Wednesday, May 23, 2012

Eldercare Q-A: Mom moved to assisted living, but she's more confused than ever!

A common eldercare situation: dementia causes your aging parent to move to assisted living. Upon the move, he or she is more confused than ever. What's up?  Assisted living offers just what the doctor ordered: structure, supportive staff, meals and personal care. But for awhile, things are topsy-turvey.

Why the increased confusion? Throughout his or her life, your aging parent successfully navigated through change. He or she adapted to new stressful situations, be it college, a first apartment, or a new workplace. During the first few days, things were forgotten--the umbrella, briefcase, or coffee mug. But soon, the short-term memory clicked in, relaying the information about the new surroundings to the long-term memory.

Your parent's transition to assisted living is drastically different. Now, with dementia, the short-term memory is diminished. Before moving to assisted living,  your parent kept things barely afloat by relying on the long-term memory. He or she knew the location of the living room and the kitchen and how to find the bathroom from the bedroom at night.

In assisted living, his or her new home, everything is upside down.  Where's the dining room?  How is the laundry done? Confusion, confusion at every turn.  How do you, your parent, and the staff handle this successfully?

Assisted living staff in Washington State, and throughout the country, are required to take specialized training in dementia. They know that a new resident will need extra time and attention, which may include reminders about wake-up time, escorts to meals, invitations to activities, etc. You can help, too, by setting up the room ahead of time with special furnishings and belongings.  During the first few weeks, make an effort to eat some meals with your parent in the dining room.

The good thing is that generally, the confusion will improve after a few weeks. The new home will seem more like home, and your parent will seem more like himself or herself.

Sunday, May 20, 2012

When I Die...Thoughts on Talking to Your Aging Parent about Death

Death. Have you and your aging parent talked about it? It's difficult, without a doubt. Yet allowing your parent to express his or her end of life wishes can be sacred, for all.

Trudy James knows. A Seattle-based trained hospital chaplain and Episcopal lay minister, James has facilitated end-of-life planning groups for years.

"People can solve their own hurts if they're listened to," says James. "Your job (as adult children) is to listen without talking, allowing them to tell you what they want."

But how to start? Be open-ended so your parent can fill in the blanks with what they desire, James advises. One idea is to ask your parent to complete the sentence, "When I die, I want..."

Typical answers include:

1.  When I die, I want things to be in order. Your parent may be adamant about dressing drawers being straightened, wills being finalized, or dishes, trinkets or antique guns parceled out to children.

2.  When I die, I want my loved ones to be OK.  That may mean adult children and others are provided for financially. Or it may mean a desire for emotional and spiritual peace, with kids getting along.

3.  When I die, I want a peaceful death.  At life's end, your parent may have specific requests such as music playing, scripture being read, an absence of pain, etc.

4.  When I die, I want to know my life mattered.  This statement speaks to the idea of legacy and may take many forms:  verbal or written blessings for loved ones, donating organs for research, giving money for significant causes, etc.

5.  I want my physical body to be laid to rest. Knowing your parent's preferences regarding funerals or cremation, and the specifics of the chosen method, allows you to do everything within your power to implement their wishes.

The sentences above can be boiled down to two basic questions:  "What are your parent's wishes?" And "Who will carry out the wishes?" For specifics on starting the discussion, check out

Trudy James presented this material earlier this month at the Seattle Senior Care Coalition, a group of professionals in the senior care field.

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