Recrafting a Life After a Stroke...

A survivor and his wife offer advice for coping   At 71, Bob Seiter was an active guy. After retiring from Kaiser Aluminum, where he worked in sales, he played golf three times a week, playing at a 14 handicap and striving to regain his 4. When he wasn’t on the fairway, he spent a lot of time volunteering. Then one morning, he had a hemorrhagic stroke, and everything changed. His wife, Sue, found him in the garage, alarmingly disoriented, called 911 and prayed. Bob was rushed to the hospital, where he spent three weeks in intensive care, clinging to life. The doctors warned Sue that Bob wasn’t expected to make it. But one day he opened his eyes and awareness began, slowly, to return. Coming Back to a New Life Then came 5 1/2 grueling weeks in a rehab facility. Then came reality. Bob recovered from the acute phase of the brain trauma, but he may never get back to normal. He doesn’t have some of the cognitive capabilities he used to have. He can’t, for example, immediately recall numbers, such as age or quantity. Ask him his own age, and he can’t answer until he first counts 40, 50, 60, 70, 71, 72, 73. His short-term memory is poor. He might forget where the TV remote is, whether he turned off the stove or where the newspaper he’s reading is. (He can’t manage reading a book yet.) He still has trouble to recalling specific words or places, such as the cities where his children and grandchildren live. “I’ve had to recraft myself,” he said. “And that means learning how to do basic things again — and accepting that I’ll never be able to do some things I...

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....

When Should You Push For a Geriatric Assessment?...

Taking a team approach can net the best results for your parents Navigating the maze of eldercare options can be challenging. A geriatric assessment can help you figure out the level of care your loved one needs. “The phrase geriatric assessment is a bit confusing,” says Norbert “Bert” Rahl , director of mental health services at the Benjamin Rose Institute on Aging. Sometimes an assessment looks at just one issue that’s causing problems for a loved one. For instance: If you are concerned about your mother’s physical status, the medications she is taking or how she is (or isn’t) managing a chronic condition, a physical assessment may be in order. If your father has mobility issues and you’re worried about how well he is (or isn’t ) getting around on his own, he may need a functional assessment. If you are worried about the psychological and emotional well-being of your loved one, a mental health assessment could be helpful. If your aging relative is displaying issues with memory, decision making and financial management skills, a cognitive assessment should be scheduled. Or, to get the whole-person “picture” of what’s going on, Rahl suggests a comprehensive assessment, which looks at all those things and how they are interacting and overlapping in your older loved one’s life. A comprehensive assessment could be coordinated by your loved one’s primary care physician. However, since these assessments require the skills and expertise of a team of specialists, they are best coordinated by a geriatrician: a physician who has trained and specialized in the care and treatment of older adults. Ask for a referral from the primary care physician or click here to find a geriatrician in your area. Who’s On Your Team? The composition of...

How Sharing a Life Story Helps Dementia Caregivers...

Conveying personal info lets others connect with your loved one One day while I was volunteering at a local adult day care, we had a new visitor who was confused and very unhappy that her daughter had left her there with us. She was agitated and was trying to leave. Luckily, when they first arrived, her daughter had handed us a one-page life story about her mother who had dementia. After reading it, I was able to more easily connect with the lady. Sharing Your Knowledge As we discussed her career as a teacher, her agitation slipped away and we ended up having a very nice conversation. Without that knowledge, things would have been more difficult for both of us. If you’re the primary caregiver of a person with dementia, you know your loved one’s likes and dislikes. You can read their moods. You know their routines and the people in their world. Nobody can care for them the same way you do. But the act of sharing your loved one’s life story empowers others to better understand his or her traits, to connect and to provide better dementia care. In turn, you receive peace of mind when you take time for yourself. A Different Reality The reality of a person with dementia often slips into a past era of their life. For instance, it may be typical for the person to prepare for work each morning as they did for many years. Or they might start preparing to send their children off to school although their kids are fully grown and have left the nest. When the people around them don’t understand this different reality, they often struggle to accept what seems like strange behavior. They may even...

Building a Network to Look Out for Your Parents...

From neighbors to relatives to the pizza delivery woman, it’s critical to have people looking out for a parent who’s aging in place If you’re looking out for a parent in declining health who continues to live alone, and who resides more than an hour’s drive away, consider yourself a long-distance caregiver. It’s a hard role to fill alone, but an informal network of eyes and ears can provide crucial aid. These supporters can be neighbors, friends, parishioners, even a mail carrier or the pizza delivery person. Predictability can make it easier to keep track of a parent’s activities, and to tell quickly if something is wrong, says Carol Bradley Bursack, author of Minding Our Elders (McCleery and Sons, 2005). When you’re on the scene, commit some time to following your parent’s routines and seeing who they interact with daily or weekly. Identify and get to know those people, who could become part of your network. If, for example, your mother goes to the bank every Monday morning, her regular teller may take notice if she doesn’t come in one day. Next time you have the opportunity, accompany your mother to the bank, meet the teller, and consider giving him or her your phone number. Your efforts shouldn’t be a secret from your parent. “Explain that it’s for safety, and that they’re not intruding, just checking on her,” says Gail Hunt, president and chief executive of the National Alliance for Caregiving in Bethesda, Md. These strategies can help as well: Find out who delivers to your parent. Anyone who makes regular deliveries to your parent, like a mail carrier, paperboy or supermarket carrier, is a potential source of help. If these people notice mail and newspapers piling up, or...

What to Know About Caregiving By 50, 60 and 70...

Essential tips for taking care of loved ones as they age If you are taking care of a loved one, you know that your challenges change as their health changes. You may also be anticipating your own needs for care as you grow older. Here are some tips to help you get prepared: What to Know By: Age 50 You may already be involved in caregiving for a spouse or parent. We want to provide care out of love and loyalty, but practical matters arise quickly and come to the fore. You’ve probably heard about what caregiving costs and pondered whether you will need to or be able to help your parents financially. Here are a few more things you may want to know about caregiving by the time you are 50. Have the difficult conversations. How do your parents want to live as they become more frail, and what plan do they have to make that happen? Finding out is key to your ability to help them. [ For more information, go to theconversationproject.org.] Get involved. Advocate for your parents and work for changes you want to see. For instance, would a change in social policy allow for a better nursing home experience for your mom or dad? Should workplaces better support caregivers? Provide support. Know how much care costs, and also consider other kinds of support. Think about housing, emotional support, and companionship. Age 60 Consider new ways of living. Knowing what your parents went through can provide motivation for planning ahead for how you want to live, whether that’s aging in place or finding like-minded people with whom to form a community. Care for yourself. Caregivers need support, too. It’s critical to find ways to take...

The Good News About Elder Care Benefits at Work...

A new survey finds they’re more prevalent, but small employers lag New Yorker cartoonist Roz Chast’s new memoir about caring for her aging parents includes a drawing of her sitting on a couch between them. The caption, with an arrow pointing to Chast’s head, says: “You Are Here: Suck It Up.” Today’s reality is that many Americans care for aging family members — more than two in five of us, according to our research at the Families and Work Institute. And it’s a reality that employers are beginning to pay attention to — with a growing number now providing help for employees who feel that they just have to “suck it up” in managing this care and their careers. More Employers Offering Elder Care Help Families and Work Institute’s recently-released 2014 National Study of Employers  — funded by the Society for Human Resource Management — found that more employers are offering several forms of elder care supports than in the past, but smaller employers lag behind their larger counterparts. Among the findings from the survey of 1,051 for-profit and nonprofit employers, which looked at changes in the workplace since 2008:   43 percent of employers report they offer Elder Care Resource and Referral (help in finding resources and information about elder care), up from 31 percent in 2008. Far more employers now offer Dependent Care Assistance Plans for elder care (the ability to set aside money from each paycheck before taxes to pay for elder care expenses) than in 2008. Currently, 41 percent do; in 2008, 23 percent did. Just 7 percent of employers offer access to respite care — short-term care given to a family member by another caregiver so the primary caregiver can rest or take time...

When Should You Seek More Family Help?...

Primary caregivers may need to call in the cavalry. Here’s what to do. If you are like most caregivers, the tasks and responsibilities that come with caring for an aging parent or loved one — running errands, odd jobs around the house, transportation to social events or doctor’s appointments, paying bills, being on call 24/7 — creep up on you as the person’s health and well-being change over time. It’s important to step back frequently and think about those changes and what they mean. One of the most significant pieces to watch is behavior. Bonnie Paul, a social worker for the Benjamin Rose Institute on Aging, has specialized in family counseling and community education for more than 20 years. She describes a typical scenario that should raise a red flag: “They aren’t just forgetting things. There’s significant cognitive change, and it’s causing them to make bad financial decisions. Or bring people into the house who shouldn’t be there. Or say things that really hurt you emotionally.” That kind of behavior is a major indicator that it’s probably time for you — the primary caregiver — to involve other family members in the loved one’s care. Another major indicator is your stress level, as indicated by things like: Changes in your weight Feeling blah, blue, depressed or anxious “all the time” Angry outbursts “for what seems like no reason at all” Forgetfulness “due to juggling too much” Letting your own house and health go “because you just don’t have time for them” Decreased family time or socialization “because you are just too tired” The important thing to remember, says Paul, is that the need for help with care has nothing to do your caregiving. “Things have progressed to the point...