By Jen Winarski, RN

Edward, 92, and Miriam, 91, live in their own two bedroom apartment in independent living at a Continuous Care Retirement Center (CCRC).  Edward is suffering from late stage Alzheimer’s and is very confused and uses a walker for ambulation.  Miriam has a history of falling with a previous hip fracture and uses a rolling walker for ambulation.  In October 2011 Miriam suffered another fall where she fractured her hip and was sent to the hospital.  Once Miriam was admitted to the hospital, Edward’s confusion became more and more increased.  Miriam was then discharged from the hospital to the CCRC health center next door to their apartment building and Edward went to visit her every day and have meals with her, but his agitation and confusion were increasing the more time he spent away from his wife.

During a care conference with the family, it was decided that Miriam and Edward were to remain together in their apartment for as long as possible and they would do whatever it took to make that happen.  In late November a multidisciplinary meeting was set that included the Wellness Supervisor and Social Worker, the Psych Nurse and Physical Therapist from the Medicare Home Health Agency and the BrightStar Nurse Care Coordinator.  After the meeting and a call to the clients’ family, the plan was to return Miriam to her apartment and to have a psych assessment done, physical therapy sessions, and the addition of caregiver hours so that the couple was never without the appropriate level of help.  Very shortly thereafter Miriam returned to her apartment and the plan was put into action.

For the next six weeks, a physical therapist came to the apartment to work with Miriam three times a week.  A Psych nurse performed a complete psychiatric visit, ordered an antidepressant, and scheduled a few therapy sessions with Miriam.  The BrightStar Nurse Care Coordinator visited the apartment once a week to reassess Miriam, helped to adjust her antidepressant dosages, and interacted with the caregivers so that their individual needs were met.  The BrightStar Nurse Care Coordinator also checked in weekly with the CCRC Social Worker and the CCRC Wellness Supervisor to update them on the status of the couple.  Also, the family was informed via phone calls or emails on a weekly basis.

Today, the couple is still together in their same apartment.  Miriam is very strong and still ambulating with a walker, but soon may not need to.  Her medications have all been well adjusted and she continues to remain in good spirits.  Edward still has episodes of confusion, but he is much happier with his wife by his side.  There are still caregivers in the apartment, but the hours have decreased as the couple’s conditions have improved.

Call BrightStar Oak Brook, IL today at 630.571.5555 to learn how we can Make More Possible for your loved one!

By Karen Everett Watson

Just a few generations ago, in the land that we call America, women spent many hours together cooking, sharing recipes, family stories – laughing and even, sometimes crying – together. We made a lot of gains in this old world – women now feel free to work and be educated, but not all of the trade-offs are wonderful. Many of those home cooked meals, we once regularly enjoyed, have been replaced with fast food and restaurants. The food is not nearly as scrumptious or nutritious, but we’ve also lost that time in the kitchen where we learned about Great Aunt Sally’s stuffing recipe, figured out how to accomplish world peace, and mended many teenage daughters’ broken hearts.

As the holidays approach, we all begin to think of the delicious recipes we’ve enjoyed over the years. Many are family originals, or at least, family-tweaked recipes that are beloved by the whole clan. For you, caregivers to older women, this time of year is the perfect time to get your loved one back into that kitchen, and pull those famous recipes from their minds, before time takes that away, too.

A few years ago, my own daughter-in-law asked me for my stuffing recipe. I was delighted. She told me that no other recipe would do, because Isaac wanted hers to taste just like mine. Since then, Jenny and I have made my “almost famous hot rolls” together and the family gathering favorite – Polenta and Stew. Whether or not the recipes are preserved, the memories we made working together in the kitchen will last my whole life through.

For older women, who spent many years preparing meals for their families, you could not give them a bigger compliment than to ask for the family recipes. But don’t cheat yourself, or them. Get them into the kitchen and you will discover the real secrets to their favorite dishes. More than that, you will give them a sense of purpose. You’ll give each other memories to last forever.

Here are a few tips to perhaps try when you get your Momma or Granny, into the kitchen.

1. Make it an occasion – invite a younger family member to join in the fun.
2. Get out the camera. Make your loved one the star of the kitchen and chronicle their recipes in photos.
3. Take notes – Not only will you want to preserve the recipes, but the history behind the recipes.
4. Ask great questions while you cook and share –
a. Momma, who taught you to cook?
b. Do you remember the first time you made that dish?
c. What was your favorite meal when you were a child?
d. Did Daddy always like your cooking?
e. Tell me about a meal that didn’t turn out?
f. Where did you find your best recipes?
g. What did your granny make for Sunday dinner?

Even if your loved one has dementia, they’ll know the answers to these questions. Their long-term memory stays intact the longest. You’ll find out things you never knew about your family, if you only ask!

I hope this inspires you to spend some great kitchen time with your loved ones. Once you have those great recipes, and memories, share them with other family members through e-mail, snail mail or on your family website.

By Karen Everett Watson

Older Americans are blessed to have access to incredible medical services. The innovations and discoveries in the medical field have lengthened the lives of millions in this country but many older Americans will continue to suffer health related issues due to the “Loneliness Factor.”

Many research studies conclude that isolation in elders has a significant impact on their physical and mental health. Isolation dramatically increases morbidity rates in the elderly, not to mention the devastation to their quality of life.

So, are your efforts to keep your older patients healthy being thwarted by the “Loneliness Factor”?

Many factors contribute to elders isolating themselves. As we age, many of us experience health related issues such as incontinence, vision impairments, and balance deficits. These physical limitations can cause many older people to isolate. The embarrassment of incontinence or lack of balance can keep them from getting out and interacting with their friends and loved ones. For those who have suffered a fall, they may choose to just stay confined to their homes because they fear falling again.

Diminished eyesight is followed by the inability to drive, which isolates many older adults, especially those who live in a rural setting.

Older people are more likely to suffer the loss of a spouse or of dear friends. Depression from grief or illness will often make older people recluse – which can lead to multiple quality of life issues. Some older women never learned to drive, and when their husbands die, they find themselves unable to attend social functions or normal activities that facilitate human interactions. Isolated seniors, especially men, have a much higher rate of suicide.

Health professionals can help the isolated senior by recognizing the symptoms. Just knowing that certain health issues often lead to isolation can be the cue for doctors, and health care managers to inquire further into the patient’s activities.

Education can help many understand the consequences of isolation. Isolated older people are much more likely to require assisted living which is something our independent seniors fear.

Interventions for the isolated have been found effective. Physical therapy can help those who fear falling. Self-help classes can ease depression and help those through their grief while exposing them to positive social interactions. Physicians can strongly encourage exercise classes for the positive health benefits, knowing the human connections can be just as beneficial.

Family connections remain the most cherished for older adults, so if at all possible, doctors should encourage their patients involve their family members in their lives.

For patients that are basically healthy, volunteering can be a wonderful way to help others while helping themselves. Older people who volunteer are healthier physically and mentally. Older volunteers are also less likely to suffer from dementia.

For the more frail patients, in-home care can often relieve the “Loneliness Factor.” Good caregivers, whether they be a professional or a family member, can be the best medicine possible for a lonely shut-in.  And while many older people dismiss the idea of assisted living, it can be a life saver for many of them. The social activities and
physical exercise fostered at assisted livings can engage and enhance the lives
of many.

By Karen Everett Watson

It’s impossible to measure the joy that pets bring into our lives. For many elderly people, pets are their reason to get up each morning! Did you know that pets provide therapy for older adults? Research has found that stroke victims recover their speech faster because they talk to their pets.

Assisted-living facilities and nursing homes have discovered the benefits of having pets around. Many will now allow their residents to keep a pet. It’s just good business – happy clients are the best advertisement! Elders, who move into a facility with a pet, adjust much easier, making it easier on the staff and less worry on the family.

There are so many health benefits to keeping a pet. They encourage us to keep a schedule. Their need for taking walks can get us out into the fresh air for good exercise. And who doesn’t stop to talk to someone walking their dog. These social connections are vital to older folks who often live alone. For the older adult who has lost their spouse, a pet plays a vital role in working through the grief.

Pets give us a sense of being needed. Older people who have declined in strength and ability still need to feel that they’re counted on. Pets depend on us for love, food and exercise. My friend, Irene is in her mid 80′s and loves her dog, Sophie. “I just need a dog,” she said. “If I’ve been out and come back home, she treats me like the Queen of England!”

Experts have found that a pet can help lower blood pressure and ease the symptoms of depression. And who doesn’t talk to their pet? Verbal responses are known to stimulate the brain and help keep dementia at bay. Jim Roswurm, a retired veterinarian, enjoys his two Cairn Terriers. “They have an unbridled enthusiasm for life,” he said. “Just a joy for living. It’s like a spark plug start for me even when this old body is tired. It’s impossible to stay depressed when my little dogs bring me a ball or a big, wet kiss.”

For an elder who suffers with arthritis or is recovering from an injury, a pet can also be a part of their therapy. Throwing a dog a ball can help with limited mobility. Brushing their pet’s hair can improve their grasp. The love and companionship of pets are tonics to our bodies and our spirits!

So, if you have a lonely elder, the chances are good that a pet would bring them great joy, a better outlook on life and the companionship they need.

By Karen Everett Watson

No matter what role you play in the life of an elder – doctor, financial planner, or elder attorney, you know that your effectiveness is linked to the other care providers in your client’s life.  For doctors, you rely on your patients getting the right medications and the proper care it takes for healthy aging. Financial planners and attorneys are more than aware that just because you have plenty of money, doesn’t mean your life will be worthwhile. It takes a team for your elder to have a good life. Sometimes that team needs a coach.

The families of older adults have a lot more options these days. The web has a plethora of information about services, healthcare, and housing for the elderly. But many times both elders and their families feel like they’re literally in a web . . . a web of confusion. Who can they trust? Are the services they need available in their area? That’s when a Geriatric Care Manager (GCM) can smooth the waters and benefit you and your elderly clients. This is their playing field.

A GCM knows all the options and what is available in your client’s locality. They know firsthand what housing options would be best if your client has dementia or just needs rehabilitation. If you client prefers in-home care, a GCM can find the right person to do the job. They don’t drop the ball after decisions have been made, but follow through to make sure that your clients continue to receive what they need, when they need it. They team up with family and spouses to bring peace of mind to all concerned.

The benefits flow both ways. When you refer your patients or clients to a Bright Star GCM, your name goes with them. Good outcomes for your clients with a GCM will insure that word-of-mouth advertising that will increase your business, as well.

So don’t let that client or patient leave your office without knowing the benefits of a BrightStar GMC. Everyone needs a team behind them when the going gets tough!

By Karen Everett Watson

Can you even imagine a world without music? How many times have you been in a bad mood and turned on the radio playing a song that changed your whole perspective? Music can be better than meds and only has positive side effects! Experts are finding that music for elders and especially for those with dementia have a wide range of benefits including pain reduction and better sleep patterns. But that’s only the beginning to the benefits of music for older adults.

 Music bonds us with our cohorts

Listening to the music of our youth is much like attending a really good class reunion. We relate to each other through our shared experiences and through the music we loved when we were young. When a group of elders listens to an old song, they’re transported to their youth and recognize each other as having similar life experiences. I facilitate reminiscence sessions with elders in assisted living. When I put on a CD of old songs, their faces light up and they just love to sing along. They know all the words and never miss a beat.

Research has shown that music therapy can reduce stress in dementia patients. The past is a safe place for those with dementia and the music of their youth helps them relive a time when they were strong and vital. It also helps them with communication skills and reduces disruptive behavior. Group music sessions are also an opportunity for elders to interact socially. But music in the home setting is also very beneficial.

Finding the Right Music

Do you want to know which songs and music will make your loved one happy? Just ask them. What were their favorites when they were younger? Patriotic songs and songs of faith are usually a favorite but music taste is very personal. You can find a numbers of websites that have the old tunes. One website I’ve used for buying CD’s is www.eldersong.com . You can also find great music for elders on the radio. My mother loves her satellite radio which has stations devoted to the older genre of music. My father prefers western music such as “Gunfighter Ballads” by Marty Robbins or anything by Jim Reeves.

Family Sing Alongs

Getting the whole family singing together is a wonderful way to enjoy music. One of my favorite memories is riding to church with my kids and my parents – singing praise songs the whole way there. My children (now grown) also grew up listening to my parents’ music. All three love the “Gunfighter Ballads” and enjoy hearing the stories my parents tell of going to local dances and the now famous bands that played for them. Johnny Cash was one of the singers they got to hear! I very pleased they were exposed to songs of yesterday and the great singers who made them famous.

The Gift That Keeps on Giving

Long after the music has stopped, the benefits keep on giving. When I’ve listened to a favorite tune, I find myself humming it hours afterwards. It’s the same for older adults. Experts say that there are lasting benefits such as improved cognition, less anxiety and stress release, all from just listening to music. So spread some joy today and encourage your elders to enjoy their favorite music!

By Karen Everett Watson

When my friend Margie helped her mom move into a new apartment, she didn’t know it would cause money problems. Her mom, Emma, had always been good with money. She raised five girls by herself while also taking care of her elderly mother. But Emma’s new apartment was further from her friends and family and she was reluctant to drive in a new area, so she began keeping to herself and spent a lot of time watching the shopping channels. It didn’t take long before Emma was deep in debt.

Emma’s problems were two-fold – loneliness and cognitive decline. If the adult children of your clients or patients are telling you about their parent’s bad financial decisions, it might be time for concern. One of the top 10 early signs of Alzheimer’s includes having trouble making change and balancing a checkbook. Bad money choices are also an indicator. If an elder begins giving large amounts to charity while neglecting to pay their regular bills, trouble is brewing.

Geriatric care managers, doctors, financial and legal professionals should encourage their clients’ families to step in before too much damage is done.  Not only should these elders be medically screened for dementia so that positive steps can be taken to hinder the progression of the disease, but legal steps should also be put in place to prevent financial disasters. Elders who suffer from cognitive decline are at a greater risk for elder fraud.

Up to date medical and financial documents can prevent more damage from being done. Medical Directives, Living Wills, Durable Power of Attorney and Estate Planning documents can save the whole family from needless heartaches. If documents are in place but have not been reviewed in the last few years, make haste to have that done.  Many laws, rules and regulations have changed that may impact your loved one’s wishes and intentions.

Margie’s mom was very fortunate to have children who stepped in. They were financially able to bail her out and began helping her with her finances. Taking away an elder’s financial freedom might be even harder than taking away their car keys, but leaving them open to fraud and financial ruin is unacceptable.

Eldercare attorneys and financial planners would be wise to refer families to a geriatric care manager (GCM) who can help them deal with difficult money issues while giving them support for the tough talks with mom or dad. GCM’s are well-trained to intercede while saving the family precious resources greatly needed for their parents continued care.

By Karen Everett Watson

Imagine a life without purpose.

Many of our seniors have to go through transitions where they are being cared for instead of being the care givers. To say the least, it goes against their grain. Being productive and doing for others is the core of their self esteem. It’s what keeps them connected to a vital active world.

I’ve been blessed with quite a few surrogate grannies throughout my life. Gracie was perhaps my favorite. She always kept busy in her little home that was right next to the church house. Floyd, her husband loved to garden and grow marigolds. Gracie could make any food taste like a feast. Floyd’s favorite food was pinto bean poured over Gracie’s chocolate cake! We all fought over her dishes at the church potlucks. She taught me to make the best macaroni and cheese you’ve ever tasted. Her hot rolls melted in your mouth. And her crocheted baby blankets were always coveted by all the young mothers at church. When I asked her to teach me to crochet, her face lit up. She was so patient with me. She not only had to put up with my clumsy attempts at crocheting, but my six-month-old son as well. I believe she loved sharing her skills with me and spending time chatting while I learned. I know I loved the time I spent with her.

After her husband passed, she went to live with her daughter. Her daughter was so good to her mother, catering to her every need. But after a lifetime of caring for her husband, keeping house and cooking meals, after all the things that gave her life purpose were gone, Gracie lost her will to live. Although she was in good health, she passed away quickly.

Sometimes we get so busy caring for our loved ones’ physical needs that we neglect their emotional ones. You might have to get creative to help your loved one stay active but even small tasks can really help them feel good about themselves. Here are a few tasks that most elders can still achieve:

1. Water house plants
2. Sweep the porch or kitchen floor
3. Fold clothes
4. Put away silverware
5. Dust the furniture.
6. Read to a child
7. Rock a baby.
8. Teach you a favorite recipe
9. Straighten out clothes drawers
10. Arrange flowers in a vase
11. Pass along the family history
12. Knit or crochet

It’s especially important for dementia patients to keep active. Knitting or crocheting has been found to be especially beneficial for dementia patients. A Southern California group called “Hands of Kindness” has started knitting groups in assisted living communities. Seniors have joined the knitting circles and have fun socializing while making blankets and caps for the homeless and cancer patients. The socializing is just as important as keeping them active. If anyone is interested in starting a chapter of Hands of Kindness in Naperville IL, or other locations you may visit their site at www.handsofkindness.org.

By Karen Everett Watson

Financial planners and elder attorneys are experts in their fields and usually deal with just one client or a client and spouse. But when it becomes necessary for their client’s children to be involved, it becomes a whole different ball game. Multiple personalities with varying opinions are now in the mix. Sometimes it becomes more about the siblings’ relationships than the concerns of the elderly parents.

So, how do you get everyone on the same page?

Staying Focused -

It’s imperative that the elder’s wishes and best interest remain at the center of the conversation. So, stating your client’s wishes when the conversations stray can help get everyone back on track. Keeping everyone informed of what is feasible and affordable will narrow the choices for most clients. But the choices in eldercare and housing are huge and the options are growing all the time. How can you stay well-versed in the best options and find appropriate costs for care?

The right decisions require the best information -

Every elder care decision can be made easier by hiring a Geriatric Care Manager (GCM). A GCM knows all the options available and has experience in family conflict resolutions. They understand intimately that one family member usually bears the biggest burden for care giving and how to get the rest of the family aware that they need to contribute more than just the giving of their opinions.

Many long-term care insurances will pay for a GCM because they know the value of their services. Money will be a big factor in making the care decisions and a GCM knows where to get the best services for the least amount of money. A GCM is also experienced in working with health professionals, senior housing professionals, elder attorney’s and financial planners and serves as a link to make a comprehensive and appropriate plan for care. There will never be a question of whether the elder’s best interests are the ultimate consideration.

A GCM’s skills at interacting with seniors and family systems while understanding what services they need now and may need in the future paves the path for a good resolution that alleviates some of the tension that develops between family members and complicates the decision making process for professionals.

Don’t hesitate to call the professionals at BrightStar when you need help understanding long term care needs and associated costs that face your clients and/or their family members. You will only enhance your value in getting them the best information from a BrightStar GCM and for offering options that instill some peace of mind.

Many times our role as a care giver starts out at a reasonable pace. We begin to juggle our lives to find the time it takes to care for an aging parent or an ill spouse. We feel good about what we’re doing and know it’s the right thing. But usually at some point, care giving becomes more than we bargained for. As our loved one needs more care, we begin to neglect our own needs. The downward spiral begins – first we try harder, then we get frustrated which leads to resentment, anxiety, depression . . . and guilt. If you’re experiencing any of these emotions I want you to stop a minute and consider a few things.

You are very important to your loved one. If you begin to neglect yourself, the chances are very good that you’ll suffer an illness and twice as likely as a non-caregiver to become depressed. If you become ill or depressed, how will you continue to give the care your loved one needs? You won’t!

Taking care of the caregiver – You! You need plenty of rest, exercise and socializing. It’s imperative to maintain your mental and physical health. When we neglect these aspects of life, we compromise everything. If we don’t take the time to care for ourselves, our attitude suffers. If we want to continue to care with a good and loving attitude, we must take care of our own needs.

Get help! – Reach out for help where you are. Family, friends and neighbors are often overlooked when we go into caregiver’s mode. Let your network of family and friends know that you need some help.

• One afternoon each week, have one of them relieve you so you can meet a friend for lunch or take in a movie.
• Ask a neighbor if they would sit in for you for just an hour or two, while you take a walk or run some errands.
• Many communities have adult day care programs at senior centers which have great activities for your loved one to participate in while you get a break.
• Once a month, you need to get away. If a relative or friend is not available, respite care is available at most assisted livings.
• Or you may decide to have in-home care give you a night off.

When you are well-cared for, then you can continue to give your loved one what they need without the guilt. Your good attitude will make a positive effect on them as well.

If you need help with care giving, or any other eldercare issue please take a look at our comprehensive service offering or contact our Geriatric Care Coordinator here at BrightStar Naperville/Oak Brook, who may be able to give you some additional tips and insights, as to how deal with changes in your aging parent(s).

BrightStar Healthcare – Oak Brook
Tower Floor
1415 W 22nd St
Oak Brook, IL 60523
(630) 571-5555