On Music Therapy

The following article link was sent to me by the author, Alpha Woodward,BMT, MMT, MTA, a wonderful music therapist here in Vancouver. She originally wrote it for Canadian Journal of Music Therapy Vol. IX, no. 1 2002

"Finding the Client in Their Environment: A Systems Approach to Music Therapy Programming," http://www.voices.no/mainissues/mi40004000156.html

Hiring Live In Caregivers

I was recently interviewed for CBC Radio about Live in Caregivers. More and more, people are going to be turning to this as a means of helping their parents or themselves continue to live in their own homes as they age.

There are a number of things to consider here--cultural differences, quality and training, monitoring, the work it takes to be an employer.

People also need to be aware that the process of hiring a live in caregiver can take several months, three is not unusual. It is not a quick fix. That means, one more reason why you need to be aware of what is coming down the road.

Plan, plan, plan. Just like your mother told you.

Okay, actually, she probably said, "Eat your vegetables." But she could have said that.

Outsourcing Eldercare?

Well, that is one way to think about it. Outsourcing--when there are tasks you want done, and you don't have the time, or the expertise, you hire someone. That is one way to look at Diamond Geriatrics, and Geriatric Care Management.

See our interview in the Vancouver Sun on Friday, March 28, 2008:

http://www.canada.com/vancouversun/news/story.html?id=ce689c24-20a5-4a7c-b83b-ad2f22edcbc6

Funding for Eldercare

A reader from Kitchener,Ontario sent me this. I think it is interesting:

There has been a lot of discussion and print about bettering our health care


system. Since I've been involved for 15 years in caregiving I may be able to


give my perspective.

When seniors get older and handicapped persons need constant care the
choice often has to be made to either put them into a care facility or taken


in by their children. With so many couples working the choice is made to
put parents into a long term care facility.

Almost every day I'm reading stories about poor working conditions in long
term facilities for workers and nurses, the main reason being that there
aren't enough workers.

What I recommend is that those people that want to take on the "job" of
taking care of their elderly parents should be encouraged to do so. This
would mean a lot less workers are needed and possibly a lot fewer care
facilities would be needed. The patient would be more content, and the
caregiver would have peace of mind. A community nurse could look in
occasionally so the caregiver doesn't feel all alone and call a doctor if
more medicines or help is needed. If a caregiver needs respite for a few
hours it could be provided occasionally.

Since the caregiver has a job of looking after their parent, they should get


benefits such as medical and dental care, similar to social services. The
surplus money in the Employment Insurance Fund could be used to give workers


some financial support if they need it. Since older patients usually have
an Old Age Pension and would most likely live with the caregiver there would


be enough financial help.

To encourage people to become their parent's caregivers the inheritance
money they get should be taxed differently so more money goes to the
caregiver when the patient eventually dies. Their wages for looking after
their parent would be deferred until their parent's death, but it would be
substantially more for doing the caregiving job. The government wouldn't be
missing this money because they wouldn't be needing so much to pay to build
long term facilities and all the wages for workers. It costs the taxpayer
far less when caregivers are looking after their own family members. The
patients would receive their proper medicines and other medical help by
their loving children, not paid people in a facility.

Of course for something like this to work the federal and provincial
governments should work together in a non-partisan way. If the federal
government had a good health plan even Ontarians would support such
a plan.That hated $900.00 Ontario health tax could be eliminated.

Prevenint Burnout

This post is similar to one I published on my counselling blog, but here I want to focus on caregivers.

One of the problems that caregivers run into is burnout. Burnout happens sometimes when people continue in behaviours or actions in caregiving which cause stress to them.This is often because caregiving roles "happen," or evolve. They are not planned Decreasing the chances of burnout may mean examining and changing your caregiving patterns which you have developed.

To change the patterns you will have to look at exactly what you are doing. What are the things that are burning you out? What would you like to be doing differently? What would give you some relief.

Then, put yourself into situations or places or times where you have the chance to do the thing differently. It might be joining something new, it might be going to somewhere new, it might be doing some things a little bit different, it might be calling on help at diffeent times, it might be finding and using resources that you were unaware of. .

Set up your goals for these experiences. Make them clear, specific, behavioural, and achievable. Also, make them realistic. We don't try to leap up a stairway in one bound, there are steps along the way to hel. It is the same with goals. Small ones, in which you achieve success can be more motivating to keep on going than trying large ones which seem insurmountable.

Keep a journal of what you have done.Write down what it was like, how it felt, and be as specific as you can about exactly what you did that made it a success, if it was.If it was not successful, analyze exactly what you did, and see if you can it in a different way. Remember too that sometimes changing behaviour takes time. Even the conscious effort to do so is one step. The fact that you tried is your first success.

Medications and Overmedications

I have a client in a very classy nursing home where she has been for three years. She was very agitated and intrusive when first admitted, and had been seen by a couple psychiatrists who put her on various medications. I have been fighting ever since to lower them. The last time I got them lowered was about six months ago.

I finally called the family physician and asked him to lower them. The psychiatrists had been afraid to do so. He lowered them.

Guess what? No difference.

Well, no, there was a difference. Her balance is better. She is eating better. She is more alert.

There is no difference in the way the home is able to manage here care.


I think to myself, how much would she be on if I hadn't been pushing? Why don't they follow this better?

I actually know why--it is because it is easier not to. It is easier not to really and truly individualize care and provide the best care possible.

That is why people need someone like what I do or a family member to do it.

Aging and Dying

A very interesting article in the New York Times about choosing to end one's life, when that choice is not arising out of depression. From The New York Times:

A Heartfelt Appeal for a Graceful Exit, by Jane Brody

http://www.nytimes.com/2008/02/05/health/05brod.html?ex=1359867600&en=addbc5016ece53c7&ei=5124&partner=permalink&exprod=permalink