Caring Currents

Last week, my kids' babysitter rushed outside yelling at me to follow. Had a child fallen off a scooter or out of the tree? Not this time. There on the sidewalk was my neighbor, an elderly woman suffering from terminal cancer. She’d collapsed while trying to take in the garbage can.

My babysitter, bless her heart, was lifting the woman up and saying soothing words in Spanish, both women's first language. The neighbor was OK. Frail and a little disoriented, but not hurt. Then her voice became urgent. Could we please not tell her daughter, with whom she lives, that she fell? Could we keep this a secret? She was worried, she said, that her daughter would move her to a nursing home or hospice, and all she really wants is to live her last days at home.

Wow. Talk about a poignant moment. I flashed back to a conversation I'd had more than a year ago with an expert on falling from the Centers from Disease Control (CDC) after the agency had released its annual fall statistics...  Read more

A recent discussion about adult diapers and humor caught my attention. In her blog, “The New Old Age,” New York Times writer Jane Gross reflects on a series of stories in Slate for what it calls its Geezer Issue or "Slate Goes Gray."

While appreciating some of the information in the series, Gross found a few articles offensive because they poke fun at aging. She was particularly bothered by a first-person review of adult diapers, written by a 27-year-old guy who admittedly had no experience with the products before being asked by Slate to do a test drive and write about it. 

I’ve written about adult diapers a few times in this space. For many seniors and caregivers diapers are simply a necessary part of daily life. This includes writing about  another diaper test drive, or in this case, a test drive threat. This was by the health minister of Ontario, Canada in a flap about the quality of care in state-run nursing homes...  Read more

A coincidence last week leads me to mention a new addition to Caring.com -- and one that’s already making a difference in at least one person’s life.

A close buddy’s step-dad, 84ish, went to the hospital with vague symptoms of tiredness and lower body pain. He was admitted and a couple of days later diagnosed with kidney cancer that had metastasized to his intestine and possibly other places. His prognosis is terminal.

This same week Caring.com launched a new feature: “To-Do” lists. These online checklists guide you through a variety of challenging caregiving situations including What to Do When a Loved One is First Diagnosed With Cancer, and What To Do When Someone Dies. A complete list is below.

My friend had never dealt closely with a cancer diagnosis. His main “job” is to support and steer his mother, who is caring for his step-dad...  Read more

When she saw the ad for a “senior memory class” in the local paper, my friend doubted she could interest her mom. Her mother’s memory issues had become a tense, hot-button topic that inevitably sent her mom into a snit. “My memory is just fine!”

Never mind that her mom's landlady had called again to say the rent wasn’t paid. Or that her mom kept forgetting to use her inhaler and was wheezing like crazy. Or that she’d sometimes struggle to recognize old friends she passed on the street.

And so my friend was downright shocked when her mom said she’d noticed the very same ad and would “just maybe” consider checking it out. Delicately holding on to this thread, my friend encouraged her mom. Of course, she'd drive her and go to the mandatory caregiver group held simultaneously in a different room. Fingers crossed, she hoped the class might actually slow her mom’s escalating memory loss, while providing a new social outlet with peers...  Read more

My friend Jessie prided herself on living as independently as she possibly could as her body weakened in a kind of variety pack of aging. Of all her debilitating ailments (broken hip, weakening heart and kidneys), one of the hardest things for her to deal with was her arthritis. Her hands and fingers were stiff and painful.

Not quite a fashion queen but a woman who took pleasure in clothes, Jessie was particularly bugged by the difficulty she had dressing. She couldn’t do small buttons; same with bitsy zippers. Tying laces; forget about it. I remember watching her struggle with her favorite winter jacket. I offered to help, and she snorted (as she usually did): “No, I can do it myself.” The truth was, she couldn’t.

This isn't an unusal problem for older people, and it's one that really takes a hit on self-esteem. Arthritis isn’t the only condition affecting the ability to dress...  Read more

True confession: I’m not a big fan of proclamation days honoring this or that thing, event, or person. So it is with some skepticism that I greet National Grandparents Day, September 7. (Yet another way for greeting card, flower, and chocolate companies to make a few bucks.)

True confession: I’m sentimental and often fall for proclamation days honoring this or that thing, event, or person when it touches me in a genuine way. I won't be lifting a finger for National Meatloaf Day (October 18), National YoYo Day (June 6), or National Pickle Day (November 14).

But grandparents? Got me. Just last week I wrote in this space about my grandmother’s vision loss, stirring all kinds of memories of this sassy woman who died years ago. It's a special relationship to be a grandchild. Not nearly as loaded as being a child; kind of once-removed from parental rules and expectations. Yet still marked by an older-younger connection, kinship, the passing of generations...  Read more

I remember my grandma’s vision going. She’d bump and crash her way around her house; hold recipes, TV Guide, and the sports section brushed against her glasses. (She was perhaps the world's biggest Pittsburg Pirates' and Steelers' fan.) She didn’t like talking about her eyesight and was reluctant to accept help.

I’m pretty sure my grandmother had macular degeneration, a progressive, incurable blindness associated with aging. Family facts are hazy, and she died years ago. A number of eye problems are associated with aging, as described well by the University of Illinois eye clinic.

Today several of my friends are going through similar things with their parents. Vision loss brings a number of significant hardships, but losing the ability to read is one of the toughest for people to take. "A major turning point sending my mom into depression," one friend said...  Read more

A friend got a call a while ago that sent her over the edge. Yet another of her mother’s home caregivers had quit, claiming she couldn’t take the elderly woman’s insults -- the third time this had happened in less than two years. This friend lives across the country from her mother and has to handle all of her care long distance -- by phone, email, and periodic visits.

Talk about a major drag. This was one. For some seniors, the fact that they need care is so demeaning that they simply can’t get beyond lashing out at the caregiver. It’s almost as if they’re trying to force them away. Perfectly understandable, but still hard to deal with -- especially for a caregiver.

I collected information from a variety of sources about what might help in such a situation. Turns out this problem is so common there’s quite a bit of thinking on it. Here’s a start...  Read more

Need a home caregiver, senior transportation, respite care, adult day care, senior housing that won’t leave a massive hole in the wallet? Need it now? I’m going to let you in on what I think may be one of this country’s best secrets. And the thing is, it shouldn’t be a secret at all. So picture me screaming this from a rooftop.

Dial 2-1-1.

You’ve heard or 9-1-1 (emergencies) and 4-1-1 (directory assistance). Meet the newest member of the country’s phone assistance services. 2-1-1 is a free, nonprofit national phone service that connects you to real people who provide local referrals to all kindsof social services, from housing, meals, and transportation to home caregivers and emergency medical care. “Support for older people,” is one of 2-1-1’s primary target areas. (Others include parents, kids, people with disabilities, the low-income...  Read more

A friend e-mailed recently with a mini update on her mom, who has dementia. Her latest challenge, she said, was her mom being absolutely unable to sit still for a dentist. She’d fight the dentist off screaming. Fear of being touched is common with those who have dementia, including Alzheimer’s. What’s merely annoying for us -- teeth being poked and prodded -- can be hellish for them.

But my friend's e-mail wasn’t a total downer. Turns out there are special Alzheimer's dentists trained in treating people with dementia. My friend’s mom already had an appointment.

It’s not hard finding these dentists online, especially if you live in a larger town. Do an internet search with the terms dental care, Alzheimer’s, and your parents’ town. Also ask your parents’ current dentist for a referral. (This is how my friend got a name...  Read more

I’ve had a slew of questions lately from Caring.com readers asking what to do when their elderly loved ones refuse to bathe, shower, or clean their bodies in any way. Talk about a major stressor. This is one. And it’s all too common. To all those out there in this situation -- you aren’t alone. A few things really can make a difference.

Understanding helps. There are all kinds of sensible reasons why older people don’t want to bathe. These include:

• Fear of falling
• Lightheadedness or dizziness
• Not strong enough to get in or out of the tub on their own, but don’t want to admit it
• Water too cold or too hot; temperature never feels right
• Annoyed or scared by the sound or feel of water; common with people with Alzheimer’s or dementia
• Depression, a kind of passive giving up on life

Try to narrow down what’s going on with your parents...  Read more

Last week I brought up how the nose-diving economy is affecting senior care. Hardest hit are services that depend on gas, like Meals on Wheels, home caregivers (who drive to work), transportation, (like the van that takes your dad to the senior center), and any program using volunteers who drive.

Rough, yes, but certainly not impossible. I promised to get back to you with tips for navigating senior care in a bleak economy. Here goes:

• Use caregiver cooperatives. Essentially nonprofit employment agencies, Caregiver Cooperatives provide an easy way to share home caregivers, which can lower costs. They're a little tough to find. Do an on-line search with your parents' town and "caregiving cooperatives," or try the Eldercare Locator.
• Hire home caregivers independently, instead of through an agency. Hiring on your own is almost always less expensive than through an agency. The trade-off is that you have to do more work...  Read more

In recent weeks, I’ve written about how rising gas prices and food costs are affecting seniors. Now comes a report predicting even more far-reaching impacts on older folks from our rocky economy. I don’t like harping on bad news, but for anyone caring for a senior, these realities are important to be aware of. Better to be prepared than caught off guard when, say, an Alzheimer’s day-program closes or a hospice volunteer quits for a new placement that’s closer to her home (less gas $$).

A survey by the National Association of Area Agencies on Aging (n4a) found that rising costs and reduced funding are forcing significant cuts in all kinds of senior services, including transportation, home caregivers, and meal-delivery. Low-income folks are hardest hit, but elders of all income levels can certainly be affected. What's more, the situation is expected to get worse...  Read more

Summer fruits and vegetables are filling markets, which is a gold mine for seniors who can only eat soft foods. (Conditions that can affect chewing and swallowing include stroke, spinal cord or brain injuries, Parkinson’s, Alzheimer’s, and cancer.)

If you're caring for someone who's on a soft diet, summer brings an abundance of nutritious, mashable, blendable, juiceable, puréeable fresh produce -- at decent prices. Don't trust your ability to prepare soft meals? No worries. The other good news is that today’s soft diet experience is far from those culinary dark ages of applesauce, pudding, and blah mashed potatoes.

What about zucchini pesto quiche, lime-strawberry slush, poached coconut-ginger salmon, orange scented carrot soup, or sherried beef sirloin tips? Recipes for these and many more yummy-sounding recipes are found in the growing body of soft diet cookbooks that take bland entirely out of the picture...  Read more

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...  Read more

Summer’s here. And with it come health risks for seniors. Older people are especially vulnerable to heat illnesses, as elaborated on by the Centers for Disease Control. The two biggest risks are heat stroke (extremely serious) and heat exhaustion (milder than heat stroke but still serious). Dehydration and heat cramps are in there, too.

There are several things you can do to help protect your parents from the dangers of baking-high temps.

Make sure they:

• Are drinking plenty of hydrating fluids, like water, and avoiding dehydrating fluids, like alcohol and caffeinated beverages
• Limit time in the direct sun and wear hats, sunglasses, and sunscreen
• Have working air conditioning or electric fans -- and know how to use them
• Talk to their doctors about the relationship between heat and their medical conditions and medicines -- some illnesses and meds affect how our bodies deal with heat
• Aren’t overdressing; some seniors can’t tell if they’re too hot and layer on clothes out of habit...  Read more

If you’re struggling to get your parents to stop driving, record high gas prices could be your ally. Gas pump shock is converting plenty of people into diehard public transportation fans.

With gas at over $4 a gallon and no relief in sight, people in all economic classes are looking for alternatives to cars. Seniors on fixed incomes are especially motivated.

If you’re trying to nudge your parents away from driving, why not bring up the price of gas, followed by some quick suggestions on alternative ways of getting around. Or offer to try-out the bus or train together, a kind of orientation tour. High gas prices may give some older drivers a welcome out: “It’s not me, it’s pure economics.” Got any ideas for alternative transportation you can add to the list?

Even public transportation and paratransit operators are watching gas prices with fear, dread, and an...  Read more

A few weeks ago I suggested buying your dad a home blood pressure monitor for a Father’s Day gift (if he has high blood pressure). A perfect present for some dads, but others would see it as an insult: “Get off my back already about my health -- jeez!”

Gift giving is tricky business, and is it just me, or is it particularly tough when you’re trying to find something for an older man? Images of unused ties, socks, wallets, and cuff links (does anyone wear these anymore?) stuffed deep into drawers.

But here it is almost Father’s Day, and even though it’s hard shopping for older dads, the urge to honor them -- just to honor them -- seems to grow with time.

I’ve decided the best approach is to “Know Thy Father.” Forget about all the advertisements. What really matters to your dad? What perks him up and touches his heart?

Dad types and what they...  Read more

Worried about how your parents will manage in a hurricane, cyclone, earthquake, flood, or other disaster? Get them gabbing. Talking is one of the most important ways to protect seniors in a natural disaster, according to a recent report from the Hartford Financial Services Group, an insurance company that funds research on aging, among other things.

A recent survey of older Americans commissioned by Hartford found that a huge majority expect to rely on others in a disaster. But most of these same folks haven’t talked about disaster planning with their family, friends, or neighbors. So the people most likely to help them don’t know what they need or expect.

The solution: Sit down for a chit-chat with your parents or other elderly loved ones and hatch out a plan for handling disasters. Covers such basics as:

• Establishing a network of people to check on them and then to...  Read more

Shingles is a pretty nasty skin condition that can be extremely painful and sometimes dangerous -- and seniors are especially vulnerable.  So the news that everyone over 60 should get a shingles vaccine adds an important item to the “To Do” list for anyone caring for a senior (or inching toward 60 themselves).

In fact, put a giant star by it on the list, as the vaccination is a recent recommendation from the Centers for Disease Control (CDC).  There's a good NPR story on it, and plenty of bloggers spreading the advice, including this Harvard Med School doc (via video!).

But  this isn’t the only vaccine recommended for older folks. I hate to add items to your list, but while you’re looking into getting your parents vaccinated for shingles, it's a good time to see what else they need. The CDC’s adult vaccination list  includes:

• Tetanus...  Read more

If your parents have high blood pressure, add a home monitor to their shopping list.  So suggests a bunch of high-powered and well-respected heart organizations, including the American Heart Association and the American Society of Hypertension.  

(Hey, this might make a great Father’s Day gift, especially for a dad who appreciates practicality.)

Their announcement got lots of attention in blogdom and traditional news. The upshot:

• Doctor’s office measurements can be misleading, either higher than usual, called the “white coat effect,” or lower.
• Because blood pressure normally varies throughout the day, home testing makes it easier to get a generalized or Big Picture look at rates, versus the snapshot of an occasional doctor’s visit.
• The immediate feedback of home testing can be a great incentive for patients, sending them out on a jog or away from the salt shaker...  Read more

Something caught my eye recently that really puts a human face on today’s economic uncertainties (beyond scowls at the gas pump).

An article in the New York Daily News looks at how some seniors are being walloped by the rising cost of food. Spikes in the price of bread, milk, eggs and other basics are tough for many seniors, especially those on a fixed income. And yes, their health is at stake.

Government forecasters say these rising prices aren’t going away any time soon, as the Associated Press reports. Bloggers are abuzz, circulating the latest stories.

Fortunately, there are ways to help. If you’re concerned about your parents' ability to pay for food, here are some possible ways to save:

• Meals on Wheels and other meal delivery programs. Many charge on a sliding scale. Because they can buy in bulk, consumers pay less...  Read more

I'll bet you think that osteoporosis (bone thinning) is a woman’s condition. I did. Looks like we need to adjust our thinking -- and we’re not alone. The American College of Physicians released new clinical guidelines this month on screening men for osteoporosis. This is good info to share with your dad and with his doctor.

These first-ever guidelines call for doctors to periodically screen older men using these risk factors: 

• Low body weight or recent weight loss combined with physically inactivity
• Ongoing use of corticosteroid drugs (such as prednisone) or some drugs used to treat prostate cancer
• Low calcium diet
• Smoking
• Previous fractures not caused by trauma

Doctors are advised to give high-risk men further x-ray testing -- as early detection is key with osteoporosis -- and several simple approaches can slow its progress, such as increasing Calcium, Vitamin...  Read more

Even if you gave your mom a gift, here's an after-the-fact Mother's Day present with meaning any time of the year:  A check-up.  If you're a daughter caring for your mom, give it to yourself.

Women around the country are being urged to give themselves a medical check-up, as part of the ninth annual National Women’s Health Week, which kicked off on May 11 (Mother’s Day). Well, not to give themselves a check-up, but to schedule one with their health care provider. National Woman’s Check-Up Day is May 12, and for motivation, you can even take an on-line pledge.

Research shows that women do a much better job caring for others than for themselves. We’ll hustle and bustle scheduling appointments for our parents, kids, and spouses -- leaving our own health as the last priority.

More than a hokey proclamation, National Women's Week, sponsored by the U.S. Department of Health and Human Services, is packed with useful activities, on-line and off...  Read more

Think “fall prevention” and what comes to mind? Walkers and canes, getting rid of easy-to-trip-on throw rugs, installing bathroom grab bars, maybe checking out senior exercise classes.

Add meat. (Lean, please.)  And eggs, chicken, tofu and nuts. Yep, protein. And make that plenty of it, especially for your mom.

As we age, we lose muscle mass, making us weaker and more prone to falling. Exercise and a balanced diet with ample protein, which builds muscle, help counter this effect.

But when looking closer at the relationship between protein and muscle, researchers at Washington University in St. Louis and the University of Nottingham in England found that protein isn’t as helpful to elderly women as to men. This recent study showed that the muscle of older women didn't synthesize or utilize protein as efficiently as that of older men.

So what’s an old gal supposed to do...  Read more

If your mom lives far away, showing up with a box of chocolates on Mother’s Day or taking her out to brunch may be impossible.  (Reminder: Mother's Day is May 11.)  Don't worry, there are all kinds of special ways you can honor your distant mom. And there's still time.

You can always go the flowers, gift, or card route -- reliable standbys. (For mailing information/deadlines, check these sites: the U.S. Postal Service, Fedex, UPS, and DHL.) Or, take a look at some off-the-usual-path ideas:

• A surprise conference call or trickle of calls through the day. Coordinate with family members. Here’s a conference call tip.
• A warm home-delivered meal. Do an internet search with your mom’s town and terms such as “home delivered meals,”  “home delivered gourmet meals," or "personal chef."
• A box of home-delivered groceries filled with delicacies or necessities...  Read more

Sometimes small efforts can make a huge positive difference. I like to think of these as heart-gems. I discovered one a few weeks ago, when I was writing a blog about nursing homes and diaper care. Many elders need diapers (incontinence is a common problem for seniors) but are too embarrassed to shop for them. (Utterly understandable.) They fret, worry, and agonize.

Simple solution: Adult diapers (and other incontinence products) can be purchased on-line and shipped to your parents in a plain package. Now this may sound old-hat to us (relatively speaking) younger folk, who are comfy with the internet (though perhaps less so than our kids). But your parents may not realize they have this option.

You can order diapers for your parents. Of if they’re somewhat computer savvy, they may prefer doing it themselves, but need pointers.  I did a search using the terms “adult diapers” and “adult incontinence products,” and came up with numerous stores...  Read more

A heartbreak in Texas offers lessons that can protect elders everywhere. Retired airplane technician and avid gardener Frank Dusek died in the middle of the night when his house caught on fire in early April. Frank lived alone in Euless, outside of Ft.Worth.

Yes, he had a smoke detector. It was found lying on a chair in the charred house -- with no batteries. The tragedy was covered by the Fort Worth Star-Telegram.

Something positive happened after Frank’s death. Fire investigators and volunteers walked his neighborhood, home to many seniors, passing out and installing smoke detectors.

The elderly are at much greater risk of dying from fire than younger people. (Check out this Fact Sheet from the U.S. Fire Administration.) Why? Because they're more likely to have hearing, vision, memory, or mobility problems that affect their ability to detect smoke, properly use a smoke detector, and escape fire...  Read more

Another terrific idea for helping our elders exercise has crossed my desk, or computer screen. (Last month it was the Wii video game.)

Senior playgrounds -- honest-to-goodness, equipment-filled, outdoor play areas -- are popular in many countries, except for the United States. It's interesting to think about the political or cultural explanations for this (a different topic), but these playgrounds do attract seniors.

I can see why. They’re marvelously designed for safe, healthy geriatric activity. Check for yourself by clicking the Good Morning America link on changingaging, the blog of geriatric physician, Bill Thomas. Then click the video "Playgrounds for the Elderly." It's worth it. (This blog post, by the way, stresses how middle agers could benefit from a romp in senior playgrounds, along with their parents.)

There are senior playgrounds in England, Germany, Japan, New...  Read more

Adult diapers hardly seem like a hot media topic. But they’ve been just this in Canada lately, thanks to the Ontario Health Minister saying he’ll wear a diaper to judge their comfort. This in response to claims that the Canadian government doesn’t spend enough money on staffing in state-run nursing homes, leaving residents in soiled diapers. (In spite of his threat, George Smitherman, the health minister, apologetically backed down from his diaper test drive, as reported by lots of news sources, including the Toronto Star.)

Check out blogger Rositta’s (a self-described cynical "middle-aged broad") take on the issue.

Wherever your parents happen to live, if they're in a nursing home, staffing is critical, especially when it comes down to how best to care for our elders in diapers. Talk about being vulnerable. They are -- especially when we can't check on them as often as we'd like...  Read more

Every day, it seems, there’s a new study saying how great exercise is for the elderly. Good to know, but piles of research don't necessarily get our older loved ones active.

A video game may. The Nintendo Wii is all the craze in retirement communities and nursing homes, as reported in numerous local papers like Connecticut’s Republican American. The Wii is known for its sports games where players swing around a remote control to bowl, box, or play tennis on the screen. You can play sitting or standing, and yes, you really can work up a sweat.

Medical experts are taking note. University of Maryland geriatric physician Bill Thomas posted a fun Wii video on his blog Changingaging. And Wiis are showing up increasingly alongside weight benches and treadmills at senior rehabilitation programs, as highlighted in the Grand Rapids Press.

All you need is a TV and about $300 for a Wii (sold in any consumer electronic store, including on-line)...  Read more

At first glance, your local cop doesn't seem like a first choice for providing eldercare.  But it turns out police around the country do just this as a regular part of their job. Keeping an eye on seniors, especially those living alone, is a routine service of many police departments. Some call. Some visit. Others ask seniors to call and when they don't, go to their home to see what's up.

I just did a web search and was amazed by the choice.  There are programs in Marshall County, Iowa; Baker County, Florida; and the town of Morton Grove, Illinois. The list goes on.  Some are run by police departments alone, or cops teamed up with social service agencies. Most are free to residents.

They're easy to find. Do an internet search using terms like "police" or "sheriff" and “senior check-in” or “senior check,” always with the name of your parent’s town or county...  Read more

A recent report on senior falling by the Centers for Disease Control (CDC) says falls are the leading cause of injury and death for people over 65.

Wow. This is sobering. What can we do? Several things, it turns out, and they’re fairly simple. It doesn’t take lots of time or money to reduce our parents’ fall risk. The CDC provides good information on fall prevention, as well as information on fall statistics if you like this kind of thing.

In a nutshell:

• Exercise, exercise, exercise. Numerous studies show that regular exercise to improve balance and stamina is a powerful way to reduce your parents’ chance of falling. Check out this info on finding exercise programs that help prevent falling.
• Declutter. Go through your parents’ house and pick things up. Look for tripping hazards.
• Make things accessible. Put things on lower shelves within easy reach...  Read more

Quick: When was the last time your elderly loved one saw a dentist? A recent tragedy in California is a wake-up call to anyone caring for elderly parents, partners, or friends. Remember their teeth. And don’t assume someone else is doing this--even when your parents are in a nursing home.

A 76-year resident of a Santa Rosa, California, nursing home died about a month ago from an oral abscess that went untreated. Dentists told her family afterward that the condition was treatable, and the woman’s death preventable. If only she’d seen a dentist. The woman’s family assumed she was getting routine dental care as a recipient of Medi-Cal, the California version of Medicaid, the federal health care program for low-income and disabled people. They were wrong.

It turns out Medi-Cal doesn’t cover regular dental care for people living in nursing homes. Under the terms of Medicaid, states have the option of providing dental care to adults...  Read more