It is beneficial to understand why your elderly Mother has a problem with hoarding. She may:

• Remember happier times by holding on to things, whether or not they hold sentimental value.
• Collect items to have a feeling of control as she may feel out of control in other areas of life.
• Combat loneliness and feel comforted by surrounding herself with possessions.

Ironically, hoarders may stop inviting people to visit because of all the clutter and it then heightens instead of helps their feelings of isolation.  As you said, it can actually become dangerous.  Falling becomes more of a worry and unsanitary conditions can hamper daily activities (like cooking).  Hoarding definitely impacts quality of life.

What can be done as treatment for hoarding?

• Many hoarders don’t see the hoarding as negative so any actions must be done in a non-threatening gentle manner.
• People who tend to hoard frequently identify their possessions as a very important part of their identities.  It is imperative to include them in any decisions to discard items so their anxiety is decreased.
• Another reason to include them in the process of discarding the clutter is so they don’t feel you, as the child, are trying to take total control over their life.
• Hire a sensitive professional organizer with experience with the elderly.  Having an outside resource helps reduce a combative family atmosphere.  Please visit www.napo.net for a referral near you.
• Check with her doctor.  Medications such as SSRI’s and anti-depressants may curb the need to hoard.  Also, a type of psychotherapy called cognitive-behavioral therapy (CBT) is very useful in treating hoarding.
• Search the web for “Hoarding and the Elderly” for many reputable resources and advice.

Thanks for your question and I wish you the best of luck,

Lisa

Your feelings are appropriate for you and there are ways to cope and refocus your thoughts to stay mentally healthy.  First, it’s important to examine if it is really guilt that you are feeling.  Guilt can be described as something we feel when we have caused something bad to happen or when you’ve acted or thought in some way that is contrary to your own standards.  These feelings should be closely examined for root causes. We didn’t make the person sick or to have memory impairment – so maybe it is not guilt we feel. What else could it be? Sadness, frustration, anger? Those feelings can be dealt with head on.

Here are a few tips that can help:

1. Don’t beat yourself up for not being perfect.    Caregiving for a family member is full of emotional and physical stress.  Try to be realistic in your own expectations of what you want to accomplish each day.  If something unexpected happens, try to accept that there will always be things out of your control.
2. Research to find guidance and information to help you decide on the best answer for things you can control.   You’ll be more confident in your decisions.
3. Talk with someone about your feelings.  If you’re in a support group, share your emotions of grief and guilt – it’s okay.  Don’t just focus on exchanging caregiving tips.
4. Seek out companionship from family, friends and neighbors to visit with you to combat feelings of isolation.  Invite them for coffee and conversation to focus on something other than caregiving.
5. Refocus your “why” questions away from negative emotions into positive affirmations.  “I’m doing a very important job, I am learning and growing from this experience, and there are resources to help me when I feel overwhelmed” is an example of reframing your thoughts.
6. Consider therapy for processing your “negative” feelings.  Speaking with a professional can be a great resource.

You can find ways to accept and deal with your emotions such as caregiver guilt.  Hang in there!

Best of luck,

Lisa

First off, know you are not alone in how you feel.  As people live longer with chronic illness and disabilities, many of us are participating in caregiving and dealing with the same issues as you.

It has become very apparent that a caregiver who is not mindful of their own health succumbs to burnout from all the concerns and duties they have every day.  It is so important to take care of yourself so you can maintain the will and capacity to continue to provide competent care.   You don’t want to become ill yourself!

I have found support groups for emotionally exhausted caregivers to be invaluable.  There you will find others to problem solve with you and give ideas on how they would handle the same problems.  Support groups are a safe place to voice your feelings without repercussions and to validate your hard work.

Sounds great, but how do you find one to attend?  Doing an internet search is the easiest but also check out your community newspapers and your local hospital outpatient services.  These are also good sources to find respite care ideas to have someone care for your family member while you attend the group.

Give a caregiver support group a try – you (and your father) will benefit!

Best of luck,

Lisa

With a GCM, you can receive assistance with family meetings as the care plan is implemented and monitored, have your questions answered by an experienced professional, and even have family members educated on why certain decisions are recommended.  Also, GCM’s offer referrals to important resources and can be the hands-on liaison between the client, family, and our established network of medical providers.

So, to answer your question, a Geriatric Care Manager can definitely help with your family situation.  All GCM’s would commend you for being proactive in seeking assistance for your parents.

Best of luck,

Lisa

Q: Why would I need to use an agency to find a caregiver for my parents? Couldn’t I just save the extra cost by hiring privately? John S., Atlanta, GA

A: The short answer is: You get what you pay for…

The long answer has to do with protection, for you and your parents. You want to protect yourself from the liability of a caregiver suing you if they injure themselves in the home. You want protection from being without care should your regular person get sick or have car trouble.  You want to protect your loved ones from abuse, fraud or extortion.

When you hire a licensed agency, they have done the background checks, drug screening and training for their hired caregivers. They have the bonding and insurance. They have more than one caregiver for extra shift work, or try ensure the right personality fit for your parents.

Saving a few bucks at the risk of so much does not seem worth it. As professional GCMs, we only recommend that families hire licensed agencies to hire caregivers for their elders.

Good Luck!

-Lisa

Q: The doctor gave my dad a diagnosis of dementia. How can I tell if it is Alzheimer’s or not?

Denise S.; Decatur, GA

A: Well, allow me to clarify that dementia is a syndrome, or cluster of symptoms, pertaining to thinking and memory loss. It is not really a diagnosis. It is sort of like having a diagnosis of a headache. The questions for me, is always, WHY? Why is there memory loss? Sort of like saying “why do you have a headache?” It is a symptom of something larger.

Alzheimer’s disease is currently the number one cause of memory loss, but there are other reasons people get thinking and memory impairment. Strokes and cardiovascular problems, Parkinson’s disease, falls and brain injury are all some of the other more common causes of dementia.

It is very important to get a true diagnosis so you can uncover the underlying reason for the memory loss. If it is Parkinson’s or Cardiovascular in nature, there may be additional treatments that would be needed in addition to any memory medications.

With all due respect to the doctors out there, getting a diagnosis for cognitive impairment should be done by a specialist – like a Neurologist or Geriatric Psychiatrist. A Neurologist is an excellent resource for thinking, memory and movement changes. A Geriatric Psychiatrist would be a great choice if you notice behavioral or mood changes. Do your research to find the right physician to meet your dad’s particular need.

Good Luck!                                                                                                                                                                              -Lisa

In the short time he has been under the care of Senior Care Options, there has been a marked turnaround in his health and attitude.  He is also getting the meds I have ordered, as I have ordered them.

The complete driving evaluation is performed to test: vision, reaction time, problem solving and behind the wheel skills. Many hospitals and rehab clinics offer this service, and Medicare may pay for a portion of the assessment.

Be very sensitive, this is a loss of independence, and it will be hard to hear. However, for the safety of the older person and that of other drivers, it is vital to address this issue.

For more information or to discuss When to Stop Driving, call a Geriatric Care Manager in your area.

First it is important to know what the needs of your senior are, and then you can narrow down how to best meet those needs. One method to determine what they require is to have a comprehensive evaluation done by a professional, either a physician or a geriatric care manager. After you know what you need, then its time to shop for the best options. Here are some guidelines to help in your selection.

To begin, the lightest amount of care is provided in an Independent Living Community for seniors, also known as a Retirement Community. You get no outside assistance, and you have complete privacy, but you must pay privately.

The next level of care is Assisted Living. In Assisted Living, you are provided with basic assistance such as prepared meals, light housekeeping, and usually linens service. If you need more “personal” care you may get it, but at an additional fee. Such things as medication management, help with Activities of Daily Living, etc. BUT they are not able to provide any direct skilled nursing, like wound care or tube feeding. For Assisted Living you either pay privately, or use LTC insurance.

Then a possible need would be Dementia Care. This is much like Assisted Living, but it is only for persons with some form of memory loss. It is usually an all-inclusive fee, because of the level of care required, so you will know up front what you will be paying for. They are also not permitted to do any “skilled” nursing care, but they are a locked, secure unit, to ensure the safety of the residents. For dementia care you pay either privately or with LTC insurance.

There are choices for those who want to remain at home as well. Home Care is also known as companion care. A non-skilled person comes to the private residence to do light housekeeping, laundry, meal preparation, bathing assistance and occasional transportation (the grocery store, hairdressers, etc.) It can become expensive for the hourly service, which is private pay, although some LTC insurance will pay.

Home Health Care sounds similar, but is very different. Home Health is skilled nursing that comes into the home to address care issues that others are not able to provide. It is very costly, and Medicare only pays when the senior is “home bound.” So it is usually private pay or by LTC insurance.

So, that leaves Nursing Home care. Nursing homes have been given the dubious honor of being the last resort for many. But they are able to provide the level of care that families at home are just not able give. It is skilled nursing, plus all of the Activities of Daily Living. It can be paid for through private pay, LTC insurance, or Medicaid. Medicaid can by tough to come by, as many Nursing Homes limit the “number of Medicaid beds”, you must qualify and there can be long waiting lists, but it can be done.

So as you can see, there are truly many choices in the type of care available, and making the appropriate selection can save you time, money and heartache. If you are unsure of the right choice, seek professional help, and they will assist you in finding the most beneficial options for your loved one.