When Aging Parents Won’t Listen

Our parents always asked that we listen to them. But what happens when they refuse to listen to us? Some adult children are finding that their parents don’t always know best when it comes to their diet, driving, housing, medication, and more.

Dad or Mom Won’t Take Your Advice: Now What?

Recent research has found that 77% of adult children believe their parents are stubborn about taking their advice or getting help with their daily problems.

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If you are experiencing this scenario, you may want to consider the following recommendations:

• Accept the situation. You may want your mantra to be “it is what it is.” Said another way, “you can take a horse to water, but you can’t make them drink.” In other words, they are still adults with the right to make decisions — even if poor ones.

• Blame it on the kids (that would be you) or the grandkids. If mom isn’t willing to change her behavior for herself, would she do it for a loved one? One approach is to say to your parent, “you don’t want me to worry, right? This (fill in the blank) will give me enormous peace of mind. Please do it for me!”

• Decide how important the matter is. Is it a safety issue or something that is just inconsequential? As the saying goes, pick and choose your battles.

• Don’t beat yourself up. Try not to hit your head against the wall too hard. There isn’t a lot we can do sometimes but stand by, watch closely, and be able to jump in when needed.

• Find an outside outlet for your feelings. If you’re angry or resentful that dad’s not with the program, confide in, strategize with, or vent to, a friend, geriatric care manager, geriatrician, online support group, sibling, or therapist rather than your parents.

• Think ahead. Is there a milestone they want to be around for, such as an anniversary, graduation or wedding? Then bring it up!

• Treat them like the adults they are. Dealing with a stubborn parent is not the same as dealing with a stubborn child. Older people should be autonomous.

• Try to understand the motivation behind their behavior. Are they acting this way out of habit, to assert independence, or because they’re depressed or confused? What are they afraid of? 

Seven Tips for a Successful Move to Memory Care

Seven Tips for a Successful Move to Memory Care

With the increasing demands of dementia caregiving, a day may come when it is no longer possible to care for your loved one at home. Whether it is for safety, health, or financial reasons, you may feel that it is now finally time to move your loved one to a specialized dementia care community.

You have done everything right. Your hard work and discipline have paid off. You’ve contacted or visited several memory care communities. You were able to match the services that different care facilities had to offer with your loved one’s needs, and found the most appropriate fit. You interviewed the staff and administration, asked all the right questions and feel comfortable with their approach to dementia care and the quality of services provided. You have made financial arrangements and secured the means to pay for residential care for years to come. You had your trusted attorney read and approve the admission agreement and you are ready for the move.

So why does it feel so bad?
The logistic and administrative aspects of moving a loved one to a dementia care community are important elements of a successful transition. But we mustn’t forget the immense emotional toll that is also involved in the move.

For starters, you are the one who has to make the final decision. The person with dementia is often unable to participate in this decision because of the lack of insight brought on by dementia itself. He/she may not understand the need for care or recognize the amount of care needed. That is your job as a caregiver and is often a solitary responsibility. You will have to make this decision based not on who your loved one once was, but rather who they are today, after the onset of dementia.

This whole process may leave you feeling uncertain that you’re doing the best move for your loved one. Add to this uncertainty, the feelings of guilt and grief that you may be going through at this very moment. Even after all the research, soul searching, hard work, and self-discipline, moving still seems painful.

The following tips are meant to help ease the move for people with dementia and to better accommodate their special needs during this vulnerable transition time. Please note: there is no one singular “best” approach and what may work for one family, may not be successful for another. Use your own discretion on how to use these suggestions and consider your loved one’s personality when doing so.

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1.  Do not announce the move in advance—Avoid anticipation anxiety by not telling your loved one that they will be moving on during the next month or so. Wait until it is close to the move-in date to inform them, or even tell them only at the very moment of the move. Moving anticipation anxiety can cause extreme negative feelings that may escalate into extreme behaviors. By not giving them too much of an advance notice, you will promote a calmer state of mind for the transition.

2.  Use fiblets—Your loved one does not need to know right away that this will be their new home for the long run. They may be happier in the idea that the stay is just for a short period of time (say, you’re having the carpets cleaned this week, or the family will be out-of-town and in the meantime you have made arrangements to have them stay at a really nice facility). You can repeat the same information when asked again until they are used to the new surroundings. Collaborate with other visitors and staff so everybody provides your loved one with the same message and works together as a team to ensure a successful move.

3.  Use medication wisely—Consult with your loved one’s doctor to adjust their medications for those vulnerable days around the move. A good doctor should be able to prescribe anti-anxiety medication to make the transition much easier for them, and for you. You may want to start the prescribed regimen about a week before the move and start weaning them off the medication a couple of weeks after the move, as they become more familiar and comfortable with the staff and new surroundings.

4.  Bring familiar items to the new home—Decorate the new surroundings with some of your loved one’s own furniture, mementos and items that bring comfort, such as photos and familiar books. Objects and belongings should be packed and moved outside of view to avoid generating anxiety. Consider eliciting the help of a family member or friend to do some activity elsewhere, so you have privacy to make the decisions on what to bring. This is also a tender moment for you as well, and when in doubt about the sentimental value of an item, keep in mind that you can always bring it at a later date.

5.  Avoid visiting during the first week—Yes…it’s always hard to let go! But those very first days can be crucial when it comes to developing new relationships with staff members and other residents. Your presence may remind them that this is not really their family and compel them to ask you to take them back home with you — setting backward the already sensitive process of adaptation. Keep open lines of communication with staff and work with them to build up their relationship with your loved one, until your visits can be safely made on a regular and supportive schedule.

6.  Take care of yourself—This is a very tender time for you too, so make sure your needs are being addressed as well. Get some extra rest and relaxation along with some exercise and fresh air. Visit friends and do something nice for yourself. You need to be cared for too, because the journey is not over yet. You are still your loved one’s voice and companion, only now you have a qualified team to do the hands-on care while you take a more consulting role.

7.  Remember that it too, will pass—As difficult as this transition is for your loved one with dementia, it is also very hard on you. In time, they will make new friends, bond with staff, enjoy the activities, move on and thrive. Later, they may still ask you to take them home once in a while and they may still feel lonely for a while. But ultimately, they will adjust, have much better care and enjoy their social life because you took the time to prepare and find the right care for them. And because of your efforts, they will have a better quality of life and be safe, comfortable, and content during their remaining years.

What Type of Physician is the Best for Helping Determine Cognitive Decline or Dementia?

What Type of Physician is the Best for Helping Determine Cognitive Decline or Dementia?

Have you ever worried that you or a loved one may be losing cognitive abilities with age? If so, you are not alone many adults over 65 have the type of cognitive decline or loss we regard as a “normal” consequence of age.

Normal Signs of Aging

According to the website, HelpGuide.org, the following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

  • Becoming easily distracted or having trouble remembering what was just read, or the details of a conversation.
  • Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by his father’s name.
  • Not quite being able to retrieve information that is “on tip of your tongue.”
  • Occasionally forgetting an appointment or walking into a room and forgetting why you went there.
  • Occasionally forgetting where things were placed that are used regularly, like eyeglasses or keys.

For many people, slight lapses in memory from time to time are a natural and normal part of the aging process; however you or a loved one are struggling with ability to perform everyday activities, or any behavior, memory or thinking skills, then there may be a bigger issue at hand.

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Symptoms of Cognitive Decline and Dementia

Cognitive decline and dementia are two common conditions that are not considered normal aspects of aging. According to the World Health Organization, nearly 50 million people worldwide have some form of dementia with nearly ten million cases added every year.

Cognitive decline and dementia differ from age-related memory loss in that they are degenerative diseases that will gradually worsen over time. For many people, symptoms of cognitive decline start out subtly and may only be noticeable to the person experiencing them.

Early-stage symptoms of dementia typically include:

  • Becoming lost in familiar places
  • Forgetfulness
  • Losing track of the time

When the disease progresses, the middle stage symptoms of dementia become “clearer and more restricting,” including:

  • Becoming forgetful of recent events and people’s names
  • Becoming lost at home
  • Experiencing behavioral changes, including wandering and repeated questioning
  • Having increasing difficulty with communication
  • Needing help with personal care

Symptoms eventually lead to “near total dependence and inactivity” during the late stage of dementia, including:

  • Becoming unaware of the time and place
  • Experiencing behavior changes that may include aggression
  • Having an increasing need for assisted self-care
  • Having difficulty recognizing relatives and friends
  • Having difficulty walking

Ways to Choose the Right Healthcare Professional

Choosing the right healthcare professional is critical if you’re concerned that you or a loved one may be experiencing dementia or another cognitive disease.

Make an appointment with one of the appropriate healthcare providers below to address your concerns:

  • Family Doctor or Primary Care Physician

According to an article published by U.S. News, making an appointment with your primary care physician (PCP) is the best first step to receiving comprehensive care. Primary care physicians should be able to get a complete medical history, family history, social history, current medication list and a review of any loss of abilities to perform day-to-day activities.

During an initial visit, your physician will most likely perform a full physical exam as well administer a cognitive assessment to gain a better understanding of your symptoms and rule out other possible conditions. Your physician may also order lab tests, including blood work, a CT scan or an MRI, as well as make a referral to a dementia-specific specialist for further testing.

  • Geriatrician or Geriatric Psychiatrist

According to the University of North Carolina School of Medicine, your best choice for a dementia-specific specialist is a geriatrician with a special interest in dementia, or a geriatric psychiatrist.

A geriatrician is a “primary care internist or family practitioner who specializes in complex conditions of older people and can provide care for all of an older adult’s medical needs whereas a geriatric psychiatrist specializes in the emotional and mental needs of older individuals. They conduct thorough memory, mood, sleep, and thinking evaluations. They are particularly good at assessing memory problems associated with life stress, anxiety, depression, excess drinking, or family conflicts.

If you are unable to obtain a referral to either one of these specialists (or your insurance will not cover the cost of these visits), your primary care doctor may refer you to a neurologist.

  • Neurologist

A neurologist has specialized training in diagnosing, treating, and managing disorders of the brain and nervous system. Some neurologists are specifically trained in diagnosing cognitive decline and dementia and so it is important for you and your family to ask your primary physician and conduct research for the appropriate neurologist to ensure you are being referred to the most appropriate specialist. During your initial consultation, the neurologist will perform more comprehensive tests to determine your mental fitness.

  • Psychiatrist, Psychologist, and Social Worker

Many people struggle following a diagnosis of cognitive decline or dementia. A psychologist or social worker can provide counseling and support and also help to address behavioral issues. They can also offer support to the family unit in order to best support the newly diagnosed individual. As mentioned above, the University of North Carolina School of Medicine suggests visiting a geriatric psychiatrist because they focus solely on the emotional and mental needs of older individuals.

If you suspect that you or a loved one is experiencing cognitive decline or dementia then starting with your primary care physician is the best first step. You shouldn’t however feel restricted by their opinion. If you are not happy with the results of primary care physician’s assessment, or, if that doctor does not seem to feel an evaluation for diagnoses and treatment of the cognitive problem is that important, then it’s time to get a second opinion.

Moving to Assisted Living Care

A decision to move to assisted living care raises many questions. You or your loved one may ask, “Is help really needed?”; “Will it be easy to make friends?”; or “Can loved ones and friends still stay close to one another?” The answer to these common questions is the same: “Yes!”

Whether you are a new resident or a loved one seeking more information, there are many ways to help make the transition successful.

Change can be challenging for anyone. It may take a few days to feel settled in, or a bit longer. The transition experience is different for everyone. You or your loved one will get there. The keys to success are preparation, a positive attitude, patience and understanding, and strong support network.

Everyone copes with change differently. Patience, support, and understanding are key themes that will help residents, loved ones, and friends adjust. Rest assured that the assisted living staff is experienced, ready, and willing to help with the process. Don’t be shy about asking questions or seeking assistance. It should be every assisted living care residence’s goal to help make your move a positive experience.

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Privacy Concerns

One of the biggest changes in moving to assisted living care is sharing space with people you don’t know. While this may seem uncomfortable, you’ll soon find that neighbors won’t affect your privacy. You’ll always have your own space. Loved ones and family members can visit, but you decide when. If you have questions or concerns about privacy or security, talk with facility staff.

 

Moving To Your New Home

Begin planning your move soon after choosing an assisted living care facility. Decide what furniture, clothes, and personal items you’ll bring and what ones you’ll store off-site, donate, or sell. Start packing well in advance of moving day. If you have a hard time making decisions about what to bring and what to leave, you’re not alone. Many residents struggle with this process. Try to remain positive and have loved ones and friends help you. Small prized possessions will go far in making your new home feel like home. When moving day arrives, ask loved ones and friends to help arrange and organize your new home. Arranging items to suit your preferences will make the adjustment easier.

 

Making the Emotional Transition

Moving is hard. It can make anyone feel stressed or overwhelmed. These feelings are generally temporary and disappear after you get settled in and develop your own routine. Give yourself time to adjust. Ask other residents if they have suggestions for the transition. Many folks find comfort in talking with a neighbor, close friend, or spiritual advisor. At first, you may tend to keep to yourself. This is normal. Try to get out and introduce yourself to other residents. Staying busy and participating in activities can make you feel more comfortable about your surroundings. Everyone is different. Some people embrace the move with open arms; others find it’s not so easy. If you feel adjusting is taking longer than you expected, you might want to have a care conversation with the assisted living care director or administrator.

 

Advice for New Residents

  • Here are some tips to make your move easier:
  • Read all assisted living care residence materials before you move in.
  • Try to meet with sales and marketing director, facility director, and/or staff before moving day.
  • Review all paperwork carefully before your move, so you can address any questions.
  • Obtain a list from the residence of suggested items to bring.
  • Pack wisely. Don’t bring everything.
  • Read and familiarize yourself with residence policies.
  • If the residence is helping you with your laundry, label your clothing to avoid any mix-ups.
  • Read the activity schedule and choose two or three programs to attend early on to meet neighbors and other residents.

 

Tips for Loved Ones and Friends

As a loved one or friend transitions to an assisted living care community, try to be involved before, during, and after the move. Residents don’t want to be treated differently. While their address has changed, they haven’t. The experience may be just as difficult for you as it is for your loved one or friend. These emotions are natural and expected. Keep these dos and don’ts in mind:

 

Do…

  • Help with sorting, packing, and moving when asked
  • Listen as your loved one or friend talks about what was left behind
  • Stay positive even if you don’t agree with the move decision
  • Recognize that moving to a new home represents a major change
  • Call and visit often, especially during the first few weeks
  • Provide support, patience, and understanding

 

Don’t…

  • Make decisions for your loved one or friend
  • Take over sorting, packing, and moving without being asked
  • Focus on your needs and wishes. The move is about the resident!
  • Criticize the decision to move to assisted living care
  • Make light of the transition
  • Rush into talking about selling the resident’s house
  • Make promises that you cannot keep
  • Be negative

Communication Strategies for Families Dealing with a Loved One’s Dementia

It can be very painful to witness the deterioration of a loved one with Alzheimer’s disease, or any other type of dementia. As the disease progresses, we see minor forgetfulness gradually morph into severe impairment and eventually our loved one’s individuality itself is compromised.

Understanding how to connect and communicate with our loved ones through this time is of the utmost importance. Learn more from these communication strategies for dementia.

Many people use the phrase, “empty shell of a person” when describing a loved one ravaged by the later stages of the dementia. Sadly, dementia does indeed transform people into shadows of their former selves, but those living with dementia are far from “empty shells.” Yes, the shell may become more and more difficult to open. Some days it might not open at all. But never forget that there is a beautiful, unvarnished pearl inside.

Understanding how to “open the shell” gives us opportunities to meaningfully connect with our dementia-afflicted loved one even for only a fleeting moment. Just as the right tools and a lot of technique is required to shuck an oyster, there is technique and artistry involved with communicating or connecting emotionally with a loved one who has dementia.

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Here are 10 tips on how to effectively communicate with someone who has moderate to severe dementia.

  • Recognize what you’re up against. Dementia inevitably gets worse with time. People with dementia will gradually have a more difficult time understanding others, as well as communicating in general.
  • Avoid distractions. Try to find a place and time to talk when there aren’t a lot of distractions present. This allows your loved one to focus all their mental energy on the conversation.
  • Speak clearly and naturally in a warm and calm voice. Refrain from ‘babytalk’ or any other kind of condescension.
  • Refer to people by their names. Avoid pronouns like, “he,” “she,” and “they” during conversation. Names are also important when greeting a loved one with dementia. For example: “Hi, Grandma. It’s me, Jeff,” is preferred over, “Hi. It’s me.”
  • Talk about one thing at a time. Someone with dementia may not be able to engage in the mental juggling involved in maintaining a conversation with multiple threads.
  • Use non-verbal cues. For example, maintain eye contact and smile. This helps put your loved one at ease and will facilitate understanding. And when dementia is very advanced, non-verbal communication may be the only option available.
  • Listen actively. If you don’t understand something your loved one is telling you, politely let them know.
  • Don’t quibble. Your conversations are not likely to go very far if you try to correct every inaccurate statement your loved one makes. It’s okay to let delusions and misstatements go.
  • Have patience. Give your loved one extra time to process what you say. If you ask a question, give them a moment to respond. Don’t let frustration get the better of you.
  • Understand there will be good days and bad days. While the general trend of dementia sufferers is a downward decline, people with dementia will have ups and downs just like anyone else.