Great Halloween Gift Ideas Roundup for Aging, Elderly, and Hosptialized Adults–Part 1: Pumpkins–Decorated, not Carved

Favorite Farm Stand 2014

Favorite Farm Stand 2014

Decorating pumpkin patch pumpkins in an unorthodox way–
Unique and fun gift for aging parents and elders.

When I lived near this farm stand I’d take pumpkins home and decorate–not carve–them on the kitchen counter….gifts for elderly friends at Halloween. However when we moved to the City, transporting them became a logistical challenge because cars in the City are basically an expensive nuisance. Thus, our car is in a garage in the suburbs. Last week I took the commuter train to the suburbs, got our car, then purchased the pumpkin, flowers etc. without knowing where I would assemble everything.

Decorating in the car would be a last resort, as there’s no electrical outlet for the glue gun. Decision: this year’s pumpkin–only one–would not require a glue gun, only the skewers to poke the holes. I forgot it last year and ended up using a fondue fork. It works too.

Halloween 2013 Scarecrow Pumplin

2012 Halloween Pumpkin, Skewers, Glue Gun, Scarecrow.    Click to enlarge

2013 Scarecrows

2013 Finished Hallwoween Pumpkins              (with fairly short stems)

This 2014 non-messy project began at the farm stand, where I selected an easily-portable pumpkin with a curved stem that had strings dangling from it. At Trader Joe’s I bought the $3.99 bouquet special, then went in search of some ornaments.

I’ve used small scarecrows in the past, but couldn’t find any this year.  The best I could do was purchase a head band with black feathers and pumpkins quivering on a spring ($2.99). That was a bit of a splurge for me, but what the heck! A dollar store was too far away.

I’ve learned to phone to double-check that it’s still convenient for me to bring a pumpkin to an elderly person–things can easily change as we know. The 96-yearr-old man’s caregiver said to come on over and decorate the pumpkin in the kitchen, which I (we) did.

2014  Whimsey Pumpkin

We placed an orange daisy in mouth to appear that a tooth is missing and added purple cheeks or ears

The finished 2014 whimsey pumpkin:We inserted an orangish chrysanthemum to look like a tooth was missing in the smile and added the purple mums for cheeks or ears.

Alternative to a fresh pumpkin: purchase ceramic or paper mache pumpkins with open tops or cut the paper mache top off, place container of water (plastic deli kind works well) inside, fill with fall flowers. Chrysanthemums in water last as long as the ones that have their longish stems inserted through the skewered hole into a fresh pumpkin’s liquidy center. The pumpkin above should last about 2 weeks. (Unused flowers are left in a glass of water and can replace any flowers that wilt.)

Today I found–and bought– pumpkins at Trader Joe’s and scarecrows at Michael’s. The scarecrows are $1.25 on sale–I bought 3. Tomorrow I will phone my 101-year-old m-i-l and tell her I’d like to bring over a small decorated Halloween pumpkin, if she would like. Having control, at 101, has become even more important to her. She has become very  particular about not having anything unnecessary around–she will recycle it to a friend or throw it away. That’s why I’ll ask first.

Trader Joe's Scarecrows

Michael’s Scarecrows

IMG_3471

Trader Joe’s Pumpkins

Related: 2013: Decorating a Gift Pumpkin: Instructions and finished product
2010: A Halloween Surprise 

The first Decorated Pumpkins 2010

2010 My first Decorated Pumpkins                    Click to enlarge

Aging Parents: A Halloween Activity ~ in the City or the Suburbs…..planning ahead…(especially for elderly who don’t get out)

Who doesn’t enjoy Halloween decorations! They’re a treat for all ages and are becoming increasingly widespread. Indoors and out-of-doors these decorations are so much more elaborate than the orange, carved, candle-lit pumpkins–and perhaps a black cat or witch– sitting on the front porches of our childhood. However…..

Are aging parents and older people getting out to see them?
And–How can we make this happen?

Country Farm Stand in Oct.

Country Farm Stand in Oct. Can you see the tractor in back?

Whether in the country or the city, various-shaped, and even white-creamy-colored-pumpkins, along with

Halloween-themed inflatables–plus ghosts and witches–are common sights. Every year it seems more suburban and urban homes and commercial establishments dress up for Halloween. Even New York City townhouses get fancied-up for the occasion–a friendly ghost, a sedate townhouse’s front stoop. City sidewalks may also yield surprises. Isn’t this a perfect time to make plans to take older people out for a great change of scenery?

And what about an evening drive when lighted Halloween displays create a theatrical atmosphere? Whether it’s day or night, how many old and/or somewhat infirmed people rarely go out, spending most of their time indoors–at home or in assisted living or more structured care facilities?  Still others don’t drive–or don’t drive unfamiliar roads or at night.

For older people who are able to get into a car–with or without our help–going for a ride provides countless opportunities for stimulation and lifted spirits. Anticipating the event is an added bonus if we make the date ahead of time.

We arranged an outing last year. It turned out to be a dreary day–yet we had smiles on our faces as each Halloween display came into view. There was anticipation as we turned a corner to a new block. We never knew what to expect, although I did a “dry run” ahead of time several years ago to scope out decorated neighborhoods. They haven’t disappointed. While a drive to the country or suburbs is a change of pace for city dwellers, cities yield their own attractions if we know where to find them. And let’s not forget decorations in store windows and malls.

Any outing that gets older people out, seeing something new, is a win-win: stimulation, companionship, something to think about long after the event itself. Indeed we know major studies confirm that connections with others and stimulation are important factors in aging well.

We may have limited free time and our elders may have limited staying power, in which case a “dry run” could be in order. Whether carefully planned or spontaneous, the benefits of a ride–long or short–are clearly worth the time and effort.

Aging plays so many unexpected tricks on older people. Isn’t is great when we can give them a treat!

Check out “Newsworthy” (right sidebar). Click links to timely information and research from respected universities, plus some practical stuff–to help parents age well.

Aging Dads: Incontinence Issues Part 2– A Urologist Weighs In

Dr. Leonard Plaine, a highly respected, recently retired urologist at NYU Langone Medical Center, was a logical choice to double-check my last week’s “Aging Dads: Incontinence Issues–Part 1″ post. He has treated men’s urological issues for many decades and I especially wanted his “take.”

Dr. Leonard Plaine weighs in:

1.  The links are well-chosen. They provide the important information men need. But he wanted to make a point about human nature, saying “Many people are not motivated to do Kegels regularly.” And that’s a good point. Some people certainly are; but what about those who have good intentions but won’t follow through? Is “Know Thyself” the key?

2.  Harvard’s Prostate Knowledge article,“A patient’s story: Overcoming incontinence,” is excellent–very complete– a piece every man wondering about incontinence issues and prostate surgery should read.

Coincidently, it was timely. Dr. Plaine had been consulted by a former colleague, earlier that day, about the advisability of his patient’s having the artificial sphincter procedure for overcoming incontinence. Dr. Plaine’s opinion raised an important caution. It involved radiation.

His former colleague’s patient had successful prostate surgery several years before and carried on life as usual. Then his PSA rose and another doctor ordered radiation treatments, which the patient had. Incontinence followed. The artificial sphincter procedure, detailed in Prostate Knowledgewas being contemplated. Dr. Plaine said once tissues in the area needed for the sphincter have been subjected to radiation, they are compromised–reducing the likelihood of a problem-free solution. In fact, he would not recommend the artificial sphincter procedure in that situation.

This prompted me to phone the friend mentioned in Part 1, whose husband had radiation after prostate surgery, was living with incontinence issues, and was considering the sphincter procedure. She said her husband consulted 2 doctors. One surgeon–according to her–was ready to do the sphincter procedure; her husband’s surgeon (who did his prostate surgery), on the other hand, was very hesitant–said chances were my friend’s husband “wouldn’t be happy.”

Lastly, I learned two new terms: “urodynamics ” and the “Cunningham clamp.”
The first is the sophisticated study of how the bladder works and helps diagnose reasons for incontinence. When ordinary answers aren’t the answer, urodynamic testing may be recommended. Mayo Clinic explains “urodynamics” testing in the preceding link.

The second, “Cunningham Clamp,” is what Dr. Plaine calls–an “old fashion” device, meaning it has been around for years, to control incontinence. Although he said he hasn’t heard much about it recently, he thinks it’s good daytime option to adult underwear, pads etc.

With hopes that some of the information in these last 2 posts will help older dads age well……..

Check out: “Newsworthy” (right sidebar). Links to current information and research from highly respected universities to help parents age well.

 

 

 

 

 

Aging Parents: Choosing The Right Doctor

If we live in a smallish town, we somehow usually know who the best doctors are. In a big city like New York City where there are many excellent doctors, people find the selection process daunting. We usually get referrals from our own doctors; we also ask friends who may connect us with other friends who’ve successfully navigated the same health issue. In cases where our problem is not “garden variety,” we may think it important to select the doctor who has had the most successful results, done the most procedures, and /cared successfully for the most patients with whatever our problem is.

The medical centers usually have specialists within the specialty (kidney stones, male infertility and erectile disfunctuon–cancer of prostate or bladder inction -voiding problems in women within the specialty (urology)

We may not need a top doctor for everyday problems. And top doctors can be prima donnas with no bedside manner. We must, therefore, prioritize our needs—personality or skill. There’s a practical element that also comes into play. Not all doctors take those n Medicare, making it more difficult for some to even find a doctor who will accept them as a patient.

For those who have no encumbrances besides a health issue, this link:

http://www.castleconnolly.com/about/nomprocess.cfm   and   http://www.castleconnolly.com/doctors/index.cfm

Aging Dads: Incontinence Issues–Part 1 Older Men

incontinence-condition

Wanting to be inclusive, this follows last Saturday’s post about women’s incontinence and the New Guidelines for dealing with it. Interestingly, a current TV ad features a group of women mapping out where bathrooms are located, before presumably going out shopping–or for lunch. Then of course we hear about the product that will make that kind of planning unnecessary.

But what about men?

Although the high rise of incontinence is in women 75 and over, and the rise is less dramatic in men, incontinence–usually temporary (3-6 months)–is common following prostate surgery. Also as men age the sphincter muscle that controls urine outflow can weaken due to more and more years of use. Doctors recommend Kegel exercises for men (with varying degrees of success depending on different factors). I’ve selected informational links from what I consider reputable sources like Mayo Clinic, as this post is intended to provide some background information before speaking with a doctor if there are issues. It should not be construed as giving medical advice, however.

Links:
—Mayo Clinic has instructions for doing Kegel exercises: http://www.mayoclinic.org/healthy-living/mens-health/in-depth/kegel-exercises-for-men/art-20045074
—Webmd weighs in: http://www.webmd.com/urinary-incontinence-oab/kegel-exercises-treating-male-urinary-incontinence
—The NY Times blog also (July 2014)–Here it’s necessary to read to the end of the article to avoid missing important information: http://well.blogs.nytimes.com/2014/07/14/ pelvic-exercises-for-men-too/?_php=true&_type=blogs&_r=0

As we get older and dine out with friends, it’s not unusual to have men get up from the table to use the bathroom. It’s a part of aging. Enlarged prostate as well as prostate cancer become problematic for many older men. That’s why PSA monitoring is important– may be the equivalent of mammograms for women.

Everyone of a certain age (boomers and older) must know men who have had surgery for prostate cancer. Whether using the DaVinci method or the traditional method, there will be some degree of incontinence for a limited time. An acquaintance is living with the same incontinence situation (following successful prostate surgery for cancer) as the person in Harvard’s Health publication–Prostate Knowledge. He is currently debating the surgery, as was the man in this very good article http://www.harvardprostateknowledge.org/a-patients-story-overcoming-incontinence#an important read for any man contemplating prostate surgery or dealing with incontinence.

Included–as always–in the current US News‘ 2014-2015 survey are the best urology departments in the US. The top 4 (all scoring at least 91.2 to /100) are: Cleveland Clinic, Mayo Clinic-Rochester, Johns Hopkins and UCLA Medical Center respectively. This does not mean they have the best urologists for men’s incontinence; but it does mean these hospitals have excellent departments, if needed. Click for the list

We try to help parents age well. While incontinence is bothersome and embarrassing and isn’t usually an ordinary topic of conversation, understandings about it may prove helpful for many.

Related: US News Best Hospitals 2014-2015 issue ranks the best urology departments in the US. The top 4 (all scoring at least 91.2 to /100) are: Cleveland Clinic, Mayo Clinic-Rochester, Johns Hopkins and UCLA Medical Center respectively. This does not mean they have the best urologists for men’s incontinence; but it does mean these hospitals have excellent departments, if needed. Click for the list.

Note: “Newsworthy” (right sidebar). Links to timely information from outstanding research institutions–and some fun stuff–to help parents age well.

 

 

 

Aging Parents: Important New Guidelines Could Make it Easier for Those nearing Life’s End

DYING IN AMERICA AND HONORING INDIVIDUAL PREFERENCES NEAR THE END OF LIFE, with recommendations for major changes, was issued last week (9/17/14) by THE NATIONAL ACADEMY OF MEDICINE’S RESEARCH ARM, THE INSTITUTE OF MEDICINE. It suggests an overhaul of current practice at almost every level. (See “Newsworthy” 9/17/14 at right for NY Times report on the report.) 

Palliative Care is mentioned several times as an important aspect of the “overhaul” ideas. While we obviously can’t count on this recommended “overhaul” to take place immediately, it would seem that those not familiar with palliative care, would do well to check out specifics in the “Newsworthy” (right sidebar) 12/16/13 NPR Palliative Care broadcast–as well as “Related” below.

Palliative care is an available option that– if appropriate–could make a significant difference for caregivers and the comfort level of elders as we try to help parents age well….until the end.

Related: Post– Palliative Care and Hospice Both Help Aging Parents: Know the Difference.
                         An Oregon Health Sciences University Prof Weighs in, supporting the new Guidelines

 

 

Aging Women: Incontinence–and Diapers!?*

Just published: The American College of Physicians’ New Guidelines
re: women’s urinary incontinence–see 
Newsworthy at right–
triggers thoughts:

1.  An experience with Mother.
2.  One of this blog’s key thoughts: Is it better for parents or better for us (in this instance the caregiver)?
3.  A prejudice about the word “diapers” used in conjunction with old/older people’s incontinence.

Incontinence was never a problem for mother. But it was a concern of hers after hospitalization following a stroke that required a catheter. Her first outing after leaving the hospital, other than to a doctor’s appointment, was lunch with me at Marie Callendar’s. She needed to gain weight and loved their pies. All went well until the end of the meal when she said she needed to get to the bathroom fast. While it wasn’t far she was frail, walked cautiously, and as we got through the first door she said she didn’t think she’d make it to the stall. Mind over matter to the rescue?

(I was always fasciated by those people who could walk barefoot over hot coals. It was, I thought, an incredible example of mind over matter. I still think of it when I’m at the doctor’s or dentist’s and anticipate pain. What works for me is asking  her/him to talk to me about anything so my attention/mind is diverted from possible pain thoughts. [Surprising what you learn! I learned one doctor's wife was in my Teachers College counseling program, among other interesting things.])

I tried this diversion tactic with Mother, suggesting that in less than a minute she’d be in the stall, seated and wouldn’t feel embarrassed. Her mind was diverted; the plan worked. Result: she felt liberated–and confident about going out. Her preference to sit near the Ladies Room lasted a few weeks then was no longer an issue….until a year later.

After a bad fall in an unlit movie theater, and resulting hospitalization, Mother came home extremely frail and weak. Although Dad was at home and had a good mind, he was old. Mom needed caregivers 24/7 for an extended period. My only request from the newly-hired, highly-recommended caregiver was that Mother get appropriate exercise, which included walking to the bathroom and back since she had no bathroom issues. I figured Dad could take care of the rest. I came back to NY, confident that things were moving forward nicely.

A month later I flew back at night to see my parents. The night caregiver “tattled.” The day caregiver (who hired the others) was using “diapers” on Mother. Made it easier for this caregiver, but was unnecessary for Mother. Saying I just happened to find  “pull-ups” in the closet, took the night caregiver off the hook and made beginning the conversation I needed to have with the day caregiver easier.

Incontinence is embarrassing enough without having people use the word “diapers” or deciding a person needs them because it means less work for the caregiver.  And wouldn’t “pull-ups” be a more respectful term than “diapers”–simply because it’s not equated with being a helpless infant?

The American College of Physicians’ new guidelines for dealing with female urinary incontinence stress trying normal (pill-free and lifestyle changes) solutions first. Doesn’t maintaining feelings of normalcy help parents–and everyone–age well?
*             *            *

Note: “Urinary incontinence (UI), the involuntary loss of urine, has a prevalence of approximately 25% in young women (aged 14 to 21 years) (1), 44% to 57% in middle-aged and postmenopausal women (aged 40 to 60 years) (2), and 75% in elderly women (aged ≥75 years)” ACP

Related: For the Guidelines as published by the ACP, click this link or link in last paragraph. They’re easily understandable and the helpfulness of the exercises is clear.

The recommended Kegel exercises–courtesy Mayo Clinic (there’s also a link within the Newsworthy article).