Our Clearwater home health agency mission is to create an environment where we set our team members up for success empowering them to provide the best in home care to the community.
EasyLiving Home Health Services Blog
Tuesday, April 15th, 2014
Depression is not exactly “preventable”; certain unchangeable factors impact risk, such as past history of the illness or family history. However, there are steps that can be taken to mitigate some of the risk factors that are common in elders. Your early intervention and support can also be critical, as depression often goes untreated in elders.
For most people, well-being increases with age, but there are certain factors that put elders at risk of depression and suicide such as:
- Loneliness and isolation (living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges)
- Reduced sense of purpose (loss of identity due to retirement or physical limitations on activities)
- Health problems (illness and disability; chronic or severe pain; cognitive decline)
- Certain medications or combinations
- Fears (anxiety over financial problems or health issues, worry about “being a burden” or losing independence, fear of having to go to a nursing home)
- Grief (death of friends, family members, and pets; the loss of a spouse or partner; loss/changes in lifestyle)
What can you do?
- Watch for signs and symptoms, especially in someone with a known family or personal history of depression. Monitor carefully if the person has heart disease, macular degeneration, or has had a hip fracture, stroke, or bypass surgery (these are all known to be associated with developing depression).
- When coordinating medical care, make sure to give thorough information to providers and keep good records. Ask questions about drug interactions and possible concerns with conditions known to be associated with depression. Keep a list of symptoms or concerns in order to be able to report accurately to providers. Consider medication management services for elders who take many medications or have difficulty remembering the medication routine.
- Encourage loved ones/friends to stay active and plan activities. Check out our post on fun activities for seniors and ways to modify activities to accommodate different needs.
- Pay attention if your loved one/friend is withdrawing from normal activities or changing patterns significantly. Keep an eye out for early warning signs of depression such as this and changes in sleep patterns, complaints of aches and pains, cognition and behavior changes. If you spot signs, you may want to read our Aging Wisely advocates’ article on approaching someone when you are concerned about possible depression.
- Help show the person ways to adapt to changing circumstances and losses. The loss of mobility or driving privileges can be devastating and cause a person to become more isolated and withdrawn. There are many ways for someone to remain active and continue favorite activities even with these changes. However, the person may not even know how to go about them (imagine driving yourself everywhere and suddenly trying to figure out how to use taxis and public transportation or being told to just rely on family/friends for rides).
- Encourage discussion about fears and concerns. Share examples (“My friend’s Mom was so worried she would have to go to a nursing home when her health was failing but she was able to get great helpers at home and she is doing so well. They even helped her get to her granddaughter’s wedding this past May.”) and anticipate unspoken concerns. For example, we’ve often found clients so relieved when their son, daughter or financial advisor reviews their financial situation and demonstrates that there is enough money to live comfortably and pay for care. The adult children are often surprised to hear that this is something that worried the parent.
- Suggest activities that provide a sense of purpose (volunteer work is a great example). Ask the person for their opinion or help; show that they are valued for their wisdom and life experience.
- Try to encourage outlets for healthy grief. WebMD offers a good overview of grief and grieving resources and Seniors for Living has some great tips in their Grief and Bereavement Resource Guide.
We’re here to help! Contact us at 727-447-5845 for ideas, resources and a wide array of helpful senior care services. Our Aging Wisely geriatric care managers can help with geriatric assessments, resources, and guide you through tough conversations and transitions. Our home care team offers customized support to keep elders active, engaged and healthy.
Wednesday, April 9th, 2014
This past week, a local elderly woman took her own life by jumping from the window in her retirement complex in St. Petersburg. We were saddened to read Nancy Yates’ story of deteriorating health and spirits. Unfortunately, there are other elders who may be facing similar situations, as well as neighbors, friends and family who may be unsure what to do to help. We will be focusing some extra attention on related issues over the next few weeks, to provide quality information to help you know where to turn and what to do (as well as bring general awareness to the issues of depression and suicide in the elderly). We start today with some important facts (and misconceptions) about depression in elders, as well as some recommended reading and resources.
- People over 65 make up about 13% of our country’s population, but about 18% of all suicides.
- Elderly white males have the highest rate of suicide of any group (over four times the overall rate of suicide).
- Depression affects more than 6.5 million of our nation’s 35 million elders.
- Depression often goes untreated in elders (many times for reasons related to the myths we’ll discuss). Untreated depression increases risk for physical and cognitive decline and often has fatal consequences (suicide and otherwise).
Here are some common myths about depression and suicide in elders, along with the realities. We hope these help to give a better picture of this issue.
Myth: It is normal to be depressed when you get older.
Reality: Depression is not a normal part of aging. Well-being generally increases with age, though there are certain factors often present as we age (isolation, illness, losses, etc.) that do put us at increased risk (particularly for those with a personal or family history of depression). Feeling down or grieving a loss is different from clinical depression.
Myth: Elderly people mainly commit suicide as a logical choice, deciding that they’d rather end their lives than live with pain or lowered quality of life.
Reality: There may be some people for whom this is the case, but research shows that for most people, untreated depression or mental illness is the most common factor. The person may be ashamed to admit to the depression or seek treatment, for fear of what that means or treatment costs. Many elders at risk of depression feel hopeless but are unaware of resources and options which could improve their quality of life. An elder may fear losing independence or being forced in to a nursing home, when there may be many other choices. Tragically, many depressed elders who die from suicide sought help (20 percent see a doctor the day they die, 40 percent the week they die and 70 percent in the month they die) but the signs were missed.
Myth: Confusion, difficulty concentrating and irritability are not signs of depression. Most elders will tell you they are sad and depressed.
Reality: In older adults, these less typical signs of depression may be more obvious than expressions of sadness. The perceived stigma of depression or mental illness may keep an elder from expressing his/her feelings. Physical symptoms like aches and pains or sleep changes might be signs that show up as well. Signs of depression in elders may mimic other diseases, and are thus often missed. An older person is much more likely to seek help for physical ailments than depression. Careful screening and a good diagnostic workup are essentials due to the complexity and overlap in symptoms.
Myth: If the elderly person doesn’t want help and isn’t being abused by anyone, there’s nothing I can do.
Reality: There are many things you can do. If you need help with how to approach the situation or talk to the person, contact an eldercare professional (give us a call any time at 727-447-5845) or helpline (the Florida elder helpline is 800-96ELDER). We will be sharing more information and discussions about what to watch for, how to approach someone when you are worried and resources to help.
In addition, Florida’s Mandatory Reporting statute (under F.S. 415) obligates certain persons (such as medical professionals, care staff, social workers, bank employees) to report abuse, neglect (including self-neglect) or exploitation of vulnerable adults. If a person may harm himself or is unable to care for herself and needs services, persons under this statute have a duty to make a report. Contact the Florida Abuse Hotline at (800)96 ABUSE.
NAMI (National Alliance on Mental Illness): Depression in Older Adults **Depression Statistics above from NAMI
National Suicide Prevention Hotline: 1-800-273-TALK (8255)
For questions, resources and consultations in Pinellas County/Tampa Bay, you can reach EasyLiving/Aging Wisely’s Senior Care Consultant at 727-447-5845.
Wednesday, April 2nd, 2014
Coming on the heels of our post about the “grumpy old man” client and ways to overcome the challenges of caring for an angry (or even mean) care recipient…our care team offers some related tips on helping the “reluctant” client to become a satisfied client.
What do we mean by the reluctant client? This might be the situation in which the client’s family has convinced him (to an extent) that he needs some help, or the doctor has insisted his patient get some assistance after a recent illness. Or, perhaps this is a client who has been cared for by a family member who needs to take a break, and the client is upset by this change. As a family caregiver, you might experience the reluctant family member who claims she doesn’t need your help or you may be trying to convince Mom or Dad to give a professional caregiver a try. These tips might give you some ideas in smoothing the path for your loved one and caregivers.
We generally don’t advise forcing someone in to accepting care. However, others often know there is a real need there and have legitimate concerns…and the reluctant care recipient often becomes one of the most satisfied clients over time. This is where our tips come in, because it’s all about getting past the initial reluctance to demonstrate just how great it can be to have a quality caregiver helping. Here are some tips for how to approach care for the reluctant client:
- Break the ice. Have a good attitude from the start and try to get a feel for what the client is feeling and how he/she is reacting to your approach. You may need to step back from being very cheery if the client is angry or upset and take a quiet approach. Other times, some humor may help break the ice. Work together with the family and other trusted persons to plan how to approach the situation to start. Sometimes, offering the client a chance to “try it out” or have some temporary help gives the client more of a feeling of control. Maybe the caregiver can be hired for a particular outing or event or to help with tasks that the client acknowledges he’d like help with, such as meal preparation, driving or light housekeeping.
- Find common ground. If possible, find out about the client beforehand. This can give you topics of conversation and help you to bond with the client. At EasyLiving, we developed a Daily Routines and Personal History Questionnaire for just this purpose. It really helps us arm our caregivers with the tools and information they need to provide the best care. Home care should be personalized to the individual, and you can help your caregivers to do this by giving them some information.
- Be a listening ear and empathize. Take the time to show you are really listening and that you understand the feelings the client is experiencing. It can be hard to hear a client’s angry tirade and complaints, but it is so important that the client feels he/she is being heard.
- Find the things that the client wants. The client may disagree with the fact that she needs help at home, but maybe she will admit it would be nice to have someone iron her blouses or assist with some gardening. If you can start by demonstrating your helpfulness with such tasks, this often shows the client the value in having the help and opens the door. As a family member, this is also a useful approach to convincing a parent to get help in the first place. It might be as simple as making sure no one is “available” one week to provide rides to doctors’ appointments and hiring a caregiver to help with that so the client has a chance to get to know the person and see the possibilities. As a caregiver, this is also important in the little things you do when helping. If the client has particular ways he/she likes things done, be open to them. Try to put yourself in the client’s shoes and imagine someone coming in and immediately telling you things should be done differently (or just doing them without asking).
- Don’t push too hard. We talk to a lot of family members who feel they know what’s best for Mom or Dad, but the parent disagrees. Be willing to start small. Acknowledge that loved ones may need time to process things and progress might be on a slower timetable than you prefer. There are a couple of great books we recommend which talk about communications between the generations and offer some great insight. They are: How to Say it to Seniors by David Solie and Another Country: Navigating the Emotional Terrain of Our Elders by Mary Pipher. As a caregiver, you might need to give your care recipient a break, step away for a minute and read his/her emotional signals. If you think you have some great ideas that would make life better for your care recipient but she refuses, allow that choice and approach it at another time.
Give us a call at 727-447-5845 if we can help with any eldercare needs or questions! Come on over to our caregiver community on Facebook to join in the discussions and share your tips or questions.
Tuesday, March 25th, 2014
Check out this clip from Seinfeld, in which Jerry finds himself confronted with a “grumpy old man” as his client when he volunteers with a senior program.
Unfortunately you may sometimes find yourself caring for such a “grumpy old man” (or woman) as a client or relative. This is the care recipient who is often angry or upset: you can’t do anything right, he or she might lash out at you, constantly complain and even falsely accuse you of something. Every suggestion you make is turned down and the client may complain about you to others or be sarcastic or mean in direct conversation. Some care recipients even lash out physically or become extremely paranoid when dementia or other issues are at hand. Here is our caregiver advice for dealing gracefully with the “grumpy” care recipient:
- Use redirection and deflection techniques. If the client is angry about something, don’t ignore his/her feelings, but it may be helpful to redirect the conversation or activity to something more positive.
- Get to know the activities that the client enjoys or finds soothing. For example, maybe there is a TV show or type of movie that makes the client laugh, or he calms down when listening to his favorite music. Exercise produces healthy endorphins, which are known to help with mood so a regular walk or other exercise can be an important tool for mood and well-being.
- Monitor and modify your own reactions. It’s easy to get stressed in situations dealing with a challenging client or loved one. It seems especially hard with loved ones, because you bring your history to the situation and it may be hard to separate behavior related to a disease like dementia from the person you know. Take a moment to catch your breath before you walk in to greet the person. Try to leave other life stresses behind, as your attitude will affect the care recipient’s. You may need to take a break occasionally, whether just taking a few minutes to walk outside or having respite care so you can have some extended/regular time away. Humor can be a good coping mechanism and stress reliever for the caregiver (and might help the care recipient too).
- Know when to take things with “a grain of salt”. In the example of Jerry Seinfeld’s client, the client accuses the caregiver of stealing and Jerry himself gets in to a bit of trouble when he takes some old albums that the client says are trash. This is not to say you should dismiss a loved one’s story of abuse or mistreatment any time. At EasyLiving, we take any client or family claim very seriously and fully investigate. However, if you become aware that your loved one is having memory issues or paranoia, be cautious with accusations. It is important to investigate fully before damaging someone’s reputation or becoming angry about what might have happened. This can occur between siblings too. Often the sibling who lives close by or has the most contact becomes the object of paranoia for the person with dementia. Before you assume your sibling is stealing from Mom, check in to things carefully and use a measured approach.
- As a caregiver, learn from Jerry’s experience and take a very straightforward approach with issues like gifts. This is why we have a strict “no gifts” policy for EasyLiving’s caregivers. If an older client wants to give something away or your loved one is making such decisions, it is probably best to consult with everyone involved beforehand so accusations don’t arise later. It is good to document any concerns or complaints the care recipient makes, talk to other family members about what is going on, or even bring in a third party to mediate or monitor the situation.
- Is there something more going on? Depression in the elderly often presents with symptoms such as agitation, restlessness and cognitive issues. You may think the person is just irritable when they are really depressed and could benefit from treatment. People with Alzheimer’s disease may experience behavioral symptoms such as agitation, paranoia, and even hallucinations and delusions. Talk about these issues with a geriatric psychiatrist or neurologist to find out what can be done. It is also important to explore possible sources of discomfort for your care recipient. Her irritation may be a sign of a urinary tract infection or his anger may be the first sign he is not feeling well or has pain.
- Safety always comes first. A caregiver should not be put in harm’s way while providing care so it is important to address real dangers, such as clients who lash out physically. At EasyLiving, we also remind our caregivers and clients/families that we support our employees and will not tolerate them being abused or mistreated. For some reason, there are occasionally family members who do not respect the work of a professional caregiver and treat caregivers less than humanely. Our first priority is always creating a supportive environment for our caregivers to do the best job, so we have zero tolerance for this type of behavior.
What are your best tips for dealing with a care recipient who is less than pleasant? Come on over to our EasyLiving Facebook community to leave your tips and comments!
Contact EasyLiving’s Senior Care Consultant at 727-447-5845 if we can help with any of your caregiving needs or questions!
Tuesday, March 18th, 2014
As a caregiver, you may have days when you feel more like crying than laughing. You may feel pretty “humorless” at times when errands pile up, you spend hours waiting in doctors’ offices and you’re just exhausted. But, most caregivers find there are also bright days in caring, as well as some pretty funny moments.
Being able to laugh and find the humor in caregiving is not only a great coping mechanism to deal with the stress, but it’s also great for your health. As we approach National Humor Month which starts with April Fool’s Day, it’s a great time to think about the positive impact humor can have on a caregiver and care recipient.
Here are a few ways that laughter really is the best medicine:
- Laughter can increase blood flow and heart rate and can mimic the effects of exercise.
- Some studies have shown the ability to use humor may raise the level of infection-fighting antibodies in the body and boost levels of immune cells. And, of course, increased stress is associated with reduced immune defense, so anything that helps reduce stress is potentially useful to the immune system.
- Laughter relaxes the body. For this reason, it can help with sleep and pain relief (laughter releases endorphins, the body’s “feel good” chemicals).
Here are a few tips for incorporating humor in to caregiving:
- Consider watching some comedy movies, sitcoms or listening to comedians’ recordings with your care recipient. YouTube is a great resource for free videos! Type in almost any subject and find funny videos of all kinds, plus clippings of old shows. If you enjoyed the Seinfeld Show and recall an episode on a particular topic, there’s sure to be a clip on YouTube. The same goes for favorite comedians like Bill Cosby. Here are a couple good ones you might appreciate: Jerry Seinfeld on Florida drivers and Seinfeld and “the old man” (Jerry volunteers to visit an elderly person–absolutely hysterical for anyone who’s ever run in to a slightly grumpy care recipient or worked in home health care).
- Encourage your loved one’s sense of humor and help set an environment of levity. Friends and family often don’t know how to interact when serious health issues are at stake. They may feel it’s inappropriate to laugh or make any jokes. Lighten the atmosphere yourself by sharing a funny story. If your loved one has a good sense of humor, encourage it. This can shine through even in a person with late stage dementia. Years ago, one of our clients used to make sharp jokes and was quite a prankster. Even when her words were jumbled in the late stages of dementia, her eyes would light up and she would laugh often when she said something. We always laughed along with her and imitated her tone and feelings. She had many bright moments and it was certainly a pleasant experience as a caregiver or visitor to have that feeling in the room.
- Seek out books, sites and people who encourage the brighter side of caregiving. One of our favorite books in this category is Mothering Mother by Carol O’Dell, about her caregiving journey with her mother who had Parkinson’s Disease and Alzheimer’s. The story is touching and will also make you laugh out loud. Though Carol would probably dispute the description, she serves as a great role model for caregivers and shows how humor can get you through the day and the longer journey. Sites like agingcare.com offer places for caregivers to share stories, including the funny moments. Just google “humor and caregiving” and you’ll find some great sites and resources.
- Did you know there are laughter clubs and laughter yoga classes? Check out World Laughter Tour for more information (they even have a resource right in St. Pete, Florida) or Laughter Yoga. Could make for a fun outing!
We’d love to hear from you! What are your tips for incorporating humor in to caregiving? What’s your funniest story from caregiving? Does your care recipient frequently crack you up? Please come on over to EasyLiving’s Facebook page now and throughout Humor Month to share and find some of our “favorite funnies”!
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