Mom needed help at home but didn’t want a stranger

My mom was in her 50s when we first looked into hiring a home health aide to help her around the house.  Unlike the typical elderly or senior person most home attendants are called to care for, mom was still pretty young, in her 50s then. But  she was now blind after a surgery didn’t go as we hoped.

In many ways a home attendant was a good solution since my brothers and I no longer lived at home. I didn’t even live in the same state. But mom needed someone to come into her home to help prepare meals, daily medications and do laundry and light cleaning.  We were also told that the home aide or certified nurses aide (CNA) could even help with bathing and personal errands.

Even after knowing this, it still wasn’t an easy decision. After all we were talking about letting a stranger into my mom’s home when we weren’t there and she  could not see.  I also worried that the agency might send a different aide every week, leaving her even more vulnerable to strangers.

DENVER - NOVEMBER 09:  Nurse Stephen Van Dyke ...

A nurse helps a woman with her exercises in her home kitchen during a home health care visit.  Photo courtesy of Getty Images.

In the more than 15 years my mom has had a home health attendant, we have a broad range of experiences and they haven’t always been pleasant.  Some aides have stolen from my mothers. Some didn’t come to work on time or at all.  Some aides sat around much of the day doing next to nothing and watching television. Some ate more of my mom’s food than she did.  Needless to say that they didn’t last long in the job.

But in fairness, we have had several regularly scheduled home aides who came to work on time and did what was expected.  We’ve even consider some to be family, including one home aide who helped my mother recover from an accident.  Over several months he made sure she did exercises daily to regain the strength in her legs and arms.  Like a baby taking a few steps without knowing it,  we watched her “walk the walker” when she was in a hurry to get somewhere.

The hardest thing about having a good relationship with a home health aide is remembering that it is a professional relationship.  If a home attendant doesn’t do what he or she was hired to do, I have to be willing to respectfully remind them. If that doesn’t work, I contact the referral agency and ask for another home attendant.

Some aides may be happy to leave, but many will not if he or she still wants the work because they don’t know if they will get another assignment with similar hours or within the areas they prefer to work.

That said, I don’t treat our home aide like a personal slave or housekeeper.  I recognize that taking care of my mother is her only responsibility when she is in my home.  I also realized a long time ago that without a trustworthy aide to help take care of my mom her personal needs would not be met and I could not work and do the other things I need to.


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Are 73-year old woman’s sexual comments harassment or sign of dementia?

A reader contacted me recently to ask for advice dealing with an elderly neighbor who constantly makes sexually inappropriate comments.  It seems the 73-year old can’t help talking about the reader’s buttocks  when they meet or talk on the phone about neighborhood business.

DEMENTIA

Common symptoms of dementia include obsessive behavior and inappropriate comments about sex. Photo by Thomas Fahy

Before you label the neighbor a dirty old man, you should know that the elderly neighbor is a married woman  with adult grandchildren. According to the reader, during the many years the two have lived near each other earlier conversations were normal and friendly. But in recent years  the reader has been subjected to such comments as:

“Girl, you  have a cute booty,”

“Baby got back. ”

“Shake it, Shake it,” and

“You have a nice firm butt.”

“Anything that a dirty old man has said to me, she has,” the reader wrote, adding that she caught the woman who is old enough to be her mother staring at her behind.  The elderly woman has even questioned other women about their  sex lives, leaving everyone present red-faced or opened mouthed.

I don’t know about you but this reminds me of the grandmother in Eddie Murphy’s Nutty Professor.

If the neighbor were a man the female reader said she would threaten to tell his wife. However, because the neighbor is a woman with whom she has social ties  the reader doesn’t know how to respond to the senior’s inappropriate comments in a way that “keeps the peace.”

It’s possible that the neighbor knows exactly what she is doing and is expressing  some pent-up desire for women.  But I decided to ask a doctor who has specialized in geriatric medicine what she thinks. The physician explained that the repeated and unexpected comments about sex are indicative of obsessive behavior and that the elderly neighbor could be showing signs of dementia.

While many people associate dementia with memory loss, confusion and  irritability,  Advances in Psychiatric Treatment says inappropriate sexual behavior is a common symptom of dementia and occurs with near equal frequency in men and women.

DementiaGuide said some  common signs of dementia can include the following inappropriate behavior:

  • Is too interested in sexual activity
  • Makes inappropriate remarks in public places
  • Says inappropriate things to people they know
  • Makes unwanted advances to people they know
  • Says inappropriate things to strangers
  • Makes unwanted advances to strangers (e.g. grabs, or attempts to fondle)

Dementia researchers  say to get past the shock of such inappropriate behavior by an older person, you first need to get past how you may feel about any older person having sex.  Ignoring the issue, however, isn’t wise if it is becoming more aggressive. I think that’s especially true if the senior person spends time with young children, teens or other disabled or elderly people.

Care givers who notice such behavior should get their senior loved one tested for dementia, especially if certain comments and actions are out of character for your senior loved one.  If their behavior is the result of dementia, researchers say it is important to manage the environment and to educate and discuss the issues with their care givers and families. Studies show that behavioral  adjustments are helpful.  However researchers say no specific behavioral intervention has been shown to be effective in this area.

As for the neighbor, if I were in that situation the next time the neighbor makes an inappropriate sexual comment I’d calmly but firmly tell her that it makes me uncomfortable and ask her to stop. If she continues with the behavior, given what the physician told me, I’d ask if she realizes what she’s doing and recommend she see a doctor if she claims not to. If those attempts to stop the behavior don’t work, I’d keep my distance.

 


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Nursing home staff cuts could affect the care your loved one receives

Nursing Home

Nursing Home (Photo credit: LOLren)

I read something recently about a trend in nursing home care that  concerned me.  Many facilities are cutting staff in the wake of declining admissions as state and federal governments cut funding to Medicare and Medicaid programs and more senior citizens and disabled people turn to alternative sources like adult day care and outpatient rehabilitation services.

I understand that like any business nursing homes need to be profitable if they want to stay in business.  But staff cuts can affect the care residents receive because the remaining staff have more residents to take care of during their shift.  That could lead to even more employee turnover, or even worse, frustrated employees who adopt undesirable solutions for handling routine needs.

For example when my mom was in a nursing home recovering from an accident she was capable of going to the bathroom with help. But often there were no nurses available to help her.  So the staff chose to put my mother in an adult diaper. It was a humiliating experience and an unacceptable solution, especially because my mom wasn’t bedridden.

When I learned what was going on I insisted that my mother  be taken to the bathroom, and my brother or sister-in-law visited daily to make sure her needs were being addressed. I know many nursing home residents don’t have family members who are able to visit regularly so it makes we wonder what happens to residents who can’t communicate their needs or has on one around to advocate for them.

If you are considering putting your loved one in a nursing home or already have one in a nursing home, in addition to asking about the services and activities offered  you should ask about the patient to staff  ratio. In other words, how many patients will one staff person be responsible for on their shift and if the patients all have similar needs. While your at it, ask the likelihood that the patient to staff ratio will change for the worse and check  the nursing home’s state inspections records. Each nursing home facility is assigned a quality of life or quality of care deficiencies rating.  The rating is  based on the prior two week period before a state inspection and the data comes from the nursing home  so there is no guarantee that things have not changed.

During your visits pay attention to how clean the rooms and common areas look as well as the overall appearance of the residents.  Are their clothes clean? Do they appear hungry or dehydrated?  Are staff members responding to their calls for assistance? Once while visiting a friend’s mother, I had to remind the staff that they had not served her dinner.

I’m not saying that a nursing home isn’t the right solution for your loved one. But you should keep informed about the changes that affect the industry because those changes will affect the quality of care your loved one receives for better or worse.

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A disconnected cell can help save your life

Did you know that a disconnected cell phone could save your life?

A disconnected cell phone can still dial 911 in case of an emergency. I gave the above flip top cell phone to my elderly mom and the disconnected smartphone to my son, who also uses it to play mobile games that have been downloaded on it.

A police officer once told me that a cell phone doesn’t have to be activated to dial 911 as long as the battery on the phone is charged.  I don’t think an operator will answer to take information about the type of assistance you need. But the cell phone’s built in global positioning system (GPS) will allow the police to track the phone to its exact location.

The officer offered this tidbit of information during a child safety outing that I organized for a mom’s group I belonged to. The officer told us that even if we think our children are too young to have an activated cell phone, we should consider giving any kid who knows how and why to dial 911 a cell phone in case the child believes he is lost or in danger.  He said his son learned first hand that it worked when he decided to test it.  Now he knows it’s not a game.

That got me thinking that what’s good for kids in danger can also be good for elderly and disabled people who live alone.  I know it’s hard for some to believe that anyone over the age of 10 would be without a cell phone nowadays. But many elderly people living on a fixed income cannot afford a cell phone. And many who can afford a cell phone don’t think it’s worth the expense if they rarely use it or have a land line.

But a cell phone, even one that is disconnected, could be the difference between life and death for an elderly or disabled person,  especially during a natural disaster.  Just this weekend, tornadoes ripped through Kansas and Oklahoma claiming homes and businesses.  Many people whose lives and property were spared were without electrical power for hours.  Some storms have left people without power for days.  In a situation like that an  elderly or disabled person who lives alone could use a disconnected cell phone to get help if they are hurt or stranded during a natural disaster.

I’m not saying it will be easy to convince an elderly person to  carry the mobile phone. Some seniors who are willing may forget to keep the phone charged.  But if their memory isn’t failing they can be trained to grab the phone if bad weather is imminent if they get into the habit of placing the cell phone at their bedside, on the table next to their favorite chair or in the basket or drawer where they keep their medicines.  It also wouldn’t hurt if you encouraged the practice when you visit or call.

So if you’ve recently upgraded your cellphone or are thinking about doing so, instead of tossing your old phone into a drawer or shipping it to be recycled,  consider this. Erase your contacts and other data and give it to an  elderly relative, friend or neighbor to have available in case of an emergency.

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Increase bathroom safety for the elderly

 

 

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Home safety tips for the elderly

 

 

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Love, marriage and the other elder care giver

Rod and Cynthia

Lets be real.  No man really wants to live with their mother-in-law.  Nonetheless, my husband Rod has shared our home with my elderly and disabled mother  since we said our  I dos.

During these eight years we’ve bickered about a lot of things.  Chores,  spending and whether I’m sometimes too lenient with our son. However, our arguments have never been about whether mom should live with us.

Maybe it has never been a issue with him because mom was living with me when we met.  In fact, she was recovering from a serious fall and had just returned home from a nursing home stay when we had our first official date. Rod was gracious enough to interrupt the evening twice so I could go home and check on her. When he proposed, Rod recognized that I had committed to taking care of my mother and never asked if she would live somewhere else, even though most of my friends and family did.

It’s not like Rod thought my mother would be able to provide some free house keeping or childcare.  On the contrary her medical issues have meant extra work for him. He has prepared her medicines, meals, taken her to doctor appointments, cleaned up after her, and overseen her care when I’ve traveled on business.

When we are home, my mother usually is too.  That often means he has to sacrifice time and privacy with me and allow home health aide workers  in our home to help take care of her. Yet Rod has never complained or made my mom feel unwelcome.

I’m not just lucky to have Rod as my husband, I’m blessed.  So on this day, our anniversary, I want to say to him thank you for being my anchor. I love you and I’m proud of the example you set for our son and other spouses and partners who take care of the people who have taken on the responsibility of being an elder care giver.

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Protect aging parents and elderly from acquaintance theft

Photo of Bank of America ATM Machine by Brian ...

Accompany elderly parent, especially those showing signs of memory loss, to the bank or limit access to debit and credit cards. Photo by Brian Katt,

During a recent walk around their neighborhood my sister-in-law’s mother and her  home health aide made an unscheduled stop at the bank to withdraw $300.

When they returned the home attendant told my sister-in-law that her mother had gotten away from her and when she saw the elderly woman again she was coming from the direction of the bank.

Although my sister-in-law’s mother is approaching 80-years old, her physical health is good.  But she is not swift enough to elude a home health care attendant who is trained to keep watch over an Alzheimer’s patient prone to wondering. While the incident disturbed my sister-in-law, she didn’t make a big deal about it because the home health aide was a substitute visiting for one weekend and because her mother had no bank card or identification with her  to allow her to withdraw funds.   Or so she thought.

The following Monday when checking her bank balances my sister-in-law noticed the withdrawal and questioned her mother.  She didn’t remember withdrawing the money and my sister-in-law didn’t find it among her things.  So she visited the bank and the branch manager said her mother came in with a woman to withdraw the money.

Even though her mother had no identification with her the branch manager authorized the withdrawal because he recognized her as a long time customer making a withdrawal she had been known to make every month until just a few months earlier.

My sister-in-law reported the incident to the agency that sent the aide and once confronted by her supervisor and made aware that camera footage was available, she confessed that she went with her mother to the bank.  She never admitted to taking the money because the teller gave the money to my sister-in-laws mother who left the bank with it.

But is a reminder of how senior citizens can become victims of acquaintance theft, which is a form of elder abuse. It has been my experience that most home aides are honest people and look out for their clients. But some do take advantage of their client’s ailments.

If your parents suffer from Alzheimer’s, dementia or any disability that impairs their memory, sight or hearing, you should take extra precautions to protect their finances.  For example you can:

  •   Set up a joint banking account so you can pay their bills and keep track of their funds.
  • Set up email alerts so that any withdrawal from the account triggers automatic text or email notification to you.
  • Limit balances on your parents debit and credit cards (My mom doesn’t have either), or withhold them altogether.
  • If your parent prefers to bank at a specific branch, become acquainted with the tellers and branch managers and ask them to notify you if she visits the bank without you or someone you’ve authorized to aid her.

Was this information helpful?  If you have other suggestions to help seniors avoid acquaintance theft leave a comment. If you have a question about senior care, being a caregiver or want advice about how to maintain a healthy relationship with your spouse and children while caring for a parent, email me at Cynthia@motherskeeper.com.

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Getting Started

Centers for Medicare and Medicaid Services - M...

Centers for Medicare and Medicaid Services - Medicare & You 2010, official government handbook. (Photo credit: Wikipedia)

So you’ve finally decided it’s time to take a more active role in your parents care.  Perhaps you’ve already assumed responsibility for making sure the bills are paid on time.  You may also accompany your mom or dad on doctor’s visit.  But is it time to move them closer to you or in your home because you’re concerned that the distance or occasional visits aren’t enough to ensure their safety?

Been there.  Know how you feel.   After years of talking about moving my mom closer to me, she and I  decided it was time in 1999.

The first thing I did was establish her residency in the new state so I could open a bank account in her name and obtain medical insurance, either through a private insurer or through a government program. If your parent already banks with a national bank like Bank of America or Citigroup, this likely won’t be necessary because you can access the account from your new home sate. But if you do want to switch banks note that social security will not transfer a participants benefits without the senior’s direct participation.

A bank account in your parent’s name also is important if you are keeping your finances separate and to establish residency and verify the senior person’s  income for nursing homes, housing programs, and government programs trying to qualify seniors for services. Residency is  especially important if your parent plans to apply for Medicaid to help pay for  the nursing home, adult day care or  home health aide.

Mom was already Medicare eligible so I went to Medicare.gov  to research the insurance plans available in the area we’d live. The site provided some great information about the plans’ benefits, costs, co-pays and prescription drug coverage.  It also allowed me to compare plans.

After I found an insurance plan, I looked for doctors who accepted her insurance coverage or were in-network and checked their background and rating.  I choose a doctor whose practice was close to our home so taking her to  senior care appointments would be as simply and quick as possible.  Because mom is blind, I also called the local services for the blind to learn what services they offered (more on that in a later post).

Even though I couldn’t apply for area services until she relocated, I was able to arrange appointments within days of her arrival and get her new insurance effective by the first of the month. And before she left New York, I made sure she had enough medicine to last until she saw her new doctor and was able to access her bank account in the state she was moving from with a debit card.

I had a lot more to do to prepare the house and mom’s best friend came along to help with that.  But the medical and financial tasks were taken care of and in many cases, that will be what most people who relocate their parents will have to tend to first.

For more information about what’s necessary to relocate and establish residency for your disabled or aging parent  contact you local state department on aging or social services.

What was it like when you relocated a parent to your home, a nursing facility or senior housing residence?  Tell us about it.

If you liked this article, you may also want to read these articles Cynthia.

 

 

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Working and being a caregiver is hard but doable

St. Louis, Missouri

St. Louis, Missouri (Photo credit: J. Stephen Conn)

Lately I’ve been thinking about when I first moved mom into my home and the impact it had on my life.  Like I said before, I was 35, single and making a career change.

That in and of itself was hard enough, but I also moved the both of us to a new city where we had no friends or family.  And I spent most of my time studying for some job required professional licenses. My life was mostly a routine of going to work, from there to the library, and back home only to do it again the next day.

It was an awful existence.  But I kept at it because I thought it was something I wanted.  Finally, I decided to talk to a therapist about the anxiety I felt over all the life changes I’d made in such a short amount of time. I don’t remember much of what we talked about, but I do remember feeling overwhelmed and confused. After a few visits to the therapist, the image of myself sitting on her couch looking confused and helpless disturbed me so much that somewhere on Highway 64 in St. Louis during the drive home  I decided that something had to change.

Since I knew that I wasn’t going to send my blind mother who had several major health issues that needed attention back to New York to live by herself, I had to make some adjustments to my career goals. So I dusted off the resume and went back to something more familiar, eventually being able to meld the skills I picked up as an associate research analyst with my journalism background.

I know that many of you won’t be able to change jobs or careers, nor may you want to. But that’s not really the point of this story.  Until that epiphany on the drive home, I hadn’t fully accepted that my life had changed when I  moved mom into my home and became her chief caregiver.  But it had in much the same way your life changes when you become a parent or get married.

Only I didn’t have family around to help me and I couldn’t leave the house without making sure her needs were addressed.  That meant that I couldn’t  work late or go away for the weekend unless I had a home health aide or neighbor check on her during my absence.

Once I accepted my new reality I was able to stop complaining and take a closer look at the elder care and volunteer resources that were available to use.  And I had time to make friends and develop a support system through church and the Society for the Blind so I could go out and have more time for myself.

I’m not going to kid you.  Being a caregiver, especially during the first year,  can wear you down. But you can adapt if you first accept that what you may need to  do most is change your attitude and how you are dealing with the situation.

 

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