Aging Parents: Caregiving With A Little Help From My Friends

Image result for "I get by with a little help from my friends sheet music image

Caregiving. Caregiver support. One size never fits all. We have our own ways of approaching and handling things.That said, a reference to this Kiplinger’s magazine article, Pitching In When Caregivers Need Help, was glaring at me as I began moving older Newsworthy articles from the column at right, to “Newsworthy Archives” (above). Having just gone through months of what qualifies as “caregiving,” I’m thinking the idea for finding additional help as offered by Kiplinger’s  three listed sites below may appeal to many.

The first site: Lotsahelpinghands–how-it-works reminds me of those community blackboards I’ve seen in neighborhoods in Portland, Oregon offering services: people helping people –a ride, someone to make meals etc. (the site has added other aspects now). It has a practical emphasis. This no doubt works well in suburbia and smaller communities and in cities where neighborhoods are important.

The second site, www.careflash.com concentrates on supportive relationships and meaningful communication and support through shared and private interactions on the internet. With a goal to “foster healing among loved ones,” it has no geographical restrictions. It seems to emphasize the “touchy-feely” and offers planned activity ideas.

The third site, caringbridge–how it works: provides a private site for family, friends and others you select–saves calling many people with the same information and allows easy updates and messages for all users invited to use the site. For those with large families and large groups that care and want to regularly share, this could be the answer. 

However, none of the above would have worked for me, I guess confirming the fact that “one size doesn’t fit all,” “different strokes for different folks” or whatever. Some of us will find our own routine and support system–out of creativity or necessity.

I live in New York City. I was “it”–the caregiver–for my husband. Whether in the hospital or at home, there was little time for private calls to family–all living in the west–or friends, spread out across the country.  And there was no time for extended conversations or daily emailing.

My solution: Once or twice a month I emailed blasts, trying to craft the nicest email I could with timely information, always adding at the end something like: “Please understand, my day is over-full, and much as I’d like to talk with–or email– each one of you, I can’t; so please don’t call me.” I created a contact group on my Mac and sent updates as appropriate.

As for support, I got by, and continue to get by, with a little help from my friends–three  friends, each helpful in different ways, to whom I will forever feel grateful and indebted.

With hopes that one of the preceding ideas will resonate with many…..

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Related: (For nostalgia’s sake–watch the performance–YouTube in color: the Beatles with Ringo singing  I Get By With a Little Help From My Friends

 

 

Aging Parents: When We Invest Ourselves in Caregiving

When we work hard at something, expend great effort–perhaps even go beyond what we thought were our limits–we’ve invested ourselves. Indeed, when we’ve put a lot of ourselves into something it permeates us. Be it caregiving or whatever, it becomes a significant part of life; the major part of life; and for some individuals–their life. Over time it’s easy to lose perspective and upset the needed balance to be emotionally and physically healthy.

                               “You’ve got to take care of yourself.”

How many times do caregivers hear that? We needn’t be geniuses to know that food and sleep are necessary for physical health and stamina; but there may be precious little of both due to circumstances beyond our control. It’s also easy to get so caught up in the demands and decisions that we forget priorities. We may think about our needs, but other demands supersede.

  • We skip meals or vitamins or meds, planning to take them later, then forget.
  • We get less sleep, planning to make it up with a short nap that never/rarely happens.
  • We fool ourselves into thinking we can remain in high gear forever, not knowing how long our caregiving will need to continue.
  • We may be in denial that people with certain conditions that require caregiving can outlive their caregiver.

Whether loved ones are at home, in hospitals, or in care centers our lives and routines are impacted. That spills over to physical health and emotions.

On a personal level: Having experienced some of the above almost half of this year, and being aware of the consequences of overextending, I tried to do it right. I ate well (although sometimes only two complete meals+snacks a day), walked about 2 miles daily, but was admittedly often sleep-deprived. Thinking I took care of myself pretty well under the circumstances, I’ve had a shock!

A few weeks ago, I got dressed to go out. I put my iPhone in my pants’ pocket. To my amazement, and almost embarrassment, after taking a few steps the iPhone’s weight (which isn’t much as we know) caused my pants to start sliding down, I put on another pair–same result. I rarely get on a scale, but I did. Scale shock! I’ve lost almost 10% of my weight, and was too busy to realize it until the other day.

Solutions and Remedies
Two Questions:

  1. How does one get more sleep when he or she is called upon to do other things? How does one turn off a racing mind? Why does exhaustion make it harder to sleep?
  2. How do we know when we’re not eating enough?

I contacted a highly experienced counseling colleague (our offices shared a waiting room and secretary years ago) to weigh in on #1. She’s one of the most effective counselors I know– always sees the big picture and has the capacity to “nail things.”  She innately “gets it.” I shouldn’t have been surprised when she lumped #’s 1 and 2 together.

“Sometimes you have to deal with the fact that you’re losing weight and sleep. But you have to accept the fact, otherwise you’re giving yourself additional stress when you already have so much. You won’t starve to death and you may not sleep–but your body will tire eventually and you will sleep.” She continues: “Feeling that you have to sleep, for example, causes stress–it keeps you awake. Focus on the awareness instead of the stress. Whether it’s sleep or eating enough, be aware of your body signals–monitor yourself; and if out of control, seek medical help.” 

                                            Monitoring Ourselves

When during the day do we make the best decisions? have the most energy? have the least patience? Sometimes things seems less solvable and more urgent at night because we’re tired, but in the morning answers and solutions come more easily. Can a walk or a certain amount of time spent exercising help us analyze problems more objectively?

                                                  About Friends

Barb just ended 6 months of 24/7 caregiving in their home, for her husband’s 91-year-old mother who recently died. That plus her private practice and cooking for four people on different diets would have overwhelmed many; being sleep-deprived was the norm. A month later, she has helped me. And that’s where friends come in.

While friends mean well, it’s important to enlist certain friends’ help for certain problems. Good friends always want to help and want the best for us. But we need to think carefully about who’s the best resource for help with a given problem, otherwise we’re vulnerable to more frustration.

If we discipline ourselves to think broadly, and remember the “6 degrees of separation” theory, we should be able to find the best help for those entrusted to our care.

As we invest ourselves in caregiving, we also need to recognize and attend to our needs. To this end the value of certain friends is priceless.

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

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Caregiving and Time for Self

  • One reality is that we can’t stretch a 24-hour day.
  • A second reality is that–and we all know this, but easier said than done, those entrusted with caregiving must take care of themselves.
  • A third reality: it’s hard not to push ourselves….just this one time or just a little bit more…but it’s not good for us if it must continue over an extended period.
  • And the last reality–at least for me–is that my time for keeping up with my blog remains in short supply for the time being.

Having set mental markers in my head to warn me of when my ability to remain helpful to anyone, even myself, is at risk–I have asked for help several times since my husband’s surgery to replace his aorta and mitral valves on February 4.

While we planned to go to the Southwest the beginning of April and had been cleared by doctors to go, there was a serious issue connected with the surgery, that hospitalized my husband on April 1st….and he is still hospitalized, although we’re hoping he can come home in a few days.

So the help I now need is finding a bit of time for myself–something I’ve done to a small extent each week. Yet as this hospital routine continues, and time walking, running, taxi-ing, bus-ing back and forth to the hospital continues to eat up time, I need more rest or unassigned time, as well as time to prepare for his homecoming.

With no family members east of the Rockies, the ultimate caregiving responsibility is mine. Good friends are a blessing and have been wonderful. With many friends in the counseling profession like myself, there’s a certain supportive understanding that most people don’t have.

For now I take a break from my blog and will get back when I can….hoping it will be soon.

 

Surviving Hospitalization of an Aging Parent or Spouse–2: 7 Tips for Coming Home

The first thing Deb, the RN-Geriatric Care Manager, said to me during her “courtesy call” at the hospital was something like:

“Get everything in order at home: fresh sheets and towels on bed and in bathroom; wash laundry, your hair; bring in a supply of groceries; do everything you need to do because you won’t have time to do it initially.” Excellent advice.

The following suggestions came from healthcare workers in the hospital
or from what worked well for me

1,  Bring all hospital records and discharge information home. Keep in a separate folder. (Mt. Sinai gives a folder containing this,) Add all future hospital/medical material and business cards from the doctors (easily accessible FAX + other contact info important) if you’re continuing with them after hospitalization. I also added them to my iPhone contacts. Depending on where I was, the information was at hand.

2.  Have a pill organizer at the ready at home if medications are part of the regimen.

3.  If there are prescriptions to be filled, ask if the hospital will phone them in to your pharmacy for you. In our case we only asked for a week’s supply from the pharmacy and they delivered. (We don’t drive in NYC and I didn’t have time for the walk back and forth–20 mins. total).
     Our physician immediately phoned our prescription-by-mail service (which he did in the past when refills were needed) for the 90-day supply. I phoned the service to double-check that they would arrive before our week’s supply ran out.  All came in a timely manner.

4.  Have a calendar or appointment book/engagement calendar that enables seeing–at the least–one week at a glance. It’s the roadmap of life following hospitalization for a serious problem, when additional services will be needed.
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A calendar with boxes for each day is perfect for keeping track of and making doctors’ appointments, and all related services (eg. physical therapy). It also allows room for jotting down our personal appointments/meetings, plus  room for schedule changes.
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Since I’m more comfortable looking at a big screen (rather than a small one) when making appointments, I add to my computer’s calendar from my old fashion appointment calendar’s boxes. Yes, the cloud can efficiently make connections between my computer and iPhone and that’s good in a “pinch;” but I prefer the computer’s screen size and the engagement calendar’s boxes. This may be age-related?

5.  Put an armchair with firm seat in a convenient place for socialization. Makes it easier for people with weakened muscles from a hospital stay to sit and get up– and enjoy the stimulation of those in the room.

6.  Make certain the bathroom is safe: a shower bench, grab bars, a raised toilet seat with arms.
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Most NYC apartments have small bathrooms. Showers aren’t wide, toilets are often inches from the vanity and sink. My independent husband was positive he needed none of the above–all of which were recommended by the hospital social workers and Deb.
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Because our bathroom was remodeled with a “comfort height” toilet right next to the vanity and sink, we didn’t need the additional raised toilet seat with arms. While the shower floor wasn’t slippery, I had concern too much shower steam could make the showerer woozy. But my husband declined the shower bench, saying the shower was so small he couldn’t have a problem.
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The shower bench, from what I understand, isn’t covered by Medicare. Don’t know about grab bars or raised toilet seat because we never ordered them and, as it turns out, they weren’t needed.

IMG_0971That said, Sr. Advisor R had her shower refitted after breaking her hip when she was 97. She staunchly rejected help and knew this was the best tactic to justify her refusal. (Click photo at left to enlarge)

I plan to have grab bars installed in the near future. If we plan to live to be 80+, why not!? And, while more costly, they needn’t look institutional.

American Standard bath safety

Click to view American Standard’s Avisia ADA-compliant offerings.

Related: 13 Tips for Surviving Hospitalization of an Aging Parent or Spouse
               Old Bathrooms, Old Parents–97-year-old’s ADA-compliant shower updates
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Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

13 Tips for Surviving Hospitalization of an Aging Parent or Spouse

How many times have people said “You must take care of yourself?” when caring for an elderly loved one who’s hospitalized.

There’s stress….too many things to take care of; possibly many people giving advice; definitely emotionally draining. And then when we feel balance–if not control–we’re knocked down by a big wave of new problems: unexpected health changes or minor setbacks, hospital staff who are too busy to answer call buttons in a timely manner or worse.

In truth, the ongoing hospital experience with my husband gives me little to complain about. That said, after 2 weeks I’m convinced these suggestions ease the experience:

First and Foremost Remember the Goal–in this case 2 goals:

  1. To get him or her well and out of there asap
  2. To keep ourselves from getting dragged down by all the stuff–from people’s attitudes (including the patient’s and family members’) to pushing ourselves to meet every expectation. In short fend off–protect against–frustration and exhaustion.

Organize, organize, organize.

  1. Decide what’s controllable. Make the most of and gain strength from that. And act on it. We can wear ourselves out worrying about things that aren’t controllable in a hospital. (Confession: I like to think everything is within my control. My counseling kicks in–thank goodness–and I identify whether or not I can control. If I’ve tried everything (talking to anyone who can help, getting all information I can,) and it hasn’t worked, I’ve disciplined myself to “let go.”)
  2.  If not staying at the hospital, each night put everything in logical order and use a tote bag or equivalent for items that need to go–the next day–to the hospital for parents/spouse/ourselves. That way nothing is forgotten the next morning.

Example: It was bitterly cold in NYC and I tried to take the bus, rather than taxis (expensive) to the hospital. So I put my down parka on a chair near the door with bus pass in one pocket, lined gloves in the other, and placed the things that needed to go to the hospital next to them. That way if the phone rang while getting ready, I wouldn’t lose my train of thought and could sprint to the bus stop if necessary without leaving anything behind.

3. Take medications and vitamins on time. Place them where we can’t forget them. It’s easy to put this off when we’re rushing–or completely forget. We need all our strength.

4. Sleep/Rest: Get enough of it. We think more clearly and make better decisions when we’re rested.

5. Ask questions to learn the hospital routine in order to make the most of the visiting hour schedule and schedule our own “must-do’s” around it. I also asked where the hospital’s food offerings were located. (Fortunately there was a Starbucks close by.)

AT THE HOSPITAL

1. If surgery is scheduled, ask how long it should take. That enables us to control what we do during that time. There’s probably a waiting area for families. Some may find the large commonality of shared concern supportive. I don’t. We’ve always lived far from family. Although friends volunteered to wait with me, I decided being surrounded by anxious people in the waiting area for many hours would be overly stressful.

So I met a friend (who’s sensitive and fun to be with) at the hospital and we left, but didn’t go so far that I couldn’t get back quickly. My husband’s doctor said he’d call my phone upon completing the surgery, which he did, saying surgery had gone well and I had about 4 hours before my husband would be awake enough to know I was there. That worked well. His call was like a 4-hour time-out from stress.

2. Get the phone number of the floor/unit/ward before leaving the hospital on Day One. It comes in handy, It helps avoid visits to an empty bed when tests, scans etc are being done. Before my husband was able to talk on the phone–in the beginning days after surgery–it allowed me to get information and leave a message in the early morning, before I went to the hospital. I was careful not to overuse the latter.

3. Remember or write down the names of every healthcare person who attends your loved one and call them by name when you say “hello” or “thank you.”  It seems to create a small personal bond, which gets faster results when we have questions or need help (in the latter case remember the “I need your help” phrase).

4. “Thank You Kevin/Samantha/Whoever” can’t be said too many times.

5. Show interest–however brief, if you can do it–in every hospital person who comes into the room. Because I counseled high school kids, I often asked where the nurses, CNAs etc. got their training and explained reason for my interest. If they were from another country I asked where they were from and if family was there and if they went back to see them; and if I’d travelled to the country or wanted to, I told them. I know my interest  meant something to them and when we needed something, they never failed to come through quickly.

6. Fight infection. Mt. Sinai had hand sanitizer dispensers and signs about sanitizing hands everywhere–at the entrance, exit, by the elevators, at the entrance to each unit, and in each room. The rooms also had boxes of gloves. I was prepared to be a watchdog about this, but everyone was trained well and automatically put hands to dispenser upon entering and exiting the room.

Every hospital may not train as well–and monitoring everything is no easy responsibility. Yet we become the eyes and ears for hospitalized aging parents and our spouses. And doesn’t that buttress the case for why we need our rest!

                           to be continued…..

Related: Hospitalization Tips that Make a Difference for Grandparents. Parents, Children and Us
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Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Aging Parents: Forcing Resistant Parents to Do What’s In Their Best Interest

FORCING ELDERS?

Sticky subject requiring careful treatment. As a high school counselor I was no stranger to dealing with sticky subjects that could threaten life and limb. There’s a delicate balance between what we’re professionally mandated by law to do, and concern about maintaining a valued relationship and sense of trust that we’ve worked hard to develop.

Likewise, a delicate balance exists between forcing aging parents to do something for their own good when life and limb are at risk and maintaining a close, loving relationship. Plus–guilt can weigh heavily. Can we force resistant parents to do what’s in their best interest when they’re dead set against it, maintain our relationship, and have no guilt?

WE HAVE NO CHOICE…

  • When elders don’t have “a good head on their shoulders” and their judgment is impaired. It’s painful but we must force them to do what’s in their best interest if there’s a threat to life and limb–their’s or other’s.
  • If our parents’ situation is significantly impacting our physical health–actually we have two choices: Bring in a professional caregiver to help full-time until we’re strong again (and get away for 6-7 days asap–break the stress), or shift responsibility to a care facility. If we’re psychologically worn down, do the above.               —Otherwise google to find family counseling agencies, explain your situation and talk with a social worker–possibly a geriatric social worker. Otherwise we effectively help no one.
  • When parents’ physical/health issues (eg. vision, balance, mobility) require living/driving changes to avoid accidents (risk to life and limb).
  • When awareness of terrible decision-making necessitates forcing parents to turn over financial or other responsibilities to us or someone we choose.

REMEMBER

–The option of non-negotiable “force” is always there–unpleasant as it may be. With stubborn parents we may need to be “flat-footed” and use it.

–When parents are old and there’s no immediate pressure to change a situation, adult children who continue to pressure, find many elderly parents eventually give in.

SOME STRATEGIES TO AVOID FORCE, GET COMPLIANCE

One size doesn’t fit all. If we know ourself, one of the following strategies may feel right.

1. When parents strenuously object, if immediate change isn’t necessary, figure out how to back off gracefully, then tread lightly, slowly and patiently–working towards the original goal in whatever way works.

2. The straight-forward approach presents a narrow range of well-thought-out options (not dictated must-do’s). Parents are involved in decision-making. Begin with objective observationMom you sideswiped a car and had a near-accident this week. Then show understanding: Of course it’s upsetting; what do you see as options?  Next, listen, she may suggest something reasonable you haven’t thought of. If not, give options, making certain to include the most acceptable, realistic one you can think of, like infolving a doctor–Do you need an eye exam? (If the doctor says vision is too ify to drive, s/he can be the “bad guy.”)

3.  The light-hearted approach using humorous exaggeration–I know you wouldn’t mind having a chauffeur-driven limo at your disposal every day and if we win the lottery it’s yours; but in the meantime we need a practical plan. Now go back to #2.

4. The majority wins approach is powerful; basically non-negotiable. Needed: at least 1 sibling, preferably 2 or more. If all–or 2 or the majority–agree on what to do, the message is something like: We’ve thought long and hard about this. There’s no perfect solution, but we are uncomfortable with your continuing to drive. Here are the options….”

5.  The easy-way-out: Have a respected “someone else” deliver the bad news: doctor? insurance company?

It’s difficult to be objective where family is concerned, especially parents. They’re our parents. We have a long history (good and/or not-so-good) together. There may be unresolved emotional baggage that prejudices us thus, compounding the difficulty. Realizing this is an advantage. Another advantage: we usually also know what pushes our parents’ ” buttons” and can consciously avoid it.

There’s one booby-trap: past promises that must be broken. If a promise has been made, never to put a parent in a care facility, for example, the difficulty is compounded. Click Mitzi’s promise–she wanted it shared.

We try to help parents age well. “Angels can do no more.” (Grandma’s saying.)

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