About two years ago when my parents came to visit, we took the opportunity to have a heart-to-heart conversation with them about the possibility of a move. My father was completely against the idea but my mom was at least willing to think about it.

In 2009, my wife and I decided that the time had come to get serious about the move.  Their health was pretty good so we felt it would be easier for them to take the physical and mental stress of the change. Plus, they might have a few years to enjoy themselves in Colorado before their health declined. We researched the local care available and when my parents made their next visit we scheduled several tours.  Together we visited twelve facilities in a six-day period, evaluating everything from the accommodations and level of care, to meal quality.

Although we were making progress, the clock had started ticking faster than we knew. Two weeks after the visit, my dad’s health deteriorated rapidly, and he was admitted to the hospital with pneumonia and congestive heart failure.  This was followed by a series of challenging moves from the hospital to a rehab center to a respite center, back to the hospital and into a nursing home.

All of a sudden all our research and plans went out the window.  With dad in Boston on a health roller coaster, my wife and I were unable to properly evaluate his needs and the situation was becoming more than we could handle.  It was recommended that we hire a Geriatric Care Manager in the Boston area to assist us. By using the internet, we found one that we could work with.  Although the cost was high ($140 per hour), my parents’ long-term care policy covered the expense. The manager immediately began by assessing and coordinating my parents’ needs. She assisted in filling out long-term care paperwork, having medical records transferred, helped with doctors and coordinated with the facility in Colorado that we eventually selected.

My mother, who is 82, enjoyed working with her because she wasn’t associated with a senior living facility and could therefore provide unbiased advice. She suggested moving Dad into a Memory Care Facility, which we did.  My mom will soon move into an Independent Care Facility on the same campus.

In our case, the combination of moving my parents, my dad’s changing health and the distance between us added up to a very stressful situation.  Hiring a professional who understood the ins and outs of senior care helped us through the crisis.  And her input helped us select the best facility available for my parents – something that gives me peace of mind as we begin the next phase of the journey.

When my Mom moved to Atlanta, I needed to find a new doctor for her.  I received a recommendation from someone at the Assisted Living Facility where she would be residing and made an appointment. After each visit, however, I had to make additional appointments with specialists, which meant carting my 91 year old Mom from one to another. It was tough since I was working full time. My mother wasn’t very helpful. She was always saying “Why are you taking me to another doctor? I’m sick of doctors!”

I learned that the Assisted Living Facility had a doctor who did “house calls” at the facility every Thursday. It sounded convenient, but the doctor always arrived at different times, so I seldom got a chance to connect with him and he eventually stopped coming to the facility all together.

I finally discovered that there were doctors called “geriatricians,” who deal exclusively with the elderly. When Mom had another fall, my sister and I went to work to find one. Unfortunately there aren’t too many of them out there and the one that was recommended to us wasn’t taking new patients. Could it possibly be this hard to find the right doctor?

I was getting desperate so I asked my personal physician and she recommended a very good one in the same office, who wasn’t a geriatrician, but who worked with many older people. After almost four years, we finally had our doctor!

This one truly understands the problems specific to the aging, and it’s made managing my Mom’s health care so much easier. She’s even trying to reduce the number of medications she takes, which is something my sister and I had been trying to do for years. She is also associated with the hospital nearest the Assisted Living Facility and will be able to guide her treatment the next time the inevitable occurs and she lands in the hospital. This is another important thing to consider.

The American Geriatrics Society has a Web site (http://www.americangeriatrics.org/) with a great deal of information about caring for your aging parents. If you go there, you’ll see that they are also concerned about the shortage of geriatricians in the country. Hopefully, as more of the population ages this specialty will become a more popular practice among doctors.

It took awhile to convince my mother that her walking was shaky enough to warrant a cane, but once we did, it worked out well. She selected a clear acrylic one that garnered lots of compliments.  She grew to like it not only for steadying her gate, but also as a conversation piece and fashion statement!

When mom’s falls became more frequent and she needed a walker, it was a much tougher sell.  It wasn’t until she went into Assisted Living and they required her to have one, that we actually made it happen. It was equipped with wheels, a seat she could sit on if she got tired and a basket below to hold items she might need during the day. We also purchased a “purse-like” cloth bag that hangs over the front of it for easy access to things like cough drops and kleenex. My sister and I felt good knowing that my mother could now get around more independently and eventually she learned to like her new “wheels.”

As with everything these days, walkers come in many different shapes & sizes. When trying to find the one that was the “best fit,” we consulted with the physical therapist at her Assisted Living facility. We learned that there were quite a few things to consider:

-It’s important to get one that’s the correct height. To determine this, have your parent drop his/her arms to the side, and be sure that the top of the walker falls just where the small bone on the outside of either wrist is located.

-Whether you purchase a walker with wheels or not depends on your parent’s fall risk. If they walk too fast with a walker that has wheels, it may be safer for them to use one that doesn’t. However, some “standard walkers,” (those without wheels) can be hard to pick up. It’s important to weigh the pros and cons before you make a decision.

-If you choose a walker with wheels, whether you select one with breaks or not will depend on your parents’ ability to use them properly. If they can’t, it will not only be confusing, but could cause the falls you were hoping to prevent when you purchased it in the first place!

A Medical Supply Store is a good source for walkers and they can help you determine the best fit. You can purchase them on-line, but be sure that you’ve consulted with a physical therapist before you do, so you know exactly what you’re looking for.  Getting it right the first time can save time, protect your parent, and improve their quality of life.

Many seniors who are healthy enough to stay in their homes, rather than move to a care facility or move in with relatives, prefer to remain in an environment that they know and feel comfortable in. But often these seniors need a little help around the house, whether it’s cleaning, doing laundry, or personal care like bathing. If children can’t provide it, then hiring a service or agency may be an option.

Before you or your parent enters into such an arrangement, there are a few steps to consider to make sure the safety of the senior is not at stake. Here are a few tips for hiring in-home help for seniors. These come from the California Bar Foundation.

• Before talking to representatives of in-home services, assess the senior’s needs to determine the level of service needed. Decide how much you can afford. Then, when you do talk with agency reps, you won’t be as easily persuaded to pay for services that are not needed.
• Seek referrals. If you don’t know anyone who can provide them, visit the local Area Agency on Aging web site.
• Find out if Medicare covers any of the cost.
• Ask many questions. Ask about the agency’s screening and training for caregivers. Do they conduct background checks? Is the agency bonded? Also determine whether the agency is responsible for caregiver taxes and insurance.
• If you or your parent is responsible for taxes (usually if you hire someone independent of an agency), visit your state’s official web site to determine what they are.
• Once a person or company is hired, take precautions in the home to safeguard valuables and important documents. Move them to another location or lock them up. Make sure things like Social Security numbers and bank account information are locked up too.

I was taking my 94-year-old Mom out one day and feeling stressed. My job and the caregiving were getting the best of me. When we arrived at our destination, I got out of the car, went around to get her and as always, reached over to unbuckle her seatbelt. In a moment of sheer frustration, I said “Gee Mom, you’d think a college graduate could learn to unbuckle her seatbelt!” We laughed a bit, but she knew my fuse was shortening by the second.

The next day, I decided to show her a way that I thought would make it easy to accomplish this task. I had to take into consideration the limited ability she had to turn her body enough to even see the buckle. To my amazement she exclaimed, “No one has ever shown me how to do that before!”

I realized two things from this experience.  First, you can’t assume that just because you’re dealing with the person who raised you, it doesn’t mean that they know or remember everything. Physical limitations, dementia and depression can take their toll in mustering up the energy to perform even simple tasks. Second, I realized that if I automatically did everything for my Mom, she’d let me. The problem with that is that she’d never learn anything new and I’d continue to be her frustrated, resentful caregiver, just doing it all because it seems easier than “showing her the ropes!”

Now, when my Mom manages to unbuckle her seatbelt, I praise her and it makes her feel good. I guess we’re never too old to learn and never too old to get a boost of self esteem that comes with learning something new!

Can you teach an old dog new tricks? Sure you can. Patience and love is the key!

For most of my life, one of my mother’s outstanding traits was her ability to socialize with others.  She had an ability to start, or add to, a lively conversation on most any subject and a way of making every stranger feel welcome, every person feel important.

Alzheimer’s changed that wonderful behavior and recently she has begun to just chatter, maybe for attention or maybe as an attempt to be her old self.  However, she now interrupts conversations with nonsensical, repetitive, often irrelevant chatter.  Or in the car, she will just talk non-stop about nothing and everything.  It can be very irritating, so my family tried humor and found that it often works… at least temporarily.

When my mother is chattering non-stop in the car, my brother tells her that he has an Eject-o-Mom installed in the passenger seat and if she continues to chatter he will press it.  She giggles and the chatter subsides!  Ten minutes later, she may be chattering again and he may have to say it again, but she giggles again and is quiet for another few minutes.

When she chatters non-stop at home, Steve tells her that the chair she is in only has a 100-word capacity and if she says more than 100 words, it and she will melt into the carpet.  And she stops to think about that and forgets to chatter for a few minutes.

While this may sound silly, it actually works.  Those with Alzheimer’s have a different reality.  You cannot teach them to modify their behavior – they will forget your teaching.  You cannot effectively punish them, for they often do things unconsciously; they react without ‘thinking’.  Nor will they long remember a punishment or what it was for.

So when I need to reprimand my mom (which can be often), I try to find a funny, nonsensical way to do it instead of using anger (which only makes the matters worse).   And with each activity that I do with my mom, I try to make her laugh at least once.  And as I try to find things to make her laugh, I find myself relaxing and finding more joy in my time with her.

There are lots of things in life to make you laugh or smile, if you only take the time to notice.  That’s one good lesson I have (re)learned while caring for my mom; and one I hope to carry with me for the rest of my life!

Caring for aging parents or loved ones carries a lot of responsibility and a range of emotions. No matter how much love you have in your heart, carrying the load of caring for your loved one will leave you drained physically, emotionally and possibly financially. Coping with the stress of senior home care has to be managed or you will not be an effective caregiver.

Managing the stress of senior home care is all about taking charge. Take charge of your thoughts, your emotions, your schedule, your environment and the way you deal with problems and unexpected situations. The ultimate goal of coping with the stress of senior home care is to achieve a balanced life.

Suggestions to reduce, prevent, and cope with the stress of senior home care:

Senior home care requires organization: Organize your time and your schedule. Write everything down so that you or another family member has reference to phone numbers, doctors, medications, in-home senior care providers, important insurance and financial numbers.

Start a personal journal: Share your feelings about the stress of senior home care. Writing down your thoughts will help you to take charge of your emotions.

Prioritize your health and well-being. Nurturing yourself is a necessary not a luxury. Healthy ways to relax and recharge:

• Go for a walk
• Call a good friend
• Sweat out the tension with a good workout
• Write in your journal
• Curl up with a good book
• Take a long bath
• Eat healthy and exercise regularly
• Play with your pet
• Work in your garden
• Listen to music
• Savor a cup of warm coffee or tea

Give yourself a break: Enlist the help of a professional senior home care provider. These professionals can provide daily or weekly help for everyday chores, errands, hygiene, meals or transportation needs. Some senior home care providers can also provide a respite from your responsibilities with as little as 15-minutes notice.

Coping with the stress of senior home care is the only possible way to be an effective caregiver to your loved ones. Your mental and physical health must take priority or you will not be able to manage what needs to be done.

This article was submitted by Linda Dunkelberger, a freelance writer and editor working for Visiting Angels (www.visitingangels.com).Visiting Angles is a nationwide senior home care provider that helps seniors with everyday tasks, errands, meals, transportation, and more.

There comes a time, if people live long enough, that hospital admission should be avoided. My mother struggled to maintain her independence into her 90s, tolerating walkers and assisted living only when necessary. Once her life was reduced to a wheelchair and skilled nursing care, she did not consider her life worth living.

While my mother was in assisted living, she appeared happy and mentally alert. After a family reunion for Thanksgiving, she developed a urinary tract infection that sent her to the hospital. She was there for two weeks, then released to a skilled nursing facility, with the goal of returning to her assisted living apartment.

The two-week stay in the hospital took more out of my mother than she could recover from. The time with no mobility exaggerated her arthritic condition to the point where walking again was impossible, even with assistance from a physical therapist. She returned to the hospital twice more with urinary tract infections, but never recovered the strength that she had prior to those admissions either. I now believe that the repeated hospital stays caused her to lose her ability to walk, and eventually the desire to live.

It was only through hospice care that we were able to stop the hospital admissions, which were counterproductive in her case. I would strongly recommend that anyone in a similar situation utilize hospice care to avoid hospital admissions for elderly relatives.

On several occasions my sister and I noticed that my Mom’s dementia would get worse. We worried that this was the “beginning of the end” of her mental competency. I recall when she started holding a terrible grudge against one of our favorite caregivers at her Assisted Living Home. The caregiver’s name was Jane, but she insisted on calling her Alice! She would relay to me that “Alice” would take showers, try on her clothes and entertain men in her apartment when she went to bed. We tried to convince her that she would never do these things, but she stuck to her story and accused us of being very naïve when we didn’t believe her!

When we took my Mom to her primary care physician, we’d routinely review all that was going on at the time, which often included falls and the worsening dementia. The doctor would check her urine and come back with the report that she had a UTI (urinary tract infection). We learned that the infection was the result of dehydration, which in turn caused her dementia to get worse.  She told us that it could also be a contributing factor to her frequent falls.

We were happy that an antibiotic would clear the infection and therefore her dementia and we had struggled to find ways to minimize her falls, so this was an important discovery.  Her doctor indicated that the juices, sodas, coffee and Ensure my mother liked weren’t anywhere near as good as “plain ole’ water,” for staying hydrated. She suggested we try putting Crystal Lite in it to make it taste better. It took time, but eventually grew to like it and drinks it all the time now. We buy 8oz bottles of water and pour the small packs of lemonade-flavored Crystal Lite into them and shake it up well. She likes to drink it with a straw. We make sure there is always a bottle by her side, but don’t have to remind her to drink it as much as we used to. 

Dehydration can have debilitating consequences in the elderly. Watch for signs like confusion, irritability, low urine output, dry skin, constipation, dizziness, hypotension or infection. They could be indicators of dehydration, which can lead to falls, stroke and renal failure. Better yet, do whatever you can to get your parents into the water habit right now!

In our situation, we were able to move my parents into a guest home on my brother’s upstate New York property and hire a full-time live-in to care for my mom.   This change gave my mom the attention she needed, but also, critically, relieved my father of the burden of being the primary caregiver which was literally killing him, physically and emotionally.

As the plans progressed, my family decided not to tell my mother that she was moving, only that she was going to visit my brother for “a while”.  All of us helped with the move.  My two sisters flew with my mother and their two cats to be greeted in Albany by my brother.  The same day I flew to Chicago to help my dad pack, oversee the movers and say good bye to our family home for over 25 years.

When we arrived in New York four days later, my mother was just happy to see us… especially my dad, her life partner.  When her bed, dresser, piano, sofa and other items arrived a few days later, she was confused but took it in stride.  After all, all her loved possessions – my father, her cats, piano, bed and dresser were there, so this must be where she lives.  She still gets confused once in a while about where she lived, but I do believe we saved her the confusion and emotion of saying good bye to her friends, very good friends.  I don’t believe she would have understood why she needed to say good bye, that she might not ever see them again.  I think, in our situation, that we choose wisely.

I would love to hear your story about moving your parents.  It is never easy.  But I have to say that my father has gotten younger since the move.  At 87, he is much happier and healthier than he was with the full burden of the main care giver for my mom.   My mom, at 82, is still my loving mom…

Submitted by Lisa Cochrane