The most enabling condition: Attitude!

Adero Allison, PhD, CSA

Hello and welcome to the Transitioning Adults plus® blog.

My name is Adero. My staff  and I operate TA plus to address the life transitions of mature adults. If you are an older adult or help provide care for someone older we will provide articles that are of interest for you and your care recipient.

The best way we can serve you is by assuring that everything we do embodies trust and integrity. We focus on answering questions and providing service that is person-centered. That means our answers focus on your needs, not on our bottom line. As a result we hope that open dialogue on issues faced by you and your older loved ones will drive this blog.

Have a question? Sign in and if we don’t know the answer we’ll ask one of our expert friends to chime in!

~ Adero

Why work with a Transition Coach?

It seems the health industry is catching on to what we have been saying all along. In 2007 when we founded Transitioning Adults plus we established a core of Transition Coaches to help older adults and their families make the right decisions rather than wait for the crisis based ‘only option’. Now we learn that hospital systems are beginning to see the benefit of the services we have offered all along.

“Gwinnett Medical and WellStar Health System, both in Atlanta, use transition coaches to help guide patients through discharge and follow up. A transition coach may go with the patient to a doctor visit and follow up with calls. In addition, patients receive their personal health records and can call coaches with questions after they leave the hospital.” Read more  (FierceHealthcare)

If help with the transitions caused by illness or aging decreases hospitalizations after you have been in the hospital what would happen if families became proactive in seeking the right services and settings for life before chronic illness or falling became an issue?

Check out our easy iTAP program that gives you access to Care Liaisons (yep – we used to call them Transition Coaches) on an ongoing basis to help you prevent some of the negative and expensive effects of not knowing your care options.

ADL’s Are Only Part Of The Picture!

Statistics show that up to 90 percent of seniors want to remain independent in their own homes for as long as possible.

Activities of Daily Living (ADLs) are “the things we normally do in daily living, including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure.”

• A search for activities of daily living on Organized Wisdom  http://organizedwisdom.com  offers  multiple resources including a checklist of ADL’s to watch

• Safety and the ability to take care of daily needs is crucial

Still ADL’s are not the first sign that help may be needed. Whether you are caring for a loved one or living alone some other signs that help may be needed can allow time for planning and maintaining control of your independence.

Pay attention to signs you or your loved one are not keeping up in other areas. These may lead to isolation or depression.

• Money Management – is keeping track of bills getting difficult? Are bills being missed or paid twice? Does a check book that used to be always in balance seem to be out of control with no real change in income or expenses? Identify trusted individuals to manage funds. Perhaps an adult child or a fiduciary. You will know the right choice for your situation and your family.

• Transportation – Are you finding yourself driving less and less? My mother, who is 91, has limited her driving to daytime and surface streets. As her reflexes slowed and her night vision worsened she recognized her limitations and chose to drive safely. Rather than allow that to limit her activities she has developed a network of friends  who like the same types of activities she likes. She is continually telling me about concerts she has attended and parties for family and friends that she goes to. Don’t let inability to drive as far or as late stop you from getting out. Find alternatives that work for you. Many cities have vouchers for seniors to use public transit – buses, trains and taxis – at discounted rates. Your local senior services office should be able to help identify resources available to you. And don’t forget to make new and younger friends. They can be a great resource and a lot of fun to hang out with!
  

• Communication technology – As our technology advances sometimes we find ourselves struggling to learn to use new communication tools. Senior Centers have classes in computer use for those who want to learn to email and send and receive pictures from family and friends. If you find that you are not able to use the devices you have used in the past seek information on assistive technologies that may make communication possible again. From the basic volume controls that make it possible to hear the telephone to on screen keyboards that allow use of a single button to type messages the options are endless. And when you upgrade to a smart phone don’t hesitate to go back into the store to ask the sales people questions about how to make the phone do what you want it to do.
  

 If you need help identifying resources in any of these areas contact your iTAP staff and let him or her do the research for you. Remember – you can prevent isolation and depression by identifying ways to stay active and engaged!

Stay involved!

Plan Ahead!

Follow your dreams!

Making Your Mature Years Exceptional

As I approach what used to be considered old age (mid-fifties and beyond) I realize my planning has been based on my grandparents life spans. Well actually my grandfathers’ life spans. Both of my grandfathers died when I was in elementary school. That would put them in their late fifties or early sixties. They looked old, acted old and had old tired bodies at that age. When I look beyond my grandfathers to my grandmother’s I realize longevity is in my genes. My grandmothers and great aunts all lived well into their eighties, nineties and beyond. I have an aunt who is 100  (8-15-09). In fact there are so many people living as centenarians a new term has been developed for those living past 110 years – Super Centenarians!

Obviously the ‘retire at 65 and live happily ever after’ fairy tale we were fed as children is not the life we can anticipate with ever increasing life spans. Unless we are independently wealthy or have large retirement resources set-aside we must consider what we will do after age 65 as perhaps second, third or even fourth careers. My friend and colleague Barbara Penn-Atkins has written a book which I recommend “70 Is the New 40! Bonus Years to Come.”

As I ponder these changes I am also looking at the opportunity we have now to shape a retirement that is exciting and vibrant. Why should we consider the latter half of life as a downhill tumble? Why not think of ways to make the journey exceptional!

So I began to look at some areas that would make life exceptional for me and ways to help other people find exceptionality in their lives. Some thoughts that came to mind follow.

Never Stop Dreaming! Roger von Oech said that “Dreams are the opening edge of our craziness”. I have used this concept to keep ideas flowing and work progressing on jobs for years but why not apply the same principal to our lives? The Bible says that “people who have no vision die” (my paraphrase). So why do we think we can just stop dreaming and let life happen? If you haven’t seen the movie the Bucket List you might want to check it out. Whether you have a terminal diagnosis, a chronic illness or just a sedentary lifestyle you can make it better by dreaming again!

Maintain a Sense of Home! Have you lost the sense that your home is your home? Have you determined that moving into a room with your children or an assisted living community means you will just live as an outcast the rest of your life? Well stop thinking defeating thoughts and start thinking about what makes home feel like home for you! Put a lamp in your room. One you like to look at that will soften the light instead of having to use the ceiling fixture for everything. Cover your bed in colors and patterns you love to see. Make sure you get covers you like to touch as well. Get a picture for your wall – your children, spouse, favorite vacation spot. If you have already reactivated your dreaming you are already way ahead of me on ways to transcend dullness and make your space feel like home. If you’ve been there thirty years maybe its’ time to de-clutter. Make you home a new home by getting rid of the clutter and reorganizing those favorite pieces of furniture you haven’t looked at in years.

Communicate Your Needs. Sometimes we get in a funk because we feel like our family and friends don’t care about us anymore. This is usually a misperception based on a lack of communication. We spend so much time being self reliant we become afraid to offer help when it seems to be needed. Communication is a two-way street so two pointers are these:
1. If you need help ask explicitly – “I have been so swamped with caring for your Dad. Could you schedule a couple of hours once a week to stay with him so I can get out of the house?”
2. If you see a need for help offer explicitly – “Mom, you look like you need a break. Why don’t I stay with Dad every Tuesday afternoon so you can have a spa break?”
This little bit of direct communication can help families reconnect and spur discussion again. Maybe the solution you offered isn’t right for your loved one but if you will listen with a willingness to hear you may find another solution that works for both of you.

“Mom, I have to work but I would be happy to help by paying for a couple of hours of in-home care while you get out. Are you willing to try that Dad so Mom can have a break?”

Don’t let old expectations bog you down. Stir things up a bit and make your mature years exceptional!

I’m A Caregiver, What Now?

By Adero C E Allison, PhD May 11, 2010

Adult children don’t always think ahead, to the time when their parents may need assistance in their home. Spouses expect to continue to share life together. Each day we get up and go to work  or volunteer positions, stop by the market to pick up a few things, have lunch with friends and return home to share dinner and stories of our day with our loved ones. Whether we are telephoning parents who live across country or chatting across dinner, an important aspect of our lives is sharing the good and bad of our days with those we love.

As time progresses many of us find ourselves in relationships that have changed, gradually without our even being aware of it. For many of us that change occurs as a partner or parent becomes ill and we find ourselves gradually providing more and more care.

Caregiving begins in most families gradually. A loved one needs a little help with a few things now and then. As time passes you may realize your loved one needs more and more help. How does a person determine when they have become a caregiver?

Caregiving actually exists on many levels. I provide care for my parents from a distance. They live independently and manage their daily lives on their own but I call regularly and check on them. I schedule visits to see for myself how things are going and I keep a list of current contact numbers I can call in case I cannot reach them. My friend moved in with his dad who can no longer live alone to provide help with the things we take for granted; things like dressing, bathing and preparing meals.

Caregiving can range from:

• · Calling to check on loved ones frequently
• · Coordinating care through professional services
• · Dropping in to help with hygiene, meals and other daily living
• · Moving in to provide ongoing assistance with daily living
• · Providing assistance with medical and daily living tasks
• · Supporting a loved one in every aspect of his or her life

More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one.

Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009

Many families find themselves in caregiving situations without even recognizing how their family dynamics have changed. If you see yourself providing the kind of help in the list above you are probably a caregiver. If you are a caregiver recognize that caring for yourself is as important as caring for your loved one. In fact, if you do not care for yourself, it is likely you will not be able to provide the kind of care you want to provide for your loved one.

Recognizing that you are providing care is a major step in allowing yourself to provide the best kind of care for your loved one and yourself.

Studies have shown that -

83% of self-identified family caregivers believe their self-awareness led to increased confidence when talking to healthcare professionals about their loved one’s care.

National Family Caregivers Association, Survey of Self-Identified Family Caregivers, 2001.

Just by knowing you are a caregiver you gain the confidence to ask the questions, seek the help and request the clarification necessary to care for your loved one.

So say it boldly. Now I’m a caregiver! And begin your empowered journey to learn what supports are available in your community to make caregiving better for you and your loved one.

Transitioning Adults plus® 1-888-795-6838 or email Info@TA-plus.com

After The Holidays

The whirlwind of the holidays has swept by and now we find ourselves in mid January. If you are like me you wore yourself down in December and caught a cold or flu to start the new year off. If the seasonal virus hasn’t caught you yet it is not too late to slow down, take a breath and make sure you are pacing yourself to allow sufficient rest to keep you healthy.

Resolutions or Plans?

Did you write New Year’s resolutions this year? This process may or may not be good for you but what is good is taking time periodically to assess what is working for you and what is not working. As you begin this year set aside a few minutes each week to jot down some things you would like to see work better. Once they are in writing you can think about what you would change in a practical sense and apply your ideas through the year. Here’s an example:

Sally is caring for her brother. She has taken him into her home and spends most of her time helping him with activities of daily living. Even when she is not helping him she is on the alert because he can no longer live independently. Sally finds a few minutes to sit down in her favorite chair. On the table by her side she has a notebook.  She picks it up and jots down -

“I need more ‘me’ time.”

Under this entry Sally begins to jot down what this would look like-.

Go to the spa this month

• driving time, spa package -3 hrs.
• maybe lunch with a friend – 1 -1/2 hrs.
• someone to spend time with Gary

Notice that Sally chose a spa day.  ’Me’ time can be whatever you like to do. Maybe you would prefer to go to an early movie, visit a book store or museum. The activity is your choice. What is important is that you set a timeline for when you want your activity to occur. If you do not set a timeline your dreams will always be dreams. Setting the timeline turns dreams into plans.

Sally went beyond this though. She took just a couple more minutes to jot down what kind of time this activity would take and that she would need to have someone stay with Gary in order for her to have that time.

Gary needed Sally about then so she had to wait until the next time she sat down to put more ideas in her notebook. This is why you have a notebook next to your favorite chair. Ideas can come in spurts throughout the day. You can jot them down on the fly.

Sally came by later and added notes to her ‘stay with Gary’ item.

• Check cost of day respite
• call for prices on non-medical  in-home care provider
• see if Michael (her other brother) will take Gary to his house for an afternoon
• Gary’s friend Roger said he would help somehow – check with him

Just by having the idea in writing Sally began to remember that there are options available to help her with Gary. Some of them cost money while others involve asking a favor or accepting help from friends and family.

Resources and Self Care

However you began your new year remember that in the back of your mind there are resources you haven’t even tapped yet to help you care for your loved one. Sometimes all it takes to remember them is jotting down some ideas in a little notebook.

As this year progresses remember to take care of yourself. If you are not run-down now plan to avoid run-down by using the resources available to you. If you’ve already over done it – take stock and plan for time to regroup and take care of yourself.

Remember – you are only able to care for others when you care for yourself first!

Have a wonderful 2010!

The Holidays Are Here!

While many of us live for this season so many others find themselves falling into depression around the holidays. To add to the problem we have more to do and less free time so even visiting may become difficult just when our loved ones need to see us the most. Isolation is a very real threat during the holidays. For this reason residential communities and assisted living homes make extra efforts to provide their residents with fun and engaging activities. But nothing takes the place of knowing your family cares.

Gift giving is one aspect of the holidays that we spend a lot of time and thought on. Whether we are deciding where to get the biggest bang for our buck or what will Aunt Martha appreciate the process can be daunting. The task of giving the right gift becomes more complicated when loved ones have limited space in their assisted living residences.

Here are some tips for gift giving to your loved ones who are receiving care, whether in residential communities or in their own homes. We hope these ideas will help you through the holidays this year!

1. Alert Systems -When loved ones are living alone and have health issues sometimes the best gift is a medical alert subscription. Many older adults do not know about services that will check on them or do not have the resources to pay for those services in addition to their other expenses.
   • Phillips Lifeline® provides a variety of signal devices to help provide peace of mind and immediate assistance in an emergency
   • Medic Alert non‐profit organization, online at www.medicalert.org, offers a bracelet or necklace with a toll free number inscribed along with the senior resident’s name and other essential information
2. Family Photos – Whether you give a photo frame with random shots of various family members or stick to the low tech photo calendar this can be a treasure to a person living in limited space. Many copy shops will take your photos and make calendars for you.
3. Media Gifts – Music and Movies make wonderful gifts that can be used repeatedly. Figure out when your loved one was between 15 and 35 and compile a collection of songs of that era. This is especially good for people who have dementia. Memories of the music of their youth can sometimes reenergize them. Put together a movie pack or classic TV shows. If your loved one loves to read but can no longer do so or finds reading  difficult books on tape offers the opportunity to regain the joy and excitement of reading. A book that might interest you is  ElderCareRead Life Scenes1, a reading activity to improve cognitive ability in people with moderate to severe Alzheimer’s and other forms of dementia. Not only does the book provide a gift for your loved one but it helps you spend quality time reading together.
4. Favorite Holiday Family Recipe – Does your family have a cranberry passed down from generation to generation that one bite of says, “Now the holidays are really here?” Favorite food items kindle memories and bring joy and laughter during the holidays. Keep in mind the limited storage capacity of the home or community your loved one may be staying in. Avoid ingredients that are hard to chew and check dietary restrictions. There are many great tasting treats for the holidays that do not have to compromise healthy diets.

Moving away from gift giving let’s touch on some tips for you, the caregiver. As the holidays approach you may find yourself more overwhelmed than usual. When friends and family ask what you would like for the holidays have your list ready. Make it realistic, including things they can readily provide. Some ideas.

1. Errands – it would really help a lot if you could drop this at the cleaners and pick it up for me again before the weekend. I can never seem to get out taking care of Mom everyday.
2. Spa Break – Would you mind coming over on Tuesday for three hours so I can get out and get my hair done and run a few errands. I haven’t had a manicure in months.
3. Visit – Mom misses all the ladies from her church. Could you get two or three of them together to come by for tea one day next week?
4. Decorate – Mom seems to love the Christmas lights but I can’t decorate with her tendency to wander off. Could you and the kids come over Saturday afternoon and put up a small tree for us?

These are tips that will help you let the people around you know how they might help you during the holidays. Isolation isn’t good for care giver or care receiver so plan ways to get together with friends.

And as the year comes to an end now is a good time to update necessary documents. Make a list of the documents you would like to review and update.

1. Check on your Powers of Attorney and make sure the responsible parties are still available to sever in this capacity.
2. Review Insurance beneficiary documents to be sure the right people are listed and their contact information is current. (Don’t forget that marriages and divorces may have caused name changes).
3. Update wills and trusts. The volatile real estate market of the last 18 months may have changed your holdings significantly. Whether things have been sold or purchased their placement in wills and trusts must be managed. Up to date records save everyone trouble in the long run.

Finally remember to find time for yourself! The end of the year is a time of reflection. Rather than run yourself into the ground with constant worry and activity take a minute here and there to relax and refresh.

From all of us at Transitioning Adults plus™ have a Merry Christmas, Happy Hanukah, Blessed Kwanzaa and a warm Solstice.

Celebrate National Family Caregivers Month

When you’re going through all of this, the last thing you’re thinking of as a patient, and especially as a caregiver, is to give yourself something that nurtures you and something that helps you not to get overwhelmed and burned out. Poetry, silence, walks, back rubs, or swimming, whatever, it’s the thing you need most, and it’s the thing you have to give yourself.

~ Marcia Wallace quotes

November is the month that we take time out to recognize the many family caregivers who give of themselves daily. Whether you are caring for someone in your home or managing care from a distance your help is appreciated, perhaps more than you know.

There are many organizations offering seminars and conferences this month to help you learn what you need to make your job easier. Here are some of the places TAplus will be this month.

• Surviving the Holidays Caregiver Forum
  When      Tue, November 3, 9:30am – 1:30pm

Where     Church of the Beatitudes’ Lounge, 555 W. Glendale Ave, Phoenix, AZ (map)

• Arizona Caregiving Conference “Together We Care” 5 more days till the conference! Don’t delay, sign up NOW! The speaker and program line-up is beneficial for anyone in the caregiving or healthcare community. Registration information . . .

When      Thursday, Nov 5 8:00a to 4:30p

Where      North Phoenix Baptist Church, Phoenix, AZ

• LGBT Boomers and Beyond Resource Fair

When         Saturday, Nov 7 10:00AM – 1:00PM

Where       725 W. Indian School Road, Phoenix, AZ 85013

• TAP Education Series: When Home Is Not the Best Option

When         Wednesday, Nov. 11 10:00AM – 11:00AM

Where        SCAN Health Plan of Arizona 1313 E Osborn St. Phoenix, AZ 85014

Click the links above for more information or email me.

How Can Care Giving Hurt Me?

Ad from the Mail Tribune circa 2007

The most obvious effects of care giving are pains noticed immediately when we strain a muscle or twist our back the wrong way helping a loved one out of the car or shower. But the real effects of care giving can be far more serious.

Many people are not even aware of the serious impact care giving is having on their lives until it is too late to reverse the damage. The medical community has begun to describe this phenomenon as Caregiver Syndrome. Are you at risk?

Caregiving typically begins with a little help here and there or a great deal of help after a traumatic occurrence such as a fall or surgery. You may put some of your activities on hold to help prepare meals, clean house and spend time with your loved one. While this is not a bad thing to do for someone you care about prolonged periods of putting your life on hold may have ill effects on you.

Are you spending time doing the things you like to do? Do you take time to see your friends and spend time together just enjoying each others’ company? Many caregivers neglect the things that make them who they are. They see their new role as caregiver as an all inclusive job. Putting life on hold permanently  causes stress related illnesses in caregivers. These illnesses include depression, heart disease, stroke and generally poor resistance to disease and infection.

“Elderly spousal caregivers with a history of chronic illness themselves who are experiencing caregiving related stress have a 63% higher mortality rate than their non-caregiving peers.”*

If you are the primary caregiver for someone you care about take the time to learn how to care for yourself while caring for your loved one. When family or friends ask if they can help be prepared to tell them what you need. Maybe you need someone to pick up things at the store, or someone to sit with your loved one while you go to the spa. Great or small your friends and family can only help if you know what type of help you really need.

Some tools to help you care for yourself:

1. Practice Positive Self-Talk. Instead of “I never make what you want to eat!” try “I am doing my best preparing good food for you each day.” Care receivers typically are out of sorts and find many things they don’t like to complain about. Don’t beat yourself up over complaints.
2. Schedule Time for Yourself. It may be that you need a couple of hours each week to yourself. Find a way to schedule family members or professional in-home care providers to come in and give you that time away. If you need a weekend you may need to plan a little longer but the time away will be worth it.
3. Breathe. Tension causes us to take shallow breaths which add to the stress on our bodies and hinders our ability to think clearly. Remember to take a series of deep breaths. In through the nose, slowly out through the mouth while letting your muscles relax. If you want you can picture yourself in your most relaxing spot at the same time. I like to see myself sitting next to a forest stream. The gurgling water of the stream and the light filtering through the trees helps me relax. Where do you see yourself? Take a mini vacation and go there when you feel like screaming.

Contact us for more information on caring for yourself while caring for a loved one.  1-866-340-9136

Don’t let caregiving overwhelm your life.

Arizona Conference on Caregiving

*Source: Schulz, R. and Beach, S. R., Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study. Journal of the American Medical Association, Vol. 282, No. 23, December 15, 1999.

Sharing Helpful Ideas from Others Who Care!

Many of you may not use Twitter or Facebook so I thought i would share some of the resources and articles I have read recently. Just today I noted information that may help you care for yourself and your loved one better. If you have found articles that resonate with you add them here as a comment to this post.

Today’s best picks include:

Coach, daughter encourage caregivers

Family’s Alzheimer’s experience leads to helping others cope

This article by Ashley Gardner – Texarkana Gazette -Published: 08/28/2009 shares how Coach Frank Boyles have turned the ravages of Alzheimers into an opportunity to help others.

New Screening Offers Support for Caregivers

Another site worth visiting offers ideas for caring for yourself as a caregiver. We all know that caregivers who do not care for themselves become useless to those who depend upon them. This review of a recent research study makes tips and ideas easily accessible. A link in the article lets you check your stress levels.

Aging Gracefully: The Benefits of Exercise for Older

Adults

It’s never too late to improve your health

Sharon O’Brien on About.com offers some tips for getting the most out of exercise without compromising your health.

Just click on the titles to check them out and don’t forget to add your picks!

Simplify!

“Our lives are frittered away by detail; simplify, simplify.” — Henry David Thoreau (1817–1862)

I remember days when I was young and evenings were spent with family and neighbors, sitting on the porch, playing kickball in the street, reading a book or maybe watching TV. As we have become adults with a desire to give our children the things we never had our lives have become complicated beyond belief.

The average household (that used to be two parents and 2.4 children ~ I don’t know what is average now) is consumed with sports events and music or drama lessons for multiple children in different locations. Parents exercise at the gym or relax at the spa and all these activities must fit between work schedules and volunteer responsibilities.

Whatever happened to the simple life? On top of all this many families are finding that the blessing of onger lives brings with it the added need to fit in trips to other cities and states to see loved ones and make sure things are going well with them.

How can you simplify without neglecting the important things in your life? I spoke on simplifying recently and hit briefly on several areas of life but today I would just like to touch on quality of life. Simplifying can mean a whole new life experience that is more enjoyable and more fulfilling.

My business partner spends time working with clients and meeting with referral partners. We both volunteer with Beatitudes Center DOAR as our commitment to give back to this community. But what comes first for Randy is his son, Korey. Family is all important and he guards his time to be sure that he is able to spend quality time with his son. I also set aside time to spend with my partner, away from the madding crowd.

When you look at the way you spend your time where do you see things falling through the cracks? Are you working long hours then bringing work home with you each night? There may be ways you can change that to allow yourself a simpler more fulfilling life. If you work at home there should be a definite door and a scheduled time to close that door between work and home life.

Take a moment or two to just think about what a perfect week would feel like for you. Close your eyes and picture yourself going through that week then open your eyes and jot down some of the things you saw yourself and your family doing. Now consider what is getting in the way of those activities.

Perhaps you need to schedule some family time that allows for playing table games so everyone can just laugh and talk together. Maybe instead of scheduling lessons and sporting events every night of the week over the next few months you might incorporate a family night into your schedule. Talk with family members and learn how to adjust things so that everyone has a voice in the process. Many couples schedule a date night to maintain or rekindle the spark in their relationships.

If you find yourself unable to work through this process alone perhaps it is time for a facilitated Family Planning Meeting.  Our Transition Coaches help families of all ages plan for the life they want to live. Don’t let circumstances drive your life. Instead remain in the driver’s seat and simplify to allow time to live!