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Who Get's to Decide?

 

You want what is best for your parents, and you worry that they need additional help.  Your parents believe that they’re managing just fine on their own.


So, Who decides?


First of all, you need to consider whether your parents are cognitively well and capable of making sound decisions.  A “sound decision” is not necessarily a decision you agree with—two people of sound mind can arrive at different decisions!

 

 

Capacity to make decisions is based upon someone’s ability to understand the choices with which they are faced, and the consequences of their decisions.  For example, as an adult with capacity, you are aware that your chance of winning the lottery is very limited, and yet you choose to spend your hard earned money on a lottery ticket.  Someone could say that is an unwise decision because the consequences are not in your favour; however, you understand the risk involved and the likelihood that you will not win.  The reason that minors are not permitted to gamble is that they do not fully understand the consequences of their decisions.  As a capable adult, you are permitted to make decisions that others might judge to be unwise, but it is your prerogative to do so.


Your parents have the same right.  If they have the capacity—meaning they understand their options, and they understand the risk associated with those options—they are entitled to make decisions. 


My parents won’t face reality — they won’t decide anything!


While it might appear that your parents aren’t planning because they aren’t changing anything, they might just be sticking with the status quo because they aren’t aware of all possible options.  You feel that your parents require more help—have you suggested various sources or types of assistance?


It is possible that your parents view the decision as a dichotomy—living at home and “getting by” as they always have, versus complete institutionalization in a nursing home.  While these may be two possible options, there is a myriad of other options that fall somewhere in between!

 

 

Help educate your parents on some of the options for assistance that won’t feel like such extremes.  If your parents are cognitively well, it is their right to choose the type of care that they feel will best meet their current needs.  Engaging your parents in the research and ensuring that they feel in charge of their own decisions will ease the process.  When your parents realize that you’re not just trying to force them out of their beloved home (as so many seniors fear!), they might be more open to alternate care options.

 

To start your research journey, you can learn about some homecare options that emphasize health and wellness.

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Are you doing everything for your elderly parents?

 

You’ve been managing your own household, your parents’ household and now your in-laws need some help too.  You already feel stretched too thin, and your parents’ needs keep increasing. You need homecare support for your parents, but they refuse to even consider it.

 

Your father says he “doesn’t need a babysitter” and your mother declares that she can “do everything just fine myself”.  And by that, what she really means is that you are doing everything just fine for them!

 

Your parents think they’re managing just fine because you’re filling in all the gaps.  They don’t realize just how much you’re doing. They just benefit from the fact that everything gets done.

 

 

For years, you’ve been trying to follow your parent’s wishes.  You respect their decisions and do your best to help support them in those decisions. They keep saying they don’t want or need any help and you’ve been trying to respect it.

 

The problem is, they not only need the help, but they are also already receiving help.  The help is coming from you, and it’s now more than you can manage on your own.   It is okay to acknowledge that you can no longer provide all the assistance that they need.  You aren’t failing to respect their decision, you are making a decision that is necessary for your own health and wellness.

 

You can explain to your parents what you are able to do, and outline the tasks that are now becoming too much.  You can outline options for how your parents can fill the remaining gaps and empower them to make a decision that best suits their needs.

For example, you are willing to do the weekly grocery shopping and visit with your parents after putting all the groceries away, but it is no longer feasible for you to be cooking dinner for them every day.

 

You can then outline meal options for them.  They could order Meals on Wheels or another meal delivery service. They could move into a retirement home where meals are provided. They can have a caregiver cook meals together with them in their own kitchen, using their own preferred recipes.

 

You can help outline the pros and cons of each option, and how each option would fit into their lifestyle.

 

Stepping back and acknowledging what you need for yourself does not take away your parents’ ability to make their own decision. It just eliminates one of the options from the list—the option of you cooking the meals daily.

 

As long as you continue to be the primary option, as long as you continue to cook dinner daily, your parents will not seriously consider any other option on the list.  You need to clearly articulate what you can and cannot do, and then guide your parents through the decision making process about how to solve the remaining gaps.

 

Homecare can address many of those gaps and provide the individualized attention and assistance they are accustomed to receiving.  Homecare is not always just about the senior client; it is often about alleviating family members who have been doing far more than is sustainable. 

 

A wonderful caregiver—or team of caregivers—can take care of your parents’ to-do list so that it doesn’t all fall on your shoulders. 

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Change is scary but it doesn’t have to be

 

You’re worried about your parents and you think they could use more help.  You suggested homecare, but they wouldn’t hear of it.  They told you: “we’ve managed just fine on our own this long, we don’t need any help.”

 

What they’re really saying is that they don’t want to face change.

That’s because change is scary.

 

 

Change is scary for all of us, at some level. Each person has a different tolerance for change, and it might take a lot more change to scare some people than others. But if you introduce a drastic enough change, eventually, any of us would feel trepidation about that change.

 

It’s little wonder then, that for seniors in their 80’s or 90’s, the thought of even a small change can be quite scary. After eight or nine decades, they are likely pretty set in their ways. They want things done a certain way; they want to keep their environment the same. As long as everything remains the same, it feels more manageable. It might help your parents to understand that homecare is all about reducing the amount of change that your parents will experience

 

Warm Embrace Caregivers are trained to match each client’s specific preferences. 

 

Caregivers DO NOT barge into a client’s home and just take over. Caregivers DO wait to be invited in, and they ASK permission to proceed. They ask how that particular client prefers the laundry or housekeeping to be done. They cook from the client’s recipes or directions to match their particular tastes.   They help to keep clients’ lives consistent.

 

 

Homecare is one of the best prevention strategies to one of the biggest possible life changes: admission to a long term care home.  Moving to long term care is a HUGE change—absolutely every single element of someone’s routine is changed. From the time they get out of bed, to when they eat, and whether they wear pyjamas to breakfast—everything is adjusted to match the schedule of the long term care home.

 

Homecare ensures that individual clients maintain their own personal routine, they maintain their home, they maintain familiar comforts.  Caregivers match clients, rather than clients matching caregivers.  It reduces the amount of change they must experience.

 

Since homecare is completely client-focused, each client calls the shots. The client decides what they’re doing each day and how they want things done and in which order.  It is very empowering for seniors to get to make all the decisions that impact their own day-to-day living.  Homecare grants this level of autonomy and independence.

 

Help your parents to see that homecare will ensure the least amount of change and help them to maintain the lifestyle that they know and love.
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Gift Ideas for Seniors

 

What do you get for the grandparent or senior who already has everything? The great-grandparents are even harder to shop for! What is the perfect gift for someone who is 80+? Different gifts are ideal depending upon where someone lives. Here are two gift list ideas to suit different living situations.

 

 

4 IDEAS FOR SENIORS LIVING AT HOME

If your 80+ relative is living independently at home (either a house, condo, or apartment), then the best gifts you can give them are practical items that will prolong their independence. Your loved one is likely very focused upon remaining at home for as long as possible; any gift you give that helps in achieving that goal is a good idea.

 

Here are some suggestions

1. Gift Certificates for property maintenance. The physically demanding activities of home maintenance are likely difficult, so provide your loved one with a gift certificate for regular home maintenance chores such as snow shovelling, grass cutting, garden upkeep, window washing, etc.

 

2. Homemaking and Household Assistance. Out-door house maintenance is not the only area of challenge for the elderly. Household chores can also become quite onerous. Your loved one will greatly appreciate a gift certificate for housekeeping. 

 

3. Assistive Devices. Assistive devices can include a whole range of products to help with any variety of needs. There are specially designed items for challenges such as hearing impairment, sight impairment, weakness following a stroke, dexterity, memory loss, etc. You might be surprised at some of the items available for purchase at your local assistive devices store. Your loved one will truly appreciate this gift if they have already acknowledged challenge in a particular area.

 

4. Transportation. Many elderly seniors no longer have a licence and no longer drive. No access to transportation can be isolating, especially in the winter months. Providing your loved one with pre-paid driving options ensures that they will not be home-bound when the winter weather hits. Warm Embrace caregivers are pleased to drive your loved ones wherever they need to go.

 

4 IDEAS FOR THOSE LIVING IN NURSING HOMES

If your loved one lives in a retirement home or long-term care centre, then different gifts might be more appropriate. Their personal quarters are much smaller, so they do not have space to keep many belongings. Here are some ideas that won’t take up too much space but will still bring a smile on Christmas day.

 

 

1. Window Ornaments. Glass window ornaments are pretty to look at, and cast a cheerful glow when the sun is shining. There may not be much shelf space available for knick-knacks, but adding a personal touch to the window doesn't take up any additional space.

 

2.Personal Items. Residents in long-term care use their own preferred personal care items such as hand soap, lotion, toothpaste, etc. A care package of your loved one’s favourite items is always appreciated! The scent is strongly linked with memory and emotion; selecting a favourite scent can induce positive memories.

 

3. Blanket or Lap Quilt. Having a cozy item such as a small blanket or lap quilt is always comforting. It can be left on the bed or on a chair in your loved one’s room. If recognition of new items is difficult for your loved one, a blanket on the bed implies its purpose in a way that new clothing items do not.

 

4. Companionship. Providing your loved one with on-going visits is probably the best gift you could offer. Warm Embrace provides Companion Aides to long-term care centers across the region. Companion Aides visit one-on-one with residents and can take them on personal outings into the community. They provide mental and social stimulation, as well as an opportunity for physical activity. This is a gift that keeps on giving long after the holiday season!

 

FOR SENIORS LIVING ANYWHERE:

Triple Vitality. This gift is suitable for someone living in retirement or long-term care, as well as those still living in the community. Triple Vitality is a proactive approach that focuses on three areas of health—physical fitness, mental stimulation, and social interaction. By maintaining strength and functioning in each of these areas, people maintain independence and enjoy an increased quality of life.

 

If you just have questions about the above list of gift ideas, please don’t hesitate to call. We love to know that the seniors in this area will have a meaningful holiday season!

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Exploring Responsive Behaviours

 

Someone who is experiencing dementia may exhibit behaviours that we do not understand.  These behaviours have been labeled ‘difficult’ or ‘disruptive’ or ‘challenging’, but is that really a fair assessment of these behaviours?

 

In caring for people with dementia, the focus often ends up being on the disease itself, rather than on the person who is experiencing the disease.  Thus, their behaviours are often automatically assumed to be associated with the disease. 

 

Sharon Stap, a Psychogeriatric Resource Consultant, contrasts older understandings of dementia with more updated approaches.  In the past, it was understood that dementia was altering someone’s brain, resulting in different behaviour. All behaviour was assumed to be a result of the disease. 

 

 

The newer understanding of dementia is that the changes in someone’s brain results in a different perception of the world around them, creating anxiety, fear and other emotions which then lead to different behaviours.  Understanding that someone with dementia is experiencing a change in perception which causes behaviour should fundamentally alter how we interact with those who have dementia.

 

Dr. Sherry Dupuis, former director of MAREP (the Murray Alzheimer Research Education Project), feels that we need to reframe our view of these behaviours.  Instead of merely seeing the ‘challenge’ or ‘difficulty’ that these behaviours cause for us, or assuming that all behaviour is attributed to disease, we need to reframe these behaviours as a form of communication.  Dr. Dupuis views behaviours as a form of personal expression, a unique way of communicating needs.  We should then seek to understand the meaning behind the personal expression.


We must remember that people who have dementia were all unique individuals prior to the onset of their illness. They continue to be unique individuals with different personalities, communication styles, interests, life histories, etc.  Dr. Dupuis charges us to never lose sight of the fact that a person with dementia is first and foremost a person who requires love, care, and understanding, not just a disease or a ‘case’ that needs to be managed.

 

One of the greatest gifts that we can offer to someone with dementia is the gift of truly relating to that person—validating their personal experiences and feelings.  Someone with dementia is experiencing the world around them differently than they previously experienced the world, and differently than you might be experiencing the world around you. 

 

 

This experience may be frightening, overwhelming, or worrisome, and the feelings that are generated and their emotional response is fully valid. We cannot be dismissive of someone’s feelings or emotional responses just because we do not deem a situation to be frightening to ourselves.  The kindest thing we can do is try to understand the emotional response and validate the feelings that someone else is experiencing.  Only then can we attempt to change someone’s experience into something more positive.
 

If someone is distressed or having a negative experience, distraction can be helpful, but it is not the first step in the process.  Stap emphasizes that you cannot jump immediately to distraction, otherwise you risk being dismissive of someone’s feelings. Stap proposes a four-step process where distraction is the final step, not the first option. 

 
The Four Steps:

 

1. Show you care

 

2. Show you want to help

 

3. Redirect

 

4. Distract

 

For example, Agnes has dementia, and she is upset and focused on wanting to return home. The first step is to acknowledge how Agnes is feeling.  You might say: “You need to get home, Agnes? I can understand why you’re so upset.”  Attempting to inform Agnes that she is already at home—known as reality orientation—is not helpful and only causes more distress; Dupuis and Stap agree that there is rarely, if ever, a good time for reality orientation.

 

 

After acknowledging and validating Agnes’ feelings, you want to show that you want to help.  You might suggest: “let’s go see if we can find someone who can help us, Agnes”.  While on the hunt for someone who can help, you have the opportunity to redirect, the third step.  You could say, “I’m tired. Before we look for someone else who can help, do you mind if we rest here by the piano?”.  After this, you have the opportunity for distraction, the fourth step.  You could then say: “You play the piano, don’t you, Agnes?  Would you play me a tune?” 

 

If you had jumped immediately to distraction via the piano when Agnes first approached you, she likely would have felt even more frustrated that her needs were not being addressed. Acknowledging Agnes’ feelings and needs, then assisting her to focus on something that is more comforting, allows for a positive experience overall.

 

Interpreting all behaviour as a form of personal expression shifts the focus off of the disease of dementia, and refocuses attention on the individual person.  Suddenly, behaviours are imbued with meaning and purpose, a form of communication. It is then our responsibility to enable the best possible form of communication and understanding, setting people up for success, regardless of dementia or other illnesses.

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Holiday Traditions

 

It’s no secret that the holiday season has become increasingly complicated with a heavy focus on commercialism—lots of shopping, busy malls, huge meals, many parties...the list goes on.  While some people may enjoy making detailed desserts that look like a Martha Stewart display, many others find it stressful. When did all this pressure become the norm?

 

If you ask your grandparents what Christmas used to be like, I’ll bet they would tell you a different story.  If they were of the generation that lived through the depression era, you can be certain that there was very little—if any—Christmas shopping to be done. 

 

Instead, the focus was on being together with loved ones, and participating in activities together.  Rather than rushing around trying to have everything in perfect order before family arrived, the focus was on doing things together as a family.  Decorations were much simpler, but usually included extended family members.  Popcorn was strung and used as a garland hung outside for the birds to enjoy. Fruit featured prominently in 

décor—orange peels were used creatively as little baskets, or peels were dried and cut into shapes. 

 

These simple traditions are low-cost and allow everyone to focus on quality time together, rather than individually rushing about stressing about fancy décor.  Perhaps this year you can slow down the pace of the holiday season and revert to some time-honoured traditions from your grandparents’ era. What a special tribute for your grandparents or great-grandparents this holiday season!

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