I'm Katie Eller, MSW, LSW, ASW-G.  I am the Training Manager for My Health Care Manager.  I have my masters in social work and specialize in gerontology.  Throughout my career, I have worked exclusively in the gerontology field and with aging adults. 

I have a passion for working with persons affected by Alzheimer’s Disease and dementia.  Prior to my position here, I worked for 5 years as the Social Service Director for a long-term care company.  I also taught a social work and aging class to social work students at Indiana University.  My blog focuses on families and caregivers, and the joys and challenges of caregiving for an older adult.

Usually I blog about information for caregivers which are often adults.  But what about the children and teenagers who are also in the family and trying to understand grandma or grandpa's health condition?  Dementia and Alzheimer's Disease are often hard for children and teenagers to understand how the disease affects their loved one.  They don't understand why grandma doesn't know them, or why grandpa thinks they are their child, or why grandma gets angry all the time.  The Alzheimer's Association can be a great resource for information and tips on how to talk to your children and teens about this disease.  There are many children's books available that explain dementia in a way that they can understand them.  Check your local book store for more information.  For teenagers, there is a respite camp called Building Bridges.  This camp provides respite as well as educational support.  2008 was the first year for this camp and it was a great success!  The Alzheimer's Association has endorsed this camp as well.  For more information about the camp, recommended books, and additional resources, check out Building Bridges.

"Caring for an older adult can be rewarding and fulfilling but can also place great physical, emotional and financial demands on those who take care of them. In fact, a recent issue of the Journal of Immunology compared Alzheimer’s caregivers to non-caregivers, finding that caregivers aged between four and eight years faster than non-caregivers. In light of these statistics, and in recognition of November as both National Alzheimer's Disease Awareness Month and National Family Caregivers Month, the American Occupational Therapy Association (AOTA) is offering tips for caring for the adult caregiver.

Research recently published in the American Journal of Geriatric Psychiatry tested an occupational therapy home intervention, the Tailored Activity Program (TAP), that systematically evaluates and tailors activities to individual capabilities and trains families in setting up and using activities in daily care. TAP reduced behaviors that trigger nursing home placement and the amount of time families spent supervising and providing care.

“Our research shows that occupational therapists play a critical role in the care of individuals with dementia and their family caregivers,” said Laura N. Gitlin, Ph.D., director of the Jefferson Center for Applied Research on Aging and Health and professor in the Department of Occupational Therapy at Thomas Jefferson University. “Occupational therapy practitioners are uniquely qualified to evaluate individual capabilities, engage individuals with dementia in activities, help families learn specific communication, task and environmental simplification strategies and to take care of themselves.”

Laurel Cargill Radley, MS, OTR, associate director of professional affairs at AOTA, adds, “Occupational therapists can help individuals and their families promote or maximize independence, safety and function.”

Occupational therapy practitioners recommend adult caregivers:

1. Join a therapy or discussion group for caregivers of older adults.
2. Share the responsibility of caring for an older adult.
3. Ask others for help.
4. Develop a schedule that distributes caregiving responsibility.
5. Consider adult daycare or home health aides to provide occasional breaks to full-time caregivers.
6. Create moments of joy throughout the day by participating in pleasurable activities.

Additional caregiver resources can be found on the Centers for Medicare&Medicaid Services’ (CMS) new Web site, http://www.medicare.gov/caregivers/.

Founded in 1917, the American Occupational Therapy Association (AOTA) represents the interests and concerns of more than 36,000 occupational therapists, assistants and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, go to http://www.aota.org/."
This article was originally published by the American Occupational Therapy Association.

November is National Family Caregivers Month!!  National Family Caregivers Month is organized by the National Family Caregivers Association (NFCA), an organization that educates, supports, empowers, and speaks up for the more than 50 million Americans who care for a loved one.  National Family Caregivers Month is a time to celebrate all caregivers!
NFCA is hosting a free family caregivers teleclass to teach family caregivers how to improve their communication with healthcare professionals and become better healthcare advocates for themselves and their loved ones.  The 2-hour teleclass is being held November 6 and 13 at 2:00pm EST.  More information on the free teleclass is available here. 
Check your local Alzheimer's Association chapter, Area Agency on Aging, and local senior community for caregiver events in your area.

It's that time of year where seniors have the opportunity to change their Medicare Prescription Drug Plan.  Open enrollment begins November 15 and ends December 31.  Seniors are encouraged to enroll or switch programs as early as possible to avoid any problems with prescription drug coverage starting in January.
Medicare Prescription Drug Coverage (or often referred to as Medicare Part D) covers prescription drugs and may help lower a person's prescription drug costs and helps protect against future higher costs.
So how does a senior know which is the best prescription drug plan for them?  A plan that has low premiums for the most coverage is ideal.  There are several ways a person can evaluate their current plan or search for alternative plans.  One way is on the internet at www.medicare.gov.  This website allows individuals the opportunity do a personalized search, which allows the person to enter in their personal information and their prescriptions; or by doing a general plan search, which allows people to search and review plans.  Navigating this website can sometimes be tedious and overwhelming, especially if multiple plans show up as alternatives...how do you choose?  The positive is that the website will list the plans in graph format in the order of most coverage to least coverage, just watch for premium costs.  Another way to evaluate your current plan or search for an alternative plan is to have your local pharmacist run your prescriptions in the Medicare system for you.  Another suggestion is to consult a professional care manager or medical social worker for guidance.  I do not suggest calling Medicare directly....I don't think I've ever talked to a human being on that phone line and callers are usually on hold for long periods of time.

My grandma is a 2 time breast cancer survivor, and I was informed yesterday by an old friend that his wife was battling her 3rd round of breast cancer.  Another friend of mine has a 28 year old friend with breast cancer.  Christina Applegate, a 36 year old actress, was recently diagnosed with breast cancer and chose to have a double mastectomy as her form of treatment.  I'm sure everyone can think of at least one person they know who has had breast cancer.
October is National Breast Cancer Awareness month.  For more information, education, preventative practices, and resources check out the national breast cancer awareness website or the Susan G. Komen foundation. 

It's that time of year to participate in the fight against Alzheimer's Disease.  The Alzheimer's Association Memory Walk is the nation's largest event to raise funding for research and raise awareness for Alzheimer's care and support.  Over 600 communities across the nation organize these walks. 
Alzheimer's Disease is the 6th leading cause of death in the U.S.  There is no current cure for Alzheimer's but researchers are hopeful and continue to make great strides in treatment options and working towards finding a cure.
I encourage everyone to participate in your local Memory Walk.  For more information, check out the national Memory Walk website to register for a walk or to donate.

More and more aging adults are moving in with their children or other family members, according to the U.S. Census Bureau.  Between 2000-2007, the percentage of parents moving in with their children rose 67% or 3.6 million.  There are many reasons why this might be occuring:
1.  Higher housing costs and the nation's current economic status
2.  Families are closer now than in the past
3.  Intergenerational households are increasing each year

The number of parents under the age of 65 that moved in with family grew 75%.  I recently read an article that stated 60 is the new 40.  Becoming a grandparent at a younger age is growing.  Some parents are moving in with their children to help raise and care for the grandchildren.  This concept gives the grandparent a "job" and responsibility while contributing to the family and takes away the cost of daycare.  Combining family resources is helping families and their expenses while also providing assistance, a stronger family bond, and preserving memories.

So pull out the sofa bed, clean out the guest room, or build on a small apartment cause mom may be moving in!  ECHO Housing is becoming more popular, Elder Cottage Housing Opportunity, sometimes coined "granny flats" or "mother-in-law suites".  This refers to a housing opportunity for seniors to share a separate living space on the same property or attached to a family member's home.  This concept brings parents closer to their families while also maintaining a sense of independence.  Zoning regulations do apply, so check with your local county or city zoning board.  For more information, check out ECHO Housing.

According to a recent study, more than 1/2 of those providing care to an aging adult experience some form of stress and strain.  This amount of stress can negatively affect your physical health, your emotional health and well-being, and your ability to provide care.  Taking care of yourself, taking breaks when needed, and utilizing the help of others is very important!  Some caregivers have been taking care of "mom" for years and oftentimes other family members forget how hard the caregiver is working, because it just becomes second-nature that you take care of mom.  I would like to take the time to say THANK YOU and shower all caregivers with applause and praise for their tremendous hardwork for being a caregiver of another person while still maintaining their own lives, jobs, children, etc. 

I love greeting cards, and I tend to spend quite a bit of time finding that right card for that right person.  A friend recently found a Caregiver Support greeting card, made by Carlton Cards...but only 1 card in a store full of every other kind of greeting cards, doesn't seem quite right.  However, the card reads, "The dedication and strength it takes to care the way you do is truly amazing.  It's hard giving so much of yourself, and yet you do so generously and lovingly.  You have a beautiful, caring heart - and you're doing a truly incredible job.  Hope you know what a difference you're making.  Hope you know how wonderful you are."
THANK YOU FOR BEING A CAREGIVER!

How would you want to spend your golden years?  I have lots of different ideas...I'd like to travel more, spend time with family and friends, be healthy, enjoy life!  I love visiting and learning from my grandmothers (and my grandfather).  It's interesting to ask them questions about their life as children, young adults, how they met my grandfathers, jobs they worked, etc.  My one grandmother has a great sense of humor and is always on the go.  She works one day a week, spends lots of times with friends and family, travels, and likes to learn new things.  My other grandmother is just a "sweet old lady" that grew up on farm, who has a green thumb, loves animals, and is a bird watcher.  Both are relatively healthy and live independently.  Some people fear getting older, but today's world offers many services and perks to seniors, such as, travel deals, wellness programs, lavish retirement communities, etc.  The seniors that have a zest for life in their golden years are an inspiration and should be applauded!

If your loved one lives in an assisted living facility or a nursing home, it is important for caregivers to know their rights as family members - and the rights of their loved one living there.  The federal government has many rules and regulations that these facilities must follow.  Each state then has additional rules and regulations that these facilities must follow.  This information is made public through the state department of health.  These facilities are also required to provide the residents/families a copy of the Resident Rights document, which is a list of your rights and can also be accessed through the state department of health. 

The social worker at the assisted living facility or nursing home is the liaison between the facility and the residents/families.  They are also to be an advocate for resident rights.  It is important for family members to educate themselves on the rules and regulations of these facilities.  If you feel the facility personnel is not working with you properly, outside assistance can be helpful.  Each community has an ombudsman, who is an advocate for people living in the residential facility.  They are employed by the state and usually work out of the Area Agency on Aging office.  To find your local ombudsman, contact your local Area Agency on Aging. 

A professional health care manager is also a good resource to utilize as an advocate and 3rd party when working with a residential facility.  Education and advocacy is a powerful asset for family members and seniors.

There are multiple products and tools on the market today to assist in dementia care and to help provide a sense of independence for the person with dementia.  Those products range from memory games to household items, like door knobs and safety devices.  But which products really work?  Mark Warner, a gerontologist, and his wife did a webcast on August 13th discussing the pros and cons of these products and how to find them.  To listen to the webcast, click on the link HealthTalk.

More than 50 million people provide care to a chronically ill, disabled, or aged family member or friend.  While caring for our loved ones is an important job, we often forget to take care of ourselves.  Statistics show that caregivers have a high risk for stress (physical and mental tension), heart problems/heart attack, sleep problems, and depression.  Caregivers also have a higher mortality rate than non-caregivers.  So, what can we do?  Take a break for a few hours or a few days...relax, have fun, take time for yourself and other family members, etc.
There are several community resources available that provide respite care.  Respite care is temporary relief or a temporary break from caregiving.  The local Area Agency on Aging offers home companions and volunteers who can come to your home to sit with your loved one while you run errands, go to lunch, take a break, etc.  To find your local area agency on aging, click on the link provided.  Adult day programs are offered in most communities and provide group programs for seniors during the day.  The provide social activities, meals/snacks, recreational outings, and assistance with care.  Most adult day programs allow you to drop your loved one off for a couple of hours up to a whole day.  Most are open Monday-Friday and are very helpful to those caregivers who work during the day.  To find an adult day program, click on the link provided.  If you would like to take a couple days off for a vacation or just a much needed break from caregiving, some nursing homes and assisted living facilities offer respite care.  This is a great option where your loved one could stay in there temporarily while receiving 24/7 medical and social care.  Most nursing homes and assisted living facilities offer respite care for up to 30 days.  Some communities also offer respite care homes or units, which allow up to 10 people to stay on a short-term basis.  Check your local nursing home, assisted living facility, Area Agency on Aging, or Alzheimer's Association for respite care information and resources.

This week, one of our fellow Health Care Managers, Jeannie Keenan, was interviewed and featured on the New York Times' New Old Age blog in a post titled "How to Make a Better Sandwich."  The article focuses on the "sandwich generation"- adults today caring for aging parents while also juggling work and their own families.

To read the article, click How to Make a Better Sandwich.

Jacqueline Marcell (author and former professor) recently posted on the web the top 10 eldercare recommendations.

1. Consider buying long-term care insurance.  Long-term care insurance can help cover home care services, visiting nurses, community programs like adult day services, and nursing home and assisted living expenses.
2. Consult an elder law attorney.  Elder law attorneys specialize in the needs of older adults and can provide guidance in estate planning, advance directives, and guardianship and conservatorship.
3. Utilize available resources, like the Alzheimer's Association or the Area Agency on Aging.
4. Review medications with your physicians.  Physicians should know all the prescriptions, OTC, supplements, and vitamins a senior is taking.  They can review the meds and determine if it is an appropriate and effective combination.
5. Consult a physician or other professional regarding mental health.  Some seniors experience depression, anxiety or behavioral issues with dementia.  A physician or professional can provide effective tips and interventions for caregivers.
6. If your loved one has dementia, learn how to effectively communicate with them (see some of my past blogs).
7. Validate feelings.  Validating and acknowledging how a senior feels about their health and overall situation instills a sense of comfort.
8. Utilize respite care services.  Adult day services and other community programs are a great way to provide social interaction for seniors while offering a break to caregivers.
9. Learn about your loved one's health conditions.  Educating oneself prepares caregivers for being effective advocates.
10. Take care of yourself!  (see some of my past blogs for information on how caregivers can take care of themselves).
    
    For more information, see healthcentral.com.

Do you know of any communities that are not designated as a 55 and older community but it just seems they have naturally turned into that?  Those neighborhoods are becoming more and more common and are referred to as Naturally Occurring Retirement Communities or NORCs.  A NORC is community, neighborhood, apartment building, or street where the residents remain for years and “age in place”, allowing a naturally occurring retirement community to develop.  To “age in place” means to grow older in one location without having to move.  NORCs offer familiarity, feelings of independence, feelings of safety, and a comfortable environment  NORCs also tend to foster social gatherings, neighbors helping neighbors, neighborhood crime watches, and more accessible public transportation (as more and more people in the neighborhood utilize the transportation service, it will naturally develop a routine route in the neighborhood).

AARP reports that more than 80% of seniors wish to remain in their own home for the rest of their lives.  To age in place successfully, requires advanced planning regarding the senior's overall health care and well-being, home environment and safety planning, and preparation for aging-related changes.  A professional geriatric care manager can assist you in planning for aging in place.  For more information regarding aging in place, check out http://www.seniorresource.com.

As you may have heard, actress Estelle Getty passed away earlier this week at the age of 84 from advanced Lewy Body Dementia.  Estelle was most widely known for her role as "Sophia" on the TV show The Golden Girls.  I remember watching that show when I was younger and even to this day, I continue to watch re-runs on TV....they still crack me up!  Sophia was the quick-witted, humorous 80-something golden girl.  She and 3 other ladies all lived together in a house in Miami.  I feel the show really did justice to the older adult population.  They showed independent women who were active in the community, had jobs, had a love life, and leaned on each other for support.  There are still stigmas today about older people like "they're bad drivers", "they're grouchy all the time", and "they don't have sex".  And, with a society trying so hard to not age, overcoming those stigmas becomes challenging.  However, I do feel that those stigmas are diminishing.  Even though The Golden Girls was filmed in the late 80s and 90s, what those ladies portrayed then is still real today.  The Baby Boomers today are active both physically and socially and are independent people who plan for the future.  As the years go on, the aging population will continue to grow and currently the number of people entering the workforce to work in geriatrics is not increasing.  I have always told my social work students to spend extra time with your grandparents and with their friends, or volunteer at an assisted living facility or nursing home.  Get to know these people- they have had very interesting lives and still enjoy life and activities that make them happy.  Some of my past patients and clients have made me a better person.  I will always work with this population, they are my passion.  As a nation, they are our future. 
Estelle was once asked in an interview what was the one thing that makes a person age well.  She simply stated humor...you have to have humor.

As a follow up to my blog about safety issues with seniors, I found another important handout on Alzheimer's Disease and wandering.  It provides good information, tips, and resources.  Please check out In Search of the Alzheimer's Wanderer by Mark Warner.  Mark is also in charge of the Alzheimer's Daily News, a publication of the Ageless Design Research Foundation.  He sends daily emails regarding news and information about Alzheimer's Disease.  To subscribe to this free publication, check out his website at www.alznews.org.

Summertime is always great to be outdoors, but with the high temperatures, the risks of heat exhaustion and heat stroke are high.  Heat exhaution is caused by exposure to high temperatures and inadequate replacement of fluids.  Those most at risk for heat exhaustion are seniors, people with high blood pressure, and people who work outdoors the majority of the day.  Warning signs include:  heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea/vomiting, and fainting.  The person's skin may be cool and wet, pulse may be fast and weak, and breathing may become fast and shallow.  If the person is not treated, it may progress to a heat stroke.  To help prevent heat exhaustion, have readily available cool, non-alcoholic beverages, stop and rest every 1-2 hours when outside, wear lightweight clothing, take a break in an air-conditioned area, take a cool shower/bath after being outdoors for a long period of time.  For more information, check out WebMD.com.

An Alzheimer's patient once came to me after he had got out of his house and was found hours later in a ditch approximately 2 miles from his house.  Wandering is often a scary symptom of Alzheimer's disease and dementia.  It's confusing and scary for a senior who does not know where he/she is or where they are going; and is scary and worrisome for family caregivers.  Wandering can occur anytime but tends to increase in the late afternoon/early evening hours.  There are several things caregivers can do to keep their loved ones safe at home. 

Tip #1:  Use deadbolts on doors leading outside, place them high or low on doors
Tip #2:  Take locks off of bathroom and bedroom doors to avoid your loved one from locking themselves in
Tip #3:  As the sun starts to go down, close the blinds/curtains and turn lights on
Tip #4:  Install appliances that shut off automatically
Tip #5:  Keep toxins i.e. cleaners, bleach, poisons; and prescription medications in a safe, secure space
Tip #6:  Remove clutter from around the house
Tip #7:  Install a door alarm or place a motion sensor in your loved one's room at night to alert you when they are awake and moving
Tip #8:  Label doors, drawers, and cabinets; this is most helpful in the earlier stages

A professional geriatric care manager can help you in reviewing your home and finding assistance for home modifications.  For more tips and information, check out The Complete Guide to Alzheimer's-Proofing Your Home and home modification tips.

This article "50 Communication Tips and Techniques for Caregivers" was recently sent to me.  This article lists good tips and techniques for communicating with someone who experiences memory loss.  These tips and techniques include information on communicating and speaking someone who has memory loss, attention techniques, nonverbal communication tips, behavior tips and techniques, and working/communicating with others who might be involved with the senior.