People Rise to the Challenge

I want to share a story that serves as an important lesson that many of us already know, but we’d likely forget under the stress of caring for a loved one. The story starts with a single sentence that forever changed my mom’s life: “People rise to the challenge.”

This isn’t my quote. To be fair, I heard these words for the first time after visiting many, many skilled nursing facilities. The source of the quote was a woman by the name of Andrea Arambula, and she was the admissions director at Belmont Village (formerly Crown Cove). It is to Andrea that I owe an enormous debt of gratitude. Andrea, if you are reading this, thank you!!!

Rewind back to December 2005. My mom had been in skilled nursing for more than five months. As dicussed in the previous blog post, skilled nursing is a mix between a hospital and an apartment. Patients usually share a room, and nearly all require treatments from a registered nurse. While my mom was there, one of her roommates passed away and several others were taken to the hospital. They did not return. While some are in skilled nursing for a short stay, many have declined to the point where it is required.

After driving 120 miles round trip, 4-5 times a week, usually after a full day at work, I decided to move my mom closer to me. I asked the head nurse for a care recommendation. She recommended skilled nursing.

She went so far as to tell me that my mom would likely be permanently bedridden, and that I should explore hospice. At the time, I was 34 years old and knew no better than to take her advice at face value. I started looking for skilled nursing facilities closer to my home in Orange County.

By chance, I called one assisted living facility and a woman answered the phone. It was Andrea.
She convinced me that my mom had no medical necessity for skilled nursing. Sure, she had problems walking, but that was a physical therapy issue. She told me something repeatedly, and I’ll always remember the words. People rise to the challenge. You just have to let them.

So I reviewed my mom’s medical records with her doctor, the assisted living community, the physical therapist and Andrea. It was a go! My mom was going to need a lot of help, but I was convinced that she would rise to the challenge.

I’ll always remember the ride there. Since my mom needed to be lifted (yes, lifted) into a wheelchair, driving my car was not an option. So I rented a shuttle, and my mom and I rode a little over an hour in the back of a wheelchair- accessible Super Shuttle (yes, the ones you take to the airport).

She was scared. I was scared. But in my heart I knew she could do it. When she first entered assisted living, she couldn’t walk. In fact, she couldn’t roll herself out of bed. She needed two people to literally pick her up and put her in a chair.

Within a year, she could walk the hallways with a walker, walk to dinner, come over to my house for BBQs, get in and out of a car, and resume some normalcy in her life. In fact, she even got featured in her physical therapist’s brochure. I guess she’s a testimonial for hard work and good physical therapy.

Each time my mother passed a new milestone, I thought of the skilled nursing recommendation and urging to explore hospice. And each time I smiled about the progress my mom made.

Why the long story? The details of the story are important. It’s human nature to fight, struggle and be determined. And regardless of your age, most people respond to the challenges they face. In the case of my mom, it was walking. In the case of your loved one, it may be something else.

So while I learned from Andrea that people rise to the occasion. I learned from mom that you have to let them.

So trust in your loved one. Trust in yourself. And I know you’ll find that you can both rise to the occasion. Perhaps – and most likely — there will be tears along the way, but there will be many wonderful moments of warmth and laughter, too.

Photo Credit: Vick the Viking

Tips for Managing Caregiver Stress

Chances are that, to some degree, you been a family caregiver for your loved one for some time now. To one degree or another, you’ve been tending to their needs: taking frequent phone calls, grocery shopping with (or without) them, and performing chores around their home.

Whether you are the child, sibling, or the spouse of your loved one, you’ll be feeling the emotional and physical strain of the role you’re playing. There’s an uncomfortable shift in the dynamics between you.

If you’re the child, you’ve become a parent of sorts. If you’re the spouse, you’re forced into a new and often unwelcome level of intimacy. And, if you’re a sibling, it’s imperative that your decisions not be clouded by childhood memories or resentments.

Being aware of these shifts in roles and responsibilities is the first step in self- care for the caregiver (that’s you, remember). The second step could be to seek support and assistance. One great resources is National Caregiver Support Groups. These groups can put you in touch with their local chapters. In addition, you can get information regarding support groups in your area from local nursing homes or eldercare agencies.

The Effects of Caregiver Stress

Dealing with the health problems of someone you love naturally produces stress in your life. It can wear you down, both emotionally, and physically.

I mentioned in my opening story that at one point in my mother’s illness, I was driving hundreds of miles each week to visit her in the hospital or skilled nursing facility. My mother’s condition was the result of a sudden event – which is different from the lingering decline described as part of the assessment process. With such a dramatic event comes shock, guilt and acute sorrow.

The time spent on the road gave me hours to think about how things could have been different; the traveling to and from her bedside took time away from my work, and my relationships. The stress of my mother’s illness was dominating my life and had manifested itself in many ways.

Stress manifests itself in three ways: physically, cognitively and emotionally. Below is a list of stress symptoms. Looking back at that period in my life, I realize stress has manifested itself in many of those symptoms.

Physical Symptoms

  • Headaches
  • Sore back / stiff neck
  • Teethgrinding
  • Sexual dysfunction
  • Heart palpitations
  • Restlessness
  • Shortness of breath
  • Heartburn
  • Diarrhea/constipation
  • Jumpiness
  • Chronicinsomnia

Cognitive Issues

  • Difficulty in making decisions
  • Decreased problem-solving ability
  • Obsessive thinking
  • Short-term memory loss
  • Decreased concentration
  • Drop in organization skills
  • Limited attention span

Emotional Signs

  • Loss of interest in hobbies or recreational activities
  • Frequent crying or tearfulness
  • Persistent sadness or depression
  • Irritability
  • Chronic anxiety

Are you currently suffering from one or more of these symptoms of caregiver stress? I’m not surprised! Even in the early stages in dealing with the chronic health issues of a loved one – whether parent, sibling or spouse – you’ll find that you’ve become (more or less) tolerant of many of these manifestations of stress.

What I’ve learned is simple: taking care of yourself is essential to the well-being of your loved one. Here’s a short list of some of the things you can do to support yourself during the coming weeks:

Seek support from others. Turn to your loved one’s neighbors and friends; or other family members. They may be able to spend a few hours caregiving while you run errands, or even just take a short nap. Don’t feel you have to do it all alone!

Find a way to release your emotions. If you’ve got a pastor, spiritual advisor, close friend, or a therapist – someone you can trust 100% – be sure to reach out to them. They will be able to listen to you lovingly, and keep what you tell them to themselves.

Take time for yourself. If you like to walk on the beach, go shopping, take your dog to the park, or simply go see a movie – do it! Do not procrastinate on this: taking time for simple pleasures every day is critical to your well-being.

Simplify your life. Ask yourself this question: What can I let go of right now? Maybe you shouldn’t tackle new projects at work; maybe you should let go of hunting for that new house – whatever you can put ‘on the back burner,’ now is the time to do just that.

Avoid excessive alcohol or drugs. Ah, the temptations of self-medication. Don’t give into them. It’s not the wise path; ultimately, the care you are trying to provide suffers, and you’re less able to take care of the other things in life. Your job, marriage or parenting duties will suffer. That’s why I highly recommend the next tip:

Continue or begin an exercise program. It’s been clearly proven: aerobic exercise causes the brain to produce endorphins, which are your body’s natural way to enhance your mood and relieve your stress. Find a way to build regular exercise into your week: walk, run, practice T’ai chi; go bowling or play a round of golf with friends. Note: Always check with your doctor before beginning a new exercise program!

Do yoga. Yoga can be a fantastic stress reliever which providing a great deal of exercise and better flexibility. I cannot recommend Yoga enough, as it alone helps me reduce my stress level and irritability. A note for the men reading this book: Yoga can be hard work, very challenging and a great way to relax and build muscle. Don’t think Yoga is effeminate or too easy!

In the wonderful book, When Someone You Love Needs Nursing Home Care, the authors, Robert Bornstein and Mary Languirand help their readers to build a long-term plan, based on six principles:

  • Plan ahead. It may be a difficult subject to broach with your loved one, but planning ahead provides them with the opportunity to fully participate in the decision-making process.
  • Get advice. Don’t discount the value of speaking with those people who have been down this same road. Join a support group (online or offline), and speak with doctors, nurses and health care professionals. When it’s financial or legal advice you need, turn to attorneys and accountants.
  • Get others involved. Share the workload with family members, co- workers, and friends. Remember they care about you, and would love to help when they can – so don’t hesitate to ask!
  • Keep colleagues informed. Those people in your workplace need to be taken into your confidence; they’ll want to know why you’re frequently absent from your desk, or unable to take on additional work.
  • Take care of yourself. We’ve already touched upon ‘self-care’ as being critical not only to your well-being but to the well-being of your loved one as well.
  • Put things in perspective – and keep them there! Short-term thinking (“Things are falling apart and will never get better”) is a trap. As I’ve learned so clearly, people grow through adversity, and you’ll never be able to know just how this growth will manifest itself. Remember that change is inevitable…“this too shall pass.”

Photo Credit: lululemon athletica.

Life, Death on Her Terms

This is a guest post from Susan B. Schaffer, the oldest of three daughters of Beatrice Belopolsky, of Burlington. Susan can be reached at schaffersb@gmail.com.

My mother was my best friend. As she approached 90 years old in excellent health, I occasionally wondered how this woman, who continued to live life with such fierce independence, would eventually leave this earth.

The matriarch of a family of three daughters, she had continued living a full life after being widowed 30 years before. She served actively on community boards, lent a hand with her six grandchildren whenever she could, and traveled the world in her unique style. She was a source of wisdom, in a quiet, commonsense way, and yet remarkably she remained completely open to learning from others. She was ageless, fitting into any group, not as a fifth-wheel elderly parent, but as a contemporary who was interested in others, happy to meet new people and have new experiences.

And so in January 2009, when Mom suddenly began reporting vague aches and pains and her typically sharp reasoning became somewhat fuzzy, I was concerned by the uncharacteristic behavior and sudden signs that she was slipping, both physically and mentally. We began the search, through a series of medical appointments, to determine the cause of these sudden changes.

In April, she was diagnosed with squamous cell cancer of the mouth. Eventually, after meeting with Mom, hearing about her active life, and looking at her blood tests, which were remarkably normal, Mom and her oncology team agreed that concurrent radiation treatment with antibody therapy was a reasonable option. Mom was realistic. She knew the treatment might not work, but she “had to give it a try.”

After two difficult months of radiation and chemo, the treatments ended on her 88th birthday. We all looked forward to Mom’s regaining her strength and her humor, but she didn’t rebound as quickly as we had hoped.

After Labor Day, we learned that the treatment had not worked; the cancer had spread and her life expectancy was now measured in months. It was the only time throughout the ordeal that I saw Mom cry. She told me that she was not afraid to die, but she was afraid of the pain and suffering to come. She wanted to be in control of her life and was thinking about whether she could just stop eating, but feared that would be just as painful.

I felt torn, wanting to hang onto every remaining minute of her time with us, but understanding her dilemma. I suggested that she discuss her options with my husband, Elliott, a family doctor and geriatrician.

Mom and Elliott had a long talk, and Elliott shared information with her about people who forgo food and water – that not only do they not experience increased pain or hunger, but in fact generally those people enjoy a peaceful death with little or no suffering. Mom decided that this was the course she wanted to take, but she was not ready to stop taking nourishment just yet.

Once Mom’s closest friends and family heard about her prognosis, they all arranged to visit her. She quietly and individually met with her brother and each of her six grandchildren and their significant others. She smiled as her great-grandsons rolled around on her bed. The morning after saying her goodbyes to her loved ones, Mom quietly informed her daughters that she was ready to stop eating and drinking.

Her choice itself was not a surprise, but the timing was a shock. We quickly arranged for one of us or an aide to be with her at all times, expecting her strength to fail precipitously. Each morning, I would approach her apartment with trepidation, wondering how much closer to death Mom had traveled overnight.

Amazingly, I found that each day Mom’s spirits grew lighter and more peaceful. There was an immediate and dramatic change the day after Mom made her choice. It was as if she realized that she no longer had to struggle – that she had taken control – and she found comfort in that.

The stream of friends and family continued, and Mom would doze lightly between visits. The rabbi came to visit and came back to chat with her each day thereafter. At first we thought we should protect her from so many visitors – that it would tire her too much – but then we asked ourselves, “Protect her for what?” She was always cheerful during these visits – nostalgic about her life and relationships – and open to discuss her decision, which almost everyone found somewhat shocking.

At the end of the first week, Mom was so comfortable that she wondered, “When is something going to happen?” We assured her that it generally takes no more than two weeks for a body to slip away without food and water. Mom continued to deny feeling any hunger. She did express appreciation for the few sips of water that she took with her pain medication; we soothed her dry mouth with a spray that helped replace saliva, and that seemed to satisfy her.

At no time in the days that passed did Mom appear to be suffering. She lived those last days with a tremendous grace that touched everyone who was privileged to spend time with her. We talked about death; she was clearly not afraid of dying. She frequently smiled and acknowledged what a good life she had lived. Mom expressed curiosity about what she would experience after death and whether she would see her parents or her husband, but then quickly dismissed her curiosity with a cheerful acceptance of her fate.

On Day 11, Mom became less responsive. On Day 12 she peacefully slipped away.

Mom taught us much at her life’s end and particularly in those last 12 days. Witnessing her grace, her humor, her wisdom, and her compassion for all whom she touched in the extraordinary circumstance of her passing was an experience that I will never forget. Seeing her take control of her death, much as she had of her life, was empowering to everyone who was with her and who heard of the circumstances of her death. I am so proud to be her daughter.


The Unpaid Family Caregiver

The Unpaid Family CaregiverIs this the picture you had of retirement?

I’m referring to the one on the left!

Are you checking in on your elderly parents living at home? Is one parent more mobile than the other and caring for their spouse? If so, how is this affecting the health of the caregiver? Regardless of who the caregiver is, the additional burden can easily drain all of their reserves. Then everyone’s safety and health may be at risk.

A lot of attention has been given to medical assistance for our frail seniors that is available at home, as well as assisted living facilities of all types. The public may not be aware of an entire industry of in-home, non-medical care that is available today.

If you are checking on elderly family members at home: Has the house and the refrigerator had a good cleaning lately? Are they eating healthy? Are the bills paid on time?  Is bathing a safety concern?  Are menial chores such as shopping, cooking, laundry, and housecleaning a challenge?

The caregiver may expend all their energy completing these tasks with no energy or time left for doing the things they enjoy. If money wasn’t an issue, would you hire help? Would there be more time for everyone to enjoy life together? I’ll bet this is the case. All these services are now available in the home.

Ryan Malone’s new book: “Saving Money on Senior Care: How to Make Aging Affordable” discusses many issues impacting families’ ability to pay for senior care and takes a no-nonsense approach to educate you on the six most impactful options: reverse mortgages, VA benefits, life settlements, Medicare planning, long-term care insurance and the unique senior line of credit.

The Unpaid Family CaregiverMoney is available to pay for in-home care, especially for those who are “house rich and cash poor.” In 1989, a government program was created to enable seniors to stay in their home by paying them for the equity in their home. The upside to this program is that there are no credit or income requirements and no mortgage payments. Yes, it’s a Home Equity Conversion Mortgage (HECM or Reverse Mortgage). It’s called a Reverse Mortgage because it pays you. This program has changed a lot over the years and I have seen it change people’s lives. It can ease financial strain and relieve concerns about losing the home. The loans are FHA insured, non-recourse loans. That means if the home is sold and sales proceeds are insufficient to pay the amount owed, FHA will pay the lender the amount of the shortfall.

Four important points about this safe, Government program:

1)      The bank does NOT keep the title to the home

2)      There are no mortgage payments

3)      Stay in the home as long as you want to and can

¨       It must be the primary residence

¨       Must pay homeowner’s insurance and property taxes; maintain the property

4)      The loan is paid off with proceeds from the home sale

¨       FHA insures the loan and pays the lender any shortfall

For more information and a calculator:

http://www.hud.gov/offices/hsg/sfh/hecm/hecmabou.cfm

A free booklet from The National Council on Aging:
Use Your Home to Stay at Home: A Guide for Older Homeowners Who Need Help Now”

Now, what would you do with the extra time and the money you may have had to pay for care?

About the Author: Linda Lewis is a reverse mortgage specialist with FutureSafe Financial Corporation and lives in California.  You can follow Linda at her website at www.ReverseWithLinda.com.

Five Tips for Finding a Quality Home Care Provider

You and your family have decided that it is time to bring in outside help to assist with the care of a loved one in need. Because you want them to be able to remain safe, comfortable and independent in their own home for as long as possible, you have chosen to hire an in-home caregiver or home healthcare agency. The next step is choosing the best care provider for you and your loved one. But how do you know who the best is?

Here are five tips for finding a quality home care provider:

  1. Get recommendations. Talk to trusted professionals and community members. Your parent’s doctor, financial advisor, attorney, other medical providers, friends or family members may have familiarity and experience with local companies that do a good job. A list of providers is also available from your local Area Agency on Aging or hospital social work department. However, it is rare for these resources to make specific recommendations.
  2. Know your liability. Understand the possible liabilities and ramifications involved when hiring a caregiver privately. Consider issues such as taxes, insurance, liability and worker’s compensation, backup coverage, background checks/oversight and training.  If hiring through a nurse registry or employment agency, the family may end up being the official employer, responsible for pay, taxes and other obligations. On the other end of the spectrum, fully licensed private duty home health agencies offer more comprehensive services and protections as employers of the caregivers.  To learn more about state agency requirements and protections, contact your state licensing agency for healthcare organizations, or visit the National Private Duty Association at www.privatedutyhomecare.org.
  3. Consider innovation. Research how current their monitoring and communications technology is. How easy is it to monitor the care your loved one is receiving? Do they use technology like telephone clock in systems and scheduling software for quality assurance?  How quickly are they aware if a caregiver has not shown up to provide care?  What methods do they use to communicate with you?  Do they offer you conveniences such as online monitoring and paying bills online or via credit card?  Do they keep up to date with aging in place technology and can they provide you recommendations that may bolster care?
  1. Get to know who you’re hiring. When talking with an agency, get a feel for their process. Will they allow you and your loved one to interview potential caregivers? How do they handle replacing a caregiver that is not a good fit? What steps do they take to ensure coverage and accountability? How do they supervise, train and support staff? Do they strive for continuity or will your loved one have different staff each time?  How many caregivers will cover the shifts your loved one requires?  It is important to discuss your loved one’s specific diagnosis and needs, finding out the agency’s experience with similar situations and any special training and guidance they provide, for example training on working with clients with Alzheimer’s disease.  While regulations standardize licensed home care agencies to a degree, these are the things that will set one agency apart from another.
  2. Research involvement. Seek out providers who have a history in the community and the industry. Check if providers are involved with local and national associations such as the Alzheimer’s Association, the Area Agency on Aging and the National Private Duty Association. Their involvement demonstrates passion and dedication for their field. Management staff that has a history in the community and the profession demonstrates a commitment, stability and a positive reputation that they would want to protect.

Photo credit: familymwr

About the authors: Alex Chamberlain is executive director at EasyLiving, Inc. (http://www.easylivingfl.com), a fully licensed, private duty home health care company serving individuals and families in Pinellas and Pasco counties in Florida.

Shannon Martin, M.S.W., CMC, serves as Director of Communications for EasyLiving, Inc. and Aging Wisely, LLC (http://www.agingwisely.com). Shannon has worked for Aging Wisely, a professional geriatric care management and consultation firm, for over 8 years.

10 Top Anti-Aging Tips for a Youthful Mind, Body, Spirit

10 Top Anti-Aging TIps for a Youthful Mind, Body, SpiritThe desire for youthful energy never leaves and is capable of staying with you well until your later years. Boomers are, however, faced with the old adage, “use it or lose it.” It’s no wonder boomers are keen to put passion back into their lives and fight the effects of aging. True we are living in a society with an obesity epidemic and what a better motivator than living an independent life well into ones retirement with an increased zest and ability to perform activities of daily living with greater ease and function.

How do function and aging co-exist and blend with fitness? They are a twin-ship, even if we don’t see them that way. No one wants to feel and look old before their time. Much of what we blame on aging: weakness, decreased range of motion and obesity can be reversed in 30 days. How do we look and feel younger in 30 days? Through a blissful discipline called Functional Fitness.

Americans are getting older every minute and life expectancy is ever-increasing. People leading full productive lives after the age of retirement are no longer a “wow.” Most baby boomers want to live active lives and learn how to enjoy a fulfilling active life. You’re as fit as your body is functional. Contrary to popular opinion, not even all young people are limber, for keeping flexibility relies on regular stretching. However flexibility, one of the three primary components of physical fitness, is extremely important to attaining a healthy life. Without flexibility, simple activities, such as reaching and bending become painful. True, muscles shorten with age, but according to the National Foundation for anti-aging, “most aging is premature.” Here are 10 tips to help you stay younger, fitter and functional.

1- Drink six to eight glasses of water each day. Hydrate skin, nourish it, and prevent wrinkles.

2- Stretch and strengthen your legs. Doing calf raises and tiptoe walking every other day improves circulation and helps prevents spider veins.

3- Incorporate upper-body exercises. Lift mini dumbbells, and stretch back muscles. This protects against osteoporosis.

4- Strengthen your abs five days a week. Sit-ups enhance blood flow to vital organs, repairing tissue damage.

5- Add aerobic exercise. Keep your heart and lungs youthful and fit.

6 – Choose aerobics that enhance brain power. Jogging, bicycling, and speed walking sharpen memory and increase attention span.

7- Use diaphragmatic breathing. Inhale through your nose so debris and pollutants are filtered from the air. Make your belly rise, and then fall slowly, exhaling through pursed lips. Relaxed breathing decreases levels of stress hormones that accelerate aging.

8- Eat baked, broiled, or grilled salmon two times per week. Its omega-3 fatty acids and vitamins combat disease-causing free radicals.

9- Try colorful vegetables. Dr. Roy Vartabedian, author of “Nutripoints,” and Nutrition Expert for Functional Fitness starring Suzanne Andrews, ® recommends spinach, broccoli and romaine lettuce daily with lunch and dinner. Dark green vegetables have cancer-fighting properties and vitamin C to boost your immune system. Tomatoes are also on this “fighter veggies” list.

10- Enjoy fresh fruit for dessert. Dr. Vartabedian suggests cantaloupe, guava, and papaya. These also combat the cell damage that causes premature aging.

About the Author: Suzanne Andrews, founder of Functional Fitness, approved by the National Educational Telecommunications Association for syndication on PBS TV and licensed occupational therapy practitioner, specializes in therapeutically proven techniques to improve function through fitness. Offering real life fitness solutions for real life challenges, she instructs you how to decrease joint pain, improve balance, thicken bones, boost energy and once again live life to the fullest. Learn how to get Functional Fitness starring Suzanne Andrews® on your local PBS station and enter to win a FREE set of 8 Functional Fitness DVD’s. Details at http://www.healthwiseexercise.com/contact.php

10 Top Anti-Aging Tips for a Youthful Mind, Body, Spirit

The desire for youthful energy never leaves and is capable of staying with you well until your later years. Boomers are, however, faced with the old adage, “use it or lose it.” It’s no wonder boomers are keen to put passion back into their lives and fight the effects of aging. True we are living in a society with an obesity epidemic and what a better motivator than living an independent life well into ones retirement with an increased zest and ability to perform activities of daily living with greater ease and function.

How do function and aging co-exist and blend with fitness? They are a twin-ship, even if we don’t see them that way. No one wants to feel and look old before their time. Much of what we blame on aging: weakness, decreased range of motion and obesity can be reversed in 30 days. How do we look and feel younger in 30 days? Through a blissful discipline called Functional Fitness.

Americans are getting older every minute and life expectancy is ever-increasing. People leading full productive lives after the age of retirement are no longer a “wow.” Most baby boomers want to live active lives and learn how to enjoy a fulfilling active life. You’re as fit as your body is functional. Contrary to popular opinion, not even all young people are limber, for keeping flexibility relies on regular stretching. However flexibility, one of the three primary components of physical fitness, is extremely important to attaining a healthy life. Without flexibility, simple activities, such as reaching and bending become painful. True, muscles shorten with age, but according to the National Foundation for anti-aging, “most aging is premature.” Here are 10 tips to help you stay younger, fitter and functional.

1- Drink six to eight glasses of water each day. Hydrate skin, nourish it, and prevent wrinkles.

2- Stretch and strengthen your legs. Doing calf raises and tiptoe walking every other day improves circulation and helps prevents spider veins.

3- Incorporate upper-body exercises. Lift mini dumbbells, and stretch back muscles. This protects against osteoporosis.

4- Strengthen your abs five days a week. Sit-ups enhance blood flow to vital organs, repairing tissue damage.

5- Add aerobic exercise. Keep your heart and lungs youthful and fit.

6 – Choose aerobics that enhance brain power. Jogging, bicycling, and speed walking sharpen memory and increase attention span.

7- Use diaphragmatic breathing. Inhale through your nose so debris and pollutants are filtered from the air. Make your belly rise, and then fall slowly, exhaling through pursed lips. Relaxed breathing decreases levels of stress hormones that accelerate aging.

8- Eat baked, broiled, or grilled salmon two times per week. Its omega-3 fatty acids and vitamins combat disease-causing free radicals.

9- Try colorful vegetables. Dr. Roy Vartabedian, author of “Nutripoints,” and Nutrition Expert for Functional Fitness starring Suzanne Andrews, ® recommends spinach, broccoli and romaine lettuce daily with lunch and dinner. Dark green vegetables have cancer-fighting properties and vitamin C to boost your immune system. Tomatoes are also on this “fighter veggies” list.

10- Enjoy fresh fruit for dessert. Dr. Vartabedian suggests cantaloupe, guava, and papaya. These also combat the cell damage that causes premature aging.

About the Author: Suzanne Andrews, founder of Functional Fitness, approved by the National Educational Telecommunications Association for syndication on PBS TV and licensed occupational therapy practitioner, specializes in therapeutically proven techniques to improve function through fitness. Offering real life fitness solutions for real life challenges, she instructs you how to decrease joint pain, improve balance, thicken bones, boost energy and once again live life to the fullest. Learn how to get Functional Fitness starring Suzanne Andrews® on your local PBS station and enter to win a FREE set of 8 Functional Fitness DVD’s. Details at http://www.healthwiseexercise.com/contact.php

Jan’s Story

Jan's StoryThe following is a guest post from Barry Petersen, Emmy Award-winning CBS News correspondent and author of “Jan’s Story: Love Lost to the Long Goodbye of Alzheimer’s”

When does a marriage die even if the love never does?

We are not talking about the kind of rifts that can lead to divorce. We are talking about when someone fades and disappears so far away mentally, that there is no longer a relationship.

A hypothetical question? Not in my life, and very soon…not in the lives of millions of unprepared Americans. As Baby Boomers age, more and more couples will face this…one with a mind diminished and slowly being erased, the other healthy and vibrant. There will be many travelers on this journey.

The reason is Alzheimer’s Disease. I first heard those words in 2005 when my wife, Jan, was diagnosed with Early Onset Alzheimer’s. She was 55. At first, I cared for her by myself. I am a CBS News Correspondent and at that point we were based in both Tokyo and Beijing, traveling between the two cities. Then, as Jan worsened and because of my need to travel for my job, I hired a live-in caregiver, a retired nurse from Tacoma, WA.

Finally, in May, 2008, I made the decision that ended our shared life as we knew it; I placed Jan into an assisted living facility in the United States. I kept living in Asia, continuing to work, and each time I went back to the US and visited her, I could mark the changes as she spiraled downward.

I learned to accept that she no longer knew me when I came to visit. The Barry she remembered is someone deep in her past, not the man in front of her today. There were tears about this, but always in private, never in front of her. She would not have understood, and that would have frightened her.

Yet it ripped at my soul. This woman I had wooed and won, who had shared adventures living in Asia and London and Moscow, who had once been a successful foreign correspondent in her own right, had gone away.

People who know us would use one word to describe us: “BarryandJan,” because we so loved being together. Now, she was adrift somewhere else, and the Alzheimer’s meant she could not tell me where she was, or why, or what it was like there.

And there was guilt. Who cannot weep when the one you love disappears, who cannot feel the rage I felt, asking myself: “Why her. Why not me?” Jan was the better person of us as a couple, the bright star in whose glow I happily lived. She was the good of us. Who had the right to take that away.

And in time there came the hardest question of them all: Is it still a marriage if only one person is mentally present?

In that answer lies the future…to spend the rest of my life alone, even though Jan had gone away? Or – decide that I needed to go on with life.

To move on was to tempt the rage of those who told me I was violating my wedding vows. Their morality was clear – the vows say ‘till death do us part,’ and that is what people have forever promised.

Jan's Story 2Except now, people live longer, and that means Alzheimer’s comes more often because the major risk factor is simply … growing old. One in eight people over 65 have Alzheimer’s. Almost one in two will have it by age 85, according to Alzheimer’s Association. And 85 isn’t that old anymore.

There were others who told me it was time to accept that my relationship, and with it my marriage, had changed and that I was alone. I was surprised at some who said it. A couple I know who have been married, happily, for decades – people I thought would be strongly pro-marriage at all costs and would tell me never to break those vows – were among the first and most adamant to say: find someone to be with, create a new life, do not surrender to loneliness, do not fold up, dry out, and die.

Dying was an option. I thought about it, faced with the sense that I had lost the one reason for getting up and going to work and enduring Shakespeare’s “slings and arrows of outrageous fortune.” My fortune was dark and doomed, or so it seemed.

It was time to make a call. I could not keep going on as I was, finding solitary friendship in ever more late night alcohol.

I reached out, not well at first, after a friend signed me up for an internet dating site. I set one rule – that I was honest about still caring for Jan, yet willing to explain that the marriage, the relationship, were victims of Alzheimer’s. The marriage, as I defined it, was gone. Finished. But if someone could understand and accept that, they also had to understand that Jan was still with us, still alive, and I was still her husband and the man who was watching over her. Jan and my care for here was a part of the package.

There were women who instantly rejected me for this, and I understood. There were others who wanted to move quickly into a relationship, and that I also understood…and rejected. Frankly, they scared me off.

In time, and with time, there was one. Mary Nell is a widow, wise in the ways of grief, who understood the being alone part far better than I, and accepted that this would be an unusual pairing because we would not be two, but three. Our relationship would include Jan.

And so it does. Mary Nell and I go together to visit. Jan can’t remember her name, but remembers that Mary Nell is a friend and throws her hands open for a big hug and hello. Even though we are together, Jan sees no connection between Mary Nell and me. And Mary Nell sees Jan as a friend, someone she now cares and worries about. It is more often Mary Nell who says…we need to bring flowers, we need to get her new shoes, or she’s out of her favorite lipstick.

The moment we leave, Jan forgets that we were ever there. She forgets the flowers we bring, or the songs we sang together as I played the piano for her.

Mary Nell and I call ourselves the “New American Family,” and perhaps we are a Marriage of Three. We surely are the precursor of the tsunami of dementia and Alzheimer’s and difficult decisions to come. We will soon be joined by millions of “New American Families.”

I do not consider that comfort. I do not want anyone else to travel this dreaded path, but it is happening. Each diagnosis, and there is one every 70 seconds in this country, will bring others to this precipice.

I have no answers for others, offering only what I have done and learned and chosen, knowing that it was right…for me.

I wish them luck. Like me, they will need it.

About the Author: Barry Petersen is an Emmy Award-winning CBS News Correspondent who has reported on everything from wars and natural disasters to Paris fashions, Welsh choirs and the return of American Jazz to Shanghai, China. His stories have been datelined from virtually every continent in a career that spans more than three decades. Petersen wrote his first book, Jan’s Story: Love Lost to the Long Goodbye of Alzheimer’s published in June, 2010, about the struggle he shared with his wife, Jan Chorlton, who was diagnosed with Early Onset Alzheimer’s Disease at age 55 and is now in an assisted living facility. Jan was also a CBS News journalist, reporting from both Japan and the former Soviet Union for CBS Radio, CBS Sunday Morning and the CBS Weekend News. Petersen is currently based in Denver, CO, where he reports for the CBS Evening News with Katie Couric and CBS Sunday Morning with Charles Osgood. Visit www.barrypetersen.com.

Dementia and Type 2 Diabetes

Dementia and type 2 diabetes are serious concerns for older adults. Both diseases are becoming epidemics in this country. The Alzheimer’s Association has become a household name, and many people know of someone who has participated in a Memory Walk. Type 2 diabetes is a disease that was once called adult onset diabetes, but that term is no longer used because younger and younger people are developing the disease. In fact, the current generation of children is the only cohort in the history of humankind at risk of not out living their parents because of obesity related diseases.

Being overweight is not good at any age, and it begins to affect the brain. “Being fat has a detrimental impact on the brain,” says Kaiser Permanente research scientist Rachel Whitmer. She is the co-author of a nine-year study of 10,276 people in Northern California that found people who are obese in middle age (body mass index of 30 or more) are 74% more likely to develop dementia than people of healthy weights.

Benefits of exercise

Physical and mental exercise can prevent type 2 diabetes and dementia.  Numerous studies have proven that exercise is beneficial when it comes to diabetes.  Now researchers are beginning to see the benefits of exercise when it comes to dementia.  A study from Seattle Washington found people who exercised at least 3 times per week were less likely to develop dementia than those who were less active. The American Academy of Neurology recently published the result of a study of more than 700 older people in Chicago that concluded, “a cognitive active person in old age was 2.6 times less likely to develop dementia and Alzheimer’s disease than a cognitively inactive person in old age.”

Diabetes and the brain

It’s known that there are cells in the brain that sense blood sugar levels (called glucose-sensing neurons). New research shows that in type II diabetics, at least some of the neurons that are supposed to sense rises in blood sugar aren’t doing their job. Many physicians think of type II diabetes as solely a disease of the body, but we may need to start thinking about it as a disease of the brain as well.

The point is maintaining a healthy body is just as important as maintaining a healthy brain. So when you are between crossword puzzles, start jogging!

Photo credit: jeffdiogenes

About the Author: Ryan Malone is the founder of InsideElder Care and author of the ByFamilies, For Families Guide to Assisted Living. He regularly speaks and advises families about how to improve their aging loved one’s quality of life. Ryan is also the president of SmartBug Media, a content marketing agency that helps companies increase leads, customers and influence. You can read more from Ryan on the SmartBug Media blog or follow him on Twitter.

How to Choose a Caregiver

The title of caregiver is not as obvious as it may seem.  Caregivers can aid in eldercare on many different levels and depending on your needs their roles can provide key benefits.

Benefits of caregivers

Your eyes and ears: Whether you live close by or far away, a caregiver can observe and update you on areas of nutrition, hygiene, activity level, services and other daily issues.

A concierge: Scheduling and staying current with weekly and monthly activities such as doctor’s visits, shopping, hair appointments, and therapy requires phone calls and follow up.  Allow the caregiver to take some of this off or your mind and your to-do list.

An influencer: Communication and opinions by close family members are sometimes not seen as being objective or carry as much weight as a professional caregiver.  Therefore it may be easier on everyone if the caregiver steps in at times to advise the patient rather than a family member.

Finding a caregiver

Before you choose a caregiver, you should determine the range of services you want so that you are making a decision that covers your predetermined needs.  Consider the following:

Make a list of daily activities: By reviewing the activities of a typical day of the patient you will be able to determine the specific duties required.  It helps to create a timeline of activities so that you plan for meals, naps and regular appointments.

Assess the degree of specialty: If the patient suffers from any degree of dementia or physical disability make sure you look for a caregiver with appropriate knowledge and experience.

Determine the need for meal preparation: Not only should you make a choice for a caregiver on their ability to prepare meals if necessary, but also their understanding and ability to create diet-specific meal choices.

Once you have your specific needs list refined, go to the following resources to be connected to the appropriate pool of caregivers to begin your interview process.

Additional resources:

www.caregiverlist.com

www.caregiver.com

10 Caregiver Questions

To make the most of your time during the interviewing process, conduct preliminary interviews on the phone rather than starting with in-person appointments.  Describe the job in detail along with the required hours needed and wages available.  If you feel the applicant may be a good match based on their experience and ability to provide references, then schedule the in-person interview.  It is a good idea to have another family member or friend participate in the interview to provide an objective perspective.  Finding that great match may be easier with a second opinion.

In preparation for the interview, create a list of questions pertinent to the job description.  Ask questions relevant to the caregiver’s experience and expertise surrounding the daily activities list you previously created.

  1. Where have you worked before?
  2. What were your duties?
  3. What type of patient medical limitations have you worked with in the past?
  4. What is your experience cooking for other people (including dietary restrictions)?
  5. Is there anything in the job description that you are uncomfortable doing?
  6. Have you had to deal with a patient emergency in the past?
  7. Can you keep track of and administer medications?
  8. Would you be able to transfer someone from a wheelchair into a car or into a bed?
  9. How do you feel about caring for a disabled person? Or a person with memory problems?
  10. Can I contact at least two work-related and one personal reference?

If you need a template for a caregiver interview, download this form as a guide:

http://www.agis.com/Document/38/professional-caregiver-interview-form.aspx

Once you narrow down your field of applicants, make sure you observe the applicant’s interactions with your family member on a casual basis before making a decision.  If your family member is able, he or she should be included in the interview process and in making the final decision.

Consider the person most qualified for the job and with whom you feel most comfortable. Always check the references of at least two final applicants. Good applicants may have more than one opportunity at a time, so don’t wait too long before proceeding with an offer.