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Deciding what to do with your ageing relatives

Many people admit with a  mixture of sadness and guilt that they are having to look for a residential care facility for their loved one – usually a spouse, parent, or grandparent. Their loved one has dementia, they explain – Alzheimer’s or Parkinson’s – or some other challenging, demanding health condition that makes them feel that they can no longer cope. Sometimes, it is the responsibility of just one person, and the burden is great; but even when a whole family takes shared responsibility it can be difficult to ensure that the elderly person is sufficiently cared for.

The stress of caring

Certainly, dementia can take its toll on the family: the unpredictability of  the disease – delusions, hallucinations, confusion, and a tendency to wander – often leave family members feeling out of control. Fear that something may happen to the parent – getting lost, becoming endangered or exposed to risk, or being taken advantage of – means that adult children or partners begin to feel that they will be safer in residential care than at home.

Deciding on care

However, a decision to place a loved one in residential care should not be taken lightly, and the range of other options in place to support family and protect vulnerable elderly people should be seriously considered as well.

Home care is a simple but powerful solution to the anxiety that comes with having a loved one with deteriorating cognitive and physical functions. Powerful, because it aims to protect both the client’s independence and dignity, and also because it supports the family’s desire to have the best possible standard of care for their loved one. Indisputably, the best possible place for an ageing person to be is in their own home and there are a range of services that facilitate this choice.

When home is not an option

But what if home care simply isn’t feasible? For many family carers, there comes a point that, in spite of their best efforts, residential care is the best choice.

Usually, family carers can cobble together a coping strategy until a place at their chosen residential facility becomes available. But for Val Caulfield, at 82 years herself, she needed extra support to care for her husband of 62 years. Roy has dementia and a tendency to wander, which Val couldn’t manage.

Respite care has been the temporary solution for Roy – a hospital for people with advanced dementia – until a spot in Val’s care centre of choice opens up.

This has been a sort of limbo for both Val and Roy – more institutional than caring – and the only stimulation Roy experiences is the card games he plays with Val when she visits each day.

Do your research

Perhaps the best advice for people who are beginning to realise that their ageing relatives need more support than they can provide, is to decide soon, and research thoroughly. By visiting and touring various facilities, you will begin to develop a sense of what will suit your loved one’s needs and your expectations.

Find out about additional services – aged care providers like Platinum will send support workers to residential facilities to provide social support for  loved ones, when family can’t get there. These services enable  loved ones to continue to live a fulfilling life, within an environment that gives family peace of mind.

Alzheimer’s caregivers’ health is as important as the sufferer’s

It probably isn’t news to the many people who are taking responsibility on a day-to-day basis for a loved one with Alzheimer’s disease. In fact there are enough online and real-world support groups out there to indicate that people who are carers for a loved one need help too. Whether every caregiver knows about or is able to access a support group is another matter of course, so the results of this research, published in the Journal of Geriatric Psychiatry and Neurology, may help to put it on the geriatrician’s agenda, when they are developing care plans for patients with Alzheimer’s disease.

Burden of care

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The study, led by Dr Valmaki et al at the University of Easter Finland, is part of the ALSOVA project at the university. It found that, if caregivers are experiencing or showing signs of depression (indicated through the use of a questionnaire) at the time that their loved one is diagnosed with Alzheimer’s disease, the psychological burden of caregiving is likely to be much greater.

The study also found that spousal caregivers were more likely to experience stress in their role compared with other family caregivers, and their level of stress is likely to increase over time and as the disease progresses.

An Alzheimer’s diagnosis has as profound an effect on the caregiver’s ability to cope, whether it is in the early stages of the disease or a more advanced stage, if signs of depression in the caregiver is present.

Support for caregivers

This study is important in that it recommends a more holistic approach to treating Alzheimer’s. It is not simply a disease that affects the sufferer – it impacts whole families. By treating the family,  with a particular focus on the mental health of the primary caregiver, outcomes for the sufferer are more likely to be enhanced.

Caregiver assessment

This could be achieved easily, at the point of the Alzheimer’s diagnosis,  by asking attendant caregivers to complete a brief questionnaire to identify their needs. Where signs of depression are indicated, referral for further support – counselling, respite care, or simply the contact details of a support group – may help to alleviate their struggle.

Understanding Dementia – Cert III training for support workers

DementiaTrainingClassroom1(Web) [6771636]    Alzheimer’s Australia

Platinum’s support workers have been taking advantage of a 3-day training course presented by Alzheimer’s Australia WA Ltd to gain their Certificate III in Dementia Care Essentials. Sharon Gronow has been delivering this fascinating learning opportunity and her warm, story-telling, scenario-building style has made learning from her a real pleasure.  Our support workers have been learning more about what dementia is, the different types, and how it might develop.  They have also explored the importance of high quality person-centred care and communication, and strategies to promote dignity and well-being in clients with dementia.

Dementia – more than just  a box of apples

One of Sharon’s most impactful explanations – of a much misunderstood distinction – was achieved by sending one of our attendants on a metaphorical trip to the market for a box of fruit. The box of apples she “bought” was used to explain the difference between dementia and Alzheimer’s disease. Without wishing to spoil the effect of the analogy on future students, it became very clear that there are many different conditions that have a similar set of symptoms – including memory loss, confusion and disorientation, lack of insight, and declining cognitive ability. They all come under the umbrella term, “dementia”.

Alzheimer’s is the most commonly experienced condition. It  is caused by the growth of lesions or plaques in the brain which interfere with nerve signals and lead to a breakdown in cognition. Other dementia types include vascular disease dementia (less common now with a reduction in the number of smokers in western cultures); Lewy Body disease dementia (caused by the growth of abnormal proteins in the brain); Parkinson’s disease affects the central nervous system, impacting movement and facial expression, with typical symptoms of dementia developing in an advanced stage of the disease. Pick’s disease commonly affects younger people, Huntington’s disease is characterised by muscle spasms and twitches, and Korsakoff’s syndrome is caused by a lack of vitamin B1 which leads to memory loss.

Person-centred care

Sharon helped our support workers to understand how valuable an approach like person-centred care is, by reminding them of her own early experiences as a support worker: old people on wards, heavily medicated to manage “inappropriate” or “difficult” behaviours; signs of ill-being including rocking, rubbing temples, calling out. A person-centred approach seeks to eliminate these signs of ill-being by – in simple terms – finding out about the person, allowing them to express themselves, creating opportunities for them to feel joy, autonomy, self-worth, and allowing them to express themselves in order for their lives to have meaning and identity. Sharon shared research that shows the impact of person-centred care: a reduction in the need for medication, and people who live longer, happier lives.

Many residential care facilities now provide this type of approach, to some extent, and there are various notable pioneers of care models that have been very effective:

  • The Eden Alternative, developed by Dr Bill Thomas and Jude Thomas, was created as an antidote to the boredom, loneliness, and helplessness that many old peDementiaTrainingGroupPhoto1(Web) [6771637]ople experienced in residential care.
  • The Greenhouse Project (following on from the Eden Alternative)
  • The Montessori model of care
  • The Butterfly Household model of care

Dignity and well-being

These innovative approaches to aged care have seen amazing results in creating a new generation of happy seniors – people who are valued, whose rich and varied pasts are taken into consideration, and who now feel valued and important again. Just as important, perhaps, is that their children and grandchildren have confidence in the care that they are receiving.

A recent UK documentary for Channel 4 exemplified the joy and love that can be experienced under a really strong person-centred care model: Dementiaville followed the lives of people living with the disease in a residential home, under the care of some amazing people. The documentary hasn’t reached Australian shores yet, but watch out for it when it does, and have your hankies ready.

The different roles that mothers and grandmothers play

Grandparents who parent

Throughout the world, the demands of life often mean that mothers are unable to raise their children as they might wish to, if circumstances were different. Perhaps women have a child when they are very young themselves; sometimes women choose a difficult path for themselves, and are not fit at the time, to raise their children. In these circumstances, a grandmother might step in and take on the parenting role. In some countries, such as China, in order for a mother to create the financial stability for her children she must invest all the hours she has in her work. Sometimes mothers cannot provide the community and life for their child that they value, because they live and work in a city far from family. This reflects the experience that Jennifer (Chinese name, Han Xu) had when her grandmother took over the role of parenting her. This is her story: Continue reading →

Mothers’ Day stories – celebrating mothers

Start young – staying fit and healthy from an earlier age protects you in later years

The older you get, the harder it is to become fit. Many diseases and health conditions take advantage of poor general health. By getting fit and staying fit when you are younger, you are much more likely to enjoy good health and avoid illness as you grow older. Your good physical health will protect you from illnesses such as diabetes and heart disease – both of which can impact your quality of life for many years, and lead to premature death – and you are also protected from many cancers. Good physical health enables you to enjoy a fulfilling life, but it is also a factor which determines your chance of developing dementia, such as Alzheimer’s, as you age. Continue reading →

Mothers’ Day Stories

Home care helps mums to stay independent

Platinum healthcare provides a range of services, but perhaps the most valuable in enabling older people to stay healthy and independent for longer, is its home care service. These services range from simple domestic support, to food preparation and personal care. They mean that where people find these tasks challenging, the worry is removed and they can get on with enjoying life. Continue reading →

Nozomi’s grandma – 99 years old and still full of energy

Mothers and grandmothers at home keep their independence

The World Health Organization stated in their fact sheet (2015) –http://www.who.int/mediacentre/factsheets/fs404/en/ – that environmental factors have an important influence on the health of people as they age. A person’s home, neighbourhood, and community all have the potential to keep them healthy for longer, and to ensure that they “age well”.

Today, as part of our Mothers’ Day celebration, we have a story about a woman who has not only “aged well” but continues to enjoy a very fulfilling life.

Nozomi’s 99 year old grandma

Continue reading →

Stories for Mothers’ Day

Continuing our celebration of mothers in the run up to Mothers’ Day, we have been overwhelmed by the number of people who wish to share their story – of a mother or grandmother. It just goes to show how much we love and admire our mothers and grandmothers, when people seize an opportunity like this to tell everyone about the amazing woman in their life.

Research in favour of staying at home

Continue reading →