Mother’s Day for Mom and Her Caregiver

Celebrating in new ways:

As we approach Mother’s Day, many of us think about how different the celebration is, now, if Mom is in the middle or late stage of Alzheimer’s Disease or another dementia. We feel sadness, but we also try to honor our mothers in ways that they will understand.

Tips abound on the Internet and in publications, and the tips are wise:

  • Simplify the celebrations.
  • Adapt your expectations about what Mom will understand and enjoy.
  • Give gifts that are meaningful today: soft items to hold, fragrant flowers, a bird feeder that Mom can watch from the living room or porch.
  • Listen to Mom’s stories about the past, if she can tell them, and tell the stories to Mom if that meets her needs better.

Still, there are important statistics that suggest there is more to do.

The majority of caregivers for older adults. . . about 2 out of 3 . . . are women; about a third of the caregivers are daughters of the older adult.

As we know, caregiving is time consuming and stressful. It causes the caregiver to put aside her needs, relaxation, hobbies and interests. While the caregiver is providing love and support, she may not have time to “receive” love and support in return.

So, on Mother’s Day this year, let’s celebrate with Mom, but let’s also celebrate the caring and generous hearts of the daughters and daughters-in-law who are by Mom’s side.

  • Provide respite for caregivers . . . time away from responsibilities.
  • Give gifts that show appreciation and provide the pampering that relieves stress: a gift certificate for a massage, tickets to an art exhibit or popular movie, a quiet meal on the patio.
  • Listen to the caregiver’s stories. She may well need to share the delights and the stresses of her caregiving days.

 

For ideas about celebrating Mother’s Day, read an article posted by the New York City Chapter of the Alzheimer’s Association at Honoring  Mother’s Day When Mom Has Alzheimer’s.

For “2018 Alzheimer’s Facts and Figures” (and caregiving statistics), go to https://www.alz.org/facts/.

 

Too Young to Be a Grandmom?!

Recently, “Grandma to Be” sent a letter to advice columnist (and Wait, Wait Don’t Tell Me panelist – yeah!) Amy Dickinson.

Grandma to Be wrote with pleasure that her daughter was expecting her first child. However, she also wrote that she had an 8-year-old step grandchild. She didn’t publicly acknowledge this youngster because she didn’t want her friends to think she was old enough to have been a grandparent for almost a decade.

Dickinson answered, essentially, that life happens when it happens. Embrace the reality.

Right!

And I would go even further. Embrace new paths. Embrace change. Embrace the possibilities! New paths can be exciting and joyous.

Becoming a grandparent is one new path that we may come to as we get older.  What are other paths you are considering for your life?

  • A new job
  • Retirement
  • Playing with your grandchild
  • Caring for an older relative
  • Moving to your dream home
  • Moving to a senior community
  • Taking up a new sport
  • Traveling across the United States

 

To read Grandma to Be and Amy Dickinson’s letters, go to Too Young to Be a Grandmom.

For help thinking about and planning your new paths, contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com. She will be happy to meet with you, at no cost for a sample session, to see if coaching is a good fit for you.

Why Did Pablo Casals Practice at Age 90?

The legendary cellist Pablo Casals asked why he continued to practice at age 90.

“Because I think I’m making progress,” he replied.

How brilliant! How positive! How engaged in life!

The Myth of the Rocking Chair

The myth about getting older is that seniors can’t work, play or learn, at least not well. When folks believe the myth, they think they must polish up the rocking chair and isolate themselves. They feel useless to others and bored with themselves.

But that is a myth.

Pablo Casals composed his last composition in 1971, at age 94. He traveled to Israel to conduct the Jerusalem Symphony Orchestra at age 96.

Astronaut and Senator John Glenn went into space at age 77.

Everyone remembers that Grandma Moses took up painting when she was 76.

And it isn’t only famous people who have accomplished great things as seniors. In June 2014, Charlotte, N.C. resident Harriette Thompson completed her 15th marathon . . .  and broke a record for women in her age group.

Teiichi Igarashi, a former lumberjack, climbed Mt. Fuji when he was 100 years old!

The Reality of New Accomplishments

There is only one secret to accomplishing great things as a senior: refusing the rocking chair and engaging in life.

What new skill would you like to develop? What new adventure is on your horizon? What passion would you like to pursue? How will you complete the sentence, “I did ­­­­­­­­­­­­­­­­­­­­­____________ at age ____________?

 

Hear an interview with Harriette Thompson at 91 Year Old Breaks Record.

 

Caregiving: Can You Make Medical Decisions?

Who Can Make Medical Decisions in a World with HIPPA?

American’s medical records are protected by the Health Information Portability and Accountability Act (HIPAA). Neither friends nor relatives have access to our medical information without the express consent of the patient.

This is usually comforting in a world with so much data and so much communication!

But what happens when a senior needs help with his or her medical decisions? What happens if there are end of life decisions to be made?

Three legal documents give others insight and permissions on behalf of a senior.

  • HIPAA authorization gives permission to the doctor to share medical information with the person(s) that the patient names.
  • An advance health care directive (living will) lists/describes an individual’s preferences about medical care, including whether certain life-sustaining treatments should be administered.
  • A medical power of attorney (health care proxy, durable power of attorney for health care) identifies someone who can act on behalf of the individual if needed.

It is not always comfortable to think about illness and end of life decisions. However, there are many resources available that can help. Attorneys are skilled at advising and preparing the documents. Information and forms are available in print and on the Internet, as well.

For a brief description of medical powers of attorney and living wills, look at WebMD.com’s Advance Directives.

 

Is This Dementia? Memory Changes

He isn’t remembering well. Does He Have a Dementia?

How often has a loved one forgotten something and, for a split second, you said to yourself, “Why didn’t he remember that? What does this mean? Should I be concerned?” Here are guidelines to help you.

The car keys are missing. Is he losing his memory?!

  • We all put our house keys down and forget where we put them.
  • We forget a name even though we know the person.
  • We go to the supermarket for eggs and come home with coffee, bread . . . but no eggs.

Are these signs of dementia?

Everyone forgets from time to time. As we get older, we forget more often.

However, it is not a sign of dementia if we can remember the keys, name and eggs after a little while and our forgetting doesn’t stop us from carrying out our normal activities.

Some forgetting is normal. Taking a little longer to remember as we get older is also normal.

Memory changes that interfere with independent activities – our work, social life, conversations, reading and learning – may indicate a health problem that should be checked by a doctor.

These memory changes may include

  • Not being able to find the right words to express something, not following a conversation, or having difficult completing a thought
  • Forgetting names of people and places
  • Being confused about where one is, not knowing how to get to a familiar location, or not being able to retrace one’s steps
  • Having difficulty recalling the information needed to make appropriate judgements and decisions
  • Not recalling where an item has been placed even with time and effort

HelpGuide.org offers a quick look at how to figure out what forgetting the car keys might indicate at What Does My Forgetting Mean?

Is This Dementia? Activities of Daily Living

Does she have a dementia?

Every day, we all take part in activities that we do routinely, often without much thought or planning. We complete work tasks, take part in hobbies and social events, cook and clean, and care for ourselves.

When an individual is not able to independently and reliability complete “activities of daily living” (ADLs) he or she may be showing signs of Alzheimer’s Disease or another dementia (cognitive impairment).

Having temporary trouble with an activity of daily living may not be alarming, but when an individual has persistent difficulties with one or more ADL, it is recommended that they consult with a physician for a thorough examination.

What are “Activities of Daily Living”?

Activities of Daily Living (ADLs) are tasks that we carry out routinely every day. They include

  • Eating
  • Hygiene: bathing, washing, brushing teeth, and grooming)
  • Dressing: selecting and putting on clothing
  • Using the toilet and maintaining continence
  • Movement: walking and getting into and out of bed and chairs

There are also Instrumental Activities of Daily Living (IADLs), which are more complex tasks that have an impact on whether an individual can function independently. For example,

  • Communication: using phone, email or other tools to communicate as needed
  • Transportation: driving or using appropriate public/private transportation
  • Shopping: buying food, clothing, medications, and other necessities
  • Food preparation: making appropriate food choices, preparing and storing foods safely, and following recipes
  • Medications: organizing and taking medications appropriately
  • Home maintenance: completing tasks related to safety, cleanliness, and proper functioning of the home and appliances
  • Finances: making sound financial decisions, keeping accurate financial records, and understanding one’s financial resources

 

The American Elder Care Research Organization provides its definitions of ADLs and IADLs, along with a checklist for informal use, at ADLs & IADLs.

Another article, by social worker Esther Heerema for VeryWell.com, provides information about the reasons for changes in ADLs and some tips for caregivers at ADLs – Causes and Tips.

Alzheimer’s Disease: A Journey in Time

When Did He Get Alzheimer’s Disease? A Continuous Journey

We probably all know that we can’t date the start of Alzheimer’s Disease. Instead, we notice changes over time.

  • Hal’s memory is not working well. He is asking the same question several times in a row or he drives to the neighborhood supermarket, but doesn’t remember what he went there to buy.
  • Susana, a sweet and passive woman for most of her life, seems grumpy and snaps at her family members.
  • Bella has bruises on her body, but doesn’t remember falling.

Alzheimer’s Disease develops gradually. In fact, it may begin to develop long before the symptoms are noticed by the patient or people around him.

We won’t know when the disease started, but it is helpful to know how the disease develops over time.

Most descriptions of Alzheimer’s Disease include three stages, starting with noticeable symptoms. The following list includes two additional stages . . . stages before symptoms interfere with daily living.

Before noticeable symptoms:

  1. Prior to Symptoms: The brain may undergo changes for many years, but there are no noticeable, significant symptoms of the disease.
  2. Mild Cognitive Impairment (MCI): People who have MCI experience some memory and thinking changes but are capable of independently carrying out daily activities. About 38% of people with MCI go on to develop Alzheimer’s Disease.

After noticeable symptoms:

  1. Early (or Mild) Stage Alzheimer’s Disease: People with an Alzheimer’s Disease diagnosis experience changes in memory, language and personality that make some tasks difficult for them. The changes are noticeable and interfere to some extent with carrying out activities of daily living.
  2. Middle (or Moderate) Stage Alzheimer’s Disease: In this stage, the person with a diagnosis needs significant amounts of help with activities of daily living, but can communicate some and carry out some activities without help.
  3. Late (or Severe) Stage Alzheimer’s Disease: Typically, in this stage, the person with a diagnosis needs help with all activities of daily living. Communication and memory are severely restricted.

Alzheimer’s Disease is a progressive disease. It is often described as a “continuum,” which reminds us of a smooth, steady progression of changes. However, this is not always the case.

  • The changes caused by Alzheimer’s Disease and the timing of those changes vary from person to person.
  • The disease does not always progress in a continuous, smooth path. There are times when some changes seem to be noticed “suddenly” or “acutely.”
  • A person’s ability to remember, communicate, and engage in activities may be stronger some days than other days.

 

For more about the progress of Alzheimer’s Disease, you might see the Alzheimer’s Association’s Stages of Alzheimer’s.

What is a Dementia?

What is a Dementia? Are there many types of dementias? Are they treatable?

As we get older, we wonder and sometimes worry about “having dementia.” What is it and what are the chances?

Dementia is a general term – and umbrella term – for many diseases that affect the brain, or “cognition.”

Cognition involves memory, thinking, problem solving, decision making, communication and/or personality.

Dementias are diseases that affect cognition and, as a result, affect an individual’s ability care for himself or herself, work, do hobbies, and socialize.

Reversible Dementias

It is not unusual for people to become disoriented and forgetful as a result of a medical condition When diagnosed and treated promptly, the dementia may be reversible. Examples of conditions that may be reversible are

  • Dehydration
  • Nutrients insufficiency
  • New medication or interaction of medications
  • Alcohol consumption
  • Depression
  • Infections
  • Thyroid disorders
  • Tumors

Irreversible Dementias

Dementias that are progressive or chronic, and for which there are no known treatments at this time, are associated with diseases such as

  • Alzheimer’s Disease (about 60% of all dementia cases)
  • Vascular Dementia
  • Dementia with Lewy Bodies
  • Frontotemporal Dementia
  • Creutzfeldt-Jakob Disease
  • Alcohol-related brain damage, including Korsakoff’s Syndrome)
  • HIV-associated neurocognitive disorder

 

For a brief description of chronic dementias, see the Alzheimer’s Society website at Chronic Dementias. A list and brief overview of reversible dementias can be found at Reversible Dementias.

Memory Improvement: Tips of the Trade – Challenges

How Can I Make My Memory Better?

We have all heard about ways to maintain a good memory, but what are the best ways?

Take a quick quiz: Look at the list below and number them from 1 (very important), 2 (somewhat important), to 3 (not important at all).

  • Do the crossword puzzle in the local newspaper every day.
  • Play a musical instrument.
  • Meet with friends for coffee and conversation.
  • Continue to work as long as possible.
  • Exercise thirty minutes five days a week.
  • Meditate when you feel stressed.

Was this quiz a trick? Well, maybe. All these activities can be helpful in maintaining a “strong” memory if you challenge yourself when you do them.

Challenging the brain helps build more connections between brain cells, and these connections are the support system for a strong memory.

  • Doing a crossword puzzle is a great way to stay sharp, if you don’t choose a puzzle that is very easy for you. Step it up. Go to the next level. Make sure you have to put some effort into completing the puzzle.
  • The same is true for playing an instrument. When you learn new music, practice it and think about what you are doing, you build connections in your brain that are good for a “strong” memory.
  • Talking with friends? Just going over the same old gossip? Enjoying being with your friends is good for your brain. However, when you tackle new ideas, talk about books you have read, or even argue about politics, you add a challenge that is good for your memory and thinking.
  • Just putting in time at the office? There is benefit to staying active by continuing to work, but as with talking with friends, taking on new tasks and challenges causes our brains to build connections.
  • Reducing stress and increasing exercise improve the biochemistry of the brain. Stress hormones have a negative effect on the brain. Exercise helps to keep a good flow of blood and oxygen to the blood…and reduces stress. Great ideas for a healthy brain!

 

For some more about maintaining a good memory, you might look at Ideas for Maintaining a Good Memory.

Memory Improvement: Tips of the Trade – Healthy Living

Healthy Living for Healthy Brains and Bodies

We all know that we feel good when we are active, eat well and have enjoyable jobs and social lives. However, we don’t always realize how important good life style choices are for our bodies and brains. Is it possible, for example, to have “stronger” brains that help us remember and think? Can we delay some diseases and avoid others?

Many life style choices are equally beneficial for our brains and our bodies. Let’s look at some of them.

  • Exercise!

Exercise improves blood flow to all parts of the body. Each time the heart beats, 25% of the blood it pumps goes to the brain to deliver nutrients and remove waste.

  • Eat well!

Look for foods that are high in fiber, healthy fats, vitamins and minerals and low in saturated fats, trans fats, salt, and simple carbohydrates such as table sugar and refine flours.

  • Socialize!

From dinner dates to volunteer activities, being with other people gives individuals a chance to learn, problem solve, have fun, and reduce stress . . . all good for the brain and body.

  • Sleep!

All people, regardless of age, need extended, fairly uninterrupted sleep to restore the body and strengthen new memories.

  • Challenges!

Challenges at work, home, in the community, and with hobbies increase our feelings of wellbeing and pride (good for positive hormones) and build the capacity of our brains to remember and process.

  • Monitor!

Keep track of health issues, medications, stress, alcohol consumption, and injuries to the head.