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Seniors Who Feel Compelled to Shop

Compulsive shoppingSome seniors have had compulsive shopping or shopaholic tendencies their whole lives. Just because they get older and have less discretionary income doesn’t mean that they will adjust to their new financial situation. Even seniors who weren’t big shoppers previously might spend recklessly in an attempt to relieve feelings of depression, boredom, grief and/or loneliness. Some feel they deserve to splurge, because they’ve been frugal all their lives, and they think that now they should be able to buy whatever they want.

Is It Retail Therapy?

As friends, family and abilities dwindle, retail therapy gives many people a short-lived mood boost. Online ordering, television shopping channels and mail-order catalogs make it so seniors don’t even have to leave home to over-use their credit and debit cards. Limited mobility and age-related health issues can make it harder for an older person to manage their behavior and hide the consequences. If a loved one who has previously been responsible with their money and kept their home free of clutter suddenly begins spending frivolously and accumulating purchases and other things, it may indicate a mental health issue, such as depression and/or cognitive decline.

Dementia also can play a role in excessive shopping. Your mom may actually need a new set of sheets but a memory lapse causes her to repeat the order several times. Deliveries arrive frequently, and unopened packages are strewn throughout the house. Impaired judgement and comprehension can also lead to unusual impulse purchases.

If no family members or friends are aware of a senior’s shopping habits, their financial situation can rapidly get out of control, possibly depleting their savings and acquiring significant debt. If advancing age or disease takes away some of a senior’s independence, they might try to make up for this loss in other areas. Like driving, spending can help them reclaim a sense of autonomy.

Some Businesses Exploit Seniors’ Weaknesses

Marketers know that older consumers tend to think of shopping as a pastime. They can be very persuasive in talking your loved one into buying things they don’t need or can’t use. They also know that seniors may not be as savvy when comparing prices and terms online and over the phone. They may think they are finding “deals,” even if the deal is something they don’t need.

For example, sellers of herbal supplements or “low cost” prescriptions often prey on seniors’ health and longevity concerns, advertising false promises of more energy, pain relief or even hair growth. The FDA does not regularly test what is in dietary supplements, and companies are not required to share information on the safety of a dietary supplement before they sell it.

Many seniors don’t realize that just because they see a dietary supplement in a catalog or on a store shelf doesn’t mean it is safe or that it does what the label says it will do. Remind your loved one that just because a supplement claims to do amazing things doesn’t mean it is safe or good for them. It might interact with a medicine their doctor prescribed, making it either weaker or stronger. The supplement could also be harmful for certain medical conditions. Point out that if something sounds too good to be true, it probably is.

Other things less reputable merchants might try to get the elderly to purchase include magazines, gold coins, stamps, products that are part of Ponzi or pyramid schemes, health food, small appliances, travel plans, expensive tools, useless insurance or other things they really can’t use anymore.

How Adult Children Can Help

Often, when adult children try to control their parents’ spending habits, Mom and Dad insist there is no problem. “It’s our money and we can spend it as we choose.” But if packages arrive daily at their home, it’s normal to worry, especially if bills are not being paid. If they don’t remember placing orders, your worry is even more justified.

Sometimes it’s best to bring in a third party to help handle the situation. Make an appointment with your loved one’s doctor for a cognitive assessment and an evaluation of their ability to carry out activities of daily living. If they aren’t comfortable with you coming into an appointment with them, then write a detailed note about any changes in memory, behavior, judgement and mood that you have noticed. Be sure the doctor receives it and reads it before the appointment. Dementia may not be the culprit, but the doctor can help rule out cognitive decline and screen for other possible causes, like depression.

A second opinion may be a good idea if you strongly suspect something is medically wrong with your loved one. If not, you may need to ask a friend, spiritual leader or financial advisor to talk with your loved one to help them set and follow a realistic budget. They may be more open to discussing their finances with someone outside the family whom they respect and feel comfortable talking with about personal matters. Also, they may be more likely to listen to and follow what this person recommends. 

Other Ways to Cope

Shopping can become the means used to avoid coping with feelings and dealing with problems directly. In some cases, shopping addictions can be related to a substance abuse issue. If you believe a loved one is, struggling with substance abuse and a shopping addiction, it is time to get help. Research also finds a significant correlation between compulsive shopping and depression. Often a doctor will recommend anti-anxiety or antidepressant medications that can help.

Many elderly people feel bored, restless, and want something new. With 24-hour shopping channels and online marketplaces like Amazon.com, satisfaction is only a quick call or click away. Compulsive shopping is one way people of all ages spend their money in order to feel better, but the elderly can be particularly susceptible. As a caregiver, you may be faced with taking away credit cards, or insisting that you approve any online or over-the-phone purchases. Or you might be able to come up with some other activities to keep your loved one occupied, happier and diverted from the temptations of shopping.

If you need assistance supervising the activities of your loved one, a Dakota Home Care Aide can provide companionship and suggest safe and healthy ways for them to pass the time. Your aide can be there for as little as one hour or up to 24-hours-per-day. Call (701) 663-5373 today to schedule a free consultation.

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Is It Hoarding or a Normal Attachment to “Stuff”?

How to Help Your Elderly Loved One “Clean House”

hoardingSeveral people I know have a problem with elderly loved ones who can’t bear to part with all kinds of “stuff.” When their home is no longer a safe or sanitary place to be, or it comes time to move them out of their homes, the elderly person wants to keep everything. Their children often have to make difficult and upsetting decisions for them. If they still have access to credit cards and a computer, many order a lot of stuff that they don’t need. Deliveries arrive frequently, and unopened packages littler the house. Some might call this “hoarding,” but is it? And what can be done to help your loved one keep just the necessities and a few sentimental items, while maintaining a kind and respectful relationship with them?

What is Hoarding?

True hoarding is a complex disorder that is not yet fully understood by the mental health profession. It can be compulsive shopping or just saving so many things that it leads to health and safety issues in the home. It can put a strain on the person’s and/or the caregiver’s finances. The most common items hoarded are newspapers, magazines, clothing and books. Elderly people might say they acquire and keep all that “stuff” because they believe that an item will be useful or valuable in the future. Or they feel some things are unique, hold sentimental value and are irreplaceable. When compulsive shopping is the problem, the explanation might be finding “deals,” even if the deal is something they don’t need or want.  

Signs and Symptoms of Hoarding

Hoarding is different from cluttering and collecting. Hoarders will save random items from their daily lives and store them haphazardly. Throwing away things, selling, giving away, or even recycling is very difficult for them. Their disorder interferes with life. Some symptoms and behaviors to watch for include:

  • Holding onto things with no value, such as junk mail, newspapers, old clothing or broken items
  • Keeping shades drawn, not allowing visitors or family members in, neglecting repair work
  • Unsanitary conditions or lack of functional living space
  • Obsessive shopping or “retail therapy”
  • Having an intense sentimental attachment to objects
  • Having more animals than they can properly care for
  • Being unable to distinguish between what is trash and what is not
  • Not considering the safety and health consequences of having too many things

Health Risks of Hoarding

Hoarding can pose the risk of physical injuries as well as serious health conditions, including:

  • Serious injuries from falling due to the inability to maneuver around items
  • The risk of fire from numerous flammable items, which can also make it difficult to remove an elderly person from a fire in their home
  • Lack of sanitation puts an immune-compromised elderly person at risk for health complications. For example, mold or bacteria growth or high ammonia levels from pets can cause serious health issues 

How to Help an Elderly Loved One Minimize their Stuff

If your mom or dad are still in their home, health and safety issues may need to be addressed. Tell them how much it worries you to have obstructed paths or unsanitary conditions, and how it keeps you from doing your best job as their caregiver. Even if your elderly loved one says they will clean up their home and/or reduce the amount of their stuff, the chances are good that won’t be able to do it without your insistent help. It can be difficult for an elderly person to make all kinds of decisions. When it comes to deciding which possessions acquired over a lifetime they can bear to part with, it’s even harder. You may have to resort to “temporary” solutions, such as saying you will:

  • Keep some “treasured” items in your home, in case they are needed later
  • Rent a storage unit to reassure them that their things are still available
  • Pack things in baskets or boxes to be “gone through later”
  • Keep their credit card safe and under your direction, for whenever they ask for it

Helping to clean the home may seem the obvious answer to clutter, but it won’t always be a welcome solution to your elderly loved one. They may be quick to react emotionally to someone interfering with or “stealing” their things, so it is best to enlist their cooperation before beginning. It’s not realistic to expect that a hoarder will change with a little assistance. Cleaning interventions have mixed results. Caregivers might always have to help keep a hoarder’s home clean and clutter free. Because true hoarding may be connected to emotional and mental health issues like OCD, depression, and anxiety, it may be necessary to seek professional help.

Tips for Accomplishing a Major Cleanup

  • Start slowly. Work on one room or area for no more than two hours at a time.
  • Narrow decisions to yes/no questions. Pre-sort multiples of things like clothing, kitchenware or tools before giving your loved one options of which things to keep.
  • Don’t have “maybe” piles. Handle objects only once and help your parent be decisive.
  • If you have the space to temporarily store things like holiday decorations or seasonal clothing in another location, be sure mark boxes or other containers clearly.
  • Box-up piles of possibly valuable paperwork for going through and organizing later.
  • Scale down collections. Ask for the story behind objects to help your loved one decide which things they really want to keep. Take pictures so they can keep the memory if not the object.
  • When deciding what to throw out, go by what they actually use, not by what is newest or best.
  • Cover the dining room table with objects other family members might want, and then let them choose items in a pre-determined order.
  • Recycle, donate or sell on consignment. Keep a receipt for donations to a charity that could be tax-deductible. Remember, the value of an item is what someone is willing to pay for it.
  • If an item is meant to be a gift to a specific family member, encourage giving it now.
  • Target recipients for specialty item. Examples: Schools may welcome musical instruments or costumes. Auto repair shops and community maintenance departments may take tools.
  • In some communities, setting items on the curb with a sign that says “Free! Help yourself!” will make items miraculously disappear.
  • Enlist the help of an outside agency – If the clutter is either not safe or too much for your family to handle, an outside agency may be able to help.
  • For a price, you don’t have to haul it away yourself. The local garbage company may have limits on how many large black trash bags it will take, and not all local dumps take unsorted trash, either.
    • Waste Management’s Bagster is a smaller-scale alternative to a Dumpster. Buy one of its large bags at a home-improvement retailer (about $30, depending on pickup location), fill with up to 3,300 pounds of trash, and call to schedule a pickup.
    • Services like 1-800-Got-Junk and 1-800-Junk-USA remove appliances and furniture as well as smaller items.
    • Smaller local junk dealers may haul things away for free if they see, on appraisal, items that they’ll be able to sell.

You won’t always be able to get permission from your loved one to give away or throw away excessive clutter or things there aren’t room for in a move to your home or assisted living. Presenting the “temporary” solutions mentioned above may help to keep your relationship on an even keel until the situation changes. Look for future blogs related to this topic. 

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Tips on How Caregivers Can Take Care of Themselves

to do listI have a single friend who is the sole caregiver of her 93-year-old mother. She also works full-time at a very stressful job. Fortunately, her mother can still be alone for most of the time my friend is at work. The only outside help she allows is when I and some other neighbors help her mom with her lunch or take her out for a short walk with her walker. Her sister takes their mom to get her hair done once a week and to routine Dr. visits. My friend uses PTO to take her mom to more important appointments. Just twice this year she asked her sister to help their mom with her dinner and to get ready for bed so that she could have an evening out. Although others have offered to give my friend more help with her mom, she says that no one else knows how to meet her every need. She usually gets less than 6 hours of sleep a night. I’m convinced that my friend is at serious risk of losing her own health, and that she may do so while her mom is still in need of her constant help.

Take a Look at Yourself

As the caregiver of a loved one, do you see anything like your own situation in my friend’s story? Are you experiencing health problems? Do you recognize them as being related to the constant stress, lack of sleep, manual labor, financial worries and lack of personal time caused by having to–or thinking you have to–do almost everything yourself to meet your loved one’s needs? Are you convinced that there are no caregiver alternatives that will help you take care of yourself, while at the same time providing your loved one with the help they need to stay at home?

Although my own situation isn’t as demanding as my friend’s yet, my husband has early-stage Alzheimer’s and is about to turn 80. The list of my responsibilities for his care, for keeping up our home, for managing our finances and for making most of the decisions related to our future, even our daily activities, is growing. Although I am 5 years younger and still in good health, I know I must take care of myself and my needs, so I will be able to take care of his needs in the future and, if possible, outlive him! Easier said than done, right!

Consider General Tips

Dakota Home Care has published two blogs with general tips for Relieving Caregiver Stress and for Avoiding Caregiver Burnout. Every caregiver’s situation is different, but why not check out these tips and note the ones that you think might help in your situation. Try not to be guilty of thinking you are the only one who can adequately care for your loved one, or of not asking for help or changing your schedule because it will make them unhappy. I review these tips on a regular basis and try to be realistic about how, as my situation changes, more of them might help me as I care for my husband.

Ten Tips that Help Me to Cope Now

Even if your loved one requires much more care than mine, some of the things I try to do to keep myself healthy both physically and emotionally might still apply to you:

  1. Practice deep breathing. This is my favorite tip from the Caregiver Stressbuster Workshop I attended. I can do it while I’m doing anything else, and it really does help me to relax and cope better in the moment.
  2. Don’t bottle up all emotions. While trying to be patient and reminding myself that the upsetting things my husband does are not his fault, I also try to remember this point from A Caregiver’s Bill of Rights: I have the right to get angry, be depressed, and express other difficult feelings occasionally. At the same time, I remember what a social worker said to me, “It’s better to be happy than to be right.” I’m working on it!
  3. Make a list of what I hope to do during the week. Even though most days don’t turn out like I thought they might, I have the list to remind me what I would like to do when I have the time, and what I’ve actually done, because I check things off. A lot of caregivers don’t know in advance what they would want to do if they had the time. Sometimes just writing it down can help to make it happen.
  4. Get enough sleep. For me, that’s 7 hours minimum. Experts say most of us need at least that much. I have the luxury of sleeping in a separate bedroom. That works for us for now. My friend uses a baby monitor with one end in her room and one in her mom’s so she can hear her mom if she calls to her.
  5. Be the one who makes plans. I’ve had to accept that if my husband and I are going to go out together and do some of the things he can still do—dinner, a movie, the symphony, a play, a drive—I have to be the one to plan the activity. I also have to be the driver and walk very slowly so he can keep up with his cane.
  6. Eat 3 healthy meals a day. I’ve had to cut down on food preparation time. When I do cook, I try to make enough for several meals. Because a Mediterranean (mostly vegetables) diet is recommended for people with Alzheimer’s and for preventing it, I try to include lots of plant matter in what we eat. We do go out to eat or bring in take-out more often than we used to.
  7. Do things without my husband. I can still leave my husband alone, so I do things like go to lunch with a friend and try not to worry about his care for a while. Because I know how good this makes me feel, I’m promising myself that I will continue to find a way to do things on my own, even if it means finding someone else to be with him for a while.
  8. Exercise at home. Even though you can’t go to the gym, you can still exercise at home. I am fortunate enough to have a treadmill, some weights and a stationary bike in the house so I can exercise without going out. Spending 45 minutes 5 days a week exercising helps both my body and mind to feel better.
  9. Do brain-building activities. Experts tell us that learning a new language, listening to or learning new music and doing some types of puzzles can actually create new synapses in the brain. Doing mentally challenging things helps me to feel like I’m still a person who can contribute in other ways than caregiving. I volunteer as my church choir director, listen to Spanish lessons while doing my morning bathroom routine, read and continue to write on a freelance basis.
  10. Take one day at a time. It’s important to plan for the future as much as you can, but it’s also good to be in the moment and enjoy what you can while you still have it. I try not to focus too much on what life could be like in the future and think more about what my husband and I can enjoy together now.

Dakota Home Care offers in home services tailored to your caregiving needs. You don’t have to do it all alone. They include help with your loved one’s Personal Care, such as bathing, toileting, and dressing assistance; a Home Health Aide to help with housekeeping, shopping, preparing meals and companionship; an RN who can provide Skilled Nursing Care, if needed; respite care that allows you to leave home for a while; and a free in home consultation with our Client Services specialist, who will discuss services and options available to you. Call 701.663.5373 today for an appointment. Learn more about our services and how to contact us by visiting our website. Additional helpful advice for “Keeping Home an Option for a Lifetime” can also be found on our blog

How Family Caregivers Can Relieve Stress During the Holidays

Photo by Ravi Kohli on UnsplashWe’ve written before about Caregiver Burnout and Ten Tips to Help the Elderly and their Caregivers Enjoy the Holidays. But zeroing in on stress—what it is and how to cope with it—can be a vital part of self-care and burnout prevention, especially during the busy holiday season.

The first step to relieving stress is to recognize when you are feeling it in a negative way, and what is causing those feelings. Stress can be described in a number of different ways:

  • Stress can feel like the inability to cope with a real or imagined threat to your mental and emotional well-being. You could compare the effect on your body to a “fight or flight” response.
  • Stressors can be physiological or emotional events that you perceive to be stressful or out of your comfort zone. What is stressful for one person might not be stressful for another.
  • Stress can have a short-term or a long-term (chronic) negative effect on your mind and body.
  • Stress can occur when the mind-body-spirit connection is out of balance. Negative thoughts can cause a physical response that makes your spirit feel “down” or even makes you physically sick.
  • A person who becomes a family caregiver experiences large and small changes in their life that may continue over time, and make a normally busy time, like the holidays, even more stressful.

Identifying stressors that are a result of your role as caregiver, added to the stress of the holidays, can be the first step to relieving your stress. These can be physical, social, emotional or economic. It can be helpful to make a list of what your stressors are. Some of the more common ones include:

  • The loss of time for leisure activities, time for yourself, sleep, healthy eating or exercise
  • Worries about finances: suddenly being in charge, and wondering how to pay for new expenses
  • Responsibility for decisions, both day-to-day and those that have a major effect on the future
  • A loss of time for friends and general feelings of loneliness
  • Changing roles and dynamics within the family and arguments regarding care plans
  • More physical work and all sorts of chores than you had to do before becoming a caregiver
  • Not being sure about the kind of care your loved one needs

Once you have identified the major causes of your stress, you can focus on what might provide some relief. What works or what you can make time for will vary from person to person.

Some stress relieving or relaxation strategies can be incorporated into your daily routine. One is just to be mindful of how you are breathing. When we are under stress, our muscles tense up and breathing can become shallow and rapid. A simple way to change this stress response is to breathe deeply and slowly. It is difficult to stay tense when you are breathing in a slow, deep and relaxed pattern. The first change you can make is to breathe from your abdomen rather than your chest. Inhale slowly and deeply. Then breathe out slowly, thinking about releasing tension with each breath. Breathing this way may feel unusual at first but with practice it can start to seem normal, and you will notice yourself becoming more relaxed.

More humor and laughter can be added to your days without taking time away from any of your other responsibilities. Sometimes it can be just a matter of perspective. You can choose to see what is humorous about a situation that you might otherwise react to with frustration, irritation or anger. Laughter truly can be “the best medicine.” It is good exercise and it actually reduces specific stress hormone levels. Recall humorous holiday memories, read a funny book or watch a funny movie or TV show when spending time with your loved one. Try not to take yourself or your situation too seriously. It will help you and the one you are caring for feel more relaxed.  Sometimes humor can be used to defuse what could be a stressful situation, rather than reacting with anger. Try to find humor in your day.

Massage doesn’t have to cost money or occur outside of the home. You can find techniques for hand or foot massage online that you can either use to calm or relax your loved one or even do on yourself. Massaging parts of the hands and feet can have a positive effect all through the body. Shoulder and back massage are also relatively easy to learn. Just be sure to consider the feelings of the person you are caring for. Make sure they are being helped and not made uncomfortable by this type of touching.

Asking for and accepting help can relieve the stress of some of the things you don’t have time for. If you haven’t done it already, hold a family meeting. Let everyone know what the care of your loved one requires and what is especially stressful for you to handle alone. Make suggestions as to what you think others could do to help, especially during the holidays. Even family members who don’t live close by could help by making telephone “visits” or sending an email or letter about holiday activities in their family or memories of their time with the person you are caring for. Graciously accept any help offered by neighbors or members of your religious congregation. Be open with them about your struggles. The Alzheimer’s Association website will help you look for a local support group where you can share feelings and experiences.

Free help and/or advice about resources may be available from your local Council on Aging or a Senior Citizens’ Center. Fee-for-service resources that can help to relieve stress may include Adult Day Care Centers, Meals on Wheels, and in-home Physical Therapy.

Dakota Home Care offers in home services tailored to your stress-relieving needs. They include help with your loved one’s Personal Care, such as bathing, toileting, and dressing assistance; a Home Health Aide who helps with housekeeping, shopping, preparing meals and companionship, as well as an RN who can provide Skilled Nursing Care, if needed. Respite Care that allows you to leave home for a while could be especially helpful in relieving stress during this time of year. We can provide a free in home consultation with our Client Services specialist, who will discuss services and options available to you. Call 701.663.5373 today for an appointment. Learn more about our services and how to contact us by visiting our website. Helpful advice for “Keeping Home an Option” can also be found on our blog.

Take care of yourself as well as your loved one! Don’t wait until you are exhausted or your own health begins to fail. Start now to become more aware of your personal stressors, to practice stress-relieving strategies and to ask for help! And check out our Ten Tips to Help the Elderly and Their Caregivers Enjoy the Holidays.

National Home Care & Hospice Month: Keeping Home an Option for Dying Loved Ones

New LogoNovember is National Home Care & Hospice Month. We invite you to join us in honoring the millions of nurses, home care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve. Dakota Home Care is privileged to share the stories of two of our clients for whom home care and hospice made a remarkable difference for them and their dying loved one. 

Todd Kuester & His Wife Terry

In the fall of 2016, My wife, Terry, was diagnosed with terminal brain cancer. She was given only 18 months to live, but with chemotherapy, radiation, and loving care she was able to live for 29 months. With the help of Dakota Home Care and Hospice, she was able to stay in our home—her dream home—until the day she died.

About a year ago, Terry’s cancer, which had been in remission, came back with a vengeance. She became paralyzed on her left side. At that point, we knew we needed help. Terry told me to put her “in a home,” because she didn’t think I could take care of her—it would be too hard. I told her “You live in a home.” I knew she wanted me to take care of her.

A doctor at Sanford hospital, gave me some names of home healthcare companies. I called Dakota Home Care (DHC) first. They sent a Registered Nurse (RN) to meet with us and assess our needs. I asked, “What if my wife doesn’t hit it off with the people you send?” The RN immediately replied, “Let us know, and we’ll get someone else!” I was very impressed by that.

In January, DHC sent us two very kind and loving CNA caregivers, Viola and Shannon. They were God’s angels on earth. They were very good to work with and seemed very knowledgeable. They came in shifts from 8:00 PM – 8:00 AM to help with night care. Terry had bad headaches. I set out her medication and Viola and Shannon gave it to her at night and helped with all of her personal needs. They did everything I asked.

Viola is from Africa, and she would sit and have conversations with Terry about her husband and how she was working to get him here. Shannon was the same way. She had lived in ND all her life, so she and Terry had a lot in common. She loved to hear their stories, and they listened to Terry’s stories, too. It was very important for her to have that interaction with other people

On March 7th Terry decided to stop treatment and go on hospice. The doctor at Sanford Hospital assigned a nurse and an aide, but they only came twice a week for about an hour. DHC worked side by side with hospice, and filled in the gap when hospice wasn’t there. I didn’t know what to expect when someone dies. I was an emotional wreck. Terry was my high school sweetheart. They told us what to expect. That was calming for both of us. It really helped to comfort me while going through the process.

The night Terry died, Shannon was on duty. I was upstairs, and she told me it was time to come down.  I got on Terry’s bed and held her hand. Shannon sat in a chair and held her other hand. After Terry took her last breath, Shannon quietly got up and left the room and gave me time alone with my wife. She came back in when I stopped crying. She sat with Terry while I made calls. When I came back, she was still there holding her hand. She didn’t leave until 4:30 in the morning. Viola would have done the same thing.

Terry passed away at home after being on Hospice for just 19 days. We’re all going to die. DHC and Hospice help people in the process of going from this world to the next, while staying at home. I’m telling my story out of love and respect for my wife. It’s beneficial to me to talk about her, and I hope it helps other people who will go through the same thing. I’m doing what Terry and God would want me to do.

Becky Mahlum & Her Husband Mike

I would not have been able to keep my husband Mike at home had it not been for the good care we received from Dakota Home Care (DHC) and the Hospice Care from Sanford Hospital. Mike died on Sept. 1st from complications of Multiple Sclerosis. (MS) He had been on Hospice care for six months, but I wish I had used it longer. He was considered terminal a year and a half before he died. I tell people that making the decision to go on hospice may feel bad at first, like you’re giving up on the person, but you shouldn’t be afraid of that decision. You can always go off of it. Just say yes to it!

A year and a half before we put Mike on Hospice, I had help from CNAs sent by DHC. Acceptance of home care can be a hurdle to get over. I had to get used to the idea of having someone in my house all the time, but I got over that! They became like family. You get attached. They make it possible for you to do all the things you have to do. Mike needed someone to be at home with him. They came during the day for 7 hours while I was at work. Having their help made it possible for me to go to work without worrying about what was going on at home. I could also arrange to have them there overnight if I had to go out of town.

DHC hires really nice people. They helped Mike with meals, read the paper to him, talked to him. He came to rely on them. His attention shifted from me to them. When they came in, they would say “Hi” to me, but then it was all about Mike. They even took care of the dog, mopped the floor and kept my house clean. And they did everything with such kindness, such loving care. It takes a special person to do that. I don’t know how they do it every day.

The combination of Hospice Care and additional help from DHC was wonderful. During certain days of the week the hospice aide would come in and help the DHC CNAs with Mike’s bathing. They worked together and were respectful of each other.  Hospice CNAs would also come for an hour in the evening, so I could have some down-time after work. It was really nice to talk to them. They gave me emotional support. The DHC and hospice people “have been there before.”

Having the hospice RN come to our house was comforting. She visited while the DHC CNAs were there. They could tell me what symptoms were normal and what showed a progression of his illness. I didn’t have to think about that or wonder if I should be doing something else for him.

I was so blessed to be able to keep Mike at home. That was what he wanted. I was especially glad that I could be there on days when he was scared. He would call out to me, and I could say “I’m here.” Having the help from Dakota Home Care and Hospice was such a gift. They helped us get through a very hard time!

If you think Dakota Home Care could help you and your loved one, call us at (701) 663-5373 to make an appointment for your free assessment.

Physician & Surgical Appointments—Transportation & Advocacy: A new service from Dakota Home Care

Transport serviceIn his 90s, my dad always needed someone to take him to a Dr. visit, not only because he couldn’t drive, but because he couldn’t give vital information about himself, describe what was wrong, ask follow-up questions or remember what he had been told and instructed to do. He needed an advocate. Now, I am going with my 79-year-old husband to most of his doctor visits, because even in early-stage Alzheimer’s, he has similar difficulties.

But what if you can’t be there to transport your loved ones or advocate for them, whether it be for regular Dr. visits or pre- and post-surgery? 

Dakota Home Care now offers services for families that can’t always transport or advocate for a loved one who can’t or shouldn’t be expected to do it for themselves.

Regular MD Appointments

Every elderly, or handicapped person probably has more than the usual number of appointments required to maintain health or to deal with chronic illnesses or pain. Even you might be intimidated during an appointment. You would be relieved to have someone there who knows the pertinent information to give about the patient and the important questions to ask. A Dakota Home Care Nurse has years of experience, will know what to say and will understand what the doctor says, giving you peace of mind and guidance through the whole process.

Services:

  • Transportation to and from the doctor’s office
  • Expertly advocating for the patient during the visit
  • Helping describe the purpose of the visit to a medical professional
  • Asking pertinent questions about the patient’s wellbeing
  • Reporting the findings of the visit and care recommendations to the family

Having Surgery

A diagnosis that requires surgery can be frightening and raise many questions about navigating and getting the best results from the whole process. There will be pre- and post-surgery doctor visits, and especially the uncertainty of what will happen on the day of the surgery and at home, and how you will manage it. Ask Dakota Home Care which of their services could simplify the big day and its aftermath for you and/or your loved one.

Services:

  • Pre- and post-surgery advocacy with physicians and surgeons
  • Checking in on the patient during the days following surgery
  • Watching for complications and calling the doctor about anything out of the ordinary
  • Making sure the doctor’s orders are being followed
  • Transportation and advocacy for post-surgical appointments

Don’t be overwhelmed by frequent doctor visits or the logistics and aftermath of surgery. Call Dakota Home care at 701-663-5373 for a free consultation regarding which of their services will be most helpful for you and your loved one.

World Alzheimer’s Month: Raise Awareness and Challenge the Stigma

World Alzheimer's MonthDementia is a collective name for progressive degenerative brain syndromes that affect memory, thinking, behavior and emotion. Alzheimer’s disease is the most common type, affecting up to 90% of people living with dementia. Other types include vascular, Lewy bodies and frontal-temporal dementia.

World Alzheimer’s Month is the international campaign held every September by Alzheimer’s Disease International (ADI) to raise awareness and challenge the stigma that surrounds dementia. World Alzheimer’s Day is on September 21st. Two out of every three people globally believe there is little or no understanding of dementia in their countries. The impact of World Alzheimer’s Month is growing, but the stigmatization and misinformation that surrounds dementia remains a global problem requiring global action. World Alzheimer’s Month seeks to unite opinion leaders, people with dementia, caregivers and family, medical professionals, researchers and the media from all around the world. More information about the campaign can be found at https://www.worldalzmonth.org/ .

Raising Awareness

Dakota Home Care is committed to supporting the goals of World Alzheimer’s Month. We respectfully provide specialized care for clients with Alzheimer’s and other forms of dementia. We work with the local Alzheimer’s Association for education and training and facilitate home consults with their specialists. We provide in-house, online and hands-on training for caregivers. Through our blog, we also raise awareness about dementia and caring for those who have it. You can learn more about these 10 related topics by clicking on the links:

Challenging the Stigma

The Oxford dictionary definition of stigma is “a mark of disgrace associated with a particular circumstance, quality, or person.” The Collins dictionary states “If something has a stigma attached to it, people think it is something to be ashamed of.” 

How to deal with the stigma associated with the disease is often a primary concern of people living with Alzheimer’s and their caregivers. The myths and misconceptions, the lack of public awareness and understanding, and the use negative labels to identify a person with dementia all contribute to the stigma.

Stigma can prevent people from:

  • Seeking medical treatment
  • Receiving an early diagnosis
  • Living the best quality of life possible
  • Making plans for their future
  • Benefitting from available treatments
  • Developing a support system
  • Participating in clinical trials
  • Contributing to disease research

Experiencing Alzheimer’s stigma

Stigma and stereotypes are a significant obstacle to well-being and quality of life for those with dementia and their families. Here are some examples of the stigma those living with dementia may experience:

  • Friends may refuse to believe your diagnosis or withdraw from your life.
  • Family members may not want to talk about the disease, or may avoid interacting with you.
  • Others may approach your care partner, rather than asking you directly how you are doing.
  • Associates may not understand all of the things you are still able to do.

Five tips to overcome Alzheimer’s stigma

The following tips are based on the experience of members of the Alzheimer’s Association National Early-Stage Advisory Group, which consists of individuals in the early stage of the disease who help raise awareness about the disease. If you are the caregiver, practice these tips and share them with your loved one who has the disease:

  1. Be open and direct. Engage others in discussions about Alzheimer’s disease and the need for prevention, better treatment and an eventual cure. Engage with others like you.
  2. Communicate the facts. Sharing accurate information is key to correcting misconceptions about the disease. Offer information to help people better understand Alzheimer’s disease.
  3. Seek support and stay connected. Stay engaged in meaningful relationships and activities. Whether family, friends or a support group, a network is critical.
  4. Don’t be discouraged. Denial of the disease by others is not a reflection of you. If people think that Alzheimer’s disease is normal aging, see it as an education opportunity. Click here for some tips for helping family and friends adjust to your diagnosis.
  5. Be a part of the solution. As an individual living with the disease, yours is the most powerful voice to help raise awareness, end stigma, and advocate for more Alzheimer’s support and research.

World Alzheimer’s Month can serve as an incentive to all of us to acquire more information about Alzheimer’s disease and other types of dementia and a reminder to not contribute to the stigma felt by those who live with it. At Dakota Home Care, these are our goals all year long.

Recognizing when Death is Near: How to Plan and What to Expect

End of life signsIt can be just as difficult to predict the exact time that someone will die as it to predict exactly when a baby will be born. However, there are signs you can watch for that will help you prepare mentally, emotionally and physically for this big change in your family’s life.

As you care for your loved who may be near death, look for normal signs like these:

  • Losing interest in and becoming less responsive to what is going on around them
  • Sleeping or seeming drowsy most of the time
  • Eating and drinking less than usual or not at all
  • Irregular breathing, including noisy or gurgling sounds, sometimes called a “death rattle”
  • Talking to someone who has already died
  • A brief surge of energy and clarity of mind

The loved ones of a person who is dying want to know what they can do to make the person more comfortable. Even though a dying person may seem unconscious, many professional caregivers think hearing may still be functional. Continue talking to your loved one. Express your love, hold their hand and reassure them that they can go when they are ready. Take advantage of a brief period of consciousness to say final goodbyes. Even though my father couldn’t talk, we put the phone up to his ear to let out-of-town family members talk to him. He seemed to respond to hearing their voices.

Don’t try to force food or water. Going without food or water is not uncomfortable. Swallowing may also be a problem, especially for people with dementia. A conscious decision to give up food can be part of a person’s acceptance that death is near. If the person’s mouth seems dry, just swab it with water and apply lip balm. A “death rattle” may be helped by turning the person to one side. Pain killers often make breathing easier, as well.

Ask for help when you need it and graciously accept it when it’s offered. Some specific tasks that you could assign to others include picking up the mail or newspaper, writing down phone messages, doing a load of laundry, feeding the family pet, taking children to their activities, picking up medicine from the pharmacy, paying bills, walking the dog, babysitting or bringing in meals. Help with any of these tasks may provide welcome relief for caregivers.

Keeping close friends and family updated can be a big job. Setting up a family blog, a mass-email list, a private Facebook page, or even a group text can reduce the number of calls you have to make. Assigning a family member or friend to make the updates for you can help reduce the emotional burden of answering frequent questions.

If the patient or anyone in the family needs help with religious traditions, funeral plans or other spiritual issues, someone can also be assigned to call the family’s spiritual leader or advisor or even the funeral home that has been selected. Hospice services also provide spiritual counseling and support.

If the loved one or the family hasn’t already decided what is the preferred location for where death should take place, there are three options for patients who are on comfort measures only (CMO):

  1. If the loved one is in the hospital, the family may wish to stay there, either with or without hospice. Staying in the hospital for longer than one day may not be an option, because many hospitals have a 2-3 day time limit for in-hospital hospice or comfort care only.
  2. An inpatient hospice unit staffed by hospice nurses, social workers, and physicians can provide excellent comfort care as well as helping families with psychological and religious needs.
  3. Many people express a desire to die at home, and many families also prefer to bring their loved one home with hospice care. Hospice services provide roughly 2-4 hours of care a day, depending on the patient’s needs. The family will need to provide basic comfort care for their loved one with guidance from the hospice team. Additional in-home services are offered by Dakota Home Care and other in-home-care companies.

The available options will vary depending on the patient’s condition, the insurance, and the family’s situation.

A dying person may have some specific fears and concerns. He or she may fear the unknown or worry about those left behind. Some people are afraid of being alone at the very end, while others want to wait until their loved ones are not there before they let go. Remember that a dying person may still be able to hear you, so you can continue to express your love and give comfort until the last breath.

Resources:

End-of-Life Comfort Care

Comfort careWhen a patient can no longer benefit from curative treatment, comfort care allows them a better quality of life. Comfort care does not seek to cure or aggressively treat illness or disease. It focuses on relieving symptoms and optimizing comfort as patients near the end of life.

Comfort care can be given at home and nursing facilities. Most patients and family members prefer home to hospitals. Hospice care is one source of comfort care delivery. Comfort care is sometimes called palliative care, but the terms “palliative care” and “hospice care” cannot be used interchangeably. Hospice can be provided in the last six months of life. Palliative care can be offered anytime in the course of an illness.

Loved ones with a wide range of health conditions can benefit from comfort care. This includes cancer, heart disease, chronic obstructive pulmonary disease, and dementia or Alzheimer’s disease. Sometimes loved ones oppose stopping aggressive treatment for a condition and moving to comfort care. They may feel that there is still hope and not realize how much discomfort the treatment is causing their loved one. It to know and ensure the patient’s needs and wishes are honored. Many people approaching death make their own choice to stop treatments that cause significant side effects, preferring treatments that improve comfort. Your loved one also may prefer to die free from the life-support, such as ventilators and dialysis.

Choosing Where to Die In Comfort

Your loved one might have preferences for end-of-life care and where to receive it. Try to clarify which type of care your loved one wants. Options might include:

  • Home care — Most people prefer to die at home or in the home of a family member. You can assume the role of caregiver or hire home care services for support.
  • Hospice care — services that help ensure the highest quality of life for whatever time remains , can be provided at home as well.
  • Inpatient care. Some people might prefer round-the-clock care at a nursing home, hospital or dedicated inpatient hospice facility.

Comfort Measures for Specific Types of Discomfort:

If your loved one:

  • Feels tired and has little or no energy, keep activities simple. A bedside commode can be used instead of walking to the bathroom. A shower stool or switching to sponging off in bed can save a person’s energy.
  • Is no longer eating or drinking but wants to eat, you can help with feeding. Try offering favorite foods in small amounts. Or, serve frequent, smaller meals rather than three big ones.
  • Has shortness of breath or labored breathing, turn the head to the side and place pillows beneath it. Open a window or turn on a fan. Oxygen or a cool-mist humidifier also might help. Ask the medical team if medication is indicated. Sometimes, morphine or other pain medications can help relieve the sense of breathlessness.
  • Is agitated or confused, try to be calm and reassuring. Remind the person where they are and who also in the room.
  • Seems to be in pain, ask the medical team to adjust medication. Focus on relieving pain without worrying about possible long-term problems of drug dependence or abuse. Pain is easier to prevent than to relieve, and severe pain is hard to manage. Don’t wait too long to give medication. Try to make sure that the level of pain doesn’t get ahead of pain-relieving medicines.
  • Has skin irritation, gently applying alcohol-free lotion can relieve dry skin. Dryness on parts of the face, such as the lips and eyes can be eased by a lip balm, a damp cloth placed over closed eyes, ice chips, or a specially treated swab. A heavy cream can be used on heels and elbows.
  • Has bed sores or pressure ulcers, turning the person from side to back and to the other side every few hours may help prevent more sores or heal existing ones. Try putting a foam pad under an area like a heel or elbow to raise it off the bed and reduce pressure. Ask if a special mattress or chair cushion might help. Keep the skin clean and moisturized.
  • Has cold hands and feet, make sure there isn’t a draft in the room. Turn up the heat and provide warm blankets .People who are dying may not be able to tell you that they are too hot or too cold, so watch for clues. Someone who is too warm might repeatedly try to remove a blanket. A person who is hunching their shoulders, pulling the covers up, or even shivering is giving signs of being cold. Avoid electric blankets because they can get too hot. 

Mental and Emotional Needs

End-of-life comfort care also includes helping the dying person with mental and emotional distress. Depression and anxiety are common. Conversations about their feelings or medication may help. Holding hands, a touch, or a gentle massage can be soothing and make a person feel connected to those he or she loves. Just being present and listening can make a difference. Music at a low volume and soft lighting can improve mood, help with relaxation, and lessen pain. Listening to music might also bring back memories that the person can share with those who are there.

Spiritual Issues

Many people nearing the end of life have spiritual needs as important as their physical concerns. Spiritual needs might include:

  • Finding meaning in one’s life
  • Ending disagreements with others and resolving unsettled issues with friends or family
  • Struggles with their faith or spiritual beliefs

Praying together, talking with someone from one’s religious community (such as a minister, priest, rabbi, or imam), reading religious texts, or listening to religious music may bring comfort. Family and friends can talk about the importance of their relationship and share memories of good times. Those who can’t be present could send a recording of what they would like to say or a letter to be read out loud. Your loved one might also find it comforting to have help with leaving a legacy — such as creating a recording about his or her life or writing letters to loved ones, especially concerning important future events.

Comfort care isn’t just about tending to a patient’s physical needs but to a patient’s mental, emotional and spiritual needs as well. Successful comfort care providers find ways to offer emotional as well as physical support. They also know when to ask for help.

Every situation is different. Dakota Home Care assigns an experienced registered nurse to visit your home, to evaluate and assess the patient’s and family’s needs. We work with the patient, family and home care staff to draft and implement an individualized plan of comfort care, including hospice care, for your loved one. Call us today at 701.663.5373 to schedule an appointment.

Resources:

Ardys Olson, RN, Reaches 50-Year Milestone in Her Nursing Career

ardysDakota Home Care is proud to announce that one of our skilled nurses, Ardys Olson, RN, has reached a milestone of 50 years dedicated to the profession of nursing! She recently was recognized in a North Dakota nursing publication, and we are thrilled to recognize her as one of our own!

 Becoming a Nurse

As a high school graduate, Ardys first thought she would go into accounting. Then a bout of appendicitis and a stay in the hospital to have her appendix removed helped her to change course and decide that nursing was her calling. She had always been interested in nursing, but actually being in a hospital setting peaked her interest even more. That and knowing that she wanted to help people turned her life around.

Ardys attended what was then Bismarck Hospital School of Nursing for a 12-months-a-year, 3-year program. (Nursing is now a 4-year program with summers off.) Too far from home to commute, she lived in the dorms and “had a blast.” She started dating her husband, Gerald, during her last year, graduated in May and got married in September. They recently celebrated their 50th wedding anniversary with a trip to Tahiti. Ardys and Gerald have 3 children and 6 grandchildren.

Raising a Family

Not long into her career, Ardys became a military wife. Gerald was drafted into the Vietnam War. When he left for basic training, she stayed in North Dakota and worked. After that, she went with him whenever she could. “Wherever we were, there was always a job,” Ardys said. They were married for three years before they started a family. When the children came along, nursing gave her the flexibility to take a 6-month maternity leave each time and then work part-time.

“It’s a beautiful thing for mothers to have a nursing career. I was able to work evening hours while my husband worked days. We required minimal child care. As a mother, it also helped to understand injuries and sickness and how our bodies function. I can’t imagine going through life not thinking how a nurse thinks or understanding what a nurse does!”

Thriving on Chaos

The majority of her career, Ardys worked in Emergency Care. She started her emergency career in a small hospital in a small South Dakota town, but for 30 years she managed the Emergency Department in MedcenterOne, a 200-bed hospital in Bismarck. “I thrive on chaos and the unknown”, Ardys said. “My job was always interesting and never routine. I had a very good staff. We were like a family.” The patient load varied from 40 – 80 patients a day, keeping Ardys and her staff of nurses very busy.

Specializing in Everything

Ardys explained that emergency departments specialize in “everything,” and there is a lot of on-the-job learning. “It’s only been about the last 15 years that nurses are required to have continuing education as part of licensing renewal. “The practice of nursing is overwhelmingly different now. When I started, nursing was mostly about comfort care. Nursing practice is now assessment, intervention, and planning.  Nurses coordinate with other disciplines such as social services, nutritional services, and the therapies to provide patients the best opportunity for a positive outcome and a return to their home environment.”

Challenging and Rewarding

When asked what was the most challenging part of her fulltime job, without hesitating Ardys replied, “The weather! The weather in ND can be difficult! Even in a big snowstorm or below zero temperatures, somehow the patients managed to show up and we had to be staffed!  Our department had to be available for emergency care.”

One memory that stands out in her career is when 8 patients who had been in a car accident in the middle of the night came to that small hospital where she first worked. “That put us in disaster mode!” She also remembers life-threatening events where things went well, patients with end-of life issues that could be helped to feel a little better so they could attend a special event, and an ill groom-to-be who was made well enough to attend his wedding.

Retiring—for a Year

Ardys retired from her full-time job in 2012 and didn’t work for a year. “I didn’t realize how stressful my job was until after I’d retired. It took me a year to recover!” After a year, Ardys started back to work part-time. “It’s healthy for me to feel like I can help other people and that I still have a purpose in life. I would like to continue to help others as long as I’m able to do the job and enjoy it. I like the in-home environment and the relationships.”

Going Beyond 50 Years

Currently, Ardys works partime doing pediatric nursing for Dakota Home care. She goes into the home to care for a child with identified medical needs. “It makes me feel good to help the parents and give them the freedom to go out from time to time. Parenthood is a 24/7 commitment. I feel like I’m helping the family as well as the child.”

When she’s not working, Ardys enjoys cooking, baking, reading and taking care of a 3-year-old granddaughter. She and her husband go to a warmer climate for a few weeks in the winter. We’re very happy that she enjoys spending a little time being part of the Dakota Home Care family and that she will continue her career beyond 50 years by working for us!

Congratulations Ardys!