Aging/Gerontology, Health Conditions/Diseases, Social Work/Helping Profession/Mental Health

Promoting Activity, Independence and Stability in Early Dementia (PrAISED) — British Geriatrics Society

Article on dementia research worth looking at….

 

Professor Rowan H Harwood is a geriatrician at Nottingham University Hospitals NHS Trust, and the University of Nottingham, with particular interests in delirium, dementia and end of life care, who maintains an active portfolio of research. He tweets @RowanHarwood Can exercise-based therapy prevent or delay disability and dependency in those in the early stages of dementia? […]

via Promoting Activity, Independence and Stability in Early Dementia (PrAISED) — British Geriatrics Society

Aging/Gerontology, Health Conditions/Diseases, Healthcare, Humanity, News, Social Work/Helping Profession/Mental Health

Rapid assessment and frailty — British Geriatrics Society

This is awesome news and more hospitals should do this! Care beds for older adults and rapid assessment and treatment. Thoughts?

 

Beverley Marriott is a Advanced nurse practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow. There continues to be a growing emphasis on older people and emergency hospital admissions, with Frailty often used as a ‘wrap’ around term for ‘older people’. Older people with multiple complex […]

via Rapid assessment and frailty — British Geriatrics Society

Aging/Gerontology, Education, Healthcare, Humanity, Social Work/Helping Profession/Mental Health

Change for Older Adults is Needed!

As my clients are aging, I see the challenges they face and what is lacking in the current healthcare system.  This has led me to End-of-Life issues, Palliative Care and an interest in healthcare.  I have come to see that there needs to be a shift and focus on allowing seniors to ‘age in place’ and the services must expand in order to do so.   Expansion obviously requires money from the government, both on a federal and provincial/state level.  Healthcare needs to shift to a Patient-Centered approach with professionals available to the patient in either a facility, clinic or in their home in the community.  There is also a need for case managers to oversee the patients with chronic and complex health issues while coordinating with the professionals that need to be involved in the patients overall care.

I have realized much with the work that I have been immersed into for many years now.  For one, end-of-life needs to become less taboo and society needs to realize that in the cycle of life-there must be death; to be born, one must die.  I feel that we need to let individuals die with dignity and at home if that is what they choose while having the necessary professionals and services in place.  As a society we need to lighten up, reduce stress levels and find what makes us happy in life.  Again, a shift is needed and I believe this will happen; with less focus on materials things and more focus on human relationships, quality not quantity.

I feel it is important that every professional re-evaluate their interests and find their passion, their niche population, their niche demographic.  As professionals, we should also advocate within our profession for any needed updates or changes. 

There are many of us out there working with seniors/older adults in many different ways. We are on the front lines, we see what is happening, and see what needs to change. It is our role as professionals to advocate for that change.

What are you going to do today to make that change occur? How can you force the change? Who do you speak to? Write to? 

These are all things to think about and dwell on and when the timing is right-creativity will emerge along with action!

Aging/Gerontology, Healthcare

I Am Old: Can You See Me?

I am old, can you see me?

 Hola a tod@s, my dear friends.

Adding to collaborate with IC-HU Project two new friends, Vera Santos y Estefanía Martín of the Spanish Association of Psychogerontology. We invite you to navigate through their website, full of resources and training, projects, courses, news, and even  job offers! 
It is essential to continue to build networks that contribute to create awareness and collaboration. As all of you know, more than 45% of people admitted to the ICU are over 65 years old. So I asked them to write a post about our elders, and here it is. I am convinced that you’ll be pleased and that will make you think. Thank you and welcome to IC-HU Project.

“Youth, as social value predominantly in our society attached to the force and extension of the stereotypes about old age, can guide us as healthcare providers to see only a body crumpled and aged that we should cure or which we have to wait because there is nothing to do. But what about the person? Are we accompanying and serving people who live in aged and sick bodies?


The person is not the body. The person feels and lives here and now. His/her life story continues to write at this very moment and the quality will depend largely on the relationship we establish with them. The human being is scheduled for emotional contact and emotional bonding from birth to death. However, when old age knocks at our door, culture, stained myths, and false beliefs, contradicts the nature of our species.

“He is so old that he can´t feel or suffer.” “Do not complicate, she is very old and hardly feels.” “I don’t think that the family is too affected. He is very old.” “The best is admitting on the guard, because of his age there is little to do.” “The patient and the family know largely that she is so old that we can do nothing more than wait.”

All these thoughts make that as professionals and citizens, we deploy a series of biased actions or omissions that contribute to the older person to increase their volume of suffering by identification with these messages: “I have no right to feel, I am old. I am a nuisance.” “I don’t want to bother.” “Too much work I’m giving.” “I’m a burden.” “Now, why complain.” “Nobody worries.” “Nobody cares as I am.”

To remove all this, it is necessary from others, emotional embrace because it is what pushes us to be free, and thus feel reality as it comes. It makes us free to live and die with dignity, away from loneliness.

Emotional embrace should be essential ingredients empathy, tuning, involvement, the presence, communication skills, and flexibility of the time. Embrace emotional, generous, should be extended to families, because they also need us and if we are able to accommodate them we can promote both the care they give to their dear ill relative.

Let us make the sense of our profession depend on the sense of the lives of the people we serve and not only of their bodies (aged or not) or diseases. Let us make our profession an opportunity of relationship and meaning.

Is there something more beautiful than being treated “as we are” until the end of our days?

*Re-posted with permission from Gabi Heras, Intensive Care Physician from:
Aging/Gerontology, Education

Seeking Assistance is Not so Easy

I will use myself as the example for this article, but keep in mind that I work with individuals who are 50+, although most of my clients are 75+.

2 1/2 months ago while camping I injured my right shoulder while relaxing. Seems kind of crazy, right? One goes camping to relax, spend time with family, friends, and in nature-relaxation is the primary goal along with time away from the city, electronics, and the fast paced life that we live in.

I went to sit in my friend’s nice lounge chair that is supposed to recline and let’s just say-things did not go the way they were supposed to. When I went to kick up the bar at the bottom of the chair to recline-the bar got caught in rocks and well my shoulder paid the price! Intense pain shot down my arm and well I have frozen shoulder. So, here I am 2.5 months later and I am much more limited in what I typically do. This is very frustrating. I cannot lift heavy things which includes a full laundry basket or a bag of groceries with my right arm. I cannot do fast or sudden movements or my shoulder/arm pays the price! I cannot type or write for long periods of time. I cannot lift my arm to write on a whiteboard or flip chart. Filing folders at work aggravates it. Opening a frozen car door-not an option, I must use my left arm.

I have been forced to s-l-o-w down. I have to ask for help and this includes at times taking off my coat. I have had to re-learn to do certain things with my left arm and hand. I have to take breaks and rest more. The muscles in my left arm are nice and strong and re-learning certain activities and doing it with my left arm is firing up neurons and such in my brain, but it is frustrating to say the least.

I am still quite young, but it turns out this is not an age thing and is quite common in women in their 30’s-40’s. Yeah for me!

So, I can continue to be frustrated or I can accept the limitations and adjust.This adjustment means asking for help of whomever is around me or teaching myself to do it a different way. I have chosen to accept the challenge and the limits and so I ask for assistance and I teach myself to do things differently. I have s-l-o-w-e-d down and rest more-not such a bad thing when you think about it.

I do physiotherapy and I consult with an orthopedic. I do the necessary exercises that are assigned even if they hurt a bit and aggravate my shoulder because in the long range-it is meant to improve my mobility and not hinder it.

So, let’s think of those who are 75+ it is an adjustment as well; slowing down, accepting the changes both physically and mentally, and both seeking and accepting assistance. Keep that in mind with each interaction with an older adult. Suggest, listen, and wait to see what they are willing to accept. Keep offering and suggesting and eventually they may accept; it requires patience.

By Victoria Brewster, MSW

Aging/Gerontology, News, Social Work/Helping Profession/Mental Health

Theatrical Presentation on Elder Abuse: Arm Yourself with Knowledge

I attended a play on Elder Abuse this past weekend titled: “Grandpa Is Not a Cash Cow & Grandma Won’t Take Any Bull” organized by Seniors Action Quebec. It was excellent! The cast, except for 3, were all seniors. Le Theatre La Belle Gang presented. The play was written by Francois Jobin and directed by Marie-Claude Henault.

Issues of financial, emotional, verbal abuse, and psychological abuse were addressed in vivid, humorous, and easily recognizable vignettes. Physical abuse and sexual abuse were not outwardly addressed, but these are a bit harder to portray within a play.

Examples of the vignettes are: adult children (sisters) discussing placement while older adult present (recently suffered a stroke), but not including her in the decision-making. A grandchild that approaches her grandfather seeking money for a class trip and this was suggested by the adult child (grandpa’s daughter), an adult daughter who is verbally abusive towards her mother and demanding a check supposedly to be used to pay the mother’s bills, residents in a senior residence sitting around talking and waiting for their Sunday visitors that might show (children and grandchildren), an adult son talking on the phone to a friend saying that if his mother, who baby sat his sister’s kids, will not take his 2-year-old daughter for the weekend, she will see the granddaughter much less often, and the infamous scam of a ‘company’ coming to a senior residence and promising the world, taking the residents money, and giving nothing in return. Another scene was of a ‘doting’ niece who started paying extra special attention to her aunt when the uncle died and suggested that her aunt update her will.

Getting older is not easy, but it does not have to be negative. There may be more dependence on others for IADL’s, Instrumental Activities of Daily Living; cleaning, meal preparation, shopping, transportation, finances, medical appointments, medication management, communication and/or ADL’s- Activities of Daily Living; bathing, toileting, dressing, feeding, ambulating (mobility), cognitive issues, auditory or visual challenges, and fewer socialization opportunities. Household management becomes more difficult and often adult children and grandchildren live out-of-town and a senior has to rely on the community, friends, and agencies or organizations for assistance.

Possible Abuse: What to Look out for and What to Do:

Potential Signs of Abuse:

  • They criticize me
  • They ignore me
  • They isolate me from others
  • I am dependent on others
  • They take control of my affairs, i.e. finances, medication, medical appointments, hiring of homecare assistance, etc.
  • They boss me around
  • They raise their voice to me and at me
  • I am lonely
  • I am depressed
  • I cry often
  • They ask me for money all the time
  • I have no decision-making power

To Counter the Possible Abuse:

  • Say no! Assert yourself to family members, friends, and acquaintances.
  • It is your life and you should be able to go out and do as you please without approval.
  • You can call or talk to whomever you want.
  • You have socialization activities whether playing cards, exercising, attending a social group or meeting friends for lunch to keep you busy.
  • Call your local, provincial or state Elder Abuse Hotline for information, clarification, with specific questions. Arm yourself with knowledge!

Some Resources:

  1. HelpGuide.org
  2. CSSS Cavendish in Cote St. Luc, Quebec- http://www.cssscavendish.qc.ca/   or 514-484-7878.
  3. http://maltraitanceaines.gouv.qc.ca/en/
  4. http://www.aqdr.org/ (French)

By Victoria Brewster, MSW

Aging/Gerontology, Book Review, End-of-Life, Grief/Grieving/Bereavement

What to Do about Mama?- Book Review

Book Review- What to Do about Mama? By Barbara G. Mathews and Barbara Trainin Blank

What I like about this book is the different perspectives on caregiving as there are many contributors. This provides any individual or professional reading the book with different scenarios, which include common situations and feelings.

The authors also describe their own care giving experiences. For Barbara Matthews, she became a caregiver for her mother-in-law. Ten years after her father-in-law died, her mother-in-law came to live in her hometown. At first, the response was no, but as health problems began to appear, the move happened. A family meeting with all helped “seal the deal” for her to relocate and be closer to family to have assistance as needed.

Another health crisis occurred creating a cycle of hospitalizations and rehabilitations. She then moved in with Barbara and her husband on the first floor of their house. Increasing assistance was added as her mother-in-law required it. Eventually, hospice services were put into place which also gave Barbara a break (respite) from providing total care.

For Barbara Trainin Blank, she was the caregiver for her mother who lived quite a distance away.  After her father’s death, her mother began presenting with forgetfulness which progressed. Her mother did not want to go to a nursing home or residence and Barbara did her best to honor this by having assistance come to her mother’s home environment. She became a long distance caregiver, an advocate, an organizer, and in some ways an unpaid care manager-organizing all the details of her mother’s life from medical appointments, to home care workers, arranging transportation, etc.

Caregiving itself has a different definition for each individual providing it. It is hard work from what I have read in the book and witnessed myself in interactions with clients and family. While I have children myself, caregiving for an adult is very different.  The needs of a child can be more or less than the needs of an adult and much easier to carry/lift a child than an adult! Also, as Barbara pointed out to me, for her an important difference between caregiving for children vs. care giving for older adults is that the first is a hopeful process preparing the child for a good future and the second is a process of trying to make life as comfortable as possible for the aging adult as they proceed toward the end of life.

Some common themes in the book are:

Care giving responsibilities:

Local or long distance caregiving?

Alone in acting as a caregiver or shared responsibility?

Potential tasks: financial care, physical care, respite, paid caregivers, volunteers, professional assistance.

Caregiving profiles:

Some quit their jobs to provide caregiving to a spouse or other family member. Some are trying to balance work with raising a family and caregiving (sandwich generation), some are alone in their caregiving role while others have siblings or other family member’s support/assistance. Some are caregiving locally and some long distance.  It is difficult to watch a parent, spouse, child or friend deteriorate and age, just as it is difficult for the person this is happening to, to admit they are aging and deteriorating, and need help.

Roles and Responsibilities:

If you can, define what the person needs assistance with: IADL’s Instrumental Activities of Daily Living; cleaning, meal preparation, shopping, transportation, finances, medical appointments, medication management, communication and/or ADL’s- Activities of Daily Living; bathing, toileting, dressing, feeding, ambulating(mobility). Determine who is assisting with what and whether the individual in question will allow the assistance.

Caregiver emotions and need for self-care:

This to me should be a no brainer; everyone needs some help and should be open to accepting and asking, but it is not easy for everyone to do so.

Self-care should be regularly scheduled as much as possible into the daily and weekly routine.

  • Arrange or accept assistance from family, friends, agencies/organizations, paid companions or homecare workers, and perhaps volunteers.
  • Take vacations or days off if you cannot go away on vacation (financial reasons, other commitments)
  • Give yourself a night off every once in a while.
  • Schedule your own appointments and keep them for medical reasons and check-ups, beauty salon appointments, to go grocery shopping, etc.

Regarding emotions and support for the caregiver:

  • Look into support groups whether run by professionals or volunteers.
  • Seek assistance of a counselor or therapist if you think it would help.
  • Call or schedule coffee breaks or lunches out with friends to talk.

Family Relations:

Communication is important between family members, between professionals and family, between other caregivers, and one person needs to be the designated person as the main contact. As a professional, I can state it is easier to have one family member to talk to, to share information with. If a phone call will not work or is not possible, then a group email addressed to the main contact with the other family members cc’d is another option. This way everyone is in the loop and aware of what is happening and the information is written.

Each caregiver or main contact has their own definition of “doing one’s part.” Caregiving one’s parent(s) is not easy and can be difficult at times as the child-parent dynamic changes. It is reverse roles and now the adult child is parenting the adult parent!

I have worked as a case manager with older adults for 14 years and fortunately I have known most of my clients for that length of time. It is hard to watch someone become frailer. I imagine it is more difficult and more emotional for a family caregiver re: a parent, child, spouse or other family member.

Barbara Matthews shared with me that over the past year of working on her social media sites, this “caregiving in a nutshell” definition has evolved:

Caregivers get involved with care giving to meet a need, solve a problem, or deal w/ a crisis.  The situation often improves—for a while.  Many times caregivers do not take into account the process of aging cannot be controlled, needs will increase—sometimes over many years, or how heavy the burden can/will become.  Therefore, it is important:  to have realistic expectations about care giving, to be prepared for the unexpected, to communicate expectations clearly to the “others” and to develop a care giving contract of shared responsibility to be signed-off on by all.

The book is worth reading and is very comprehensive.

By Victoria Brewster, MSW