About Aging Parents

Why the Obsession with the Bowels?!

noreply@blogger.com (Kathy Quan RN BSN PHN) — Mon, 01 Mar 2010 00:18:00 +0000

Does every conversation with your elders involve the state of their bowels? Listen in on the conversations with their friends and you'll find out more than you ever wanted to know about them as well.
Why oh why do they obsess? And then they eat too many prunes or take to many laxatives and end up with diarrhea! They need to understand that as they age and the body slows down, so will the everyday functions. They may not need to go every day and they can cause more problems than good with the laxatives. Fiber can turn to cement if they don't drink liquids. Read more...

I also have a discussion about this issue in my book.... The Everything Guide to Caring for Aging Parents.... click on the link in the sidebar to purchase a copy.

Happy Valentines Day & Chinese New Year's

noreply@blogger.com (Kathy Quan RN BSN PHN) — Sat, 13 Feb 2010 19:04:00 +0000

Wishing all of you a very Happy Valentine's Day! Feb. 14th this year also marks the beginning of the fifteen day Chinese New Year celebration. It's the Year of the Tiger now. Enjoy!

Hospice Care for Alzheimer's and Dementia Patients

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 05 Feb 2010 01:08:00 +0000

Did you know that your elder with Alzheimer's or other end-stage dementia could qualify for hospice care? Medicare has established guidelines for end-of-life care for patients who have entered a terminal phase of dementia.

In the last and most challenging stages of dementia, caregivers can get support through hospice. It is paid through Medicare, as well as most private health insurances fro those under 65. Intermittent visits from nurses, hospice physicians, health aides, medical social workers, spiritual counselors and trained volunteers can help to reduce the burden of caregiving.

If your elder has shown a weight loss of 3 or more pounds in the last six months, is now dependent in at least 2-3 ADLs (the more the better), cannot converse effectively, is incontinent of urine and stool, and in the last 6 mos. has had a severe health issue such as an infection, aspiration pneumonia, stage III or IV bedsores, or has had an exacerbation of a co-morbid illness, they may qualify for hospice care. The physician has to certify that they have 6 months or less to live. (They can live past six months and as long as they don't show improvement will most likely qualify to continue care until they pass away.)

Hospice care can help to palliatively control and prevent issues such as hallucinations and behavior problems, and infections from such sources as skin breakdown, incontinence, and aspiration. Any pain and respiratory distress can also be controlled to make for a peaceful passing. The earlier the hospice can get involved, the better the control of these issues.

Although dementia patients will most likely not benefit from the emotional and spiritual support that hospice can provide, the caregivers and family members should be able to enjoy this benefit at time when they can be in the most need of care and support.

The hospice agency can assess and help determine if your loved one is eligible for hospice care. An order for a hospice evaluation is needed from the primary care physician. If your loved one is not quite yet eligible for hospice care, the hospice will be able refer to home health or to palliative care until they do meet criteria.

If your loved one is on a managed Medicare or Medicare Advantage program, they will revert to regular Medicare for the hospice care. If they need medical care for a non-hospice related issue, the managed care remains in effect. The hospice agency can explain this.

Don't overlook this valuable resource option. Talk to the physician and arrange for a hospice evaluation. Find an accredited hospice through the National Association for Home Care and Hospice (NAHC) or the National Hospice and Palliative Care Organization (NHPCO).

Is it Time to Consider Hospice?

noreply@blogger.com (Kathy Quan RN BSN PHN) — Sat, 30 Jan 2010 04:33:00 +0000

When your aging parent reaches a point at which he/she seems to be declining and not able to bounce back, it may be time to consider palliative care. Perhaps hospice is an option. Talk with the primary care practitioner and see if a hospice eval can be arranged. Hospice care can help all of you ease into the next phase and maintain a good quality of life and eventually achieve a peaceful passing for your loved one, with dignity and without pain or discomfort.

If your elder doesn't yet meet hospice criteria, the hospice nurse may be able to recommend other options such as home health care. Perhaps some PT to strengthen muscles and increase safety would be advised, or an OT eval for some assistance with energy conservation techniques.

Happy New Year!

noreply@blogger.com (Kathy Quan RN BSN PHN) — Thu, 31 Dec 2009 20:35:00 +0000

Wishing everyone a very Happy New Year!!! Hope this new year and new decade brings you happiness and the strength and courage to continue your journey with your aging parents, spouse, or other loved ones.

Remember to take time for yourself, accept help as needed and to remember only to sweat the big stuff and let the small stuff go.
Have a safe and health New Year's Eve and a terrific 2010!!

noreply@blogger.com (Kathy Quan RN BSN PHN) — Wed, 23 Dec 2009 21:47:00 +0000

Wishing everyone the merriest of Christmases. Even if it's not your holiday, I hope you have a great end to this week. Next week brings us a New Year with lots of hopes and wishes for better things for all as we enter a new decade. Celebrate, have fun, take time to enjoy and make memories. Be safe!

Peace on Earth, Good will Towards ALL Men (Women and children too!)

When the Unexpected Happens....

noreply@blogger.com (Kathy Quan RN BSN PHN) — Tue, 15 Dec 2009 21:08:00 +0000

I'm a bit behind the 8 ball now..... Hope your holidays are coming along and that you are taking time to ENJOY them.

Thanksgiving in our house was a little overwhelming as we found my 82 year old mom had spent the night before in the tub and couldn't get out. She was in remarkably good shape despite this. Spent a couple of days in the hospital (without an answer to why she fainted) and we had our turkey in the ER.

I spent a few days and nights with her and we figured out some things....

Now we have a web cam (granny cam) installed so we can "spy" on her (even works from my smart phone) and make sure she doesn't do that again! (We chose the Panasonic model.) We didn't opt for the typical answer of the little necklace life alert mechanism because it would be in the bedroom or the kitchen or somewhere, and she'll be down somewhere else in the house. Her income is VERY FIXED and even $30/mo for this service would be too much esp. if she doesn't use it right.

There are similar systems that don't have installation fees and a monthly cost. They don't connect to a live person; they simply dial programmed numbers until it get's a response. Some only dial 911. That isn't always what you need and can prove costly for non-urgent issues. We're investigating them. I'll let you know if they work out. I've added several to the Aging Parents Amazon Store if you want to check them out.

She has cordless phones and we have placed them in better access areas. One sits on the bath bench in the bathroom gets swapped out daily so it's always charged and ready. It's not waterproof of course and so she moves it away from the spray, and (hopefully) keeps it within easy reach. We keep a reacher in the tub area too.

We're in more frequent phone contact. Most of all she has been given a new set of exercises to do every day forever now by the home health PT to help strengthen her muscles. This has made the biggest difference. (Thanks Charlene!!!) The few visits she was allowed worked wonders!!!

The shower water has to be cooler so it doesn't make her BP drop. (She loves it way too hot!) She HAS to eat! And she has to drink more liquids. No coffee doesn't count, in fact it dehydrates you. (Dehydration and not eating much that day contributed to her fainting and falling. Perhaps a heart problem, but nothing has been detected as yet. )

She tried to tell me one day she had drunk 2 (16 oz.) glasses of water in the kitchen plus her 2 cups of coffee. Well the web cam told me there had been no glass on her TV tray, and no dirty glasses in the kitchen told rest of the story..... caught ya Mom!!!! So now she knows she can't get away with that!

We know that this isn't the perfect solution and things WILL change again sooner than we like, but she still has her independence for now. Moving to my house wouldn't solve it. Assisted living is out of the financial picture.

Like giving up driving, it would be another big step towards dependence and she would again decline rapidly. That isn't essential just yet. Might be one day soon, or maybe not for awhile. We'll take it one day at a time and be prepraed to make more changes as we have to. Meanwhile Mom has her dog and her TV as loud as she wants it.... CNN all day long and OLD movies when she tires of the same old news stories.

God love her she's healthy and that helps and hinders the situation in various ways. The economy sucks and we don't have many choices. Everyone's story will be different, and yet in so many ways the same.......

It's holiday time and we may only have this one left with Mom so we will make the most of it. Make memories with your loved ones this year. Take some time for yourself too!!!!

Happy Thanksgiving

noreply@blogger.com (Kathy Quan RN BSN PHN) — Thu, 26 Nov 2009 19:26:00 +0000

Wishing everyone a very Happy Thanksgiving. Make wonderful memories today and give thanks for your family and friends.

Medicare Open Enrollment

noreply@blogger.com (Kathy Quan RN BSN PHN) — Thu, 19 Nov 2009 00:30:00 +0000

Medicare's Open Enrollment started last week and continues through December 31. It's time to review all of the options for your elders in their health care options. Medicare has a great setup on their site to explain the differences and provide comparisons.

Each plan can be confusing and each one gives you some great propaganda. Secure Horizons ran a campaign a few years back promising everyone in the local senior "village" that they would have lifetime coverage if they needed a nursing home under this plan. Of course they didn't mention that "lifetime" span had to be their last couple of weeks on earth! So be sure to read the small print and ask lots of questions. The choice become effective Jan.1 and can't be changed until next year.

Look into options for medications, equipment etc. There are varying amounts of copays and coverage rules under each plan.

Are You Caring for a Veteran?

noreply@blogger.com (Kathy Quan RN BSN PHN) — Thu, 12 Nov 2009 00:28:00 +0000

The average caregiver today is most likely a member of the Baby Boom generation (born between 1946 and 1964) which means many of us had parents, aunts, uncles, and perhaps siblings or cousins who served in WWII. We honor them and their memories today on Veteran’s Day.

We also honor ALL veterans for the many sacrifices they have made and make each and every day to keep us safe. Freedom indeed is not Free!!! Thank you!!!!

If you are caring for someone who was a War veteran, or is the spouse or widow/er of a veteran, you might want to check out these resources (Veteran’s Angels OR the American Association for Wartime Veterans) for TAX FREE financial assistance in the care of that person if they meet eligibility requirements.

Another terrific and often overlooked resource is Cleaning for a Reason, a great service to anyone undergoing chemotherapy or other cancer treatment. It’s also a wonderful place to volunteer if you run a cleaning service.

As we work our way towards the holidays, please remember to take some time for YOU! It’s also flu season and if you let yourself get rundown you are much more susceptible colds and flu. Wash your hands often and then wash them again! Stay well!!

It’s probably more important to be organized this time of the year as well. And learn to Delegate. Others may not do it as well as you would, but it’s done. Be grateful and move forward! Take time to enjoy the smells of the season and the memories. Make a few more with your loved ones and rejoice!

photo from stock.xchng.com

A Nice Plug for the Book

noreply@blogger.com (Kathy Quan RN BSN PHN) — Sun, 01 Nov 2009 18:27:00 +0000

Received a mention of The Everything Guide to Caring for Aging Parents in the Best Bets Book section from Bess Pinon, the Library News program coordinator of OregonLive.com today. Thanks!!

Caregiver Fatigue: Take Time for YOU

noreply@blogger.com (Kathy Quan RN BSN PHN) — Sun, 18 Oct 2009 18:03:00 +0000

Well it's been awhile since my last post. As any of you who are helping to care for aging parents know...sometimes you get overwhelmed and lose focus. So this is probably a good time to talk about doing something for YOU.

Caregiver fatigue (also known as burnout) is a common problem for anyone who works in the health care field or cares for loved ones full or part time. In actuality this can apply to almost anyone at any time of their life. For example, in new mothers we attribute it to post partum depression or at the least sleep deprivation.

Whatever you term it as, the point is that you can't go full steam ahead for endless periods of time without taking a break. And you can't feel guilty that you need this break!!!! It's just a fact of life and you have to deal with it and need to plan for it. If you try to be a super hero and keep going despite the fatigue don't be surprised if things begin to go wrong.

You may become impatient, you may become a klutz, or make mental errors. Your ability to cope and handle any situation will be challenged to the limits. In reality, you put yourself at risk, and you put your elder at risk as well.

In order to best take care of someone else you MUST take care of YOU as well. And you need to ensure that you remain part of the solution and don't become part of the problem. Yes that means YOU. No one gets a pass on this one. Everyone needs to be sure to take some time for themselves.

So you need to plan for this either by making arrangements with other family members to spell you, or to hire someone for some respite care. And if other family members are unable or unwilling to help out, then they should help to shoulder the expense. And this may not be an easy thing to convince them of. Until you walk a mile in someone else's shoes, it may never seem as difficult as it really is.

Meanwhile, you need to do little things for yourself to minimize the fatigue as well. This can be as simple as taking a mental break several times a day. Walk outside, or go into a separate room and close the door. Take some deep breaths, close your eyes and escape on a mental vacation to your favorite places. Then stop and rethink the tasks at hand for the next few hours. How can you work smarter and not harder to accomplish your tasks and goals. What two things can you do at the same time so that you can sit for awhile or maybe get a nap?

Try to anticipate needs and save yourself some steps. When you make meals, make enough to freeze some for another day, or to feed your own family as well as your elders. Look for shortcuts that will save you time, but not cost you more in the long run.

Rest when you're tired, and make it be a rest period, not just a slow down. And get some time for you.

Safety Issues in the Bathroom

noreply@blogger.com (Kathy Quan RN BSN PHN) — Tue, 22 Sep 2009 23:14:00 +0000

Grab bars in the bathtub or shower can be a life saving piece of equipment. They are available at most large hardware stores such as Home Depot, Lowes and Orchard Hardware (OSH). Many large chain drugstores also carry some and medical supply houses stock them in a variety of lengths.

They can be installed by the average DIY handy person, but they must be installed according to the directions to ensure that they are safe and work as expected. Attaching to a stud is recommended when possible and using toggle bolts or inserts when not. When drilling through tile, special precautions should be taken and a dab of silicon can help to waterproof the screws and holes. Professional grab bar installers may also be consulted.

In most instances, a home safety assessment by a physical therapist from a home health agency would be a covered expense under Medicare if the client meets the homebound criteria. The therapist can consult on the size and placement of the grab bars (but will not install them for you). Once installed, the therapist can make a return visit to instruct you and the client in safe and proper use of the grab bars. The therapist can also assess the entire home and make recommendations for improved safety and other equipment that may be needed. The client's physician must order the assessment.

A bath bench or chair can be a very useful safety device especially if the client gets short of breath or tires easily. A lawn chair can work in a pinch, but it should be used with a non-slip mat to ensure that it doesn't move or slide. It may tip easily too and the client should not use it for security or balance.

Some bath benches or chairs come with a hole to allow for any incontinence and ease of cleaning the client's bottom.

Again, the physical therapist can instruct in the safe use of the bath bench or chair. Or they may refer to an occupational therapist for instruction in bathing and hygiene with the adaptive equipment.

A raised toilet seat may be recommended for those who have difficulty bending to or rising from the toilet. Anyone who has had hip or knee surgery usually has this ordered post operatively. These come with or without safety rails attached. These safety rails are available for the toilet without the elevated seat as well. These can be especially helpful for anyone who needs something to push with to get up or may not be secure sitting on the toilet.

You can view some of my suggestions on the Aging Parents Store at Amazon.com. Thanks!

Never Forget 9-11-01

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 11 Sep 2009 18:27:00 +0000

Today, we must take a moment of silence to remember and send our thoughts and prayers to those who lost loved ones in NYC, PA, and Washington DC. Never Forget!!!!

Problems With Medications

noreply@blogger.com (Kathy Quan RN BSN PHN) — Tue, 08 Sep 2009 22:20:00 +0000

In a recent newsletter from Shelley Webb at The Eldercare Support Group wrote about how to find a compounding pharmacy because her dad is having difficulty swallowing now. This reminded me that so many people don't understand that not all medications can be crushed or chewed safely. In fact, some shouldn't be altered at all. So I wrote this article at Suite101.com about Taking Medications Correctly.

Anyone who is chronically ill, aging or is on hospice care can have great difficulty taking medications. Some may go down easily while others stick or choke. And it's not always the ones you might suspect that cause the trouble. Some people can swallow the horse pills just fine, and have an awful time with the tiny ones. So it's hard to predict.

People with dementia may refuse to take the medications and anyone who is dying may not be conscious or alert enough to swallow them reliably. This presents a dilemma for the caregivers. In some instances, medications can be crushed and put into a small spoonful of pudding, Jello, or applesauce. A little bit of jelly or even peanut butter can work too. But you have to be sure you get all of the medication into the bite and that it is safe to crush this medication. Ask the pharmacist!

Some meds can be dispensed in liquid form. If your mom or dad still refuses it because of dementia, you can add it to a small glass of juice. But not too much because you need to be sure they finish it.

Some medications need to be altered by a special pharmacist known as the compounding pharmacist. Discuss your issues with the physician and have him/her contact a compounding pharmacy. The talk it over with the pharmacist to figure out the best way to administer this medication.

Get RID of the Throw Rugs!

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 04 Sep 2009 00:08:00 +0000

I can almost guarantee you that one of the first things the home health nurse or physical therapist will encounter and discuss with you and or your elders is those throw rugs!

While they can be pretty especially if they are of the expensive persian rug variety; they can be one of the most dangerous hazards in the house. Yes, they cover a variety of mishaps or old and worn carpets, but they can also present a trip waiting to happen and I don't mean a vacation!

Most older people shuffle their feet when they walk. They may have spent a lifetime telling you to "pick up your feet," but now they have the shuffle themselves. This can feel like a safe gait and many times it can be, but it can also cause them to trip over cords, oxygen tubing and throw rugs.

A fall can result in a broken hip, broken wrist, ribs, or even more serious injury such as a head injury from hitting an object or the ground. I don't have the statistics at my fingertips, but hip fractures result in a huge number of deaths each year. This is often as a result of the surgery necessary to repair or replace the hip or from complications afterwards such as pneumonia.

Even a broken wrist which can seem like a much less harmful injury can be devastating for an older person. Just imagine yourself with an arm immobilized. Can you get yourself dressed, groomed, bathed, or even wiped after using the toilet? Compound this with the many other disabilities your elders may have and you can have a real disaster on your hands.

Go through the house with your elders and clear the pathways of clutter, cords, and throw rugs. If they need long extensions of oxygen tubing consult with the respiratory therapist from the vendor company and see what options can be set up. Perhaps some lengths of tubing can be safely placed permanently and quick-connect adapters used as they move about the house as opposed to dragging long lengths of tubing everywhere. There may be some expense ibvolved, but it can be far less costly than dealing with an injury from a fall.

photo: Herman Brinkman/stock.xchng.com

Sign Up For Medicare at 65

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 28 Aug 2009 19:39:00 +0000

About three months before turning 65 is when it is advised to sign up for Medicare. You can read more about this in my article on Suite101.com. Open enrollment is coming up soon. You can only make changes once a year now to Medicare choices. Here's another article that may help you understand. It was written a couple of years ago, but the basic information and the info in the links will give you some ideas of what you need to consider. See the Medicare site for the latest information.

Confused About Health Care Reform?

noreply@blogger.com (Kathy Quan RN BSN PHN) — Mon, 24 Aug 2009 18:46:00 +0000

Worried about health care reform? Need some plain simple language to tell you more about the FACTS and not the rumors about losing everything or death panels for seniors? Here's a link to some very basic information in plain simple language.

Medicare and Medicaid will still be there for you...

Medicare's Site for Caregivers

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 21 Aug 2009 20:12:00 +0000

Medicare has a web page just for caregivers with a long list of links to help answer some of your basic questions about caregiving for your aging parents.

With Open Enrollment coming up in a few months this may be a good time to begin exploring options if your loved one's Medicare plan isn't meeting their financial needs. There's several links on this web page to help you understand the options and find information to compare choices.

Phone Solutions for the Hard of Hearing

noreply@blogger.com (Kathy Quan RN BSN PHN) — Tue, 18 Aug 2009 18:51:00 +0000

If your loved ones are experiencing difficulties using the phone due to hearing loss, I would sincerely suggest investigating this phone. The Clarity/Ameriphone XL50 offers some terrific options such as the big number pad. It also has the ability to adjust the tonal quality of the voice which is really important in moderate to severe hearing loss. It's like an equalizer that filters out the tones the person can't hear as well and amplifies those s/he can hear. It also has a volume adjustment and a Boost function. The Boost can be set to be on continuously, or as needed by pushing a button while listening.

Being unable to hear well on the phone can be such an isolating thing for anyone, but especially for the elderly who rely on the phone for socialization. This product can help them get back into circulation.

We recently bought one for my mother-in-law who is severely hard of hearing and has hearing aides. It's going to work out really well. She's not technically adept and this phone is easy for her to manipulate. She has to adjust it slightly for my voice versus my husband's and she was able to do this on her own. It's too loud for my father-in-law, but he doesn't use the phone a lot and can use an extension phone.

More information and reviews are available on Amazon.com.

Beyond Coping The Joyful Art of Caregiving 2009 Telesummit

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 14 Aug 2009 22:02:00 +0000

This telesummit ends TODAY, but you can still get the information by clicking on the registration link below....

I am participating in an important FREE telesummit sponsored by The Eldercare Support Group for anyone caring for an aging patient, friend or family member such as parent, grandparent, in-law, etc.
(UPDATE: My presentation was on be Saturday Aug. 8 at Noon ET)

TELESUMMIT SCHEDULE AND FREE REGISTRATION

WHEN: Aug 3, 4, 5, 6, 8, 9, 11, 12, 13, 14, 2009
EXPERTS: Tonia Boterf, Denise Brown, Barbara Freisner, Andrew Mayoras, Danielle Miller, Kathy Quan, Hueina Su, Shelley Webb, Brian Willie, and Jason Young

To learn more about this virtual event, its speakers and how to register, visit:
Beyond Coping The Joyful Art of Caregiving 2009 Telesummit

Once you register, all the details about attending the calls will be emailed to you.

CAN'T ATTEND AT THE SCHEDULED CALL TIME?

That's not a problem because all the calls will be recorded and each will be available for 24 hours after it is completed. You'll also be able to RElisten in case there was something you wanted to hear again.

We also understand that you may want to listen several times or have the information available for family and friends to listen, so besides recording the calls, we are also going to turn them into MP3 audio recordings, CDs and transcripts. You'll be able to purchase them at a very affordable price at the time of registration.

But again, the sessions themselves are all FREE to attend.

Won't you join us?
Again, here's the link to register:
Beyond Coping Telesummit

Welcome to About Aging Parents

noreply@blogger.com (Kathy Quan RN BSN PHN) — Fri, 14 Aug 2009 19:17:00 +0000

Welcome to About Aging Parents. I'm Kathy and I am the author of The Everything Guide to Caring for Aging Parents which offers tips, resources, information and how-to's for those facing the task of caring for aging parents, grandparents, in-laws, etc.

I have been a nurse for over 30 years and the majority of my experience has been in home health care helping patients, caregivers and family members learn the art of caring. The vast majority of my patients have been aging parents and it has been about helping families cope. I drew from my professional as well as personal experiences to write this book as a guide to navigating this stage of your lives.

I hope this site will be helpful to those of you who are just beginning to face this issue as well as those who have been dealing with these issues for some time now. My own mother just turned 82 and my in-laws are in their 80's as well so in addition to my professional experience, I bring my own perception to the table as well. I helped to care for my father who died from the complications of diabetes at the age of 57. We learned to navigate the Medicare ESRD system (end stage renal disease) and Medical (that's California's version of Medicaid).

Together we can navigate this journey, and hopefully make it a more pleasant time for all of us.