Vacation For The Caregivers “JUST DO IT”

This is an article written by Greg Pledge, who cares for his mother in Ontario, Canada. 

I am writing this article with hopes that I will reach as many of caregivers out there that read Shelley’s web site. I sincerely hope that the word “Vacation” and the importance of taking one really hits home. Why, you may ask: because it is vital to our survival.  I am a 44 year old man and  have been caring for my Mom for about 8 years. Prior to caring for my Mom, I looked after my father for 2 years with the aid of my Mom until he passed away in Feb 2002.

 Becoming a caregiver is unlike any job you will ever do in your entire life! And it is not a job that comes with a manual.   Perhaps if you work in a health care facility there will be an operations manual but looking after someone at home, especially if it is a family member, or a very good friend is very difficult.  My reason for saying this is that it is very hard to separate yourself from the person you love  while caring for them because it is just not a black or white decision when it comes to providing for them. You have to apply “Tough Love“.

Another important fact is that it’s not a 9-5 job; therefore you can’t just clock out after your 8 hour day. It’s a 24/7 job and if you’re like myself, you give up working and earning a pay cheque to accommodate the needs and daily requirements of the loved one. We do this because we love our parents, sister, brother or very good friend.  It is “Unconditional Love“.  For myself, taking care of my Mom started without any warning. It began gradually prior to my Dad’s passing and than afterwards. It was day to day, week to week and month to year to year. I had to learn all the dos and don’ts of caring for someone you love.  It was on the job training. I had to do a lot of research along the way and thank goodness for the internet and the available resources to access information.

 Unfortunately at that time, Shelley‘s website and caregiver support via face book was not around to my knowledge. So I did what came natural to me.  I asked a lot of questions and attended all doctor and specialist appointments. I even utilized government assisted resources that my Mom could qualify for and got a care assistant that comes in 4 days a week for one hour a day to help with bathing and meal preparations and just general social communication for my Mom.

So many of us we are not perhaps fortunate enough to have a million dollars in our bank accounts, so we have to draw on what resources we have, personally and with the aid of what the government will grant us. Because of my Mom’s pension income which was higher than other pensioners, she did not qualify for government assistance full time aid here in Canada, Ontario. I had to use our own financial resources combined with her pensions. Thank goodness I was able to get some help through an agency here in Canada called the CCAC (Community Care Access Centers). I have a wonderful lady by the name of Mary who comes to our home to help me with some of the daily requirements of caring for my Mom. Together we form a team and I am very grateful for her help. Mary has educated me over these past 5 years and I am so grateful for the emotional support, not just for me but for my Mom, as well.

Now that I have given you a background history to my situation, I will discuss the importance of taking a holiday. Caregivers burn out – very fast!  The reason again for this is that our job is 24/7.  Time management is crucial and every hour of our day needs to be planned out. AND during that day we MUST find sometime to detach, relax and gather strength to continue to do the job. If you are like me, I am sure some of you have families, a husband or wife, and/or children and you have to divide your time as best you can to give of yourself to all the important parts of your life. For me, I have my partner of 5 years and he has been very supportive with my caring for my Mom. He works full time and when he gets home he tries to help me in what ever he can to give me a break. However it has to be said and definitely recognized that being a caregiver will put a tremendous strain on your relationships! And your social life! It is extremely imperative that you take time not only for yourself but for your family, friends etc.   Without them you will break!  And you will collapse.  You will find that without taking time off and going on a vacation, the care you are providing for the one you love will start to suffer, and you may even find yourself starting to resent them. I am being blunt and honest in this article because I am sure we all have felt this way at sometime. It’s so important that you DO NOT feel guiltyor ashamed because it’s natural and totally understandable. When you get to this poin,t it is a clear sign and “RED FLAG” indicating that it’s time for you to take a holiday! You are no good to your family, friends and most importantly to the one you’re caring for, if you are “BURNED OUT”  It took me over 8 years to finally agree with my partner and go on a mini-holiday.  

Fortunately for me, my partner works in the travel industry and he had won a trip to New York City, all expenses paid for hotel accommodations plus some meals and drinks. He won the trip in February of 2010 but the actual date of the trip was not until July 1, 2010. So I had lots of time think about it and prepare. YES! I felt very guilty for sometime and this is very common amongst us caregivers.  But you have to “GET OVER IT” and bring yourself to the conclusion that if you don’t take some time for yourself, you are likely to run the risk of getting sick and ending up in the hospital.  This would end up being even more stressful as you are the “GLUE” to keeping things together and if you’re like me, you run a well ordered and organized care facility in your home. Once you are removed, everything goes to hell in a hand basket, as they say so you MUST take care of yourself FIRST!

Taking a vacation, even if it is just a weekend trip away, will help you in so many ways. In my case, it gave me the ability of clearer insight to the situation I was living in and I was able to get in touch with myself again after so many years.

 When you are caregiver you tend to lose yourself into the situation and forget about who and what your are all about as a person but more importantly a human being and your contribution to your own personal life and being able to socially interact with society.  While I was away, I had forgotten just how much I enjoyed meeting new people and to laugh again and be carefree!  I had forgotten what it was like to relax and not feel like I was on a 24/7 call button “RED ALERT”.  I was finally able to “CRY.”  Yes, I had bottled up so many emotions inside over the years and just could not let them out!  And one night while sitting on the deck of our cabin with my partner after spending a fantastic day together and meeting new people, it hit me!  What hit me you ask?  All the emotions, anger, frustrations ect… because I just could not let my Mother see these emotions as I did not want to upset her. I cried for about an hour.  I felt horrible for my partner but he actually was glad to see me let it all out. I began to re-connect back to ME!  And then from within, the emergence of my being started to surface.

Over the years I had doubted if I was truly doing the right thing by caring for my Mom at home. And was I truly doing everything I possibly could to maintain her quality of life and dignity. I was able to answer yes to some of the questions but had to give more serious thought to the latter of my queries.

After 4 days, I had been able to re-charge and become more focused, giving myself permission to truly answer my questions and concerns without guilt. I had made sure that my Mom was well looked after while we where gone. Our good friend was staying in our home to be there 24/7 with my Mom. Our neighbours of over 30 years were very willing to be there to help anytime should my Mom call them.  Judy, my neighbour, had been a registered nurse for many years so I knew Mom was in very good hands. However, you do need to br prepared for what I call the “Caregivers Aftermath”.

Even through all your good planning and excellent care instructions for your temporary caregivers, things can happen. In my case my Mom suffered a major panic attack (she suffers from the health condition known as “GAD” General Anxiety Disorder).  She had been put on anti-depressants for a about 8 weeks prior to me leaving.  The doctor said that this would help my Mom with her GAD. I had researched a lot of medical websites and the general consensuses was treatment with anti-depressants.  In addition to the treatment plan, she was taking Clonazepam but Mom had been on this medication for over 40 years so it was not working like it had in years prior but because she had been on it so long she could not just come off it right away. We had been trying to slowly take her off of it under the doctors supervision.  Since this was my first time  ever going away, it impacted my Mom with very high anxiety. She got scared and became panic stricken, causing her to have sever palpitations which mimic the feeling of a heart attack.

When I got home I was immediately briefed by everyone, and concerns and questions where fired at me regarding my Moms state of mind and care. I had to call a general meeting with our friend and my neighbours to talk to them about the state of my Moms GAD and all that I have done over the past year to get her treatment and look into possible medications and assure them I had the situation under control.

After I had done the damage control and was able to assure all involved everything was okay, I then had to turn to my Mom and address her issues. While I was gone my Mom had two falls which was completely a surprise since my Mom had not had any falls for over 3 years, and I certainly would have not gone away had this been happening. I made an appointment with her doctor prior to me going away so should something  happen, I had the appointment there to be examined. We had an MRI scheduled a few months prior to the trip as my doctor wanted to see how my Moms back was healing and if there where any further progressions from previous injuries from the past. My Mom was in a lot of pain and it was very apparent that she was much weaker in her legs since I had gone on my holiday.  It took me from July 5 up to now to get things back to a somewhat orderly manner.  However, something did come of this trip and even though this article is about the importance of going on a holiday for yourself and how you need the break in order to protect your health, this article will become a two part article.  Look for the 2nd part of it in the near future.

Because while I was caring for Mom over the past 8 years, I had become so absorbed into her well-being and daily needs, it became a routine which just did not allow me to think clearly and logically about the health care quality for Mom. 

Now that I’ve  had the chance to get away and be removed from the situation by taking a short vacation and clearly my mind, I can see that I/we were doing more harm than good by keeping my Mom in our home and trying to care for her.  Sometimes you end up putting the person you love and care for at a higher risk of injury and/or in some way being an enabler and cutting short their possible longevity by socially isolating them. This was the case with my Mom.  She did not want to get involved with outside community workshops or senior groups. She would just rather sit in her chair and watch her TV and do nothing but complain about the things she could no longer do!

As her son and caregiver it finally came upon me to face that difficult cross road. “Is now that right time for a senior home”?

I hope this article has helped some other caregivers and given insight and provided you with some facts and the importance of doing what is right for you.  One: taking the holiday but also gaining clarity of thought so you can revaluate your care provider situation and look at it with a fresh mind and see it for what it may truly be either good or perhaps not so good.

God Bless and stay tuned for my follow up article on “When is it time for your loved one to go into a senior care facility/ home?”

Sincerely,

Greg

Greg Pledge is a writer and caregiver for his mother in Ontario, Canada.

 Some people are very good at “going to their happy place”.  I am not.  I am much too much a realist – it’s probably the nurse in me.

Since becoming a caregiver, I have had an opportunity to revisit meditation.  What I didn’t know back then is that there are different types of meditations.  Along with the visualization meditations there are some that simply concentrate on breathing; some that concentrate on just “being”;  and some that deal with a specific subject such as how to take anger and turn it into positive motivation. 

Meditation is important for caregivers.  As caregivers, we are often filled with stress and negative feelings (not necessarily towards our care recipient, but perhaps towards physicians, hospitals, siblings, insurance companies, etc.)

We are also often overwhelmed and the thoughts in our heads are running around like a chipmunk gathering seeds for the winter.  We MUST slow down.  Meditation is a good way to do this and it doesn’t take much time.

Colin Allen, in Psychology Today, April, 2003, states that  Neuroscientists have found that meditators shift their brain activity to different areas of the cortex – brain waves in the stress-prone right frontal cortex move to the calmer left frontal cortex. This mental shift decreases the negative effects of stress, mild depression and anxiety.

Here are 4 of the daily benefits that meditation can give us:

1.  Reduced Stress

Meditation helps us to switch off the worries that can plague us throughout the day.  It quietens the mind and allows us to clear our heads of all that mumbo jumbo.

2.  Improved Health

Lowered blood pressure, less headaches, improvement in other stress-related ailments and even pain relief have all been proven to be part of the benefits of meditation.

3.  Detachment

As busy caregivers, it is easy to get distractions by small irritations such as having to wait in lines at the pharmacy or having to deal with things like adult diapers that have not been placed where they should have been placed.  The solution is not to avoid these small problems because they will inevitably reappear.  The solution is to develop a detachment in order to keep things in perspective.  Meditation helps with this by clearing the head of these irritating thoughts.  The purpose is not to develop an indifference but to see the situation for what it really is…a minor occurence.

4. Happiness and peace of mind

I remember a time when I was in college and in the middle of mid-terms.  I had just purchased a small condominium and had many boxes remaining to be unpacked after the move AND my best friend was getting married.  My mother asked me what I wanted for Christmas and I remember writing her a poem instead of a Christmas list.  I don’t recall the entire poem but the last line was “ALL I want is some peace of mind.” 

Most of us are seeking happiness and peace of mind in one way or another.  It may be through a spiritual journey, or simply by trying to live a better life.  Meditation helps with increasing our happiness by taking us directly to the source of happiness, which can be found in simply “being”.  When you are simply being, there are no worries, past, present or future because they are all shut out.  This is not to say that they won’t return once our meditation is finished but for that few moments, we can be at peace and tap into the happiness that is available to us.  According to Tejvan Pettinger ” Meditation shows us that happiness is not dependent on outer circumstances, but on our inner attitude.”

The benefits of meditation are real but they will not occur with just one or two sessions.  It may take some time for you to relax and allow the meditations to work.   They should be practiced at least once every day for best results. 

You can find some good meditation CDs at your local bookstore or on iTunes.  The iPhone has some meditation aps available, as well.  Two that I like are called “Simply Being” and “Meditation Oasis”.

Because of our belief in the goodness of meditation for caregivers, when we launch our new membership program in September (Team C.A.R.E. – Caregiving Activities Resources and Education), a monthly downloadable meditation will be included along with 6-8 other meditations to get you started.

I hope that you’ll give the practice of meditation a try and let me know how it works for you.

 One of her callers was expressing concern about helping her aging mother-in-law transition from her home into a MUCH smaller assisted living apartment.

 The caller stated that her mother-in-law refused to part with anything even though much of what she had were items of little value.  The talk radio show host stated that the mother-in-law had a psychological problem known as hoarding (formally called CHS – compulsive hoarding syndrome).

 While I absolutely believe that such a condition exists and that many people suffer from it, I don’t believe that all elderly folks who have large amounts of what we would consider “useless items” are hoarders.

 Many of our aging parents were born or grew up in the depression era and, as such, were taught not to waste ANYTHING.  Old newspaper, little bits of string, and worn clothing could usually be “recycled” into something that could be utilized – bedding for chickens, quilts, hair ties, etc.  So to lump all aging parents who have a lifetime collection of odds and ends (with which they are very reluctant to part) into the category of hoarders is a mistake.  Sometimes, elders just become overwhelmed at how to tackle disposing or “recycling” of all that they have accumulated and they just need a little (no, probably a lot) of help sorting things out.

 But that doesn’t mean that all of our aging parents are exempt from having this syndrome.  This past month, our local news recounted the story of an elderly couple who had been literally buried under their “stuff” for almost a week until a neighbor happened to realize that she hadn’t seen them and decided to investigate.  The couple was in bad shape but were taken to the hospital, treated and are safe. 

Compulsive hoarding syndrome is described as an acquisition of and the inability to discard items, even those that have no value what-so-ever (think trash and in the worst case scenario, think human and animal waste).  Their homes can end up becoming so full of “stuff” that only trailways remain throughout the home in order to get from one room to another.  Bath tubs and showers become unusable because they become filled with items. 

Some people who hoard also seem to collect animals – we’ve all heard of so called “cat women” who seem to take in  multitudes of cats until their homes become inhabitable and there is no more money left to buy food for them or provide veterinary care.  The ASPCA must then step in order to prevent harm to the animals.

Obsessive Compulsive Disorder has been linked to hoarding but many people who hoard don’t have other OCD-related symptoms.  It’s also interesting to note that there is an element of perfectionism in hoarding.   Hoarders will often try to rid their homes of items and begin to make piles of items to keep and items to discard.  They then become SO fearful of making the wrong decision about which items to discard that they just put everything back.

Often people (even friends and  family members) are unaware that their aging parent or grandparent has a problem with hoarding.  Sometimes, an elders falls or becomes otherwise incapacitated and is taken to the hospital.  When the social worker or home health agency comes out to the home to evaluate it so that the elder may return upon discharge from the hospital, they find that they home is “unhabitable” and the elder must be discharged to a nursing home.

So what can we, as loving spouses, children, grandchildren or friends, do about hoarding? 

Treatment of hoarding is often a huge challenge because people who hoard don’t often understand that there is a problem.  It’s also complicated by the fact that researchers are not yet sure which type of treatment is best.  If the home is thoroughly cleaned and sanitized forcefully while the elder is away, once they return,  it won’t be long before the area returns to its previously jam-packed status.  If the hoarder collects animals, they will do so again (apparently to fill an emotional void).  Please remember that if you find it necessary to undertake a forced clean out in order to keep your loved one safe, that they should not be present at the time – this could be very emotionally and psychologically dangerous for them.

There are basically 2 types of treatment for hoarding: psychotherapy and medication. 

Cognitive behavior therapy is the type of psychotherapy that is generally used to help hoarders so if you are looking for a therapist to help your loved one, look for one that practices this type of therapy. 

The class of medications that are used to attempt to help hoarders are called SSRIs (selective serotonin reuptake inhibitors) which are anti-depressants such as Paxil.  There is not a guarantee that SSRIs work well though. 

Hoarding is one the biggest threats to independence in our elderly loved ones.  It causes loss of mobility, risk of falling,  is a barrier to proper body care, prevents emergency response systems from providing help in a timely manner, and also causes denial of home health care.

If you suspect hoarding in an aging parent or loved one, attempt to get them some help before the situation becomes dangerous to them. 

And when I am called upon to consult with a family caregiver, I most often find her at the end of the proverbial rope. A stroke, a diagnosis of dementia, or simply the physical decline that her parent is experiencing with age – each can play a significant part in getting her there.  And the subsequent medical events that her mother or father may endure – be it a fall or a hospitalization – can act as a strong wind that further loosens her grip.  She has been inching down the frayed line for years, unsure of how to climb up or who could help her to do so.

From the outside looking in it’s her exhaustion that concerns me most – mainly because she doesn’t feel it; and over time I have come to understand why. 

Just like the firefighter who runs toward the burning building without the thought of the heat or the smoke, a caregiver can’t allow her exhaustion a moment’s attention. Doing so, she reasons, would render her unable to tolerate the night in the E.R. or the umpteenth trip to the pharmacy.  And so she buries it – in to-do lists and phone calls, behind three-minute showers, and under the stack of unopened mail.  Before long she is numb.  And unlike the fire, the caregiving continues and the caregiver is always on-call; always clutching the rope.      

This mental picture of the dangling caregiver is one that comes to mind quite often when I meet with caregivers and their stories unfold. And sometimes, the most important thing I can do for a caregiver is to share what I’m thinking.  I learned the importance of this several years ago from a beloved supervisor who believed that anything felt or seen in my mind’s eye would be grist for the therapeutic mill. 

She was right.

As I begin to talk about the rope and the grip that seems to be slipping, I am inviting the caregiver to rest for a moment, to get in touch with where (s)he is and how (s)he feels.

Sometimes my invitation is declined, but more often than not it’s accepted. And when it is there is almost always a long silence followed by a deep breath before the tears.  In moments like these I celebrate exhaustion because the caregiver is feeling the weight of all she does – I celebrate because she is feeling instead of being numb.

And I know that it won’t be long before she understands that there are indeed stronger ropes available and nets that can be placed below her in case she falls. 

*Guest expert Maria Basso Lipani, is a licensed clinical social worker (LCSW)and has been working with chronically and terminally ill older adults and their families for the better part of the last decade.  She is founder of the web site Geriatric Care Management.com.  I extend my gratitude and thanks to her for providing this article to us.

As part of our holiday festivites, along with the family barbecue, many of us will be attending fireworks displays or, in places where they are allowed, launching off a few of our own.  (Tonight, I’ll be attending a huge fireworks display that is launched directly over one of our largest lakes here in Idaho.)

While most of us love the brilliance, the colors and the excitement that a good fireworks display brings, there are some who do NOT enjoy them.  In fact, for some, fireworks are terrifying.   

I was reading an article this week over at UPI.com that talked about how fireworks can be hard on military veterans, the elderly, those who suffer from PTSD (Post traumatic stress disorder) and pets.  (You can read that article here.) 

On the same day that I read the article, a friend of mine said that she and her husband had spent most of the day with her elderly father-in-law, a veteran himself, who interpreted each noise from a launched firework as an attack by the Germans. 

It seems to be the individual fireworks launched by over-zealous individuals who cannot wait for the evening of the 4th (or from those that are left-over and set off later in the week) that seem to cause the most problem.  “They sound like gunfire and they’re unexpected”, says the author of the article.

We need to remember that many of our aging parents and loved ones served in one (or more) of several wars and as they are aging, and especially if there is dementia involved, they may not view fireworks as the colorful celebration they once happily anticipated. 

If you are caring for an aging loved one who is not fond of fireworks, Dr Larry Lachman, a licensed clinical psychologist, recommends the following:

• an air-conditioned movie theatre
• an indoor mall perhaps containing a noisy restaraunt
• a camping trip or hotel visit far away from major fireworks displays
• short-term medication to help with anxiety

If your loved one’s behavior seems to change after this holiday, assistance can also be found from veteran’s groups, hospital programs or your own private physician.

Have any of you experienced this type of reaction from your aging parent of loved one?  Can you offer any further tips to help other caregivers?

You see, the Lady’s Slipper orchid (genus cypripedium -I don’t know the species of mine) is my absolute favorite flower in the whole world (the pink ones in particular, but they are almost impossible to obtain as they are considered endangered).  I have the yellow ones…and these yellow ones were taken from my father’s garden at the lake cabin he loved and where he spent 5 months out of every year until he became too ill to travel. The cabin was built on land that my grandparents once owned.  Two of my other uncles had cabins on the same beachfront property.  My parents received these orchids from my Uncle and Aunt who brought them from their home.  So whenever these orchids bloom, I cherish every moment I see them. 

Additionally, my mother secretly placed one in my wedding bouquet (she was a floral designer and so, of course, she provided my gorgeous flowers. “NO carnations”, she said.)  I pulled out that Lady Slipper before I tossed my bouquet and took it with me on my honeymoon.  Poor Mom…now that I think of it, I should have hired someone else so she could have relaxed (but she probably wouldn’t have gone for that idea anyway). 

The Lady’s Slippers didn’t bloom last year while my father was living the last few weeks of his life.  The greenery came up….but no blooms.  Perhaps they knew something was wrong.  My father pondered several times why they weren’t blooming and I had no answer.  “I’m sure they’ll be here next year” I’d say.  In my mind I was thinking…but sadly, you won’t be here to see them.

There will always be things that happily remind you of your parent, spouse or loved-one.  Be sure to take time now to determine what those treasures are and how you can keep them in your life after your loved one is no longer there.  You can believe that if I ever move from this house that those Lady’s Slippers are going with me! 

And someday I’m going to find some pink ones!

As a caregiver to my 81 year old Mother, I want to get the message out there to other caregivers, that it is very important to be involved in the senior’s healthcare appointments.  Attending the doctors appointments when ever and if ever possible can make a difference between life and death! I know that statement my sound over exaggerated but it’s NOT! After reading Shelley’s bulletin on “The Importance Of Going To Doctor Appointments” with the people/family members that you are caring for is a necessity for their well-being. I feel extremely compelled to add to the bulletin that Shelley has posted.
 
I have been caring for my Mom for 8 years since my father past away from Cancer in 2002. Prior to his passing he would never let either my Mother nor I attend these appointments with him. So we felt like we where not a part of the care process and it was like he felt he had to do this on his own, because it was his illness and his responsibility to deal with it alone. There was only one time that  I did attend an appointment with my Dad’s oncologist and this was only after the cancer had reached stage 4. Since this experience I have felt it necessary to be with my Mom when she is going to any appointment concerning her health. These appointments over the years have been with her GP (Family Doctor), neurologist, nerve conduction specialist, an internist and finally a psychiatrist.  

I do this for a few reasons. First it is because I deeply love and care for my Mother and want to be there for her should she have any questions after the appointments. These questions range from what did the doctor mean about that statement, or when do I take this medication and for how long. Why? Must I take it but with out eating first? And so many more other questions. This provides my Mom great relief knowing that she can come to me to answer the question which is causing her uncertainty and unnecessary stress. My Mom suffers from (GAD) so it is very important that I try to minimise stress which could bring on an attack.
 
My Mom has difficulties remembering instructions from doctors and other medical health care professional she has seen over the years. My Mom relies on me to talk with the health care professionals on her behalf. This is to make sure accurate and precise details of her health are communicated. If you are caring for someone that suffers from (GAD) General Anxiety Disorder you will help to reduce the possibilities of them having a panic attack, which can be very crippling for your loved one.  She does try to tell the health care professional what she is currently experiencing with her health but has problems communicating some of the symptoms or she forgets.
My Mom does not have Dementia or Alzheimer’s disease, but I have been advised that (GAD) can simulate the symptoms of dementia. So again I want to stress just how important it is for you to attend appointments. I want to make a point so there is no miscommunication, my Mother has not been diagnosed with Dementia or Alzheimer’s and it is not my intention to lead you to think she has these health conditions.
 
As our general society ages and gets to the age of 65 years old and over, it has been documented that they do become less mobile/agile and a little more feeble on their feet.  Their ability to retain information becomes more difficult and this can easily frustrate them. It is important to make note that they have a shorter attension span and can be somewhat more argumentative. In addition they tend to dwell a lot on what they cannot do anymore and how useless they are feeling / and becoming a bourden on us children/caregivers. It is something that I have learned to just take it for what it is and not let it affect me.

 By all means do NOT feel sorry for them and cater to their every whim. You are doing them more harm then good. They need to feel useful and a part of the family environment, even it is just helping to set the table. I have strayed away from my general point of attending their doctor appointments. So I need to come back to emphasizing that please take the time and go to the appointments. Know your parents medical history, make up a person a file and each time you go into the doctor’s office, discuss your general observations of how the one you care for has improved or not but talk to the doctor and don’t LET THEM intimidate YOU! What you are doing is being a voice for your Mother, Father, Sister, Brother or friend. And in my personal experience this has saved me a lot of additional stress and confusion when it came to time to administering medications and gets the well being of care to our loved ones. Another very important point I want to make in this article is that if you feel the doctor is giving you a brush off and his advise/opinion does not seem sound “GET ANOTHER OPINION”.  Don’t be afraid as I have done this a few times and I truly feel I have saved a life - “My Mom’s”.
 
Another important factor is “Education.” We have a wealth of information at our finger tips and it’s “The Internet”. USE IT! Knowledge is POWER! You will get more respect from the health care professionals if you seem to know what you are talking about and it shows you are taking a great interest in the care of the person you look after. When prescriptions are prescribed, immediately look them up on the computer and look for any type of drug medication interactions which could harm your loved one. Pay close attention to side effects! And make a general daily diary that you can refer to so you can accurately detect early reactions before something serious happens. One very important note I have learned is that taking vitamins with prescription drugs can lesson the effect/strength of the drugs so you want to make sure that a vitamin is given 2 hours before or after.
 
Some doctors tend to treat seniors as if they complain about every little ache and pain, and that in general, nothing seriously is wrong with them.  So they tend to get brushed off or passed off back to there GP. If you truly feel that there is generally something wrong and it is legitimate in your thoughts, I would get as many professional opinions as possible. Or go right back to the drawing board and start over again! I have done this with my Mom over the years and it has paid off! For example, my Mom had been seeing an optometrist for 40 years and she came to trust him! He told her that she had macular degeneration and was going to go blind. This was a sudden shock to my Mother and she just could not accept this final diagnosis. Believe it or not we consulted with my Mom’s eye glass specialist (Again use all resources you can think of to get opinions and suggestions). My family had been seeing this eyeglass optometrist for many years and he recommended my Mom see this specialist in a downtown Toronto hospital that deals specifically with diseases of the eye. Long story short, it turned out my Mother had cataracts and was not going to go blind. A few months later she had two cataract removal operations and she can now see excellent and only needs reading glasses.

To conclude my long letter! I am just going to state that NO matter what, it is imperative that you be there and involved with all appointments as you are the front of the line for the loved ones care! 

Gregory F. Pledge
Brampton, Ontario, Canada 

I originally purchased this book thinking it was a resource for caregivers on keeping an aging parent out of a nursing home for as long as possible. I soon found out that it was much more.

Having been a registered nurse for almost 30 years and a caregiver for my father who lived with me in my home for 4 years before he passed away, it was my goal to keep my father out of a nursing home. I’ve done clinical practice in several of these homes as part of my training (I apologize to all nursing homes who do their best to provide great care within their limited budgets) but I am not a fan of them!

Not only does Dr. Fisher explain how suddenly a crisis can occur that places a parent or aging spouse into a nursing home, but he also provides wonderful information for those of us in our mid-life years on how we can better avoid ending up in one ourselves.

He discusses the importance of maintaining our independence by taking care of our bodies and also discusses systems which should be put into place as soon as possible (durable powers of attorney for health care, trusts, wills and long-term care insurance).

This is a great book for everyone, not just for those who are caring for aging relatives.

There is also a hierarchy among physicians, although they will often deny this.  Specialists are perceived better than family practice physicians with neurosurgeons and cardiothoracic surgeons residing at the top of the list. 

Doctors of Osteopathy (D.O.s) are seen at the bottom of the doctor hierarchy and were initially shunned by the medical doctors (MDs) as quacks and phonies as referenced by the article “Dubious Aspects of Osteopathy” by Stephen Barrett, M.D.  They have become increasingly more accepted as society moves towards preventive medicine and a more holistic approach to health care.

So what exactly is a Doctor of Osteopathy and what are the differences between a D.O. and an M.D.?

The practice of osteopathic medicine was founded in 1874 by a medical doctor (M.D.)named Dr. Andrew Taylor Still who was dissatisfied with the effectiveness of 19th century medicine.  He believed that many of the medications that were being prescribed were useless and that physicians should concentrate on wellness rather than illness.  His pioneered the concept of wellness and his practice also included the use of chiropractic principles, manipulation and “laying on of the hands” to promote diagnosis and healing.

Both types of physicians are licensed to practice medicine, write prescriptions and perform surgery.  Both require 4 years of undergraduate study in either pre-medicine or a related science.  Both require 4 additional years of medical training before being allowed to take their medical exams (which are comparably difficult but yet not quite the same).  Both a medical doctor and a doctor of osteopathy may elect to choose a specialty which would require between 2 and 6 years of additional training.

The difference between the two practices is really a differences in philosophy.  While medical doctors (which are based on allopathic medicine) evaluate the disease within their patient in terms of how it affects only certain parts of the body, the osteopathic doctor evaluates the disease within the body as a complex related network. 

The doctor of osteopathy also receives training in the muscular and skeletal systems and is more likely to use alternative medical approaches such as manipulation, meditation, laying on of the hands, and he may recommend consults with naturopaths and/or accupuncturists. 

Doctors of Osteopathy (D.O.s) are less likely to specialize than medical doctors (M.D.s) because their emphasis is on preventative care and of taking time with patients in order to assess their total health needs.  In saying this, I must also say that medical doctors are leaning towards preventative medicine much more now, as well. 

When choosing a physician for yourself or your loved one, you want to be aware that both types of practitioners are equally capable and qualified, so choose one that resonates with you.  For more information on finding a good physician, see “Finding a Good Doctor for Your Loved One.”

Osteopathy has evolved since then

This year, we had to do a little rearranging of the garden because the chickens figured out how to get over the fence and were eating up the seedlings, the raspberry chutes and any trace of rhubarb they could find.  Well, we now have them fenced off in the orchard so that the garden is safe from those feathery friends.

The article below was written by Barbara Friesner of AgeWiseLiving and as a gardener, of course, it resonated with me.  I was also happy to read more about container gardens and raised-bed gardens because I have both.  But let me just note that her weather must be much better than mine here, because we’ve had an enormous amount of rain and a late start to our gardening.

 
“It’s only the beginning of June but with this year’s weather, we are well into gardening season. For so many Seniors, having their garden is a very big reason they want to stay in their home.  Not only does a garden look pretty and give an enormous sense of satisfaction, (and attract birds and butterflies) but it’s also a great exercise and promotes flexibility and strength which also helps prevent osteoporosis and reduce stress.
Clearly there are lots of really good reasons to have a garden.  However, some people can have too much garden, and for them, the garden can be overwhelming.  They can easily get it under control by reducing the size of the garden to what they can easily manage and then hiring a gardener or a neighbor kid to take care of the rest.

Conversely, some people want a garden but have only a little bit of space – or none at all.  For  those with no space at all, container gardens are a great solution. (So you can have a garden in an apartment, too.)  They can be inside or out and you can plant anything in them (fruits, vegetables, flowers, shrubs, trees).  Plus they can be any size, shape or height you want. Check out ContainerGardening for more pictures of container gardens.
If you have any outdoor space at all, I am a huge proponent of raised garden beds.  They are great for seniors and anyone who can’t, or doesn’t want, to spend hours on their knees, killing their back!   According to raised-garden-beds.com, there are other great reasons for raised bed gardening, too.

1.  Plant roots need air.  In an ordinary garden, you can’t avoid stepping in the garden bed occasionally when doing your everyday gardening.  With the raised garden, you garden from the path and not pack down the soil.
2.  Raised beds tend to drain away excess moisture better than ordinary garden beds.  This is another advantage that helps the plant roots to breath.  In areas that have saturated soil like Florida and many areas of the South, raised beds may be the only way you can grow many types of plants.
3.  Soil conditions and types can be controlled more efficiently in a raised bed and they can be varied easily from bed to bed.  Raised beds are the answer when topsoil is thin.
4.  Water, fertilizer, compost, mulch, etc. can be applied more carefully because they only need to be applied to the garden beds.
5.  Various studies have shown that raised garden beds produce 1.4 to 2 times as much vegetables and flowers per square foot as ordinary beds, due mainly to the above advantages so you can have a smaller and more manageable garden and still produce more.
But as the years go by, even container and/or raised gardens can be tough on the body.  So here is some advice from gardening expert, Rebecca Kolls,  on how to keep the strain to the body to a minimum.
*Warm up by doing a few stretches before starting any gardening activities and working with your garden tools. Doing this will help reduce any muscle soreness you may experience later on.
*Drink plenty of liquids (avoiding alcohol), to keep your body well hydrated.
Be sure to take care of cuts, bruises scrapes and insect bites right away to help avoid infection.
*Work in the garden early in the morning or late in the day to avoid blazing midday sun and heat which can make even the healthiest senior ill or weary.
*Wear comfortable clothes and shoes.
*Wear a hat and gloves to cover exposed skin and use sunscreen to protect against sunburn and sun damage.
*When you start to feel fatigued, take a break for a few moments.
*Rotate your gardening tasks every half hour or so.
*Avoid using tools that will put you in awkward body positions. If possible, take advantage of the new breed of ergonomic garden tools which are designed to reduce strain and injury because they work in conjunction with your body movements.

  Check out the Today Show’s Home & Garden segment  about gadgets that will help keep seniors in the garden.  (There are so many great new gardening tools out there, it almost makes me wish I were a gardener!)
*Keep your tools sharp, well oiled and in good working condition. This will help avoid resistance when using them and cut down on the manpower needed to execute certain tasks. Remember that proper body positioning will minimize muscle soreness and fatigue.
Now that you have all this great information . . . go play in the dirt!”

© Copyright  AgeWiseLiving™  2010   Barbara E. Friesner, Generational Coach and adjunct professor at Cornell University, is creator of  “The Ultimate Caregiver’s Success System”™, the ultimate eldercare instruction manual that shows you exactly how to resolve your eldercare issues by choice, not crisis.  To get your F.R.E.E. downloadable MP3 and receive Barbara’s weekly eldercare success articles, visit www.AgeWiseLiving.com.