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    adult children

    The iPad and Alzheimer’s

    Before my mom passed away, she was diagnosed with Alzheimer’s disease. When she was first placed in an assisted living center, she was quite alert and had a very sweet, loving disposition. She often referred to the aides and her fellow residents at Harbor Point as “dearie.”

    When I visited, I would talk to her a lot about her friends and relatives who had written to her or called her. Often she became confused when she tried to remember what they looked like or who they were. I found that showing her a photo of that person when I mentioned their name took away a lot of the stress and frustration, and she would recognize the person right away.

    When we celebrated her 90th birthday at a local restaurant. 12 people from the family joined her at the party. One of her nieces (Cheryl) gave her a gift card to her favorite restaurant (Ninety Nine), and she was just thrilled.

    My wife, Mary, took a number of pictures of everyone who had attended the party and I loaded these pictures onto my iPad. When I visited mom the week after the party, I mentioned what a wonderful gift her niece, Cheryl, l had given her. She was confused and thought it was another niece who had given her the gift. I immediately opened up the iPad, showed her the pictures of the party and pointed to Cheryl. “There she is, right after she gave you the gift.” Mom recognized her and acknowledged how nice it was of her to be so generous.

    I often used pictures from my iPad to put Mom back in touch with the important events and people in her life. One of my projects involved I borrowing all my parents’ old photo albums and scanning hundreds of pictures into iPhoto on my computer. My dad had been a real photo buff and often developed many of his own pictures. Several of these pictures were classic shots of both my parents when they were quite young. I have a wonderful photo of my mom in her beautiful white high school graduation gown. She looks absolutely stunning! I’ve also got several pictures of mom and dad as young sweethearts.

    I downloaded hundreds of these pictures onto my iPad and divided them into several albums representing different periods in my Mom’s life. When we would talk, she would often ask questions like, ”When did you get married? Was I there?” I would then go directly to the pictures of our wedding and show her that she was, in fact, there and looked quite attractive. We would go through a number of pictures from her past and discuss the events around them. She loved to look at pictures of my father when he was a sharp young soldier during WW ll. That would lead into extensive conversations about how great a father and husband Dad was.

    The iPad made it so easy to share pictures with her. The photos take up the whole screen and are quite clear. We could make pictures smaller or larger by squeezing or extending our fingers on the screen. Mom could change photos by just brushing her finger across the screen or tapping it. It was such a wonderful tool to share memories with her.  Frankly, I don’t know how I could have shared all these memories with her without it. The iPad enriched each visit we had together. And that made all the difference in my visits with her.

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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Are you your parent’s parent?

    Recently I have been giving a number of talks at Assisted Living Communities about the ideas in my book, Passing the Torch: Critical Conversations With Your Adult Children. I make a point of talking to a number of attendees before each meeting. Many of them are the adult children of elderly parents who are beginning to struggle with maintaining their own homes and leading an independent life.  I can see the turmoil their children are going through. I went through it myself.

    When you see your parents making every effort to maintain control of their lives but at the same time watch that control slip away, it is a very sad thing. When my mom kept getting lost making the trip from her apartment to the dining hall at her independent living community, I knew we had a problem. But I tried everything I could not to disrupt her life and keep her in an environment where she was comfortable. I didn’t want to upset her. We hired round the clock aides to assist her, but after a month we realized it wasn’t working.  She became even more confused when the aides kept changing every 8 hours.

    Finally, my wife presented me with the cold, hard facts that I had been trying to ignore. My mother could no longer live in her lovely two bedroom apartment. We had to move her to an assisted living community that specialized in serving memory impaired residents. I was shocked and upset but I knew my wife was right.

    My wife found a wonderful facility close to where we live that had only 50 residents and was known for its Alzheimer’s care. The day finally arrived when we were going to move her. I was a nervous wreck. What if she refuses to go or gets very upset? I slipped into my role as her child, not willing to become the strong parent that I needed to be. But my wife rose to the occasion.  She told my mother that we were going to a place where they would help her get back on track and start to feel better.

    The first few nights were ok, but she kept asking me on the phone, “When am I going to go back home?” My wife assured her that she would stay there until she was doing better. After a few calls to the director stating that I thought this was a bad decision and my mom was ready to go back home, the director suggested I not call my mom for several days. She was absolutely right. My calls were the trigger that made her think back to her previous life and kept disrupting her adjustment.  I held off on my calls and she began to adjust.

    After a week my wife stated, “We’ve got to move her furniture up to her new room and store what she doesn’t need.” Again, I became my mother’s child.  I was concerned that she would be unhappy with me or disapprove of what I was doing.  I responded with, “What if in a few weeks she demands to go home and says she doesn’t want to be there. What do we do then?” My wife replied, “ If she says that, do you really want to move her back to a place where she’ll be lost and confused? Do you think that is the right thing to do?” I knew we were making the right decision, but it seemed so hard at the time.

    My mom remained at her new home and was quite happy until her passing in 2014.. We know that we took the right steps to change her environment and put her in a community that offered her the care she needed. I am sure that there are many other adult children facing the same decisions I had to make. Fortunately, I had a courageous wife who would not let me ignore the reality before me. I learned that it is very difficult to become your parent’s parent, but it is often the only thing you can do.

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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Are you a good health care agent?

    One of the most important jobs you may ever have is to be designated a health care agent or health care proxy for another person, possibly your parent. In this role you will make heath care decisions for them if they cannot make them themselves. One of the best sources I know of for the forms to designate a health care proxy is provided by www.agingwithdignity.org. Their forms are approved in more than 40 states.

    Aging With Dignity recommends that you do the following things to be a good health care agent/proxy:

    1. Know your loved one’s wishes ahead of time. Ask questions when discussing their wishes with them so that you understand what they want.
    2. Introduce yourself to the doctors and nurses caring for your loved one. Make sure that they know you and know how to reach you. Make sure that they have a copy of the document naming you as the health care agent/proxy.
    3. Ask questions of the doctors and nurses and follow through with them as they are treating your loved one so you know that your loved one’s wishes are being followed.
    4. If you run into problems, ask to speak to the social worker, patient representative or chaplain of the hospital or institution your loved one is in. If a doctor or nurse does not want to follow their wishes, contact the ethics committee of the hospital, hospice, or nursing home.
    5. Be courteous but be firm. Sometimes doctors or their staff ignore a patient’s wishes if the health care agent/proxy doesn’t push for them.
    6. Obtain a HIPPA release form and have your loved one sign it giving you authority to see their medical records. Without it you will be often be denied any information about their condition or health.

    Aging With Dignity provides a document called The Five Wishes, which allows your loved one to specify in detail exactly how they want to be taken care of. It also has a place for them to name their health care proxy/agent. It combines both a living will and health care proxy into one form. Once it is witnessed by two people and signed by the person it becomes a legal document in more than 40 states. Call 1-888-594-7437 or go to the website www.agingwithdignity.org to order the form.

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    PERMISSION TO REPRINT:
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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    2010 in review

    Namaste, Embracing the Most Vulnerable in Nursing Homes

    Namaste Care is a program designed to improve the quality of life for people in nursing homes or assisted living facilities who are agitated, unresponsive or near the end of life. It is often used with people who have advanced dementia. Namaste, is a Hindu term meaning “to honor the spirit within” and was selected to describe a program that brings honor to people who can no longer tell us who they are or cannot care for themselves without assistance.

    Joyce Simard, a veteran elder-care social worker, founded the Namaste program. She was concerned that some residents were too frail or disoriented to participate in group activities in nursing homes. She noticed that they would often sleep or slump in their wheelchairs near the nurses station all day. She said, “ That’s not quality of life. What they really need is someone to touch them in a loving way” She has written a book entitled The End of Life Namaste Care Program for People With Dementia”

    Namaste Care takes place in a designated space that helps to create a safe and comforting environment for all who enter, including residents, their families and staff. Hand and foot massage, carefully brushing or combing a persons hair, and moisturizing the ladies faces with “Ponds” cold cream, are a few ways that bring pleasure when done with a loving touch. Resistance to shaving that many men display because they do not realize that they need to be shaved disappears when shaving is accomplished the “old fashioned” way with shaving cream and “Old Spice” after shave lotion.

    Scents of the season are used to provide sensory stimulation.  Flowers that are in bloom, like lilacs in the spring, produce smiles as well as the scent of cinnamon in the fall and winter.  Almost everyone will smile when someone is blowing bubbles or may be wearing an outlandish hat!  Moving arms and legs to music helps keep limbs flexible.  Nourishment and beverages are offered throughout the day so that people with a diminished appetite have more opportunities to eat and drink.

    Namaste programs are being incorporated in facilities around the world. On Cape Cod the Epoch Group has made a very big commitment to the concept. It is now used in all Epoch living centers in Massachusetts and Rhode Island. At Epoch Senior Living in Brewster, MA 20 out of 160 residents may be in the program at any one time. A framed statement on the wall of the Namaste room spells out the Namaste Mission: “To embrace our most vulnerable and provide them with a sense of comfort, calmness and serenity because their lives are still relevant.”

    A Breakthrough in Home Care

    Many seniors want to do everything they can to stay in their homes as they get older. But often they need help to handle various responsibilities including getting to medical appointments, shopping, socializing with friends, preparing meals, and managing things around the house. They usually have two choices to get these services. First they can rely on family members to help them. This is often difficult if their children are working or are not in the immediate area. Second they can hire aides to come to the home. But this can be very expensive. Aides often cost $20 an hour or more and many seniors just can’t afford them.

    But a new alternative is emerging. It is a volunteer not for profit organization created by a community to allow neighbors to help other neighbors. Each senior pays a fee to become part of the network. Fees vary by community and services offered . They range from $175 to $900 a year. Community members volunteer to provide most of the services. Discounted fees are available to people with lower incomes.

    Beacon Hill in Boston was probably one of the first neighborhoods to offer such a program. Beacon Hill Village was founded in 2001. ( www.beaconhillvillage.org)To be a member you must be 50 or older and live in communities surrounding Beacon Hill.  Services offered to members include:

    Referrals to discounted, vetted providers for everything from dog walkers to plumbers
    A volunteer to assist you in your home or around town
    Geriatric care management for you or your family members anywhere in the US
    Preferred access to MGH Senior Health Medical Practice
    Rides home from a medical procedure that are required by the hospital/doctor
    Personalized grocery shopping—we will drive you or deliver groceries to your home
    Discount prescription drug card—complements Medicare Part D coverage
    Discounts to all providers: Electricians, plumbers, organizers, personal trainers, massage therapists, homecare specialists

    A similar program was recently set up on Cape Cod. It is called Nauset Neighbors (www.nausetneighbors.org) and boasts that “One call does it all”. It is also staffed by volunteers and serves the communities of Brewster,Orleans, Eastham and Wellfleet.

    There are now eight open villages in Massachusetts, including similar groups in Falmouth and  Martha’s Vineyard.  There are currently about sixty others nationwide, over 120 in the planning stages and the numbers are constantly growing. Each village is unique to its area and resources.  Nauset Neighbors is part of the Village to Village Network whose aim is to exchange information and experience.

    Doctors, Watchdogs against Elder Fraud

    By now most of us have heard about Bernie Madoff and the billions of dollars he swindled from people all over the country. But we may not be aware that this type of fraud, on a much smaller scale, is happening around us all the time. And the people who are most often the victims of these crimes are the elderly.
    About 7.3 million older Americans, or one out of every five people over 65 have already been swindled according to an Investor Protection Trust Survey released in June. Recent research from behavior economist David Laibson shows that people tend to make poorer financial decisions as they get older.

    But some states have taken steps to help seniors avoid these scams. 23 states including California, Connecticut and Pennsylvania have enlisted Doctors and other medical professionals to be the watchdogs in the fight against elder fraud. Working through the Investment Protection Trust, state regulators are alerting medical professionals to specific red flags that help identify older Americans who may be more vulnerable to investment fraud abuse.

    In routine visits with their patients these doctors are trained to ask such questions as “Who manages your money day to day” or “Do you regret any financial decisions you made recently?” Other questions include, “Is anyone pressuring you to give them money?” or ” Has anyone asked you to change your will or your power of attorney?”

    More than half of the 67 doctors who were involved in a pilot study in Texas discovered that their patients had been approached with phony financial offers. Financial Planners should also become vigilant in their interactions with their older clients. When I was a practicing financial adviser I learned that one of my older retired doctor clients, in the early stages of Alzheimer’s disease, had been contacted by scam artists all over the country. They told him he had won a lottery and he needed to give them his bank account numbers so they could wire him the money. His wife had to finally get an unlisted phone humber so they would leave him alone.

    Elderly parents often will not share these occurrences with their adult children because they don’t want to be viewed as incompetent or gullible. Therefore it is important that their children discuss these problems with the parents’ doctors and ask them to use the questions I have listed above.

    How to talk with Mom and Dad

    Opening up a conversation with your elderly parents about important issues can often be a very stressful and difficult task. You know there are certain things you need to talk to them about but you often fear that they might speculate what your motives are. So how do you open up those conversations without embarrassing yourself and upsetting your parents?

    First you must remember that one of their primary concerns ( according to David Solie in hs book, “How to Say it to Seniors” )is maintaining control of their lives. They don’t want to be told that they can’t drive anymore or that they have to move out of their house into a retirement community. Even if these choices are in their best interest they will be very reluctant to comply if they don’t feel that they have made the decision.

    But you also need to know that you don’t want to wait until its a crisis to approach your parents. In my 30 years as a financial adviser to hundreds of families, I never saw things go well when families tried to make decisions after a loved one was already in trouble. These situations are fraught with emotion and people don’t often think very clearly when things are unraveling.

    Now, while your parents are still healthy ( hopefully) plan out what issues you need to discuss with them before you approach them. Try writing them a letter expressing your concerns and thoughts. Don’t give them the letter but use it as tool to explore your own emotions. Narrow down your concerns to be as specific as possible. What are you anxious about? Enroll the ear of a friend or spouse and read your letter to them. Do they think your concerns are legitimate and worth discussing? Finally, listen to the letter as if you were your parents. Where do you think there will be resistance or stubbornness?

    Once you know the focus of your conversation develop an ice breaking phrase that you can use  with your parents. Make sure your questions are open ended and leave room for them to express their opinions. For example,” Mom, recently one of my friends told me her mom was having difficulty keeping up with all the chores around the house. What do you think she should do?” Or, “Dad, can I get your opinion on a couple of things?” Or as simply as “Mom, can we talk?” One of my favorites was “ Dad, how are you enjoying those golden years?”

    Your parents probably want to talk about the same concerns you have, but they just don’t want to upset you or mention things that are uncomfortable. They certainly don’’t want to be told what to do. But by easing into the conversation and creating an environment that is safe, you can eliminate a lot of stress for them and yourself. You’ll also give them the opportunity to age with dignity and peace of mind.

    2010 in review

    The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

    Healthy blog!

    The Blog-Health-o-Meter™ reads This blog is doing awesome!.

    Crunchy numbers

    Featured image

    A helper monkey made this abstract painting, inspired by your stats.

    A Boeing 747-400 passenger jet can hold 416 passengers. This blog was viewed about 2,800 times in 2010. That’s about 7 full 747s.

     

    In 2010, there were 20 new posts, growing the total archive of this blog to 45 posts. There was 1 picture uploaded, taking a total of 10mb.

    The busiest day of the year was September 19th with 49 views. The most popular post that day was What’s Important to Mom and Dad.

    Where did they come from?

    The top referring sites in 2010 were discussions.apple.com, parentcareplanning.com, facebook.com, mail.yahoo.com, and linkedin.com.

    Some visitors came searching, mostly for ipad alzheimer’s, bob mauterstock, government programs for the elderly, government programs for elderly, and alzheimer’s ipad.

    Attractions in 2010

    These are the posts and pages that got the most views in 2010.

    1

    What’s Important to Mom and Dad May 2010

    2

    Should you have a pre-paid funeral plan for your parents (or yourself)? February 2010
    2 comments

    3

    The IPad and Alzheimer’s August 2010
    1 comment

    4

    4 Steps to Protect Your Parent with Alzheimer’s December 2009
    4 comments

    5

    About Bob Mauterstock December 2008
    2 comments