703-329-0900

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 Rather than preach, create an invitation: “I notice you’ve been falling” (or losing weight, or seeming kind of withdrawn).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.

Signature Strength: Courage

In the tradition of “positive psychology,” we encourage family caregivers to know and use their signature strengths. These personality traits can become reliable tools. Courage, for example, has many faces beyond bravado and derring-do. See if you recognize yourself in these descriptions.

 

Honesty and integrity are facets of courage.
Are you a person who insists on living by your values? Do you prize authenticity? Courage is at the root of what it takes to

  • know your limits and take respite breaks when you need to;
  • talk compassionately with a family member about behaviors that are not healthy;
  • ask a sibling to participate more in helping out with Mom or Dad.

 

Steadfastness
Another aspect of courage is the willingness to continue even if the going gets tough. Think about ways you advocate for your parent with the healthcare system. Or perhaps you’ve found yourself calmly handling once-unimaginable tasks in personal care or wound care.

 

Maintaining focus
Courage also involves feeling several things at once, yet staying focused. A courageous person may feel fear. But they steady themselves with a belief that they can make an impact. The thoughtfully courageous assess situations with eyes wide open. They see the risks. Rather than run, they look for ways to reduce the chance of a negative outcome.

 

Tempering qualities
The roar of a lion—a blustery manner or righteous indignation—may look like strength. But that type of courage is not usually constructive in family dynamics. Better to remember that lions can be tender too, and they work for the overall good of the pride.

Courage may not be something you think of as your signature strength. This fresh look at the many sides of courage may help you see the daily bravery you exhibit as a family caregiver.

 

Are there days when you don’t feel like a lion?
We all feel that way from time to time. Usually it’s when there is more to be done than we think we can accomplish. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services can help you look authentically at the situation, and find your courage to take the next step. Give us a call at 703-329-0900.

Preparing for Cold and Flu Season

Did you know that 60% of people with flu symptoms leave the house during their illness? Furthermore, 70% of them go to the drugstore. A good reason to stay clear of the pharmacy during peak cold and flu season!

 

Good preparation involves a lot more than a vaccine.
Cold and flu germs are highly contagious. If an infected person sneezes, anyone within a 3-foot radius is likely to get exposed. And those flu germs live up to 24 hours on hard surfaces. Not to mention that the sick person unwittingly starts spreading germs as early as three days BEFORE feeling any symptoms and continues to be contagious up to 24 hours after the natural break of a fever.

 

Tips for yourself and for your loved one

  • Get the flu vaccine. Even if it’s not a perfect match with this year’s influenza virus, it will minimize the intensity of symptoms.
  • Get eight hours of sleep at night. In one study, those who got fewer hours were three times more likely to catch a cold.
  • Wash hands often. Touching hard surfaces (counters, doorknobs, the poles on public transit) is a sure-fire way to bring germs into your body, usually through rubbing your eyes or eating.
  • Frequently clean surfaces at home and work.
  • Shy away from crowded situations.

 

Avoid the pharmacy by stocking up ahead of time on

  • soups, teas, and other fluids to keep well hydrated;
  • fever reducers: Ibuprofen, acetaminophen, or aspirin;
  • saline drops or a neti pot to gently flush nasal passages;
  • honey and/or cough drops to soothe the throat;
  • decongestants (to dry up the nose), cough suppressants (for nighttime sleeping), expectorants (for daytime purging of mucus in the lungs). Consult with the doctor beforehand to be sure there are no conflicts with prescribed medicines;
  • lots of tissues. Don’t keep used ones around;
  • humidifiers to ease breathing;
  • wedged pillows to sit (and sleep) more upright.

 

Are you prepared for getting sick?
Very likely you have many people relying upon you. And as a family member, you don’t readily get a “sick day.” As the Northern Virginia experts in family caregiving, we at Senior Care Management Services see family members work themselves so hard that they frequently succumb during cold and flu season. Let us help relieve the stress ahead of time so you have a chance to dodge the illness. Give us a call at 703-329-0900.

Making the home safer

Most hazards around the home are obvious once you are made aware of them. But they are easily overlooked in the course of day-to-day living. Don’t let your loved one get injured because of a simple oversight! Here’s a home safety audit you can do yourself.

 

Lighting
In every room of the house, you want to be sure there is even light from the center and to all corners. Those little objects that cause a stumble frequently hide in the shadows. A common location for a fall is moving at night from the bedroom to the bathroom. Place nightlights along the path to light the way for sleepy eyes and a body in a hurry. Stairs and wet or icy walkways also pose extra dangers for a fall, so be especially sure to keep those areas well lit.

 

Floors
Remove all throw rugs if you can. Or put sticky tape on the underside to pin corners down and keep the rug from slipping. Keep pathways open and tidy. Pick up piles of paper, shoes, boxes, towels and trip hazards. Find alternate paths for cords and wires, or tape them down to the floor.

 

Stairs
Be sure to fix uneven or loose stairs. Handrails should be securely fastened to the wall.  The edge of the stairs should be painted a bright color with non-stick tread on the surface. If stairs are carpeted, be sure the carpet is securely nailed down.

 

Bathroom
Bathrooms are particularly dangerous as they combine hard and often wet and slippery surfaces. Be sure to use rubber-backed non-skid rugs and apply a non-skid mat or decals in the tub or shower floor. Grab bars by the shower and toilet are a must. And a toilet seat riser is a good idea if your loved one is at all unsteady rising up from a chair in the living room.

 

Would you like a home assessment?
We at Senior Care Management Services can spot a trip hazard the minute we walk into a room. It’s not rocket science, but you may simply be so used to your parent’s house, that you don’t notice. As the Northern Virginia expert in aging well, we can help you identify the fixes needed to spare your loved one the consequences of a fall. Give us a call at 703-329-0900. We know home safety!

Preparing for Hip or Knee Replacement

If your loved one is slated for joint surgery, don’t underestimate the impact.
Expect that he or she will have reduced energy and greater needs. Limited mobility will create surprising challenges. Things you take for granted will need extra care and attention. Plus, the body simply needs time and energy to rebuild bone, muscle, and nerve connections.

There is much you can do ahead of time to help prepare a smooth path for recovery.

Support physical preparation for success

  • Opt for an outpatient procedure if possible. It’s less invasive. Plus, recovery at home reduces the risk of complications.
  • Consult a physical therapist. There may be exercises your loved one can do now to tone key muscles that will be needed after surgery.
  • Support your relative in trimming excess weight and cutting down on alcohol and tobacco. They all impede healing.

 

Make practical arrangements

  • Plan to provide daily help the first two weeks. The grogginess of pain meds and the difficulties of bathing, dressing, and walking make it unwise for your parent to go solo.
  • No driving! A “chauffer” is needed for 3 to 6 weeks for errands and medical appointments.
  • Stock up on easy-to-reheat meals. High-protein and high-fiber foods are wise—to promote healing and reduce any constipation from pain medicine.
  • Plan to have a trusted friend or family member at the hospital, especially if there are mood or memory problems.

 

Rearrange the house

  • Create a center of operations on the first floor. Ensure phone, remote, computer, books, meds, and water are all within easy reach.
  • Devise a downstairs bed that is low (feet can touch the floor when sitting on it) and firm.
  • Place a commode at bedside for the first week or so. Really. It makes life MUCH easier!
  • Remove throw rugs—a serious trip hazard—and create wide thoroughfares. Your relative may be clumsy when using crutches or a walker.

 

Round up assistive devices

  • Put a toilet seat riser in place.
  • Get a bath bench to make showering safe.
  • Buy a grabber for reaching things that have fallen.
  • Purchase sock aids to reduce the need to bend when putting on socks.

 

Is surgery on the calendar?
Most people with painful hips or knees eventually opt for surgery. As the Northern Virginia expert in family caregiving, we at Senior Care Management Services can help you prepare so that the person you care for can come home and enjoy a more comfortable, speedy, and solid recovery. Give us a call at 703-329-0900.

Signature Strength: Wisdom

Each of us has strengths . . . and, well, areas that could use improvement. As a family caregiver, you may often feel inadequate. Or guilty. Or think that you aren’t doing enough. Such negative self-assessments are common. A more balanced assessment would acknowledge that you also have qualities that shine.

Most of us believe that to be better people, we need to focus on our trouble spots. Over the next months, we will be drawing on the science of “positive psychology,” which shows that cultivating what works is just as productive as scrutinizing the things that aren’t working well. For example, each of us has characteristic “signature strengths.” Wisdom may be one of yours.

Wisdom and knowledge
Are you the type of person others turn to when they need advice? If so, you probably have the strength of wisdom and knowledge:

  • Curiosity and a love of learning
  • Willingness to look at all sides
  • Ability to change your mind
  • A tendency to take time to reflect, look inward
  • An understanding of social dynamics
  • Empathy

 

Wisdom is more than being smart.
It’s a special kind of intelligence that blends the heart and the brain. The more life experiences you have had—including losses—the more opportunities you have had to develop a wider perspective. The wise individual is able to listen to the heart but not be overcome by emotional extremes.

Using both sides of the brain
Wisdom is commonly associated with age. Brain studies reveal that older adults use both sides of their brain—the analytical side plus the more intuitive side— more equally than do younger adults. As one scientist put it, “they are in all-wheel drive.”

Cultivate your wisdom
Learning from the habits of wise individuals can help you foster this strength. Explore something unfamiliar. Try a new perspective. Pause and reflect. Strive to interpret the actions of others with kindness and compassion.

Would an outside perspective help?
Sometimes that wider perspective is most readily accessed by working with others outside the family system. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services can help you gain new insights and cultivate your own wisdom for the tasks ahead. 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.