Will the weather outside be frightful? Read the following to help prepare yourself and your family for this winter’s “big one”.

Each June in Florida, hurricane preparation begins. Personal “Hurricane Boxes” are stocked and insurance policies
checked. When Home Depot runs out of plywood (to cover windows), stores run out of bottled water and more than a #1 level hurricane is approaching, reality hits.

After being without electricity for several days, I have learned the following lessons- the hard way:

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We sincerely appreciate our caregivers and we thank them often. The work they do, their devotion and our work have brought tenderness into my life. I often tell my coworkers that my job has changed me. I am not making that up, anticipating my next raise!

Back in the dark ages, I found socializing to be awkward, embarrassment-inducing and

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I have to confess. I am a list-maker. My excuse is that I am a visual and kinetic learner. Seeing the words in front of me and the actual movement of writing help me to remember what I have to do, or buy or who to call. 

It may not be polite to carry a list of the following communication tips, but you can review them and try a few at a time. They are even useful in everyday life, especially when meeting new people.

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25 years ago, walking to an Ocean City, NJ beach with my three-year-old daughter, I sang at each street corner. "Stop, look and listen, before you cross the street. Use your eyes, use your ears, and then you use your feet!"

Approaching a person with dementia is significantly different than greeting a friend or family member. It is important for you to know that their brain is changing. They are confused or anxious. They may not remember you, that you were coming, or why you are there. To ensure that your appearance does not startle a person with dementia or put them "on edge", try the following, which is very similar to that little song: 

Direction

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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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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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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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Planning elder care is fraught with emotional minefields. Perhaps nothing is harder than when dementia or Alzheimer's strike, and a loved one’s skills or judgment has degraded and family action is required. This may mean taking away car keys, insisting that a caregiver comes part of the week, or that the elder move to live in a facility.  This is always easier if you know that your parent, when entirely competent, had expressed a preference for how to handle the situation. The trouble is that we find that many families have not made such plans.

This is the first of a series of blog posts on lessons learned on navigating that difficult terrain.  In future posts, we will address how to handle situations when someone’s competence has declined due to dementia, stroke, or other factors. For today, we will assume the elder is competent to make decisions.  This leads to our first recommendation:

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Download a flyer for this web conference here

Caring Companion Home Care of Concord, MA and the nonprofit National Private Duty Association (NPDA) will host a consumer education web conference entitled Depression and Older Adults – What Every Caregiver Should Know on March 13, 2012, at 8 p.m. EST. The live and interactive program will provide advice on how family caregivers can work with professionals to identify this condition and develop an effective plan of care for a loved one with depression. Caregivers will learn how to identify key issues and problems, locate needed experts and resources, and outline a plan to provide the best care for a parent. The event is free of charge and anyone can participate.

“Unrecognized, untreated depression is widespread among elders, who may present somewhat different symptoms, and who may need different types of treatment than younger people,” said Deborah Bier, PhD, director of the Concord office of Caring Companion. Bier holds a doctorate in therapeutic counseling, and has spent more than 20 years working with people of all ages with physical, cognitive and emotional disabilities. “Effective treatment can bring about an amazing improvement in quality of life and ability to function. This webinar is the type of increased public education and awareness that’s sorely needed.”

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Note: The following was published in our monthly column "Living and Loving: Elder Care in the 21st Century" in Gate House News' Concord Journal.  We will continue this theme of elders and emergency preparedness in this blog with periodic articles on the subject.

We are now in the middle of the Holiday Trifecta -- Thanksgiving is past, and the year-end holidays are around the corner.  Holidays can be especially stressful for those of us whose parents may be declining. This covers a wide range -- in some cases, it can be as simple as realizing that you will need to begin to devote regular efforts to help a loved manage through daily life; in others, we might face the grief of knowing, or fearing, that this is probably the last holiday season together.

Because remote family members visit so often during the holidays, we often receive requests at this time of year to help assess whether someone is still safe, and to identify the kinds of help available and what might be needed.  We also notice enormous stress in uncertain adult children hoping to do the right thing with their parents while navigating uncharted waters.  In this column, we will provide holiday visit guidelines, from how to manage a short trip to considering whether a member can continue to live alone, safely and unaided.

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Aging has changed during the past generation.  From an elderly woman choosing to live alone in Belmont, MA rather than enter assisted living, to a Concord wife with mild dementia struggling to provide senior care for her ailing husband, to a Bedford couple in their 90s and still home with outside help, we see many more families with elders who have moderate to significant needs. Those terms of care can stretch into years.

This requires a change in attitudes and expectations for families to reduce their stress. It’s necessary to reset our expectations and assumptions that result from such widespread changes. Let me illustrate with a story.

Ted and Mikie

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