On October 19th Canadians will be going to the polls.   Seniors in our communities who have traditionally been the most likely to vote and seem to truly understand that it is a democratic right that must be exercised have so much at stake in this election.  The senior population has exploded in Canada as the baby boomers age.  Health Care, home care and resources that support this most vulnerable demographic are more than strained.  Where do the major parties stand on issues that impact our aging loved ones?

SENIORS

Conservative Party of Canada

• Would extend a retraining program for older workers.
• Would increase the Guaranteed Income Supplement.
• Would change sentencing laws to take into account age and vulnerability for crimes against seniors.

Liberal Party of Canada

• Offer $700 million to boost the Guaranteed Income Supplement.
• Would expand the Canada Pension Plan.
• Promise a voluntary, tax-deductible savings plan.
• Will tackle stranded pension plans i.e. manage private pension plans after a corporate bankruptcy.

New Democratic Party

• Pledge to support $700 million increase to the Guaranteed Income Supplement.
• Would work with the provinces to double the Canada and Quebec pension plans.
• Would protect pensioners and those on disability are protected when the company goes bankrupt.
• Support making home care an insured service under the Canada Health Act
• Pledge more money for long-term care beds
• Would double loan amounts for Home Adaptations for Seniors' Independence program.
• Promise tougher penalties for elder abuse.
• Would work with the provinces to make voluntary contributions to public pensions possible.

HEALTH CARE

Conservative Party of Canada

• Promises incentives for doctors and nurses to practice in rural and remote areas.
• Would fund Brain Canada research.
• Pledge defibrillators and proper training in every recreational hockey arena.

Liberal Party of Canada

• Would convene a first ministers meeting on health care within 60 days.
• Promises a Canadian brain health strategy.
• Wants a Canadian health promotion strategy to reduce obesity.
• Has an appetite for a national food policy to encourage healthier eating, and clearer food labeling.
• Offers incentives for doctors and nurses to practice in rural and remote areas.
• Would work with the provinces to lower the cost of prescription drugs.

New Democratic Party

• Commit to six per cent escalator for health care funding.
• Pledges $165 million to hire more doctors and nurses, repatriate Canadian health care workers practicing abroad and fix credentials for foreign doctors.
• Would create a Children's Nutrition Initiative to provide healthy food in schools.
• Pledge to create a Canadian Food Strategy to encourage healthier eating.

Green Party of Canada

• Create a Canadian Disabilities Act and basic income program for the disabled.Would create a national food plan that focuses on local grown, health choices.
• Calls on every party to endorse the five principles of the Canada Health Act.
• Would create a national pharmacare plan.

Sundowner’s Syndrome

How to handle Sundowner's Syndrome

If an elderly parent is having an episode of Sundowner's Syndrome experts suggest that a caregiver: Here is some practical advice that caregivers can use to try and lessen the affects of sundowning:

• Draw the curtains. That way, they can't see the sky's change from light to dark. When drawing the curtains, turn on inside lights as it grows dark outside, to keep the environment light and calming.
   
• Provide a peaceful setting. Guide the person to an area away from family activity and other distractions. Try to prevent excessive noise during sunset.
   
• Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
   
• During the evening, when the sun is setting is another good time to plan activities. Arts and crafts, and even pet therapy also have a calming effect.
   
• Have a routine. Maintaining a routine tends to alleviate the severe anxiety experienced by those sundowning. Even simple tasks like putting on pajamas can be helpful.
   
• Use music. Sometimes soothing music will help to calm and relax a person with Alzheimer's or dementia.
   
• Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it's most comfortable.
   
• Use a nightlight. Keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.
   
• Monitor diet. Restrict sweets and caffeine consumption to the morning hours. Serve dinner early.

Whether or not you fully understand Sundowners Syndrome, the look of terror and bad behaviors that accompany this time of day are extremely taxing and stressful. Doing everything you can to eliminate the affects of sundowning will make for a more pleasant evening for everyone in the home.

Sadness, agitation, fear, as well as other mood and behavior changes that occur just before dark are called Sundowner's Syndrome, or sundowning. Caregivers might notice that their parent who has Alzheimer's disease or dementia becomes more agitated at twilight. People with Sundowner's Syndrome may also "shadow" you, following you around and doing everything you do. They might ask you questions over and over or interrupt you when you're speaking to someone else. They may lose their full language abilities, and abstract thoughts may become especially difficult for them to comprehend.

Sundowner's Syndrome behaviors and emotional issues:

• Anger
• Agitation and outbursts
• Anxiety
• Pacing
• Fear
• Depression
• Stubbornness
• Restlessness
• Rocking
• Hallucinations
• Hiding things
• Paranoia
• Violence
• Wandering
• Crying
  

Causes of sundowning

Doctors and researchers aren't sure that causes sundowning, but the theory is that the symptoms have something to do with the onset of darkness.

Some medical professionals believe that the syndrome is an accumulation of all of the sensory stimulation from the day that starts to overwhelm and cause stress. Others speculate that it is caused by hormonal imbalances that occur at night. Another theory suggests that the onset of symptoms at night is simply due to fatigue; while some believe it has to do with the anxiety caused by the inability to see as well in the dark.

Relax, Breathe and #LetGo - Find Your Sanctuary

Earlier this year, we asked women about their lifestyle - nearly half said they were feeling moderately or extremely stressed & shockingly 40% feel like they're about to burn out. We weren't surprised, we feel it too. From our everyday never-ending 'to do' lists to the pressure the media puts on us to be the 'perfect woman'.

Earlier this year, women were asked about their lifestyle - nearly half said they were feeling moderately or extremely stressed & shockingly 40% feel like they're about to burn out. We weren’t surprised, we feel it too.

From our everyday never-ending 'to do' lists to the pressure the media puts on us to be the 'perfect woman'. We rush around trying to do more, be more, give more. But we don’t need to be like this 24/7, it’s not healthy.

We need to #LetGo of all this pressure every now & again. Sanctuary are on a mission to get women to Relax, Breathe and #LetGo. So we’ve created a film with advice from women who truly know the importance of stepping back every now and then and appreciating life’s precious moments.

Doctors' group urging federal parties to support measures for seniors care

The Globe and Mail
Published Monday, Sep. 21, 2015

Canadian doctors, eager to put health care on the election agenda, are challenging federal leaders to back a $3.3-billion package of measures they say would have an immediate impact on caring for the nation’s aging population.

A top-up of federal health funding to provinces based on demographics, catastrophic coverage for prescription drugs and changes to caregiving tax credits could all be put in place by the next budget, says a new report commissioned by the Canadian Medical Association.

The package of three measures, costed out by the Conference Board of Canada in a study commissioned by the CMA and to be released Monday, is part of a broader campaign by physicians for a national strategy on seniors care.

Cindy Forbes, who recently became CMA president, said the study is designed to “entice” federal parties to put one or more of the policies into their platforms. By putting a price tag on some quick wins that any future government could make on a complex file, the group is hoping to spark debate on a topic that for the most part has been noticeable for its absence during the campaign.

“The system we have now was really built 50 years ago for acute care. We didn’t build it to look after a large population of aging patients with complex diseases.” said Dr. Forbes, a Nova Scotia family doctor. “As physicians we see we have to do something about it now.”

Getting politicians to focus on long-term structural changes that will take years to implement is tough, Dr. Forbes said, so instead the study offers some short-term remedies with a manageable cost.

“We are really looking at the federal government taking a leadership role,” Dr. Forbes said. Changes are needed to support seniors and their caregivers in the community and to make sure all Canadians have the same access to services such as palliative care, she said.

So far during this campaign, parties have unveiled some heath-care measures, but they have been overshadowed by talk of the economy and jobs. The New Democratic Party last week promised to invest in home care, help provinces build 5,000 more nursing-home beds and improve palliative care. It also has pledged to work with the provinces to lower drug prices.

The Green Party has a national pharmacare plan in its platform and Liberal Leader Justin Trudeau committed to working with the provinces on health care in a letter sent to premiers earlier this month.

The Conference Board study estimates it would cost the federal government $1.6-billion next year to compensate provinces for the additional health-care costs of an aging population through a top up of the Canada health transfer. That cost would rise to $1.9-billion by 2020, it estimates. Provinces would benefit from the extra funding based on demographics, with Ontario, Quebec and British Columbia expected to experience the greatest share of the country’s aging-related health-care costs.

The study also looks at the cost of covering out-of-pocket expenses for prescription drugs for households spending more than $1,500 a year or 3 per cent of their income. It estimates such a plan would cost the federal government about $1.6-billion in the first year, rising to $1.8-billion by 2020.

The final recommendation is to change two non-refundable tax credits – the Canada Caregiver and Canada Family Caregiver tax credits – into refundable credits. This would mean that Canadians who qualify could be able to use the credits to receive funds, rather than just apply them to reduce their income. The study estimates the change would cost $91-million in the first year.

The CMA is planning a series of initiatives to encourage the public to join in their call for a national strategy on seniors care, including events in New Brunswick, Alberta and British Columbia in the coming weeks.

The Caregiving Challenge

“Mama…” said the small five year old voice from the backseat, “Mama, do you love Boppi more than me?”

I was headed to the airport to fly to Omaha − again. It was the fall that Coleman was starting kindergarten, and it was a bumpy ride − the kind of time when you just need your mom. I fought back tears and tried to fill the space with words about love being really big − big enough for everyone, not about less for my baby than for my father. But to my five year old I was simply leaving − again.

My dad (“Boppi” to the grandsons) had suffered a major stroke that summer. He was totally paralyzed on his right side, rehabbing to regain speech and unable to walk on his own. Mom, who had just retired from 30 years of teaching, was thrust into the role of primary caregiver. A year later we discovered mom’s brain tumor, and suddenly the strongest woman we had ever known was in her own real trouble, incapable of basic functions, unrecognizable to us and no longer able to be responsible for dad. My sisters − Jennifer a nurse, Susie, a lawyer − and I commenced weekly calls to coordinate the schedule and the million decisions and details that needed tending. Like a lot of families, our situation was made more challenging by the fact that only one of us lived in the same state as our parents. And the burden on our local sister was especially intense.

Let me be clear: I wouldn’t trade anything for the hours spent caring for my parents. Looking into my Dad’s eyes as he practiced forming words to speak again, I tried to emulate the same patience he showed when teaching us three tiny girls “Silent Night” so we could sing for our grandparents. Walking with Mom as she took first tentative steps in the hospital, I remembered how she had taught me to walk, to run, to love the mountains. We were blessed with parents who truly treasured and sacrificed for us. “Holy” feels like the right word to describe the responsibility I felt now that they were dependent on us. Somehow I would teach this to Coleman − love really is this big.

Even with an incredible network of extended family, parish members and family friends, we simply could not do it alone. We needed professional home care workers at the house − so that we could be at our jobs and care for our own kids, with the peace of mind of knowing our parents were safe from falls, missed meals or meds, or a burner left hot on the stove. I knew that what we paid the agency was not at all what those workers were taking home as wages. For a time our parents were both in a nursing home, where they relied on an amazing crew of mostly African immigrant workers (I don’t think either of my parents had ever before met any African immigrants). They were kind and attentive; but since they didn’t have a union, they probably made nothing more than minimum wage. I remember one young woman who helped Dad as a home care worker − she actually came on her own time to visit him at the nursing home. They had made a connection, and she wanted to make sure he was doing ok.

The Maxwell family, 1970

The bond between my dad and this worker is what Ai-Jen Poo and Sarita Gupta, two of the most innovative workers’ rights advocates of our time, are trying to lift up with the new national movement they are building called Caring Across Generations. They’re trying to change the culture around caregiving – nurturing connections between young and old, affirming that an aging population is a blessing, recognizing the imperative of investing in a skilled caregiving workforce.

They are demonstrating the transformational power of millions of personal stories, stories like mine. My ability to care for my parents, and for my son, is intimately linked to the labor of others.

Caregiving is hard and important work, and we need to fairly compensate the largely female workforce caring for us and our loved ones. Secretary Tom Perez tells the story of meeting a woman who left her calling as a home care worker for a job in fast food − because it pays better. This is just one of the many reasons that the Labor Department’s historic new rule extending minimum wage and overtime protections for home care workers is long overdue.

But we need to do more than just provide basic labor standards. Home care workers need and deserve not just a higher floor but a higher ceiling. We need to create incentives and build career ladders in order to attract talent to an occupation that will be in greater demand than ever as the Baby Boomers reach their golden years. In her book, “The Age of Dignity,” Ai-Jen Poo notes that the number of people who will require long-term care is expected to skyrocket in the coming decades, from 12 million to 27 million by 2050. How are we going to fill the need for skilled caregivers when the median wage is barely $20,000 per year? My sister Jennifer, the health care professional, talks about how we need to build a culture of empathy where  policies that are fair and respectful to frontline workers leads to fair and respectful care for our loved ones.

And we need policy solutions that enable families to care for their loved ones. As we explain in the new DOL report, “The Cost of Doing Nothing,” our failure to enact a sane paid family and medical leave policy is leaving millions of families on their own at some of the toughest times in our lives. Both of my sisters suffered real loss of income in order to make time for our parents; I was the only one of us whose employer had a leave policy that enabled me to juggle my responsibilities without a cut in pay. When you face new responsibilities and expenses associated with a family health crisis − or with the miracle of welcoming home a new baby − the last thing you need is stress about your own paycheck. Countries around the world have figured out how to ensure that their people never have to choose between the families they love and the paychecks they need. We CAN do better; that’s why President Obama and Secretary Perez issued a Labor Day call to action this year: it’s time to lead on leave.

I love Ai-Jen’s comparison of the caregiving challenge to President Eisenhower’s investment in the federal highway system. We need a new infrastructure for caregiving. We need new policy that is responsive to the needs of 21st-century working families. We need to put people to work in good home care jobs providing compassionate services that sustain workers and their families. We need systems that real people can navigate, as well as the space for innovation and creativity in sustainable new models for home-based care.

Many of us have been called the “sandwich generation,” a term I’ve truly come to hate. A sandwich sounds so innocuous − something nice to have for lunch. It doesn’t do justice to the awful, wrenching moments when I felt stretched between my son, my parents and my job − feeling every day that I was failing the people I loved most. But we can transform these challenges into opportunities. We can be the Caregiving Generation − the ones who figure this out − so that no one is going it alone, so that we ALL can cherish our little ones, honor our elders, pursue our own careers, and respect the workers who make rich lives of work and family possible.

Mary Beth Maxwell is the principal deputy assistant secretary for policy at the U.S. Department of Labor and a senior adviser to Secretary Perez.

Just one thing…

The idea of enjoying one more day with the people we love and have lost is expressed in novels, songs and poems.  It is a crushing ache for many that have lost their loved ones too soon.  We consider the things we would say; the sentiments of love, affection or the questions we might ask.   This is a particularly interesting thought when we are faced with dementia and Alzheimer’s.   Our parent’s are still with us but the history and stories begin to slip away.   The time is now to fill in the holes and ask the questions about their history and your own. 

Michael McQueen is a social researcher and author that lost his father at the young age of 51.  He was saddened that so many questions that he had about his dad would never be answered and was passionate that others would not share that regret.  McQueen has discovered that certain questions kept cropping up and has narrowed it down to five.  

• What is your greatest regret?
   
• What were your hopes and dreams as a child?
   
• What would you like to see change in the world in the next 10 years?
   
• What was the most rebellious thing you did as a young person?
   
• What can you remember about your first kiss?

Enjoy the time with your loved one filling in that verbal history and remember to share your own stories with the people closest to you.  They are the fabric of our families and only grow richer and more treasured with time. 

*McQueen’s site, Histography, asks users to answer a series of emailed questions over the course of a year, covering “the whole spectrum of life” to produce a detailed online memory box. Then, “at the end of the journey”, the answers are compiled into a hardback book and given to loved ones.

Talking to your Parent about Care

It is painful to watch our loved ones begin to struggle with the daily activities of living.  We want to broach the subject of care but it can be uncomfortable and we often avoid the difficult conversation that needs to take place.   Your loved will have fears about losing their independence.  They may feel that they are coping sufficiently and are unwilling to acknowledge the reality of their need.   Consider that the cognitive impairment that so often comes with aging through dementia /Alzheimer’s  may be impeding their ability to process and cope with the changes in their abilities.

Taking steps to be proactive about care for your loved one is a gift you give both your parent and yourself.   Consider these tips when it’s time to talk to your loved one about bringing in a support worker to assist with the tasks of daily living.

• Acknowledge their feelings around loss and grief.
   
• Reflect on the personality of your loved one before you sit down and talk about the changes that need to be made. Do they respond best to direct conversation or will they respond better to a less direct approach.
   
• Pick a time when you are both relaxed and not stressed. If you attempt to talk when you are both already feeling stressed then the outcome will be less then optimal.
   
• Don’t criticize or debate their fears. Allow them to talk openly about their fears about losing privacy, independence. Work through their concerns with them and reassure them that getting support will prolong their ability to be independent.
• Talk with care providers, doctors, health care workers and support services beforehand to get information so that you are armed with answers as questions come up with your loved one. The more information you have the better you will be able to reassure your parent or loved one.
   
• If your loved one is in need and is resistant to even talking about receiving support enlist the help of your family doctor to explain that assistance with their daily activities will help keep them healthy and safe.

It is very important to remember that when dealing with the challenges of caring for your aging loved one that you are not alone. Remember there are services and resources that are specifically designed to assist your loved one with the tasks of daily living. Taking care of yourself is also about taking care of your loved one.  Reach out and get the expertise and the help you need.

 Christine Rudman is a Social Worker
and founding partner at WellStory Senior Care

6 Things to know about someone with Dementia

I can still smell the flowers.
I don't garden anymore, but I can still smell the flowers. Bring me some roses. This will remind me of my past.

I can still communicate.
I can't talk the way I used to, but I can still communicate. Be patient as I try. This will help me feel connected.

I can still make decisions. 
I don't have the judgment I used to, but I can still make decisions. Give me choices. This will make me feel like I’m a part of things.

I can still wash my face.
I can't take a bath by myself anymore, but I can still wash my face. Assist me with direction. This will help me feel purpose.

I can still sing. 
I can't dance anymore, but I can still sing. Help me enjoy music. This will enrich my life.

I can still move my body. 
I can't walk unassisted anymore, but I can still move my body. Walk with me, and support me if I stumble. This will help me feel engaged.

You are my lifeline. I depend on you. But please don’t do for me what I can do for myself. Recognize what I can do and help me to function as a person. 

You are key to the quality of my life.

5 Qualities of an Excellent Support Worker

With appropriate and timely support many seniors can continue to enjoy living in their own homes. Quality personal support can be an invaluable asset in maintaining the quality of life your loved one has been accustomed to. Look for these characteristics when considering personal support for your loved one. 

Empathy

Empathy is the core characteristic of a support worker. A superior caregiver can put themselves in the shoes of the senior they are caring for, and always strives to give the support that they would want for themselves and their loved ones. A truly empathic professional support worker tries to understand what it feels like to have limitations and the challenges of having to depend on others for care.

Dependability

Seniors even more than anyone else thrive on predictability and routine. You should expect that the worker caring for your loved one is on time, on schedule and doesn’t cancel. A trusting, consistent relationship is crucial to creating a warm, comfortable environment where the intimate caretaking tasks such as bathing can be completed.

Patience

You should expect that the support worker caring for your loved one consistently exhibit patience. When faced with a senior with dementia that repeats himself or herself a superior professional support worker will respond by either listening again or compassionately redirect. They will not respond impatiently by saying “You just said that.” Tasks should also be performed patiently and not in a hurried, perfunctory manner. A skilled worker never forgets they are dealing with a human being and perform their tasks in a gentle and respectful way.

Flexibility

An effective caregiver must be able to switch on a dime. Health crises happen and routines must be altered. Support workers must also be flexible enough to adjust to these events as well as the changing moods of their clients. Seniors have good days and bad days as much as anyone. A good professional support worker can empower the senior by acknowledging their mood and adjust their schedule to accommodate them. This respect helps to build a deeper bond and greater trust.

Great Communication

The hallmark of a superior support worker is someone that can communicate with warmth and kindness. Your loved one deserves to have their professional support worker guide and assist in a compassionate way and when ever possible make their interactions light hearted and fun. This trusted relationship can be fulfilling for both parties when the support worker communicates effectively and with a loving nature.

Handing over some of your duties to a professional support worker is a big decision for many. Family caregivers often have a lot invested emotionally in trying to do it all alone. A professional support worker can relieve an enormous amount of stress on you and your loved one. Expect the best care for your loved one.

When Mom or Dad Refuses to Bath

Seniors who were once clean and well dressed adults commonly refuse to take showers and wear fresh clothes. There are a few contributing factors that you can take into consideration when approaching this issue. 

1. Depression is common amongst seniors. Parents who no longer take an interest in personal hygiene or wearing clean clothes may be struggling with depression. A checkup with a doctor to discuss their mood and low energy is a good first step. 

2. As people age, they lose more and more control over their lives. One area they may feel that they can assert their independence is around bathing. It is a difficult transition for seniors to be told when and how often to perform tasks that they routinely accomplished independently their whole life. Take into account their need for autonomy by offering options such as which day or time of day they prefer to bathe.

3. Seniors do not have the same sense of smell as they once had. They may not pick up on odors in their house, on their partner or even when they may be less than fresh. A gentle respectful nudge may be necessary. 

4. When our days are no longer marked by work or activities it becomes more difficult to gage time. A senior’s memory isn’t what it once was and they may forget or misjudge the last time they bathed. A conveniently placed calendar can help your loved one keep track of their baths. 

5. It is not uncommon for individuals in this day and age to bath daily. During our parents youth it would have been unheard of to bath so frequently. At a time when families were large and a one-bathroom house was typical a daily bath would have been an unrealistic luxury. Considering their prior bathing schedules and not our own is considerate.

6. As seniors lose mobility and strength, fear of falling, injury and being alone and helpless is a real and legitimate concern. It seems reasonable to avoid tasks where there is risk. As caregivers we must assure their safety by supervising bathing or having professional support assist in the supervision.

7. Seniors may feel great discomfort having a family member assist them during bath time. Bathing is a very intimate and personal task that many people consider highly private. Insuring that they are afforded, as much privacy as their abilities allow is respectful and comforting. 

Well it is never an easy decision to reach out for help, timely in-home care by a familiar and trusted caregiver can be a welcome relief to both family caregivers and their loved ones by easing the awkwardness and discomfort around these very personal challenges.

 

10 Simple Ideas for Reaching Someone with Dementia

You have received the assessment from the doctor that your parent has dementia or Alzheimer’s, or perhaps you have slowly noticed the changes yourself. With the right resources and support you can continue to enjoy a meaningful and loving relationship with your parent.

It can be frustrating to communicate with loved ones when they are struggling with dementia. Understanding that their brain is not functioning normally and that information is not received or retrieved the same way anymore will help you to be more understanding. Imagine yourself in a group setting and there is laughter and conversation and for you it is like a ping-pong ball bouncing around that you can’t catch or follow. It is much like that for seniors with dementia. Socializing can become not only tiring but anxiety provoking as they struggle to keep up. The risk of depression increases as they come to feel left out of the loop.

Informing yourself about the condition and anticipating and preparing for the assistance you may require can help put your mind at ease. 

These helpful tips will assist you in communicating with your loved one who has dementia. 

1. Speak naturally and calmly. Speak in an adult voice and do your best not to treat them in a childlike manner.
2. Have conversations in a quiet place without distractions.
3. Refer to people by name always. Avoid he and she.
4. Your face is powerful for engaging. Keep eye contact and smile warmly it reassuring.
5. Try your best to not debate and correct information they are sharing particularly if you know what they are attempting to get across. 
6. Only talk about one subject at a time. Your loved one does not have the mental agility to bounce from subject to subject. 
7. Listen actively. They will have good days and bad days and they may be sharing something precious.
8. Be patient. Recognize how scary it must be for your loved one.
9. Understand that dementia is progressive - adapt to their capabilities
10. When you can’t be patient reach out and get help!

When it's not just a light appetite; barriers to healthy eating.

There is a reason that restaurants are so happy to provide a seniors menu; seniors eat less and develop particular tastes.  This transition is natural but the need for good, healthy, muscle and bone building foods is more important than ever.  Muscle loss and Bone density decreases, as we get older and makes us more susceptible to falls.  There are also a host of foods that guard and promote brain health.  The percentage of seniors that will have some form of dementia in their 80’s is over 70 percent.  Good brain health is crucial for living a full, enjoyable life. 

If you are caring for a senior there are barriers to eating besides a natural decrease in appetite to keep in mind.

Difficulty chewing and swallowing

Dentures and teeth issues can limit the texture and types of foods seniors may enjoy.  Seniors also may develop dysphagia, a condition that impairs the muscles of the mouth and throat making swallowing more difficult and the risk of choking much higher.   If these are issues assuring that the foods they love are cut up in small bite size pieces, providing easy to eat proteins like eggs or smoothies with a good whey protein powder will help.   Vegetables cooked longer and whole grains are also familiar and easy to eat.

 

Dry mouth

Dry mouth is another natural reality of aging that can also be exacerbated by medications.  A dry mouth can make bread, crackers, pasta and rice difficult for a senior to chew and swallow.  Adding moisture to foods through gravies, butter or cream cheese on breads and providing a glass of water at the table to sip between bites are effective.

Upset Stomach and Digestion

As we age indigestion seems to be more common.  Our stomachs are less happy to welcome the same variety of foods and flavours.  The best way to ward off stomach issues is to keep a food journal to discover what types of foods is the indigestion culprit. 

Vegetables such as onions and peppers, spices such as garlic or ginger, fatty foods, caffeine in coffee and alcohol can be a problem. 

Declining sense of taste

As we age our sense of smell becomes less sharp and that decline causes foods to become less flavourful.  So much of eating is about enjoying the taste that when it becomes blander we are less inclined to eat.  Seniors also may reach for the saltshaker in the hopes of giving food more zip.  Increasing the sodium in our diet is not a healthy option. 

Adding more flavors through seasoning and sauces may make food more enjoyable. 

The adage Eat to Live never becomes more real then when applied to the diet of a senior.  Adequate calories intake and vitamins and minerals can and will ward off a host of medical issues.

Bathing How-To's for Parents with Alzheimer's

If you feel that the reason your mom isn't bathing is that she thinks she has already taken a bath, or that she just doesn't see the point, try tying her bath to something fun. Say something like, "Let's both get cleaned up and pretty and we'll go for lunch." This could nudge her into thinking it's worth her while, and even fun, to spruce up.

Make sure the shower and/or bath are safe and comfortable. If the bathroom tends to be cool, see if there is a way it can be warmed up before a bath. If a shower is the best route to go for the person, install a grab bar to for stability while getting in, a comfortable stool to sit on and a hand-held shower head. This type of shower head keeps the water from continually coming down on the person's head, so the elder is forewarned when it's hair washing time.

If dementia, such as Alzheimer's, is so advanced that the elder is frightened of water, or scared of the tub or shower, you may want to try a different tactic. A person can get clean with sponge baths.

Whether you are using a sponge bath method or helping the person with a shower, talk about what you will do next, taking into consideration the person's dementia and where they are mentally. Don't surprise them. Describe your every move in a low, soothing voice. Say, "I'm going to wipe your face with this nice warm cloth, okay?" "I'm going to lift your arm and wash, but I'm keeping you warm and comfortable under this blanket."

Find products like dry shampoos so you don't have to wash hair as often.

Take privacy and modesty into consideration. Some people, don't want family or others close to them to bathe them. A Senior Care service may be able to cope much better than family members. 

Remember that a daily bath isn't necessary. Also, please ask yourself if all the fuss is because of your own standards and what people will think of you if your mom isn't pristine all the time, or if it's really about her health and comfort. Try to compromise. Yes, cleanliness is important for good health. But a complete bath or shower daily is not next to Godliness. It could be closer to torture for your loved one. Try to find alternatives and a middle ground so that some sort of hygiene is maintained with a minimum of unpleasantness.

Maintaining a Safe, Dementia-Friendly Environment

The home is an important place for everyone. For the person with dementia, a familiar environment can help her connect with the past and maintain a sense of who she is. However, some practical changes may need to be made to keep the home "dementia-friendly."

When modifying your home environment, keep it familiar, striking a balance between safety and independence. Too many restrictions can make it difficult for her to take part in daily activities, and can seriously affect her self-esteem. 

Keep in mind some of the changes that occur with dementia: decreased balance and reaction time; visual-perceptual problems; physical limitations that make it more difficult to walk; memory; judgment; and insight. Also keep in mind that you are more likely to be tired, and feel under pressure, making it more difficult for you to anticipate risk and prevent accidents. 

Adapt the task to the person's current abilities. For example, a person who enjoyed wood-working may no longer be able to use power tools but may still be able to nail, sand and paint in the workroom. Be aware of changes as they happen and re-evaluate the need to make further changes to adapt to his abilities.

Some areas of a home may have more risks than others. Pay extra attention in the garage, work room, basement and outdoor areas. 

Take a few minutes to complete the following checklist on home safety. Keep in mind that, as the disease progresses, you may need to update your responses.

Home safety checklist

✓  Do I need to store the scatter rugs and secure the carpet to prevent falls? 
✓  Are the stairways safe for the person I am caring for? 
✓  Is the person with Alzheimer's disease able to use the electrical appliances in the kitchen and bathroom safely?
✓  Should the hot water heater temperature be lowered? 
✓  Are there any medications, cleaning substances or gardening chemicals that should be locked away?
✓  Do I need to be there when the person with Alzheimer's disease has a cigarette or should I hide the lighter and matches?
✓  Should I lock some of the doors or do I need to change where on the doors the locks are? 
✓  Should I consider installing some safety equipment in the bathroom (e.g., grab bars, elevated toilet seat, non-slip mat)? 
✓  Does the lighting sufficiently eliminate shadows that may cause confusion? 
✓  Are there items that confuse the person with Alzheimer's disease (e.g., pictures, mirrors)? 

This information is taken from the Alzheimer Journey, Module 2: On the Road. You can get a copy from your local Alzheimer Society.

Safety tips

• Make sure to keep fire extinguishers, smoke detectors and carbon monoxide detectors in the house and test them regularly to make sure they are working.
   
• Lock any hazard areas or cover the doors or locks so that they are disguised. Place locks either high or low on doors to make them less obvious.
   
• Remove locks in bathrooms or bedrooms so he cannot get locked inside. 
   
• Use child-proof locks and doorknob covers on drawers and cupboards that have dangerous materials inside, such as knives, cleaning liquids and appliances.
   
• Consider registering the person with the disease with our MedicAlert® Safely Home® program to assist emergency responders to identify the person who is lost and bring the family back together. 
   
• Use appliances that have an automatic shut-off feature, and keep appliances away from sinks and other sources of water. 
   
• If you are concerned about the person using the stove, install a hidden gas valve or circuit breaker that prevents it from being turned on. Or consider removing the knobs from the burners. 
   
• Store dangerous tools, such as grills, lawn mowers, any power tools, knives and firearms, in a secure place.
   
• Remove any toxic plants or decorative fruits that she might mistakenly try to eat.
   
• Remove any medications or other substances from open areas such as the kitchen table and counters. This might include vitamins, prescription drugs, or even sugar, sugar substitutes or seasonings. Keep medications in a locked area.
   
• Supervise him when using tobacco or alcohol as both may have harmful side effects and may interact with certain drugs. Always supervise him when smoking as he may forget a burning cigarette and start a fire.
   
• Check the temperature of water and food, as she may have difficulty telling the difference. This applies to water temperature in a bath, for example, and the temperature of hot food.
   
• Install safety equipment in the bathroom, such as grab bars, to prevent falls.
   
• Add non-slip stickers to slippery surfaces such as tile floors and loose rugs. Or remove rugs completely.
   
• Use contrasting colours to make steps and transitions (e.g. the beginning of a staircase) easier to see. Avoid dark rugs as they may appear to be a hole.
   
• Use good lighting at entries, outside landings, between rooms, on stairways and in bathrooms.
   
• Keep emergency numbers by the phone for quick access.
   
• Remember that symbols lose meaning (skull, crossbones, “toxic”, “poison”, etc.)
   
• Consult an occupational therapist for advice on safety, and adapting the home to make it as safe and accommodating as possible.

For further details on keeping your home safe, see the publication, Home Safety for People with Alzheimer’s Disease on the website for U.S. National Institutes of Health, National Institute on Aging at http://www.nia.nih.gov/Alzheimers/Publications/homesafety.htm

What do we see?

This poignant poem was found among the things of a elderly man in a nursing home.

Cranky Old Man . . .   
What do you see nurses? . . .   What do you see?
What are you thinking . . .   when you're looking at me?
A cranky old man . . .   not very wise,
Uncertain of habit . . .   with faraway eyes?
Who dribbles his food . . .   and makes no reply.
When you say in a loud voice . . .   I do wish you'd try!'
Who seems not to notice . . .   the things that you do.
And forever is losing . . .   A sock or shoe?
Who, resisting or not . . .   lets you do as you will,
With bathing and feeding . . .   The long day to fill?
Is that what you're thinking? . . .   Is that what you see?
Then open your eyes, nurse . . .   you're not looking at me.
I'll tell you who I am . . .   As I sit here so still,
As I do at your bidding . . .   as I eat at your will.
I'm a small child of Ten . . .   with a father and mother,
Brothers and sisters . . .   who love one another
A young boy of Sixteen . . .   with wings on his feet
Dreaming that soon now . . .   a lover he'll meet.
A groom soon at Twenty . . .   my heart gives a leap.
Remembering, the vows . . .   that I promised to keep.
At Twenty-Five, now . . .   I have young of my own.
Who need me to guide . . . And a secure happy home.
A man of Thirty . . .   My young now grown fast,
Bound to each other . . .   With ties that should last.
At Forty, my young sons . . .   have grown and are gone,
But my woman is beside me . . .   to see I don't mourn.
At Fifty, once more . . .   Babies play 'round my knee,
Again, we know children . . .   My loved one and me.
Dark days are upon me . . .   My wife is now dead.
I look at the future . . .   I shudder with dread.
For my young are all rearing . . .   young of their own.
And I think of the years . . . And the love that I've known.
I'm now an old man . . .  and nature is cruel.
It's jest to make old age . . .  look like a fool.
The body, it crumbles . . .   grace and vigour, depart.
There is now a stone . . . where I once had a heart.
But inside this old carcass . . . A young man still dwells,
And now and again . . . my battered heart swells
I remember the joys . . . I remember the pain.
And I'm loving and living . . . life over again.
I think of the years, all too few . . .  gone too fast.
And accept the stark fact . . . that nothing can last.
So open your eyes, people . . .   open and see.
Not a cranky old man.

Look closer . . .   see . . .   ME!!

Money Problems Caused by Alzheimer's

Money management problems for people with Alzheimer's are a fact of life. Learn how to spot them, what steps to take, and how to protect your loved ones from becoming victims of scams or financial abuse. 

Early on, a person with Alzheimer's may be able to perform basic tasks, such as paying bills, but he or she is likely to have problems with more complicated tasks, such as balancing a checkbook or check-register. As the disease gets worse, the person may try to hide financial problems to protect his or her independence. Or, the person may not realize that he or she is losing the ability to handle money matters.

Signs of Money Problems

Look for signs of money problems such as trouble counting change, paying for a purchase, calculating a tip, balancing a checkbook, or understanding a bank statement. The person may be afraid or worried when he or she talks about money. You may also find:

• Unpaid and unopened bills 
• Lots of new purchases on a credit card bill 
• Strange new merchandise 
• Money missing from the person's bank account

A family member or trustee (someone who holds title to property and/or funds for the person) should check bank statements and other financial records each month to see how the person with Alzheimer's disease is doing and step in if there are serious concerns. This can protect the person from becoming a victim of financial abuse or fraud.

Take Steps Early

Many older adults will be suspicious of attempts to take over their financial affairs. You can help the person with Alzheimer's feel independent by:

Giving him or her small amounts of cash or voided checks to have on hand 
Minimizing the spending limit on credit cards or having the cards cancelled 
Telling the person that it is important to learn about finances, with his or her help

To prevent serious problems, you may have to take charge of the person's financial affairs through legal arrangements. It's important to handle the transfer of financial authority with respect and understanding.

You can get consent to manage the person's finances via a durable power of attorney for finances, preferably while the person can still understand and approve the arrangement. You can also ensure that the person finalizes trusts and estate arrangements.

Guard Against Financial Abuse and Fraud

People with Alzheimer's may be victims of financial abuse or scams by dishonest people. Sometimes, the person behind the scam is a "friend" or family member. Telephone, e-mail, or in-person scams can take many forms, such as:

• Identity theft 
• Get-rich-quick offers 
• Phony offers of prizes or home or auto repairs 
• Insurance scams 
• Health scams such as ads for unproven memory aids 
• Threats

Look for signs that the person with Alzheimer's may be a victim of financial abuse or fraud:

Signatures on checks or other papers don't look like the person's signature.

The person's will has been changed without permission.

The person's home is sold, and he or she did not agree to sell it. 

The person has signed legal papers (such as a will, power of attorney, or joint deed to a house) without knowing what the papers mean. 

Things that belong to you or the person with Alzheimer's, such as clothes or jewelry, are missing from the home.

The Guilt Trap

We have all felt it; that uncomfortable twinge when we feel like we aren’t living up to our expectations or someone else’s. Anyone who has children has experienced it many times when they’ve been hurt or disappointed. Sometimes it pushes us into right behavior that can move us to work harder or be more sensitive but more often it is an irrational wave of self-condemnation that instead breaks us down. 

Lives have been never been more complicated. We have the duties of work, children, and community pulling us in different directions. It seems at times impossible to juggle. Add the responsibility of an aging parent to that list and we are quickly overwhelmed and…. guilty.

You feel guilty because you can’t visit enough. You feel guilty because you’re irritated that you have to repeat things or listen to the same story over and over. You feel guilty that you feel resentment that your parent is no longer a support but a responsibility. You feel guilty because your parent may not have been like the Cleavers and you carry wounds around your childhood that make it challenging to be a compassionate caregiver. Sometimes you feel guilty because you imagine for a fleeting moment the relief their death will give you. 

This guilt can be self-created or come from siblings, extended family or even our culture. We desperately want to do the right thing by our parents but guilt unchecked leads very quickly to exhaustion and resentment. You are human, imperfect and must forgive yourself when you are impatient or struggling. There is no shame in giving away some of the duties and asking for help. It only frees you up to enjoy more meaningful moments with your parent. Know your limits, set up a care system before a crisis arises to prevent burnout. 

Finally remember that while it seems that your parents got old and in need over night it was inevitable and a journey we all share. Reach out, express your needs and recognize the hidden blessings in this very intimate experience.

Our Parents WellStory

My parents have been married almost 60 years.  They have raised 3 children and loved and spoiled 9 grandchildren.  People who know them would say they are “in love” and lived in each other’s pocket. The Golden years and particularly the last year have not been easy for my mom and dad. The challenges of health issues, Alzheimer’s and a very unsettling move from their family home of 50 years have thrown their world off its axis. I have learned and am continuing to process a very important lesson as I witness this time in my parent’s life. We are uncomfortable with grief. 

As a caregiver and as a daughter I organically threw myself into coping with the basic tasks that could no longer be performed physically by my parents; making sure they were safe, eating, clean and medical needs monitored. The areas that get pushed aside while we safeguard our loved ones are the emotional needs, the profound sadness of a life changed forever.

My parents had a relationship dance, a set of roles that they lived by for their marriage.  My mother the consummate 50’s housewife doted on my father.  She cared for their home and kept his belly full.  He in turn was the breadwinner, her protector and a gregarious charmer that provided a window to the world for my shy mother.

They flourished in these roles.  They understood their purpose and their worth and value to each other. Last year my mother stopped cooking, doing laundry, cleaning their home. My father lost his drivers license.  Their routine of 60 years was halted.  My brothers and I decided with my parents that assisted living was the best option for them. The house was sold and a new miniature version of their home was created in their assisted living apartment.   We all breathed a sigh of relief knowing they were safe. The more difficult hurdle was to help them make sense of their new life together.

My mother cries, often.  I have started to measure her life in good days and bad days.  It wasn’t until yesterday when I was driving with my friend David as I expressed with misty eyes how deeply I missed my father being able to be my confidant and hero in times of need did it truly resonate in me that my mothers crying wasn’t just a symptom of her Alzheimer’s but an expression of grief.  My father has changed.  The traits she grew to rely on are just a memory.  I want to learn to be comfortable helping her express that sadness, frame it and hopefully focus on all they she can still be grateful for.  

We are a culture incredibly adept at tasks but we struggle with the messy, heartfelt vulnerable sharing. Next time I walk in to one of her bad days instead of assuring her that she’s ok I will share a tea, hold her hand and have a good cry with her.   

Christine Rudman is a social worker based in Toronto, with her brother Marty founded Wellstory.

The lessons we learned navigating the strained seniors resources for our parents was the impetus for starting WellStory. Assisting families by preparing for and managing the challenges of aging loved ones while extending their stay happily and safely in their own homes is our vision.

We invite you to leave a comment - share your WellStory

When is it Time to Talk about Money?

Once upon a time your parent or parents fed, clothed and put a roof over your head but now they are aging and the tables make a natural turn.  For many families the time comes for the children to take over the finances of their parents.  It is a daunting task and a difficult subject to brooch when your parents may be losing so much of their independence.  Finances can be very personal, particularly for our parent’s generation. They have managed their money for a lifetime and it can be a touchy subject. 

There are certain red flags to look for when your gut tells you that you and your siblings should be stepping in concerning your loved ones finances.

• Do they have a diminished capacity in the form of chronic illness, heart disease, diabetes, cancer
• Have they lost their license?
• Do they have memory loss, dementia or Alzheimer’s?
• Have you noticed unopened mail?

To protect the financial security and future of your parents it may be time to have a sit down with your siblings and discuss next steps.  

1. Tread with sensitivity.  If you can have this discussion when they are still healthy and can make plans for the future it will give them peace knowing the changes are not immediate.  If you are in more of a crisis situation and changes must take effect quickly reassure your parents and let them know what is happening.
2. Find all financial accounts and documents.  With any luck they keep their information in a convenient place, if not you may have to do some detective work. 
3. Collect and start paying the bills to keep their accounts in good standing.
4. Establish a power of attorney. You will need this to make any financial decisions and to have access to your loved ones accounts.
5. Document everything you do on your parent’s behalf. 

While this step is an awkward one remember that you are protecting the security of your loved one and helping to protect their financial future and safety.  It is a loving gesture.  

Dotty

DOTTY from Brett and Mick on Vimeo.