A long-time hospice nurse—someone deeply committed to caring for the seriously ill—created this list of the top five deathbed regrets she frequently observed in her patients. She vowed to take these lessons to heart. Do any of these ring true for you?
The care plan and meeting
If your loved one is admitted to a skilled nursing facility, Medicare requires the staff develop an initial, personalized care plan within the first 48 hours. This describes who should be doing what. Then, within the first 14 days, the staff must assemble a comprehensive assessment, which must include your loved one’s needs and strengths.
Do you strive for perfection?
It’s important to do the best you can when caring for a loved one. But aiming for perfection can bring on problems. For yourself, in terms of anxiety, depression, and low self-esteem. And for your relative and other family members, who may feel burdened by living under the stress of constant measurement and judgment.
For many people, a pillbox is just the ticket. But as we age, we may take more medicines. Filling the box requires more concentration. Remembering to take the meds can become more challenging. Many families turn to technology to help an aging loved one.
Gather important documents
If you are the person most likely to step in if your loved one is unable to get to the bills—a hospitalization, dementia—you need to get oriented. And organized! It’s easy to lose track of paperwork, especially someone else’s. Professionals recommend gathering important documents in a file or binder for safekeeping. Put that in a locked and fireproof location. Consider a small home safe. Or a safe deposit box at the bank.
Calling a family meeting
April 10 is Siblings Day! How are things going with your siblings? Does everyone in your family participate in the care of your loved one? Is there agreement on the problems? The solutions? If not, you aren’t alone with this issue. But you could probably use a family meeting or two to get everyone rowing in the same direction.
If your spouse is younger than 65 and has received an Alzheimer’s diagnosis, you may feel in a world all your own. You probably don’t know anyone else in this situation and may sense a social stigma. It can be scary. Lonely. And feel just not fair!
Did you know “false teeth” need to be brushed daily, just like “real teeth” do? Learn how you can help your loved one avoid infections, maintain good nutrition, and extend the life of their dentures.
Choosing a meal service
Food is so profoundly linked to health and love, it can be distressing to realize that someone you care for is missing meals or otherwise eating poorly. There are many services available to help, each with their own special procedures. Learn about the questions you’ll want to ask.
Is it time for memory care?
People with moderate dementia are rarely aware of their need for help. It will be the family members who make any placement decisions. How do you know when this option should be explored?
If you are not the primary caregiver
If someone else in your family has primary responsibility for the care of your loved one, that doesn’t mean you don’t have anything to contribute. Far from it! Caring for an older adult is more than one person can do alone. There are many ways to lend a hand (even if you don’t live nearby).
Addressing fatigue in heart failure
February is Heart Month. If your loved one needs frequent naps and gets out of breath easily, he or she may need a daily life energy budget. (This is especially true for people with heart failure.)
Home modifications for vision loss
If the person you care for has a low vision diagnosis, three types of modifications to the home can make life easier: Lighting, glare control, and the use of color contrast. Fortunately, these strategies are relatively inexpensive.
Where are the paid caregivers?
Frustrated in your search for a paid caregiver? You are not alone. There is an extreme shortage of helpers right now. Even before COVID, the demand for aides was greater than the supply. The “Great Resignation” hit the caring professions hard. Caregivers close to retirement left early. And many younger workers decided to opt for safer, less demanding jobs. In some states, as many as 38% of direct-care workers chose other occupations last year.
Caring for a parent long distance brings its own challenges. With planning, organization, and frequent communication—plus a little help from technology—you can provide effective support.
The yearly “Wellness Visit”
Catching things early is big with Medicare. Every year, all Medicare enrollees are eligible for a free “Wellness Visit” with their primary care doctor. This is NOT an annual physical, so don’t use that term when making the appointment. Beyond basic vitals—height, weight, blood pressure, and pulse—there is no physical examination. If a physical exam is done, your loved one may have to foot the bill.
Are you the primary caregiver?
Being primary can be quite a job. In many cases it involves driving to the doctor and managing medications, handling finances, providing for daily needs, coordinating care services, and keeping the elder’s spirits up. If you are that person, don’t try to do it alone—even if it seems like that’s the only choice.
Dry eye syndrome
Our eyes show us the world. If something goes wrong with them, it can affect our total well-being. Dry eye syndrome makes eyes feel gritty, burning, itchy, and sensitive—discomforts that are hard to ignore! It typically manifests with age and affects as many as 30% of older adults.
Cold weather safety tips for indoors
The dangers of cold weather are obvious outdoors. But there are dangers indoors, too, most often because the house thermostat is set too low. People can die from being too cold. Older adults are especially at risk.
Healing torn relations
Take any roomful of people and likely two-thirds of them have relatives who aren’t talking to each other. Families are messy. Hurts abound. Some people wait until a serious diagnosis to reconcile. They often regret the years of separation they can never retrieve. Others try forgiveness earlier in the process. There’s no right or wrong.
Dementia and small children
The grandparent–grandchild relationship can be precious, like no other. But even young children notice if Grandma or Grandpa isn’t acting the way they used to, or the same way others do. And they will have questions.
Is your home safe for older guests?
If you expect older visitors this season, check your home for hazards. Older adults often have impaired balance and vision. This makes them prone to falling, especially in new surroundings. And fragile skin and bones can mean double trouble if someone does take a spill.
Not taking meds as directed?
Taking the right medicines at the right time is extremely important to health management. But 75%–96% of older adults admit that they frequently make mistakes with their medication. Is your loved one among them?
Gifts for those with memory loss
Deciding what holiday gifts to give a person with memory loss can be challenging. From seasonal activities to digital picture frames or fuzzy robo-pets, we’ve got suggestions!
Honoring family caregivers
November is National Family Caregivers Month. We want to express our gratitude to you, who are part of the 40 million people (one in six Americans) who care for an older adult friend or relative. So many family caregivers feel invisible, we thought we’d give you some perspective on the scope of family caregiving across the country.
Suppose they don’t get better …
Are frequent visits to the ER a significant part of the past six to twelve months? Does your loved one seem more fatigued? Less interested in eating? Perhaps a bit withdrawn? These symptoms may be hallmarks of a serious illness your relative will overcome. But it’s also possible that these signal that your family member no longer has the reserves to beat their condition.
Palliative care for seriously ill veterans
If the person you care for is a veteran and is seriously ill, they may qualify for a VA program designed to control symptoms that cause pain, discomfort, or mental or emotional distress. Called “palliative care,” this program is available even if the problems are as a result of treatments, not just the medical condition itself.
Putting anticipation to work for you
Do you ever wish you could wave a magic wand for more joy? Patience? Optimism? Motivation? Maybe less irritability and stress? It’s actually accessible now, no wizardry required. Just a shift in attention. Welcome to “anticipation.”
What is Lewy body dementia?
The most common form of dementia is Alzheimer’s disease. However, there are many other conditions that also bring on memory problems. It is important to accurately identify the cause, even if there’s no cure, because this will shape the best strategy for addressing difficult symptoms.
October is National Crime Prevention Month
It’s unpleasant to imagine that your loved one might become the victim of crime, but it’s worth considering. There are valuable preventive steps to take. Unless your relative lives in a high-crime neighborhood, their greatest risk is a property crime in or around their home.
Who is who in skilled nursing facilities?
If your loved one is discharged from the hospital to a skilled nursing facility (SNF), their care will be in the hands of a team of specialists. It’s a good idea to understand the players’ roles so you know whom to call upon for what.
When your loved one is depressed, suggest exercise
Depression is common in older adults. It’s long been known that brisk exercise can help reduce depression. But it turns out that exercise doesn’t have to be vigorous to make a difference. Even mild exercise can be effective.
Are you prepared for a disaster?
No one likes to dwell on the possibility of disaster. But we all need to prepare for one, just in case. Help your relatives gear up for safety. Whether you live across town or across the nation, the action items are the same.
Could medicines be the culprit?
If your loved one has balance problems, the culprit may be in the medicine. Many common medicines have side effects that can impair balance and lead to a fall. Over 40% of persons age 65 and older take five medications or more. This increases the chance that at least one of the drugs has side effects of dizziness, blurry vision, drowsiness, or muscle weakness.
Caring with a stepparent
Has your parent remarried? If so, you may be sharing the caregiving with a person you don’t know very well. Biological families often encounter tensions when it comes to eldercare. Add a stepparent and the challenges can grow exponentially.
Noncancer screening tests
Medicare pays for many screening exams, and even counseling sessions, to help nip common illnesses in the bud. Screening tests are designed to identify problems before symptoms emerge. They are usually for people who are considered to be “at risk” for getting a specific disease. Here are some of the most common noncancer preventive services that Medicare covers. Ask the doctor if your loved one should be tested.
Listening: The other half of the conversation
Good communication requires both speaking and listening. Oddly enough, if you make a specific effort to listen, it can open doors. Once “heard,” the other person may be more willing to hear your point of view. Deep listening is more difficult than it sounds. It’s not passive. It requires concentration. It also takes humility and empathy.
When grandpa has dementia: Teens and tweens
For a teen, a relative’s dementia can turn a close relationship into one that’s now awkward, confusing, and embarrassing. And creates feelings of guilt.
The doctor interview
After you have scoured the Internet to help your relative find a potential new doctor—someone on their plan and with no obvious red flags—it’s time to get more specific. The doctor’s website may provide some descriptive information, but most likely, you’ll want a conversation.
Caught in a cycle of negativity?
For most family caregivers, frustration and guilt are common, as is anxiety and resentment. These feelings are normal and reasonable under the circumstances. It’s not realistic to eliminate negative emotions. Caring for an ailing family member IS emotionally taxing, especially in the case of memory loss. But sometimes the negativity can feed on itself.
Senior centers: Worth a fresh look
Even pre-COVID, many 90-year-olds adamantly refused to go to a senior center, saying they didn’t want to be around “all those old people.” (!) Does this sound like your loved one? Admittedly, the senior centers of the past tended to focus on bingo and crafts. These activities are of limited interest to the newest generation of older adults. Happily, senior centers have been updating. Bingo and crafts are still there. But the upswing in technology use during COVID catapulted many centers into the 21st century
With summer’s warm weather, be on the lookout for dehydration in your loved one. The signs include confusion, fatigue, weakness, and sleepiness. Some people become dizzy and their balance is thrown off. Dry mouth, headaches, and muscle cramps are other symptoms of dehydration.
Dementia and finances
If the person you care for has dementia—memory or thinking problems from a condition such as Alzheimer’s, a stroke, or Parkinson’s—unpaid bills or a messy checkbook may have been your first sign that something was amiss. Certainly, in the later stages of dementia, your loved one won’t be able to manage their finances. But what about the in-between?
The “Sandwich Generation”
Elderly parents are living longer. Children are often dependent for more years than expected. Add to this the ongoing responsibilities to spouse/partner and jobs, and there is little wiggle room for the millions of family caregivers who find themselves squeezed in the middle as the “Sandwich Generation.”
Swollen legs and feet
Many older adults experience swollen legs and feet. For some, it’s because of sitting a lot and leading a sedentary lifestyle. For others, it’s the water retention side effect of a medication. And for others, the swelling—called “edema”—is a symptom of a chronic or even serious illness such as heart failure or liver or kidney disease.
Does brain training work?
The brain is another organ to keep fit, and regular workouts are a good thing! Our brains enable many types of thinking: Problem solving, planning, attention, and memory. They manage our emotions and help us understand the emotions of others. Our brains also control movement (balance, speed, and coordination). And it’s where we process our spatial awareness—used for packing a suitcase or reading a map.
Understanding the rhythm of a disease
Much of the strain of caring for a loved one lies in the loss of a predictable routine, a sense of “normalcy.” Understanding the course of your loved one’s condition—the rhythm of how it unfolds—can empower you to respond more flexibly to its challenges.
Text message scamming: “Smishing”
Your loved one may be watching for phishing scams on email, but now there are scams carried out by short message service (aka, texting). “Smishing” scams rose 58% in 2021. Nationwide they cost victims over $10 billion. Seniors are a prime target, as three out of five now own smartphones. While convenient, smartphones present new opportunities for getting scammed. Time to alert your relative to smishing.
Caregiving with kids
Children generally like to feel included. But they may not know how to relate to an ill family member with limited abilities. Here are some ideas for home-based activities with elementary-age children.
Living with cancer as a chronic condition
Has your loved one been diagnosed with cancer? The vast majority (67%) of people with cancer live for another five years or more. A cancer is considered “stable” or “controlled” when tumors shrink or at least temporarily stop growing. This is not the same as being cured—no tumors—but it does make cancer more of a manageable chronic disease, like diabetes or asthma.
When you envy others
Do you ever look at friends and find yourself mad or upset because they have free time? They don’t have a relative that needs help? You might even wish they had it harder, had some real challenge in their life. And then you feel guilty. If this sounds familiar, you are not alone. Envy is a natural human emotion.
Primary care providers
A primary care provider (PCP) is charged with monitoring and treating a person’s whole body. Specialists abound and indeed are important. But we are more than the sum of our organs. Your relative’s PCP helps ensure that specialists are not doing things that counteract each other. If you are looking for a new PCP, there are several types of providers to consider.
Cooking tips for the visually impaired
Is low vision making it harder for your loved one to cook? If food preparation has been one of their pleasures, they are probably grieving not only the change in their eyesight, but also the loss of creating and serving delicious meals. Even if cooking has not been a passion, the ability to safely prepare food for oneself is critical for maintaining independence and self-esteem. Fortunately, there are ways to empower your relative with simple strategies and inexpensive tools. Here are some techniques that augment and use all the senses. They also protect safety.
Interrupt the stress cycle with deep breathing
We’re breathing all the time. But when it comes to stress relief, not all breathing is equal. Our bodies are built to handle periodic crises. When we sense danger, our bodies release “stress hormones” that enable us to respond powerfully and fast. When the crisis is over, those hormones are no longer released. The body returns to relaxed, “normal” mode. But chronic stress is damaging. When we’re stressed every day, the “fight-or-flight” hormones keep running. Not a lot, but enough to upset the body’s balance and undermine physical health and mood. The body is distracted from its routine tasks of repair and maintenance. This can result in significant consequences.
Poetry and dementia
If the person you care for has dementia, you may have noticed their withdrawal from conversations, movies, even from reading books or the newspaper. Anything with an involved plot line is now too difficult for them to follow. Poetry, on the other hand, involves rhythm and images, which can stimulate memories of experiences, emotions, smells, tastes, and other sensations. All quite accessible by persons with dementia. Plus, many older adults went to school when poetry was an active part of the curriculum. Exploring fun poetry together may tap into positive memories from the past.
Those who donate organs, eyes, or tissue leave a tremendous legacy, often the gift of life itself: Allowing someone a steady heartbeat. Or the vision to see a grandchild. Or healthy skin to cover a burn or cancer site. National Healthcare Decisions Day (April 16) is when everyone is encouraged to create or update their advance directive. These end-of-life documents include a section for letting family members and healthcare providers know whether you choose to be an organ donor.
Should Dad move in?
Combining households has many benefits: Less hassle running back and forth between two residences, less worry about Dad eating well and remembering his meds, more family social time for him, cost savings on rent and utilities, etc. But if things do not work out, disentangling could cause hurt feelings and damage your relationship. Consider these questions before you move in together.
The journey of late life
Families spend three to five years caring for an aging relative. At first it may be light chores or small errands now and then. But over time, health challenges emerge and needs grow. In his book, My Mother, Your Mother, geriatrician Scott McCullough outlines eight “stations” in the journey of late life. For each one, he offers insights and tips to help you counter the modern system of “fast medicine” with personalized solutions he calls “slow medicine.”
People who go through chemotherapy for cancer often complain about “chemobrain.” If your loved one is under treatment and is having trouble with memory, thinking, and concentration, it is likely from the chemo drugs. The fuzzy thinking may not go away right when chemo stops. But it usually recedes over time.
Juggling multiple schedules, keeping other relatives informed, ensuring prescriptions are filled … these are but some of the many duties you may face as a family caregiver. In some instances, a simple spreadsheet can do the trick. But an app makes it easier to coordinate with others.
Psychological first aid
Anxiety and stress commonly accompany family caregiving. The ongoing pandemic and its stream of variants are only adding to that. Perhaps you could use a little “psychological first aid.” These are skills or techniques first responders are trained to teach or apply to distressed persons after urgent physical issues have been addressed.The goal of psychological first aid is to help people feel safe (physically and emotionally), calm, and hopeful. Connected to others. Sound good? Try these strategies on yourself.
When your relative has money questions
Is Dad asking if he should sell the house now that Mom is gone? Or perhaps Aunt Mary is anxious about her stock investments. Even if you are good at managing your own money, helping a relative make financial decisions can bring a lot of pressure. Consider hiring a professional to advise you.
Reducing the nausea of chemo
If a loved one in your life is undergoing chemotherapy for cancer, very likely they are dealing with the common side effects of nausea and vomiting. Not fun. Encourage them to follow these tips.
Protecting the house from Medicaid
Care in a nursing home is expensive. For an extended stay, most people will need to pay quite a bit out of their own pocket. If there are no savings, Medicaid—the joint state-federal health insurance for low-income individuals—will step in.
Signs of an online “sweetheart scam”
Romance crime is on the rise. Over 25,000 people reported a sweetheart scam to the Federal Trade Commission (FTC) in 2019, a threefold increase since 2016. Individuals age 65 and older were the hardest hit, with a median loss of $9465 (across all ages, the median loss was $2500 per individual). If your loved one has been taken advantage of, they are not alone! Romance scams are the second most common crime reported to the FBI.
Subtle signs of a heart attack
We all know the classic heart attack portrayed over and over again in movies and on TV: Someone writhing in sudden, severe chest pain.
But many heart attacks aren’t like that at all. Instead, they start slowly, typically with some mild, on/off pain or tightness in the chest. These signs are so much less dramatic than what people expect, they too often are ignored. The result, sadly, is often fatal when in fact a prompt response could have saved a loved one’s life.
When your relative is actively dying
In the last two weeks, as a loved one is nearing death, it is natural to want to be at their side. But then, what? Especially if you have never been in this situation before, you may feel uncertain—even awkward—about what to do. The ideal is to be a calm, reassuring, and loving presence focused on keeping your relative comfortable. Here are some tips.
Need a new doctor?
The pandemic has brought on a wave of physician retirements. Perhaps one of your relative’s doctors has sent a letter announcing the close of their practice. Yikes!
When choosing a new physician, it’s worth the time to do some research. The right fit is critical to your loved one’s health and well-being.
Friends? Who has time?
If you are like most family caregivers, your social life has dropped in priority as you juggle your loved one’s needs. There just aren’t enough hours in the day to keep up all your friendships in addition to your family responsibilities.
A spouse’s grief in the face of dementia
Grief is the expected response to a loved one’s death. We expect to mourn, and we receive comfort from others. But in the context of a dementia, such as Alzheimer’s disease, the loss is not as clear cut. Your partner is “here but not here.” And you do not receive the same support or acknowledgment for the very real losses.
Making the best use of your time off
Time off from caregiving is precious. But after a break, many family caregivers find they don’t feel as refreshed as they hoped they would. Current research provides insights about how to get the most from a respite break.
Writing the last chapter
If your loved one has health challenges, they may be feeling a loss of control. Add to that a terminal diagnosis and a sense of doom may prevail. But recognizing that life is coming to a close does not have to mean one waits glumly for the end. Following are some of the many ways hospice patients have chosen to take action and purposefully write their own “last chapter.” Perhaps one of these might appeal to your loved one:
Private pay services for care at home
Typically, it’s family members who fill in to perform the necessary tasks. But for many, perhaps including you, there are obstacles to helping on a regular basis. (Quitting your job to provide care is risky. Leaving work midcareer jeopardizes your retirement options and savings.)
Hearing the TV better
Is your loved one having trouble hearing the television? Closed captioning isn’t helping enough? Check out these possible solutions.
Engaging activities for persons with dementia
It is usually obvious what a person with dementia is no longer able to do. But finding things your loved one CAN do may feel like a challenge, especially if memory loss is severe. Here are some tips:
Help at home: Community programs
For nonmedical support, check out community programs. Many are provided by nonprofit organizations. Others by faith communities. And still others by local government. Most offer discounts or a sliding-scale fee.
Holidays without your loved one
The holiday season is a festive time of year, but it may not feel much like a celebration for people grieving the loss of a loved one. Holidays are an especially tender time for missing those who are no longer with us.
The special needs of Vietnam-era vets
Almost 3.5 million members of the military served in Vietnam between 1964 and 1975. Was your relative one of them? This group of veterans continues to face physical and mental health problems.
Products for addressing incontinence
There are many undergarments designed to help with incontinence. They can’t prevent it, but they can help your loved one feel more comfortable with outings and retain their dignity despite the embarrassment of accidents.
Is Medicare Advantage the best choice?
Once a year, Medicare offers the option to change plans. In 2021, the Open Enrollment period is October 15–December 7. Your loved one may be considering a switch to a “Medicare Advantage” plan. There are pros and cons.
Depression after a scary diagnosis
If the person you care for has a life-threatening illness, you might think it’s only natural for them to feel down. Even hopeless from time to time.
But weeks of sadness are not a side effect one simply has to tolerate. It is not uncommon for someone with cancer or a similarly scary diagnosis to become depressed. But depression can and should be treated. Effective treatment makes for better quality of life. It can also improve other symptoms, such as pain and insomnia.
Too many pills: When less is more
More than half of older adults take five or more medications per day. That’s “polypharmacy,” and can be dangerous. Taking too many medicines can cause problems such as dizziness, mental confusion, and heart failure. It can create an increased risk of falls, which often lead to the end of independent living. An estimated 10% to 30% of older adult hospitalizations are due to medication problems.
Managing emotional outbursts
If the person you care for has Alzheimer’s disease or another type of dementia, you may find their sudden emotional swings more difficult than their forgetfulness. Among many things, the disease has taken away their inhibitions. They can become quite irrational. And they are more likely to make a scene in public than they ever would have before their dementia. Family members mention embarrassment as one of the most difficult aspects of caring for their relative.
The “dignity of risk”
One of the most challenging dilemmas when caring for an aging parent is balancing their preference for independence with your concern for their safety. If you have noticed lapses in cleanliness, meals, bill payment, or other areas, you may be worried that your loved one is not able to safely live alone. They may refuse assistance, however, not recognizing there is a problem.
Not all socks are created equal
What do a marathon runner and your aging parent have in common? Both could benefit from compression socks! By applying pressure to the legs, compression socks help the valves in the veins do their work—so blood is pushed back to the heart and doesn’t pool in the legs. Older adults with edema (swollen legs), varicose veins, or deep vein thrombosis find that compression socks ease discomfort and can even prevent problems.
Dealing with anxiety
It’s only natural for family caregivers to worry. Understandably, we spend a lot of time thinking about “what’s next.” But if you are in a pattern of persistent worry and are starting to feel the stress in your body too—perhaps headaches, loss of appetite, or trouble sleeping—you may be dealing with anxiety.
Services at home: Medicare
Medicare is health insurance provided by the federal government. It covers adults 65 and older, as well as persons with disabilities. In terms of home care, Medicare pays for visits only by medically trained staff. In that light, there are two programs: Home health and hospice.
Coping with another person’s pain
When your family member is in pain, you are suffering, too. The “mirror neurons” in our brains are programmed to recognize pain in others. That’s good news in that it arouses compassion and spurs us to action. But it can be bad news, too. When you are highly attuned to a loved one’s pain, you are at higher risk of depression, burnout, and poor health yourself.
What is a daily money manager?
A financial advisor manages investments. A daily money manager (DMM) is someone who comes to the home once or twice a month to handle the mundane aspects of personal finances: Paying monthly bills (but your loved one signs the checks). Balancing the checkbook. Navigating health insurance claims. Resolving billing errors. Tracking donations. Organizing paperwork. Gathering documents for tax time. Their job is to catch unnecessary expenses while making sure important payments are made on time.
The decision to stop dialysis
Dialysis is life sustaining yet also quite taxing for the patient. About 25% of people who choose dialysis later decide to stop. Typically, this is because the burdens of this kidney disease treatment have severely reduced their quality of life. The tradeoff becomes no longer acceptable.
Learning to forgive yourself
According to psychologist Rick Hanson, PhD, we all have an inner critic and an inner protector. Together they help us maintain a balanced perspective. But too often as family caregivers, we have an overload of guilt, shame, and remorse, always feeling our performance is subpar, that we haven’t done enough. This is not healthy. The inner critic has an important role, but it’s not to pulverize our self-esteem.
The healing power of music
Can listening to calming music actually ease pain? Can singing silly songs make you happier? Researchers say this isn’t just a folktale—it represents some of the measurable effects of music on the mind and body.
Although it’s not yet clear exactly how music works its magic, studies show that it is strong medicine, both in the moment and as treatment over time. Among the benefits, music
Dealing with criticism
Receiving criticism is never a pleasant experience, especially from family members. Whether it is a sibling griping about how you care for a relative or complaints from the person you are caring for, you may feel suddenly flooded with difficult emotions. Perhaps anger, shame, or confusion.
We can’t stop others from giving criticism. But we can become wiser about how to deal with it. Try these tips:
What is a Medicaid spend down?
There are two forms of government health insurance:
– Medicare. Basically, age-based insurance for older adults (age 65+), regardless of income and assets. (Assets include money and belongings, such as a house or car.)
– Medicaid. Income-based insurance funded with federal and state dollars. (The state where your relative lives may have a name different than “Medicaid.”) This insurance is for individuals who have very little means. The financial asset threshold is often set at $2000 or less.
Medicaid will sometimes pay when Medicare will not.
The most common expense covered by Medicaid is long-term care in a nursing home. Speaking very generally, Medicare pays for the first 100 days after a hospitalization. If a person needs to stay longer—permanently move into the facility—they must cover the cost from their own savings. Once nearly all their resources have been exhausted, they can apply for Medicaid, which will pick up the tab.
If making it to the bathroom in time is a frequent concern for your relative, they may have an overactive bladder. More than 33 million Americans contend with this condition, in which misfiring nerves cause the bladder muscles to contract involuntarily. Your loved one may be too embarrassed to bring it up with the doctor, or even with you. But it should be checked out. It’s not a “normal” part of aging. Overactive bladder (OAB) is a real and treatable medical condition. And you certainly want to be sure it’s not something else.
The basic symptoms of OAB include an urgent need to urinate more than eight times in a day and/or more than once or twice a night.
Many people let incontinence worries run their lives. They stay close to home for fear of accidents. They withdraw from social activities, dreading they have an odor from leaks. They may become anxious or depressed. And multiple nighttime trips to the toilet can result in insomnia and fatigue, bringing on more depression.
What’s involved in giving care?
Perhaps you call regularly to offer emotional support. Maybe you handle finances. Perhaps you visit weekly. Or you may live with your loved one 24/7. Caring takes many forms. You may feel this is simply what a loving daughter/son/partner would do. But that doesn’t mean it isn’t time and energy from your day. Or night, if you skimp on sleep to create time to help.
Whether you provide hands-on care or assistance from afar, you ARE a family caregiver. And that means you need to watch for burnout. Use this list to take an inventory. Consider what is realistic for you. And think about options to help manage the load: Friends, family, community programs, paid help.
Explaining your needs to others
Are you worried that asking for help sounds like whining? You may believe you “should” be able to do it all without assistance. Or think you are “just” doing what any good or loving daughter (or son, or spouse) would do. Like many caregivers focused on family harmony, you may have become used to minimizing…
Medical management without dialysis
Dialysis typically buys a person some time. But it rules their life—and possibly yours. It requires strict adherence to the schedule. Also, severe food restrictions. Your relative’s energy level will fluctuate. That makes planning for other activities difficult. There is an increased chance of infection because of the access port for dialysis. And there are side effects: Itchy skin, trouble sleeping, headaches, and dizziness. Cramps, nausea, weight loss, and fragile bones are not uncommon.
Giving “awesome” new meaning
It turns out that feelings of amazement, marvel, and wonder are beneficial emotionally AND physically. Exposing yourself to an awe-inspiring experience twice a week can replenish your well and increase feelings of connection. Learn more about the science of awe and what you can do to bring it more regularly into your life. Check out our blog for family caregivers.
Signs of financial abuse
Older adults are frequently targeted for financial abuse. They typically have more funds than their younger counterparts do. They tend to be generous and naïve, not understanding all the ways they can be scammed. Some have memory and thinking problems. And even if they do realize they’ve been “taken,” they may be too ashamed or…
Seeds of family resilience: Focus on rewards
Research on stress often involves family caregivers. No matter how much you love the person you care for, taking care of an ailing relative can be stressful! To offset the stress, consider the power of positive thinking. Studies show that people who “seed their lives” with moments of positive emotions are more resilient in the…
How to get durable power of attorney
There may come a time when your loved one will need help handling financial matters. Maybe filing taxes. Or interacting with Social Security. Or signing a contract to move into a new residence. If your relative is unable to do these things because of illness or problems with dementia, you will need to show a…
Transitioning from curative care
At some point, the burdens of treatment may just become too much for your loved one: The nausea of chemo. The rigors of dialysis. Wearying trips to the ER. Perhaps the person you care for is already having these thoughts, to let nature take its course and stop fighting for health that stubbornly eludes them….
Managing arthritis pain
The most common arthritis is osteoarthritis, which occurs most often in the hands, knees, hips, lower back, neck, and feet. It affects roughly half of those age 65 and over. With osteoarthritis, the smooth layer of cartilage between the bones in the joints deteriorates, causing bone to scrape directly on bone. Ouch! If your loved…
Should you take over Mom’s checkbook?
Money matters are often intensely private. And no one wants to infringe on a family member’s independence. Yet it is through (sometimes expensive) financial mishaps that you may learn of changes in your parent’s memory and thinking. Signs of a problem Diseases that affect memory also tend to impair arithmetic skills and reasoning. That’s why…
Dog training organizations are looking toward a new challenge: Training highly skilled “dementia dogs.” These dogs are individually trained to meet the needs of persons with memory loss problems. They provide safety and companionship. They also relieve the anxiety of family caregivers. To support a person with dementia, dogs are trained to help with memory…
Time for smart monitoring?
From sensors and cameras to remote alarm systems, today’s marketplace offers a plethora of technology to help older adults safely age in place. Those devices with monitoring features are particularly useful if your loved one lives on their own, whether near to you or far away. Indeed, many apps and devices can help you stay…
Coping with vision loss
It’s common for those newly diagnosed with a vision-loss condition to feel anxious and depressed. Understandably so! They worry about losing their independence. Also, that they will need help with many activities of life. This in turn suggests a loss of privacy. Many newly diagnosed persons report a sudden lack of confidence and feelings of…
What is “cremation authorization”?
With National Healthcare Decisions Day coming up on April 16, it’s good to review who your loved one has chosen as their healthcare power of attorney (sometimes called a “proxy” or “agent”). This is who will make decisions for them when they are no longer able to do so themselves. Often this occurs in end-of-life…
Is Dad taking his meds “as directed?”
Did you know that nearly half of adults taking prescription medications for a chronic condition make errors in taking their meds? The most common problem areas: Memory. Forgetting to take a medication Organization. Failing to order a refill in time and running out Convenience. Being away from home and missing dose(s) Side effects. Experiencing unpleasant reactions…
How to read an Explanation of Benefits
Before your loved one pays a medical bill, wait for the insurance’s Explanation of Benefits (from Medicare, this is called a “Medicare Summary Notice”). This document indicates what services were billed by which providers for what days. It is an important summary to help you catch errors, duplicates or, sadly, even identity theft or fraud….
Maximizing your resources
When we think of “resources,” as family caregivers we might think of money. Or time. But there is another resource we’re using every day that is often overlooked: Emotional energy. Our emotions and mood contribute mightily to our ability to deal with challenges. When circumstances are difficult, it’s hard to generate enthusiasm or initiate projects….
When kidneys fail: Dialysis?
If the person you care for has chronic or advanced kidney disease, dialysis will come up as a treatment option. This procedure mimics the cleansing function of the kidneys. It mechanically “rinses” the blood to take out toxins. Dialysis is not a cure for kidney disease. But it does buy some time. People often live…
When high blood pressure goes untreated
Don’t confuse a lack of symptoms with a lack of risk. A person with high blood pressure usually feels “just fine.” And that makes it easy to also feel unconcerned. Your loved one may not be motivated to treat high blood pressure. Or may want to stop taking medications because they don’t notice any difference….
Dementia communication: Speaking
Nearly every type of dementia compromises the ability to process language. It’s harder for the affected person to grasp words, to comprehend their meaning, and to track what’s being said. Communication with your family member may seem a frustrating struggle. Still, aim for interactions that maintain a positive relationship. Your emotional tone is key: Pay…
Age-related macular degeneration
Age-related macular degeneration (AMD) is a very common condition affecting the retina of the eye. It causes blurry vision and dark spots in the center of the visual field. This makes it challenging to read, drive, and recognize faces. Although AMD typically gets worse over time, it does not lead to total blindness. It is,…
“For better or for worse …”
Are you supporting a relative who is also a caregiving spouse? Many long-lived couples see it as both a duty and a privilege to walk that last mile with their partner, fulfilling vows of “for better or for worse.” That does not mean the journey is easy. Caregiving partners often experience physical challenges as they…
Keeping blood pressure in check
Only 24% of people with high blood pressure have it under control. The remaining 76% are at very high risk for death or disability through heart attack, heart failure, or stroke. In fact, in 2018 high blood pressure was listed as a primary or contributing factor in nearly a half million deaths. With COVID-19, high…
A robo-pet for companionship?
There is no doubt that seniors are suffering emotionally, and physically, from the social isolation of the pandemic. Those with dementia have been especially hard hit. Even elders who live on their own with no memory problems are struggling with loneliness, depression, and anxiety. How is your loved one doing emotionally? Want to introduce a…
Slowing the progression of glaucoma
Glaucoma is a leading cause of blindness among older adults. It causes pressure in the eyeball to build up to a point that the optic nerve is damaged. There is no cure or repair. That’s a grim reality if your loved one has been diagnosed with this disease. Fortunately, glaucoma’s progression can be slowed and…
Problems with hygiene
It’s not uncommon for a holiday visit to reveal that things with mom or dad are newly amiss, particularly in the area of personal grooming. Maybe mom has always been fastidious about her appearance, and now she’s disheveled. Or dad didn’t change clothes the entire time you were there, and maybe even had a strong…
Repairing identity theft
It’s a fact that scam artists prey on older adults. Scammers steal identifying information and use it to obtain cash, make purchases, or open new credit card accounts. If your relative’s identity has been stolen, take action quickly. But be methodical! Keep track of every report you make. Log every call. Send any documents by…
Montessori for people with dementia
Caring for a loved one with moderate-to-advanced dementia often leads to bewilderment. And sadness. Perhaps your relative seems withdrawn. Or is fidgety, pacing, or wandering. They may seem to recede each day. How can you connect with them now? How can you keep them engaged? Experts in dementia care are culling tips from pioneering educator…