This study, conducted by JAMA, demonstrates “as the population ages, a greater number of hospitalized older adults will have impaired cognition due to a rising prevalence of Alzheimer disease,1 delirium,2 and other related disorders. Such patients often face major decisions about their medical care at a time when they cannot communicate their preferences or participate in decision making. Prior research examining hospitalized adult patients of all ages has shown that between 25%3 and 40%4 lacked the capacity to make medical decisions based on standardized assessment, and 1 study of hospitalized older adults report that 43% had some degree of cognitive impairment.5

When patients cannot make decisions, clinicians turn to surrogate decision-makers. The surrogate decision making should be is most commonly a close family member who in some cases has been chosen by the patient as a health care power of attorney.”

From our experience, these surrogate decision-makers are overwhelmed and not prepared to make the critical, frequently life threatening or at the least life altering decisions demanded quickly by health care professionals in a hurry.  Family members, frequently living at a distance and doing this telephonic, are trying their best to fulfill this role. The use of  “Dr. Google” seems to lead most families into a state of overwhelming inadequacy when they realize how complex the health care system has become to the average consumer, let along a older adult who is use to deferring to the doctor on all health care decisions. This is where a Geriatric Care Manager comes into place to guide and direct the cleint and families through this process. Geriatric Care Managers are typically licensed by another profession such as Registered Nurses or Social Workers and have advanced degrees in their speciality along with the required certification in Care Management. Most have worked in the field in another capacity for over 20 years and are viewed as experts.Unfortunately, we have seen others trying to capitalize on this need by claiming to be “Patient Navigators” or “Health Care Navigators” . Caveat emptor! Please review the education, qualifications and years of experience of anyone you are choosing to fulfill this role.

The post Surrogate Decision Making appeared first on Holistic Aging.

Even Aging Life Care Managers, like myself, that are experts in the field of managing aging, recognize the solution involves putting a team together and using each team member’s strength.  While it can be challenging to coordinate all aspects of care from afar, Holistic Aging can provide resources specific to families attempting to manage their parents care.

Come Together as a Family in Caregiving

Invariably, the demands of caregiving bring out old patterns and unresolved family tensions. Past wounds reopen and childhood rivalries reemerge. Conflicts can arise when adult children have differing opinions on the reality of their parent’s needs or illness. Discourse surfaces when the caregiver duties are unequal among the siblings. One adult child typically bears the burden of care, while the others feel out of touch.

• Have a family meeting, possibly conducted by a third party such as an Aging Life Care Manager, where the entire picture of the caregiving needs is expressed honestly and directly
• Be realistic of your expectations of your siblings. I always tell our clients; “Everyone can contribute what they are able. Past relationships with the parents, along with current life pressures and comfort with direct caregiving roles will play into this”. Family members that cannot provide the direct care may opt to manage finances, review insurance, run errands, or be the person paying for external support such as the Aging Life Care Professional assistance or a caregiver to provide caregiving respite. Express appreciation to all family members for help they are able to provide.
• Try to forgive family members who continue to refuse to help in a loved one’s care. The one thing we have control over in a situation is our reaction. Attempt to work through your negative emotions to take care of yourself and move forward.
• Express your feelings both honestly and directly. All family members should know their help is both wanted and needed. All family members should be kept informed of the parents condition

Recognize and acknowledge the legacy of family dynamics

The demands of caregiving bring out old unresolved tension in the family structure. It is not unusual for adult children attempting to work together in help their parents, find themselves replaying their historical role in the family hierarchy. Ideally, the experience of caregiving is a time for siblings to come together and provide mutual support to one another.

• Strained sibling or other relations can contribute to the difficulties you face. It is challenging to coordinate care, especially with all the adult children living at a distance.
• This makes it hard to agree on the legal and medical decisions required on behalf of your loved one when everyone’s opinion does not have equal weight.
• It is important to resolve these conflicts immediately as ignoring them creates greater challenges and impede a family’s capacity to provide the greatest quality of care for a parent.
• Try to respect other sibling’s perceptions and find opportunities to compromise.
• Recognize and resolve childhood rivalries

Unequal Division of caregiver duties

The problem we see most often is discord surfaces from the unequal division of caregiving duties. In most instances, one sibling takes on the primary role of caring for a loved one. This may be because he or she lives closest to a parent, is perceived as having less work or fewer family obligations, or is considered the “favorite” child. Regardless of the reasons, this situation can lead the overburdened caregiver to feel frustrated and resentful and other siblings to feel uninformed and left out.

• Avoid the “caregiver martyr syndrome”. One family member may commit to care for an older loved one, and the caregiving consumes that person’s life. These caregivers believe they are the only ones who can care properly for their family member. Tunnel-vision takes over and caregiving becomes their identities.
• Family members can gently point out the areas of concern and offer to reduce the caregiver’s load by pitching in where they can
• If family members can’t provide direct care, there are other ways to help. They can offer to pay for respite care or a “Day at the Spa” for this primary caregiver.
• Senior caregiving is a noble undertaking but is not a job for one person. What happens to the patient when their overextended caregivers are hospitalized or even die prematurely? In order to prevent this common scenario, it is critical for caregivers to shake the martyr syndrome.
• Hiring a Life Care Manager can change the dynamics of this martyr syndrome also. Often a caregiver will accept the expert advice of the Aging Life Care Manager more seriously than a family member or friend.

Disagreement of what is the best option for your parent

Mom has been diagnosed with dementia and it is clear that she can no longer live alone. Two of the adult children feel that an assisted living facility is the best care option, but your brother disagrees. Every conversation you have with him seems to lead to confrontation and hurt feelings.

• Some siblings may be in denial over their parent’s condition. Adult children who seem unable to accept the reality of their parent’s illness may be protecting themselves from facing their eventual decline, death and their own loss.
• Use a systematic process for helping you determine the best option in care for your parent(s). Have your brother make a list of why he feels staying in the home is the best interest for your parent and you make a list of why you feel an assisted living is in their best interest. Share your thoughts systematically and nonjudgmentally.
• This is a surmountable decision and it would be wise to navigate this journey with the expert assistance of an Aging Life Care Manager professional who has led many families on this journey.

Providing care for an aging or ill parent can bring out the best and the worst in sibling relationships. Allow each siblings to help in ways they are able and divide tasks according to individual abilities, current life pressures and personal freedoms. If siblings are unable to help with care, seek other assistance to provide a respite for yourself.

If communication is particularly contentious, arrange a family meeting. Make sure to include an outside facilitator or Aging Life Care Professional who can ensure that everyone’s voice is heard.

On an airplane, an oxygen mask descends in front of you. What do you do? As we all know, the first rule is to put on your own oxygen mask before you assist anyone else. Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important things you can do as a caregiver, often the most frequently forgotten. Meeting your needs will benefit those you care for.

The post Tips For Families Caregiving for Loved Ones appeared first on Holistic Aging.

The first thing you need to do is educate yourself all about Alzheimer’s. Please know that Alzheimer’s Disease begins slowly, it first involves the parts of the brain that control thought, memory and language. Over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. Here at Holistic Aging our staff can help educate you and tell you everything you need to know about Alzheimer’s. You can learn more about our amazing staff here – https://holisticaging.com/about/ 

The next step is to be patient. Adjusting to an Alzheimer’s diagnosis is an ongoing process and each person reacts differently. We know it’s hard to deal with a loved one with Alzheimer’s. Which is why we have a customized approach. We will meet with the family and client for an assessment. Our assessment is customized to the person with Dementia and occurs in their current living environment. When we develop a customized plan for your loved one, we will talk about where they are in the disease process, financial status, ability to improve the current living environment along with the family and client desires.

Another step you will want to take is providing your loved one with a calm and soothing environment. When caring for a loved one at home, you can control the environment and the atmosphere you create while caregiving. These factors play a large part in helping a person with Alzheimer’s feel calm and safe.

Honestly, there is so much to take into consideration when dealing with Alzheimer’s disease. We know it is overwhelming! If you are caring for a loved one with Alzheimer’s disease or dementia and need support, contact Holistic Aging today at https://holisticaging.com/contact/ we are here for you!  

The post Family with Alzheimer’s Disease – How We Can Help appeared first on Holistic Aging.

As parents, it is hard to acknowledge and accept responsibility for how much influence we have over the development of each of our children. Through my work with older clients and their adult children on a daily basis, I am frequently reminded of this influential power over a life time.

Typical Family Dynamics

As a Life Care Manager, I have counseled many adult children who resent their role in caring for their parents at the end of their lives. Not deliberately, of course, Mom and Dad may be doing things that alienate and push adult children away. Adult Children confide that their parents were never there for them when they were younger and now they resent being there for their parent. Parents don’t understand what they did to make the adult child turn away from them. My education and experience as a Registered Nurse, Aging Life Care Manager and mom of three typically leads me back to the parent and the adult child with perceived mistreatment by the parent.

Instead of offering advice to adult children on care of their parent, I decided to instead address the parent themselves with some advice that will benefit both generations over time.

Parenting Warning Signs

Parents whose entire being exists for their children often have unrealistic expectations of their adult children’s duty to them. Are you the parent who calls (text or email) your adult children so often that they ignore your calls? Are you a meddler always offering unsolicited advice?  Is your constructive feedback really just plain criticism? If any of the above sound familiar, treat them as red flags that cannot be ignored. Your goal is a better relationship and, as the parent, you’re in the driver’s seat.

In his book, When Parents Hurt, psychologist and parent Joshua Coleman, Ph.D advises parents in recognizing what they can do to improve the relationship and how to let go of what they cannot. Do you feel validated solely by your role as a parent? Coleman suggests that parents who exists for their children often have unrealistic expectations of their adult children. “It’s particularly difficult for parents who expect their kids to fix emotional problems from their (the parent’s) childhood, by being a shoulder to cry on, a sounding board, a confidant,” he says. Kids generally don’t want that role.

The establishment of an open environment of respect and valuing of your adult child’s lifestyle choices can help set the tone when the adult children need to gather together and help the older adult(s) in the aging process. As I have frequently told my aging clients’ adult children; your mom or dad will consider themselves your parents until the day they die. Your parent most likely modeled and taught you how relationships work, be that healthy or unhealthy. This means it is okay for both you and them to set your own boundaries.

Parents Should Use Gratitude

Dr. Coleman recommends parents can change this relationship by practicing the principles of gratitude; give thanks! The problem is, gratitude doesn’t always come naturally. The negatives in our lives—the disappointments, resentments, and fears—sometimes occupy more of our attention than the positives. Below, I highlight a number of practices for cultivating gratitude:

Count your blessings:

You can do this through mental imagery or writing it down in a diary. This simple practice is effective because it not only helps you remember and appreciate good things that happened with your children in the past; it can also teach you to notice and savor positive events that are currently happening.

Mental subtraction:

In the words of Joni Mitchell, “you don’t know what you’ve got till it’s gone.” But sometimes just imagining that something is gone is enough to make you appreciate what you’ve got. Mental Subtraction involves focusing specifically on important relationships, such as those with your children. Although it may be painful to imagine your life without them, doing so once in a while can serve as a reminder not to take that person for granted and may improve your relationship as a result.

Savor:

Ever notice that the first bite of cake is usually the best and then less and less so? Savor your relationship with your children. In the age of smartphones, it’s a common experience to see an entire family together with all their eyes glued to a screen of some type. Really notice your adult children, connect with them without distraction, praise generously; appreciate sincerely.

Say “thank you”:

Gratitude can be especially powerful when it’s expressed to others. Writing a thoughtful, detailed “Gratitude Letter” to your children is a great way to increase your own feelings of gratitude and happiness while also making the adult child feel appreciated and valued. Comment on a specific time you noticed what a great parent your daughter or son is. Tell them how proud you are of your their commendation at work. Each of these can make a huge impact on your relationship.

In the end, we are parents until the day we die. It’s our job to take the high road — even if we’re frustrated by past actions of our children.

None of us is perfect, but we can always check in with ourselves to ask: Is my relationship with my child as good as it can be? What can I do to make it better? The daily practice of gratitude is a great place to start. As a Life Care Manager, our goal is to help heal the entire family unit in whatever way we can.  We have counseled many families in developing more positive ways of healing themselves and their final years of a relationship with their parent.

For more tips on how to improve family dynamics when parents and adult children don’t get along, visit our website today!

The post When Parents and Adult Children Don’t Get Along appeared first on Holistic Aging.