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The Golden Touch

John Mills — Thu, 13 May 2010 12:33:32 GMT

As well-known speakers on the issue of eldercare, my partner and I are involved in many vital and meaningful discussions around aging population. What we’ve discovered is that sometimes the issues around our elderly are vast and complicated (like Medicare and the Healthcare Reform Act) – and sometimes the issues that touch the aging most intimately are the simplest things. One of those simple issues is TOUCH. We hear about touch as a medium for healing in so many arenas of life – in premature infants, seriously ill and even terminally ill patients.

As advocates of for healthy, wonderful resources in eldercare, eCareDiary hopes to move this conversation to the top of the list for the aging population. As a society, we may be powerless over many issues facing our aging parents and grandparents, but this is ONE thing that we can simply and easily bring back into their lives. It is only a question of awareness.

Why? The reasons our aging population grow physically more and more isolated are vast. To begin with, it’s common that they will have lost those who were closest to them – their spouses, best friends, siblings – in some cases, even their children. It’s also possible that we, as care providers, are so conscious of being aware of their frailty, that we go too far – hardly touching them at all. Even hugging them from an invisible half-inch boundary becomes our norm.

What to do. There are so many simple ways to reengage ourselves with the elderly population. For daughters, granddaughters and female care providers, sometimes the simple act of providing a manicure or pedicure is a restorative physical connection. For myself, the opportunity to shave my dad was always a fond intimacy between us – and a way for him to feel good about himself.

What are the benefits. According to the Touch Research Institute, elderly massage is one of the most useful treatments for all levels of Alzheimer's patients. It’s been shown to facilitate relaxation and even communication. Touch can also greatly assist in pain management and can also create an increase in strength and muscle awareness. (And all things being connected, this can help the elderly population to avoid falls and other injuries, simply because their bodies grow weaker or less self-aware over time.)

Finally, touch can also have a profoundly calming effect – which can help the patient to deal with medical and lifestyle interventions much more easily and in a way that is more deeply connected to their loved ones and care providers. In short, touch can be a bridge that breaks their isolation. This is even more true when the patient may have lost their verbal abilities for one or more reasons.

As our patients and loved ones move into their golden – and even their platinum years, bringing the intimacy and caring of touch back into their lives – and even into OUR lives – is a strong and powerful connection that we should definitely not overlook. After all, even the powerful healing of a simple hug can make all the difference in a person’s day.

John Mills, Co-Founder of eCareDiary
http://www.eCareDiary.com

Register at eCareDiary.com to save YOUR family and care providing tribe a world of confusion and difficulty regarding patient care, information and wellness updates.

PS: If you are care provider, please feel free to reach out to us to get your organization and your patients set up – eCareDiary is a powerful tool, and we’re here to support you, your patients and their loved ones.

Journaling to Storytelling: Writing with Significance

Margery Pabst — Wed, 12 May 2010 15:41:59 GMT

Caregivers report that journaling is one of those activities that reduces stress by providing quiet time. Also mentioned is the sense of getting back in touch with oneself as insights are created on the page. Writing does have a way of informing and illuminating what can seem to be a blur of experience for all of us, in whatever role we find ourselves.

One of the questions I get is “How can I take my story and help others with it?” “How can my story have meaning and resonance for others?” It is a classic question and one that professional writers grapple with constantly.

Here is a way to consider those heady questions. Journaling encourages us to be free thinking and to allow thoughts to fall on the page in whatever way they fall. It is an outpouring of our souls, our thoughts, along with observations and feelings of the moment. By its very nature, journaling moves this way and that without the “shape” of a story. Storytelling has a shape intended to provide others with some sort of roadmap; it has a more conscious plan to it with events laid out to provide interest, intrigue, and sometimes advice. Helping others by sharing your thoughts/insights means that your journaling needs to take more the shape of a story.

Here’s how I shape my random thoughts into something that others might reflect on and use. My “stories” are often not very long but events are altered to capture interest and encourage others to reflect on them.

First, I draw a time line of some event, incident, or issue. I physically draw a line on a piece of paper and then along that line list in CHRONOLOGICAL ORDER the sequence of events--a “this happened, then this happened, etc.” approach.

Second, I review the sequence and try to pinpoint a key idea or event in the sequence, something that I or someone else did THAT MADE ALL THE DIFFERENCE to the outcome of the situation. For example, when I was caregiver to my Mother, the sequence of events (in some abbreviated form) were the following:

-Mom is weak and feeling bad.
-Mom is diagnosed with bone cancer.
-Mom is treated with chemo and radiation.
-There is little to no improvement.
-The family and Mom realize that keeping her as comfortable as possible with palliative care is the next step.
-Mom is eager to talk about her life and to reconnect with friends and family, particularly people she hasn’t seen in awhile.
-Dad is averse to having visitors at the house.
-My brother, Jim, and I strategize ways to honor both our parents’ wishes.
-Jim and I develop a strategy to get Dad out of the house before visitors arrive.
-The plan works for the most part.
If I were to tell the story in this chronological sequence, it might be somewhat interesting, but if I select either “Mom is eager to talk abut her life” or “ways to honor both our parents” as a beginning for the story, I have a better chance of making this meaningful to others. I can focus on the “life review and legacy” aspect or “the need to honor your parents’ values” as the central theme of my story.

I encourage you to try this right now. If you are already journaling, then turn to a few pages in the journal, list a sequence of events on a timeline, and then select a key piece and focus your story around it. If you are not keeping a journal, write a series of events like my example and then decide what key piece in the sequence gave you meaning and enrichment.

As caregivers, helping others by telling your stories can be tremendously rewarding, because your words will not only help the one person hearing it, but will also have the high potential of being shared with others. I have shared my Mom’s story of her desire to review her life and legacy; it has struck a chord many times.

The sheer act of storytelling will also empower you! What do I mean by that? Explaining “how” you made it through, “how” you or your care partner succeeded provides your caregiving relationship with more strength and insight for the next situation you may face. Storytelling can truly become your ‘fuel for transformation’.

Margery Pabst is the co-author of “Enrich Your Caregiving Journey”, a book of over 130 tips for caregivers to take care of themselves while caring for others. Margery will be speaking on the topic “Storytelling: The Fuel for Transformation” at the Eden International Conference to be held in Denver June 13-15. You may find out more about Margery and her book by going to www.pivotalcrossings.com.

What the CLASS Act Means For You

Howard Gleckman — Mon, 10 May 2010 13:42:22 GMT

Editor’s Note: This article was originally posted on Caring for Our Parents.

The new health law creates, for the first time, a national, voluntary long-term care insurance system called the Community Living Assistance Services and Supports (CLASS) Act. Participation will be optional, but if you enroll, you'll get a basic cash benefit for life to help pay for personal assistance if you are disabled or very frail and unable to care for yourself. Here is how CLASS will work:

How Will I Enroll?

The insurance probably won't be available until at least 2012. Once policies are on the market, you may be able to sign up through your work. If your employer agrees to offer CLASS, you'll be automatically enrolled starting at age 18 unless you choose to decline coverage. If you do opt-out, you'll still be able to buy in later, although your premiums will be higher.

How Much Will Those Premium Cost?

That's a really important question, but we don't know yet. The government will have to work with insurance experts to design a benefit plan people will want to buy at a premium they can afford. Supporters of the bill hope to be able to keep the premium below an average of $100 per month, although a new report suggests they'll cost an average of about $115. If you are poor, or a student, your premiums will be as low as $5 per month. And, as with private insurance, the younger you are, the lower your premium.

Can I Be Denied Coverage

No. As long as you are working at least part-time you'll be able to enroll. And you'll have to pay premiums for five years before you can collect benefits. But you can't be rejected or required to pay higher rates because you have pre-existing health problems.

What Will the Benefits Be Like?

Like the premiums, the exact benefit amount is uncertain, but it will probably be between $50 and $75 per day for most people. It is very important to know that the benefit will be paid in cash, so you'll have lots of flexibility to use the money however you want. For instance, you could pay a friend or family member to stay with you, hire an aide from an agency, put in a wheelchair ramp or grab bars to make your home safer, or spend a few days a week in an adult day center. Benefits will be available to people living at home, in assisted living, or in a nursing home.

$75-a-day Doesn’t Sound Like Much If I Have to Go to a Nursing Home

You're right. It isn't. But 85 percent of people get care at home and this will make it a lot easier for them and their families. Combined with Social Security and a pension, it may even make it possible for some people to move to an assisted living facility.

What If I Already Own Long-Term Care Insurance?

You won't have to enroll in CLASS, so you can simply keep the coverage you have. Some insurance companies may redesign their policies so they work with CLASS insurance, much like private Medigap insurance supplements Medicare. For now, if you own a private policy and like it, keep paying premiums. If you think you need insurance now, don't wait, go ahead and buy it. But ask your agent how your new policy will work once CLASS policies become available.

Are Insurance Companies Really Going to Sell Policies that Will Work With CLASS

Some will. Others think they can sell similar coverage at a lower cost than the government and may try to sell policies that compete against CLASS insurance. But we won't know for another couple of years.

I’ve Heard CLASS Is Going to be Another Budget-Buster. Is That True?

CLASS is designed to be self-funding for the next 75 years. But until we know how many people will buy the insurance, there is no way to predict how the law will work. No other country has ever tried a voluntary national long-term care insurance system like this, and many experts worry that too many healthy people will decline coverage, driving rates up even higher for those who do want to enroll. If that happens, the program might shut down without some government funding.

Will CLASS Make It Harder for Me to Qualify for Medicaid?

No, although you'll first have to spend your CLASS benefit before Medicaid pays its share of your care. But because CLASS benefits are far more flexible than Medicaid's, that may be an advantage to you.

Howard Gleckman is the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Care Crisis. Mr. Gleckman is a Resident Fellow at the Urban Institute and editor of the Tax Policy Center's blog, TaxVox.

Aging in America and Showing up for our Elderly

Susan Baida — Mon, 10 May 2010 13:06:59 GMT

There are so many hurdles as our loved ones age. In my grandmother’s case, she had rheumatoid arthritis. She was diagnosed in 1968, the year I was born, and she always said that she was in a slow but steep decline ever since. She turned 50 years old a year after her diagnosis and passed away at seventy-nine years old in 1998.

There were many challenges as my grandmother aged. She couldn’t get into anything below knee level, and sometimes she would spend days on end without leaving her home. But she never lost her spirit – my Grandmother loved being out, seeing people, breathing in the air and having the sun shine on her. She actually believed the sun had curative properties for her arthritis. She’d sit out in 100 degree weather pointing her elbows and joints in the direction of the golden hot sun.

In some ways, we were lucky – my grandmother was very open about her pain; she asked for help and accepted help because she wanted to live a full and active life. She loved going out on the town. She didn’t care how much pain she was in as long as she could get out even for a car ride to the grocery store. She’d sit and wouldn’t mind waiting in the car just so that she could get out of the house. Sitting at home was like death to her.

All these years later, working in the field of advanced aging leads me to one big conclusion about this – and a few humble tips about aging in America. My conclusion? My Grandma was not unique. Her generation was raised at a time when you toughed it out. Unlike our generation, who publicly works through the most intimate issues of our lives – on everything from the 5 o’clock news to support groups – their generation would stoicly throw their chin in the air and say things like, “It is what it is.” Precisely.

Aging in home and remaining independent are VERY important to the aging population here in America, and helping our loved ones to accomplish this is equally important to the baby boomers (and everyone, I think). There are some very complicated and sophisticated things that we MUST address as families, communities and even as a nation (like healthcare, nutrition, quality of life, etc.). But there are other things that can ONLY be addressed locally, like lifestyle. THOSE are the issues where all of us can make a difference when it comes to advanced aging.

Take the time to TALK to your aging loved ones and your families about this. If your mom or dad or grandparent wants to age in home, help them to make the simple changes that they need before it becomes impossible or humiliating to them. Start moving things OUT of those bottom cabinets and shelves, and help them to simplify tasks like grocery shopping and trash removal. Be sure that YOU (and everyone else who needs to) KNOWS their medical history and who their medical providers are. Don’t be afraid to talk about the MOST important things, like health care proxies.

Finally, remember that you have sphere’s of influence in your life. Think outside the box. Aging in America is a much bigger issue than your parents or grandparents. Consider your neighborhood and the other communities in your life, like your church or synagogue. Look around. Who’s having trouble getting up and down? Who uses a cane or a walker? Befriend those people – be available to them. Chances are that the simplest tasks, like carrying groceries, has become more challenging than we could imagine at thirty, forty, fifty or even sixty. Take the TIME to be perceptive enough to see the unspoken, sometimes even secret needs of those who may be too proud to even ask for help. Sometimes offering is all it takes.

Susan Baida, Co-Founder of eCareDiary
http://www.eCareDiary.com

PS: If you are involved in a care facility, please feel free to reach out to us to get your organization and your patients set up – eCareDiary is a powerful tool, and we’re here to support you, your patients and their loved ones. http://www.eCareDiary.com

The Truth about Aging Successfully

Rita Mary Dichele — Tue, 04 May 2010 19:17:41 GMT

Rita Dichele holds Masters’ degrees in Counseling and Healthcare Administration. Currently, she is an advanced doctoral learner at Capella University where she is writing her dissertation on successful aging. Rita resides in Shrewsbury, Massachusetts and serves as a board member on the Council on Aging. She is a town appointee for the Shrewsbury Cultural Council, facilitates two groups at the Shrewsbury Senior Center, and is a certified SHINE Medicare/Medicaid counselor. Rita is also a past presenter at the 2009 American Society on Aging Conference.

Aging is the process of growth and movement as we progress through each stage of life. The interesting concept of aging is that each of us ages chronically, but emotionally and physically we age in our own unique ways. For instance, one person may suffer physical hardship related to illness and disease because of an immune system that has been predisposed by genetic makeup, lifestyle habits, and environmental conditions.

Unfortunately, many older persons are subjected to myths about aging that often create detours to age successfully.

In 1975 Pulitzer Prize winner Dr. Robert N. Butler authored the book titled, Why Survive? Being Old in America in which he describes the negative attitude regarding the aging process. Dr. Butler referred to any negative attitude toward the aged as “ageism” which he considered was consistent with other types of discriminating and stereotyping of people such as “sexism” and “racism”. Dr. Butler suggested that ageism is perpetuated from one generation to the next because of aphorisms such as “You can’t teach an old dog new tricks.”

Subsequent to Dr. Butler’s research, stereotyping of the elderly has evolved to a level of erroneous stereotyping that has been heightened, for example, by the mass media, especially by television and movies made in the 1970’s and 1980’s. Moreover, literary accounts of the elderly have portrayed ageist attitudes that preempt elderly capabilities to be productive individuals who are able to age successfully.

Notwithstanding previous portrayals of the elderly, a new image of the older individual has emerged. Because many of the famous actors are aging such as Jack Nicholson, Robert Redford, Sally Fields, Diane Keaton, characters in the movies are now being depicted as characters that are aging successfully. Thus, as a result new stereotyping is being generated that focuses less on ageist attitudes.

But nevertheless, there does exist today many myths about aging that are often perceived by the public at large as absolute truths, thus causing many to believe that aging invariably can lead to a future in which one disengages from the mainstream community. Perhaps individual acceptance of certain myths may take the mystery out of why so many older persons experience depression, substance abuse, and isolation.

Furthermore, in many instances later life can be less stressful. Unfortunately, members of our society perceive the elderly through stereotype lenses that suggest that as we age, we decline and live out our lives vulnerable to the vicissitudes of time. The problems of the widowed, those living alone, and certain minorities are often exaggerated inferring that older persons are troubled by later life stresses. This concept can often add to the typical stereotype of the older individual who is at risk of living the rest of his/her life to the fullest.

Current research conducted by gerontologists, individuals who study the elderly, suggests that aging is something to look forward to, dispelling common myths about aging. In fact much is being written about how older individuals are more resilient than their younger counterparts. Also, older individuals are more able to sustain lifestyles that are consistent with their previous days such as active sexual relations, living independently in their own homes, continued capabilities to make informed decisions, and cognitively able to process information and learn “new tricks”.

Furthermore, most older persons no longer live in poverty despite living on a fixed income. For instance, the creation of Social Security, Medicare, Medicaid, Food Stamps, and Supplemental Security Income can remove economic hardships once a widespread problem with older individuals.

And finally, old age is a period of greater adaptation because older individuals are able to assimilate into their lifestyles more changes than younger individuals. For instance, older individuals are able to reconcile change because earlier life experiences have prepared them for the uncertainties of life. Decisions made early on will affect the lifestyle choices in later life.

In conclusion, statements made to the contrary places older individuals at risk to living out a life in a compromised manner and in many instances causing some individuals to have to adjust to a lifestyle that just does not have to occur. Future predictions of the baby boomers monopolizing the older generation should provide hope to older people that those misguided myths about aging will dissipate. Thus, ageist attitudes will no longer be present and will yield to stereotyping that has replaced old stereotyping which historically has contributed to myths of aging successfully. Therefore, the real truth regarding aging successfully can be appropriately validated.

Getting From Here to There and Everywhere in Between

Priya Vin — Fri, 30 Apr 2010 00:21:47 GMT

Priya Vin has worked in the aging and developmental disabilities field for 5 years and is based in northern New Jersey. Her experience has been in program management. She received her Master's in Social Service Administration from the University of Chicago, where she specialized in health care policy. She is excited to be contributing to eCareDiary. Priya's contact information is priyavin80@yahoo.com.

You recently found yourself looking for ways to help your parents or the older adult in your life get themselves to important appointments or social activities. This could be a hard task. It starts with a conversation with them. Then thinking about the possible solutions. Luckily, there are a lot of resources out there. When you begin the conversation with them, you will want to ask them a few questions.

How were they running their errands or getting to their favorite spots before?
What was the cost like?
Where do they routinely go?

While talking to them, try to understand if they are comfortable with changing from their old routine to a new routine. Often, people want to stick with what they know because it is familiar and gives them a sense of independence.

There are a lot of services available to older adults and explaining the options might be convincing enough to change routines. There will probably be added benefits to alternate forms of transportation, such as lower cost, safety, or reliability. But hopefully, they can maintain their sense of independence.

Car

Most people get around with a car. It is a great mode of transportation and it can give a nice sense of independence. However, as you get older, it can become increasingly difficult to be a safe driver. Before you worry too much, it is a good idea to see if your parent or older adult friend can still drive their car.

When you talk to them, you will have to see if they can still drive in a safe way and if they are physically capable of doing it as well. You want to talk to them about their eyesight or any other medical issue. They might just need to update their eyeglasses prescription. But getting it checked out by the doctor is a good idea.

So talking to them about this will have to be done in a delicate way. But you will have to explain and persuade that it is not safe to drive if they are not able to do so. Also, reassure them there are other modes of transportation and that you are willing to help them find it.

AARP has great resources on this topic. They have a few different sections on driving and there is one about talking to an older adult about driving. There is also a section on driver safety .

Public Transportation

If your parents do not own a car, how do they normally get themselves around? Do they rely upon public transportation? Public transportation is a good option because it usually does not cost as much and can be good and reliable. If your parent does not already take public transportation, you might want to think about it as possible option. But this obviously depends if they are mentally and physically able to. In many instances, a discount is offered to older adults. You will have to have a conversation to see if they can continue using public transportation.

Suburban and rural areas

If your parents do not own a car or live near public transportation, there are other options. They should contact their local Area Agency on Aging. According to the National Area Agency on Aging, Area Agencies on Aging (AAA) were established under the Older Americans Act (OAA) in 1973 to respond to the needs of Americans 60 and over in every local community. By providing a range of options that allow older adults to choose the home and community-based services and living arrangements that suit them best, AAAs make it possible for older adults to remain in their homes and communities as long as possible.

The local Area Agency on Aging is a wonderful resource for your parents' needs for transportation or anything else. They will know about other local resources, such as private transit, specialized transit, and senior transit.

Network of Support

If you are not fortunate to be around for your parents or the older adult in your life, it might be a good idea to set up a network of support. Try talking to neighbors, other relatives in the area, or other older adults to facilitate a network. You might be surprised how this really would work.

Resources and More

A lot of issues, like figuring out proper and good transportation, arise when you become someone's caregiver and it can be frustrating. But there a number of solutions and ways of helping that person out.

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