Posted on Mon, Jun 18, 2012
Technology is a double-edged sword
Forget about Homer in the Odyssey. Today's sirens are the songs and vibrations of our cell phones.
I constantly hear from my clients how little time they have as their smart phones keep streaming info to them during our sessions... and the clients keep looking at them!
Let's face the fact--when you provide Alzheimer's care to a loved one, your phone becomes your life line!
Growing up we had one telephone land line until I was a teenager, then dad added another. No, I was not a privledged teenager, although it was a pretty pink princess phone... Dad did this to save his sanity!
Back in 1899 when dad was born, there were no phones. Well, that's not totaly true. Thanks to Mr. A.G. Bell in 1876, we had the birth of the the telephone. But the telephone back then was a far cry from what we have now, and service was limited.
The phone replaced the telegraph and in that era phones were mostly used to transmit the most essential informaiton, and not all news was good. So, I grew up in a home where the ringing of the phone often signaled that someone was sick or dying.
Especially if the phone rang after 9pm.
Gone are the good old days for many of us, where if you were home you answered the phone, and if you weren't home, the person just called back. There were no answering machines and sometimes nobody home to take a message.
Think about that. It wasn't that long ago that when people made plans, they showed up at the designated meeting area on time. No calling to say that you were running late, or had to cancel at the last minute.
But then came the message machines, the pagers, the cell phones and now smart phones that bring the mobile Internet to the palm of our hand.
Alzheimer's Caregivers are on Call 24/7!
For many caregivers, the added stress and anxiety of being digitally connected is increasingtheir caregiver stress! Being so connected has changed the way that we give and receive Alzheimer's care.
Gone are the days where getting in touch meant during normal business hours or -- Egad! -- waiting at home for a phone call.
Now, we put in a call to the doctor and then go about our day.
Shutting off the phones is not a logical option, however, depending of the stages of dementia that your loved one is in. Different stages of dementia will call for (no pun intended) different strategies.
In the early stage of dementia, the caregiver support you may have to give might be of plans and reassurance to a loved one. This is the time to set boundaries. Yes, you want to be there for your loved one, but unless it's a 911 situation, being on call 24/7 can be stressful!
Set the times that work best for you.
Many of my clients work full time and/or are raising families. For many, a quick phone call in the morning or on the way to work provides the reassurance your loved one will need to give you both peace of mind.
During the middle stages of dementia is when many caregivers get bombarded with phone calls.
If you haven't already done so, give your loved one and their caregiver a unique ring tone. This way you will know who is calling- and will reduce your anxiety every time the phone rings.
Set time limits for both, twice a day or whatever works best for you.
For emergencies (especially if you are at work) set up a unique ring pattern. For example, the caller will let the phone ring 3 times, hang up, then call back immediately. That way, if you hear three rings followed by another phone call, you will know the person calling needs to get in touch with you immediately. This works well even if your phone is set on vibrate.
When a person is in the severe stages of dementia, phone calls from your loved ones will usually end. A person in the severe stage no longer has the memory or capacity to use a phone. During this stage of dementia you will be receiving phone calls from the the in-home caregivers, aides, ALF, or hospice.
No matter what stage of dementia your loved one is in, setting a unique ring tone and pattern will be a sanity saver.
I know first hand the anxiety and stress that a ringing phone can bring.Whether I was at work, in the car, with the kids or out with friends, a call from home meant a problem.
When you are providing Alzheimer's care every call appears important. But, you don't have to go through this journey alone. In the first chapter of my book, available for download free, I will tell you how to make the best and most practical decisions about providing the best care for you and your loved one.
Posted on Fri, Jun 08, 2012
I'm often asked a simple but loaded question, "did I purchase my long term care insurance policy because of my mother?"
My answer is yes, but no.
Watching my mother as well as thousands of clients going through their different stages of dementia certainly had an impact on me.The rising tide of dementia and their caregivers grows daily.
Reading news and the e-mails from Alzheimer's Care groups such as the Alzheimer's Association is quite the reality check:
With no cure and no way to stop it, Alzheimer's disease will become the number one cause of death and disability.
The way I look at it, long term care insurance is an investment in me and my family.
Over the years I, like many of you, have been paying for insurance, some required and others voluntary.
Take home insurance for example. After 10 years of paying rediculously high premiums, the one and only time I went to use my home insurance was a joke. Thanks to a dimwitted insurance adjuster the amount the insurance company gave me to cover the damage from a burst pipe never covered the necessary repairs.
The same thing for flood insurance. In the past 40 years living in South Florida on the beach never once did we get flooded out, although those who lived inland and didn't have the high premium to pay got constantly flooded.... let's just say that if you live in South Florida, you are going to pay for premiums to cover the cost of the entire state!
Don't even get me started on wind storm insurance. Over the years I've paid out over $100,000 thousand dollars. No claims were ever put in and it was never used. My money was blown away.
Actually home owners, flood and hurricane insurance is required by the bank to protect their asset, if you own your home out right then insurance isn't required.
The way I see it, when it comes to long term care insurance, my asset is me.
I know first-hand Alzheimer's and other dementias can ravage the not only the person with this disorder, but their caregivers, family dynamics and finances.
The stages of dementia that a person will go through is costly. Long term care insurance will be your financial buffer.
Home health care is expensive. Depending on where you live and your needs, the cost to care for your loved one will range from $10 to $60 dollars an hour.
So, you might ask, should you buy long term care insurance? Should your loved one?
A few years ago I had the opportunity to meet Stephen Moses President of the Center for Long Term Care Reform.
Stephen is passionate about the benefits of Long Term Care Insurance. And you should be too!
Years ago I believed that Medicare paid for long term care. It once did, but no longer.
Medicare Only pays for the first 100 days in a hospital, after that you are on your own.
To make your life even more complicated, the Medicare rule is that your loved one needs to go directly to a nursing home within 3 days of discharge from a hospital stay. Talk about pressure!
Some of my clients feel that "self insurance" is the way to go. For a while anyway. The reality is that the cost for care in their (or your) home will be more than $200 a day. If your loved one with dementia is in an assisted living facility, the costs are even higher, and that doesn't include the aides that you will need to hire.
The reality is, different stages of dementia will require different care. Most long term care insurance policies cover not only home health care aides, but also day centers and certified geriatric care managers. Some plans will even pay for family members who provide care.
When it comes to long term care planning, nothing beats long term care insurance.
Contact me to get started on this path. I will provide you with a list of resources to get started today.
Posted on Tue, Feb 28, 2012
Last week I received a crisis text message from a client in Texas informing me that her mother was hospitalized.
Long story short, nine months ago her mom moved in to care for her mother who has dementia in Miami Beach, Florida.
Abuela is an 89-year-old fearless, feisty, independent woman who firmly believes she can take care of herself.
Back in 1984, this twice divorced and retired professional bought a one bedroom condo with a great view of the ocean where she has happily lived alone for the past 28 years.
Abuela was doing fine up until last year when her granddaughter flew in for a weekend visit.
Two days turned into two weeks.
Sound familiar?
I received an S.O.S phone call toward the end of her unexpected and extended stay. After doing a home assessment and spending time with both of them I made several recommendations that were quickly and successfully put in place... except for the in-home aide.
We got the aides to come, but Abeula sent them away when they came to the door.
Sound familiar?
Once mom moved in we slowly introduced an aide to help with bathing and grooming.
Introducing an aide is not something that's done quickly, especially when the person with dementia believes that they do not "need" the help.
Lets face it, Abuela might not have needed the help, but her daughter sure did!
A few months and several phone calls and e-mails later, I was called in to do another visit. Abuela's stages of dementia had changed, and so had her caregiver. As a result, mom was now under stress and anxious from the constant demands of Abuela. With no time for herself, and sharing a bedroom, there was no privacy. Additional aides weren't an option because mom couldn't handle Abuela's anger at having "unneeded" people in her home. And Abuela refused to go to a day center.
As I say in my dementia book, "the stress of caregiving without help is detrimental to the caregiver." The types of dementia care needed will change as the stages of dementia progress.
Now fast-forward to the crisis text message. The message I received is was that mom is sick and hospitalized. She had just been newly diagnosed with leukemia, and can no longer be a caregiver.
Now we have two separate crisises. The first is getting immediate help for Abuela, who should not be left alone, and the second is to manage mom's medical condition from afar.
There was no back-up plan in place. The family believed mom, now diagosed with leukemia, would always be the caregiver for Abuela. Are you making any similar assumptions in your situation?
I know first-hand what it's like to be sick while providing dementia care. The flu or any other illness (or broken bones or surgeries) didn't care that I was the caregiver. Traveling through the different stages of dementia, the person I was caring for was oblivious to my needs.
As a caregiver, getting sick isn't something we plan for, and getting better while providing dementia care isn't easy! But, it happens to all of us. At some point while caring for a person with dementia or Alzheimer's disease, you the caregiver will need some tender loving care.
Caregiving is exhausting and stressful to say the least. The constant physical and emotional toll that we caregivers go through on a daily basis wrecks havoc with our sleep cycles and makes us more prone to physical injuries and stress.
In my dementia book I cover this type of situation. You can not care alone!
But for now, here's your Plan B, Plan C, and Plan D:
Plan B is now in place: the family has hired in-home care from an agency that will come in for two hours in the morning and three hours in the afternoon. Abuela isn't happy about this (quite the understatement) and the aide is having a difficult time doing her job, because according to Abuela, "she's not needed or wanted." This is normal.
Plan C is to rent a two-bedroom apartment in Miami and have them both share space and an aide.
Plan D, which is our goal, is to have both of them move to Texas as soon as possible. From there, they can both find an apartment that's near the medical center. Mom will receive her treatment, and they will both share an aide.
These plans may seem simple, but it took hours to come up with a soloution that worked best for this family. After factoring cost-of-care, current and future needs, finances and location, these were the most logical and cost-effective solutions.
As a therapist and certified geriatric care manager who has worked with thousands of families I've learned to expect the unexpected.
There's an old expression that says, "Man makes plans and God laughs."
No matter which of the stages of dementia you're currently in, now is the time to develop your back-up dementia caregiver plan.
Posted on Wed, Feb 15, 2012
When I first started to care for my mother, it took me a while to realize that when a person cares for a person with dementia, their life is not their own.
I had an epipany one day when I felt the demands of others had taken over my world.
I sat down and figured out that between caring for mom, dad, spouse and two kids--when I divided that hour into 60 minute increments--I basically had only 10 minutes each hour for myself.
There is not much you can do in 10 minutes!
I don't know about you, but for me that was my awakening as a dementia caregiver, or as Oprah woud say, my "A-ha moment."
Another "A-ha" moment happened while I was in my car driving home after two hours of convincing mom to go to a day center and then actually trying to get her there. I just sat in the parking lot and cried.
I know what you are thinking... Nataly, you are exaggerating!
Nope, I'm not. I sat in the parking lot and hysterically cried. I cried for my mother, my children, my family and myself.
Alzheimer's care will break you.
When you are dealing with a person who has any form of dementia there is no "me" time. What you get are stolen moments. And even when you get those stolen moments, somehow they get used for someone or something else.
Alzheimer's Care is 24/7. There is no escaping this fact. Even when you are "off" you're "on."
Dissrupted sleep next to a monitor, clutching your phone like a child's blanket, constantly on red alert for the sound of a foot step, fall, or worse--the chime of a door opening.
Time is the only commodity that can't be bought, sold, traded or bartered for. Time is all we have. And as my mom's symptoms of dementia progressed, and through her various stages of demnetia, there were times where I longed for those precious 10 minutes of time.
Sometimes I found them and others I didn't.
I did the only rational thing I could do: I made lists.
When I made lists, for once, it was about me. Okay, mom was in there too. Her needs, my family's needs, my needs (see I'm still last), but that is what happens when you become an Alzheimer's caregiver.
Forget about spring cleaning, I was time cleaning!
I didn't know it back then, but I learned over time that to be an affective caregver, you have to learn to say NO.
Just like our cluttered homes and lives, as a caregiver sometimes we have to sit back and take stock of our lives.
Is it possible that we are too connected that we've lost connections?
Over the next few months I will be sharing tips that you can use to make caregiving easier by time cleaning.
As caregivers we can never have enough time on our hands. Send me your time saving ideas and I'll add them to our list.
Posted on Sat, Dec 17, 2011
I just got a phone call from my client who was sorry to inform me that she has to cancel...again!
Slow down a moment before you rush to judge.
Cancellations are common when you are dealing with anyone going through the many different stages of dementia. Jane's husband, Bob, has Frontal Temporal Lobe Dementia (FTD) and he has become our weather barometer! Anytime the weather changes, so does his mood and behavior.
I started tracking this unusal phenomena when I noticed a pattern of cancelations a few months back. Bob's symptoms of dementia kick into high gear whenever a weather front came through.
Bob is more accurate than my arthritic knee!
And this not only true for Bob, because over the years I've tracked cancelations caused by weather. It seems like the weather has an adverse affect on many who have dementia. Easy going people suddenly become argumentative and non-compliant.
A weather front comes in and so too do the behavioral problems!
And this weather problem brought in more problems for my client. Jane not only missed our scheduled appointment (which we rescheduled to a phone session), but she also couldn't attend a luncheon that she was looking forward to.
Add into the mix that the concert tickets she purchased months back went unused--they never attended the event because of the bad weather.
So, this was a good time to revisit an idea I had suggested to Jane about bringing in a home aide for "Plan B" situations.
There comes a time for every caregiver, depending on the symptoms of dementia, where going out of the house will be a major issue. This is also true depending on the stages of dementia your loved one is in. As a caregiver, if you want to attend an event, there will come a time when you will need to bring in the reinforcements.
Many of my caregivers avoid hiring an aide until the very last moment. This may happen for a myriad of reasons: "I want to be with him," "He won't accept a new person," "I can do it myself" and "He still likes to go places" are just some of the reasons I hear. Again, depending on the stages of dementia, the reasons will vary.
The reality is, for many caregivers, accepting the fact that extra help is needed means also coming to terms with the fact that your loved one's condition is declining. And that is a very difficult idea for many caregivers of Alzheimer's patients to accept.
Another issue is the quality of care. Different stages of dementia will require additional care and support from others to ensure they are successfully cared for safely at home.
For Jane, we discussed adding additional hours with an aide so that the next time she makes plans for the day or evening she will know to have an aide in place.
Emotionally, this was a hard conversation for Jane to have. She finally accepted, though, because as the well spouse it meant she had become what I call, one of the "married-singles." It is a huge transition to attend events without your spouse after many years of marriage.
Jane and I also talked about our "in-and-out rule." When the aide comes in, Jane goes out. When the aide is out with Bob, Jane stays in the house. This way, Jane will be able to go out of the house and not worry as much. Her husband Bob is a wanderer and has walked out of grocery stores, malls and other events. I wrote about ways to stop wandering in an earlier post.
Take it from me: When a caregiver finally gets some hours off duty and is miles away from home, being glued to the phone in case an emergency happens takes all the fun out of the outing.
It's just better to be safe than sorry knowing an aide and your loved one is safely secured at home.
Respite care does not always mean hiring in help. Over the next few weeks I'll be writing about the different types of respite care and how different types of respite care can help you.
Posted on Tue, Dec 13, 2011
Growing up I always found gift giving for my parents difficult. Ties, perfume, cologne, perfume...boring!
My parents "oohed" and "ahhed" over my gifts, but the reality was, how many ties did my father need?
So when mom started having symptoms of dementia, the holidays really stumped me!
Bathrobes and slippers were my go to items. They made me feel good, and mom seemed to enjoy the gifts, that is, until I was the one who had to clean out the home and found all of my "wonderful" presents never used!
It appears that I'm not the only one with this problem because I've received several emails over the last few days from
caregivers looking for holiday giftsfor their loved ones.
Through the years I've learned some gifts are better than others. The various stages of dementia will call for a little more ingenuity.
As many of us know, dementia affects everyone differently. There are many different symptoms of dementia, and those symptoms will help you pick the right gift. For example, some symptoms restrict activities and other symptoms might make other activities better. The key is to understand what the person with dementia is capable of doing and choosing your activity acccordingly. Different stages of dementia will result in different choices.
I'm constantly on the look out for great activities. Early this year I decided that my go-to gift would be jigsaw puzzles.
A recent article correctly noted that, "Dementia slows down the brain’s function and playing games like crosswords and solving puzzles is good for the affected person." This supports other findings like the one published recently in the Huffington Post where researchers from Germany found individuals who participated in dementia therapy (such as with puzzles) were effective at stopping their dementia from progressing further. The one-year study based on 61 participants also found patients were able to keep doing their everyday tasks. However, patients who only took dementia-slowing drugs had their dementia progress.
In addition to their therapeutic effects, puzzles also make for a great activity to do together.
So I set out to find the perfect puzzle.
The problem I faced was this: All the puzzles I found in nearby Miami stores were either too childlike or had too many pieces. I wanted something that would be age appropriate as the person progressed through their different stages of dementia.
Now, you should know that I'm a sucker for my clients, so it's not uncommon for me to troll the Internet late at night looking for just the right activity. I was searcing for an art book and suddently I stumbled onto a website that physically woke me up....
I found the perfect collection of jigsaw puzzles! These puzzles are based on nostalgic covers of the Saturday Evening Post, a well-treasured publication from the past of many dementia patients. Saturday Evening Post covers are perfect subject matter because they are age appropriate, fun and there are many to choose from.
Truth be told, everything looks great on the Internet, but before I recommend anything to my clients, I have to rigourosly test the product myself. Call me skeptical, but I've been burned too many times. So I contacted the maker to find out more.
It turns out that Karen Miller, the manufacturer of the puzzles, has a passion for the elderly. I learned that in 2007 she saw a show about Alzheimer's, and the show brought back all the memories of her mother. She remembered how her mother had suffered through many strokes and the symptoms of dementia. Karen is not only licensed to use the Saturday Evening Post covers, she was able to bring them back to life in her own unique way. The site describes how Karen came up with the idea:
"Her Mom always liked puzzles and playing cards, both became very difficult for her. Puzzle pieces being too small and puzzles too big were frustrating for her."
Karen also makes memory cards that are great for matching games and terrific for reminicence therapy.
I have personally found that the artwork on these puzzles motivates and stimulates memories, the pieces fit well in hands and they are solidly built. I also find it amazing to listen to patients as they remember their memories of Norman Rockwell and the Saturday Evening Post.
To learn more about these terrific puzzles, visit Karen's website at http://memoryjoggingpuzzles.com
Posted on Wed, Dec 07, 2011
I can remember it as if it was yesterday. Sitting in my very first support group at Mount Sinai in Miami Beach. My mother had just been diagnosed with dementia and I was told attending a support group would help.
There were six of us in a large, spread out dinning room that felt more like a lecture hall than an intimate table for ten.
A quick scan of the room to see who my seat mates were brought me down to earth. I was 38 years old and caring for my mother. All of the others were much older and caring for a spouse.
I felt like a fish out of water.
People nodded and smiled at me. Being who I am I struck up several conversations only to be paternally struck down. I was too naive and being a newbie I didn't know what others knew....
Caring for a parent is totally different than caring for a spouse
So, innocently I sat through this group listening to the doctor talking about the different stages of dementia and how my mom was going to act and be. I honestly tried to befriend the others in the group who gave me a "knowing" smile and said, "It's different, it's not your wife."
I didn't get it back then because I thought that we are all in this together and going through the different stages of dementia should have been our bond.
Nothing can be further than this truth. Caring for a spouse is different than caring for a parent.
Some things stick with us and make us better caregivers. For me, this lesson hit home, then and now.
Back then, I had no idea that years later I would be a licensed therapist and running the group, not only for the Alzheimer's Association, but for the Alzheimer's Educational program at the Wien Center.
Because of my own experience, I was very sensitive to the needs of each group, children and spouses. Even though both groups will experience many of the same stages of dementia, the reality is that each stages of dementia means something different to each group.
With this in mind, I tried to find a balance for my groups. Spouse, child, friend, culture ... the different stages of dementia were in my mind for each group I ran. Talk about stress!
The reality is that group balance and cohesion depends on many factors. Even with the right mix I still felt like Richard Dawson hosting Family Feud.
So, here are my Dementia Zone top five tips for understanding the differences between spouse and child caregivers:
1- The expectation is different. Adults fall in love and get married, and as spouses they share a dream to spend their lives together. Spouses expect to grow old together and so, despite the imperfections, many tolerate the ups and downs that marriage brings. Even in their wildest dreams, despite vows of "in sickness and in health," few people ever expect or plan for dementia.
2- The intimacy is different. Spouses have sex and sexual needs. Despite what children may want to believe, it's totally natural to have, want and be able to be sexual beings throughout our lives. But when your sexual partner has dementia, it changes the entire dynamic of the relationship.
3-The interaction is different. Couples have their own form of communication. But dementia changes the way we interact and communicate with other people. As a result, spouses become responsible for taking control and being in charge of a person who was once capable on their own. They find themselves directing (or even ordering and pleading) for their spouse to do the most ordinary, everyday things, including bathing and grooming.
4- The role is different. When you are married to a person, there is a written and unwritten "code of roles." For example, (depending on the generation) some couples may subscribe to the idea that "men work on the outside, women work on the inside." Today, both sexes can be equal partners, but every relationship still has roles. Who pays the bills, who cares for the car and lawn, who grocery shops... dementia will change this.
5- The socialization is different. The reality is the wife is usually the one to direct the social functions of the family. Just like Judy McCoy in the "Love Boat." When the wife has dementia, socialization for the spouse slows down or ceases altogether. No matter which spouse has dementia, friends start to fade away and, due to the different stages of dementia, socializing with others becomes very difficult.
If you are caring for a spouse with dementia, you will want to check out The Well Spouse Association, which is dedicated to helping out the spousal caregiver. WSA is filled with great resources, articles and advice that offers spouse specific caregiver support, all helping you through your journey. Go to http://www.wellspouse.org/
In the meantime, if you'd like to talk to me about your caregiving situation, just contact me through this website or call me at (305) 904-9506. I look forward to hearing from you.
Posted on Fri, Dec 02, 2011
I don't know about you, but as a caregiver working in the field of dementia, even I can get a little distracted!
With so many demands on my time and energy, it's easy to let the small things slip through the cracks.
Take health insurance for example. Due to an unfortunate situation (my hubby forgot to pay the bill) we were dropped by COBRA. Once I realized we didn't have medical coverage, I started on the hunt for a new policy. It wasn't as simple as it once was. Individual policies are expensive and confusing. Co-pays, deductibles, doctors, medications, in-state, out-of-state....let's just say the entire process was overwhelming, but not nearly as overwhelming as picking a Medicare plan! And I'm a health care professional!
Which leads me to today's topic:
Medicare Plans and Scams
Over the past several weeks I bet you have been getting an awful lot of Medicare Advantage plan information. You're probably not only getting this through your mail, but also in email and text messages on your cellphone too. I, for one, had totally forgot that this is the season for Medicare enrollment!
With only a few days left to go, many unscrupulous insurance agents know if they don't get you to switch and sign up by December 7, they will lose their hefty commissions. So, I'm writing this article today to help you save money on health insurance.
The problem for caregivers of dementia patients is that by saving money you might just lose some of your benefits. Some plan advisers may leave out important details about coverage or outright misrepresent the plan. With so many plans to choose from, depending on the different stages of dementia you're dealing with, many Medicare plan representatives I spoke with were just as confused about what's covered in their policies as I was!
In "Alzheimer's Disease and Other Dementias: The Caregiver's Complete Survival Guide" I talk about what has happened to several of my clients who did not know or didn't do their Medicare homework. Depending on the stages of dementia your loved one is in, keep in mind they will have drastically different medical needs than people who do not have dementia. Keep the special needs of dementia in mind when you review your Medicare options.
So, before you sign up for a new plan, here are The Dementia Zone's top five tips to make an informed Medicare insurance decision.
1-A Medicare Advantage Plan is not the same as a Medicare supplement. A Medicare Supplement works in addition to your original Medicare coverage and a Medicare Advantage Plan works in place of your original Medicare, and may provide additional features.
2- Ask important questions. Each Medicare Advantage Plan is different. Although all Medicare Advantage Plans must cover at least the medically necessary services, Medicare Advantage Plans can charge different deductibles, offer co-payments (for instance $30 per office visit) or have various co-insurance terms (such as 20% of the procedure cost).
Some Medicare Advantage Plans have a limit on how much you can spend in a year and some plans do not have a spending limit.
Medicare Advantage Plans can also offer additional services like eyecare, dental care, and fitness programs. Consider what you need before you look at plans.
3-Verify before you switch. Ask yourself, what is the true cost? Is your doctor on the plan? Which hospitals will you want to use?
Depending on the symptoms of dementia your loved one is facing, your needs for physical therapy and rehabilitation will change. Be sure you know the plan's restrictions.
Ask yourself whether you will want to use their service providers, or what you will need to pay if you go outside their plan. Check the rules! Some plans insist you get a referral to specialists or engage in high-cost testing and procedures in certain situations.
4- Check the prescription plan. Are the drugs you are using on the formulary? Know that the drugs you may need in the future might not be on their plan, depending on which stage of dementia your loved one is in.
5-Check additional services. Medicare Advantage Plans also offer additional services like eyecare, dental care, and fitness programs.
Additional services are great, buy only if you actually use them or your doctor is on them. Don't be tempted to join up for somethingn new thinking you might use a fitness club, especially if you hate working out!
6- Never assume. Even if you are with a plan you love, don't automatically re-sign with that plan without checking the details. Plans change, doctors change, medical conditions change. Remember, once you are enrolled, you will be in this plan for one year (unless you appeal). If you are unsure about something, ask questions now or telephone Medicare at 1-800-633-4227 for assistance.
Posted on Thu, Nov 10, 2011
I just got back to Miami last week and I’ve been in a bit of a funk.
I miss being in North Carolina and this time I left the dogs and the hubby behind. For the first time in weeks the sun is actually shining and I have the whole house to myself. It’s every caregivers dream come true, so what’s up with my mood?
If I didn’t know better, I’d say I was depressed.
The reality is that I have Missing Disease.
I miss my old home in Miami Beach where I cared for mom and the kids, I miss North Carolina, the dogs, the hubby, although not in that order. I miss the chaos of the fun times and having a full house...I miss all the big windows where the light streamed in.
I miss my “normal” life.
The same thing goes for many of my caregivers and people with dementia.
A few months back, a client confided in me that she was depressed. We spoke about the sadness and loss of being a caregiver. This woman is the most active 85-year-old that I know! She still works, exercises, and socializes but the daily strain and worry over her husband with mild dementia has been getting to her. She had tried several anti-depressants over the past year but they didn’t help.
We talked about grief and sadness for the future that has changed.
Hearing so much about the wonders of medication through television advertisements she was convinced that there was a medication for her that would work and she went to see a new psychiatrist.
When I saw her at our next visit she was so much more upbeat that I was curious about which medication the doctor had gaven to her. It turns out the doctor spent time talking with her and then diagnosed her with “Missing Disease”.
According to her doctor, many of the elderly are incorrectly diagnosed with depression because they are feeling sad. My client had every right to feel sad. Her husband has dementia and she's worried about him and their future together. The daily questions and forgetfulness have been getting to her because its been changing her state of “normal”. So the prescription that she got from her doctor was to talk with me!
Unfortunately, the word "depression" has been too over-used in our society. Whenever we are down we automatically think that it’s depression. People look confused when I ask them if they are depressed or sad!
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods of time.
Sadness is a normal process and reaction when we are disappointed. Let’s face it, as dementia caregivers we have a lot to be sad about!
Loss of control, unexpected changes, stressful life events, time demands, increased responsibility, additional expenses, fear, anxiety, worry, contemplating the future.....a total change of our "normal".
There are many remedies for Missing Disorder and none of them involve a trip to the pharmacy. Some of the techniques that work well are talk therapy, aromatherapy, meditation, nature therapy, music and art therapy and lifestyle changes such as diet and exercise.
Here are your top 5 Dementia Zone tips that you should know about depression
1- True clinical depression is a mood disorder in which feelings of sadness, loss, anger or frustration interfere with everyday life for weeks or longer.
2- Check for a medical condition. Hypothyroidism or underactive thyroid, lack of sleep, heart conditions and drug interactions can cause depression.
3- Medication may be helpful in the short term (and so are placebos). Studies have shown that anti-depressants are most helpful for those who have severe depression.
3- Talk therapy has been shown to be more effective then medication and there are no side effects! Find a good counselor or support group.
4- For many, depression will run its coarse. Despite what you may believe, you may not need to be on medication for the rest of your life. Often times, the reason people feel worse when they go off their medications is due to physical and mental withdrawal symptoms.
5-Check the three S’s- get enough Sleep, get a boost from Sunshine, get a handle on your Stress.
About that client ... I saw her yesterday and she is as happy as can be!
Tune into the next article to find out why. But for now, enjoy the story of Bob and Babs:
Posted on Tue, Nov 08, 2011
Let’s be honest. Long car trips are boring. Short ones can be too. There are only so many times that you can play car-color bingo or license plate tag. One year, out of desperation to save my sanity and to keep the kids from a major back seat meltdown, I invented a new game: “Name The Road Kill”.
As macabre as that may sound, driving in Florida--other than the odd possum, armadillo or raccoon--the roads are pretty much clear.
The kids were occupied for hours. They would spot something from a distance, thinking it might be an animal, only to find out it was a piece of tire.
Times have changed. As a caregiver, I’m changed, but our family tradition lives on. And so, to keep me focused on my drives after license plate tag and car color bingo, I now count the road kill.
This is why on my drive up to North Carolina in late October I noticed there were an awful amount of animals that didn't quite make it to the other side of the highway.
What I thought were tires from a distance turned out to be deer. I’m not talking one or two. I counted over nine deer. Starting in Georgia, the deer obviously were not crossing at their designated cross walks.
Being a Florida girl, I never experienced or realized this large mammal driving hazard until last spring. That's when I was driving back to Miami and a deer leapt in front of my car at dawn. Another time, a deer and fawn raced across the road in an urban area. I slammed on my brakes and thankfully, no one was behind me.
Unless you have encountered it, having a deer suddenly jump in front of your car is a heart-pounding experience.
No one wants to hit Bambi!
As caregivers, when we think of driving, and early stages of dementia or elderly driving, we typically do not consider wildlife suddenly jumping in front of their cars!
When safely at home I did a quick search and found out that I was not alone.
Deer collisions become more frequent during fall and winter due to deer migration and mating season, which typically occur from October through December. Deers are looking for mates and cars are an afterthought.
According to the National Highway Traffic Safety Administration, there are about 1 million car accidents with deer each year that kill 200 Americans, cause more than 10,000 personal injuries, and result in $1 billion in vehicle damage.
On average, more collisions between cars and deer occur in November than in any other month, according to State Farm Insurance.
For the fifth year in a row, State Farm reported that West Virginia tops the list of states where a driver is most likely to run into a deer. The other states in the top 10 are Iowa, South Dakota, Pennsylvania, Michigan, Montana, Wisconsin, Minnesota, North Dakota and Wyoming.
Over the past several months I’ve had several encounters with deers over the past several in North Carolina that, like my wandering mom, I never reported.
So, here are my top 5 Dementia Zone tips for Fall Driving:
1- Reschedule appointments. Some of our loved ones are early birds or late risers. Know that most deer/ car encounters occur between the hours of 6:30-7:30 AM and 4:30-6:30 PM.
2- October thru December is peak mating time for deer. They will be out and about. Mating is their concern and not your car.
3- Deers are herd animals. If you see one, there are others around. Slow down.
4- When you see a deer crossing sign. Know that you are entering an area where deer will cross. Use special caution in this area.
5- Hit the deer. Sounds cruel, but when there is a deer on the road, swerving or braking may be your first reaction. The experts say it is safer to hit the deer than to swerve into oncoming traffic or to hit a stationery object, such as a tree, barricade, or another car.
Uncle Walt coined the term "Twitterpated"- Now I get it!