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.

Giving Back to Caregivers

As a blogger, most people will tell you, “stay on message.  Don’t deviate, or you’ll lose readers.”  They are right.  On rare occassion it is justified, however.  That occasion is today.

I received an email today from Gladys Broxton, the executive director at Regency Park Oak Knoll in Pasadena.  Gladys was one of the first people who brought me in to give my “Assisted Living Saved My Mom” talk.  She is also an enromously compassionate woman who runs a wonderul assisted living.  Great staff.  Long tenure.  All the things you look for when you evaluate assisted living communities.

At Inside Elder Care, we’ve always spoken about the very difficult job that caregivers undertake.  Many times it is thankless.  All of the time, it is very tough work.  In this light and with Glady’s permission, I am reposting the email she sent me below.  Help if you can.  And if you can’t — think some good thoughts.

Dear Friends, Family, Staff and Colleagues:

I come to you with a heavy heart requesting for your financial support to help one of my staff members who is in great need of financial assistance for burial.

Rosario Rodriquez has been working for me 6 years as an exceptional caregiver.   She is a young, kind, and caring individual who works extremely hard to provide the best care for my residents.  She and her husband, Eduardo has been married for only 2 years.  Her husband is gravely ill with liver cancer.  His battle with this rare cancer is almost over.  Rosario and her husband have no life insurance and no medical insurance.  Her husband was being treated at USC because he was part of a research project.  However, he is losing his battle, and doctors are telling them that they can’t do anymore to help him.  This burden is insurmountable and I am amazed by Rosario’s strength and love for her husband.

At this point her husband has no more strength left.  The cancer has caused his skin to leak fluids, the doctors have now put him on hospice, and Rosario is faced with the obvious and inevitable circumstance of him passing.

I come to you all asking for you’re help by donating any amount that comes from your heart.  I hope to collect enough to at least ease the financial burden for Rosario in some way. She is not aware that I’m asking for donation’s she has so much pride I admire her so much for her strength, love and faith for the past two years.

Please keep her and her husband in your prayers.  If you can help, please contact me as soon as possible

Sincerely yours,

GLADYS BROXTON
EXECUTIVE DIRECTOR
REGENCY PARK OAK KNOLL
255 SO OAK KNOLL
PASADENA CA 91101
626-578-1551

Neil Moore Eases Long Distance Caregiver Stress with Connect 4 Healthcare

My mother lives in San Diego. I live about an hour north in Orange County. One sister lives an hour north of Los Angeles. My other sister lives in Baltimore, Maryland.

As one might imagine, long distance caregiving is an issue with which my family continuously grapples. It’s the peace of mind and communication that always seems to be the toughest to maintain. Who calls the community? Who calls the family? How do you maintain any consistency in the update you get on her care? The questions can be endless.

That’s why I was so excited when I started following Neil Moore and Connect 4 Healthcare more than 6 months ago. Neil’s brought the company from a great idea and a prototype to a service enormously valuable to families like me.

In this Leaders in Elder Care interview, I had the chance to catch up with Neil was really excited to hear that Connect 4 Healthcare was living up to its potential.  I am glad to be able to call Neil a Leader in Elder Care and hope you enjoy the interview.

About Neil Moore

With over twenty years of successful health care business experience, Neil Moore has spent the last 16 years on the management teams of health information technology companies in roles that include management of application development, marketing, sales, clinical consulting and strategic partnerships. Before starting Connect 4 Healthcare, he was Executive Vice President of Evention Healthcare, Inc., a long-term-care software start-up, where he was responsible for Strategy, Marketing, Sales and Business Development. In 2007, Evention Healthcare was purchased by the largest long-term care pharmacy services provider in the US (Omnicare, Inc).

How Neil Describes Connect 4 Healthcare

Founded in 2008 by Neil Moore, Connect 4 Healthcare, LLC provides an easy-to-use, inexpensive web service (Connect for Healthcare™) that enables long-term care providers to improve resident/client care, the family experience, operational efficiency and differentiate themselves in the market place by dramatically improving and documenting their communication with families using modern technologies. In just a few minutes per week, the Connect service enables care providers to deliver regular, proactive updates to the entire family through the Internet, Email and Text Messaging – no matter where they might be – in 70% less time than it takes them to answer a typical update call from just 1 family member.

Contact Information

www.connect4healthcare.com

Book Review: The Caregiver in MidLife by Ellen Besso

The Caregiver in MidLife
Where Theirs Needs End and Yours Begin
By Ellen Besso
(Self-Published; 101 pages with exercises; $14.99 e-book)

It’s no secret that I am not among the norm as someone who is the primary caregiver for his family.  In fact, 73% of caregivers are women, the average age of which is 46 years.

Many books on caregiving have been released over the years.  On the surface, Ellen Besso’s book, “The Caregiver in MidLife” may appear like that of a traditional caregiver book.  In fact there are some things in common: personal stories, self-cleansing and strong bonds between the writer and reader that “we’re in it together.”

By that is where the similarities end.  You see, Ellen Besso is a life coach.  And the words “victim” and “cannot” are not words commonly used by coaches – especially life coaches.  It’s here where Besso’s book creates separation and a credibility that cannot be denied.

Besso takes a unique angle in discussing the expectations, emotions and transformations Baby Boomer women face in their role as a family caregiver.  Besso argues that women are hardwired to be caregviers and details fascinating conflicts between the demands of caregiving and life realities such as hormonal changes, motherly instincts and the pressures to “finally do something” with one’s life.

“The Caregiver in MidLife” teaches you how to regain the life you put on hold, and how do it in a way that is comfortable, empowering and respected by the loved one to which you provide care.

Chapter 4 addressed a topic I’ve not thought of formally, but one that is real.  The chapter focuses on role changes as women move through life.   Besso argues that as women grow, they separate from their parents and learn to better create boundaries between the role of mother/father and daughter.  As a caregiver, the role of daughter and caregiver can sometimes be in conflict.

Besso also shares a very interesting theory that some sibling caregiver rivalries may be a subconscious way of trying to be the “favorite” in the eyes of the parent.  While that is likely not the case in our family, I can see where lingering feelings from childhood could manifest in this fashion.

Besso’s coaching skill comes through more subtly at the beginning of the book.  But it takes a far stronger and more inspiring tone as the book progresses.  I found myself excited in a Tony Robbins sort of way to take control of my situation, draw boundaries and regain control of the parts of my life that had been neglected.

But one area that left me yearning and somewhat confused was in Chapter 7.  In this chapter, Besso describes her experience moving her mother to an assisted living community.  Whereas Besso assumed total control of her circumstances earlier in the book, her almost fight-free acceptance of her mother’s care being under someone else’s control seemed to contradict the books premise.  I was expecting an equal if not more determine tone from Besso as it is such a transformative transition for any family.

“The Caregiver in MidLife” also includes a book of exercises addressing time management, personal feeling and attitudes and support networks (to name a few).  Kudos to Besso for including these exercises!  I am huge fan of them because they personalize lessons learned in the book and enable the reader to move from hypothetical to practical at their own pace.  There is a reflective power of workbooks enabled when you can review your thoughts and progress from time to time.

Overall, I was very happy to read the book and thought Besso did a good job of mixing the encouragement of a coach with the reality that we face as caregivers.  At 101 pages, it is a quick read that will leave you feeling upbeat and better prepared to address your own life.

“The Caregiver in MidLife” is available at www.ellenbesso.com.

Providing Elder Care Doesn’t Have to Affect Your Job Security

I just read an interesting article in US News & World Report.  Entitled How Providing Elder Care Affects Your Job Security, the article spoke about the workplace inflexibility people face when caring for parents versus that of their children.

Employees providing eldercare say they have significantly less access to the flexible work options needed to fulfill their work and personal needs, compared to employees caring for a child under age 18 and workers not providing dependent care, according to a survey of more than 2,200 employees ages 17 to 81 by the Sloan Center on Aging & Work at Boston College. That’s because many flexible schedules were designed with the parents of young children in mind, according to Marcie Pitt-Catsouphes, the study principal and head of the Sloan Center on Aging & Work. “Many of those polices were developed in the late 80s and 90s in reaction to the increase in the number of women, particularly women with young children, in the workforce.” Eldercare doesn’t always conveniently fit into the same mold.

In my opinion, much of the work and life stress associated with elder care has to do with our inability to build padding  into our schedules. As professionals, it’s easy to fall into the trap whereby our schedules are 100% allocated.  But that leaves us unavailable for emergencies, especially as they related to our loved ones.  If you plan at 80% capacity, it is far easier to address emergencies as they present themselves.  It’s also easy to reallocate that time to your “to-do” list if it becomes clear that your day or week will be uneventful.  And if an emergency does occur, you can calmly deal with it without negatively impacting your professional commitments.

The other thing we neglect to do is to create a support network. These are groups of friends and family members who can help you complete specific tasks such as picking up the kids, dropping on prescriptions, etc. Support networks are critical in elder care because a micro-contribution by many people creates a fantastic experience for your loved one, while simultaneously creating a stress-free existence for you.

Finally, I recommend a frank discussion with your employer to inform them of your situation and to reiterate your commitment to accomplishing your work objectives. The reality is that many professions now don’t require you to be in the office to accomplish your job.  Things like Blackberries, call forwarding, etc are great tools for working remotely.  By proactively discussing your circumstances with your employer, you are more likely to have the flexibility you need to handle both responsibilities.

Having lived this challenge when my mother had her stroke, I learned the hard way that regardless of the time management tools you use, unless you build padding into your scheduled, something stressful will always come up.  In the By Families, For Families Guide to Assisted Living, I write the chapter “Making Room for Priorities” to address this topic and provide the stress-reduction and time-management tips that most people don’t think about when their family members additional care.

Loving Back

I had breakfast last week with Pete Todd, founder of Loving Back.  Based in Orange County, California like me, Loving Back was launched to help you care for your aging parents.  Inspired by seeing friends and loved ones overwhelmed by the stress and challenges of providing care, Loving Back is dedicated to connecting you online to other caregivers, rated providers and helpful resources.

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