Dementia Care

 

Nearly one-third of people over the age of 65 are hard-of-hearing while nearly 50% of people over the age of 85 suffer from some form of hearing loss. Because hearing loss is usually a gradual process that begins in one's forties, it is commonly not recognized until it is significant. It is important to be able to recognize signs of hearing loss, have it diagnosed and treated.

Symptoms of hearing loss:

• Have trouble hearing over the telephone

• Find it hard to follow conversations when two or more people are talking,

• Need to turn up the TV volume so loud that others complain,

• Have a problem hearing because of background noise,

• Sense that others seem to mumble, or

• Can't understand when women and children speak to you.

Hearing loss in seniors can lead to others mistakenly thinking that seniors are confused, difficult or apathetic. Additionally, the senior may be embarrassed by the loss and resist seeking out medical help. The inability to fully communicate can lead to frustration and isolation. The key here is communication and enlisting the following strategies to bring these seniors back into the conversation:

• Make sure that you are looking at the listener and you are in a well-lit area.

• Don't shout, this can often create increased sound distortion.

• If there are 2 or more people present, make sure that only one person is speaking at a time.

• Address them directly by saying their name before starting a conversation so they have time to focus.

• Many people with hearing loss rely on lip-reading. Keep your hands away from your mouth and avoid smoking, chewing gum or eating while talking.

• Slow down a little but not too much. A natural and unhurried rate of speech allows the hearing impaired person to capture more words, read lips and facial expressions.

• If one ear is better than the other, make sure you are directing your speech to the better ear.

• Hearing loss can include certain sound distortions. They may hear your voice but not be able to decipher certain words or pitches.

• Minimize extra noise in the environment when have a discussion, like turning the TV or dishwasher off.

• If possible, avoid having discussions in settings that may have sudden loud sounds like busy streets, near construction areas or near airports.

• Depending on the level and type of hearing loss, certain words are almost impossible to understand, try rephrasing the sentence or find a different word. Don't repeat the word or sentence over and over again.

• Avoid sudden changes of topic. When the subject is changed clearly state the new topic and look for acknowledgement before proceeding.

• Write specific information, such as appointments, directions and schedules down, if you are talking over the phone, have them repeat the information back as many words and numbers sound similar.

• Understand that illness or tiredness may affect any person's ability to follow a conversation.

• If the listener looks confused, clarify that they understood what you were saying.

The best course of action to take if you suspect hearing loss is to see a doctor as soon as possible to determine the cause and treatments available. If you suspect hearing loss in a senior that you are caring for or that you care about, remember to be compassionate about discussing the possibility of hearing loss. It is important to be supportive regarding the options and opportunity for treatment. Motivation for the decision to seek treatment should be to increase their quality of life by providing the ability to participate in all social interactions to the best of their ability.

Aging happens naturally, but aging well takes careful planning. Take steps to ensure that your financial, living, and medical needs will be met in old age.

Aging is a time of transition. Many people start taking steps to eat better, get regular exercise, and manage stress to extend their healthy years. But it goes beyond that: Healthy aging should include thinking ahead to the financial, medical, and family issues that you could face in old age.

Your Personal Security Plan

Older adults face many decisions in the last decades of their lives. Taking some time to look at the issues ahead and plan accordingly can make the future easier and more enjoyable for both you and your family. Here are some areas to consider:

• Your money. Saving for retirement is important, and you want to make sure you have enough money to live on and enjoy life in your old age. You also want to make sure that money is protected, that you can get to it if you need it, and that you have enough to take care of yourself and your family. You should also make decisions about what should happen to that money when you die by preparing a will or trust document that spells out your wishes.
• Your health care. You may need more health care in old age than you did when you were younger. It’s important to make sure that you have health insurance coverage, possibly a second plan to cover costs not met by Medicare, and that you understand the coverage and have enough money on hand to cover what your plan doesn't. Keep your health and life insurance policy information stored in a safe but accessible place.
• Your life. The onset of a health emergency – such as a heart attack, stroke, major injury, or terminal illness – is not the best time to make key decisions. Preparing advance directives like a durable power of attorney, a living will, and other documents that state your end-of-life wishes can save you and your family from unneeded stress in a time of crisis.
• Your care. It's tough to think about not being able to take care of yourself, but that point may come. Friends and family members may not be able to give you the level of care that you need when living with a debilitating illness. While you're still healthy and able, make decisions about potential living arrangements, like a nursing home or assisted living facility, hospice care, home health care, and other available care options, depending on your condition. Choose which options you prefer in various situations, and consider how you will pay for them.
• Your home. Your home may be easy for you to navigate and comfortable for you now, but think about how that may change when you get older. A big house with lots of stairs to climb may present a serious challenge if you have health or physical problems. Take stock of your living arrangements to see if safety modifications or remodeling can be done now to provide for your health at home later.

Protecting Your Partner

It's never too early to start thinking about how you're going to handle and pay for your care in old age, especially if you’re the primary breadwinner in your household. A debilitating illness such Alzheimer's disease or a serious stroke can quickly deplete your financial resources. Consider your health, and the health of your spouse, partner, or family members. Make preparations and provisions and develop a plan to deal with these issues in the event one of you becomes sick.

Although financial assistance for senior health care is available, it's best to begin planning well in advance. Programs like Medicaid have strict rules and regulations, and may not cover enough of your medical expenses for you to maintain a comfortable standard of living. Start looking at your financial options early and consult with legal and financial professionals to ensure that you and your family are cared for in your old age.

Figuring Out What You Need as You Age

When you’re ready to start planning, there are people who can assist you in making the necessary arrangements. An elder care attorney can advise you and your spouse or partner on legal issues and financial arrangements and draw up legal documents.

Also, consider having a geriatric medical assessment done. This process can give you a picture of your overall health. The earlier health problems are identified, the more input you’ll be able to have in your future care and the care of your family. Your health care team can help develop a plan to make sure your living arrangements are safe and will serve your needs in the years ahead. An assessment is an especially good idea if you are already experiencing some health problems or signs of dementia.

Although no one likes to think about getting old, putting a plan in place earlier rather than later can help you maintain the lifestyle you want to have as you enter your later years.

When an aging parent begins to experience dementia or Alzheimer’s disease, aggressive behaviors can develop that hurt.

Dementia can cause personality changes that include aggression and verbal abuse. It’s not unusual for a parent experiencing cognitive decline to pinch, hit, kick or overreact to criticism or minor stress.

Understand that it’s not personal
Coping with a parent who has dementia is never easy. It’s important to understand aggression and negative behaviors are caused by triggers that can be controlled. One of the most difficult things to do is not take hostility and anger personally.

Handling aggressive outbursts
Acknowledge that your mother or father is upset and reassure them.

Don’t argue. If you need some time to get collected, leave the room.

Use distraction. Try to refocus your parent’s attention to something pleasant. Humor, music or a gentle back rub might help calm angry outbursts.

Don’t react by being upset. Use role playing with siblings, friends or your spouse to practice remaining calm and collected.

Try to understand what your parent is really trying to say. Dementia makes it difficult to communicate. Personality changes stem from lack of inhibition and judgment about how to behave appropriately.

Be patient, don’t ask questions that are difficult to answer or might be overwhelming. Focus on your parent’s strengths in conversation and always remain calm.

According to the UK Alzheimer’s Society, call for help if you need it. Never try to restrain a person with dementia who is acting violently. Give them space.

Try to identify causes
A study published in the American Journal of Psychiatry, found depression, combined with dementia can contribute to hurtful, aggressive behavior that might require treatment with medications. Other causes include taking too many medications and sleep disorders. Speak with your parent’s health care provider about options.

The Centre for Addiction and Mental Health (CAMH) suggests patients with dementia do best when they have contact with the same people, are allowed to care for themselves as long as possible, stay in the same living situation and follow consistent routines. Try to identify whether any of the aforementioned are making things worse.

Losing a parent to dementia can hurt. Understanding how to deal with a parent's aggression and hostility can make it easier to cope and help calm hurtful criticisms, verbal and physical outburst and overreactions. Remember too, that it’s important to talk to family, friends or a support group about your feelings.

As your parents age and need assistance with life's tasks – anything from balancing a checkbook to dealing with insurance claims – its hard to know how to take charge, without taking over. How do you help your parent, without making them feel as if they're losing their independence? How do you get the job done without condescending, or making them angry?

How many times have you found yourself "showing" someone how to do something by doing it for them? It's human nature. But while it might make sense to show by doing when you are "teaching" someone younger or less familiar with a particular topic than you are, it usually leads to anger when you do this when you are "assisting" someone with a task that he previously has been perfectly capable of handling himself.

It was probably hard enough for your mom to agree to let you help her pay her bills and balance her checkbook after your dad died. And even once she agreed, it wouldn't be surprising if she told you that she didn't know why you were insisting on helping her since she is perfectly capable of doing it herself.

The truth is that acknowledging that you need help with the business of life is really, really hard for most seniors. If they come to the point where they need your help, they are confronted with their own limitations. And those limitations won't "get better" in most cases. Deep down, your mom knows that this is the beginning of the end of her independence as she has come to know it.

So, how do you take charge without taking over?

1. Let them take the lead

If possible, do the tasks alongside your mom rather than doing it for her. While this approach might take longer than doing it yourself, you allow mom to retain some self esteem by letting her take the lead.

2. Ask what they need help with

Let your dad tell you what aspects of a particular activity he needs your help with, and if possible, try to limit your assistance to just those things, at least for now. Of course, if your dad doesn't have a realistic picture of what he can do for himself, you will need to gently find a way to help him see your perspective.

3. Be respectful

Ask permission before you just jump in. For example, when you take your parents to a doctor's appointment, don't just assume that they want you to come into the examining room with them. Instead, ask them if they'd like you to be there the whole time, or if perhaps you can just be called in toward the end of the visit to make sure that YOUR questions are answered.

4. Set up invisible safety nets

For example, if you come every Sunday and set up your mom's medications in a weekly medication management system, you can have some expectation that she will take the correct medications at the right time. But it wouldn't hurt to also have a way of checking that once or twice during the week. This might take the form of a medication management visit by a home care company or trusted friend or relative or perhaps daily medication reminder phone calls from you.

5. Ensure safety

Make a distinction between safety and everything else. When your dad's safety is on the line, you might just have to take charge by taking over. On the other hand, if you'd just prefer that something be done a certain way or at a certain time, there might be an opportunity to loosen the grip a bit.

Your job as your parent's caregiver is to keep them safe, comfortable, and happy. As long as you keep that in perspective you should have no trouble taking charge without taking over.

Sheri Samotin is a Certified Professional Daily Money Manager, Certified Professional Coach and founder of LifeBridge Solutions, a one-stop shop for family transition coaching, caregiver coaching, medical billing advocacy, money management, household transition services, and estate administration support.

Most of the seniors that I come into contact with on a daily basis have such rich pasts and continue to be a huge source of inspiration, at least to me. There is great misunderstanding out there about what it is like to ‘get old’, after all ‘getting old’ is very subjective. At the age of 42, my children think I am REALLY old, but my clients think I am still quite young. Both are correct, it is a matter of perspective, isn’t it?

Let’s start with a question recently asked by a friend, “What made you decide to devote your life to seniors and their families”?  The first thing that came to mind was my earliest work experiences and how they have culminated into what is a life devoted to seniors.

At 17 years of age I was (and still am) an eternally optimistic and cheery person who loved spending time with all older people. My first job out of high school was working as a nursing aid at a convalescent center in San Diego County. I would show up for a 7a shift eager to see all of the residents. That shift was over at 3p, but almost daily someone wouldn’t come in for the 3p shift and it would be offered to me. This was great because it paid time and a half, and I was able to spend more time with the residents.  A few times the third shift, at double time, was offered and I would stay. Twenty-four hours later, I would head home feeling exhausted but satisfied that I could make a living spending time with such fascinating people.

The caregiving continued in college, working for a home care agency many weekends over the school year and during the summer months. I loved it and was good at it! After graduation and looking for a job,  I recalled something often said to me,” If you do what you love for a living then it isn’t work at all”. And so began a professional career working with seniors and their families. See Bio.

Fast forward 25 years!  I am the owner of Constant Companions Home Care in San Diego and S. Riverside, still assisting seniors to maximize their quality of life, no matter what their situation.

My passion for working with seniors continues. Why? Because, the seniors that I have met are truly amazing people! Their lives inspire me daily, and I hope to do the same for our readers through this series.

Let’s explore the histories, trials, tribulations, triumphs and current endeavors of seniors all over the world. If you know someone, including yourself, who has a wonderful story, past or present, email me at gbrown@constantcompanions.net . Together let’s celebrate our seniors, one story at a time.

Dementia is a broad term that describes the process of a decline in cognitive abilities that interferes with activities of daily living. The most recognized and prevalent form of dementia is Alzheimer’s
Disease which accounts for 50-70 percent of all dementias. There are, however, other causes of dementia:

·       Depression

·       Vascular disorders, such as multiple strokes in the brain

·       Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease

·       Chronic drug/alcohol use

·       Hydrocephalus – Accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors

·       Degenerative neurological diseases, such as Alzheimer’s, dementia with Lewy bodies, Parkinson’s, and Huntington’s

See More information on Dementia 

Our 360 approach:

By the time our office receives a call to provide dementia care to a senior the family has usually been very involved for an extended period of time, providing most of the daily care. The call comes because the family is in need of support and guidance. Our 360 approach is just that, an all-encompassing circle of support for the entire family. During our extensive intake process, we identify where the home care worker can provide support for family members as well as the senior themselves.

We don’t aim to replace the family, we are there to support and only take over the duties that prevent family members from enjoying their time together, due to caregiver fatigue. If you are in need of a helping hand, call us.

“It is our mission to enrich the lives of each of our clients by providing the best in compassionate care, second only to family.”