The Care Manager becomes a Caregiver

Categories: Aging Advocacy, Dementia

On May 13 my world changed.  It was a change I thought might be occurring.  It was a change I had been researching.  It was a change that I desperately did not want.  On May 13, my husband was diagnosed with frontotemporal dementia or FTD.  With those words, the care manager became a caregiver.

The journey has been difficult to date, but nothing compared to what lies ahead.  In 2009 my husband was diagnosed with hyperthyroidism.  He had lost around 25 pounds and was demonstrating symptoms of depression.  But being a salesman in the current economy was a daily exercise in frustration to say the least, so I thought I understood.  His symptoms were treated but only the thyroid tests showed significant improvement.  The depression lingered, and none of the usual medications seemed to help.

There was one symptom that made me quite curious.  My husband declined to help with our finances.  I would ask him questions about unusual bills or investment decisions that needed to be made, but he said he didn’t understand how I was handling our money.  After several attempts to explain my way, I asked him to lay out our monthly payments in a way he understood, and we would talk from his perspective.  He never quite got around to doing that.

In the meantime, our loving bond seemed to be strained and sometimes felt non-existent.  What in the world was happening???  Was our marriage in trouble?  My husband showed little interest in planning anything whether it was a trip to the grocery store or a trip to Mexico.  Something was really wrong.  Where should I look to find more answers?

Since we had covered the possible physical ailments, I decided it was time to take a look at his emotional and cognitive well-being.  I asked his doctor for an order for neuropsychological testing.  I half expected him to decline my request; instead he gave the order to me without hesitation.  The test results indicated some depression and some deficit in the executive functioning area of the brain – the frontal lobe.  Fear set in.  This must be a mistake.  Surely not MY husband!

From there we visited a neurologist who ordered an MRI.  The results were normal for my husband’s age – but we expected this outcome.  Then the doctor asked if we wanted to have a PET scan: a high-tech imaging test that looks at the brain differently than an MRI and is more accurate in diagnosing FTD.  We said yes; and the scan said yes.  Degeneration of the frontal lobe, and some left temporal lobe as well as some right temporal lobe degeneration.  Frontotemporal dementia.

Since May 13th, we have attended more doctors’ appointments, adjusted to changes in medication, applied for Social Security Disability Income (SSDI) and quit his job, completed a driving assessment (he passed with restrictions), are very thankful we had decided to buy long term care insurance, and are now living as normal as possible until the disease changes our lives completely.

I will continue my work as a geriatric care manager, but I am closing down both my blog and my podcast session with Kevyn Burger.  Both decisions sadden me deeply, but I know I want as much time to be with my husband as I can find.  Every minute of every day that I know he is in our home with me makes me happy.  I feel his presence even when he’s sitting on the deck reading or vacuuming the rugs or taking a nap.  I want to imprint these moments in my mind.

Thank you for being loyal followers.

Deborah Dolan’s Top 5 Reasons for Seniors to Become Comfortable with a Computer

Categories: Active Senior Living, Caring For Elderly, Elderly Drivers, Grandparents, Helping Seniors, Resources, Uncategorized

Just because you didn’t grow up learning how to use a computer, that doesn’t mean that it’s too late to try it now! Need a few reasons why? How about for communication purposes, to read research and reviews on doctors/medications, to find updated news, to order products/items online instead of having to drive or get a ride to the store – and there are many more reasons! Here are Advocate on Aging Debora Dolan’s top 5 reasons to become comfortable with a computer:

1. The rest of the world depends on the computer for information and communication – time to join in!
2. Your grandkids will say that they know more than you if you don’t become computer literate! Why not become computer savvy to be able to communicate with your family in a different way?
3. It helps you connect with those places you no longer are able to travel to – from the grocery store to the Turkish flea market!
4. The internet gives you the tools to care for yourself. For example, you can keep your medication list on file and current, research the reasons why you have been prescribed a certain medication, or view your medical records.
5. Using a computer gives you reason to think, which means it allows your brain to organize information and solve problems. All of these activities promote mental acuity to help you stay mentally young.

How “Senior-Friendly” is Your Favorite Restaurant?

Categories: Active Senior Living, Caring For Elderly, Helping Seniors

Some restaurant experiences can be all about the ambiance – the soft lighting, beautiful music and creatively designed menus. As you take your seat and begin to enjoy yourself with others at your table, you notice that it can be difficult to hold a conversation with loudness of the mood-setting music. Once you take a glance at the menu you notice that between the low-lighting small type, it can be hard to read the list of options.

As the baby boomer population ages, will more restaurants need to cater to the needs of seniors?

“Fast forward 20 years, and we baby boomers will have yet another perspective to offer on many aspects of life!” said Advocate on Aging Deborah Dolan.  “Seriously, our citizens over 70 are frequent customers to various restaurants around town.  It would be an excellent business practice to increase the size of the menu font to 14 instead of 12 or smaller, and be sure the font type is simple – straight lines and no curly-ques.”

As for using “cheaters,” or reading glasses, Deborah agrees that they can be very helpful. “Readers in a basket is a good idea. How about those flashlight with magnifying glass in a basket as well to help so the ambiance created by the low-lighting remains intact? Don’t forget the comfort foods on the menu!  I rather like the idea of ‘prune brulee’!  A little creative thinking increases the pleasure for everyone!”

Long-Term Care for Seniors: Dr. Robert Kane Shares Insights

Categories: Active Senior Living, Aging Advocacy, Caring For Elderly, Grandparents, Hospitalization, In-Home Care, Medical, Uncategorized

In a recent article from the Star Tribune, reporter Warren Wolfe dug deep into the issues that can arise while caring for elderly loved ones. The article features Dr. Robert Kane, a physician who heads the U of M Center on Aging. Kane was so frustrated with the problems he and his sister faced after caring for their aging mom that he wrote a book about the long-term care system.

Advocate on Aging Deborah Dolan shared her thoughts on the article and Kane’s work. “Dr. Kane expresses beautifully from personal experience the essence of a geriatric care manager (GCM),” said Deborah.  “He speaks well of the advocacy a strong, knowledgeable GCM can provide to elders and their family.  Even in the best of circumstances when you are an adult child of an aging parent providing the daily love and support they need can be ‘grueling,’ and a geriatric care manager can help.”

Deborah had the privilege of meeting with Dr. Kane several years ago as she was growing her geriatric care management business, and he spoke of his experience with his mother.  He had formed the on-line support group and found that he had many colleagues in a similar position of caregiving as he and his sister.  Deborah was not sure if he was promoting his number one lesson just yet, but she is glad to know the importance of a GCM has found a prominent position on his list of lessons learned.

For Kane’s work, Deborah is appreciative. “Thank you, Dr. Kane, for your support both as a care manager and as a volunteer with the Senior Linkage Line.  An additional resource of the Minnesota Board on Aging is www.minnesotahelp.info, an online directory of services designed to help people in Minnesota find human services, information and referral, financial assistance, and other forms of help’ (taken from the website).  It is a wonderful point of beginning when families are ready to take the first step in finding help for their aging loved ones.”

Expert shares insight about becoming caregiver for elderly mother

Categories: Aging Advocacy, Caring For Elderly, Resources

In a recent article from the Star Tribune, reporter Warren Wolfe dug deep into the issues that can arise while caring for elderly loved ones. The article features Dr. Robert Kane, a physician who heads the U of M Center on Aging. Kane was so frustrated with the problems he and his sister faced after caring for their aging mom that he wrote a book about the long-term care system.

Advocate on Aging Deborah Dolan shared her thoughts on the article and Kane’s work. “Dr. Kane expresses beautifully from personal experience the essence of a geriatric care manager,” said Deborah.  “He speaks well of the advocacy a strong, knowledgeable GCM can provide to elders and their family.  Even in the best of circumstances when you are an adult child of an aging parent providing the daily love and support they need can be “grueling,” and a geriatric care manager can help.”

Deborah had the privilege of meeting with Dr. Kane several years ago as she was growing her geriatric care management business, and he spoke of his experience with his mother.  He had formed the on-line support group and found that he had many colleagues in a similar position of caregiving as he and his sister.  Deborah was not sure if he was promoting his number one lesson just yet, but she is glad to know the importance of a GCM has found a prominent position on his list of lessons learned.

For Kane’s work, Deborah is appreciative. “Thank you, Dr. Kane, for your support both as a care manager and as a volunteer with the Senior Linkage Line.  An additional resource of the Minnesota Board on Aging is www.minnesotahelp.info , ‘an online directory of services designed to help people in Minnesota find human services, information and referral, financial assistance, and other forms of help’ (taken from the website).  It is a wonderful point of beginning when families are ready to take the first step in finding help for their aging loved ones.”

Contraindicate: Do Medication Benefits Outweigh the Risks for Seniors?

Categories: Active Senior Living, Aging Advocacy, Caring For Elderly, Medical, Podcasts

 Contraindicate: Do Medication Benefits Outweigh the Risks for Seniors? [10:09m]: Play Now | Play in Popup | Download (81)

What happens if your loved one has been taking his or her medication for weeks, months, or years and suddenly it no longer has the same effects as it once had? Deborah Dolan, Advocate on Aging, and Kevyn Burger, host of the show, discuss the effects of medication changes as seniors age and tips for keeping those changes under control. Analysis of risk verses benefit is a top priority in determining seniors’ medications. Elder persons and their loved ones must be their own advocates or engage the assistance of a geriatric care manager to ensure that the individual’s best interest is maintained. Each person has a right to question every aspect of his or her own care to ensure knowing why each medication is being prescribed. The number one tip for being your own advocate is “ask, ask, ask.”

Podcast: Family Caregivers Month

Categories: Caring For Elderly, Planning, Podcasts

 Celebrating Family Caregivers Month [12:39m]: Play Now | Play in Popup | Download (16)

Who’s the caregiver in your family? Deborah Dolan, Advocate on Aging and Kevyn Burger, host of the show, talk about help for families, geriatric care managers and the sandwich generation. During the show, they invite client, Kari, in to talk about how care managers have helped her as the main care provider in her family.

Podcast: Aging & Elder Care

Categories: Aging Advocacy, Planning, Podcasts

Click on the play button below to hear this episode of the Advocate on Aging.

 Aging and Elder Care [7:54m]: Play Now | Play in Popup | Download (22)

Welcome to the first podcast of Deborah Dolan, an Advocate On Aging, and Kevyn Burger, host of the show.  In this episode, Deborah and Kevyn discuss Deborah’s background in geriatric care as well as the journey of starting her own company, Senior Life Transitions.  Deborah shares her expertise on planning for the future, resources for elder care and enjoying your “golden years”!

Excuse me, Doctor, but I’m over here!

Categories: Aging Advocacy, Caring For Elderly, Hospitalization

Recently I accompanied an elder client to a doctor’s appointment.  Estelle was a new patient so we had no idea what to expect from this visit other than the doctor was a specialist in pain management, and Estelle had plenty of chronic pain.  What occurred is nothing like Estelle had ever experienced before; yet as a geriatric care manager for the past 8 years, what happened during the appointment is becoming too common and very unsettling.

Estelle’s daughter filled out form after form after form with Estelle’s medical history, current medications, and why she was seeing the doctor.  Yet when we walked into the examination room, the doctor was sitting behind a desk staring at a computer screen and a young woman was sitting behind him peering over his shoulder.  He apologized saying he was learning a new computer system and training a new office person at the same time as he was seeing Estelle.

For the next hour the physician, his eyes glued to the computer monitor, proceeded to ask a litany of questions barely waiting for an answer from Estelle or her daughter before he asked another.  Many of the questions were the same questions Estelle’s daughter had just answered on the myriad of forms.  Where does it hurt?  How long has it been hurting?  Did you do something to injure this area? On and on while seldom giving Estelle the common courtesy of eye contact or time to answer.  After an hour the doctor wrote Estelle a prescription for oxycodone, and asked Estelle’s daughter to make another appointment in a week; he would do an exam then.

This is just one example of a numerous doctors’ appointments where the physician failed to use common courtesies and effective communication skills.  In 1971 a study conducted by Albert Mehrabian concluded that 93% of communication is non-verbal:  55% of communication is body language, 38% is tone of voice and only 7% of what is being communicated is done so through words.  What did the doctor’s non-verbals say to Estelle?

My interpretation was:

• this computer is more important than you
• you are merely an interruption in my day
• you do not deserve my attention
• I don’t really care if I can help you or not

My role in a doctor’s appointment is to serve as an advocate for the elder patient.  Most often what I do is guide the physician toward effectively communicating with their patient.  I ask the physician to speak directly to the patient (not me); to slow down and give the elder person time to process an answer; to be patient; to use common courtesy; to give the respect that our elders have earned.

My recommendations for the doctor and others who see themselves in this scenario:

• make eye contact unless you know that it is a cultural negative to do so
• make small gestures such as touching the patient’s arm
• lean forward telling the patient you are listening
• nod in understanding
• wait for the patient to answer a question before you ask another

For the sake of quality care, I ask you to think about your communication style especially with your elder patients.  If you are a care partner for an elderly person, resolve to become an advocate for better communication between the physician and their elder patients.  Everyone benefits!

Stroke Risk Heightened for Stressed Out Caregiving Spouses.

Categories: Caring For Elderly, Resources

Providing care for an ailing spouse can cause its own ailments, according to a new study.

Caregivers who regard their duties as highly stressful may be at increased risk for stroke. Published in the journal Stroke, the study examined 767 people who were responsible for providing in-home care for a sick husband or wife.

The caregivers who said tending to their spouse caused “a lot of strain” were 23% more likely to have a stroke compared with their caregiving counterparts who said they felt no strain regarding their responsibilities.

The study found that the stroke risk was most pronounced among men.
“Highly stressful caregiving can include many difficult and uncontrollable stressors such as witnessing the suffering of a loved one, managing stressful behavior problems, financial strain, social isolation, and providing physically and psychologically demanding personal care tasks,” write the researchers, led by William E. Haley, PhD of the University of South Florida in Tampa.

Dr. Haley said that providing counseling to the caregiver can help them manage their own stress. Some caregivers also benefit from getting more day to day help and from going to support groups. He also said caregivers should seek programs or help from a geriatric care manager that will teach them ways to feel better prepared in taking care of their spouse.

Previous studies have shown that caregiver stress can increase the risk of depression.