When the word “abuse” is heard, many individuals often visualize the victims as young children and/or women. There is, however, another cohort of individuals who are abused as well – Older adults. Whether abused by relatives, health care professionals or “trusted” acquaintances, abuse among older adults is generally under-reported and unrecognized. Below is some brief information about elder abuse and the types of abuse that older adults experience. Elder abuse, as defined by the Administration on Aging, refers to “any knowing, intentional, or negligent act by a caregiver, or any other person, that causes harm or a serious risk of harm to a vulnerable adult." Physical abuse is any action that causes bodily harm like hitting, pushing, or slapping. Since such actions generally result in bruising, it is important to inquire about any markings you notice on an older adult. It is also just as important to make sure their explanation matches the size, color and location of the bruise. For example, a bruise that is purple or blue indicates it is fresh as opposed to one that occurred last week. While it is common for older adults to bruise easily, it is essential to inquire about any and all markings, especially if there have been changes in your loved one’s social environment (i.e. new friends, visits from estranged relatives, etc.) Financial abuse or exploitation can occur in the form of forged checks, unauthorized bank withdrawals and credit card usage, coaxing someone to sign over his/her property, etc. This type of abuse can generally be identified by reviewing your loved one’s financial records and questioning any abnormal transactions you notice. Emotional abuse can consist of yelling, threatening, or preventing an older adult from engaging in certain activities. Signs that someone is being psychologically abused can include - being “on edge” when around a particular person, telling you about “mean” things someone is saying to them, or overhearing a conversation whereby it appears someone is threatening them. Even a statement like “You better do what I say or I’m going to put you in a nursing home!” can be construed as emotional abuse. Sexual abuse is defined as any coerced, forced or threatened attack that is sexual in nature. Sexual contact is also considered abuse if the victim is unable to give consent. Noticing this type of abuse can be harder as bruises can be in places that many people don’t see, like around the chest or genital area. Aside from examining your loved one, asking directly about this type of abuse may be the only way to initially identify it. Neglect is defined as a caregiver’s refusal or failure to provide an older adult with the care they need, especially around issues like hygiene, nutrition, medical attention, etc. If you are noticing significant changes in your loved one’s hygiene, appearance and weight, while they are under the care and supervision of a relative or health care professional, it may be possible they are being neglected. While it may be hard for us to believe older adults, especially our parents, can fall victim to abuses other than phone/mail scams, it is important to understand that by monitoring your loved one’s care, following up with any “odd behavior” you notice, talking directly with him/her about your concerns and/or consulting with his/her medical professional it can help minimize the chances of them being taken advantage of. Do you have any questions you would like to ask about warning signs or resources avaiable for elder abuse?
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With all the new technological advancements that seem to be coming out everyday for older adults, trying to keep up with the changes can be inundating and confusing, especially if you are not tech-savvy. As a result, I spoke with Melody Wilding, Director of Communications at eCaring, and asked her some questions to gain a better understanding of the latest “buzz” surrounding technological devices geared towards helping family caregivers and the individuals they care for. Ms. Valentin: What is Caregiving technology? Ms. Wilding: Caregiving technology is any type of innovative program or device that aims to improve the caregiving experience. The tool or device can be directly related to improving medical care and/or increasing a caregiver's social connectedness and sense of community. There are a few basic categories that most caregiving technologies fit into - medical devices and assistive technology, Cloud-based caregiving tools, and social and community tools. Ms. Valentin: How could caregiving technology enhance a caregiver's situation? Ms. Wilding: While a loved one may spend a few hours in the hospital or at a physician’s office, the majority of his or her time is spent at home. Until now, however, the home environment has essentially been a “black box” in the home health care continuum due to the lack of reliable mechanisms for providing actionable, real-time care information from the home. This gap often leads to a multitude of unfortunate consequences like unplanned hospitalizations. In-home care management and monitoring technologies are breaking open this “black box” and fundamentally transforming the ability to monitor a person’s care at home. One example of in-home care management is the the cloud-based care management system, eCaring, which allows home care aides, family caregivers, and patients themselves to enter enormous amounts of real-time health care data. Important data like medication intake, vital signs, daily routines and mental state, are able to be tracked regardless of a user’s computer skills or health care literacy. Ms. Valentin: What are some other common devices used and how can they be beneficial? Ms. Wilding: In addition to real-time, round-the-clock cloud-based platforms, medical devices are another popular area of caregiving technology. Medical devices like automatic medication and pill dispensers, electronic blood glucose monitors and personal emergency response systems (PERS) tend to be useful tools for many family caregivers. When caring for an older adult, chances are family caregivers are trying to manage information between a dizzying numbers of parties. According to the Family Caregiver Alliance, there are over 43.5 million adults providing care to someone 50 years or older in the United States. Now more than ever, technology is becoming an indispensable tool for managing and coordinating care. The benefits of these tools are far-reaching and have major implications for improving quality of life for older adults and their caregivers. The National Alliance for Caregiving reports that the most important technological benefits reported by caregivers are saving time (77%), caregiving logistically made easier (76%), making the care recipient feel safer (75%), increasing their feelings of being effective (74%), and reducing stress (74%). Whether you live around the block or across the country, no one can be with his/her loved one 24 hours a day. Yet families should know, at all times, whether their loved one is eating well, sleeping properly, taking their medications, etc. Technology can help individuals, families and their health care providers respond immediately and help to keep small problems from becoming big ones. Do you have any questions about caregiving technology? Or information about available products you, as a family caregiver, have used and want to share with other family caregivers? If so, please share them below. Melody Wilding, Director of Communications at eCaring, is a recognized expert on aging and healthcare technology and is a trained geriatric social worker. Melody has worked with older adults clinically in community-based, senior living, and psychiatric settings; developed aging-competency trainings for healthcare workers, worked on advocacy campaigns to support Medicaid home care services, and is a member of the Committee on Leadership In Aging. She can be reached at: melody@ecaring.com or find her on Twitter at @MelodyWilding Having a relative/friend in the hospital can be extremely stressful for a variety of reasons. Aside from stressing about your loved one’s condition, additional stressors like answering questions related to his/her medical insurance and medication and/or producing legal documents can quickly make an overwhelming situation seem impossible to manage. In order to make the situation seem manageable it is important to know what steps/actions you can take before a crisis arises. Below are a few recommendations to consider: 1) Create a Folder – important documents like a Health care proxy, Power of attorney, a list of medications, health insurance, and other pertinent information should all be kept in one place as, at one point or another, a health care professional may ask for them. Having a folder, file or place you can turn to easily to get the documents can save you a lot of time and hassle from trying to remember where you put them and from having to sort through a mound of unrelated documents. As is the case for many people, you usually can’t find something until you are not looking for it. 2) Prepare a Hospital Bag – should your loved one be admitted into a hospital, he/she may feel more comfortable and less anxious if they have some of their own belongings. Personal items like a nightgown/pajama's, eyeglasses, dentures, reading materials, etc., can help reduce any anxiety your loved one may be experiencing as a result of being in a different place, wearing different clothes, and sleeping in a different bed. You should also include some items for yourself like a cellphone charger, quarters for the vending machines, reading materials and snacks. 3) Delegate Responsibility - if you are the primary caregiver, chances are you will have to keep various family and friends updated on your loved one's condition and progress. Appointing someone else who can do this can be a great relief, both from a time and stress perspective. You may also want to consider delegating other tasks you are generally responsible for like cooking, cleaning, going to the Pharmacy, etc. One less thing for you to do can help you focus more attention on your relative and yourself. Having a loved one in the hospital is no "walk in the park," especially if it is an unexpected occurrence and your loved one's condition is critical. Preparing beforehand can help minimize the stress you experience. Do you have any other suggestions or tips you would like to share regarding a loved one’s hospitalization? Please do so below… After reading my last blog post about Alzheimer’s disease vs. Dementia, Molly Clarke a social media coordinator for Social Security Disability Help, * – a website that helps individuals apply for Social Security Disability(SSD) or appeal a denial – contacted me and inquired whether she could provide some general information about applying for SSD. SSD is an entitlement individuals with disabilities, those diagnosed with a terminal illness and/or family caregivers should know about. Below are some responses to questions I asked her which I thought would be helpful for individuals and families helping someone with Alzheimer's disease. Ms. Valentin: Why should an individual who has been diagnosed with Alzheimer’s disease or his/her family consider apply for Social Security Disability benefits? Ms. Clarke: A diagnosis of Alzheimer’s disease, especially early-onset Alzheimer’s disease, is often followed by a flood of questions—How will this change my life? Will I be able to support myself and my family if I can no longer work? Am I going to be able to afford my care? Social Security Disability benefits can help alleviate some of the financial barriers a family may be facing - especially if they can no longer work. If you meet the criteria to apply for benefits, then the benefits paid can be used for everyday living expenses, medical needs, supportive care, etc. Since Alzheimer’s disease most commonly affects individuals over the age of 65, the majority of individuals who suffer from the condition are already at or near retirement age. This means that they can choose to apply for early retirement benefits or Old Age/retirement benefits instead of disability benefits. Early onset Alzheimer’s disease, however, occurs at a significantly earlier age—typically in the 40s or 50s- and affects about 5% of those diagnosed with Alzheimer's disease. If you or a family member is diagnosed with Alzheimer’s disease at a younger age, applying for Social Security Disability benefits to cover everyday living other expenses should be greatly considered as it generally affects an individuals’ ability to earn a gainful living. Ms. Valentin: What does the Social Security Disability application process look like? Ms. Clarke: The typical Social Security Disability application process is comprised of several stages and can take months or even years to receive a final decision. Listed below are the different steps receiving disability benefits can entail:
Fortunately, the Social Security Administration (SSA) recently added early onset Alzheimer’s disease to the Compassionate Allowances program. Under the compassionate allowances program, applicants with particularly severe conditions can have their application approved in as little as ten days. Whether applying through the standard application process or through the Compassionate Allowances program, you will need substantial medical records and documentation to back up your claim. This can include hospital records, medical testing, personal notes from a doctor, lists of medication, etc. Without this medical evidence your application can be delayed or even denied. Ms. Valentin: What should someone do if his/her application for disability benefits is denied? Ms. Clarke: If an application is initially denied for any reason, as stated a before, you can file an appeal. If your case was originally reviewed under the Compassionate Allowances program, it will retain priority status throughout the appeal’s processes as well. In other words, once an application is designated as a Compassionate Allowances claim, it is approved for expedited review at all stages, including any appeals. To ensure that an application has the best possible outcome, individuals should consider retaining the services of a qualified attorney or advocate. A legal professional will know the ins and outs of the application process and will be able to help collect and fill out any documentation an individual needs in order to be approved. *Disclaimer: Social Security Disability Help is an advertising services that is paid by the lawyers and advocates whose names are provided in response to people who request assistance. It is not an attorney referral services and is in no way affiliated with the Social Security Administration. Do you have any questions about Social Security disability or stories you would like to share regarding you/your family’s process of applying? If so, please share them below. Throughout my work with family caregivers, a common confusion that regularly arises regarding memory loss is the belief that Dementia and Alzheimer's disease are one in the same. While it is true some people, even health care professionals, will use the terms interchangeably it is important to understand the fundamental differences between the terms so that you can truly understand what you may/may not be up against and can properly plan ahead. Dementia is an umbrella term that is used to describe the many symptoms associated with someone who is experiencing symptoms like confusion, disorientation, forgetfulness, language problems and/or visual impairments. It is also important to know that medical conditions like a urinary tract infection, a stroke, a thyroid condition, etc. can cause dementia-like symptoms; Side effects of medication, or alcohol can also mimic dementia. There are currently at least 50 known causes for dementia. Alzheimer’s disease is one of the most common causes of dementia. It is defined as an irreversible, progressive neurodegenerative disease that initially affects a person’s short-term memory and eventually progresses to affect his/her long-term memory and physical capabilities. Alzheimer’s disease is a specific disease and according to one medical model consists of three stages - Early, Middle and Late. Below is a brief summary of some of the signs you may notice in an individual with Alzheimer's disease. Early stage Alzheimer’s disease consists of intermittent memory loss which can make identifying a memory problem difficult especially if lack of sleep, exhaustion, depression or stress are "blamed" for the forgetfulness. Changes in personality and/or forgetting to attend a recently scheduled meeting/appointment are generally signs that something is wrong. Middle stage Alzheimer’s disease is characterized by more forgetfulness and drastic changes in mood. Behavioral issues like wandering, paranoia, increased agitation and/or hallucinations are also common during this stage. This stage can be confusing because of the ability for an individual to remember specific details of past events while forgetting more recent occurrences. Late stage Alzheimer’s disease is characterized by a more progressive decline. The ability to remember past events becomes harder and confusion regarding people and places can become prominent. Incontinence, slurred speech and difficulty walking can also be present during this stage. The essential thing to know about Dementia and Alzheimer’s disease is they are not the same. Someone who has dementia does not necessarily have Alzheimer’s disease. One of the best questions you can ask your loved one’s medical team should they issue a dementia diagnosis is, “What is causing the dementia?” While it may be hard for the medical team to give you a definitive answer, especially during an initial evaluation, an answer or even a speculation can at the very least help you begin the process of planning ahead. Do you have any thoughts you would like to share or questions to ask? Please do so my commenting below. December is a time of year that many individuals look forward to because of the holidays. Whether it is celebrating traditions, being around family and friends, or shorter work weeks - for the most part people enjoy this month. And while for many, this time of season is considered festive, fun and cheerful for others it can also be anxiety-provoking, depressing and emotionally exhausting. Holidays often equate to engaging in family-oriented gatherings, which depending on family dynamics, can result in increased anxiety for some individuals. Worrying about mom's approval of a new boyfriend/girlfriend, wondering whether dad will continue to express his disappointment in your career choice, or stressing about your sibling(s) capability to understand how much help you need with caring for your parents, are a few examples of situations that can provoke anxiety thereby causing a person to dread the holiday season. This time of year can also be depressing for individuals who lack familial support, are not involved in a significant relationship or are going through a life-hardship that prevents them from celebrating the season as they normally would. And while they may choose to not celebrate, commercial advertisements and/or innocent questions like, "What are you doing for the holiday?" or "Have you finished shopping yet?" etc., can serve as a reminder of what they don't have thus causing a negative association with the holiday. Last but not least, emotional exhaustion is a common feeling many individuals experience during this time of year. Sometimes the mere thought of all the planning, traveling and socializing a person will have to do to prepare is enough to bring about a cloud of gloom. In other cases, memory of last year's disorder, dysfunction or drama can serve as a blockade to feeling cheerful about the holiday. With all of that said, it is important to be aware of your feelings during this time of year and to not let it get the best of your ability to enjoy it or to function. Talking with friends and family you trust and/or with a therapist about your feelings can help you get to the bottom of what you are experiencing and learn ways to resolve it. Does the holiday season increase your anxiety or make you depressed? How do you deal with it? Please share your thoughts below. Alzheimer's disease is a disease that affects millions of individuals and their families. Of the many behavioral symptoms associated with the disease, one of the most exhausting, stressful and emotional is dealing with a loved one's refusal to eat, bathe, attend doctor's appointments, etc. While it is normal to try to rationalize with your loved, for many families the attempt is often unsuccessful. One approach I often recommend to families is to look at the situation from a "Good cop, Bad cop" perspective. The essence of the "good cop, bad cop" approach is that the cop who is perceived as good is the one who will succeed in convincing the person to do as he/she wants, whereas the "bad cop" is unsuccessful. For many individuals with Alzheimer's disease the "bad cop" is usually the person who cares for them most - the primary caregiver. Why? Because he/she is most likely the one who is reminding their relative what they should or should not be doing. So, what should you do if you are the "bad cop?" 1) Find a Trusted Relative - It is not uncommon for individuals with dementia to trust and abide someone who they see as 'good' and/or knowledgeable. Whether it is a grandchild, a next door neighbor or your cousin in another state - knowing who this person is and getting them on board to have a discussion with your loved one can be helpful. 2) Consult The Physician - Many older adults, especially of certain cultural backgrounds, will often listen to anything his/her doctor says. In some cases, families have enlisted the help of their family physician and/or neurologist to get their loved one to begin taking medications, take showers, stop driving, etc. All that is usually needed is for the physician to "prescribe" a regiment or routine for your loved one. 3) Don't Undermine Their Intellectual Capability - Individuals with dementia should not be considered unintelligent. While they may be forgetful, it doesn't mean they don't understand what is going on. Therefore, try to refrain from talking about your loved one in their presence as if they are not there, especially if they are in the early stages of the disease. The last thing you want them to feel is like they no longer have control in decisions, no longer have a say in what happens and no longer have a purpose. While there are a lot of other factors that come into play when trying to get a loved one on board, in my experience, RESPECT is the biggest factor. Remember that your loved one is a grown adult who should be treated as such. To treat them any less will only result in more resistance and a lot more stress for everyone involved. Do you have any tips you would like to share about the "Good Cop, Bad Cop" technique I described above? Has someone else had to step in to convince your loved one to do something? If so, who? Feel free to share below. During this time of year, much is discussed about how the holiday season can bring about feelings of exhaustion and stress for family caregivers. What is not often mentioned, however, is the loneliness that family caregivers can experience because of the responsibilities that come with the caregiving role. For many family caregivers, especially primary caregivers, partaking in family traditions and/or festivities during the holiday season is extremely challenging. Attending the office holiday party, family gatherings or even doing some gift shopping generally have to be sacrificed. As a result, a family caregiver can feel left out, lonely and unimportant. So, what can be done to minimize the potential for family caregivers to experience such feelings? Below are a few suggestions for both family caregivers and non-family caregivers. Family Caregivers: Ask, ask and ask again! If there is an event you would like to attend, don't automatically assume you cannot go because no one will help out. First, try asking a relative or trusted friend to help. If they can't, proceed to go down your list of reliable people. If you don't have one or there is no one left, consider reaching out to local community agencies for respite care. Doing so may give you a chance to escape for an evening dinner or a day shopping spree. Be Creative Think outside of the box. Maybe having your traditional gathering on a specific day is impossible this year, but that doesn't mean you can't plan it for another day. Start a new tradition by having a holiday lunch instead of a holiday dinner. If mornings are better for your loved one, then have a holiday breakfast. Being flexible with plans can give you the opportunity to still partake in certain family rituals and potentially open the door to new ones. Be Honest If you are being invited somewhere and can't attend, be honest with your reason why. Don't just assume that the person will know why you are unable to attend. Tell them something like "I would love to attend but I have to go home and make sure my mother takes her medication." By doing so, you are not only providing insight into your World, but are also taking a stance for yourself, other caregivers and leaving the door open for an offer for assistance. Non-Family Caregivers: Ask and Offer If a someone you know turns down an invitation for a holiday drink, dinner or party because of caregiving responsibilities, consider offering the opportunity to go out another time. Even if the caregiver turns down your second offer, the fact that you are willing to work with their schedule may be enough to show you care and possibly leave the caregiver feeling less isolated. Be specific Simply asking "Is there anything I can do?", in many cases won't generate an adequate or true response. Be specific and ask a family caregiver if they need any assistance with holiday shopping (i.e. a gift card from a specific store, wrapping paper, holiday cards, postage stamps, etc.). Depending on your abilities you may even want offer to cook a holiday dish, bake a dessert or assist with household chores. Don't be scared While you may not want to seem intrusive, you cannot let fear prevent you from helping out another person - especially a close friend, relative or neighbor. All too often I hear stories about friends and families who seem to disappear whenever caregiving presents itself. The reason often given by many "non-caregivers" is "I wasn't sure what to say?" or "I call in every so often to see how she is doing and she tells me she's fine." While such reasons can be valid, they really don't offer the support and assistance family caregivers need. Instead, try to follow the suggestions above; They can go a long way to reducing feelings of isolation. Remember, one of the points of this holiday season is to share it with family and friends. While celebrating a holiday on its actual day is ideal, family caregivers often have to switch things around. This can mean celebrating Christmas in July or having a Thanksgiving breakfast instead of dinner. Be flexible, be honest and be open to all types of assistance and offers. Do you have other suggestions for family caregivers and non-caregivers? If so, please share them below. |
Christine M. ValentinAs a licensed clinical social worker, I help individuals caring for a loved one reduce feelings of anxiety, depression and stress. This blog is meant to share with you, many of the suggestions I recommend to many family caregivers. Sign up to receive them directly. Archives
July 2020
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