Burnaby Seniors' Resources Society

 

 

5 Signs It Might Be Time For a Retirement Community: Independent Living

It’s never easy to come to terms with having a parent transition from living at home to moving to a senior’s community. The process requires a lot of adjustments, but is an inevitable part of the aging process.

With so many different options, it can be daunting to choose the type of living arrangement that best suits your loved one and their unique circumstances.

What is Independent Living?

Independent Living is perfect for active seniors who are looking for maintenance free living in a safe environment. They would still have access to home care services, but also have access to additional support services such as meal preparation, laundry, housekeeping, and emergency response.

5 Signs that Independent Living might be right for your loved one are:

1.    Struggling with keeping up with household tasks such grocery shopping, cooking, cleaning and laundry.

2.    Feeling overwhelmed by home and yard upkeep and maintenance.

3.    A sense of isolation. Feeling inactive and disconnected from friends and the community.

4.    Worries over falls and unexpected injuries. What if something happens and there is no one around to help?

5.    Still passionate about their independence. Want to make their own decisions and come and go as they please.

Choosing a retirement community should not be complicated. At AgeCare, we begin with working with the family to assess their parents’ needs and wants. It’s a consultative approach, as there are many stages in the aging process.

While moving is always stressful, by planning ahead and giving your parent the time and space to cope with change, they can continue to enjoy their independence and thrive in their new home.


Blog submitted by:

Joel Grigg,

Retirement Living Consultant

Harmony Court Estate

http://www.agecare.ca/community/harmony-court/retirement-living/

Between Two Lands: Adult Children Navigating the Cultural Divide

When Parents Grew Up in Another Culture

by Peter Silin MSW, RSW, CCC

 

Adult children who were either born in Canada or who came here at a young age and whose parents came to Canada as adults have some unique challenges. They are in a sense bi-cultural, having grown up surrounded in the home by their parents' originating values and culture while outside the home they are immersed in those of Canada. This dichotomy arises in families of many cultures including Chinese, South Asian, Filipino, Korean, Mexican, South American and others. This month Elder Voice focuses on bi-cultural children caring for aging parents.

The differences between Canadian and other cultures  regarding eldercare can be significant. One woman wrote to Slate Magazine in May, 2013,  "(In our culture) we have books devoted to various good deeds children did for their parents, and an entire ethical code on how children should behave towards their parents, including: do not disobey, do not travel far while your parents are still living (so you can take care of them), so on and so forth. Adult children are expected to live with their parents, to take care of them."

We frequently see as clients these bi-cultural adult children. They are struggling to navigate between wanting to respect and honour their parents  according to  the family  values and culture while at the same time needing to live and work in Canadian culture. There is often tremendous guilt, shame, anger, and fear  when it appears  they have to make choices. There can also be conflict.  One of our clients said to us, "My mother told me I should quit my job and take care of her. I said no. But she thought I should drop everything that I had worked for."

Pressure happens for differing reasons. For some adult children, family roles and traditions play a part.  For example, an oldest son  may find it harder to accept a work promotion out of town  than his younger brother or sister.  Or  a child whose  English was better  became the  family interpreter. Their parents came to depend and lean on them to navigate outside the home, leading them to feel resentment--"why me?" --and then guilty for thinking this.

Not only do adult children risk shame and censure from their immediate and extended family, they may risk it from the community as well. For some the only solution they can find is to distance themselves from their community.  They are never free of the guilt and loss. Moreover they know that  their parents  may feel shame as the children's actions will be seen  in the community  as a reflection on those parents.

Adult children feel often feel economic as well as emotional pressure. There may be the expectation that children will pay for caregivers and other services or will  invite their aging parents to live with them   As one of our clients noted: "I was lucky I had siblings that could do it, but if I didn't I would have had to have her move in with us (husband and family) and I would have had to hire a caregiver. I don't know what I would have done; we could not afford that."  

Bi-cultural children often find their marriages threatened.  If they choose to fulfill the expectations of their parents, then their partners, no matter how understanding, sometimes feel abandoned and as though they are always second in line. The stress  increases as parents needs become greater. Canadian culture accepts that at some point, the most appropriate option for an aging parent might be seniors' housing or a nursing home.  But as one of our clients told us, "In our culture, we just do not do that."

Parents also go through a struggle. We hear often,  "this is what I did for my parents, and I expected  it of my children." They feel a sense of betrayal and  loss and may even feel that they have failed when they see their children appearing to break from traditional culture and values. There is also fear. Who will take care of me? What will happen? And especially--how will I be taken care of?

Expectations are often unspoken. As one adult son said to us, "No one said this is what I have to do, I just knew it was what my parents expected."

Part of the solution is to make the unspoken, spoken, an approach that may not have even been considered. When concerns are expressed, children sometimes find that their parents understand, and are willing to discuss options. We encourage children  to be very clear about what they can and cannot do, and to work with their family to find solutions.

There are often resources to be found in multicultural or immigrant service organizations with counsellors who  work with families. Sometimes there are community supports that parents can be connected to such as Adult Day Centres, any seniors centre, or within their mosque, temple, or church.  

Adult children who come in for counselling find that  sitting in a non judgmental and accepting environment gives them a place  to find solutions that fit. We help them focus on setting appropriate, but also culturally sensitive, boundaries. We  help them find ways to face their families and communities without the guilt, shame and stress that the struggle brings up  Support groups for adult children such as those from the Alzheimer's Society are especially helpful as participants hear others in the same situation.

Marital counselling is helpful to many adult children who find themselves pulled between parents and spouse. The goal of the counselling is not to "get a partner to understand," but rather to create a place for them to find solutions where both feel valued and heard.

There are times when everyone cannot be satisfied. Sometimes  compromises and solutions  only partly help. But the good news is that many adult children and their parents successfully navigate between two cultures. It helps to remember that despite  cultural differences and economic realities, the relationship between parents and adult children is still founded in respect and love.

Diamond Geriatrics is a Care Management, counselling, and consulting company based in Vancouver, BC. Established in 1995, we are Western Canada's oldest  eldercare consulting company. Call us at  604-874-7764 or visit www.DiamondGeriatrics.

 

Meaning Behind the Behavior - by Karen Tyrell

 Looking for the meaning behind the behaviour can dramatically assist caregiver of those with dementia, to determine effective solutions for difficult situations.  This is what Karen Tyrell – Dementia Consultant and Educator from Personalized Dementia Solutions encourages in her workshops and in her book, “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours”.

Here is a story from Karen’s blog to help understand this concept better:

Generally, as a society, we can be very impatient. We strive for short, quick and to the point conversations. That’s when difficulties arise when we have to care for people with slow moving Parkinson’s disease, such as sweet and gentle Mr. Milos.

Mr. Milos lived in a care home and had been doing for years. He could walk on his own but was very frail and staff needed to accompany him on walks to help steady him. When he was not being monitored, he was sat in a tilted wheel chair, so that his head would be supported.

In the afternoons however, when Mr. Milos was not being monitored and was sitting alone in his wheelchair, he would slowly try to get out. He would throw one leg over out of the wheelchair, he showed anxiety, and his slippers always would fall off. Staff who were walking by were always kind and without a thought they’d say, “Oh, Mr. Milos, let me help you sit up in your chair,” and “Let me put your slippers back on, they’ve fallen.” They would help him straighten up in his chair and put his slippers back on and walk away. However, they didn’t ever stop to find out if he needed anything or why he wanted to get out of his chair.

Watching him struggle to get out, I knew there was a deeper reason behind his behaviour; I had to investigate why he wanted to get out of his chair. It was too much effort for him to do for no reason.

I decided to explore and talk with Mr. Milos. I went over and sat beside him, and made sure he could see me. I asked, “How are you doing Mr. Milos? I see that you want to get out of your chair, is there something you need to do?” Keeping in mind that with Parkinson’s disease, you need to be very patient when communicating, I asked one question at a time and gave him plenty of time to get his answers out. He informed me that he had to go to work, and he was concerned about his boss being tough on him for not going to work on time. He was showing anxiety about getting to work and not being able to go. I had to do some quick thinking and using therapeutic reasoning to help, and I said, “oh don’t worry, it’s a holiday today. The boss has given everyone the day off.” Mr. Milos relaxed immediately. He even said in his slow stutter, “oh, I forgot it was a holiday today.”

The challenge in working with people affected Parkinson’s disease, especially in later stages, is that you need a lot of time and patience to communicate with them, and understand them. When caregivers, busy with many tasks and many patients, don’t take the time to patiently wait while the person with Parkinson’s disease gets his or her message across, they’ll never know what the person might need and the person’s needs may go unattended. I’m a great advocate for using interpersonal therapy, which is take an extra few moments to connect with the person with dementia, to understand their needs, their message, and their situation. This will improve any difficult situation and the overall wellbeing of persons with dementia.

If you have questions about how to connect with a person with dementia, please feel free to contact Karen by calling 778-789-1496 or view her website at: http://www.dementiasolutions.ca

Viscous Cycle : C.R.U.D (Completely Ridiculous Useless Debris) by Susan Borax and Heather Knittel


We recently visited a client who was extremely relieved to have dealt with her own personal Mt. Washmore (her term for describing the mountain of laundry that had previously lodged itself in the center of her living room).  In a previous CRUD blog we excoriated the sheer volume of laundry related products amassed by clients in pursuit of wardrobe maintenance. But piles of unwashed laundry or laundry waiting for folding contribute to the disarray.  People, who have a lot of clothes and not enough time to wash, fold and put them away, find their space compromised by the presence of multiple overflowing baskets stationed anywhere there is an empty surface, including every seat in the house.

There are many good reasons why laundry does not get done in a timely manner. Laundry is one of those household tasks that you can perform ostensibly while you are doing something else like reading, cooking or watching Ellen. It’s not like you have to watch your soapy clothes sloshing around through the circular window. But, you could get distracted and be unpleasantly surprised by mildewed clothes that accidently stayed overnight in the washer. If you care about your wearing apparel you know it is prudent not to mix your delicate garments with heavily stained denim in the same load. Thus, the simple task of doing laundry gets broken up into multiple segments that encompass sorting loads, treating stains, deciding what can go into the dryer and what needs to be hung to dry and worst of all, separating what needs to ironed. If you are fortunate enough to have your machines on the main floor of your home, you may be able to manage all this complexity without too much difficulty. But, if your washer and dryer reside in the basement or if you have to leave to use communal laundry facilities or a laundromat, your motivation may be diminish. Postponement only leads to even worse consequences.  Rather than run out of underwear you may have to resort to emergency tidy whitey purchases or at the very least a trip to Walmart to pick up even more unsightly laundry baskets. 

CRUD Challenge

When laundry gets to the point when it threatens to overwhelm we suggest that our clients drop off their unwashed loads at a local establishment to at least get them back to square one. While this one- time solution may be pricey, it is worth it for the sense of relief that accompanies dealing with the problem in one fell swoop. If nothing else, it allows the individual to address the clutter that the laundry piles have the habit of camouflaging. 

From our viewpoint, most systems break down at the folding stage. Once the items are removed from the dryer they either remain in heaps atop the machine or get transferred to baskets. In either case, the clothing looks so rumpled they look like you slept in them for week.  Remember, you cannot throw stuff in the dryer and dash out to a double-feature and hope for the best. Instead you’ll have to haul out the ironing board and remove the wrinkles from what was supposed to be permanent press.

As you can probably gather, doing laundry requires employing management skills or it can easily gain the upper hand. You could reduce your wardrobe as a means of shrinking (no pun intended) your laundry woes. Calling your mother won’t help.


This Blog is provided by Good Riddance Professional Organizing Solutions.

To know more about Susan Borax and Heather Knittel:

Website: http://www.goodriddance.ca

Susan Borax and Heather Knittel
  Tel: 604-421-5952

Email: goodriddance@shaw.ca

Finding Help: Taking the Confusion out of Elder Care by Peter Silin

The first steps in finding help on the rollercoaster of caregiving can be the most stressful ones. This month Elder Voice describes sixteen of the most common types of services and support  available.     

There are two main "streams" of help available to caregivers: the public and the private systems. In the public system, services are provided through your local health authority or health unit. In the private system services are available for a fee and not covered by subsidies. There is a much wider range of services available privately if you are able to afford it.

The following describe some of the many services available. Where we at Diamond Geriatrics provide those services, we describe what we do: 

Assessment: Start with talking to your physician about why the changes you see are occurring  and if they are reversible.  After a basic investigation, he may refer you to a specialist  or clinic for further assessment and treatment for the condition he suspects. If he suspects dementia, options include refferal to a dementia clinic, a hospital inpatient or outpatient assessment unit, a geriatric mental team or a geriatrician or geriatric psychiatrist. These are medical assessments, rather than an assessment of support and service needs. 

Needs Assessment and Care planning: Either through the public system or a care management company such as Diamond Geriatrics, you can engage a care manager who will  do a needs assessment. This  will help you determine what kind of services you need, where to find  them, and how to implement them. As a private care provider, Diamond Geriatrics' comprehensive assessments look at the full range of your needs. We explain the system, the options, and will help you find and coordinate all of the services available both for the present and in the future. We work closely with the public system.

Companionship and personal care: Home Care companies provide services such as help with bathing, dressing, medication, shopping, cooking, and housekeeping. You may be eligible for some home support through the public system. You can also hire a company privately or combine the services from both streams. Home care companies provide hourly or round the clock help. Some have minimum hours per week or per shift, most have a two hour minimum per shift but not per week. They also vary according to price and quality. Before contacting a home care company, make a list of what you or your loved one needs help with. We recommend that you interview at least two agencies. Remember, you are the employer--you get to ask the questions and set the boundaries of what you want. Diamond Geriatrics helps you choose the agency and monitor the care they provide.

Adult Day Care: These are mostly publicly funded programmes that pick up  participants in the morning, bring them to the programme, provide a meal and recreation  and bring them home in the afternoon. They are staffed with a minimum of a nurse and recreation staff.

Mobility and home safety: Home health equipment companies provide equipment such wheelchairs, walkers, or commodes. They can retrofit your home with railings, lifts, ramps etc. You can  rent, buy, or rent to own the equipment. It is often helpful to have a physiotherapist or occupational therapist do an assessment before you call a home health equipment company.

Seniors Housing: When you investigate seniors housing, you may hear terms such as independent living or supportive living, assisted living, nursing homes (complex care) or extended care. The terms and meanings vary but basically they refer to the amount of help available in each setting. Think of it as being a continuum from least amount of help to full care. There is seniors housing in both the public and private sector with a tremendous variation in quality, size and cost. An expensive private residence is not necessarily better than a public facility. Some of the best and most compassionate care we have seen has been through the public sector. Diamond Geriatrics  will guide you   in assessing what you need and  choosing what is best for you. We will help coordinate your move and follow up with you wherever you move for as long as you need us to make sure you are getting the best care possible. 


Rehabilitation Services: Physiotherapists and Occupational Therapists help people to recover after some kind of loss of functioning, either from a fractured hip, long hospitalization, or changes in cognition. Hiring private rehabilitation therapists can make the difference between being able to live at home, or having to go into seniors housing. We work with our own physiotherapists and OT to provide assessment and treatment.

Downsizing and Moving Services: Downsizing and moving services help to take  away the stress and worry  about moving by doing everything. They will pack up what you want to take, dispose of what you do not want, help plan for space usage in a new place, and deliver and set up your belongings.

Care monitoring and advocacy: Care or Case managers  track the services you receive for quality, reliability, and effectiveness. Public case managers may have 150 or more individuals under their watch and are only available during work week hours.They control access to all public services and housing. Diamond Geriatrics Care Managers also track services, but as a "boutique" service we follow only 20-25 clients per care manager and are available 24/7, 365 days a year. We follow up and work closely with family members when your relative is either at home or in a residence, monitoring progress, recommendations for care and revising care plans and approaches. When you are far away, we are there in the same way you would be.


Drivers: Companies that specialize in driving seniors and people with disabilities cost more than a taxi but they also do a lot more--taking people in for an appointment, accompanying them for shopping, unpacking groceries. With repeated outings, they build a relationship with their clients. Sometimes this service is also available through a home care company.

Meals: There are several companies that provide nutritious and tasty frozen meals that can be ordered by phone or online. Public programmes such as Meal on Wheels deliver food, while others like Wheels to Meals brings individuals to a centre to have a communal meal. Many senior centres provide inexpensive and nutritious hot meals. We sometimes recommend the frozen meals available in any supermarket--they have come a long way from the tater tots and frozen peas of the 1960's TV dinners!

Safety Monitoring and Alarm systems: There are several companies that provide alarm systems that can be activated by pressing a button or are automatic in the case of a fall. Some companies also provide visual monitoring, or can monitor if medication is taken. When there is a problem detected in any area, the monitoring company will alert you.

Problem Solving and Counselling: Counsellors are sometimes available on a limited basis through the public system and non profit agencies. Professional counsellors from Diamond Geriatrics can help you work through the tough decisions you have to make to find solutions. We help you with emotional issues such as grief, loss, stress, coping, guilt and transition or practical issues such as mediation and family meetings and care planning.


Online support and information: There are dozens of sites that focus on advice to seniors and caregivers with a range of information. Several of these have forums where caregivers provide support and information to each other.

Support Groups: Caregiver information and support groups are available both through the public system and through all of the "disease specific" organizations such as the Alzheimer's Society, Parkinson's Foundation, Diabetes, and Arthritis Society. They are essential in helping caregivers cope and have excellent up to date information on the disease, all in addition to providing emotional support.

By now you have the picture-- there are dozens and dozens of different services available to seniors and caregivers. You can find many of the types available from Elderpost.com These include money managers, personal historians who will make a book or a video of your life, hearing and vision companies, elder law attorneys, financial advisors and personal money managers and more. Diamond Geriatrics can help you find them and put together a care system and plan which suits you. 

 

Diamond Geriatrics:

Taking the confusion out of Eldercare

 

Diamond Geriatrics is a Care Management, counselling, and consulting company based in Vancouver, BC.Established in 1995, we are Western Canada's oldest  eldercare consulting company. Call us at  604-874-7764.                      www.DiamondGeriatrics.com

 

What She Can Do. Not What She Cannot by Peter Silin, MSW, RSW, CCC

So often, it seems, the focus on someone with dementia is on what they cannot do. Partly, of course, this is because they need help   to make up for the deficits in  their  abilities-- to wash, bathe, prepare food, even spend time alone. But the challenge is to  remember to look for and pay attention to  what she can do.This is the difference between quality of care and quality of life. This month Elder Voice focuses on ways to help illuminate  potential as much as we do disability.

The following two scenarios demonstrate different aspects to finding the  potential and abilities of the people in care. What we can see are clues to how improving quality of life.

Scenario 1: Dinner in the dementia care unit of the nursing home where Mrs. A. lives is served on plastic dishes and cups. When we asked the  Administrator why the residents were given plastic instead of china which most of us  would use in our homes, she told us "they" (the residents) would drop and break them which would be dangerous as some people their don't keep their shoes on.So it is done for safety and due to the limitations of the residents.  Yet when we walked into the dementia unit of the home a kilometer down the road  during dinner time, the  tables  were crowded with glassware and china.  Clearly, her beliefs made her unable to see potential and it affects the quality of life.

Scenario 2: 96 year old Mrs. B. lives on a noisy, crowded, heavy care floor of a nursing home,where most of the residents have dementia. A former well known portrait artist whose subjects included members of the royal family, she can no longer walk. Due to dementia, her  short term memory is so poor   she may not remember what she was told two minutes after being told. When you see her in her wheelchair alone and staring out a window, she looks like she is in another world. But the other day as we came to check up on her and her care, we told her about a trip we  took into the jungle of Mexico, where the villagers still made their own chocolate and coffee from wild cacao and coffee beans. She replied, "Most of us don't  know where our food comes from anymore. We have lost so much." Despite her dementia and appearance, her words showed remarkable awareness and insight.

In nursing homes, it is easy to see how short staffing can affect approaches to care, which can lead to the depersonalization of residents with dementia.  They become seen by some  staff as a homogenous group of "them."  As  these caregivers rush to try to complete the personal care for several residents in a row, a home can become almost factory like--get the first one up and washed and ready for breakfast and then move to the second, and then to the third. If there is a behaviour problem, give them a pill. Staff stop paying attention to a person as an  individual and don't think about who she is, what she may be capable of, and more important,  how to challenge her and make her life as meaningful as possible.

To combat this, we need to shift our attention when we think  about someone with dementia-- whether they are at home or in a facility, or whether we are paid or non paid caregivers--so that their dignity and self respect are maintained. Here are some of our thoughts and the key words we use to help us to remember what should be the basis of our relationship with the people we care for:

CAN When someone with dementia is treated as though they are  able  to do, enjoy, or benefit from something, we often find that they do so. We need to be ready to exam what we think of as truth and recognize whether this is just our assumption. So go ahead and make assumptions about what she can do. She can use nice china. She can have a meaningful conversation.  She will enjoy dinner in a nice restaurant.  She can help cook. She can make decisions. 

WITH Think of yourself as caring with and doing with, not caring for him or doing  for him. What can you do together? Go shopping with him, as opposed to for him. Cook with him, not for her.  Go for a walk together, don't take him. Choose clothes with him, help him to dress, don't dress him.

RELATIONSHIP Always remember you are  in a relationship be it your client, parent, or patient. You are part of the equation when you are together. Whenever you can, enjoy yourself as well. Do things that are fun for both of you of you. Something as simple as showing pictures of your grandchildren, trying out different perfumes or colognes, watching hockey, or  talking about what you will do or have done lately. When you share yourself and your enjoyment   he will feel that and will experience the pleasure with you.

LISTEN Understanding the needs of someone with dementia isn't always easy, especially when a caregiver is tired, stressed or busy. To discover what she wants might take  a while and you may have to interpret her words or behaviour.It takes both patience and skill. But if we are willing and ready to really listen, by taking the time to stop and focus and let go of our assumptions about what she is trying to tell us because we think she will not make sense, we will hear her.

CHOICE  As we begin to listen, to do with and not for, and stop making assumptions about what someone can do, we find we are engaged with a person who has more ability to make decisions than we thought. He may not make decisions about everything, but he will have the opportunity to do what he can. And if it appears that he is not able, then before we take away the choice and opportunity, we need to know if there is a way to help him so that he can. In other words, is the difficulty with him in choosing, or with us and our lack of skill or willingness in helping him to choose? 

 We know that dementia is a progressive disease; this means by it's nature that the ability of someone with dementia to make decisions, interact, perform self care and recognize people declines. As that happens the approaches of doing  with, encouraging choices, and  listening become more of a challenge. But before we conclude this approach is no longer effective, we need to remember to think about the fire that  burns dimly for  a long, long time before it finally goes out.       

 



  Diamond Geriatrics is a Care Management, counselling, and consulting company based in Vancouver, BC.Established in 1995, we are Western Canada's oldest  eldercare consulting company. Call us at  604-874-7764 or visitwww.DiamondGeriatrics.com

 

BSOSS' Seniors Helping Seniors Help Themselves by Linda Comba

“Growing old is not for the faint of heart!” I’m sure that many of us have chuckled over this aphorism. That is, until we are old and experiencing those life altering changes and losses which are so overwhelming. Those annoying aches and pains give over to serious physical health concerns. Our social support network shrinks as family and friends become less available to us through death and incapacity. The opportunity to make new connections diminishes. The meaningful roles which defined our purpose in life, our self-worth, are no longer open to us.

 

Yes, facing these changes and losses can be unbelievably challenging, and coping with them and moving on does take courage. And sometimes it takes a listening ear and a helping hand to overcome the feelings of loss, loneliness and depression associated with widowhood, serious health problems, social isolation, increasing personal dependence and overwhelming caregiving responsibilities.  

 

Since our inception in 1987 as a non-profit organization, the Burnaby Seniors Outreach Services Society, through our peer counselling and related activities, has been providing emotional support and encouragement to older citizens of Burnaby and their family or friend caregivers, assisting them to enhance their quality of life, to develop problem management strategies, and to maintain the greatest level of independence and dignity possible.

 

BSOSS programs include:

. Senior Peer Counselling, a free, confidential one-to-one supportive counselling to seniors facing emotional stress as a result of life changes. It is not professional counselling nor does it replace it.

. Reconnections, a facilitated peer supported group experience of self-discovery and personal growth which assists seniors to develop or enhance the skills and confidence they may need to find purpose or reconnect into the community after they have experienced a significant loss.

 . Burnaby Family Caregivers Project, a free programme which assists seniors or boomers who are caring for an elderly family member or friend, providing education talks, a support group, phone consults, and an annual resource and information fair, in order to improve the quality of life for the person for whom they are caring   and to reduce caregiver stress.

 

In addition, we provide community outreach, education, information dissemination and referral when necessary to more appropriate community agencies and professionals. As peer volunteers or members of the Board of Directors, seniors have the opportunity to do something personally enriching, meaningful, useful and stimulating.

 

Although the BSOSS programmes are coordinated by gerontologists, our premise is that seniors are uniquely qualified to provide support and encouragement to other seniors who are struggling to cope with significant losses and changes in their lives. Extensive skills training combined with a warm and caring personality and the knowledge, insight and wisdom gained from a lifetime of coping with loss and change give the peer helpers the understanding, empathy and patience to assist others.

 

The key to successful peer helping is the training we provide all our support volunteers in the fundamentals of empathic listening and counselling techniques, problem solving methodology, age related issues and community resources. The opportunity to learn and do something meaningful and rewarding is also of immeasurable value to the senior peer volunteers. They take away with them effective interpersonal and life skills to use for themselves and share with those with whom they come in contact on a daily basis.

 

If you are or if you know a senior or family caregiver in need of the support our peer volunteers or professional staff can provide, or if you are a senior wishing to do something meaningful in your community, please contact us at 604-291-2258 or email bsoss@telus.net. Additional information is available on our website: www.bsoss.org.

 

Caring for Seniors with Mobility Problems by Wendy Scott of Nurse Next Door

 Mobility problems have serious consequences for seniors, dramatically altering quality of life. Accidents, two-thirds of which are falls, are the fifth largest cause of death in the elderly and can both be caused by, and result in, mobility problems. The following scenarios can answer some of the most common questions.

 

Q.        How can I help my parent recover from a temporary disability that caused mobility problems?

A.        For a temporary disability, you might want your parent to recover either at your home or your parent's, until normal mobility is restored. Or, you may want to hire a home care aide who can assist your parent -- by shopping, cleaning and cooking, as needed -- until your parent is back on his or her feet.

You have the same options if the disability is long term, but the situation would then be ongoing.

Some parents enter assisted living, or even nursing homes, when mobility becomes very limited. Others move closer to, or in with, a grown child. Others hire home care aides or transportation providers.

Q.        Are there any devices that could help my parent's mobility problems?

A.        Ask your parent's doctor or occupational therapist about mobility aides -- devices that should help him or her get around more easily. Some of these include canes, walkers, transfer boards and transfer discs (to help slide out of bed), canes with large handles, risers (sort of like booster chairs) for chairs or couches, swivel seat cushions for the car, and wheelchairs.

Q.        What changes need to be made in my parent's home to accommodate the new wheelchair?

A.        Homes can be modified with:

  • Ramps, instead of stairs, at entrances
  • Widened hallways to permit easy wheelchair passage
  • Roll-in showers that are wide enough for wheelchairs and have grab bars to hold on to
  • Raised toilets that are easier to access and that have grab bars next to them
  • Sinks and counters at levels that can be reached from a wheelchair
  • Wider doors that are easy to open.
  • Stair lifts

Q.        Should my disabled parent get a handicap parking sticker due to mobility problems?

A.        Having a handicap parking sticker would ensure that your parent could always park close to the entrance of the building he or she is going to and might enable your parent to get out more.

Handicap parking stickers can be obtained from your state's registry of motor vehicles. The application usually requires a doctor's signature.

Of course, many communities provide rides for seniors, which would be another option, as would taking a cab or getting a ride from a friend or relative.

Q.        How can I help my parent with mobility problems when she fears that she will fall again?

A.        Have a trained professional -- which includes geriatric care managers, certified aging-in-place specialists, and most employees at home care agencies -- evaluate your parent's home to make sure it is "fall proof." This will most likely involve:

  • Removing any clutter from the floor
  • Clearing passageways from the bed to the bathroom
  • Securely fastening all rugs
  • Removing non-secure scatter mats
  • Enhancing lighting in all entrances and staircases
  • Installing grab bars in the bathrooms
  • Adding banisters next to all steps that don't have them
  • Replacing stairs to the front door with a graduated slope.

In addition, encourage your parent to speak with her health care provider about exercises to improve balance, or to see a physical or occupational therapist (someone trained to help people overcome disabilities to function in work and home environments) to learn these exercises.

Q.        How can I help my parent cope with her frustration over mobility problems?

A.        Here are some ways you can help:

  • Suggest that your parent join a support group. Sharing frustrations and coping strategies with others in her situation could help. You should check with your communities Aging and Disability Resource Centers for local groups near you.
  • Some seniors have benefited from the regular practice of relaxation techniques, which have been found to decrease anxiety and boost the immune system. Talk with your parent about the different relaxation techniques available, and see if one feels comfortable for her.
  • Another option is to ask your parent's doctor for anxiety medication.

Q.        How can I help my parent who has mobility problems, an uncertain gait, and seems very frail?

A.        Movement and exercise can help strengthen muscles and bones and diminish the balance problem. However, your parent will need to move carefully and safely, perhaps with the help of a walker or of an attendant -- either a family member or home care aide. Here are some suggestions:

  • Talk with your parent's health care provider to learn if any exercises would help. Be sure you know how to do them properly, and then guide your parent while he or she does them. Or, if you live far away, encourage your parent to do the exercises and help find someone to work with him or her to do them properly. Offering positive reinforcement for movement, while also acknowledging any pain your parent may be experiencing, can strengthen your parent's determination to keep moving as much as possible.
  • Ask your parent's physician to arrange for someone to show you how to help your parent get around. This person could be a physical therapist, visiting nurse, occupational therapist (someone trained to help people overcome disabilities and to function in work and home environments) or social worker, who could also help you arrange for medical equipment (wheelchair or walker).
  • Warn your parent not to carry bulky loads, such as laundry or garbage, as these could destabilize him or her. Find someone to do your parent's laundry as needed and to take out the garbage.
  • Have a physical therapist teach your parent how to fall safely and how to get up from a fall. Practicing these measures could help overcome fear of falling.

Q.        How can I help my parent who seems depressed over mobility problems?

A.        Here are some specific things you can do to help your parent cope with mobility issues:

  • Validate your parent's sadness and frustration over this major change in life.
  • Help your parent think of alternate ways to see friends (such has inviting them to his or her home instead of meeting them somewhere) or participate in social events (have someone help her to get there).
  • Make sure your parent receives successful treatment for the depression.

 

Wendy Scott is the Owner & Director of Care Nurse Next Door Home Care Services in Burnaby, New Westminster and Tri Cities and has a passion for inspiring and improving the lives of others. Nurse Next Door provides home support, companionship, personal care, palliative or live-in care, Alzheimer’s and Dementia care, and meal prep and housekeeping services.   Wendy can be reached for questions or comments at wendy@nursenextdoorburnaby.com.  Read more at www.nursenextdoor.com or call us for a free in home consult 604-553-3330

You Have A Cold? by Dr. Margret Holland, B.SC., N.D

Understanding how your body responds to invading organisms can be a huge advantage in eradicating a viral infection and even in preventing a more serious illness that may follow.

The typical response is where you develop a runny nose, watery eyes and maybe even looser stools and vomiting. The goal at this stage is to help the virus to move more quickly out of your body. You may also develop chills as your body tries to increase it’s baseline temperature (fever), this happens in order destroy the virus with heat and to encourage the development and circulation of white blood cells.

You must not take anything during this stage to dry up the mucous secretions or bring down your fever. To do so would be to encourage the virus to continue to thrive and thereby prolong and/or worsen your infection. At this point in your illness, you should rest, keep warm, drink plenty of fluids and take herbs that support the development of the white blood cells. Any of the Echinacea’s available on the market are a good choice. A good Chinese preparation is GanMaoLing to serve a similar purpose, vitamin C and zinc will also be of benefit.

When your body has attained it’s new base line body temperature, it will stay there for several hours to several days. When the fever has accomplished it’s goal, it will start to come down of it’s own accord.

At this point, you will start to feel hot and sweaty and you will be less inclined to climb under the covers. It is now safe for you to try and decrease your fever. Cooling baths, and other fever reducing products may be of benefit.

Understanding this process makes it easier to comprehend why the use of fever lowering medications during the early stages of an illness may not be the best medicine. In fact, trying to stop your natural immune reactions will, overtime, do more harm than good. If you are unable to completely destroy the virus, it will remain dormant in your body and slowly deplete your overall health. This is the suggested cause of diseases such as fibromyalgia, multiple sclerosis and chronic fatigue. Often in patients suffering from these illnesses they will be able to pinpoint a time in their lives when they were chronically sick with one “flu-bug” or another. If you have progressed to any of these illnesses, it is wise to consult with a Naturopathic Physician in order to overcome the latent infection and re-reinforce your natural immunity.

Dr. Margret Holland's website: http://www.drhollandnaturopath.org/

 

If Sherlock Holmes Were A Caregiver: Understanding Aggressive Behavior and Dementia by Peter Silin, MSW, RSW, CCC

86 year old Susan was a client of ours whose dementia had been progressing steadily over several years. Her caregivers were a set of dedicated, compassionate, gentle and caring people. They were committed to giving her the best quality of life possible, keeping her clean and comfortable, preventing skin breakdowns and infections, and providing her with nutritious food and a variety of stimulating experiences. Despite their skills and caring, at one point Susan started becoming aggressive while they were helping her with personal care, yelling, threatening, grabbing their hands and wrists and not letting go, and more. When she "turned on them" it was a shock.

As dementia progresses, caregivers often find that their loved one's personality and/or behaviour changes. It can be particularly challenging when they suddenly and uncharacteristically become physically or verbally aggressive. Caregivers need to be detectives to search for the meaning of this behaviour. While it can be challenging to move beyond the emotion you may feel and focus on the reason, shifting into a questioning mindset is key. And when you know what to look for, it is, as Sherlock Holmes might say, "Elementary, my dear Watson." This month Elder Voice looks at what may be behind aggressive behaviour in dementia.

Aggressive behaviour is often a reaction to something; it is a way your loved one has for trying to communicate with you when they otherwise can't. In other words, there is probably a good reason for aggressive behaviour. It is not random and does not "just happen" or come out of the blue. Consider the context in which it occurs.

Issues that may trigger physical or verbal aggression include the following:

  • Delirium due to a physical condition such as a urinary tract or chest infection;
  • Over-medication, or a reaction from the interaction of multiple medications;
  • The existence of pain which the loved one is unable to locate, describe or even verbalize. It may be something that is chronic such as arthritis, or it may be something that has happened such as a fracture, pressure sore, toothache or mouth infection. When they are moved or touched in a way that contacts the area of pain, they react to try to stop it.
  • Discomfort due to constipation, environment (heat/cold), seating or positioning, and others;
  • Fear of the person giving the care. Even if it is a family member or someone they have known for a while the person may forget who that person is or the caregiver may remind them of someone else with whom they are not comfortable;
  • Fear of the situation: Especially during intimate care or bathing, to have intimate touch by someone can be embarrassing and threatening especially if they do not understand what is happening or why;
  • Historical reasons for the behaviour such as a history of physical or sexual abuse.
  • Visual or auditory hallucinations--seeing or hearing things or people that are not really there but seem very real to them;
  • Over tiredness; and
  • Feelings of loneliness or abandonment

To understand what the problem is consider the above and also the events that precede, accompany, or trigger the behaviour. Try to determine if there is a pattern to the outbursts that you can detect. You might want to keep a log for several days and see if a pattern arises.

Some of the things to observe are the following:

  • Bowel movements regularity;
  • Changes in urine or urinating patterns;
  • Time of day or night at which the behaviour occurs;
  • Who else is around;
  • Where they are at the time, e.g. in a chair or in bed;
  • What else is happening at the time (i.e. feeding, TV or other disturbance, etc.)
  • What was happening when the behaviour started;
  • Whether there have been changes in medications or routines;
  • If there has been a change in caregivers;
  • If it happens when the person is being moved;
  • If they appear to be talking to someone or watching something you cannot see;
  • Whether it occurs around certain care, or when a particular part of the body is involved, such as intimate care, eating, or when an arm or leg is moved; and
  • if there is any skin redness or open areas.

It is very important that you involve professionals. The family doctor may order tests, change or review medications, or refer you to a specialist in Geriatric Mental Health. A pharmacist can review medications as well for possible unintended side effects. Diamond Geriatrics can do a full assessment for you which includes looking at the environment, behaviours, and interactions.

Sherlock Homes would look at a mystery from every angle. It is sometimes helpful for caregivers to step back and think about how they are approaching the person they are caring for and see if there is anything about their own behaviour which may be contributing to the escalation in behaviour. Are you feeling stressed and is this influencing how you provide care? Do you need to slow down and approach your loved one more slowly, so they are not startled? Maybe you need to explain what you are going to do, or find a way to provide distraction.Do you need to have someone take over for you or work with you? Try to remember that as dementia progresses, the skills and approaches you use in providing care may need to change. Also, what worked one day may not the next day so you need to be flexible. Most important, remember that it is not a rejection of you or an indication of the kind of care you are trying to provide.

In summary, it`s easy to believe the actions of a loved one with dementia may seem random. There may be some truth to that belief at times but not usually as it relates to aggressive behaviour. It may not be easy for you to cope with, but the behaviours may be the clearest way that your loved on has to communicate with you. Your challenge (and opportunity) is to realize this, and to solve the puzzle.

 

Diamond Geriatrics is a Geriatric Care Management, counselling, and consulting company based in Vancouver, BC. Call us at 604-874-7764 or visit our website: www.DiamondGeriatrics.com

Dementia, Elopment and Wandering by Peter Silin, MSW, RSW, CCC

On a recent rainy afternoon, we got a call from the sister of a client who lives in one of the best nursing homes in Vancouver. "Peter," it's W," she said in a voice tight with worry. " I'm in T's room. She's gone and nobody knows where she is. She isn't in the building. "A couple of hours later she was found by the police, forty blocks away. Unfortunately, the family of a Vancouver area woman received much sadder news in December, 2013 when she was found dead two days after wandering away from her nursing home. This month, Elder Voice focuses on wandering, a risk for sufferers of dementia whether they are at home or in a facility.

The terms wandering or elopement (and hereafter we will use wandering) are generally used to describe the event of someone with dementia leaving their home or facility on their own when they are not safe to do so, either because they will not be able to find their way back or they will not be willing to come back. In the person's mind, however, many times they are not aimlessly "wandering." Rather, they are engaged in what is to them purposeful and meaningful behaviour. For example, in their mind they may be "going home" but do not remember that the place they are looking for is no longer their home. Often wandering is associated with being disoriented to time--they are trying to find their mother and don't remember she died many years ago, the home they are thinking about is the one they lived in growing up, or they are going to work despite not having worked for sometimes decades. Sometimes they are just going for a walk and do not realize they will not be able to find their way back. Their wandering may be the result of a real need, for instance they may be trying to leave an environment that is troubling to them or trying to find something to eat. At times, wandering is the result of an agitation or restlessness which causes them to pace. In such a condition, when they see an exit, they may simple take it.

The potential for the incidence of wandering in someone suffering from Alzheimers is as high as 60%. If the individual has wandered before there is a 70% chance of re-occurrence attempts. Although the risk is high, the timing of wandering is often unpredictable. A client of ours had lived in her Nursing Home for over a year before wandering away for the first time.

One reason that the timing of wandering is unpredictable is that abilities and sometimes personalities change with the progression of Alzheimer's disease. This means that someone who previously was not at risk to wander could become so with the passage of time. Functioning and orientation also fluctuate day to day in someone with Alzheimer's--one day they may want to go home, and another day they are content to stay where they are. Moreover, there is often a kind of gray zone of awareness and ability as the disease progresses in which someone may or perhaps may not be able to find their way back.

The management of wandering can be a delicate balance between allowing people their personal freedom and their right to make decisions balanced with intervening to place limitations on them which may upset and worry them and the reasons for which they may not understand. That is why with Alzheimer's disease caregivers often feel as though they are "chasing the dragon," meaning they are putting measures in place only after they are necessary.

Wandering may not always be predictable, but there are times when it may be more likely to occur than others. For instance, if someone has just moved into a facility, if they have just had their car keys taken away, if they have had a change of caregivers or if a family member they are used to seeing does not visit for quite a while. If they start talking about wanting to see their mother, or about having to go find their child or go to work they could be indications they will wander. If they are up a lot or late at night, they may try to leave while a caregiver is sleeping. Pay attention to increasing agitation and anxiety. Note signs that abilities are changing--not just memory but also what we call executive function-- insight, judgment, reasoning and planning--because when those deteriorate a person is not able to assess their ability to do something safely such as go for a walk.

If you are considering a nursing home for your loved one, always ask about the systems they have in place to deal with residents who wander. They should have both electronic systems (such as locking doors, video monitoring, and alert systems that trigger an alarm as well as protocols for staff to follow to keep track of residents who may wander.

It is unrealistic to think that wandering can always be prevented unless someone is monitored individually 24 hours a day. If they are determined to leave their home or facility they often can do so, taking off an alert bracelet, slipping out with a visitor, or learning a code that unlocks a door. In the event of this happening, you'll want to be prepared to help facilitate a successful search. For example, have an up to date photo of the person available so police and others will know what the person looks like. Make sure the person has identification on them, either in a pocket, a wallet or a purse, or make sure they are wearing some kind of medical alert bracelet with their address and the contact details of a family member. Register them with the Alzheimer's Society Medic Alert programme. Consider having the person wear a personal GPS device that will alert someone when they are outside a certain perimeter or that will locate them if they do leave

In terms of seeking to reduce the incidence or likelihood of wandering, there are several things that can be done. These steps can be divided into person centred and environmental actions.

In person centred approaches, remember that what we are calling wandering is often purposeful behaviour. Find out what someone is looking for, what they are trying to achieve. Are they lonely, scared or bored? Can you help them safely to have what they want? Try to distract them with an activity or by talking about their past, by looking at old photos, or with a coffee. Tell them you will take them home tomorrow or that their son is on holidays and will be back next week. If they have just moved to a facility, provide them with more attention and visiting until they settle and start to feel like the facility is home. If the behaviour is occurring at a specific time in the day you might hire a private companion for that period. Review medications which might be causing anxiety or restlessness. Put coats and hats and keys somewhere out of sight.

Environmental approaches can include:

  • Making sure doors and windows are locked or alarmed and if at home ensuring the alarm system if monitored.
  • Reviewing their environment to see if it is creating anxiety, for instance too much stimulation, too hot or cold, confusing or disorienting.
  • Putting a sign on the doors which tell them not to go out without someone.
  • Ensuring a facility is equipped to deal with someone who wanders.
  • If they are pacing, finding a place where they have the freedom to pace safely.
  • Putting things around them that are familiar to them and which remind them of their past and the people in their lives and which help them feel at home where they are.
  • Providing continuity in their environment such as ensuring they have the same routine and same caregivers.
  • Orienting them tactfully: for instance, "lunch is downstairs in an hour." or "your daughter will be here to see you later."
  • Installing an in-home video monitoring systems that will track movement around a house.
  • Enlisting the support of neighbours by asking them to be aware if someone is walking on their own.

To subscribe to Peter Silin's monthly newsletter, go to his website:

http://www.diamondgeriatrics.com/

 

The ABC's of RRSP's by Gerry Steckler, CMA

 

Most Canadians are aware of the existence of Registered Retirement Savings Plans (RRSPs) but they really do not know much about how they actually work or how they can use them to benefit them fully.

If you think that an RRSP is that thing you're putting money into to save for retirement, and you think that it's a type of investment like a mutual fund; then you should know that it's simply a saving or investment account with certain tax-saving characteristics.

There are three main reasons for saving within an RRSP:

  1. To save for retirement.
  2. To help purchase your home under the First Time Home Buyers Plan.
  3. To pursue further education under the Lifelong Learning Plan.

Contributions are tax deductible

You can claim your RRSP contribution as a deduction on your tax return. For example, if you're earning above $50,000 per year, a $1,000 RRSP contribution reduces the tax you pay by approximately $300.00. So in essence the contribution costs you only $700.00. This can have a huge impact on saving over a long period of time.

You won't pay any tax on investment earnings as long as they stay in your RRSP. This tax-free compounding allows your savings to grow faster.

RRSPs can be especially useful for regular employees or self employed business owners who pay a lot of tax on their employment income. By contributing to an RRSP, they are allowed to defer their income tax. They benefit from lower taxes payable now, and then will expect to pay it later when they withdraw the funds (presumably when they retire and are at a lower tax bracket).

What happens to my RRSP when I retire?

How can a spousal RRSP reduce your combined tax burden?

For answers to these questions, see my next article, or contact me to find out sooner.

Gerry Steckler, CMA

Cell: 778-989-5575

Webpage - www.dfsin.ca/gerrysteckler

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Anne Waller of Citizen Support Services and Co-Chair of BSIS Welcomes you

I am very fortunate to work in Burnaby; voted the best run City by McLeans Magazine in 2009. Citizen Support Services has been a member of BSIS since the early 90's. What started as a small group of non-commercial organizations has grown into a Society of 30 + members, including businesses, all specializing in helping seniors in Burnaby.

The Society members work together to find solutions to challenges that seniors are facing in their daily lives. We offer a variety of services to assist seniors in living independently and enjoying a better quality of life.

By offering our Healthy Aging Series of free workshops and our annual Seniors' Resource Fair, we are able to educate both seniors' and their family members in topics of interest and also the many services available to seniors' living in Burnaby. We see ourselves assisting families with the transitions that happen as we age.

As Co-Chair for BSIS for a number of years, I can see the advantage of working as a team  for a common goal - to help seniors live a more productive, healthy and enjoyable life. If you are searching for answers for yourself or a loved one, please check out the Members page.

 

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Disclaimer:

BSRS provides links to BSRS member’s websites for your convenience.  BSRS does not monitor, have any control over, or have any responsibility for the content of any member’s site, and is not responsible for any consequence of your use of their site or links. The inclusion of any link does not imply BSRS’ endorsement of the linked site or organization.