Wednesday, September 25, 2013

Eldercare Truth: When Making Decisions for Your Parent, Trust Yourself

Decisions, decisions.  If you care for an aging parent, you've got so many decisions.  In-home help vs. retirement living, assisted living vs. an adult family home.  It's enough to drive you nuts!

I work with adult children who make huge decisions on behalf of their parents.  Usually, I'm helping them find an assisted living community or an adult family home that will provide comfort and care.  I listen to their desires, their parent's needs and wants, and of course, we talk about money and location. Then we tour.  More questions surface, and sometimes the "deal breakers"--the things that initially seemed so important--drop off as we see various options.

Often my clients will ask, "If this was YOUR mother, which one would you choose?"  Good question, except I can't answer it for several reasons.

First, my mother has been dead for nine years.  But more importantly, mothers and fathers differ widely in their tastes.  If your parent typically vacationed in a tent when you were growing up, he or she might not feel comfortable in a posh assisted living with all the bells and whistles.  Some elders love communities that remind them of cruise ships on land; others prefer those that resemble country lodges, and still others opt for the bed and breakfast type.

So how do I answer that question, "If this was YOUR mother, which one would you choose?"  I say something like, "Only you can answer that question.  But as you look around enough, you'll know.  You'll be able to picture your parent in that place."

And you know what?  It works.  At least almost all the time.

Monday, September 23, 2013

Eldercare Resource: Support Groups Need These Things to Work

If you care for an aging parent, a support group could help.  Support groups bring people together who might not otherwise know each other, for the purpose of offering specific assistance and encouragement. Effective groups have:

1.  A purpose or purposes--Some focus solely on encouraging members to share their journey with their aging parent or loved one.  That means expressing their feelings, and discussing the direction they see themselves going. The Biblical phrase: "Rejoice with those that rejoice and weep with those who weep," describes this group. Other groups allow members to give feedback to the person who shares.  Still others have an educational thrust, offering information about aging, the disease process, and specific community resources available to caregivers.

2.  A leader who combines strength and compassion--He or she knows the group's purpose and invites participants to join in. When someone speaks too long, monopolizing the group's time, the leader gently yet firmly insists that the person stop so everyone can speak.  I've led support groups, and I know that a leader sometimes breaks the rules effectively.  When a member was suffering with fresh grief,  perhaps having just heard a difficult diagnosis, or having recently placed a parent in a nursing home, I knew they needed more of the group's time to process their feelings.

3.  Defined structure--Support groups work best when they meet at least once a month, at the same time.  Generally an hour to 1 1/2 hours works best. Depending on the group, members may want to exchange email addresses and/or phone numbers, so they can check on each other in between sessions.

You'll note I didn't require that the group leader have an advanced degree in social work.  That preparation would be nice, but effective group leaders often have backgrounds in teaching, nursing, or other types of "people work."

Do you have any experience with caregiver support groups you'd like to share?

Tuesday, September 17, 2013

Dementia Tip: Your Loved One Jumbles the Facts? Slide Back Your Chair

If your parent has dementia, it can be tricky when a care provider asks him or her direct questions.  The nurse says, "Do you have times when you can't make it to the bathroom in time?" Your parent answers, "No."

You know otherwise. So how do handle the dementia version of the facts?  Two responses immediately spring to mind.  Contradicting your parent in front of an authority--even if you're right--doesn't work.  It sets off a chain of defensiveness.  A better way is to wait until after the formal conversation is finished to correct the mistakes in private.

Often my clients teach me things I'd never know otherwise.  Not long ago I observed a third way to handle skewed facts caused by dementia.  An adult child sat next to her father, who had Lewy Body Dementia. Across from them sat a social worker who did his "intake":  a series of questions designed to pinpoint care needs.

As the social worker began to ask questions, it became apparent that the older man's answers didn't match the reality. For example, when the incontinence question came up, the parent shook his head.  "No problems."

His daughter quietly slid her chair back a few feet.  Because of his diminished peripheral vision, caused by dementia, her parent could no longer see her body language.  She "corrected" his answers, simply by nodding or shaking her head, and taking notes on certain points that needed explanation later.

Who would have guessed that simply sliding a chair could have made such a big impact in ferreting out the truth while maintaining an elder's dignity?  We listen.  We learn.  We grow.
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