Archives for Barbara

Bladder issues

Bladder issuesIf making it to the bathroom in time is a frequent concern for your relative, they may have an overactive bladder. More than 33 million Americans contend with this condition, in which misfiring nerves cause the bladder muscles to contract involuntarily. Your loved one may be too embarrassed to bring it up with the doctor, or even with you. But it should be checked out. It’s not a “normal” part of aging. Overactive bladder (OAB) is a real and treatable medical condition. And you certainly want to be sure it’s not something else.

The basic symptoms of OAB include an urgent need to urinate more than eight times in a day and/or more than once or twice a night.

Many people let incontinence worries run their lives. They stay close to home for fear of accidents. They withdraw from social activities, dreading they have an odor from leaks. They may become anxious or depressed. And multiple nighttime trips to the toilet can result in insomnia and fatigue, bringing on more depression.

Once a doctor has ruled out other issues, encourage your family member to use these recommended strategies to live more fully with OAB:

  • Limit caffeine and alcohol, and quit smoking. All three irritate the bladder.
  • Drink six to eight glasses of water a day. This seems counterintuitive, but concentrated urine is a bladder irritant.
  • Eat a high-fiber diet to prevent constipation, which tends to put pressure on the bladder.
  • Lose weight, also to reduce pressure.
  • Do pelvic floor exercises (Kegels) to learn how to consciously stop the flow.
  • Do bladder exercises to train the bladder to retain fluid for longer.
  • Go to the bathroom every two hours to proactively keep the bladder empty.

Depending on the cause, suggested medical treatments may include medications, injections, gentle nerve stimulation, or surgery as a last resort.

Is your relative’s life run by OAB?
If so, it’s time to encourage a visit to the doctor. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice recognize how emotionally and socially debilitating OAB can be—for your loved one and for you. Give us a call at 1-800-897-3052, toll-free.

What’s involved in giving care?

What’s involved in giving care?Perhaps you call regularly to offer emotional support. Maybe you handle finances. Perhaps you visit weekly. Or you may live with your loved one 24/7. Caring takes many forms. You may feel this is simply what a loving daughter/son/partner would do. But that doesn’t mean it isn’t time and energy from your day. Or night, if you skimp on sleep to create time to help.

Whether you provide hands-on care or assistance from afar, you ARE a family caregiver. And that means you need to watch for burnout. Use this list to take an inventory. Consider what is realistic for you. And think about options to help manage the load: Friends, family, community programs, paid help.

  • Chores. Laundry, yardwork, housekeeping, repairs
  • Meals. Shopping, cooking, cleanup
  • Transportation. Errands, doctor appointments, worship, social activities
  • Medical advocacy. Talking with doctors, deciding on treatments
  • Help in a crisis. Availability on short notice. The legal right to make medical decisions if your loved one is unable to speak
  • Medication management. Tracking what’s been prescribed. Getting refills on time. Daily reminders to take meds
  • Coordinating care. Finding, hiring, supervising, and scheduling providers
  • Money management. Paying bills, balancing the checkbook, banking. Handling investments and real estate
  • Dealing with insurance. Tracking deductibles and copays. Signing up for prescription insurance, long-term care coverage, disability and veteran benefits
  • Legal assistance. Ensuring paperwork is attended to: A will or living trust. Durable Power of Attorney. Advance health care directive
  • Financial assistance. Finding programs and/or pitching in to cover expenses
  • Intimate care. Bathing, dressing, toileting, feeding
  • Emotional support. A sympathetic ear. A hug. Reassuring your relative that they are not alone

Plus the work of being constantly on the lookout for evidence of new difficulties, falls, confusion, blue mood, scammers, etc.

You are a family caregiver!
At Iowa City Hospice, we are surprised how many people do not acknowledge their contribution as giving care. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we know how much heart and energy you put into the tasks you perform for your loved one. Be it big or small, hands-on or far away, what you do matters! Let us help you. Give us a call at 1-800-897-3052, toll-free.

Explaining your needs to others

Explaining your needs to othersAre you worried that asking for help sounds like whining? You may believe you “should” be able to do it all without assistance. Or think you are “just” doing what any good or loving daughter (or son, or spouse) would do. Like many caregivers focused on family harmony, you may have become used to minimizing the personal impact of caregiving.

Wanting help does not mean you are weak. And being frustrated, tired, or resentful does not mean you don’t care for the elder in your life. It simply means that there is more on your plate than can be done alone.

Before you ask other family members for help, define for yourself very specifically how caregiving has affected your life in these key areas:

  • Physically. Are you getting enough sleep? Eating right? Exercising? Keeping up with doctor and dental exams?
  • Emotionally. Are you frustrated with making all the decisions alone? Lonely or bored by a restricted lifestyle? Sad or guilty because nothing you do can make your relative better?
  • Financially. Are you losing income because you can’t work the hours you used to? Paying for your relative’s expenses? Unable to afford to hire someone to give you a break?
  • Socially. Are you missing out on fun activities? Is everything you do focused on being productive?

Once you name the impact, it can be easier to ask for help more directly. Consider:

  • “I’m overdue at the dentist. I need you to take care of Mom while I go. Which day next week works best for you?”
  • “It’s time for another decision about Dad’s care. I’d rather this were a joint decision. Can we schedule some phone time for tomorrow?”
  • “I haven’t seen my grandchildren in months. I’d like to go visit over the Labor Day holiday. Let’s set up a time next week to get plans in motion so Mom will be covered while I’m gone.”

Having trouble asking for help?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see family members struggle with this constantly. We can help! Give us a call at 1-800-897-3052, toll-free.

Medical management without dialysis

 Medical management without dialysisDialysis typically buys a person some time. But it rules their life—and possibly yours. It requires strict adherence to the schedule. Also, severe food restrictions. Your relative’s energy level will fluctuate. That makes planning for other activities difficult. There is an increased chance of infection because of the access port for dialysis. And there are side effects: Itchy skin, trouble sleeping, headaches, and dizziness. Cramps, nausea, weight loss, and fragile bones are not uncommon.

Unless your relative is doing home dialysis, they will need transportation to and from the center. A typical schedule involves two to three sessions a week. A session lasts about four hours.

One option to consider is managing the disease without dialysis. Admittedly, this may shorten length of life. But even patients on dialysis often decide to stop the treatment when the difficulties outweigh the benefits.

People who say “no” to dialysis from the beginning place a high value on quality of life. They prefer the thought of living on their own terms for eight months to living fifteen to twenty-four months with the rigors of dialysis.

People who receive the least benefits from dialysis are

  • persons age 80 or older. Only 1:3 is alive two years into dialysis.
  • persons with other serious conditions, such as heart disease or diabetes. Two years into dialysis, only 2:3 are still living. This goes down to 1:3 if they have two serious illnesses.
  • persons with dementia. They have trouble following the restrictions. The procedure can also be confusing or scary to them.

Deciding against dialysis does not mean no treatment. Your relative’s doctor will prescribe medications for blood pressure and fluid buildup. And to address fatigue. All of these treatments support easier walking and breathing. A better daily experience.

Deciding against dialysis is very personal. Ask the doctor to talk about your relative’s best- and worst-case scenarios with and without dialysis.

Is your family facing a dialysis decision?
These are not easy choices. But it’s good to know all the options. As the Iowa City Hospice experts in family caregiving, we at Iowa City Hospice can help you and your loved one weigh the pros and cons so you know treatment decisions will align with your relative’s personal values and goals of care. Give us a call at 1-800-897-3052, toll-free. You don’t have to do this alone.

Giving “awesome” new meaning

Giving "awesome" new meaningCan you recall taking in a majestic view or the miracle of dewdrops on a spiderweb? That sense of awe—the magnificence of it all. In the presence of amazement and wonder, we feel connected with something much greater than ourselves. Our problems seem to shrink.

It turns out that these moments of awe have measurable physical and emotional benefits. Research shows they boost the immune system and arouse kindness and generosity. An “awe-some” life is good for us.

What makes an experience awe inspiring?

  • Seeing, hearing, or perceiving something that takes you beyond your normal sense of what’s possible.
  • Fully understanding and accepting this new perspective that you are both very small and part of something very grand.

Do you have to go to the Grand Canyon to experience awe?

Not at all! Wonder and amazement can be found at home. What is necessary is that you take the time to unplug and see things anew. (Leave the phone behind!) Give yourself uninterrupted time to immerse in the full experience of what you see, hear, smell, touch, feel, or even taste.

  • Take an “awe walk.” Try a local park, or even your backyard. Don’t go for a walk. Go for the experience. Slow down. Tune into your senses. Take in the setting each time as if it were brand new.
  • Listen to music that transports you. It’s not just visuals that can inspire awe.
  • Expose yourself to art. Instead of trying to see everything in a museum or on a tour, linger with what moves you. Savor a few pieces.
  • Awe journal. Recall past events when you were awestruck. Sights, sounds, smells, feelings. Relive the experience as you write.

According to the research, measurable benefits can be found by consciously opening yourself to awe twice a week.

Have you been feeling detached?
In trying times, it’s easy to feel alone and isolated. This is not good for your body or your psyche. Nor for your ability to care for your loved one. As the Iowa City Hospice experts in family caregiving, we at Iowa City Hospice have found that simple moments of marvel can often help a family caregiver rekindle the spark they need to keep on caring. You don’t have to do this alone. Give us a call at 1-800-897-3052, toll-free.

Signs of financial abuse

Signs of financial abuse

Older adults are frequently targeted for financial abuse. They typically have more funds than their younger counterparts do. They tend to be generous and naïve, not understanding all the ways they can be scammed. Some have memory and thinking problems. And even if they do realize they’ve been “taken,” they may be too ashamed or scared to admit it.

Indeed, studies suggest financial abuse is on the rise. It is likely now the dominant form of elder abuse.

Perhaps the saddest of all facts is that 50% to 65% of the time, the abuser is a member of the family or someone known to the victim. Maybe an adult child at loose ends or grandchild with a drug problem. Even spouses are perpetrators.

Common signs of trouble

  • A “new best friend.” Fraudsters prey upon loneliness to become deeply involved in an elder’s life. They can be strangers or relatives who literally or figuratively move in to “help.”
  • Isolation. Can you still connect with your loved one easily and privately? Abusers may hide the phone, hide glasses and hearing aids, or listen in on every contact. Another strategy is to emotionally manipulate the older adult into mistrusting everyone but the abuser.
  • Unusual financial activity. Watch for sharp reductions in assets, bounced checks, unpaid bills, or collection notices. A new check signer or additional credit card may spell trouble. Also, a recent change in the will or trust. A report of forged checks is definitely a red alert.
  • Frightened or secretive behavior. Some abusers threaten repercussions for any disclosure or complaint. Shame may cause your relative to retreat and comply.

If you suspect abuse: Contact the Elder Abuse Hotline in the state where your loved one lives or AARP’s ElderWatch program (1-800-222-4444). Or consult with an elderlaw attorney.

Does something seem amiss?

As the Iowa City Hospice experts in family caregiving, we at Iowa City Hospice understand how frightening it can be to realize your loved one may be the victim of financial exploitation. Give us a call. Let’s talk. 1-800-897-3052, toll-free.

Seeds of family resilience: Focus on rewards

Seeds of family resilience: Focus on rewardsResearch on stress often involves family caregivers. No matter how much you love the person you care for, taking care of an ailing relative can be stressful!

To offset the stress, consider the power of positive thinking. Studies show that people who “seed their lives” with moments of positive emotions are more resilient in the face of challenges. This doesn’t mean ignoring or denying the negatives. Instead, it means taking time to notice the “micro-moments” of things that are going well.

So, does this mean you should go to more movies or eat more chocolate? Not really. Researchers focusing on “positive psychology”—the study of what’s working well—find that more lasting happiness comes from focusing your attention on activities that feel meaningful to you. The good news is that a shift in attitude or attention costs nothing and generally does not add inches to your waistline!

For example, despite the hardships, family members also mention the following rewards in caregiving:

  • “I am grateful to be able to give back.”
  • “I now feel much closer to my mother.”
  • “I’ve become more patient, more compassionate.”
  • “I’ve learned to appreciate the little joys and triumphs in each day.”
  • “I’m proud of the new skills I’ve learned. I had no idea I could do these things.”
  • “This has given me a chance to reexamine my priorities and be sure I am living the life I want to lead.”

If you are looking for ways to feel stronger and less stressed, perhaps it’s time to think in terms of the rewards in what you are doing. By accentuating those activities that have meaning for you, you can find more enjoyment in your caregiving and become a better, more resilient caregiver in the process.

Do the negatives outweigh the positives?

If so, give us a call. As the Iowa City Hospice experts in family caregiving, we at Iowa City Hospice understand the enormity of what you have taken on. You don’t have to do this alone. Contact us at 1-800-897-3052, toll-free. As knowledgeable professionals, we’d be glad to help.

How to get durable power of attorney

There may come a time when your loved one will need help handling financial matters. Maybe filing taxes. Or interacting with Social Security. Or signing a contract to move into a new residence. If your relative is unable to do these things because of illness or problems with dementia, you will need to show a document proving they chose you to act on their behalf. This document is called “durable power of attorney” (DPOA). A simple “power of attorney” (not durable) is useful only while a person is able to make decisions. Incapacity voids it.

Under what circumstances. It’s important to discuss the potential challenges of the future while your loved one is of sound mind. Often a DPOA is signed to take effect immediately—with the understanding that the power won’t be exploited. Other families prefer a “springing” DPOA, which goes into effect only when a physician certifies incapacity. This limitation sounds good. In reality, though, it can cause delays and complications.

For how long. A person can revoke (change their mind about) a DPOA at any time, as long they are mentally competent. Otherwise, it is valid until death. Upon death, a person’s financial affairs must be handled by whoever was legally named as “executor” or “trustee” of the estate.

How to create a DPOA. Fill-in-the-blank DPOA forms are available online. Typically, they are signed with a notary who officially confirms the signer’s identity and free will. A notary may be available at your relative’s bank. Some notaries are “mobile” and make house calls.

Incapacitated and no DPOA. To take charge financially without a completed DPOA, you must be appointed by the courts. Not surprisingly, this is a lengthy process.

Consult with an attorney. Giving someone the ability to access bank accounts and make financial decisions is not small. Your loved one would be wise to get legal counsel before completing a DPOA.

Is it time for a DPOA?
It’s wise to have a designated financial decision maker in case of an inability to attend to financial matters. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see too many situations made more difficult because the paperwork had not been completed ahead of time. Are you worried about this possibility? Give us a call at 1-800-897-3052, toll-free. We can help point you in the right direction.

Transitioning from curative care

At some point, the burdens of treatment may just become too much for your loved one: The nausea of chemo. The rigors of dialysis. Wearying trips to the ER. Perhaps the person you care for is already having these thoughts, to let nature take its course and stop fighting for health that stubbornly eludes them. They may wish to enjoy the time they have left—months, weeks, days—without futile treatments. To prioritize peace and comfort. Imagine time and energy to visit with those they love. The opportunity to eat what they want—ice cream, anyone? Or to simplify their meds—no more cholesterol pills.

Supporting your loved one’s quality of life can be profoundly rewarding. Both you and your relative may find it emotionally liberating to let go of complexity. Instead of spending energy on unproductive cures, you can create loving memories. A simplified schedule presents more time for reminiscing and intimate sharing between you, the person you care for, and other family members. Facing the end, reconciliation is common. Long-held grudges often disappear as people realize their bonds with loved ones are more important than the ill will they have carried.

If this sounds appealing to your relative, you don’t have to go it alone. Transitioning from curative care does not mean no care at all. Hospice can provide your loved one with many different types of support. And the services are paid for completely by Medicare and Medicaid!

  • Weekly visits from a nurse to help manage pain and other difficult symptoms
  • Equipment needed for comfort, such as a hospital bed, delivered to the home
  • Bathing and grooming of your loved one several times a week by a nurse’s aide
  • A social worker or chaplain to support emotional or spiritual needs
  • All the medications your family member needs to stay comfortable (pain, trouble breathing, etc.)
  • Instead of 911 calls and grueling trips to the ER, you can call hospice—anytime, 24/7. A nurse can provide guidance and have any needed medications or supplies delivered. Hospice care won’t stop the inevitable, but it can make for a softer landing.

None of us will be here forever. But on the last leg of the journey, it’s nice to have discomforts managed and caring professionals available for guidance and support.

Do treatments seem futile?
Many clients get to the point where quality of life becomes more important than eking out a few more days or weeks, especially when there’s pain and discomfort. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice can assist you through this challenging time. Give us a call at 1-800-897-3052, toll-free.

Managing arthritis pain

The most common arthritis is osteoarthritis, which occurs most often in the hands, knees, hips, lower back, neck, and feet. It affects roughly half of those age 65 and over. With osteoarthritis, the smooth layer of cartilage between the bones in the joints deteriorates, causing bone to scrape directly on bone. Ouch! If your loved one has stiffness or pain associated with this condition, it very likely limits their ability to enjoy their usual activities. Fortunately, there are many ways to relieve pain and reduce wear and tear.

  • Weight loss. If the arthritis involves the hips or knees, a weight loss of even 10 pounds can make a significant difference.
  • Low-impact exercise. Motion is lotion. Think in terms of fluid movements and low-impact activities such as tai chi, swimming, biking. Check for special arthritis exercise classes sponsored at senior centers.
  • Hot and cold compresses. Moist heat helps relieve immediate pain. Cold can be used after exercise to reduce muscle pain.
  • Topical creams. Ointments with capsaicin—an extract of chili peppers—have been shown to provide relief for some people. But the ointment must be applied four times a day.
  • Assistive devices. A cane can take some of the burden off knees and hips. Other devices may help with tasks that involve grabbing and opening. Ask the doctor for a session with an occupational therapist.
  • Omega-3 fats. These fats tend to reduce the inflammation of the joints. They are found in oily fish such as salmon and tuna, and in walnuts. They can also be taken as supplements.
  • Over-the-counter pain relievers. Acetaminophen, ibuprofen, and naproxen are effective for short-term relief. Using them for longer than 10 days at a stretch is not advised.
  • Supplements. Studies done on glucosamine and chondroitin reveal mixed results. These compounds can also change the effectiveness of other medications. Check with the doctor or pharmacist before trying them.

Is arthritis a limiting factor?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we see how this painful condition makes it difficult for many older adults to enjoy their lives. Sometimes even to manage daily life independently. While there is no cure, we at Iowa City Hospice have seen how lifestyle modifications can reduce pain and increase your loved one’s ability to function on their own. Give us a call at 1-800-897-3052, toll-free to learn more.

Iowa City Hospice