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Category Archives: family caregiving

Alzheimer’s Communication, Take a Few Deep Breaths

When my mother would say something mean, nonsensical or just downright crazy it would bring up emotions like anger in me immediately. Imagine a person being very mean to you and how you might feel. Since I was raised in a feisty Italian-American family it was not unusual for my “temper” to flair.



Alzheimer’ and Communication, Take a Few Deep Breaths

When I moved to Delray Beach, Florida to take care of my mother one of my most difficult problems was learning how to communicate with her. If you are caring for a person suffering from Alzheimer’s or dementia you know how difficult this can be.

When my mother would say something mean, nonsensical or just downright crazy it would bring up emotions like anger in me immediately. Imagine a person being very mean to you and how you might feel. Since I was raised in a feisty Italian-American family it was not unusual for my “temper” to flair. If I reacted the way I had in the past my mother would either get “meaner”, or she would go into her room and stay there for hours on end often refusing to speak. I would end up with a pain in my stomach and a range of feelings that included a sense of hopelessness. I realized during those first days that I needed to learn how to deal effectively with this new, unfamiliar, communication with my mother.

The first thing I decided to do was work very hard to learn a new set of skills to deal with these situations. I learned to label (identify) and accept my initial feelings. What was I feeling: anger, frustration, confusion, sadness or a combination of all of these feelings? I found that by identifying my feelings I could corral and contain them. Then, I could deal effectively with my mother and the situation at hand. Once I had my mother settled I would go into a separate room and let my feeling come to the surface. First identify, second feel, and third dismiss these feeling as part of the sometimes craziness called Alzheimer’s disease. I know my mother didn’t mean what she was saying and I knew from my previous 50 years with her that she would never say or do the things she was doing if she could help it.

As I was learning this new behavior, I read an article about taking a “few deep breaths”. I tried it. Before I knew it, I was able to use this technique to blow away all the bad feelings and find myself relieved. I also learned to take a few deep breaths once the communication episode with my mother was starting. This really helped put me in focus and remind myself about what needed to be accomplished. The task at hand.

So my advice to you is to learn how to take a few deep breaths. Nice and slow, deeper and deeper breaths. It works. You might also envision yourself blowing away big dark clouds and replacing them with nice big white puffy clouds.

I learned to accept my initial reaction to these situations as part of being human. In other words, I came to understand that it was OK to have my feelings, my emotions. I also learned that I needed to keep these feelings in check and find a way to diffuse the anger within me. I came to understand that my mother was now evidencing behavior that was a result of her own confusion and the deterioration taking place in her brain. I came to accept the Alzheimer’s disease for what it is–something mean and sinister that was not going to go away. I learned to take control of the situation at hand.

You can do it too, I know you can.

I want to add something here. As a result of developing new communication techniques, acceptance of the situation, exercise, good nutrition, and the introduction of alternative medicines my mother is no longer malevolent–mean.

Original source: I am an Alzheimer’s CareGiver

 

Alzheimer’s Communication, Take a Few Deep Breaths

When my mother would say something mean, nonsensical or just downright crazy it would bring up emotions like anger in me immediately. Imagine a person being very mean to you and how you might feel. Since I was raised in a feisty Italian-American family it was not unusual for my “temper” to flair.



Alzheimer’ and Communication, Take a Few Deep Breaths

When I moved to Delray Beach, Florida to take care of my mother one of my most difficult problems was learning how to communicate with her. If you are caring for a person suffering from Alzheimer’s or dementia you know how difficult this can be.

When my mother would say something mean, nonsensical or just downright crazy it would bring up emotions like anger in me immediately. Imagine a person being very mean to you and how you might feel. Since I was raised in a feisty Italian-American family it was not unusual for my “temper” to flair. If I reacted the way I had in the past my mother would either get “meaner”, or she would go into her room and stay there for hours on end often refusing to speak. I would end up with a pain in my stomach and a range of feelings that included a sense of hopelessness. I realized during those first days that I needed to learn how to deal effectively with this new, unfamiliar, communication with my mother.

The first thing I decided to do was work very hard to learn a new set of skills to deal with these situations. I learned to label (identify) and accept my initial feelings. What was I feeling: anger, frustration, confusion, sadness or a combination of all of these feelings? I found that by identifying my feelings I could corral and contain them. Then, I could deal effectively with my mother and the situation at hand. Once I had my mother settled I would go into a separate room and let my feeling come to the surface. First identify, second feel, and third dismiss these feeling as part of the sometimes craziness called Alzheimer’s disease. I know my mother didn’t mean what she was saying and I knew from my previous 50 years with her that she would never say or do the things she was doing if she could help it.

As I was learning this new behavior, I read an article about taking a “few deep breaths”. I tried it. Before I knew it, I was able to use this technique to blow away all the bad feelings and find myself relieved. I also learned to take a few deep breaths once the communication episode with my mother was starting. This really helped put me in focus and remind myself about what needed to be accomplished. The task at hand.

So my advice to you is to learn how to take a few deep breaths. Nice and slow, deeper and deeper breaths. It works. You might also envision yourself blowing away big dark clouds and replacing them with nice big white puffy clouds.

I learned to accept my initial reaction to these situations as part of being human. In other words, I came to understand that it was OK to have my feelings, my emotions. I also learned that I needed to keep these feelings in check and find a way to diffuse the anger within me. I came to understand that my mother was now evidencing behavior that was a result of her own confusion and the deterioration taking place in her brain. I came to accept the Alzheimer’s disease for what it is–something mean and sinister that was not going to go away. I learned to take control of the situation at hand.

You can do it too, I know you can.

I want to add something here. As a result of developing new communication techniques, acceptance of the situation, exercise, good nutrition, and the introduction of alternative medicines my mother is no longer malevolent–mean.

Original source: I am an Alzheimer’s CareGiver

 

Finding a ‘Medical Home’ for $2 a Month

clipped from blogs.wsj.com

Good primary care is cheap, country doctor Benjamin Brewer declares in his latest WSJ.com column.

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It’s almost become cliché to speak of “soaring health-care costs,” so it’s rather jarring to see the words “cheap” and “care” in the same sentence. But Brewer says good quality primary care is “cheaper than your cellphone bill. Cheaper than a tank of gas. Cheaper than dinner and a movie.”

blog it


Finding a Medical Home May Be Just What the Doctor Ordered

THE DOCTOR’S OFFICE
By BENJAMIN BREWER, M.D.

I’ve always considered my practice a one-stop shop for nearly anything medical. We can provide the initial evaluation for almost any problem and treatment of most things. My wife considers my practice my second home, considering all the time I spend there.

Recently, the Illinois Medicaid program decided that nearly every recipient of public aid needed something called a “medical home.” The idea is to provide an accessible, lower-cost point of entry into the health-care system than a hospital emergency room. A practice that agrees to provide the home makes a commitment to take an active, integrated approach to coordinating a patient’s medical care.

Does the “medical home” system sound like a good one to you? Do you think some patients would take advantage of it? Is there a lesson here that might lead to solving our current health care crisis? Join a discussion.2

My practice signed up for the medical home program. It was either that or opt out of Medicaid entirely. Because we’re in a rural area with a lot of patients on public assistance, we decided to give it a try. Last May, we became the official home for 177 Medicaid recipients. The next month we were shocked to find ourselves responsible for coordinating the care of more than 2,200 people on Medicaid. By July, those who had signed up or were placed on our roster by the state leveled off at about 1,700. Patients can change doctors if they want to. The advantage to us is that for the first time ever an insurer, in this case Illinois Medicaid, is compensating us for being a medical home, something we were already doing in large measure. If Medicare and private insurers acted the same way, I’d be more hopeful about the future of primary care. (See this article3 on the efforts of a business coalition to shore up primary care through medical homes.) We’re receiving an average of $2 per person per month in addition to our office visit fees for services that we had traditionally been obligated to provide free.

At our practice this means patients’ records are maintained electronically. Patients and their doctors have 24-hour access to the information or advice from us by phone or email. We provide prenatal care, delivery services, child and adult care in the office and the hospital. We measure our quality quarterly by looking at some key indicators. We don’t avoid patients of any age or gender or those with chronic, pre-existing conditions. We maintain a list of available specialists and coordinate referrals and follow-up.

Two bucks a month may not sound like much for all that work and responsibility, but it should just about cover the costs for our electronic medical records, computers, quality tracking and annual IT support. For the insurer and for patients, there should be savings and better health. Patients who don’t have a medical home incur higher health costs and report more illness.

A case in point comes from the 875 readers of my last column4 who anonymously completed the online health survey called “How’s Your Health” that I mentioned. Some had primary care doctors in addition to saying they are seeing a specialist. Of those people, 25% said they’d lost track of “who is in charge” of their care. These people reported a 100% increase in being hospitalized or using the emergency department in the last year compared to those with a single doctor coordinating their care. In addition, the group that said it “doesn’t know who is in charge” had a dramatic decline in all indicators of health. (Thanks to Dr. John Wasson at Dartmouth and Dr. Gordon Moore at the Ideal MicroPractice Project for crunching those numbers and passing them along.) If the gaps in care for these astute WSJ.com readers resulted in such problems, I can only imagine what folks with lesser skills and means would report. Back in the ’90s, managed care failed at cost control by trying to make primary care physicians gate-keeping clerks and pushing the liability risks for such management on doctors. I’m not advocating a return to that failed approach.

But it makes sense to me that there be fair payment for primary care services that require a lot of what is now largely uncompensated work beyond an office visit. The cost would be peanuts, and the benefits of improved care could be enormous. What’s missing in the debate over our nation’s health-care crisis is that primary care is cheap. Cheaper than your cellphone bill. Cheaper than a tank of gas. Cheaper than dinner and a movie. It’s so cheap the average person doesn’t value it properly. I could have covered my salary for 2007 and the costs of all my staff and overhead for less than $20 per patient per month, including maternity and hospital care. My practice covers 80% to 90% of what the average person would ever need a doctor for. Compare that to what you or your employer is paying for health coverage, and you’ll find that the high costs are due largely to catastrophic illnesses, hospital charges and money going to middlemen.

Even though I’d like to, I can’t offer comprehensive primary care on a subscription basis for $20 per month. The Illinois Department of Insurance would send me to the slammer for running an unlicensed insurance company.

But most Americans could afford a package that combined $20-per-month primary care, $4 generic pharmacy prescriptions and some catastrophic coverage. If the combination was tax-deductible for the individual, then I think it would be a slam dunk. Netflix can rent you 4 movies a month for $23.99, but I’m not allowed to rent you a medical home for less than you’d spend to watch a movie each week. Before we’re saddled with an unaffordable national health plan, we should consider renting an affordable medical home.
URL for this article:
http://online.wsj.com/article/SB120277184155560513.html

Hyperlinks in this Article:
(1) http://forums.wsj.com/viewtopic.php? t=1355
(2) http://forums.wsj.com/viewtopic.php? t=1355
(3) http://online.wsj.com/article/SB120175692402331541.html
(4) http://online.wsj.com/article/SB120156202509523589.html

 

Caregiver Resources


The list on the follow page is a comprehensive list of caregiver resources. It is well worth copying for future reference.

AARP: This organization supplies information about caregiving, long-term care and aging, including publications and audiovisual aids for caregivers. The free online seminar Planning for the Care of Aging Parents is just one example of the educational resources provided.
(800) 424-2277

Alzheimer’s Association 24/7 Helpline: Referral and support.
(800) 272-3900

Benefits CheckUp: This Web site, operated by the National Council on the Aging, identifies federal and state assistance programs for older Americans in each community.

Caregivers Marketplace: A free service for family caregivers that offers savings and education on a wide range of goods and services for anyone who “gives, gets or needs care.”
(866) 327-8340

Caregiving Online: The site pulls together other sites that offer information on maintaining caregiver health

Caregiver Survival Resources: The site aims to help others cope with the demands of caregiving.

Centers for Medicare & Medicaid Services: The official U.S. government site for people on Medicare.

Children of Aging Parents: A nonprofit, charitable organization whose mission is to assist the nation’s nearly 54 million caregivers of the elderly or chronically ill with reliable information, referrals and support, and to heighten public awareness that the health of family caregivers is essential to ensure quality care of the nation’s growing elderly population.
(215) 945-6900 or (800) 227-7294

ElderCare Online: An online community designed to provide comprehensive information and support for those caring for aging loved ones, especially those coping with Alzheimer’s.

Eldercare Locator: A national directory of community services.
http://www.eldercare.gov/eldercare/public/home.asp
(800) 677-1116

Family Caregiver Alliance: Tracks action on key legislative issues of concern to family caregivers and offers advice on how to get involved in advocacy efforts.
(415) 434-3388

Family Caregiving Guides and Directories: A Department of Health and Human Services directory of Web sites for caregivers.

First Gov for Seniors: A Web site maintained by the Social Security Administration to provide an up-to-date overview of health, wellness and financial issues of interest to older persons and their families.

Healthy Caregiver: A magazine and online community dedicated to the issues and interests of contemporary adults caring for aging parents.

HomeCare Online: The National Association for Home Care’s virtual headquarters. NAHC is committed to representing the interests of the home care and hospice community.


Hospice Net
: Organization provides information and support to patients and families facing life-threatening illnesses. Hospice Net is an independent, nonprofit 501(c)(3) organization working exclusively through the Internet.

National Alliance for Caregiving: The NAC is dedicated to providing support to family caregivers of older persons and the professionals who help them and to increase public awareness of issues facing family caregiving.

National Association of Professional Geriatric Care Managers: Care managers are professionals who coordinate caregiving services. They can be helpful when family members are not able to play an active role.
(520) 881-8008

National Family Caregivers Association: NFCA is dedicated to making life better for all of America’s family caregivers. Family caregivers focus on their loved ones’ needs; NFCA focuses on family caregivers.

National Hospice and Palliative Care Organization: The largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end-of-life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for the dying and their loved ones.
(800) 658-8898

Today’s Caregiver magazine: A print and Web magazine dedicated to those caring for loved ones, written for caregivers by caregivers and dealing with topics like stress and depression management, financial, legal and medical advice, housing and incontinence.

U.S. Administration on Aging: The federal agency that develops programs and information resources for the elderly and their families.

Family Caregivers Online Newsletter: Online educational resource with practical information for family caregivers.

——————————————————————————–
Leah Dobkin is a freelance writer based in Shorewood, Wisconsin. She has more than 30 years’ experience working in the field of aging. She has prepared educational materials and articles for family caregivers, businesses and nonprofit organizations on this subject, has spoken at conferences and has conducted training for employees, employers and community service providers throughout the U.S. E-mail editors@workforce.com to comment.

“caregiver resources”, “robert t demarco”, alzheimer’s, blog, caregiver, caregiver resources, dementia, elder-care, family caregiving

 

Caregiver Crisis Looming

About 34 million Americans act as caregivers, devoting an average of 21 hours a week to the task. These individuals provide 80 percent of the long-term care received in the United States. Unpaid caregivers, usually friends and family members, provide the majority of support for disabled individuals in the United States, grossing the equivalent of $350 billion in free labor last year — more than the total Medicaid or Medicare expenditures in 2005.

Source United Press International

By ROSALIE WESTENSKOW
UPI Correspondent

WASHINGTON, July 9 (UPI) — As the percentage of Americans over 65 steadily grows, so does the demand for long-term care — a burden that falls largely on the shoulders of family members, experts said Monday.

Unpaid caregivers, usually friends and family members, provide the majority of support for disabled individuals in the United States, grossing the equivalent of $350 billion in free labor last year — more than the total Medicaid or Medicare expenditures in 2005 — according to AARP, a non-profit membership association for those ages 50 and up.

About 34 million Americans act as caregivers, devoting an average of 21 hours a week to the task. These individuals provide 80 percent of the long-term care received in the United States, but many lack the time and training to give their loved ones the care they need, said Melody Barnes, executive vice president for policy at the Center for American Progress, a progressive think tank.

“Family caregivers often have low to no training (and) have to juggle multiple roles at home and in the labor force,” Barnes said Monday at a panel discussion.

One of the reasons unpaid caregivers have taken such a prominent role in long-term care lies in a shortage of professionals working in that sector.

“Multiple factors account for the shortage of caregivers, including the poor compensation, the lack of opportunities for professional development and the lack of benefits,” Barnes said.

At the same time, shrinking family sizes project a deficit of available descendants to care for the elderly in the future, said Robert Friedland, founding director of the Center on an Aging Society at Georgetown University.

“Right now, and for the next decade or so, the population at greatest risk for needing long-term care — people age 85 and older — are more likely to have had children and more likely to have three or more children,” Friedland said. “In contrast, by 2050, the population age 85 and older is less likely to have had children and, if they did have children, are more likely to have had one or two children, rather than three or four children.”

But as the baby boomer generation steps into retirement, more and more caregivers will be needed. By 2050 the number of individuals between the ages of 75 and 85 will double, and the number over 85 will quadruple.

Unless something dramatic happens during that time period, the number of caregivers — paid or unpaid — will not be large enough to meet the demand for long-term care, Friedland said.

“After 2015, the pool of primary caregivers is going to get shallower, not deeper,” he said.

In the face of these changing demographics, policymakers and others need to start exploring ways to bolster the long-term care sector, said Robyn Stone, executive director of the Institute for the Future of Aging Services at the American Association of Homes and Services for the Aging, a membership group for non-profit organizations that provide care to the elderly.

“If we don’t do something about addressing the formal, long-term-care workforce, we are going to have some serious problems” in the future, Stone said.

Currently, most healthcare workers garner lower paychecks if they work in long-term care than in other sectors of the industry.

“We need to have financial and other incentives specifically for this sector,” Stone said.

Policymakers can also provide support to family caregivers, easing the emotional and physical stress they carry, said Carol Levine, director of the Families and Health Care Project at the United Hospital Fund, a health services research organization.

The recent formation of the New York State Family Caregiver Council, set up through the New York Office of the Aging and slated to begin its work this fall, represents an optimistic step toward a more collaborative approach to long-term care, Levine said.

“It’s a very diverse group and they have the support of the highest level of state government,” Levine told United Press International. “It has a mandate to dig into the issue.”

A long-term-care insurance plan that spread the costs of providing care across the population would be a better solution than today’s system, said Judy Feder, dean of the Georgetown Public Policy Institute.

“The financing structure has got to be a public-private partnership, with a strong public core around which the private sector can build,” Feder told UPI.

Such a plan could expand the safety net for low- to middle-income families and provide other means of helping individuals cope with disability and the prospect of time-consuming and expensive long-term-care needs.

A federal bill three years in the making proposes a similar plan. The Community Living Assistance Services and Supports Act, sponsored by Sens. Edward Kennedy, D-Mass., and Tom Harkin, D-Iowa, would establish a voluntary long-term-care insurance pool. Participants who paid a monthly premium would be eligible for monetary benefits if they became disabled and would be able to choose what services to buy with the money.


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

caregiver, caregiver-crisis, family caregiving, long-term care

 

Caregiver Resources


The list on the follow page is a comprehensive list of caregiver resources. It is well worth copying for future reference.


Source Workforce

AARP: This organization supplies information about caregiving, long-term care and aging, including publications and audiovisual aids for caregivers. The free online seminar Planning for the Care of Aging Parents is just one example of the educational resources provided.
http://www.aarp.org/learn/course/ and http://www.aarp.org/research/housing-mobility/caregiving/
(800) 424-2277

Alzheimer’s Association 24/7 Helpline: Referral and support.
info@alz.org
(800) 272-3900

Benefits CheckUp: This Web site, operated by the National Council on the Aging, identifies federal and state assistance programs for older Americans in each community.
http://www.benefitscheckup.org and http://www.ncoa.org

Caregivers Marketplace: A free service for family caregivers that offers savings and education on a wide range of goods and services for anyone who “gives, gets or needs care.”
http://www.caregiversmarketplace.com
(866) 327-8340

Caregiving Online: The site pulls together other sites that offer information on maintaining caregiver health
http://www.caregiving.com

Caregiver Survival Resources: The site aims to help others cope with the demands of caregiving.
http://www.caregiver911.com

Centers for Medicare & Medicaid Services: The official U.S. government site for people on Medicare.
http://www.medicare.gov

Children of Aging Parents: A nonprofit, charitable organization whose mission is to assist the nation’s nearly 54 million caregivers of the elderly or chronically ill with reliable information, referrals and support, and to heighten public awareness that the health of family caregivers is essential to ensure quality care of the nation’s growing elderly population.
http://www.caps4caregivers.org
(215) 945-6900 or (800) 227-7294

ElderCare Online: An online community designed to provide comprehensive information and support for those caring for aging loved ones, especially those coping with Alzheimer’s.
http://www.ec-online.net

Eldercare Locator: A national directory of community services.
http://www.eldercare.gov/eldercare/public/home.asp
(800) 677-1116

Family Caregiver Alliance: Tracks action on key legislative issues of concern to family caregivers and offers advice on how to get involved in advocacy efforts.
http://www.caregiver.org
(415) 434-3388

Family Caregiving Guides and Directories: A Department of Health and Human Services directory of Web sites for caregivers.
http://www.aoa.gov/eldfam/For_Caregivers/For_Caregivers.asp

First Gov for Seniors: A Web site maintained by the Social Security Administration to provide an up-to-date overview of health, wellness and financial issues of interest to older persons and their families.
http://www.seniors.gov

Healthy Caregiver: A magazine and online community dedicated to the issues and interests of contemporary adults caring for aging parents.
http://www.healthycaregiver.com

HomeCare Online: The National Association for Home Care’s virtual headquarters. NAHC is committed to representing the interests of the home care and hospice community.
http://www.nahc.org

Hospice Net: Organization provides information and support to patients and families facing life-threatening illnesses. Hospice Net is an independent, nonprofit 501(c)(3) organization working exclusively through the Internet.
http://www.hospicenet.org

National Alliance for Caregiving: The NAC is dedicated to providing support to family caregivers of older persons and the professionals who help them and to increase public awareness of issues facing family caregiving.
http://www.caregiving.org

National Association of Professional Geriatric Care Managers: Care managers are professionals who coordinate caregiving services. They can be helpful when family members are not able to play an active role.
http://www.caremanager.org
(520) 881-8008

National Family Caregivers Association: NFCA is dedicated to making life better for all of America’s family caregivers. Family caregivers focus on their loved ones’ needs; NFCA focuses on family caregivers.
http://www.nfcacares.org

National Hospice and Palliative Care Organization: The largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end-of-life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for the dying and their loved ones.
http://www.nhpco.org
(800) 658-8898

Today’s Caregiver magazine: A print and Web magazine dedicated to those caring for loved ones, written for caregivers by caregivers and dealing with topics like stress and depression management, financial, legal and medical advice, housing and incontinence.
http://www.caregiver.com

U.S. Administration on Aging: The federal agency that develops programs and information resources for the elderly and their families.
http://www.aoa.gov (click tab for “Older People and Their Families” for a caregivers handbook that can be downloaded.)

Family Caregivers Online Newsletter: Online educational resource with practical information for family caregivers.
http://www.familycaregiversonline.net

——————————————————————————–
Leah Dobkin is a freelance writer based in Shorewood, Wisconsin. She has more than 30 years’ experience working in the field of aging. She has prepared educational materials and articles for family caregivers, businesses and nonprofit organizations on this subject, has spoken at conferences and has conducted training for employees, employers and community service providers throughout the U.S. E-mail editors@workforce.com to comment.

“caregiver resources”, “robert t demarco”, alzheimer’s, blog, caregiver, caregiver resources, dementia, elder-care, family caregiving

 
 
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