Family Caregiver Support

Problems with hygiene

It’s not uncommon for a holiday visit to reveal that things with mom or dad are newly amiss, particularly in the area of personal grooming. Maybe mom has always been fastidious about her appearance, and now she’s disheveled. Or dad didn’t change clothes the entire time you were there, and maybe even had a strong odor.

There are many possible reasons for such changes:

  • Poor vision or reduced sense of smell. Your loved one may not see stains on garments or smell their own odors. Without these cues, they may neglect to bathe or do the laundry.
  • Depression. Especially if your relative shows little interest in things they used to enjoy, it may be that depression has sapped their motivation. Ask your loved one’s doctor to do a depression screening.
  • Fear of injury. Slippery surfaces, poor lighting, and unsteady balance combine to make the bathroom a dangerous place. Try installing a light in the shower, also grab bars and nonskid pads. Add a bath chair and a handheld showerhead so your loved one can clean up while seated.
  • Memory issues. Periodical forgetfulness is one thing. But a change in personal hygiene can be a sign that your relative is struggling with dementia. It may be that they need memory prompts or actual assistance.

Bringing up the subject. Take a respectful, go-slow approach. Are they making a choice to bathe less frequently or having trouble navigating the bathroom? (Bathing 1–2 times a week IS enough to stave off skin problems and infections.) Similarly, with clothing: Unawareness, or problems doing laundry? See what they say and learn if/how you might help. Or tell the doctor what you’ve observed and let the doctor explore possible causes. It may be easier for your relative to be candid with a professional than admit their problems to you.

Have you noticed a change in personal grooming?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, January is often when we at Iowa City Hospice get calls from concerned family members. Give us a call at 1-800-897-3052, toll-free. We can help you decide on an optimal approach and next steps.

Repairing identity theft

It’s a fact that scam artists prey on older adults. Scammers steal identifying information and use it to obtain cash, make purchases, or open new credit card accounts.

If your relative’s identity has been stolen, take action quickly. But be methodical! Keep track of every report you make. Log every call. Send any documents by certified mail. The Federal Trade Commission (FTC) recommends the following steps:

Things to do right away:
Call the companies where the fraud occurred.

  • Talk to the fraud department. Explain there is an identity theft situation.
  • Ask them to close or freeze the accounts to avoid new charges. (They may require an Identity Theft Report from the FTC. See below.)
  • Identify the charges that are fraudulent. Ask that they be removed.
  • Change logins, passwords, and PINS.

Place a free, one-year fraud alert by contacting one of the three credit bureaus. That company must tell the other two.

File a report with the FTC. Go to IdentityTheft.gov or call 1-877-438-4338. They will give you an official Identity Theft Report and recovery plan for free. You may need the report to get further action on the accounts.

Next, clean up your loved one’s credit
Contact each of the credit bureaus listed above.

  • Ask to have fraudulent information removed. For example, names of accounts opened, unpaid bills. They are required to comply with your request to block this information if you have an FTC Identity Fraud Report.
  • Consider placing an extended fraud alert or credit freeze. This way, no new accounts may be opened without your loved one’s consent.

Continue to monitor service records and bills so you can quickly challenge suspicious activity.

Has your loved one’s identity been stolen?
Just what you need, right? As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see this far too often. You are certainly not alone! Give us a call at 1-800-897-3052, toll-free. We can help you prevent this from happening in the future.

Montessori for people with dementia

Caring for a loved one with moderate-to-advanced dementia often leads to bewilderment. And sadness. Perhaps your relative seems withdrawn. Or is fidgety, pacing, or wandering. They may seem to recede each day. How can you connect with them now? How can you keep them engaged?

Experts in dementia care are culling tips from pioneering educator Maria Montessori’s work with very young children. She developed activities aimed at meeting the individual’s interests and abilities. Activities that are enjoyable and stretch the mind without overwhelming.

Well-matched activities for persons with dementia generate positive feelings and have been shown to reduce agitation and other problem behaviors. People with dementia need pleasure and purpose too!

To engage your relative in a Montessori way, think about activities that stimulate the mind and/or body or senses. Then consider your loved one’s past lifestyle and hobbies. Did they involve

  • home. Activities might include setting the table. Folding towels and napkins. Matching socks. Caring for a doll. Arranging flowers. Peeling potatoes. Stirring a mix.
  • office. Provide a briefcase, paper and pens, file folders. Supply a newspaper or magazine, and if safe, blunt scissors to “cut out interesting articles.”
  • garage. Ask your relative to “do you a favor” and sort items, maybe buttons from screws. Give sandpaper and blocks of wood. Provide a junk gadget that can be taken apart “for repair.” Avoid small objects if your relative tends to put things in their mouth.
  • exercise and/or outdoors. Kick a beach ball back and forth. Toss beanbags at a target. Sweep. Rake. Load a wheelbarrow and move things.
  • games. Try easy jigsaw puzzles or building blocks. Match colors or numbers on poker chips, dominoes, or cards.

If an activity seems a fit, don’t hesitate to try it again soon. Chances are your relative won’t remember they’ve done it recently.

Having trouble connecting?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice have seen many people with dementia go through a stage of withdrawal. Or conversely, a phase of lashing out. Matching activities to the right skill level is a great way to make for happier, more rewarding days. You don’t have to do this alone. Give us a call at 1-800-897-3052, toll-free.

Add a dose of laughter to your life

Don’t you just somehow feel better when you laugh? It turns out, that’s not just fantasy.

Laughter has physical benefits at the cellular level. Research consistently demonstrates that a good belly laugh engages many different systems in the body.

And laughter delivers emotional health benefits as well.

Studies show that laughter

  • supports the heart. If we’re laughing, we’re not stressing. The stress hormones are the root cause of heart attacks, because they damage the circulatory system.
  • relaxes muscles. Good, deep breathing is part of laughing. It stimulates oxygen flow to the muscles and triggers muscle relaxation.
  • lessens pain. The body’s natural pain-relieving hormones, the endorphins, are released when we laugh.
  • boosts immunity. Laughter helps combat infections and other diseases by triggering better antibody response at the cellular level.
  • eases mood. Laughter is emotionally distracting. It can interrupt the blues and cast everything in a new light.

Want more laughter in your life?

  • Read children’s books. They are often silly (Amelia Bedelia, anyone?). Ask a librarian for recommendations. The illustrations alone may bring a chuckle.
  • Look for humorous gift cards. Maybe even buy one to put on your refrigerator. In a couple of weeks, send it to a friend, and give yourself a new one!
  • Play with a pet. If you don’t have a pet, find out if there’s a dog park nearby and go watch. Dogs are naturally joyful.
  • Spend time with funny people. Some people have a knack for finding the humor in things. Laughter is contagious. You may even learn to laugh more at yourself!
  • Choose comedy. When you’re selecting a movie to watch or a screensaver for your computer, look for something funny.
  • Make silly happen at home. Dress your toast with raisin eyes and jelly mouth. Wear goofy socks. Play a game with friends.

Or, just plain start laughing. Whether you’re laughing at someone’s joke or laughing for no reason at all, your body responds the same.

Laughter is good medicine. And it’s free!

Is laughter in short supply?
If so, chances are you are doing too much. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice see many family members over-burdened, burning their candle at both ends. If it feels like a luxury to laugh, it’s time to re-evaluate. Give us a call to learn how we might help: 1-800-897-3052, toll-free

Leaving a legacy with StoryCorps

The desire to leave a legacy calls strongly to many older adults. Perhaps this is of interest to an elder in your family. A legacy does not have to be financial in nature. One way to leave a legacy is to record a personal story and bequeath its insight to future generations.

StoryCorps, a project of the American Folklife Center at the Library of Congress, makes this possible. It holds a collection of more than 300,000 recorded conversations. And it wants to hear from our nation’s elders.

The StoryCorps “Connect” project involves 40-minute remote video interviews. This is ideal for a grandchild and grandparent. All that is needed is for both parties to have a computer with a microphone, a tablet, or a smartphone. (Check on the need for technology help beforehand.)

At StoryCorps.org you can find interview tips and suggested questions. At the end of the interview, you can even upload photos with the recording to the Library of Congress. Go to https://archive.storycorps.org/ to open a free account and set up a video interview.

StoryCorps recommends preparing ahead of time. Each person should be in a quiet room, uninterrupted. Figure on four to eight open-ended questions. But if something unexpected and interesting emerges, be willing to switch course.

Questions can run the gamut.

  • What are you most proud of?
  • When did you feel most uncertain and what helped you cope?
  • What do you feel most grateful for?
  • How has your life been different than you imagined?
  • Who was a big influence in your life and in what way?
  • If you could hold on to one memory in your life, which one would it be and why?

This holiday season, consider inviting a young person in your family to uncover a “conversation of a lifetime.” Your loved one may relish the exchange and enjoy contributing to our national archive of American stories.

Looking for other legacy ideas?
Give us a call at 1-800-897-3052, toll-free. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice know how touching conversations like these can bring families closer together. Legacy building is one of the most gratifying experiences of this phase of family life. Let us help.

“Should we delay that procedure?”

Should your loved one go ahead with cataract surgery? What about a hip replacement? Dental work? A cardiac stress test? In light of COVID, other health issues seem to pale. But putting off treatment or tests can result in tough consequences down the line. How do you know which procedures are worth the risk?

Consider the following:

Is your loved one especially high risk? In addition to advanced age, high risk includes those who are obese or smokers, or who have cancer or a heart, lung, or kidney condition.

Is your relative’s town currently a “hot-spot”? If local transmission rates are high, best to wait until they resolve.

Is the condition “urgent”?

  • Pain or infection. Pain is usually a sign of trouble, often an infection. Left untreated, infections can spread and even trigger sepsis, a potentially life-threatening condition.
  • Danger if you wait. Ask about the risks of doing nothing. Would delay cause lasting damage? Increase surgical complications?
  • Risk to independence. Could waiting affect your relative’s ability to live on their own? Getting cataracts removed may be more urgent if your loved one is falling or cannot drive safely.
  • Ability to participate. For those with dementia, waiting could result in more problems later because of reduced ability to participate or cooperate with the procedure.

How is risk reduced? What protections are in place on the provider side? Is a negative COVID test required before a procedure? Can that hip replacement be done as an outpatient surgery with recovery at home?

What about precautions afterward? Following a procedure, your relative may be considered a virus risk to others. Rehab or an assisted living facility may require a 10- to 14-day quarantine after discharge from the hospital. Are you and your loved one prepared to address this kind of isolation?

Not an easy decision
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice frequently see families faced with these difficult choices. You don’t have to sort through this by yourself. Let us help you evaluate the options. Give us a call at 1-800-897-3052, toll-free.

What is high blood pressure?

High blood pressure is sometimes called “the silent killer.” This is because it is dangerous but has few outward symptoms.

As the heart pumps, it pushes blood through the blood vessels, creating pressure on the artery walls. High blood pressure means that your heart is having to work extra hard to get the basics of circulation accomplished.

Nearly two out of three adults age 60 or older have high blood pressure!

Besides age, other factors make it more likely your loved one, or even you, could develop high blood pressure.

  • Chronic conditions. People with diabetes, kidney disease, or sleep apnea are at higher risk for high blood pressure.
  • Race/ethnicity. Forty percent of African American adults have high blood pressure as compared with 25%–28% of adults in other racial/ethnic groups.
  • Body weight. Being overweight or obese is strongly associated with high blood pressure.
  • Lifestyle. Too much salt in the diet and/or too much alcohol raises the risk. As do stress, smoking, and lack of exercise. On the other hand, becoming more active and quitting smoking significantly decrease risk.

When blood pressure is measured, the result is two numbers, such as 114/76 (read: 114 over 76). The top number (114) reflects the pressure in your blood vessels when the heart contracts. A reading of less than 120 mmHg is considered healthy. 120-129 mmHg is “elevated,” and 130 mmHg or more is considered high.

The bottom number reflects the pressure in the blood vessels when the blood is “coasting” while the heart fills up between beats. A reading of less than 80 mmHg is normal, and a larger number is considered high.

A crisis level occurs when the top number is higher than 180 and/or the bottom number is higher than 120. When you get a reading like this, if the person you care for has pain in the chest or back, problems breathing, trouble speaking, changes in vision, or numbness or weakness, call 911 immediately! If not, wait 5 minutes and take it again to see if the readings come down. If they don’t, then get medical attention right away.

Does the person you care for have high blood pressure?
Fortunately, this is something that can be monitored from home. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice have helped many families put systems in place to monitor this silent killer and keep it under control. Give us a call at 1-800-897-3052, toll-free.

Dementia and communication: Listening

People with Alzheimer’s or other memory loss conditions often have trouble expressing themselves, sometimes right from the start of the disease. This can easily lead to confusion and frustration for both of you. Your willingness to exercise patience is key to successful communication: Patience and calm, over and over and over again. This is hard! AND it’s essential to keeping a positive relationship.

There are some practical tips, too. Even in the early stages, word finding can be difficult, so they may describe an object rather than name it. They may forget what they just said and say it again. They are easily distracted. You can help by using the following strategies:

  • Avoid groups. One-on-one conversations work best.
  • Limit distractions. Turn off the TV or radio. Do one thing at a time; for example, converse OR put on shoes.
  • Allow time. Rushing creates stress, which makes it harder—for us all!—to find the right words or keep thoughts organized.
  • Offer encouragement. Don’t interrupt or try to finish their sentences. Smile and make eye contact. Project the reassurance that they can take all the time they need to say what they want to say.

As dementia progresses, you may need to redefine what a conversation is with your loved one. It may be less of an exchange of ideas and more an opportunity for your relative to engage with you. Your focus is on making the exchange a pleasant one.

  • Avoid correcting them. It’s okay if the details aren’t right or their logic is “off.” When inaccuracies are pointed out, they may misinterpret your corrections as dislike or disrespect.
  • Learn to read their tone and body language. Search for the emotion or meaning behind their words. For example, repeated questions often indicate anxiety. A sudden demand to leave a gathering can be a sign of confusion or overwhelm.

Is communication a problem?
We at Iowa City Hospice recognize that it’s sometimes difficult to converse with a relative who has dementia. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we can help you listen beyond the words and support your loved one to express themself as best they can. Give us a call at 1-800-897-3052, toll-free.

Video chatting for the “tech challenged”

Many older adults are embracing technology to stay connected with family and friends during the pandemic. Although some popular technologies—Zoom, FaceTime, and Skype—are relatively simple, they still require a computer, tablet, or smartphone. Plus some tech savvy.

Your loved one may be challenged to learn new skills because of memory issues. Or perhaps arthritis or vision or hearing problems.

Weigh the tech options for your family member against these criteria:

  • Very simple interface. Every feature adds complexity. Best is a large screen, large buttons, volume control, and limited choices. Look for a “senior tablet” or “senior smartphone.” Or consider a voice-activated device with a screen, such as Amazon Echo Show. “Alexa, call Sally” is pretty simple. Some people may still need a helper, though.
  • No setup required by the older adult. Ideally, you can send or bring the device preconfigured. Look for services that will set up a new device—including with contact lists for phone calls—and then send it to your loved one’s home essentially ready to plug and play.
  • Tech support available. There will be problems! Ideally, the device needs to be fixable remotely (by you or a technician not at the house).
  • Wi-Fi handled. Someone needs to get the device hooked up to Wi-Fi. Or, the device should come with its own built-in cellular connection.

Devices that respond to voice commands are understandably attractive. But consider privacy issues. Is the artificial intelligence assistant always listening? Where and how are the audio requests stored? Are your loved one’s data being sold to third parties? Are there protections against hackers?

Another option is using the phone plus a digital photo frame that you update remotely. It’s not nearly the same as video chatting, but your loved one can still keep abreast of growing grandchildren and family activities.

Worried about an isolated relative?
As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we at Iowa City Hospice know how difficult it can be to stay connected. But there are options that address some of the more common difficulties. Give us a call at 1-800-897-3052, toll-free.

“Should we bring Dad home?”

In the context of COVID, many families are wondering if an older relative would be better off moving out of their assisted living, memory care, or skilled nursing facility. It’s not an easy question to answer.

The advantages of facility living. Facilities have staff on site 24/7 to assist with residents’ needs. They can provide meals and a comforting routine. Staff coordinate readily with medical personnel. Support can be ramped up as needed. With COVID protocols in place, there are usually limited opportunities for residents to engage with people they know.

Issues to consider about relocation.

  • Exposure to COVID. If members of your household are going to work or school, will your loved one truly have less exposure than in a facility?
  • Caregiving support. If your relative moves in with you, what level of support can you realistically offer? If into an apartment, do you have a home care agency lined up to help? Can they provide 24/7 care (the safest)? What are the agency’s COVID protocols? You don’t want caregivers bringing the virus into the home.
  • Cost. What is the expense relative to the cost of facility living? Is this sustainable?
  • Social isolation. Loneliness, boredom, and depression are devastating. Persons with dementia are declining rapidly under isolation, and deaths are increasing. (Weight loss, falls, and sudden frailty are signs of a big problem.) Assess your relative’s ability to connect with others in the facility as compared to the proposed new situation. Which is better?
  • What if your loved one gets sick? How will you care for them? What if you get sick?

This is a difficult decision. You need to reflect upon the pros and cons with a realistic accounting of resources and capabilities. And consider implications for the future—when your relative’s needs may increase and/or the threats of COVID decrease.

Pondering a move for your loved one?

As the Iowa City, Muscatine and Cedar Rapids expert in family caregiving, we at Iowa City Hospice have seen families struggle with this decision, especially if dementia is a factor. Let us put our expertise to work for you as you weigh the advantages and disadvantages of each scenario. Give us a call at 1-800-897-3052, toll-free.

Iowa City Hospice