Choices ~ Healing ~ Love
August 1, 2003 VOLUME 4 ISSUE #11
Publisher & Editor: GAIL R. MITCHELL- Grm4Love

The summer has been incredibly hot and humid with many seniors being forced to remain homebound. I found this particularly difficult for my mother as she had spent quite a good part of the unusual winter we experienced inside as well. She is normally a very outgoing, people minded person.

The past few weeks, close friends of mind along with myself and caregivers at the boards are struggling with our parents decisions to minimalize their daily lives...the old phrase "KISS" or "Keep It Simple Silly" comes to mind. As I paid an unexpected visit to my mother today, I found myself beginning to speak on terms as I never had spoken with her before.

As I reflect back on our dialog, I remember saying that aging has taken on a whole new meaning for her generation and for mine as well. It is no longer what it was once thought of being. I spoke about being a "latch key kid". Both my parents worked two and three jobs while we were young and growing so that they could give us the so called, "American Dream". All those materials possessions and opportunities that were lost for them. I thought out loud how she and my father had to place their mother's in nursing homes at the end of their lives because they worked full time and were unable to leave their jobs to care for them.

As we sat in the park there were many other frail elderly people escorted around by companions. Some were with canes, some on walkers and some in wheelchairs. This is a huge apartment complex composed of thousands of seniors right here in the middle of Manhattan. Each person hoping to remain as independent as they could. Many were just surviving. At times I believe my mother is only surviving. And yet, I think to myself, what for? The days when she and my father would traipse throughout the city, walking everywhere were long gone. The days of my dad driving them to the mountains for weekend retreats of fresh air were long gone. And the days of my mom wanting to go to the theater, a great movie and a wonderful lecture were all gone.

Last night, my friend Monica in Mexico shared with me how upset she was with her mother because her mother consciously decides not to take her medications. Something I can relate to constantly with my own mother. Monica is saddened because her mother never did more with her life. She never had a purpose to live. She never volunteered. She was always self-absorbed in her pain and what she felt she was missing out on. Jeanette is upset because her mother is suffering with COPD and CHF and her mom wants to get rid of all the clothes and materials things she no longer uses or needs. This is such an incredibly bittersweet, melancholy time for caregivers who want to give their parents things they never experienced before and they have no desire to be apart of it. They are busy surviving.

And I think of those vibrant seniors who are going back to school in the late 80's. Still dancing. Still singing... still embracing life in a whole different way.

I shared my viewpoints with my mother on the losses she has experienced. The losses I have experienced... Was my life a success or a failure? She had difficulty in expressing what this new aging process was like for her. She knew that she was happy to still be living on her own and independent in her own home. She was happy to not need someone caring for her 24/7 as she had on several occasions. She was finding new ways of finding love, joy and peace from within herself. She was content having her local friends to dine and sit in the park with. Her day was full with just doing everything necessary to maintain her independency. There weren’t enough hours in the day for her to accomplish all she needed to.

And I thought to myself about my own aches and pains. How I wouldn’t do some of the things I dared to do in my twenties. So what is it all about? Having more compassion and understanding. Are the frustrations Monica, Jeanette, I myself and so many other caregivers because we are slowly not taking the risks to live our own lives more fully? Are we sad and upset with our parents because we are not doing more for ourselves? I reminded Monica that it was so easy as caregivers to help others but were we truly helping ourselves to remain balanced, whole and healthy. At times we’d like to think that we were, but in truth, we weren’t totally, so much of the frustrations that we get caught up in with our parents are issues we may need to look within to resolve.

I asked my mother if she would like to go out for dinner. She lit up and said, “Yes, to Artepasta!” You always go there without me when I am in the ER room at the hospital and I want to go there for dinner with you! Later as we taxied to the restaurant, my mom took my hand and lovingly said to me, “Thank you for speaking with me on aging. It made me feel real good….” It was truly a tender moment for both of us.

May your journey be gentle and beautiful!
In Love & Light,
Gail
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UPDATES AT THE SITE

Spotlight

Jack Lewis

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Empowering Caregivers Chats Discontinued Until Sept 15th

We have discountinued our chats until September 15th. At this time we will resume with the same schedule. We may also have some new additions. Many of you show up in the room at unscheduled times. We encourage you to check in at the time frames indicated in EST or Eastern Standard Time so that you may find one another. We are aware that you aren't always able to attend chats at the scheduled times, so we hope that you will connect and continue to participate in the community posting messages etc. We look forward to seeing you once again in the fall.

Mary C. Fridley
Questions & Answers
August 2003
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Alan Cohen
Your Primary Responsibility
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John Felitto
From Judgement To Love
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Beth Witrogen McLeod
Caring For An Aging Parent: Did I Do Enough?
Balancing Love, Caregiving And Guilt

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Or click on this link:
Featured Guest Experts
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NEW CAREGIVING ARTICLES AT THE SITE

If you are interested in submitting an article(s) please go to: Submit. You will find a form for submitting your article, bio/profile, copyright permissions, etc. Please review our guidelines for acceptance, submit and we will notify you upon acceptance.

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In Memory
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CAREGIVERS CONCERNS

It's Hot Outside

Summer is here again and it’s time to remind you about the hazards of dehydration in your older loved ones and how to prevent it.

Dehydration is a serious problem for older adults that disrupt all body functions including digestion and elimination, temperature control, cellular function, circulation, vitamin and mineral absorption, and detoxification. It is one of the top ten reasons for hospitalization and it is estimated that half of those not treated quickly will die. Bodily water loss of just 10% results in dehydration and 20% is fatal. So what makes your loved one so vulnerable and how can you prevent it?

Normal aging changes contribute to increased risk. As we age, we basically dry up and dry out. Total body water content decreases (especially on the cellular level) due in part to the loss of muscle mass, which holds more water than fat mass. Changes in kidney function contribute to an inability to conserve water and a decreased sensitivity to thirst contributes to not drinking enough. Chronic disease processes add to the risk because of decreased cognitive awareness, limited movement or immobility, isolation, and depression. Medication side effects also increase the risk as well as environmental stresses. People bothered by incontinence or urinary urgency may avoid fluids in an attempt to decrease symptoms.

Dehydration can come on fast and become a medical emergency. Signs and symptoms include fatigue, increased confusion and disorientation, dry mouth and tongue, sunken eyes, sudden weight loss, rapid heartbeat, dizziness, and difficulty speaking. Orthostatic hypotension, or blood pressure that drops when moving from a lying down position to sitting then standing, also occurs contributing to falls. Some of these symptoms may be hard to identify if your loved one has dementia or is taking several medications that cause related side effects.

Prevention is the working word here and there are several proactive measures you can take. Always be mindful of how much your loved one is drinking. Consult with his or her physician about how much should be consumed in a day. A common formula used in institutions to calculate fluid need is 30cc/kg of body weight. But each individual is different and chronic disease will change the need, so please consult with a physician. Offer clear fluids frequently with water accounting for at least half the fluid intake each day. If your loved one will not drink plain water, offer other clear fluids such as cranberry juice, lemonade, decaffeinated iced tea, and apple juice (check first to see that he or she has no dietary restrictions).

I also suggest mixing half water and half-clear liquid. Put it in a sport bottle and encourage your loved one to sip on it frequently. If a loved one has dementia, offer fluids every two hours. Keep in mind that a fluid is any food that melts at room temperature, so ice cream, Jell-O, and sherbet fall into this category. Juicy fruits such as watermelon, oranges, and grapes are also good choices. A word of caution about caffeinated beverages, though, and some diet drinks: they act as diuretics increasing the risk for dehydration.

If a trip out is planned, listen for air quality reports because poor air quality will exacerbate breathing problems. Also try to avoid outdoor activities on those hot and humid days and hot and dry ones as well. If your love one must go out keep it short, moving quickly from one air-conditioned environment to another. The ability to sweat is diminished with age and compromises the body's ability to cool efficiently. Heat exhaustion or hyperthermia can occur rapidly and is a medical emergency. Signs to watch for include fatigue, dizziness, nausea and vomiting, and confusion. If you suspect heat exhaustion, get your loved one to a cool environment immediately, offer fluids, and call for an ambulance.

For the loved one with mobility problems who is afraid to drink too much, be sure there is easy access to a bathroom or a commode and offer assistance every two hours. A loved one with dementia should be reminded every two hours and assisted if needed. Provide comfortable clothing that is easy to remove avoiding zippers and buttons that can be difficult to manage.

Keep in mind that summer heat puts you at risk, too. Do yard work and outdoor exercise in the morning and add the tips above to your personal health consciousness.

Have a blessed and relaxing summer.

Copyrighted Mary C. Fridley RN, C

Mary C. Fridley RN, C is our featured Question & Answer columnist at Empowering Caregivers as well as a contributing editor. She is a Registered Nurse board certified in gerontology with more than twenty years of experience in the geriatric health field. She is a writer of advice columns and articles for caregivers as well as a public speaker. Write to Mary at: info@gero-resources.com and visit her site at: Gero-Resources.com

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IMPORTANT NEWS

New Guide Helps Families Get Quality Palliative Care
For Relatives and Friends

The 16-page booklet, entitled “Palliative Care: Complete Care Everyone Deserves,” provides an easy-to-understand definition of palliative care, descriptions of who can benefit from palliative care, the elements of good palliative care, advice on how to obtain such care, and a list of related resources. A special section also addresses ways that families can work with long term care facilities such as nursing homes to ensure their loved ones receive any necessary palliative care.

To request a copy of this free booklet, e-mail info@caregiving.org. The booklet is also available for free download on NAC’s Web site at www.caregiving.org/care.pdf, and FRIA’s Web site at www.fria.org.

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New York State Receives Federal Approval To Extend Medicaid Benefits to Working People With Disabilities

HHS Secretary Tommy Thompson on June 26 announced that the agency has approved New York's plan to extend Medicaid benefits to uninsured working people with disabilities. Medicaid benefits will be offered to working people with disabilities who are between 16 and 64 years old, have incomes 250% or less of the federal poverty level and have up to $10,000 in assets. State officials expect more than 20,000 people will enroll in the new program in the next five years. This type of Medicaid expansion was approved under the Ticket to Work and Work Incentives Improvement Act of 1999, which encouraged people with disabilities to work and allowed them to retain their Medicare, Medicaid and other health benefits. Currently, 27 states have extended Medicaid benefits to 45,000 people with disabilities who work : MEDICAID

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The Alzheimer's Family Relief Program (AFRP)

AFRP Application Guidelines:
The patient must be diagnosed by a practicing, certified physician as suffering from "Alzheimer's disease," "probable Alzheimer's disease," or "dementia of the Alzheimer's type." The physician's statement must have one of the above diagnoses for the patient to be eligible.

Emergency grants are provided for expenses such as short-term nursing care, home health care, respite care, adult day care, medications, medical or personal hygiene supplies, transportation, and other expenses related to care for a patient with Alzheimer's disease. Grants are not provided for payment of nursing home fees. Eligible applicants may receive grants of up to $500.

Applications are funded based on established need and on a first-come, first-served basis. First-time applicants will receive priority treatment; repeat applicants are placed on a waiting list and are considered as funding becomes available.

Liquid assets (which include cash, checking and savings accounts, money market accounts, stocks, bonds, and mutual funds) of the patient and caregive may not exceed $10,000. Liquid assets do not include the patient's car or house. However, all of the patient's assets will be taken into consideration in determining the urgency of need.

Applications must include original signature and a corroborating statement from the patient's physician, health professional or social worker before they are presented to the AFRP Review Committee for consideration for funding.

The extent to which assistance can be provided, as well as the number of patients who can be helped, is determined by the availability of funds. At times, it may be necessary to place an approved request on a waiting list until funds become available.

Candidates for grants may apply more than once and can become eligible for additional assistance 90 days after the preceding grant has been awarded. Applicants are encouraged, however, to explore alternative sources for additional help. For more information please contact Jarmel Wilson, LSWA, AFRP Manager, at jwilson@ahaf.org or call 1-800-437-AHAF (2423).

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People Without Drug Coverage, Including Seniors, Pay 72% More Than Federal Government for Medicines

Uninsured U.S. residents, a group that includes millions of seniors without prescription drug coverage, pay an average of 72% more than the federal government for prescription drugs, according to a survey released July 15 by the U.S. Public Interest Research Group, the Washington Post reports. In the survey, U.S. PIRG interviewed more than 500 pharmacies in 18 states and the District of Columbia to determine the amount that uninsured residents paid for the 10 most commonly prescribed medications compared to the Department of Veterans Affairs, the Department of Defense, the U.S. Coast Guard and the Public Health Service (Ishida, Washington Post, 7/16). The survey found that uninsured residents of Washington, D.C., and Northern Virginia on average paid 80% more for medications than the federal government. In addition, the survey found that of the large metropolitan areas examined, Baltimore, Washington, D.C., Philadelphia and Boston were the most expensive cities in which to purchase prescription drugs. U.S. PIRG Consumer Program Director Ed Mierzwinski said, "HMOs and the federal government use their buying power to negotiate fairer prices for the drugs they purchase. Unfortunately, uninsured consumers have no one doing the same on their behalf so drug companies are making money hand over fist from chronically ill Americans without prescription drug coverage." Click on this link to read more: Study

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Breast Cancer Protection Law. Your Help is Needed!!!

There's a bill called the Breast Cancer Patient Protection Act which will require insurance companies to cover a minimum 48-hour hospital stay for patients undergoing a mastectomy.

It's about eliminating the "drive-through mastectomy" where women are forced to go home hours after surgery against the wishes of their doctor, still groggy from anesthesia and sometimes with drainage tubes still attached.

Lifetime Television has put this bill on their web page with a petition drive to show your support. Last year over half the House signed on.

PLEASE!!!! Sign the petition by clicking on the web site below and help women with breast cancer get the care they need and deserve!! There is no cost or monetary pledge involved. You need not give more than your name and zip code number.
http://www.lifetimetv.com/reallife/bc/pledges/bc_mast_pledge.html

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INFORMATIVE CAREGIVING ARTICLES & INSPIRATION

Quotes

When the people fear the government you have tyranny...when the government fears the people you have liberty.

Thomas Jefferson

They've boiled the Bill of Rights down to just one: "YOU HAVE THE RIGHT TO REMAIN SILENT!"

Swami Beyondananda

The things that will destroy us are:
politics without principle;
pleasure without conscience;
wealth without work;
knowledge without character;
business without morality;
science without humanity,
and worship without sacrifice.

Mahatma Gandhi

I used to believe that we must choose between science and reason on one hand, and spirituality on the other, in how we lead our lives. Now I consider this a false choice. We can recover the sense of sacredness, not just in science, but in perhaps every area of life.

Larry Dossey, M.D.

What a man thinks of himself, that is what determines, or rather indicates, his fate.

Henry David Thoreau

Each man had only one genuine vocation -- to find the way to himself... His task was to discover his own destiny -- not an arbitrary one -- and live it out wholly and resolutely within himself. Everything else was only a would be existence, an attempt at evasion, a flight back to the ideals of the masses, conformity, and fear of one's own inwardness.

Hermann Hesse
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Your Primary Responsibility

A friend confided in me that he was struggling to understand his responsibility in a world obsessed with war. I told him the answer is simple: choose peace.

While you cannot control the attitudes or actions of politicians or others, you have total control over the thoughts, feelings, and energy you are exuding. If you are steeped in fear, anger, a sense of victimization, or separateness, you are contributing to the darkness. If you hold a sense of peace, wholeness, compassion, kindness, and the presence of love, you are contributing to healing. As Kipling nobly penned, "If you can hold your head when all about you are losing theirs. . '

Mother Teresa was once asked to speak at an anti-war rally, and she refused. "If it were a pro-peace rally, I would attend," she explained. "But fighting against war, like fighting against anything, is just another form of war."

Ram Dass recounted that on his altar he has pictures of Christ, Buddha, and many other spiritual masters. He has recently added a photo of George W. Bush. Why? As Ram Dass explains, "Until I can find the same divinity in George W. Bush as I find in other holy beings, I am stuck. When I can see and honor his soul, then I am in a position to protest. Until then, I am ineffective."

The power of prayer and intention goes a long, long way. At any given moment the world situation is a precise expression of the consciousness of all the people who live here. As you shift your consciousness in the direction of peace, wholeness, and faith, you tip the balance in that direction. You literally become the tipping point for the world you would like to create.

Be less concerned with what you are doing and more concerned with how you are doing it. Actions that spring from fear or hatred, no matter how nobly clothed, create only more of the same. Actions that issue from faith and love, no matter how humbly clothed, create only more of the same.

A visionary thrives under all circumstances, for he or she sees beyond the obvious. At this time the world needs good visionaries. If you would save the world, begin with your own consciousness.

Copyrighted by Alan Cohen, M.A.

Alan Cohen, M.A., is the author of 20 popular inspirational books and tapes, including the best-selling The Dragon Doesn't Live Here Anymore . Alan's newest release "Why Your Life Sucks" can be purchased from his web site and most books stores. To request a free catalog of Alan's books, tapes, seminars, phone 1 800 568-3079, www.AlanCohen.com email admin@alancohen.com, or write P.O. Box 835, Haiku, HI 96708.

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MESSAGE BOARDS & EMAIL BAG

Hi y'all, I am 55 & am taking care of my 85 year old Mom who has Kidney cancer, wet, end stage macular degeneration (blind), diabetes, (type 2 insulin dependent), & COPD....I need a place to know that there are other people going through what I am, and their thoughts and ways of dealing with the agony a loved one goes through on the way to their final peace. It would feel so good to have a place just to talk about what I feel too, anger, frustration, sadness and coping... I have hopes of meeting new friends in here. Puppluv

My name is Stephanie, I am 48. My father is 83, my mother is 82. My father has progressive Parkinson's, and my mother has a deteriorating disc in her back. I have moved back to the USA from Norway,with my two small children and husband to help care for my parents. My brother, near and dear, has been diagnosed with diabetis, and is going blind, his wife has M.S. I have now become a central support giver for everyone. I am overwhelmed, dealing with all the sickness, sadness, and financial implications. I need to be strong, and read, and get support, but at this moment, right now, sitting here, I am just at the wall. I read everyone out there's intro and situations. It makes me feel less alone. My father fell twice this week, so I am now staying with them and driving back and forth from my own family, my parents, and my brothers. My dad tends to diagnose himself, and now have overdosed twice on l-dopa, so we had to take his meds away. He is angry at the world. I love him , my mom, my family, and my brother. I just hope I have enough love for them all. Stephanie

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JOKES & HUMOR

Flasher

A little old lady was running up and down the halls in a nursing home. As she walked, she would flip up the hem of her nightgown and say, "Supersex."

She walked up to an elderly man in a wheelchair. Flipping her gown at him, she said, "Supersex."

He sat silently for a moment or two and finally answered, "I'll take the soup."

The Surgery

An older gentleman was on the operating table awaiting surgery and he insisted that his son, a renowned surgeon, perform the operation. As he was about to get the anesthesia he asked to speak to his son. "Yes, Dad, what is it?"

"Don't be nervous, son; do your best and just remember, if it doesn't go well, if something happens to me ... your mother is going to come and live with you and your wife...."

Thoughts

Gardening Rule: When weeding, the best way to make sure you are removing a weed and not a valuable plant is to pull on it. If it comes out of the ground easily, it is a valuable plant.

If quitters never win, and winners never quit, then who is the fool who said, "Quit while you're ahead?"

Whenever I feel blue, I start breathing again.

Why does a slight tax increase cost you two hundred dollars and a substantial tax cut saves you thirty cents?

In the 60's, people took acid to make the world weird. Now the world is weird and people take Prozac to make it normal.

How is it one careless match can start a forest fire, but it takes a whole box to start a campfire?

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