Monday, January 28, 2013

Taking a Zen Approach to Caregiving

By Judith Graham

You try to help your elderly father. Irritated and defensive, he snaps at you instead of going along with your suggestion. And you think "this is so unfair" and feel a rising tide of anger.

How to handle situations like this, which arise often and create so much angst for caregivers?

Jennifer Block finds the answer in what she calls "contemplative caregiving" — the application of Buddhist principles to caregiving and the subject of a year-long course that starts at the San Francisco Zen Center in a few weeks.

This approach aims to cultivate compassion, both for older people and the people they depend on, said Ms. Block, 49, a Buddhist chaplain and the course's lead instructor. She's also the former director of education at the Zen Hospice project in San Francisco and founder of the
Beyond Measure School for Contemplative Care, which is helping develop a new, Zen-inspired senior living community in the area.

I caught up with Ms. Block recently, and what follows is an edited transcript of our conversation.

Q. Let's start with your experience. Have you been a caregiver?

A. My experience in caregiving is as a professional providing spiritual care to individuals and families when they are facing and coping with aging and sickness and loss and dying, particularly in hospital and hospice settings.

Q. What kinds of challenges have you witnessed?

A. People are for the most part unprepared for caregiving. They're either untrained or unable to trust their own instincts. They lack confidence as well as knowledge. By confidence, I mean understanding and accepting that we don't know all the answers – what to do, how to fix things.

This past weekend, I was on the phone with a woman who'd brought her mom to live near her in assisted living. The mom had been to the hospital the day before. My conversation with the daughter was about helping her see the truth that her mother needed more care and that was going to change the daughter's responsibilities and her life. And also, her mother was frail, elderly, and coming nearer to death.

Q. That's hard, isn't it?

A. Yes, because we live in a death-denying society. Also, we live in a fast-paced, demanding world that says don't sit still — do something. But people receiving care often need most of all for us to spend time with them. When we do that, their mortality and our grief and our helplessness becomes closer to us and more apparent.

Q. How can contemplative caregiving help?

A. We teach people to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and to pay close attention. Most people don't want to do this.

A person needs training to face what is difficult in oneself and in others. There are spiritual muscles we need to develop, just like we develop physical muscles in a gym. Also, the mind needs to be trained to be responsive instead of reactive.

Q. What does that mean?

A. Here's an example. Let's say you're trying to help your mother, and she says something off-putting to you like "you've always been terrible at keeping house. It's no wonder you lost my pajamas."

The first thing is to notice your experience. To become aware of that feeling, almost like being slapped emotionally. To notice your chest tightening.

Then I tell people to take a deep breath. And say something to themselves like "soften" to address that tightness. That's how you can stay facing something uncomfortable rather than turning away.

If I were in this position, I might say something to myself like "hello unhappiness" or "hello suffering" or "hello aging" to tether myself.

The second step would be curiosity about that experience. Like, wow, where do I feel that anger that rose up in me, or that fear? Oh, it's in my chest. I'm going to feel that, stay with it, investigate it.

Q. Why is that important?

A. Because as we investigate something we come to understand it. And, paradoxically, when we pay attention to pain it changes. It softens. It moves. It lessens. It deepens. And we get to know it and learn not to be afraid of it or change it or fix it but just come alongside of it.

Over hours, days, months, years, the mind and heart come to know pain. And the response to pain is compassion — the wish for the alleviation of pain.

Let's go back to what mother said about your housekeeping and the pajamas. Maybe you leave the room for five minutes so you can pay attention to your reaction and remember your training. Then, you can go back in and have a response rather than a reaction. Maybe something like "Mom, I think you're right. I may not be the world's best housekeeper. I'm sorry I lost your pajamas. It seems like you're having a pretty strong response to that, and I'd like to know why it matters so much to you. What's happening with you today?"

Q. Are other skills important?

A. Another skill is to become aware of how much we receive as well as give in caregiving. Caregiving can be really gratifying. It's an expression of our values and identity: the way we want the world to be. So, I try to teach people how this role benefits them. Such as learning what it's like to be old. Or having a close, intimate relationship with an older parent for the first time in decades. It isn't necessarily pleasant or easy. But the alternative is missing someone's final chapter, and that can be a real loss.

Q. What will you do in your course?

A. We'll teach the principles of contemplative care and discuss them. We'll have homework, such as 'Bring me three examples of someone you were caring for who was caring toward you in return.' That's one way of practicing attention. And people will train in meditation.

We'll also explore our own relationship to aging, sickness, dying and loss. We'll tell our stories: this is the situation I was in, this is where I felt myself shut down, this was the edge of my comfort or knowledge. And we'll teach principles from Buddhism. Equanimity. Compassion. Deep inner connectedness.

Q.  What can people do on their own?

A. Mindfulness training is offered in almost every city. That's one of the core components of this approach.

I think every caregiver needs to have their own caregiver — a therapist or a colleague or a friend, someone who is there for them and with whom they can unburden themselves. I think of caregiving as drawing water from a well. We need to make sure that we have whatever nurtures us, whatever supplies that well. And often, that's connecting with others.

Q. Are other groups doing this kind of work?

A. In New York City, the
New York Zen Center for Contemplative Care educates the public and professionals about contemplative care. And in New Mexico, the Upaya Zen Center does similar work, much of it centered around death and dying.

People who want to read about this might want to look at a new book of essays, "
The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work" (Wisdom Publications, 2012).

http://newoldage.blogs.nytimes.com/2013/01/11/taking-a-zen-approach-to-caregiving/?smid=fb-share


"Learn About Senior In Home Health Care in Mid Tennessee

Senior Helpers Provides Many services in the Mid Tennessee area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Adams, Alexandria, Auburntown, Bethpage, Brush Creek, Carthage, Castalian Springs, Cedar Hill, Chestnut Mound, Cottontown, Cross Plains, Dixon Springs, Elmwood, Gallatin, Goodlettsville, Gordonsville, Greenbrier, Hartsville, Hendersonville, Hickman, Joelton, Lafayette, Lancaster, Lascassas, Lebanon, Madison, Moss, Mount Juliet, Nashville, Old Hickory, Orlinda, Pleasant Shade, Pleasant View, Portland, Red Boiling Springs, Riddleton, Springfield, Watertown, Westmoreland, White Creek, White House, Whitleyville and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Mid Tennessee Home Health Care Company.  "

Sunday, January 20, 2013

Elder Companions

What Elder Companions Do and How They Help

By Paula Spencer Scott, Caring.com senior editor
Last updated: September 29, 2012

Elder companions -- sometimes called home companions, who also cater to a younger population -- do just what the name implies: provide company for people who live alone, especially those who are homebound because of frailty or dementia. Most importantly, these companions function as an extra set of hands, eyes, and feet to the person you care for when you can't be there.
Specifically, most companions can assist with the following:
  • Meal preparation
  • Light housekeeping
  • Laundry
  • Grocery shopping
  • Errands

How they help

Elder companions are ideal for those who spend much of their time alone and require some assistance with basic daily tasks. Family members can work or handle other activities -- or simply take a few hours of respite -- while their loved one has company and some supervision. Companion care also provides valuable social benefits, decreasing isolation and improving quality of life. Warm relationships are often formed when a consistent companion is on the job -- a boon for both the companion and the person he or she visits.

What they cost
Cost can range from free services provided by local volunteers to between $10 to $25 per hour for help arranged through an in-home care agency, depending on the type of care needed, time of day, location, and services provided. Medicaid or Medi-Cal may help pay some of the costs of care from a licensed provider for those who have low income and few assets.

How to get started
You can find companions on your own in much the same way you'd find a babysitter: by talking to neighbors, friends, or family members. Or you can try these options:

  • In-home care agencies. Use Caring.com's Senior Living Directory to search for in-home care agencies, most of which provide elder companions, by city or zip code -- and to see ratings and reviews.
  • Meals on Wheels. In addition to providing the hallmark service they're known best for -- home deliveries of meals to older adults and others with mobility limitations -- many local Meals on Wheels programs provide outreach services, including a Friendly Visitor Program that pairs a volunteer with a neighboring senior. Begin your search for local help at the Meals on Wheels website.
  • Area Agencies on Aging. Trained staff at your local Area Agency on Aging can usually provide referrals for local help.
  • Local newspapers. Try placing an ad briefly describing your needs in a local newspaper.
  • Local high school students. Contact area high school counselors. College-bound students often need community service experience and are available to provide some care and company during afternoons and evenings.

http://www.caring.com/articles/caregivers-guide-to-elder-companions


"Learn About Senior In Home Health Care in Mid Tennessee

Senior Helpers Provides Many services in the Mid Tennessee area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Adams, Alexandria, Auburntown, Bethpage, Brush Creek, Carthage, Castalian Springs, Cedar Hill, Chestnut Mound, Cottontown, Cross Plains, Dixon Springs, Elmwood, Gallatin, Goodlettsville, Gordonsville, Greenbrier, Hartsville, Hendersonville, Hickman, Joelton, Lafayette, Lancaster, Lascassas, Lebanon, Madison, Moss, Mount Juliet, Nashville, Old Hickory, Orlinda, Pleasant Shade, Pleasant View, Portland, Red Boiling Springs, Riddleton, Springfield, Watertown, Westmoreland, White Creek, White House, Whitleyville and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Mid Tennessee Home Health Care Company.  "

Sunday, January 13, 2013

5 Surprising Ways to Make a Bathroom Safer

By Paula Spencer Scott, Caring.com senior editor

How ironic: The bathroom is the room for personal hygiene and, therefore, promotes good health. But along with the
kitchen, it's the most dangerous room in the house. The top causes of bathroom accidents (some 200,000 a year): slips, falls, and scaldings.
Find out five safety basics -- and where people often go wrong.

1. Get a grip -- but not just any grip.

Installing grab bars next to the toilet and near or in the bathtub and shower is an easy and relatively inexpensive way to give anyone added support.
But avoid this common mistake: Assuming that any visible bar is a good grab bar.
A slipping adult who reaches for a bar on the wall is going to exert a lot of body weight on that bar. If it's poorly anchored to the wall -- as are many bars intended only to hold the weight of towels -- the person will continue to fall and possibly injure an arm, too. The grab bars should be solidly connected to the structure of the walls (and they can double as towel bars). Skip diagonally placed grab bars because if the grabber's hand slips, a fall is more likely.

2. Simplify the shower/tub entry.

Many new homes feature walk-in shower areas that don't require climbing into a tub, and/or sunken tubs that can be stepped down into, more like entering a swimming pool. Both of these innovations eliminate that precarious wobble over the rim of a tub.
But avoid this common mistake: Overdoing the fanciness of the design so that there are steps leading up to a shower or bath area. Steps are a slipping hazard. A level platform area around the shower or tub is better. It's also wise to avoid a curb at the point of the walk-in entrance. That way you prevent accidental trips and, if necessary, the design can accommodate a wheelchair.

3. Don't lock the door.

We associate the bathroom with privacy -- but it can come at a price. In the event of an accident such as a fall or a medical crisis, you or a loved one might not be able to exit the bathroom on your own. If the door is locked, help can't get in, either -- and might not realize you're in trouble. This problem can happen to anyone of any age; older adults, who have more chronic illnesses and more problems with balance, are especially vulnerable.
But avoid this common mistake: Don't overlook safety regarding the door to the shower. While shower doors don't lock, they can be blocked if the person in the shower collapses and it's a door that opens in to the shower, as opposed to out into the room. Shower doors should always open out to the room.

4. Lower the temperature for vulnerable skin.

A hot shower is a luxury -- but on younger and older bodies with thinner skin, hot water can become much too hot very quickly. Often a temperature setting has been the same for years; be sure to revisit it if there's a new family member in the house or if you notice yourself turning the lever well away from the hottest end of the hot-to-cold spectrum. Below 120 degrees is a safer setting. The National Kitchen and Bath Builders Association recommends installing pressure-balanced and temperature-controlled valves in the bath and shower to help prevent scalding.
But avoid this common mistake: Don't ignore what the temperature controls look like. Knob-style fixtures add to the scalding danger. Better: lever-style fixtures. Often accidents occur because users can't manage to turn off the water if they lack a strong grip.

5. Right-size the commode

Older adults often begin to have mobility issues relating to arthritis and other conditions, or problems with hips, knees, or back. Stooping low to sit on many standard-model 15- to 17-inch commodes can be a challenge. Two simple fixes are molded plastic seats that raise the seat as many as four inches, or adjustable seats that attach to an existing seat. You can also have a plumber install a new model or one that's hung from the wall at the appropriate height.
But avoid this common mistake: Know that a tall toilet isn't right for everyone just because of age or condition. A small woman, for example, may feel insecure sitting on one where her feet barely touch the ground. That presents a falling hazard. Also, if you use an adjustable seat, be sure to attach it securely. One that slips can lead to a dangerous fall.

http://www.caring.com/articles/ways-make-bathroom-safer

"Learn About Senior In Home Health Care in Mid Tennessee

Senior Helpers Provides Many services in the Mid Tennessee area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Adams, Alexandria, Auburntown, Bethpage, Brush Creek, Carthage, Castalian Springs, Cedar Hill, Chestnut Mound, Cottontown, Cross Plains, Dixon Springs, Elmwood, Gallatin, Goodlettsville, Gordonsville, Greenbrier, Hartsville, Hendersonville, Hickman, Joelton, Lafayette, Lancaster, Lascassas, Lebanon, Madison, Moss, Mount Juliet, Nashville, Old Hickory, Orlinda, Pleasant Shade, Pleasant View, Portland, Red Boiling Springs, Riddleton, Springfield, Watertown, Westmoreland, White Creek, White House, Whitleyville and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Mid Tennessee Home Health Care Company.  "

Sunday, January 6, 2013

When Is It Time to Hang Up the Keys?

Free seminar helps families talk to older drivers
by: Ford Burkhart | from:
AARP | December 2012


Here's a little secret about talking with an older parent about a possible end to driving: Try some small talk.

Start with, perhaps, the hazards of driving in inclement weather. Then work up to what happens when eyes age and reflexes slow.
                  

That approach worked for Diane Valuck, 65, of Tucson, when she and her mother, Jean Valuck, had long conversations in 2001 about hanging up the keys. They included the perilous winter driving in Michigan, where Jean lived.

Jean eventually acknowledged she could no longer handle the winter road conditions, and she didn't fancy the cost of keeping a car in good repair.

At 85, Jean made her decision. She sold her Pontiac and for the last decade of her life used the transportation offered by her assisted living center for shopping and medical appointments.

The elements in the Valucks' example come right off the pages of an AARP seminar, "We Need to Talk."

When is it time to talk?

The free seminar, also available online as a 90-minute webinar, helps family members recognize when to initiate "the talk" and illustrates how to work toward the decision after warning signs appear.

Those signs can include getting lost in familiar territory, running over curbs, paint smears on the fender or dents in the mailbox post by the driveway.

"We're not telling anybody to stop driving," said Hal Parrott, 79, of Scottsdale, a seminar leader. "If there's a problem, we just want you to know how to proceed."

Some of the tips seem aimed directly at families like that of Harriet Warren, 85, of Tucson.

Warren says she still drives quite well. But her children, who live in various parts of the country, worry.

The seminar urges people like Warren's children to gather plenty of solid information before jumping to a conclusion that a parent should no longer drive.

Next page: What about alternatives to driving? »

It spells out methods of observing driving skills over time, with an eye to assessing whether a parent can make adjustments to decreasing mobility and other common results of aging. It emphasizes taking note of changes in driving behavior, such as running yellow lights.

"It's the subtle clues that count, and a real friend will notice them," said Mindy Fain, M.D., codirector of the Arizona Center on Aging at the University of Arizona. "The little things can make people no longer want to be with you as the driver. So ask a loved one. That's a good test."

Alternatives to a car

The seminar encourages people to think about alternatives to driving. For instance, it points out how taking taxis for errands throughout the year may turn out to be a far cheaper alternative to maintaining a car.

To help a parent see a bus ride as a normal event, adult children are urged to ride the bus with the parent several times before the parent needs to make a solo bus trip.
For all drivers, AARP Arizona offers two related sessions:

The AARP Driver Safety class covers new laws and techniques that can help counteract the physical consequences associated with aging. Enter a ZIP code at the AARP Driver Safety classroom course locator find a class.

In Arizona, auto insurers aren't required to offer a premium discount for taking the class. Some do, but only for customers who take the in-person class, not the online version. The four-hour class costs $12 for AARP members and $14 for nonmembers. The Driver Safety online course is $15.95 for AARP members; $19.95 for nonmembers.

CarFit is designed to adjust vehicles to fit drivers' bodies and accommodate physical limitations that often come with age. Participants drive their own automobiles to a CarFit session for a free, 20-minute one-on-one assessment.

http://www.aarp.org/home-family/getting-around/info-12-2012/senior-driving-safety-classes-az.html

"Learn About Senior In Home Health Care in Mid Tennessee

Senior Helpers Provides Many services in the Mid Tennessee area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Adams, Alexandria, Auburntown, Bethpage, Brush Creek, Carthage, Castalian Springs, Cedar Hill, Chestnut Mound, Cottontown, Cross Plains, Dixon Springs, Elmwood, Gallatin, Goodlettsville, Gordonsville, Greenbrier, Hartsville, Hendersonville, Hickman, Joelton, Lafayette, Lancaster, Lascassas, Lebanon, Madison, Moss, Mount Juliet, Nashville, Old Hickory, Orlinda, Pleasant Shade, Pleasant View, Portland, Red Boiling Springs, Riddleton, Springfield, Watertown, Westmoreland, White Creek, White House, Whitleyville and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Mid Tennessee Home Health Care Company.  "