Caring Currents

If you live in a food obsessed corner of the country, as I do, then you probably know about the slow food movement, which spread from Italy. Think local, sustainable, organic, good-for-you ingredients. Think a return to home-cooked meals, prepared with care from scratch. Think the opposite of, well, fast food.

So what, then, is the emerging philosophy known as slow medicine? Simply put, it's a less aggressive -- and less costly -- approach to medical care for the elderly than the status quo. Fewer hospital stays. Less risky interventions. Comfort over cure. It's about the opportunity to choose quality-of-life over quantity-of-years for folks entering their twilight days (typically those 80 plus).

In other words, more is not necessarily better.

When we imagine the best medical treament, we think of doctors pulling out all the stops in sleek hospitals, using life-saving, high-tech gadgets and...  Read more

The other day I read a piece of caregiving advice that cut through all the rest and really spoke to me. It applies to pretty much any situation or circumstance, and it's so very simple: Avoid being in a hurry. 

In other words: Slow down.

The writer happened to be someone in a Caring.com discussion group that's generally focused on how rushing and old age don’t mix, causing all kinds of tension between seniors and their caregivers. Stiff joints, muscle weakness, aches and pains, fears -- whatever the reason, old age is, in the natural life cycle, a time for slowing down. Accepting this, and planning for it, can make life so much easier for seniors and the people caring for them.

How do you plan for slowness? Well, I think there are two approaches. One is practical and the other philosophical.  

On the practical side:

• Be realistic about how much time it will take...  Read more

Every year, nursing home and assisted living administrators share the same story: Around the holidays, admissions spike. The reason? Adult children who may not have seen their aging-in-place relatives since the last holiday season come home for a visit and are shocked by what they see: a once well-kept home now in disarray, or a formerly robust relative looking startlingly frail.

Sometimes, of course, you may in fact come home to a real emergency, and residential care may in fact be the best option. Other times, the problems can be handled without a move, by measures such as enlisting part-time, in-home caregivers, helping your relatives register at an adult day center, or hiring a housekeeper and signing them up for a meal delivery service. (Check out Caring Local for resources in your family's area.)

Before you can help, though, you need get a realistic sense of where things stand. Asking direct questions right off the bat may put your relatives on the defensive, but you can learn a lot simply by looking around...  Read more

Here's the first step to solving countless behavior problems presented by someone with Alzheimer's: Ask, "Why is this happening?"

I'm not referring to the rhetorical question, "Oh why is this happening to me?" although it's sure understandable if that one crosses your mind. But when you're faced with upset, a refusal to cooperate, or even a catastrophic reaction, don't write it off to the craziness of the disease. You can usually solve the matter by stepping back to consider, "Why is this behavior happening? What might be triggering it?"

I first grasped this concept from Joanne Koenig Coste, whose insightful 2003 classic, Learning to Speak Alzheimer's, describes her theory of "habilitation care." Her basic idea: You can't rehabilitate someone with Alzheimer's, but you can habilitate them -- step into their world and adjust things accordingly in order to help them be as capable as possible...  Read more

Last week, when I interviewed Michele Mason about caring for her neighbor, Andy, during his final days, she told me that the experience made her less afraid of her own death.

"It was incredible to watch Andy let go and accept his death." Michele said. "It made me feel less afraid to die."

When we watch a close friend or relative pass away, most of us can't help but reflect on the eventual conclusion to our own story. And many caregivers, like Michele, find that helping a dying patient makes the prospect of their own death a little less frightening. Particularly if the loved one dies peacefully, without a lot of pain, helping someone at the end of his life can be a humbling and awe-inspiring experience. This is the thesis of Final Gifts, by hospice nurses Maggie Callanan and Patricia Kelley, a book I recommend to anyone who has a dying relative or friend...  Read more

Last week I talked with three daughters who have all cared for their ailing mothers. The specifics of each situation are unique but one thing the trio has in common: They have all been -- or still are -- long-distance caregivers.

For two years, Barb Silver made a monthly trek to her mother's home on the other side of the country for a five-day visit. She says that period of her life, before her mother died, is a blur because she was sleep deprived and jet lagged much of the time. Judi Kaplan spent 18 months shuttling back and forth between her home in San Francisco and her mother's Santa Monica address before recently relocating her to the Bay Area. Janice Shapiro continues to make regular visits to her frail 93-year-old mother, now in a nursing home on the East Coast.

Providing assistance from afar presents challenges, regardless of whether its motivated by love, duty, guilt, or a combination of all three...  Read more

When people find out that my mother was an alcoholic, and that my sisters and I cared for her up until her death from the complications of a drunken fall, they're often at a loss for words. Unless, that is, they're in the same or a similar situation. And then the stories come pouring out.

Dealing with an aging parent who has a drinking or addiction problem isn't quite like any other challenge. How do you cope day to day with someone who can be kind and communicative one moment and raging and incoherent the next?  How do you keep a family member safe who could stumble and fall when drinking alone or pass out in an alcoholic stupor? What about hiring a caregiver or finding a home? Our experience was that no assisted living facility would take my mother, and although we found a part-time caregiver with the patience of a saint, my mother fired her on an almost weekly basis. 

If you're...  Read more

A dear friend’s mom planted herself on her couch last summer, announcing her intent to stay right there. Facing the inevitable reality that her mother (who has several health concerns) couldn’t live alone much longer, my friend OK'ed the trial run of living with her mom. 

Things went fine for awhile, as mother and daughter generally get along. But my friend started to feel suffocated. Her teen children were in and out of the house, but her mom was, well, always there. It culminated when her mom walked in on her and her (adult) boyfriend having some private time and, well, you can imagine.

Everyone needs at least some time alone at home. Private time. Puttering time. Time to soak in the quiet or to blast the Supremes or Rolling Stones as loud as you want.

With kids afoot, parents manage this in a number of ways: play dates and sleepovers, summer camps, and, of course, school...  Read more

The 25th annual National Alzheimer's Disease Awareness Month kicks off November 1. But perhaps it's time for a new name. Awareness is no longer the problem it was 25 years ago. Everybody knows a family touched by the long arm of Alzheimer's, it seems. More than twice as many people are now afflicted, from under 2 million back then to more than 5.2 million today.

A more apt name? National Alzheimer's Disease Coping Help Month. Okay, that's a clunky mouthful. But the critical issue today is coping day to day. Yes, research toward a cure is a priority, but frankly, this is extremely unlikely to happen in the lifetime of those who are currently afflicted. Prevention is also critical, if a little tricky because we don't exactly know the cause mechanism for Alzheimer's, and so far the biggest risk factor is one we can't control: age. Again, too late for our elders.

The pressing need is for help in the here and now...  Read more

Will you be escorting someone with dementia to the polls on Tuesday? No law specifically forbids a person with Alzheimer's disease or dementia from voting. There's no federal eligibility standard. But no sensible person could ignore that it's a problematic, case-by-case question.

Add it to the list of tough calls caregivers are forced to make. Don't feel guilty, though, if you decide, after thoughtful contemplation, that it's time that this great right and privilege joins the list of traditions and pleasures that the person in your care, sadly, can no longer partake in.

Why shouldn't someone with dementia vote? Five possible reasons:

* It's illogical: If a person can't manage their finances or legal affairs because of cognitive erosion in thinking and judgment, how can they evaluate the issues and make a political decision?

* It's possibly unethical: Even if you "know" someone impaired is a dyed-in-the-wool Democrat or Republican, voting for him (say by absentee ballot) is not the same as an individual casting his or her own vote...  Read more