Sunday, October 29, 2006

Website on Dementia

Congratulations to Alzheimers Society of BC and Vancouver Coastal Health Authority on putting together their new website on dementia. It took a huge effort, but was well worth it. An excellent source of information and support for both Caregivers and people who have dementia, Alzheimers type or other.

Check it out: http://www.vch.ca/dementia/

Tuesday, October 24, 2006

When the Same Side of the Fence Looks Different

A client of mine was telling me about her family's background. They never got along, and now they are not seeing eye to eye on what is best for their brother. She is 78, her brother in care is 83, and the other brothers are 76 and 73. A month ago, she informs me, they got into an argument. She was so stressed from trying to be a long distance caregiver and explaining to her brothers what she was doing, that she blasted them both verbally, and hung up on them. It is harder because th these two younger brothers live in town. Although physically closer, they have never been as emotionally close to the brother in care as this woman and he were with each other.

"We just don't agree, " she told me, "We want different things."

I told he I thought that wasn't so. "I think you want the same thing--what is best for your brother. The problem is that you don't agree on what that is, and there is a long history between you all, and it is impacting on your trying to make a decision. But your goal is the same. You want what is best for him."

These are the issues that make caregiving difficult. Our histories, our patterns, our relationships, our birth order, our relationships with parents. Sometimes things are difficult because we can be overwhelmed by and run by our fears, by our guilt, or by other needs and circumstances. Sometimes sorting these out can be the hardest part of caregiving.

But, if they are sorted out, if that is what people want to do, they can be one of the gifts that come from the caregiving experience. So when you look back, as these people may, they could say to themselves, " that is one last gift our brother gave to all of us-- each other."

Thursday, October 19, 2006

A Different View of Dementia

I took a client of mine to the doctor's today. She didn't want to go. She has Alzheimer's disease, and it is progressing. She didn't understand why she was going.

And it was raining today, a typical dreary Vancouver fall with a cold drizzle on our faces warning us of a wet Winter to come. We had some extra time, so I stopped at an art gallery, as she has always loved art. She still has her collection, it is taking over all the walls of the tiny suite in her assisted living building.

The walkway to the museum was strewn with leaves, a patchwork of fallen colour. Overhead, many of the trees were still hanging on to their leaves, even as they have turned to brown. She stopped for a moment and picked up a yellow oak leaf , and exclaimed, "Oh, look at this, look at how pretty it is. " Then her eye caught one of the brown ones on a tree. She reached up with excitement , picked it, and held it up for me to see. "Will you look at this , " she said. " How do you suppose these , uh, these things get this shape?" Her smile was wide and she shook her head in wonder.

She couldn't find the word for leaf. There are many words she searches for and can't find as she gets stuck in the dead ends that are the maze in her mind. She doesn't like where she lives, and doesn't understand why her daughters don't ask her to come live with them. She hides things, then can't find them and thinks the staff are stealing.

But still, she could look at the ground and be excited at the colours of the leaves and thrill at their shape.

Which leads me to a place of wonder because I know on the path where she saw colours and shapes, I saw the possibility of slipping, and where she felt excitement, I felt cold and wet .

I think how much she has to give. What is sad is, she doesn't even know she has something of value to give, and wouldn't believe it if I were to tell her.

It reminds me again that, while I have to be aware of how much people with Alzheimer's have lost, I also have to look for how much is still there. And sometimes when I look through their eyes, I see so much more.

Monday, October 09, 2006

How Care Really Happens in Nursing Homes

Briefly: Tanny, 85 year old woman in a local nursing home, diagnosis of frontal lobe, probably stroke related dementia. Becoming progressively less verbal, but still her eyes light up as though someone had turned on the Christmas lights when she sees someone she cares about. A huge grin spreads on her face. She makes you feel like you are the special one.

Tanny is restless, she wanders the halls of the home, every now and then stopping to wipe a wall of the insects she imagines she sees there. In the dining room, she clears the tables--sometimes before the other residents have finished eating. On a bad day, she clears them before the other residents have sat down.

The other day I was visiting. I stopped at the housekeeper's cart and asked for a couple cloths and a cleaner that we could spray.

I gave Tanny one of the cloths, and said, "Let's clean some of these railings." She held out her cloth for some spray, and followed me.

"You take one railing, " I said, " I will do the other. ""

We went down the hall together, she doing one side, I doing the other. When we got to some doorways, she stopped and cleaned the g lass. We did it for about twenty minutes, and then were back at the Housekekeeper's cart.

I asked the housekeeper if she could do that with Tanny when I wasn't there. She couldn't do that she said, but " Every day when I do the dining , Tanny comes to help me. She clears off the tables, and wipes them all down. Sometimes I have to do them after her,. But she does it. Then she will sweep the floors. We do it together every evening, don't we Tanny?" she said with a smile.

And that is how care should happen in Nursing Homes. It doesn''t have to be the nurse, or the care aide, or the recreation worker. It can be anyone, and it should be everyone, who participate with residents in life--their life, and who notice what the resident's lie looks like.

That is what best care is all about.

Have a loved one in a nursing home? Look around to see who is providing the best care.

Wednesday, October 04, 2006

How Many Ways Can You Say Old?

I was thinking the either day about all of the ways we talk about older people--

Seniors
Golden Agers
Prime Timers
Third Agers
Old People
Geriatrics
Elders
Ancient
Dinosaurs

Probably many more. In some ways, it almost seems like the evolution in ways we talk about older people is similar to the evolution in how we talk about people with lower IQ's. The first designations--moron, cretin, etc., became insults and then we talked about retarded people, and then we talked about exceptionnal children, and then we talk about developmentally disabled, and then we talked about people with developmental disabilities.

And it seems like things shift because the descriptive words become insults, almost as though to be one of "those" people was objectionnable . The words became judgments, and the people are judged undesireable or to be like them is undesireable.

And what does it say about our society and culture if that is what happens when we talk or think about our mothers and fathers and grandparents and great grandparents?

How do we shift to valuing and cherishing a whole segment of our people--ourselves?

I dunno, actually.

But we could call them something different again.

We could call them--how about-- I mean, you know, if we have YUP pies, for Young Urban Professionals, and we have DINKS, for Dual Income No Kids, and "gay people" is already taken, and happy people"" doesn't have a great ring to it-- well how about OP's for Older People. Or SOPs--Seriously Older People? Or Oppies and Soppies?

Kind of catchy, don't you think?

Monday, October 02, 2006

Average Costs of Private Nursing Homes Tops $75,000

Recent costs in the U.S. say that the average cost of a private care facility and a private room can be over $75,000 per year.

A lot of money.

What can you do?

In Canada, remember that there are lots of publicly funded facilities that do not cost that much, they are either income or income plus asset based costs. The care is excellent in many publicly funded facilities, but the look and luxe may not be there. Remember too, that many people do not need a "Nursing"Home, they need help with personal care. This can be a lot cheaper, even in the private sector.

Consider LTC insurance, a line of credit on a home, getting in-home help (average costs about $19.00 per hour).

Look at your needs and what the future may hold for you. What other alternatives, such as assisted living, or family care homes, may work for you.

You might also consider selling one or more of those pesky adult children who keep on telling you to move to a nursing home. They make great wall ornaments in the right setting, and can also be programmed ( you know that, because they keep telling you the same thing over and over again).

Caregivers and Caregiving

October 10, 2006, I will be giving a lecture for St. Vincent's foundation and funded by London Drugs. Caring for the Caregiver, I will talk about different ways for people to view their relationships, and practical ways to be a successful caregiver.

Van Dusen Gardens (Floral Hall)
5251 Oak Street (at West 37th Avenue)

Tuesday, October 10, 2006 1:00-2:30 pm

For information or to register call 604.838.5585 or Email kwhitby@providencehealth.bc.ca