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6/14/2010
Question: My elderly Mother has now moved in with my husband and I. (moved in September, 2009). Gave up her apartment due to a fall in the bathtub. I have really noticed that sometimes her 'mind' floats back to the past. Forgets to eat; however, I or my husband prepare meals and then she eats.Extremely stubborn. She has 'accidents'..i.e. wets herself. How can I get her to wear 'Depends' at night? I don't want to upset her.
Your mother’s ‘accidents’ may be caused by many factors. Incontinence is “losing urine when you don’t want to, and having to change your lifestyle in order to manage your bladder and urine control.” ( The Canadian Continence Foundation)
Facts
- Incontinence affects 1 in 4 women and 1 in 10 men
- It can be treated, managed or cured
- It is not a normal sign of aging
The first step is to talk to a health care professional to find out what may be causing the incontinence. A doctor, nurse practitioner, or continence advisor will complete an assessment with your mother. They will ask your mother and you questions about the problem. Once the assessment is completed, your mother, you and the health care professional will make a plan. The plan will be based on your concerns. Education is a major part. You will learn how the bladder works, what can cause leakage problems, and the treatment options. You might be asked to make some lifestyle changes, do exercises, or use absorbent products to keep dry. Follow up visits are important. The health care advisor is your partner in working towards bladder control.
Tips for talking to your health care professional
- Make an appointment specifically to discuss your concerns about incontinence
- Keep track of how much you drink, how often you go to the bathroom and how often you leak urine
- Prepare a list of all medicines you take, or bring all of them with you to the appointment
- Don’t wait until the end of an appointment to mention it – your doctor needs time to discuss it with you
- If your doctor doesn’t have much experience with incontinence, ask for a referral to another health care professional such as an urologist, urogynaecologist, Nurse Continence Advisor, or physiotherapist trained in continence care.
I strongly encourage you to contact your health care professional. They are there to help. You and your family are not alone.
Other Resources:
Hearing the words “you have breast cancer” may bring disbelief, denial, anger and then acceptance. At the same time, decisions about treatment need to be made. As her husband and caregiver, you need to understand her disease and the treatment plan. You also need to take care of yourself so that you can take care of your wife at home. You, other family members and friends can help in various ways.
Offer emotional support:
- respect her feelings
- remind her that she is loved by friends and family
- give her privacy and emotional space
Offer practical help:
- go with your wife to her appointments
- write down questions and answers during her appointments
- offer to make meals, do laundry, do grocery shopping or other
- suggest outings like a scenic drive, a movie or a visit with friends
Continue your support after treatment:
- radiation therapy can make some women feel tired during or after the sessions
- less frequent contact with her health team may make your wife feel anxious and afraid that the cancer will return
(adapted from The Intelligent Patient Guide to Breast Cancer. Ivo Olivotto, Karen Gelmon, David McCready, Kathleen Pritchard, Urve Kuusk). ISBN 0-9696125-8-3
Other Resources:
Written by:
Linda Lsyne
Former National Coordinator
3/12/2010
You are not alone. Many Canadians are juggling the demands of work and family caregiving responsibilities. Whether it is caring for elderly parents or young children, the increased stress and anxiety can lead to a situation where neither the caregiver role nor the employee role is being performed well. The stress and anxiety can also affect your health.
You are wise to recognize the need for open communication with your manager. The following tips and strategies can help you with your discussion.
Be Prepared:
Propose a solution that will get you more flexibility and less stress. At the same time give your employer the confidence that this solution will benefit the organization through better productivity and/or attendance.
Be Clear:
- Explain your current situation.
- Let your manager know that you want to give your best efforts to your work.
- Ask for what you want in a respectful way and be open to discussing your options.
Once your manager knows the situation that you are in and how you are feeling about it, (s)he can support you.
Listen:
- Hear what your manager has to say.
Most managers want their employees to succeed. (S)he may recommend some resources that can help you with stress and time management or work/life balance, such as an Employee Assistance Plan.
Build Trust: You may have already established trust if you have worked for your organization for some time and the overall quality of your work and attendance have been good. If you are new to the company you could:
- Offer to submit weekly accounts of your time to show that you are being productive even if you are working odd hours, or working from home.
- Schedule weekly meetings with your manager to discuss how your work is going under the new arrangement.
You might have to accept closer monitoring than usual until your manager is comfortable that you are still getting your work done under the new arrangement.
Organizations need a healthy and productive workforce to be successful. Allowing employees flexibility to manage their home and work lives creates a win/win situation. Working with your manager to find a solution is an important step to achieving balance in your dual roles and in caring for your health.
You can find more information on work life balance on Caregiver Connect under Caring and Working.
Resources:
Canadian Mental Health Association, Work/Life Balance
Shepell-FGI, Wellness Articles
Belcourt, Monica, Bohlander, George, Snell, Scott, Sherman, Arthur. Managing Human Resources, 3rd Canadian Edition. Scarborough, ON: Nelson Thomson Learning, 2002.
McShane, Steven L., Canadian Organizational Behaviour. 6th Edition. Toronto, ON: McGraw-Hill Ryerson, 2006.
Written by:
Heather McLintock-Trites
National Manager, Pension and Benefits
VON Canada 12/10/2009
You are wise to recognize that you need to take care of yourself even though it may seem hard to make time for hobbies, social times with friends or other enjoyable activities.
Another important aspect of self-care is regular physical activity. Regular exercise can help you to maintain or improve your cardiovascular health, endurance, flexibility, strength and balance, all of which are important for your own health and well-being, and will also help you in your caregiving role. Health Canada offers a Physical Activity Guide for Older Adults.
- If you are used to being physically active e.g. walking, cycling, tennis, golf, swimming, aquafit, yoga, tai chi, try to resume that activity, even if it is on a limited basis.
- If you have not been physically active recently, check with your family doctor to make sure it is okay to start exercising, then check with the local community centre, seniors’ centre, mall walking clubs, the YM/YWCA or fitness centre about exercise programs and facilities.
- Contact the nearest VON branch to see if it offers the SMART program (Seniors Maintaining Active Roles Together).
- The Canadian Chiropractic Association has recently developed the Fit-in-15 program, which is designed to help you establish a daily fitness habit.
- If your family member cannot be left alone for even a short period, speak to your home care provider, family or friends so that you can get a break from your caregiving responsibilities and some time for yourself.
- You may choose to exercise with a friend or in a group, which will provide companionship as well as physical exercise.
Once you start exercising regularly, you may notice benefits such as:
- better overall functioning
- fewer aches and pains
- more energy
- better posture and balance
- stronger muscles and bones
- relaxation
- reduced stress
- reduced risk of many health conditions such as heart disease, high blood pressure, adult-onset diabetes, osteoporosis, stroke, depression and even premature death; and
- improved overall feeling of wellbeing
You may also find that your regular physical exercise makes your caregiving tasks seem easier.
4/9/2009
The following are some tips for those who are not closely or immediately connected with the daily care giving routine – keep these in mind if you are supporting a family member or friend who is providing care to a someone with Alzheimer’s Disease.
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Encouragement and support for the caregivers needs to be in context. What does that mean? Caregivers have generally learned what works and what doesn’t. Suggestions for improvement may seem reasonable, but may not be welcomed in a well-established routine.
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Educate yourself about Alzheimer’s Disease. This will give you a better understanding of what the caregiver is coping with on a daily basis.
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Respect the caregiver’s routine because it is so essential for caregivers to maintain a routine; enquire before visiting about the best time to come and how long is an acceptable visit.
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Remember that what you see during a short visit is only a snapshot of the caregiver’s day.
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Respect the caregiver’s “down time” (if they have any) – caregivers need a naptime too.
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People with Alzheimer’s Disease may become upset if their caregivers are talking on the phone. If the person is unable to talk when you call, be understanding.
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Understanding requires being informed of what a caregiver’s day looks like, the needs and routine of the person they are caring for and a genuine appreciation for the situation
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Be prepared for short conversations or the need to vent to you.
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Be prepared for plans to be cancelled or changed at a short notice
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Ask how you may best help and ask frequently. Let the person know when you are available to help. It is hard for a caregiver to ask in the first place but becomes unlikely to happen again if the response is negative
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Everyone has to eat but not everyone has the time or energy to cook. Treats are always welcome.
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Offer to run errands or be an extra pair of hands for doctor’s appointments.
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Even sending a card or email lets the person know you are still thinking of them
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Listen- often caregivers just need someone to be their sounding board – a good friend is perfect for that.
Remember that caregivers are caregivers, whether the care receiver is at home or in a long term care home. The same suggestions apply.
To learn more about Alzheimer’s Disease and related dementias, click here 1/7/2009
Moving a loved one who is living with Alzheimer’s Disease into a Long Term Care Home is an individual decision that comes at a different time and under different circumstances for everyone. It is a decision that weighs heavy on you as a caregivers and may leave you with an overwhelming sense of guilt. However, there are times and situations when a higher level of care may be needed for the person with Alzheimer’s Disease. Early on, many people with Alzheimer’s Disease do well at home. Eventually, though, even the most loving and accommodating family may be unable to meet the needs of a person with Alzheimer’s and need to think about long term care options for their loved one.
Alzheimer’s Disease is a progressive condition that slowly erodes the ability of those living with it to think clearly and as the disease progresses, provide for their most basic daily needs. While caring for an individual with Alzheimer’s Disease in the home where loved ones are nearby is preferable because of the familiarity and convenience it affords, this unfortunately is not always reality. For example, adult children may live at a distance and the spouse is coping with the challenges of day to day care giving on their own.
Ultimately, the progression of the disease may bring about behavioural, physical and cognitive factors that necessitate a move to a Long Term Care home. For instance, behavioral issues such as aggression, paranoia, hallucinations, delusions and false beliefs may take a toll on both the individual and the caregiver. Additionally, physical challenges like falling, incontinence, wandering and even limitations imposed by the home environment may mean the home is no longer the safest place.
By preparing ahead of time, the move from home to a Long Term Care home can be made easier for both you, the caregiver and the person with the disease. Long Term Care placement may be one of the most difficult decisions you ever have to make. Being prepared can help make this decision less stressful. Often, when a space becomes available in a long term care home, you will be required to make a decision quickly. It is important therefore, to familiarize yourself with the long term care facilities in your area and ask questions about the services, policies and costs of the facility before hand. In choosing a Long Term Care Home, some considerations may be: location, menus, appearance, Alzheimer friendly, safety, care philosophy, resident to staff ratio, activities, behaviour management, medical care, individualized care, interaction and bathrooms. 7/9/2008
Preparation is the key to planning a successful family meeting. This pre-planning includes creating a list of the types of help that are needed now and the types that may be necessary in the future. The list may include the need for physical care, social stimulation, transportation, shopping, chores, maintenance around the home, financial assistance, legal issues and other necessities that you and the family identify based on your specific situation.
Develop an agenda incorporating items from the above list. This agenda must be shared with each family member before the meeting date so that they can make additions to the agenda as well as to be prepared to discuss the specific topics pertaining to the best ways to care for and support your parents. Two items you may want to include on the agenda are how to include your parents in the decision making process and how they can be encouraged to accept help.
Appoint a coordinator, other than the primary caregiver (the one who provides the majority of care right now), who will keep things organized so that the primary caregiver can focus on the person who is ill and have time to relax.
Exchange solutions and ideas while understanding and acknowledging each person's point of view in a nonjudgmental manner. Allow everyone to share what he or she is able to do to meet various needs. Recognize that family members tend to vary in what they regard as easy and burdensome. Therefore, certain tasks must be matched with family members according to these varied perspectives.
Note: Some of the needs identified may require accessing service providers in the community. There can be a discussion around who is able to do the research and make contacts as well as consider how to pay for the services. Since some of the services and help you are considering for your parents may be required on a long term basis, it is wise to plan for a review of any agreements made at this meeting at a mutually agreed upon time in order to make adjustments and changes. I suggest that this timeline be a month or two out, not six months.
Document the plan by writing down all task designations. Include details and be sure everyone gets a copy. Include everyone affected by the caregiving decisions even if they can't attend the meetings. You may want to hold the first meeting without the involvement of your parent(s) but after that they must be involved, too.
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