I had an experience today that was a wake-up call for me!

I have helped my mother through several major and minor transitions over the past years, and I’ve researched and written quite a bit on the subject.  But, today I experienced just a glimpse into how hard these transitions must be for our aging parents.  Mine was a humbling experience!

My husband and I decided to visit a new church today.  Our current home church is such a long drive each Sunday, and we really chose that church 15 years ago to meet the needs of our then 3 teenagers.  So, my husband and I discussed options and selected a nearby church that we had attended once for a special service.

Nothing prepared me for how I felt as I walked inside that church.  It was a feeling of being lost!  And, I was not alone.  My husband was with me.   I knew no one.   We didn’t know where to sit (my husband joked we were probably in someone’s established seat).  The service format was different; much of the music was different.   I heard so many names and references to people that meant nothing to me.    I found myself looking at every detail, taking it all in with every sense.  I was trying to make sense of it all, putting it in my personal framework.  Not easy!  The pastor greeted us and commented, “it is hard changing churches.”  And, then it hit me.

How must our aging parents feel as they are going through a transition?

• when everything has changed around them
• when they must adjust to a new home, new ways of living and doing things.  (A move into a retirement community really is an adjustment to a whole new culture.)
• when we ask them to downsize and expect them to part with “things” that carry a lifetime of memories with them
• when they are moved away from everyone they know, and every place that they hold dear.  (their church, physicians, pharmacy)

Yes, transitions for your aging parents are often necessary.  But, I encourage you to approach them with extra patience, empathy and a spirit of partnership.

Next time, before you discuss a major change with your aging parents, it might be helpful to put yourself in a situation similar to mine today.  Go someplace where you know absolutely nobody and where you feel totally out of your comfort zone.

I guarantee you will be able to relate more empathetically to your parent and will respond with more compassion.

If you’re reading this blog, I know you are concerned about healthy aging and quality of life for your aging parent (and yourself!)  Please read on to see how your “one vote” can make this headline come true!

Please watch her short video, and if you support her efforts, vote for her as many times and as often as you like

(If you’re new here, you may want to subscribe to my blog posts or request my Free E-Course. Thanks for visiting!)

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A big part of my summer is gardening. I love all parts of it; planning, planting, the feel of the soil, the smell of the plants, tending to the plants and anticipating the fresh and plentiful produce later this summer. If your elderly parent enjoyed gardening in their younger days, consider ways to downscale or modify the work involved so they can still enjoy it.

Interesting side note: “Garden therapy” has been shown to be effective in the treatment of Alzheimers. A British study shows that it relieves anxiety in those with dementia. All the more reason!

In listening to my mother share stories about their community garden in her retirement center, I’ve come up with the following tips:  
• Consider creating a raised bed. It will reduce kneeling or bending over the garden. You just build a wood structure and fill it with soil. There are also raised bed kits.
• Consider a potted plant on your deck. Even herbs could be a good selection. The fragrant smell and getting outdoors could do so much to lift the spirits.
• Involve your parent in choosing what to plant. Even one plant may be enough. My mother’s neighbor has just one tomato plant that she lovingly cares for everyday. And, when her plant starts to yield, she proudly shares the tomatoes with all her neighbors.
• The best times of day to garden for the elderly is early morning or evening to minimize the sun, heat and humidity.
• Consider adaptive gardening tools. Think about your parent’s specific needs as you consider tools with the right grip, length, weight and durability.

The benefits are many:
• The whole cycle of planning, planting, tending, harvesting is a wonderful activity for the body, mind and soul.
• It’s a great activity to do with your aging parent. Conversations will likely lead to stories of past gardening, family times, memories.
• The fresh air and sunlight is healthy.
• Smell and touch of the soil, plants and their yield can be very healing.
• Being immersed in an activity that they can lose themselves in can help them put worries out of their mind.
• And, as my mother always says, she has to have a purpose in each day. This is one activity, all summer long, that meets her need.

I’d love to hear from others. Will your elderly parents garden this summer? Could you add to my list of tips and benefits?

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Last Friday morning, I joined a group of eldercare professionals to hear about a “new” technique for communicating with those with dementia.  The 3 speakers (one of whom had traveled from Oregon) were incredibly passionate about sharing the wonderful technique with us.

The Validation technique was created by Naomi Feil 30 years ago.  It is a tested method of communication with disoriented elderly that helps reduce stress, and enhance dignity and happiness.  It’s all about accepting the feelings of another person and reaching out to them with empathy.

There is extensive training for those who wish to become certified.  But, in our seminar, we only received an overview.  I’ll share what I learned and provide a link to one of Naomi Feil’s books that family members/caregivers may find useful.

Naomi Feil says there are 4 stages in final life.  It’s important to understand what stage the person is in to know how to apply the Validation technique.

• Mal-oriented. The person is unhappily oriented to reality.
• Time confused. The person has lost cognitive capability and clock time.  He/she is still verbal.
• Repetitive motion. The person uses repetitive motion to replace lost speech.
• Vegetation. The person has retreated inward.

How does the technique work?  We were taught 3 key concepts.

• Centering exercise. Before working with a person with dementia, use this centering exercise to prepare.  Think of a color and breathe deeply.  It really helps you clear your head and be able to focus on the other person.
• Mirror the other person’s facial expression, tone of voice or beat of repetitive motion.  They showed us a video of Naomi doing this.  It’s quite powerful:  http://www.youtube.com/watch?v=CrZXz10FcVM
• Use anchored touch and music. We learned about the various touches: touch associated with mother, father, friend, partner or child.  For example, if a person with dementia keeps wanting their deceased mother, the ‘mother touch’ could be used.  We tried it.  As we used the ‘mother touch’ on another person, we looked straight into their eyes and sang “Twinkle, Twinkle Little Star”.  The touch and the music helps the person feel like they did when they were with their mother and helps them feel at peace.

Our presenters shared that when they decided to implement this program at a nursing home that had serious problems, they had to also show benefits, including cost benefits.

• In 2007, the average number of meds per patient was 18.  In 2010, the average number was down to 5.
• There was a reduced number of psychotropic meds and number of falls.
• There was a sizeable increase in staff retention and ROI.
• Census is consistently at 100% after implementing Validation.

Their mission is now “to create an environment where moments of joy, independence and wellness are the focus of each and every day.”

The biggest take-away for me was that if this technique is consistently used, no one will have to face the vegetative state.

Here is a book written by Naomi Feil, describing Validation techniques for family caregivers: Validation Techniques for Dementia Care: The Family Caregiver’s Guide to Improving Communication

Today, I want to highlight the main points of a wonderful article that I read recently. It pointed out that around the holidays, admissions spike at nursing homes and assisted living facilities. I asked a nurse friend of mine, “Is this true” and she said, “It definitely is”. So, why?

Many of us live across the country from “aging in place” parents. A lot can happen in one year, in terms of your parent’s health and home. If you find yourself in a home that’s in disarray or facing someone who is in frail health, you may find yourself in a reactive mode, wanting to jump at a solution. You may want to immediately ask direct questions. But that will likely put the your parent on the defense. There’s a better way to approach the situation.

Before you leave for your holiday visit, read the major points of this well-written article. A link to the full article is below. And, by all means, if you face a deteriorating or emergency situation with your parent, take a step back (and some deep breaths)…and try to frame the situation with an empathetic and loving approach.

Here are the main points of the checklist:
1. Look in the frig (is there outdated food in it?)

2. Drive their car (check the state of the tires, oil, antifreeze)

3. Take a peek at the mail (keep an eye out for unpaid bills)

4. Investigate the bathroom (check for cleanliness)

5. Take a note of how the pets are doing

6. Talk to the neighbors (a bonus is establishing a relationship with the neighbors and also someone to keep an eye on their home and them, even if just from the outside)

7. Identify some benchmarks ( consider marked declines from the previous year)

8. Go to the source. This is probably the most important ‘next’ step. Take the time to sit down with your parent, listen to their concerns, worries and perceptions. Ask what you can do to help. As when dealing with any of life’s difficult problems, oftentimes an individual (young or old) needs time to process a conversation, suggestions, etc. Give your loved one time to let your conversation sink in. Then, after the holiday, you can (as a family and ‘team’) engage in devising plan for solutions that meet your parent’s needs.

Here is a link to the complete article:
http://www.caring.com/blogs/caring-currents/looking-in-on-aging-relatives-a-home-for-the-holidays-checklist

Home Instead Senior Care (a provider of non-medical home care and companionship to older adults) sponsors a “Be a Santa for a Senior” program across the country.  For the 2008 national campaign, 400,000 needy seniors received gifts from 27,000 volunteers.    Since the annual program began, 930,000 gifts have been delivered to 568,055 seniors.

The needy seniors served don’t ask for much.  Common requests are socks, pajamas, hand/body lotion, blankets.  “One lady is asking for a Bible, puzzle and blanket.”

Most of us reading this post have elderly parents.  My mother often remarks that her friends tell her how fortunate she is to have two children who care about and for her.  Think of the many elderly who have no one and very little financial means.  While there are many programs to ensure children get clothing, toys and food at Christmas,  people often don’t think about the isolated and lonely seniors.

You can reach out and help those seniors through this program:

• Call your local Home Instead franchise and ask if they are sponsoring the program in your area.  http://www.homeinstead.com/findhomecare/default.aspx
• You can involve your church or civic group in the “Be a Santa” program.
• If you aren’t able to purchase gifts, you can help with gift wrapping and delivery.

Consider being a “Santa for a Senior” this year.  Help provide the human contact and social interaction that is so very much needed by these seniors.

In a small but important way, “you” can brighten the life of a senior this Christmas!

Source: http://www.montgomeryadvertiser.com/article/20091116/LIFESTYLE/911160304/Santa-program-helps-fulfill-elderly-wish-lists

University of Pittsburgh researchers have shown that at the time of transitioning our parent to a nursing home, we (as family caregivers) face the same level of anxiety and depression as when we bathed and fed our parents at home.  Think about why!  We are no longer in control, our parents are at their most vulnerable, and we have entered a “world”  we know little about nor have experience in!

Why is it that we adult children sometimes view the nursing home staff as an adversary? How can we find a way to partner with the staff?

Dr. Pillemer, a gerontologist at Cornell University, believes we have to see ourselves as allies, not adversaries, to the nursing home staff.  He says that “family members can …work with staff to solve problems.”

Here are some of his suggestions:

1. Take requests and complaints to the right level. He suggests the staff social worker as a good place to start.
2. Practice “clear and respectful communication.” Avoid blaming the other person or putting them on the defensive.  Phrase the problem in terms of why it’s important to your parent.  Once you think you’ve reached agreement on an issue, be sure to clarify the agreement verbally.
3. Keep visiting and monitoring. Dr. Pillemer says that “the amount of visiting done is directly related to the quality of care”.
4. Give positive feedback as often as possible. Hugs and friendly coaching go a long way to set a positive tone.  The article gives an example of how one nursing home still receives a fruit basket each Christmas from the family of a former (now deceased) resident.  A staff member there says, “That’s so thoughtful.  It says we made a difference in people’s lives”

The 5th way to partner comes from Dr. Eleanor Barbera (founder of  My Better Nursing Home).  She recently shared that every family (with a loved one in a nursing home) should ask to attend the “care plan meetings” for their loved one.  These meetings occur when the person is first admitted, and then at regular intervals.   You’ll come away with a fuller understanding of your parent’s overall care and also will be establishing yourself as an advocate for your parent.

So, become an ally and partner with your parent’s nursing home staff.   Do the following as often as possible.   Take every opportunity to be present, say ‘thank you’, and handle problems in a respectful, solution-oriented manner.  Be aware that  many of the staff giving hands-on care haven’t received a lot of training, work under stressful conditions and receive low pay.

As Dr. Pillemer says, “It’s an extremely challenged system”.

Source: http://newoldage.blogs.nytimes.com/2009/10/19/easing-tensions-in-the-nursing-home/

Dennis Fortier

As we enter into National Alzheimer’s Awareness Month, you may wonder why we should bother promoting awareness.  Those who have been touched by Alzheimer’s are already aware and those who have not been touched can’t really help — so what’s the point?  After all, doesn’t it make more sense to skip the awareness effort and just focus all resources on a cure?

As it turns out, lack of awareness and education are major contributors to the burgeoning Alzheimer’s problem.  And while the benefits of awareness may not be obvious, they are very real.

For example, do you know what you can do today to reduce your risk of getting Alzheimer’s later in life?  If not, your lack of awareness is fueling the ongoing problem.  Do you know how we can immediately improve the efficacy of those drugs currently approved for Alzheimer’s?  Sadly, most patients and many physicians do not. How clear is your grasp of the relationship between a healthy heart and a healthy brain?  For many of us, investing a few minutes to improve our understanding of that relationship could yield long-lasting health benefits.

The answers to these questions along with four other important perspectives are summarized in a short article on the Brain Today blog (link)*.  The full article can be read in about five minutes and, with a couple of additional clicks, can be forwarded to your online networks.

In the spirit of National Alzheimer’s Awareness Month, please visit the Brain Today blog (link)* and read the article and then encourage your social networks to do the same.  In this way, you will become a part of the solution, doing your part to thwart Alzheimer’s through the simple act of awareness.

Source:  Dennis Fortier is President of Medical Care Corporation and Editor of the Brain Today blog (link)*.  Brain Today is a non-commercial publication devoted to interpreting the daily news about brain health and distilling the true value of that news.

* link=http://braintoday.blogspot.com

Did you realize this form of dementia is preventable?  In my Blog Talk Radio interview with Jason Young, geriatric clinician, Jason said the biggest preventive step people can take (in avoiding dementia) is to stay “heart healthy”.    Such a simple statement.  But, it is profound.  No matter what age you or your aging parent is, the more that you do for your physical health will absolutely impact the health of your brain.

I imagine every reader has heard this before but I am going to repeat the key health strategies for staying “heart healthy”.

But, this time, realize that every choice (food, exercise, lifestyle) you make each and every day… will impact if, when and for how long you will spend your later years in a nursing home.  Then, think about what that will mean for your children!

Strategies to stay “heart healthy”:

• Prevent or treat high blood pressure.
• Do not smoke.
• Stay a healthy weight.  That will reduce the risk of diabetes, yet another risk factor for dementia.
• Keep total cholesterol under 200 mg/dl.
• Get a total of 30-60 minutes of exercise at least 5 times a week.

Now, share this message with your family and friends!

You are not alone. The Alzheimer’s Association website lists the following facts:

• As many as 5.3 million people in the United States are living with Alzheimer’s.
• Every 70 seconds, someone develops Alzheimer’s.

One of the most important things we can do (for ourselves and our aging parents) is to educate ourselves and serve as our parent’s advocate as we navigate the complexities of health care issues.

Join me and Jason Young, geriatric clinician, as we explore many of the questions you may have about dementia and Alzheimer’s. What are the warning signs? How is a diagnosis made? What are the common treatments? How can you best help and communicate with your parent? How about you…what support options exist for you?

This Wednesday, July 22nd, 5pm EDT.   Mark your calendars now.  Click on the following link and in the BlogTalkRadio icon, click the “Remind Me”.  You’ll be able to add the event to your Google or Outlook calendars or request an email reminder be sent to you prior to the show.

http://www.blogtalkradio.com/DaleC/2009/07/22/Parent-Diagnosed-with-Alzheimers-Where-Do-I-Start

Hope you’ll be able to join Jason and me for this informative conversation!  And, when you do, you’ll have the opportunity to ask Jason your questions directly!