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When your parent drinks too much

Alcohol is a sensitive subject. Consider asking your parent’s doctor or a respected friend to initially bring up the subject. Tell them the reasons for your concern: slurred speech, unexplained falls or bruises. Be specific in your examples. Your parent will have less face to save with a trusted friend or professional than with their own child.

If you do talk, don’t say “alcoholic.” Even if it’s applicable, this is a loaded term. Tread lightly. A confrontation will just make your relative defensive and could jeopardize your relationship long term.

Instead, clear yourself of judgments about what he or she “should” do. Your relative is an adult and has the right to make unwise or unhealthy choices. He or she is doing the best they can, using the coping strategies that are readily available to them.

Open the door. Let them know that you notice some things aren’t working well and that you care. Rather than preach, create an invitation: “I notice you’ve been falling” (or losing weight, or seeming kind of withdrawn). “Are you concerned? Want to talk?” If yes, great. If no, just make it clear you’re available any time.

Casual help. Rediscovering meaning, purpose, and connection is one route to recovery. Separate from a conversation about alcohol, help your loved one explore ways to feel engaged with life, perhaps through involvement with others. Maybe you can go together to a social activity to make the first time easier. Or you might help remove barriers by providing transportation or covering costs.

Formal programs. Older adults also respond well to short-term interventions that address the specific isolation and loneliness of late life. If your loved one shows interest, help him or her find a recovery program that is geared to the needs and concerns of aging.

Is alcohol a problem?
Alcohol use is surprisingly common in late life. At Senior Care Management Services we see it frequently. As the Northern Virginia experts in family caregiving, we can help you strategize about optimal ways to approach the situation. Give us a call at 703-329-0900.

Late-life veterans’ issues

If the person you care for is a combat veteran, you may not have heard much about those experiences. You are not alone. In generations past, veterans made it a point to put the war behind them and “forget.” But things can take a dramatic turn in later life. As they face the challenges of serious illness, many vets start having symptoms that appear to be a delayed form of PTSD.

Common triggers
Physical pain, need for medication, or dependence on others can bring up old, traumatic memories. Dad may start to have nightmares or insomnia. Or you might notice an unexplained change in Mom’s temperament. Researchers believe this comes on because the stress of illness makes it too hard for the mind to continue suppressing the bad memories. For instance:

  • Trouble breathing from an illness such as COPD brings up past anxieties.
  • Pain can provoke memories of one’s own or another’s injuries.
  • Medications for pain or other conditions can cause fuzzy thinking. This in itself interferes with keeping combat memories at bay.

Moral and spiritual concerns
Sadly, combat veterans have experienced the worst humanity has to offer. Your family member may have had to bury feelings about things he or she was called on to do in the line of duty. As the reality of “meeting one’s maker” draws closer, overpowering emotions of shame, guilt, and regret may arise.

What you can do.
Veterans typically don’t like to talk about their wartime experiences. But they will talk with another vet. The Veterans Administration is aware of these late-life issues. They have counseling available for vets and for family members. In addition, hospice and palliative care programs often have a “We Honor Veterans” program. Their practitioners are specially trained to support the care needs of those who selflessly answered the call of duty.

Let us help.
At Senior Care Management Services we have deep respect for the contribution of our men and women in uniform. As the Northern Virginia experts in family caregiving, we can guide you to resources that will help ease the invisible wounds your loved one carries from their service. Give us a call at 703-329-0900.

Does Mom have a drinking problem?

Alcohol use is on the rise among older adults. And it’s not easy to spot. Many of the signs resemble common problems of aging. And who wants to think that when Mom stumbles, for instance, it might be because of drink?! There’s a lot of shame associated with drinking, so older adults—especially older women—often hide the activity.

Chronic drinking
About two-thirds of older adults with drinking problems have been drinking much of their lives. They’ve been “getting away with it.” Or they may have stopped in middle age, and then relapse in late life.

Late-life triggers
The remaining one-third of older adult drinkers with a problem are people who may even have been teetotalers in their youth. Keep your eyes open! Even if Dad never seemed interested before, alcohol could be his “comfort” now. Loss makes elders particularly susceptible, for instance after the death of a spouse or a move to a new living situation. Pain or failing health are other common triggers. Even something as happy as retirement can pull the rug out, removing friendships, identity, and daily routines. With so much idle time, it’s easy to fall into a drinking habit without realizing it. When one drink becomes two or three, it can lead to dependence.

Loss of meaning and purpose are huge culprits
Loneliness and isolation lead to depression and anxiety. Without social contacts, it’s just too easy to “self-medicate” the emotional pain with alcohol. Older women generally, and men who have lost their partners, are especially vulnerable to drinking in later life.

Signs of a drinking problem

  • Unexplained falls and bruises
  • Moodiness, irritability
  • Poor sleep
  • Weight loss
  • Forgetfulness
  • Changes in appearance and hygiene
  • Increased secrecy, hiding bottles

In a follow-up blog post, we will describe constructive ways to raise this sensitive subject with your loved one, as well as things you can do to help him or her.

 

Are you worried?
Maybe this is a new issue. Or maybe your relative has been a lifelong drinker at no small expense to the family. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services know how delicate this issue can be. And sometimes even painful. Give us a call at 703-329-0900 to talk about the options. You don’t have to face this alone.

Balance exercises to prevent falls

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

All it takes is short but consistent focus for Mom or Dad to significantly reduce the chance of a fall. In one study, two 15-minute sessions of balance exercises over a six-month period was enough to make a difference. That’s only 30 minutes a week. Depending on your situation, this may even be something you can do together.

  • Routines are simple. Mom won’t be daunted by the balance activities recommended by the National Institute on Aging. Standing on one foot and heal-to-toe walking are easy to do at home.
  • No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. Dad can even hold on to a table or chair until he feels more stable.

Tai-chi
It turns out the most effective exercise for preventing falls is tai chi. This gentle activity has been practiced in China for centuries. Tai-chi involves slow, graceful movements combined with controlled breathing and awareness of the body’s position.

Research has shown that people who practiced an hour of tai-chi three times a week for three months experienced a 43% reduction in falls. They also had a 50% reduction in injuries from a fall.

Tai chi is best done with a teacher and in a class. But if that’s not an option, there are DVDs that teach tai chi. The local library may even have some to lend out.

Get the doctor’s okay first
There are many reasons a person might have poor balance. Just to be safe, ask for a fall risk assessment before starting an exercise program. You want to be sure your loved one has all the bases covered.

Does your Mom or Dad need help with balance?
The exercises aren’t difficult, but they do take time. And it’s much easier to stick with them if they can be done with others. Let us help you explore the options. As the Northern Virginia experts in aging well, we at Senior Care Management Services are quite adept at helping older adults become more physical and focus more positively on their bodies. Give us a call at 703-329-0900.

Reducing the risk of falling

Has your mother fallen recently? She’s not alone! One out of four adults 65 and over experiences a fall each year. That makes falls the leading cause of injury for older adults.

Falls are serious business
A few statistics: In the U.S. an older adult dies once every 20 minutes as a result of a fall. Disabilities from a fall include injuries that can be life changing: a traumatic brain injury or broken hip. Especially for seniors, falls pose a danger to an independent lifestyle. They often usher in a permanent need for daily assistance.

Who is at risk for falling?
Has Mom or Dad fallen twice in the past year? Have you noticed balance or gait problems? Has there recently been a severe fall? These are signs of “high risk.” Other signs involve poor vision, or taking medicines that list dizziness as a side effect.

A fall risk assessment
To be safe, ask your relative’s doctor to do a fall risk assessment. This includes a review of

  • underlying medical conditions. Many chronic diseases affect and the ability to get around.
  • the home environment. The doctor can write an order for an occupational therapist or other trained professional to do a home assessment. They can identify simple ways to remove hazards and make the home safer.
  • medication use. Some types of drugs, or daily use of four or more prescription drugs, increase the risk for falling.

 

Preventing falls
A recent review of numerous studies show that some strategies are better than others. The most effective measures for preventing a fall include:

  • Exercise, especially activities that promote balance.
  • Getting regular eye exams and following through with corrective procedures.
  • Removing hazards around the house.
  • Wearing sturdy shoes and slippers. A firm sole is better than a soft cushy one because it’s easier to feel the ground below.

 

Are you worried about a fall?
As the Northern Virginia expert in family caregiving, we at Senior Care Management Services understand the difficulty of your situation. You can’t be too forceful about changes. And at the same time, the consequences can be pretty serious. Put our experience to work for you. Give us a call at 703-329-0900.

“I don’t need help” – Part 3

It’s not easy to lose abilities and admit you need help. The reluctant elder in your life is more likely to ease into acceptance if you provide good listening, compassion, and a commitment to working together. In this third installment of our series, we look at elders’ concerns around privacy and pride.

Privacy
Having someone underfoot can feel intrusive, especially if your relative is used to living alone. Perhaps he or she fears being judged, or that word of unhealthy food choices or alcohol use may get back to the family. Maybe your relative tends toward hoarding and is embarrassed. Or has worries about safety with a stranger or the risk of theft. All of these are reasonable concerns for any adult who values their independence. You can address privacy concerns by

  • starting with part-time help;
  • hiring a friend;
  • working with an agency that does background checks and drug testing.

 

Pride
“Do you think I need a babysitter?!” Our culture values self-reliance. Anything that implies a need for help suggests weakness or incompetence. When you approach your relative,

  • shift from “we think you need help” to “we want to help you stay in charge of your life.” As noted in Part 1 of this series, working with your relative toward a common goal is a welcome and respectful approach;
  • clarify what type of care is needed. For instance, a nurse to dress a wound is different from someone who cooks and cleans;
  • start with a short-term arrangement, framed as “while you recover” or “just to see how it goes.” Then consider a more permanent arrangement;
  • talk about getting help as a way to liberate your loved one’s energy to do other activities he or she really enjoys;
  • emphasize your relative’s other abilities. If Mom can no longer do housekeeping, make sure to praise her often about her cooking talents.

 

Would a little coaching help?
At Senior Care Management Services we understand what a delicate line you have to walk— respecting a relative’s concern while at the same time addressing real issues of health and safety. As the Northern Virginia experts in family caregiving, we can help you grapple with your own frustrations and find the balance you need to take the next step with your loved one. Give us a call at 703-329-0900.