Tag Archives: families

Tough Choices from Tender Hearts: Caregiving During a Pandemic

About a month ago, the Centers for Medicare and Medicaid Services (CMS) issued new guidelines that advocate family visitors to return to nursing homes. At this time only three states are not allowing visits. The guidelines provide specifics on how to visit a family member while remaining safe. Unfortunately, it still means making tough choices between a resident’s mental and physical health.

Reducing Social Isolation

These guidelines highlight the need for residents in long-term care to see family members and loved ones. With these guidelines in place, it helps to bring loved ones back together. What about caring for family members who remain at home? What are the recommendations for keeping everyone at home safe?

Guidelines for Home Visits

In May 2020, AARP published an article on steps to take in safely visiting older family members in their home. Those steps included keeping visits short and wearing protective masks and eyewear when possible. The article also suggested staying away if you feel sick, keeping younger family members away for the time being, and visiting while outside.

Making Tough Choices

Despite the good intentions of these guidelines, serious questions are raised. How are caregivers managing? They are making decisions based on what is best for their family members while balancing issues of safety, health, and protection. These kinds of decisions are not new in caregiving.

The combination of trying to provide care while maintaining social distance and health is even more difficult. And caregivers are also conflicted about bringing love ones into a nursing home and out of the home environment, even though it may be the best possible option.

Lessons Learned?

The COVID-19 pandemic highlights the overwhelming need to address caregiving and those who provide it. We need to take the lessons learned from this ongoing experience and make better options for caregivers, both paid and unpaid. Caregivers continue to continue to give their best. It’s more than past the time to focus on their needs and provide better choices.

Kathy Dreyer, Ph.D., is an Advisor at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

The Trauma of Relocation for People with Dementia

 

 

A sudden relocation from home for a person with dementia can be traumatic.

My husband and I have made the decision to right-size our lives and sell our house of 23 years. For many years now, I have anticipated this moment wondering how I would feel.   Surprisingly, it wasn’t a hard decision to make.  However, I recognize that moving day could be a different story.

The decision to relocate is one we made being of sound mind and body.  As overwhelmed as I sometimes feel about our move, it must pale in comparison to what people with dementia feel when they are moved to a different environment.

Easing the Trauma of Relocation

My husband and I will adapt to our new surroundings.  I will find a place for all of our things and make our new house into our home.  The people I love most will be with me,  including my fur-babies.  I’ll drive to visit my friends and attend the same church.  All will be right in our world.

This mile-marker in my life makes me think long and hard about what moving day must be like for someone with dementia.  I can’t even imagine.  The sudden loss of leaving the familiar and the people you love must be horrifying.

Stop and think for a moment how you would feel if someone walked into your home and said that you had to leave for a new place that you had not chosen for yourself.

Imagine your behavior.  Would you be crying, screaming, punching, kicking?

The AGE-u-cate Training Institute program Compassionate Touch begins with looking at life through the lens of someone with dementia.   We discuss the grief and loss that often accompanies a person with dementia when they move into a long term care facility.

Realizing that people with dementia communicate with us through their behaviors is a pivotal moment in Compassionate Touch and Dementia Live Training.

So how can we ease a transition into a long term care facility for someone with dementia?  Here are a few tips:

    • If possible, set up their new space with familiar items prior to move-in day.
    • Remain positive and keep your personal emotions in check.
    • Minimize chaos on move-in day by limiting the number of family members present to no more than two.
    • Allow the staff to immediately begin bonding with your loved one.
    • Refrain from prolonged day-long visits until your loved one is settled in and comfortable.
    • When your loved one says, “Take me home” don’t say, “this is your new home.”  Rather, “I understand how hard this is, and I love you.”

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

World Alzheimer Report: Private Sector Response

Let’s not wait for the public sector to develop plans to address the dementia crisis. The private sector can and should play a large role.

This expert is from the Alzheimer’s Disease International website referencing the World Alzheimer Report of 2019.

“The report reveals the results of the largest attitudes to dementia survey ever undertaken, with almost 70,000 people across 155 countries and territories completing the survey. It spans four demographic groups: people living with dementia, carers, healthcare practitioners, and the general public.”

Further, the analysis of the study was carried out by the London School of Economics and Political Science (LSE).

Specifically, some of the key findings of the report include:

  • Almost 80% of the general public are concerned about developing dementia at some point, and 1 in 4 people think that there is nothing we can do to prevent dementia
  • 35% of carers across the world said that they had hidden the diagnosis of dementia of a family member
  • Over 50% of carers globally say their health has suffered as a result of their caring responsibilities even while expressing positive sentiments about their role
  • Almost 62% of healthcare providers worldwide think that dementia is part of normal aging
  • 40% of the general public think doctors and nurses ignore people with dementia

Call to Action for Private Sector

In addition, the report lists several calls for action, many of which rest with local, state, and national governments and agencies thereof.  However, the private sector can do a lot to address the disheartening vital findings. People are hurting, suffering, concerned, and uneducated about dementia.

Conversations at my faith community are under-way about how to minister to persons with dementia and their caregivers. Educate citizens about dementia to demystify, normalize, and create an environment of understanding and acceptance.  This is an excellent place to start.

In conclusion, call upon local experts to help start the conversation within your circle of influence and ask questions.  Success will come with each small step.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

The Important Role that Money plays in Caregiving Decisions

It’s no secret that families tend to shy away from the topics of money and death more often than not.  The fact, however, is that caregiving decisions often revolve around money, as care options will vary greatly depending on one’s assets.  So money plays a very important role in the choices that are made and discussions that take place between family members.

Understanding generational differences with respect to money can help today’s caregivers.  Like my own parents who were raised during the Depression,  money for our oldest generation was to be saved.  Before the era of mass production of goods, this generation did not waste, valued “things” in terms of their quality and how long they would last.   Older generations did not accumulate debt but rather watched their nest egg grow through hard work and perseverance.  One of their goals is the ability to leave an inheritance for their children.   In turn, adult children have expected this nest egg, rightfully or not.  And this is when conflict arises when families are faced with decisions on parent’s long-term care.

Too often, parents are reluctant to talk with their children about their financial situation.  My advice was always to give their children the gift of talking about it BEFORE  needs arose for decisions to be made that may conflict with theirs.  So plan A is always for families to approach this difficult topic earlier than later.

Try to start the conversation with a what-if scenario.  “Mom, we want to make sure that decisions regarding care are ones that you had envisioned.   We never know what to expect, but what if you fell and broke your hip and this required you to have ongoing care.  Can we talk about what this might entail and what you would want as next steps?”

Or another conversation starter might look like this:  “Dad, you have always been such a wonderful provider and keep such great care of your finances;  I know everything is fine now, but what if something happened to you?  Can we talk about how you would like help with paying bills?”

Children and other family members need to be respectful of the money issue, understanding that when one gives up oversight of their finances, even if it’s perceived as such, it’s a huge step in losing independence.  Tread these waters gently, approach with a sincere heart and understand that an initial response from others may be to pull back.  If that’s the case, then give it time, and reapproach maybe at a different time and with another family member present.

Put yourselves in the place of that person before approaching, and ask how you would like to hear the words of the person talking about the difficult money topic.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  

http://www.AGEucate.com