Saturday, December 22, 2018

Faith at Life's End: Dealing With the Ups and Downs

Faith at life's end can blossom, or it can flicker.

For Karl Krienke, faith was his firm foundation.   Listening to the speakers at his memorial service a week ago, I couldn't help but pick up that theme. A professor emeritus, he taught at Seattle Pacific University for 44 years in physics, mathematics and computer science. He earned a doctorate in astronomy and felt confident that discovering the universe brings us closer to the Creator.

Ordained as a minister in the Free Methodist Church, he combined theology with his love for science and astronomy.  At one point he said, "We are in the process of discovering God as greater than we even envisioned before."  That faith carried him to the end.

Faith, for others, though, is difficult at life's end.  The minister who delivered the sermon at Karl Krienke's funeral spoke of his mother's fear she had lost her faith.  She had served God faithfully as a missionary in India for years, and had devoted her whole life to God.  But at the end, she doubted herself and wondered, "Will I go to heaven?"

"I just can't hold onto God," was how she expressed her uncertainty about the future.

That angst about being worthy enough to go to heaven isn't uncommon among those who were raised in the early to mid 1900s in conservative churches.  A brand of Christianity banned certain practices such as drinking, dancing, wearing jewelry, playing cards, etc.  The emphasis was on works; and the insinuation was that doing or not doing certain things proved you were a true Christian.

My father was raised in that culture.  In his last days, he agonized over his eternal destiny.  "I don't know if God can forgive me," he would say.  No, he hadn't committed the unpardonable sin.  Not even close.  He was a Christian pastor who had worked tirelessly in helping people understand and live the Gospel.  Somehow now he was stuck on his unworthiness.

It broke my heart to see him suffer so.  I prayed for guidance in what to say, besides "I'm so sorry."
After I finally got up the nerve to speak, I said, "Daddy, do you remember what you told us so many years ago about God's love?  That God loves us no matter what?"  I promised him that every time I spoke with him I would remind him of God's love.

And what about the elderly missionary woman who was sure she lost her hold on God?  I'm sure her son thought a bit about what to tell her.  He said, "I know you think you can't hold onto God.  I want you to know something.  God is carrying you, holding you tight, and he won't ever let you go."

Monday, November 26, 2018

Eldercare Q-A: Assisted Living, Memory Care, Which does Dad Need?

A client is asking:

My 85-year-old dad has been healthy until now.  He's beginning to shuffle which I know can be a sign of Parkinson's or Alzheimer's.  His  younger brother has Alzheimer's and lives in a Memory Care Community.  Dad hasn't been eating, he no longer drives and he lives in an isolated community near a mountain pass.

I want to know:  What's the difference between assisted living and memory care?

My answer:  

In Washington State, assisted living communities, including memory care communities, are authorized by law to do heavier care than in most states.  However, the level of care here varies.  Here's what I mean:

Light to moderate care assisted living--These communities focus on activities and provide light care such as medication management, help with bathing and dressing, and cueing.  Residents with dementia can live here as long as they have no behaviors which would potentially endanger themselves or others.  No exit-seeking, wandering into other resident's apartments, or socially inappropriate behavior.  In addition, these light to moderate care communities usually can't care for people who need a lot of help in the day or night.  If a person has a diagnosis of dementia, they might need to move to memory care in another building later. 

A building with both assisted living and memory care in the same building.  This type of building has separate areas for assisted living and memory care.  Alternately, there are two buildings--and two programs--side by side on the same property.  The memory care residents have a program specially designed for their needs.  It is a quieter setting with higher staffing than in assisted living.  It is secure so residents can't leave the building.  In memory care residents are able to receive care that includes feeding and behavior management.  People often will move into the assisted living area and move to memory care when their dementia advances.  

Stand-alone memory care communities--A resident in this type of community must have a dementia diagnosis.  Generally residents have varying degrees of dementia. Some are pleasantly confused.  Others have significant dementia.  Like other memory communities, and many assisted living communities, residents can generally stay through end of life. 

A little complicated?  I sent this brief explanation with examples to my client so we can discuss which type of community he would prefer.  Families have different priorities.  Some absolutely don't want Dad to move twice.  Others want a great fit now and if necessary will move Dad later.  Touring several communities may help spotlight the one that works best.

What experience do you have with memory care?  Has it been positive?

Friday, November 23, 2018

Eldercare Resource: 'Nancy's Lifts' does more than give rides to seniors.

Nancy Balin, owner of Nancy's Lifts
Nancy Balin owns a business, to be specific, a transportation network company.

It's called Nancy's Lifts. She drives seniors and others to places they need to go:  doctor's offices and hair stylists, meetings and outings. And even to the airport.  Many of her clients are debating on whether to give up driving altogether or to adapt to a new lifestyle that requires minimal driving, so they are relieved to have as an alternative a safe, known driver like Nancy.

There's more to this story:  a year ago Nancy worked as a lawyer while heading a fledgling not-for-profit organization called Family Jewels Foundation.  Its mission was to save young men's lives by alerting them to the symptoms of testicular cancer, the number one cancer in the 15 to 44 age group.  Nancy had been personally affected when her 20-year-old son died of the disease.  Early detection likely would have saved his life.

Speaking about testicular cancer and fundraising for her foundation  takes lots of time.  So Nancy retired from the lawyering and launched the driving business, to help pay the bills. 

First she passed an extensive  defensive driving course, got her business license and met the other state requirements.

Why do her clients--seniors and others--choose her?  Nancy has lived in the Bothell/Woodinville area--her main service area--for over 15 years. She is well acquainted with Western Washington.

"I'm local. I know how to navigate.  I speak English well, and I have references," she says.

"I have elderly parents.  So I treat my senior passengers like I'm driving with my parents."  That means reminding them about packing the C-Pap Machine, their ID and their medications.  It means Nancy putting the belongings and luggage into the car herself.  It may mean pulling the walker out of the trunk and escorting the senior into the doctor's office instead of dropping them off at the curb.  

Often her passengers will ask her about the rest of her life, and she says, "I'm doing this to help me be able to save young men's lives."  She often asks people, 'Do you have any males in your life ages 15 to 44 whom you care about?' Many of them do."  So Nancy educates them about testicular cancer, in the hopes that their families won’t have to suffer the way hers has.

Nancy is giving seniors and others a lift while working to save the lives of young men.  For more information about Nancy's Lifts, call 206-550-9570.

Monday, October 29, 2018

One Woman's Story: For the Love of Dad, She Did the Near Impossible

'Tis the season for cheerleaders.  Not always the ones waving pom poms and working the crowds at football games

Take a Boomer named Dianne.  A week ago she called me in a panic.  Her father's significant other had died just two days earlier.  Dianne's dad had dementia, and she was his only living relative.  She'd already been riding a roller coaster of emotions in the light of the recent loss when she found an elderlaw attorney a few days later.  The attorney gave Dianne my name and I found myself helping her sorting out the details that would put her dad's life back together.

1.  Step One:  Finding the money for her dad.  Dianne wanted to find an adult family home for Dad within an hour's drive of her home  But how to pay for it?  All she had was a checkbook, and credit cards with debt.  She needed a current bank statement.  And her name wasn't on the account.  So she went to the bank and pleaded their case.  Her dad was able to tell him this was his daughter and he wanted her to handle his money.  One down.

2.  Step Two:  Finding a new home.  With an accurate statement of assets--a bit more than Dianne had thought--and a statement of monthly income, Dianne was able to approach the adult family home that I had helped her find.   She and her dad visited the home and met the residents--all men.  And Dianne's dad struck up a conversation with one of them.  They liked the home.  Best of all, the owner would allow him to convert to Medicaid funding after six months.  The owner contacted the doctor and began arranging for admission.  Two down.

3.  Signing the power of attorney.  That document was needed for Diane to assume responsibility for her dad's move-in and other financial, legal and medical matters in the future.  So she set an appointment with the elderlaw attorney she had talked to a few days earlier. Her dad was losing competency, but knew her and could agree in front of the lawyer that he wanted his daughter to take care of him.   Three down.

What an amazing daughter!  She should be named "Daughter of the Year!"  Her dad will move into his new home in two days, and the whole process took eight days from start to finish.   I'm so impressed and proud to have been part of her team.

Sunday, September 30, 2018

Silver Age Referrals: When High Tech and High Touch Meet, Families Win

What does a great database have to do with helping find the best assisted living and adult family homes?  What does an amazing database do for people searching for what could be their loved one's final home on earth?

Plenty. At Silver Age Housing & Care Referrals, where I work, we have a team of professionals who love to help families.  While our primary job is to work with people finding housing and care, we bring to the work an incredible array of skills and experience including occupational therapy. caregiver support, administration, finance and marketing.   We share information.  We help each other as we work with families in King, Snohomish and North Pierce Counties.  And all of us
have personal experience with helping our family member or members with a difficult transition.

Did I forget to mention our extra team member?  It's a super database, without which we'd be lost, frustrated or at the very least hampered in our efforts.  And while the database isn't human, it gives us the information we need to seem superhuman.

In King County alone, there are 1100 adult family homes, plus several hundred assisted living communities.  We're able to update records on our 600-plus partnering organizations, and search for so many categories.  We can find an adult family home in Bellevue where caregivers speak Japanese.  And other homes with experience in Huntington's Disease, Multiple Sclerosis and more.

We know which adult family homes can take Medicaid funding immediately.  I wish there were more!  And homes that take Medicaid after a certain number of months or years.

It's so gratifying for us to find just the right fit for a person's unique needs.  Even if someone has the same diagnosis as another client, they each have a different combination of needs.  This summer we celebrated 10 years of serving seniors, and we are still finding this to be true.

How did we get such an incredible database?  Our owner, Abby Durr, founded Silver Age in 2008.  After a year or two of working with spreadsheets, she realize she needed something more sophisticated to track all the vital information.

Hence the fancy data base.  She got some help, big time, from her husband, an IT specialist.  We like to call him our 12th Man. And while the work of Silver Age is high touch--we meet face to face or voice to voice with people whenever we can--the high tech feature can't be beat.

Thursday, September 20, 2018

Senior communities: For profit? Not-for-profit? The Kenney tells the story well.

When it comes to eldercare, be it retirement and assisted living  or home care, many people choose the not-for-profit model.

I'm on the Board of Directors for The Kenney, a continuing care retirement community in West Seattle.  I've also been employed by three other not-for-profits since I began working in the eldercare field in 1994.   Here's what I've discovered:

What sets not-for-profits apart?

1. Not-for-profits are mission-driven and accountable to the community at large. Many are connected with a church or a hospital, and their responsibility to the broader community is well defined. Their tax exempt status presupposes the practice of "giving back." That's certainly true of The Kenney, a faith-based community.  If residents run out of money, or outlive their money, a benevolence fund through The Kenney Foundation may be available to help them pay their monthly fees.  This allows them to stay and continue to live a purposeful lifestyle.  The Kenney also gives back to West Seattle.  Groups including the West Seattle Pastors Group, Tiny Tots and West Seattle Chamber of Commerce meet here regularly. The Kenney Foundation will soon be sponsoring a fundraiser for veterans.

2. Corporate investors don't set the organization's policy. Boards of directors, who are community volunteers, work with management and administration to make the key decisions which are in line with the community's mission. At The Kenney, as in other not-for-profits, board members are experts in their respective fields of finance, education, health care and ministry.  Another difference: extra dollars go, not to stockholders or owners, but back into the organization, to improve staffing ratios, train employees and build innovative programs that make seniors smile.

2. 3. In general, not-for-profits do a better job of retaining their high quality employees. I've watched the senior communities I've worked in do many things--big and small--to attract excellent caregivers and other employees and to keep them. In-services, scholarship opportunities and specialized training build staff morale and increase tenure. So do simpler things like the monthly staff meetings where all departments can set common goals and celebrate those with five years of service, ten years, etc.  At The Kenney, many staff in the dining services and caregiving staff have worked there more than 15 years.  The Kenney has a staff member celebrating 34 years of service this month!  The big plus?  She knows every resident by name.

For more information on not-for-profit eldercare organizations, contact their national association, Leading Age.

Friday, August 31, 2018

Certified Senior Advisors Offer Ethics Plus Knowledge to Their Clients

"Are you a nurse?"

I'm asked that question from time to time.  My answer:

"If I were a nurse, all the patients would die the next day."

I have a fair amount of medical knowledge, most of it acquired through osmosis by working in a nursing home for 12 years with seniors and their families.  But I'm not a nurse.  I have great respect for nurses, though, and I work alongside of them as our company Silver Age Referrals  helps families find assisted living and adult family homes for their loved ones.

I'm not an elderlaw attorney, either, yet I refer people to those experts in the law on subjects including Medicaid.  Neither am I a physical or occupational therapist, yet I know how valuable these professionals are to what Washington law calls "vulnerable adults."

From the organizers/planners, to the Realtors specializing in working with seniors, to the Geriatric Care Managers who oversee the care of elders on behalf of families, professionals helping seniors run the gamut. 

In the best of worlds, we work together, pooling our skills and expertise to benefits seniors.

If my client needs help I can't provide, I refer to a professional.  But how do I know that this person will have, in addition to knowledge and expertise, the ethics needed to work with "vulnerable adults" and their families?

One helpful factor is the CSA alongside the professional's name.  That stands for Certified Senior Advisor.  It means membership in a national organization called the Society of Certified Senior Advisors.

Members study and pass a test on a broad-based curriculum that includes senior-related topics including:  Trends in Aging, Physiological Changes in Aging, Mental Health, Grief and Loss, Caregivers and Caregiving, Chronic Illness, Cognitive, Aging, End of Life Planning, etc.  There are also segments on Estate Planning, Financial Choices, Long-term Care Coverage, etc.

The organization requires continuing education, as well.  One of the most important aspects of the Society is its strong emphasis on ethics.  If members get into trouble ethically, there's a process which can lead to censorship or ousting from the organization.

I'm delighted when I can refer to a professional who is a CSA.  Not because they're perfect, but because they know how to treat seniors and their families ethically.  They know how to do the right thing.

Tuesday, July 31, 2018

Help for the Caregiver, Family: A Calendar & Friends

As a little girl, I attended more funerals than most adults today do in their lifetime.  A pastor's daughter in the Midwest, I sat in the front row with my little sister, while Mother sang a solo and Daddy preached the sermon.  Mostly I remember the food:  Jello salad, fried chicken, mashed potatoes.  Yes, and cookies, pies and cakes.

Community, so important in the 50s,  has waned.  Yet the needs, not just during the time of death, but during extended illness, are still there.  How do we cobble together a caring community which allows us, in the words of Scripture, to "bear one another's burdens?"  How do we help caregivers get a break from the important work they do so they can be revived?

Care Calendar is a great help.  This program organizes needs so others can meet them. The recipient lists needs:  meals, visits, light housework, transportation to medical appointments, etc..  Friends and family sign up on the calendar for the tasks they choose.  The program also sends reminder emails a day ahead of the assignment. And each group of helpers has a leader to keep things running smoothly.

My friend Lupe is our recipient.  She is fighting cancer and needs all her strength for the battle. I do what I can when I can do it.  So far, it's been bringing a cooked meal and visiting with her.  Others fill in other gaps.  They clean her house, drive her to chemo appointments and stay with her.

Care Calendar was born when a mother of nine children had a serious illness, and her husband needed a simple, organized way of telling the family's story and the needs of each family member.
It has so many applications, however, but particularly for the caregiver and the person in need.

What do you think of the CareCalendar idea?  Could it help you or your friends?

Wednesday, July 25, 2018

Caregiving, illness and stress: sharing the load

Are  you overburdened?  Or do you live or work with someone who is?  Aging parents, or aging, period, can bring overwhelming stress to all.

I've been thinking a lot about this subject, so I turned to the Bible.  It turns out that in Galatians 6, in the New Testament, there are two references to burdens that may at first seem contradictory.

"Bear ye one another's burdens" in v. 2 seems to indicate that we are to help others who are overwhelmed by life. Yet in v. 5, the command is that "every man should bear his own burden."  Which is it?  Or can it be both?

There are actually two different Greek words for burden.  Baros in v. 2 refers to an overloaded ship, with cargo so full that it's in danger of taking in water and sinking.  Picture a person or a family in that situation.  Their physical and emotional resources are shot.  They don't know where to turn.  They have taken on so much cargo, otherwise known as baggage, that they feel they're sinking.  They need help!

The other Greek word for burden, found in v. 5, is Phortion.  Another nautical word, it refers to the normal load a ship is designed to carry. If a ship is to sail properly, it needs a certain amount of cargo.  If it's empty, it cannot set full sail and make full speed, and it tosses and pitches violently in rough seas. The analogy works in life, too.  We need some stress to produce and to feel alive.

In another explanation of the burdens, the one  mentioned in v.2 is like a bolder that no one can roll up a steep hill.  And the other burden in v. 5 is like a backpack that we can strap on and navigate through life.

Bottom line, we all have burdens from time to time, and we're given strength to carry them or to allow others to help us.  And we can reach out and assist others whose burdens are otherwise unbearable.

Another blog post soon will cover a way people can team together to help families facing illness.  Stay tuned.

Thursday, June 28, 2018

Moving from Rehab to a New Home is Easier Said than Done

Six professionals, all working in the senior care field, gathered around a table for a general discussion.  One of them, Susan, recently stepped into an unfamiliar role, a role that was fraught with obstacles.

Susan's mother had been living independently when suddenly, due to illness, she landed in the hospital and then in rehab. The doctor's verdict was that she could no longer live independently.  Assisted living, or possibly an adult family home, seemed the best answer.

Susan started the search but found that finding a great place for her mother was easier said than done.  Yes, she had experience working with seniors and their families.  But she needed more than the list the social worker gave her.  Another issue:  the social worker had little time to help people. 

Speaking of "the list," Susan said, it was difficult to work with.

"Assisted living communities and adult family homes were grouped alphabetically by city.  But some cities are so spread out that it takes a lot of effort to find these places.  The list had facilities that no longer existed.  Pricing was missing from the list, as was any kind of description regarding the care provided.  And there was nothing about availability."

After many calls and some visits Susan finally found a new home for her mother.  Yet she realizes there has to be an easier way.  Perhaps hiring a geriatric care manager?  Or working with a good referral agent?  Both those options can make the job easier.  Speaking of referral agencies, Silver Age Referrals can help. 

Sunday, June 24, 2018

Beneath the Surface, Seniors Want to be Seen

Texts, emails, Facebook?  With seniors and their families, these communication modes have limits.  They're great for conveying simple information like dates and times, and yes and no.  However, when we want to learn about the "real person," and want them to learn more about us, we need to go face to face or at least voice to voice.  A simple telephone call or visit can reveal our client's likes and dislikes, distinct personality and sense of timing.

I learned about face to face or voice to voice contact at a young age.  My father was a minister in a small church of between 100 and 150 members.  One of his goals was to make 60 or 70 monthly personal visits to families.  That number seems staggering, but he did it!  He knew the family with the sick grandpa living far away and the one with the teething toddler.  He knew about rebellious teens and out-of-work dads.  I remember him talking down an alcoholic by phone in the middle of the night, and leaving our house to visit the dying.

Decades later, I still value the idea of voice to voice.  Personal contact allows us to see the person, inside and out, if you will.  And with seniors especially, that's very important.  I've made assumptions about elders by hearing statements from their loved ones, such as "My mom is you know, like any other 85-year-old lady with a walker, grey hair and glasses."  When I actually laid eyes on the woman, I got a completely different picture.

Today I read a newspaper article by Hannah Brencher, author of "Come Matter Here."  In it she talks about a simple prayer she uses to direct her life, one word at a time.  It's "Reduce me to love."  She shares a story of a disheveled homeless man who enters their church, starts playing his harmonica in the foyer, and says to Hannah, "Look beneath the surface.  Beneath the surface, we all just want to be seen."

I think that especially applies to seniors.  Beneath the surface, like all of us, they all just want to be seen.

Thursday, May 31, 2018

Eldercare Q-A: Dad needs care; Mom won't budge. What do I do?

A client asked me this question a week ago.  More specifically, she said,

"My dad has dementia, and my mom is trying to care for him.  It's not working.  She asks him to take a bath, and he doesn't.  Same with brushing his teeth.  He's not defiant; he just forgets.  Almost immediately. Mom refuses to hire outside caregivers; the only outside caregiver she will accept is me. I work two jobs and can't help any more than I do now.

"They have money.  It's not the issue.  But pride is.  I'm almost wrung out from the stress.  Yes, I love both of them deeply. What can I do?"

My answer to her and to others in the same, or similar boats:  I'm so sorry you are in this difficult situation!   You seem understandably torn, wanting to help your parents while maintaining a sense of sanity. Since your mother is competent, though stubborn, it's impossible to force her to accept help for her husband, either in the home or elsewhere.,

There are some things you can do, though, to make the situation bearable until something changes.

1.  Increase your personal support.  Support groups allow you to vent your feelings, and to hear from others, so you don't feel so alone.  There are Alzheimers Support Groups throughout the country.  They encourage caregivers, both spouses and adult children.  And they offer information and resources.

2.  Visit assisted living communities which have memory care areas, so you can get an idea of what your parent or parents might need when the time comes.  Start with research online to get the basics, and later do on-site visits.

3.  Consider hiring a geriatric care manager.  A geriatric care manager understands the needs of the elderly and of those with dementia specifically.  He or she can ask a lot of questions about your parent's situation and come up with a plan of action that will benefit the entire family.

4.  See if your parents will agree to care on a trial run of home care, or a temporary "respite" stay in an adult family home or heavy care assisted living community.

Monday, April 30, 2018

Decision Fatigue: Do you suffer from it?

I first heard the term "Decision Fatigue," in church last Sunday.  The more I thought about it, the more I realized that pretty much all of us who work with seniors, or are seniors, have it to some extent.

We tire when we make too many decisions.  On average, we make 35,000 decisions a day.  Big ones, little ones,  What to wear?  What to eat?  What to buy?  And the list goes on. 

No wonder at the end of the day, we're fatigued.  When we make too many decisions over a day's time, we are more apt to go for a candy bar, or make a bigger decision that's not in our best interest or in the interests of others.

So what's the cure?

In general:  Stop being the decider of everything.When you can, delegate tasks or stop doing them. according to "The Cure for Decision Fatigue , from Jim Sollice in The Wall Street Journal.  The Internet can be a real energy drainer.  When you click on the Internet during work time, you're allowing fatigue to set in.

For adult children:  Use mornings to schedule a talk with the administrator about your parent's care.  Certainly don't opt for the end of the day when you are both tired. Late morning is often the best time to discuss important topics with your aging parent.  You haven't made too many decisions; you are relatively fresh and can give the conversation your best.

Saturday, April 21, 2018

Everyone Needs More than One Mother--Why and How?

"Everyone needs more than one mother.  I borrowed that phrase years ago, and it's proven true.  

Many of us lose our mothers well before they die if  mental illness, dementia or other diseases take away much of who they are. 

"She's just not the same," many adult children say about the "new mother" who often seems like a different person from her former self.  Her new behaviors--saying things that don't make sense, forgetting, fibbing, being overly defiant or overly needy--seem confusing.  Once in awhile, the mother her children remember from before her illness shows up and children may be pleasantly surprised.  I've heard: "She recognized me.  We had a short conversation and she actually made sense!"

Confusing?  You bet.  My mother was chronically mentally ill and passed in 2004.  Toward the end of her life dementia also set in.  When I grappled with her behavior and with my response, professionals would say things like,  "Embrace the person your mother is now.  And embrace the other mother, the one you remember."

I tried.  I didn't totally succeed, but I gave it my best shot.  And I also grieved the mother I'd lost years before.  Now that I'm working with adult children who are making important, difficult decisions for their aging parent,  I'm convinced that the grieving and acceptance go hand in hand.,

But my premise:  "Everyone needs more than one mother," still seems true.  Many of us don't have the "model mother" even in childhood.  I know my children didn't. But God often puts others into our lives who can make up the difference in filling that maternal role.  In my case I had substitute mothers throughout my life including my youth group leader who taught me how to back pack, an elderly, wise woman who cheered me on as I began to write professionally, and a good friend who kept me afloat during my kids' teenage years

Like many of you, I've ended up in the mothering role as well.  These days I fill those shoes as I help adult children find placement for their aging parents.  It's a difficult role, and it's my pleasure to help. A long time ago, in college sociology class, our working group named leaders.  My classmates named me the emotional leader.  Kind of like a mom.

Happy Mothering!

Friday, March 30, 2018

Adult family homes, assisted living: good but not like heaven

"This side of heaven, you won't find a perfect home."

Some 20 years ago I heard that statement.  And it certainly rings true, today.  At Silver Age Housing & Care Referrals, where I work helping families find quality housing and care, chiefly assisted living and adult family homes, we do our level best to rise to the standard of the heavenlies.  But the truth is:  no one can find the perfect home.

That doesn't keep us from trying.  We take our "matchmaker" job seriously, to find homes that will be good fits.  Together with the family, we search for a home that will make their loved one feel comfortable and cared for.

The search isn't always easy.  Take Rick and his family.  At 63, he was one of our youngest clients.  He had suffered Traumatic Brain Injury as a result of a motorcycle accident at age 22.  For the next 41 years, he lived with his parents, until their physician told them, "No more."  The stress was building; they needed a break from caregiving. 

What does Traumatic Brain Injury look like?  That depends on what part of the brain is injured.  Some people have seizures.  For others, behavior and personality are affected.  Anger erupts for seemingly no reason.  And nearly all TBI patients have short-term memory loss.

That was Rick's issue.   He remembers his high school days in detail, and events up to the time of the motorcycle accident.  Today he is pleasant and polite, but won't remember any conversation 15 minutes later.

He and his parents talked about his needs for a new home in what we describe as an intake.  It's a key part of our process, because we can't find the best home for anyone unless we discover not only their diagnoses and medications, but what makes them tick.

So we drew up a list of must-haves:  1.  The chosen home had to fit the family's budget.  2.  It had to be within 15 minutes  from the family home.  3.  It needed caregivers who were highly experienced and who could learn more about Traumatic Brain Injury and how it compares with dementia.  4. Preferably there would be one or two younger residents and at least one male caregiver. 5.  It must allow smoking outside.

 I looked for these qualities in the homes I researched and visited. The top three homes were the ones we toured together.  Rick and his family liked one home especially, and two weeks later, he moved in.

Today I visited.  Rick seemed happy.  He didn't remember seeing me before, but that's part of the condition.  He walks outside from time to time, something he had always enjoyed.  He likes the food.  And he has bonded with the male caregiver.

Is this adult family home heaven?  Of course not. He has only been there two weeks.  Give him two more weeks, and he will feel more and more at home.  In the meantime, the caregivers are enjoying him.  He helps with the laundry, folds and puts away his clean clothes, and looks for other things to.  "I like to help," he says.

Monday, March 26, 2018

Why Loneliness Kills Seniors--and Some Ways to Combat It

What is the greatest health threat in the aging population?
  • Smoking?  No, but don't start the habit now.
  • Obesity?  Bad, but it doesn't rise to the top.
  • Cancer?  Very dangerous, but something else has it beat.
The answer:  Loneliness. 


Bruce Frankel isn't.  He explored the topic last December in a presentation "The Loneliness Epidemic" for a national group called The Society of Certified Senior Advisors.  If you work with seniors, have an older parent or relative or you are a senior yourself, this information could help change a life.

"Isolation and loneliness constitute the greatest public health hazard for the aging," said Frankel, quoting John Cacioppo, who headed the University of Chicago's Center for Cognition and Social Neuroscience until his death earlier this year.

Some 42.6 million seniors suffer from chronic loneliness, caused by factors including a loss of social confidence, and a loss of friends and social contacts as their world shrinks, Frankel says.

Here are frightening results of loneliness:

1.  Lonely people have a 50% greater risk of early death compared to those who have social connection.

2.  Loneliness increases the risk of stroke by 32%, dementia by 64.9%.

3.  Loneliness affects the body's physiology:  it increases cortisol, damages white blood cells, impairs the immune system and increases inflammation.

More affects of loneliness, according to Frankel:  "When we're lonely, we become hypervigilant.  We perceive more danger than we otherwise do.  We become hypervigilant to signs of rejection and judge our relationships weaker than they are.  We are more defensive, more aloof."

Steps Away From Loneliness:

1.  Don't deny it.

2.  Understand what it does to the body and especially the brain, and how it interferes with interactions with others.

3.  Respond.  Find at least one person to trust.  As you move forward, seek out like-minded people to connect with. Consider volunteering.

4.  Expect the best. 

Do you have personal experience with loneliness?  How do you and/or others combat it?

Wednesday, February 28, 2018

This eldercare blog celebrates 250-plus posts!

In 2010 I hatched a dream.  Incubating in my mind for months, the dream came to fruition in this blog.  For years I'd worked with adult children as they grappled with issues relating to their aging parents.  I'd had my own struggles with my parents who had died several years earlier.

I reasoned, "Why not use what I have learned and would continue to learn to help others?" Specifically I wanted to educate, encourage and applaud Baby Boomers as they sloughed through a real-life course they'd never studied in school.  After all, who takes a class on "Everything you ought to know about understanding your aging parent?"  I was a writer, so the written word was my medium, and this blog, Boomers Guide to Eldercare, launched in 2010.

Time flies.  I realized a few weeks ago that I'd published the 250th post.  So I celebrate this milestone a bit late, which is my style.  This post is number 252.

Publishing a blog is an educating process.  Over the years, I interviewed and took courses from doctors, nurses, social workers and more.  I learned the most from my clients who often took heroic measures to advocate for their aging parents. The original blog labels, "Know Yourself," "Know Your Parent," "Communicate With Your Parent," and "Advocate for Your Parent" expanded tremendously to include posts on faith, caregiver helps, end of life and hospice.

Readers today have shifted a bit from the early days of this blog. Besides adult children, there are Boomers who are looking ahead at health care options for themselves, and lastly, senior care professionals such as marketing directors, social workers and administrators.

A few of my favorite posts?  "One Woman's View:  Mom's Mental Illness is so, so sad," "Faith and Dementia:  One Man's Story," and "On Giving Up Worrying (About My Aging Parent) for Lent."

If you've read this blog before, what do think of it?  Do you have any topics related to eldercare you would like to read about?

Sunday, January 28, 2018

Note to Adult Children, Senior Care Pros: Mind Your P's &Q's

Mind your P's and Q's. 

If you're a Millennial, you might say, "What?"  But if you're a Boomer, chances are you heard this phrase growing up.  Many times.

Translated, Mind your P's and Q's is "Mind your manners," "Mind your language."  "Be on your best behavior."

If you work with seniors or if you have an elder in your life, I'd like to suggest another meaning for the P's:  three words that are important, for one reason or another.

PATIENCE--We know that seniors walk more slowly, so we change our pace to meet theirs.  Other parts of their bodies also require us to adjust.  We speak distinctly and sit face to face when we know they're experiencing hearing loss.   But what about decision making?  For many independent seniors, a decision like giving up driving or moving to a retirement community is huge, requiring months and even years to process.  As  professionals, or as adult children, it's frustrating to hear for the seemingly millionth time,  "We're just not ready yet."  So what do we do? Probably the biggest gift we can give seniors in the throes of decision is emotional space.  We also can acknowledge the difficulty they're facing, saying things like  "I can tell this is hard for you.  I want you to know I'm here to help.  Another tact is to extend invitations to explore options but with no  strings attached. 

PERSISTENCE--This may seem to contradict the patience idea.  This is the Yin and the other the Yang.  As senior professionals, if we are so patient that we wait a long time before contacting a senior prospect after the initial visit, he or she may go elsewhere.   As adult children, if we don't bring up the issue at all, our parents may jump to an erroneous conclusion that we don't care. My advice is to keep talking, but at a slower pace than you might prefer.

PUSHY--Don't do it!  Seniors hate even the slightest hint of pushiness.  Their idea of pushiness is likely different than yours!  You can tell when they're viewing you as pushy if they don't answer your calls or return messages or if their tone of voice or body language screams, "I'm not interested.  Don't talk to me!"   But pushiness isn't always such a bad thing.  I remember working with a single woman in her 90s who had a heart condition and other severe medical problems but who was alert and oriented.  She loved her condo, but realized she would need more care as time went on.  She visited retirement communities, but kept stalling and stalling on this difficult decision.   Later, after moving in and settling in comfortably, I asked her, "Do you think I was pushy during the time you were deciding about moving?  I waited for her answer.  "No, not really.  But maybe a little pushy.  But not too much."

Thursday, January 11, 2018

Senior Care Referral Agents--How We Spend Our Days

One of my favorite children's storybook authors, Richard Scarry, wrote an immensely popular book in 1968 called, "What do people do all day?"  In it, darling animals build houses, fly planes, keep house and grow food.

People ask you and me, perhaps in different words, "What do you do all day?"  I am a senior care referral agent, and I help families find the right choice in in-home care, assisted living or adult family homes.

I'm not alone.  At Silver Age Housing and Care Referrals, where I work, we are a team.  Each member has an area or areas of expertise:  occupational therapy,  caregiving, ombudsman experience and finance.  We share knowledge, benefitting our clients.

There are approximately 70 senior care referral agencies in Washington State. Like the characters in Scarry's book, we keep busy helping families.

Ever day, all day, we do the following:

SUPPORT--This is the social work part of our job.  When a family member calls us, the first thing we often ask is, "What's going on with  your loved one?"  Then the story--and they are nearly all different--comes tumbling out.  Mom had a stroke, is in rehab, and needs a more permanent home.  Dad has been caring for Mom and his health is now failing.  Mom lives in Illinois, and daughter has been using all her frequent flyer miles and cash to fly back and forth.

Bottom line, placing a loved one is one of the hardest things a family can do.  It's hard because it's our mother, or father, or other loved one for which we're making the decision, not simply a client. And it's hard because this might be their last home on earth.  Very often professional help can make the job easier.

Another thing  that helps:  the referral agencies' services are generally free to families.  The communities pay a commission to the agency on move-in.

TEACH--A senior care referral agent is a vital source of information.  At Silver Age, we know which communities accept Medicaid, which specialize in heavy care and which are located in the family's desired locations.  We provide a list of questions to ask when touring communities, and we tour alongside the family.  We have questions that we feel are especially important to ask; the family will think of others.  They are experts on their loved one; we are very knowledgeable about assisted living communities and adult family homes.  We inspect them before touring with a family and we check to see which places have enforcement letters from the state and may not be worth touring.

INSPECT BUILDINGS AND EVALUATE PROGRAMS  People often ask me, "Are you a Realtor?"  There certainly are some similarities.  Like a Realtor, we keep abreast of what's available.  Depending on the client's desires, we will search for communities with full kitchens, two bedrooms, or patios.  Finally the community has to be a good financial fit for the client. So in many ways we are like Realtors.   But there are differences.  Care needs--both physical and cognitive-- are a huge concern for many people.  Memory care is another potential issue.  For still others, an active social program is a must-have.  For most families, the key issue, besides availability of care, is the vital interaction of residents with staff.  Many people compare searching for  an assisted living or adult family home to looking for a college, private day school or kindergarten.  The building is important, but it's not everything.  Caring, knowledgeable staff are what matter most.

Need some help with obtaining housing and/or care for a loved one?  Contact Silver Age Housing and Care Referrals.

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