Tuesday, April 7, 2015

Hi!  I am in the process of developing a series of six informational videos each related to a different aspect of senior care.  This video focuses on the 'caregiver' and her experience moving her Mom into Heritage Assisted Living.  Please share your experiences related to caregiving….

Wednesday, January 7, 2015

Bloom where you are planted.

The desire for humans to garden is eternal and ageless. The youngest child is caught up in the magic of planting a seed and watching it grow. The elderly, experienced home-grown horticulturist finds peace, renewal and hope as they carefully watch the weather, work the soil, and plant the heirloom seedlings sprouted from saved seeds handed down from generation to generation. They say gardening is like therapy, but cheaper – and you get tomatoes.
As we age, the desire to ‘plant and grow’ never fades, but many of us find the traditional ‘in-ground’ large-scale plot too challenging to maintain. Newer methods of growing are proving to be better for the environment, and the back. Raised surface beds, wide mound gardening, square-foot gardening, container gardens, and elevated beds provide creative ways to continue gardening, and achieve maximum harvest and enjoyment with minimal effort.
Good soil, seed, water, mulch and sunlight are the five simple key ingredients to a successful garden. Run your hands through your earth. Soil is alive. It should be easy to work, should smell rich and loamy, and drain well. You want the oxygen to reach the root systems, and the living organisms to thrive. Heirloom seeds saved and passed on from generation to generation provide a strong connection to the past and future, and perform well. These open-pollenating plants also sustain the necessary honeybee populations that are dying off at alarming rates from pesticide use. Many garden centers also now sell heirloom and organic seeds. Rainwater is free  – and free of chemicals and pollutants sometimes found in municipal and well water. In Michigan it can be easily collected in large buckets covered in cheesecloth to prevent mosquito infestations. Thick mulch around emerged plants provides protection, helps retain moisture and reduces water use, and nearly eliminates weeds. Use all-natural mulch that will compost easily and it can simply be worked into the soil for enrichment the following spring. And lastly, everything needs sunlight to thrive – even people. After a winter like we had, our bodies and our souls seek needed sunlight. It boosts our mood, strengthens our bones, and recent studies have found a strong correlation between reasonable sun exposure and cancer prevention.
At Ganton Senior Communities our campus gardens are a very important component to the physical and spiritual health of our residents. They are encouraged to participate in our many garden areas on whatever level they can. From painting creative plant markers, to planting and caring for tomatoes, to helping to water and weed – growing season is a favorite for our seniors. Even those who choose to simply sit and rock and admire a pot of petunias in bloom are important to a garden, as everyone needs a cheerleader. To watch how our gardens grow, ‘like’ us on Facebook – Reflections Memory Care, Heritage Assisted Living and Lakeview Senior Living. Now, get growing!

‘Caring for the Caregiver’ – finding local support for the journey ahead

Have you ever been on a plane, and just before takeoff the flight attendant instructs you on what to do in the event that the plane looses cabin pressure? You are told to place the dropdown oxygen mask on yourself first, and then help your children or other passengers to apply theirs. The purpose is simple: If you place other’s needs ahead of your own, you will become a statistic and be of no help to anyone. The same rules apply to being a caregiver for others on terra-firma. Take care of yourself first, so that you can be of service to others.
Being a caregiver can be very rewarding, but it can also be very stressful.  Your time, energy and resources may become stretched beyond the breaking point.  This type of stress is particularly dangerous if left unchecked and can profoundly impact your own physical and emotional health.  As a caregiver you have a personal responsibility to take care of yourself first. Listed below are some helpful tips for caregivers to keep in mind when caring for a loved one:
#1 Take time for yourself!  This may seem like an obvious observation, however, often caregivers don’t plan for time spent away from their loved one and then neglect their physical and emotional needs.  Reach out to other family members, friends, or a trusted visiting nurse service in order to spend a day shopping or having lunch with friends; join an exercise class; take a walk; get a massage; simply drive around and decompress! Don’t assume vacations are a thing of the past – search out local facilities that offer short-term respite care.
#2 Take advantage of local services! Calhoun County is very fortunate to have a great network of organizations providing services and resources for seniors – the Office of Senior Services, http://www.calhouncountymi.gov/government/senior_services.  Reach out to your local Chamber for connections or local senior centers and facilities for their suggestions.
#3 Acknowledge your feelings!  Oftentimes caregivers experience a range of emotions while caring for a loved one.  Rising responsibilities can cause anxiousness and worry; increased dependence of a loved one for daily care and oversight can cause feelings of anger and resentment; and watching a loved one’s health deteriorate can cause tremendous guilt.  It’s important for caregivers to reach out others and share these feelings in order to understand it is all a normal part of the process.
In an effort to support area caregivers, Ganton Senior Communities has partnered with licensed Master Social Worker, Lisa Ottenhoff, LMSW, ACSW of Comforts of Home Counseling, to offer ‘Caring for the Caregiver’, a new, ongoing, information and strategy-rich therapeutic support group held the first and third Thursday of each month from 5:30 p.m to 7:00 p.m at Lakeview Senior Living, 14661 Helmer Road South in Battle Creek.  Pre-registration is required by calling 269/964-0153.
Lisa offers extensive experience in the behavioral health care field and holds a Bachelor’s degree in Education from the University of Michigan and a Master’s of Social Work degree from Western Michigan University.  She is a state Licensed Master Social Worker, a member of the Academy of Certified Social Workers and is certified as a Qualified Mental Health Professional. 
Ganton’s own Diana Duncan, Life Enrichment Coordinator for Reflections Memory Care, joins Lisa.  Diana has over four years of experience working with individuals diagnosed with Alzheimer’s and/or dementia.  She is a certified support group facilitator through the Alzheimer’s Association and has been trained in the “Best Friends Approach”, a person-centered care program for caregivers. Together they provide a dynamic and positive program setting where caregivers can get the real support and guidance they need.  For more information, please call 269/964-0153.

Understanding the VA Aid & Attendance Pension

Finding ways to pay for assisted living and memory care is challenging and stressful. Many families are not aware of a VA benefit that can help – the Aid & Attendance Pension. Aid and Attendance (A&A) is part of the VA’s ‘improved pension’, which consists of 3-tiers. A&A is the highest level awarded to a veteran or surviving spouse who requires assistance with their daily living such as dressing, bathing, cooking, eating and medication management. The application process can be lengthy and frustrating to document, but with the help of a knowledgeable Elder Law attorney in your area, well worth the effort. 
Service Eligibility: Any war-time veteran with 90 days of active duty during a period of war is eligible to apply. A surviving spouse may also apply. You must qualify both medically and financially. 
Military Conflict Eligibility:
Indian Wars: January 1, 1817, through December 31, 1898. The veteran must have served thirty days or more, or for the duration of such Indian War. Service must have been with the U.S. forces against Indian tribes or nations.
Spanish-American War: April 21, 1898, through July 4, 1902, including the Philippine Insurrection and the Boxer Rebellion. Also included are those individuals engaged in the Moro Province hostilities through July 15, 1903.
Mexican Border War: May 9, 1916, through April 5, 1917. The veteran must have served for one day or more in Mexico, on the borders thereof, or in the waters adjacent thereto.
World War I: April 6, 1917, through November 11, 1918, extended to April 1, 1920, for those who served in the Soviet Union. Service after November 11, 1918, through July 2, 1921, qualifies for benefits purposes if active duty was performed for any period during the basic World War I period.
World War II: December 7, 1941, through December 31, 1946, extended to July 25, 1947, where continuous with active duty on or before December 31, 1946.
Korean Conflict: June 27, 1950, through January 31, 1955.
Vietnam Era: August 5, 1964, through May 7, 1975, and February 28, 1961, through May 7, 1975, for a veteran who served in the Republic of Vietnam during that period.
Persian Gulf War: August 2, 1990, through a date to be prescribed by Presidential proclamation or law.
Congress has not enacted legislation that would make the periods covering the 1983-1984 Lebanon crisis or the invasions of Grenada and Panama wartime service.
Medical Eligibility:
The veteran or eligible spots must need the assistance of another person to perform daily tasks – such as eating, dressing, tolieting, bathing. You also qualify if you are blind or in a nursing home for mental or physical incapacity, or residing in an assisted living facility.
Financial Eligibility:
To qualify financially, an applicant must have (on average) less than $80,000 in assets – excluding their home and vehicles.
Applying for the Aid & Attendance Pension Benefit:
The process requires a copy of your DD-214 or separation papers, a medical evaluation by a physician that details current medical issues, net worth limitations, net income, and a list of out-of-pocket medical expenses. You may contact the VA system for more information at: 877.222.VETS, your nearest VA health care facility, or contact a local Elder Law attorney experienced in working successfully with the benfits officer at the Veterans Benefits Office.
Amount of assistance from the Aid & Attendance Benefit:
Amounts will vary from person-to-person, and circumstance-to circumstance. Currently the A&A Pension can provide up to $1,758 per month to a veteran, $1,130 per month to a surviving spouse, or $2,085 per month to a couple. If a veteran is still independent, but has a sick spouse, they could still be eligible for up to $1,130 per month. To best assess your personal situation, and to optimize all the benefits you are eligible for, consider having a local Elder Law attorney review your situation and help you expedite your claim.
Qualification timeline:
Once you have submitted all of your paperwork it takes about 8 to 10 months to get a ‘determination’ letter, sometimes longer. To insure all of your paperwork is in order and filed properly, consider working with an Elder Law attorney experienced in this area, and familiar with all of the regional centers. Often these professionals know which facility and staff are better at expediting the claim, and have working relationships that can ease the process. Once you are qualified, the Aid & Attendance Pension can be made to cover retroactively for up to a year. 

Simple Strategies for Seniors to Stay ‘Heart-healthy’ in the Winter

The winter months take their toll on us, and our hearts. As we age we are less able to tolerate the cold temperatures and become more ‘at-risk’ for cold-related heart attacks. In cold weather, there is more oxygen demand by the heart because it is working harder to do the work and maintain body heat. The most common time of the day for a heart attack to occur is in the morning. Know the triggers and warnings for winter-related heart attacks, and develop a simple strategy to survive.
  1. Bundle up. As we age, we tend to feel colder. Temperature has a direct effect on the cardiovascular system, so it becomes even more important to keep warm. Cold weather can cause blood vessels to constrict, blood pressure to elevate and blood to become more prone to clotting. If your home is cool in the winter, consider wearing layers of clothing – and even a hat indoors, to maintain your body heat. If you need to go outside, dress in layers, and take extra care to protect your head, hands and feet. 
  2. Eat healthier. Cold weather makes us crave carbohydrates, but it’s important to try to eat fresh produce and well-balanced meals in the winter. Replace heavy cream-based soups with fresh vegetable clear broth-based soups. Try to keep fresh fruit and vegetables on hand for snacking. After checking with your physician, consider adding a heart-healthy vitamin D supplement to your daily routine to make up for the lack of sunlight during the winter. 
  3. Take needed medications. Be extra diligent in the cold winter months to take any prescribed medications as directed, and at the proper times of the day. Ask your local pharmacist to look over your entire list of medications, over-the-counter drugs and herbal supplements you are taking to see if there are any that might adversely interact and cause health complications. If you find yourself ‘forgetting’ to take your medication, consider investing in an inexpensive weekly pill holder/reminder container, or ask a relative to help with your reminders. Always keep a complete list of every medication, over-the-counter drug, and vitamin/herbal supplement you are currently taking posted on your refrigerator and in your wallet in the event of a medical emergency. Tell your loved ones where they can find the information if they have to act on your behalf.
  4. Get happy.  Shorter, cooler days spent inside can cause a person to become lethargic, hungry and disinterested. As many as 80% of folks in cold, gray, northern tier states such as Michigan are affected by some level of Seasonal Affected Disorder – or SAD. People suffering from SAD are less likely to practice healthy behaviors, such as exercise and healthy eating. Take time to do things that lift up your mood –  such as going for a walk, enjoying a hobby, or spending time with people you enjoy.
  5. Hold off activities until later in the day. People tend to try and start their daily activities earlier during the winter because the days are so short. Blood pressure naturally spikes in the morning and you could be putting yourself at greater risk for a heart attack by doing early morning activities. The heart takes it’s time warming up, not unlike your car on a cold winter morning. If you are going to go outside and engage in any activity (such as shoveling or taking out the trash) wait until later in the day, and carry a charged cell phone in the event of a slip-and-fall, or a medical emergency. Program in phone numbers for immediate help.
  6. Get your flu shot. Our immune system weakens in the winter. If you get the flu it causes increased stress and inflammation to your heart, and could possibly lead to pneumonia. Your heart and lungs are interdependent, and a stress on one, or both could prove to be fatal.  Getting a flu shot could reduce a person’s risk for a major cardiac event (i.e. stroke, heart attack, heart failure, or cardiac death) by as much as 50 percent.
And finally, know the signs of a heart attack. They are very different for men and women. Keep small bottles of low-dose baby aspirin in your home and car – and on your person if you go out. At the first sign of distress, take a low-dose of baby aspirin and call 911, or have someone immediately take you to the closest emergency room.

How to talk to your parent about assisted living

We all want to stay in our own homes for as long as we can. Our aging parents see the move out of the family home as one symbolic step closer to the end of their independence and life. Understanding this is how your parents feel, there may still come a time when it’s not in their best interest to live alone at home.  How do we talk with them about the realities and dangers of staying at home once their health is failing, and how do we convince them that a move to an assisted living center could be a very good – and positive option?
Most older parents have an outdated vision of ‘assisted living’ as an ‘old folks home’ or a nursing home. This mindset is hard to overcome, but after you do some research on local modern assisted living communities, sometimes a tour of some ‘favorites’ with your parent can help open up the conversation. They are then able to see beautiful, vibrant, active communities in motion, and help start to change their mind-set. The talk about assisted living with a parent is a conversation that needs to start long before the need arises so they feel a part of the decision making.
First – let’s talk about the positives of assisted living: In an assisted living, they don’t have the responsibility of keeping up a home, so they are relieved of the need to hire help or let the house deteriorate. They enjoy private apartment living – filled with their own personal belongings. They have people around should they need medical help or other assistance. They enjoy three meals a day with choices of high quality, delicious food and snacks with nutritional value. They have their housekeeping and laundry done for them. And perhaps most importantly, they make new friends and have an abundance of activities to choose from.
Secondly, on the ‘plus-side’ for you: You know that you can’t keep providing the constant oversight for your parent that has been taking over your life, and by extension, taking over the lives of your spouse and children. But, how do you go about convincing your parent that it’s time think about moving to assisted living? Below are some tips to start the conversation with your parent about making the move.
• First, plant the seed. Don’t approach your parent as though you’ve already made the decision for him or her. Just mention that there are options that could make life easier and more fun.
• Plant the seed.  Offer to tour of some local assisted living centers, if he or she is willing, but don’t push it. Drop the subject if necessary, and wait for another day.
• Watch for a ‘teachable moment.’ Did Mom fall, but escape getting badly hurt? Use that as a springboard. You may want to wait a bit, or immediately say something like, “Wow, that was close. Once you’re feeling better, maybe we could go look at the new assisted living center over by the church. We’d both feel better if you had people around.” Go with your gut on the timing, but use the “moment.”
• Don’t push unless it’s an emergency. It’s hard to wait, but you may need to. Wait for a very lonely day when Mom is complaining about how she never sees her friends anymore. Then, gently, try again.
• Check with family or friends. Talk to your friends and friends of your parents. See if any live happily in an assisted living community nearby, or if their parents do. Just like your first day of school when you looked for a friend – any friend – who may be in your class, your parent would feel much better if there were a friend already in the center.
• Go for a visit. Even if they won’t know anyone, you can still take your parent to watch a group having fun playing cards or wii bowling. Show off the social aspects of a good center. Keep it light and don’t force the issue. Tour more than one center, if possible, and ask your parent for input.
• Stress the personal privacy. Show interest in how much privacy a resident has. Ask about bringing furniture from home and how much room there is. Take measuring tapes and visualize, if you can see some rooms, how your parent’s room(s) would look. Show excitement, as you would do if you were helping them move into a new apartment – because that’s what you are doing.
• A safety net! Stress the personal safety aspects of the new living arrangement.
• No more chores! Stress the fact that there’s no yard cleanup, but flowers can be tended to. There’s no need to call a plumber if the sink breaks, but there are plenty of things to do if people want. There’s plenty of freedom to be alone, but company when they desire it.
• Try it out! Consider having them ‘try it out’ through short-term respite care for a time when you need to be away from the area and are unable to help with their needs of daily living. Often an elderly parent may come into an assisted living for short-term respite care, and want to stay at the end of the respite.
• Join forces. Have a family meeting with the parent and tell him or her how much better the family would feel if the move were made.
• Bring in a third-party. Enlist a respected family friend, the family physician, or your spiritual leader to help make the case for the move. Parents may be open to hearing the same message – but from an outside party, not their (grown) child.
• The loving choice. Let your parent know that it would help you to know that they are safe. Tell them that you are worried about their care and well-being.
The more open your parent is to the conversation, the more engaged they are in selecting a community, the more they understand how living alone in their home is negatively impacting the lives of those around them through worry and time and energy – the more open they will be toward making a decision to move into a safe, secure assisted living community.

How to Prevent Loneliness and Social Isolation in Seniors

Social isolation among seniors is all too common, and will continue to increase as the older population grows. Good health and quality of life for seniors is directly connected to their ability to stay active and socially connected. As they age-in-place in their home, that becomes increasingly difficult. Here are some ways to promote social health and connectedness:
• Offer to help drive.  It takes all your senses functioning at peak condition to be a safe and confident driver. As seniors age, they become more hesitant about their driving skills as their mobility, reflexes, eyesight and hearing start to diminish. With early dementia, judgement can be compromised. All of this creates a reluctance to venture out and do the things they used to enjoy. By finding volunteers to drive to activities, events and appointments, seniors will be more willing to venture back out into life.
• Encourage hobbies and life-long learning.  Ask your senior what they like to do, and what they would love to learn more about – now that they have more free time. Then, find ways to help them accomplish this. It could mean joining a bridge club at the local senior center, taking part in a knitting class, or learning a new hobby like photography. Help them find the passion in their life again.
• Help support religious and spiritual pursuits.  There is comfort in maintaining a regular church routine or spiritual connection with other people. Many seniors find peace and happiness with regular church fellowship, and most churches will place a senior on their midweek home visitation schedule to reconnect. In all cases, spending time with people with a shared belief and values system, thinking about something greater than self, is often inspiring and uplifting.
• Volunteer.  Even if a senior has some physical limitations – they are a wealth of wisdom and skills earned and crafted over a lifetime. Participate in a local grade school as a room ‘grandparent’ to offer patient one-on-one help with reading, or crafts, or simply story-telling about what life was like growing up years ago. Local animal shelters and Red Cross centers often need help with a number of tasks. Call your local volunteer hotline to find all the volunteering needs in your community.
• Having pets or plants to care for is fulfilling.  The act of nurturing can relieve feelings of social isolation. Make certain that the senior is capable and willing to properly care for the pet before giving a pet as a gift. Having a small raised bed or container garden can satisfy a senior’s nurturing drive, and the activity promotes greater health.
• Encourage healthier eating and fitness to promote positive body image.  When you don’t look and feel your best – you tend to isolate, no matter what your age. Help your seniors to eat fresh, healthier foods, and avoid unhealthier processed foods. Keep fresh, washed fruits and veggies –  and salad fixings on hand for quick, healthy snacking. Buy a deli roasted chicken for sandwiches and salads throughout the week. Plan a short ‘mall-walking’ excursion once a week to chat, and window shop. The small steps lead to big fitness and health gains for seniors.
• Have regular hearing and vision tests. When hearing and vision decline, seniors will isolate, instead of participating in activities and conversations. If a senior used to enjoy reading, but has lost interest – it might be because there has been a change in eyesight, and glasses need to be adjusted. Requests to repeat information or statements will often mean there is a hearing loss that could be corrected with a hearing aid. Help your senior stay engaged in life by having eyes and hearing checked annually.
• Encourage using mobility aids, if needed. Balance abilities decrease with age, and falls become a very real possibility. Fear of loss of balance that result’s in a fall, and possible injury can lead a senior to want to limit their activities. If balance is compromised, talk to your senior about using a cane or walker for greater stability.  They may refuse, for vanity reasons – but encourage them to try it for a short while. Often, after using a cane or walker after just one week, most seniors really enjoy the renewed sense of freedom they create.
• Encourage neighborly visits and interactions. With families often living a great distance from aging parents, neighbors become invaluable to seniors. Contact your neighbors close to your parent(s) and ask if they will stop by occasionally to say ‘hello.’ Trusted neighbors will often see changes in daily behaviors and coping that are hard to monitor from afar.
• Shared eating encourages positive interaction.  Encourage seniors to share a meal with others whenever possible, whether it’s with a church group, the local senior center, or a friendly cafĂ© or diner. Dining with others is also likely to help encourage better nutrition, which is crucial for the elderly. Look for opportunities to take a senior out for a meal, or bring over and share something together. Also, look into congregate meal opportunities at local churches and senior centers. Often they also include transportation to and from the site.
 Understand and discuss incontinence issues.  A senior who experiences incontinence may be hesitant to leave their home. Medications and incontinence supplies have come a long way recently, and with the proper help and aids, seniors can feel confident about leaving the home and not being embarrassed.
• Give hugs. Friendly, platonic touching from friends and family, like hand holding or hugging, can lower stress and promote feelings of well-being. People deprived of touch can experience decreased well-being. A simple, friendly hug can make a big difference in the day of a senior – or, anyone.
• Spend extra time if they recently lost a spouse. Older adults are at highest risk for becoming depressed and socially isolate right after a spouse has passed away.  More than flowers, for a senior the greatest gift you can give is your time and simple companionship.  If the depression and desire to isolate continues on for a lengthy period of time, discuss medication options with their doctor to help better manage on-going depression.
• Be supportive of the primary family caregiver.  Caregiving can actually trigger social isolation. All too often, they don’t call doctors when they are sick, and they have little or no time to exercise or eat well. Take whatever steps you can to make a caregiver’s life easier and to allow them to have a social life of their own.
• Is it dementia? Early stages of dementia and Alzheimer’s often trigger isolating behaviors. Confusion, loss of short-term memory, and general feelings of depression combine to cause affected seniors to opt-out of activities they normally enjoyed. If you see withdrawal from activities happening, consider scheduling an appointment with a physician who specialized in geriatric medicine for an assessment. Some forms of dementia and Alzheimer’s are responsive to new, emerging medications.
• Consider assisted living. The emotional, spiritual, physical and social needs of seniors are at the core of every well-run assisted living community. Everything from shared meal times to group field trips to interesting locations helps to encourage seniors to stay active and make new friends. In addition, well qualified clinical staff are able to monitor any changes on a daily basis, while resident care staff help foster independence and encourage interaction. Look for a fully licensed and accredited community that upholds these important aspects in their mission statement. The right assisted living community will help your senior put some ‘life’ back in their years!