Thursday, February 5, 2009

When an Aging Loved One Resists Care

How many times has your mother refused to change her clothes? Has your father resisted getting out of bed? Has your wife pushed you away when you tried to brush her teeth? Many times a caregiver will be particularly frustrated by her loved one's refusal to help himself. At times she can't help but think that the person she cares for "36 hours a day" is going out of his way to make her miserable! The increasing irrationality of individuals with dementia makes it even harder on the caregiver.

Individuals who resist care and assistance are trying to communicate to you. If dementia, stroke, vision loss, hearing loss or other illness limits one's ability to speak and convey information effectively, body language and physical actions take on a greater role in communication. Refusal to accept care, physical contact or participation in an activity is the individual's way of telling you something.

When your loved one resists care, step back calmly and think:

Are there any environmental factors such as lighting, shadows, noise, commotion or other external influences that are causing the problem now? (Before you say something, think about what you are going to say. Check your emotions and frustration before you speak. Your increased frustration can contribute to your loved one's agitation. (Put yourself in her shoes. Use your knowledge of her personal background to pinpoint patterns and reasons for her reaction. (Is this confrontation worth escalating?

Choose your battles wisely. A head-to-toe bath is not necessary every day or even more than once each week. Similarly, clothes do not have to be changed every day if they are not soiled. (Refusal to accept care or engage in once-pleasurable activities is a sign that something is amiss. The caregiver can assess the situation for specific complicating factor and make adjustments if necessary: (Refusal to get out of bed: illness - Assess physical factors such as injury from a fall, bruises, temperature/fever, urinary tract infection, or oral infection.

Keep a thermometer handy and know how to use it. Make a point every day or so of inspecting skin for dryness, sores or bruises. Catching skin or mouth sores early on will limit long-term damage and illness. (Refusal to join family or participate in even small activities: environmental - Assess for too much noise, harsh lighting, or specific individuals who cause distress. Correct these distractions and integrate positive factors such as music, aroma, comfortable fabrics and warmer room temperatures.

Refusal to perform tasks and activities: depression - The inability to fully perform tasks for oneself can cause an individual to avoid those situations. Assist them as much as possible while encouraging them to do as much for themselves without embarrassment. This is time-consuming, but it is the best route for enhancing self-esteem and independence. (Refusal to take medication: physical side effects - Sometimes side effects result from medication that are unbearable to the recipient. Learn what possible side effects can occur from the drugs your loved one takes. Consult with the doctor to see if over-the-counter anti-nausea, anti-diarrhea, or anti-dizziness products can be taken with prescription medications.

Perhaps the medication can be taken at bedtime or mealtime to reduce side effects. When administering the medication, tell your loved one how it will help them and use distraction if side effects occur. (Refusal to bathe or change clothes: embarrassment - Limit other people's presence (even their voices), approach in a non-threatening way, undress/bathe one area at a time and keep the rest covered, speak calmly and tell your loved one what you are doing each step of the process. Talk about pleasant memories and stories as you are bathing/dressing. (Refusal to eat or clean teeth: illness, incapacity - Oral hygiene is essential for elderly persons since poor hygiene can make eating painful and compromise nutrition.

Don't let oral health get to a point where it is a problem. The sense of taste declines with age, so make efforts to improve the flavor of food, make it appear appetizing, and ensure that portions are of the right size and consistency. You may need to provide pre-cut portions or thickened liquids. See if better shaped utensils and plates help your loved one feed herself. (You may have to use your own creative ideas to get around resistance. One caregiver's mother often refused to settle down for dinner. So the caregiver helped her mother get dressed up a bit with a nice sweater, a brooch and her purse. The two dined out on the patio without incident.

If your loved one still resists care even after adjusting for other factors, remember that confronting your loved one at that time of heightened emotions may make both of you more agitated.

Dan Lynch is the President of Tender Hearts at Home, a Cincinnati, Ohio elder care company. Dan and his wife Jody found themselves in the challenging situation of caring for their ailing elder parents. Neither parent wanted to move to a nursing home, but Jody and Dan experienced difficulty in finding dependable in elder care. After falling in her home and remaining unfound for five hours, Jody's Father eventually transferred to a nursing home where his health steadily declined until his passing. This experience ultimately led Dan and Jody to form their company, Tender Hearts at Home, providing personalized senior care for the elderly and those in need who wish to remain independent in their own homes for as long as possible. Their company offers service in Cincinnati and Southwest Ohio in the counties of Warren, Butler, Hamilton, & Clermont.

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Monday, February 2, 2009

Mental Challenges That Seniors Face

The vast majority of older adults function very well in their later year but at the same time, some older adults develop mental challenges. I'm going to review the major mental health problems in this article that older adults may face, and what can be done to address those problems. I will also review the losses that can occur in later life and associated bereavement and grief.

Let's Start With The Symptoms of Depression.
Many people, including older adults, assume that it is reasonable to become depressed later in life. Since depression and emotional suffering are considered a part of later life, some mental health problems may be overlooked and not treated. Depression is not a normal part of aging. Results of a major epidemiological study (Weissman, Bruce, Leaf, Florio, & Holzer, 1991) indicate that fewer older adults (1-2%) meet the diagnostic criteria for a major depressive episode (MDE) than younger adults (3-4%). However, a larger proportion of older adults report clinically significant symptoms of depression that do not meet the diagnostic criteria for an MDE. Also, the rates of depressive symptoms are higher among older adults in inpatient medical centers and long-term care facilities than they are among seniors who live in retirement communities. Here is a list of symptoms used to diagnose MDE. These symptoms must be present for at least two weeks and impair normal daily functioning:

  • Feeling sad, blue, or depressed or experiencing a loss of interest or enjoyment
    in life.

  • At least four of the following symptoms:
    • - changes in appetite (may be accompanied by weight loss or gain)

    • - changes in sleep (too much or not enough)

    • - agitation or retardation of movement

    • - fatigue or decreased energy

    • - feeling worthless or guilty

    • - problems with attention and concentration or difficulty making decisions

    • - thoughts of suicide

It's important to note that to be considered part of depression, these symptoms cannot be the direct result of an organic factor like medication, medical illness, or an abused drug. They also cannot be part of usual bereavement after the loss of a love one.

Understanding the Difference between Depression & Dementia - The symptoms of depression and dementia can be very similar in a lot of ways. Both can cause:
  • sleep disturbance

  • loss of interest in pleasurable activities

  • poor attention/concentration

  • loss of appetite or unexpected weight loss

  • agitation or retardation of movement

  • irritability

  • memory impairment

Some unique differences between depression and dementia are as follows:

  • Depression is more identifiable by emotional symptoms like feelings of guilt or regret, thoughts of suicide or general loss of energy.

  • Dementia symptoms are more physical like decreased language ability, difficulty organizing or losing things and in later stages, incontinence.

These are the challenges that mental health professionals face in determining whether an older adult is experiencing depression, dementia or both.

Dysthymia is a chronic, less severe form of depression. People with dysthmia experience depressed moods most of the time for at least two years. People often experience distress following an upsetting event. When the distress starts getting in the way of an individual's daily functioning, then he or she may be experiencing an adjustment disorder. Adjustment disorders occur within three months following a specific event and normally do not last longer than six months after the stressful event has ended.

Effective Treatment Comes In Three Basic Types - The basic types of treatment for depression are psychotherapy and antidepressant medication. Psychotherapy includes cognitive behavior therapy, interpersonal psychotherapy, and psychodynamic psychotherapy. Cognitive behavior therapy and interpersonal psychotherapy are both time-limited therapies.

Cognitive behavior therapy helps patients to understand the link between their thoughts, behaviours and emotions and to modify unhelpful thoughts and behaviors. Interpersonal psychotherapy focuses on depression's associated interpersonal factors, including grief, role transitions, interpersonal conflict and loss of interpersonal skills.

There are many medications available for treating depression. They are called Tricyclic antidepressants or TCAs and selective serotonin reuptake inhibitors or SSRIs. TCAs tend to have more side effects therefore clinicians usually prescribe SSRIs. Because older adults tend to metabolize medications more slowly than younger adults, these medications are started at lower doses and increased gradually to proper levels.

If you notice these symptoms in one or more of your parents or an elderly friend, encourage them to get help. A doctor who is experienced with geriatric medicine would be able to identify the symptoms and treat accordingly. Taking care of your health as you age is very important since health can greatly affect quality of life.

Identifying Bipolar Disorder and Mania - BIPOLAR DISORDER, formerly known as manic depression was named for the two emotional poles of the syndrome. Seniors with bipolar disorder cycle back and forth between periods of normal functioning and depression. Some people with bipolar disorder return to their normal level of functioning following an episode while others fall into major depression. The onset of bipolar usually comes when people are between 18 and 22 although it can appear later in life.

TREATMENT includes mood-stabilizing medications and psycotherapy may also be beneficial in helping people cope with the interpersonal and practical consequences of bipolar disorder.

MANIA - manic symptoms are rare among older adults who do not have a history of this disorder, however, most older adults can have manic symptoms as a result of medications, medical illness or drug abuse. Mania can be characterized by symptoms of extremely elevated or irritable mood swings, impairment in daily functioning or interpersonal relationships and at least 3 of the following symptoms:
  • inflated self-esteem or feelings of invincibility

  • decreased need for sleep

  • extreme talkativeness

  • racing thoughts or shifting ideas

  • high distractibility

  • increased level of activity

  • engaging in behaviours with potentially serious consequences

Again, if you know someone who is displaying symptoms of bipolar disorder or mania, encourage them to see a qualified doctor. Most people can live normal lives with these disorders if treated.

Anxiety Disorders (Panic Attacks, Generalized Anxiety, Phobias, Obsessive-Compulsive Disorder, PTSD) - Anxiety is a normal response to stressful situations. Generally healthy older adults develop excellent skills for coping with this. Anxiety becomes a problem when it prevents an individual from engaging in normal activity or enjoying activities. It is very common for anxiety to accompany other psychiatric disorders, most notably depression.

PANIC ATTACKS are short periods (usually several minutes) of intense fear that come on unexpectedly. These periods are accompanied by symptoms such as heart palpitations, sweating, shortness of breath, nausea, chest pain, dizziness, shakiness, fear of losing control, going crazy, or dying. Some people experience panic attacks in response to certain situations while others experience them without any apparent trigger.

TREATMENT often includes a short-acting sedation medication and cognitive behavioral psychotherapy.

GENERALIZED ANXIETY DISORDER is commonly seen with older adults. As its name implies, people with GAD experience excessive worry or anxiety about multiple things, and it impairs their daily functioning. People with GAD experience at least three of the following symptoms: restlessness, problems concentrating, irritability, muscle tension, sleep problems, or premature fatigue. Sometimes the symptoms of GAD are directly due to a medical condition like thyroid, cardiovascular, respiratory, metabolic, or neurological disorders.

TREATMENT often includes a long-acting benzodiazepine and cognitive behavioral psychotherapy.

PHOBIAS are extreme fears of specific situations or objects. The most common phobia is agoraphobia, which is the fear of being in places where one cannot easily escape. This phobia makes it less likely that people will venture from their homes. Another phobia is social phobies which is extreme fear of social or performance situations in which a person may feel embarrassed. Social phobia is often experienced as public speaking anxiety. Other phobias are of animals, natural environments (such as heights, water), blood or needles, and certain situations like airplanes or enclosed spaces.

TREATMENT - cognitive behavioral therapy has been found to be helpful in treatment of phobias. The focus is primarily on teaching relaxation techniques and then exposing the person to the feared object or situation while relaxed.

OBSESSIVE-COMPULSIVE DISORDER or OCD is a disorder where people have recurrent obsessions or compulsions that are severe enough to impair their daily functioning. Common examples are obsessions with contamination (being infected with germs), doubts, or a need to have things in a certain order. Compulsions are repeated behaviors like hand washing, repeating a word to prevent someone from getting hurt, checking locks, cleaning. One compulsion that may be a problem in later life is hoarding things such as newspapers, clothes or other objects.

TREATMENT for this disorder should of course be conducted by licensed professional experienced with geriatric medicine.

PTSD or Posttraumatic Stress Disorder may develop after exposure to an extraordinarily stressful event, such as being threatened with death or personal harm or witnessing the death or severe injury of someone else. This disorder was first recognized in the United States after the Vietnam War. Most studies with this disorder have been conducted with war veterans, Holocaust survivors, and disaster victims. PTSD involves recurrent thoughts about or images of traumatic events, recurrent nightmares, feelings of reliving the event, or intense distress when reminded of the event. People with PTSD avoid thoughts about or people who were involved in the event, feel distant from others, have difficulty experiencing emotions, are very irritable, have trouble sleeping or concentrating, or are hyperaware of their surroundings. Often times, people attempt to medicate themselves with alcohol or drugs which definitely makes things worse.

TREATMENT for PTSD often includes anti-anxiety medications, antidepressant medications, and psychotherapy to minimize the impact of the traumatic event on the person's life.

PSYCHOTIC SYMPTOMS AND DISORDERS - Approximately 10 percent of older adults admitted to psychiatric hospitals report that psychotic symptoms began after the age of 65 (Webster &Grossberg, 1998). The most common causes for these symptoms are dementia, severe depression, and various medical problems such as infections or metabolic imbalances.

The Forms of Loss That Seniors Experience - Most literature on grief and loss focuses on bereavent after death of a loved one. While this focus is extremely important, there are many other losses that occur in later life.

PHYSICAL HEALTH - Normal aging involves loss of physical abilities such as hearing, vision, loss of muscle and bone mass, decreased sensitivity to touch, smell, and taste, decreased ability to heal from injuries and illnesses, slowed metabolism and loss of skin elasticity.

Later life may also be accompanied by chronic illness and disease for many such as cardiovascular problems, diabetes, osteoporoses, arthritis, cancer, chronic pain and kidney disease.

These illnesses and resulting disabilities can lead some older adults to stop participating in the things they enjoy doing including sports, gardening, housekeeping, cooking and attending social events. Once this happens, they are more likely to suffer from reduced cognitive functioning, loss of independence and loss of valued social role. For instance, a woman may think of herself as a mother, a wife, a community advocate or a friend. These roles provide meaning to her life and shape her sense of self-esteem. Once a person experiences this kind of role loss, it is important to replace it with another role of value otherwise, they are at risk for social isolation, depression and further decline.

WHAT CAN YOU DO? Remember that every person has inherent worth and something to offer. Don't be blinded to an individual's strengths in the face of loss. Consider, for example, a nursing home resident with multiple sclerosis who had become quadriplegic. Despite her physical loss, she was able to make audio recordings of her life story and favorite recipes to share with her children and grandchildren, thus leaving a legacy to her family. Explore each individual's remaining strengths. What are they good at? Capitalize on those strengths. Identify ways they can get involved in the community and help others. This gives their life meaning.

BEREAVEMENT AND GRIEF is the experience of the death of a loved one. Later life is accompanied by the loss of an increasing number of friends and family members. As people age, social networks shrink, leaving some older adults with fewer or no friends or family members. Some people learn to adapt but others who experience multiple losses are not able to cope as well. The effect of multiple losses may be overlooked by those around older adults and therefore, go untreated.

Loss of a spouse is tragic at any point in life, but the secondary losses (losses that occur as a result of the death) can be traumatic after 50 or 60 years of marriage. Not only has the individual lost a spouse, they have also lost their daily routine, companionship, valued social roles, and what some describe as "a large piece" of themselves. In short, some bereaved spouses feel as though they've lost their lives and their world as they knew it. These seniors are at great risk for social isolation and depression if they do not maintain their activity level and social interaction.

WHAT CAN YOU DO? Help your loved ones identify their individual strengths and the activities they enjoy. Help them find ways to engage in those activities to help them through the grieving process and to prevent emotional and physical decline. Be aware of your own attitudes toward dying, death and grief. Most people are very uncomfortable talking about death or listening to someone else talk about it. Grieving people often feel alone in their experience and do not want to burden others with talk of death. Giving a grieving person an opportunity to share personal feelings can be a very powerful experience.

Encourage the expression of feelings, needs and beliefs and listen closely to what is being expressed. Whether an individual is experiencing denial, anger, confusion, fear or guilt, you should remain calm, even when the emotions of the grieving person are intense.

Do not take anger or irrational outbursts personally. Remember, they are grieving. Because each person experiences grief very differently, do not tell a grieving person that you know what they are feeling or understand what they are going through. Instead, tell them you are sorry for their loss and offer your sympathy and support.

Never try to talk individuals out of their feelings. People experience intense emotions following a loss and need a safe place to express them. Use active listening skills, responding to statements without agreeing, challenging or disputing their perspective. Just listen carefully and acknowledge that you have heard what they said.

Allow the person time to think about their loss. This is especially important for older adults as they may be processing information more slowly.

Summary - Later life presents a host of challenges and losses but for the most part, older adults are able to deal with these challenges. A small portion of older adults will develop mental health problems such as the ones discussed in this article. It's important to understand the symptoms of these challenges and to know that there is help out there.

If you know someone or have a loved one who is suffering from any of these disorders, please encourage them to seek professional help so that they can lead a quality life.

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Thursday, January 29, 2009

Maintaining Independence in Your Golden Years

Most of us have some semblance of a plan in place for retirement. We all know that we should save as much as we can, preferably by investing in our employers' retirement plans so that we'll have a nice nest egg to sustain us later in life. Planning for your later years should be more comprehensive than simply saving your money. You should ask yourself: How will I be able to take care of myself - independently - once my body starts to break down?

It's a grim prospect, but it is one we all must face (if we're lucky enough to live that long). Assuming that you make it to age 70 or 80, what do you think things will be like for you? What kinds of things will you want to do with your time? If you like to travel and have a companion, you may find that these years are when you appreciate traveling the most. For ordinary day-to-day living, however, you'll want to make sure that you can take care of most things by yourself. Things like bathing, moving around the house, preparing meals, and keeping things tidy should be things you can do for yourself. I know it isn't pleasant, but you should realize and plan for what happens as your body reaches old age. You'll probably have arthritis to deal with, which is hard for anyone. Fortunately, there are mobility products and other solutions available that can keep you independent.

If you live long enough, at some point you will probably require long-term care. If you've made it that far, congratulations; you've earned the right to have people waiting on you. On the other hand, most people will prefer to remain independent for as long as possible before that day. In order to do that, you will need to make sure your home is as accident-proof as possible. I have a few pointers for that.

Let's start in the bathroom. If your loved ones are concerned about you falling in the shower, ease their minds by buying a floor mat and installing a grab bar. If your physical condition is such that you should only take baths, then don't risk a shower. You could even buy a bath lift that lowers you into the bath and raises you back up when you're done. Make sure there are grab bars and dry floor mats in other places in the bathroom also, like near the sink.

In other areas of the house, like the living room and bedroom, you may find it prudent to use a walker to get around. Or, if you prefer, there are electric scooters or power wheelchairs designed for indoor use. There are many, many ways for you to make your home life more convenient and safe as you get along in years, which will keep you independent and taking care of yourself.

Randy McIntire is a technical writer specializing in mobility devices for seniors and the disabled. Randy's particular area of expertise is stair lifts. For more information about stair lifts, visit US Medical Supplies.

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When Pets Outlive Their Owners

When Walter died at the age of 97 there was no one left in his immediate family except Millie.

Millie was a more-or-less cocker spaniel of questionable heritage. Her legs were too short for her body, and there was an interesting ruff around her neck that suggested a chow somewhere on the family tree. Millie was a happy little love-any-burglar-to-death gal who gave Walter a reason to get up in the morning, and lots of little jobs to keep him on schedule throughout the day.

While Walter wasn't rich by any means, he was rich in the love he and Millie shared. His only real worry as he got older was about Millie, who was a far sight younger than he was. "I want you to make sure that Millie has a home when I go," was his emphatic instruction the day we met.

It took some doing, but we made it happen. The fact that Walter was prepared to do what needed to be done to make it happen is what gives this story its happy ending.

Walter was able to remain active in his church because someone came to give him a ride every Sunday. After we brainstormed a bit, Walter decided to approach this much younger woman (age 75 or thereabouts) about adopting Millie "when the time comes." She knew Millie, and they got along.

Now, this woman, while willing, was living on a fixed and fairly low budget. Her only concern was that she couldn't afford the food and veterinary care Millie would need. The loving part she could handle.

So we set up a meeting with Walter's attorney. This attorney drew up an addendum to Walter's will, setting aside a sum of money in a special trust to be used for Millie's care as long as she lived. Any money remaining in the trust when Millie died was designated to a rescue organization, to be used to help other Millies.

The day Walter passed away and I got the call, I simply had to call Millie's new mother, and we made arrangements for Millie to go to her new home. While Millie obviously mourned Walter, she made a good adjustment in time, and she is now thriving. I'm sure Walter is looking down and watching with a smile, because everything turned out the way he wanted.

Millie and Walter's story isn't typical. How many times, when an owner dies or moves to long term care, do beloved pets end up in shelters, with three days to be adopted before they are euthanized? Or even worse, end up on the street? I don't know, but I do know that it's far too many.

We make arrangements for our children to have care if something happens to us. We do the recommended planning for our own care, should that be needed. We prepare wills and trusts to bequeath our stuff. We're rarely as prepared as Walter was to take care of our pets, who depend on us just as much as our children.

If you know older persons with pets, ask if they have made any pet lifecare arrangements you should know about. If the answer is, "Yes," offer to help get their instructions written down, so there is no confusion about what will happen to the pet should the worst happen. If you know that there will be funds available to help subsidize the cost of caring for an older animal, offer to help your senior get any necessary legal advice to set up lifetime pet care arrangements. Your senior will probably be relieved, and you may well save the life of a treasured pet who depends on us.

Worried that you don't know what you don't know about senior care planning? The place to start is at the best senior care site on the web :

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Monday, January 26, 2009

Throw-Away Seniors

So, what's it worth to keep an elderly family member around? They can't do much to help with the housework. They're always in the way. They can't hear you too well, when you try to say something to them. They get all squinty-eyed when they watch TV. Why should we keep them around, when it's just as easy to put them in an assisted living facility, and let them take care of them? That way you can forget them, and concentrate on living your own life.

I'm sorry to say that this is what is happening in our world today. When seniors become a burden to their adult children, they get put away and forgotten.

Wait a minute. These are the people that put a roof over our head, food in our mouths, clothes on our backs, a good education, and made sure we were shown love, as we grew up. They are the reason for us being who we are today.

Remember when your Mom said "No" when you wanted to go skating that time when you were 10, and you said you "hated her"? Or how about the time you came in late from that date (3 hours) and Dad grounded you for two weeks? Remember how you argued with him how unfair it was? I guess they should have considered putting you into a detention center, with kids your own age, because you were just too much trouble for them to bother with.

And, how about when you retire, and maybe can't get around too well by yourself anymore? Do you want to be put away by your kids, so they don't have to worry about you? Our kids are watching and learning from us. They will end up treating us the same way we treat our parents.

Mom knew about the storm rolling in when she said you couldn't go skating with you friends. Remember how your buddy got the case of frostbite on that one? But you hated her because you couldn't go.

And your Dad sat there on the couch, knowing that you weren't that experienced a driver, listening to the sirens in the distance, wondering if you were still alive. And yet, when he expressed his worry, you argued with him. Parents only have so much to use to try to straighten kids out, and grounding is one way. I'll bet you weren't late again for a while after that.

For centuries, the family unit was ruled over and governed by the eldest. Seniors were revered as a well full of knowledge and wisdom. There were no family decisions made without consulting them. But now, we seem to know it all, and don't need them anymore.

We yank them out of the comfortable home that they have lived in for years, throw them into a small apartment, where they no longer get any privacy and don't know anybody, and them we forget about them. This is the single greatest fear that seniors have today. This is why they don't tell you about something that hurts, or something that bothers them that could turn into a life-threatening situation. They are so afraid that you won't think they can handle living in their home anymore, and start making decisions for them. They are aware that they may be thrown away at any time.

Now, there are some good facilities around, and the seniors are treated well, for the most part, and there is a definite need for these places, but too many times our parents are placed there just for our convenience. This is wrong. They took care of us; now it's our turn to take care of them. They gave us love when we needed it, we should return the favor.

There are so many systems available today that help seniors maintain their independence in their own homes. There are Personal Emergency Response Systems that have a button they can wear around their neck, and can push to get help, when there is an emergency. There are even automated systems that don't require any physical input from the senior. They are designed to react automatically in an alert situation. If you haven't heard about these, just check out my Bio.

We can no longer deny our children the chance to get to know their grandparents, or deny our parents the chance to see their grandchildren grow up. They actually enjoy helping with the kids. They have an unending supply of experience that we can learn from. One of the biggest things they can teach us is patience, for our kids, and for each other. They have survived a lot in their lifetime, and are still here. They must know something.

This country and our economy are falling apart around us. There are those that think we are soon going to evolve from a democratic society to a socialist one. If we are going to save this great country, and keep our free way of life going, we need to fix it. And the best place to start is within the family. One citizen may not be able to make a huge impact on our society, but if we each start small, in our own family, the changes will be monumental. We need to start by asking our parents what they think this Country needs. They know what needs to be done; maybe we should listen to them, and not just throw them away because we feel a little inconvenienced.

About the Author:

Mark Beghtel was originally trained as an Electronic Warfare Technician in the US Navy, and has worked in the private Electronics Industry since 1983. He has dedicated his life to providing systems that help people, installing and maintaining Fire- and Security-Alarm systems, along with many different PERS Systems. He is now the Manager of Technical Services for TSI Distribution, the nationwide distributor of the QuietCare® System, which provides automatic monitoring of the Activities of Daily Living of Seniors, to help keep them in their own home, and independent as long as possible. They also offer monitored and non-monitored PERS Systems, and Mark's job is to ensure all of the systems are installed properly, through training, account setup and maintenance.
Company Website:

TSI QuietCare® is a nation wide quality PERS provider and can be reached at (941) 752-1656
On a personal note, Mark plays Bass and Keyboard, along with providing backing vocals in a Bradenton/Sarasota Rock Band. The band site is

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Monday, January 19, 2009

Coronary Heart Disease In The Elderly

Coronary heart disease (CHD) is the most common cause of mortality and morbidity in the elderly. In western countries, it accounts for 80 – 85 percent of all cardiac deaths in older people.

When a person ages, his or her cardiovascular system will undergo some normal and expected changes. These can be age-associated changes in cardiac anatomy; age-associated changes in cardiovascular physiology; and age-associated changes in pharmacokinetics and pharmacodynamics.

The presentation of CHD may be altered by these changes together with other age-related changes in the kidneys, brain, and musculoskeletal systems. Ultimately, the diagnosis and hence the treatment of heart disease in elderly may become more complicated.

Various conventional risk factors for CHD among younger people such as smoking, hypertension, hyperlipidemia and diabetes mellitus remain important factors for elderly. Furthermore, age is a powerful and independent risk factor for CHD. The risk increases when men reach 55 years old and above and women reach 65 years old and above.

Females have a much lower risk of CHD compared to males, but this gender differential diminishes as age advances. For example, the event rate is 1:5 in favor of females at the age of 35, but by the age of 70, the ratio is almost 1:1.

Symptoms such as breathlessness, giddiness or palpitation are quite common for the CHD in the elderly. Sometimes, musculoskeletal problem in the elderly may prevent the patient from complaining of exercise related angina. Instead of complaining of chest pain during a heart attack, an elderly patient may develop difficulty in breathing or symptom of stroke. Silent heart attack is also common. As reported in the Cardiovascular Health Study and the Framingham Heart Study, some 40 percent of unrecognized heart attack was found in those aged between 75 and 84 years.

In the management of heart disease, some diagnostic procedures such as treadmill exercise may not be suitable because of the associated joint problems in the elderly. It is also more risky to perform coronary angiography and coronary angioplasty procedures for the elderly patients with the presence of diminished kidney function. Following a heart attack, the in-hospital mortality and risk of subsequent reinfarction or its complications are all increased in the elderly patients. The use of clot busting medication (thrombolytics) has an increased risk of cerebral hemorrhage in the very elderly. Some age-associated changes in kidney or gastrointestinal function may require reduction in the usual drug dosages when heart medications are used in older patients.

Feel free to use this article on your website or ezine as long as the following information about author/website is included.

Heart Disease Prevention - 8 Simple Ways You Can Do Immediately, Go to:

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Make an Impact on a Senior's Emotional State

Communication can easily be by far one of the most difficult parts about dealing with the elderly, deterioration. Sometimes complex sentences or questions can be confusing, so making them simpler Communication can easily be by far one of the most difficult parts about dealing with the elderly, especially when it comes to those who have suffered significant emotional trauma or mental rephrasing may make things easier for residents, or using specific words with which residents connect can be helpful. Body language and facial expressions can not only convey the point you are trying to get across, but can make an impact on a resident's emotional state.

If a resident is hard of hearing or has a similar physical communication problem, then using alternative methods for communication is in order. These could include things such as writing or other visual cues can give residents not only a sense of interpersonal connection, but some amount of mental stimulation through the act of reading and writing. Residents may enjoy talking about their past, and this can be a great way for them to work through emotional trauma they've experienced, though a resident who does not wish to talk about his or her life (especially, for example, veterans of war) should never be pushed to do so.

Sometimes it can be beneficial to have someone act as a facilitator for a conversation between residents. Certain losses in communication, such as social graces or speaking ability (a conversation between a very quiet and hard of hearing resident can be extremely difficult), can be mitigated by having an employee stand by and help communicate ideas between residents. Employees can also provide topics and points of interest for conversations between residents, as this is one of the best ways to keep residents both mentally active and socially involved.

Touch is a surprisingly effective method of communication. Some residents might gain a huge sense of comfort from a mere hand on the shoulder, a quick hug, or a congratulatory pat on the back. While some residents might not appreciate physical connections, or might even actively avoid it, it is generally very successful with those that do. In short, there are a great number of ways with which to communicate with the elderly, one must simply be creative in how one attempts to do so. Don't be afraid to try communicating in a way you haven't tried before, as a resident might respond in a way you didn't expect.

Jason Rosete

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Caring For Elderly Parents Starts Now

If you're fortunate enough to grow to a ripe old age you'll inevitably be faced with scores of life changing situations. Some are oh so subtle and others slam you squarely across the head. Growing old comes slowly almost interminably slow but when it finally arrives it ascends like a black mist descending from above.

Elderly parents arrive first at this marker set in time and through them we see ourselves in just a few years more. With extended age comes a multitude of situations that need attention and for the most part all require money and a lot of detail.

Unless you are wealthy and money is no object for concern, every family will be faced with life changing decisions concerning elderly loved ones.

My wife and I had a boulder cast our way recently that literally changed our lives. We live many hours by car from our parents and generally see them two times a year although we talk often on the phone. We are a 'close knit' family. We both have siblings who live close to our parents so periodic reports on how mom and dad were doing were the normal All four parents are all now in there eighties and still driving and living at home. They all had their share of medical problems over the years but for the most part all was well, or so we thought.

It began with subtle remarks from family members and more noticeable concerns that are associated with advanced age. Lack of concentration, forgetfulness, and mobility loss to name a few. Serious and minor medical conditions began to present themselves with many surgeries to deal with. Reality painted a clear and unambiguous statement; our parents need help and how and who is willing to provide that help.

Of course every family situation will be different but allow me to share a little about my own life crisis to emphasize the utmost importance of family planning within a family structure. I will be short not to bore you but please remember this could be you.

It happened suddenly with a Friday night phone call from my sister in law; dad is in the hospital and needs surgery, he was found lying on the floor and reportedly had been there for days. Mom didn't have the where with all to call 911 or go to a neighbor for help. Social services are now involved and they say 'Nan' needs full time attention and can no longer live by herself. The refrigerator was nearly bare and little food was found in their apartment. The situation demanded immediate resolution and decisions had to be made on the fly. The time for quiet relaxed get together among family to discuss elderly parents had escaped us and now we were faced with immediate action.

None (zero) of my wife's family living in the general area of my in-laws were willing or able to help in any substantial means. The thrust of the situation suddenly and dramatically became ours to deal with. We are not wealthy although we have a beautiful home with a lot of land and both works in a self-employed business. Taking my in-laws into our home would be life changing to say the least, my wife and I had to make this decision quickly and within hours a call was made to my sister-in-law informing her that they could live with us. What followed in the next 48 hours was harrowing and stomach wrenching not to mention nerves wrecking. Our lives were changed in ways I could not begin to describe. Family members seemed unsympathetic and were just glad to see the 'Problem' go away. My wife and I began our new life together.

We are often asked why we didn't place them in a nursing home? The time will come when my wife and I will have to make that hard decision but until that day comes the 'Right Thing to Do' is to care for parents in a loving caring environment with all the hard ship and baggage that comes with it. My in-laws have no assets and live on social security with a myriad of outstanding medical bills. We take one day at a time and trust in God to provide our needs. Fifteen months have past and life goes on with both 'Nan' and 'Pop' deteriorating slowly but still able to do limited functions.

This type of scenario is duplicated everyday across the world with family members faced with hard life changing decisions. The point of this article is to exclaim the importance of family planning for aging loved ones. Please don't put it away as a 'Well someday we'll get together' moment. As subtle as aging is it is also a stark reality and if your fortunate enough to stay healthy and out of a life taking moment in time. Don't procrastinate make that first phone call to a sibling or cousin and get the 'Ball rolling'. Plan a family get together and have a picnic, enjoy the day in the sun and then sit down all together as a loving family and candidly discuss the plan of action that will be implemented near the end of your parents life. When the day comes to implement the plan there will be no crisis, no indecision on what action to take, no arguing, only loving caring family taking care of family.

Life begins with a cry and gasp for air. Death ends with a whisper and stillness.

About Author:
Gary Kenneth Archer is a web designer, webmaster, professional woodworker and naturalist
who is a frequent contributor to: Natural Health Products and
All Natural Supplements

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Help the Elderly Remain Active and Healthy - 7 Special Tips to Help a Senior Live an Active Life

If you're reading this, it's probably because you have an elderly parent or other loved one who you're worried about. You want this person to be active and healthy, but he or she just does not seem motivated to do much anymore.

WELL, YOU AREN'T ALONE. There are thousands of caring sons, daughters, caregivers, and friends who are committed to helping elderly people lead the highest quality of lives possible. I imagine you have tried a variety of things to help, but have had mixed results at best. You might even have decided that it is futile and that not much can be done. However, the important thing to remember is that YOU CAN REALLY MAKE A DIFFERENCE in helping elderly people stay active and interested in the things around them.

Here are a few things you can do to motivate an elderly person to remain active and engaged in society.

1. The #1 thing to keep in mind is that you can't force a senior to be active and to exercise. Your efforts will not succeed if the elderly person feels coerced into doing it. Therefore, patient and friendly persuasion goes much farther than confrontation.

2. Educate the elderly person about the benefits of activity and exercise. Don't assume that she knows why it is so important. Give her literature and find ways to direct your conversations toward related issues.

3. Focus your efforts on encouraging the elderly person to try things that you know or believe she has enjoyed in the past or that have a high likelihood of being interesting to her now.

4. It is often useful to break activities down into parts so that the elderly person does not feel overwhelmed. A walk to the mailbox could be a small step that leads to a walk down the street at some point.

5. Offer praise and support when the elderly person completes the activity. Acknowledgement is important to everyone and the elderly are no different. Praise can go a long way to helping a senior feel motivated to continue the activity in the future.

6. Participate with the elderly person in the activity so she does not feel ill-at-ease or that you are pitying her. If you are enjoying the activity and being with the person, make sure she knows it.

7. Encourage the elderly person to see a physician if there is any indication that medical issues are contributing to her reluctance to participate in activities. Sometimes the elderly person is not feeling well and may be reluctant to admit it.

The primary things to remember when helping an elderly loved one or friend to be active and interested in life is that it requires patience and perseverance. It is important to identify WHY they are reluctant to participate and develop your INTERVENTIONS around those issues.

Steve Watson has provided assistance to seniors and their families for over 8 years. He owns a home health agency in Tallahassee, Florida called Comfort Keepers that provides home health and companion care for seniors who want to remain in their own homes and be as independent as possible.

Steve has his PhD from the University of Georgia in Public Administration and Master in Counseling from the University of Delaware. He received his certification as a Care Manager with specialization in geriatric issues this year.

If you are interested in learning more about how to help an elderly parent or other loved one remain active and healthy, check out this blog at or his web site at where you can, among other things, subscribe to an informative newsletter.

Article Source:,_Ph.D.

People with Alzheimer's Disease - Helpful Tips for Encouraging Then to Remain Active

Alzheimer's disease is a devastating condition that affects approximately 1-2% of the general population. It is one of several conditions that are called dementias, accounting for about 50% of reported cases of dementias.

While the symptoms and outcomes of Alzheimer's disease are very serious, the assumption that people with the disease can no longer function is incorrect and unfair. People in the advanced stages of Alzheimer's are certainly very limited, but many other people can still be active with a little help from family or friends.

Your ability to help a loved one or friend with Alzheimer's disease be as active as possible rests with the approach you take with her. By following these steps, you can greatly enhance your chances of success.

1. Keep it simple - break tasks such as cooking or performing personal hygiene down into specific milestones that can be followed in order. For example, telling someone with Alzheimer's to cook an omelet will be overwhelming to her and will probably not succeed while instructing the person to perform each specific task that goes into making the omelet will be easier to follow and less stressful.

2. Be calm and reassuring - people with Alzheimer's disease can be very sensitive to the feelings of others and will react negatively to irritation or impatience.

3. Familiarity and repetition - do not give up if the person does not succeed with the task or activity the first time. Repeating the task over time will often improve her ability to complete it successfully.

4. Do not argue or attempt to convince - if the person is not receptive to a task, do not push her too hard to do it. At this point, it is best to redirect her to something more familiar and safer and then try again with the original task at a later time.

5. Plan the activities - spontaneity is not a good approach to take with someone with Alzheimer's disease. Plan activities carefully and minimize interruptions and surprises.

6. Use visuals to stimulate and reinforce activities - people with Alzheimer's react positively to visual prompts. Posting signs around the home that provide instructions such as "brush teeth" or "wash face" can be very helpful. Also, a collage or scrap book of pictures can help to stimulate memories and turn into an enjoyable activity.

There are a variety of activities that people with Alzheimer's disease can enjoy. Much of it depends on the individual's interests and level of functioning, and on the approach that is taken to encourage her to participate. Remember, process is more important than the outcome when encouraging people with Alzheimer's to participate in activities. A kind, gentle, and supportive approach is usually far more successful than placing high expectations and providing negative feedback.

Steve Watson has provided assistance to seniors and their families for over 8 years. He owns a home health agency in Tallahassee, Florida called Comfort Keepers that provides home health and companion care for seniors who want to remain in their own homes and be as independent as possible.

Steve has his PhD from the University of Georgia in Public Administration and Master's in Counseling from the University of Delaware. He received his certification as a Care Manager with specialization in geriatric issues this year.

If you are interested in learning more about helping an elderly parent or other loved one remain active and healthy, check out this blog at or this web site at where you can, among other things, subscribe to an informative newsletter.

Article Source:,_Ph.D.

Sunday, January 18, 2009

Helping an Elderly Parent Stay Safe - Adapting to New Responsibilities and Opportunities

"Recently I have noticed that Mom is slipping a little -- forgetting things that she used to remember easily, wearing clothes that are not clean or do not match, and needing help with her checkbook and bill payments. I want to help but the thought of parenting my parent feels uncomfortable and even a little scary to me. I don't want to aggravate Mom, but I know I have to start supervising her activities more so that she will stay safe and protected."

Although the process of children assuming parental roles with their parents has been occurring for most of human history, this fact is not very soothing to people who have to face the issue now. Acknowledging that our parents are declining and becoming more dependent on us for health and safety can be very difficult and stressful. After all, Mom and Dad were always there to care for us and support us through hard times and difficult decisions. How can it be that our "foundation" is disappearing and a role reversal is occurring before our very eyes?

Unfortunately, the transition from being a child to assuming a parental role with parents can be rocky. There are several reasons for this.

• Parents are not often willing to acknowledge that they need help, especially from children they have raised. It can be just as difficult for parents to move into child-like or dependent roles as it is for their children to become more parental with them.

• Unresolved issues and negative emotions from decades ago can often emerge due to the change in relationship from more distant or diffused where parents are more independent and children are managing their own lives to much more intimate where children must supervise the day-to-day activities of their parents.

• Knowing when and how to intervene in the lives of parents can be challenging and frustrating to their children. If children move too slowly to take more responsibility for their parents, harm may occur to their health or safety while moving too quickly can damage the confidence of their parents and encourage dependency when it may not be necessary.

• Children who live long distances from their parents may be unable to provide direct supervision. This creates feelings of guilt in children who do not believe they can do enough and also parents who think their children already have to do too much for them.

There are useful steps that children of aging parents can take to make their transition to parental responsibility more manageable and less stressful. Most senior care experts agree that doing nothing to address emerging care issues will only delay the inevitable for children and may put their parents at risk. Conversely, taking definite and measurable steps to properly identify the needs of parents and instigating appropriate actions or interventions will often help children gain more confidence in their abilities to help their parents. It will also ease anxiety in parents because they will understand what is going to be done to help them and why and reassure them that they will not lose all independence in their lives.

Steps that the children of aging parents can do to help them cope with declining physical and mental abilities and general quality of life are:

• Don't accept the notion that you are going to parent your parent. Parents have decades of experiences and knowledge and the pride of lifetime accomplishments behind them. It may be helpful to use techniques that you may have used with your children or that you know your parents used with you to redirect behavior. However, treat your parents with respect and as adults who happen to need some help.

• Help your parent focus on the things they can still do well while acknowledging the things they can no longer do without assistance. Find activities or responsibilities that your parent can do safely to maximize her independence and sense of control.

• Try to face any unresolved issues or negative emotions that may be interfering with your ability to help your parent. Talk with your parent about these issues and emotions if you can, or seek the assistance of counseling or a support group to help you manage the emotional discomfort and pain.

• Accurately assess the needs of your parent and identify interventions that address those needs with the least amount of disruption. If you are not sure how to do this, seek the help of professionals such as geriatric care managers or social workers who can diagnose problem areas and recommend appropriate actions.

• If you are unable to assist your parent due to living out of town or having other responsibilities, use the services of an appropriate home care agency that can provide help for your parent while reducing your stress level and concern. Home care agencies come in various forms, ranging from homemaker and companion care services to home health agencies that provide nursing and rehabilitation care. You can choose the service based on the level of care needed by your parent.

A good rule of thumb is to act on your intuition. If you believe your parent has declined to the point of needing extra assistance and supervision, you are probably correct. Also, remember that you are not alone in caring for your aging and declining parent and that there are resources available to help you.

Steve Watson has provided assistance to seniors and their families for over 8 years. He owns a home health agency in Tallahassee, Florida called Comfort Keepers that provides home health and companion care for seniors who want to remain in their own homes and be as independent as possible.

Steve has his PhD from the University of Georgia in Public Administration and Master's in Counseling from the University of Delaware. He received his certification as a Care Manager with specialization in geriatric issues this year.

If you are interested in learning more about how to help an elderly parent or other loved one remain active and healthy, check out this web site at where you can, among other things, subscribe to an informative newsletter.

Article Source:,_Ph.D.

Saturday, January 17, 2009

How to Deal with Aging Parents

Statistics show that people are living longer and longer. The age that people live to has grown dramatically in the past 20 years. Because people are living longer there is usually greater need for assistance as we age. In the majority of households the assistance that seniors receive usually comes from their children.

In many families seniors never imagined that they might need assistance from the children. Likewise, many children of aging parents never thought that they would be assisting their parents as they age. Sometimes, this children assisting parent role reversal can lead to conflicts for the children and the parents. Because of this, many children want to know how to deal with aging parents.

There are six (6) key steps to follow on how to deal with aging parents:

1. You should prepare yourself and your family for the undertaking. Even though this is your parent, it is like including another from member of the family in a significant way. Your spouse and your children should be aware of what you plan to do. There will be less resistance or conflict if everyone knows the plan. If you can get your spouse or children to actively participate that is even better.

2. Remember that you are at a different stage in life than your parent. For most of us, development does not stop once we reach adulthood. You are not the same person you were when you were 21. Your parent is not the same person they were when they were your age.

3. Try to look at their concerns from their perspective. Respect their desire for control and regularity. None of us are comfortable with change and this is even truer with seniors. Remember that the only thing worse than change, is change that you have no control over. Be sure to make your parents feel that they still have some control over their life.

4. Try to help your parent maintain the highest level of independence for as long as possible. The level of independence you start with will depend on the unique situation of your family. Don't be afraid to include assistance and decrease the level of independence if necessary.

5. Have a management plan for the essentials like money management; bills; health plans; and any necessary equipment or modifications.

6. Most importantly, help your parent maintain as good of health as possible. No one will live forever, but there are things we can do to help maintain our health as long as possible. Studies show that this factor, more than any other, can make the greatest difference in the quality of life of your aging parent. It is this last point that most children of aging parents seem to have the most difficulty with. For assistance with how to deal with an aging parent, I recommend consulting a Health Concierge. A Health Concierge is a professional that is expert in decisions about how to deal with aging parents.

Dr. Lindsay has more than 18 years of clinical practice experience and reviews new health products and services. For more information about a Health Concierge or a Free Consultation, go to Health Virtual Assistant Concierge

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Friday, January 16, 2009

Why Should Older People Bother to be Active and to Exercise

Inactivity is a very real problem among senior citizens in the United States. The Federal Centers for Disease Control and Prevention (CDC) reports that approximately 28-34% of adults aged 65-74 and 35-44% of those aged 75 and older are considered inactive. Inactivity means that someone does not engage in any leisure-time physical activity. In addition, the CDC reports that only 31% of individuals aged 65-74 report participating in at least 20 minutes of moderate physical activity three or more days per week with this figure being even lower for those aged 75 or older.

One of the most fundamental questions that will be asked by many elderly persons when encouraged to be more active and to exercise is “why.” If you are not prepared to deal with this question, you probably will not be very successful in helping your elderly loved one stay active.

A good way to answer the “why” question is to understand the difference between chronological and functional aging. We have all seen 1964 Ford Mustangs automobiles on the road. Some are in great operating shape while others may be in varying degrees of disrepair. All of these 1964 Mustangs have the same chronological age (45 years as of 2009) but vary in functional age because of their condition. Clearly, some of these automobiles are “functioning” better than others. Well, it is the same for people. If we focus solely on someone’s chronological age, we are missing quite a bit of information about that person’s functioning ability and potential. At 45 years of age, the 1964 Mustangs on the road are not all the same, so there is hope for people too!

There are actually important physiological, psychological, and social benefits to being active that clearly makes it one of the most important factors in maintaining a high quality of life for the elderly. Exercise and activity can:

• Improve the quality of sleep, reduce arthritis pain, improve cardiovascular and pulmonary functioning, lower blood pressure, and improve flexibility.
• Enhance relaxation and reduced stress and anxiety, postpone age-related declines in central nervous system processing speed and improve reaction times, and improve mental health.
• Divert attention from problems, create and enhance friendships, and provide empowerment to want to be more involved in life.

The evidence is compelling that activity and exercise can have very positive impacts on an older person’s physical, psychological, and social well-being. However, the high incidence of inactivity among the elderly suggests that there may be a disconnect between our understanding of the benefits of activity and exercise and the utilization of this knowledge among older people. One of the most commonly cited reasons for this disconnect is the lack of education available to senior citizens about the benefits of physical activity and exercise. That is where people like you come in – becoming a conduit for passing important information and encouragement on to your elderly friends and loved ones about the benefits of “keeping active.”

Click here for more information about how to help elderly loved ones stay active and healthy