How to Get Training as an Unpaid Dementia Caregiver...

Whether in person or online, you can find helpful instruction The Best Friends Dementia Bill of Rights states that people with Alzheimer’s or other dementia deserve to have care partners well trained in dementia care. Yet the vast majority of these individuals are cared for in a private residence by untrained and unpaid family members. Although these family members have the best intentions, they may not realize they are up against possibly the most complex caregiving situation imaginable. To say the least, it’s emotionally, physically and financially draining. Yet they attempt to juggle this added responsibility while still maintaining a career, family and social life — all of this without adequate training. Self-Education and Community Help The only way to survive is through ongoing self-education to aid in the “on the job training.” But even when we learn on the job, someone is typically there to guide us. Family members must find educational solutions that work for them, so that means trying different approaches to find the one that works for their unique situation. Contact the big dogs — the Alzheimer’s Foundation and the Alzheimer’s Association — and get registered to receive important information about training opportunities they may offer. Each has unique strengths and weaknesses when it comes to training. Contact local memory-care facilities in your area, too. They often have training classes for professionals and unpaid caregivers. Also, inquire about support groups; when you attend a support group, you get some of the best training possible as you learn from others who are ahead of you in this journey. Lack of Time? Go Online For some people, however, attending these classes in person adds yet another level of complexity to an already overwhelming schedule. The classes are...

What Japan Can Teach Us About Long-Term Care...

Here’s a sobering calculation: The odds that Americans turning 65 today will eventually need assistance with bathing, dressing and other personal activities are about 50/50. And those who’ll need long-term care can expect to incur costs of $138,000, on average, estimate Melissa Favreault of the Urban Institute and Judith Dey of the U.S. Department of Health and Human Services. Yet people age 55 to 64 with retirement savings accounts have a median balance of $104,000 in them, according to the National Institute on Retirement Security, a nonprofit based in Washington, D.C. See the problem? America’s Broken Long-Term Care System Sad to say, America’s system for financing long-term care is badly broken. If we take a few ideas from Japan, though, we could help avoid a long-term care catastrophe. Japan has the highest proportion of people 65+ in the world. And 20 years ago, its long-term care approach looked much like the current failed U.S. system. But Japan took a few key initiatives in 2000 that are widely admired among long-term care policy experts. Before I explain what they did, first let me offer a brief look at the U.S. situation. Long-Term Care Financing in the U.S. America’s private long-term care insurance market is contracting and its policies are expensive. Only about a dozen companies now sell coverage, compared with about 100 more than a decade ago, according to Marc Cohen, chief research and development officer at LifePlans, a firm that helps health- and long-term care insurers manage risk. Tom McInerney, chief executive officer at Genworth, the nation’s largest long-term care insurer, estimates that between half and two-thirds of Americans can’t afford to buy in the traditional long-term care insurance market. A 60-year-old married couple would pay $3,930 per year, on...

How to Visit Your Aging Parent the Right Way...

Taking a different approach can make things better for both of you Katherine Arnup, a retired professor at Carleton University in Ottawa, Canada, and now life coach, got an education in caregiving when her sister and parents got sick. She later became a hospice volunteer. She drew on those experiences for her latest book, I Don’t Have Time for This!: A Compassionate Guide to Caring for Your Aging Parents and Yourself. Arnup writes about the importance of being “being present” when you visit an aging parent. The following is excerpted from one of the book’s chapters. Settle In, Look Around When you arrive to visit your parents, take the time to get settled. It might help to take a few deep intentional breaths before you open the door to their house or apartment. Once inside, resist the urge to start blathering on and on just to fill the void, or to cover up your discomfort or nervousness. Listen. Observe. How does the house or apartment look? What changes do you notice since your last visit? Is your father wearing clothes with obvious stains? Are there a week’s worth of papers stacked up beside his chair? What might this mean? Is it typical? Might it be a hazard? Not Your House Because of our discomfort, we often fall into the habit of cleaning up, putting things “back in their place,” or throwing things out that we consider to be garbage or recycling. These actions are likely to cause unnecessary frustration and confusion for your parents. They know where everything is now, and you’re only disrupting that order. Sometimes it’s hard to remember that it’s their house, not yours. I’m not suggesting you ignore signs of distress or mental confusion. But...

How to Create Meaning in Dementia Care...

One of the most important things to a caregiver of someone with Alzheimer’s is to know their loved one is happy. However, they are often so overwhelmed by the responsibility of caregiving, that the fun of being together is lost. All engagement tends to be for survival and not for enrichment. This often results in a negative atmosphere affecting the mood of everyone, including the person with Alzheimer’s. Left unchecked, the resulting tensions will often lead to behavioral issues from both individuals. Slipping Away Unsure how to even act around each other, the care partners (the person with Alzheimer’s and his or her caregiver) may fall into a world of isolation. They may worry about what others think or feel their situation is unlike others’. They can become so uncomfortable that they may withdraw from family, friends and society. Changing these tendencies is important to the health and well-being of both individuals because meaningful human interaction, whether in a one-on-one situation or in a group setting, is important to everyone’s happiness. Finding Happiness With Alzheimer’s disease, it’s important that engagement is adapted to meet the changing needs of the individual while focusing on the things that enrich the person’s life and bring happiness. For this to work, the caregiver must accept how things are now and discover ways to incorporate meaningful activities on daily basis. While a caregiver will routinely look back at how things were, it’s vital to appreciate that the person with Alzheimer’s is the same person as in the past. It’s the disease that’s making the individual act different, and typically, the same things will still bring happiness to his or her heart. These men and women still want to be included in activities and to...

Cards That Offer Better Words for a Serious Illness...

Their cancer-survivor maker knows the pain of kind but hurtful sentiments If you have ever had cancer or another serious illness, you can probably make a long list of unhelpful things that friends, family and well-meaning acquaintances have said to you. “Everything happens for a reason.” “I read about this miraculous new treatment on the Internet!” “Oh, I knew someone who had that same thing and they died.” Emily McDowell, a cancer survivor, has heard them all. In response, the Los Angeles graphic designer came up with a set of eight “Empathy Cards” to be used when traditional “get well” cards just don’t work. She launched them this week. Another set is due out in December, she told NPR’s Ina Jaffe in an interview. A Terrifying Diagnosis McDowell learned 15 years ago, at age 24, that she had Stage 3 Hodgkin’s lymphoma, a cancer of the lymphatic system. “The most difficult part of my illness wasn’t losing my hair, or being erroneously called ‘sir’ by Starbucks baristas, or sickness from chemo,” she said on her company’s website. “It was the loneliness and isolation I felt when many of my close friends and family members disappeared because they didn’t know what to say, or said the absolute wrong thing without realizing it.” Among the potentially offensive comments: referring to cancer as “a journey.” “With time and distance, some people do come tothat conclusion on their own that this … feels like a journey,” McDowell told NPR. “But a lot of people really feel like ‘If this is a journey, I’d like my ticket refunded,’ or ‘This is a journey to hell and back.’ ” Coming Up Empty To be fair, it is hard to know what to say. When we...

4 Things to Do When Your Parents Are Resisting Help...

Taking these steps can reduce frustration and stress — for all of you “Doctor, my mom needs help, but she won’t accept it and she won’t listen.” Sound familiar? It’s a complaint I hear all the time from families worried about older parents and aging relatives. And it’s a very real issue that we must address. For better health and wellbeing in older adults, it’s not enough to identify the underlying health and life problems — although that is a key place to start. Because even if you’ve correctly identified the problems and learned how the experts recommend managing them, older parents often seem, well, resistant. Understandably, this causes families a lot of frustration and stress. Here are four actions I always recommend that families take when older parents are resisting help. Consider the possibility of cognitive impairment In other words, is a problem with brain function contributing to this resistance? Now, let me emphasize that you should not assume that your parents are in their wrong mind just because they are making health or safety decisions that you don’t agree with. That said, because it’s very common for the brain to become vulnerable or damaged as people age, decreased brain function is often a factor when an older person resists help. This can affect an older parent’s insight and judgment and can also affect how well they can process your logical arguments. It’s important to spot such cognitive impairment. Some of the impairment is often reversible. For example, older adults frequently develop delirium when ill or hospitalized, and an older person may need weeks or even months to recover to their best thinking abilities. Cognition can also be dampened by certain conditions, like hypothyroidism, or by medication side effects....

Why the Arts Are Key to Dementia Care...

This form of communication can engage intuition and imagination When you receive a serious medical diagnosis, it can feel as though that diagnosis replaces your identity. I am no longer myself — instead, now I am cancer, or heart attack or dementia. But even when we carry a diagnosis, we also continue to live our lives. We are more than our diseases and care plans. People can live as long as 20 years with a diagnosis of Alzheimer’s disease  disease. Family and professional caregivers, as well as community members, need tools to ensure that people with Alzheimer’s can be more than their disease. But how? Conversation can be challenging, in person and by phone. How can we stay connected and foster what has come to be called the “personhood” of someone with dementia or Alzheimer’s? The answer is: the arts. A symbolic and emotional communication system, the arts don’t rely on linear memory and rational language. Rather, the arts engage our intuition and imagination. Their building blocks for expression are movement, gesture, words, patterns, sounds, color, rhythm, texture and smell — to name just a few. As access to rational language falters, a person’s imagination can soar. Memory vs. Imagination You don’t need to be an artist to use the arts for expression. These tools are available to everyone. Over the last 20 years, I have worked to encourage care partners to communicate with people who have dementia through creativity. The shift from expecting and correcting memory to opening and connecting through imagination can be profound, especially for family members. After years of distance, the arts can help families rekindle an emotional connection. I remember in one workshop for caregivers, I was demonstrating how they could use open-ended questions...

How to Help Mom and Dad Move to a New Home...

Here are five tips to make the transition less traumatic for your parents For most people, moving from one home to another is exhausting. Even when we get help with packing and transporting our possessions, moving means changing countless aspects of our everyday lives — from making a new place for the silverware to potentially finding new friends. And it can mean saying goodbye to memories we’ve made over the course of years. Older adults often have a much harder time with the transition. For your parents, moving can go from merely taxing to highly traumatic. That’s when it becomes transfer trauma, also known more broadly as relocation stress syndrome. “You’re literally transitioning to a completely different phase of life, to a completely different environment,” says Tach Branch-Dogans, president and CEO of Moving Memories and Mementos of Dallas, Texas, who spoke at the Aging in America 2015 [www.asaging.org/aia] conference of the American Society on Aging [www.asaging.org] I just attended. That’s true whether a person is voluntarily downsizing or being moved into a nursing home, she says. Symptoms of Transfer Trauma Moving can result in a host of physical and psychological changes, including loss of sleep, agitation, depression, withdrawal, short-term memory loss, irritable bowel syndrome, loss of appetite and nausea, Branch-Dogans says. Tracy Greene Mintz, a Licensed Clinical Social Worker in Redondo Beach, Calif., who has worked and lectured extensively in the area of relocation stress syndrome, says loss of control is at the core of transfer trauma. “This week you’re going to be at home living independently; next week you’re going to be in assisted living. The abruptness with which we move older people … is very damaging psychosocially and emotionally because it strips the older adult of control,”...