Parentcare 101: Twenty Mini-Vacations A Day

Say a Little Prayer

2011-03-03T18:30:00.001-05:00

Sometimes it's all too much. Too many tasks. Too much caring. Too many options or too few. We need to pump up the faith that we'll find the right path. Say a prayer.

Quick, heartfelt. Arrow prayers, one friend calls them. Straight shot to the Divine, to the Spirit, to God. My mother's favorite? "Lord, give me strength!" Prayed aloud with all her frustration and need behind it, this was (and is) a pretty powerful prayer.

Prayer on a long breath. One of my favorites? From the Psalms--"Create in me a clean heart, O God, and renew a right spirit within me." And another--"Come Holy Spirit, fill the hearts of your people and kindle in them the fire of your love. Send forth your Spirit and they shall be re-created, and you shall renew the face of the earth." Takes a little longer. Makes you focus on what you're saying. Takes you away from the current challenge. Try the Lord's Prayer or the Prayer of St. Francis. Any prayer that you've memorized and on which you can really focus.

Prayer on the Beads. I grew up in the Catholic tradition and found that repetitive prayer on the Rosary was just the thing to slow down the monkey mind and give me a sense of connection with the Holy Spirit. As I've moved in my spiritual journey to other expressions of Christianity, I've explored other prayer bead traditions--Buddhism, Hinduism, Islam, Bahá'í Faith--and finally settled on the Anglican beads. The Anglican Rosary holds deep symbolism in its very structure, but has no one set of prayers associated with it.
The basic approach is to pray an opening prayer of faith on the cross and another prayer to settle into the Spirit on the Invitatory. Choose one prayer to repeat at each Cruciform bead and one prayer (or seven phrases) to say at each Week bead. To complete the prayers takes about 10 to 15 minutes. Enough time for a pause. Enough time to quiet monkey mind. Enough time to get a grip and return to caring. Renewed.

Say a little prayer...because you're worth it.

Blessings on your caregving today!

Clean Out a Drawer

2011-02-25T09:33:00.002-05:00

"Clean out" anything does not sound like a mini-vacation, does it? But I'm finding a great deal of pleasure in cleaning out a chest of drawers. My father-in-law has just moved to a skilled nursing residence near us, and we've decided to add this chest to his furniture. So everything now stored in that chest has to find a new home, whether that's in another part of our house, or to charity, or to the trash. Every day, I take 10 or 15 minutes to make some progress--unload a drawer, go through the contents, confirm with my husband what we can pitch.

So far I have the chest emptied, and the contents waiting for new homes are stacked all over the downstairs. But it feels good. Sorting through pieces of my life to which I've clung but which are no longer important in my current life's rhythm. Knowing that I'll be re-gifting and sharing with others who will get more use and more enjoyment out of the extra linens, candles and craft items from that chest. Getting away from the computer, moving about, setting my mind in a different direction.

In a caregiver's busy schedule, the traditional "spring cleaning" which overturned the entire household in one fell swoop is not possible. But 10 minutes to clean out a drawer? Very possible...and very cleansing on many levels. Pick a drawer or part of a closet or a table surface or a corner of the garage. Clean out a little; get big benefits.

Blessings on your caregiving today!

Open Up a Talking Card

2011-02-18T19:29:00.004-05:00

I hope that you all have been able to add a special activity into your routine. The activity that will refresh your spirit for caregiving. I can report that it's Friday, the day for contra dancing, but I'm not going dancing because...I got a better offer! A good friend from out-of-state is visiting, so tomorrow, we'll go touring, have a sleep-over, and talk and talk. A weekend getaway close to home.

Even if you've got your activity in place, remember to take those mini-vacations on the days when your activity is not planned.

Here's another idea. Ask someone close to you to buy you a talking greeting card. Or go out and buy one for yourself. Check them all out. You can have a mini-vacation just listening to all the talking cards in the rack. For my birthday, my husband bought me one with Ms. M&M Green on the cover. She's wearing those knee-high white boots and a sassy smile. When I open the card, she reminds how being so good-looking can be "such a burden." Sigh! Makes me laugh every time. I've got it on my desk, and when I need a lift, I open that card.

Get a card, get a laugh.

Blessings on your caregiving today!

"Time for Ourselves" Plan - Part The Last

2011-02-11T19:06:00.004-05:00

Have you done it? Have you arranged for care for your dependents while you take some time for yourself? For those of you whose elders are living in their own home or in a residence with assistance, Step 4 is easy. My father-in-law is living in a skilled nursing residence, so I know he's safe and cared for. But Step 4 may be the hardest for those of you who share your home with your elder. Have you hesitated in your plan thinking that it's just too much effort or that you really don't want anyone else caring or that it's been harder to get things in place than you considered?

It's all right. Continue to work through the Plan steps. Keep in front of you the vision of taking that time for yourself doing something you really enjoy. Now is when that first choice of activity you made is tested. I know I've wanted to give up or not follow through. But I love to dance! And I feel SO-o-o good after an evening of contra dancing, that I know dancing will be a lift to my spirits and will give me more energy to keep going during the week. Don't give up.

If you've been able to make those arrangements, then we're at Part The Last.

Step 5. Do the Activity.

Yeah! We get to do our activity. Everything is in place. Now we can enjoy the fruits of all our planning. In my plan, contra dancing is a Friday night activity. So I'll give you an update next week.

Blessings on your caregiving today!

"Time for Ourselves" Plan - Part 4

2011-02-03T08:59:00.003-05:00

Last week our goal was to plan to put our Time for Ourselves activity into our routine. I'm working to put contra dancing into my schedule. I now know that the dancing society meets every Friday evening and the best time to go will be when my husband is on the Friday work schedule. Those are the days when I'll have use of our one car. So that will be twice or three times a month. I'd like to go every week and that may happen, but right now I'm not going to make it difficult. I'm going to make this first enhancement to my schedule as easy and stress-free as possible. I want to set myself up for success with no chance for excuses. I can definitely have transportation a couple times a month; I'll start there. I still need to get in touch with a few more friends who'd like to join me in this, and together we may arrange to carpool. All to the good.

I also found out that there is a small fee for each dance attended. It's something I can afford, but I'll need to budget it in. With annual tax time looming, I'm in the process of reviewing finances, so this week, I'll make sure this item is in the budget.

So now I have a set plan for attending and I'm moving on. How did your planning go? I hope you've been able to look at your schedule and block out time for this very important Time for Yourself. When you've done that...

Step 4: Arrange for your dependent's (children, elder's) care

This week, you will put into place the final "arrangement" piece of the Plan. If you need to arrange for daycare or evening care for your elder or your children, this is the week to do that. For your elder, take into consideration what companionship and services will be best for the current situation. You can consider these possibilities:

Ask a friend, neighbor, or family member to sit with your elder
Does your church have a ministry for seniors or volunteers who make home visits? Check with your minister or priest if you don't know.
Check out the local Senior Center to see if they have activities that would interest your elder at the time you'd like to take for yourself.
Call your local Area Agency on Aging or County Department of Aging or Social Services and ask for local elder daycare programs or volunteer organizations that provide in-home visits.
Check online or paper telephone yellow pages for "Senior and Aging Organizations" to find companies who can provide in-home care on a short-term basis.
Assisted Living communities sometimes offer respite care. Your elder could stay for a few hours, overnight, or even for a full week. This service is not always promoted front and center, so you might need to make a few phone calls to verify if the residence provides respite care.

If you get this piece in place, you'll be ready to start your activity. I know you can do it.

Blessings on your caregiving!

"Time For Ourselves" Plan - Part 3

2011-01-28T09:04:00.003-05:00

How did you do this week? Did you gather what you needed for the activity you've chosen?

I chose contra dancing and I made sure I had the right shoes and dancing clothes, I spoke to one of my friends, but do need to contact another. I know when and where the dancers meet. I'm ready to move on.

If you need to gather more materials or do a bit more research on the activity you've chosen, take another few days to finish, then move to...

Step 3: Plan to insert this activity into your week.

Now we begin to think about the time for our activity. First, decide how much time you'd like to spend on this activity. If this is a class you've chosen, then you already may know days and times. If not a scheduled activity, then you can create your own schedule. Two hours on Wednesday evening; 1 hour on Saturday morning. The hour when Dad has a nap which is different each day. What might fit your current rhythm?

Second, think about how those hours you spend on your activity will shift other things in your week. There are three ways to find time for a new activity, or more accurately, to make a "time exchange".

Make no changes to the list of things you're currently doing. Get up earlier or stay up later to compensate for the time you'll spend doing the new activity. Exchange awake time for sleep time.
Decide that something else will not get done. Exchange one task time for another.
Ask someone else to do something on that current list so you can spend that time on your activity. Exchange someone else's time for yours.

Consider the pros and cons of each option carefully, taking into account that overall, the goal is to add some relaxation in your life, not sleep-deprivation or excessive anxiety. Also remember that your goal includes adding this activity on a regular basis so that it will become routine.

Already sounds hard, feels hard to me. I'm feeling a little tightness inside thinking about this. At the same time I really want to dance. So I'm going to take a breath and figure out how contra dancing will fit.

I know you can do the same. Check in next week for the progress report.

Blessings on your caregiving!

"Time For Ourselves" Plan - Part 2

2011-01-21T08:16:00.004-05:00

Last week I got all excited about encouraging us to make time for ourselves. I bet you could tell that I've got a lot of passion for the subject of Choices. Why? Because when I finally got the concept, it was a major revelation. There are a lot of things that we do on an unconscious level for which we don't have a choice (breathing, for one; beating heart, for another) and many decisions we make on an instinctual level based on our experience, culture, education, upbringing, preferences, and code of honor or duty. We act without thinking, but we've made the decision to act without thinking. Now when I find myself saying, "I just can't do anything else!" or "Oh, I couldn't do that", I know that it's time to examine my motivation, my reasons for acting in a certain way. Then I can make a Choice, Consciously. I may still choose to act the same way, I may choose to continue to act without thinking becasue it makes the most sense. But I'm very aware of why. It's quite empowering.

Enough soap box.

I promised I would share what I chose for my time-for-me activity. Here it is...Contra Dancing!

Contra dancing is the dancing that you see in movies based on Jane Austin when everyone gushes about going to a ball or to the assembly. You see two parallel lines of dancers who move around the lines in patterns called "figures".

I was introduced to contra dancing years ago in Michigan and went to quite a few dances. When I moved to North Carolina, I found a group that sponsors the dancing, but let the idea fade into the background.

Contra dancing has everything that we talked about last week for the activity. The group holds a dance every week. I adore dancing and the moves are easy to pick up. I love music, and I don't need a partner. Contra dancing energizes me, lifts me up and is just challenging enough that I have to clear my mind of my worries and focus on the figures. And I get some exercise. Good all around.

I've made that first choice. Did you make yours? If you need another week to decide, take the time, and when you're ready...

We're on to Step 2 of the plan: Prepare for the activity.

This week, gather what you'll need for the activity. Do you need a space cleared for your activity? Do you need equipment or supplies? Do you need to gather information or read up on a skill? Do you need particular clothing? You may need to purchase something to be ready, but it may be that you don't need to purchase anything, because you already own what you need. If so, this week you want to gather it all together, brush it off, clean it, whatever helps you prepare for the activity.

For my activity, I have to make sure that I have proper shoes for a couple of hours of strenuous dancing, comfortable clothing, and directions to the dance. I'm thinking of asking some friends to join me, so I need to contact them. So I have a bit of prep to fit in this week.

You still don't need to think about finding the time. Think instead about getting prepared and about how much pleasure you'll get from your activity.

I'll let you know how I'm doing next week. Go out and prepare!

Blessings on your caregiving...and finding time for you.

The "Time for Ourselves" Plan

2011-01-15T14:20:00.006-05:00

I don't have the time!

I say this on a regular basis. I don't have time for a mini-vacation. I just can't get away for a few hours. Take time for me? Impossible. I sure could use a few more hours in the day.

And what would you do with those few more hours? Fill them up with tasks and activities for someone else, but not for you?

This week, I received an e-mail from Shelly Webb, the founder of The Intentional Caregiver. She's a nurse and caregiver, and she noted in her message that caregivers with whom she interacts insist that they don't have time for themselves.

Well, here's a news flash. We only get so many hours in the day. That's not going to change. Another news flash, we caregivers make CHOICES on how we'll spend our time, and--drum roll, please--we CHOOSE to put everyone else's priorities before our own well-being and health. We ALLOW requests and demands around us--from job, church, family, friends, the community--to become all important and discount our own needs. We CREATE false importance by judging everything as necessary RIGHT NOW.

Do you feel the pull of RIGHT NOW?

Part of carving out some time for yourself begins with looking critically at your situation. Does everyone you're serving (spouse, kids, parents, family and you) have what they need for survival? Food, clothing, a safe place to live, medical care? If yes, then take a breath. RIGHT NOW is under control. The rest of the giving on your list is gravy, a blessing, icing on the cake. In that "gravy time" is time for you.

Let's you and I together get that time for ourselves. There are only five steps involved:
1) Choose what you want to do for yourself.
2) Prepare for this activity.
3) Plan to insert this activity into your week.
4) Arrange for your dependents'(children, elders') care.
5) Do the activity.

Over the next four weeks, you and I are going to do one step at a time and at the end of four weeks we will be ready with time for ourselves. You may need to move faster or slower, but follow the steps in this order and you'll have a fun, relaxing activity ready to go.

So first, this week, choose what you want to do for yourself.

Don't skimp. Make this choice something that pulls at your spirit, brings you to life, peels the stress away, really lifts you up. Think of something that you will want to do at least once a week for at least 30 minutes. Maybe it's quiet time, going to a movie, a long bubble bath, shooting hoops, taking up painting, building a bird house, playing with your kids, date night with your spouse. It's got to be something that gives you a wonderful feeling and de-stresses you or you won't feel compelled to put it in your routine.

For now, I'm not asking you to consider anything about where the time is going to come from. I am asking you to consider what brings you true pleasure in life and choose at least one activity based on that.

I've already got some things in mind. Do you? I'll share what I've decided next week.

Blessings on your caregiving!

I Need a Drink!

2011-01-06T11:11:00.003-05:00

Have you heard this or said this with enough exasperation to know that the day has been a tough one? Most of the time, this phrase refers to something with an alcoholic kick. We caregivers know that, except for an occassional glass of wine or a beer, drinking alcohol on a regular basis is not a way to care for ourselves.

No, I'm talking about taking a breather with a non-alcoholic beverage. Could be a cup of coffee, chocolate or tea. Could be a tall glass of lemonade or water with a slice of orange. Whatever beverage you prefer given the weather and your mood.

First, choose your time. I suggest a 15 minute break, so you want some quiet for that 15 minutes. Turn off your phone(s), TV, radio. The kids are at school, Mom's taking a nap, most of the office is in a meeting, you choose.

Then proceed in 3 steps: Set a place; Prepare the drink; Savor.

Set a Place
Gather a nice placemat, your favorite mug or glass (even the good china), any tableware you might need, a napkin (cloth is good, but a printed paper one would work, too). Choose a spot to sit with a nice view and set a place. This is for you, so make it special.

Prepare the Drink
Start the coffee, heat water, get ice out of the freezer, slice a lemon, whatever is needed to get that drink ready. Take your time. Be aware of your actions through each step of the preparation process. Focus on the process, take a breath.

You may get the coffee on and then set your place while it's brewing. You make the choice. Don't rush. You're not trying to get done fast; you're creating a mini-break.

Savor
At the place you've set, serve yourself your drink, then sit and savor. Don't read the paper. Don't check your e-mail or texts. Smell the aroma of the hot chocolate. Place that cool glass of ice water against your cheek. Take a sip. Feel the liquid on your tongue and sliding down your throat. If it's too hot, blow on it. If it's too cold, wrap your hands around the glass. Take your time.

Let your thoughts wander, but always come back to your drink. The beverage you prepared for yourself. Because you deserve this brief interlude. Take a breath between sips. Finish all of it. Take a deep breath. Steadily, put everything away, clean up as much as you need to. Take another breath.

Ah-h-h-h. Wasn't that great? Time to move on with your day.

Blessings on your caregiving!

Give Yourself a Gift

2010-12-27T16:27:00.004-05:00

December is the big gift-giving season, and for many of you, buying or making or re-gifting was part of your routine. You continued to give care to a loved one, but in addition, you made sure that there were presents for your family members, friends, your child's teacher, the mailman. Didn't have to be something large or expensive, just something to express how you feel.

Did you remember to get yourself a gift? Did you select something that you really wanted, wrap it up and tag it "From Santa"?

Probably not. We usually don't. We think about how others will feel if they don't have a present. We spend a lot of energy choosing the right gift for a friend or relative. We expect those around us to give us presents, sometimes expecting that they'll get us just the right thing, even if we haven't given them any clues or hints what that right thing may be. Many times those close to us come through, and we're delighted.

But there's nothing written in any rule book that says we can't give ourselves a gift.

Maybe it's a new basketball or electronic gadget or a sweater we've had our eye on. Maybe it's the commitment to ask our neighbor to come and stay with our elder while we go to a movie. Maybe it's a long bubble bath. Maybe it's just time to sit and watch life unfold out our window.

This is the gift-giving season and as a caregiver, you do a lot of giving all year. How about acknowledging the effort, the love, and the care?

How about giving yourself a gift?

Happy Holidays, and blessings on your caregiving!

"Here We Come A-Caroling..."

2010-12-16T20:09:00.003-05:00

Last Sunday, I joined friends at church for a Carol Sing and Pot Luck. Just a group of us around a piano with an acoustic guitar for interest, singing for all we were worth. I'm writing this while one of my favorite Christmas CDs plays in the background, and I find myself humming along. This evening while making dinner, I made a point of putting on Christmas music and singing along the whole time I was cooking.

And guess what? A very busy, stressful day turned brighter as I let myself get carried away with the music and added my own "special" rendition. Now I have the Chipmunks stuck in my head. And other beautiful, crazy, touching and funny music. Much better than anxiety over the snowy, icy weather; over what to get my father-in-law who has dementia for his community Christmas party; over too much work.

So I suggest that when your caregiving and holidays collide into near chaos, put on your favorite music and sing along. Right out loud. Go ahead, belt out the words. If you're singing Christmas carols, the rest of the family can join in. Doesn't matter if you're off key. Doesn't matter if you forget the words. You're just letting out some energy and embracing the lift singing out loud can give you.

So sing. Sing for joy. Sing for the holiday. Sing for life.

Blessings on your caregiving today.

Smile at the Cashier

2010-12-02T11:44:00.003-05:00

We are in the midst of the holiday shopping, celebrating, expecting and remembering season. With caregiving adding another dimension to an already stressful (even fun can be stressful) time, practicing small acts of kindness help relieve some of the simmering energy that seems to follow us around. One of those acts is simple.

Every time you arrive at a check-out counter during the month of December, say a cheery hello and smile at the cashier.

Grin, even.

That's all. You don't have to make conversation (although connecting at the check-out can be very pleasant). You don't have to overdo it.

Even if you're having a crummy day, make those lips curve up, smile and say hello to the cashier. Hey, the guy or gal behind the counter is just trying to make a living, right? And odds are the cashier has nothing to do with your crummy day (if they do, that's for another post).

For just a moment, while you're at the check-out, lighten up. If you smile every time you greet a cashier, you will feel better. People around you will feel better, too. Guaranteed.

The holiday season is for feeling joy and cheer as well as stress and pressure. One way to feel joy and cheer is to ACT joyful and cheery.

Try it. You'll like it!

Blessings on your caregiving today.

Go Dancing!

2010-11-28T15:24:00.005-05:00

Over the Thanksgiving holiday while visiting relatives, I learned that two couples in my family have taken up dancing as a way to make lemonade from life's more tangy lemons. One couple decided to spark up life with Salsa dancing, the other with general ballroom dancing. And since they are sharing this as a couple, the caregiver gets a break while taking time to keep the marriage connection strong. Another great example of a twofer. Square dancing is another type of dancing that some of my friends enjoy, and many maintain the activity well into their senior years. These couples say that it keeps them young and healthy.

Don't have a partner? Go for Country Line Dancing or Contra Dancing. There are no partners in Line dancing, it's low impact exercise and the country music is lively. Contra dancing is a form of dance that is done in two long lines. You hook up with a partner (or several during a dance session) while you're there. If you're not familiar with Contra dancing, watch one of the dance scenes from a movie based on Jane Austen's novels, like "Pride and Prejudice". Most Contra dancing groups give lessons right before the dance so that you'll learn the basic moves before the main event.

There are also aerobic dance exercise videos and/or DVDs, and plain old shakin' your booty to favorite tunes on the radio, your mobile player or an old vinyl record. Hip hop, ballet, tap, folk dancing--there are as many styles as there are music and emotions to express.

Let's be clear. Dancing is not about having the "right" moves. It's all about moving to a beat, relaxing and sweating a little--or a lot. Dancing makes your mind concentrate on your body and the music, not on your daily challenges. It's refreshing in so many ways. And it's adaptable. You can make your dance break a Mini-vacation (get up and dance to one song on the radio), a Pause-of-the-Day (take a dance lesson or move to a 45-min. dance video) or a Gift-of-the-Month (an evening of square dancing).

Pick your music, pick your style. Don't just sit there...Dance!

Blessings on your caregiving today!

LOL!

2010-11-07T16:35:00.004-05:00

In Texting-land, LOL stands for "lots of laughs" or "laughed out loud". Today, I'm talking about the second translation. On Friday, I was getting my hair cut and my stylist and another stylist, along with all the clients in the salon were sharing stories about life--mostly funny, unexpected situations that people have found themselves in. There was a good deal of acting, voice impressions, pantomime, affirmation and Laughing Out Loud. Belly laughing, guffawing, hootin' and hollerin'. By the time I left, I had a fabulous new "do" and I felt light and easy.

My stylist shared that before this other stylist joined her in the shop, she didn't laugh much, didn't have much fun in her job. But now, because she works with another person who has a healthy funny bone, the styling is still great, but tension and the pressure in her gut are gone. Laughing out loud is good for the soul, good for your health.

In an earlier post, I suggested keeping a Need a Smile folder of humorous e-mails to help you laugh. But there is nothing so contagious as hearing a laugh from another person. When I'm working in my office, I sometimes hear my husband break out into uproarious laughter at a comedy he's watching downstairs, and it makes me grin. If I were in the room with him, I know I'd be laughing with him.

I'm sure you've had the experience, too. A smile on a friend's face grows into a smile on yours and then it just seems to escalate into a chuckle and then into a big laugh. And tension melts away in the physical release. Laughing together brings out the added dimension of face-to-face connecting and loving.

So LOL with someone soon. It's good for you!

Blessings on your caregiving.

Count to 100

2010-10-30T16:45:00.004-04:00

Does your mind race around trying to keep track of the things you have to do? Mine does. Even with my compulsion for list-making, my monkey mind just hops around and bounces back and forth, reviewing what I've done, setting up what needs to be done, flicking through my mental file just who's on my "To Delegate" list, on and on.

Monkey Mind does pretty well (with the help of those lists!) and often, as my little internal file keeper is reorganizing and categorizing what Monkey Mind is tossing around, she brings to the surface some important item that got buried or a new idea for solving a current situation. So I don't like to put the lid on Monkey Mind or Ms. Inner Filer all that often. However. When I'm ready to go to sleep, I really do need the dynamic duo of Mind and Filer to take a break. Whew! Tough one.

There are a lot of suggestions I've read--no computer, no e-mail, no phone, no TV; visualization of a pleasant landscape, reading a few pages of a soothing book, listening to soothing music or sounds. All good suggestions. I do these from time to time. But I find that what helps me most is to count to one hundred.

Get comfy in bed; relax against the pillows; turn off the lights, TV, radio; settle into the dark and the relative quiet.

Tell yourself that you will focus on this counting until you reach 100. If you reach 100 and you're still wide awake, then you may need to try that visualization method, but you're going to allow yourself to stick with this to 100.

Then direct your attention to your breath.
Breathe in, as you breathe out, count 1.
Breathe in, as you breathe out, count 2.
Breathe in, as you breathe out, count 3. And so on.

Don't try to breathe deep or change your breathing rate. Just, every time you breathe in and out, count.

If a thought comes wafting in (and it will), gently redirect your attention to your breath and continue counting. If you hear sounds from the other room, or feel movement on the bed for whatever reason, acknowledge it and go back to attending to your breath and counting. If you lose count, start where you left off and keep going. Don't angst about missing numbers, just resume your attention and your counting.

I usually count from one to ten, then start over because counting from one to ten is so completely a part of me that I can do it, well, in my sleep. And that is the point.

With this method, even though I give myself permission to count to 100, I get to the 5th or 6th round of counting to 10 (or to 50 or 60 if I count in sequence), and I'm out. For the night. I even feel skeptical some nights when I'm really wound and I'm certain that Monkey Mind and Ms. Filer will never let me sleep. Attending to my breath and counting works every time.

Now I know you're going to say, "But that's kind of like counting sheep, and that's silly." Counting sheep does work for some people. If it works for you, by all means, continue. My problem is that when I'm counting sheep, I start to make up stories about each one, why is this one underfed, why is that one so fluffy, and did that one have anything to do with the fire at the farm earlier that day. So you see, sheep do not help me in the least. They could be labelled "Enablers" to sleepnessness. Let's not go there.

Try the breath counting. It works for me. It could work for you.

Pleasant dreams and blessings on your caregiving.

Look Around You; REALLY Look

2010-10-22T15:37:00.003-04:00

I've just gotten back from the UU Christian Fellowship Revival in Texas which counts toward my need to "Get Outta Dodge." Working from home, caregiving in your home, not ever leaving home--not good for your mental health. That would be a post in the Blog "Take a Vacation!", but we are in the business here of sharing ideas for Mini-vacations.

My break did remind me that no matter how big the Texas sky or vast the land there, I love the scenery of North Carolina. It speaks to me deep down. Not just the landscapes, but the view right out my windows. So today, for your mini-vacation, I invite you to look outside. Not a glance or a quick scan, but a 5- or 10-minute-study. Look out any window (or step out on the balcony, porch or deck to get smells and sound effects) and really look.

What do you see? A busy street with cars and trucks and motorcycles and SUV's? Is it tree-lined or paved? What colors do you see? Are the buildings brick or wood or siding? What color? What shape or texture? Or do you see a green lawn or stones in every shade of brown and beige? Any wildlife? Birds, bees, bears? Any pets masquerading as wildlife? Is it windy or calm? Is there sunlight bouncing around or is it overcast? What shape are the clouds...or is it clear? Are there people outside? How are they dressed? I have a friend that loves picking out people on the street and making up stories about where they're going and where they've been. Be a little creative if you want.

You can stop me any time now.

Your turn. Get up from your computer and look out the window. Really look.

Blessings on your caregiving today!

Dancing the Twofer

2010-10-08T08:23:00.005-04:00

All experts agree that everyone (even you, Caregiver) needs to "exercise" 30 minutes a day to help maintain physical health. I put "exercise" in quotes because the more I read, the more I've come to understand that it's about Movement. You need to get out of the car, off the couch, out of the office chair in front of a computer and Move.

Now for some reason (excuses, laziness, stubborness, bad weather, whatever), I have not yet become disciplined enough to always get in a nice aerobic bike ride or my session at Curves or even a brisk walk.

So at the very least I try to go for a Movement Twofer, as in Two-for-One Effort.

I've chosen some household tasks that I'd like to do on a regular basis. Things that take physical effort. And I plan time to spend 30 minutes on that activity.

Vacuuming is a great Twofer. Especially if you move some furniture, vacuum sofa pillows and vacuum the stairs. Add picking up throw rugs and going up and down stairs to dump them in the washer, and you're working up a nice, warm glow--as elegant ladies (who do not sweat!) say.

Scrubbing the shower is also a great Twofer. Wiping down the walls, scrubbing the floor, rinsing everything off. Oh, yeah.

Mopping the floors. I have a fairly large kitchen, so moving furniture, getting the bucket ready and mopping, all done at a steady pace...definitely glowing after 30 minutes of that.

And hey, while you're doing that, turn on your favorite music. Something with a good beat for dancing and boogy your way through the activity you've chosen.

Dancing the Twofer. Now there's a reality show just waiting to happen.

Not!

Blessings on your caregiving today!

Buy Yourself Some Flowers

2010-09-30T12:07:00.004-04:00

It would be really great if those who loved us could read our minds. Then, they would know when we needed a pick-me-up and they'd come through with a hug, or a card or flowers. But our closest friends and relatives do not have superpowers and can't read our minds (darn!). Sometimes we need to give ourselves that pick-me-up. That's the whole point of mini-vacations.

That's the whole point of flowers.

Flowers don't cost much. They're free if you raid your own yard or the neighbor's (with permission, of course). I can get a small bouquet of mixed flowers in an array of colors for $5 at my local grocery and I get about a week's worth of colorful pleasure. If you go to your local florist, you may be able to purchase just one rose or daisy or carnation and bring that bit of nature and color into your home.

Then you can take a little time arranging them in a vase, slipping them into a tall glass or just sticking them in a coffee can. Then you can decide where you'd like them displayed.

And all this time you're thinking about how pretty they are and how they brighten the place up. Nice break from other things that are usually on your mind.

Even guys like flowers. I know this because my husband is always pleasantly surprised whenever I bring home a small bunch just for him.

So don't wait for a telepath with mind-reading abilities to come your way. If you need a mini-vacation, pick up some flowers, take a little time with them. Then savor them while they last. Wow! The mini-vacation that keeps on giving. What's not to like?

Blessings on your caregiving day!

Too Much Information

2010-09-09T18:03:00.004-04:00

When I was in active caregiver mode, I found a book titled Breathing Space by Jeff Davidson (2007 edition is still available), and found a powerful way to decrease the level of stress in my daily life. I state it as:

Cut Down On the Amount of Information Coming at You.

Before I began caregiving for my Mom, I watched local and national news on TV, I read a local newspaper, two national newspapers and several magazines, and I listened to radio talk shows and spent lots of time on the phone and with e-mail and the Web.

I was Connected!

Then I became a caregiver, and I allowed the pattern of information flow to continue.

I was Connected...and completely overwhelmed.

Breathing Space really helped me look at all the sources of information literally flying at me. I started to detach. I chose one evening TV news program. I stopped listening to the radio shows. I stopped all the magazine subscriptions except one that I truly enjoyed (mini-vacations here). I stopped reading all the newspapers. I got myself off every marketing e-mail list that did not have to do with my caring and limited my e-mail and online time to one-half hour every day. During certain hours of the day, I let all my personal calls go directly to voice mail and only checked messages twice a day.

I finally began to feel that breathing space Jeff Davidson talked about. And saved some money, too.

In our society, there is an unspoken rule that we NEED to be connected to information and people 24/7/365. That's just not true.

Why do you NEED to listen to three news programs, all of which are reporting the dire straits of the world? You're caring for a parent. That can be pretty dire all by itself. At the very least, it's plenty stressful. You don't need to know every detail about the world's stress, too.

Why do you NEED to answer every phone call the moment it arrives? Truth, most calls can go directly to voicemail and you can screen them later.

Become aware of every bit of information around you. Think about how each source of information affects you emotionally, how much time each takes, and whether it's adding any value to your crowded life. If the information stresses you, takes too much time telling you things you already know, and rarely brings you pleasure (only another "have to"), get it out of your life.

Create Information Breathing Space. Ah-h-h.

Blessings on your caregiving day!

Mini-Vacation by Pet

2010-08-24T17:03:00.004-04:00

For my mini-vacation today, I pet the cat--and I don't even own a cat.

For you pet owners (even if your children are the "owners"), you already have a good handle on the "Mini-vacation by Pet". When you're feeling down or overwhelmed, you call to your pet and the roaming, four-legged kind comes to share a hug or a brief tussle. Or you meander over to the rabbit, bird or guinea pig cage and watch the little creature do its rabbit, bird or guinea pig thing. Mini-vacation by Pet is a marvelous event.

At this moment in my life, I don't have a pet, so I borrow my neighbor's. In our neighborhood, a quiet circle of townhomes, we have the official neighborhood cat. There are plenty of dogs who appear regularly at the end of their owners' leashes, but only one outdoor cat who has made the townhome circle and the surrounding land and woods his personal territory. His name is Fritz. He's slate grey with snow white markings and a quiet confidence that has most of the bird population shaking in their feathers. He transforms into Fritz, the Hunter, hunched and stealthy, when he's on the quest of a squirrel to tree.

He knows when I open my front door. He stops what he's doing and trots over to curl through my legs. I make sure that his head, neck and ears get a lot of attention because that's what he likes. I take time to talk with him and feel the soft fur under my fingers. I appreciate his lean, athletic form and his long grey tail. He purrs and meows and we share a few moments of simple companionship. Then as if by mutual consent, we both move away, he to another neighborhood adventure, me back into the house.

And I feel better. Simple as that.

Have you taken your mini-vacation today?

Blessings on your caregiving!

Beware the SHOULD

2010-08-17T18:26:00.006-04:00

There is one word in the English language that I'd swear is responsible for 75% of caregiver stress--SHOULD. As in, "I should visit Mom more often." Or "I should be doing more for my father." And you don't even say it aloud, but over and over in your mind. No wonder you're stressed.

And then there are the siblings of SHOULD adding another load of stress:

I ought to...
I need to...
I have to...
I've got to...
I must...

In my conversations with caregivers, I sometimes will ask "Why?" when someone shares a caregiving activity that seems overwhelming. "Why do you drive to your Mom's house every Saturday (a total of 6 hours of driving)? Your brother lives two blocks away." Answer: "Because I just HAVE to!" said with a slight whine and a plea for understanding.

Caregivers, this is not a good enough answer. This answer has a ring of martyrdom to it. If this is your answer for your caregiving, a good question to ask is, "Why am I doing this? For my parent or for me? Why does even thinking about this caring activity get me so stressed? Why do I think I HAVE to?"

Don't become a martyr. Be a caregiver. For yourself first, then your spouse, your kids, your parent. In that order.

As soon as you hear yourself (aloud or in your mind) use SHOULD or its siblings, stop. Right there. And remember SLICK:

S = Is your parent's or someone else's Safety at risk if you don't do your SHOULD?
L = Is you parent's or someone else's Life at risk if you don't do your SHOULD?
I = Is your SHOULD Important to your parent's basic needs--meals, clothing, shelter, healthcare?
C = What are the Consequences (to your parent, to your state of mind, to your family) if you don't do your SHOULD right now? (You might be surprised at how small the consequences usually are!)
K = Can someone else--someone you Know or your parent Knows--do your SHOULD?

If you've answered Yes to any of the first three questions, then your SHOULD needs some priority and you can use C and K to decide how to fill that SHOULD. Putting some emotional energy and effort behind this SHOULD is probably a proper thing.

If you've answered No to all three SLI questions, then it's all right to take this concern out of the SHOULD bag and change your language to "I'd like to..." "I'd like to spend more time with Dad." "I'd like to get that grass cut over at Mom's house sometime in the next week." Just changing the language takes off the pressure. Again, use C and K to decide how this activity you'd like to do will fit into your schedule--or into someone else's.

Beware the SHOULD and its siblings. Ask, "Why do I feel I should...?" Remember SLICK. Change the language to "I'd like to...".

Don't let a minor SHOULD stress you out. Kick that bad guy to the curb. Save your energy for the SLI stuff in caregiving.

Did you get your mini-vacation today?

Should I Be Anxious?

2010-08-04T09:47:00.003-04:00

There are a LOT of statistics making the rounds of the Internet, some with no references to back-up the data, some reported by the American Institute of Stress and re-reported in ezine articles. One I've just read states that 75 - 90% of all doctor's visits are caused by stress-related illness. Headaches, high blood pressure, back pain, heartburn, ulcers--there can be a stress component to these and many more physical complaints. Even if only half the statistics are true, they are enough to tell us that stress, and the accompanying anxiety or anger, can affect our health, our mood, our lives.

We know that everyone has stress in their lives--caregivers have their own unique versions of stress--but the important factor is how we handle that stress, the anxiety, the anger.

In June 2010, ABC News did a report on anger management and Dr. Redford Williams from Duke University shared a 4-question check that you can take when you're feeling angry. I think it works just as well for anxiety. When you feel irritated or get that stomach-churning nervous feeling, ask yourself:

What situation is triggering this feeling? Is this an important situation? Is someone in danger? Is there some injustice happening? Is it important to my well-being?
Is it appropriate to be angry/anxious in this situation? Would my friends get angry in this situation? Would anyone feel anxious?
Is the situation modifiable? Can I change anything about what's happening?
Given the circumstances and possible consequences, is it worth it to do anything in this situation? Should I act on my anger/anxiety?

Pay close attention to Question 3. For caregivers, especially those of us who like to be in control, this is usually the most important question. In caregiving, we must often accept that we can not do anything in the current circumstance.

A "No" to any one of these questions, Dr. Williams says, means that the situation does not warrant intense emotion or action. Take a couple of deep breaths, remind yourself this is life with some frustration thrown in, use any mini-vacation techniques that work for you.

Four "Yes" answers, however, mean that this is probably a situation where your anger or anxiety is justified, and you should consider acting to change the situation.

I don't have many anger flare-ups, but I am a master of anxiety. I can get tied in knots about the smallest things. But when I use the 4-question check, I can objectively judge whether I need to be anxious about the situation or just LIB (Let it Be). Nine times out of ten, it's an LIB. For Number 10, I try to decide if I need to change or whether I need to influence the situation.

In caregiving, there are many opportunities for stirring the anxiety pot, but the 4-question check can help you calm that pot and realize that you can save your anxiety for another day.

Ah-h-h. That feels good!

Blessings on your caregiving.

Blow Some Bubbles

2010-07-29T16:04:00.003-04:00

For my mini-vacation today, I blew bubbles. Lots of shiny, floaty, pretty bubbles.

Last weekend, my husband and I celebrated a friend's wedding. I remember when the bride and groom were showered with rice as they left the church. Rice symbolizes fertility, wishing the couple prosperity in their marriage, and feeding the Evil Spirits so they'll stay away. Sometime in the 1990's American wedding parties began using alternatives, like confetti, popcorn, flower petals, or birdseed. Our friends arranged for each of us to get a tiny plastic bottle of bubble soap. As they walked from the church to the trolley car (another story), we showered them with bubbles.

Of course, we didn't use all our bubble soap at the wedding, so the bottles came home with us. And now, I'm putting them to good use for mini-vacations.

There is something very relaxing about creating bubbles with your own breath. It's a bit magical. There's this shiny film of liquid poised in the oval of plastic, dripping just a little, and then you gently blow. And a bounty of bubbles appear, floating in shiny abandon until they pop. Amazing.

You don't need to attend a wedding. You could buy some bubble solution at a store. But you can also make your own solution at home. You can become a bubble-blowing expert. Goodness, the possibilities are endless!

But as caregivers, we know that we probably don't have time to become a bona fide bubble-blowing expert. At least not right now. But we can dunk our little ring in bubble solution and blow. Imagine some of your troubles popping into oblivion. Imagine your wishes, hopes and prayers rising into the universe. Just watch the play of light over the bubbles.

Bubbles make great mini-vacations. All you have to do is...blow.

Blessings on your caregiving day!

Staycations

2010-07-20T12:01:00.005-04:00

"Staycation" A noun. Created in the early 2000's. Similar to a vacation, except the activities are done close to home. Or in the backyard. Or on the couch. ~LaVerne's Kinda Informal Dictionary

I like this new word that the media created not long after the financial crisis hit. It says that we can take time off, and we don't have to hassle with packing or airline security or finding a place for the pet. Don't misunderstand. I cherish my time out of town. I work from home, so if I don't get out of town regularly, I have a bit of an emotional meltdown. Just ask my husband!

But there are times when getting the heck out of town doesn't work. Like last summer, when my husband was in school and keeping up with his Dad's care, and I was knee deep in a major project for a client. We weren't going anywhere. But we could plan regular staycations.

Make a list of all the things you usually do on vacation. Go out to eat. Play miniature golf. Or 18-holes of golf. Swim. Read a popular fiction novel. Watch a marathon of a favorite TV show. Go to the movies. Whatever.

Now plan to do all these things. Maybe in one week (now there's some serious down time!), or a long weekend. Maybe one activity a week for a couple of months.

It is summertime, and staycations may include the family, but not necessarily. Fall is coming. The kids are going back to school. While you're planning for the family's Fall schedule, don't forget you. Plan regular staycations for yourself. You'll have something to look forward to all the time. And that can really lift your spirits when the caregiving gets rough.

Staycation! It's a word whose time has come.

Blessings on your caregiving--and your staycations!

Be a Tourist

2010-07-13T14:03:00.004-04:00

I was off last week, taking my own gift-of-the-month. We drove to Wrightsville Beach in North Carolina for a few days, not too far from our home, and the trip reminded me of an easy way to plan for a brief break close to home.

Play tourist, right where you live.

Go to the library, bookstore or AAA office (if you're a member) and get a tourbook for your state or local area. Check out your state's tourism bureau on the web and look for tourist maps in grocery stores. I found a map of North Carolina Civil War sites that makes a good resource for small trips around the area. I picked up a great book in the bookstore called "Day Trips from Raleigh-Durham" and I requested a copy of the AAA tourbook that covers North Carolina. When I'm planning a couple of hours for a local holiday, I look through these books for the tourist attractions--museums, parks, shopping centers, historic sites, craft studios, buildings of local significance, and factory tours. In many tourbooks, the entry for an attraction will note how long a typical visit lasts. I pick what strikes my fancy and fits my schedule. Then I act like a tourist and visit.

In tourist mode, I've learned a lot about North Carolina and seen beautiful local scenery which I would never have known existed--all while giving myself time away from the normal stresses of life.

These local mini-trips are low-cost, save gas, and help the local economy. It's all good.

Take care of yourself today. Be a tourist.

Blessings on your caregiving!

Dying To Care

2010-06-29T16:48:00.006-04:00

My usual intent here at 20 Mini-Vacations is to be up-beat and encouraging. Today I'm going to get serious and give you a sobering fact.

You may be dying to care.

Right now.

Shelly Webb at The Intentional Caregiver says in her June Newsletter "It's been said that almost 50% of caregivers die BEFORE the person for whom they are caring." Fifty percent. Count 'em, that's HALF! In his keynote presentation at the Raleigh Triangle Caregivers Conference Dr. Jamie Huysen confirmed this statistical fact with research to back it up.

Half of the 80 million family caregivers out there (Dr. Jamie's number) will die before their elder.

Why?

Because we caregivers do not take care of ourselves as well as we should.
Because we come up with every excuse we can think of to avoid taking a break.
Because we let guilt instead of common sense be our guide.
Because we don't think we're important enough to give ourselves even mini-vacations.
Because we don't trust anyone else to help, to care our way, to care the correct way.

Any of this resonate?

Dr. Jamie told his audience that caregivers who do not take care of themselves, who do not find time to laugh and play, who are in the caregiving role 24/7, who do not use every supporting resource available--these caregivers can become victims of post-traumatic stress disorder. Yes, PTSD, the disorder by soldiers in war. Or these caregivers develop PTSD's milder, yet still disabling, cousin: Compassion Fatigue.

The good news? Early Death, PTSD, Compassion Fatigue. These are all PREVENTABLE.

All you need to do is to give yourself the same consideration that you give your ailing parent, your spouse, your children, your volunteer group, your pet. Put yourself at the top of your Care List.

Every day, among all the things you do for someone else, do at least one thing for yourself.

Every day. Without fail.

Then, you'll be Living to Care.

POD: Take A Class

2010-06-23T07:35:00.004-04:00

I exhibited at the Triangle Caregivers Conference yesterday in Raleigh, NC, and in addition to the sessions on the business of caregiving and dementia care, there was a whole track of sessions on Self-care--exactly what we talk about here at 20 Mini-Vacations. My table neighbor in the exhibit hall was a gentleman from a wellness center that offers yoga classes, and that led me to this post.

A one-hour session of yoga with an experienced instructor is a great Pause-of-the-Day, and attending twice a week provides even more physical and psychological benefits. If yoga is not for you (I'm a Tai Chi person myself), then choose another physical activity where there is movement, interaction with people other than your elder or care team, and the chance to work off tension.

If you already have an exercise routine in place that works for you, consider one class in some area you'd like to explore--learn a language, woodworking, try out a new computer program, explore history, take up pottery creation. The important part is to remove yourself from the "caring environment"--in which, by the way, you are not personally receiving much care--and place yourself in a stimulating, distracting, and pleasurable environment where you get real relief and satisfaction.

Where do you find classes, even free or low cost? Check out the local university or community college; the city or county recreation and education departments; the newspaper; public bulletin boards at the library, shopping center, or market; ask your friends. Once you are tuned to this low-key search, you'll begin noticing POD class opportunities.

Have you taken your mini-vacation today? If not, right now is a great time.

Blessings on your caring--for YOU!

Power Tools Course

2010-06-15T13:38:00.007-04:00

I have been impressed by the number of conferences and classes that exist to help caregivers find resources for their aging elders and care tools for ailing seniors to live more independently. There are fewer opportunities for caregivers to learn to care for themselves.

One of the classes that does focus on the caregiver's needs is "Powerful Tools for Caregivers". This class is a six-week educational program developed by Legacy Health System's Caregiver Services and provides family caregivers with the skills and confidence to better care for themselves while caring for someone with a chronic illness. Class members receive The Caregiver Helpbook as a take-home reference. Legacy Health reports that many class participants have fewer feelings of anger, guilt and depression and increased confidence in coping with the demands of caregiving. After attending you're also more likely to use community services that can help ease your burden. It's all good.

The topics covered during the program are:

Taking Care of You;
Identifying and Reducing Personal Stress;
Communicating Feelings, Needs, and Concerns;
Communicating in Challenging Situations;
Learning From Our Emotions; and
Mastering Caregiving Decisions.

The wonderful news is that many local councils, support groups and organizations are now arranging for this course to be offered around the country. Check with your local AARP chapter, Area Agency on Aging, caregiver support group or on the Internet to find out if there will be a class offered in your area. The course fee is small--usually between $10 and $25 for six weeks--but no one is turned away because of cost.

This is a great opportunity to learn some techniques for coping with stress, become more confident and find better balance in your life. If you learn of a session near you, I encourage you to attend.

Blessings on your caregiving day!

GOTM: Go Train a Dragon

2010-05-18T18:50:00.003-04:00

For my birthday at the end of April, I saw one of the best movies to consider for a Gift-of-the-Month--"How To Train Your Dragon". Now, I do realize that this movie has moved to second tier movie theaters by now, but if it is still in the theaters, go now! What a wonderful getaway to a far away place with a heartwarming, sophisticated tale of a young man's discovery of his full potential. It's in 3-D, but we saw it without the 3-D effect and it was still a visual delight and fun to experience. And we didn't even need to borrow children to take with us; there were plenty of unaccompanied grown-ups in the audience.

That's what a GOTM is all about. Floating in another world outside reality for a few hours. Movies are a great way to immerse yourself in an enjoyable experience and let the everyday cares go for just a while.

Don't forget the movie alternatives: renting a DVD, movies on demand on cable, movies by mail, movies on computer. If you can't make it to the theater, use an in-home alternative. But remember, your choice of film and no interruptions (turn down the lights and turn off the cell phone, just like you were in the theater!).

Have you planned your GOTM yet for May? What did you do? Was it relaxing enough to encourage you to plan for another? If you've let the month slip by, don't worry. Plan for June. It's the begnning of the summer movie season, so lots of good films arriving weekly. Check them out.

The Need a Smile Folder

2010-05-06T13:30:00.003-04:00

I had a wonderful time at the Golden Jubilee exhibition yesterday and encourage all of you again to explore the conferences and exhibits in your local area. Often your local Office on Aging or the Area Agency on Aging will have information about local meetings where eldercare providers show off their services and where you can gather information.

While I was away, I received an e-mail from my sister which contained a half-dozen cartoons featuring Maxine, the crusty senior citizen who tells it like it is and makes me laugh out loud. It was one of my mini-vacations for the day--and a delightful one. I immediately saved that e-mail in a folder called "Need a Smile?". There are about 20 e-mails stored there, some funny, some inspirational, all sent by friends near and far who were thinking of me and sent me their good wishes. I do receive humor that doesn't make me laugh and some inspirational pieces that are too sappy for my taste, so I save only the "best" (my personal judgment) in the Need a Smile folder.

I know of other people who do the same thing in paper by cutting out articles and cartoons from magazines or newspapers and keeping them handy when life feels particularly rough. It only takes one or two of these to make the day a little brighter.

If you don't have a Need a Smile folder, start one today. Electronic, paper or both. Then when you need that mini-vacation, you have a good laugh or inspiration right there.

Blessings on your caregiving!

GOTM: Local Conferences

2010-05-01T10:26:00.003-04:00

Last year around this time, I encouraged you to check out the caregivers conferences and workshops in your area (Caregivers Conferences). Although these conferences do focus on eldercare, they let you "get away" for a few hours to plan, think and absorb new information in a new environment. So I class these as a Gift-of-the-Month.

In the Triangle area of North Carolina, we're blessed to have several conferences throughout the year. I've been extra busy this week preparing to meet some of you at the:

Golden Jubilee
Date: Wednesday, May 5, 2010
Time: 9AM - 1PM
Where: Jim Graham Building, NC Fairgrounds, Raleigh, NC
Sponsored by : Resources for Seniors

AARP has a powerful workshop called Prepare To Care (contact your local AARP chapter for times and locations); and the Triangle Caregivers Conference will be held on Tuesday June 22, 2010. And check out the Alzheimer's Association for their workshops and booklets.

Join me at the Jubilee.

Blessings on your caregiving!

Gift-of-the-Month

2010-04-22T13:18:00.003-04:00

As a caregiver, you've got your Mini-vacations and your Pauses-of-the-Day. Now let's talk about GOTM, the Gift-of-the-Month. This is a break of at least 3 hours, half a day or more, to do something fun, something for yourself. I call this the Gift-of-the-Month, but if you can arrange a morning or an afternoon off during each week, take the opportunity.

A GOTM is an extended breather, time completely away from caregiving.

I do realize that as a caregiver, when you can arrange several hours away, your first thought is to "catch up". There are errands to run, maybe a seminar to attend that will increase your knowledge of your parent's condition and the resources available to you, household tasks you've let fall behind. And if finishing a list of errands relieves your spirit, there's nothing wrong with that.

Just remember the fortifying power of a GOTM that is a complete gift. A gift to you. For you. For no one else.

Remember this the next time someone asks, "Can I help?" or "Can I do anything for you?" or "What would you like for your birthday?"

Be prepared to say, "I'd like you to help me take an afternoon (or a day) off."

Right now, brainstorm a little about what you could do if you had several hours or a full day free. Then you can ask for help in arranging that time off. In the next few posts, we'll talk more about what might be part of those gifted hours.

Blessings on your caregiving!

Long Distance Comfort

2010-04-20T14:27:00.004-04:00

I've been out of town on a business trip, and the week away reminded me of the trips I made back to my hometown while caring for my Mom. Long-distance caregiving is defined as living over 30 minutes away from the elder who needs care. This definition is a practical one. If you spend 30 minutes driving to and from your parent's place and spend an hour or two handling the current situation or visiting, you have spent the morning or afternoon in caregiving. You will have to arrange to be away from your job or find childcare during that time.

Today I'd like to talk to those of you whose parents live a day's drive away or more. In your case, a daytrip is not possible. Your visits may mean at least a weekend or more.

There are many aspects of longer-distance eldercare that are worrisome and difficult, but one of the most unsettling things is that, for bursts of time, you will be traveling and living in a place that is unfamiliar—your parent’s home (which is no longer yours), a relative's apartment, a hotel room. You will be without the surroundings that give you comfort. Your spouse, life partner or children may or may not be able to go with you, so another part of your support is missing.

These times away from home will be stressful. Don’t add to the stress by cutting yourself off from everything that makes you smile and feel comfortable. You are doing your best for your parent. Plan for Mini-vacations and Pauses-of-the-Day. Pack a bit of home to take with you. Think about where you'll be staying and what will give you most pleasure. Consider...

Tapes, downloads or CD’s of your favorite music. Don’t forget to bring along a player if your parent doesn't have one.
Keep your cell phone with you, even if you turn it off. Make sure you have the phone numbers of your best friends on speed dial in case you need some long-distance hugs.
Plan on watching that favorite ball game or sports event on TV.
Bring your favorite pajamas, robe or quilt, something to relax in after a stressful day.
Bring a stuffed animal (this is no time to be shy about Fluffy!).
To move your whole body, pack walking or exercise clothes and shoes.
If cooking or baking relaxes you, bring your favorite recipes to cook or bake your favorite foods.
Pack your personal journal to let out those pent up emotions.
Bring your favorite books--in paper, electronic reader, or tape.
If this is a visit of longer than a weekend, plan to do one favorite thing while you’re there—take in a movie, golf, visit a museum.
DVD's of movies or TV shows slip easily into luggage. Bring something that will make you laugh or escape into a fictional world. Don't forget a player.
Bring bubble bath, favorite cologne, scented candles, a picture of your significant other.
For longer stays, consider bringing your pet if the situation will not be unsuitable or tax you further.
Bring your favorite coffee, tea, soda pop, foods. Your own brand of coffee in the morning can brighten the day.

You have the idea. Pack up your comfort and take it with you.

Blessings on your caregiving!

Move Your Whole Body

2010-04-08T10:02:00.003-04:00

There's a Curves gym a short walk from my house, and I just got back from a good, relaxing workout. I have to admit that words like "exercise", "workout" and "gym" bring to mind images of a roomful of sweaty people who look determined but not very happy. I've tried to change my mind set to "move your whole body" every day.

For a Mini-vacation that may mean walking up and down the stairs 3 times or doing knee lifts for 1 minute; for a Pause of the Day, that may mean a walk around the block (twice if you have little blocks) or mopping the kitchen floor.

Yesterday, "move your whole body" meant transferring winter clothes from the master bedroom into another bedroom closet and moving the spring/summer clothes in. It took 30 minutes of hauling clothes from one room to another and folding things into drawers. Talk about your weight training, cardio, and stretching!

Other days, it means Tai Chi or an exercise video or calisthenics chosen from a FitDeck. Some days I take two breaks--one to vacuum the downstairs, another to vacuum the upstairs.

My aunt doesn't run through the commercials on her recorded TV shows. During the commercials, she gets up and walks around room. For an hour show, there's 15 minutes of movement without even trying hard. Chasing your dog, chasing your children, chasing your spouse (Ooh La La!). All these count.

If your parent is wheelchair-bound and taking her out for a roll would give you both pleasure, then go ahead.

You don't have to think "sport" or "workout". Just think "Get up off my backside and move my whole body." And make sure that PLEASURE is a key component of the experience.

Take some time right now. What activities can you identify that are not sports or traditional exercise, but that allow you to move? What do you already have available to you (videos, a gym close by, a jump rope, catchy music with a beat) that you can have on hand for a Mini-vacation or POD? What types of movement do you enjoy or that complete a chore you'd like to finish?

Blessings on your movement...and your caregiving!

Express Your Thoughts and Feelings in Writing

2010-04-06T15:32:00.004-04:00

Friends and family can be great listeners, and we take full advantage of their gift to share our troubles and our joys, to work out a particular issue, to discuss options, or to get a hug or a smile of encouragement.

For some hurts, for some emotions, at some times in our lives, sharing verbally does not make the grade. Talking is speedy, impermanent. Spoken words lift into the air like feathers or bullets; most go unattended; some drop like rocks on the people we love. Texting has even more quickness about it, and no time for real depth and introspection.

Writing, on the other hand, is an activity that engages your mind, all your senses, and is physical. Writing is the safest way I know to pour out everything. I've written things, confessed things in my journal that I could not reveal to anyone, even to my psychological counselors.

And that is the first requirement of a writing space...privacy and safety. I know that many people like to journal on their computer or PDA, and that is certainly the way to go if it allows you the privacy to express your deepest emotions.

I truly prefer writing by hand. It's slower, gives you ample time for thought without the blinking cursor pulsing with the message to "Get on with it, why don't you!". And my computer actually hums at a low pitch while it blinks at me. Handwriting is blessedly silent, quiet, unassuming.

Handwriting has a sensual component (sensual meaning that it engages many of your senses). You can choose a pen, or several; choose an ink color; choose a pencil; choose which type or size of paper or journal or notebook you'd like to use. A composition book or writing journal, lined paper or unlined, decorated or not, thick cotton paper or thin onion skin--all add to the experience, the intimacy, the comfort. If you're using a notebook, you can add in articles you've read or pictures that speak to you.

A paper book is very portable and does not rely on a battery or plug. PDA's are portable, too, so it's all about what feels right for you.

Handwriting lends itself to a flow of consciousness style. With handwriting, you're less likely to edit as you go. You just write. Doesn't matter that it's not grammatically correct. It doesn't matter if you curse or rail away at the Fates. The journal is for you. The writing is for you. No one else will read it (unless you want them to).

And my very favorite reason for a paper journal...you can write 24/7. No one else clamoring for the computer. No need to boot up equipment and get sucked into social networking or e-mail. Open the journal or slip out a piece of paper, grab a pen...and write.

My journaling time is usually 3AM. There's something about that hour that wakes me when I'm under stress. The only way to calm my racing thoughts and express my emotions and deepest longings is to journal by hand. The soft light of a candle or one table lamp by my side. Me, curled on the couch or the window seat. Writing everything that flows through my mind until I feel the words slow down and finally stop. When the writing flow finishes, I can sleep.

I return to my late-night writings every so often. They tell me how much I've grown, how far I've come. They remind me that I have survived other crises, revelled in other joys...and so I shall again.

A post from the Productivity 501 blog, Using Different Parts of Your Brain, says that research discovered that different parts of your brain are activated depending on whether you write by hand or on computer. And the difference is more than what can be accounted for by the different motor activities. This finding argues for using both methods to tap into your healing and expressive potential. Thinking of that and my own preferences, I do use computer journaling tools for some sharing and handwriting for others.

But it has been with pen and paper that my most intense inner work and emotional release have occurred.

Privacy, comfort, portability, engaging the senses, reviewing your progress--all of these enhance your journaling experience. But no matter how you choose to express yourself in writing, take time daily. It's a perfect Pause of the Day.

Blessings on your caregiving!

Work With Your Hands

2010-04-01T19:58:00.007-04:00

Many of the activities that you do as a caregiver are mentally exhausting. Doing your parent's taxes, trying to figure out a new way to encourage your mom to eat, reading up on treatment for your father's condition, arranging for care--all of these tax your brain. And the emotional stress adds another level of tiredness that seems to seep down to your bones.

One way to dispel that mental fatigue is a Pause of the Day (POD)--15 to 30 minutes--doing something with your hands, focusing on their movement, not on the present problem you're resolving. Choosing that "something" does take a little planning (yes, I know, more thought...but big payoff!).

The something should be:

An activity that you can do for a short time, put down and pick up tomorrow or next week without missing a beat.
An activity that is active. Your hands--better yet your whole body--are involved.
An activity that requires you to pay attention to what you're doing, either to avoid injury or to produce good results.

Let's just brainstorm for a moment. Knitting, crocheting, needlework, sewing, staining furniture, trimming bushes, weeding the garden, building models, creating stained glass light catchers, weaving, pottery, washing dishes by hand, checking the smoke detectors, dusting, sweeping, mending a sail, filling the birdfeeders...

What we're listing here is a mixture of hobbies and light household tasks. We've always labeled hobbies as "enjoyable", but we can also reframe household "chores" into household "pauses". I actually enjoy making the beds. I like the way each bed looks after I've smoothed the bedspread down and plumped the pillows. So I leave that pause until later in the day, take my time with it, and enjoy the result. I hate gardening, so pulling weeds for 15 minutes does absolutely nothing positive for my attitude, but you may find it's just the thing to put a pesky problem into perspective (lovely alliteration, LaVerne!).

As I noted, you may need to plan just a bit. If you want to work on refinishing furniture or on a sewing project that will span many "pauses", you'll need workspace that will be undisturbed until the next time you're ready for a pause. Because the lure of the activity may pull you into spending more time than you want to devote, set a timer. No need to add the frustration of overshooting your time limits to your day.

Pick an activity you like, set aside 15-30 minutes every day for enjoying that activity, set aside workspace if necessary and ... pause.

Blessings on your caregiving day!

Read an Enjoyable Book

2010-03-25T08:49:00.005-04:00

We've started to explore the Pause of the Day (POD), a longer break of 15 to 30 minutes during which you can redirect your attention from the cares of caregiving to something enjoyable, something for you.

You'll notice my suggestion is not a "good" book, because people often equate "good book" with high school reading lists and literature we should read. I'm advocating reading for enjoyment, not for instruction or learning. Of course, if reading a heavy tale of survival or a history text uplifts you, makes you feel good and generally lightens your spirit, then have at it. I'm a romance kind of a gal, usually mixed with science fiction, Jane Austen's world, mystery or fantasy. I read plenty of things that stimulate my mind, make me ponder, push me to think critically. For a POD, I need pleasure, emotion, the sigh of a happy ending, a reaffirmation of Goodness. What you're striving for in choosing a book is a lightening of your spirit, a release of emotion, a way to escape the real drama you face each day.

Once you've chosen a book, for your POD, read one chapter. Or set a timer and read for 30 minutes. Make a pact with yourself. No interruptions. Turn off the cell phone, go to a room where you can close the door, sit out on the porch with no company except nature. And enjoy!

Blessings on your caregiving today!

Yoga Care for Hands

2010-03-12T15:45:00.003-05:00

Here's a mini-vacation you give to your hands as well as to your spirit. You have, no doubt, heard of the different forms of Yoga that provide a full-body and mind stretching and strengthening. This month I was introduced to a form of Hand Yoga, and I share it with you as a way to take a break and soothe those tired muscles and tendons in your fingers, palms and wrists.

Warm-up. Begin by "washing" your hands (no water, no soap, just skin-to-skin), rubbing them together, making sure you gently rub each finger along its length. Count 20 seconds to make sure you've spent long enough. Get everything nice and warm. Then begin the exercise.

Step 1. Place your hands in a classic prayer or honor position--palms together, fingers together, all fingertips pointed to the sky. Make sure that your elbows stick out and press your palms lightly together.

Step 2. Keeping the heels of your hands together, slowly open your hands, starting at the top of your fingertips, slowly down your fingers, finally opening the palm. The heels of your hand are still pressed together and your hands form a "V", your fingers curved slighty backward so you feel a pleasant stretch. After a slow 3 count, bring your hands together again slowly, palms first, then fingers, then fingertips. You are now back to the beginning prayer position.

Step 3. Still keeping the insides of your hands together skin-to-skin, simply spread your fingers so that they resemble a lady's fan, held at a right angle to your body. Give yourself a nice, gentle stretch in this position. Elbows remain sticking out.

Step 4. With your fingers spread, open your hands again slowly, this time starting at the heel of the hand, separating palms next, then fingers, until only your fingertips are touching. Now your hands form an open-air, curved roof.

Step 5. Keep your fingertips touching while you pull all your fingertips together. With your fingertips all touching in the center, your hands form the infinity sign, a figure 8 on its side. Other images are two bird beaks touching, a pair of thick-rimmed glasses, or a mask.

Step 6. Keep your fingertips touching and move your hand back into the open-air, curved roof position of Step 4.

Step 7. Close the space between your hands so that they again form the Lady's Fan of Step 3. Bring your fingers together to return to the beginning prayer position.

Repeat Steps 2 through 7 three times slowly and deliberately. Keep those elbows sticking out. After the final repetition, gently flick your hands several times as if you were flicking water off them. You're done!

Hand Yoga positions, called Mudras, are varied, and a quick search of the Internet retrieved many hand positions that you can hold for relaxing and healing.

Here's to Happy Hands!

Pause of the Day (POD)

2010-03-09T18:41:00.003-05:00

Recently I've been focusing on mini-vacations and self-care, Caregivers, but don't forget to explore the other articles in this Blog. Look on the right-hand side under "Labels" to find articles on other topics of interest to caregivers. If there is something you've thought about but don't see it here, check the Parentcare 101 website, and if that doesn't work, contact me directly.

Now on to other ideas for talking a break. Mini-vacations are those short breathers (under 5 minutes) you take throughout the day. Mini-vacations are stop-and-smell-the-roses kind of breaks. A Pause of the Day (POD) is longer, perhaps 15-30 minutes in length, and you should try to schedule one of these once a day.

One of the easiest POD's is to choose a favorite half hour comedy show on television and make a point to watch it regularly. It has to be something that makes you grin widely, laugh out loud, giggle or hoot every time. "I Love Lucy" reruns, the Three Stooges, "The Daily Show", "Everybody Loves Raymond"--doesn't matter how goofy or if other people think it's "stupid". This is YOUR POD and if a show makes you laugh, it qualifies for POD status. Think video taping or DVR recording if the show is on at an inconvenient time. Think TV on DVD if the show now longer airs.

Pick your show, pick your time, sit down and have a good belly laugh. You'll feel much better. I promise.

Blessings on your caregiving!

The Mini-Vacation List

2010-03-04T08:41:00.006-05:00

So far, in our discovery of mini-vacations, we've talked about 8 different ways that you can take a short break throughout the day, whenever you need it. Eight ways means that you can try a different one each day for a week and see which one (or more) works best for you.

It's time to start a list.

Right now is a good time to jot down those mini-vacations that do work for you and keep that list handy. You may want to post it on your computer, in your PDA, on the refrigerator, in your parent's Care Log--all of the above and anywhere else that's easy to get to. Add to the list as you discover new ways to pause. Then when you need that break, you can whip out the list, look it over and choose a mini-vacation. Ah-h-h.

So far, here's the list:

Light a Candle
Take 3 Deep Breaths
Watch the Birdies Go Tweet!
Get a Hug
Is It Important?
Daily Calendar
Count Your Blessings
Consider the Empty Bowl

Have you found anything else that gives you a lift and helps you center yourself for the next task? Add it to the list.

And share it with us.

Blessings on your caregivng day!

Take 3 Deep Breaths

2010-03-03T17:48:00.004-05:00

You've heard people encourage one another, "Take a breath", meaning "stop a moment" or "don't run on so frantically." I say it frequently here as a reminder that we don't need to run headlong into activity. We're allowed to pause. That's what mini-vacations are all about.

Today's suggestion for a mini-vacation is a simple one. When life starts to pile up on you, take three deep breaths.

And I mean, "deep", from the belly, not from the throat, not from the chest. Breathe in through your nose and let your belly (that's right, where your belly button is) relax and expand. You women out there, don't worry about looking fat. You're doing this for your sanity. It doesn't take much time. You can suck in your tummy later. For now, let it expand and fill with air as you breathe in, slowly and steadily.

Then breathe out slowly and completely, through either your mouth or nose. The idea is to blow out all your tension with the air. Allow your shoulders and neck to relax as the breath pours out. Close your eyes if it will help you to expel the tension.

Concentrate on what you're doing, how you feel, how much tension is released, the point at which there's no more air to blow out.

Complete the breath.

Then repeat. Twice.

Now move on with your day. Doesn't that feel better?

Blessings on your caregiving!

Pause for a Reality Check

2010-02-25T20:09:00.004-05:00

As caregivers--and in our other life roles--we sometimes create drama around how important our activities are. We load up on anxiety believing that if we don't accomplish something immediately or don't act right now, the whole world will fall apart. At least our little corner of it. I find myself falling into that stress-anxiety cycle, and I'm not a primary caregiver at the moment.

How do we control that anxious reaction to our situation?

I saw a recent report of research that discovered that people can control their irritated and angry reactions by asking one simple question: How important is this?

I've used this question to explore the source of my own nervousness and anxiety, but I frame it more specifically: On my personal Importance Scale of 1 to 10, 10 being imminent injury or death, how close to 10 is this situation?

We throw out the phrase "a matter of life and death" without really thinking. "A matter of life and death" is when a surgeon calls a librarian (me) and says that he is operating on a child, and he has encountered an unexpected complication in surgery. He expected and is familiar with two things he sees in the operative field, but the third is not usual. He'd like to know (right now, please) if this third condition has ever been reported in the literature. Any information would be helpful. This qualifies for a 9 or 10 on the Importance Scale.

Today's reality is that I have overbooked my schedule, want to visit a friend recovering from surgery, plan to exhibit at a local conference tomorrow and realize I may not have a car. Yes, this is all stressful, but certainly down near 1 to 3 on the Importance Scale. My anxiety often comes from pride. I like to be in control, like to be on top of things. I feel that I'm really good at time management. But life has a way of grinning and going its own way. Time for that reality check.

When your own anxiety meter starts to ratchet up (Yes, you know what it feels like. Either the tense stomach, aching shoulders, squeezing headache, or some other physical sign that is your personal symptom), your mini-vacation should be a pause to ask

"How Important Is This?"

and then use the Importance Scale to get some perspective.

Most of the time, you'll recognize that what you're trying to accomplish or solve is not so critical. A little time, a bit of adjustment on your part, a shift of your perspective will resolve the issue or show you a different way to approach it.

One small question. One small caregiver victory.

Try it. Let us know if it works for you.

Happy mini-vacation!

Consider the Empty Bowl

2010-02-23T11:57:00.003-05:00

There is a story Sue Bender relates in her book “Everyday Sacred” of a monk who, each morning, takes his empty begging bowl in his hands and stands in the flow of crowds in the city. Whatever is put in the bowl that day—money, rice a bit of fruit—he uses for his nourishment. Each morning he begins again with an empty bowl, and each day he finds that he receives enough to live.

Each morning we are blessed with a new day. A new beginning. Whatever we did the day before, whatever decisions we made, are done. Finished. Can not be taken back.

But the new day provides the opportunity to do something new. To change the direction that we might have chosen yesterday. To begin again.

Move on. Move forward. Look back only to seek clues for how to move forward today.

Nothing is set in stone.

For each morning, you have an empty bowl.

For your mini-vacation, find a bowl in your house—any bowl. Something that reflects you. If you love to bake, perhaps a mixing bowl; if you cherish fine china, a piece from your favorite pattern; a cereal bowl that you use for breakfast. Place the bowl where you can see it and remind yourself that yesterday is past. You have an empty bowl into which to gather new gifts, new decisions, new challenges, new woes, new joys.

Maybe things are not going very well today. Mini-vacation!

Consider your empty bowl.

Remind yourself to do something different, to look at the problem from a new perspective, to seek out new advice.

Are you berating yourself for past decisions? Do you miss the present because you’re focused on the past? Can you not look at today with fresh eyes because of the past? Do you sit in judgment on yourself? Mini-vacation!

Consider your empty bowl.

Life gives you endless chances to make a new decision, change directions, take a breath. Life gives you an empty bowl.

Blessings on your caregiving day!

A Calendar a Day

2010-02-18T20:18:00.006-05:00

One of the best items ever created for lightening the day is the Page-a-Day calendar. And I will shamelessly co-opt these handy little helpers for our Mini-vacations.

You've seen them in gift shops, book displays, and of course in those shops in the mall devoted to calendars. They're usually a standard size, about 5" X 6", just enough to display nicely on your desk, workbench or kitchen counter. And they come in a variety of topics--jokes, games, languages, quotes, inspiration, tips, pets, puzzles, comics. I'm partial to the Scrabble(TM) calendar and Dilbert comics. But I've used ones for women who do too much and scripture verses. You really can't miss with these babies.

Now I know that there are many websites and electronic versions of these page-a-day calendars. I'll even share some good websites in the future. But there's something about having a calendar in paper (you can recycle!).

A daily paper calendar reminds you that yesterday has passed, you can't see tomorrow, so your best plan is to focus on today. Rip off a page. That's right, give it some attitude. Yesterday's gone. A new day!

It would be nice if our concerns and troubles could be solved just that easily, but at least with a page-a-day calendar, you take action to separate one day from another and give yourself a pat on the pack for getting through the day just past.

If you want to browse the possibilities, go to your favorite search engine and type in "daily calendars". Skip all the entries for the government calendars of daily activities. You have enough things in your life that will raise your blood pressure. Watching state or local government move ponderously forward will not help you lower it. There are several websites that specialize in paper calendars and there you can browse and get an idea of what might suit you.

Pictures and facts about dogs. Or cats. Or fish. Music. Inspiration. Favorite TV show. Dream Cars. Fact or Crap (this is real!). Golf. Sudoku.

This is something you choose totally for you.

It's not too late to start for 2010. Find a calendar. Rip a page every day. And take time out from your caregiving to take care of you.

Blessings to you!

Get a Hug...And Then Another

2010-02-16T17:20:00.004-05:00

A hug is an excellent mini-vacation. You connect with another living, breathing human being. A hug is warm and wonderfully supportive. A hug lets someone else care for you.

Mind you, hugs come in various varieties. So I am not advocating those wimpy embraces where a four-inch space separates you from your hug partner and everybody's elbows are poking out. Those kinds of hugs are hardly worth it. And avoid the vise-huggers. They believe that a good hug should squeeze the air out of you so you're gasping for breath and wondering how your nose got smashed against their chest.

No, my fellow caregivers, find people who will let you wrap yourself around them, move in close and hug you like they care deeply for you. You need an embrace long enough to allow time to sink into the comfort of warmth and strength. You need to feel supported, not smothered or afraid that the other person will break. Think about the child who jumps into your arms with no inhibitions, and wraps herself around you. Truly, that's the kind of hug that gives you the connection you need.

If you're short on people, a pet can offer good hug potential. Same principles apply. Goldfish? Not a good hug. Too slippery. Gerbils? Too small. Cow? Now there is some possibility if you like cows. I'm partial to dogs, but a good llama can work, too.

But really, folks, there is nothing like the hug of a spouse, a child, a friend, a family member who wraps you in love and care. Just walk right up to one of these special people and say, "I need a hug."

Nothing wrong with asking for what you really need.

Get a hug (or two or twelve) today!

Light a Candle

2010-02-11T09:15:00.003-05:00

It's winter right now in the Northern Hemisphere and that means short days, skies of slate gray, piles of snow at times, and the tension of cabin fever crawling up your spine.

It's a time for candles.

There's a reason why February 2--in addition to being Groundhog Day, a Quarter day in the solstice calendar and a Roman festival to Pan--was called CANDLEMAS in the Christian calendar. Well, all right. The Christians took over Pan's festival and transformed the torch-lit street festivities into a more sedate candle-lit procession. They both had the right idea. In the darker days of winter, Let There Be Light! And lots of it.

You can celebrate, too, with a Candle Mini-Vacation. Any candle will do. Tiny little tea light; big, fat 3-wick; slender taper. You pick the size, the color, the scent. Put it in a safe place (out of reach of children, pets, ailing elders and wayward spouses) where you can see it. Take a deep breath...and light it.

And watch.

Notice the color of the flame. Does the flame flicker as the furnace kicks up a gentle current? Is the flame unmoving in stillness? Catch a whiff of the candle's scent or the lingering burnt tang in the air. Clear your mind of all that is pressing in at the moment and just enjoy the soothing simplicity of the candle.

Leave it burning for a while, or blow it out. Light it again later.

Until the candle has melted down to a puddle or burned away to nothing, you have instant mini-vacation. I'm heading to my matches and my cafe-au-lait pillar candle right now.

Blessings on your caregiving day!

Watch the Little Birdies Go Tweet!

2010-02-09T14:49:00.004-05:00

I'm not talking about the tweeting on Twitter or the cartoon Tweety Bird (even though she's a favorite!). I'm talking about watching our feathered friends who hop around on our lawns, across our decks and perhaps in our indoor cages. Taking a few minutes to observe the birds flit about, scrounge for food and just sit there can be very relaxing and can remind you of the whole of nature that exists and continues to thrive right beside your current situation.

There are lots of ways to watch birds. And just as Your Situation is Unique in caregiving (Care Tip #3 in Caring for a Distant Parent), your bird watching opportunities right where you live will also be unique.

1) The easiest way to watch is to take a little time to observe the surroundings right around your home or apartment. Where do birds congregate within sight? What time of the day do they appear (birds do have rhythm!). Then when you need a mini-vacation, be at the window or on the porch at that time and watch for a few minutes.

2) Draw the birds in closer. Go to the local hardware store and buy a small bag of "all purpose" birdseed, usually the store brand. It's inexpensive and several bird families like that seed. Scatter the seed where you'd like the birds to appear. If you scatter, they will come.

3) Get formal and buy a window-mounted bird feeder. These come in small sizes or in the large economy sizes, but the point is that you will hang your feeder on any window--somewhere you can easily and safely refill the feeder--fill it with that all purpose seed and see who shows up for lunch.

4) Get crazy and buy a whole set of feeders with pole systems and hanging hooks and suet feeders and nut feeders and ones that look like lighthouses and others made from copper that shine in the sun and...

Sorry, I've got a small deck system that holds 4 feeders and I participate in the winter Feederwatch for Cornell University, so I'm just a little crazy.

5) Or go indoor crazy, do some research on birds that do well in cages and buy a pair to live in your home with you and provide endless mini-vacation possibilities.

Birds reside everywhere that we do. (In big cities, the birds are called "urban birds". So sheek.) So go to your window. Walk out on your balcony. Hang a feeder. Scatter some seed. See what kind of feathery beauty appears. Smile at the antics. Scold the birds for arguing over a sunflower seed. Share your troubles.

Just lovin' these mini-vacations.

Blessings on your caregiving day!

Count Your Blessings!

2010-02-04T17:32:00.002-05:00

Have you taken a mini-vacation today? If not, this is the time. Right now.

Close your eyes and let your mind wander over the last 24 hours. Pick out something positive that happened, something a little surprising, something a bit wonderful.

Was a co-worker especially effective? How about that smile from a friend? Did someone at the grocery let you in front of them? A good show on TV, a hug from your child, the warm sun on your face, sparkling snowfall.

Can you remember at least one good thing that happened during the day? Picture it in your mind. Savor it. Remember it with a smile. If you had more than one good thing happen, take some time with each event to remind yourself that all is not stress and tasks and caregiving.

Take a deep breath and let it slowly out.

Open your eyes.

Better?

Put this in your basket of mini-vacations to take out and enjoy anytime.

Remember, life gives us blessings every day if we only take time to look.

Blessings on your caregiving day!

What's a Mini-Vacation?

2010-02-02T19:14:00.005-05:00

A Mini-Vacation is a brief count of moments to stop and smell the roses--literally or figuratively.

In the midst of caring, while facing the challenges of parenting, employment, eldercare, and living, we often become so enveloped in the “have to’s” and the “musts” that we forget to breathe. We don’t look up and notice that the sky is clear blue or that our children have just made a marvelous discovery or that the snow sparkles like glitter or that our spouse is looking particularly good that day.

Caring for elderly parents is not a sprint, but a marathon, and as a caregiver, you need to find the right caring pace that will allow you to thrive during the journey over weeks, months and perhaps years.

The most powerful technique I learned and used during my caregiving experience was one I learned from one of my spiritual teachers, the late Sister José Hobday, an American Indian nun who lived in New Mexico. She taught that the quality of experience we foster in our lives will ultimately give us more joy and peace than the quantity of tasks or things we do. She recommended a simple daily practice:

Take 20 mini-vacations a day.

Throughout the day, take regular micro-breaks in your routine to focus on something pleasant. All you need is a few seconds or a few minutes and your focused attention. When you shift your attention from your current concerns to something you truly enjoy, you briefly release your mind, body and spirit from stress and clear them to continue with renewed energy.

In her teachings, Sister Hobday encourages 20 of these breaks a day. That averages out to about two every waking hour. What does this mean? It means that as we look toward the future in our caregiving role, we don't have to see endless stress and tasks before us. We learn to divide our tasks for others into short bursts of activity interwoven with time for ourselves.

Mini-vacations may take a small amount of planning, especially if you wish to have pictures or music readily available. But for the most part, just look up, notice the world around you, move around in it a little. There are endless opportunities for a break in your routine.

Twice a week in this blog, we'll be sharing ideas for mini-vacations and reminding each other to take a break, take a breath, and care for ourselves.

Blessings on your caregiving day!

Returning to the "New" Blog

2010-01-28T10:04:00.004-05:00

It's been a busy four months since I last posted, and I've missed my time out here in the Blog-o-sphere with you. I'm happy to announce that an updated version of my current work CARING FOR A DISTANT PARENT will be available during the next month. I'll let you know when that arrives.

I've also been working with my website provider to re-invent my website Parentcare 101, and that will launch in the next month, also.

I've spent a lot of time out and about, talking to caregivers like you at conferences and presentations, answering questions you've asked through the website, and considering how this blog can best help you.

The Parentcare 101 website provides the resources and links you need to help your parents. Time and time again, however, caregivers have shared that they feel overwhelmed and routinely forget to care for themselves. I'd like to let this blog be a reminder that if you don't take care of yourself, you cannot care for your parent.

So first and foremost, this blog will be a place to find ideas for daily mini-vacations and ways to take a break and take a breath. I'll occasionally revisit some topics on helping your parent, but I'll focus on those little ways that help caregivers thrive in this marathon we call caregiving.

Join me here every Tuesday and Thursday!

Blessings on your caring!

A Break for Writing

2009-08-23T18:43:00.002-04:00

A look at my calendar tells me that I've scheduled a revised edition of my book, "Caring for A Distant Parent", to be published in October 2009. So I'm taking some time off from this Blog to work on that revision.

I'll be back with you later this year. Please continue to direct questions that you have to me and visit the Parentcare 101 website often for resources, organizational contacts, and Healthy Chocolate.

Until then, Blessings on your caregiving!

Advance Medical Directives--Resources

2009-08-17T18:17:00.012-04:00

When I decided to write about Advance Medical Directives (AMD), I had not foreseen that this topic would be a centerpiece of the current public debate about health care reform. All the talk in the news, on blogs, and in town-hall meetings whether invoking the myth (not reality) of government "death panels" or debating the merits of insurer-paid consulting for end-of-life decisions--all this talk is about what we have been discussing over the last few posts.

Advance Medical Directives. A statement of what procedures and health care you would like if you are unable to physically express your preferences. As I've said before, these decisions are numerous and can be complicated. I've recommended that you consult all the resources available, such as a doctor, social worker or an eldercare attorney to help you decide what will be best. If your insurance coverage will pay for such consultation, all the better.

Let's look at some final subjects concerning the AMD.

Special Issues
• Both Your Parents Are Alive
If both your parents are still alive, it is possible that each of them, independently, may have written a Will and Advance Directives, but have never discussed these documents with each other, let alone with you. You may have to speak with each parent separately to discover where the documents are and their content.

• Second Marriages; Blended Families
The same communication caution applies if one or both of your parents have entered into second marriages.

There may be communication barriers because you are related to only one of the couple. Your stepbrothers and stepsisters may face the same barriers with your parent.
If there is some evidence that your parent and her spouse have prepared separate documents, it may be best to talk with each parent away from the other so that you can learn the truth about the documentation, not what your parent told his or her spouse.

• The Directives and Other Documents

The Advance Medical Directives are always written in a document separate from a Will or a Durable Power of Attorney. The Directives may be attached to these other documents or the other documents may refer to them. The Advance Medical Directives may stand alone.
A Will may be drawn up for a couple or for an individual. Advance Medical Directives, however, are always written for the individual. A Will for a married couple would then refer to two Directives.
A Durable Power of Attorney is drawn up only for an individual, so it will refer to only one Advance Medical Directives statement.

Suggestions
Talking about the end of life is a difficult subject. In our society, we have been taught to fear death. However, death is a natural and inevitable part of life. In fact, it is the last rite of passage.

Keep the Advance Medical Directives in mind as your parent ages. Express your wishes. This may encourage him to express his own choices.
• If your parent is reluctant to be specific about his wishes, prepare your own statement and share it with him.
• If your parent is making out a will or trust, ask if Advance Directives will be part of it. Ask to see the final document.
• Remind your parent that Advance Directives are for her benefit, as well as yours. Whom would she choose to make such decisions if she can’t--a stranger? Or will she retain some control over the process by expressing her choices now?

Finally, if your parent refuses to discuss this and has not written any statement of Advance Directives, continue to seek out information. Conversations with your parent’s contacts, though difficult, may give you a hint of how your parent feels. Realize that your parent’s reluctance may come from deep sources of fear or discomfort of which you are unaware. Be firm, but not stubborn; be gentle and loving, but persistent in the face of her humanity.

To Read More
Laurence, Michael J. A Matter of Life and Death: Informed Advance Health Care Directives. Booklocker.com, Inc. 2007.

Schneiderman, Lawrence J. Embracing Our Mortality: Hard Choices in an Age of Medical Miracles. Oxford University Press, 2008.

“Advance Directives for Health Care Decision Making”. Tennessee.gov, Department of Health, Advance Directives. Accessed 8/17/2009.
Compares Advance Directives with Living Wills and Power of Attorney.

Aetna/InteliHealth Web Site. Under “Your Health” click on “More” > “Caregiving” > “Caring for Seniors” > See articles on End-of-Life Decision-Making and Living Wills. Accessed 8/17/2009.

Advance Medical Directives - 2

2009-08-12T09:08:00.004-04:00

Hello, Readers!
I'm back from a short break. I spent some time at the North Carolina Outer Banks, a great place to watch the ocean and regain perspective on what's important in life. Hope you all had a good week.

In my last regular post, we began to discuss the Advance Medical Directives document. We talked about the types of decisions that you might be called upon to make, and the importance of knowing what each procedure stated in the Directives involves. Let's look at some other things to keep in mind for the Directives.

Forms for an Advance Directives Statement
The following sources will have forms available. Contact any one of these:
• A lawyer; particularly one specializing in elder law (see July's post on Eldercare Attorneys)
• The social worker at a hospital, hospice, home health agency, nursing home, or long-term care facility;
• The Attorney General’s Office in the state where your parent lives; or
• Caring Connections, a website created by the National Hospice and Palliative Care Organization (NHPCO), a national consumer and community engagement initiative to improve care at the end of life.

The Spiritual Side
In caregiving, especially in long-distance caring, there is a possibility that you, or your family, may not be with your parent at the end. Although not part of the standard wording, you may want to add a statement in the Advance Directives about honoring a person’s religious practices—calling a minister, rabbi, imam or priest, arranging for rituals that might bring comfort to your parent. The Directives are reviewed by health care staff regularly, and the staff will try to follow any reasonable request.

The Directives In Use
You must be an advocate for your parent’s wishes, whether you live close or far away.
• If your parent is admitted to a health care facility, request that the Advance Directives be filed on the top of your parent’s medical records chart. This will mean that every time a nurse or doctor looks at the chart, he will see your parent’s wishes first. When you visit the facility, check that your request has been fulfilled to your satisfaction.
• Make sure that the facility personnel understand your parent’s wishes. Speak personally with every member of your parent’s health care team.
• Every time a new doctor (usually a specialist) enters the treatment process for your parent, reiterate your parent’s wishes verbally and note that the Advance Directives are with the medical chart.
• Check your state's regulations or ask your parent's doctor. Some states require that the physician call the caregiver regularly to ask about Directives. In some states, this call must be made even at the time of intervention, such as before administering CPR.

In a crisis situation, the doctors and nurses may NOT refer to your parent’s chart for Advance Directives information. You might have heard of people being resuscitated even though they had written orders to the contrary. This is why it is important to mention those decisions regularly and keep those Directives at the front of the minds of the health care staff caring for your parent.

In my next post, I'll finish up with some special issues about the Directives and resources for further reading.

Blessings on your caregiving day!

Vacation

2009-08-03T08:00:00.002-04:00

If you are enjoying this blog, you might enjoy seeing all of my Care Tips in one place. My latest book, Caring for a Distant Parent, includes advice from professionals, stories from caregivers, and tips from my experience to support you on your entire caregiving journey. You can order it directly from the Parentcare 101 website or send me an e-mail.

I'll be on vacation this week. Please check back on Tuesday, August 11, 2009 for the next installment on Parentcare 101. Have a good week!

Advance Medical Directives

2009-07-30T16:34:00.004-04:00

“It’s a good thing your dad died quickly,” Alice told her son. “He wasn’t stuck on those machines like a vegetable. I don’t want that either. Pull the plug, you hear?”

This is not a sweet "Hallmark" moment, but it does let you know this woman's basic wish concerning life-sustaining measures. More effective--and carrying legal force--is a document called Advance Medical Directives (AMD). Along with the Durable Power of Attorney, the AMD is an important tool in information gathering and in caregiving.

What Are Advance Medical Directives?
Each person has the right to accept or refuse medical treatment. Advance Medical Directives, or simply Advance Directives, protect that right if a person ever becomes mentally or physically unable to communicate his wishes due to serious illness or injury.

The Advance Directives state clearly what life-sustaining measures a person wishes the doctors and nurses to take on his behalf. The Directives:
• Protect a person in extreme conditions such as brain damage, permanent coma or terminal illness when he is unable to communicate; and
• Limit life-prolonging measures when there is little or no chance of recovery.

In most states, law now requires that a statement of Advance Directives be on file for each resident or patient in a hospital or nursing home. Also, each state may use a different document, such as a living will, a medical/durable power of attorney or a general statement. Consult legal counsel in the state in which the Advance Directives will be used.

What Types of Decisions Might You, As Caregiver, Need To Make?
The woman’s off-handed comment above to “pull the plug” actually may mean making a number of decisions concerning:

The use of Cardiopulmonary Resuscitation (CPR) to revive her;
The use of a respirator (a machine to mechanically work her lungs) to keep her breathing;
When and if to treat infections that, if untreated, would shorten her life;
The use of feeding tubes to provide nutrition if she could not eat normally;
Providing appropriate pain relief;
When and if to use dialysis to clean her blood by machine if her kidneys no longer functioned; and
Organ donation (specific organs or entire body).

For each of these situations, the health professionals will look to you, as caregiver and decision maker, as well as the AMD for guidance if your parent is unable to express her own wishes.

Perhaps, due to current circumstances, you feel that you won’t have to make these decisions for your parent, but life happens, circumstances change, and you may find yourself responsible for important emergency or end-of-life decisions. Prepare now.

Know What Each Procedure Involves
Each of the life-sustaining measures noted above has many variations and intensities of treatment. While making decisions and preparing the Advance Directives, if you are unfamiliar with a procedure or don't understand the language describing the procedure, consult a physician before completing the Directives.

Implications
According to a recent study, only 27 percent of adults have Advance Directives in place. This means that most people, when faced with end-of-life decisions, have no guidance, may be guessing about the patient's wishes and may decide based on their own preferences, not those of the patient. Take the guesswork out--for you and your parent--by having Advance Medical Directives in place. In other studies, stress levels for the family making end-of-life decisions were significantly reduced when Advance Directives were in place. The family could concentrate on the person's quality of life and be guided by her own wishes in the decision to stop life-sustaining treatments. Suffering is not needlessly prolonged. There is less agonizing over a decision; your parent has already told you, in writing, what to do.

This is one of the most powerful ways you can honor your parent. Honor her wishes on the manner in which she wants to live and die.

Do Not Hurry
Because numerous procedures and treatments are discussed in the AMD, be prepared to spend some time compiling this document. You or your parent may not be writing the document yourself (although you can), but deciding what options would be best under what circumstances may take some time. If you are helping your parent with decisions and information, the discussions may carry over several sessions. Do not hurry the process; these are some of the most important decisions your parent--and you--will ever make.

In my next regular post, I'll provide more tips and suggestions for the Advance Medical Directives. Until then, Blessings on your caregiving day!

Final Thoughts on the Durable POA

2009-07-28T08:13:00.006-04:00

We've been discussing the durable Power of Attorney over the last several posts. Let's wrap up with a few final suggestions.

Talk to your parent about a Durable POA now (or Living Will, Living Trust). Stress that this does not give you immediate control--but transfers control only when he gives you control, when he is incapacitated, or when trusted professionals give you control. Reassure him that you want the best care for him.
If your parent avoids the issue, try asking the people on your contact list to help. Perhaps one of them can persuade your parent to take this important step.
Tell your parent that you are arranging for your own Durable POA (and you should!) and would like to know what he wants, or to help him arrange his.
Be involved in drafting the POA. Share the tips from this Blog with your parent.
If your parent worries about putting too much control into one person's hands, suggest that two documents be prepared: a POA for financial affairs and a POA for medical affairs. You can be one agent; perhaps another sibling or relative can be the other. This separates the control and may make your parent feel more comfortable.

Suggest that two agents be named if your parent feels that checks and balances are needed. Be careful of the wording. If the POA names you AND another, then BOTH people must sign documents or give verbal permission for procedures. This can unnecessarily delay care if either of you is unavailable. In my mother's document, my sister and I were named so that EITHER of us could act. We could work independently and quickly when a need arose, but were expected to consult each other.

Is the POA the Only Way To Become an Agent for Your Parent?.
There are other legal ways to become an agent for your parent.

You can add your name to your parent’s bank accounts and safe deposit box.
Your parent may have a Living Trust, which will cover the financial issues and help you avoid probate. Your parent may also have a Living Will, which will generally cover the health care issues. These are good arrangements to have, but can be complicated to set up. Your parents may balk at the involved process.
You can apply for legal guardianship before your parent is mentally incompetent. This is a long and distressing court process which your attorney will probably advise you to avoid. However, once your parent has been declared mentally incapacitated (according to state regulations), gaining legal guardianship is a fairly straightforward process. You may want to wait until incapacity is certain.

The DURABLE POA, signed and recorded while your parent is still mentally alert, is a straightforward document and versatile. It lets you take over when the need is the greatest and goes into effect only when the attorney and the doctors--and your parent, if able--agree. If your parent's condition improves, the POA is no longer in force and your parent takes over his affairs again.

What If My Parent Won't Do This?
Your parent is an adult. The truth is that if your parent is over 21 and mentally alert, she has the right to arrange her affairs in any way she wishes no matter how inconvenient and stubborn it may seem to you. Do what you can, be gently persistent, look for another opportunity to bring the subject up. Use this Blog, the Parentcare 101 Website, and the books in the Parentcare 101 Booklist to prepare yourself in other ways. As I did, you may get the opportunity when the first crisis hits.

Resources to Read More
Haman, Edward A. The Power of Attorney Handbook. Clearwater, FL: Sphinx Publishing, 2006.

Schumacher, Vickie. Understanding Living Trusts: How You Can Avoid Probate, Save Taxes and Enjoy Peace of Mind. 5th ed. Schumacher Publishing, 2003.

**You can request these articles from your public library:
Hochberg, R. Mark. Underpowered? Anything less than full power of attorney could keep your agent from doing the right thing if you’re incapacitated. Financial World, v 164, n20, p78, 9/26/95.

Jamison, Judith J. Are your powers in place? Best’s Review--Life-Health Insurance Edition, v 98, n11, p90, March 1998.

What's In the Durable POA?

2009-07-27T15:40:00.003-04:00

We've been talking about the durable Power of Attorney, one of the most important documents that you'll need as a caregiver.

Different laws exist in each state regulating such documents so your parent’s attorney (at least an attorney in the state in which your parent resides) can draft a basic document. From experience I learned that there are some things that must be included:

1. The POA should be DURABLE. This means that it goes into effect when your parent is considered incapacitated, and your role will last until your parent’s death or until he regains competency. "Competency" has a legal definition in each state and criteria for passing control to you. For my mother, her personal physician and her attorney had to verify that she could not take care of her affairs.

2. The POA should include specific financial items. Every POA includes standard language that describes the types of finances for which you will be responsible. In addition, whether you know your parent’s financial holdings or not, be sure that every type of asset or investment is covered.
• Add wording for investments such as stocks, bonds, REITS and mutual funds. Without wording that gives you access, most investment houses and brokerage firms will not permit you to work with your parent’s investment accounts.
• Also insure that you have access to the safe deposit box (especially if your name is not on the box with your parents). Additionally, find the box keys and have them available. There are two keys for each box.

3. The POA should cover Health Care. States are adopting standard language for this. What you want is the right to admit your parent to a hospital (no, it’s not automatic) and to make decisions on all care. In this document can be included a statement of Advance Medical Directives (we'll get to this in a future post) although most health care facilities will also want the Medical Directives in a separate document to attach to your parent’s chart.

Even with specific wording in place, be prepared to obtain a notarized attorney’s statement for some brokerage houses and investment firms. If your parent is receiving Social Security checks and you‘ll handle that money, you will need to apply with the Social Security Administration to be the “designated payee”. But the DURABLE POA will smooth the path with these organizations and clearly state your parent’s intent in the matter.

Some Important Tips

Once you have the signed Durable POA, keep the original safe and make plenty of clean copies. You will need to file a copy of it with each organization when you are representing your parent.
Find a Notary Public near to your work or home. You may need to send notarized copies of the POA. The Notary will also be used for other documents as you manage your parent's affairs.
DO NOT give the original POA to any of the various organizations that will need a copy (such as banks, the hospital, etc.), even if they plead and threaten. Explain your limitations. Send a copy. A copy is acceptable if you are firm about it; suggest a notarized copy.

I had only one original in my possession, signed with great emotion. In only one instance did I agree to hand over the original--to an investment firm who would not budge—but we agreed that I would send it registered mail with a return envelope to be mailed immediately back.

I'll finish next time with some final suggestions for the POA and talking with your parents about this important planning tool.

Until then, blessings on your caregiving day!

The DURABLE Power of Attorney (POA)

2009-07-21T16:39:00.003-04:00

As soon as you have noticed that your parent may become disabled in the near future (see your Reality Checklist), your next priority should be a DURABLE Power of Attorney (POA). This legal document allows you to act as your parent’s agent in all matters. If your parent is anything like my Mom, when you approach the subject, you might get responses like:

(1) I’m perfectly capable of handling my own affairs, and I’d rather keep control.
(2) I don’t want to talk about it. How dare you even mention such a depressing subject!
(3) Oh, don’t worry. I have a will in place. I intend to die on my feet (at my job, in my sleep, etc.)

And that was the end of that discussion.

What Does This Document Do For You?
Every practical discussion of eldercare stresses the importance of having some document in place that will permit you to take over if your parent becomes incapacitated. I lend my voice to these authors. Why? Because it’s crucial.

The DURABLE POA, written properly, permits you to:
• Write checks
• Manage your parent’s household
• Admit your parent to a hospital
• Make decisions about his medical care
• Access the safe deposit box, and carry out a host of other daily household activities
• Rent or sell your parent’s house
• Manage financial investments.

In short, it permits you to make decisions that your parent would make himself if he were able.

My Experience
It was in the Spring that my sister and I recognized that our mother's mental condition was failing. We began to gather information and knew about Power of Attorney documents, but did not make the connection to our situation until the Fall and Mom's emergency admittance to the hospital. When I arrived at the hospital, I watched in distress as Mom tried to pack for a trip that we had taken long ago and directed me to find things in the hospital room chest of drawers that clearly would not be there. Her physician was certain that she had normal pressure hydrocephalus, a condition in which spinal fluid backs up into the brain causing damage, hallucinations and dementia. There were tests to perform and treatments he would try; there was a good chance she would recover her mental facility. But that might take as long as a year. For now, Mom needed help to make medical decisions, maintain the house and deal with her finances. I needed a POA.

I called my sister and Mom's attorney. By the next day, the attorney had a document prepared that we could use for both financial and medical decisions. Knowing my mother's efforts to be fair to both her children, the attorney suggested that my sister and I both be named as agents with an "either/or" wording. We could act independently but were expected to consult one another. Then he encouraged me to get it signed any way that I could.

I called the social worker at the hospital who said that Mom was actually lucid in the morning--between 10 and 11 was best. This morning improvement in thinking is common in dementia patients. The social worker agreed to be a witness for the document signing. I entered Mom's hospital room trembling with anxiety. If she really did not understand the document, then we would have to try other, more complicated options. If Mom got stubborn about something in the document and did not sign (as she had done in the past for other things), then we would not be able to help. Long, shaking minutes passed while Mom read the document and asked questions. I silently thanked God and everything divine that she understood what the document was and what its conditions were. Once assured that my sister and I held equal authority and that her attorney (a long-time friend) was in favor, she accepted the help of the social worker to hold her arthritic hand steady and signed her name.

If there is any way that you can avoid this kind of situation with your parent, believe me, you want to.

We'll talk about the POA over several posts, because it is one of the most important documents in caregiving. It will help your parent. Even more, it will help you.

Until next time, blessings on your caregiving!

Talk With an Eldercare Attorney

2009-07-20T09:46:00.004-04:00

The physician examined Jeff’s father and diagnosed mild dementia. “I had plenty of medical questions,” Jeff said, “but I had legal ones, too. Like who is liable if Dad causes injury or damage through his actions? I’d like to sell the house, but Dad is resisting. Do I need legal guardianship? What are alternatives to this process? Dad doesn’t have a will. What does that mean in the long run?”

In your plan to gather information, an important source is an attorney who specializes in elderlaw or is familiar with the laws and regulations as they relate to seniors in the state in which your parent resides. Because state laws concerning eldercare, senior rights, facilities certification and property ownership differ significantly between states, it is vital to speak with a lawyer in the state of your parent’s residence, not yours. The attorney is one of your parent's care team but may become a source of advice for you in your role as caregiver.

In general, eldercare law is defined by the age of the clients served and by those professionals who specialize in laws and regulations concerning seniors. Your parent's current attorney may be able to fill this role if he is well versed in state regulations and law for this area.

Topics With Which an Eldercare Attorney Can Help
In addition to legal issues that concern younger people, advancing age brings with it new areas in which to learn, explore options and make decisions. An attorney familiar with elderlaw can advise in the following areas:
• Financial and Estate Planning
Estate planning includes the management of a person’s financial assets during the person's lifetime and planning how the estate will be divided upon the person's death through wills, trusts, asset transfers, tax planning, and other methods.
• Planning for Possible Incapacity
In this area, the senior chooses in advance how health care and financial decisions will be made if he is unable to do so. Legal document which might apply include durable powers of attorney, health-care powers of attorney, an Advance Medical Directives statement, living wills, and other means of delegating the decision making. The attorney may also be able to advise on conservatorship and guardianship proceedings in the event that your elder has not planned for incapacity. I'll touch on some of these in future posts.
• Long-term Care Planning
Long-term care issues such as quality of care, admissions contracts, prevention of spousal impoverishment, and resident's rights. It also includes life care or retirement community issues such as evaluating the proposed plan/contract.
• Retirement and Pension Plans
Counseling regarding Social Security and navigating the system (retirement, disability and survivors' benefits) and other public pensions (veterans, civil service) and benefits as well as private pension benefits.
• Insurance Coverage
Medicare, Medicaid, Medigap insurance, and long-term care insurance.
• Housing issues:
Home equity conversion and age discrimination. Buying and selling property.
• Age discrimination issues
The attorney may bring cases under the Age Discrimination in Employment Act.

The Costs, The Benefits
Consulting an attorney is not inexpensive, but one or two visits may be all that is needed to set you and your parent on the right track. When you think of the cost, also think of the costs to yourself if you don’t consult a professional:
• Consulting an attorney reduces your research time in legal matters. Your time is valuable.
• The attorney can act as a sounding board for your ideas and can determine the legality and legal consequences of what you'd like to do. This will help you avoid legal pitfalls that, in the long run, may cost much more money than the initial consultation.
• Speaking with an attorney about the concerns you have will often make you feel better, give you a feeling of having a little more control and being prepared. Peace of mind is a valuable commodity.

Finally, remember that this is a relatively new area of law and the attorney you choose may not be familiar with all the topics described above. Find out what her area of expertise is and if she is not qualified to give you complete answers, ask her to refer you to someone who can.

Blessings on your day!

LTC Insurance: Tips & Suggestions

2009-07-14T07:18:00.003-04:00

Long-term care (LTC) insurance can be a good investment and is worth serious consideration. Over that last few posts, we've been discussing the financial and coverage issues surrounding the decision you make for your parent and for you. Today, let's take a look at some other, general, things to consider. I use "you" here to refer to you personally or your parent.

In addition to details about the payout benefits, check that the LTC policy you are reviewing covers the following:

• How will this policy interact with others, such as Medicare, Medicaid or retirement policies? You may need to use other policies first before this one can be used.
• "Take-it-with-you." If you are purchasing the policy through your employer, can you take the policy with you and is there an increase in premiums for doing so? Premiums do not always increase when you leave your company.
• Out-of-state or out-of-country coverage. If you travel a great deal or spend part of the year in a second residence, this coverage might be of interest.
• Suspension of premiums while receiving benefits. While you are receiving benefits from the policy, you should not be paying premiums. What documentation is needed to inform the insurance company of a change in status?
• Reserved LTC comunity bed during a hospital stay. During an assisted living residence or a nursing home stay, there may be times when you need to be admitted to the hospital for treatment. Make sure that the LTC policy reserves the bed in your residence community or nursing home until your return.
• For insurance premiums and benefits to be tax deductible, the policy needs to be "qualified" under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

As I've mentioned before, saving for long-term care should have as much priority in your financial planning as does saving for your child's education or for your retirement. Given its importance, here are a few final suggestions for planning.

• Consider an LTC policy when you or your parent is young. Age 40 is not too young, and you will be able to purchase a higher daily benefit for a much lower price. The high-end premiums quoted in the example above are for a policy purchased at age 50, but would be higher at an older age.
• Buy an LTC policy when you or your parent is healthy. A fairly clean medical exam permits you to buy a higher daily benefit at a lower rate. Even if you decide to increase the daily benefit later (and the premium), most companies leave the basic premium where it is and base the premium increase only on the increased part of the daily benefit.
• If you wait too long in terms of age or health, insurance companies will refuse to cover you or the rate will be prohibitive.
• Buy a policy even if it covers only half the cost. You and your family may be able to fund the rest of the cost from savings or investments.
• If you have an LTC policy in place, do not cancel it when you or your parent becomes eligible for Medicare/Medicaid. Each state has varying rules for qualifying for Medicare/Medicaid assistance, so have an eldercare attorney review the policy and then decide.
• Before purchasing a policy, get an opinion on its value from an objective source, one not interested in selling you insurance. An eldercare attorney, a financial planner or a knowledgable friend are all good choices. Some states also have an insurance counseling program from which you can request an objective opinion.

To Read More:
Abromovitz, Les. Long-Term Care Insurance Made Simple. Practice Management Information Corporation, November 1999.

Lipson, Ben. JK Lasser’s Choosing the Right Long-Term Care Insurance, Wiley, 2002.

Rowley, Stephen F. The Consumer’s Guide to Long-Term Care Insurance. 1st Books Library, 2004.

For easy purchase, go to the Amazon.com Parentcare 101 Bookstore.

Blessings on your caregiving day!

The LTC Policy by the Numbers

2009-07-10T07:10:00.003-04:00

Buying long-term care insurance is not the only way to pay for the care and assistance you and others might need as you age. Another way is to have a savings and/or investment plan in which you put so much money away a month until you have saved enough money to cover several years of care.

Only about 8% of all elderly reside in a nursing home, so you may choose to play the odds and not plan for nursing home care. It's a gamble, but you may be willing to accept the risk if money is tight. But recent statistics show that from 60-75% of the US population will require extra care in the family home or will live in some type of assisted living community. Three out of four people. Those are odds I'm not willing to play.

Saving or planning for long-term care is as important as saving for college, for retirement, or for the big vacation. You use the same priniciples. You have a timeline; you can estimate how much you may need (see the post on Costs of Care); you can estimate how much you'll need to put away each month and how much interest the funds need to earn to meet the total cost. Long-term care insurance can augment or take the place of the savings plan.

So the question is: is an LTC policy really cost-effective? This is something that you will need to judge for your own and for your parent’s situation. Let's look at an example.

As we learned last time, LTC insurance can be used for both in-home care and nursing home care. But nursing home care is the larger burden, so we'll start with that. I'm talking to you or this is you, talking to your parent.

Let’s assume that you’ve purchased the insurance at age 50 and when you're 70, you develop a condition that requires nursing home care. You’ve been paying premiums for 20 years. You can expect to be in the nursing home 3 years (a number from the statistics experts).

Cost of insurance premiums
• High end, high coverage options = $250/mo X 12 mo/yr X 20 yrs = $60,000. Benefit = $120/day
Your Benefit from the policy
• 365 days X 3 yrs = 1095 days X $120/day = $131,400
Nursing home cost
• Average $176/day X 365 days/yr. = $64,240/yr X 3yrs = $192,720

You’ve paid $60,000 in premiums, but the benefit you will receive is $131,400. You’ve certainly gotten your money back in this scenario. The benefit does not cover all the cost of the nursing home, but without the policy, depending on your assets, you could be responsible for most of the $192,720.

You can do the same calculation for in-home care. Remember, the LTC insurance benefit for in-home care may be only a fraction of the $131,400 we calculated above.

Since costs vary widely, it pays to check out nursing home and assisted living costs in your (or your parent’s) area and shop around for insurance to find the best plan for you.

What about Medicare/Medicaid, you ask. You will need to factor the government insurance in, but here are the facts. What will Medicare/Medicaid pay for?
• For a retirement community which may provide meals and some transportation: Nothing.
• For help with activities of daily living (ADL), such as bathing, dressing, eating, medication: Nothing, except for some medication expenses. No professional training is needed to help with these activities, so these are not eligible under the government insurance plans.
• For medical care provided in the home: A large portion of the cost for a limited amount of time.
• For skilled nursing care: A large portion of the cost for a limited amount of time. Professional nursing training and skill are needed for the care.

Consider the LTC policy benefit as a pool of money on which you can draw if you need it. And statistics show that you will need money for long-term care. Consider LTC insurance as a savings plan much like your retirement plan.

Take some time to consider the financial options. Long-term care insurance may be just the thing to give you long-term peace of mind.

Blessings on your caregiving day!

Long Term Care (LTC) Insurance

2009-07-07T08:25:00.003-04:00

We've been talking about finances and in my last post, I shared some cost estimates for providing care. It's a hefty price tag no matter how you look at it--you and your parent will pay this in money, emotional stress and/or personal effort, no doubt in all three. I'd like to share some options for the money side. One of the most important financial aids to consider is Long Term Care Insurance.

In the 1980's, the company for which I was working offered LTC policies to me as an employee, to my spouse and to my parents or in-laws at a reasonable group rate. I found out that any policy would remain in force at the same premiums if I left the company. I immediately signed up and arranged for a policy for my father-in-law. Three years ago, as Dad's health declined, the family made plans to care for him at home and later in an assisted living facility. Three years ago, that 25-year-old policy kicked in a chunk of change to help pay for Dad's expenses and supplemented his income to allow for him to live in comfort with good care. It was one of the best investment decisions my husband and I ever made.

Care Tip: Talk to your parent about purchasing a policy, certainly, but consider a policy for yourself, especially if you're over 50. The earlier you purchase, the lower the premiums will be and the lower the overall cost.

Let's talk about the basics of LTC coverage. I'm using "you" to mean you and/or your parent; I'm assuming you're considering your own policy.

What Might an LTC Policy Cover?
An LTC insurance policy is designed to cover a variety of care options that you may need if you are chronically ill or have become mentally incapacitated and need continuous care over an extended period of time. A basic policy will pay:
• A daily sum to cover the cost of a nursing home stay.
• A daily sum to cover the costs of supportive services provided in your home, such as 24-hour nursing care, a health aide, meal service, or housecleaning.
• A daily sum to cover the expenses of living in an assisted living community.

Activities of Daily Living (ADL)
Most LTC policies judge a person’s physical competence in terms of how many Activities of Daily Living the person can perform on his own. These activities include such things as bathing, dressing, preparing and eating a meal, and taking medication. Each policy will state what it considers to be “full function”. If a person cannot perform 3 or 4 of the ADLs described (depending on the policy), then the person may begin to claim benefits from the policy. Usually a doctor’s statement is needed to verify eligibility.

Make sure that the policy clearly states when and under what conditions benefits are triggered. Make sure that you understand how the policy is defining each ADL and share that information with your doctor who will be writing the report to send to the insurance company.

Some Benefits of an LTC Policy
When looking for a policy, pay attention to the following:
• The daily benefit for the nursing home. Most insurance companies will give you a choice of the benefit you want from as low as $60.00/day to $200.00/day. Each increased amount also increases the premium cost of the insurance. To choose a benefit level, visit or call several nursing homes in the local area to determine the average price. Even choosing the lowest benefit translates into money you or your parent will not have to pay from current income sources.
• The daily benefit for in-home care and what is covered. The in-home care is usually stated as a percentage of the nursing home benefit. Again check some local sources such as the Volunteer Nursing Association to estimate local costs for such services.
• The assisted living benefit. Some policies include a benefit if the person lives in an assisted-living facility as a result of a decrease in the number of ADLs the person can perform.
• The criteria for invoking the policy. In how many of the ADLs must the person be deficient and what documentation is necessary to gain benefits?
• When do benefits begin? Many policies specify that benefit payments begin 90 days after the patient has met the criteria (qualified) for benefits. Until that time, you are still responsible for paying the premiums.
• Increasing benefit provision. What provision is made to increase the daily benefit (from $60/day to $90/day, for instance)? Most policies allow you to increase with a medical affidavit and an increase in the premium, but some companies only allow changes to the policy once per year during an “open enrollment” period.
• Cost-of-Living increase. Costs are sure to rise and some policies provide an automatic adjustment of the daily benefit based on the current cost-of-living indexes. Some companies charge an extra premium for this adjustment.
• The lifetime limits for the policy. The higher the limit, the better, but higher limits mean higher premiums also.

So, the best LTC policy can provide benefits for home care, assisted living communities and nursing home care. In my next post, I'll share some other things that you need to consider when looking for a policy and a way to decide how cost-effective a policy might be for you and your family.

Until then, blessings on your caregiving day!

Estimating What Your Parent Can Afford

2009-07-02T10:03:00.003-04:00

In my last post, I shared with you some average costs of eldercare, but the most important figure you need to know is what your parent and your family can afford on a monthly basis for caregiving. No matter whether your parent will remain in his home or move, the calculation is an easy one:

For home care, remember that home, food and clothing expenses must be paid in addition to the new expenses of caregiving.

(Parent’s Current Income) - (Parent's Current Expenses) = Funds Available for Care

In other words, the difference between your parent's income and his current expenses is what you have available for care. If you and other members of the family are willing to pitch in, that can be added to the "Income" side. If your parent can economize household or vehicle expenses, then that can be subtracted from the "Expense" side. Be as accurate as you can when making the calculations; this will help when you begin to research available services.

The "Income" side of the financial picture is probably stable at this stage of your parent's life. However, you have room to maneuver with the "Expenses".

Moving to a long-term care (LTC) community, for example, replaces many of the expenses your parent already has. To determine what's available for a new living situation, add up:

Your parent's current income
House payments or rent
Utility expenses (electricity, gas, propane, sewer, water)
Telephone
Food
Transportation (car insurance, gas)
Property Taxes
Cable fees
Home Insurance
Home maintenance (gas for the lawn mower or snow blower, light bulbs, carpet cleaning, for example)

Whatever your parent pays for these basics and all her income will now be shifted toward payment for a retirement or LTC community or for living with you. If there are any LTC insurance benefits available or financial help from the family, this allows for more options.

I was speaking with one caregiver at the Caregivers Conference last week who said that her mother resisted moving into a community because she was sure that it would cost her less to stay in her home. When her daughter did the math, she showed her mother that, in fact, moving to the community they'd chosen would cost exactly the same or a little less. And her mother would no longer have to do laundry, cook every meal, or clean. She could join in activities and would have time to explore some hobbies and visit friends. Her mother made plans to move that day.

Take the time to do the math. Keep the figures handy when you start deciding on care and housing options. Open up conversations with your parent about finances and try to work as a partner with your parent to find financial solutions that work for him and for the family. You'll be glad you did.

Blessings on your caregiving today!

How Much Will Your Parent's Care Cost?

2009-06-30T08:40:00.004-04:00

Who pays for your parent's care? The short answer--your parent does and you do. Sometimes, insurance or the Government does.

So, one of the most important types of information you need to gather as a caregiver is financial--you need to know something of your parent's finances and your own. Let's start today with some basic cost figures so you can begin to estimate.

There are several ways that the financial aspects of your situation may play out.
Your Parent May Stay in His Own Home
This means that any care expenses are added to the day-to-day home maintenance, transportation, food and clothing costs your parent currently has.

In 2006, the average cost for a home-health aide was $20 per hour.

In the 2008 PBS television special, "Caring for Your Parents", one family reported that they spent $200,000 per year on 24-hr, comprehensive home care.

If your parent remains in her home, you, the caregiver, will also spend money from your own pocket to support her.

A recent study published by the National Alliance for Caregivers states that the average amount that caregivers who live nearby spend on home care for their parents is $8,496 per year. This includes food, transportation, and medical care and supplies.

When the caregiver lives at a distance (over an hour away), the costs will average close to $14,064 per year. As a long-distance caregiver, you must consider that your household may have to support an extra expense of up to $1172 per month in expenses to help care for your parent in her own home.

Your Parent May Move in With You
This means that you are adding another member of the family to your own expenses. Since your parent no longer needs his own home, monies previously spent on his house and its upkeep can now be dedicated to pay for his care. You will need to work out with your parent how the finances in the new, blended family will be handled. The care expenses are similar to those stated above, but you might be offering your own time and effort to offset some of the cost.

Your Parent Might Move to an LTC Community
Expenses for a long-term care facility, whether an assisted living facility or skilled nursing home, can run from $3,000 to $7,000 per month, depending on the quality of care, the level of care that your parent needs, and the region of the country in which you live. Costs for comparable care in Delaware, for example, are $1500 more than in North Carolina (based on personal research, December 2007). If your elder needs to move into an LTC facility, that’s $36,000 to $84,000 per year.

In 2005, the cost for a semi-private room in a nursing home was $176 per day. Annually, this adds up to $64,240. Fortunately, some of this cost will be covered by Medicare or Medicaid if your parent is eligible. Note that the average stay in a skilled nursing home is 2.4 years.

Whatever your situation, there will be money involved. In the next few posts, I'll look at how the financial end of care might be solved.

Finding Local Services

2009-06-26T07:47:00.003-04:00

My day at the Triangle Caregivers Conference in Raleigh, NC, gave me some time to think about how caregivers might gather the information they need more quickly, especially when it comes to locating local services. As a caregiver, what might you be seeking?

Medical Facilities and medical professionals for your parent's health.
In-Home Services so that your parent can remain in her home longer.
Home-related information so that your parent can keep his home in good repair.
Housing options for the time when your parent can no longer live alone or wishes to lighten his responsibilities through a different living situation.
Long-term Care Facilities, including assisted-living and nursing homes.
Financial Counseling which might include discussions of reverse mortgages, budgeting, estate planning
Legal Services for living wills, advance medical directives, powers of attorney
Geriatric Care Management to assess your parent's needs so that you can arrange the best services.

You can see that there are many areas of concern. As a caregiver, you won't need to deal with them all at once, but over time, you will touch on each of these areas and need to explore possibilities and options.

What works best is to find those organizations and agencies where your parent lives that do a first information gathering for you. Gathering contact information about local resources is what these groups do for a living, so they are the experts. Once you've identified these "gatherers", you can return to them each time you have a decision to make. So who are these gatherers?

We've already talked about the value of a caregivers conference, especially where local service providers are exhibiting. Look for workshops, conferences, gatherings where the community comes together to present services.

Use an Eldercare Referral Service. Your employer may have access to one of these through your Employee Assistance Program. Many are fee-based groups that locate providers and services for you. Often the services and providers pay to be listed, so the cost to you is minimal. However, the best place to start is the US Government's Eldercare Locator. It's free and once you explain the type of serivce you're seeking, they can get you started.

Find the local Area Agency on Aging. The AAAs were created by Federal law in 1965 to provide support and services to older Americans. With the 2001 reauthorization of the Older American's Act came a new initiative, the National Family Caregiver Support Law. Area Agencies on Aging now have the responsibility to plan, provide and coordinate multifaceted systems of support services specifically designed to support caregivers. Contact them to see if they have a list of resources or can guide you in the right direction.

Hook up with the AARP and its local branches. The AARP website is full of information on caregiving and the local branches keep track of local services. Check the website or call the national office (1-800-424-3410) to find the local group.

Non-Profit Resource Gatherers. I've found that dedicated, local non-profit or government groups are often the most diligent and most helpful when it comes to guiding you to resources. In the North Carolina Triangle where I live, for example, a non-profit group named Resources for Seniors publishes a comprehensive directory of services in Wake County; in Orange County, two counties over, the county government provides a listing of resources in that county. Check the Senior Centers, call your public library, ask around as you arrange for other services, search the web. Local caregiving circles are fairly small and you'll be able to locate these gatherers fairly quickly.

So, find the information gatherers in your parent's community. Bookmark their websites, put them on speed dial:

Local Caregiver Conferences
Eldercare Referral Services, especially the Government's Eldercare Locator (1-800-677-1116, www.eldercare.gov)
Local Area Agency on Aging, Caregivers Support
AARP
Local non-profit information gatherers

If you have any other suggestions of information "gatherers", let us know. Have a wonderful day!

I'm at the Caregivers Conference Today

2009-06-23T06:00:00.000-04:00

Hello, Friends,
Just a reminder that I'm at the Triangle Caregivers Conference in Raleigh, NC today. I'll be back on Thursday to share what I've learned.

Blessings on your caregiving day!

Caregivers Conferences

2009-06-18T10:49:00.003-04:00

I'm running late this week. I'm preparing to exhibit at the Triangle Caregivers Conference at the McKimmon Center in Raleigh, NC on Tuesday, June 23, 8:30 - 3:00, so this post will be short. If you're attending, stop by and say hello.

When I was caring for my mother several years ago, conferences such as this one did not exist. Now, they are more prevelant. The basic format is a one-day conference full of speakers, exhibits, lunch and time to talk with providers and other caregivers. Some conferences are sponsored by a group of local care organizations, as this one on Tuesday is; others are the product of an independent group. For example, I'll be exhibiting in Orlando, FL in November at Caring for Aging Parents: Tools for a Successful Journey. This conference is organized by Stewart Miller Institute for Excellence and its purpose is to match up caregivers with the resources they need. The Institute is organizing events throughout the South through 2010.

I have found it a bit difficult to locate these conferences. They are often advertised by word-of-mouth and sometimes through newspaper ads. That means that you do have to keep your eyes and ears open and ask the professionals that are helping with your parent's care.

Conferences are a great way to gather a lot of information in a short period of time. The day away allows you time to consider options and study resources. And someone else makes lunch and cleans up. It's a good deal.

On the Parentcare 101 website, I've placed a new link that I will be working on right after the Tuesday conference. I'll be searching for conferences in the US and websites that may track such conferences, especially ones that serve the caregivers of aging parents. If you hear of anything in your area, let me know and I'll add it to the list.

I will not be posting on Tuesday, the 23rd, but I'll let you know what I learned on Thursday. Talk with you then!

Details of Your Parent's House

2009-06-16T15:27:00.005-04:00

Sometime during the process of your parent's aging, you may be faced with arranging the sale of your parent's house. Or you may be helping your parent in this stressful activity. Selling a house involves a lot of paperwork, a variety of activities, answering questions, and making decisions. Adult children often cite that one of the most draining aspects of preparing the house for sale can be filling out the "disclosure" form and highlighting the house's selling points, mostly because they were so unprepared.

The "disclosure" form is required by State law and in general requires the seller to reveal any known defects or damage to the property. Not too long ago, I was helping my sister-in-law set up the sale of my father-in-law's house in Florida which had been hit by the double hurricane whammy of Charlie and Ivan in 2004. The real estate agent was thorough in asking about all the damage incurred during the storms and if, when and how the damage had been repaired. Not having lived in the house ourselves nor been involved in any of the repairs, we had to dig deep in our memories of what our parents had talked about and rely on a folder of receipts that they had kept. Every question was a new, hard memory search. We both wished we had paid more attention.

The selling information is another long form that details every aspect of the house's items which will be included in the sale. How old are the appliances? When was the roof replaced? Was anything remodeled recently? What about the furnace and water heater? Included here is everything you, if you were the buyer, would want to know before plunking down your hard-earned cash. I've sold at least 4 houses over my lifetime and believe me, this kind of information is hard enough to remember when you're selling your own house, but when you have to do it for your parent...you can imagine the headache.

The solution is to begin to gather this kind of information as soon as you have any indication that you will be involved in selling your parent's home, even if that might be years in the future. Whenever your parent talks about something that has been repaired or replaced, note it in a notebook or computer file. Try to note the age of everything permanent in the house--roof, carpets, flooring, windows--and the year the home was originally built.

Other things to note:

Swimming Pool -- when installed, is there regular maintenance, how old is the pump
Homeowners Association (HOA) -- are there dues, how often, how much, what's included, where are the HOA documents
School District -- what district, where would children attend school
Room Sizes -- the real estate agent will take measurements, but if you're selling "by Owner", you'll need this information
Bathrooms -- how many, how old are the fixtures
Water/Sewer -- what water system (city, county, well), city sewers or septic system. last time the septic system was serviced
Windows -- wood, fibreglass, double- or single pane, when installed
Storage space -- large or small closets, basement or attic available
Garage -- how large, any storage

Finally,
What makes the house special? The house's characteristics and its location both have special features. Ask your parent why, exactly, he likes this house. Take a look around with objective eyes. Hardwood floors, an extra office space, the view out the back, near to shopping and bus stops, plenty of storage, alarm system, sunlights, stained glass windows, nearby walking paths--all of these can be added to selling information to give the house the extra push it might need in the market.

Get a picture of your parent's house as real estate. Gather the details with business in mind as well as your memories. When it's time to complete the paperwork, the process will be easier and less stressful for everyone.

Blessings on your caregiving day!

Persuasion, Games and Resources

2009-06-11T07:49:00.010-04:00

In the last post of this series on talking with your parent, I'd like to discuss some persuasive techniques, a common conversational "game" we all play and finish with some resources for further reading.

Persuasion
If you truly believe that a certain course of action is best for your parent (and would better balance your responsibilities), you may need to use gentle persuasion.

Consider first what type of argument might best sway your parent, not necessarily what you see as the most important or the most critical issue. What factors does your parent consider when making decisions? Saving money, not being a burden, maintaining independence, making the healthiest choice, getting a bargain, being safe--on which of these does your parent place the highest value? That's the approach to take.
For example, to persuade a parent not to drive, one family might need to prove that not having a car will save a lot of money; another family might need to stress that someone else might get hurt. Try several approaches over time to find one that will work.

Most elders wish to maintain their independence. So if your parent is reluctant to talk with you about aging, stress that the longer she waits to make decisions, the fewer choices she will likely have. One fall, one illness, one disability will immediately limit options. Making plans now, however preliminary, with your help and support, will allow her to continue to make her own decisions and maintain her independence for a longer period of time.

Do not dictate, unless his safety or the safety of others is an issue. Most people balk at orders. Think how you would feel if someone made a demand of you. Reform the demand into a request or suggestion.

The "Yes, but..." Communication Game
In his landmark book Games People Play (Random House, 1964), Eric Berne presents many communication games that we humans devise to get our way, deny reality or avoid honesty. He describes one of our favorite communication games: "Yes, but…". We share a problem that we face with a friend. The friend suggests a solution. We respond, "Yes, but…" and come back with a reason why we cannot do it. Your parent will do the same thing.
Here's how such a conversation might go:

You: You've told me the housework is hard for you. How about hiring a cleaning service?
Your parent: That's a thought. But I don't like strangers in the house. They'll rob you.
You: If you hire a reputable company with workers who are bonded, that shouldn't be a problem.
Your parent: Yes, perhaps that would be Okay, but they charge too much.
You: I might be able to help you with the cost. How about finding out how much it might be?
Your parent: Oh, that's sweet of you, but I really don't have time to call.

The game of "Yes, but..." is not about finding solutions. The purpose for your parent is:

To reject all the solutions presented.
To assure himself that since you could not offer a viable solution, he is superior in reasoning; he has won.
To play until the final silence when you can think of no more options. This demonstrates that you are inadequate because you could not come up with a solution good enough. He has won.

The purpose for you in the game is:

To feel helpful, a "good" child, as you propose solutions.
To accept the familiar role of "child" to his "parent"; his all-knowing, to your less than adequate knowledge.

In the end, "Yes, but..." brings no solution to the issue at hand. There is no reason to play unless one of the purposes appeals to you. The way to stop the game is not to play.

To "They charge too much", answer, "Oh, that's too bad. I didn't realize that." And change the subject.

To "I don't like strangers in the house", answer, "I can understand that," and change the subject.

Call the game. Sometime during the dialogue, say lightly, "Well, it's clear that you really don't want any help cleaning the house. Is there something else that you need?"

Change the subject. Or talk about your own house cleaning techniques. "Yes, but..." takes you in circles and provides little progress toward your goal of gathering information and finding a solution.

Promises, Promises
Beware of making hasty promises. Saying “I promise you’ll never have to give up the house” shuts the door to alternatives that may be more suitable in the future. Keep the options open. Instead say, “I know how much you love this house and I’ll try to help you as much as I can, but I can’t promise that you will be able to stay here forever.”

Respect Your Parent
•Your purpose in asking about your parent’s needs is not to dictate or decree, but to find a solution that’s best for your parent. Respect his wishes. You cannot run his life, just as you cannot run the lives of your older children. Advise, support and stand ready to help.
•How do you treat your adult friends? Try to treat your parent as you would any other adult but with a extra dose of respect.
•Let him know you respect his opinion; be tolerant of some of his indecision in stress; give him the support to make his own decisions.

When the Decision Is Made
After all the discussion and persuasion, remember that your parent is an adult and if she is mentally capable and is not endangering herself or others, she has the right to her own decisions--and to living with the consequences. By talking with her, you have done what you needed to do. Accept her decision, even if it's not the one you would have chosen, and work to find your balance within that reality.

Resources for More Reading
The following books are available through the OBC Eldercare Bookstore.
Berne, Eric. Games People Play. Random House, 1964.

Edinberg, Mark. Talking with Your Aging Parents. Boston: Shambhala, 1988.

Shulman, Vernard H. and Raeann Berman. How to Survive Your Aging Parents…so you and they can enjoy life. 2nd Ed. see Chapter 10: “How To Talk About Difficult Subjects”. Surrey Books, 2001.

Taylor, Dan. The Parent Care Conversation: Six Strategies for Dealing with the Emotional and Financial Challenges of Aging Parents. Penquin, 2006.

On the Web:
The 40/70 Rule, Home Instead Senior Care, Omaha, NE. A guide, video and several articles that include conversations starters and how to continue the dialog. Excellent ideas.

Techniques for How You Speak

2009-06-09T07:54:00.005-04:00

Communication Skills. A lot of training firms and consultants make a lot of money helping people build their communication skills. Communicating in business has its own quirks, and the business world has social rules that are fairly standard. A person can learn to recognize the rules and use them. Communicating with your parent comes with unwritten and unspoken rules that often shift, with baggage from the past and with unforeseen emotions. The conversational goals when considering parentcare are to learn not only the facts of the situation, but to become aware of fears, desires, and capabilities--your own as well as your parent's.

Therefore, how you speak is just as important as what you say. Try these techniques from the experts.

"I" statements instead of "You" statements.
Instead of saying “You’re getting really forgetful, Dad.”, try “Dad, I’m really worried about your safety. Would you consider cutting back on using the lawn mower?”
“Mom, I know you’ve had a few minor accidents in the house. I’m afraid you’ll get seriously hurt. How can that be prevented?”
In the "I" statement, express your concerns, your feelings. Encourage your parent to suggest solutions and make his own decision. Instead of accusation or criticism, make a simple request.

Beware of “should”, or “must”. Think of how you feel when someone uses these words with you. Saying “You really should...” or “You must…” will only increase resistance.

Use an encouraging tone of voice. Always moderate the tone of your voice. Keep the tone interested, not belligerent or demanding. Don’t ask simply “Why?”, which might be taken as an accusation. Ask instead,“What makes you think that?" or "How did you come to that conclusion?”

Ask open-ended questions. An open-ended question encourages more than a "yes" or "no" answer. Unless you want to play "20 Questions" with your parent, you want to encourage her to share with openings like: “How would you do that?” “What do you think?” “Tell me more.” "Give me some of your ideas." These are all good ways to get your parent to talk.

Active Listening. Once your parent is talking, really listen to understand him, not necessarily to respond. Too often we're so intent on trying to figure out how to respond, we forget to ask a follow-up question that might shed light on issues we didn't know existed. Listen actively.

Offer referral advice. If straight advice from you results in resistance from your parent, switch gears and offer suggestions on where to find more information, what questions to ask, or whom to ask.

Stick to the facts of the matter at hand. If you're talking about your parent remembering his medicine, don't bring up the issue of driving. Focus on one thing at a time. Don’t bring up emotional baggage from years ago, don’t add extra drama to the conversation. There's enough emotion floating around.

Calm Repetition. As we've said before, conversation is a way to manage your parent's expectations, to set your boundaries. Sometimes, in the face of complaints, pleas or demands from your parent, your best technique is calm repetition.

Example
It's Monday and you're visiting your mother. She is insisting that you visit tomorrow. You've questioned her, and there's no pressing reason for you to visit. You'll be back on Thursday. So you state calmly, "Mom, I won't be able to come tomorrow, but I'll be back on Thursday."
"Surely you're not too busy to drop in for a few minutes after work," she says.
Repeat again calmly, "Mom, I won't be able to come tomorrow, but I'll be back on Thursday." Do not change the words; do not add any emotion behind it. State the fact.
It usually does not take long for your parent to receive your message. Repeat this cycle as many times as you wish. But when you are ready to leave, give her your usual farewell greeting and leave. And come back on Thursday.

In this situation, you may sense loneliness on your mother's part, and you may want to arrange for someone else to visit. But once you've made your decision on what your plans are, calm repetition will help you communicate your decision to your parent.

What other techiques have you learned for talking with your parent--or your siblings, or your husband--that helps communication?

Conversation Starters

2009-06-04T07:11:00.005-04:00

We're talking about talking. How you might gather information about your parent and her wishes directly from her. So how do you get started?

First, you might ask, "Why do I have to start anything at all? Why can't I just wait for my parent to bring the whole subject up?"

Answer: You're very fortunate if your parent does bring up the topic of his aging and his ability to live independently, because then you know that he is thinking about it and his interest makes conversation easier. You want to start the conversation because you're reading this blog. You're actively considering future possibilities, but you don't have a clue about your parent's thoughts or plans. You've noticed that your parent's status has changed in some way, and you want to learn more. You’re starting the conversation because your first priority is you, and you’d like to get a head start on planning and organizing for future needs. You know that caring at any distance is tough and you want to be more prepared, more effective.

Start Early
If you can, start talking while your parent is younger and healthy. What is his current lifestyle? What are his wishes for lifestyle as he grows older and perhaps faces physical limitations? Once your parent becomes ill, what was a difficult subject may graduate to an impossible one. Start the discussions as soon as you can.

In my family topics of illness and dying were openly discussed. Although we never sat down with specific questions, my mother made it clear through casual conversation what her desires were. When my sister and I faced decisions about my mother's care, we had a firm grasp on what she would want. Those years of casual discussion made later action easier.

Your Parent's Perspective
Before beginning the conversation, take some time to consider your parent's point of view. What do you know about how she feels? As she ages, what do you think is most important to her? Consider the following:

Remember that control and independence--both financial and emotional--are paramount to all of us and certainly to your parent. If she is capable of her own decisionmaking, advise and guide, but let her make her own decisions.
In our society, asking for help signifies a loss of control. Be aware that your parent may be reluctant to ask for help or even for advice because of this perception. You need to be savvy and use tact to draw her out. Assure her that she still calls the shots.
Try to put yourself in your parent’s shoes. How would you feel if you could no longer drive, no longer walk, no longer remember the simplest things? How does the collapse of her world sit with you? In your own emotions, you may find the empathy to lovingly guide her to a decision.

Conversation Starters
Bringing difficult topics into the open can be tough and a bit frightening. Try to make a natural shift to an aging topic.

Talk while helping with a simple task--washing dishes, folding laundry, replacing lightbulbs, caring for a pet or playing a game.
Looking through old pictures with your parent can spark conversation and provide opportunities to communicate in a non-threatening way. Asking questions about other relatives can give you insight into how your parent feels about growing older.
Seize the moment. Listen for opportunities to ask How? What? Do you ever think about it? This means actively listening and digesting what your parent is saying and then finding a natural opening to ask your questions.
Clip a news or magazine article about the issue you’d like to discuss and share it with your parent. Then mention the article in conversation. “What did you think of that article?” may open up the path to good communication.
Pretend you're seeking advice for yourself (which is not a bad idea!). Ask for your elder's opinion. It may encourage him to start thinking and talking.
If both you and your parent have joined AARP (another good idea), use the information in that organization's magazines and bulletins to open discussions or to share your feelings about your parent’s aging.
To talk about death, try approaching it the way you’d talk about a trip. “Mom, is there anything you’d like me to know or take care of before you’re gone?” asked in an interested and light tone may get the results you need to prepare for her passing.

Can you think of other ways in which you might start a conversation with your parent? What have you tried that worked pretty well? Share with us.

Managing Expectations

2009-06-02T07:59:00.004-04:00

We've been discussing gathering information about your parent's circumstances so that you can plan your caregiving. Before we move to other areas of information that may need your attention, let's explore the unsettling activity of talking directly to your parent. After all, your parent knows the details of his situation better than anyone and if he is mentally alert, you should be able to glean important facts that will make a substantial difference in the care you arrange.

A recent AARP report shows that about two-thirds of Boomer women (69%) have had conversations with their parents about their ability to live inependently as they get older. But over 30% have not. An earlier AARP study on parent-adult child communications about aging states that the two most common reasons that adult children and their parents do not talk about living independently is because there is “no need” or because of “poor communications”.

If your parent doesn't live with you or you have an unsettled relationship with your parent, you may well fall into that 30%. And you likely have one of those two top reasons for not discussing care issues. Even if you've talked with your parent before, remember that "Nothing Is Set In Stone." Circumstances will change and you will need to speak with your parent again.

The “no need” reason simply does not apply. Your parent wants to stay independent as she ages—it would be easier on you, the caregiver, if she does—but without discussing the issues and concerns, she may not discover all the options that exist to maintain her independence. And without some conversation, you will have a poor idea of what your elder needs for independent living.

Communication is essential. Good communication is vital. If one of your reasons for avoiding discussion is that you have “poor communication”, now is the time to work on your communication skills and to build some bridges.

Even without heavy emotional baggage where our parents are concerned, we adult children know that our communication with our parents can be strained, especially when talking about something as stressful as quality living, illness, and death. During our next several times together, I'll be sharing some tips on talking with your parent, and I hope that you will share any techniques that have helped you break the ice about stressful topics.

Today, let me suggest that most communication with your parent is an attempt to Manage Expectations.

I write this with capital letters because it's a common business buzz phrase. To Manage Expectations is to clarify to another person what you can and can not do, what you will and will not do in a certain situation. Often, while clarifying, you must become an educator, explaining any limitations that you're under and teaching the other person selected details of your position so that they understand the boundaries you must set. Managing expectations means, most importantly, communicating your boundaries, your view, your own expectations.

Do Not Assume.

Do not assume that your parent knows how you feel, what you're prepared to do, or how you plan to arrange for care. Do not assume that you know what your parent expects from you. Unless you or your parent has obtained a divine gift for mindreading, neither of you can know each other's expectations until you get more information--from conversations, from behavior, from other observers. Your father expects that you'll visit him every day. You don't know this. Your job and family commitments make twice a week the most you can promise. He pouts. You wonder why and feel guilty. Your mother expects that you will drop everything at her phone call and come right over no matter the urgency of her concern. For you, dropping everything every time she calls will jeopardize your income. You know you need to clarify why you don't come and must find out what she really needs--perhaps more company, not necessarily yours.

Set boundaries, communicate those boundaries, stick to your decision until something changes. That's Managing Expectations.

Next time I'll share tips from other caregivers on how to manage those expectations.

Blessings on your caregiving!

The AARP Reports
Skufca, Laura. Are Americans Talking with Their Parents About Independent Living: A 2007 Study Among Boomer Women. Research Report. AARP, November 2007.

Barrett, Linda L. Can We Talk? Families Discuss Older Parents’ Ability to Live Independently…Or Do They? Research Report. AARP, April 2001

Where Are the Records?

2009-05-28T10:00:00.005-04:00

“My grandmother kept her savings money interleaved between lingerie in a drawer. After a few hours, we found enough to pay for a meal service. I’m glad I remembered her mentioning that.”

“My mother is very organized. She showed us a file drawer in the den in which she had files for every investment, insurance policy and bank account. After she was hospitalized, my brothers and I found other things around the house, but we knew basically where everything was.”

“My dad has everything on the computer. Checking account, insurance records, he’s a real technology buff.”

We've been talking this week about gathering information on your parent's status and some tips for recording and storing that information. Part of what you need to know is where your parent keeps the household, financial and medical records.

Money. Insurance. Bank Accounts. Title for the House. Title for the Car. Investments. All important topics for a caregiver who may need to manage the finances as well as provide care for an aging parent. Touchy subjects. Emotional subjects. We live in a society where financial information is not readily shared. Your current salary is not going to come up around the office coffee pot or the holiday dinner table. And if you live miles away, time constraints and the desire just to “catch up” may push this topic to the back of the conversational closet. When preparing to care for your parent, social reticence and personal unease about finances put you at a disadvantage.

If you think that you might be your parent's caregiver in the near future, at the very least, KNOW WHERE THE RECORDS ARE KEPT.

Is the bank book in the old desk in Dad’s office? Does your mother keep a file cabinet in the basement for the insurance policies? Are all the credit card bills in a shoebox under the bathroom sink? Does your father keep stock certificates in folders under the mattress? Doesn’t matter. Even if you don’t know the details of your parent’s financial situation, you’ll be better able to care for your parent if you know where to look for important information.

What To Look For First
• Health insurance cards and plan descriptions
• Other insurance information: life, travel, accident
• Descriptions of current Medicare/Medicaid regulations and coverage
• Bank books, checking/savings/credit union account records
• Certificates of Deposit (CD’s)
• Social Security benefits papers
• Taxes
• Liabilities: the mortgage, credit cards, car payments
• Retirement benefits papers from employment (there may be two or three sets of records if your parent moved from one company to another)
• Investment accounts, stocks, bonds, property
• Safe Deposit Box keys and location of the box
• Locations of jewelry, heirlooms, boats and furniture
• The Will or Living Trust, Power of Attorney, Advance Medical Directives

Suggestions
• If your parent won’t tell you exactly where she keeps things, keep your eyes open while you visit. Her actions may give you some clue as to where to look.
• If your parent is reluctant to talk about finances, reassure her it’s for her welfare that you ask, not because you want to steal from her. You can’t blame your parent for being cautious. You’ve probably heard of children walking off with their parents’ assets. Planning care should be a partnership with your parent. Try to make it one.
• If your parent will not share with you, find out if she has shared any information with one of her friends, your siblings, a lawyer, a neighbor or her accountant. Perhaps she's entrusted someone else. Don’t fume about her lack of trust in you; be relieved that there will be someone you can ask if the need arises. Add that person to the Contact List.
• If your parent will not share with you and has not shared with anyone else, do a little reconnaissance on your own when you visit. Take a quick peek in:

Kitchen and bathroom cabinets
Any office area or desk
All closets; flip through clothes in drawers
Any storage area: attic, basement, shed, garage

Your purpose is to locate the records, not remove them. If your parent becomes incapacitated later, then you'll be better prepared to find the necessary paperwork.

If your parent can give you a "records tour", all the better. If not, be prepared to play detective. You'll be doing your parent--and yourself--a huge favor if you know where the records are.

Blessings on your caregiving today!

Your Parent's Contact List

2009-05-26T09:11:00.005-04:00

Caregiving often means that you must rely on people who live closer to your parent to support him and to let you know how he’s doing. Neighbors, family, friends, professionals, ministers, work colleagues--all of these people may have a role in your parent's life and can help you check on his status and be a useful source of information as you walk the caregiving journey.

If all your family members live out-of-town or if you are an only child, the list of contacts becomes a vital source of support and help that will permit you to make informed decisions about your parent's care and to mobilize help when you cannot be there physically. Creating a care team (which we'll talk about in a later post), of which some of these contacts may be a large part, is good caregiving.

People who should be in your parent's Contact List:
• Family attorney
• Minister where your parent attends church, or spiritual partner
• Family accountant and/or financial planner
• Family physician
• Neighbors
• Your parent’s supervisor, if he still works outside the home
• Friends
• Family
• Landlord or Apartment Manager, if he rents
. Local Police

A note about the police. Find out how the local police handle situations when phone calls to homes go unanswered. If your parent doesn't answer the phone when you expect her to, can the police intervene and how will they?

If your parent does fall ill and you assume a more active caregiver role, this list may expand to include:
• All physicians treating or consulting on your parent's case
• Contacts in their living facility
• Local organizations providing services to your parent
• ElderCare Referral Agencies
• The Eldercare Locator service
• Real estate agent
• Social workers
• Hospital nurses
• Geriatric Case Manager
• Funeral Home Director

Look for a Holiday Card List or Address Book
If your parent has an address book or a holiday card list, now is a good time to find out where he keeps it and perhaps look it over for other ideas of contacts. If your parent becomes too ill to keep in touch with his friends, you can write a letter to the people in the card list or address book to let them know the situation and encourage them to write or call.

When thinking of whom to add to your list, consider...
Whom does my parent trust and turn to in times of trouble?
Who has a key to my parent's house?
Who looks in on my parent regularly?
Whom does my parent consider a confidant and friend?
Who helps with my parent’s finances and legal questions?

Important Tips
•Collect these names while your parent is still well. Meet as many as you can. Establish your own relationship with them. Discover from whom you might be able to ask for help. With this information, you'll feel more comfortable asking if a crisis occurs.
•Keep the list of contacts where you can easily find it. Either a section of your daily planner or a separate notebook works fine.
•The list must be portable; as part of your parent’s care team, you must be able to carry it with you.
•If you are using a palm pilot, cell phone and/or e-mail, be sure to have a back-up list electronically or in paper. I have heard horror stories of caregivers scrambling because their cell phone was damaged or stolen and all their contact numbers were lost.
•Don’t forget to note mailing addresses, cellular, work and home phone numbers and e-mail addresses for all contacts when they are available.

Your parent's contact list works alongside your parent's Care Log. Having this list goes a long way to reminding you that you are not alone. There are other people in your parent's life who care and will be able to help. Having this list provides you with more resources to call upon for support and information so that you can care more effectively.

Blessings on your caregiving day!

Keep a Care Log

2009-05-21T07:28:00.003-04:00

We're talking about gathering information about your parent's status and as you learn more, you'll need to record what you've discovered. A place to begin is a Care Log.

The Care Log is simply a day-by-day record of the care your parent is receiving. Each entry marks an event in care: a discussion with a physician, medications prescribed, medical terms, an accident, diagnoses, decisions made, options offered. Start the Log as soon as you become concerned about your parent's health. Record what you know at the time and any questions you need to ask. My own notes were hurried and telegraphic as I listened and spoke with people on Mom's care team, but I later filled in the blanks as I learned more. This log was helpful in several ways:

•As my mother's illness progressed and she moved from hospital to rehabilitation to nursing care, healthcare personnel changed with those moves. I found that new physicians rarely studied her chart in detail before speaking with me. They asked me (I was astounded!) when certain procedures had taken place, what medications she was taking, what was the last medical approach. Only after this interview, would they consult the chart for details.
•Each new facility needed dates and physicians' names. Without the log, I would have been lost. With the log, I could easily find pertinent dates, relate details of discussions and maintain continuity in what care was being provided.
•The log was the main tool I used for sharing my mother's status and details of care with other members of the care team, with family, and with friends.

IMPORTANT: If you become the primary caregiver, this log must be portable--part of your daily planner, PalmPilot or a separeate notebook. If it's electronic, have a backup! My Mom's Care Log was a plain steno notebook. I filled one and part of another over my 5 years of caregiving.

When recording conversations with health professionals, take time to do the following:
· Note the date, time, the person with whom you're speaking, their position, the correct spelling of their name, with which institution they are affiliated (hospital, nursing home, rehabilitation center, etc.)
. Tell the speaker that you are taking notes and may need him or her to repeat things for you
· Ask the speaker to spell and explain any term with which you are unfamiliar
· Even if the speaker uses understandable English when describing your parent’s condition, ask for the medical term for the diagnosis or condition. If you wish to research the subject later, you will need these terms.
· Immediately after the conversation ends, read over your notes and fill in any details, expand on your shorthand, add your impressions. Anything that will clarify the situation and jog your memory in the future. You may be consulting this log months later.
· Make notes to get more information if you need it
. Add any new person to your Contact List (we'll talk about this resource in a later post)

Here's a sample of notes I recorded when my mother first entered the hospital.

10/28 8:30am
Dr. S T E V E N S, Jackson [Hospital]
Cat Scan--
Stroke? She's incoherent (didn't know what day it was)
Doesn't know, memory lost from yesterday
Dehydrated
Blood Sugar Low, BUN low (Liver function)
CNS: [Central Nervous System] Lumbar Puncture for neural infection
Large lump on left breast, mammogram to be taken
Neurology needed
Thursday we will know more
10/31
No heart attack!
Kidney function back to normal
Monday, biopsy on breast lump
No stroke: encephaletic pressure in the head; blocked ventricles?!
MRI for blockage
No neurologist [here]--U Pitt [she will need to be sent to Pittsburgh]
Breast Surgeon: S I R I P O N G
Spinal tap
Bone scan for cancer
Chest/ Upper, Lower GI

Remember that caregiving can last for months or years. But my caregiving experience taught me that whenever I now head for the hospital, doctor's office, clinic, I take a notebook with me, ready to write down what I learn. It's a good practice for your parent; it's a good practice for you.

Blessings on your caregiving today!

The Reality Checklist

2009-05-20T06:36:00.009-04:00

This week, we're beginning a series of posts on gathering information to plan and prepare for parentcare. The first area of information that we identified last week was evaluating your parent's physical--and I'll add here--mental and spiritual status.

You may want to gather information when you first notice something has changed. Your normally even-tempered father's been irritable on the phone. He repeats things, complains. You've noticed at your Mom's house that the house is unusually disorganized--dishes in the sink, wash undone, a layer of dust on tabletops. Your parent’s behavior and temperament have shifted slightly, like a blurry photograph. Your instincts kick in. Something’s just not right. It may be the first time you realize that your parent is aging. And with a hand squeezing your stomach, you also realize that you are miles away. Part of that tension in your stomach may be the certainty that you will have to face caregiving when you and your parent are not on the best of terms. A lot of the worry comes from realizing that you don't know enough about your parent's day-to-day living.

Even if you are well along in your caregiving journey, you will need to establish an objective base line against which you can compare your parent's progress or decline. Then you can easily recheck every few weeks or months to see if anything in your parent's care routine needs to change. Remember that nothing is set in stone. Regular status checks help you to keep your information up-to-date, so you can arrange for proper care at the proper time.

You need The Reality Checklist. The Checklist contains a simple set of questions that cover the five major areas of a person's well-being: physical, mental, emotional, spiritual, and social. It helps you to gather facts as well as impressions. If you are to help your parent, you must be able to identify and communicate in concrete terms what has changed, what your parent can no longer do, physical symptoms, and what's not working in your parent's care.

· Don’t wait for a crisis, a fall, an illness, an accident. Honor your instincts. If you think your parent’s circumstances are changing, they probably are.
· Gather specific information about your parent. You may feel your father is depressed, but what behavior leads you to this conclusion? Has he lost touch with friends, cannot leave the house? Be as specific as you can.
. Constructing a picture now of your parent’s life will help you when you begin to look for ways to care for him.

Use The Checklist, then go on to...

. Confirm your own observations and impressions with others. Check with your siblings, other family members, neighbors, friends with whom your parent is close.
· After putting as many facts together as you can, talk with your parent. Ask him questions about how he’s getting along, what difficulties he may be having.
. Begin to ask “what if?” What if my parent will not be able to drive soon? What if she’ll need a housecleaner to help with the house? With each question, begin to think about the kind of services that might be needed.
. Consult the resources offered on the Parentcare 101 website to help you understand your parent's status and to make decisions.

With the Checklist in hand, you have a way to evaluate how your parent's doing. You have books, organizations and websites to consult for more information. You have health professionals, friends and relatives who can support you. You're doing great!

Blessings on your caregiving.

Information Is Good Care

2009-05-14T07:12:00.007-04:00

During the next few weeks, we're going to discuss gathering the information that will help you during your caregiving journey. I've heard the saying "Information is Power", but in caregiving, "Information is Good Care". Having the right information at the right time is important in any aspect of life, but in caregiving that information becomes your bedrock. And you have an advantage. I know--and I'm sharing with you--the types of information you're going to need in advance. Even if you're at the beginning of the caregiving journey, you already have some idea of what you'll need. As a caregiver to your parent, at some point, you will need to know and be able to communicate:

Your parent's physical status--health, abilities, mental acuity
Where your parent's household, medical and financial records are filed or stored
Who will be helping with your parent's care--family, friends, professionals
Information about your parent's house
Personal financial resources available for care--your parent's, yours, your family's
Housing options for your parent
Legal issues that will guide you handling your parent's affairs
Insurance issues surrounding your parent's care
Your parent's spiritual needs
Your parent's wishes about their care, end-of-life decisions, living arrangements

In the long run, especially if your parent does not live with you, caregiving may be less about personal, physical, active care tasks but more often a series of information gathering expeditions and communicating decisions, managing resources, taking copious notes, and organizing others to provide actual care.

When you accept the job of caring for a parent, you do just that. You accept another job--at least part-time, and full-time if your parent has substantial needs and lives with you.

A lot of papers, e-mails, telephone calls, texts, websites, books, articles, information will be coming your way. Start thinking about how you might organize it so you can refer to it later.

Start now by thinking about the list of types of information listed above that you'll probably need for your parent. In each of those areas, what information about your parent do you already know? How much detail do you have? Do you need more?

What don't you know? In what areas do you feel a need for some serious information gathering? Can you suggest to the rest of us any areas that are particularly pressing?

Write a comment, send me an e-mail.

In the next few weeks, we'll start working through these areas and talk about what you're looking for and how to find it.

Nothing Is Set In Stone

2009-05-12T08:15:00.004-04:00

Molly began helping with her father’s care a few months ago and is finding the experience far more difficult than she ever imagined. “I have such a hard time making decisions,” she admits. “What if I make the wrong choice? What if Dad doesn’t like the home nurse I hired? How can I choose when it’s Dad’s health, his life, I’m deciding? I want to do the right thing, but I’m afraid I’ll mess up somehow.”

We all want to do what’s best for our parent. We want to do what will work for us, too. In this striving for the best, for perfection in choosing, remember: there’s one thing certain in caregiving…Change.

Your parent’s condition will improve. Or worsen. Care services that worked well for a while suddenly don’t. The physician who has been seeing your parent retires. The rehabilitation therapist suggests that your parent may not be able to live alone again. The surgery that wasn’t needed last month is now critical.

The decision you made last week was made in last week’s situation and with last week’s information. This week will probably be different. Nothing is set in stone.

Adjustment and change. Normal.

What a relief!

Your first decision doesn’t have to be perfect. It just has to fit the circumstances and information you have that day.

Considering Options
When you’re making a decision that seems particularly difficult or complex, try the following:

• Create a list of alternative choices. Write down as many as you can think of. One of those choices may be to postpone the decision. Brainstorm.

• Evaluate each choice. If you don’t have enough information about a choice, ask questions, find out more. Note the possible positive outcomes to each choice and the possible negative outcomes.

• Weigh the importance of those positive and negative outcomes on a scale from 1 to 10 (1 = I don’t care if this outcome happens; 10 = If this outcome happens, it will substantially affect my life and my parent’s care). There may be many negative outcomes to one choice, but those outcomes may not matter much to you or to your parent’s well-being.

• With your evaluations and the weights of the outcomes in hand, make a choice. Notice that now you have back-up choices if your first one doesn’t work out.

Permanent Consequences
There are some decisions that, by their nature, do have permanent consequences for you or your elder. The choice to remove an artificial respirator when signs of life have faded, the decision for surgery that will remove diseased tissue…these bring a permanent change to a person's health status. Using the suggestion for considering options above still applies, but the outcome weights will be near 10 for some choices. These decisions are particularly difficult.

But over the course of caregiving, nearly all the decisions you make for your parent will not have permanent consequences…inconvenient, less than optimal, aggravating consequences perhaps, but not permanent.

Resist acting or thinking that a decision is one of life-or-death when it is not.

To read more, try:

Simon, Sidney B. Getting Unstuck: Breaking through Your Barriers To Change. Chapter 4: Change and Options. p. 85-114. Grand Central Publishing, 1989.
This chapter provides more details about brainstorming choice options and how making effective decisions keeps you moving forward.

Throughout the caregiving experience, remember that you always have a chance to make changes, to adjust, to do something better, to do it differently. That’s the wonder and happiness of being human. We always have options. Usually more than we imagine. Next time we'll start exploring sources of information that will help rev up your imagination.

Blessings on you and your caregiving!

Your Situation Is Unique

2009-05-07T08:53:00.011-04:00

This week here at Parentcare 101, we're talking about some life-long lessons that we caregivers need to take to heart. Today's topic discusses a fact that we often forget. Everyone's caregiving situation is unique. Let me share some stories from caregivers I've met.

Martha lives farthest from her hometown where her father still lives. She gets along well with one of her brothers, but has never felt close to the other two. Now that her father is ailing, she knows that they all need to talk about what’s going to happen, how they will care for him. It doesn’t help that her father is the classic curmudgeon. She dreads the conversation for she knows her brothers will expect her to do everything—and if she’s not careful, she just might take on that traditional role.
Kenneth is an only child. He and his parents have always been close and when his mom and dad both fell ill, he did not hesitate to arrange his life so that he could be with them as much as possible. He commutes the 100 miles several times a week. After a year, his wife can’t understand his continued devotion. She’s not sure she could do that for her parents. But she does understand that the hours Kenneth spends, he gives freely, from love.
Jordan’s father was abusive and walked out on the family when Jordan was 12. Now, when Jordan has a family and a good job, his ailing father is demanding aid from him. Jordan gave his father the number of the Area Agency on Aging in his father’s city and left it at that.
In my own situation, I was very surprised when a social worker commented, “You’re very fortunate, you know. You and your sister are talking and agree on the kind of care your mother should have. And all your relatives are happy to let you do what you want in the situation. That’s pretty rare.”

Family circumstances mold the way we approach a parent’s care. Some adult children freely give their time to their parents out of love. Others must wrest their caregiving from a morass of negative memories. In some families, the siblings are not talking. In some families, parent and child are best friends; in others, there is pitched battle whenever the two meet. Adult children live at varying distances; one with four children, one with none, all of them holding jobs, some married, some not. The variations of family types are infinite.

To add to the confusion, there is no contract between you and your parent, spelling out how much you owe your parent. There was no legal document drawn up at your birth with the mutual obligations specified. There are no guidelines to tell you how much each sibling should contribute or will. You make those decisions for yourself.

Across families, the care choices to be made, questions to be answered and the emotions are often the same—do we use home health care or move Dad to an assisted care facility? I'm so relieved Mom is settled in her new place. Which nursing home? I feel guilty that I’m not doing enough. How much can Mom do on her own? How will we pay for Dad’s care? I'm angry that my sister won't do more.

But for each situation, the caregivers enter uncharted territory. The way the decisions are made and how they are carried out are always different, based on the family situation.

Choose what’s best for the FAMILY.

Your family includes, first of all, YOU. Then comes everyone closest to you : spouse, children, parents and everyone involved with the caregiving: siblings, friends, relatives. That’s a lot of people, all of whom have worries, responsibilities, desires, just like you. Cut yourself--and everyone else--some slack.

What's the point here? There are several. Remember...

· Every family is different, so take ideas from other families, but do NOT compare your decisions against those made by other families. Do what’s best for your family.
· What you can give today may not be the same as what you can give in the future. Revisit your role in the process frequently.
· Review your priorities often; they will change with changing circumstances. How other families care may not be what you’re prepared to give or capable of giving. Recognize this, listen to advice, but remember that your situation is unique.

Think about the specifics of your care situation, the people involved, the finances available, the housing resources available, the relationships. Have you heard of any other caregiving circumstance exactly like yours? Do you listen to advice, but rework it to fit your own circumstances?

Once you’ve decided on what’s best for your family and for you, let go of the anxiety and get on with the doing. Do what you can. It will be enough.

Your First Priority is You

2009-05-05T08:26:00.006-04:00

Are you kidding? I have my kids, my job, my spouse, my parent to think about. They’re my top priorities.

Think about your life now.

How do you feel...

When you haven’t gotten enough sleep, haven’t eaten a decent meal in days, have pushed yourself until your head and shoulders and stomach throb with tension?

When you haven’t had a chance in weeks to connect meaningfully with another person, talk out your worries, have fun just doing nothing?

When you haven’t had a moment to yourself in days?

You can't serve others with energy, patience and love when you have less than your best to give.

Making Yourself Your Top Priority Does NOT Mean…
· Ignoring the responsibilities and obligations that you have to your loved ones.
· Refusing to do something for your parent simply because it is “inconvenient” or because you “don’t feel like it”.
· Misusing your choices in life to disregard real needs your parent may have.
. Becoming self-absorbed.

Making Yourself Your Top Priority Means…
· Recognizing that you have a right to your own life, that your needs are just as important as anyone else’s.
· Letting your own life and well-being take precedence so that you will be ready physically and emotionally when you most need it.
· Refusing to give of your time and energy unstintingly to others without giving yourself the same proportion of time and energy.
. Striving for balance within your life so that you are not the last person to whom you apportion your time and effort.

Recognizing your own needs, dealing with your own emotions, getting help when you need it, considering your personal goals throughout the period of your caregiving—all these things insure that you will have the endurance to care effectively for a long period of time, especially if that period of time begins to stretch from months to years. Taking care of yourself is not selfish when you are a caregiver. It is essential.

To maintain your well-being, experts agree that you must pay equal attention to five areas of your life:
1. Physical: the health of your body. Establishing good health habits, nutritious eating, rest, exercise and regular medical check-ups.
2. Mental: keeping a limber mind, learning something new every day, solving puzzles, maintaining a sense of humor, fostering your creativity, organizing your life experience in your mind, the sense of self-worth.
3. Emotional: the capacity to feel deeply, be sensitive to feelings (yours and those of others), a willingness to experience feelings and the appropriate responses to those feelings.
4. Spiritual: The core dimension of you, the profound sense of who you are. Living with a sense of hope, recognizing a set of clear values and a sense of worth and peace. Feeling that there is meaning and purpose to your life. Giving yourself time for quiet, reflection, prayer.
5. Relational: Developing rich and meaningful relationships with others. Building a supportive network of friends who offer understanding, closeness and empathy. Being part of a community of folks who care for one another.
from "Seeking Your Healthy Balance" by Donald and Nancy Tubesing

Remember also that you have other priorities after yourself and before your parent.
· If you are married, you made a commitment to your spouse that brought you together as a new family, separate from your parents. Statistically, your spouse will survive long after your parents have passed on. Long-term, it makes little sense to jeopardize your marriage and alienate your partner while caring for your aging parent.
. If you have children, your responsibility to them also takes precedence. Your parents are part of the past and guided you to where you are now. Your obligation is to see that your children are guided into the future. Do not ignore your children’s needs while caregiving; guiding the next generation is a way to honor your parents.

Suggestions:
· Read this blog, visit the Parentcare website, the Parentcare 101 Bookstore, use all the resources and suggestions you find to help you balance your life and remind you to nurture yourself.
. When you are overwhelmed, remind yourself that your first priority is you. Give yourself a 15-minute break of quiet, then set your priorities and tackle the problems facing you.

For Reflection and Sharing:
When you read "Your first priority is you.", what is your reaction? Do you think you can take this advice seriously? Have you taken this advice to extremes and ignore your parents' true needs? What would it mean in your life if you gave yourself the same measure of time, consideration and care that you do others? What one thing can you today to put a little more balance in your life?

Your First Priority: Resources

2009-05-05T08:02:00.011-04:00

Many of the ideas in today's post Your First Priority Is You were taken from the following resources. Use them to help you find your balance in caregiving and set your priorities. Books that are in print are available through the Parentcare 101 Bookstore.

Dolan, J. Michael. How to Care for Your Aging Parents…And Still Have a Life of Your Own! Los Angeles: Mullholland Pacific, 1992. (Read especially the Epilogue)
Golden, Stephanie. Slaying the Mermaid: Women and the Culture of Sacrifice. Harmony, 1999.
Louden, Jennifer. The Woman’s Comfort Book: A Self-Nurturing Guide for Restoring Balance in Your Life. HarperSanFrancisco, 2005.
Moffatt, Betty Clare. The Caregiver’s Companion: Words to Comfort and Inspire. iUniverse, 2000.
Tubesing, Donald A. and Nancy Loving Tubesing. Seeking Your Healthy Balance: A Do-it-yourself Guide to Whole Person Well-being. Pfeifer-Hamilton Publishers, 1991.
Uustal, Diann B. Caring for Yourself - Caring for Others: The Ultimate Balance. Educational Resources in HealthCare, Incorporated, 1997. (Out-of-print, but worth reading. Check your local library).

To search for articles or more information on the web or in your library, try these search concepts combined with an AND:

Concept 1: Self-Care, Self-Nurturing, Wholeness, Whole Person Well-Being, Wholistic Medicine, Self-Help Techniques, Nurturing Behavior, Life Balance
Concept 2: Caregivers—Psychology (subject heading in library catalog), Caregiver Stress, Compassion, Fatigue

Search examples: Wholeness and Caregiver Stress; Life Balance and Caregivers; Wholistic Medicine and Compassion

Preventing Falls: Resources

2009-04-30T08:25:00.012-04:00

If you haven't read it, please take a look at today's tips to prevent falls in the post "Preventing Falls".

There are many good articles about preventing falls on the Web. I've listed the ones in which I found the information I've shared. They have good details to get you started.

Department of Health and Human Service. Centers for Disease Control and Prevention. Injury Center. Preventing Falls Among Older Adults. Accessed 4/30/2009.

Wright State University--Miami Valley College of Nursing and Health. Tips to Prevent Falls in the Elderly. Updated 9/16/1998. Accessed 4/30/2009.

Tremblay, KR and CE Barber. Preventing Falls in the Elderly, Consumer and Family Online Fact Sheet No.10.242. Colorado State Cooperative University Extension. Updated 6/9/04, Accessed 4/30/2009.

Health A to Z. Preventing Falls in the Elderly. Merck Source: Health Information, Pure and Simple. Published 10/18/99. Reviewed 2/3/2003. Accessed 4/30/2009.

To find more detail , in your Browser Advanced search box, use three search concepts combined with an AND:
Concept #1: Falls or Falling
Concept #2: Preventing or Prevent or Avoid or Prevention
Concept #3: Elderly or Seniors or Older Adults or Elders or Aged
Search examples: "falls and preventing and elderly"; "falling and elders and avoid"

Happy Reading!

Preventing Falls

2009-04-30T08:22:00.008-04:00

Earlier this week, we talked about the importance of preventing falls in keeping your parents healthy and independent. It is equally important for you to check your own situation for hazards so that you can continue caring effectively. Here are some tips in each of the five prevention areas:

Prevent Osteoporosis

Eat or drink sufficient calcium. Post-menopausal women need 1,500 mg of calcium daily. Men over 50 need 1,200 mg per day. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds.
Get sufficient vitamin D to enhance the absorption of calcium into the bloodstream. Men and women over 50 need between 400 IU and 600 IU daily. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement. Check with a doctor for more details.
Do regular weight-bearing exercises. There are many ways to add weight. Lifting books and walking use weight and gravity to give your bones a workout. Use light exercise bands, hand-held weights, or weights that slip around wrist or ankle when exercising or when doing housework, gardening, or mowing the lawn with a push mower.

Get Moving!

You've heard this before, many times...because it's TRUE. Maintain a regular exercise routine (e.g., every day for about 15 minutes, every other day for 30 minutes a day) designed to increase muscle and bone strength, and to improve balance and flexibility. Choose something enjoyable that you will stick to, and be consistent. Mix it up. Walk one day, use light bands for strength exercise another day, do water aerobics another. Check with a doctor to design a program right for you.
Undertake daily activities in a safe manner, such as reaching and bending properly, taking time to recover balance when rising from a chair or bed, learning the proper way to fall, and learning how to recover after a fall.
For improved balance, try Tai Chi. Researchers at Emory University in Atlanta found that this Chinese martial art of slow steady body movement improved balance in older people after just a few weeks and cut the risk of falling nearly in half.

Check Your Vision

Clean eye glasses often to improve visibility. It's a simple thing, but critical!
Wear the glasses prescribed by the physician. Don't be vain, we're talking about avoiding broken bones and torn muscles.
Have annual checkups by an optometrist to discern the extent of age-related eye diseases such as cataracts and glaucoma.
Use color and contrast to define balance-aiding objects in the home (e.g., grab bars and handrails).
Add contrasting color strips to first and last steps to identify change of level.

Review Your Medications

Know the common side effects of all medications being taken.
Talk with a physician or pharmacist about ways to reduce the chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance.
Remove all out-of-date medications and those no longer in use.
Suggest that a physician or pharmacist conduct a "brown bag lunch" medicine review of all current medications at a local senior center and attend.
Limit intake of alcohol as it may interact with medications.

Make Your Home Safe

Did you know that one-third of all falls occur inside the house? You do a safety check if you have an infant or toddler in the house. Why not give your parent (and yourself) the same consideration?

Inside

Do a safety check around the house. Check for clutter, extension cords, scatter rugs that may slide and flooring that may be uneven.
Improve lighting
The bathroom can be a dangerous place. Add sturdy handrails in the tub, shower and by the toilet.
For a checklist of ways to make the home fall-resistant, check out the web site at the National Center for Injury Prevention and Control (See the "Preventing Falls: Resources" post).

Outside

Be very conscious of where you’re walking when moving out and about. Slow down.
Uneven walking surfaces, like uneven pavement, cracks and sidewalk potholes can be treacherous. Make sure that all the walks and driveway at the house are in good repair.
Mother Nature does her share to trip up a walker. Snow and ice are the biggest culprits here. Prevention means proper shoes for inclement weather and a bag of kitty litter in the car to take care of slippery spots.

Dress Properly for Walking

Wear low-heeled shoes with rubber soles. You’ll see many seniors in good athletic walking or running shoes. These give support and do not easily slip. Avoid leather soles and scuffy slippers.
Ask your doctor where you might obtain protective gear available to protect hips and limbs when you do fall. Elbow and knee pads that are used for roller blading or skateboarding are good.
Make sure that clothes fit properly. No long pant cuffs over which you might trip. Keep sleeves the proper length so that you can get a good grip on a handrail, walker or cane. Trousers that are too baggy can impede your progress.
For women, consider using shoulder bags that you can carry across your chest or small backpacks instead of purses which you clutch under your arm or hold in your fist. Shoulder bags and small backpacks keep both hands free to assist in balance and for gripping.

Many of these tips come from organizations and professionals who have many more suggestions. I've listed these in another post entitled "Preventing Falls: Resources". Check it out!

Have a safe and happy day!

"I've Fallen..."

2009-04-28T07:59:00.003-04:00

We smirk at the commercial of the older woman calling out for help, but the statistics are sobering. According to the Red Cross, one out of every three persons over the age of 65 sustains an injury through a fall each year. Other sources report that, overall, falls are the second leading cause of unintentional injury and death in the United States and the leading cause of injuries. Falls are the leading cause of death for Americans over 65. About 90% of those who fall are aged 65 or older. Two-thirds of those who fall will fall again in six months.

Although we do hear of broken hips or thighs that require hospitalization for the elderly, most falls do not result in serious injury. However, there is often a psychological impact. You know from your own experience that if you fall, you become vigilant, at least for a while, in any similar situation which might cause you to fall again. For the elderly, the psychological impact can be even more dramatic. My mother, in her 60's, slipped and fell on an icy patch while running errands. Bruised shoulder muscles brought her pain for weeks. More restrictive was the way that she began staying home, stating in even the mildest winter weather that she might fall. Staying home made her depressed and fearful, since she was not engaging in activities that she enjoyed and that may have lifted her spirits. Studies show that approximately 25 percent of community-dwelling people aged 75 or over unnecessarily restrict their activities because of a fear of falling.

From these statistics it is easy to see why preventing falls for your parent is the #1 measure you can take to increase your parent's chances of living longer as an independent, active individual. Preventing falls will also relieve you, the caregiver, of unnecessary worry and more care duties. Preventing falls is a good practice not only for your parent but also for you, so that you can care without the burden of injury. Since the majority of falls happen at home, many can be prevented.

There are five major factors that contribute to falls:

· Osteoporosis
Osteoporosis is a condition wherein bones become more porous, less resistant to stress, and more prone to fractures. It is a decrease in bone density which contributes to falls and resultant injuries. In some cases, a bone breaks spontaneously, causing the fall; in others, the fall comes first with breakage as a result.

· Lack of Physical Activity
Physical activity helps muscle tone, bone strength, and balance. All of these physical capabilities are needed to stay upright on unsteady ground, walking up or down stairs, and dressing.

· Impaired Vision
Medications, aging, and illness can all contribute to changing vision. Less visual acuity means that we miss obstacles and may feel less balanced.

· Medications
Dizziness, drowsiness, and decreased alertness are side effects of some medication and all can contribute to falls. Be particularly aware when a new medication is added to what is already prescribed. Often a combination of medications will cause a problem when taking only one drug will not.

· Environmental Hazards
These hazards include icy sidewalks, wires lying across a floor, slippery tubs, throw rugs, and pets. Inside or outside the house, anything that hinders walking or contributes to uneven or unsteady floors can be a cause of a fall.

Begin this week to become more observant of your parent's environment, perhaps to ask more questions. Has your parent been tested for osteoporosis? What are the side effects of her medication? When you visit, look out for potential hazards in the home that could easily be fixed. Can your parent see clearly?

Make your preliminary list and on Thursday, I'll share things you and your parent can do in each hazard area to prevent falls, and provide a few resources to read more.

Until then, be safe!

Myths of Eldercare

2009-04-23T06:58:00.006-04:00

I'm wrapping up this week of blog introduction with a reality hidden beneath the fuss and flurry that is often a caregiver's life. A reality that affects how you and your parent react to the dynamic caregiving situation you both have entered. A reality of which you may be totally unaware.

After the first months of caregiving, as I recognized that my relationship with my ailing mother was more complicated than I ever imagined, I spent a lot of time reading and talking to others about the emotional and relationship side of parentcare.

What I learned along the way was that I had bought into the Myths of Eldercare:

MYTH 1: In all families, parents and children love each other unconditionally.

MYTH 2: No matter the quality of the parenting, parents deserve a child’s unquestioning devotion, duty, love and service.

MYTH 3: Every child is obligated to care for his parents as they age.

MYTH 4: A person honors her parents only if she sacrifices her own life and mental health for the sake of the parent. Without total sacrifice, the child can not be judged as “good”.

Note the "all-or-nothing" quality of each of these myths. They are rarely stated outright and never written down. We breathe them in from our families' actions, conversations with friends, from newspapers and television. The myths invade us as easily as secondhand smoke and become a part of us. And in living, we act as if these myths were immutable laws. They become the bars of a cage, restricting the options we have in life. Often we don’t even think about what we are doing. We just act.

What are the Facts of Eldercare?

FACT 1: Parents and children should love each other unconditionally. But let's be honest, dysfunctional families exist. Even in "normal" families, love's depth and expression are different and different even between each parent and child.

FACT 2: Parents are human, and their love is not always given in a fair or evenhanded manner. Some parents are abusive; some have abandoned their families. Being a parent is no guarantee that a child will offer unquestioning devotion, duty, love and service. (Talk to a teenager sometime for clarification on this point.)

FACT 3: There is no contract or rule that obligates a child to care for an aging parent. The Bible says, “Honor Thy Father and Thy Mother,” but it’s vague on how to do that. In any case, you can not mandate love or respect.

FACT 4: Sacrificing your own well-being in caregiving does your parent no good. It drains precious energy away from caregiving and weakens you. To care for someone else, you must first care for yourself.

What I'm asking you to do now is to be honest with yourself. Have you accepted any or all of the myths as Truth? If you have, how might your belief in the myth affect how you talk with your parent, decide priorities in your life?

And just as important...does your parent believe in any of the myths? Does that belief bring with it expectations that you might not be able to meet?

A counselor once told me that 80-90% of our behavior comes from the subconscious, from our instincts, from beliefs deep within us. Until we pull the myths up into our thinking, conscious decision-making brain, we will act on them instinctively, perhaps to our detriment.

What myth do you believe? Is your belief filling you with guilt or with joy in your caring? Do you need to discard that myth for something more realistic, more positive? Is your myth helpful?

Welcome to Parentcare 101!

2009-04-21T08:47:00.002-04:00

My mother lived in the small town in which she had been born. When I began caring for her, I lived over 250 miles away. My sister, my partner in caregiving, lived another 500 miles away from me. The geographic distance promised to add logistic difficulties to an already difficult situation. Within weeks, I recognized another sort of distance that would play a tremendous role in my caregiving--I didn't particularly like my mother.

These were the facts of my situation. They were unique to me.

What are the facts of your caregiving circumstance? I'm guessing they are different. What can you recognize as challenges? What about your situation makes you breathe a sigh of relief that, at least that one thing is working among everything that you deal with on a daily basis? Do you view your caregiving as a duty, a sacred trust, payback or a little of all three?

In Parentcare 101, you and I will take a look at your unique situation and offer tips and suggestions. These ideas will be perfectly valid if you care for an elder who lives with you or with whom you have a loving, supportive relationship. But in Parentcare 101, I acknowledge that for many of you there is distance in parentcare...either because your parent does not live with you or because your relationship with your parent is not perfect. Together, we'll explore what needs to be done, how best to get it done and whom you should ask for help. Although all of your situations are different, caregivers deal with three areas of care:

Providing Basics for Your Parent: food, shelter, clothing, health care, transportation and a social environment;
Caring for Yourself: placing yourself at the top of your priority list so that you will have the energy and stamina for caregiving; and
Preparing for the Future: gathering information about your parents, their home, available resources, always looking forward just a little.

Each week in Parentcare 101, I'll focus on one of these areas. I plan to post twice a week on Tuesdays and Thursdays. With this schedule, you'll know when to check in for something new, and we'll have time for comments and processing one topic before moving on to the next.

An integral part of the service of this blog is the Parentcare 101 website. The website and this blog will work hand-in-hand to share tips, resources, and advice. I know that those of you caregiving now have a lot of great ideas. Bring them on.

To get us started on our journey together, on Thursday, I'll talk about the "Myths of Eldercare" and how those myths can block good care for your parent and for you.

See you on Thursday!

Coming Soon!

2009-04-14T09:05:00.002-04:00

On Tuesday, April 21, 2009, Parentcare 101 will launch. Looking forward to sharing CareTips and resources for caring for your aging parents. See you on Tuesday!