Seniors Palliative Care Options

As our seniors age, we as caregivers see changes in their health and physical functioning.  Sometimes the changes that we see can be frightening and it is scary looking into the future.  Aging is inevitable.  How we face the challenges of the aging process will help us to deal with things that may feel overwhelming.

Has your senior’s health declined to the point that it is time for you to consider end of life options?

Most of us want our seniors to remain comfortable no matter how well or ill they may be.  Many of our seniors have expressed their wishes for their end of life care in documents such as The Five Wishes or a living will or a durable power of attorney or proxy for healthcare.  In these documents, your senior has made it clear how the end of life medical care should be handled such does he want to be resuscitated, does she want a feeding tube, does he want mechanical ventilation or a breathing machine, does she want to stay in her home until the end, or does he want nature to take its course or have everything possible done?

You have choices in the care of your senior that will help you honor their wishes.  The goal of various care options is to maintain comfort, staying as pain free as possible while also maintaining as much physical function for daily activities to preserve good quality of life as possible.

Palliative care allows you to help your senior stay comfortable in the face of serious illness, manage the symptoms your senior may have and reduce everyone’s stress-even your own.  You can receive palliative care in your home or in a hospital.  It begins with a referral from your doctor.

This healthcare approach tries to reduce your loved one’s suffering; it does not hasten or postpone death.  You can receive palliative care while you are getting treatment for certain diseases including curative care but it also covers those who are nearing the end of life.  Your healthcare team in palliative care includes doctors, nurses, social workers, chaplains, and other professionals who work together with you to create a plan of care that will meet your family’s needs.  It offers support for both your loved one and your family members.

A recent World Health Organization statement describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

There is a difference between hospice care and palliative care even though they share similar treatment goals for reducing suffering.  Hospice care usually treats people with an end of life diagnosis who have six months or less to live.  Palliative care often treats people who may be expected to recover or extend their life with a chronic disease as well as those who are nearing end of their life.

These decisions are very difficult, perhaps the most difficult you will ever have to face.  Keep the lines of communication open with your senior, your family members, and your healthcare team.  Consider all your options and educate yourself on the approach that will best meet all of your needs.

If you have experiences to share about palliative care, we would love to hear from you.

When Your Senior Says NO to Caregivers

Many of us who care for seniors are facing the need for in-home caregivers.  We know our parents or grandparents need a little bit more help with some activites in their homes.  However, we are not able to be with them during the day when these activities are needed.  Making a decision to get help is a tough thing to do, but is only the first step in the process.

We search diligently to find just the right person to do some daily activities such as housekeeping, grocery shopping, driving to appointments, preparing meals, yard work, and personal care such as bathing.  They may need someone to be a companion who will sit with them and supervise their safety.  It can be a tedious process to locate, interview and check out the references on someone that you will be bringing into your senior’s home; a task that requires your attention to detail.

Most times when you finally find someone you can trust, things work out very well and you can rest assured that your senior is safe.

Unfortunately, sometimes things don’t work out as well.  There are times when your paid attendant doesn’t come as they are scheduled, they may not do what you expect them to do or they just don’t “gel” with your senior.  For these reasons, you have to start from scratch and find someone else.

“But I Don’t Need a Caregiver”

At other times, it is your senior who is resistant.  They might fight against the notion that they are in need of any help.  They might think that this person is an interloper or stranger and not accept them into their home.  They might be afraid that this person is going to steal from them or just simply not complete tasks the way they want them to such as not folding the towels right or putting the milk carton in the wrong place in the refrigerator.  Many times, our seniors have never had any help in their home. This could be a totally foreign idea for them to grasp and one that makes them feel uncomfortable.

As happened in our experience, our grandfather fired the helper we hired for our grandmother and we didn’t find out until after our grandmother fell and hurt herself.

Transition Tips

Here are some tips to make a smooth transition when you introduce a caregiver into your senior’s home:

  1. The most important thing to do is involve your senior in the decisions. Explain to them the reason that you are trying to help them accomplish certain tasks.  Let them help you decide which things they can do safely and what they actually need help completing.
  2. Let them tell you what traits they would like in a home caregiver.  Perhaps more than one is needed depending on the task at hand.
  3. Let them be there when you interview potential caregivers.  Let them establish a rapport to see if their personalities mesh well.
  4. Be there on the first day and for several days in the beginning and continue to pop in and watch what is happening, observe the interactions and the work being done.  Facilitate as needed to keep things running smoothly.
  5. Let your loved one help “train” the caregiver.
  6. Maintain continuous communication with your in-home caregiver to keep things on track and informed about any problems before they become insurmountable.
  7. Be reachable in an emergency or make arrangements for someone else, another family member or close neighbor, to be available if needed.
  8. Listen to your loved one’s concerns and feedback.  Work together to provide for their well-being.

This advice is aimed at those seniors who are still sufficiently mentally alert to participate in the process.  If your senior is suffering from dementia, you will be in charge of the decisions without much input.  We recommend that you think back to the time when your senior was more independent and remember what they would want.  A type of person that might be able to deal with someone with special needs becomes very important.  Being there in the beginning and at other intervals to observe what is happening continues to be advised to keep things running smoothly and safely.

We would love for you to share your tips on how you made the transition successful!

Aging in Place Introduction for Family Caregivers

Buzzwords and lingo are common with the senior/aging “industry”, with many having meaning only to industry organizations or service providers. Aging in Place is a buzz word (yes, it’s really a phrase but typically said almost as a single word) that has real meaning to both family caregivers and their senior loved ones.

This episode introduces the concept of aging in place, the ability of seniors to age in the home of their choice, and the implications of that choice for the seniors’ families and other caregivers.

Most of our senior loved ones – and even more baby boomers looking ahead to their retirement years – express in surveys their desire to age in place in their own homes. For some it is not practical due to health issues or physical limitations. For others, though, it is virtually a requirement given the cost of alternatives.  Regardless of the reason your senior loved ones want to live in their own home, there are many things to consider to make sure they can stay safe and enjoy living in that home.

References discussed in the episode and Senior Care Corner posts with more information:

Our plan is to record and post a podcast episode every two weeks.  We jumped the gun a bit with a second episode in a desire to get a second episode on iTunes and because we just loved recording the first one.Come back to check out future episodes and other posts here at Senior Care Corner.

If you want, you can subscribe to our podcast at iTunes or leave your name and email address in the signup box at the right and we will send you periodic newsletter updates with links to our new posts.

Podcast Transcript  (so you can follow along or read at your convenience)

Seniors’ Five Wishes: Key Health and End of Life Decisions

Welcome to the inaugural episode of the Senior Care Corner® Podcast!

We are introducing the podcast in hopes this medium helps reach more family caregivers.

The format of each episode will include news items for family members and other caregivers, in depth discussion of a featured topic and a tip for enhancing the life of that senior in your life.

The feature segment in this episode is a discussion of seniors’ Five Wishes, which is a process of making and documenting key decisions on health care and end of life issues to help keep a difficult time from being even more difficult for seniors and their families.

As we have said before (see the blog post link below) and will say many more times, while these are difficult conversations and sometimes harder decisions it is much better to make them in advance of being needed.

Resources Discussed in this Episode

Podcast Transcript  (so you can follow along or read at your convenience)

Seniors Spring Into Action!

Seniors, and all of us, are learning how important being active is to our health and well-being.

Spring is a great time to get our bodies into motion.

If your senior loved ones are not active now, it is time to begin—it is never too late to start!

There are many physical benefits of physical activity at any age, but seniors have added benefits that can help them improve their golden years.

  • Manage weight
  • Improved circulation especially blood flow to the brain
  • Control blood pressure and blood sugar
  • Can help with prevention of stroke, heart attack and high cholesterol levels
  • Increase socialization experiences
  • Increase stamina
  • Increase muscle strength to help prevent falls
  • Improve joint flexibility

Physical activity does not have to be strenuous or lengthy but only regular.  There are many activities that can increase  movement this spring such as gardening, walking, hiking a new path, biking, exercise class, yoga, tai chi, water aerobics, tennis, walking the dog, playing with the grandchildren, badminton, croquet, picnicking in the park or walking in the rain.

((We encourage you to have your senior check with the doctor before participating in any strenuous activity.))

Here are some items we think you might find helpful to get your senior (or you) moving at home, in the neighborhood or at the park, along with affiliate links to Amazon.com.   Whether for your use or as a gift, these can help get the action going!

Books:

Senior Fitness:  The Diet and Exercise Program for Maximum Health and Longevity Dr. Ruth Heidrich demonstrates that the senior years don’t have to be filled with aches and pains.

Strength Training for Seniors:  How to Rewind Your Biological Clock Michael Fekete discusses how regular exercise can reduce a person’s biological age by 10 to 20 years.

Yoga for the Young at Heart:  Gentle Stretching Exercises for Seniors Susan Winter Ward presents an introduction to yoga for seniors.

Fitness DVDs:

Stronger Seniors Core Fitness DVD– Chair Pilates Exercise Program developed by Anne Burnell, Stott Pilates Master Trainer … for the National Council on Aging (NCOA)

Stronger Seniors® Chair Exercise Program – Developed by Anne Burnell, Continuing Education Provider for Older Adult Populations for the American Council on Exercise (ACE) and Faculty for The National Council on Aging.

Fitness Gear:

Aerobic Pedal Exerciser Use for Arms & Legs

Valeo’s Yoga Kit Ideal for beginners getting started or intermediate yoga enthusiasts, this kit has everything you need for using at the gym, yoga studio, or at home.

The beautiful weather of spring can inspire you and your loved ones to get active and keep your bodies moving.  Daily activity is one of the healthiest changes you can make for yourself.  The best part of staying (or getting) physically active is that it will help  maintain physical function and independence through aging, expanding life options into the future.  Help your senior choose an activity that she or he loves or – even better – one you can do together and the physical activity can reap rewards beyond improved health.

Access to Preventive Care for Seniors

Seniors struggle to afford the lifesaving tests and procedures that are recommended for them to stay healthy.  Under the 2010 Patient Protection and Affordable Care Act, the government is attempting to close the gap between the cost of care and the accessibility of preventive care.  The goal of the new legislation is to eliminate the out-of-pocket costs to seniors for many types of preventive services.  Medicare beneficiaries will also be eligible for free annual wellness check-ups and no cost cancer screenings.

Preventive tests, screenings and services recommended for all seniors include:

  • Vaccinations including an annual flu vaccine, one dose of zoster vaccine for those over 60 years and pneumococcal vaccine if not received in the past five years
  • Colorectal cancer screening-fecal occult blood testing, sigmoidoscopy or colonoscopy from age 50-75 years
  • Breast cancer screening-biennial screening from age 50-74 years
  • Osteoporosis testing-all women 65 years and older or beginning at age 60 if increased risk for osteoporotic fractures
  • Diabetes screening
  • Lipid panel testing-beginning at age 35 for men and 45 for women who have coronary heart disease risk
  • Smoking cessation counseling-everyone should be asked if they smoke and those who are smoking be given counseling for cessation
  • Cervical cancer screening
  • Blood pressure testing
  • Aspirin use-to help prevent heart attack and stroke in men aged 45-79 and women aged 55-79 when the benefit outweighs the risk of gastrointestinal bleeding
  • Screening for alcohol misuse
  • Test for depression
  • Obesity monitoring-all adults should be screened and offered behavioral counseling interventions

Under the healthcare reform act, is has been decided that the cost of these screening tests is minimal compared to the cost of treating these disorders and the number of lives that can be saved each year.

At the present time, it is estimated that 90% of Medicare beneficiaries see their doctor at least once a year and as often as six times a year.  However, many do not receive these tests during the year when they visit their doctors.  Many seniors rely on their doctors to recommend the tests they need instead of advocating for themselves.

Sometimes seniors have to overcome numerous barriers to accessing healthcare options not just the cost of these tests but obstacles such as transportation, disability, cultural barriers, fear of pain, and fear of the results.

To gain access to these important tests, seniors can attend a free health screenings in their area frequently held by a variety of providers.  Learn about the tests, what they tell you about your health and how to prevent medical occurrences will help you have a healthier future.