I don’t know about you, but it seems like every day I see a television ad for the shingles vaccination. I have known a few people who developed shingles and were in a fair amount of pain. The pain occurs during the actual bout of illness, and for some, persists after the attack.
So just what is “shingles“? Shingles is caused by the exact same virus as the chicken pox.
Today there is a vaccine to prevent chicken pox. But almost all of us over the age of 50 have had chicken pox before the vaccine was discovered!
Once you’ve had chicken pox, the virus that causes it (varicella-zoster), stays within your body in a “latent” or inactive stage. Then when you are older, usually after age 60, the virus can reactivate.
When this happens, nerves become inflamed and a rash develops into blisters, similar to those of chicken pox. The pain can either be dull, intense, or like a burning sensation. Once the episode is over, the rash drys out but often there is scarring and tenderness remaining. Sometimes the continuing pain, referred to aspostherpetic neuralgia, can be debilitating. The likelihood of this kind of pain associated with shingles increases with age.
The tricky part of the shingles vaccination is that it prevents only about 51 % of shingles cases. However, the vaccine does reduce the likelihood of the more severe cases that lead to ongoing and debilitating pain.
If you have Medicare, it is important to note that the vaccine is covered byMedicare part D. It is also important to call your Medicare Part D provider to determine your copay amount: which is often $50 to $75.
Zostavax is not cheap and far from foolproof, but it certainly can prevent a lot of misery.
Like any other medication, you or your care giver should ask your physician if it is right for you. Your doctor is the one who should help you weigh the risk versus the benefit for you individually.
So if you thought chicken pox could be crossed off your worry list, you were wrong!
Thank goodness my grandchildren will not have it on theirs!
Chances are you are either my son or my daughter. Statistically that’s the way it is. Although neither of us really thought it would turn out this way.
I may be unable to express my thoughts or feelings anymore due to dementia or other ailments associated with my aging.
But I want you to know how grateful I am for the care that you give. I know that you are busy with your family, your career, your own precious life. And yet you still find time to help me. You are amazing! You are brave!
If I could, I would also tell you this:
Don’t forget to take care of your own health and well being. It is not OK with me if you run yourself ragged while caring for me!
If you need to take a break from care giving, I give you my wholehearted permission to do so. There is respite available, I encourage you to find it!
Don’t feel guilty if you miss a visit or you don’t think you are doing things quite right. You are doing a fantastic job and I am so proud of you!
Try not to compare who I was to who I am now. It would make me incredibly sad to see you discouraged in any way!
Finally, when you’ve given it your all, I ask that you give the responsibility of my care to others. You may grieve the loss but you must not feel responsible for it!
Please accept my heartfelt thanks.
Love,
Mom, Dad, Aunt Ellen, Uncle Carlos, Esther……………and the list goes on!
May is the month that we celebrate and honor you, the geriatric care giver!
This month, I really encourage you to think about the message in this letter. Give yourself a pat on the back! Don’t feel guilty if you aren’t perfect! Grant yourself permission to grieve along the way! Relish in the value and bravery of your work! Most importantly, ask for help when you need it!
Finally, as you care for others, don’t forget to include yourself on the list!
There were four of us siblings living in four different states. Our parents lived in yet another state upon retiring. Everything was going well until the inevitable health changes occurred as my parents aged. It got so bad that when we called my folks and didn’t get an answer, we called the local hospital to see if they were there!
My husband, yes he is a saint, approached my parents to see if they would want to move to Minneapolis where we live so they would have support and advocacy which they were sorely lacking on their own. My parents were eager to move, and we found a house with a great in-law apartment within our same neighborhood. We all settled in, and life moved forward.
Until, my mother became increasingly ornery and cantankerous. She complained about everything in Minnesota from the price of milk to the newscasters on television. I was hurt by her complaining and thought she should be more gracious under the circumstances. After all, every one of us had to make accommodations and sacrifices with the change in our living situation.
And then, she began repeating her self. Why didn’t I catch this sooner? Of course, dementia! I was a social worker and gerontologist, but I didn’t recognize the signs in my own mother. I was too caught up in my own anger and hurt to see the signs. I had spent my career in care management. I could easily spot the early signs of dementia in elderly clients, but I totally missed it in my own mother!
Once I knew she had dementia, my anger dissipated. I knew what the enemy was, and it was not my mother.
So my husband and I shouldered more and more of the care giving duties. My dad with his diabetes and heart disease; my mom with her arthritis and dementia. We attended medical appointments, set up medications, brought in homemaking, meals on wheels and home health aides. We listened, reassured, soothed, and comforted them. The roles of parent and child reversed at a slow and achingly painful pace.
I was not always gracious. I resented my siblings for being so far away. My sister in Chicago was my emotional rock, but it wasn’t the same as providing the requisite day to day support. Caring for aging parents is not for the faint hearted. It is gut wrenching emotional and physical work.
Watching my beautiful, wonderful parents decline was something I had always dreaded because as a geriatric care manager I knew what it entailed.
My parents are gone now, having both died in the past two years.
And you know what? I can honestly say I would do it all over again. It was hard. So very hard. But I would do it all over again.
Cynthia Reid, MA, LSW Gerontologist and Colleague of Deborah Dolan
Thank you, Cynthia, for sharing your very personal and poignant story. May is National Caregiver’s Month. There are thousands of Deborahs and Cynthias out there. Tell us your story. We’re great listeners and full of admiration for all of you!
As a geriatric care manager, I have talked to so many wonderful seniors about so many things: tragedy being one. Make no mistake, tragedy is not a novelty to the elderly. If your loved one was born anytime before 1930, he or she experienced two of the most significant events of modern American history: the Great Depression and World War II.
For those of our senior citizens over age 80, roughly 11 million strong, they have lived through many a disaster. Natural disasters such as tornadoes, floods, hurricanes, blizzards, tsunamis, and landslides to name a few. Failures of machines and technology have occurred also throughout their lives from the Hindenburg crash to the space shuttle Challenger and Columbia explosions. Not to mention more commonplace casualties such as auto accidents, plane crashes and ship wrecks.
On April 19th, 1995, the face of tragedy began to change in our country with the bombing of the Murrah Federal building in Oklahoma City. Terrorism! It felt different from accidents or war. It was intentional, it was home grown and its purpose meant killing civilians and innocent children.
Six years later, who can forget September 11, 2001? This act of terrorism was the next generation’s Pearl Harbor and led the United States to war. The nation rallied and people united against evil. To our elders, a remembrance of another attack and quiet confidence we would prevail as we had before.
But now, the Boston Marathon bombing. A major American city on lock down. Senseless slaughter of civilians again! Where will it strike next?
Our instincts immediately draw us to our children! How will we explain this tragedy? How will we ready our children for a world that will realistically include more of the same?
As we comfort our children, let’s not forget to talk to our elders. Terrorism is a kind of tragedy foreign to them even though they have endured long lifetimes filled with disasters. When we sit down to talk, to reassure our children and grandchildren, let’s remember to do the same with our elderly loved ones. To be there. To reassure them. To comfort them. To love them. To chase away the fears. To listen.
Last week I spoke of President Obama’s new plan for mapping the brain, referred to as the BRAIN initiative. As a geriatric care manager and care giver, I am excited about the possibilities of this new endeavor! From experience, I have seen that when this country focuses on and directs funding towards a problem, solutions are found!
But I also know that things take time. The task of mapping the brain and then finding effective treatment for brain disorders is years away. How do I help those seniors I care for and love now? Today? Perhaps music therapy?
Music therapy is a staple treatment for elderly people with dementia. Research shows it is effective. But it is typically conducted in a group setting out of necessity. Music stirs the soul, but it is very individualized. The strong emotions buried in the brain are linked to what type of music you liked when you were young. So what if one person loved Glenn Miller and someone else in the group only liked Hank Williams music? Music from the same era, but definitely different styles and messages! Trying to reach every person in the group setting is difficult.
So how could we change this? How could we make music more individualized for each person?
Well one organization is trying to do just that with startling results! Music and Memory, based in Mineola, New York, trains elder care professionals how to set up personalized music lists on iPods or other similar gadgets for seniors in their care. Mostly the seniors live in nursing homes across the country. Dan Cohen, MSW is the executive director of Music and Memory and has appeared on many public forums to promote this program: including The Doctors, CBS This Morning, NPR, CNN, and MSNBC to name a few.
I don’t even have words to describe the amazing effects personalized music has on persons with advanced dementia, so I am including a youtube link for you to watch one of the elders served by Music and Memory. As they say, a picture speaks a thousand words! Here it is!
Amazing! Isn’t it? And the surprising part is that the clarity of thought continues after the music stops!
One thing that Music and Memory needs to continue their work is more iPods. If you have one you can donate, contact the Music and Memory website to learn how.
While understanding the brain enough to successfully treat or cure dementia is years down the road; I can be glad for two things! One, there is a clear path toward true understanding and treatment of brain disorders. Two, it is possible to bring joy and animation today to those whom dementia has silenced.
Last week, President Barack Obama pledged $100 million towards a new goal for the United States that is much closer to home. And yet this challenge seems even more daunting than outer space: to build a map of the human brain.
This high tech project will be called Brain Research through Advancing Innovative Neurotechnologies or BRAIN. Whew! Needless to say I will only refer to it by it’s acronym!
Now, I don’t know about you, but I still marvel at how my television remote control works. Don’t even make me wonder about my cell phone! And for GPS, I can’t even go there! The task of mapping the brain belongs to those whose talents are far different than mine!
But in all seriousness, I know the time to map the brain and unlock its mysteries is critical. As both a care manager and care giver, I see the toll that brain disorders take on patients, loved ones, care givers, and quite frankly the economy.
And the list goes on to include brain injuries, strokes, mental illness and even childhood disorders such as autism.
We know the likelihood of having a brain disorder increases with age. We also know that the population of America is aging. From experience, we have seen that money invested in research like the space program has given us a much greater return on our investment.
While brilliant scientists clamor for the chance to work on this tremendous feat, I remain quietly hopeful that there will be a cure or at least effective treatment for the scourge of dementia that is stealing the essence of those seniors I care for and love. That as a geriatric care manager, I can someday focus more on active senior living than bracing families of elders for the unavoidable decline they should expect with a neurological diagnosis.
Until then, I will continue to work hard and advocate fiercely for the elderly in my life. Shoulders lifted, head held higher, hope in my heart. Meaningful understanding is on the horizon! One small step for man one giant leap for mankind!
Ahhhhh! It is finally April after a long winter! The old saying “April Showers bring May Flowers” is rolling about in my head. My thoughts have turned to rainy days followed by blossoming trees and then to why has my elderly client Benbecome so resistant to bathing? What?
As a care manager, I have concluded that my mind is never far from its problem solving mode for my clients. So there it is. That childhood rhyme has turned my thoughts from rainy April days to how can I help Ben overcome his resistance tobathing?
Many elders have issues with bathing. It does require some sleuthing to find out why because each person is different. Once you find out why, then you can formulate solutions. The solutions should be focused not only on health and hygiene, but maintaining dignity as well. The dignity piece can be tricky because often adult children are involved which can be embarrassing for seniors.
First, the good news! Elderly folks don’t need to shower as often because their skin is dry, thin and very fragile. It is, however, important to clean private areas and under skin folds daily. But that can be as simple as using baby wipes in those areas. I recommend warming the wipes first. You can do this by quickly running the wipe under a stream of warm tap water. Lotions can be used daily to help fragile dry skin feel smooth and smell nice!
Even so, elders should have a bath at least weekly. If they resist, there are usually reasons why! (Remember behaviors are often a communication tool when words are absent.)
Reasons for resistance:
concern about falling
getting cold
lack of energy
embarrassment if assistance is required
difficulty with mobility
depression and lack of motivation
early signs of dementia
Solutions to try:
install safety equipment such as grab bars, tub bars, shower seats and hand held shower heads – occupational therapists know all about these gadgets
keep towels, blankets or a warm robe in the bathroom. If your senior receives personal assistance, their helper can even warm items in the dryer prior to use
if you senior is lacking in physical strength or energy, make certain their bathing time is when they feel their best, typically later in the morning for most elders
when embarrassed, make certain your elder is covered with a robe, blanket or towel right up until the point they enter the shower or bath
if your senior was always pristine about their hygiene and is no longer, be sure you discuss with the physician to rule out depression or early signs of dementia
These are just a few solutions I have tried that have worked. If you have tried your best and your senior’s health or hygiene is getting worse, have a discussion with the physician to rule out a more serious problem.
Oh, and back to Ben! He told me he stopped bathing after buying a new shower chair. He didn’t like the water pouring on him from the shower head when he sat in the chair. We fixed that problem by purchasing a hand held shower head that he could control while seated. It really was an easy fix for a potentially huge problem!
For Christians, Easter is a very holy holiday. Easter also represents a time of renewal. We associate Easter with the coming of Spring and new life.
As caregivers, it is important to understand the religious needs of our elderly loved ones every day. Special religious holidays such as Easter often hold personal memories and traditions. For those seniors living in assisted living or nursing homes, there will be religious services held in their community. If your senior is able to attend services with you, then be sure to plan accordingly. Make sure you have a “Plan B” in mind in case your loved one finds the services, crowds or outing overly stimulating. Plan your exit before you enter! Finally, for those who are unable to get out, many churches and parishes have volunteers who will come to their home and meet the spiritual needs of the day.
Many Easter traditions are also non-religious in nature and can be shared with elders in preparation for Easter time.
Easter lilies are wonderful to bring to your loved one. They smell lovely and are the traditional floral symbol of Easter
Have the grandchildren go over and dye Easter eggs together. If dyeing the eggs is too difficult, decorate with stickers instead
Bring an Easter basket to your senior. Think of creative contents like Springtime magazines or seed packets if you senior can’t have candy
Try to make sure that your loved one eats some of the foods that were traditions in your family’s celebration in the past
For our Jewish friends, Passover is a very holy holiday as well. Passover is also a celebration of birth, rebirth and the coming of Spring. It is the celebration of the Hebrews being led by God from enslavement in Egypt. Passover encourages people to take responsibility for their lives as well as their communities. What better way to contribute to the world than by caring for our elderly loved ones! Invite a lonely elderly person to your seder. Allow them to participate as fully as they are able in the rituals of the seder. Share in the rich traditions of Passover.
It is interesting that both Easter and Passover signify renewal and life. And yet so many of our elderly friends feel on the periphery of life. Caring for the elderly should also include spiritual care. Helping seniors to celebrate their religious traditions is an integral part of caring for their basic human needs; it supports their dignity.
I spoke ofAdvocacy in last week’s blog. I can honestly say advocacy is my passion. I devoted my blog on March 30, 2010 to advocacy as well! Really? Was that just three years ago?? That was before I knew I was living the role of advocate for my husband and his terminal (yes, I said the “t”word) illness.
Back in 2010 I wrote: “I think of my role as advocate as the person who takes all the pieces of my client’s healthcare jigsaw puzzle and makes sure they fit together to create a cohesive and complete picture. With so many health issues and sometimes so many physicians and caregivers involved, the pieces become scrambled, and it’s my job to put them back together.”
Last week in 2013 I added: “To advocate for an elderly friend or relative requires strength of personality, conviction, suspension of one’s own personal biases, and tremendous patience. Perhaps the most difficult situation would be pleading for your loved one’s cause even if no one else supports it. This is an extremely difficult position and not everyone is up to the challenge!”
On May 13, 2011, I took on what was to be the most personal advocacy role of my life. My husband needed my care. I had known for a while that something was wrong. But on that day, we received his diagnosis: Frontotemporal Dementia (FTD).
What I knew then:
Advocacy meant having all the pieces of a puzzle, knowing what they were, and putting the puzzle together
I knew I was a strong advocate with plenty of time to devote to this important role
What I know now:
I can think I have all the pieces but then a new one emerges; then I set about restructuring the puzzle using the new pieces along with the old
As the number of pieces increase and become more complex, I need to seek a new frame in which to organize all the pieces
I am still a strong advocate, but I need additional help to provide my husband the ever increasing care he needs
While caring for him, I need to keep our household running smoothly without his assistance that he gave so generously in the past
I still need to fulfill my other roles of Grandma Deb, daughter, sister, mother and breadwinner
I learned that advocating for a loved one tugs at your heart in ways you could never imagine
Finally, I learned that one of the most important attributes of an advocate is having the insight to know when your well is running dry. This includes having the courage to ask for help or respite. Every advocate and caregiver needs respite. Respite gives you time to rekindle the fire so you can continue to identify new pieces of the puzzle, formulate the new configuration and not forget who you are beyond your advocacy role.
“There! I’ve acknowledged my “well is running dry.” I feel better; almost as though I’ve confessed to a secret. No secret, though. Just a difficult reality.
As a care manager, I would guess the two words I use most in speaking with clients and families are “advocate” and “plan”. It is hard to have one without the other, however, today I will focus mainly on advocates!
If you think about it, throughout our lives we are constantly selecting advocates we believe will promote our best interest. We look for the right physician, dentist, hairdresser, realtor and even the right godparents for our children. In these situations, we use specific criteria based on our own personal values and belief systems.
Sometimes our elders get stuck in thinking that their best advocate should be their first born son, their eldest daughter or even the adult child who lives the closest. Not very reliable criteria for character and trait selection! If you fall into one of those categories and the advocacy role is right for you, then great! But if you know in your heart of hearts that you don’t have the “right stuff” to do what it takes, it’s OK to turn down the job! Advocating for an elderly person isn’t a good fit for everyone!
Attending physician appointments to be a second set of eyes and ears
During hospitalization, surgery or other medical procedures
Ensuring proper medication and dosage are followed
Assisting in setting follow-up appointments
Coordinating medical information among other physicians and medical settings
Coordinating insurance coverage, co-pays, and deductibles
Coordinating in-home services if needed
Planning for future transitions as necessary
Assisting with writing advance directives
Finally, if you believe you have the attributes of a strong advocate, you also must ask yourself if you have the time to devote to this important role. Today, it seems like no one is immune from crazy schedules and advocating for an elder can take a lot of time.
Is advocacy the right role for you? Be honest with yourself. If the shoe doesn’t fit, don’t try to squeeze into it. It will be painful for all involved! Please share your experience as an advocate.
Do you have a question that you want answered? Click the help button below and email your question to the Advocate on Aging, Deborah Dolan! Your question will be posted on the blog anonymously with an answer, allowing other to comment and ask for more information on a variety of topics. Thank you for sharing!
