Dementia Caregivers Deserve Summer Vacation, Too

Paula Spencer — Fri, 04 Jul 2008 07:00:00 -0000

Summer's half over, even for dementia caregivers. Will you take a vacation?

Dementia care partners tend to be especially housebound. Unfortunately going without a break is a good option only for martyrs or people looking to get sick.

Earlier this year, the journal The Gerontologist described an innovative, stress-cutting idea called "assisted vacations" -- special group trips designed for care partners and their loved one with dementia to take together. Sounds like a dream? Too bad it was only a pilot program. Meanwhile, no more excuses:

"I can't take her anywhere overnight"

People with dementia tend to not do well in new environments.

Try visiting a familiar place from your parent's past rather than a new location.
Trust your instincts; your parent may be unable to travel -- but don't let that stop you.

"I don't have backup care."

This dilemma is proof that you can't go it alone. People with dementia tend to do best with familiar faces.

Plan ahead. Enlist an elder companion now -- someone in the home a few days a week whom your parent can get used to (and who can give you day respite) so that person can fill in overnight for you down the road.
Inquire whether anyone at a day facility you may use (who knows your parent) could be a fill-in caregiver.
Consider vacation respite care. It's being marketed as a new specialty service by some geriatric care consultants, such as the "Vacation Respite for Renewal" program.

"I don't have any money."

Caregiving is a savings-sapper. But you don't have to travel far to get a break.

Fall on the mercy (and good company!) of a friend or relative.
Do a house-swap with a relative who can look after your parent while you live the relative's life for a weekend.
Failing an overnight getaway, give yourself a series of "staycations." Stay home but have another caregiver fill in while you take whole days off doing local activities (sightseeing, museums, mall meandering) you no longer have time for -- all alone or with the rest of your family.

"She gets so upset when I go."

It's sadly ironic that a person going through so many changes in her mind reacts so poorly to changes in her environment.

* Find loving care and go anyway.

Holly at the Lewy Body Dementia blog recently wrote about her Dad crying and declining in health when she and her husband went away. But to their credit, they did it. It's a bit like the child with separation anxiety; it would be impossible to stay glued to the child's side constantly. If you know she's in good hands, you endure the painful sound of the Velcro separating…and you go. Because you have to.

Image called "Book your seat!" by Flickr user muha..., used under the Creative Commons attribution license.

Seniors Hit Hard By Overdraft Charges

Stephanie Miles — Fri, 04 Jul 2008 07:00:00 -0000

High banking fees are taking their toll on senior citizens, according to several new reports, which reveals that debit cards may be to blame.

The Center For Responsible Lending has found that seniors spent $4.5 billion in overdraft fees last year, in large part because many of the elderly are switching over to debit cards after years of relying on checkbooks and cash. Debit card purchases and cash advances can easily trigger overdrafts -- and the resulting bank fees -- if older account holders are confused as to how the cards work and when the electronic withdrawls will hit their accounts.

What's more, many banks follow practices that result in greater overdraft fees, according to the report, including "routinely re-ordering daily transactions to subtract highest-dollar amounts first, and holding deposits longer than necessary."

At the same time, some financial institutions are jacking up the fees they charge for emergency overdraft coverage, according to an article in USA Today. Bank of America recently raised its overdraft fee from $20 to $25, while Washington Mutual raised its fee to $34 from $32.

For seniors on fixed incomes, these fees -- which quickly add up -- can easily decimate their monthly budget. What can your parents do if they're being affected by onerous overdraft charges? Peter Miller, a blogger at the Reverse Mortgage Guide blog, recommends setting up online access to the account so that you or your parents can easily monitor account balances and see which checks, debits, and deposits have cleared.

Also, if your parents are hit with overdraft fees but are otherwise good banking customers, advise them to contact their bank and request that the fees be waived. Many institutions routinely waive overdraft charges, and it never hurts to ask.

Photo provided by Flickr user TravelStar, used under the Creative Commons attribution license.

How to Take a Vacation With Diabetes

Sarah Henry — Thu, 03 Jul 2008 07:00:00 -0000

Summer is here and gas prices are astronomical. There goes the road trip. So many obstacles in the way of a summer holiday. Here's one that shouldn't stop you: your parent's diabetes.

It's true that eating on the road (or in the air) can present challenges for your parent with type 2 diabetes, but with planning and attention your parent can take a break and still keep her blood glucose and weight in check.

That doesn't mean, however, that she can take a break from her disease.

Need inspiration? Fellow traveller Alan, an Aussie type- 2er who blogs about his condition, just completed an around-the-world jaunt that lasted seven weeks and took in nine cuisines.

He's come back with a bag of tricks to share, including:

1. Order appetizers or soups. Either of these options is often meal in itself, but if it isn't, your parent can order both. It's smart to skip main courses, which are often piled with too much food.

2. Test, don't guess. If your parent eats at a restaurant she's likely to revisit, she should test one hour afterwards to check her blood sugar. That may affect her decision to return -- or her menu selection when she does.

3. Eat and exercise. If your parent's hotel includes a low-carb breakfast choices, great. If not, or it's prohibitively expensive, take a stroll together in the area the night before to find a cafe that will do the job.

4. Cull carbs. Substitute salad or vegetables for fries. If your parent is eating Asian food, where rice is served with every meal, leave most of it on the plate.

5. Stay strong. Raised to clean her plate and not waste food, it can be hard for your parent not to eat everything put in front of her. Remind her it's okay to leave some.What advice do you have for others whose parents may be taking a trip?

Image by Flickr user Jeremy Keith used under the Creative Commons license.

Does Older = Wiser?

Connie Matthiessen — Thu, 03 Jul 2008 07:00:00 -0000

Several recent studies confirm the notion that age confers a certain measure of wisdom. For example, researchers at the University of Texas found that people 60 and older reported more feelings of peace and calm than did their younger counterparts. And a study in the journal Neurobiology of Aging concluded that older people are better able to control and regulate their emotions than younger people are.

If you're caring for an elderly parent or relative, you may be skeptical of these findings, especially if you're frustrated by loved ones' refusal to take steps that seem logical for their own health and safety.

For example, you may find your parents' refusal to leave their cluttered, unmanageble home for an assisted living facility unfathomable -- and extremely unwise. You're baffled by how stubbornly your parents resist your reasonable arguments (and the lure of the glossy brochures you bring by to tempt them). Your parents are putting their health at risk, and creating family discord. Where's the wisdom in that?

If you're trapped in this type of struggle, it's time to employ some wisdom of your own. David Solie, a geriatric specialist and Caring.com expert, explains that aging involves so many losses that elderly people tend to hold on tight to the areas of life they still control. In your parents' case, their house -- or apartment -- is far more than a home; it represents their past, their memories, their sense of identity.

In a recent interview, Solie describes how he handled the situation when housing became an issue for his aging mother. He also provides helpful advice in his answers to readers questions, and on his blog.

Understanding your parents' experience won't resolve all your conflicts, of course. It won't make your parents' home safer, or diminish your worries about their health. But it will help you and your parents step away from your power struggle, communicate with each other, and take a more empathic, productive approach -- which represents wisdom, no matter how old you are.

Image by Flickr user Konstantin Sutyagin, used under the Creative Commons licencing agreement.

Brain Injuries Are the Biggest Risk When the Elderly Fall

Sarah Henry — Wed, 02 Jul 2008 07:00:00 -0000

Most folks think that the greatest danger a senior faces from falling is a broken bone, usually a hip. Not so.

Fifty percent of all elderly people who take a tumble and bang their head suffer fatal brain injuries, according to a just released Centers for Disease Control and Prevention study. And many more wind up in the hospital with head injuries that can cause long-term problems that affect thinking and other functions.

Talk about a wake-up call. Here's another: Every year, one out of every three Americans aged 65 and older take a spill, and a third of such falls cause injuries serious enough to require medical treatment.

Falling is such a big problem among the aged that Caring Currents has visited the subject several times in the past few weeks and included fall prevention tips such as reducing floor clutter, installing adequate lighting, and encouraging your parents to do exercises to maintain strength and balance.

The CDC has other suggestions, along with advice about preventing brain injuries in the elderly.

Now it's your turn. Do you have any recommendations to help safeguard seniors from taking a life-altering slip?

Image by Flickr user blucolt used under the Creative Commons attribution license.

Cancer Patients Tell It Like It Is

Melanie Haiken — Wed, 02 Jul 2008 07:00:00 -0000

Don't soft-peddle cancer news. That's the message from cancer patients everywhere these days, it seems. Go ahead, use the "C-word" -- we can handle it.

NPR correspondent and blogger Leroy Sievers has become a hero to his fellow travelers in what he calls "Cancer World" ever since he began blogging about his fight with metastatic colon cancer almost three years ago. It gets harder to tell the truth, though, when the news is not good. On June 9th, in a post baldly titled "The Disease Has Exploded," Sievers tells his readers that his latest scans found new tumors in his brain, lungs, liver, pelvis, and more. There's not a lot more his doctors can do, yet he ends his post on a strong note: "I still have some fight left in me."

Sievers' announcement triggered a second explosion, an outpouring of support from readers battling cancer themselves. Moved to acknowledge this community, Sievers asked an assistant to create a gallery of posts and photos that puts faces to more than 350 readers battling cancer themselves. The result is incredibly uplifting, a testament to bravery and spirit.

Fighting back -- while telling the truth --- was the theme of another cancer story playing out on the national stage this month, that of Ron Davis, President of the American Medical Association (AMA), diagnosed with Stage IV pancreatic cancer at the age of 51. Bald from chemo, Davis addressed the AMA's annual meeting in a speech titled "The Circle of Life" in which he talked openly of his prognosis and of what it's like to be a doctor battling a deadly disease. "As a physician, I know the survival statistics for someone with Stage IV pancreatic cancer. But if the five-year survival is 5 percent, that's not zero.... So never take away someone's hope."

At the end of Davis's speech, he choked up, telling the audience that since his diagnosis four months ago, he's spent more time with his wife and three sons, who then joined him at the podium for a hug. The standing ovation lasted three minutes.

Dr. Len Lichtenfeld of the American Cancer Society was moved to transcribe Davis's remarks in his blog, calling Davis a "man who has decided to fight his battle with cancer vigorously, publicly, and while always moving forward with his responsibilities every day as a leader in medicine."

The AMA was deluged with so many requests for Davis's speech that they made it available as a video clip on their website.

Let's hear it for the honest and brave.

Image of Ron Davis, President of the American Medical Association and cancer patient, addressing the opening session of the AMA House of Delegates in Chicago on June 14, 2008.

New Fall Prevention Tools Keep Seniors Steady

Nell Bernstein — Tue, 01 Jul 2008 07:00:00 -0000

Last week, we looked at new legislation aimed at easing the epidemic of falls among elders.

Turns out -- as with many aspects of getting older -- there are some high-tech options in the works to help keep seniors steady on their feet.

Some were designed for use in nursing homes or assisted living settings but could also be used by caregivers at home. Unlike Personal Emergency Response Systems, these systems are designed to prevent falls rather than respond to them:

The FallSaver is a small patch that attaches to the thigh with a "tilt sensor" that's activated when the wearer stands up. This is most useful for a senior who really shouldn't be walking without assistance -- if he gets up from bed or a chair, the device signals a care giver and alerts the wearer to sit down until help arrives.
The University of Virginia is developing a Gait monitoring device that measures a user's footfalls to establish a baseline gait, then notifies a care giver, health care provider, and the senior herself if the gait begins to vary -- indicating that she may be at risk for a fall in the near future.
For a tech-savvy generation that's adapting to everything from fully-automated homes to video game crazes like the Wii, there's the option of trading in their canes for souped-up robotic walkers. Guido the Smart Walker scans the room for tripping hazards, gives the user a verbal heads-up through a speaker, then stops automatically should its operator try to outsmart it and head into the hazard anyway.

Combine these high-tech solutions with basic fall-prevention measures, and we just might make a dent in one of the greatest threats there is to our parents' safety, mobility, and long-term quality of life.

Photo by Flickr user CBGB_Hoser, used under the Creative Commons licensing agreement.

Parkinson's Meds Help -- But May Cause Scary Side Effects

Paula Spencer — Mon, 30 Jun 2008 22:15:05 -0000

Worried that your parent gambles too much? Or maybe you've noticed she buys loads of things she doesn't need from TV shopping channels? If she also has Parkinson's disease, the culprit may be her medication.

A new study, from the University of Pennsylvania, isn't the first to make the link, but it's the largest to date, involving more than 3,000 people. It finds that dopamine agents used to treat Parkinson's symptoms place people at higher risk for impulse-control disorders. The risk is two to three times higher for such disorders as:

Problem or pathological gambling
Compulsive buying
Compulsive sexual behavior
Binge eating

It seems that dopamine helps motor control but also affects the part of the brain involved with reward systems. The effect held true both for levodopa and for dopamine agonists (pramipexole, ropinirole, pergolide). Thirteen percent of Parkinson's patients on these meds had at least one impulse disorder -- and more than a third of that number experienced multiple disorders.

What's the message here for all of us?

Odd behaviors may not be what they seem (and are usually a red flag of some kind).
It's not enough for your parent to be informed about the side effects of medications being taken -- caregivers need to be aware of them, too.

Image by Flickr user Shoshanah, used under the Creative Commons attribution license.

Vascular Dementia Resources for Caregivers

Stephanie Trelogan — Mon, 30 Jun 2008 07:00:00 -0000

Last week, USA Today ran this interesting piece on vascular dementia. Also called multi-infarct dementia, vascular dementia is caused by multiple strokes that disrupt blood flow to the brain, leading to damaged tissue. The symptoms are very similar to those of Alzheimer's disease, and the two types of dementia often occur together.

Although the USA Today piece focused on a woman in her 30s, vascular dementia usually begins between the ages of 60 and 75. And since it's the second leading cause of dementia in the US (after Alzheimer's), I thought I'd list some blogs and resources especially for those of you caring for people with vascular dementia:

In his memoir Dementia Diary: A Caregiver's Journal, Bob Tell writes about his mother's 16-year decline into what he calls "the opaque fog of dementia." Check out Bob's blog for more about vascular dementia and his experiences caring for his mother.
Another blog I like is Susan Lanza's The Dementia Caregiver's Toolbox, which offers information and resources for caregivers of people with dementia.
You can find out more about vascular dementia on the websites of The National Institute of Neurological Disorders and Stroke and The Alzheimer's Association.

What are some of your favorite resources and blogs on vascular dementia? Do you have any advice or words of wisdom for other caregivers? I'd love to hear from you.

Image by Flickr user Image Editor used under the Creative Commons attribution license.

"Wings" For Frail Seniors Who Can't Travel On Their Own

Kate Rauch — Mon, 30 Jun 2008 07:00:00 -0000

I have a good friend whose mom hops on a plane every summer to visit her. Or did. For the first time my friend doesn’t want her 80-plus mom flying alone, feeling her health simply isn’t up to it. She still wants her mom to visit, and her mom wants to come -- and she probably can.

There are several ways to help frail seniors travel. Most aren't what I’d call super budget-friendly, but they’ll allow your parents to get up and go -- worth every penny, for some.

With senior travel escort services, you pay a trained caregiver to fly (or go by rail) with your parents. The amount of help the escort provides during the rest of the trip can be negotiated. They're easy to find on-line using key words like, “senior travel escort," “senior check in and travel," and "senior travel companion." It may help to add the name of your parents’ town. Advantage: One-on-one care. Disadvantage: Pricey. The client usually pays the escort’s air fare and an hourly salary (around $10 to $25) for travel time .

Ask friends or family to travel with your parents, especially teens or other (more able-bodied) seniors who aren’t locked into a work schedule. Advantage: The comfort of someone you and your parents know. Although you pay their airfare and maybe some pocket money, a salary usually isn't expected. Disadvantage: Can be hard to find someone. Plus you and your parents will have this guest for the entire trip (which could be a positive or a negative).

Find out what the airlines offer. Most airlines provide some free assistance to seniors or people with disabilities, such as escorting them on and off the plane, helping with their carry-on luggage, and providing wheelchairs at the airport. Advantage: It’s free. Disadvantage: Limited to certain tasks or services; impersonal service.

A traveling nurse escort can accompany the sick or very frail. Do an on-line search using terms like “traveling nurse escort,” “nurse travel companion," or "flight nurse." Advantage: Skilled medical care at your parents’ side. Disadvantage: Super pricy. Makes sense only when there’s a medically compelling reason.

You escort your parents. Advantage: It's all in the family. Disadvantage: Takes time and money.

My friend and her mom are weighing all of these options. I’ll let you know how it goes. To help you plan, here's some good general advice on senior travel from HealthDay news service, a Caring.com air travel checklist, and an information-packed "Anyone Can Travel" book written by two nurses.

Image by Flickr user casers under a Creative Commons attribution license.

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