How to Select Home Care........


Hi Everyone……
          Another year is coming to an end.  The biggest holiday season of the year is upon us!  I hope you are taking good care of yourself as well as your loved ones.  Last month, I was telling you about the issues facing family caregivers.  One of those issues is how to be open to asking for help when you need it.  That help can come in the form of family, friends, neighbors, professionals, etc.  Have you ever considered non-medical home health care options?  A person coming into your home to assist you with meals, laundry, bathing, and just being a companion for a loved one can have great benefits to you and yours.  But, how do you choose a home health aide?  You have to pay attention when you are interviewing home care agencies and individuals.  Be aware that professional home care companies should be covering their employees who come into your home with insurance.  Be sure to have that one of your interview questions……is the person coming into your home covered by the company’s insurance?  Once that has been established, there are other questions you might consider asking.  Here is a small list:
          1.  How does the home care company find their employees and what are their hiring criteria?
          2.  Does the company do background checks and/or drug screening?
          3.  Are the aides certified in CPR or other health training?  You especially want to know if the health aide understands how to deal with Alzheimer’s or Parkinson’s if that is what your loved one has.
          4.  Can the aide help with lifting and transfers if necessary?  Can they help with bathing, dressing and toileting? 
          5.  How is the aide assessed by the company?
          6.  What happens when the regularly assigned aide cannot come to work on a particular day?
          7.  What happens if you are not satisfied with the care the aide is giving your loved one?  Can that aide be easily replaced?
          8.  How does the agency evaluate the quality of the home care the aide is giving?
          9.  Is there a supervisor assigned to an aide and how is the aide supervised?
          I am sure you can come up with more questions.  Write them down and be sure to ask them of the agency when you are interviewing to see which agency suits your needs best.  Do your homework, and that will greatly assist you in your decision making.  Consider extra help over the holidays when there can be more events and even stressors for you. 
          Please have a Happy Holiday season……enjoy these special days……take care……Regina

 

Caregiver Stragegies........


A Message From Regina


Hi Everyone…….
          Most everyone I know is either a caregiver, is going to be a caregiver, or may need a caregiver.  As we age, events happen which we cannot predict.  For some of us, it occurs gradually.  For some, an accident or diagnosis may change our lives more quickly.  How do we cope and face the tasks before us?  Because I have been a support group facilitator for caregivers whose loved ones had Alzheimer’s or Parkinson’s as well as having been a 24/7 caregiver myself, I am always interested in what human service agencies are doing to help.  Recently, I was reading a Caregiver Resource Guide produced by the AARP for Arizona specifically.  In the opening pages, AARP divided caregiver needs into 3 categories:  1) Get the type of assistance you need; 2) Connect with others; 3) Take care of yourself.  I agree with this set of three but also know that there is so much more that is needed to complete the picture.  Let’s break down the 3 areas and see what else can be suggested. 

  1. Getting the type of assistance you need:  How do you determine that?  What is that which is happening is so traumatic that you feel helpless?  My best suggestion is ASK FOR HELP.  You  may never have had to do this, but now is the time to find those resources which can make this transition easier.  Ask professionals like an agency for aging social worker, or your doctor or health provider network.  Talk with a parish nurse if you belong to a parish.  Ask friends and family you can turn to.  Don’t try to walk the path alone.  Remember too that no one agency or person has all the answers.  Keep the conversation going.

  2. Connecting with others:  This is not just talking with health professionals or family and friends.  Find a support group of folks who are dealing with the issues confronting you.  The Alzheimer’s Association has many support groups (About Seniors conducts a weekly group in our area for them). If you are dealing with Parkinson’s, the PMD Alliance is active and has many groups and resources for you.  You can find out more on these websites:  www.aboutseniorsaz.com and www.pmdalliance.org. 

  3. Taking care of yourself:  So many people put this at the end of their list of things to do.  We don’t feel as though we can take time away from our loved ones.  We feel selfish if we do that.  Believe me, that is wrong thinking!  Please remember that your health is very important for 2 people now.  What would happen to your loved one if something happened to you??  Make sure you go to your doctor’s check-up for your health.  Go to your dentist.  Exercise.  Take some time out from your caregiving responsibilities to re-charge your energy.  Two lives are counting on you!

          Another option for connecting is the internet.  You can browse and find more options for help in your community.  If you have questions, also feel free to email me at our website or go to our blog. 
          Have a Happy Thanksgiving and enjoy the simple pleasures of food and company that the holiday can bring…….take care……Regina


 

Healthy Aging from the “AFA Care Quarterly”


 


Hi Everyone……..
              One of the newsletters that I like to read comes from the Alzheimer’s Foundation of America.  It is always full of news and good advice for folks with AD and for caregivers.  However, a particular article from a recent edition holds good advice for all of us!  Since many of us will live longer lives than previous generations, we want to know how to live our best life.  There are studies on longevity in our communities and lots of talk about those areas where people live longest in this world…..the Blue Zones.  A lot of what results is really common sense and includes things that all us know.  So, I am going to use the AFA’s outline here for you to peruse and consider (my comments will be in the parentheses):

  1. Eat well (We all know that fried foods, red meat, sugar, taste awfully good, but try to limit or reduce your consumption of these and add more veggies…..even one more serving a day can help.).

  2. Stay active.  (Aren’t we fortunate to live in communities with rec centers?  Use them!).

  3. Learn new things.  (Again, we are lucky to live in an area where there are so many options for fun courses as well as college courses.  Like to cook?  PORA offers cooking classes with a real chef from time to time.  Learning another language and traveling qualify too!).

  4. Get enough sleep.  7 – 9 hours is good.  (I know that if I do not exercise in a day or if I have coffee, tea, chocolate after noon, I do not sleep well.  Do some sleuthing to find out what it is that is disturbing your sleep if you are having problems!).

  5. Mind your meds.  (Medications react differently for people.  Talk with your doctor or the local pharmacist to see what reactions your meds may cause.).

  6. Stop smoking and limit alcohol.  (Enough said!).

  7. Stay Connected.  (This is SOOOOO important!  Recent studies have shown that this may be the most important thing we all can do to stay healthy longer.  We are social beings and contact with others is essential.)

  8. Know your blood pressure.  (If you are getting your regular check-ups, this shouldn’t be a problem.  If you feel any changes in your system, see your doctor.  Also, have a blood pressure cuff at home.  It could help.)

  9. See your doctor.  (As I mentioned above, this should be a regular part of your year.)

  10. Get a memory screening.  (I am not sure that I am entirely on board with this one.  That is mostly because there are no cures for memory loss at this point unless the loss is caused by a physical problem.  However, if you want to see how you are doing, by all means have your memory checked.)

                                             Be well……take care…..Regina
     

Disclosures for Placement Companies........


A Message From Regina

Hi Everyone…………

          This month, I want to talk with you about some recent developments in our referral and placement industry. First, we are proud to announce that About Seniors is now a member of PASRS (Professional Association of Senior Referral Specialists). PASRS is a local Arizona-based trade association consisting of referral specialists, care communities, non-profits (like the Area Agency on Aging) and other organizations who adhere to a higher standard of service and assistance for those families looking for help with placement or senior eldercare services.  Be sure to look for PASRS membership logos when using a placement specialist. 

In addition, the governor of Arizona recently signed legislation into law, called HB2529.  We at About Seniors anticipated and fully support this law.  In short, it requires all referral companies (national companies doing business in Arizona too) to disclose conflicts of ownership or interests in facilities and communities.  It also requires a referral business to disclose fees and how much a referral company will be paid by facilities, when providing services. Failure to do so will result in financial civil penalties for any company or facility that fails to provide these disclosures.  We feel this law helps bring professionalism to our industry and supports the rights of clients and caregivers to know certain things and avoid being mislead. 

So be sure that any placement agency you work with, About Seniors included, gives you a disclosure to sign which acknowledges that you have been apprised of the fees paid by any facility to that placement company.   If you have any questions about this new disclosure ruling, please email me or call the phone number listed below and speak with a referral specialist.  Be well…..take care…..Regina

Travel Plans are Important!


Hi Everyone……
I used to facilitate Alzheimer Caregiver Support Groups and Parkinson’s Caregivers Support Groups.  It always surprised me when caregivers were planning little driving trips with their loved one or even going some distance by airplane.  You certainly can still travel when someone has limitations, but you do need to spend some time planning.  Recently, I found this information on a caregiver.com website.  Here are some of the more salient bits of information and notes from me inside parenthesees:
 
“Advise hotels, airlines, tour operators, or people you are visiting that you are traveling with someone with memory impairment. Be specific about your safety concerns and special needs. If you are staying in a private home, guest home, or bed and breakfast, do not surprise your overnight host with your loved one's condition. Explain it fully, well in advance. Do not think they won't notice. Don't be upset if they feel they cannot handle the visit—especially if there are children in the home.

  • Never travel without a full set of reservations……(if flying, be sure to use TSA and notify them in advance!!)
  • Always provide family members with an itinerary and call home regularly.
  • Make a list of the daily routine and special items you need to take with you.  (Get a zip envelope easy to carry for these papers)
  • Always have the person with memory loss identified, preferably with a bracelet your loved one cannot misplace.  (Check with the Alzheimer’s Association for these)
  • Use good judgment when telling your loved one about the trip. Discussing it too far in advance may produce anxiety and agitation.

(Be cautious with this tip.  A loved one can obsess about travel if you talk about it too soon)

  • Be flexible. Have a contingency plan that allows you to leave early if your loved one becomes ill, agitated, or wants to go home.
  • Keep your sense of humor and laugh at all the things that happen. They will be part of a wonderful memory of your travels together.
  • If the trip is prolonged, develop a list of medical professionals and Alzheimer's Association chapters along your route.
  • Never leave your loved one alone or ask strangers to watch him/her. A person who does not know your loved one or the disease will not know how to react in a difficult situation.
  • Avoid traveling at peak travel seasons such as Thanksgiving and Christmas
  • Take medications with you to manage stomach upset, diarrhea, or other temporary problems caused by changes in food and water.  (Be aware of incontinence issues too.  Diapers may be necessary)
  • Get help and find out who can help in countries where you do not speak the language.  (Plan ahead!!)
  • Search the internet or check the Yellow Pages to see if there is a travel agent in your area specializing in planning trips for people with disabilities. If so, use the specialized service.  (Again, the Alzheimer’s Association and/or Parkinson’s groups may help)
  • Enjoy each day and the little pleasures each day can bring………take care…….bon voyage…..Regina

Helping someone with dementia feel comfortable in the shower/bath.......


Hi Everyone……not only was I a 24/7 caregiver for my then husband Ron who had vascular dementia and ultimately Alzheimer’s, but I was a long distance caregiver for my Mom who also had Alzheimer’s.  One of the biggest issues for her was bathing.  She was so afraid of the shower.  For her, a bath was a much more acceptable way of washing.  Here is an excerpt from a caregiver website which will give you some ideas about safe bathing for your loved one with AD:
BATHING
Helping people with Alzheimer’s disease take a bath or shower can be one of the hardest things you do. Planning can help make the person's bath time better for both of you.
The person with Alzheimer’s may be afraid. To reduce these fears, follow the person's lifelong bathing habits, such as doing the bath or shower in the morning or before going to bed. Here are other tips for bathing.
Bathing Safety Tips

  • Never leave a confused or frail person alone in the tub or shower.
  • Always check the water temperature before he or she gets in the tub or shower.
  • Use plastic containers for shampoo or soap to prevent them from breaking.
  • Use a hand-held showerhead.
  • A rubber bath mat and put safety bars in the tub.
  • A sturdy shower chair in the tub or shower. This will support a person who is unsteady, and it could prevent falls. You can get shower chairs at drug stores and medical supply stores.
  • Don’t use bath oil. It can make the tub slippery and may cause urinary tract infections.

Preparing for a Bath or Shower

  • Get the soap, washcloth, towels, and shampoo ready.
  • Make sure the bathroom is warm and well lighted. Play soft music if it helps to relax the person.
  • Be matter-of-fact about bathing. Say, "It's time for a bath now." Don't argue about the need for a bath or shower.
  • Be gentle and respectful. Tell the person what you are going to do, step-by-step.
  • Make sure the water temperature in the bath or shower is comfortable.

During the Bath or Shower

  • Allow the person with Alzheimer’s to do as much as possible. This protects his or her dignity and helps the person feel more in control.
  • Put a towel over the person's shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
  • Distract the person by talking about something else if he or she becomes upset.
  • Give him or her a washcloth to hold. This makes it less likely that the person will try to hit you.

After a Bath or Shower

  • Prevent rashes or infections by patting the person's skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
  • If the person has trouble with incontinence, use a protective ointment, such as Vaseline, around the rectum, vagina, or penis.
  • If the person with Alzheimer’s has trouble getting in and out of the bathtub, do a sponge bath instead.

 
……I wish I had known some of these suggestions when I was worried about my Mom.  I hope this gives you some support for your loved one……take care……Regina.

Decision-making Help for families........

Hi Everyone……as you know, About Seniors is a company whose purpose is to help families or individuals find alternative living solutions when that is needed.  How do they and you choose what environment is right?  Here are some questions and guidelines for you to consider:
Use the following checklist to assist you in assessing assisted living communities. If possible, both you and your loved one should be involved in the decision making process. The more an older person participates in the planning process, the easier it will be to adjust to the new environment.

Assessing an Assisted Living Community as you tour the facility:

  • As you arrive at the facility, do you like the location and outward appearance of the community?
  • As you enter the lobby and tour the building, is the decor attractive and home-like?
  • Did you and your potential resident both receive a warm greeting from staff?
  • Does the administrator/staff call residents by name and interact warmly with them as you tour?
  • Do residents socialize with each other and appear happy and comfortable?
  • Are you able to talk with residents about how they like the residence and staff?
  • Do the residents seem to be appropriate housemates for your loved one?
  • Are staff appropriately dressed, personable and outgoing?
  • Are the staff members that you pass during your tour friendly to you?
  • Are visits with the resident welcome at any time?
  • Is the community well-designed for resident's needs?
  • Are the recreational and non-living spaces free from storage items or other obstacles?
  • Is the floor plan easy to follow?
  • Are doorways, hallways and rooms accommodating to wheel chairs and walkers?
  • Are elevators available for those unable to use stairways?
  • Are hand rails available to aid in walking?
  • Are cupboards and shelves easy to reach?
  • Are doors of a non-skid material and carpets firm to ease walking?
  • Is the facility clean, free of odors and appropriately heated/cooled?
  • Does the facility meet local and/or state licensing requirements?
  • Is there a written plan for the care of each resident?
  • How long after admission is this care plan written?

What is the procedure for assessing a potential resident's need for services and are those needs reassessed periodically?

  • Can a resident be discharged for refusing to comply with a care plan?
  • When may a contract be terminated and what are refund policies?
  • Are there any government, private or corporate programs available to help cover the cost of services to the resident?
  • Are additional services available if the resident's needs changes?
  • Are there different costs for various levels or categories of services?
  • How do you pay for additional services such as nursing care when needed on a temporary basis?
  • What are the billing, payment and credit policies?

Medication/health care

  • What is the facility policy regarding storage of medication, assistance with medications, training and supervision of staff and record keeping?
  • Is self-administration of medication allowed?
  • Who coordinates home care visits from a nurse, physical therapist, occupational therapist, etc. if needed?
  • Are staff available to assist residents who experience memory, orientation, or judgment losses?
  • Does a physician or nurse, visit the resident regularly to provide medical checkups?
  • What is the procedure for responding to a resident's medical emergency?

Services
Is staff available to provide 24-hour assistance with activities of daily living (ADL) if needed?

Features of individual units

  • Are different sizes and types of units available?
  • Are units for single and double occupancy available?
  • Do residents have their own lockable doors?
  • Is a 24-hour emergency response systems accessible from the unit?
  • Are bathrooms private with handicapped accommodations to accommodate wheelchairs and walkers?
  • Are residents able to bring- their own furnishings for their unit and what may they bring?
  • Do all units have a telephone and cable TV and how is billing handled?
  • Is a kitchen area/unit provided with a refrigerator, sink and cooking element?
  • May residents keep food in their units?
  • May residents smoke in their units? In public spaces?
  • May residents have pets?

Social and recreational activities

  • Is there evidence of an organized activities program, such as a posted daily schedule, events in progress, reading materials, visitors, etc?
  • Do residents participate in the neighboring community?
  • Do volunteers, including family members, come into the residence to help with or conduct programs?
  • Does the facility have its own pets or provide for pets to visit the facility?

Food Service

  • Does the residence provide three nutritionally balanced meals a day, seven days a week?
  • Are snacks available?
  • May a resident request special foods?
  • Are common dining areas available?
  • May residents eat meals in their units?
  • May meals be provided at a time a resident would like or are there set times for meals?

 
……this list was found on the caregiver.com website.  I think it is quite comprehensive.  Also, be sure to ask for the assistance of a qualified placement agency like About Seniors.  They can really be your advocates and can be of invaluable assistance with no cost to you.  Happy Summer……take care……Regina

Driving Issues As We Age........

Hi Everyone…..I am a resident of the Sun Cities and am aware of the driving issues facing our community.  It always surprises me when a caregiver for someone who has dementia or other neurological issues says that he/she cannot take the keys away from their loved one.  So, that person with reduced comprehension or mobility is still driving which is not only a danger to them but also to all of us!  Here is a list of questions to ask yourself when making that decision to take away the keys or not.  It comes via a compilation from the National Institute of Health (NIH)
If you answer yes to any of the following questions, you should be concerned about your loved one’s driving skills. It might be time to ask whether it’s time they retire the keys.

  • Has a friend or family member expressed concern about your loved one’s driving?
  • Has the doctor advised limiting driving for health reasons?
  • Has your loved one been pulled over by a police officer and warned about poor driving behavior?
  • Has your loved one been stopped by the police or had near misses or accidents in the last 3 years?
  • Does your loved one sometimes get lost on familiar routes?
  • Do you notice that your loved one concentration wanders when they drive
  • Does he or she become confused or angry?
  • Do other drivers honk frequently when they are behind the wheel?
  • Does your loved one complain that cars or people walking seem to appear out of nowhere?
  • Does your loved one have trouble moving their foot between the gas and brake pedals, or do they confuse the two?

It’s important to be aware of gradual limitations and how they may affect driving. If you’re not sure whether a driving problem is developing, discuss the situation with family members, friends, or the doctor to seek advice. The most important thing is that everyone be safe on the road.
Adapted from NIH SeniorHealth Older Drivers
….and I would ask one more question…..do you help them drive by telling them when to stop and which ways to turn?  Important questions to consider…..take care….Regina
 

April 2018 Blog on Preserving Brain Health

Hi Everyone…….I recently read an article in the AARP monthly newsletter that arrives every month in my mailbox.  As we all know, there are many ideas floating around out there which talk about how to preserver our memory.  There are many charlatans as well as bona fide experts in the field of dementia who are eagerly telling all of us what is best.  Certainly, the Blue Zone diet and information has substance.  The Longevity Study at Banner is indicating that those who are living longest stay socially connected.  But what about all those warnings that have been floating around for years?  Are you still cooking with aluminum pans?  Are you still using deodorants which contain aluminum?  Do you use ginseng?  Are you overdosing on your crossword puzzles and other word games?  Well, in the December issue of the AARP magazine, they addressed these concerns.  Here is a synopsis of what they said:

  1. Aluminum in pots, pans, cans and anti-perspirant:  I think that was the first thing I remember from what “experts” thought might be causing AD, because this element is found in the neurons of people who had AD.  However, it is the 3rd most common element in the earth’s crust, and “the small amount that you get from cookware and antiperspirants is not likely to increase your risk.”
  2. Ginseng:  I remember the arrival of ginseng in our daily vocabulary.  It was thought that if we used it in our tea or in supplement form that it would boost our brainpower.  However, researchers have not been able to corroborate that.  Plus, it actually interferes with other prescription drugs like those for diabetes, for blood thinning and depression.  In addition, it can cause sleep problems, headaches, and digestion issues.
  3. Brain games:  We all have our favorite word or number (Sudoku) games.  I always felt guilty that I wasn’t doing the NYT crossword puzzles.  After all, I was an English major in my undergraduate years!  But, I have no patience with them.  I do like those games where you have to find a word which may be written backwards, diagonally, or upside down!  Now researchers are saying that these games are good for making you more proficient at those games not for increasing brainpower.  Well, surprise.  What does help is taking a class, “designing a quilt, working with technology, or researching your geneology.”  The idea is doing something that is not rote and also engaging with others.  Listening to music is also on the good list.

So, stay connected and take care of yourself as well as your loved one…….Happy April…..Regina

HOW DO YOU "TAKE A BREAK"??

Hi Everyone, Recently About Seniors sponsored a caregiver symposium which featured experts in the field of Alzheimer’s, dementia, hospice, legal issues involving caring for someone with dementia, emergency care and caregiving in general.  As we would expect, everyone on the panel that day agreed that “stress” is the main issue for family caregivers who are on call 24/7.  How to deal with this stress to prevent the caregiver from becoming the patient, was a key issue.  The caregiver MUST have a break regardless of how brief that might be.  What can that “break” look like?  I have a list here of “Lucky 17” (St. Patrick’s Day inspired) ideas for you to try, or make it your bucket list to use to try one or more each day in the month of March.  Here goes:

1.  Laughing so hard your tummy hurts.
2.  Take a hot shower.
3.  Go for a drive on a pretty road…..Hassayampa Preserve is an easy drive or the White Tanks.
4.  Listen for your favorite song on the radio.
5.  Lie in bed listening to the birds outside.
6.  Putting warm towels out of the dryer up against your face.
7.  Find an article of clothing you like on sale for half price.
8.  Make a chocolate milkshake. (or vanilla!).
9.  Take a bubble bath.
10. Go to a support group where you can have a good conversation.
11. Laugh at yourself or the silly things that can happen in a day.
12. Invite a good friend over to visit.
13. At the mall, play with a new puppy.
14. Have someone fix your hair.
15. Make chocolate chip cookies…..if you have a toaster oven, you can buy premade mix and cook one cookie at a time!
16. Just sit in a chair or couch holding hands with your loved one…..even if it is only a couple of minutes…..and just breathe.
17. Watch the sunrise with your loved one and realize you have been given another beautiful day.

Have a wonderful month.  The weather is warming, and just step outside to let the sun warm your face.  Take care…….Regina