LTS Weekly News Roundup

Caregiving in the News:
AAFP: Caregiving Affects Health of Three-Quarters of Caregivers, According to National Survey
A national survey conducted by the American Academy of Family Physicians has found that caregiving has negatively impacted the health of 72% of caregivers across the U.S.

Psychology Today: Man the Fixer, Woman the Nurturer – the Caregiving Gender Gap This article explores the gender gap that occurs in caregiving and debates whether or not women are predisposed to caregiving as a result of fulfilling traditional maternal duties.

Elder Health in the News:
TIME: Brain Food: Berries Can Slow Cognitive Decline According to a recent report in the Annals of Neurology, women who frequently ate berries slowed down their brain decline by 1.5 to 2.5 years.

New York Times: The Faces of Alzheimer’s Cathy Greenblat, a professor of sociology at Rutgers, decided to challenge the way the U.S. views Alzheimer’s through a series of photographs and a book titled “Love, Loss and Laughter: Seeing Alzheimer’s Differently.”

Caregiving and the Importance of Laughter

“Laugh when you can. It is cheap medicine.” – Lord Byron

As a caregiver, you can experience emotions such as depression, anxiety, sadness and hopelessness on a daily basis and it's easy to become bogged down. How can you avoid being swept up in all of this emotion and lift your spirits? Laughter! Laughter and caregiving is something that we have touched upon in past posts, but we want to reiterate for a couple of reasons.

It’s important for you to have a sense of humor while caregiving. Full-time caregiving can be a rollercoaster of emotion, and, that being said, you experience very emotionally charged and intense situations. However, throughout the day, there will always be an opportunity for laughter and joy. We don't mean laughing at the expense of your loved one, but being able to recognize the comedy in a situation can be a great opportunity to diffuse some of the stresses involved with caregiving. Something that creates stress in your life now could be a good opportunity for laughter.

If you find that you aren’t finding any opportunities to laugh during the day, find a way to create laughter during your day. You can put on your favorite t.v. show, search on to YouTube, browse social media sites for something funny, or call up a funny friend. Why? It’s incredibly important and good for your health.

Laughter can do all of this and more:

   Reduce stress hormones

   Lower Blood Pressure

   Increase blood flow

   Increase infection-fighting antibodies

   Relieve pain

Put laughing every day on your list of things to do, and you’ll feel the emotional and physical benefits.

LTS Weekly News Roundup

Caregiving in the News:
NPR: One Roof, Three Generations, Many Decisions
In the first of a series of broadcasts, NPR has begun examining how the recent recession has forced many into multi-generational homes. As a result, they will discuss issues of elder care, the costs of caregiving, and the costs of long-term care insurance.

McKnight’s:Caregivers for Medicaid recipients often live in poverty, study finds
UCLA released a study this past week revealing that caregivers providing services to adults using Medi-Cal earn less than $11 an hour and have monthly incomes of $1,970. This is 200% below the federal poverty level.

Elder Health News:
The New York Times: Too Many Pills for Aging Patients
With more than 40% of people over age 65 taking five or more medications, there has been an increasing trend of over medicating seniors which leads to hospitalizations.

TIME: No Regrets! Successful Aging Means Letting Go of ‘What Ifs?’
Research from Science has indicated that adopting a‘no regrets’ philosophy will lead to emotional health later in life. Through a series of chance games, researchers determined that the elderly who readily blamed themselves for circumstances beyond their control were more likely to be depressed.

LA Times: You’re never too old to reduce Alzheimer’s risk with exercise
A recent study tracked 716 elderly people, and the results indicated that the participants who spent the least amount of time partaking in physical activity were more likely to develop Alzheimer’s Disease.

Long-Term Care Industry News:
US News & World Report: Long-Term Care Needs Demand Your Attention Now
A combination of shrinking financial resources and fewer health-care workers is creating an unprecedented health care crisis.

Caregivers: Dealing with Issues of Anxiety and Depression in the Elderly

Caregiving is one of the most emotionally taxing jobs, and it can be even more difficult when you are caregiving for a loved one with depression or anxiety. Sadly, depression and anxiety in older adults is not completely uncommon. Older adults experience a significant amount of loss as the years pass. They experience loss of work, death of friends and loved ones, and their own physical and mental declines. These losses lead to depression and anxiety.

Caregivers are affected by the depression and anxiety of their elder loved ones. It is challenging to care for a depressed or anxious loved one and also take care of oneself. It is therefore very important that caregivers not ignore the signs of depression and anxiety either in their loved ones or themselves.

Here are some things to remember while caring for someone with depression or anxiety:  

It’s not about you. This may be the harshest way to put it, but remember that your loved one isn’t depressed or anxious because of something you are doing. Separate yourself from their depression and anxiety, and this will help relieve some of the feelings of frustration and anger that can develop. Depression and anxiety are clinical diseases and even the most qualified caregivers in the world couldn’t treat them without medication.

It’s okay to take a break. When you’re feeling overwhelmed by emotion, remember that it’s okay to put everything down and take a 15 minute break. Everyone can feel overwhelmed by emotion, and admitting to yourself and your loved one that you need a break is okay. Taking this time for yourself can help you regroup and be support your loved one.  

Know the symptoms of depression. Educate yourself on the warning signs and symptoms of depression. Understanding why and how your loved one is feeling will help you understand the disease more.  

Contact your physician immediately if you notice a change in your moods. If you see any symptoms of anxiety or depression in yourself, seek treatment. It’s easy to think that these emotions will pass, but depression and anxiety are serious illnesses.

Here is a wonderful article from HelpGuide.org about helping people with depression and anxiety while simultaneously supporting yourself emotionally. 

Caregiving and the Boston Marathon

Yesterday, LTS employees had the opportunity to watch the Boston Marathon runners go right by our front door. The runners were incredibly inspirational for many reasons. The runners endured unusually high heat, heartbreak hill, and 26.2 miles to achieve their goal. It got us thinking – caregivers and marathon runners have some striking similarities. Both require incredible self-discipline, motivation, physical and emotional strength and the ability to create and stick to their goals.

Caregivers incorporate all of these things into their daily routine. Caregivers have incredible emotional strength. Dealing with the ups and downs of caregiving, while painful at times, serves to strengthen caregivers and their resolve to help their loved ones. Caregivers experience fatigue, frustration, fear, depression and more, but they endure and continue to care for their loved one with commitment and determination.

We congratulate all of the Boston Marathon runners. We applaud caregivers everywhere! Here are some photos from the marathon to keep you inspired.

LTS Weekly News Roundup

Caregiving in the News:
New York Times: Reconnecting Through Art
The Rubin Museum of Art in Manhattan has been hosting “Mindful Connections” once a month, which is an opportunity for caregivers caring for loved ones with Alzheimer’s or dementia to bring them to a 90-minute art discussion. This is part of a larger trend to use art as a way to stimulate conversation and communication in people with Alzheimer’s or dementia related illnesses.

CNN: Caregiving for loved ones the ‘new normal’ for boomers
43.5 million Americans care for someone older than 50, and with more and more baby boomers retiring, this number is expected to grow exponentially.

Elder Health in the News:
World Health Organization: Dementia cases set to triple by 2050 but still largely ignored 
In a press release issued on Wednesday, the World Health Organization has indicated that by 2050 70% of the population will be living with dementia. This number roughly translates to 115.4 million people, which is three times the current number.

Genworth Financial: Cost of Care Across the United States
Genworth has released their 9th annual Cost of Care survey. The cost of facility based care has increased steadily, and it is expected to continue to grow by an average of $15,300 yearly. Rates for home care providers have seen almost no increase over the past five years.

Long-Term Care Industry News:
InAudit: Long-Term Care Insurance and Three Ways of Buying It!
This article discusses the different LTCI policies and encourages readers to view LTC policies in the same context as home insurance.

Low Impact Workout for Seniors: Stretching

Finding appropriate low impact workouts for your elderly loved ones can be a daunting task for a caregiver. It is important that all physical activities have minimal risk of injury. Walking, while relatively safe is not the only possible low impact workout- stretching is a good way to activate muscles, limber joints and increase blood flow safely.

Some important benefits of stretching are decreased risk of injury and the ability to stretch sitting, standing or lying down. Stretching will improve flexibility, increase your range of motion, and increase overall joint health. This is important for seniors because falls and other accidents are possible if stability is compromised. Having optimal joint health coupled with increased flexibility can help to decrease injuries.

Here is a great piece from About.com about stretching for seniors.

Caregiver Ideas: Music Therapy Playlist 1957

In past posts, we have discussed incorporating items from the past to help soothe people with Alzheimer’s. Here at LTS, we’re always trying to find innovative ways to provide some relief to caregivers and to their loved ones, so we thought that incorporating music from the past would be a great tool for caregivers to use while caregiving. Like items, and possibly even more so, music can bring up memories of the past. It can open up opportunities to talk to your loved ones about their past, and also free up some down time for you!

We put together a playlist of the top Billboard hits of 1957:

1. “Singing the Blues” – Guy Mitchell

2. “Don’t Forbid Me” – Pat Boone

3. “Young Love” – Tab Hunter

4.“Butterfly” – Andy Williams

5.“All Shook Up” – Elvis Presley

6.“Love Letters in the Sand” – Pat Boone

7.“Teddy Bear” – Elvis Presley

8.“Tammy” – Debbie Reynolds

9.“Honeycomb” – Jimmie Rodgers

10.“Wake Up Little Susie” – Everly Brothers

11.“Jailhouse Rock” – Elvis Presley

12."You Send Me” – Sam Cooke

13.“April Love” – Pat Boone

LTS Weekly News Roundup

Caregiving in the News: 
New York Times: The Caregiver’s Bookshelf: A Law Guide for Seniors 
The New York Times New Old Age Blog frequently recommends books for caregivers. In this post, they recommend “Everyday Law for Seniors” by Professor Lawrence Frolik and Professor Linda Whitton.

Huffington Post: Corporate America’s Looking Caregiver Crisis 
U.S. companies lose $33.6 billion a year in lost productivity due to caregiving, but eldercare benefits in the workplace still remain unaddressed.

Elder Health News:
Huffington Post: Will New DSM-5 Diagnosis End ‘Dementia’ Stigma? 
The mental health experts helping to update the DSM-5 have proposed changing the diagnosis of “dementia” to “major neurocognitive disorder.” The reasons for this vary, but one primary goal is to stress a decline as opposed to a deficit.

Long-Term Care Industry News: 
Wall Street Journal: Medicaid Gets Harder to Tap 
State by state, Medicaid program regulations vary, and some states are becoming stricter. It’s becoming increasingly more difficult for families to use Medicaid to help pay for long-term care.

Caregivers at LTS: Karen

“The greatest joy is watching him smile, when he smiles,” said Karen about her father-in-law. “I tell my husband – I just live for that.”

Laughter is one thing about caregiving that brings joy to Karen. Another is taking her father-in-law out to eat fried clams at Red Wing Diner just down the street from her house. The third is having conversations with him.

“He loves having conversation. He has a great sense of humor. If I can just banter back and forth, that makes him laugh. It makes it all worth it for me,” she explained.

Karen’s father-in-law lives with her and her husband in their split level home. They live in the top level and he lives in the bottom level. He has a family room, a living area, a bathroom and a small dinette in his make shift home.

“He’s got everything he needs down there,” explained Karen.

Karen and her husband are the two primary caregivers for her father-in-law, Harvey. He moved in after being diagnosed with vascular dementia and Alzheimer’s disease, and it took a lot to get her father to this point.

Harvey had been successfully living independently in his home since his wife’s death 13 years ago. He had been able to maintain his independence at home for so many years with the help of his eldest daughter. She did his grocery shopping, prepared his meals, did his laundry and helped him with housecleaning. However, his family started to notice a decline. He had memory lapses and frequently repeated the same story. He stopped changing his clothes and caring for his personal hygiene. Things he had been using for years, like the TV remote, became too complicated. The pedals in the car were too close together. He fell frequently and couldn’t help himself up without assistance. The warning signs were all there, and the family knew that he was no longer safe to live alone.

“There were so many indicators that something really needed to change, but that’s such a complicated thing,” she explained. “We knew it was going to end up taking an event to get him out of his home because he was so unwilling to do anything else.”

That event came in October 2011, when Harvey’s daughter found him on the floor of his home. He had suffered a stroke which put Harvey into a Boston area hospital for a week and into rehab for two more months. It was there he finally received an official diagnosis. A CT scan and an MRI revealed the tell-tale amyloid deposits that indicated Alzheimer’s disease, and he was given an additional diagnosis of vascular dementia.

Her spouse assumed the role of Power of Attorney and Health Care Proxy, and they began to transition her father-in-law into their home, despite objections from people who advocated for an assisted living facility or a nursing home. For Karen and her husband, it had been an easy decision. Before the dementia and Alzheimer’s disease had set in, the family had agreed to take her father-in-law into their home if he ever lost his ability to live independently. This was a conversation that her father-in-law had actively agreed too.

“Years ago my husband and I had offered to have Harvey come and live with us if the time ever came that he was no longer able to live alone. It became very evident to all of us that he could not go home by himself, and that he needed to come live with us,” she said.

Eventually, with help from the rehab employees and her family members, Harvey agreed to move in with them That’s where her work experience at Long Term Solutions became incredibly useful. Karen is a nurse care coordinator at LTS, so she works all day long helping families address the care needs of their loved ones.

“My experience at LTS helped me in so many ways,” she explained. “I knew exactly what needed to be done in order to have Harvey come live with us. I knew what equipment we needed, what adaptations would need to be made to provide safety in bathing and toileting, and I knew the questions to ask and where to find resources.”

She credits her colleagues at LTS with helping her find lists of local agencies to provide her with home health aides to help care for her father. They provided her with contact information and email addresses to multiple aides in the area.

“I was even able to find a geriatric nurse practitioner who would come to the house… the employees at LTS were so helpful,” she said.

Her husband went to work measuring assistive equipment, putting up grab bars, and making the downstairs as accessible as possible for her father-in-law. They had almost everything in place, when were told that Harvey didn’t have the appropriate diagnosis for insurance to cover a hospital bed.

“The care coordinators in rehab, a lot of times, they don’t know all of the answers. For instance, I was led to believe if the physical therapists ordered the hospital bed, it would be covered. I found out about a week before he was discharged that he didn’t have the diagnosis for that,” she said.

Another physical therapist suggested looking on Craigslist.

“Our daughter who I lovingly refer to as the ‘Craigslist Queen’ was able to locate a used hospital bed for us within 15 minutes,” she said laughing.

With the hospital bed in place, they were ready to bring Harvey home.

“That first day arriving at our house, Harvey was all smiles, and he was so glad to be with us. That lasted about 48 hours. He slept all night the first night. He was so pleased with his caregivers, the food, our dog, and he even liked our cat! I remember coming to work that first day after Harvey moved in saying how smooth the transition had been.It was amazing! However the next day I came to work singing ‘the party’s over’.”

Harvey was no longer so pleased. While experiencing sun-downing, he gets angry and lashes out at Karen’s husband. He can say many hurtful things about being kept a prisoner in his home. Harvey has moments of confusion and agitation, and he can feel lonely and fearful. He needs help with almost everything, toileting, changing his Depends, showering, and walking. His left foot was affected by his stroke, and the dementia and Alzheimer’s make it difficult for him to remember how to walk. Harvey rarely sleeps through the entire night, and Karen and her husband monitor him with a baby monitor. However, there are things he can do himself, and Karen is working hard to allow him the dignity of doing what he can do on his own.

Karen and her husband have two caregivers for 12 hours during the morning, and they manage caring for him at night. To avoid stress, Karen and her husband go on a date once a week. They make sure they have an aide for every Friday night. They take vacation when they need to. They just took a two week vacation in January, but it’s difficult for her husband to take time off.

There is still an amazing amount of stress involved, even with these breaks. It’s a combination of financial stress, selling her father-in-law’s house, family dynamics, and other things.

“These past three months since Harvey came to live with us have been filled with adjustments for him and for us. Harvey no longer talks about going home to his house, he feels safe with us. He seems to be more settled being in our home. My husband and I have learned so much. This journey, traveling deeper into the world of Alzheimer’s is full of the unknown, it’s dynamic. Just when we think we understand it, it changes. It’s full of fearful moments and joy-filled moments. Whatever it is, we are traveling the road together, supporting and loving one another. To provide care for him is a privilege we would never want to miss. My payment you may ask? It’s Harvey’s smile! ” she concluded.