Health Risks Associated with Caregiving

Hello readers,

I am pleased to share more thoughts about health risks for caregivers. In a previous post, I misquoted research done and it was picked up by reader Claude Thau of Kansas (if I’m remembering your home state correctly). The JAMA article I quoted actually indicated that caregivers had 63% higher mortality indicators than noncaregivers. I misquoted the article and I am happy to provide the clarification.

Certainly the point of the original post was that health risks for caregivers can and should be minimized — and that’s why I’m really happy to have Mr. Thau’s attention drive home the point once again.

I bring this message of “CAREGIVERS, SEEK WELLNESS” as a once-again (albeit temporary) caregiver myself.  My 58-year old cousin from Dallas was diagnosed with younger-onset Alzheimer’s a few months ago. She has come to CT to have me teach her how to live with it. And so I am. But my heart stops when I “lose” her in the grocery store, even if for a moment. And my brain is distracted when I’m at work, wondering when she will reappear from volunteering with our residents. And I don’t sleep well, considering the financial strain every time she has an urge to buy something or gets up to use the restroom, or even rolls over in bed. And my heart aches with my 9-year old’s frustration when “Auntie P” wakes her up to check on her in the wee-hours of the morning.  My dog loves her though as Pat feeds the dog breakfast again…(we had to hide the treats).

So I know first hand how hard it is – but we MUST take time to get to our own MD visits, do some tai chi before they wake up in the am, rest and rejoice with friends through support groups – or journal to get it out of your system. Be well caregivers, in any way you can when you can. We are here to support you and will help you think of ways to minimize your risk factors. Check www.agingcareacademy.org for more ideas.

And now I’m off to schedule my overdue mammogram – thank you Ms. Sarah, secretary on our Dementia Special Care Unit for reminding me that I’m important too!

Tips for Coping: Communications

Pamela Atwood, MA, CDP, Director of Dementia Care Services, Hebrew Health Care

That is the first thing I tell the caregivers of people with memory loss.  And it is human nature, our gut instinct. We think, “Maybe they are better today” or sometimes, “Is it a good day or a not so good day?” and we test the memory by quizzing people.

“What did you do at Day Center today?”
“What did your aide make you for lunch today?”

Unfortunately, these quizzes have two negative effects: we feel sad when the person with memory loss cannot answer correctly, and the person feels stupid or crazy. Instead of quizzing, make statements about the present moment like, “I’m sure you must have had a full day at the center. Are you tired now or would you like to help make supper?” “It’s been a long time since your lunch. Would you like something to drink?”

Here are some other basic rules for communicating with someone with memory loss:

Be “argue-free.”
There is no point in arguing. If the person says something incorrect or something you know to be untrue, let it go. It only makes things worse if you argue.

Point out remaining strengths.
Avoid criticizing or correcting. If people with memory loss become unsure of themselves, they can have more problems with communication. Compliments go a long way (regardless of memory loss!).

Focus on the emotions, not the words.
If someone excitedly says, “There’s my sister!” when she should have said “daughter,” let go of the mistake and support the happy moment: “Isn’t it fantastic to see her!”

Watching someone with memory problems struggle with communication is painful for caregivers and family members. It requires patience and support. For more information on communication tips or to join our support group call us at (860) 920-1810.

Caregiver Corner: Encourage Independence with Personal Care

Pamela Atwood, MA, CDP, Director of Dementia Care Services, Hebrew Health Care

One of the most challenging aspects of caregiving is assisting with personal care. However, independence increases success and minimizes how stressful these tasks can be.  Caregivers that keep the individual’s remaining abilities in mind are most successful.

Some basic tips to encourage independence with toileting, bathing, dressing, grooming and eating include:

Help the person feel in control
You may need to experiment to learn what the individual can do for him or herself. Give the person time to complete the activities that can be done with coaching and cueing only.

Use task breakdown
Give instructions a step at a time breaking tasks into individual actions. “Brush your teeth” sounds simple, but requires a great deal of cognitive and physical activity. Coach the individual through each step. If you separate each action, you may find the person can still accomplish the task with cueing only.

Simplify routines
Lay out clothing, prepare bathrooms, and offer one food item at a time. Activities of daily living can quickly become overwhelming to someone with cognitive impairment.

Monitor for safety and health
Install grab bars (do not use towel racks), use non-slip mats, and ensure the water is a comfortable temperature. Monitor for choking while eating. Observe for skin irritations if the person is incontinent.

If you need more ideas, there are many professionals at Hebrew Health Care who can assist you. Ask the day center staff or home care nurses for other ideas on how to maintain independence. There are also great resources available through various caregiver groups. If you would like resources, access Aging Care Academy website at www.agingcareacademy.org or contact us at (860) 920-1810.

What two household items can reduce stress, improve memory?

Pamela Atwood, MA, CDP, Director of Dementia Care Services, Hebrew Health Care

What do you need to adjust to experience “successful aging”?
What happens when “I” becomes “we”?
What’s the difference between dementia and Alzheimer’s?

Get the answers to these questions and more at www.agingcareacademy.org.
Visit our “Tip of the Week,” review our articles, and sample a free podcast TODAY.

Caregiver Corner: Surviving the Holidays

Pamela Atwood, MA, CDP, Director of Dementia Care Services

Holidays represent opportunities for togetherness, love, laughter and sharing with family and friends. In reality, they can be stressful times for everyone. They can be completely overwhelming to caregivers, and often represent loss, sadness and disappointment. Keeping these survival tips in mind will help caregivers make the most of this holiday season.

Be realistic
Know your limits, and the limits of your loved one. Adjusting expectations will help caregivers, family and friends. Activities often need to be simplified and minimized to reduce stress levels. If you usually serve 20 people, serve only 5 this year. Or instead of making all the food, have guests bring the holiday dishes that mean the most to them. Caregivers can expect the normal tensions of the season, plus the stress of caregiving responsibilities. Let others know what they can do for you – and then let them do it!

Involve your loved one but recognize signs of stress in them
The care recipient may want to participate in festivities, but not feel comfortable in large crowds. Observe for symptoms of increasing anxiety or cues that s/he is becoming over stimulated. Explain to your host in advance that you may need to leave early and unexpectedly. Avoid a scene by explaining in advance. For people with dementia, most gatherings must be with smaller groups and for shorter periods of time than in the past.

Try to stick to routines
Especially if your care recipient has dementia, sticking to the usual routine is very important. Taking on too many holiday tasks will stress out caregivers and thus care recipients.

Adapt gift giving
Ask for gifts that are useful, such as adaptive, washable clothing, tapes of favorite music or old movies, respite time, subscriptions to newspapers or magazines, or labeled family photo albums. Beware of toxic plants, such as poinsettias, holly and mistletoe.

Take care of yourself
Be sure to get enough rest, eat properly and exercise. Caregiving depletes your physical and emotional energy; caring for yourself can get it back. Limit alcohol consumption (a depressant drug). Be realistic about our own emotional needs but keep a sense of humor – the best coping strategy to survive the holiday season.

Information MUST HAVEs for Caregivers

What’s hidden under the floorboards, or in the attic? Does dad keep a list of passwords for his online banking, or are they all in his head? Mom might be eligible for VA benefits, but where is the discharge paperwork? What information do caregivers need to have on hand to assist family members?

Faith Parker is a Hebrew Health Care Volunteer and 25-year active Auxiliary member, and recently she attended an Aging Care Academy® seminar. Faith’s family has found themselves in a position of caring for elder family members or friends of family, near and far. Faith has been using resources we gave her and compiled a list of all the information caregivers may need some day. With her permission we share it, and encourage you to share it with your friends and family.

Full legal name and residence
Birth date and place, birth certificate
Social Security and Medicare numbers
Employer(s) and dates of employment
Education and military records
Sources of income and assets; investment income (stock, bonds, property
Insurance policies, bank accounts, deeds, investments, and other valuables
Most recent income tax return
Money owed, to whom, and when payments are due
Credit card account names and numbers
Safe deposit key and information
Will, beneficiary information
Durable power of attorney
Living will and/or durable power of attorney for health care
Where cash or other valuables might be kept in the home
Blood type
latest EKG
latest blood work
medications including over the counter, time of day, dosage and illness
allergies including to any medications
names and numbers of all physicians
DNR location
attorney
accountant
financial advisor
long term health policy info 
all other medical ins policy numbers and contact information
Cemetery information
Religious affiliation
Passwords for internet programs, etc. 
Alarm codes
Neighbors phone number
Where apt and car keys are located
Veterans status, numbers and paperwork
Pets – pet care/vet
Names and contact info for important family members

While gathering this information may seem like a full-time job, doing it in advance of an emergency is always easier than in crisis mode. If the elder can gather it and put it in a safe place, that is even better. Much of this list, and the resources Faith compiled them from, were provided by the National Institute on Aging. They have some great resources, including the a booklet called “So Far Away,” an “Advance Care Planning” sheet, and “Getting Your Affairs in Order” AgePage (visit www.nia.nih.gov/health/topics/legal-planning for these and other free resources). There is also a superb “Emergency Preparedness, For Seniors, By Seniors” booklet from the Red Cross (www.redcross.org ). One of the best resources to keep it all in one place is a book by local Connecticut author Lynn McPhelimy called In the Checklist of Life. When you read the reviews online, you will agree it sounds like a necessity for every family.

Thank you Faith for sharing your compiled list. And thanks to the National Institutes on Aging and the Red Cross for providing such valuable information to us all – for free!  For more information on caregiver seminars, visit www.agingcareacademy.org.

INFLUENZA 101

By Marichelle B. Cirunay, BSN,RN Infection Preventionist, Hebrew Health Care

Symptoms?

  • A 100oF or higher fever or feeling feverish (not everyone with the flu has a fever)

  • A cough and/or sore throat

  • A runny or stuffy nose

  • Headaches and/or body aches

  • Chills

  • Fatigue

  • Nausea, vomiting, and/or diarrhea (most common in children)

Prevention?

* VACCINATION

Do I have the flu or a cold?

The flu and the common cold have similar symptoms. It can be difficult to tell the difference between them. Your health care provider can give you a test within the first few days of your illness to determine whether or not you have the flu.

In general, the flu is worse than the common cold. Symptoms such as fever, body aches, tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose.

When should I seek emergency medical attention?

Seek medical attention immediately if you experience any of the following:

  • Difficulty breathing or shortness of breath

  • Purple or blue discoloration of the lips

  • Pain or pressure in the chest or abdomen

  • Sudden dizziness

  • Confusion

  • Severe or persistent vomiting

  • Seizures

  • Flu-like symptoms that improve but then return with fever and worse cough

Treatment

If you have been diagnosed with the flu, you should stay home and follow your health care provider’s recommendations. Talk to your health care provider or pharmacist about over-the-counter and prescription medications to ease flu symptoms and help you feel better faster.

  • You can treat flu symptoms with and without medication.

  • Over-the-counter medications may relieve some flu symptoms but will not make you less contagious.

  • Your health care provider may prescribe antiviral medications to make your illness milder and prevent serious complications.

  • Your health care provider may prescribe antibiotics if your flu has progressed to a bacterial infection.

Are there ways to treat the flu or its symptoms without medication?

You can treat flu symptoms without medication by:

  • Getting plenty of rest

  • Drinking clear fluids like water, broth, sports drinks, or electrolyte beverages to prevent becoming dehydrated

  • Placing a cool, damp washcloth on your forehead, arms, and legs to reduce discomfort associated with a fever

  • Putting a humidifier in your room to make breathing easier

  • Gargling salt water (1:1 ratio warm water to salt) to soothe a sore throat

  • Covering up with a warm blanket to calm chills