Wednesday, January 5, 2011

Alzheimer's Care Giving

"What makes a good care giver for Alzheimer's"?  Dan was curious to hear about what made our services special. Dan's wife Lisa is suffering from Alzheimer's and they have been trying several agencies without much success. " My wife prefers to sleep in all the time and it is not good for her health. She needs to go out a bit more and also eat better. Right now the appetite is not there and she is losing weight".

Dan's concern is legitimate. The caregivers right now sit and watch the TV, because his wife is sleeping. " This is ridiculous. Isn't there a better way?". "Of course there is a better way" I told Dan. The most important thing to realize with Alzheimer's patients is that there are no standardized approaches that would work for all Alzheimer's cases. Each case is a unique case and the care plan has to be developed customized to work for that client. It may or may not work for the next client. Also the approach has to be one of constant improvement.

Caring for Alzheimer's and Dementia clients can be quite unlike caring for any other type of situations. A patient rehabilitating from surgery or muscular dystrophy etc are all capable of thinking and understanding. They can have good communication with you and understand your conversations. They can also tell what they need and what they don't. However, in the case of Alzheimer's clients, the caregiver has to do the thinking. Alzheimer's clients are like children and the caregiver becomes the parent.

Alright, Care giving for Alzheimer's is not just a regular care giving job. There are some unique approaches that helps in caring for Alzheimer's clients.

Creativity

In many situations verbal communications does not get very far with Alzheimer's clients. Clara, one of my client's wife recently asked me to take her husband Paul to the doctor's office. Paul has been very challenging to handle, he does not understand any verbal communication. The nurse at the doctor's office asked Paul to sit on the hospital bed. Paul was not getting it. They tried several ways to get Paul on the bed. No luck. I then jumped up on the bed like a kid and started bouncing up and down like a kid, "hey Paul, want to try this?". Paul could see this was a lot of fun and he to jumped up on the bed. Next the nurse wanted to get his BP and Paul would not the girl touch her. I rolled up my arm showing off my biceps and Paul instantly did the same. Nurse could now take his BP, making it look like she was checking out his muscles. Here standard verbal communication did not work. But they can mimic your actions.

Change of scene, Nancy's dad has been driving away all the caregivers she hired for him. I covered this under my previous blog " I don't need a nanny". here the difference was the dad does not know the caregiver as a nanny or a caregiver. He thinks she is someone he knows and she is there to hang out with him. So the approach has to be constantly creative. Look for things that will connect with your Alzheimer's clients and develop from there. Don't be stuck to a standard approach.

Take Charge
When the caregiver for Nancy's dad meets him, she would immediately take over. "Fred, are you ready to go on our lunch date", would be her opening conversation. She would take charge of the situation right away and orchestrate the activities. Remember, you are able to think and act and your Alzheimer's clients depends on your thinking ability. Take charge and please do not wait to be told what needs to be done.

Enthusiasm

Smile a lot and that brightens up your clients face and her demeanor. Show enthusiasm and drive to be there. In my experience, I have seen the Alzheimer's clients are very perceptive. They may not be able to express it, but it certainly reflects in how they connect with you or responds to you. Enthusiasm sends out a positive vibe and I have seen in most cases than not, they respond positively to it.

Patience
You will need a lot of patience. Many communication may be repetitive and in circulatory mode. Owing to their reduced information retention capacities, they are bound to repeat their questions or conversations. Don't be offended, it has nothing to do with you. It is a function of the disease they are going through. Also there are no rules of conduct that your Alzheimer's client is going to remember. We have have the patience to start the conversation all over again and again.

Endurance
Let us be honest. Caregiving for Alzheimer's clients can be very taxing. You need to have good endurance skills. So make sure you rest well and you have fun doing what you are doing. If you ignore your health, there is only so much you can do to help someone with Alzheimer's.

Love & Compassion
Caring for Alzheimer's clients is like parenting. Your words and action has to come from a high point of love and compassion. Trust me, you are doing god's work taking care of Alzheimer's clients. If you are the chose one to provide care, you are already better than most people.

Have a good night folks and thanks for reading my blog. If you have any feedback, I will be delighted to receive them.

Warm Regards
Sam

Friday, December 31, 2010

"I DON'T NEED A NANNY"

"Sam, my dad does not know I am talking to you. I am not sure how to approach this, but we think he needs help. However, he refuses any help. He says that he does not need any nanny to look after him." Nancy used the tissues on my table to dab the tears. "Dad loves to do things around the home. He does not need any help there.  But he is very lonely. He needs to go out more and he cannot drive"

It is rude to say I have heard this conversations several times from different family members over a period of time. Nancy was choking with emotions and the situation was very real for her. Always this  question comes up about how to convince your parent. Honest answer to that is that there is no standard response to it. We have to see each as a unique case and develop our response.

"Nancy, we do not provide nannies" I said.  There was a curious look on Nancy's face, like did I come to the wrong place? " Tell me more about your dad so that I can develop the best approach to help your dad". During our conversation we developed a game plan. Our caregiver will be introduced as a friend of Nancy's. She will come in and take dad out for walks, movies shopping etc. Nancy liked the idea immediately.

I have heard it too many times that in the west, people abandon their parents. NOT TRUE. What I have seen here is no different than what I have experienced in other parts of the world. The offspring here are as concerned here about their parents as they are  in other parts of the world. They hurt to see their parents suffer, many go to great lengths to keep their parents healthy in their own home.

Earlier this week I met with a son who was completely emotional when we spoke of his parents. They needed care and cash was tight. Yet the son was willing to go to any lengths to provide care. During our conversation we found out that his dad was a Korean War Veteran. I asked him if his dad is getting A&A benefits. The son was not aware of it. So we helped them start the processing for A&A. On the way out, I kissed his mom's hands. I could see she was crying and thanked me profusely for treating her so humanely.

Okay guys, this is the last blog from me for this year. I promise to write again only next year. Have a safe new year everyone and let us welcome 2011. Yeah, it is going to be a great year.

Wednesday, December 29, 2010

I am thankful for.......... in 2010

As we approach the end of the year, it is always a good time to take a look back and see how far we have come, what to be thankful for and who to thank for everything. It feels like a cleaning service that we can do to our mind, make it fresh to start the new year with fresh energy and fresh perspective.

I have found this approach useful for many reasons. It is like doing new shopping all the time, while we do not put away the ones that should be removed. In effect we start hoarding things, new items coming in while the old one still remains. However, we rarely think about doing the same approach to our life, our mind. so let us take a moment to reflect on what went right, how can we be thankful to what we could accomplish in the year completed.

Recently I was attending a Geriatric Care Manager's conference. In one of the breakout sessions, there was a question about how we manage stress. AS GCMs, as care giving professionals and as professionals associated with providing care, we absorb a lot of stress that goes on in our clients life. This is only natural, the client sees us as someone whom they can open their heart to, share their problems and concerns. It is a gift that we can offer this to our seniors. However, as a result we absorb much of this stress and unless we learn how to handle this, it could affect our health. The speaker suggested a simple solution. Each night before she goes to bed, she meticulously writes down 10 things she is thankful for, in the day. It took a while for me to hit home on the impact of this suggestion. This was brilliant.

When we take a moment to be thankful, we are displacing in our mind "what went wrong" with "what went right". Human nature is such that we all ponder over issues, we search for solutions. And if we cannot find solutions or not happy with the options, unconsciously our mind keeps roaming, searching for better alternatives. similar is the situation when we had disagreeable situations during the day. We continue to be irked about it and play out scenarios in our mind.  In short, we are not giving it any rest. Mind, like our body needs rest to recharge.

When we express our thankfulness, we are shifting our mind to more positive aspects of the day or the year. Our anxiety level comes down when we are able to appreciate the goodness in our daily lives. We tend to look at cup half full, not half empty.  So friends, let us take a simple step of reflecting on the good things that happened to us during the year. Free our mind of worries and approach the new year with energy, love and enthusiasm. Have a great night everyone.

Saturday, December 25, 2010

Respite Care for family caregivers

"I did not expect to go down like this. I am in a bind now, my wife is not keeping good health and I am not able to take care of her or myself",  Paul (not his real name) was sharing his frustration with me. I met Paul at a nursing home. The nursing home has declared that Paul is ready to go home, even though he cannot even move his own wheel chair for ten feet.

Paul has been taking care of his wife for about 7 years now. His wife, Andrea (not her real name) is a stroke victim and has one side completely paralyzed. Paul has been keeping good health and hence did not consider taking any help. Everything was going fine till recently when after returning from a doctor visit, Paul collapsed. He has been in hospitals and nursing homes for the last few weeks. He is very worried about the wellbeing of his wife and now himself too.

We come across several such instances. As family caregiver, the stress builds up progressively and  cumulatively. The family caregiver often associates guilt, when considering some form of help. They feel guilty and feel it is their  responsibility to provide care. Here is what we would normally tell someone like Paul.

You cannot be the husband, father and caregiver
You have the best intentions. However, you are as human as anyone else is, maybe a better human. However, if you try to do everything, progressively this would affect and ruin your health. Are you prepared for a day when you both will need care-giving? You should continue to be the husband and the dad and should consider getting some care-giving help. Getting some help now can avoid getting a lot of help later on.

Start with Respite Care

Paul, choose a day in the week where your wife can be taken care of by a care giver. Use this day to relax, and get your things done. Go out and do your stuff. Your wife will be well taken care of. Recently we were taking care of Janet for about 45 days when her daughter was away on vacation. Janet sends her daughter away on vacation every year as she has been the primary caregiver for her mom for several years. Janet sent her daughter on a world cruise, while we took care of Janet.

Consider few hours of help in a day
Try getting few hours of help every day. Remember out of the 24 hours in a day, you are still the primary care giver. Care giving services are there only for 20-30% of the time? You are still taking care of your wife for the rest of the time.

No Guilt Please
You should not have s sense of guilt that you are not doing enough. This often is the case. You are doing more than what others would normally do. More importantly, you are not the reason for your wife's poor health.
Hence there should be no reason for you to feel guilty about taking care of your self. In reality this is a pure act of love. You are taking care of yourself to take better care of your wife.


Always remember, stitch in time saves nine. You can contact me if you need help. I am just a phone call away at 626-639-0226

Sunday, December 19, 2010

Loneliness and Seniors

Of all forms of diseases and problems that man faces, loneliness is the worst. Loneliness can lead to both physical and psychological illness. Back in 2008, US News published a great article about "Why Loneliness is Bad for Your Health".http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2008/11/12/why-loneliness-is-bad-for-your-health.html. Loneliness results in social and physical issues like alcoholism, blood pressure, stress, cardiovascular disease etc.


In the senior care industry, we often find that companion care is about 70% of the service needs. Mary Ann, a client of mine (not the real name), calls me at least 4-5 times a day. She always calls to talk about some problem or the other. However, the truth of the matter is that there are no real problems that needs to be addressed. So than what is the problem that we are trying to solve? It is loneliness. Mary Ann calls to connect with me, in some ways I am her life line.When she comes on the line, she stays with me for about an hour. Bless her heart, she just needs to talk to someone.

The feeling is felt more acutely during the holiday season. The media highlights all the fun and warmth of companionship, the joy of giving and sharing. Seniors who are lonely find this the hardest of all the seasons. Mark (not the real name), another client of mine asked me where I am with my Christmas shopping. He lingered on a bit longer to add that he is not doing any shopping this time. He does not have any known friend, relative or kids. I met Mark, when he was getting discharged from a nursing home. "Son, I am going home to die" were the first words he said. Mark had a very successful life and he lived his life to the fullest. Never married and he has outlived all his friends and family.

There are things that we can do to improve this situation. To start with we can all connect with one senior in our community. Visit them, share some time with them, bring them a nice wine or something appropriate. I cam across another excellent article about seniors and loneliness in this holiday season,"Adults and Seniors Combating Loneliness This Holiday Season", http://www.articlesbase.com/elderly-care-articles/adults-and-seniors-combating-loneliness-this-holiday-season-3835088.html. Companionship is priceless and we need to realize that we are all rich in our resources to provide companionship. Make a difference in one life, that is all it takes.  Have a great holiday season everyone.

Thursday, December 16, 2010

EMERGENCIES ARE NOT PLANNED ACTIVITIES

 Of course, who does not know that!!  However, how many of us are panned to face emergencies when it happens? "Great emergencies and crises show us how much greater our vital resources are than we had supposed." ... William James.  Could not have said better. It is when we pass through emergencies, that we realize how deep our resources are and also who we can rely on. If it were not for emergencies in life one would not know their strength and weaknesses.


It was about 10:00 pm when I got the call from the Executive Director of a RCFE. "Sam, I need a caregiver like 1 hour back. Can you get me one?" To start with I really appreciate the fact that she called me, that shows her confidence in me. Now I am under pressure to perform. Sally's resident needed immediate care and she was on the phone just when I was ready to hit the bed. "Emergencies have always been necessary to progress. It was darkness which produced the lamp. It was fog that produced the compass. It was hunger that drove us to exploration. And it took a depression to teach us the real value of a job"......Victor Hugo.

Necessity is the mother of invention and for that same reason, I decided to make it happen. Within 30 minutes the situation was resolved and everyone was happy. The caregiver was fantastic, they asked us for more services.

Let us get back on track on our discussions. How many of us plan for emergencies? How many of us develop support systems?  I am not talking about just insurance policies her, but the whole idea about planning for tomorrow. When communities develop plan on emergencies, very often the elderly and the disabled are not kept in perspective. I read a very nice article that I want to share here on Disaster Planning on Elderly and Disabled. http://ezinearticles.com/?Disaster-Planning-for-the-Elderly-and-Disabled&id=5212666

Good night every one. Today was a very good day for me and I hope it has been for all of you. I hope you all wake up bright and sparkling to carry through the rest of the day. God bless.

Tuesday, December 14, 2010

Home Care Services for Long Term Care Insurance in Arcadia-CA

"I felt like pulling my hair out " Molly said about her frustrations trying to get the claim processed with her LTCI company. "They won't pay" Molly has been trying for the last 6n years to get claims processed for her husband. Both Molly and her husband had excellent LTCI with no benefit cap, with inflation protection. "It is an excellent policy" her friend Jeff said. Jeff is also an insurance agent who also sells LTCI. "Is there anything you can do to hep Molly? They are such a wonderful family".

Molly husband suffered a stroke and unfortunately for him, his one side has been paralyzed for the last several years. For 6+ years, Molly tried everything she knew to get the insurance company to accept the claim and start paying benefits. Molly tried 3 different agencies and each time the insurance company rejected the claim. Molly ended up paying the agencies out of pocket and eventually she had to cancel their services. Molly became the principal and the only care giver.

When we got involved, we realized that the insurance companies were not being difficult. There were details to the process that needed to be taken care of. We were able to start the services within 15 days and has been servicing the client since then. Another client Maria had a different story to share. Her husband has advanced stages of Alzheimer's and she too was facing problems getting the claims processed. She had changed 5 agencies before they came to us. " No agency was willing to do the processing on our behalf", said Maria. "You can deal with your insurance company and our agreement is with you". I have come across several such cases whether there is benefit assignment or not.   Maria was close to tears when we said we will do the insurance processing for her and the service is complimentary. "God bless you" is all she could manage to say.

I thought about putting this in my blog today as today was a very good day. I got the approval for claim for yet another client who thought they were not even eligible for the benefit. This was a particularly challenging case. However, we have been very fortunate that the insurance companies have always worked positively with our approach.

We we decided to structure our offerings, we kept the customer in mind. LTC insurance, unlike any other insurance, the benefits are needed when you not in the best physical health. It is a lot to expect of our seniors if we tell them that they have sort through the details of insurance claims process. We want to keep it simple for our seniors. Our seniors have given the best years for us. This is a small way of contributing back towards helping our seniors.With my background of 22 years in the corporate world, I could easily get to the details that the insurance companies wanted. The claims department loves us. "It is fun to process your files, it is so simple and all details are there for us to process it. You make our lives easier". Said Blake who is one of the claims processor.

If you or anyone that you know have long term care insurance and wants help getting the claims processed, please give us a call at 626-639-0226. We are a non-medical private duty home care agency located in Pasadena, CA.