Don’t Wait for a Crisis to Happen
Published July 15, 2011
My name is Clare Colamaria. I am a native Saratoga Springs
resident, a former caregiver and a senior care family advisor, and I have a
story to share with you.
Most of us don’t really think about or like to think about
aging, deteriorating, or becoming dependent, so much so that we often forget to
consider what happens if a family member becomes dependent on us. Am I right? Most of us are so busy trying to keep up with our hectic lives that we fail to plan for when our elderly loved ones start to decline or are no longer able to meet their own needs.
Unfortunately, I learned the hard way what happens when you
wait until a crisis to take action; I learned firsthand how situations change
quickly and dramatically, and not only for your loved one, but for your entire
family.
My story begins like this. My father was 90 years old,
living alone and fending pretty well for himself. He was very social and loved sharing fun times with his grandchildren, family, neighbors and friends. In January of 2007, my father became very sick with pneumonia, which landed him in the hospital for 10 days or so. He was discharged and sent back to his home, where he would receive in-home rehabilitation therapy. Pneumonia really changed my fathers’ lifestyle, energy and mental state, which in turn changed how my brother and I kept an eye on him. We encouraged him not to drive any longer, which was difficult for my dad and one more step toward losing hold of his independence. We needed to ensure that he was taking his medications properly and on time, eating right, drinking enough fluids and
bathing. We had to worry about things like getting him out to socialize and
maintaining his home, the list goes on and on. Obviously, my dad needed more assistance than we could provide with our own busy lives to manage. We juggled our daily schedules with work, children and dad’s care. We brought in private help a few days a week, but even then we continued to worry every day and night. We tried to be there as much as our days allowed us, feeling sad and guilty each time we left his house.
This went on for a full year until my dad fell ill with pneumonia again, nearly fatally this time, and back in the hospital he went. Dad remained in the hospital for several weeks and when his doctor wanted to discuss discharge, there was one major change. They wanted my father discharged
straight into a nursing home! My brother and I looked at each other in disbelief, did we hear him correctly? It can’t be. Not our dad. We were thrown into crisis mode; we were confused and overwhelmed; we had so many questions: Where do we start? Who do we talk to? What questions should we ask? From there, we started a new chapter in our lives. The next three years was a rollercoaster ride.
Because of my family’s experience I was inspired to begin
researching the different ways in which I could help other families when faced
with similar circumstances. How could I help families make informed and logical
decisions out of emotionally charged situations, alleviate some of their worry, narrow down the countless phone calls, and help them come up with and find answers to more specific questions? Well, between my one and a half years of research and personal experiences with my dad, I was driven to create a company called A Senior’s Choice.
A Senior’s Choice, my inspiration and passion, assists families in becoming proactive in the planning
of care and safe living conditions that can accommodate the constant changes
that occur as we age. We are your transition specialists. We provide families with the proper resources needed for the physical, mental and financial changes we are faced with and by doing this we help create peace of mind for everyone involved. Of course there are times when a crisis unexpectedly happens, and in those situations we take you by the hand and immediately introduce and connect you to the best options that are available for the needs of your loved one and
your family. There is no need for each family to reinvent the wheel when faced with a crisis. We are already well-versed in the many different avenues of senior care, from in-home care to the various levels of assistance in senior living communities.
As Saratoga TODAY’S newest Families TODAY columnist, I will share with you different viewpoints and courses of action that should be considered while exploring options for families in upcoming editions. I am very grateful for this opportunity to express what I have learned and encountered through my family’s own crisis, which has forever changed my life. Let us take a closer look on the numerous ways of caring for our loved ones with integrity.
Safety First
Published August 12, 2011
In my first column, I spoke of the crisis my family was faced with several years ago that inspired me to create my business and passion. I told the story of how my father’s illness changed many aspects of my family’s life. If I knew then what I know today, I would have explored the many different options available. This would have made a world of difference for our entire family because our choices would have been very different.
So, why do I say that? I say that because of what we did not do, what we did not know and what we learned the hard way. When my father fell ill with pneumonia the first time and was released from the hospital, we were given very little information to go on. We were given names, numbers, days and times of the in-home rehab specialists that would be provided for a specific length of time under my father’s medical insurance.
Ok, what else? There really was no one to talk to and assist us with preparing for what lay ahead, what to expect, what to avoid, how to keep dad safe in his home or transitioning dad out of his home and into an assisted living community. Families going through a crisis are so overwhelmed with the crisis itself that they cannot see past it; it leads them moment to moment, step by step and your entire family just wishes it were over.
Let us take a deep breath, sit back and look at the whole picture. Let’s discuss what other alternatives could have been looked at. Once your loved one is discharged from the hospital and scheduled for rehabilitation, whether in-home or in a rehabilitation center, be sure to discuss goals for recovery. Discuss time frames and safety issues. What additional assistance will your loved one require while recovering? Has the illness or injury affected their physical state, mental state or perhaps both? And, if so, what steps will you as a family member or caregiver’s need to address?
Here are some questions you should ask yourself:
• Are your loved one’s living conditions appropriate for recovery?
• Can they move about free of fall hazards (rugs, stairs, slippery flooring, obstacles, and lighting)?
• Do they need guidance moving about (walker, railings, a helping hand)?
• What distance can they handle before tiring?
• Are they able to prepare meals for themselves and will they receive proper nutrition and fluids?
• Are they able to manage their medications?
• Can they us the bathroom and bathe safely and properly?
• Can they dress with stability?
• Are they able to contact others if they need help and will they?
Of course the list continues as you get into more details, but these questions are a good base to start with.
While your loved one is recovering, several issues need to be discussed based on how well they rebound or if recovery is delayed for one reason or another. In any case, you should consider the options and resources that will best fit the needs of your loved one now and in the weeks and months to come.
Safety is the number one concern most families address first.
For more information or answers to your questions, please contact us at www.aseniorschoiceonline.com or call Clare at (518-424-2527).
What Part of the Equation are You?
Published September 9, 2011
Do you know someone or are you someone who is worried about your aging loved ones or, is that aging loved one you?
It is one thing to be thrown into crisis mode and forced to make quick decisions on unstudied facts because of sudden illness or tragic mishaps of a senior loved one, but it is a totally different situation and feeling to observe the changes of our loved ones over time. Some of our elders are well aware of their gradual decline and are faced with fears, worries and stresses. One of which is for them to actually admit and discuss these thoughts:
“I shouldn’t share my fears and worries with my children or caregivers because I do not want to burden them; they have their own lives and own concerns. I don’t want to be more trouble for them.”
I hear this a great deal from my clients. This thought process can be dangerous. This type of thought pattern is an obstacle for protecting themselves and the ones they love. I would encourage you, the senior, to let your loved ones know your concerns, worries or fears. It will allow them to help you in areas of importance such as your safety, continuing your independence as long as possible, downsizing if that is your wish, securing your finances and your estate. When lines of communication are open, everyone involved will be in a more stable, emotional position which in turn will allow for the proper choices to be made in securing a comfortable and safe lifestyle for you.
On the other hand, some of our elders are unaware of their decline due to diseases which affect their memory or their ability to make informed and rational decisions. In cases such as these, loved ones must become involved and take the initiative to explore safety, finances and estate planning for their senior loved one. It is best to seek professional assistance in these very personal matters.
Then there are the cases where decline is evident to everyone except the senior loved one. It could be because they mentally still feel 25 years old and they continue to push themselves to unrealistic goals or because they are flat out in denial that they may need some form of assistance. Or perhaps they feel that if they admit to needing assistance, their loved ones and/or caregivers will barge in and take over completely, leaving them with no say in the matter of their choices in life. We cannot allow our senior loved ones to feel this way. I don’t think any of us are looking forward to getting older and being faced with the day to day decline that was once something we observed in others.
The fact of the matter is, everyone directly involved with an aging senior loved one experience some form of worry, fear or perhaps some family members feel inadequate because they do not live nearby to their senior loved ones. These family members may experience additional feelings of guilt, sadness or even anxiety because the responsibilities of the actions required are falling upon their siblings who live closer to their aging loved one. Each position holds its own difficulties and challenges. The only way to try and alleviate some of these stresses is to confront them in a gentle and informative manner. Let’s face it, don’t we all feel better after a good heart to heart? Let each other know how you care and sometimes worry about them. Once you open up your heart and mind to one another, the sky will seem a bit brighter and you can tackle the matter at hand in a positive and effective way.
Don’t be afraid to ask for help no matter which area of the equation you are in.
For more information and proper resources that fit your needs and the needs of our aging loved ones, please go to www.aseniorschoiceonline.com or call Clare directly at (518)424-2527.
Knowing When Your Loved One Needs Assisted Living
Published on October 14, 2011
The topic of assisted living can be a very touchy one and
should be handled with great care. Sometimes it can be hard to know when it’s
time to seek an assisted living facility. Here are some signs that could mean your loved one may need an assisted living facility:
1. They are suddenly less social and become very reclusive.
2. Tasks that were once easy have become difficult and labored.
3. They are having trouble taking their medication properly,
miss doses or take too many.
4. They aren’t eating as well as they used to and seem to
have suddenly lost weight.
5. The house is not kept up the way it used to be- laundry
is not being done and groceriesare not being purchased.
6. They are having trouble taking care of their own personal
hygiene- showering on a regular basis, washing their hair and brushing their teeth. .
Signs such as these could mean your loved one would benefit
from an assisted living facility. As difficult as it is, this means it’s time
to broach the topic and do some research to find potential facilities. There are many assisted living communities throughout the country. As similar as their services may appear, each one has individualized style, services, amenities, costs and licensures. It is best to seek professional advice as well as talk with friends and extended family members who may have personal experience with this topic. It’s a difficult time for everyone involved.
So let’s look at the upside of things. Your loved one needs a little help and may be moving into an assisted living facility very soon. This means big changes, but not all of them are bad!
Here are some of the great things they will love about their new home:
1. Assisted living has a negative connotation, but many people who are living in these facilities enjoy life even more than before! It gives them a chance to remain independent and get the help they need without feeling like a burden to
their family and friends. In fact, some move in simply for the social aspect of it!
2. Assisted living is fun! Most facilities have regularly scheduled events to keep everyone active, meeting new people and having a good time. Whether it be a game of cards with your neighbor, a few drinks before dinner with old friends, or movie night with new residents, there is always something going on to keep them upbeat and enjoying life.
3. Assisted living offers each resident their own personal room and space to call their own. They can decorate it however they please and have whatever furniture they want, which makes them feel more comfortable. Residents are also free to spend their day however they wish- that decision is theirs to make freely.
So as you can see, although moving a loved one into an assisted living facility can be a tough decision, it isn’t necessarily a bad one. Once they get settled in (and with a little time they will), they will feel very comfortable and at ease with their new home and it will give the entire family some peace of mind knowing their loved one’s needs are being met.
To find out more about assisted living and other related
topics please call Clare Colamaria, founder of A Senior’s Choice, at (518)
424-2527. For information about A Senior’s Choice, go to www.aseniorschoiceonline.com.
November is for Alzheimer’s Awareness and Giving Thanks to Caregivers
Published November 11, 2011
Did you know November is Alzheimer’s Awareness Month? I often wonder if it is a coincidence that this dreaded disease which affects one in two Americans over the age of 85 is highlighted during the same month as our national holiday Thanksgiving.
Alzheimer’s disease is the sixth leading cause of death in the United States, well below the leaders of heart disease, cancer and stroke. Yet this disease seems to be the most feared simply because there is no cure for its manifestations, which include dementia. So, as the holidays quickly approach and you gather with your loved ones to share in the celebration of all that we are thankful for, remember to give thanks to the caregivers in your life. The devoted family
members who give the extra time, energy and courtesies to our aging loved ones,
the ones who give of themselves unconditionally. The holidays are the perfect
opportunity for the children, siblings and other family members to be aware of
the growing needs of our aging loved ones.
Here are 10 warning signs for early detection from The
Alzheimer’s Association
- Memory changes thatdisrupt daily life – sometimes forgetting names or appointments but
remembering them later.
- Challenges in planning orsolving problems – difficulty in following a familiar recipe or keeping
track of monthly bills.
- Difficulty performingfamiliar tasks at home, work or leisure – |forgetting their way home from
the store, confusion with remote controls or microwave settings.
- Confusion with time orplace – can lose track of dates, seasons and the passage of time.
- Trouble understandingvisual images – they may not recognize their own image in the mirror
thinking someone else is in the room.
- New problems with words inspeaking or writing – sometimes having trouble finding the right word or
calling things by the wrong one.
- Misplacing things orlosing the ability to trace their steps – continually misplacing glasses
or remotes and sometimes accusing others of stealing.
- Decreased or poor judgment- they may mishandle money or pay less attention to grooming themselves.
- Withdrawal from work orsocial activities – starting to remove themselves from hobbies or social
gatherings.
- Changes in mood or personality- developing very specific ways of doing things or becoming irritable when
a routine is disrupted.
Finding out that a loved one has Alzheimer’s disease can be
stressful, frightening and overwhelming. As a caregiver you must remember to
take care of yourself first, stay healthy and strong. Get the support and
assistance you will require to maintain a healthy environment for you as well
as your loved ones. It is so important not to become burned out from being a
caregiver. By getting the right support and assistance you need, whether from a
professional service, friend or neighbor it will allow you down time, time to
take a stroll, go to the movies, out to lunch with a friend. Whatever brings
you peace, relaxation and enjoyment will also benefit your aging loved one.
During the upcoming holidays, take a good close look at your aging loved ones and their environment. Are they safe and are their needs being met? Do they need additional
assistance, and, if so, how do we go about finding the best solutions and
resources? Please keep in mind that we do not want to take our loved one’s dignity away, but empower them with a sense of security through the care we provide for them.
So, let’s remember to give thanks this holiday season to our
loved ones and caregivers young and old. Have a safe and happy Thanksgiving!
Clare Colamaria is the founder of A Senior’s Choice. For
answers to your questions or to find the care and support you need, call (518)
424-2527, email Clare at info@aseniorschoiceonline.com or visit their website
at www.aseniorschoiceonline.com.
Your Wish List
Published December 16, 2011
The holiday rush is approaching, and everyone is busy making plans. If you are concerned about an elderly loved one living alone, or in a nursing home or community, this time of year can be all the more hectic.
About a week or so ago, I went down into my basement to bring up the outdoor Christmas decorations and take advantage of the unseasonably warm weather. As I moved things around, I came across a shopping bag filled with the lights and decorations from my father’s room at his nursing home. My heart stopped. I realized with great sadness that this year, for the first time, I wouldn’t be carrying the bag nor the holiday spirit it contains into my father’s room – I wouldn’t see the joy light up on his face as he prepared to watch me gleefully decorate his small yet intimate surroundings.
As I reflected on the previous year, I remembered how sick my father was during the weeks between Thanksgiving and Christmas. Another trip to the hospital with pneumonia and dehydration, and the horrible questions that came with it: Will he survive this one? Will he see this Christmas, and if so, what will it be like this year? Surely not like others of the past.
I recall asking myself, “Are we doing right by him?” I recall us asking him over and over again, “Do you wish to get better; do you wish to keep fighting?” I recall him nodding a weak yes.
My two brothers and I were his voices. It was up to us, with the medical guidance of his physician, to make certain that his wishes for the level of care and comfort were being met. It was up to us to communicate clearly and effectively all the important details that would ensure the best level of care and compassion this hospital could offer our father, a very sick 94-year-old man. Our main objective and goal as our father’s proxy (The person the doctor should talk to when the patient is unable to speak for him or herself) was to follow through with what he had expressed to us during the more capable years of his life.
If we were not there to speak on his behalf, what actions would have taken place? I am not sure I would want to know the answer to that question. I would like to ask anyone who is reading this article to ponder this for a moment… have you thought about who would speak on your behalf should something happen to you and you were unable to communicate your wishes? Have you set forth your instructions, and, if so, with whom? That is also another very important decision to consider: who?
I feel that people of all ages need to think about this topic, because let’s be honest, you just never know what tomorrow will bring. It may feel uncomfortable or perhaps awkward to bring up the topic “end-of-life care and wishes.”
Most of us would rather sweep this under the rug and pretend it won’t happen to us or that we shouldn’t have to deal with this situation, however, death is a part of life. So, the subject “end-of-life care” is in fact a necessary responsibility we need to address and talk about. What if something happened to you? Imagine the turmoil it will cause your loved ones if you do not prepare your advance directive. What if a life or death circumstance was placed in their hands because you were unable to communicate your wishes regarding your care? Think about it.
Recently, I was invited to join a bio-ethics group meeting in Albany. This newly-founded group of professionals from all different areas of care management, marketing, social services, medical doctors and professors joined together to discuss finding a way, a better way, of bringing awareness to these delicate subjects. How do we help people understand not only the importance of end-of-life care on an ethical level, but also how it would affect and save the health care system valuable time and money. I was honored to be invited and I found it fascinating yet frustrating at the same time because there is still so much information that the general public needs to hear regarding these subjects.
My main goal for this article is to help educate my readers about this very critical subject matter. I would have to say from the many discussions I have had with all sorts of people, that as a dying wish, we would all hope to die with dignity. Let’s empower ourselves in the way we leave this world by taking immediate action now.
Many of you know it is a wise idea to have a living will drawn up by an attorney with an appointed power of attorney and proxy. I would also recommend two additional documents for your records. One would be an advance directive: A written document that indicates what type of medical treatment you would want and who the doctor should talk to when you are unable to speak for yourself. This document is a combination of a living will and a durable power of attorney for health care. And secondly, a POLST, which stands for physician orders for life-sustaining treatments, which is a doctor’s order form that documents the patient’s wishes, not only about CPR but for other end-of-life choices. When you have a POLST form, your wishes will be respected whether you are in the hospital, the ambulance, a long-term care facility or your home. In your area this form may have a slightly different name, such as MOLST, or medical orders for life-sustaining treatments. You can find out more about these documents online or through a respected attorney.
It turned out that my father bounced back once again (we called him “Jimmie, the come-back kid”) and he returned once again to the nursing home just before Christmas. He was alert, joyful and his usual loving self over the holidays, but there was one major difference on December 25, 2010. This year, instead of me picking dad up to bring him to my brother’s home for the day, my brother and I and our children brought Christmas morning to him and spent silly, joyful precious time with our father, their Papa. By the second week of January, my father began his final descent, slipping away slowly, letting go. He was now ready to say goodbye to this life he loved and held onto so strongly. As difficult as this conversation was for me to bring up, I asked him softly if he was tired of this life, if it was no longer fun and if he wanted to go home to his God… he gave me a gentle nod and whispered ‘yes.’ I asked him if he was tired of fighting… again he whispered ‘yes.’ I then said to him, “Ok dad, if that is your wish; I will miss you, we all will, but I understand.” We then sat in stillness holding hands and gazing out the window into the cold dusk winter sky. My dad went home to God January 28, 2010, as he wished.
I highly recommend the book “The Caregiver’s Path to Compassionate Decision Making” written by Viki Kind MA. This book provides information and strategies to help remove the constant anxiety of “Am I doing the right thing?”
Clare Colamaria is the founder of A Senior’s Choice. For more information, call (518) 424-2527 or email info@aseniorschoiceonline.com.
Tallying up the subtle changes
Published February 17, 2012
We all know someone who is elderly – a parent, relative, neighbor or even an acquaintance you chat with while on the treadmill at your gym. And oftentimes we worry about them. These somebodys, unbeknownst to them, might be creating a sense of worry or concern for those around them because of small changes in the way they execute typical tasks. Their routine may seem a bit off.
What are the subtle signs? They may look unstable on their feet or appear to get lightheaded when bending over or standing up. Do they forget where they parked their car? Well, I do that sometimes too, but if an elderly person regularly gets turned around, and is often found wandering through parking lots looking for their vehicle it may be a source for concern. This change in routine is hazardous in several ways, and it’s your responsibility to take notice.
They could be wandering for a long time in hot, humid or cold weather, they could get struck by a car because they are not paying attention to anything other than searching for their car and they are susceptible to becoming preyed upon.
It is up to us, the younger citizens and observers, to step in and either address these concerns or bring it to the attention of someone close to the individual that is raising concern. In my experience, it is the children, nieces, nephews and sometimes grandchildren of seniors who contact me with concerns for their elderly loved ones. Very rarely does an elder contact me directly because they are worried about themselves, on the contrary, most will tell you they are “just fine, don’t worry about me.” RED FLAG!
Beware, Beware! It is time to take notes and give special attention to your elderly loved one’s habits. Pay close attention to changes in their daily activities like their sleep habits or hobbies- perhaps they used to read the newspaper daily and now you notice it just sits on the table unopened. Also look for changes in their emotions. Are they lonely or depressed, perhaps not as active because they have lost interest in something that once brought them great joy? What about their medications, do they need constant reminders to take them?
But what do you do if you notice a change? Well, first you need to really think about how these declines or changes are affecting their life. Has it impacted their safety and well-being and, if so, to what extent? Do not ignore or make light of these subtle telltale signs, start a list or log.
Some things will need immediate attention. For example, if you notice your elderly loved one is having trouble keeping their balance, you’ll want to secure things like railings at doorways, and make sure they have support bars and handles in their shower. Replace or remove loose carpets or throw rugs that could cause them to trip and fall.
Here’s the thing: you know what causes you to worry or even get aggravated and upset, so pay attention and ask for assistance if you find problems that need to be addressed.
I remember the days of juggling my work, my children, my home, my father, his home and all that went along with it. It takes a lot of time, energy and patience and not all of us have it to give. If that is the case, you need to admit that you can’t do it all on your own and get assistance for not only your loved one’s sake but for yours as well. I would say this is a great place to start.
There are many resources available for assistance in the home. There is companion care, which is a social and verbal assistant for your loved one – a companion to prepare meals, help with tasks like grocery shopping, light housekeeping and getting dressed, or bringing them to the senior center for some socialization.
This type of care will not only lift their spirits and help your loved one remain alert and vibrant, but it will also enable you to keep a sense of normalcy in your life because you have given yourself peace of mind knowing they are being looked after. This will lighten your workload and responsibilities.
It is your responsibility to make sure your loved one’s needs are being met, but it does not mean you can’t hire someone to assist you in doing so. Sometimes companion care alone is not enough, you may need someone to assist in hygiene or transferring them from a chair to the bed. This type of service is referred to as home health aides. These aides can also give medications to your loved one and much more. Any of these in-home care resources can be hired for as little as three hours per day or as much as 24 hours a day, seven days a week if that is what is needed. It all depends on your needs, wants and what you or your loved one can afford.
I just want you to know there is help and assistance for almost every area you are concerned about or know you will need to address in the near or distant future. Don’t be afraid to ask for assistance.
For answers to your questions or to find the proper resources for your needs, go to www.aseniorschoiceonline.com or call Clare (518) 424-2527, founder of A Senior’s Choice, Your Eldercare Crisis Coach.