for each. IMPORTANT:  You then add in the supplements that they should both be taking, Vit D – 1,ooo units per day / Multi-vit for seniors / Vit C – 1,ooo units / Joint compound 1-2 pills per day, per person. Ask the pharmacy when you ask about their meds if those supplements are OK to add. Now, once a week you fill up their daily pill containers. They never again worry about what pill when. You handle it all and simply leave the container there for them. Remove their pill bottles to a large bag in the storage room. You will now make the call each month to order the pills and try to buy them for a 90 day amount. Use a pharmacy that has a computer and call back system. Give them your cell phone, they should be able to call you once a month and tell you when they are ready for pick-up. Picking up pills and the worry of doctor OK’ing the Rx is a nasty chore, so make sure the pharmacy is up to date. (I use Walgreens and like their price and their computer program.)  This is a key issue to care for seniors…medications are understood and given on time, every day. Make sure you mark the weekly pill containers with their names (I use nail polish or stickers) This way; medication is given to keep the pain away and keep their body functions going without the ups and downs of missing medications —-bodies feel and act much stronger. If they have to take food with their meds, make sure you get them into the habit of having a yogurt or small apple sauce container before they take their pills.

Don’t be afraid to change oxygen delivery companies. One of the biggest problems with oxygen is poor service or delivery. If your mother needs to use her portable containers…she needs them. For her to wait for them is not acceptable. Make sure the oxygen machine is one that moves up to 10 and adds a little moisture so she keeps feeling strong as long as possible. Medicare pays for this service so make sure the money is spent on a company that is reliable.

To review:

  • General cleaning of the house; like kitchen and bath is done weekly or twice a month by another person. Family, friend or professional.
  • Bath lady is hired min. once a week to give your mom a good comforting bath.
  • A clutter free area for a walker and ease of use is made by you and a friend as you clear up the house. Adding safety touches anywhere that a problem may arise.
  • You enlist your own family to help on a weekly basis. You give out chores and they all go to work in a flurry of activity. The yard, the garage, the garbage, the wash, the big items that need repair are all handled and you can relax.
  • You choose a day during the week to come and make dinners. You will be shopping for the food, have a menu plan at hand and then hit the kitchen. To make it easier you have your husband and kids join you that evening for dinner at the grandparent’s home. This is the slow cooker meal or the big pasta dinner. Leftovers and other meals are placed into nice storage containers that freeze and chill well. Salad mix, fruit, cookies, nuts, pies whatever their favorite treats are left behind. DONE = a week of meals for them to choose and microwave. Yeah.
  • You take over their medications. You know and understand what they are and how they work and what time of day to give them. You buy new and load up the big pill containers for the week and your parents are now safe and snug as bugs in a rug.
  • Check the service companies that are providing the oxygen, medications, bladder control or diabetes equipment. Make sure they bill properly to medicare and that they are easy to use. Do not be afraid to change. You may have to have the doctor re-write prescriptions, but this is just done once and then the ease of using a business that is good with their customer care is essential as your parents move into more and more use of medical equipment.
Most of all, caring for parents in their home is done with your schedule not theirs. It is a hard thing to do, but you have to say…here is my time. I am here with you two days a week and an additional evening. I will call you each morning when I get to the office and each evening before dinner. You set the rules, you call and stay on the phone for less than five minutes. Your day is yours, your time is yours to set. Your parents? They adjust and begin to enjoy life without the worry that they are over burdening you.
Blessings on all that you do for your parents. Care giving is not a fun ride, but it just how loving people live their life and honor those in their family.
Thank you…now, do me a favor please. Would you please click the ‘Sign-up’ button and you will receive a notice when I have updated my site…and join me on twitter at @SeniorCareTips I try to add tips and help those that have questions on a daily basis.
Blessings, francy