Tuesday, 25 March 2014

Dementia - Finding Your Way Program

The statistics are staggering - more and more people every year are diagnosed with dementia.Ontario is projecting that in 6 years that number  of people in the province with this issue will be in the range of 250,000. Given our aging population, I suppose a rise in dementia as that senior cohort gets older is not too surprising.  For those witnessing the cognitive decline of someone they love, it is extremely difficult to come to terms with losing the person you know, while still seeing them as physically present. We are fortunate that there are organizations we can turn to for information and emotional support. In Ontario, our Alzheimer's Society has partnered with our provincial government to expand something called the 'Finding Your Way' Program in multiple languages to accommodate our ever increasing multicultural population.

According to a recent news release "The program will help prevent people with dementia from “wandering” and going missing, and help caregivers and other family members prepare for such incidents, if they occur... The Finding Your Way (TM) safety kit contains tools and resources to help ensure the safety of the person with dementia without depriving them of their independence or dignity, and information to help families create personalized safety plans. The kit includes:
* An identification kit with space for a recent photo and physical description that can be shared with police in an emergency
* At-home safety steps to help prevent missing incidents from occurring
* Steps to safeguard a person with dementia, such as using the Alzheimer Society of Canada’s MedicAlert® Safely Home® program
* Tips on what to do when a person with dementia goes missing and when reuniting after a wandering incident
* The latest information on locating devices". (Quoted from: www.alzheimer.ca/on/~/media/Files/on/Finding-your-way/FINAL_FYW%20Phase%202%20News%20Release_Jan28.ashx)

For further information on this program you can go to www.FindingYourWayOntario.ca

For more information on Alzheimer's Disease see the article Common Warning Signs and Symptoms of Alzheimer's

Tuesday, 18 March 2014

Comparing Housing Options for Seniors

I have done many lectures for groups of seniors and their families over the years. What I find interesting is that more often than not, the piece of information most know little about, is the difference between each level of care and how you determine the kind of place you may need to go to when the time is right. I think that most people assume that there are 'seniors homes' where seniors can go. Until you are in a situation of having to make a decision, what that means and where you actually can go, is not the sort of information you seek out. Unfortunately, it is something people should learn about before the need for it creeps up on them. Knowing the difference and when to start looking might very well impact quality of life and choices available. The sooner you become aware of options, the better. Needing little or no care affords you far more choice and, in some cases, may prevent or delay the need for long-term care.
So, for those of you that might need some info on different levels of seniors care and accommodation here is a quick overview.
Independent Seniors' Apartments - these are usually private apartments with no care but potentially with rent geared to income. Some might have a visiting doctor or social type programs but essentially they are for the well and independent who does not need any significant care.
There are now some Senior Condominiums which are for purchase units but usually if they are billed as 'Seniors' settings then there is either some care or housekeeping available and often dining facilities on site. Again though, one would have to be fairly independent in this type of a setting. Life Lease/Equity Units are a variation on a Seniors' Condo because you purchase a the right to live in the unit, not the unit itself.
Retirement Residences - are usually privately owned and operated. Some provinces do have regulation/legislation - most recently Ontario has added this dimension to retirement living. While most residents go in when they are fairly independent, there is usually the option of adding care as needed for a price and often meals on site. Costs vary depending on many factors. Some homes add the option or indicate that they provide "Assisted Living' which may simply mean that the 'care portion' is included or available. More and more homes do have the capacity for significant care or even managing people with dementia. 
Long Term Care /Nursing Homes - are for those requiring significant care but are medically stable. The government of each province sets the rates so all homes in this category charge the same. As well, they usually manage applications and waiting lists. All meals are included as well as care. In most provinces the resident is responsible for room and board costs and incidentals they may require. 
Complex Care - this is for the medically unstable person or one with very complex issues. These places are more like a hospital-like setting and doctors and nurses are on staff all the time. 
Palliative Care - usually this is for people that have a prognosis of 3 months or less. Comfort care only is provided. 

Tuesday, 4 March 2014

Relocation and Visiting Tips

If after considerable thought and effort to keep a senior in their home, you come to the conclusion that relocation is the best option, there are several things you can do to assist. First of all, the decision should be as co-operative a process as possible. The senior should be involved in the decision making as much as possible and before starting your search discuss financial concerns and limitations.Figure out what area they would like to live in and if possible ensure that it is somewhere that friends or family can get to easily. Make a list of things they want to have in their new home and neighbourhood keeping in mind that you will need to know things that are 'deal breakers' and things they can live without. Make up a list of questions (as a reference you can certainly download our 'visiting tips' from our website). Take a new questionnaire to each home. You may want to narrow down your search to 3 places that meet your/their needs and then take them on tours. Ensure you try the food and if possible speak to residents. If they will allow, take photos of each home to assist you when you are trying to decide. Also make notes during each visit. To assist with decision making, you may want to make a list of the pros and cons of each home and then perhaps suggest a trial stay for a few days or a week so they can get a feel for the place before selling or renting their current home.

Wednesday, 26 February 2014

Having the Talk - Part 2

Now that you have identified that you need to have a conversation with your loved one, how do you actually sit down and have it? I suppose we should go back one step first though. Before you have this talk, be prepared to listen, be non-judgmental, be supportive, be prepared for the emotions everyone involved might experience and be prepared. If you can, do your homework in advance so you have some answers - know possible resources/options and costs. If you are pulling in other family members, ensure you are all going to be on the same page when you meet and not work at cross purposes.

The meeting location should be comfortable for everyone with limited distractions. If there is an agenda of sorts you can use it to stay on topic. Ensure you work in time for everyone to have a chance to talk and do your best to ensure that the person you are talking about has a chance to speak and is given every opportunity to stay in their own home for as long as possible, as long as it is safe, with supports in the home if necessary. Be careful not to argue, criticize or make it about the others in the room. The focus is and should only be the 'senior', why there are concerns, and solutions to fix them. Use observation and facts only. Don't demand or force anything. Focus on positive things and what can be done to help. Prioritize the things that are most important first and if you can devise a 'team plan' so responsibility is shared for the tasks required, things will be far easier for all involved. Set up a 'task list' for everyone. Keep in mind that this might be the first meeting of several and things may need to be monitored and tweaked as time passes. Sometimes if people see that all efforts have been made to keep the person in their own home, if relocation is ultimately required, it is far easier to accept and get 'buy in'.

Monday, 24 February 2014

Getting through the hard stuff - discussing care and relocation

 How do you discuss care and relocation with someone you love? How do you convince them that giving up some independence may actually keep them independent for longer?

I think this ranks among one of the more difficult discussions anyone can have. And sometimes, it takes many tries and some added help before the other person truly understands the concerns. I think often people get into a groove of functioning in a certain way and as long as nothing major happens (and sometimes this is because there is someone else in the house with them which may allow them to function in a co-dependent fashion) they don't realize the potential dangers or issues that others outside their setting see. Sometimes when that second person is gone, things fall apart and then reality sets in. I think the trick, is getting the supports in before this happens. So how do we do this? For the 'caregiver'/family, I think you need patience and you need to be able to open the lines of communication. Often both are very difficult to do. It might be easier though, if you start talking early on. Before anyone is sick, or in need of help or things hit a crisis point.

I know when I have done lectures separately for seniors and children of seniors, there is a common theme. They are both worried about what the future holds, but they are also both afraid to talk about it to the other person. Everyone is waiting for the 'best time' to talk about it when there really isn't one. But, being 'afraid' doesn't make anything better or anything go away. Talking about it may actually  be the thing that makes things better - it will give you an understanding of where the other person stands, what they want and what makes sense in terms of their financial situation and other factors. And talking about it early on allows you both to plan. The longer you leave a discussion like this, the less likely you will have much choice when the time comes.

Sometimes it's easier to start talking when you make it about someone else. For example, talk about a friend both of you know, who didn't plan ahead and who had a crisis that created a major problem for all parties. Use it as a way to broach the subject as it relates to them and what they would want. If the person refuses to have the conversation, you may have to wait a bit to raise it again or bring in others to aid you like a trusted clergy or doctor. Unfortunately, there are situations where people do live at risk and there is nothing anyone can do about it. In these situations, sometimes things do have to get worse or a crisis has to happen, before any intervention can happen. Bottom line - if someone is competent, you can't force anything nor can you make decisions for them without their consent.

Next time.... Having the Talk...........

Friday, 21 February 2014

Tax Credit for Home Renovations

Since tax time is around the corner, I thought some of our readers might benefit from knowing about a fairly new tax credit that Ontario has created. there is now something called the "Healthy Homes Renovation Tax Credit" which is for those 65+ years old (or those living with someone of that age) who are doing or have done renovations to their home in order to make it safer and/or more accessible for them. There is a list of all renovations that are eligible for the credit including small things like grab bars to larger things like ramps for wheelchairs,kitchen renovations to assist with safety and access etc. Before doing renovations you might want to check the list online to see what qualifies or if you have recently done a reno you can check to see if it meets the criteria to claim it at www.ontario.ca/taxes-and-benefits/what-expenses-qualify-healthy-homes-renovation-tax-credit. With the tax credit you can claim up to $10,000 worth of improvements on your tax return. For information on this tax credit or to use their online 'credit calculator' you can visit www.ontario.ca/taxes-and-benefits/healthy-homes-renovation-tax-credit.

Tuesday, 18 February 2014

Caregiving

I think the role of 'caregiver' in a family can be one of the most difficult to have. Often people go from being the 'child' of their parent to seemingly suddenly, becoming their 'parent'. The role reversal in itself is a huge thing to come to terms with for so many. For many, its a role that a person is 'thrust' into rather than knowingly eased into. Often there is no time to look for an 'instruction manual' on how to do this right. It's easy to become overwhelmed and over time experience burnout and in extreme cases, the caregiver themselves can experience physical and mental health issues.

Over the years, working with caregivers, there are a few things I have come to observe which might assist caregivers/future caregivers who are reading this blog. Firstly, communication is key. Caregivers need to be good at communicating to medical staff, support workers, family and friends. You need to be able to ask questions and let people know what is happening with you and your loved one. For some it takes the form of phone or in person contact, for others, a communication book works, especially when there are other caregivers who you may not see daily. Secondly, education is important. You need to ensure you know everything you can on the particular issues and illnesses impacting your loved one & the resources out there to assist you. Someone once told me that fear comes from not knowing. An incredible relief can be had when you know exactly what you are dealing with. Thirdly, when you take this on, you have to be prepared to share the responsibility in caring for that person with others - be it family members, friends or paid support workers. To ensure that burnout doesn't happen you have to learn to prioritize, stress manage and look after yourself. If you need help for yourself, ask for it. If you need a break, take it. In order to give care to someone else, you have to remain healthy and give care to yourself.