As your parents age, are you confident that they’re coping with the changes that come with age? Are you sure?

Many aging Americans don’t like to admit when they need help. Others can’t see that they might need some assistance with everyday tasks. While it’s important that parents know there is no shame in asking for help, there are a few ways you can assess your loved ones and make sure they’re still thriving while living independently.

  1. Check out the car. On your way into the house, take a detour to your loved one’s vehicle. Is there any noticeable damage? Did your parent tell you about scraping the paint or dinging a door? If a senior has a banged-up car and hasn’t mentioned any accidents, it may be time to take them for a driving evaluation.  
  2. Give a hug. You should, of course, always offer a hug to a loved one you’re visiting, but this hug isn’t only a show of love: Take the opportunity to gauge any frailness or weakness you spot in the hug. When you’re close, evaluate the senior. Are they brushing their teeth? Do they smell clean? If you notice anything odd, don’t hesitate to bring it up.
  3. Get a snack. Even if you’re not hungry, ask for a snack and something to drink. This gives you the chance to check out the senior’s kitchen, and evaluate its general upkeep and what’s in stock.. It also gives you the opportunity to watch your loved one in action. Can they make a cup of coffee? Are they struggling to cut up a piece of fruit? Pay attention to how they navigate the kitchen.

If you think your parents need assistance, it’s time to sit them down for a gentle, honest talk. Consulting experts in aging such as Capital City Nurses for home care, or A Geriatric Care Manager for other advice is a good idea. If there are any physical changes to your loved one or to their vehicle(s), it may be time to bring them to a doctor for an evaluation as well.

Whether you’re just checking on a relative or worrying about mom and dad, it can be hard to evaluate if a senior is thriving in their environment. With these tips, you can take a look at your loved one and determine if they need some extra help managing their home or their health.

David Letterman was famous for his Top 10 lists on his late-night television show. Most of them often brought a chuckle, while some were downright awful. But what Mr. Letterman understood was the power of creating an easy-to-remember list that could be recited the next day at lunch or around the water cooler at work.

We’ve created such a Top 10 list, but it’s not intended to make you laugh. It is intended to be memorable and frequently discussed with your loved ones. While you may not want to recognize one or more of the signs on this list because to do so would be to admit that your aging parents need some help at home, it’s vitally important that you know what to look for so you can act before an accident happens.

Here is the list: 10 Signs Your Elderly Parent Needs Help at Home

  1. Stacks of unopened mail or unread newspapers and magazines
  2. Spoiled food in the refrigerator
  3. Empty pantry and cupboards
  4. Declining personal hygiene (body odor, unkempt hair, unbrushed teeth)
  5. Mood swings and unexplained changes in mood
  6. Lack of interest in hobbies, reading, and conversation
  7. A strong smell of urine in the house
  8. Piles of dirty laundry and beds without sheets or blankets
  9. Difficulties with standing, walking, or mobility
  10. Forgetfulness beyond a simple “senior moment”

If you’ve noticed one or a combination of the above signs, then it may be time to start the conversation about next steps for your aging loved one. Many options ranging from part-time home care aides to assisted-living facilities are available. There are many ways to help you protect your elderly parent when you notice the signs. This list of indicators is a place to start.

 

Special contribution from Barbara Kane, LCSW-C and Linda Hill, LCSW-C, of Aging Network Services

As geriatric social workers, we work with adult brothers and sisters who are caring for their aging parents. They are often reengaging with one another in very intense circumstances, sometimes after decades of being focused more on their own families than on their family of origin.  The stakes are usually high, as can be the associated emotions and opinions about how to best help their parents. As they sit in our Bethesda office, sometimes with one or two siblings on a conference call, they may silently wonder whether they are even going to continue a sibling relationship once this last parent dies. The process is never easy, but once we have a plan of care in place, siblings frequently look at one another with a rush of gratitude and maybe even a new respect.

Coordinating care for aging and ill parents is difficult for many adult siblings and frequently reawakens old wounds and conflicts. The presenting problem is not the sibling relationship; it is the effective care of the aging parents. Still, working to resolve issues related to taking care of their parents may offer siblings a fresh opportunity to resolve past conflicts.

Division of Roles

We often find that discussing roles and responsibilities is an opportunity to coach siblings on how they can work together more effectively. In a consultation, we may interrupt them to show healthier ways of communicating, both listening and talking. With siblings, we point out that each has different temperaments. We work to help them acknowledge and respect these complementary differences and the strengths of both.

After a couple of sibling sessions with the help of our coaching, we advise siblings to continue these meetings on a regular basis themselves.  Perhaps monthly meetings which they can regard as care planning discussions or business meetings is a good way to check in with each other.

Here are some questions that siblings may use to guide them in their discussions:

  • Do you feel that I have been doing enough?
  • Do you feel that I have been doing too much?
  • Is there anything that I have said or emailed over the last month that bothered you?
  • Do you feel that I have asked you for approval for big care decisions during the last month?
  • Do we need to revise our division of labor?
  • Do you feel I have been respectful of you in tone and action?
  • Have we communicated enough over the last month?
  • Are any old wounds festering?
  • Overall, how do you feel we are doing as a team?

It may seem that monthly meetings are not necessary.  But even if the aging parent is quite stable, sibling relationships need to remain on an even keel throughout this journey of caregiving.  Many families are split by geographical distance and it is often the out of town sibling who has the harder time with feeling out of the circle of care. These meetings, even over the phone, can go a long way towards keeping all the siblings feeling good about each other and the work they are doing together.

For this may be the last time that adult siblings have such a profound reason to come together.

While memory impairment is often what comes to mind when one thinks of Dementia, agitation is what most often causes my phone to ring with a request for an evaluation. Behavioral changes, paranoid delusions, hallucinations and long periods of screaming were described by the psychiatrist Alois Alzheimer, for whom Alzheimer’s Disease is named, in 1907 in his original case description of the disease nearly 100 years ago. ‘Agitation’ is a term that is most often used to describe a wide variety of behavioral symptoms seen in patients with dementia. The medical term used to describe these symptoms is the Behavioral and Psychiatric Symptoms of Dementia, or BPSD for short.

It is estimated that BPSD affects up to 90% of all individuals with dementia over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs.

There are several categories of BPSD, these include:

  • Disturbances of emotional experience such as mood lability, depression, anxiety, irritability/hostility, apathy, and crying spells.
  • Psychotic experiences including delusions, hallucinations, and paranoia.
  • Sleep Disturbances such as sleeping excessively, waking up frequently, sleepwalking and its related conditions.
  • Appetite Disturbance can manifest as low to non-existent appetite and weight loss, excessive appetite/demands for food, and ingestion of non-edible substances.
  • Disinhibited Behaviors include wandering (present in about 25% of patients with Alzheimer’s), yelling (seen is 25% of Nursing Home residents), excessive talking, inappropriate sexual behaviors, and hypermetamorphosis (the need to touch, and sometimes hoard, every object in sight).
  • Personality changes can manifest both as acting in atypical ways as well as experiencing a ‘distillation’ of the personality so that the person behaves as a caricature of themselves.
  • Uncooperative behaviors are most often related to personal care such as bathing, dressing, taking medications, and grooming activities.
  • Certain behaviors can be more commonly associated with different types of Dementia. For example, hallucinations can be a prominent feature of Lewy-Body Dementia, and Complex Sleep Related Behavioral Disorder is often associated with Parkinson’s Dementia, and changes in personality can be the first symptoms of Fronto-Temporal Dementia.

While these behaviors are often manifestations of the underlying brain damage caused by dementia, they are sometimes related to co-occurring medical conditions which should be evaluated as part of an assessment of BPSD. These include things such as urinary tract infections, vitamin deficiencies, thyroid abnormalities, diabetes, kidney and liver function, and pain syndromes.

Assessment of BPSD begins with a thorough evaluation consisting of gathering information from multiple sources to learn not only about the onset and evolution of the BPAD and underlying dementia, but also a detailed assessment of medical conditions, all medications being taken by the individual, as well as an assessment of the possible contributors/triggers of the BPSD from the living environment.

Improvement of BPSD is often achieved through a combination of adjustments in medication, treatment of any underlying medical conditions, and modification of the individual’s environment/caregiver approach. Because there are so many different types of agitation and because each patient’s background, life story, medical issues, and temperament are unique, an individualized approach that takes all of these variables into account is most likely to be successful.

Dr.Nicholas Schor

Dr.Nicholas Schor,M.D Address

 

elder ladies enjoying christmas

It’s easy to lose track of what the holidays are about. There are presents to buy, decorations to hang, cards to write, and carols to sing. But while you’re hustling to make your holidays merry, remember that this season isn’t about reindeer lawn displays or buying the most presents; it’s about spending time with your loved ones.

For seniors, this is especially important. The holiday season can often lead to feelings of depression in seniors, especially if they feel isolated from family and friends. Depression is a common condition in many seniors. The Kadlec Senior Clinic reports that 10% of elders who live independently report depression. The numbers escalate when seniors live in nursing homes (25%) or are forced to stay in hospitals (45%). The holidays can exacerbate feelings of depression if elders aren’t able to make family gatherings or can’t decorate their homes the way they used to.

This holiday season, give the senior in your life the gift of connection. Organize a family decorating day, and help your favorite senior string lights and put up a holiday tree. Spend the day baking festive cookies or helping them send holiday cards. A few hours out of your day can dramatically help a senior feel the uplifting spirit of the season.

If you live too far to visit your loved one, consider sending them some holiday cheer in the form of Capital City Nurses. Our multi-tiered services include everything from full-time nursing care to Daughter Down the Street visits, which are designed to get seniors out into the world and interacting. We can help elders get to their favorite holiday play, visit and bake cookies, or take them caroling with their senior group.

At Capital City Nurses, we know that connection is the key to aging successfully. Help seniors stay connected by taking time with them this holiday season. A few hours a day can help stave off depression and create beautiful holiday memories.

Elderly people yoga lifestlye.Vector illustration

Dealing with mobility issues on a daily basis can be a pain. Joints ache, balance wavers, and a nice, firm chair looks so much more inviting than a walk around the block. But if you want to feel better and reduce your arthritis pain, moving is the key.

A study presented at the American College of Rheumatology/Association of Rheumatology Health Professionals found that low-impact exercise helped seniors suffering with arthritis to improve their balance and decrease pain.

How? It’s all about the moves.

Participants took low-impact classes for an eight-week period, focusing not on sweating, but on movement. By the end of the period, 88% of the seniors could climb stairs more confidently, 66% felt better about carrying their groceries, and 91% felt the classes reduced their fatigue. The best part of the study is this: Ninety-six percent of the seniors who took the classes were then motivated to try other forms of exercise.

So what do these numbers mean for those who are having trouble with their joints? They mean that you don’t have to run a marathon to get fit. Tai chi classes or a simple walk can transform your life as you age. Sedentary seniors don’t need to jump right into intense exercise. Basic movement classes can dramatically transform your pain levels and improve your mental outlook.

At Capital City Nurses, we know it can be hard to move, especially with arthritis. If you need help with motivation, our Daughter Down The Street or Son Stopping By program can help you. An experienced companion can visit you as often as you’d like to inspire you to do simple exercises and encourage you to keep moving.

Seniors can have it tough when it comes to aches and pains, and exercising isn’t always fun. But with a commitment to some low-impact activity, you can greatly reduce your pain and improve your confidence in the physical world. Doesn’t that sound like fun?