Sleep Eluding Your Senior (& You)? Finding & Correcting the Cause

Sleep and our sleep patterns have become hot topics in the health arena of late.

With the advent of wearable devices that track our movement, sleep, eating and drinking, we seem to be focusing on how much – or little – we sleep as a cause of trouble for us and our seniors.

Many of us, as we get older, seem to find it difficult to stay asleep all night, fall asleep when we get into bed or awaken earlier than desired in the morning.

It’s not uncommon for many of us to wake up several times during the night or are restless while we sleep.

In a National Institute on Aging study of people 65 and older, more than one half of the men and women reported at least one chronic sleep complaint.

Recent Sleep Research Results

A recent research study published in the journal Brain indicated there is a cause for our seniors waking quickly (popping up) in the middle of the night or too early in the morning.

Researchers have found a group of neurons in our brains that act as a ‘sleep switch.’ This neuron group (ventrolateral preoptic nucleus) found in the hypothalamus appears to be prone to degeneration with age, meaning the nerves controlling sleep begin malfunctioning.

Those researchers also believe that the degeneration of the neurons also causes insomnia that is characteristic of nighttime wandering in people with dementia and Alzheimer’s disease.

The result of this new research could be improved sleep for ailing seniors, with the ability to better target their disorder with medications that can have fewer side effects than those currently being used. A newer, more specific sleeping aid is under development.

At this time, sleeping aids given to seniors result in instability, balance difficulty and falls as it affects receptors in not only the hypothalamus but also the cerebellum where balance is controlled.

Researchers found a specific neurotransmitter called galanin. They feel we lose half of these nerve cells with galanin between young adulthood and our older years. The fewer the nerve cells, the more trouble with sleeping we experience.

Most eye-opening to us, those with the smallest number of nerve cells had Alzheimer’s disease.

Importance of Sleep for Seniors

We all know how we feel when we have not slept well or slept for fewer hours than we need. It makes it hard to focus on the activities of living that we need to complete, including our jobs, caregiving, or our own safety.

It is the same for our senior loved ones.

Not sleeping well or long enough can put our seniors at risk for falls, injuries and behavior issues that can put them at risk.

Researchers in the study outlined above state:

“Sleep loss and sleep fragmentation is associated with a number of health issues, including cognitive dysfunction, increased blood pressure and vascular disease, and a tendency to develop type 2 diabetes. It now appears that loss of these neurons may be contributing to these various disorders as people age.”

Many people have come to believe that seniors don’t need as much sleep as they age. That is just not the truth, according to research results. Older adults need the same number of hours of sleep as they did when they were younger.

There are many reasons older adults don’t sleep as well.

  • Arthritis pain
  • Frequent urination
  • Sleep apnea
  • Restless leg syndrome
  • Medications
  • Alcohol
  • Caffeine
  • Excessive napping
  • Insomnia
  • Medical diseases

Correcting Sleep Disturbances

Because so many seniors have difficulty sleeping, and that difficulty can affect their health and well-being, it is important to look for the root cause(s) of the sleep problem and then correct it.

Here are some suggestions to help your senior loved ones improve their sleep pattern.

  1. Visit your senior’s doctor to be sure you are doing all you can to relieve medical concerns, such as restless leg syndrome or sleep apnea.
  2. Set a bedtime routine. Go to bed at the same time and get up at the same time.
  3. Get outside during the day to get enough exposure to sunlight.
  4. Don’t drink too many fluids close to bedtime, forcing your senior to the bathroom in the middle of the night. Avoid caffeine containing products late in the day as well.
  5. Get moving during the day. Staying physically active, expending energy to be ready for sleep.
  6. If taking a nap, be sure it is short enough to allow for sleep at night. Napping in the late afternoon could upset your senior’s ability to fall asleep at bedtime.
  7. Use a natural sleep aid such as melatonin if your senior’s doctor approves.
  8. Try lavender in their pillow or in a warm bath at night.
  9. Keep your senior’s bedroom an atmosphere of good sleep, with darkness, calm, and quiet surroundings.
  10. Be sure the mattress is comfortable and doesn’t compound the sleep problem.

Seniors can experience not only inadequate hours of sleep, they can also have numerous restless periods, inability to get into a deep sleep, difficulty falling asleep and wakening too early.

Sleep Important for Family Caregivers, Too

Sometimes lack of sleep by your senior loved one can also keep you, as their caregiver, up at night as well. They may be making noise that wakes you up. You may be sleeping with ‘one eye open’ waiting for them to wander. You may be worried that they will fall. You may be afraid of them staying awake at night and sleeping during the day when you have planned activities or appointments.

Regardless of the specific reason, their poor sleep could be negatively affecting your health as well.

Many seniors get placed in long term care facilities when their caregivers can no longer handle poor sleep patterns in their seniors, falling in the night and behaviors induced by sleep deprivation.

Taking some time to correct sleep disturbances will help not only the quality of your senior’s life but yours as a caregiver as well – – addressing the long term interest of both of you.

A Shot in the Arm – Immunizations Protect Seniors & Family Caregivers

August marks our celebration of Immunization Awareness Month to get us all ready to enter this winter’s flu season prepared!

We know how important and life-saving immunizations can be for every member of the family but especially our senior loved ones who may be vulnerable to contracting illnesses.

The Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases sponsors Immunization Awareness Month in order to get the word out that it is time to get immunized not only for seasonal flu but other important vaccines as well.

Immunizations help prevent diseases. Getting our seniors properly immunized will help protect their health.

Immunizations for Seniors

Here is a reference for you to track which vaccinations are typically important to those over 50 years. Check with your senior loved one’s doctor to see what has been given and what is needed.

Vaccine    Schedule for Those Over 50 
Influenza (seasonal flu) Every year
Shingles (herpes zoster) Once dose over for 60 years
Pneumococcal PCV13 Once dose
Pneumococcal PPSV23 One or two doses; One more dose after 65
Chicken pox Two doses
Hepatitis B Three doses
Hepatitis A Two doses
Tetanus, diphtheria, pertussis Td/Tdap initial dose; repeat every ten years
MMR Talk with your doctor


The CDC website has an interesting interactive quiz to determine exactly which immunizations you need, no matter your age that you might like to do.

Once your senior has had their vaccines, it would be a good idea to keep a shot record so that you can inform all healthcare providers of the dates given. Here is one you might like to use from the National Foundation for Infectious Diseases.

Seniors & Seasonal Flu

For seasonal flu, there is another option for seniors over 65. Fluzone High Dose is a flu vaccine that contains four times the amount of vaccine compared to regular flu shots. It is designed to give the person who receives it a greater immune response to protect them from the most flu strains during the flu season.

This particular flu shot could be more beneficial for our seniors because as we age our immune defenses can become weaker putting us at greater risk for contracting flu. Talk to your senior’s doctor to see if this is a good choice for them.

The time of year seasonal flu is a concern is typically from October to May. You can be immunized for the flu as soon as the vaccine is available but try to get it done by October. If you don’t get one by then, please get one as soon as you can to protect your senior from illness and potential hospitalization (or worse).

Caregivers are Not Immune

As a family caregiver it is equally (maybe more) important for you to get your immunizations on schedule as well. If you ignore your health and contract a preventable disease, you won’t be able to continue to care for your senior loved one as you are now.

Get your shots when your seniors get theirs!

Find the nearest location that will give you and your senior their vaccines quickly and easily using this locator. Don’t forget, there are many local drug stores and senior centers that are providing flu shots this season some require no appointments. Check out the places in the community that give you and your senior convenient access in addition to the doctor office.

You can support your senior loved one by keeping track of their vaccines and knowing what they need at what age. Making the necessary appointments, taking them to the doctor or clinic, and keeping the records of their vaccinations are things you can do to help prevent life threatening situations.

Staying Healthy – Habits that Can Help Your Senior and You!

One of the best ways to prevent illness is to get vaccinations when they are due. In addition to getting your shots, there are things that we can all do to stay healthy throughout the year.

  • Wash your hands and encourage your seniors to do so regularly and often! You can use soap and water or alcohol based lotions. Don’t forget to sing the birthday song to be sure you are getting enough friction going to kill germs.
  • Cover your cough – whether you use a tissue or your sleeve, prevent passing airborne germs from infecting others. It is best not to cough or sneeze into the palm of your hand but if you do be sure to wash thoroughly.
  • Stay away from people who are sick – don’t visit or allow visitors when people are sick.
  • Stay home if you are sick.
  • Avoid touching your nose, eyes and mouth to prevent spreading germs to your hands – this is often an unconscious habit so it takes some attention to avoid it!
  • Keep surfaces clean especially if someone in the household is sick – don’t forget commonly used items like the TV remote, telephone, door knobs or surfaces our senior’s touch to help them walk.
  • Get plenty of sleep!
  • Drink enough fluids – your senior needs a bit more fluids if they are sick.
  • Eat a variety of foods to get all the nutrition you and your seniors need – keep your senior’s immune system strong with good nutrition all year long!

Sometimes we all, including our seniors, need a reminder about the importance of preventing the spread of germs.

We hope that you and your seniors are able to avoid the flu this season and that you all get the vaccines that are recommended for you!

Dementia Impacted by Vision & Hearing Issues – Caregivers Can Help

Do you have a senior loved one with dementia and notice your senior having more difficulty seeing or hearing things lately?

Have you observed subtle changes in them such as straining to see or hear, sitting closer to you or turning up the volume of the TV?

Did you realize that even seemingly small changes could be the result of a sensory loss that could be corrected?

Sometimes when we are caregivers of seniors with Alzheimer’s disease or other dementia, we can’t always determine which came first, the dementia itself or the altered behavior you’ve noted.

It can be difficult to tell if these subtle behavior changes are caused by the dementia, confusion associated with cognitive loss or some other unrelated reason.

Or could it be that our senior loved ones are just frustrated with how their life has changed?

Sensory Loss Can Lead to Dementia

We continue to learn more about what impacts the lives and health of older adults, thanks to growing numbers of research studies.

Research shows that having a sensory loss, such as a hearing impairment, can lead to dementia. We are also learning that having a vision loss can further worsen symptoms of dementia.

Losing the ability to see and hear can have profound impacts on behavior and escalate the symptoms of dementia.

The good news is that there are strategies and treatments to diagnose and treat sensory loss in those with dementia.

Cataracts Common Among Seniors

Have you talked with friends and neighbors, or even family members, who have had recent surgery on their eyes? It seems all of us know someone who has had cataract surgery these days and usually in both eyes.

Cataracts are all too common and are the leading cause of vision loss in those over 55. (Even our pets get cataracts as they age!) The lens of the eye gets cloudy making it hard to focus light images through the eye onto the retina. Images are sent from the retina to the brain.

How many of us have looked lovingly into the eyes of our family and friends and seen what appears to be a cloudy film over the color of their eyes progressing toward the center? I have.

Cataract surgery has become common and is performed every day on numerous people. It has been estimated that more than three million cataract surgeries, lens transplants, are done each year in the US. It takes about 30 minutes, typically with few complications or pain. Recovery is generally within a day with the senior resuming their normal activities.

Ignoring cataracts can lead to blindness. Even before that happens, the quality of life of those suffering with diminished vision can be severely hindered.

Treating Cataracts Improves Dementia?

A new study out of the Case Western Reserve University and University Hospitals Case Medical Center in Ohio has found that having cataract surgery can have more benefits for the person suffering with dementia than their improved vision. The results were presented at the recent Alzheimer’s Association meeting in Copenhagen.

Along with the vision improvement, it was found that mental decline was decreased in those with Alzheimer’s disease and other dementias. Better eyesight improved their quality of life according to researchers and caregivers.

The study, which should be noted was small, found that those who had cataract surgery after six months showed a slower decline in memory and thinking difficulty and improvements in behavior. Even the caregivers reported improvements in their care recipient with dementia.

Health Assessments Still Important with Dementia

The researchers stress the need to routinely assess the general health of people with dementia. Care providers should be looking at more risk factors such as balance, vision and medical risks. They also encourage other sensory interventions be pursued for people with dementia including vision screening and hearing loss as this will also improve quality of life.

Those diagnosed with dementia often don’t get full medical evaluations for a variety of reasons, including reduced ability to understand directions from the healthcare provider, being resistant to care or the attitude that ‘why put them through it’ or ‘there’s no need for extra care’ with regard to someone with dementia.

This study highlights that need for interventions that are able to improve the quality of their life and keep them safe. Falls are more likely in someone who can’t see well. Depression and isolation can occur when a senior is having trouble hearing conversation and can’t see clearly to remain engaged.

Providing sensory stimulation also can benefit the caregiver who is under stress to keep their senior safe and happy.

Impaired Hearing Leads to Isolation

If your senior has a hearing impairment, it could cause them to reduce their participation in events and activities, beginning to withdraw. It seems only natural to think that if you can’t hear others talking, hear the music that is playing, hear the dialogue on TV, or join the conversation that this could also lead to depression and decreased quality of life.

A study carried out by the Gerontology Research Center found that social relationships are important to a high quality of life as we age.

  • In the US, it is estimated that 36 million adults have some degree of hearing loss.
  • 1 in 3 people between the ages of 65 and 74 has hearing loss and nearly half of those older than 75 have difficulty hearing.
  • Only 1 out of 5 people who could benefit from a hearing aid actually wears one, including many who own them.

This study found that older adults with hearing loss participated in groups and met with friends less than those without a hearing loss. Those with hearing loss self-reported a poorer ability to live their lives than if they had normal hearing.

It seems that we all know that not having adequate hearing or vision would impair our day to day ability. However the statistics show that knowing there is a problem and correcting the problem may be two different things for many seniors.

The impact of these deficits is even worse for someone diagnosed with Alzheimer’s disease or other dementia. They may not be able to express their needs clearly.

Their frustration with their limitations could be mistakenly thought to be confusion from the dementia.

Vision & Hearing Intervention Steps

There can be many reasons for loss of hearing or vision. They could be age-related, caused by external factors such as loud noise, or stemming from a medical condition such as macular degeneration, tinnitus, head injury, tumors or an infection.

Depending on the cause of the loss, your senior may be able to receive treatment.

The first step would be have them evaluated thoroughly by their medical team. Visiting the family doctor, audiologist and eye doctor should be done regularly — especially if something is suspected.

Vision correction through prescription lenses, medications for glaucoma or surgery for cataracts is something to be explored and not disregarded because there is a dementia diagnosis. If your senior has a vision loss you can do things such as give large print materials, brighten the area with adequate lighting and offer contrasting colors in things they use such as plates and furnishings. Making their world bigger, bolder and brighter will make it easier for them to maneuver through it.

Hearing correction can be something that will help your senior remain involved with the world around them longer. Hearing aids, hearing modifications such as amplification systems, assistive listening devices and strategies such as looking them in the face to talk or talking more loudly but not shouting the first time can help your senior understand better. You can also reduce noise distractions such as undue noise or loud sounds while you are trying to communicate.

The effort to get your senior loved one to the doctor, unless their dementia is too advanced, will be worth the sensory gain that will improve their daily living.

Do you have any experiences you would like to share about how sensory loss affected your senior?

We would love to hear how you overcame vision or hearing losses and the changes they experienced after you intervened.

Triple Decker Sandwich Caregivers Face Financial & Emotional Squeeze

Caregivers face many difficulties each day, don’t we? It might be finding time to do it all — even half of it — making everyone happy or just getting a shower some days!

This of course doesn’t change the passion that we have for providing care to our senior loved ones. We are fulfilled even in the midst of extreme pressure. We are where we should be and there is no place you would rather be!

But couldn’t it be even just a bit easier sometimes?

Let’s add a few more wrinkles to the caregiving challenge – finances and emotions. We don’t want to think about either one but to be a healthy caregiver, we need to be able to recognize the potential to feel squeezed by both of these realities and face dealing with them so we stay in control.

Financial Burdens Mount

According to a recent report from the Pew Research Center, in 2012 nearly half (47%) of adults in their 40s and 50s have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). Of those people, 15% are providing financial support for their seniors.

That’s a good description of those in the sandwich generation, more specifically who are in the middle of a triple decker sandwich!

It has been estimated by Family Caregiver Organizations that, on average, family caregivers have helped with expenses for two to six years, spending an average of $19,525 in out-of-pocket expenses.

That can make a real impact on the budgets of U.S. households!

Who are Sandwich Generation Caregivers?

Sandwich generation caregivers are said to be often women in their mid-forties who hold jobs outside the home, care for an elder parent or family member as well as children and are married. They devote some 20 hours a week to caregiving.

That is not to say that men aren’t in the sandwich generation — they are and their numbers are rapidly growing!

It seems, according to the Pew Research report, the bulk of the financial support from those in the sandwich generation is being provided not to our seniors but to our grown children. 48% of adults 40-59 give some support to grown children but only 21% to seniors over 65.

According to the report, one area of financial support to grown children is college. Also more younger adults are unemployed or underemployed earning less than they have in the past and have moved back home.

Supporting Seniors vs. Grown Children

The public, however, seems to feel 3 to 1 (75% versus 52%), that adults have a responsibility to support seniors instead of grown children. Unfortunately, caring for everyone pulls the sandwich generation in every direction.

When Pew Research asked about their financial status, these statistics were presented:

  • Among those who are providing financial support to an aging parent and supporting a child of any age:
    • 28% say they live comfortably
    • 30% say they have enough to meet their basic expenses with a little left over for extras
    • 30% say they are just able to meet their basic expenses
    • 11% say they don’t have enough to meet even basic expenses
  • Adults who are sandwiched between children and aging parents, but not providing financial support to an aging parent:
    • 41% say they live comfortably

Not investigated in this report was the number of seniors who provide financial assistance to their children aged 40-59 or how many seniors are supporting their grandchildren. We have seen the statistics that a greater number of grandchildren have become the full time responsibility of older adults.

The number of grandparents raising their grandchildren is in the millions and 4.9 million children under the age of 18 live with grandparents, 20% of these kids have no parents present in the household.

Emotional Burdens Mount

In addition to spending their earnings, not saving for their own retirement or even borrowing to support everyone, adults in the sandwich generation feel emotional pressure from their family members who rely on them. Despite mounting stressors, adults in the sandwich generation, according to the same Pew report, state that they are very happy with their lives compared to those who are not caregiving (31% compared to 28%) and 52% more say they are pretty happy.

Not surprisingly, many adults who are caregiving for both seniors and grown children report that they often feel rushed compared to those who are not caregivers. If they are not now providing hands on care, they expect to have to do so in the near future.

Not only do sandwich generation adults provide financial support but physical caregiving, with day to day activities that can also increase emotional stress. Sandwich generation caregivers report that they feel that they provide emotional support to their seniors 68% of the time and to their grown children 76% of the time; they feel depended upon.

The older their parents become, the more care and attention they require and the greater the stressors will be for sandwich generation carers.

It is interesting to note that the report of sandwich generation caregivers found that for those who have given their parents financial support in the past 12 months, 54% say they give emotional support frequently, compared with 25% of those who say they didn’t give money to their parents. It seems that the more involvement overall leads to a greater amount of perceived emotional support and stress too.

Lest we forget about the grown children, sandwich generation caregivers report that they frequently provide even more emotional support of the children, 78% compared to 65% for their seniors. It seems only natural that we feel more invested in the children’s life at this point. Many parents (47%) report that they feel a stronger bond with their grown children than they felt with their own parents at the same age.

Significant Changes for “Sandwich Generation”

The Pew Research study was conducted in both 2005 and 2012. During the time that elapsed, the most interesting change in the data was the result that the demographics of sandwich generation caregivers is changing perhaps more than the seniors for whom they care.

42% of Generation Xers have a parent age 65 or older and a dependent child, compared with 33% of Baby Boomers. In 2005, the Gen X accounted for only 20% compared to 42% of Baby Boomers.

It will be fascinating to see the changes reported next time the study is carried out in the future. It is inevitable that more people who find themselves caring for their senior loved ones at the same time they are caring for their children, their jobs, and their own relationships will continue to feel squeezed and unsure of which way to turn.

There will be more of us in this position as our population ages. What types of assistance or policy changes will be instituted to support sandwich generation caregivers remains to be seen. There are a multitude of needs that this group will look for help to be met.

What are your challenges as a sandwich generation caregiver? How would you like them solved?

Thriftiness While Saving the Planet – Green Caregiving with Seniors

We hear a lot about recycling and being ironmentally friendly. But what does that really mean to the life of a caregiver who is struggling to get everything done for the day without worrying about separating paper and plastic?

Actually, when you think about going green it conjures up a lot of effort and great changes that are required to make a difference.

In reality, it doesn’t take much change to make a difference in the environment — and in their wallet.

It can also be a great way to share with senior loved ones, many of whom will identify with the “waste not, want not” approach they remember from their youth.

Why Should Caregivers Go Green?

Some environmentally friendly activities can cut down on your workload. You may find that hard to believe, but it’s true. Doing things that save the environment will also save you and your senior loved one some money.

Helping the environment and taking steps to be more sustainable can help us all live better lives, especially our children and grandchildren, because we are helping make the planet healthier. We can feel good about our part in changing the air and water in our world for the better.

Everything we do has an impact in either a positive or negative way. For some the goal is to reduce their carbon footprint. What does that mean exactly you ask?

Our dictionary defines carbon footprint as

‘the amount of greenhouse gases and specifically carbon dioxide emitted by something (as a person’s activities or a product’s manufacture and transport) during a given period”.

Being green can reduce the production of greenhouse gases, reduce the amount of waste in our local landfills, clean the air that we breathe and help protect the earth.

Ways to Go Green & Save

Did you know that you could save these resources when you go green (see suggestions below)?

  • 20 gallons of water at each dishwasher use
  • 2,500 gallons of water and 55 square feet of forest with one meatless meal a week
  • Half a million trees used for newsprint
  • 100,000 barrels of oil a day in warm-cold clothes washing
  • Reduce air pollution of one million cars with one compact fluorescent bulb
  • 5 gallons a water a day by turning off water during brushing teeth
  • Reduce greenhouse gases formed when transporting our food long distance
  • Save 18.5 million trees, 2.2 billion tons of carbon dioxide and other greenhouse gases, and 1.7 billion pounds of solid waste every year by getting bills online

Green Caregiving

There are a lot of little things that you and your senior can do in their home and yard that can, added together, improve the quality of the planet and improving their lives.

As a bonus, some of these activities can be done as a way to find inexpensive activities that involve you both and other family members, some of these ideas will save you work too. You can do these together and have a common goal. It sure won’t be boring!

  1. Don’t rinse your dishes before putting them in the dishwasher; run the dishwasher only when it is full
  2. Hang dry clothes (the old fashioned way your parents probably did it!)
  3. Practice ‘Meatless Mondays’ each week
  4. Recycle newspapers, glass, plastic, aluminum
  5. Use one less paper napkin a day
  6. Use warm-cold water instead of the hot cycle to wash clothes (clothes will still get clean)
  7. Look through oven window instead of opening door and don’t pre-heat unless making bread or baked goodies
  8. Replace one or all light bulbs with compact fluorescent bulbs
  9. Turn off water when brushing teeth (or dentures)
  10. Plant a tree
  11. Buy secondhand items at thrift and consignment stores; reuse items and re-purpose things; visit garage sales
  12. Go to a farmer’s market and get food grown locally; look for locally grown in the grocery store
  13. Install a programmable thermostat, set thermostat a few degrees lower or higher to save on heating/cooling costs and energy production
  14. Turn off lights when not in the room
  15. Donate or consign things you no longer need or want instead of trashing
  16. Recycle old phone books
  17. Stop your junk mail and billing paper statements; get bills online
  18. Take a shorter shower, reduce number of baths and install a low-flow shower head to save water
  19. Use a reusable water bottle instead of bottled water, recycle plastic containers
  20. Fix the leaky faucet or running toilet

Passing Along Habits from Their Youth

We’ve found that many seniors take pride in actions that they feel are making the world a better place for their grandchildren and great grandchildren. They may also feel they are passing along some of the thriftiness with which they grew up from the “hard times” of their youth.

As caregivers, you will also be able to find ways to spend time with your senior loved one, give them ‘jobs’ to do and make even more memories!

When we practice being green, we are being good role models for all our family members. We are also making an impact!

Overcoming Loss of a Senior Loved One When You’re a Family Caregiver

How can you hope to handle it?

You have spent years caring for your senior loved one. You have given your all to serve them, protect them, meet their needs and love them unconditionally.

The inevitable outcome of aging is death and we all know that our senior loved ones are moving closer to it each day.

Even though we know death is a part of life and will come sooner than later, we can never truly be prepared. You might ask yourself the following questions as you struggle with loss.

How do I live without her/him?

What do I do now? How will I spend my time?

What will define me? Will I have an identity without caregiving?

How do I grieve, heal and then carry on?

Will I forget the sound of their voice, the look in their eyes or the things they did?

Somehow you’ve got to deal with the feelings of loss and continue to live your life.

Preparing Yourself for Loss as a Caregiver

Naturally, as family caregivers, we tend to begin the mourning process as soon as a diagnosis is made. It could be many years later that a loss may come, but beginning to grieve for the person we love as we realize that he is declining due to the disease process can be a healthy thing for us. We may not even recognize that we indeed have begun grieving and feel the oncoming loss for years.

Be aware that loss causes pain — emotional and physical. As a caregiver you may experience even more fatigue as the end nears and the demands of caring become greater. Avoid finding external ways to relieve your pain, such as alcohol.

It is better for your health to ask for help and get some respite so that you can deal with emotional pain without artificial means. Get your network in order so that you have people to call on when you need them the most.

Be ready to deal with your feelings and emotions. When you repress these feelings or ignore them, they will rear their ugly heads at a most inconvenient time in the future and likely be more difficult to deal with then. They will linger if not dealt with at the time. There are no right or wrong feelings but they need to be faced and accepted.

No Single “Right” Way to Deal with Grief

Each person handles grief differently and on a different time schedule — that is OK.

There is no one right way or length of time to process your grief. Therefore, don’t compare yourself with others even siblings.

Give yourself permission to cope in your own way but keep working on healing. Your loved one would not want you to hold yourself back from living.

Many people who are experiencing the loss of someone they spent a great deal of time caregiving find themselves being extremely fatigued. For years they have put their own needs on hold and set aside their feelings to show a brave face. This leads to a letdown and exhaustion.

Be prepared for this occurrence when your loved one passes by putting yourself first. You may need to tell others to give you some time to rest and get your feelings under control before you make life decisions and even plan a family gathering too soon.

Overcoming Loss to Begin Healing

Losing a loved one, especially someone for whom you have spent years providing care, requires you to go through the process of grieving. Your grief can’t be undone. In order to heal, you have to allow yourself to walk through all the stages of grief and actively deal with your emotions.

There are a number of things that you can do to help manage your grief. We hope these suggestions help you.

  • Keep a journal of your feelings. It is confidential so write how you feel exploring your grief including sadness, guilt, loss, anger, loneliness, regret or other feelings that may surface. Get to the root of your feelings.
  • Talk to a professional if your grief does not seem to be lessening or if your physical health is being affected.
  • Join a bereavement group or support group.
  • Connect with your faith community, talk to others who are grieving in your church, join a support group for spouses experiencing loss.
  • Plan memorial celebrations. By honoring your loved one and their contribution to the family or community you will heal. You may want to plan the ceremony on an anniversary of their death or on their birthday.
  • Plant a tree or plant in their memory. This is a way to be reminded of them every day when you are able to look at the garden. If there is a special plant or flower that was their favorite or brings a special memory, plant that. Our family has a special place in our hearts for Shasta daisies!
  • Make memory books with photos or other memorabilia. You can also memorialize them with memory bears, jewelry or other personal articles.
  • Reflect on your own needs, as you are no longer providing care to your loved one. What will make you happy? What do you want to spend time doing? Do you want to work, go back to school, or volunteer? Is there a way you can help others since your found caregiving rewarding?
  • Be patient with yourself! Your grief can reappear, especially at special times such as holidays, anniversaries, and birthdays. Your grief can also be triggered by sounds such as their favorite song, smells such as their perfume and tastes such as their favorite cookie. When this happens you will be brought back to exploring your feelings and remembering the good times.

Being a caregiver is the most rewarding and fulfilling “job” you will ever have. There is no question that you are doing what you are supposed to be doing and where you should be.

With all the love you have given to your care recipient, losing your loved one will take time to overcome and accept. Remember to live life as your loved one would want.

Stages of Alzheimer’s Disease – Help Seniors Stay Engaged & Active

Family caregivers of persons with dementia are growing in numbers as the number of elders diagnosed with Alzheimer’s and other dementia’s increase.

Dementia diagnosis has often come later in the disease but more and more, of late, the diagnosis occurs in the early stage of dementia. There are benefits to an early diagnosis, though many believe waiting is preferable as there remain few treatments and no cure for Alzheimer’s.

There is a person diagnosed with Alzheimer’s disease every 69 seconds!

Family caregivers play a strong role in keeping their senior loved one connected and engaged throughout the stages of Alzheimer’s. Activities can keep persons with dementia engaged in their environment and improve their quality of life throughout all stages of the disease. Activities can also help reduce certain behaviors common to dementia including wandering, sundowning and agitation.

Stages of Alzheimer’s Disease

There are seven stages of Alzheimer’s disease, each holding challenges for the person with dementia and their family caregivers.

Stage 1 – no impairment, no identifiable memory loss

Stage 2 – very mild cognitive decline, highlighted by memory lapses and trouble finding words

Stage 3 – mild cognitive decline exhibited by difficulty coming up with words, difficulty remembering names of new people, trouble with new tasks, forgetting what was just read, losing objects, trouble planning and organizing

Stage 4 – moderate cognitive decline, shown by clear-cut symptoms such as inability to remember names, difficulty with challenging arithmetic such as bill paying, becoming moody or withdrawn, forgetfulness, difficulty with complex tasks

Stage 5 – moderately severe cognitive decline with gaps in memory, need help with day to day activities, inability to remember own name or address, confusion about day/time/place, need help choosing appropriate clothes, can still eat and toilet self.

Stage 6 – severe cognitive decline with memory loss and personality changes, help needed for daily activities, unaware of recent events or even surroundings, unable to remember spouse or family names, help needed with dressing, sleep disturbances, incontinent, personality changes include delusions, repetitive behavior and wandering

Stage 7 – very severe cognitive decline with inability to respond to their own environment and carry on conversation, require help with all activities, impaired swallow, inability to hold own body up and rigidity

Activities for Persons with Dementia

During Stages 1 and 2, most of your senior loved ones’ activities will continue unchanged. They will be able to participate in hobbies and complete activities that they have enjoyed, such as sports, reading, hobbies and travel.

As their disease progresses, it may be up to you – the family caregiver – to plan, schedule and organize the activities that will keep them involved, their mind engaged and allow them means to socialize. You will be the one to get the supplies ready, put them out and clean them up. Your senior may be able to perform the activity once the needed equipment is set up for them but unable to gather and put away the pieces of the activity but enjoy participating and feeling useful. As the stages progress, you may need to supervise and direct the steps in an activity.

As the disease progresses, your senior will begin to withdraw from the activities or hobbies that they have come to love. When you observe your loved one retreating from their favorite activities, you can discuss it with them. If you can determine where they feel unable to participate, you can often modify the activity to make it easier and less confusing for them to continue to enjoy. If, for example, your senior enjoyed woodworking then select some projects that are less complex and keep the tools organized so that they are stored in order of use such as measuring tape, saw, hammer and nails, and paint.

When sequencing is clearer, they will likely be able to complete the task without as much frustration.

Another strategy to keep your senior loved one engaged with others is to reduce the number of people in gatherings. Too much noise, activity and stimulation can be disturbing so keeping the groups smaller will make it easier for them to interact without over-stimulation.

Find a Schedule that Suits Them

When planning the day’s schedule, keep in mind the things your senior loved one is used to. If they always eat lunch at noon, then put that in the plan. If they prefer to bathe in the morning, schedule that then. If they always do laundry Monday afternoon, make time for that. If they take a nap every day from 1-2 pm, be sure to keep from scheduling activities during their rest time. When you over-schedule or upset their routine, this could lead to escalating behaviors.

As the stages progress, be aware of changes in physical abilities. Don’t plan activities that they are no longer able to perform such as hiking or playing monopoly if they have trouble walking, decreased stamina or trouble focusing for long periods.

Many people with dementia do better in the morning than the afternoon. They find it easier to focus and concentrate in the morning. The afternoon brings tiredness and distraction, not to mention sundowning. It is often a good idea to schedule activities and events in the morning when your senior is better able to participate and engage with others.

Find Activities Enjoyed in the Past

When planning activities, no matter what the stage of the disease, finds things that your senior enjoyed in the past. If they liked music and played an instrument, give them the opportunity to do it again. Or you may try to provide activities that relate to the career or job they had throughout their lifetime such as filing or organizing paperwork if they were office workers.

Involve them in the running of the household helping with daily tasks such as table setting or laundry. If they enjoyed gardening, find some tasks they can do outdoors such as pulling weeds or raking leaves.

Keep tasks simple as the disease progresses and offer things that are repetitive such as folding towels or washing a window. The fewest steps and least amount of decision making in the later stages will reduce frustration. As the stages continue, be aware that your senior may be a passive participant watching what you do, tapping their foot to music or clapping hands.

Don’t sweat the small stuff. If a task isn’t done perfectly, don’t worry. It is really about the process, engaging your senior and keeping them involved in their life. Activities can offer a feeling of being needed or having a purpose in life and not like they are a burden on the people who are in their life.

Keep on trying new things, give them an outlet for self-expression whether it is a creative activity that is old or new to your senior loved one and keep a positive outlook. Arts and crafts, music and singing are favorite activities.

The more engaged they are throughout the stages of Alzheimer’s, the happier the entire household will be.

Technology Tools Giving Digital Boost to Seniors & Their Family Caregivers

The age of technology can provide us as family caregivers with a great amount of information and data to help us care for our senior loved ones.

Technology gives us numerous ways to learn about their disease and how it impacts them, what treatments are recommended, their medications, medical procedures, and even provides a map to the doctor’s office.

With technology we can help organize loved ones’ medical documents, keep track of their health history and medications, schedule their doctors’ appointments and track their vital signs.

There are tech devices that can help prevent wandering, falls and burning the house down, as well as letting us know when our seniors don’t take their medications, get up too many times in the middle of the night or don’t open the refrigerator for breakfast.

And the best seems yet to come!

Tech Benefits Caregivers Too

Not only is technology helping extend our capabilities as caregivers but it is helping to improve our own lives as caregivers.

Technology can also help us to stay in touch with other family members, giving them up to the minute communication on our senior loved ones.

We can use technology to share our family photos, talk face to face, even across the globe, and ‘talk’ with people we never met about how to overcome many of our caregiving dilemmas.

Tech is getting ever more convenient for us, too. Our smartphones make using the technology even easier. We can get real time information about the lives of our senior loved ones via our smartphones. We can get alerts about their daily routines, their safety, set their thermostat, and even take a look at the person knocking at their door from our smartphones – – no matter where we are at the time.

Getting Information from the Internet

In an effort to find ways to use technology to learn even more about our senior’s health, we put together this list of a few (there are many more examples depending on the type of information you find helpful) online calculators that can give you interesting and useful information.

Some of the information you can gain will help you plan for the future and make action plans to improve your senior’s aging and financial status.

When you visit those sites, you will have to enter some personal data and whether you choose to do that is up to you (please exercise caution if using an insecure wifi connection). The descriptions of the calculators come directly from the sponsoring organizations.

Use the Health Care Costs Calculator to estimate your health care expenses in retirement and the costs associated with different health issues, and to explore how much you can save by improving your health.

Use the AARP Retirement Calculator to plan your financial future so you can retire when — and how — you want. You’ve got options. This calculator will help you discover what they are.

The Living to 100 Life Expectancy Calculator uses the most current and carefully researched medical and scientific data in order to estimate how old you will live to be.

How old is your heart age? Did you know that your heart age can be older than your actual age?

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.

Is your memory normal? Your report will include a science-based brain health score and a personalized plan for what to do next.

Other Electronic Resources for Caregivers

Using our computers, tablets or smartphones to access the internet in order to help us be better caregivers is simply a part of everyday life now. We can use our devices to

  • organize our medical data into spreadsheets, tables and charts if we desire
  • create medication lists that are easy to update with changes
  • keep a journal of symptoms, medical histories, procedures and doctors’ names and contact information
  • scan in our senior loved one’s documents such as advance directives, test results and insurance information
  • keep a log of vital signs
  • hook up to apps that can tell our seniors’ healthcare team this key information

and SO much more!

In addition to health calculators, there are many health quizzes that you can do online in an interactive manner to help you learn more about a disease process or how to prevent symptoms. You enter data or answer questions and instantly get results including action steps about what to do if needed. One such online quiz is real age. You can find out your seniors’ ‘real age’ to see if they are healthier than their chronological age or are aging faster than expected.

Another convenient way to use technology to gain valuable information is through locators. There are locators of every kind available online, on our tablets and our smartphones. We can locate not just a restaurant or gas station nearby but a doctor, dentist, elder law attorney, flu clinic, hospital, senior care facility and a place to buy whatever we need for our seniors.

Tech Helping Us Keep Loved Ones Safe

Technology can also help us keep our senior loved ones safe while enabling them to continue living independently if they want.

Home monitoring devices that we can track remotely via smartphones or computers that will tell us if they have fallen, get up in the night, move through the house often enough, turn on the stove, keep the temperature comfortable or let someone in the front door.

We can use GPS devices in their phone, implanted in their clothing or shoes or even under the skin to find them if they wander.

Personal electronic response systems (PERS) that can alert first responders that our senior loved ones need emergency help. These devices can alert us as well via our smartphones.

There are computer systems that allow paid caregivers to report to family caregivers how the day went, if the pills were taken or if meals were eaten.

Great Technology Promise for the Future

There are a number of digital tools that are available now and many, many more coming soon to market, like robots (yes, robots) that will help us help our senior loved ones. Wherever possible, family caregivers should take advantage of some of these devices to make more of your time available to do the things that technology can’t, such as give a gentle reassurance through your personal presence, your soft voice and kind words, and your hand holding.

If these devices and systems and shortcuts make it easier for you to stay healthy yourself and make the days of caregiving easier, you may find they are worth the cost and effort they may take to initiate. No one can replace you but technology can support you in your role of family caregiver, making life better for both your senior loved one and you.

What technology or shortcuts like calculators have you used, or are using now, did you find useful?

What are you hoping technology will do in the future?

Good Health News — Chronic Disease Diagnoses & Related Deaths Declining

As our population continues to age, more will become victims of chronic diseases. Many family caregivers of older adults have encourage senior loved ones to take steps in their lifestyles to prevent or lessen the likelihood of developing chronic diseases.

Good news! It appears our efforts seem to be paying off, great results are coming from making the positive improvements that we know we should.

Good news also comes with bad news. In this case, the good news doesn’t mean that we can stop being healthy and doing the right things to maintain our health.

Yes, the bad news is that we still have to keep moving and eat a balanced diet! Not really that bad, after all.

Stroke Incidence Declines

A recent report celebrates the findings that in the last twenty years, the rate of strokes in seniors has dropped 40% in Medicare patients over 65. This includes both types of stroke – ischemic and hemorrhagic.

That is something to celebrate!

Even better news is that death from stroke also declined during this time frame.

This is especially good news, as stroke is the fourth leading cause of death and treatment after stroke is time consuming and costly.

Researchers found that, even though diabetes is on the rise, cigarette smoking, measured systolic blood pressure, and total cholesterol values have decreased, which all have contributed to a decline in stroke. At the same time, the use of statin drugs to lower cholesterol and anti-hypertensive medications have increased greatly, also contributing to the reduction in cases of stroke.

Alzheimer’s Rates Falling

Researchers have shown that in developed countries including the United States and Germany, the rate of new cases of Alzheimer’s has decreased.

Since the late 1970’s, the rate of dementia diagnosis was 44% lower. The sharpest decline was seen among people in their 60s.

Why is this happening? Researchers postulate that the improvement in cardiovascular health has led to a reduction in dementia because a healthy heart allows for blood to carry oxygen and even energy to the brain. They also refer to the cognitive reserve theory to explain that the more education a person has can help their brain adapt to Alzheimer’s changes. They also feel that staying mentally stimulated throughout the aging process also allows for the brain to compensate.

In the midst of this decline in new diagnosis, the fact is that millions of Americans have Alzheimer’s disease, the sixth leading cause of death in the US, which has no real treatment or cure at this time.

Alzheimer’s Research Continues

Researchers continue to focus on protein buildup in the brain and how it leads to Alzheimer’s disease. Proteins such as beta amyloid and tau have been studied for some time but a new protein called TDP-43 has been found during autopsies of a large number of those with Alzheimer’s disease. This may be a new piece of the puzzle. It is currently unclear if this new protein is a cause of Alzheimer’s or a consequence. This protein has been linked to ALS or Lou Gehrig disease.

Another new development is the potential for blood testing to predict the diagnosis of Alzheimer’s disease. Scientists from Britain have identified 10 blood proteins that they say can predict with 87% accuracy whether someone with early signs of memory loss will develop Alzheimer’s disease within a year. They feel that diagnosing the disease earlier before the brain is damaged will lead to not only better treatment but an ability to find a cure through clinical trials of these individuals without brain involvement/damage.

There has been some resistance to knowing a diagnosis that early in the disease if you are affected, but the hope for a cure and the ability to treat it earlier may be worth the stigma for us all. The test will not be available soon as they need to increase the rate of accuracy before it can be implemented.

We should continue to see more research into a cure for Alzheimer’s disease due to the National Alzheimer’s Project and the Alzheimer’s Accountability Act, which represent a bipartisan effort to ensure that Congress gets the information they need to set research funding amounts for the budget each year. Their goal is to effectively treat and prevent Alzheimer’s by 2025.

Chronic Disease on the Decline

In addition to Alzheimer’s and stroke, another disease that statistics show has taken a much anticipated decline is cancer. Annual statistics from the American Cancer Society shows the death rate from cancer in the US has fallen 20% from its peak in 1991. This decline could mean that 1.2 million cancer deaths were avoided.

Researchers feel that the decline in cancer deaths is attributable to a decrease in smoking and early detection efforts. While many cancer sites are declining some continue to be higher than desired including melanoma, liver, thyroid and the pancreas.

In addition to stroke, cancer and Alzheimer’s dementia, cardiovascular heart disease deaths have declined since 1996. This could be due to lowering cholesterol levels using statin medications, improved diets, and lowering blood pressure rates. Other important changes related to lowering heart disease deaths is the number of people who have stopped smoking, improvements in diet, and better medical care which is diagnosing and treating heart disease more effectively.

Need to Keep Up Healthy Living Efforts

There is good news for chronic disease prevalence and lowering death rates but this doesn’t mean that we need to stop trying to stay healthy.

We need to continue to help our seniors make as many positive changes to their lifestyle as they can in order to prevent chronic diseases so that they can lead an independent life as long as possible.

We need to do the same so that we can continue to be caregivers.

We know that eating right, sleeping well, getting physically active, stimulating our brains, reducing our stress, participating in preventive health screenings and following our current medical treatment plans will help our seniors live a longer, healthier and happier life. Let’s do it together!