Aging Parents and Caregiving–Joan Lunden’s story

This week, nextavenue, the PBS online newsletter, published–reblogged:

Joan Lunden on Challenges, Guilt and Caregiving,

Her breast cancer battle and selfless life story are inspiring

posted by Sherri Snelling, December 1, 2014 More by this author

Joan LundenSherri Snelling, executive director at Keck Medicine of USC and author of A Cast of Caregivers – Celebrity Stories to Help You Prepare to Care, is a nationally recognized expert on America’s 65 million family caregivers with special emphasis on how to help caregivers balance “self-care” while caring for a loved one.

Joan Lunden

Photo from JoanLunden.com

When she stepped onto the stage at a recent AARP convention, Joan Lunden looked as sunny and radiant as she always has. Famous as the 17-year co-host on Good Morning America in the ‘80s and ‘90s, Lunden later transformed into a healthy living guru and businesswoman who inspires everyone she touches.

She came to talk to the gathered boomer-and-beyond crowd about caregiving — a role she had played with her mother, who died in 2013……………………..

……Lunden’s life has been a series of triumphs and challenges. As a young girl, she lost her father, a cancer surgeon, in a plane crash. As she began her career as a TV broadcast journalist 30 years ago, she also became a caregiver both to her brother, who had health complications from type 2 diabetes, and to her mother, who was eventually diagnosed with dementia. What Lunden didn’t know at the time, she says, is that caring for her brother and mother simultaneously is when her caregiving journey began………..click link for full article 

(Note: Posts are off-schedule this week due to travel and lack of internet access.)

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

Aging Parents: Help for Caregiver Stress–The Best Stress-Relief Posts I’ve Found

Stress accompanies caregiving…

Yet caregiver stress differs from ordinary stress, eg. from the work place. Its “ingredients” differ: love, caring, devotion, loyalty, pushing oneself to–and beyond–the limit. Of course satisfaction, frustration, anger, resentment and fatigue are common byproducts–generating stress. Can non-caregivers appreciate this?

Unlike Supreme Court Justice’s Potter Stewart’s famous pornography quote: “I know it when I see it,” I believe we can only know caregiver stress if we’ve experienced it. With so much information about reducing caregiver stress (about 17,700,000 items on Google; 1.990,000 on Yahoo) shouldn’t we have learned to manage it by now? In an effort to try, the beginnings of a select list of stress-relief links concludes this post. Meanwhile, caregivers deal with–

Three apparent roadblocks:

1, One size doesn’t fit all (neither the elders we care for–nor us)
2. Non-caregiving family members often can’t/don’t appreciate the stress, and don’t help.
3. We’re often not very good at asking for–no insisting on–help when we need it. Is giving up “ownership” difficult? (True, they may not do as good a job as we.)

Knowing what happens to us when we’re stressed–cranky, short-tempered, impatient, overwhelmed, (you fill in)–should wave a red flag that we need relief. That’s a first step in solving half the problem. When we know our stress-relief activity, we’re can solve most of the other half.

Finding out what works. There’s something that relaxes each of us and helps us see solutions more clearly and move forward. We just need to discover it.

When counseling, I would suggest stressed counselees think–perhaps while taking a shower–about what they enjoyed doing that relaxed them. I vividly remember one teenager who said she remembered hooking a rug in middle school. She loved doing it; remembered it took her mind off her problems. She still had a lot of the string (rags or whatever) and tried it over the weekend. She excitedly reported it still relaxed her and she realized a few things. Different strokes for different folks.

If I were musical, I’d probably play the piano. It seems like a wonderful stress reliever. That said,  I’ve identified 3 stress-relief activities, often suggested by experts, that work for me and may for you.

1. Walking fast (but not overly-exerting), the same boring walk day after day for 30 minutes. No distractions (alone and no cell phone). I notice the same things again and again: homes, wildlife, flowers, even rocks. Forced to focus on my surroundings, my mind rids itself of problems and order replaces emotional and intellectual chaos. Solutions appear out of nowhere. Plus getting exercise; and doing something for ourselves, no matter how small, makes us feel better.

2. Gardening inside or outdoors, depending on season and where I am. No cell phone; sometimes music. Gardening (planting, pruning, pinching, weeding, deciding right plant for right place) absorbs me. Stress evaporates. Plus I’ve accomplished something.

3. Being with my pets. They say “Dogs have masters; cats have slaves.” No matter. Petting the dog or cat–or just watching them–slows things down, refocuses our thoughts, and–we’re told–lowers our blood pressure (haven’t tested that).

The beginning effort to compile links to caregiver stress-relief posts I like is below. It’s in progress; obviously incomplete. Recommendations welcomed.

Also check out The 2nd annual virtual Caregiving Conference, March 29, 2015. It’s free. Register on the Caregiving.com website: http://www.caregiving.com/2015/01/save-the-date-virtual-caregiving-conference-on-march-29/

The List  (in progress)

1.  Avoid Caregiver Burnout–Slideshow: of 14 Ways–WebMD  http://www.webmd.com/healthy-aging/caregiver-14/slideshow-caregiver-burnout
2.  Caregiving.com http://www.caregiving.com/the-caregiving-years/  This is excellent with text and videos of “The 6 Stages of Caregiving.”
3.  Caregiver Stress: Tips for Taking Care of Yourself: Mayo Clinic http://www.mayoclinic.org/healthy-living/stress-management/in-depth/caregiver-stress/art-
4.  
From the Heart of a Caregiver  (affirms letting go)
https://generationsofcaring.wordpress.com/2015/03/22/from-the-heart-of-a-caregiver-thank-you/
5.  Managing Stress: Care for the Caregiver–BrightAngel (Alzheimer’s Foundation)
http://www.brightfocus.org/docs/pdf-publications/caringcaregiver_stress.pdf
6. The HelpGuide: http://www.helpguide.org/articles/stress/caregiving-stress-and-burnout.htm
This is long, excellent and very complete.
7.
Tips to Manage Caregiver Stress–WebMD:  http://www.webmd.com/balance/stress-management/caregiver-advice-cope
8. What Can I Do to Prevent or Relieve Caregiver Stress? US Dept. Health & Human Services: http://www.womenshealth.gov/publications/our-publications/fact-sheet/caregiver-stress.html#f
9
. In 2012 the Family Caregiver Alliance, Nat’l Center on Caregiving, updated statistics on caregivers, with many topics including “Impact of Caregiving on Caregiver’s Health.” (“an estimated 17-35% of family caregivers rate their health poor-fair”)

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And Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.


 

 

HAPPY ST. PATRICK’S DAY–ps. If you’re seeing this after St. Pat’s Day*

*These are such excellent plants for elders that anytime you can easily buy one, which is around St. Patrick’s Day, why not go for it!

IMG_3913

Oxalis Regnelli –Shamrocks at Trader Joe’s in Arizona.

Bring interesting, fun to watch, blooming-year-round, easy-care Shamrock plants to elders for St. Patrick’s Day. Green or purplish leaves that open in the morning and close at night, they bring a little life into the home.

IMG_3914Seemingly at $4.99 –now $2.99–don’t they make great last-minute (or even extra) St. Patrick’s Day gifts for aging parents–or anyone we care about?!  Click link for earlier post about these and other easy-care, flowering-year-round plants.

—AND ENJOY A SPIRITED ST. PATRICK’S DAY.

 

Aging Parents and Vacation Planning

When parents are old–healthy or not–can we plan vacations very far in advance?…Very far away? Do we dare to go on vacation?

March: Vacation advertising increases. It looks enticing, yet caution often fills our thoughts and precedes our making a commitment.

  • Can we risk going?
  • If our elders are going to miss us, do we feel guilty?
  • Do we have confidence in the person who will care for them and contact us if problems arise?

We can decide to afford trip cancellation insurance. That covers one aspect. Yet our uncertainty  remains:
–Do we forgo a needed, well-earned or simply badly-wanted vacation?
–Will guilt and concern weigh on us emotionally and taint the trip?

A previously planned trip to Italy with friends presented this dilemma. We went. The night after our first day there, the call I dreaded came from a caregiver: “Mother was having very serious problems.” While it was awful to be awakened at 2 am with that call, I’d prepared a plan of action–just in case. I’d accomplished 1-4.  Now it was time for #5.

The Plan: 5 Necessities Before Going Away

1.  Make peace with the fact that parents’ emergencies are unpredictable; if we knew when to expect them, wouldn’t our life be easier?
2.  Make peace with the fact that we’re entitled to a vacation.
3.  Prepare detailed contact lists, along with itinerary, for everyone who might be involved should there be an emergency.
–If they need us, they can find us. It’s not rocket science, unless we’re in a cave somewhere.
–If they need another family member his/her contact info–phone, fax, email–is listed.
–If doctors are needed, their contact info–phone, fax, email–is listed.
–ditto for clergy information.
4.  Have a plan for getting to your parent’s home or bedside on a moment’s notice.
–Arrange beforehand to be met at the airport if flying is involved, plus having a back-up for that someone, should he or she be unavailable.
5. Check out options for an emergency return before leaving. I now know–on a few hours notice–how to fly from Milan to the West Coast the same day. Wish I’d thought to check that option before leaving.

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The Details

Mother was having medical issues as we prepared to leave. If friends weren’t involved, I might not have gone. Living 3,000 miles away, I lived with a constant–but not burdensome–awareness: I might need to get to the West Coast on a moment’s notice. While I’d done it previously for Dad’s quintuple bypass surgery, thoughts of vacationing on another continent were unsettling.

Years earlier I’d attended an aging parents program that included a short film featuring an adult child whose married life was consumed by concerns about her parents’ needs and health issues. Her ongoing apprehension was such that every time the phone rang, she stressed. It seemed plausible that she would make herself sick and that her husband would book a one-way flight to a far-away place–alone!

While admittedly the film seemed exaggerated, I remembered it as the trip neared. Second thoughts about going toyed with my rational self. The latter prevailed.

Night 1–Milan: the phone call. Mother was home with a caregiver who phoned while family attended a birthday celebration and weren’t answering phones. After giving her instructions, I made immediate plane reservations, using the 4 most important words I know in such cases (mentioned often on this blog) “I need your help.”

In the wee hours of the Italian morning, the airline personnel seemed to go out of their way to get me to my destination in the shortest time possible.

#4 (above) went like clockwork.  Many years ago I spoke with my brother and a good friend about their flexibility should I need to fly back on the spur of the moment. My brother was there, at the ready.

At the house our frail, semi-asleep mother could barely keep her eyes open–in no condition to appreciate the new Italian sweater I brought–or anything for that matter. But I knew she was glad I was there and I was glad to be there.

With a list of Mother’s doctors contact info and an updated list of her medications always in my wallet, (another necessity as we know), I could immediately communicate intelligently with her doctors. Turned out medication– too much, some unnecessary–caused the problem. So simple, yet emotionally and physically draining for everyone involved.

What I learned?

  • When stress is high, it’s comforting to know we have a plan–don’t have to worry about certain things and we do have some control over others.
  • When coming a distance, having someone who cares and shares our concerns there to meet us is welcoming and supportive.
  • Having essential information at hand makes communication with professionals effective and efficient.
  • Last but not least, when the unexpected happens and we can’t do it alone, “I NEED YOUR HELP” are four important words.

I also learned we have good friends who we had to suddenly abandon in Italy. They survived; so has our friendship. And mother lived 2 more years..

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

Aging Parents: Make Elderly Happy~Thanks to St. Patrick’s Day

St. Patrick’s Day. Another opportunity to make elderly people happy: happiness created by anticipation if we’ve planned ahead to do something with them; unexpected happiness from an unexpected gift or communication. And you don’t have to be Irish to participate.

A NYC ad campaign, ubiquitous in the NYC subways throughout the ’60’s and 70’s, proclaimed: “You don’t have to be Jewish to love Levy’s real Jewish Rye.” Likewise in NYC, we don’t have to be Irish to love corned beef and cabbage, catch the spirit, and participate in St. Patrick’s Day festivities. Every important politician, it seems, is Irish that day, marching–with high visibility– in the popular  St. Patrick’s Day Parade.

4 Ideas to Lift Spirits and Make Elders Happy:

Oxalis regnellii Shamrock Plant

Oxalis regenlli /Shamrock Plant~Click to enlarge

1.  A clover plant giftoxalis regenlli is a three-leaf clover–a perfect St. Patrick’s Day gift for elders. It needs little care, likes light but doesn’t require much sun and if it’s getting dry, we’re warned–the clover begins to droop. Its leaves open each morning, close each night, and it flowers throughout the year. Hard to kill, fun to watch, and easy to love.

The one above is a bad example, with only one flower. (Result of going on vacation.) The only work is cutting off the dead flowers. Doesn’t cause any allergies unless you eat it!

Usually Trader Joe’s sells inexpensive oxalis plants for St. Patrick’s Day. Perhaps due to the cold NY weather, there were none yesterday when I shopped there. Don’t know the situation in warmer climates.That said, there’s still time to purchase one in florist shops or at nurseries and corms/bulbs are sold on-line (Click oxalis link above.)

2. A gift of an Irish beverage: Guinness, a bottle of Bailey’s Irish Cream, a bottle of whisky, or tea. According to IrishCentral.com, “Ireland is famous for Guinness, obsessive tea drinkers and some of the best whiskey on the planet.”

3. A gift of foodIrish Soda Bread:
BX0216H_Irish-Soda-Bread_s4x3.jpg.rend.snigallerythumb.jpeg –a particularly good gift for aging parents, grandparents and elders we care about. I loved it when my counselees’ would bring some, made by their mothers, to my office.  Some bakeries are selling soda bread now.  (Link gives video and recipe for those who have time and like to bake).FN_Corned-Beef-Cabbage_s4x3.jpg.rend.snigallerythumb.jpeg

        --Corned beef and cabbage or shepherd’s pie: –to eat at home (ours or theirs). Otherwise plan to cook a favorite food and call with a dinner invitation; or take elders out to dinner so they can eat whatever they wish. In any case, add an Irish beverage–Guinness? whiskey? Bailey’s Irish Creme? Irish coffee? tea?

4. Unexpected communications: elders prefer a phone call or a snail-mail card to email.

We didn’t have to be Jewish to love Levy’s Rye Bread. Likewise, we needn’t be Irish to love the St. Patrick’s Day spirit. Can we take advantage and use this opportunity to lift the spirits of our parents and grandparents?

         

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Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

Aging Parents: Is It Better To Have A Friend Be Your Doctor?

January 20th’s NY Times, Science Section’s “Hard Cases” column, Too Close to a Patient for Comfortmakes the case, based on AMA guidelines and other sources, that objectivity in medical care may be compromised by doctor-friends. “Medical care supplied by a relative — or an old friend, or a trusted employee — just seems so logical. After all, who could care for you more? But that is just the problem…”

The article triggered 2 thoughts and a dilemma:

1. When I was too young to know about medicine, I remember hearing that a doctor could not do surgery on a family member. Might have been true—or not. A playmate was having surgery. She was 9.

2. In graduate school, the professor in “Techniques of Counseling” gave us a practical list of counseling do’s and don’ts followed by his saying something like: “Be forewarned: if you’re trying to counsel a family member, your emotions will dictate and you may forget this.”

If the emotional ties of friendship can interfere with doctors’ objectivity, how do we reconcile this when it comes to helping aging parents, the elders we care about, and ourselves?

Boomers and those older, remember doctors who knew your family, possibly made house calls, and definitely made hospital visits. It was more “warm and fuzzy” then. Today’s efficiencies, however, dictate something entirely different.

I hear people say “It’s not the doctor’s “bedside manner” that matters. Agree. Knowledge and expertise are most important. But it helps if we feel s/he cares about us, doesn’t it?

Three people immediately come to mind. They don’t have friends as their doctors; yet they’re confident in their doctor’s ability to is do what’s best for them and they feel a certain bond–perhaps a professional-type friendship. Another commonality: they make every effort to take care of themselves to the best of their ability. It appears doctors appreciate this.

1. Several weeks ago I reconnected with a friend, living in a large city in the west with excellent healthcare available. I was unaware that she has a serious, unusual vision problem. Asking about her doctor, she related she did the research and now has the best doctor–adding she was concerned that, because she’s now on Medicare, it would be a challenge finding a doctor who would take her. Then she said, laughingly, something like “When we met he told me he isn’t taking new patients, but I’m ‘vibrant’ so he’s making an exception.”

2. Sr. Advisor R, at 101, has obviously had many doctors over the years. This last year a new best ophthalmologist  (taking few new patients) has been doing his best to maintain her sight, which was rapidly worsening.

She was initially concerned that he thought “She’s old, I can’t do much.” R made him realize she takes very good care of herself (corroborated by the lab tests her primary care doctor sent), lives in her home by herself, and will do everything possible to maintain her independence. He, like her other doctors, respects that–and her. For several months there was no improvement. 12 weeks ago there was slight improvement in one eye. I drove her to her last appointment and there was even more improvement in that eye. The doctor was cautiously optimistic; said to be sure to call immediately if she noted any change–not to wait for her next appointment. He wasn’t a friend but he cared. R’s spirits lifted.

3. Next I check with my friend of decades, who had polio as a child. In her mid-70’s, she has seen countless doctors who were not friends. “Confidence in them,” she says, is a must or she finds a new doctor. She has made changes over the years, as allowed in her health plan.

And we learn a tip–

She writes thank you notes after each appointment. The notes aren’t a hidden agenda to make them like her, she says, but actually to let them know that she’s very appreciative of their help. In addition, reading her note must make them think about her again after her visit. “It puts you on a level that most patients aren’t on,” she says.

A tip for us personally? And for those we care for and about. .

 

Related: New England Journal of Medicine‘s May 2014: Ethical Challenges in Treating Friends and Family..