We are about to enter the "Holiday Trifecta" period, with Thanksgiving and New Year's sandwiching Hanukkah and Christmas. Whether we rush to enjoy the bacchanalia of celebration, or slow down for a period of reflection, all of us who play a role in managing care for an aging family member know the stresses of holiday travel and celebration. We strive to include the elder as much as possible, to avoid taxing him or her too much, to meet the care needs, and (we hope!) to build yet another loving holiday memory for family members of all ages.

Celebrating year-end holidays can be even more taxing if travel is involved. Here are a few tips to make holiday celebrations as positive as possible for everyone:

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A fun-filled evening to benefit the Alzheimer's Association!

This coming Friday, the Liberty Alzheimer's Partnership will host a fun evening of music to raise money and awareness for the Alzheimer's Association. Music of the 40s, 50s, and 60s will provided by the Golden Tones, a chorus of senior citizens based at the Wayland Council on Aging, and by the Vocal Revolution (formerly Sounds of Concord), an award-winning barbershop chorus. Singing along and dancing are not allowed - they are required!

It is an early evening (5:30pm-8pm), to allow families to bring members of all ages, from youngsters to those who may be suffering from dementia. Light supper will be provided. Location is First Parish in Concord, 20 Lexington Road.

It will be fun and inspiring, and for a good cause. We hope you will join us!

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“She’s running me ragged!” A client said that to me recently, speaking not of her small child but rather of her aging mother. A dutiful daughter, she finds herself sometimes overwhelmed with the tasks of caring for an aging parent. It is a common conundrum: how do we care for aging parents while maintaining sanity in our own full lives?

How long will it last?

One important criterion when you care for an elder is how long the current condition will last. If someone had a hip replacement, your role is time-bounded and the strategy is to be sure you have enough resources to weather a short-term crunch.

But sometimes the caregiving lasts for years, as with chronic conditions like COPD or with Parkinson’s Disease. In these cases, learning to manage your own stress is as important as being sure that Mom gets to the next medical appointment. A good maxim is to remember the admonition before each airline flight: put on your own oxygen mask first – you are no good to anyone if you pass out. Remember you are in a marathon, not a sprint.

Signs of Caregiver Stress

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Care for aging relatives can be expensive, however your family chooses to cover it. Whether it is an assisted living facility, home care, or living with family, many financial and personal trade-offs are required – often over a period of many years. As we discuss this with families, the value of long-term care insurance (LTC) becomes clear.

Long term policies can be purchased at any point, but as you would expect, cost and rates of declined service increase dramatically with age. If you are still in your fifties, you should seriously consider purchasing it. This is not, however, a commercial for new purchasers; we will focus this post on what you need to know if a loved one already has the policy, how to understand what it covers, and how to calculate its benefits.

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Summertime vacations always bring an increase in calls from concerned adult children with some flavor of this question: “During vacation, we noticed Dad is slowing down. We think he might need help at home, but we aren’t sure. How can we tell?” The decision is not always clear -- keep reading for tips we have developed working with many families.

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We are proud to announce that we are opening service in Maine, and plan to begin serving New Hampshire by the end of the month.  Karen Banning of Biddeford, who previously has served as Client Care Coordinator in Massachusetts for two years, has been appointed Director. The Seacoast office is located in Saco.

Our unique communications system, with online daily reports, photos, and status checks, continues serve as the hub of a system that provides better communications, better service, and better quality of life. That is our vision and the basis of our success.

Caring Companion's Alzheimer's and dementia services are based on an approach called Habilitation Therapy, developed by the Alzheimer's Association of Massachusetts and New Hampshire. Habilitation Therapy encourages safe, positive reinforcement of the patient's current state in preference to trying to reorient the patient to current facts on the ground, which often leads to unnecessary stress between caregiver and patient.

The Seacoast office will offer in-home care on both an hourly and live-in schedule. Many services are available and may include personal care, transportation, meal preparation and homemaking. We look forward to extending our service area and the families we can help in the process. Thanks to all our clients and friends for your ongoing support.

Father’s Day changes dramatically once Dad is no longer independent, sometimes introducing questions of identity and authority as power is realigned. In early retirement, our fathers usually managed their own affairs and retained a psychologically important position of power in our lives – even if the life-long relationship has been more troubled than we might have hoped. But once Dad begins to depend upon us, the experience of honoring our fathers usually changes. Let us, then, take a moment to consider ways to celebrate this Father’s Day successfully, and perhaps to take a few lessons forward to the future.

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Teepa Snow is a dynamic, inspiring, insightful coach for professionals and families who support Alzheimer's patients. She will appear in Newton on Wed May 29, 2013, to give a FREE seminar, entitled Essentials for Your Journey Together. This is a rare chance to see such a gifted speaker on Alzheimer's Disease.

At Caring Companion Home Care, we use videos of some of Teepa's training when we train our own caregivers to work with Alzheimer's patients. She is funny and empathetic, and her West Virginia accent stays in Massachusetts ears long after the video ends. If Alzheimer's is an issue in your life, take the chance to see Teepa.

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By Vernon Doucette,
Boston University Photography

Concord residents had a terrific opportunity to learn from one of the nation's leading Alzheimer's researchers last night as Dr Robert Stern, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University's School of Medicine, spoke at the Concord Council on Aging. Stern, an excellent speaker, filled evening with both useful information and hopeful stories. 

I knew we were in for a good evening when he started off with what most would consider a professional and political No-No: he told a joke about a man suffering from Alzheimer's Disease. And his point was well-taken: successful Alzheimer's caregivers have to have a sense of humor.

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This past week the Boston Marathon bombings put parts of the city and suburbs on lockdown, providing an unwelcome example of a type of emergency families rarely plan for: terrorism and police actions. Most people who care for elders think often about the elder’s own health crises, and all of us have to plan for blizzards, power outages, and related events. But reassuing a frightened elder during an act of terrorism? Not so much.

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I posted recently about a Johns Hopkins study on aging senior citizens: For Older Adults, Participating in Social Service Activities Can Improve Brain Functions. Today's story is about a man who could be Exhibit A for this point: local hero Al Armenti.

Al is well-known in his home town of Concord MA.  Well into his 90s, he is very active in many social service activities, in his church (First Parish in Concord, a Unitarian Universalist congregation), and in music circles.  He is a combat veteran and has been a peace activist for decades.  Recently, I received an email from Al reporting on his participation in the St Patrick's Day with the Veterans For Peace.  He writes by way of explanation that "As a long-standing member and, because of my age, I was allowed to ride in the back seat of an open convertible."  That's okay, Al, I hope that if I am still fighting the good fight when I'm nearly 100, someone gives me a ride in the parade, too.

Although it seems that Al has been a dedicated member of Veterans For Peace for since the Revolutionary War, his participation is somewhat more recent.  This is not a small commitment: a few days before the parade, Adrian Walker wrote a column in the Boston Globe about VFP's efforts to march in the traditional St Patrick's Day parade:  Antiwar Veterans Group Battles to March in St Patrick's Day Parade.  Al also sent along a video of the event (he appears in the red convertible toward the end).

The picture above at the right is Al playing his mandolin, which he still does in public.  One of his favorite songs is Pete Seegar's humorous My Get Up and Go Has Got Up and Went.  Delivered with a twinkle in his eye and an engaging smile, the song as Al sings it is clearly ironic.  His 'Get Up and Go' is doing just fine.

So here's to you, Mr. Armenti! You aren't old - you have just been young for a very long time!

Congratulations to our own Dr. Deborah Bier, PhD!  The Home Care Association of America, the home care industry's largest trade organization, has asked her to deliver another of her popular series of webinars training professionals and families who are dealing with Alzheimer's Disease and Related Dementia (ADRD). In 2012, Debbie's first webinar was so popular that they immediately asked her to deliver three additional sessions on similar topics. We learned later that her sessions were being downloaded by agencies around the country to use in their training. Quite a compliment to her work, and a demonstration of the high quality we try to deliver at Caring Companion.

Debbie's trainings and webinars are based on a program developed by the Alzheimer's Association of Massachusetts and delivered through the state's Executive Office of Elder Affairs.  We use the approach, called "Habilitation Therapy," in training our caregivers for dementia clients.

Details of the webinar are below. 

Alzheimer's Disease and Related Dementias (ADRD) require a many resources to manage on a daily basis, draining caregiver energy, time, finances and patience. But there are proven methods to make care easier, safer, and more enjoyable for both patient and caregiver. Learn some of these little-known best practices, used successfully by both professional and family caregivers alike.

Deborah Bier, PhD, is the director of care for Caring Companion Homecare in Concord MA and has been a holistic psychotherapist for 25 years. Certified by the Commonwealth of Massachusetts's Office of Elder Affairs and the Massachusetts Alzheimer's Association, she trains dementia caregivers and coaches dementia families. Her particular expertise is in helping multi-generational families apply wellness approaches to managing chronic illness. She holds a doctorate in therapeutic counseling, and is a widely published writer and speaker specializing in health and healing.

Probably the single greatest reason we are called to serve families is to provide care following a fall by an elder. Particularly when people have lived in a home for decades, we see that homes and people have not adapted to the extra care needed to prevent falls. These are preventable events, and families with elders will be well-advised to attend Emerson Hospital's free workshop.

Falling - Don't let it happen to you or someone you love

People familiar with Alzheimer's Disease and related dementias listened with interest last month as NPR reported recently (Alzheimer's 'Epidemic' Now A Deadlier Threat To Elderly) on the Alzheimer's Association release of statisitcs showing that Alzheimer's death rates are soaring, even as death rates from other diseases decline. The 68% increase in Alzheimer's deaths between 2000-2010 does mask some good news: other health factors like heart diseaes, which typically kill at earlier ages, are declining - leaving longer-living patients vulnerable to Alzheimer's as they age. Paradoxically, however, the only disease with a rising death rate and with no effective treatment and no cure or vaccine receives scant funding for research into solutions.

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People concerned about elder care and resources for senior citizens living in Concord should attend Saturday's Healthy Concord Community Forum at the Harvey Wheeler Center, 9:30am - 12:30pm. This is a chance to alter the resources and emphasis the Town places on issues of elders and elder care.

Back in the fall, the Town of Concord embarked on a healthy community planning project to assess the physical, mental, emotional, and spiritual health and overall well-being of the community. The project has worked to identify Concord’s existing assets and resources, define residents’ needs, and determine opportunities for improvement. The focus of the Healthy Communities effort has been on local issues that affect health and quality of life, such as:

• Public health concerns such as heart disease, substance abuse & air quality
• Housing and education
• Youth development
• Access to health/medical care
• Child care and elder care
• Recreation
• A clean and healthy environment
• A safe environment
• Arts and cultural pursuits
• Transportation

For more information contact Jill Block, Healthy Concord Coordinator at This email address is being protected from spambots. You need JavaScript enabled to view it. or Susan Rask, Public Health Director at This email address is being protected from spambots. You need JavaScript enabled to view it. . Register by e-mail to This email address is being protected from spambots. You need JavaScript enabled to view it. . Please specify if childcare is needed.

Last chance is TODAY! Local residents can support Meals on Wheels by bidding on some terrific restaurants and other contributions available until 10PM EST tonight. March for Meals is a national campaign sponsored by the Meals on Wheels Association of America to raise awareness about senior hunger, recruit volunteer Meals on Wheels drivers and raise needed funds. This month the March for Meals online auction, with gift cards to restaurants, grocery stores, coffee shops and other food-related businesses as well as Red Sox tickets. Place your bids here.

Minuteman Senior Services is a non-profit organization that has been helping elders and their family caregivers in Massachusetts locate appropriate eldercare assistance since 1975. Their mission is to help seniors and people with disabilities live in the setting of their choice by engaging community resources and supporting caregivers. Over 22,000 people each year turn to them for help. Caring Companion Home Care has worked with Minuteman in a variety of capacities for years, including as an approved home care agency in their publicly-funded program for low-income seniors. Through the Executive Office of Elder Affairs, Caring Companion Director of Care Dr Deborah Bier was trained in pilot program with the Massachusetts Alzheimers Association for Rehabilitation Therapy, and we now use this as the basis for all our Alzheimer's training for our caregivers and client families.

Yesterday I attended a presentation by Dr Gregory Martin, Chief Medical Officer of Emerson Hospital in Concord MA.  Dr Martin highlighted, with justifiable pride, a recent program by Emerson to reduce their already-low rate of hospital infection. Anyone familiar with current elder care issues at hospitals knows the concern that the facilities can be a petri dish of infection, and with frail elders and compromised immune systems, the risk of becoming sicker in a place designed for healing is one of the frustrating ironies in today's health care world.

As a home care agency owner, I was particularly interested in his remarks about reducing infection for clients with catheters, since so many of our clients have them. 

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Earlier this week I attended a meeting of the New England Health Information Management Systems Socitey (NEHIMSS) about use of mobile technology in health care, including home care. The session, delivered by Dr Fernando Martinez, focused on hospital systems and issues of security and cost as well as quality of care. But I was again struck by the importance of the data collected by home care workers and the potential to improve health outcomes, reduce cost, raise patient quality of life, and lower the stress of family caregivers if the data is documented and followed by either an educated lay person (family member or non-medical case worker), so that earlier intervention can eliminate hospital stays.

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Karen Tannenholz works in our office, and last summer she faced the kind of sudden medical emergency we help many people through. Stressed families often imagine their circumstances are unique, but Karen’s story reveals threads common among many: feelings of growing confusion, helplessness, stress, anger, and even humor are all normal. Ultimately, deeper appreciation of each other can emerge as we navigate together through some of life’s most difficult passages. To hear Karen’s story, click 'Read More' below:

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Hats off to Mary Baum, Nancy Crowley, and the team at Concord Park for their terrific PhotoVoice project! I attended the open on Thursday November 29, and it was very impressive. We had previously blogged about this project (see our post from October 31). The emotional power of the images and the descriptions reveal a lesson we always emphasize to the families of our clients and to our caregivers when we conduct training: although reasoning and language ability may decline, the emotional experience of people with dementia remains vivid. This is why it is so important to “meet them where they are.” Absent safety concerns, the immediate facts are irrelevant, but the emotional life of the person are real.

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