Helping a loved one transition to memory care

Tom knew Sarah could no longer remain at home.

It was impossible for him to be home all the time and even with occasional help from family and friends and a local agency, taking care of Sarah—whose battle with Alzheimer’s disease had begun slowly but escalated recently—was becoming more difficult.

Tom knew they had reached the stage at which Sarah needed intensive memory care.

Yet, like many people, he had no clue where to begin. And even though he had accepted the need for care, would Sarah—if she even understood what was happening? Yet what had been her wishes? Where would she enjoy living? How might he even broach the subject?

While every situation is different, the transition from home to memory care can be a difficult conversation to have, if not with the person experiencing memory loss, at least with other family members.

If your loved one’s memory loss is beginning to require care beyond what you can provide, that person’s safety is at risk—plus, despite your best efforts, your loved one may not be receiving the care or even lifestyle he or she deserves.

Discussing such a transition can prompt a lot of stress, agitation and even downright anger if the topic is not approached properly. That is why it’s important to bring this up at a good time.

Discussing memory care is often best done on one of your loved one’s better days and at the person’s best time. If the loved one is at his or her best in the morning, consider bringing the subject up over breakfast, rather than later in the day.

Certainly, it’s very important to listen to the person’s wishes and consider individual thoughts and feelings. The discussion may, in fact, take place over time.

My loved one is transitioning to a memory-care community. Now what?

Whether your loved one has decided to make a move on his or her own, or you needed to make that difficult choice, it’s important to ease into the transition. There are a number of ways you can help them. Consider some of the following suggestions by clicking here.

A careful plan can help you to ‘right-size’ your living space

In my work as a certified relocation and transition specialist, I come in contact with many people who have lived in the same home for 20 or 30 years or even longer and who have found their accumulation of things to be overwhelming.

In fact, because of all their “stuff,” they often can’t face the idea of moving into smaller accommodations to begin retirement, as a result of health changes or to reduce home costs.

Moreover, the issue of dealing with too much stuff can affect anyone, regardless of age, even though I typically work with older adults transitioning to a smaller home or a senior living community.

Armed with a few strategic tips and guidelines, however, most people can tackle even the most difficult home-organization project with confidence.

The key is about “right-sizing” your living space.

A good place to start is by categorizing possessions into groups: items you need, love and want. A good space will contain only what we need and love and a little bit of what we want.

A great space will have only what we need and love.

A common stumbling block clients describe to me is hesitance to get rid of their children’s old belongings or items they have stored for friends and family.

I tell them not to let this hold them back from taking the first step toward getting organized. Contact children and friends to find out if they want their items back or no longer have use for them. If not, there are many ways to dispose of them, including donation to a nonprofit or selling them online.

The old adage that one person’s “trash” is another’s treasure is true!

Of course, letting go of items collected over the years is tough. Sometimes, though, it can help to take a last look at an item and share your memories about it with a family member or friend—and then pack it away for good.

Depending on your ultimate goal for reorganizing, it’s important to ask yourself if you really do need an item. As just one example, instead of keeping a dinner service for 12, reduce it to four.

I often provide these tips in seminars at senior living communities or work directly with individuals and families contemplating a move.

But whether you plan to right-size your living space with the help of family members or with a professional, the best way to approach what can often be an emotional situation is with the benefit of a good plan.

—Carolyn Doerr owns Caring Transitions of Mechanicsburg

Personal care: A blend of support and independence

Several Diakon Senior Living Services staff members recently discussed the fact most people call what we offer in our personal care communities assisted living.

Because of varying licensures in Pennsylvania (Maryland is different—what we offer there is called assisted living), what Diakon’s senior living communities provide is technically called personal care.

Yet the term simply means we are providing assistance to people with the activities of daily living.

As we grow older, there may come a time it becomes harder to live on our own, yet we still want an independent lifestyle.

Personal care is helpful when it’s not possible for us to remain in our own homes any longer. Personal care allows people to continue to enjoy an active lifestyle, programs, activities, social opportunities—along with daily care.

People who receive personal care typically live the same lifestyle as before, except with the benefit of a little added care when it’s needed.

Click here to learn how personal care can help with daily tasks.

Banding together to make a difference

Alan Lane is the father of a young entrepreneur who wanted to share his idea for coping with anxiety disorders in the hopes of helping others. Joshua enlisted his family to take his idea from concept to online business. And he’s just 7 years old! Alan shares more about the genesis of Joshua’s Rubber Band Balls.

Joshua has Obsessive-Compulsive Disorder—or OCD—and anxiety. A friend from church suggested that he try putting rubber bands together and taking them apart to help control fidgeting. That helped—and so he took the rubber band ball everywhere.

One day earlier this year, Josh and I were waiting for his mom at a medical appointment. He had the ball with him and I said, “I bet you could sell those.” He responded right away.

“Sissy can take pictures and Bubba can make a website. You can mail them and Mommy can help, too.”

Sissy is Joshua’s 14-year-old sister, Rachel, and Bubba is his 19-year-old brother, Tyler.

When his mom came out after her appointment, Joshua said to me, “Are you going to tell her about my business plan?”

And that’s how it started. We’ve been selling them since February of this year, online and through Facebook.

It’s great to hear from the people who buy them. A grandmother in Georgia got one for her granddaughter, who has anxiety. A teacher in California purchased one to use in her classroom. We recently established a partnership with the Ronald McDonald House in Hershey for children with cancer to use the balls.

Joshua also has had seizures since he was very young; they are controlled with medicine. He has a service dog, Spot, who sleeps with him and is a source of comfort. So he wanted some of the money from the sale of Joshua’s Rubber Band Balls to help train service dogs for other kids.

Now, we donate 10 percent of proceeds to Merlin’s KIDS, which provides trained service dogs for children. Through a friend, we just had the chance to meet the New Jersey woman who founded Merlin’s KIDS.

We helped Joshua start this business because we want to give back and help people. And one of the most rewarding parts has been the way our whole family became involved. But we never forget who’s the boss. When it’s time to discuss business, Joshua calls the meeting to order and it’s not over until he says so!

—Alan Lane

You can meet Alan and Joshua and purchase Joshua’s Rubber Band Balls at the Diakon Outdoor Adventure Challenge at the Diakon Wilderness Center Sept. 14. Also visit https://joshuasrubberbandballs.com/

Five tips for choosing the perfect active retirement community

In my career in sales of senior living accommodations, I’ve found that one of two things happens when older adults begin their journey to retirement communities.

They either know exactly what they want and need … or …

They’re overwhelmed by the abundance of available options.

That second situation is not surprising: There are many things to consider, from services and amenities to programming and opportunities for exploration and learning.

My goal is to not let the search for the perfect senior living community become a challenge, so here are five brief tips that can help you or your loved one choose the right community.

Before you begin, however, I always advise making a list of your personal wants, needs and desires. After that list is complete, search for senior living communities both near you and a little farther away (but see the caution below about family and friends). Don’t write off a community just because it’s a little farther than you thought you’d like—it might just be the perfect community for you.

Plus, be sure to schedule tours, check items off your list and try to picture what your life would look like there. Here are my personal suggestions for building your list:

1.    Consider the environment. Do you thrive in the city, where there are plenty of shows to attend, musical performances to enjoy and shopping and dining opportunities? Or do you prefer the laid-back countryside full of peaceful walking trails, horseback riding and nature? In either case, be sure to tour communities that fit your preferences. If you’re open to a good mix of both, you may find communities that offer the best of both worlds. But never settle for a lifestyle that’s less than what you want.

To read more suggestion, please click here.

Building a positive relationship with birth families (Part 2)

I concluded part 1 of this blog post: “Now that we have established why it is important to build a good relationship, let’s talk about how to do that.”

Introductions

I always introduce myself the same way every time I meet a new birth parent: “Hello, my name is Eleanor; I am your son’s/daughter’s/children’s foster mom. I’m sorry to have to meet you like this because this must be a hard time for your family. Your son/daughter/children (insert comment about a positive trait here).”

Let’s break this down:

First, I use the words “foster mom” right away—I have had birth parents say things such as, “Oh, you are the lady watching my kids,” or assume this is a paid “job” for me—so I make certain to introduce the idea immediately that I am the person mothering their children right now. We are going to be co-parenting these kids for the foreseeable future, so let’s be clear on our roles right away.

Second, I acknowledge that this is a difficult situation. Whatever has happened up to this point, there is no question it’s a challenging time for everyone involved. Showing empathy for the family makes you seem less of an enemy.

Third, in making a positive comment such as “Your son has such an infectious smile,” you establish the fact that while you are mothering or fathering the child at the moment, you also want to be clear that this is their child. As far as the compliment, well, what parents don’t want to hear nice things about their kid? Besides, being friendly never hurts when meeting people the first time.

Photo album

The first time I meet parents I show up with a small dollar-store photo album to give them. I always ask the caseworker first if this is okay—and if there are safety issues I need to be aware of.

I include a photo of our family (if safe to do so), a photo of our house (again, if safe to do so), a photo of the child’s bedroom, our playroom, our pets and so on. In the early days, I always try to get a few photos of the kids playing or eating or involved in similar activities and include those. I work really hard to make sure I have at least one photo in which the child is smiling!

I used to not include photos of the kids being held or cuddled by us (I always assumed it would be upsetting to the birth parents to see photos of their child being held by someone else) and then had one mother tell me that she was afraid her son was not being loved while we had him. I immediately showed her all the photos on my phone of him being held, cuddled and rocked and she felt much better, so now I include those photographs, too.

While children are with me, I keep printing photos and taking them to visits. Plus, I scribble notes on the back about what we have been doing and what the kids have been up to each week. If my children were not living with me, I know I would wonder what their days looked like, so I try to make sure parents know what their kids are up to.

Crafts/Artwork

If your foster child is in preschool or school, you should have an abundance of craft projects coming home. I take one or two to each visit and give them to the parents. Kids love showing off their work!

Holidays

For Mother’s Day, Father’s Day, Christmas and so on, I help my foster kids make a small gift or buy something small for them to give to their parents. Most parents are touched to receive something and most kids really enjoy giving gifts.

For the child’s birthday and Christmas I normally take a small gift in my bag to the visit that falls closest to the holiday. If the birth parents did not bring anything to the visit, I let them know I have something in my bag for them to give their child if they would like to.

I have had birth parents burst into tears at this point because they just didn’t have the extra money to buy anything for their child and are so happy to have something to give.

I once had a fellow foster parent tell me I was enabling the birth parent, but I disagree. Most birth parents have all kinds of enormous tasks to complete, which can include finding housing, getting a job, completing rehab or attending parenting classes, so having money and time to buy their child a gift can be just one too many tasks for the week.

And it doesn’t take much effort for me to pick up an additional small gift; often, this kindness will go a very long way.

Don’t take it personally

All birth parents with whom I have worked have, at some point, critiqued the way I was caring for their child. One didn’t like the brand of diapers I was using; another insisted I must be neglecting to change her son because he had a (slight) diaper rash. One mom got upset that I had juice for the child in the diaper bag, while another was concerned I didn’t have juice on hand for her to give her child.

I figure it’s not about me.

This parent has almost no control over their child’s life, so they seek it where they can. I smile and tell them I hear them, but I don’t rush out and buy a new brand of diapers or run to the store for juice boxes. Their concern or anxiety is not typically about diapers or juice anyway.

Ask the parents about their child

Parents know a lot about their kid, how they go to sleep, what their favorite television show is, what they like to eat and so on—so ask!

In doing so, you will learn important information about the child you are parenting while also acknowledging the birth parents’ role in their child’s life. They are probably not feeling amazing about themselves or their identity as parents right now, so acknowledging they know a lot about their child they can teach you will be validating to them.

Boundaries

Sometimes, maintaining a positive relationship means setting good, firm boundaries. If parents are given my phone number or manage to get hold of it and start texting or calling constantly, I politely but firmly tell them that I am busy caring for their child and we will talk at the next visit. Your social worker can help you with setting boundaries if you need to, but I often find that having a frank but polite chat solves most issues.

Sure, it’s not always been smooth sailing with every birth family, but for the most part we have been able to build positive and respectful relationships with our foster and adopted kids’ parents, grandparents and even extended family.

It has not always been easy and has sometimes involved a lot of tongue-biting on my part—but it has been 100% worth the effort!

—Eleanor Delewski, Diakon Adoption & Foster Care parent

(A final note about language: for a child who has been adopted, the commonly accepted terms are “parent” for the adoptive parents and “birth” or “first parents” for the child’s original parents. However, for a child in foster care, “parent” typically refers to the birth parent, with “foster parent” being used for the moms and dads caring for the child while he or she is in foster care. For clarity, the term “birth parent” is used in this blog post to refer to the foster child’s original parents, but I fully recognize that while a child is in foster care the birth parents are still the legal parents of the child. Not everyone agrees on what language should be used for which parent, but that is a debate beyond the scope of this post.)

Distinguishing between dementia and normal age-related memory loss …

The email was puzzling: Would I be able to get the staff colleague the document she had requested?

Eh … what document? my mind immediately wondered.

Apologizing in both text and email, I asked for clarification. What had I promised to do?

We had discussed the item two weeks ago, came the reply.

Ugh! But I was still drawing a blank.

Fortunately, I can attribute this instance of memory-loss to the fact we get so many requests in my office that if I don’t write them down immediately, I’m typically on to whatever item is staring at me from my inbox and that other request is … well … gone.

We often find aging parents exhibiting similar behaviors and our immediate question typically is: Is this normal aging or something else?

Many older adults consider this question themselves over fear for the future. And the question is not easy to answer but, over time, answers usually become clear.

So, is it normal memory loss?

It’s common for forgetfulness and memory lapses to occur because of normal changes in the brain associated with aging.

The National Institutes of Health notes that this situation may make it harder to learn new things or retain information as easily as in the past. And, according to the Alzheimer’s Association, typical age-related changes may include making a bad decision once in a while, missing a monthly payment, forgetting what day or time it is but remembering it later, forgetting words or meanings of words and losing things from time to time.

These memory lapses can fluctuate as time goes on, but are perfectly normal.

But what they are the signs of cognitive illness? Click here to read more!

Why foster families need to build positive relationships with birth families

When I recently dropped my foster kids off for their visit with their birth parents, my toddler was excited. He had a new doll he wanted to show his mother and father.

When his parents arrived, he ran to them and proudly showed them his new toy. His dad picked him up and showered him with hugs and kisses. The little guy kissed his dad back and then reached for me, saying “Mommy kiss!”

I paused, uncertain how his father might handle the situation. But his dad walked right over to me and said, “Of course you can give Mommy kisses, too,” and held his son as he planted slobbery kisses on my cheek.

This is what foster care should look like.

The little boy has no hesitation in showing love for his parents in front of me, but also no concerns in showing his love for me in front of them.

He loves all of his parents and expresses it with typical toddler abandon. But can this situation be hard for the adults? Absolutely!

This boy has been in my home 100 days now. I have tucked him into bed and kissed him goodnight 100 times. For 100 days this precious little boy has called me “Mommy” and I will admit that my heart aches a little watching him run from me to his first mommy and throw himself into her arms.

And although she has never said it, I am sure that it must be unbearably hard for her to watch her son kiss me and call me “Mommy,” too. After all, she gave birth to him and raised him for two years.

I cannot imagine what it does to her to watch her son love another mother.

Nevertheless, we are all making the situation work, loving this little boy together and allowing him to love us all, too. For his sake—and for the sake of his infant sister—we are all putting our own hearts aside and focusing on what is best for the kids.

My husband and I have been fostering or parenting children adopted from foster care for 13 years. Twelve children have called us Mom and Dad, seven little foster loves who were ours for a season before going home or moving on to another family member, one “home-grown” daughter, two sons adopted from foster care and our current two babies, who are our ‘for-now’ son and daughter.

Our experience over the years has taught us a few things about building positive relationships with birth families.

Why does it matter?

In Pennsylvania, the average time a child spends in foster care is 20 months. So you are probably going to be seeing your foster child’s parents for a long time. If the case transitions to adoption, you may well be connected to these people for many years to come.

I am not saying building a positive relationship is an easy thing to do. Depending on what led to the child’s being placed in foster care, it can be really hard to smile and be friendly to your child’s birth parents.

But foster parenting is all about doing hard things, and it is really important to build the best relationship you can. The first meeting with birth parents, in fact, can set the tone for the relationship, so I think it is very important to make a good first impression.

Occasionally, however, I will hear a fellow foster parent question whether it’s important to have a good relationship with your child’s birth parents. I believe it’s vital—for the following reasons:

• Your foster child’s parents, no matter what their mistakes, are people worthy of respect, kindness and grace. I think every human is worthy of this.

• Your child loves them. I have had foster parents argue this point, saying essentially that “this is the person who neglected/hurt/hit/left/and so on the child; how could they love him or her?” Years of fostering has made me understand that, no matter parents’ mistakes, your foster child loves his or her birth parents. Children will notice how you treat these people they love.

• If your foster child is reunified with his or her family and you have had a good relationship with the birth parents, you may well get updates on how the child is doing. I think one of the hardest parts of foster care involves loving a child who leaves your home and then never hearing how the child is doing. If you can build a good rapport, the child’s parents may send you updates; it always helps me to know the kids I have loved are doing well now that they are back home.

• Although we know reunification does not happen in every case—in fact, about 25% of foster-care cases end in adoption of the child, often by the foster parents—the goal of foster care is nevertheless reunification with the birth family. So keeping all relationships positive is ultimately in the best interests of everyone, especially the child.

(And, in those instances the case moves toward termination of parental rights, birth parents may be given the option of signing for termination voluntary. Some have when they know their child is with foster parents who love them, take good care of them and are willing to adopt. If your child’s birth parents perceive you as rude to them, mean or dismissive, they are not nearly as likely to agree to a plan in which you will raise this child you love.)

Now that we have established why it is so important to build good relationships with birth parents, let’s discuss how exactly you do that!

—Eleanor Delewski, Diakon Adoption & Foster Care parent

Continued in part 2, For foster families: Building positive relationships with birth families (to be published in two weeks)

Supporting an aging loved one during short-term rehab

I took a 95-year-old relative for minor surgery recently and, afterward, she complained just a little about having had to put up with the inconvenience of the procedure.

As several family members have chuckled on occasion, our relative is quite fortunate overall. While she had to care for her husband as he faced health issues for a number of years, she’s had relatively few significant health issues herself.

And she still lives alone—and drives! Undoubtedly, most of us hope for that future.

Unfortunately, as we age, the likelihood increases that we may face varying issues including chronic health conditions or other diseases, surgeries or falls. Often, those situations can be improved with short-term rehabilitation.

Short-term rehab encompasses physical, occupational and speech therapies that can help people reach their individual potential and, quite frequently, return to the lives they love.

The care team at a short-term rehabilitation center creates a personalized plan that can help older adults regain strength, manage medical conditions and transition back home. In addition to offering care around-the-clock, these centers also typically offer education and resources for both seniors and their families.

Many short-term rehabilitation centers, such as those operated by Diakon Senior Living Services, offer private and semi-private suites, therapy gyms and personalized instruction, nutritious dining designed to enhance health, and space for socializing. The goal is an overall positive experience that helps patients thrive.

If my relative required short-term rehab, it’s likely she would say she did not need it. She would not be alone in that self-assessment. Many older adults tend to decline short-term rehabilitation after being released from the hospital. Often, this is because they’d rather go home and don’t see the value in rehabilitation, according to Aging Care.

You can help them to understand their stay is only temporary—and it can lead to their remaining healthier longer. In fact, if they return home too soon and aren’t yet healed properly, they can be setting themselves up for a longer stay in rehabilitation later on.

To make this process easier on your loved one, click here to read about a few things you can do.