10 Tips for Great Doctor Appointments 4 Your Senior

Featured

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

Advertisements

Routine gives Alzheimer’s n Elders Good Home Care

Featured

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

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

When Your Medical Team Gives Up

When your medical team gives up and you are left alone with your care through a terminal illness or Alzheimer’s. by francy Saunders

Dealing with terminal illness

George walking with Kirbee

George is still healing from the fall he took two weeks ago. The rib cage is feeling better, but it’s still sore and his bruises have turned to a mud-yellow. It was time to check-in with the physical therapist and the nurse practitioner to review his progress and give us guidance.

Alzheimer’s is a very emotional condition and even though we have doctor appointments that does not mean George wants to get up in the morning. His bed is a safe place from the world of confusion. Everyday is a battle to get him up and going without arguments and upsets.

First, I have to make sure he has an up energy. I start with only positive talk and a strong voice tone. I often take a few deep breaths first so I can pump myself up to hand out the energy to him. A special high protein meal has to be served on a day that he’s going out the door. His medications are given to him early so his dementia pills and Zoloft can kick in and keep him calm. Not to mention his bladder pills that help him from nasty runs to the bathroom all day. Once these pills are given and the meal is taken he already begins to feel better. I also talk to him during that meal. I tell him what we are doing, what is happening in the world and our family. I remind him of a special day or event and talk to him as if we are going on adventure; even if it’s just to the doctor’s office.

Once up and out of bed, I have to be next to him to guide him on his daily groom. He no longer showers without me in the bathroom. His Parkinson’s could kick in at any time and take his balance away so I am there to start the shower and get the water at a comfortable degree. I help him into the tub and then he takes over. When the shower is over; I’m there with a hand to help him out and get dry and attend to his personal needs with a reminder for deodorant and moisturizer cream for his legs.

I have already laid out clothes for the day that fit the situation. George gets very cold these days so even in the summer I have to think of light weight but warmth. Then there is the shaving, the whole teeth clean and another reminder for his face moisturizer with SPF for going outside. As he is grooming; I’m cleaning his glasses and talking to him in an up tone with excitement to keep him interested in his day ahead.

All through this process; he pauses and wants to rest or go back to bed. It’s very important for me to keep focused on his progress and keep him on task in a way that is not pushy – but encouraging. I check how he looks and give his eye brows a trim and choose shoes that are good for walking. Then I get him settled in the living room with the TV news so I can do my own personal groom.

The amount of time it takes to get George ready for an outing is really quite staggering. It leaves very little time for me to get ready and often I skip my own breakfast because the time simply falls away. There is my bag to fill with sugar treats if George gets upset and water for his never-ending thirst because of his medications. Then there is his binder with all his medical notes and ID’s to put into my bag. I must have all of the information because we use the Veteran’s for our health care and they need the numbers and names at a moment’s notice. Then its time to pull out the car and get his walker loaded.

His walker is heavy and really hard for me to get into the back seat. George would want to help me with it if he saw me struggling to get it in the car. I always do it ahead of time so he can get in the car and just relax, not be distracted with anything around him.  I have to remember to have the car cool or warm according to the weather or George gets upset and then I need to be prepared with my map if we are going to a medical office that’s unfamiliar. Luckily, we live very close to our Veteran’s health facility at American Lake. It’s just a short drive with no traffic.

I get George out the door and into the car without using his walker so it takes time to guide him and constantly talk to him to keep him motivated and interested in what we are doing. I give him input on what we will do “after” the appointment so he has something fun to think about, not fuss over the upcoming appointment and wait in the office before we see the doctor.

Once at the parking lot by the medical building I try to park as close to the door as possible so its easy for him to walk. The check-in can be quite complicated and I have to make sure he is seated and calm before I go up to the desk. Then I need to be ready with ID and if I have a letter of review for the doctor it is presented to the staff at this time, to be placed into his file. This way the doctor can pre-read the review of care questions or description of his latest challenges that I want him to address during the appointment.

It was our day for physical therapy appointment and our PT is a very nice man who addressed George with respect and walked him slowly to his office. Once there we reviewed George’s fall and his healing progress. The PT tested him for injuries and gave us a few suggestions for exercises.

This was our second appointment this week and I was busy asking questions of the PT about exercises and what areas I should address in the time coming up. As we finished the appointment, the PT told us that he really could do nothing else and it was up to us to do the exercises and address the physical declines that were coming up. My mind is always clicked into using the time I have with the medical professionals for questions and I was busy checking my notes and then we were walking out the door to the car.

I was getting George tucked into the front seat and trying to get the dumb walker back in the car. My mind running ahead at a stop at the store to get some pre-cooked chicken for dinner and asking George if he wanted an ice cream treat on the way home. I was thinking of getting home to the dogs and making a call to his sister about his appointment results. I was thinking of carefully getting the car backed out of the parking area when I was surrounded by disabled patients all backing out of their parking spots at the same time. I was thinking of the co-pay money and wondering if I had enough to get a few extra things at the store. I was thinking of George being left in the car alone when I ran into the store; did he look like he was calm enough to be left on his own? My mind was going a million miles an hour and I was checking my mirror and getting ready to back out of the parking spot.

George reached over and touched my arm. Reaching for my hand he looked at me and I noticed he had tears in his eyes. I stopped the car, pulled back in the parking space and put on the break and looked at him. He held my hand and squeezed and said. “He could do nothing else, that’s what the doctor said the other day. I think it’s just you and me now, Francy. They have given up on me.”

It hit me. I was so busy with my own mind, my own mental to do list, my own thoughts of the day..that I had forgotten the physical therapist’s wording. He did say he could really not do any thing more. George had heard that and taken it in and it had hit him. I had been so busy thinking and he was busy feeling. I had been worried about the full day and all that I had to do ahead of me and he was “in the moment”. I was busy being in charge of our outing and George was quietly absorbing his surroundings.

George had watched the other Veterans that were clearly in medical stress, and judged his own inability to walk well into the building. Feeling that he did not do well with his physical testing and knowing that there was no medication or treatment that was going to change his Alzheimer’s/Parkinson’s condition. He was coming to the conclusion that his medical team had given up.

We cried together. The loneliness of terminal illness is a very personal time. It hits you in different ways at different times. For George and I its a loss of little bits and pieces of his mind and who George has been in his life. It creeps in the door and sits there in silence until we can absorb it and process it. George was right; the medical staff had nothing else they could do for him.  He was in a decline and there was no stopping it. He had a taken a hard fall and was stunned by the pain of his recent injury when he had been such a strong and athletic all his life. Realizing that his body and his mind simply could not be willed to work…was frightening for him.

His medical team is still there. They are polite and helpful but they have no way to make him well again. All we can do is walk this path together and it does become overwhelming at times. We can  just hold on to each other and feel our way through the hurt. George pulled away and looked out his window. He was ready to go home. So I turned the car back on and began to pull out of the parking space…as I backed up George used a very quiet voice; “I’m glad, I’m not alone, Francy…I need you.”

Don’t let your seniors be alone when their medical team gives up. You may not be able to save the day…but you can save the moment. You can call your parent or family member and give them a giggle. You can stop over and give them a hug. You can put your busy day aside and give them a few minutes of your time. Your senior may know inside that their life’s journey is coming to an end; but they should not have to be on that journey without those that they love and have shared friendship with for years. Go and visit them, give them a reminder that love and friendship never end.

Blessings on you…francy

George took a Fall

Guide for families giving care to seniors

Out this fall by francy 'Guiding Family Care'

George took a fall and I wanted to update you. by francy Dickinson

I am in the middle of designing my front cover for my ‘Guiding Family Care’ eBook for senior in home care-giving. I am going to have it out by September. So the cover has to be done… I was in the middle of the design process and George took a fall.

He had gone downstairs to let the dogs outside and he went out on his own. He was doing things out there, without a cane or walker. He tripped over the hose,  landed on his hands and Cheryl saw him go down and let out a holler. Gosh that is a scary call.

I raced downstairs and the dogs were hovering over him, he was in shock. I had him stay still for a while to see what was injured and he was able to move. Cheryl and I got him to his knees and then to his feet and over through the downstairs door to her sofa. He sat there for a while saying very little and confused. His Alzheimer’s takes such a hit when anything like this happens.

When he got up he was sore and I had him go up the stairs slowly with our help and then the pain started to hit. His ribs had been cracked and his arm and shoulder were bruised. So for the last three days we have had quite the time of it. I am giving him full care; that means transition, grooming, bathroom transition and bringing him meals. He is in less pain in his recliner chair, but unable to move it without help. He has a whistle that he blows when he needs me. It’s just simple things with care giving, but they all add up to time and energy and added stress when the daily routine is blown apart by a fall.

–> I think George blew the whistle less today…so its been four days and the pain is still there, but getting less. He is learning how to adjust to it and walk with his walker again. I took him out the door and across the street – to get the mail and he walked with more speed today. His Parkinson’s tends to make him shuffle, but he was able to pick up his feet in a better walking stance. I can not let him just sit…he has to keep thinking and moving or he will lose his movement memory.

Just another bump in the road that care givers have to adjust to and think about. I thought I would share it all with you, so you can understand the continued stress of being a care giver…at the same time allowing him to heal slowly and get his mind and his muscles strong. So easy to think that falls are the end of an elder’s life. But that is rarely the case; they just make life more difficult…so I am doing my best to motivate him to move safely and heal strong.

My personal frustration is trying to work in-between the whistle blows…but I am getting there. Leave me a comment if you have a similar challenge. OH, a good friend has done an author page for me, if you would be kind enough to visit I would appreciate it. Just click here. When I get the eBook done I will ask you to spread the news for me. It should be out in a couple of weeks, I’m excited and in hopes that George keeps healing so my writing time can increase. Keep your fingers crossed; I want to get this book out the door and into the hands of families that need care giving help on a budget.

Blessings, francy

Alzheimer’s and Afraid

Alzheimer’s and afraid to leave the house or safety of a room:

Fears overcome seniors with dementiaDear Francy; My mother is terrified of leaving the living room…she no longer wants to go to the bathroom or to her bedroom. She feels safe in the living room and she clings onto the chair and I have to pull her out of the room to the bathroom. What can I do to release this fear?

First rule; do not connect with the fear yourself. In other words, do not show worry on your face over her fear..treat your mother with smiles and talk to her in a normal tone of voice. Get her to follow you on a daily tour of the house, maybe have her hold a dust wand or rag while you are touring so she feels the movement of cleaning the home. For instance; “Mother would you come and help me with the laundry for a few minutes?” This everyday routine is soothing and your voice shows no change of character…on a good day she will follow you because she is doing something “for you”. That is how our family responds to us the best…they do things “for us”. Lunch time, you ask her to come make a sandwich for you. If you set up a commode to use; place it at the far end of the living room so she has to walk over to it and be close to leaving the room and then slowly move the commode every few days closer to the bathroom. Taking it easy and slow and using your mild calming voice is the ticket.

Ideas:

  • Always remember to review the small and large problems with her doctor so he can adjust her medications to help her through her fears.
  • Therapy for dementia and Alzheimer’s is not considered helpful when they go into the moderate and above stages.
  • Calming, reassuring and cheerful demeanor is the best treatment to receive positive responses.
  • Third party care can release the tension and often kick-start the brain into a different focus. Ask a family friend to visit, get an in-home care person for a couple of hours a few times a week, etc. Change is fearful for the Senior but it also might spark different feelings that can change the atmosphere of the home.
  • Use music to change moods. Morning music is upbeat and happy, afternoon is slow and calming, evening is fun music with voice, and nite time music is slow and calming.
  • If TV is on all the time; monitor it like you would a young child. The TV voices and noises make a difference in the senior’s mood. Find stations that are of interest and then turn it off for a few hours in afternoon to encourage a rest or nap without noise.
  • Ask the doctor about sweets; I find afternoon sweets with tea help the brain to re-energize. I give George cookies with tea at 4PM every day…then make sure his dinner is on time around 6-6:30PM with meds

Dear Francy; My Aunt is not sleeping in her bed, she is sleeping on the couch and it is not a comfortable couch to sleep on. How can I get her to move to the bedroom again?

IDEAS:

  • Make sure the bedroom holds comforting things in it and not memories of things that might upset her. Pictures of spouse or relatives that have passed can be overburdening. Move the pictures from the wall and put them somewhere else in the house. Make the room comforting. Update the room in small ways and refresh bedding.
  • Take your Aunt into the room while you are there and have a talk on her bed. Allowing her to reset her mind that the room is warm and friendly. Looking through her drawers and have her help you sort them out. Get her re-involved with the room in a positive manner each time you visit. Even having her take a nap, on her bed, while you clean the house or do her chores.
  • Put in a night light in the room and in the hallway to the bathroom for ease of night vision
  • Make sure there is a phone, emergency button or a cell phone available by her bedside table
  • Change the living room furniture so the couch is not as comforting as it has been in the past. Place a TV chair in the prime space of TV viewing. Make sure the chair is comforting and has a table that is easy for her to use for her snacks and other personal behaviors.
  • Call her mid-day and make sure she is not napping all day. In order to have good rest, she needs to have exercise and movement during the day hours
  • If she is using the TV to keep her mind busy…put a small TV in her room with an under pillow speaker
  • If she is responding to time alone, get her a senior rescue anipal. Like a cat, that will fill her day with movement and love. Older animals are easy to adapt to seniors and they mind the senior’s problems like unsteady and forgetful. Cats can stay indoors, use a potty box and eat and drink from a larger bowl that does not have to be replaced during the day. Place a fluffy cat blanket on her bed so she can welcome the cat in the room with her and not feel lonely in bed.

I hope this helps with the everyday issues that all families face with their dementia senior’s care. Thank you, for your gift of care, these are hard issues to face on a daily basis. Keep talking and asking for help…your care has so much value. It is totally understanding that frustration and self doubt will consistently arise while caring for anyone with dementia. Keep strong; your love and kindness do make a difference in this person’s daily routine.  

Senior Emergency Tips, Plans and Packs

how to make a senior emergency kit

Your own senior emergency kit

Emergency Kit for Seniors…Ideas
by francy Saunders

Dear Francy; Mom is in a retirement home so I’m not worried about her care in the middle of a small emergency. But after watching Japan and all the sadness, I worry about who would help her in a big emergency?

Katrina, Japan…I think we have all taken note, that it takes at least three days before people are getting help. That is what happens, there is always a time that we are each alone and need to plan on how to make it over the first few days of a big emergency. So I wanted to write down some ideas, I have given classes in Senior Emergency for many years and I will share some notes with you.

These ideas are for anyone but I’m gearing the information for older seniors. Find a backpack…they are easier to grab and take out the door and if you have to walk you can put it on your back. If you are weak, be practical, make the backpack very light and keep only the most important life-sustaining things inside and you can drape the backpack on your walker to carry it, if need be. If you cannot carry anything use a small overnight case with wheels.

Your Emergency Pack;

You can buy a pre made emergency pack at large stores in the sports department. There are simple things put together for your needs. You can then add to it or make your own.

THINK…what would I need with no electricity or if I have to actually leave my home?

  1. Light weight slicker/raincoat rolled up in bottom of the pack. Add a Ziploc with 3 pairs of socks, 3 undies, hand cleaner, small plastic cup and a small pack of hand wipes from the dollar store.
  2. Clean Ziploc bags; small baby shampoo can be used for hands or hair. Small Toothpaste and new toothbrush. Small Hairbrush. Use small tissues in your pack for toilet paper. If you need bladder control, add in a few pads for that purpose. Gum can clear your mouth and make you feel like you are having food, and if it’s sugar based it will give you a boost. A plastic garbage bag for you to use for many things, folded flat.
  3. Rx Ziplock; buy a box (usually 3) face masks, small Sun protector cream, Neosporin tube, a few Band-Aids, aspirin or Advil and chap stick.
  4. Meds; Make a copy of your medical ID and insurance and fold it and add to a Ziploc with information. A pair of old glasses in a hard case. A photocopy of your Rx from the doctor (glasses too) and 3-7 days of meds in a Ziploc container. Be able to tell the rescue people the name of the pills you take each day. If you are Diabetic or other health issue…make a large ID for the outside of your backpack and say DIABETIC…Ann Clark. I have one for George that says ALZHEIMER’S GEORGE – that way anyone helping you will see it and understand your needs.
  5. Write down a few names for others to connect with to help you. Example for George: Wife; Francy Cell #0000, Sister in Oregon Cell# Email address, Son in Calif Cell# Email#, Dr Name Office phone# — if you’re sick or confused, someone can look at that paper and help you get to family for help.
  6. Pair of older tennis shoes, small radio, matches, a can or bottle opener and some sort of small pocket knife, spoon and fork. Large black marker to leave a note on your house about where you went, so your family can find you.
  7. Money/10-$1 bills/2-$5 bills / 1-$10 bill  Put that in an envelope and keep in your pack or case. If you need to get a taxi or pay for help you will have a few dollars to do so. Do not put in too much money you do not want to be robbed. Copy the name of your insurance and policy # so you can contact them about your home or renters insurance.
  8. Small blankets out of a foil type of cloth can be purchased for your kit. A blow up neck pillow that stores flat and folds up. There are other items that you will find in the hardware stores or large chain stores in the sports section and always look for things at the Dollar store. Once this backpack is prepared put it by the exit door in a place that is easy for you to get to and grab. If the power is off and you have to leave the home, you can crawl to the door to stay safe and pull or push your backpack out the door with you.

In the middle of an emergency:

Seniors need to ask for help, do not stay behind, do not stay alone. Go outside or put a big message in your window with HELP on it so someone comes to help you. Find a young couple to join. You can watch the children while they do the needed chores. They will have the energy to help you.

The world has changed, now messages get out on cell phones, text on cell phones, Internet via Skype, ham radio and satellite phones. So be prepared with the family information in your kit so someone can read it and make a call to your family.

Make a plan ahead of time to connect with family. Say something happens big in your town; make a plan that everyone will go to a certain house, or a certain central place in the city. Or appoint a family member out of your area to be the central hub of information. That way everyone will be on the same plan of action. Red Cross will help you find your relatives so try hard to stay calm and know that when the emergency passes, things will clear and help will come to you.

As a senior you can help make the emergency calm, by telling children stories and re-assuring the other adults. You have years of experience of small emergencies…so during a crisis you’re a valuable help and your caring ways will ease a great deal of tension for others.

  1. Take UR marriage certificate to a copy shop and have it reduced so you can put it in your kit. Copy your passport information, if you can not grab your purse or your ID  the emergency – Your backpack will have copies of things to help you. Tuck in a small book of family pictures –so if you have nothing left, your memories would be in place. Remember everything goes into  Ziploc bags to keep dry.
  2. Pets/Put an extra lead and/or cat carrier by your backpack. Have a couple of days of food for dog or cat in a Ziploc and a small bowl for food and water. Make sure your animals have ID’s. If you cannot take them with you…let them be free in the backyard, not locked in the house or on a chain. If you love your pets you will leave your home and be safe, you can always get reconnected with your pets in the days after an emergency. Many emergency safe spots will now take animals, no need for you to stay in peril. Your animals will be OK if you think ahead and have a plan.
  3. Water is heavy; take a few bottles with you for your own use. At least three small bottles will keep you well for a couple of days. If you can tuck in a couple of Boost or Ensures so you have protein shakes that would be great.
  4. Food:/ Take protein bars, they last in your backpack and they are easy to eat and keep you nourished until you are helped with real food. Do not give your food away. Eat privately…you have to keep up your strength. Younger people can go longer without food…seniors cannot. Be sure to have those protein bars well wrapped and in an additional Ziploc for safety.

No matter what the major emergency is… it will be a few days before the services reach you. So just think through what you would do. Where would you go to be safe, ask a neighbor to help you, or know you will sit on your front porch until someone comes to help. Talking about it and knowing that even in a retirement community…you need to be prepared. If there are two of you, make two backpacks the more you have for each other the better. It’s always best to plan to stay close to your home, walking may have been enjoyable on a warm summer day…but not in the middle of a crisis. Just stay low, stay safe and be helpful to others, so they will be helpful to you.

When you think of things when life is good and calm…and plan for an emergency you can then put the thoughts away and go about your life. You will know that no matter what happens you are prepared and ready to face it. Millions of elders have lived through horrid emergencies and have had worthwhile lives and continued to give their family and friends joy for years after. BE PREPARED- you are loved.

For other tips please go to my website www.SeniorCareWithSpirit.com

Thanks for all you do for your seniors…francy