How to Discuss a Family’s Concerns about the Safety of Your Aging Loved One

Plan to Talk about Future Living Arrangements

Deciding when and how to discuss a family’s concerns about the safety of your aging loved one is difficult at best. Family and friends recognize signs that tell them their aging parent should no longer be living alone, but how does the family address their concerns with the parent? How do you talk to your father about his ability to continue to drive safely? Avoiding these difficult topics does not make the situation go away and family dynamics become tense.

Tara Koestner, Administrator, of The Continental at St. Joseph’s (CSJ) Assisted Living Center advises families to start these discussions early while aging family members are still doing well. By having sensitive discussions while the aging adult is still doing well, the family improves their chances of a smooth transition from independence to increasing dependence. Ideally, the family can develop a plan that respects the wishes of their senior family member as to where they will live when they become frail. The most important step is getting the discussion started. Tara recommends having a plan to start the conversation. She has developed the follow list of tips to assist family members feel more comfortable discussing their concerns about their loved ones future health and living arrangements:

Tips for Initiating a Conversation

Extended family decision makers need to agree in principal.

Although extended family members may not agree as to when their loved one should have assistance with daily living, hopefully, they can agree on the type of help (home health, assisted living, skilled care, or long term care) would be appropriate when assistance is required. The Continental at St. Joseph’s administration recommends that the family elect one person to be the healthcare “manager” and other family members agree to support the manager’s efforts. Tara Koestner states, “If extended family members can agree in principal first, the decision making process regarding when changes are needed to keep senior adults safe goes smoother.

Approach the subject of alternative living arrangements indirectly.

Use an example of someone else their age and a problem that they are dealing with. Ask your loved one, “What would you do in that situation?” Or try to offer some small tips, like using a pill organizer, to manage medications.

Watch for openings to the conversation.

Senior adult comments about difficulties or sarcastic remarks about “being put away” may be subtle statements indicating that more help is needed. Listen for hints of frustrations or worries your family member may have.

Share your feelings about their changing life. Assure them that they can always ask you for help when they need it.

Be direct, but non-confrontational.

You want to get your point across without making your loved one feel like they’re being interrogated. Use a matter of fact approach with as little emotion as possible.

Make a list.

The Continental at St. Joseph’s management suggests that families consider giving the aging adult a list of questions and concerns and schedule a time to discuss it them. This gives the senior adult time to prepare for the discussion and a chance to think about the types of help that they would be open to considering. Focus your list on key points. Let your loved one know that you do not want to guess about the type of assistance they may want in future. Guessing can lead to serious mistakes and hard feelings. Discuss with them their concerns about their current condition and their feelings about the future. Tell them the list includes subjects are you worry about and you need to know their thoughts on the subjects. Try to cover these topics:

  • Current housing: Is their housing accommodations still ok? Would some simple modifications help?
  • Daily activities: Do they need help with house work, laundry, meal preparation, or bathing? Can they hear the door bell and telephone ring? Are they still able to socialize with friends?
  • Mobility: Are they experiencing any difficulty with balance, walking, or getting out of the chair? Have they considered using a cane or walker? Can they still see well enough to drive? Are they able to park the car with ease? Are they able to react safely to varying road situations? Are they getting where they need to go?
  • Health: When did they see the doctor last and what did the doctor say? Are prescriptions current? Do they remember to take their medications on time? Would installing a Life Alert system make them feel safe?
  • Finances: Does their insurance coverage provide for home health care? Would they consider letting a home health aide come to their home to assist them? Do they have long term care insurance? Are they or their deceased spouse a Veteran and eligible for VA financial assistance to help pay for assisted living expenses? Do they need to consider making an application for Elderly Waiver Assistance through the State Human Resources Department? Would it be a good time for a family member to be added to the bank account to pay bill should an emergency arise? Who is the financial power of attorney?

Tara Koestner warns families to expect some resistance to discussing these issues. This is normal. Senior adults may try to reassure family members telling them that everything is fine or telling you to mind your own business. But remind them that the family will be dealing with these issues sooner or later, it is best to plan ahead by learning what the senior adult may see as appropriate for their future so you can respect their wishes:

  • Respect their feelings. If they are clearly avoiding the subject, try again later.
  • Push the issues of health and safety, while keeping in mind that they are in charge of their own lives.
  • Act firmly, but with compassion. If you decide that it can’t wait any longer, tell them that the situation has to be dealt with immediately.
  • Involve other people that they turn to and trust such as a minister, doctor, lawyer or family friend.
  • Get information from community resources such as home health care, meals on wheels or a transit bus to get where they need to go. Share these options with them.

Most importantly, keep the conversation positive. Try not to ‘parent’ your parents. Continue to treat them as important decision makers. As long as their judgment is not impaired, they should be able to make their own decisions. Discuss all of the alternatives, home health care and assisted living centers are viable options for helping senior adults bridge the gap from independence to accepting help.

The Continental at St. Joseph’s Assisted Living Community for Seniors in Iowa

We are an Assisted Living and Memory Care Community in Iowa, recognizing that there has been an obvious gap in lifestyle opportunities, the Continental at St Joseph’s steps forward to bridge this gap between independence and dependence.

Our Staff

At The Continental at St. Joseph’s our full time Registered Nurse, trained assistants, complete dining staff, recreational activities coordinator, and housekeepers understand that the residents don’t live where they work, but they work where the resident’s live–in their home.

Our professional staff also understands the importance of addressing our residents’ entire needs, from their physical health to their social well-being. With this “holistic approach” our staff often hears comments like, “I wish I’d moved here sooner, I love my new lifestyle and feel healthier than I have in years!”

Staff Testimonials:

“Where else could you go to work and se 50 grandparents every day and get paid for it? It also doesn’t hurt that they have a couple of baking activities each week.” -Scott Hukriede, Maintenance Supervisor

“It’s a pleasure to work in such a beautiful place surrounded by such caring co-workers and pleasant tenants.” -Juwan Terry, Resident Assistant

 

Tenant Testimonial:

“How wonderful this place is!! My husband John Grismore died recently and I have only been living here a short time but I want to express to you my appreciation for all the many things you have done for this town and the people of this town. This building (CSJ) gives us a wonderful place to live- good food- caring personnel. Thank you!” – Virginia Grismore

Exclusive Features of Assisted Living Apartments & Neighborhood:

  • Kitchenette in each apartment, (includes microwave & refrigerator with ice maker)
  • Full Bathrooms (includes shower with seat, grab bars, removable hand held shower head)
  • Home Style Kitchen Available for use
  • Lovely, Dining Areas & Terrace overlooking view of Cooper Creek
  • Recreational Patio Areas
  • Activities of Daily Living Assistance available

Exclusive Memory Care Apartments & Neighborhood Features:

  • Lovely, Secured Patio Area
  • Partial Bathrooms in each room
  • Supervised, Well-Heated Bathing Room
  • Assistance with Activities of Daily Living
  • Purposeful, Carefully Selected Decor to enhance memories & cueing
  • Supervised Home Style Kitchen
  • Wander Protection System
  • Specially trained staff, RN on Call 24 hours/day

For more information, please visit this website: http://www.thecontinentalatstjosephs.com

How to Be a Heavy Drinker: Hydration for Seniors

As I write this article, we are not experiencing particularly warm weather in Iowa. It’s 64 degrees in June but as soon as I blink it’ll be 101. Hot weather brings up the topic for this month’s informational article. However, hydration is not the only concern for seniors when the weather is warm.

There are a number of factors that can contribute to dehydration. Some of them include diarrhea, vomiting, overheating, diabetes, diuretic medications, high fever and excessive sweating. If you experience any of these, be aware and make sure you are drinking plenty of fluids.

You may ask yourself: What is hydration? Well, it refers to a person’s body water balance. Dehydration, which is the real problem, occurs when people don’t have enough fluid in their bodies. Many seniors have problems with hydration. Dehydration is both a serious problem and easy to prevent. If not treated it could result in death.

What puts seniors at greater risk for dehydration? First, is that the ability to feel thirst lessens with age; seniors may not realize when they need to drink more. They may also be using the bathroom more frequently which means they are losing more fluid. Another factor is that as we age we lose muscle and gain fat. Muscle holds water, fat does not. As we age the amount of water in the body decreases. In addition, medications that increase urination or help with constipation can also put seniors at risk for dehydration.

So what should you look for in order to know if you are dehydrated? Symptoms include thirst, dry mouth, dark yellow urine, fatigue and irritability. If it progresses to dizziness, blackouts when sitting up or standing, confusion, muscle weakness or cramping, sunken eyes, low blood pressure or increased heart rate you need to go to the ER or contact your doctor immediately: these are life threatening symptoms.

If you’re not a big fan of dehydration there are steps you can take to be proactive: don’t wait until you’re thirsty to drink, by this time you’re already experiencing dehydration.

Try carrying a water bottle with you so you can take drinks frequently, aim for a minimum of eight cups of water each day. When the temperature rises, increase your fluid intake, too. This will help replenish what is lost when we sweat. We should all start and end the day with a cup of water. Do not substitute alcohol or caffeinated drinks for water. Last but not least, know the signs and symptoms of dehydration so that you can take action immediately.

Take care, keep hydrated and enjoy the warm weather…..whenever it returns.

The Continental at St. Joseph’s is the leading assisted living community in southern Iowa, located in Centerville.

 

By: Kristen Sheston

Kristen Sheston is the Assistant Administrator at The Continental at St. Joseph’s

Spotlight on Senior Health: Identifying Malnutrition and Ways to Combat It

Good nutrition is important for people of all ages, especially seniors who may be facing several obstacles to a healthy diet. For families and caregivers, knowing what to look for and possible causes for inadequate nutrition can be a life saver– literally.

Identifying the causes of malnutrition may seem obvious: not eating, not getting enough nutrients, or possibly a medical condition. But malnutrition is often caused by a combination of physical, social and psychological factors. For example:

• Health problems: decreased appetite, certain medications, trouble chewing, difficulty absorbing nutrients.
• Limited income or social contact: trouble affording groceries with the cost of expensive medications. Seniors eating along may not enjoy meals and lose interest in eating.
• Depression: loneliness, poor health, and decreased mobility may contribute to depression and loss of appetite.
• Alcoholism: acting as a substitute for meals. Alcohol also decreases the appetite.
• Restricted diets: limited salt, fat, protein and sugar can be bland and unappealing.

When an insufficient diet goes undetected it may lead to fatigue, depression, weakened immune system and risk of infection, reduced red blood count (anemia), muscle weakness which can then lead to falls and fractures, digestive, lung and heart problems and poor skin integrity. Proper nutrition is particularly important for older adults who are seriously ill and those who suffer from dementia or experience weight loss.

The first step to combating this issue with your loved one is knowing what to look for. Take time to observe their eating habits and not just at special occasions. If they live alone, who buys his or her groceries? If they live in a long term care facility, visit during mealtimes. Next, look for the physical signs: poor healing, easy bruising, dental problems and weight loss (changes in how clothing fits). Finally, know their medications. Many drugs have an effect on appetite, digestion and the absorption of nutrients.

So what can you do if you suspect malnutrition? Start by encouraging your loved one to eat foods packed with nutrients; add nut butters, fresh fruit and vegetables, eggs and cheese to food. Another easy way can be to wake up bland foods by experimenting with herbs and spices or lemon juice. You can also seek the help of a dietician with this step. Planning between-meal snacks can be particularly helpful since older adults tend to get full quickly. Try making mealtime a social event by joining them or encouraging them to eat with others. By encouraging daily physical activity, the appetite is stimulated and bones and muscles become stronger. If cost is a concern, try providing money saving tips like clipping coupons or watching sales. Encourage them to visit restaurants that offer senior discounts. Visit with your loved one’s doctor about changing medications that affect appetite.

Remember, identification and treatment of nutrition problems early on can promote good health, independence and increased longevity. Assisted living communities like The Continental at St. Joseph’s can ensure that your loved one is getting three well-balanced each day. If you suspect signs of malnutrition be sure to take steps now to ensure your loved one’s health.

Kristen Sheston is the Assistant Administrator at The Continental at St. Joseph’s, the leading assisted living community in southern Iowa, located in Centerville.

More information is available at http://www.thecontinentalatstjosephs.com/.

Bucket List

A “Bucket List” is a new phenomenon based on a movie of the same name in which two terminally ill men try to fulfill a wish list known as “The Bucket List” before each kicks the bucket. After they break out of a cancer ward, they head off on a road trip with an itinerary that includes racing cars, eating giant plates of caviar and slinging poker chips in Monte Carlo.

In April, several Continental at St. Joseph”s tenants in Centerville, Iowa welcomed Amy Crawford of Iowa Hospice to do an activity based on The Bucket List. The tenants of the assisted living facility identified items that were needs, such as food, medication and shelter. Next, participants pinpointed their wants, which might include going on a cruise, seeing a family member they have lost touch with, or attending an exercise class a few times a week. I was surprised at some of the things that our tenants were dreaming of!

The Bucket List idea can be taken in many different directions. Recently, I read an article in The Journal of Active Aging about a triad of retirement communities that implemented a wellness program that dared its residents to partake in their “100 Ways to Wellness Challenge.” “Our 100 Ways to Wellness program was a list of 100 wellness tasks designed to inspire residents to step outside of their comfort zones and engage in life in very meaningful ways,” said Allison Pait, Wellness Director and one of three creators of the program. Some of the 100 Ways to Wellness include bringing your own coffee mug instead of using Styrofoam, inviting a neighbor over for tea and learning to send an email.

Kisco Senior living also encouraged participants in the program to journal their progress and then rewarded them with drawings each time they completed one of the tasks. In addition to journaling, taking pictures of what an accomplished goal looks like, could be very motivating.

After reading this article, I was inspired to write my own bucket list and I challenge you to do the same. What do you want? What do you need? What will it take for you to feel fulfilled? How great would it feel to do something you’ve been dreaming of?

I invite you to take a step outside of your comfort zone. Try something new. Prove someone wrong. I guarantee, you’ll feel amazing inside and out.

Kristen Sheston is Assistant Administrator at The Continental at St. Joseph’s, Inc. in Centerville, Iowa. More information is available at www.thecontinentalatstjosephs.com.

All the Lonely People

After reading an article from “A.A.R.P-The Magazine” about an epidemic of chronic loneliness in our country, I was compelled to share this information with all of you. “This affliction”, experts tell us, “is an ever-present, self-perpetuating condition that pushes people away from relationships that sustain us and make us happy.”

In reading this piece I, being in the assisted living industry and holding the Assistant Administrator position at The Continental at St. Joseph’s in Centerville, Iowa, was excited to hear that age does make a difference with chronic loneliness: “Those who said they are suffering most are not the oldest among us, but rather adults in their 40s and 50s.” Good news for me, not so much for the estimated 44 million adults over age 45 who suffer from it. Aside from age, loneliness was equally represented in those surveyed, regardless of race, gender, or education levels.

Not only is chronic loneliness undesirable, there is also evidence that it significantly increases chances of diabetes, sleep disorders and other potentially life threatening problems and an increased risk of high blood pressure, higher levels of the stress hormone cortisol, weakened immune systems and Alzheimer’s disease.

So now that you’re aware of what chronic loneliness is and why it’s no good, what can we do to combat it and, in turn, live a healthier, more enjoyable life? While there”s no easy cure, here are some steps that we encourage at The Continental at St. Joseph’s that may help to broaden your horizons:

• Nurture your personal relationships.
• Don’t substitute electronic communication for face-to-face contact.
• Take time to volunteer.
• Join a social club or community organization.
• Stay in touch with former colleagues after you retire.
• Educate yourself about loneliness.

Remember, everyone feels lonely from time to time, for example, after a divorce or loss of a loved one. This is situational and, although painful, is a temporary condition. Chronic loneliness, however, is a destructive cycle that can be difficult to reverse.

This information is vital as the 40-50 year olds surveyed in this study begin to enter their later years. Settings like an assisted living can help older adults battle such situations because of their non-isolating set-up. For example, residents of The Continental at St. Joseph’s are encouraged to eat meals together in the main dining room. Three meals a day are provided and there is a small fee for a room tray if there is no apparent need for one (i.e. illness). In addition, activities are built into each and every day; even when weather is bad there are plenty of people to socialize with and many opportunities to participate which are already planned for them. Likewise, older adults in their own homes may miss out on social interaction for days or weeks if weather is unfavorable.

So in closing, I’d like to remind those feeling lonely, whether temporary or chronic, that they need to start small. Realize that you are vulnerable and that it is not easy to rid yourself of this condition. You will have to work to keep loneliness at bay. You will have to say yes to an offer to participate even when you would rather not. But just like exercise is important for physical health, interacting with others is important for our mental health.

On that note, have a healthy and happy 2011!

Kristen Sheston is Assistant Administrator at The Continental at St. Joseph’s, Inc. in Centerville, Iowa. More information is available at www.thecontinentalatstjosephs.com.