Caregiver Blog, News Feeds, Video Feeds, Useful Links

Monday, December 31, 2007

AARP: Can't Afford Surgery in United States? 500,000 Americans Went Overseas for Treatment in 2006

AARP has an article titled "Traveling for Treatment - Soaring U.S. Health Costs Are Driving More Americans Abroad For Medical Treatment, " by Anthony Mecir and Katharine Greider, Sept. 2007. For many people going overseas is the only affordable way to get the surgery they need without bankrupting their savings. For example, one couple gave up their medical insurance when the premiums were over $1,000 per month. They flew to New Delhi, India, where instead of costing $40,000 to $60,000, a hip surgery plus the travel expenses cost $15,000.

People who cannot obtain or cannot afford insurance due to pre-existing conditions may not have a choice if they need a knee replacement, hip surgery, prostrate or other surgery. The medical tourism websites say that people may save from 30% to 80% of the cost by going outside of the United States for surgery.

For example, Bumrungrad, Thailand, has a JCI accredited hospital with state of the art equipment. English is spoken more often there than any other language. The article said the 45 to 65 year old group, including self-employed people without medical insurance, early retirees, and workers who have lost their benefits are among the patients there from the United States.

I have an acquaintance who is unable to obtain medical insurance in the United States due to pre-existing conditions. This person is much too young for Medicare, but needs a knee replacement due to wear and tear for many years following a knee reconstruction.

A chart at the website We Care Health Services compares prices of surgeries in the United States, the United Kingdom, and India. A total knee replacement in the United States can cost $30,000, and in India the chart lists it at $7600. Bypass surgery in the United States is $35,000 and in India $6,500.

If someone without insurance must pay out of their savings for surgery, overseas surgery may be the only option left. The article said people who have never traveled or had a passport have gone overseas for treatment due to financial necessity.

There are precautions one can take, such as checking for JCI, Joint Commission International Hospital Accreditation Program. You can check for overseas hospitals that have a large number of U.S. trained, board certified, medical doctors, and state of the art equipment.

The website at Med Journeys has information about costs and savings, surgical procedures, doctors, hospitals, and other pertinent information.

For those who are self-employed, who have lost their insurance, and who cannot obtain insurance due to pre-existing conditions, getting an affordable surgery overseas may be the answer.

Sunday, December 30, 2007

American Academy for Orthopedic Surgeons: 90% of Knee Replacements for Arthritis Provide Dramatic Improvement

The American Academy for Orthopedic Surgeons says that "improvements in surgical materials" have greatly increased the effectiveness of knee replacements for arthritis. The first knee replacement was in 1968, and approximately 300,000 are performed each year. People who have knee pain that limits daily activities may benefit from a knee replacement. Ninety percent of people who have a knee replacement experience a "dramatic reduction of knee pain and a significant improvement in the ability to perform common activities."

The website explains that after surgery a person can expect to participate in the following.

Recreational Walking
Swimming
Golf
Driving
Light hiking
Recreational Biking
Ballroom Dancing
Normal Stair Climbing

Recently I visited with a gentleman who had both knees replaced five weeks ago. He was sitting in the jacuzzi at my healthclub. Having both replaced at once is unusual. When he finished soaking int he jacuzzi he walked back to the clubhouse area and I could not see any difference in his walking from any person with healthy knees.

He explained that he had always been athletic, and that the wear and tear on his knees had worn them out. After the surgery he said he made an especially active effort to exercise, perform the physical therapy, and follow all the recommendations. He was looking forward to getting back into playing golf.

Saturday, December 29, 2007

American Heart Association Says People Often Wait Too Long to Get Help for a Heart Attack

Sometimes caregivers or seniors aren't sure if someone is having a life threatening emergency, and they may wait to call for help because they are afraid it will be a false alarm. They may be afraid they will appear to have overreacted, to be mistaken, or to have created an alarm foolishly all for nothing. But even waiting minutes can cost a life. The American Heart Association says "people often aren't sure what's wrong and wait too long before getting help" for a heart attack. A review of the common heart attack symptoms and emergency procedures can guide a caregiver when someone might be having a heart attack. First, call 911 immediately, because getting fast medical assistance can save a life. When you call 911 the Emergency Medical Services will arrive within minutes and begin lifesaving treatment then. Taking time to drive someone to the hospital uses up valuable time, and 911 is faster. Even minutes can make the difference in saving a life.

Below is The American Heart Association list of the signs of a heart attack.

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. May occur with or without chest discomfort.


Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness


A senior who is enjoying a pleasant time with friends and who does not wish to say anything might hesitate to suddenly voice the impression that he or she might be having a heart attack. Perhaps the person is afraid of looking foolish if it is a false alarm. Or, a person might wait to see if it gets worse, but this can cost a life.

As a caregiver I have called 911 anytime I thought a life threatening emergency might be occuring. Medical personnel have never, ever, made me feel I was using their time foolishly. Even if it turns out not to be a life threatening emergency, medical personnel have always said something like, "You did the right thing, and we are glad you called. It's better to check it out than risk losing a life. You're doing a good job as a caregiver, and you're keeping people safe."

Seniors and their families have said to me, "We're so glad you did not hesitate to call 911." Don't be afraid to take responsibility for calling emergency personnel. When in doubt, it's always the right thing to do. Don't hesitate.

Thursday, December 27, 2007

Caregiver Tips for Assisting Seniors Who Have Arthritic Knees

The American Academy of Orthopedic Surgeons offers an overview of the most common type of knee arthritis, osteoarthritis, and suggestions for treatment. Caregivers for seniors who are in the early stages of arthritis may be using nonsurgical treatments for arthritic knees. This can include lifestyle modifications such losing weight, switching from high impact exercise to swimming or bicycling, and avoiding movements such as climbing stairs.

The website explains that a doctor or physical therapist can provide advice regarding beneficial exercises. Supportive devices that can be used include a knee brace, inserts for shoes to provide additional cushioning, or using a cane. Elastic bandages to reduce swelling, ice, heat, and liniments are sometimes used to reduce pain.

Water therapy exercise is becoming popular for people with arthritis wherever a pool is available. Group classes of water aerobics provide a chance for people to exercise gently with the help of the buoyancy of water. Often a jacuzzi is nearby too, and the heated water is another way people reduce arthritis pain.

At our local pool and jacuzzi the water aerobics classes include many seniors in their 70's, 80's, and even 90's who are exercising arthritic joints with slow, smooth movements in water. There is also a water walking lane. The water in the pool is 4 feet deep, and in the water walking lane people walk their laps, just like they would on a track, but in the water.

Wednesday, December 26, 2007

Caregivers Self-Care - Keeping a Sense of Self, Creativity for Living Fully

Focusing our thoughts and energy on meeting the needs of others doesn't give caregivers much time for self-development and personal growth. Creative paths are needed to continue to nurture the caregiver's sense of self. When an interruption of one's dreams and life goals occurs, living a fulfilling life seems to be a thought that is put aside while caring for others.

The new normal that occurs when caregiving becomes a lifestyle means thinking creatively out-of-the-box is needed. The caregiver's sense of self needs to continue amidst the focus on others, and this is a big challenge.

A new feature at the Caregiver's Beacon is a list of websites for Living Creatively. If you would like to suggest a site to add please email me, Kristi Marie Gott, at kgott@charter.net.

If you have an inspirational quotation you would like to add it would also be much appreciated. Thank you and best wishes.

Monday, December 24, 2007

" May Peace be your gift at Christmas and your blessing all year through!" ~Author Unknown

Tonight is Christmas Eve. Best wishes to everyone for peace, spiritual fulfillment, and blessings. May the spirit of God's love surround you and fill you, strengthen you and guide you. Best wishes this Christmas, Kristi Marie Gott

Sunday, December 23, 2007

What About Starting a Network of Caregivers' Telephone Helplines?

When caregivers need help but don't know where to turn, a Caregivers' Hotline could be a source of quick referrals to resources. Similar to the mental health hotlines, this could be a number to call when caregivers need to find a support group, a counselor, a place to vent, or resources for the person the caregiver is assisting. This idea has come to me because during the holidays, when part of the people are having a great time, I've been contacted by caregivers who are overwhelmed with stress and need help.

A Caregivers' Helpline, similar to other helplines, such as mental health helplines, could refer caregivers to resources in the same way. It could be a place to call for caregivers who are feeling they are in a crisis. Counselors could refer the caregivers to groups, caregiver counseling, caregiver support, resources to provide caregiver relief, and other helpful resources.

The holidays can be happy times, but doctors and counselors know that the holidays can also be times of crises. When the "cognitive distance" between those who are enjoying the holidays and those who are overwhelmed with stress becomes too great for overworked caregivers, the sense of isolation intensifies.

Some type of help is needed for those caregivers who are in crises, during the holidays or anytime. A network of Caregiver's Helplines or Caregivers' Crises Hotlines, staffed by volunteers who are trained in referring people to resources, and in good listening skills, would reach out to isolated caregivers who are in a crisis.

Many caregivers are not proficient with the internet, or cannot afford computers. A telephone number would be a way to reach these people. I volunteer at a seniors' center and many of the seniors have a spouse who is a caregiver, and who does not know how to use computers. Many younger caregivers have never had the time to study computers or high tech, and/or, have never had the finances to afford computers in the midst of family financial crises.

Saturday, December 22, 2007

Caregiver's Christmas Story to Enjoy - Wisdom in Giving - O. Henry's "Gift of the Magi"

The spirit of giving is the spirit of Christmas, and gifts of the heart mean the most. The thought and caring that the gift represents is the most treasured part of the gift. Caregivers give from the heart not just on Christmas, but every day of the year. The celebrated short story writer from the 20th century, O. Henry, wrote about gifts of the heart in his Christmas story, "The Gift of the Magi." The young lady and young man, newly married and struggling in poverty, each put special thought into a worthy gift for the other. The clever twist at the story's end, so typical of O. Henry, gives it a special meaning.

Below is the short story, O. Henry's "Gift of the Magi."

One dollar and eighty-seven cents. That was all. And sixty cents of it was in pennies. Pennies saved one and two at a time by bulldozing the grocer and the vegetable man and the butcher until one's cheeks burned with the silent imputation of parsimony that such close dealing implied. Three times Della counted it. One dollar and eighty- seven cents. And the next day would be Christmas.

There was clearly nothing to do but flop down on the shabby little couch and howl. So Della did it. Which instigates the moral reflection that life is made up of sobs, sniffles, and smiles, with sniffles predominating.While the mistress of the home is gradually subsiding from the first stage to the second, take a look at the home. A furnished flat at $8 per week.

It did not exactly beggar description, but it certainly had that word on the lookout for the mendicancy squad.In the vestibule below was a letter-box into which no letter would go, and an electric button from which no mortal finger could coax a ring.

Also appertaining thereunto was a card bearing the name "Mr. James Dillingham Young."The "Dillingham" had been flung to the breeze during a former period of prosperity when its possessor was being paid $30 per week. Now, when the income was shrunk to $20, though, they were thinking seriously of contracting to a modest and unassuming D.

But whenever Mr. James Dillingham Young came home and reached his flat above he was called "Jim" and greatly hugged by Mrs. James Dillingham Young, already introduced to you as Della. Which is all very good.Della finished her cry and attended to her cheeks with the powder rag. She stood by the window and looked out dully at a gray cat walking a gray fence in a gray backyard.

Tomorrow would be Christmas Day, and she had only $1.87 with which to buy Jim a present. She had been saving every penny she could for months, with this result. Twenty dollars a week doesn't go far. Expenses had been greater than she had calculated. They always are. Only $1.87 to buy a present for Jim. Her Jim. Many a happy hour she had spent planning for something nice for him. Something fine and rare and sterling--something just a little bit near to being worthy of the honor of being owned by Jim.

There was a pier-glass between the windows of the room. Perhaps you have seen a pierglass in an $8 flat. A very thin and very agile person may, by observing his reflection in a rapid sequence of longitudinal strips, obtain a fairly accurate conception of his looks. Della, being slender, had mastered the art.Suddenly she whirled from the window and stood before the glass. her eyes were shining brilliantly, but her face had lost its color within twenty seconds.

Rapidly she pulled down her hair and let it fall to its full length.Now, there were two possessions of the James Dillingham Youngs in which they both took a mighty pride. One was Jim's gold watch that had been his father's and his grandfather's. The other was Della's hair. Had the queen of Sheba lived in the flat across the airshaft, Della would have let her hair hang out the window some day to dry just to depreciate Her Majesty's jewels and gifts.

Had King Solomon been the janitor, with all his treasures piled up in the basement, Jim would have pulled out his watch every time he passed, just to see him pluck at his beard from envy.So now Della's beautiful hair fell about her rippling and shining like a cascade of brown waters. It reached below her knee and made itself almost a garment for her. And then she did it up again nervously and quickly.

Once she faltered for a minute and stood still while a tear or two splashed on the worn red carpet.On went her old brown jacket; on went her old brown hat. With a whirl of skirts and with the brilliant sparkle still in her eyes, she fluttered out the door and down the stairs to the street.Where she stopped the sign read: "Mne. Sofronie. Hair Goods of All Kinds." One flight up Della ran, and collected herself, panting. Madame, large, too white, chilly, hardly looked the "Sofronie."

"Will you buy my hair?" asked Della."I buy hair," said Madame. "Take yer hat off and let's have a sight at the looks of it."Down rippled the brown cascade."Twenty dollars," said Madame, lifting the mass with a practised hand."Give it to me quick," said Della.Oh, and the next two hours tripped by on rosy wings. Forget the hashed metaphor.

She was ransacking the stores for Jim's present.She found it at last. It surely had been made for Jim and no one else. There was no other like it in any of the stores, and she had turned all of them inside out. It was a platinum fob chain simple and chaste in design, properly proclaiming its value by substance alone and not by meretricious ornamentation--as all good things should do. It was even worthy of The Watch.

As soon as she saw it she knew that it must be Jim's. It was like him. Quietness and value--the description applied to both. Twenty-one dollars they took from her for it, and she hurried home with the 87 cents. With that chain on his watch Jim might be properly anxious about the time in any company. Grand as the watch was, he sometimes looked at it on the sly on account of the old leather strap that he used in place of a chain.

When Della reached home her intoxication gave way a little to prudence and reason. She got out her curling irons and lighted the gas and went to work repairing the ravages made by generosity added to love. Which is always a tremendous task, dear friends--a mammoth task.Within forty minutes her head was covered with tiny, close-lying curls that made her look wonderfully like a truant schoolboy.

She looked at her reflection in the mirror long, carefully, and critically."If Jim doesn't kill me," she said to herself, "before he takes a second look at me, he'll say I look like a Coney Island chorus girl. But what could I do--oh! what could I do with a dollar and eighty- seven cents?"At 7 o'clock the coffee was made and the frying-pan was on the back of the stove hot and ready to cook the chops.Jim was never late.

Della doubled the fob chain in her hand and sat on the corner of the table near the door that he always entered. Then she heard his step on the stair away down on the first flight, and she turned white for just a moment. She had a habit for saying little silent prayer about the simplest everyday things, and now she whispered: "Please God, make him think I am still pretty."The door opened and Jim stepped in and closed it.

He looked thin and very serious. Poor fellow, he was only twenty-two--and to be burdened with a family! He needed a new overcoat and he was without gloves.Jim stopped inside the door, as immovable as a setter at the scent of quail. His eyes were fixed upon Della, and there was an expression in them that she could not read, and it terrified her.

It was not anger, nor surprise, nor disapproval, nor horror, nor any of the sentiments that she had been prepared for. He simply stared at her fixedly with that peculiar expression on his face.Della wriggled off the table and went for him."Jim, darling," she cried, "don't look at me that way.

I had my hair cut off and sold because I couldn't have lived through Christmas without giving you a present. It'll grow out again--you won't mind, will you? I just had to do it. My hair grows awfully fast. Say `Merry Christmas!' Jim, and let's be happy. You don't know what a nice-- what a beautiful, nice gift I've got for you."

"You've cut off your hair?" asked Jim, laboriously, as if he had not arrived at that patent fact yet even after the hardest mental labor."Cut it off and sold it," said Della. "Don't you like me just as well, anyhow? I'm me without my hair, ain't I?"Jim looked about the room curiously."You say your hair is gone?" he said, with an air almost of idiocy.

"You needn't look for it," said Della. "It's sold, I tell you--sold and gone, too. It's Christmas Eve, boy. Be good to me, for it went for you. Maybe the hairs of my head were numbered," she went on with sudden serious sweetness, "but nobody could ever count my love for you. Shall I put the chops on, Jim?"Out of his trance Jim seemed quickly to wake.

He enfolded his Della. For ten seconds let us regard with discreet scrutiny some inconsequential object in the other direction. Eight dollars a week or a million a year--what is the difference? A mathematician or a wit would give you the wrong answer. The magi brought valuable gifts, but that was not among them. This dark assertion will be illuminated later on.Jim drew a package from his overcoat pocket and threw it upon the table."Don't make any mistake, Dell," he said, "about me.

I don't think there's anything in the way of a haircut or a shave or a shampoo that could make me like my girl any less. But if you'll unwrap that package you may see why you had me going a while at first."White fingers and nimble tore at the string and paper.

And then an ecstatic scream of joy; and then, alas! a quick feminine change to hysterical tears and wails, necessitating the immediate employment of all the comforting powers of the lord of the flat.For there lay The Combs--the set of combs, side and back, that Della had worshipped long in a Broadway window. Beautiful combs, pure tortoise shell, with jewelled rims--just the shade to wear in the beautiful vanished hair.

They were expensive combs, she knew, and her heart had simply craved and yearned over them without the least hope of possession. And now, they were hers, but the tresses that should have adorned the coveted adornments were gone.

But she hugged them to her bosom, and at length she was able to look up with dim eyes and a smile and say: "My hair grows so fast, Jim!"And them Della leaped up like a little singed cat and cried, "Oh, oh!"Jim had not yet seen his beautiful present. She held it out to him eagerly upon her open palm. The dull precious metal seemed to flash with a reflection of her bright and ardent spirit.

"Isn't it a dandy, Jim? I hunted all over town to find it. You'll have to look at the time a hundred times a day now. Give me your watch. I want to see how it looks on it."Instead of obeying, Jim tumbled down on the couch and put his hands under the back of his head and smiled."Dell," said he, "let's put our Christmas presents away and keep 'em a while. They're too nice to use just at present. I sold the watch to get the money to buy your combs. And now suppose you put the chops on.

"The magi, as you know, were wise men--wonderfully wise men--who brought gifts to the Babe in the manger. They invented the art of giving Christmas presents. Being wise, their gifts were no doubt wise ones, possibly bearing the privilege of exchange in case of duplication.

And here I have lamely related to you the uneventful chronicle of two foolish children in a flat who most unwisely sacrificed for each other the greatest treasures of their house. But in a last word to the wise of these days let it be said that of all who give gifts these two were the wisest. O all who give and receive gifts, such as they are wisest. Everywhere they are wisest. They are the magi.

Friday, December 21, 2007

A Story About the True Meaning of Christmas

This week I saw a true life story that showed the real feelings of Christmas. One motivated lady made a loving difference in the individual lives of many seniors. The spirit of sharing and fellowship, of good will and friends, and of giving is the true meaning of Christmas. When seniors live alone, and live far away from their families, a seniors' group can be a substitute family, especially if a few motivated individuals help facilitate a gathering.

For example, the 30 or so seniors who come to lunch each day at the local Central Coast Senior's Center for the Senior Nutrition Program become like a family since over lunch they share their news, joys, sorrows, and challenges. I learned something this week when I went over to take photos for the Central Coast Seniors Center website.

Deb Clark, in the center of the group in the photo below, a Senior Nutrition Program specialist, had single handedly created decorations, Christmas treats, and handmade gifts for the seniors who come to the center five days a week for lunch.

Many of these seniors are widowed, and eating one meal a day with friends is very special for them. Deb put on a Christmas party and they got into the spirit and the air was filled with Christmas cheer.



Deb made a special point of interacting personally with each senior, and had individual cards and handmade gifts. All year long she had taken photos of the fun times they had at lunch, and each senior received a handmade scrap book and photo album made the "old fashioned way." Deb used yarn to tie the handmade books together, and filled each one with photos, names, and comments custom written for each senior.

They were so happy with these gifts. The fact that Deb saw each person as an individual, and each book was one of a kind, made each senior know he or she was special. Since many live alone, and do not have family nearby, Deb creates a substitute family at the Senior Nutrition Program.

There are also another 50 or so meals that are delivered by drivers each day, and Deb has met all of these people when she went to their homes to set up the meal deliveries. She also sent gifts and cards to the homebound people.

This is a story about the true feeling of Christmas. Deb Clark and her spirit of giving, of recognizing each person as a unique individual, is an inspiration.

Thursday, December 20, 2007

"Peanuts" Christmas Music Video for Caregivers Enjoyment

A few moments of whimsy and humor can be a lift for caregivers. Charlie Brown and the Peanuts gang are featured below. Enjoy.

Twenty-Three Minute Care for the Caregiver Video - Important During the Holidays

Caregiver stress during the holidays can go up as the demands on time and energy go up. Tension, problems sleeping, irritability, and depression can happen at the same time that holiday merrymaking and shopping for gifts are occuring. The contrast between life's realities and idealistic visions of holidays can be stressful as people try to live up impossible standards. A sense of peace is more important than the spending encouraged by the advertisers, and this time of year doesn't need to be a race to achieve the most festivities.

The 23 minute Care for the Caregiver video is especially important when caregivers may feel their energy is stretched and stressed to the max during the holidays. A few minutes of quiet meditative contemplation might be all a busy caregiver can manage at times, but even this will stop the ongoing marathon of stress for those caregivers who are faced with many tasks.

Best wishes to everyone. Enjoy the video.

Wednesday, December 19, 2007

Christmas and Bereavement

Coping with the loss of a loved one and with holidays at the same time can be one of the most isolating and painful situations. While red bows and words of joy are part of the decorations everywhere, the grieving person feels many mixed emotions. People who are bereaved can feel pain over loss, sometimes guilt over being here without the loved one, relief that someone is no longer suffering, and isolation from the cheerful shoppers and festive music and events. It can be a roller coaster emotionally.

Hospice all over America provides workshops as the holidays are coming up to help bereaved people cope. There are grief groups for every type of loss. In a typical group each member might introduce herself or himself, and describe the loss and the loved one. Facilitators from Hospice provide guidance. It's a time to open up with others who have also experienced a loss and who will understand.

Each loss is completely different. Everything in the groups is confidential, so members feel free to share safely. There is no judging, just unconditional acceptance and listening. Sharing with a group helps to relieve the tension, stress and pain of the grief and people are able to work through the grief.

When the loss of a loved one has occurred during the Autumn or early Winter the comparison of the pain of loss and the festivities make it especially difficult to cope, for many people. Hospice provides a place that is a safe haven for sharing with others, and individual counseling is available also.

Tuesday, December 18, 2007

Caregiver Christmas - Childhood Memories and Nostalgia - "The Night Before Christmas"

I just got off the phone after talking to a caregiver who can't get into the mood for Christmas. Sometimes it doesn't seem like Christmas or it's hard to get into the spirit. A little bit of whimsical, light hearted Christmassy thinking can help, especially when stress and exhaustion are burdensome. I read "The Night Before Christmas" to one of the seniors I assist, and she said it helped her get back into the nostalgia and spirit. If you need a little lift to get into the Christmas mood, perhaps remembering Christmas when you were a child and heard this poem will help. The Night Before Christmas is below. Enjoy and read it to someone you care for.



THE NIGHT BEFORE CHRISTMAS

by Clement Clarke Moore

'Twas the night before Christmas, when all through the house

Not a creature was stirring, not even a mouse;

The stockings were hung by the chimney with care,

In hopes that St. Nicholas soon would be there;

The children were nestled all snug in their beds,

While visions of sugar-plums danced in their heads;

And mamma in her 'kerchief, and I in my cap,

Had just settled down for a long winter's nap,

When out on the lawn there arose such a clatter,

I sprang from the bed to see what was the matter.

Away to the window I flew like a flash,

Tore open the shutters and threw up the sash.

The moon on the breast of the new-fallen snow

Gave the lustre of mid-day to objects below,

When, what to my wondering eyes should appear,

But a miniature sleigh, and eight tiny reindeer,

With a little old driver, so lively and quick,

I knew in a moment it must be St. Nick.

More rapid than eagles his coursers they came,

And he whistled, and shouted, and called them by name;

"Now, Dasher! now, Dancer! now, Prancer and Vixen!

On, Comet! on Cupid! on, Donder and Blitzen!

To the top of the porch! to the top of the wall!

Now dash away! dash away! dash away all!"

As dry leaves that before the wild hurricane fly,

When they meet with an obstacle, mount to the sky,

So up to the house-top the coursers they flew,

With the sleigh full of toys, and St. Nicholas too.

And then, in a twinkling, I heard on the roof

The prancing and pawing of each little hoof.

As I drew in my hand, and was turning around,

Down the chimney St. Nicholas came with a bound.

He was dressed all in fur, from his head to his foot,

And his clothes were all tarnished with ashes and soot;

A bundle of toys he had flung on his back,

And he looked like a peddler just opening his pack.

His eyes -- how they twinkled! his dimples how merry!

His cheeks were like roses, his nose like a cherry!

His droll little mouth was drawn up like a bow,

And the beard of his chin was as white as the snow;

The stump of a pipe he held tight in his teeth,

And the smoke it encircled his head like a wreath;

He had a broad face and a little round belly,

That shook, when he laughed like a bowlful of jelly.

He was chubby and plump, a right jolly old elf,

And I laughed when I saw him, in spite of myself;

A wink of his eye and a twist of his head,

Soon gave me to know I had nothing to dread;

He spoke not a word, but went straight to his work,

And filled all the stockings; then turned with a jerk,

And laying his finger aside of his nose,

And giving a nod, up the chimney he rose;

He sprang to his sleigh, to his team gave a whistle,

And away they all flew like the down of a thistle.

But I heard him exclaim, ere he drove out of sight,

"Happy Christmas to all, and to all a good-night."

Monday, December 17, 2007

A Caregiver's Christmas Experiences - Times of Friendship

Being a 24 hour, stand-by-assist caregiver at Christmas time often means trying to bring a little of the spirit of Christmas peace to someone who is battling illnesses and disabilities. The memories of Christmas's that took place in healthier, happier times contrasted with the current situation can lead to people feeling more melancholy. But, as a caregiver I'll always remember the special Christmas's I've spent with people when we created a sense of peace and friendship to cheer up the day.

One such Christmas happened when I arrived to assist an elderly lady who was disabled after a series of strokes. She received much pleasure and comfort from one of the most enormous cats I've ever seen, who was also a fluffy ball of love. I knew the financial situation was not good, and obtaining food was a challenge for this lady.

When she saw me come in on Christmas with several extra bags she tried to give me a disapproving look, "What do you think you have there?" she said. Her style was to appear gruff but there was a heart of gold under the crusty outside.

"I have a surprise!" I said, knowing she probably had not had any nice surprises for a long time.

Many elderly people on fixed incomes that I have assisted have lived on economical frozen dinners, of the least expensive sort, and I knew from past experience that she did too.

I gave her a hug and said, "Merry Christmas." Then I took my surprise into the kitchen. As we watched ice skating and Christmas movies we had a good time joking back and forth about what the surprise was going to be. I sat in a chair with her cat on my lap, and she said he was always especially glad to see me.

I spent quite awhile working in the kitchen, and the house began to smell wonderful after I put the "surprises" into the over.

When it was time to eat I went in and prepared a regular Christmas dinner with all the goodies. Turkey, cranberries,dressing, mashed potatoes, carrots and dessert. We sat with our TV tables and oohed and aahed while we watched the figure skating. The fluffy cat got a nice dinner of turkey too.

The togetherness we shared made it a happy Christmas, despite the situation. The time we spent together was precious. Although this was not like a television ideal of the Christmas festivities, we shared a beautiful day.

Sunday, December 16, 2007

From the "Someone Cares" Caregiver Ministry - Inspirational Video with Scott Krippayne

The Someone Cares Online caregiver ministry features support, conferences, training, lectures, and music. The video below "Someone Cares" has music from Scott Krippayne. For those times when an inspirational uplift would be welcome the pictures and messages are beautiful.

Saturday, December 15, 2007

Caregiver's Beacon Features Video Medley of Favorite Christmas Carols

When so many of us have different Christmas's from the idealistic ones pictured on television the season can be a challenge. For those who are battling illness or accidents, and for exhausted, stressed caregivers, finding joy amidst sorrow, or peace amidst the hustle and bustle is not easy.

For your relaxation the Caregiver's Beacon is temporarily featuring a video feed of beautiful hymns and carols from the world famous Mormon Tabernacle Choir, and a Christmas carols medley video.

Click on a video on the left side of the web page in order to start it. Enjoy.

AARP Article - Mini-strokes May Occur Before a Big Stroke

An article at the AARP about strokes by Linda Greider is titled "Avoiding the Big One." It is subtitled "Someone dies every 3.5 minutes from a stroke. 80% of 'brain attacks' are preventable. A mini-stroke could be the prelude to a full-blown stroke." The article tells the story of a woman who dozed off, and realized when she awakened that her legs weren't working right. Ten minutes later the symtpoms were gone and she did nothing about it, like most people. But, later medical tests showed she had suffered a "TIA," a transient ischemic attack, also known as a "mini-stroke," which can be a warning that a major stroke may occur next.

Symptoms, according to another article at the AARP, can include "dizziness, confusion, difficulty speaking, numberness or weakness on one side, and a severe headache."

Strokes are the number one cause of adult disability and the third most common cause of death in the United States.

Medical intervention can prevent a major stroke, so it's important to treat a TIA, or mini-stroke, as an emergency. In a mini-stroke someone may have weakness on one side and difficulty speaking. This may last for ten minutes, an hour, or longer.

It's common that when the symptoms go away people decide to take no action, but it's important to get treatment in order to prevent a more serious stroke, possibly within the next week or month.

Caregivers are often the people who first notice that something is not right. You can ask, "Are you OK? What are you feeling? Are you dizzy? Can you see me?" and other questions to find out what is happening and call 911 for emergency medical help.

If you notice someone who can normally walk alone or with a walker is suddenly having more difficulty than usual this can mean a medical professional needs to check the person immediately to find out the cause.

Promp treatment can make the difference between levels of severity, so its important to get immediate medical help. Don't hesitate to call 911 for an ambulance.

Thursday, December 13, 2007

Alzheimer's Patient, 83, Rides Bike 20 Miles, Saved by Tracking Bracelet

An article in the San Luis Obispo Tribune is titled "Alzheimer's Patient, 83, Rides Bike From Pismo to Santa Maria Before Being Found, Bracelet May Have Saved His Life." The Alzheimer's patient wore a Project Lifesaver Bracelet. Rob Bryn, Sheriff's Department, said, "He was 20 miles away, 83 years old on a bike. This is totally outside of the dementia profile for a search. We would have never found him."

The article was written by AnnMarie Cornejo and appeared on Monday, Dec. 10, 2007. Once again the importance of tracking bracelets for Alzheimer's sufferers is highlighted with this rescue.

It was the first time Mr. Joseph Taylor had gone that far from home. Usually when a person with dementia is missing the search is in the nearby area. The Project Lifesaver Bracelet can be tracked by land or air.

I was a caregiver for an Alzheimer's patient once who had also gone missing. While her husband was taking nap she left the house, walked downtown, and was picked up by tourists who spent the afternoon driving around town trying to find out who she was and where she lived. When they stopped at a local restaurant she was recognized by some old friends, and she was returned to her home.

In San Luis Obispo County there are two other Alzheimer's patients who have not been found, Janet DeFelice, 88, missing since June, 2007, and Vernon Erno, 82, missing since 2003.

The unpredictable aspect of Alzheimer's means that someone who has not previously wandered far from home could change and, as described, leave the area unexpectedly.

When I was in nursing school one of the teachers told the story of her mother, who had dementia. The mother lived in a locked facililty, but evidently slipped out when the doors were opened for some visitors. A search and rescue team covered the area. A call came in from a family who had returned to their unlocked home and found a strange woman taking a nap on the couch. Guessing she might be from the nearby nursing home they called there.

In my home area, San Luis Obispo County, California, The Poject Lifesaver Bracelets are worn by about 35 people but there are 5,000 people with dementia in the county.

Wednesday, December 12, 2007

The Lighter Side of Alzheimer's Caregiving - A Grocery Shopping Trip

Taking people who are not ambulatory, and who are on oxygen, out in the car to the grocery store, is something I've done frequently as a caregiver. One day, my spirited 97 year old lady with Alzheimer's was ready for a trip to grocery store. I pushed her wheelchair down the ramp from the house. So that she wouldn't feel she was falling forward when we downhill, I always went first. By pulling her backwards in the wheelchair, I was a brake system. When we got to the car I assisted her with the transfer, positioned her with pillows behind her, and at the side by the door, and lifted the oxygen tank in beside her.

I folded up her wheelchair, rocked it back on the wheels, got some momentum, and swung it up into the trunk.

When we got to the grocery store we did a similar routine in reverse. Once inside the store I pulled the wheelchair with my left hand, and pushed the grocery cart with my right hand. Her purse was in her lap, so she could take care of paying for the groceries. She liked to exercise her feet and legs by "walking" with them while she sat in the wheelchair, so the footrests were off.

When we got to the produce section, I left her for a moment to find some items from her grocery list. When I turned around, she had disappeared. A quick scan of the produce section did not reveal her. How could a person in a wheelchair with an oxygen tank on the back disappear so fast?

I zipped around the first aisle corner and saw a group of people gathered near the cake mixes. Several people were reaching to the highest shelves for mixes, and others were discussing recipes. In the middle was my 97 year old lady, holding court, and giving advice on how to customize the mixes with her vintage recipes.

When I walked up someone said, "Oh, I thought she was here by herself so I was helping."

Whew. I was glad she was O.K. It was a frightening experience for a moment, and I learned from it to keep her in sight at all times. She explained she had just "walked" with her feet and rolled the wheels with her hands because she was in a hurry to get to the cake mixes. Later we laughed when I explained it had caused me some worried moments.

Tuesday, December 11, 2007

Feelings of Isolation During the Holidays Common in the Caregiving World

Caregivers and those whom they assist often cope with feelings of isolation, and during the holidays this may be accentuated. The family-oriented activities, shopping and spending, and rounds of festivities are enjoyed by those who are fortunate to have family, finances, and health. But there is another side to the holidays, for those who are struggling with caring, health, money problems, stress and exhaustion.

Being left out of the ideals of holiday cheer adds to the sensation of isolation for those who cannot participate. After Thanksgiving I visited with a caregiver in her 60's, with health problems of her own, who takes care of her mother who has Alzheimer's.

For a Thanksgiving treat they went out for a special meal at a local Denny's restaurant, part of a casual restaurant chain we have in California, since it was just the two of them. She said the waitess assumed they must be traveling or on their way to festivities. The waitress took their order and said, "And what do you have planned for Thanksgiving?" My friend said she smiled and replied, "This is it."

Those who have suffered an illness recently or a bereavement can find coping with the expected holiday cheer to be a challenge. A goal of a feeling of inner peace might be more realistic in these situations.

Are the holidays a giant spending spree? Or a giant eating binge?

For me and many others, focusing on a time of peace and serenity, and closeness to spirituality is the real meaning of Christmas.

Monday, December 10, 2007

Ten Points for Caregivers to Know About Vascular Dementia

"Vascular dementia is preventable; therefore early detection and an accurate diagnosis are important," according to an article at emedicine.com . The article is titled "Vascular Dementia" and was written by Kannayiram Aliagiakkrishnan, MD, MBBS, Associate Professor, Department of Medicine, Division of Geriatric Medicine, at the University of Alberta. It explains that vascular dementia is the second most common cause of dementia, after Alzheimer's Disease. Vascular Dementia, the article explains, is "not a single disease; it is a group of syndromes."

Some of the points in the article that caregivers might like to know include the following.

(1) A stroke causes increased risk of vascular dementia.

(2) There is a wide spectrum in types of vascular dementia.

(3) Alzheimer's Dementia and cerebrovascular disease together can occur and this is "mixed dementia."

(4) The article said "one-third of patients with vascular dementia are found to have significant Alzheimer's pathology."

(5) Dementia is "nine times higher in patients who have had a stroke."

(6) People with vascular dementia frequently have changes in behavior and mood, and assessment for depression is important.

(7) Memory deficits, social and occupational functioning, and verbal difficulties are some of the characteristics of people with vascular dementia.

(8) Risk factors include smoking, high blood pressure, heart disease, diabetes, and cerebrovascular disease.

(9) A study in Rotterdam showed an increased risk of vascular dementia with a higher fat intake diet, and a lessened risk with an increase in fish in the diet.

(10) Other symptoms can be "agitation, wandering, aggression and sleep disorders."

Sunday, December 9, 2007

Hope4Stroke.com - Caregivers Can Know the Stroke Symptoms and Call 911

At Hope4Stroke.com three symptoms of stroke are listed as: (1) having a crooked smile when asked to smile, (2) when asked to hold arms out like sleep walking one arm is lower and (3) the person's speech might be garbled or words incorrect. If caregivers see any of these symptoms the directions are to call 911 immediately and get to a hospital.

Rapid medical response can make a big difference, so it is important to act quickly. Minutes might make the difference in the severity of the stroke.

A stroke causes communication in parts of the brain to decrease or stop. Speech, memory, sight, feelings, swallowing and other functions may be affected.

I was a caregiver for a 97 year old lady once who suddenly began having difficulty speaking. Throughout the day she had been fine. Her speech was suddenly garbled and she was not using words that made sense.

I called 911, and she was taken by ambulance to the emergency room. The hospital was able to treat her quickly, to minimize the effects of the stroke. Later she was able to return home, begin her daily walking exercise again, and go back to her reading, television, and other activities.

The cause of a stroke is either when a blood vessel has burst or there is a blocked blood pathway.

The website explains that 60% of the people who have a stroke become depressed. The article advises people to work hard for rehabilitation, and to avoid comparing yourself to others who have had a stroke because everyone's recovery will be different.

The website explains that in the United States there are 4.8 million survivors of strokes and it is the top reason for disability. Each year there are 750,000 more stroke cases, and strokes are the number three reason for death.

Caregivers for stroke survivors are often overwhelmed with the needs of the loved one who had a stroke. A caregiver's personal freedom and spare time can be taken up with caring and feeling tired, sad, and overburdened is not unusual. Joining support groups, such as the one at caregiver.com can help and be a way to learn tips.

It's important for caregivers and family members to understand the frustration and depression that someone who has had a stroke often experiences. The person might say things in a frustrated way that are unkind, but it is due to the tension of the circumstances. It helps if the family knows this so no one takes things personally.

Caregivers often feel there are few places to get help, and become severely run down.

Saturday, December 8, 2007

My Alzheimer's Caregiving Experiences - Some Moments on The Lighter Side

After driving down a long gravel road through the mountains, I arrived at a ranch nestled in the coastal foothills one day, to assist a 94 year old gentleman who had Alzheimer's. His wife explained they had started their dairy farm in the 1920's. This was before their farm had indoor plumbing, central heat, electricity, and refrigeration. The huge red dairy barn sat next to a beautiful creek. Originally they had milked all the cows by hand and delivered the milk in cans by driving a team of horses and a wagon down a dirt road to a pick-up station.

The first evening I was a caregiver there I began to clean up the kitchen after dinner.

I took some of the scraps out to throw in the grass next to the creek for "the animals", as directed. It was getting dark. Suddenly I heard a wierd sound from nearby that cannot be described. My heart began pounding.

A large animal was moving quickly toward the scraps as darkness fell. As I hurried back to the house I heard more similar noises. By the light from the house I saw another movement.

It was a huge bird, dragging a long, enormous tail. It had to be a peacock.

When I got back into the house I told the couple what had happened. They laughed and explained they had not just one, not just two, but five peacocks. The next day I saw one sitting about ten feet up in the fork of the tree by the front door. I hadn't known they could fly.

I was staying for several weeks on a row of 24 hour caregiver shifts. I got used to seeing the male peacocks come up to the windows suddenly and flare their six or ten foot wide gorgeous tails out.

My client with Alzheimer's loved to watch the peacocks. He was unable to be ambulatory, and used a wheelchair. He had lost most of his verbal ability. But he still enjoyed the beautiful peacocks showing off their feathers outside the windows.

We joked that the peacocks knew I was the one who threw out the scraps, so they were peering in the windows to beg for treats. It seemed as if they knew which room I was in, and gathered at the window.

We kept ourselves amused every day by watching to see what the peacocks were going to do next. It provided a lighter side to the day, and I still laugh when I think of it.

Friday, December 7, 2007

Wii Bowling Allows 87 Year Old Lady to Swing a Remote Control Instead of a Bowling Ball in This Video

Wii Bowling is demonstrated in the above video by an 87 year old lady who was videotaped by her grandson. Swinging a remote control at a screen showing the bowling lane and pins is easier than swinging a heavy bowling ball, plus you can do it without actually going to the lanes. Seniors' Centers are getting into Wii Bowling Tournaments with each other. Wii Sports have opened up a world of new activities for many seniors.

You can see more videos and read about the sports that can use "Wii" at their website. People who are sitting down, on a couch or chair, can also swing the remote control for Wii Bowling. This opens up an activity for people who use a wheelchair.

Thursday, December 6, 2007

New Features at The Caregiver's Beacon - Alzheimer's and Dementia Video Feeds, Eldercare News RSS Feeds, and Slideshows

There is a set of new, customized features at The Caregiver's Beacon blog. (1) Custom video feeds from You Tube continually update videos on Alzheimer's, Dementia, and the related brain issues. (2) A custom RSS feed from Medical News Today lists the last several weeks worth of articles on Alzheimer's, Dementia, Home Care, and Caregivers. (3) A custom newsreel feed lists the titles and beginnings of news articles on nursing homes, eldercare, and caregivers.

Additionally, for the relaxation of caregivers, seniors and other readers, there are several more features. A slide show provides continually changing photos of ocean sunsets.

For hobbies and relaxation there is also a link to read about this day in history, and to do crossword puzzles other puzzles.

As before, there is a long list of caregiver blogs, a list of healthcare blogs, and a list of helpful resources for caregivers, seniors and people with disabilities.

Tasty, Tempting Recipes for Caregivers to Make for Seniors on Soft Food Diets

Vegetable stews with pasta, home-made chicken noodle soup, and pureed vegetable soups are some of the aromatic and tempting foods that caregivers can make for seniors who are on a soft food diet. The smell of the stew or soup cooking, and the aroma when it's served, helps to encourage seniors with poor appetites to eat. When seniors are on a low-salt, low-sugar diet, the cooked fresh vegetables, perhaps seasoned with some herbs, make the food flavorful instead of too bland to seem appealing.

At Health Touch caregivers can read a check-list of foods allowed for seniors whose doctors have advised a soft diet due to swallowing or chewing difficulties. A diet of moist, soft food, eaten in very small bites, chewed slowly and eaten slowly, can be important for people with swallow difficulties, to prevent choking. The foods may need to be pureed, but if it only needs to be soft and moist below are some ideas for recipes.

For a soup base you can use water, salt-free bouillon or broth. Cut the vegetables up into very, very small pieces, and remove the seeds or skins. Add the vegetables first that will take the longest to cook. You can add herbs that the person cooking for you will be able to digest easily. Some herbs can be added right away, and others added toward the end of cooking the stew.

I have had good results with adding combinations of some of the following herbs, but not all of them at once; rosemary,thyme, sage, oregano, basil and parsley. The rosemary and thyme has been the most popular, and the smell of the herbs filling the house while they simmer is wonderful. It's a uplift by itself.

To choose the vegetables I ask the person whom I am assisting. If someone's memory is not good I can ask about certain vegetables individually. People often like to be included in the meal preparation, and to feel a part of the activity. They may enjoy sitting in the kitchen while I cut up vegetables and we can visit for awhile.

Adding small pieces of meat or fish is optional and up to the cook. Adding chicken or turkey, diced very small, works well.

Toward the end of the cooking you can add pasta, or cook it seperately and combine it before serving. Again, be sure it is diced into very small, fine pieces.

Health Touch recommends avoiding "broccoli, cauliflower, cabbage and brussels sprouts." Also the list said to avoid "cooked beans and peas."

If you make a large amount in a stew pot or crock pot you can freeze small servings in plastic containers and microwave it later. Some of it will have evaporated when you reheat it, but you can add water or broth so it has enough fluid.

Creamy soups, with pureed vegetables, can be made in a similar fashion. You will simply need to use a blender. Vegetables and cheese make a tasty creamy soup.

Making the stews and soups gives the house, condo, or apartment a warm, comforting feeling, and a friendly atmosphere. I like to ask people if they can remember what their favorite foods were when they were a child, and try to recreate those recipes.

Wednesday, December 5, 2007

Christmas Caregiver Memories and "Heart Pictures"

One of my favorite Christmas caregiver memories is the "heart picture" I have of the time I prepared Christmas dinner with a 96 year old lady, who was in a wheelchair and on oxygen, for about 20 of her relatives and friends. Because she was born in 1908 she was an expert on old fashioned cooking from scratch, no mixes or frozen food. I treasured having the opportunity to share these times with her and learn her secret vintage cooking and baking recipes.

About a week before Christmas we bought several turkeys and stored them in her extra fridge. A few days before Christmas we began baking and cooking. We baked cornbread from scratch, no mixes, and made cornbread stuffing the way her mama did. For pies we made our own crusts and pie filling from fresh fruit. She didn't look in a cook book. She knew the ingredients by heart and it was "a pinch of this, a pinch of that," and then checking for texture and taste. We used fresh cranberries and fresh produce for everything.

Her special baked yam casserole with marshmellows had secret ingredients and spices that made it incredible. As we continued preparing food both of her refrigerators and freezers filled up.

I did the heavy lifting of the turkeys, of course, but we sat together at the kitchen table talking recipes and her life history while we mixed, cut up vegetables, and stirred. The house smelled so homey with the pie spices and other seasonings in the air.

On Christmas Day we loaded everything into the trunk and backseat of her car and drove about 60 miles to her relatives' house. It's warm in California on Christmas, so they had chairs and tables outdoors.

We set up all the foods on long tables and added the salads and other goodies that others brought. We wound up with enough food for 40 or 50 people and everyone was able to take leftovers home.

It was a Christmas Dinner prepared by someone with cooking skills going back to the early 19th century. You can't get that in a restaurant, or out of a mix.

But best of all, she and I had shared an experience that made a beautiful memory, a "heart picture" during the holidays.

Tuesday, December 4, 2007

Caregivers and Seniors Be Alert During Holidays - It's the "Heart Attack Season"

Associated Press writer Lauran Neergaard warns in "Holidays Bring the Heart Attack Season" that December and January are months when the highest number of heart attacks occur. In her article she says people need to beware of overeating rich holiday foods, consuming too much alcohol, being in denial, and shrugging off chest pains as indigestion during festivities. Sometimes people do not wish to interrupt a holiday festivity but it's important to get help quickly if a heart attack is occuring.

The article explains that a 2004 study showed peaks of death from heart attacks occur around Christmas and New Years. Some hospitals say the numbers of heart attacks start rising around Thanksgiving.

Caregivers who are assisting people who are at risk are often the first ones to notice that something is wrong. If any heart attack symptoms occur don't hesitate to call 911 for an ambulance. Elderly people who have Alzheimer's or Dementia may not verbalize or explain how they are feeling but caregivers can observe them for symptoms.

The article has advice for ways people can be safer from a holiday heart attack. Avoid heavy, high fat meals. Travelers need to be sure they have their medication prescriptions filled so they won't run short. Avoid too much salt, which causes fluid retention and makes the heart pump harder. Exercise often falls by the wayside during the colder weather and holidays, but it's important to keep it up. Alcohol consumption needs to be kept to a moderate level.

Seeking treatment quickly is vital if the symptoms of a heart attack occur. During the parties and dinners people need to be sure they are not in denial. If in doubt as to whether it is indigestion or a heart attack get to an emergency room quickly or call 911.

Monday, December 3, 2007

"Safe Lifting Environment" Campaign Addresses Caregiver Lifting Injuries

At Safe Lifting Portal caregivers can join the "Safe Lifting Environment Campaign and Support Injury Prevention, which is an industry wide effort to reduce caregiver injuries. Caregivers in the health industry have one of the highest rates of back injuries due to the lifting involved. An analysis done by The National Institute for Safety and Health recommends a 35 pound limit for patient handling tasks. Whether you are lifting people from the bed to a wheelchair, doing a partial lift for a transfer, or repositioning someone who is in bed there are techniques and lifting devices to prevent back injuries.


Tom Waters, Phd. in the August 2007 American Journal of Nursing refers to an analysis that recommends a 35 pound limit for patient handling. The analysis was done by the National Institute for Safety and Health.

At the website for Nursing Center you can read the article by Tom Water, PHd, about the 1994 National Institute for Occupational Safety and Health Revised NIOSH Lifting Equation and the recommended 35 pound maximum weight limit for patient handling.



When I worked for caregiver agencies it was not uncommon to be asked by a patient/client to do a total lift of a patient weighting around 100 pounds from the bed to the wheelchair. Because I had previous training as a Certified Nursing Assistant, Home Health Aide, and in Acute Care, I knew the dangers. I would decline to do a lift like this, and requested a lift device, which can be delivered to the home. Get more help and/or use a lift device when this happens in order to be safe. A patient or client could also be dropped or both people could fall during a heavy lift.

Often the patients do not wish to be lifted by a lift device, perhaps because it is a new and strange idea. Or the caregivers may not use one because they are not familiar with the lift device or trained in how to use it. In facilities the caregivers, aides, and nurses are working under a time pressure, and the lifts may be in use by someone else.

When the lift device is introduced in a user friendly manner, and the caregivers are trained well, it can become another part of the usual routine.

There is a list of states at the website which have passed or introduced legislation to reduce injuries from "hazardous manual lifting."

OSHA, the U.S. Occupational Health and Safety Administration has released ergonomic guidelines for nursing homes with guidance to reduce lift injureis.

Family caregivers provide the majority of home care, and too frequently they do not realize the risks they are taking when they lift people from the bed to the wheelchair, or do transfers when people are too weak to assist. Repositioning people in bed, which requires leaning over and lifting is also a risk. But, there are lift devices that can do the work and save people from back injuries.

Frequently caregivers and their patients do not use safe lifting techniques due to lack of training and lack of familiarity with lift devices. For more information you can visit the The Safe Lifting Portal , which also has a section called "Ask the Lift Doctor" where you can submit your questions.

Sunday, December 2, 2007

Low Income Seniors and Disabled People Can Turn to National Food Bank for Groceries

Seniors on low fixed incomes and disabled people who are struggling with high prescription costs and healthcare costs can turn to The National Food Bank for groceries. The national network of community locations providing groceries is called America's Second Harvest. Local warehouses have grocery supplies through the National Food Bank which are distributed at community locations.

To find a distribution center near you enter your zip code into the search box at the website for The National Food Bank, or search for your town plus "food bank."

The website explains that 5.9% of seniors,or 1.5 million households, struggle with "food insecurity." This term means when "access to food is limited by lack of money and other resources." Nearly 3 million seniors are served by the Food Bank each year.

As a caregiver I have seen many situations where a senior's refrigerator and cupboards were almost empty. In these cases I contacted the person's family members and local community resources to get a plan started, so these frail or disabled people would have groceries.

Meals that are delivered from Seniors Nutrition Programs are a big help also. Seniors Nutrition Programs in my area welcome a donation of $2.75 per meal but the donation is not required.

Saturday, December 1, 2007

Nutrition Programs Available in Most Areas Deliver Meals to Homebound Seniors

Caregivers and seniors in most areas who are homebound or frail can arrange to have local Seniors' Nutrition Programs deliver balanced meals Monday through Friday, including extra meals that are frozen to keep for the weekend. A small donation is accepted but not necessary. For information in your area you can contact your local Area Agency on Aging or ask at a local seniors center for information.

I spoke with Senior Nutrition Program specialist Deb Clark, (pictured in the photo) about it last week. She uses the kitchen at the Central Coast Seniors Center as a base of operations for the Oceano area. Deb provides about 30 meals a day at the Central Coast Seniors Center and another 50 or so are delivered to homebound seniors and their caregivers. Often the meals go out to a family member who is a caregiver, as well as a homebound or disabled person.

This also serves a purpose for those who live alone of having someone stop by daily to see if a frail senior is alright or needs help. Many seniors also wear a Life Alert Emergency Medical Response call button on a cord like a necklace or as a wrist bracelet so that help is just a push button away.

The meals arrive in styrofoam containers and the portions are large enough that many seniors have leftovers for an afternoon snack or with dinner. When an elderly spouse is a caregiver it can be a great help to have meals delivered for both people. On Friday some elderly couples have extra meals for the weekend delivered that they can freeze and microwave later.

For seniors who are not housebound the meals are also served in various locations and your local Area Agency on Aging can help you find a serving location near you.

For example, at the Central Coast Seniors Center about 30 seniors arrive around 11:30 each day and enjoy a hot, well-balanced meal while having a chance to interact socially. Isolation and loneliness can be a problem for seniors, and a chance to have lunch with a group of friends is a big help. The group can become a supportive group, and Deb Clark, who manages the one at the Central Coast Seniors said she feels they are part of "her family." Birthdays and special occasions are shared, and friendships develop.

Seniors who are homebound or frail are at risk for neglecting their nutrition and if they have a balanced meal delivered or go to a location to share a meal with others it's one way family members know they are getting a healthy meal.


Friday, November 30, 2007

Caregivers' Self-Care During Holidays - Know You Are Special

It is tempting to overlook our own needs in order to take care of others during the holidays. However, if we are not functioning well or our own health gives out we won't be able to continue caregiving. The giving spirit of the holidays seems to spur the impulse sometimes to meet ideals of generosity and caring. As caregivers, we are already putting our heart and soul into helping others and giving our best efforts.

When I worked in medical offices we knew that the holidays are one of the busiest times. The stress and exhaustion that occurs when people try to heroically sacrifice themselves for others is common during the Thanksgiving to New Years weeks.

Guilt is common among caregivers, and so is wishing we could do just a little more. If you feel like this perhaps it will help to know you have plenty of company.

By the end of the holidays caregivers can be collapsing from exhaustion.

We all wish we could do more. But, just being a caregiver means you are a warm, caring person, and a very special person. There is no need to try to prove yourself further.

What can each of us, as caregivers, do to take good care of ourselves? The self-care tips are frequently listed and probably familiar to most of us. Nutrition, vitamins, exercise, social time, activities and hobbies, relaxation and stress reduction are some of the steps. Easy to say, but not always easy to do when time and money cause constraints.

Finding respite care is one of the top priorities and challenges. This can include programs from the Alzheimer's Association, the Area Agency on Aging, Adult Day Care, Shared Care, and paid Agency Caregivers or Independent Caregivers who meet the necessary criteria.

Thursday, November 29, 2007

Fisher Center for Alzheimer's Research - Says "Interact With The Afflicted Person Within His or Her Own Frame of Reference"

The Fisher Center for Alzheimer's Research Foundation, directed by Nobel Laureate Dr. Paul Greengard at The Rockefeller University, says "interact with the afflicted person within his or her own frame of reference for the world, even if it has little to do with reality." Different stages of Alzheimer's or Dementia require different approaches to interaction and communication.

When I was working at a skilled nursing facility that specialized in Alzheimers and Dementia there were three main sections in the building for the residents. Each wing was for residents at a different stage. The style of communicating was according to the stage of their illness.

(1) Early Stage. One wing had residents in the early stages of Alzheimer's or Dementia, who might be forgetful or confused sometimes, but still recognized people and places much of the time. Part of the time they might seem as if there was nothing wrong with the way the brain was functioning, and then part of the time some confusion or forgetfulness would occur.

People in the earliest stages might still be gently cued or prompted to bring them back to our usual reality when they became confused. If this did not seem to work, or it caused agitation, then we would just go with their reality.

(2) Mid-Stage. A second wing had people in the mid-stage of Alzheimer's or Dementia. In a way, this was the most challenging wing for the staff. One moment someone might be completely lucid, and perhaps later in the day, when fatigue or sundowners began, the person might be in another world.

For example, there was one resident who would be fine in the morning, but in the late afternoon she would ask for some dressy clothing, her fancy hat and a dress purse. She would want to get ready to put on her fanciest outfit to get on a plane later for "the trip."

We might say something like "OK, but let's just eat dinner first, before you go, then we'll get ready." Moment by moment the reality changes and after dinner everything would be different again.

The residents in the mid-stage wing were sometimes agitated or combative, and we learned to relate to them in their own reality, not to argue or contradict.

(3) Advanced Stage. The third wing had residents who were in advanced Alzheimer's or Dementia. They usually had severe difficulty with the ability to speak, to perform simple tasks of the activities of daily living, and to walk.

However, some could walk very well, but had severe sundowners and agitation. When they were in a sundowners episode they might walk and walk. Up and down, and all around the halls of the facility they would go, which was locked to protect them from wandering outside and getting lost.

We learned to determine what the person's reality was, and to speak and interact with each unique person by referring to his or her reality.

Wednesday, November 28, 2007

Alzheimer's Association Brain Tour - Pictures of the Brain Make It Easy for the Average Person to Understand

Understanding the effects of Alzheimer's Disease changes in the brain is made easy for everyday people who don't have medical backgrounds by the Brain Tour at the Alzheimer's Association. A series of illustrations that a layperson can understand show the difference between looking at a healthy brain and a brain with Alzheimer's. Illustration #8 shows a brain without nerve cell loss or tissue loss next to the brain with changes from Alzheimer's. A picture of healthy brain cells under a microscope is shown in illustration #10, compared with a picture of damaged, Alzheimer's brain cells.

The abnormal clusters that build up between the cells are easy to see in the Alzheimer's brain. The tangled strands in the photo of the Alzheimer's brain are also easy for a layperson to see, especially compared with the healthy brain in the microscopic picture.

Pictures of early, mild to moderate, and advanced Alzheimer's are illustrated showing the progression through different parts of the brain. The first section of photos shows brain basics, and after understanding the parts of the brain it's easy to understand which parts are affected as Alzheimer's progresses.

In the early stages "learning, memory, thinking and planning" are affected.

The Brain Tour explains that in the mild to moderate stages "speaking and understanding speech, and your sense of where your body is in relationship to objects around you," is affected.

In the mild to moderate stage alzheimer's may cause people to fail to recognize others and to have different behaviors and a changed personality.

The illustration of severe Alzheimer's shows the shrunken brain with much cell damage. At this stage the people with Alzheimer's cannot recognize others, communicate or care for themselves.

You can sign up for a free email newsletter from the Alzheimer's Association at the end of the Brain Tour.


Tuesday, November 27, 2007

Ninety-Six and Ninety-One Year Old Seniors Use Artwork to Stay Mentally Sharp and Active

Senior artists Florence Erb, age 96, and Margaret Haak, age 91, (both pictured below with their paintings), use painting with watercolors and oils to stay mentally sharp. They are both active with a social group of other senior artists, many in their 80's and 90's. Margaret Haak is proof that it is never to late to exercise the mind by learning something new. She began art and painting at the age of 69. Both senior artists said they enjoy the outlet for creative expression, the other senior friends they make at the art groups, and sharing social time with other senior artists.

Florence and Margaret are part of the art group at the Central Coast Seniors Center, San Luis Obispo, California. But, for others outside this area senior centers, clubs, and seniors classes are available everywhere.
Pictured on the left is Florence Erb, 96 with her watercolor painting of a lighthouse.
Below is a photo of Margaret Haak, 91, with her painting of an Arizona landscape.








Monday, November 26, 2007

Reverse Mortgages Explained by Specialist, Sigrid Hurn

Sigrid Hurn, of The Califonia Reverse Mortgage Company, a member of The Generation Morgage Company, recently explained the uses of reverse mortgages and answered questions at a forum. Seniors from the Central Coast Senior Center, San Luis Obispo County, California, learned from Sigrid (1) what types of reverse mortgages are available, (2) what limits there are on the amounts, (3) how to apply and what it costs, and (4) how to choose different plans for reverse mortgage income.

Seniors may use the income to pay for sudden health expenses, prescriptions, in-home caregivers, nursing home care, or for a variety of other choices. If seniors are having financial stress from mortgage payments a reverse mortgage can eliminate the monthly payments.


A reverse mortgage is a Federal Government insured loan program which provides income for senior home owners. Sigrid explained that it is not paid back until a person moves permanently out of the home.


To qualify for a reverse mortgage a senior needs to own the home, be at least 62 years old, and to be living in the home.


Sometimes a sudden illness causes a financial situation that makes getting a reverse mortgage helpful or necessary. If a large mortgage payment is causing financial problems for seniors living on fixed incomes the reverse mortgage can get rid of the mortgage payment, freeing up that money for health expenses.


Other people get reverse mortgages in order to access the cash from home equity while they are alive in order to travel, pay for grandchildren's college, or make other dreams they have come true.

For more details you can visit Sigrid Hurn's website at http://reversemortgagelady.com/.

Sunday, November 25, 2007

Seniors' Life Story Telling - A Chance to Communicate, Share, Understand

Seniors' life story telling gives later generations insight into what it was like ,on a day to day basis, to live through different eras and cultural changes. Understanding the different conditions of daily life that existed during a senior's childhood, 60 or 70 years ago, helps explain things that might be puzzling to someone today. For example, if you wonder why grandmother never throws anything away, it could be a habit from growing up during the Great Depression.

I know someone like this and here is his story. He is in his mid-70's now, and describes living in a tent in the California Central Valley as a child during the 1930's Great Depression. The family had come to California from the Oklahoma dustbowl. His mother had died of pneumonia and his father worked in the fields.

He remembers his father would drag a long bag for the cotton, that looped over his shoulder while he was picking. As a child he played by riding on the cotton bag as his father dragged it along the ground.

For a Christmas tree there was often a dried cotton stalk with cotton balls for decorations. Toys were blocks of wood and imagination was used to turn them into cars or tractors.

When he was about 6 years old he began working in the fields picking cotton too. School attendance was only possible between field work, and after the eighth grade he stopped attending school and helped the family survive by working in the fields full time.

This senior today has several storage buildings full of personal items that he collected throughout his lifetime. He keeps everything, and explained it's a habit from living during the Depression. Survival was hard, everything was reused, and objects were too difficult to obtain to be able to easily discard them.

I used questions and prompts to encourage him to share his story. He said he hadn't thought about it lately, but he would like a copy of the longer version I made of his story to give to his children, who haven't heard it before. Often people talk in generalities about their life history and the details of daily living don't come up.

It was easy to understand my friend's habit of being a "collector" after I heard his story. His adult children were glad to have it as part of the family history.

Saturday, November 24, 2007

Jacqueline Marcell's Book "Elder Rage, or Take My Father Please" Has Advice and Humor Too

At the website for "ElderRage - Or, Take My Father Please!" eldercare expert Jacqueline Marcell tells about the times she had to intervene when her father, who was mostly blind, and had bad hearing and memory loss, hid the car keys so he could take the car out later. He insisted he did not know where the keys were. After Jacqueline heard a clanking when he walked she found the car keys masking-taped to his leg.

Another story titled, "Midsummer's Nightmare at the Alamo" tells of the time her father came in to wake her and tell her there were two guys in the house, one wearing a coon-skin cap like Davy Crockett, and another who looked like someone from the FBI. He pointed at Jacqueline's mom and said, "There's one of them now." But when they got closer to get a better look he said, "Oh, that's no guy, that's my wife."

By the end of the story Jacqueline's Dad is back in bed. Jacqueline relates, "I went back to my bed and intensely studied the texture of the ceiling as tears streamed down the sides of my face and clogged my ears. I'd have never guessed that I'd have to be my parent's parent..."

Jacqueline has been featured on television shows such as Regis Philbin's show, and on CNN. On the website you'll see over 50 endorsements for Jacqueline and her book, as well as information about her weekly radio show and schedule of speaking engagements.

Jacqueline's site has a wealth of Alzheimer's and eldercare information. She is a caregiver advocate who understands well the situations Alzheimer's caregivers encounter, from having experienced them herself.

Friday, November 23, 2007

Alzheimer's Day Care Center - Participants Feedback Is Enthusiastic


Relief for exhausted caregivers can be obtained when a senior with Alzheimer's is able to attend a Day Care Center. For example, today's post is the story of a local Alzheimer's Day Care Center, The Santa Maria Wisdom Center, part of the Life Steps Foundation.


It is highly recommended by one of my friends whose 82 year old mother participates. Stella Carrasco, 63, is the sole caregiver for her mother, Mary Chaparro, 82, who has Alzheimer's. They are pictured in the photo on this post at a local Craft Fair. They gave me permission to write about them on the internet so that other people could read about their story.


At 9 am a special bus run by the Wisdom Center picks up Mary, in Oceano, California. Between 3:30 and 4 pm the Wisdom Center bus brings her back home.


The Wisdom Center provides breakfast, lunch and an afternoon snack for Mary. Stella said her mother enjoys getting to eat meals with a group. She said it's good for both of them to have some time apart.


The Wisdom Center is very multi-cultural, and people there represent a variety of ethnic groups. There are bilingual speakers on the staff.


Stella has had many years of being the sole caregiver for her mother. The exhaustion and isolation were serious problems, and now that her mother attends Day Care Stella has time to rest, go for walks, play the radio, and other activities that we usually take for granted.


Stella said that before her mother started the Day Care Center she was warned about facilities, but in this case there are no worries. Her mother, Mary, enjoys the Day Care people and activities and loves to go there.

Stella said everyone there is kind and respectful, and Mary enjoys the people, arts and crafts, and other group activities. The Wisdom Center is supplying some colored pencils and drawing paper for Mary, who likes colored pencils better than other mediums for drawing.Stella looks forward to getting together with friends and attending activities now that she has some relief in her caregiving schedule.

Alzheimer's Day Care is available in many areas, and you can check your phone book or the internet to local Day Care in your area.

Thursday, November 22, 2007

Caregivers Can Read Medical Weblogs - Doctors Blog About What's Really Going On

Caregivers and seniors who want to understand the issues doctors face today and what really goes on can read medblogs, short for medical blogs. At KevinMD.com internal medicine physician and blogger Kevin Pho says "people not involved in healthcare have no idea what goes on "behind the curtain." Some of the posts have covered subjects such as "the death of primary care," "defensive medicine,""malpractice," "reimbursement," and "health care reform."

KevinMD has been featured in publications including The Wall Street Journal, British Medical Journal, and American Medical News.

He's also been interviewed on CBS News by Katie Couric.

The KevinMD Med Blog Power 8 Lists the medical blogs that were exceptional during the past week.

Many of the subjects in the Power 8 included information that would be helpful in saving money on prescriptions, understanding how emergency rooms work, and other topics useful for caregivers.

Wednesday, November 21, 2007

Caregivers and Seniors Can Find Healthy Holiday Recipes at Mayo Clinic.com


If you are a caregiver preparing holiday meals for seniors who have special needs, you can visit The Mayo Clinic website. Recipes in the Healthy Living section include heart healthy diets, diabetic diets, high fiber diets, low sodium diets, and more. Traditional Thanksgiving recipes that are high in carbohydrates can be redesigned to be healthier.

The Cooking Clinic section has topics such as "Recipe Makeovers: 5 Ways to Create Healthy Recipes, " "Ingredient Substitutions," and "Adjusting the Servings."

For example, instead of traditional gravy there is a recipe for "Roasted Turkey With Balsamic Vinegar Sauce."

Olive oil, rosemary and garlic are used to season the turkey while it's cooking. Instead of the usual gravy recipe you use 1 cup of balsamic vinegar, 1 cup of defatted turkey drippings, and 3 tablespoons of brown sugar.

A 5 ounce serving has 247 calories, 34 grams of protein, only 10 grams of carbohydrates, and 6 grams of fat.

The featured Healthy Living Recipes included such variety as corn tamales with avocado-tomatillo salsa, spicy red lentils, and baked apples with cherries and almonds.

With recipes from the Mayo Clinic caregivers can prepare healthy Thanksgiving and Christmas dinners.


Tuesday, November 20, 2007

Alzheimer's Sundowning - Things That Can Help

For many years I worked with caregiver agencies, and many of the clients had Alzheimer's Sundowning. I found that the things that helped were unique in each person's case. Below are descriptions of some typical situations and what worked to make things better.

One lady who had sundowning had previously wandered outside, while her husband was napping in the late afternoon. She walked downtown in a tourist area. Passing travelers saw she looked like she needed help and picked her up in their car.

She couldn't remember her name or where she lived, and they drove around for hours trying to see if anything looked familiar to her. Although she had lived in the town for decades, she did not recognize anything. Eventually someone recognized her and was able to guide them to her home.

When her husband became ill and was hospitalized, I arrived as a 24 hour stand-by-assist caregiver for a long row of days. The first afternoon I was there she became more and more agitated. Suddenly she went out the door and walked rapidly toward town, saying she had to catch a train to go home.

I caught up with her and used my cell phone to call someone with a car to come and pick us up. She accepted that I was a friend. She believed she was staying with me for awhile for company. She didn't recognize her own home.

During the next days I got a system going. We spent afternoons playing dominoes, coloring pictures, eating healthy snacks, looking at magazine pictures, doing easy jigsaw puzzles, playing easy card games, doing crossword puzzles and looking at photo albums. I might be doing most of the picture coloring but she picked out the colors. Visual activities worked well, but conversation was difficult because she could not follow it.

For the crosswords I would read the question and we'd make guesses together on the answers. For cards I would lay them out and play both sides but she watched while I explained it. Even if I was doing most of the activity she was still enjoying participating by watching.

When she lost interest I switched to another activity and so on. We put the pictures we colored up with tape. She enjoyed making more pictures with me each day.

If she was participating in an activity it kept her attention busy, so she didn't hop up and start out the door to go wandering when sundowners started in the late afternoon. Watching TV didn't work well because she didn't get involved enough with it.

I also found that having lots of lights on helped. I'm not sure if it made her feel it was earlier in the day, or if she could see better, or if it helped avoid shadows and hallucinations. But, having the house well lit helped.

Being active during the day helped her sleep better at night. We tried going out in the car for scenic drives, going for walks, and going downtown to sit and watch people and activities.

All these things helped pass the time, keep her attention, and provide enough activity, without overdoing it. By night time she was ready to rest.

Too much activity though and exhaustion or stress could make sundowners worse. It had to be a balance that was just right, but since each day is different all I could do was try my best.

Soothing music also helped. Some people liked to listen to soft spiritual music and old favorite hymns, such as "Shall We Gather At the River." Others just seemed more content and calm with any smooth, easy going music that was popular with their age group.

I would try to keep my voice and actions calm and quiet, and just go with the flow. One lady with Alzheimer's Sundowners frequently thought we were in an airport. When I was assisting her as she used her walker to head for the bathroom she would say she hoped we didn't lose her husband in the airport.

She had me tear up pieces of paper and drop them on the floor, so that her husband could follow them to find her. She was so afraid of losing him in the airport. In the morning she knew she was in her own home and recognized us. But by late afternoon Sundowners time she thought she was in an airport.

The people with Alzheimer's Sundowners will not believe you if they don't recognize their own home, but you insist that they are indeed in their home. Just going with the reality they are experiencing instead of arguing is important. Wherever they say they believe they are, that is the location and reality you go along with.

If they don't recognize their home, I've asked them to stay in the house for the night, before returning to their own home tomorrow. Usually in the morning they recognize it as their own, but when late afternoon Sundowners starts then once again they may want "to go home."

At any moment people with Alzheimer's may be completely cognizant. But you cannot make assumptions, because in the next moment that can change. Clear thinking one minute, with good memory recall, can switch to confusion with lack of memory the next minute.

Exhausted Caregivers During the Holidays Are Hidden Heroes

Caregivers often put their heart and soul into taking care of people whom they assist. During the holidays exhaustion and stress, "caregivers' syndrome," may be worse due to the extra rushing around. Preparing for festivities is fun, but it can be tiring. Recently I have had several caregivers speak to me about the added exhaustion and stress they feel at this time of the year.

I wish there was a special award to give to all the caregivers who do so much to make others lives better, and who often go without thanks and praise for all they do. Being a caregiver is very special. It's not a high status or high paying role, but in the world of nonmaterial things and goodness of heart it's at the top.

During the holidays it would be nice to go out of our way to tell caregivers they are special and wonderful. Caregivers who are on "stand by assist," meaning they cannot leave the person they assist alone, give up their own dreams, time for friends, and hobbies, because they care about others.

Isolated and sometimes forgotten, caregivers are the hidden heroes of the world today.