Family Caregiver Support

Caught in a cycle of negativity?

Caught in a cycle of negativity?

For most family caregivers, frustration and guilt are common, as is anxiety and resentment. These feelings are normal and reasonable under the circumstances. It’s not realistic to eliminate negative emotions. Caring for an ailing family member IS emotionally taxing, especially in the case of memory loss. But sometimes the negativity can feed on itself.

You can avoid amplifying a downer mood. According to stress and coping research, you can reduce your distress by concentrating on the ultra-present moment, the here and now.

To interrupt the cycle

  • observe yourself. Practice noticing your thoughts and feelings. Get curious about your emotions. Explore them objectively, as though you were outside yourself. Your thoughts and feelings aren’t “you,” they are one part of your experience.
  • identify your thoughts. We increase our own suffering when we allow ourselves to get stuck in “shoulda, woulda, coulda” thinking. Those “shoulds” and “if onlys” try to rewrite the past. They are a springboard to anger and depression. The “I wants” and “what ifs” focus on the future. They tend to prompt anxiety.
  • acknowledge your negative feelings. None of them is wrong. Don’t judge them. They are temporary and will subside (as long as you don’t feed them!).
  • accept what is. Life is a series of moments. This one may not be your favorite. But what’s happening right now is a done deal. If you simply allow it and don’t fight it in your mind, you’ll be that much less stressed.
  • focus on the present. Stay out of the past and future in your thinking. Take a few deep breaths. Shift your attention to create room for something positive right now. Think of something that engages one of your senses: The taste of your coffee, the color of the sky, or the music on the radio, for example.

Repeat as needed to refresh your outlook!

Is caregiving dragging you down?
You are not alone! As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice work with countless families struggling with the frustrations of providing care for an aging loved one. We can help. Give us a call 1-800-897-3052, toll-free.

Senior centers: Worth a fresh look

Senior centers: Worth a fresh lookEven pre-COVID, many 90-year-olds adamantly refused to go to a senior center, saying they didn’t want to be around “all those old people.” (!)

Does this sound like your loved one?

Admittedly, the senior centers of the past tended to focus on bingo and crafts. These activities are of limited interest to the newest generation of older adults.

Happily, senior centers have been updating. Bingo and crafts are still there. But the upswing in technology use during COVID catapulted many centers into the 21st century. They had to update their delivery platforms so older adults could participate from a distance. They also revamped their offerings to appeal to the “younger old.”

  • Relevant classes. These days you are likely to find Beginning Smartphone, Cyber Safety, and Zoom 101. Also, health and fitness classes such as yoga and tai chi. Zumba, a Latin-inspired dance-exercise, is a popular cardio workout. There are classes to stretch the mind—learn a new language, watch a TED talk and discuss the topic. Or take up a hobby such as photography, gardening, or painting. Some centers are hosting intergenerational activities for teens and seniors. Ever been to a team cake decorating contest?
  • Transportation. Many senior centers sponsor field trips. Some to scenic places, others to the theater or music hall. They do the driving! This makes fun outings possible again for isolated individuals or those who are no longer driving. Also common are free driver programs. They help older adults get to medical appointments or go food shopping.
  • Coffee, tea, and food! Some centers have opened cafés for coffee or tea, hoping to entice reticent seniors through the door. Another attraction is a low-cost or free weekday lunch. And some even feature “pop-up chef days.”
  • Expert help. Medicare and insurance counseling are frequently available. So is help filing with the IRS at tax time.
  • Volunteer opportunities. Many classes and programs are led by seniors. Your relative might enjoy pitching in as a helper.

If the person you care for has resisted the senior center, propose having a coffee if there’s a café. Or sign up for a field trip to the theater and go together. These are low-commitment ways to let them get a fresh sense of the center and overcome any outdated impressions.

Concerned about a loved one’s isolation?
COVID brought awareness of its hazards front and center. We at Iowa City Hospice have been impressed at the many ways senior centers stepped up to the plate. As the Iowa City, Muscatine and Cedar Rapids expert in family caregiving, we encourage you to check out their new offerings. You (and your loved one) might be happily surprised. If isolation is a worry, give us a call at 1-800-897-3052, toll-free.

Combatting dehydration

Combatting dehydration

With summer’s warm weather, be on the lookout for dehydration in your loved one. The signs include confusion, fatigue, weakness, and sleepiness. Some people become dizzy and their balance is thrown off. Dry mouth, headaches, and muscle cramps are other symptoms of dehydration.

It is estimated that 20%–40% of seniors are dehydrated.

Getting them to drink more fluids is not always easy. Try these strategies:

  • Offer foods that are high in liquids. Try juicy fruits and vegetables, soups, popsicles, jello, yogurt, or smoothies.
  • Serve tasty fluids. Lend some zing to water by adding citrus or cucumber slices, fresh mint leaves or lavender. Offer broth as an alternative to sweets. Soda and coffee may only add to dehydration. And alcohol is definitely not advised. Water, milk, and juice are the safest. Talk to the doctor before using sports drinks.
  • Promote the habit. Set a timer for reminders. Or google “hydration apps” for tracking assistance. Another tip: Drink a glass of water after every visit to the restroom.
  • Keep a lightweight pitcher of water out and handy. If you are visiting, pour yourself a glass and bring them one too.
  • Address worries about incontinence. Provide incontinence products for reassurance in case your relative is limiting fluid intake for fear of accidents.

When to be especially vigilant
People with memory problems are at greater risk for dehydration. (They forget to ask for something to drink.) So are people who have trouble getting up and walking or are dependent on others to bring them water. Dehydration is very likely to happen if your loved one has a fever, nausea, vomiting, or diarrhea. Or if they exert themselves in the heat. Older adults who are constipated, and those with kidney stones, benefit from extra fluids as these conditions are linked with chronic dehydration.

If you are concerned about dehydration, ask for a medical assessment.

Is dehydration a possibility?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice notice that dehydration is often at the heart of common but concerning symptoms. Want help with eldercare? Give us a call at 1-800-897-3052, toll-free.

Dementia and finances

Dementia and finances

If the person you care for has dementia—memory or thinking problems from a condition such as Alzheimer’s, a stroke, or Parkinson’s—unpaid bills or a messy checkbook may have been your first sign that something was amiss. Certainly, in the later stages of dementia, your loved one won’t be able to manage their finances. But what about the in-between?

It’s tempting to simply take over once you discover errors. But being entitled to manage money and buy what we want is central to adulthood. Taking that away prematurely may spin your relative and your relationship into turmoil and may not even be within your legal rights.

Consider these strategies for respectful money management.

  • Become power of attorney. Have your loved one legally allow you or another trusted person to make financial decisions.
  • Protect their accounts. Put bills on autopay as much as possible. Freeze credit reports—used for opening new credit cards—on the three credit agencies: Experian, TransUnion, and Equifax. Ask vendors to notify you if a bill is unpaid.
  • Block scammers. Create a fraud shield by registering your loved one’s phone number on the Do Not Call Registry.
  • Provide some cash. Your loved one needs to feel empowered. This generation is cash oriented. Give them ten or twenty 1-dollar bills a week. Reconcile yourself that this “waste” is really an investment in their self-esteem.
  • Set weekly limits on their ATM card. Especially if they are accustomed to doing their own withdrawals.
  • Consider a monitored prepaid credit card. You set a monthly and per-purchase limit. The card will decline any sale if it’s over budget. Cards such as True Link Visa allow you to block certain vendors (liquor stores, casinos, online ordering, and phone orders). Some have settings to alert you if your relative is initiating a restricted activity.

Are you worried about a loved one with dementia?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice work with families juggling the twin needs of protection and autonomy. You don’t have to do this alone. Give us a call at 1-800-897-3052, toll-free.

The “Sandwich Generation”

The "Sandwich Generation"Elderly parents are living longer. Children are often dependent for more years than expected. Add to this the ongoing responsibilities to spouse/partner and jobs, and there is little wiggle room for the millions of family caregivers who find themselves squeezed in the middle as the “Sandwich Generation.”

When you are pressed on both sides like this, it’s easy to feel guilty and lose sight of the joy in your life. To reduce guilt, support your resilience, and make sandwich caregiving more gratifying, look for easy ways to dedicate some quality time on a regular basis to each of your key relationships—including with yourself!

  • Ensure parent care is not just a rote set of to-dos. Instead, take stock of what you enjoy about the person or situation. Is there a daily comic you could share for a laugh? Or memories to savor by scrapbooking together or labeling old photos and recalling past times?
  • Enlist the help of children living at home or nearby. Maybe your teen or young adult child can cook meals, do shopping errands, or drive mom where she needs to go. As with parent care, also identify activities you and your child can enjoy together. Look for your child’s strengths and let them be the leader or teacher now and then.
  • Keep your noncaregiving relationships alive. Don’t neglect your partner. Make regular dates for one-on-one fun time. Watch out for continual conversation about caregiving. This is just about the two of you. And don’t forget your friends. Caregiving may be a big part of your life, but it’s not all of who you are. Dedicate regular time—even just short texting—to stay in touch with your buddies. Caregiving isn’t going to last forever. You don’t want to lose them.
  • Do something once a week to boost your professional self. Read an article related to your career. Make a call to a colleague for a quick networking session.
  • Take some “being” time for yourself. It’s easy to get swept up in “doing” all the time. Give yourself at least 15 minutes a day for emotional or physical renewal.

Are you feeling squeezed in the middle?
You aren’t alone! As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice notice that the pandemic has resulted in many more multigenerational households. Parents are needing care, and adult children are moving back in. We understand how complicated it can get! Let us help you relieve the pressure. Give us a call at 1-800-897-3052, toll-free.

Swollen legs and feet

Swollen legs and feetMany older adults experience swollen legs and feet. For some, it’s because of sitting a lot and leading a sedentary lifestyle. For others, it’s the water retention side effect of a medication. And for others, the swelling—called “edema”—is a symptom of a chronic or even serious illness such as heart failure or liver or kidney disease.

Additional signs of edema include difficulty walking, stiff joints, a sudden weight gain (2–3 pounds in a 24-hour period), or skin that is stretched, shiny, discolored, or painful. If you suspect your loved one has edema, ask the doctor to do a thorough workup.

Strategies that might help

  • Elevate. Sit or lie with feet elevated, ideally higher than the heart. Let gravity do some of the work!
  • Reduce sodium. Too much of this important mineral can cause the body to hold onto fluids. Ask about the best salt substitute for your loved one. Use herbs, lemon juice, and other condiments to add flavor to food.
  • Wear compression socks. Ask the doctor for a fitting. These special socks may be helpful for keeping fluid from settling in the feet.
  • Check shoe fit. Tight shoes can contribute to fluid retention. In turn, fluid retention can cause shoes to become uncomfortably tight. Try a bigger size.
  • Exercise. Getting up and moving around helps the heart and veins do their job of keeping fluids where they belong. Walking and swimming are recommended.
  • Monitor drinks/fluids. Some conditions are best managed with limited fluid intake. Others do better with more fluids. Find out which is best for your relative’s situation.

Ask the doctor which of these strategies are best for your loved one’s condition.

Keep the legs and feet clean and dry. Use moisturizing lotion, but not between the toes. Inspect daily for cracks and inflammation. Split, dry skin can become painful and infected, causing even more health problems.

Does your relative suffer from edema?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see this problem a lot. Give us a call if you’d like some help with the doctor’s recommendations: 1-800-897-3052, toll-free.

Does brain training work?

Does brain training work?The brain is another organ to keep fit, and regular workouts are a good thing! Our brains enable many types of thinking: Problem solving, planning, attention, and memory. They manage our emotions and help us understand the emotions of others. Our brains also control movement (balance, speed, and coordination). And it’s where we process our spatial awareness—used for packing a suitcase or reading a map.

It’s never too early or too late to focus on one’s brain health. If your loved one—or you, for that matter—would like to improve brain fitness, consider these “exercises” that research studies have proven effective.

  • Draw a map from memory. Start with the neighborhood. Strive for detail.
  • Do math in your head. Try mental math first, then pull out the calculator to verify.
  • Use your nondominant hand. If you are right handed, try brushing your teeth, eating, drawing, or writing with your left hand. It’s hard! But that’s the point. Challenges cause your brain to grow new brain cells and build new pathways.
  • Learn something new. Take up a musical instrument. Learn a new language. Start a new hobby.
  • Practice focused attention. Take 15 minutes a day to purposefully concentrate on what you are seeing, hearing, feeling, smelling, or even tasting. Mentally stretch your awareness to observe outside your usual patterns of perception.
  • Socialize. Interacting with others builds your emotional intelligence and improves mental health. (Isolation fosters depression and anxiety.)
  • Brain-training apps. The jury is still out on how effective these are. If they are enjoyable, try them. But don’t spend a lot of money hoping for improved cognition in daily life.

Fuel for the brain. The brain is 2% of our body weight but consumes 20% of our daily calories. Good food, physical exercise, and adequate sleep help it get the oxygen and nutrients it needs.

Concerned about brain fitness?
We at Iowa City Hospice frequently see families and older adults worried about Alzheimer’s disease. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we encourage you to talk with the doctor and get a full assessment. You don’t have to do this alone. Give us a call at 1-800-897-3052, toll-free.

Understanding the rhythm of a disease

Understanding the rhythm of a disease

Much of the strain of caring for a loved one lies in the loss of a predictable routine, a sense of “normalcy.” Understanding the course of your loved one’s condition—the rhythm of how it unfolds—can empower you to respond more flexibly to its challenges.

Do any of these patterns ring true for your situation?

  • Relapsing pattern: Repeated flare-ups of illness followed by a “return to normal.”Actually, with a relapsing pattern, there are two “normals.”
    • Have systems in place for flare-ups.Ensure that your employer, other family members, etc., know what to expect when you have to move to Plan B.
    • Return quickly to “healthy mode.”It’s also important to have a strong Plan A in place for those times when your loved one is doing well.
  • Progressive pattern: A steady decline over time.With this pattern, things are continually changing, and unfortunately, “normal” seems to always get worse.
    • Watch out for irritability, burnout, and depression among family members.
    • Breaks from caregiving are essential. You need to pace yourself for the long haul!
    • Allow yourself to mourn the changes. Join a support group (online or in person), talk with a counselor, or write in a journal.
  • Plateau pattern: A sudden event causes change but levels out to a “new normal.”The initial shock of a stroke, for instance, wreaks havoc on a family’s routines. But after you adjust to your loved one’s new abilities, life can become more predictable and less stressful.
    • Keep your focus on what your loved one CAN do.Instead of focusing on what “used to be,” turn your attention to the pleasant activities that are possible within your relative’s limitations.

While you may not be able to change the disease, sometimes understanding its rhythm can help you find routines that make it less stressful.

Is it hard to find a reliable routine?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice understand that predictability goes a long way to keeping things simple so you have reserves for when the situation gets complicated. Let us help. Give us a call at 1-800-897-3052, toll-free.

Text message scamming: “Smishing”

Text message scamming: "Smishing"Your loved one may be watching for phishing scams on email, but now there are scams carried out by short message service (aka, texting). “Smishing” scams rose 58% in 2021. Nationwide they cost victims over $10 billion. Seniors are a prime target, as three out of five now own smartphones. While convenient, smartphones present new opportunities for getting scammed. Time to alert your relative to smishing.

Smishers masquerade as businesses your loved one may already deal with: Amazon, Netflix, the bank, or the postal service. Typical ploys involve bogus claims of

  • a “shipping issue” (25% of smishing messages are delivery scams)
  • “problem with payment” method, or an invoice they say needs verifying
  • concerns about “suspicious activity on your account”

Before your loved one gets a scam text, counsel them:

  • Don’t reply to the text, even if it says to “text STOP” to be taken off the list. Any reply lets the scammer know the phone number is “responsive.” They can sell that valuable information to other con artists.
  • Don’t call the number. Instead, go to the official website of the company to get its phone number. Call, and work with the company directly if there’s an actual problem to be solved.
  • Don’t click on any links. It will likely go to a website that looks authentic but is simply set up to collect account numbers and logins. Or to download malware to harvest such information later.
  • Copy the message and text it to 7726 (SPAM). There is no charge to do this. It will notify the phone carrier of the problem so they can investigate.

Ways to protect your loved one’s phone:

  • Check the settings on the mobile device and turn on spam protection.
  • Talk to the phone carrier about its protective services. A “call-blocking” service can be extended to cover spam texts as well.
  • Consider call-blocking apps. They identify and can filter out suspicious senders for texts and phone calls. The wireless phone trade association (ctia.org) has a list of apps for Apple and Android devices.

Is your loved one new to smartphones?
There’s a lot to take in with new technology, and unfortunately, some of it involves learning precautions against bad actors. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice hear some very sad stories about financial exploitation of older adults. If you are worried your relative may be vulnerable to a scammer, let’s talk about safety. Give us a call at 1-800-897-3052, toll-free.

Caregiving with kids

Caregiving with kids

Children generally like to feel included. But they may not know how to relate to an ill family member with limited abilities. Here are some ideas for home-based activities with elementary-age children.

Finger foods are fun to prepare and eat together.

  • Keep it simple: Chunks of cheese with crackers, peanut butter in celery, wash-and-eat fruits such as grapes and berries.
  • Set the table with fancy china or make it a “picnic” with paper plates and cups. 

Side-by-side reading nurtures a relationship.

  • Both can collect and share favorite comic strips or children’s books.
  • If your loved one has dementia, reading from picture books can help stimulate conversation.

Photographs spark memories.

  • Looking at old photo albums together can bring family history alive. Better yet, have the child write “captions” for the album.
  • If your elder family member wasn’t along on vacation, let the young one do show-and-tell with photographs.

 Everybody needs an exercise buddy.

  • Play “catch” with a soft beach ball, nerf ball, or big rubber ball either overhead or by bouncing between two players.
  • Watch gentle exercise shows together such as PBS’ “Sit and Be Fit.” Or purchase a DVD or video for exercises that are geared to the elder but are healthy and safe for both.

Children are observant and curious. Their noses are sensitive to smells. If odors tend to be present, make sure there’s plenty of fresh air circulating and consider having a bouquet of flowers in the room. Talk with children ahead of time about your loved one’s situation. They will be less likely to blurt out awkward questions or to worry that your loved one’s condition is contagious.

Looking for ways to involve the children?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice support multigenerational families. Give us a call if you need ideas. 1-800-897-3052, toll-free.

Iowa City Hospice