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.
Friday, April 6, 2012
Monday, April 2, 2012
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.
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.
Friday, March 30, 2012
LTS Weekly News Roundup
Caregiving in the News:
USA Today: Caring for elderly parents catches many unprepared
More than 42 million Americans are providing care for an adult, and it’s becoming clear that they are incredibly unprepared to do so.
ChicagoNow: Caregiver Stress: Ten Ways Our Thinking Gets the Better of Us
This blogger writes about ten cognitive distortions that caregivers can experience, and how caregivers can readjust their mindset to avoid stress.
Elder Health in the News:
InformationWeek: Elderly Patients Want Docs to Explain Technology
A Linkage Technology Survey just revealed that 4 out of 10 elderly Americans would prefer to have a doctor teach them how to use a medical monitoring device
PsychCentral.com: Bilingual Skill May Protect from Dementia
Bilingualism increases mental health, and this in turn slows the onset of dementia.
Long-Term Care Industry News:
Bloomberg: Genworth Bets on Long-Term Care as Insurers Flee Market
Genworth, unlike many other long-term care insurance companies, is not going to leave the long-term care industry anytime soon.
Chicago Sun-Times: Long-term care benefits come most easily if you know your policy
This article encourages claimants to contact their agency to understand their policy and the filing process, as confusion over this can lead to denied claims.
USA Today: Caring for elderly parents catches many unprepared
More than 42 million Americans are providing care for an adult, and it’s becoming clear that they are incredibly unprepared to do so.
ChicagoNow: Caregiver Stress: Ten Ways Our Thinking Gets the Better of Us
This blogger writes about ten cognitive distortions that caregivers can experience, and how caregivers can readjust their mindset to avoid stress.
Elder Health in the News:
InformationWeek: Elderly Patients Want Docs to Explain Technology
A Linkage Technology Survey just revealed that 4 out of 10 elderly Americans would prefer to have a doctor teach them how to use a medical monitoring device
PsychCentral.com: Bilingual Skill May Protect from Dementia
Bilingualism increases mental health, and this in turn slows the onset of dementia.
Long-Term Care Industry News:
Bloomberg: Genworth Bets on Long-Term Care as Insurers Flee Market
Genworth, unlike many other long-term care insurance companies, is not going to leave the long-term care industry anytime soon.
Chicago Sun-Times: Long-term care benefits come most easily if you know your policy
This article encourages claimants to contact their agency to understand their policy and the filing process, as confusion over this can lead to denied claims.
Tuesday, March 27, 2012
Ideas for Caregiving: Incorporating Items from the Past
Recently, The Sun reported that the Bristol Royal Infirmary has created a ‘reminiscence’ room to treat patients with Alzheimer’s and dementia. This really got us thinking! This idea is a great way to address some of the anxieties that people with Alzheimer’s experience. Many of these anxieties arise from disparities between the environment they are currently in and the environment they last remember being in. A lot of the time, people with Alzheimer’s or other
dementias lose more recent memories first, so they remember their youth more easily as the disease progresses.
Incorporating items from the past into the room doesn’t just soothe anxieties; it offers an opportunity for people with Alzheimer’s to talk about memories associated with those items. It can create an environment conducive to conversation, and let you learn a little bit more about your loved one.
We understand that it might be challenging to remodel a whole room or other living space, but if you are caring for someone with Alzheimer’s, please do try to bring an item or two into a designated space or room to make this concept workable. At the worst, it will be ignored, and at the best, it could let you know more about your loved one and provide some relief from anxiety.
You can read The Sun article by clicking here.
Incorporating items from the past into the room doesn’t just soothe anxieties; it offers an opportunity for people with Alzheimer’s to talk about memories associated with those items. It can create an environment conducive to conversation, and let you learn a little bit more about your loved one.
We understand that it might be challenging to remodel a whole room or other living space, but if you are caring for someone with Alzheimer’s, please do try to bring an item or two into a designated space or room to make this concept workable. At the worst, it will be ignored, and at the best, it could let you know more about your loved one and provide some relief from anxiety.
You can read The Sun article by clicking here.
Friday, March 23, 2012
LTS Weekly News Roundup
Often, it’s difficult for caregivers caring for people with
cognitive impairments to understand why they are behaving differently. This
author breaks down the different brain processes that are affected in that
situation, and how understanding this is beneficial to caregivers.
This article discusses compassion fatigue resulting from
caregiving, and they use Reggie Gooch as an example. He is 98 years old, and
was a full-time caregiver for his wife, Millie, who recently passed away at the
age of 102. The two years he dedicated to caregiving left him mentally,
physically and emotionally exhausted.
Elder Health in the News:
A recent study indicates that a high BMI is associated with
an increased risk of poor cognitive performance in seniors ages 60-70.
Three studies released this past week have indicated that
taking aspirin daily can help prevent cancer in addition to reducing the risk
of clot formation.
Long-Term Care Industry News:
With monthly premiums on existing policies increasing by an
average of 40%, policy holders are trying to determine ways to keep their
policies.
The author discusses several options for creating a
sustainable system to address the current and upcoming needs of seniors.
Thursday, March 22, 2012
Ideas for Outdoor Activities with the Elderly
We’ve been having amazing weather in Massachusetts. So, we can't stop thinking about excuses to get outside. If you’re a caregiver for an aging parent
or elderly loved one, it can be difficult to find activities that will engage
your senior loved one and get them out into the sun. Here are some ideas:
Walking
Walking is a great way to get outside and fit a little exercise into your day.
Photography
Buy a disposable camera for your elderly loved one, and get outside. It’s a fun way to talk about your surroundings and find interesting things to photograph. After, you can put a scrapbook together with the photographs.
Reading
This is a good option if your elderly loved one has mobility issues. If they have vision impairments, you can read to them, or bring an eReader or glare resistant tablet with adjustable font sizes. Find some comfortable lawn chairs and start reading.
Picnicking
Bring a light snack, and head out to a nearby park. You can call ahead of time to see how accessible the park and picnicking area is.
Yard Games
Horseshoes, croquet, and beanbag tossing games are all good options if you’re looking to create some entertainment in your backyard.
Do you have any other additions to this list?
Walking
Walking is a great way to get outside and fit a little exercise into your day.
Photography
Buy a disposable camera for your elderly loved one, and get outside. It’s a fun way to talk about your surroundings and find interesting things to photograph. After, you can put a scrapbook together with the photographs.
Reading
This is a good option if your elderly loved one has mobility issues. If they have vision impairments, you can read to them, or bring an eReader or glare resistant tablet with adjustable font sizes. Find some comfortable lawn chairs and start reading.
Picnicking
Bring a light snack, and head out to a nearby park. You can call ahead of time to see how accessible the park and picnicking area is.
Yard Games
Horseshoes, croquet, and beanbag tossing games are all good options if you’re looking to create some entertainment in your backyard.
Do you have any other additions to this list?
Tuesday, March 20, 2012
Vacationing with an Elderly Loved One
Many times, caregivers caring for senior citizens avoid travel because of some of the hurdles involved with vacationing. Planning a vacation is overwhelming, let alone taking mobility, medications, and other aspects of caregiving for the elderly into consideration. Here at LTS, we think that with a little extra planning, it’s entirely possible to travel with elderly loved ones!
Plan, plan and plan some more:
Extensively research multiple destinations to determine which one will be the most accessible for your elderly loved one. Once you’ve established a destination, figure out the easiest way to travel there. Take time and accessibility into consideration. Would it be easier to take the train? Trains can be more comfortable and less hectic than an airplane, but the travel time may be a little bit longer. Would driving be the best option? Take all of this into consideration, and take your time to research as much as possible. Lastly, contact the transportation company to see if they have senior discounts and accommodations for senior travelers.
Preparation:
Travelers regularly underestimate the amount of paperwork that is necessary when traveling. Make a list of all of the documents you’ll need before you leave, and cross-reference your list a couple of times on your travel day. You need to take all of these documents into consideration:
Passport
License
Medicare Card
Health Insurance Card
Bank Cards
Credit Cards
Checkbook
Tickets
Vacation Itinerary
Medication List
Doctor’s notes
While packing, create a list of all of the items you want to bring. Once that is complete, look through the list again and classify each item as ‘definitely need,’ ‘maybe need’ and ‘don’t need.’ Re-evaluate your list, and try to eliminate as many superfluous items as possible. Remember, the goal is to pack light and pack only what you need.
Travel Day:
The temperature in trains and planes can be unpredictable, so dress your elderly loved one in layers. Wear comfortable, easy to remove shoes. If traveling by airplane, bring extra plastic bags for your items to expedite the security checkpoint process. Go over your necessary documents list, grab the luggage, take a camera, and have fun!
Plan, plan and plan some more: Extensively research multiple destinations to determine which one will be the most accessible for your elderly loved one. Once you’ve established a destination, figure out the easiest way to travel there. Take time and accessibility into consideration. Would it be easier to take the train? Trains can be more comfortable and less hectic than an airplane, but the travel time may be a little bit longer. Would driving be the best option? Take all of this into consideration, and take your time to research as much as possible. Lastly, contact the transportation company to see if they have senior discounts and accommodations for senior travelers.
Preparation:
Travelers regularly underestimate the amount of paperwork that is necessary when traveling. Make a list of all of the documents you’ll need before you leave, and cross-reference your list a couple of times on your travel day. You need to take all of these documents into consideration:
Passport
License
Medicare Card
Health Insurance Card
Bank Cards
Credit Cards
Checkbook
Tickets
Vacation Itinerary
Medication List
Doctor’s notes
While packing, create a list of all of the items you want to bring. Once that is complete, look through the list again and classify each item as ‘definitely need,’ ‘maybe need’ and ‘don’t need.’ Re-evaluate your list, and try to eliminate as many superfluous items as possible. Remember, the goal is to pack light and pack only what you need.
Travel Day:
The temperature in trains and planes can be unpredictable, so dress your elderly loved one in layers. Wear comfortable, easy to remove shoes. If traveling by airplane, bring extra plastic bags for your items to expedite the security checkpoint process. Go over your necessary documents list, grab the luggage, take a camera, and have fun!
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