Originally posted @allaboutestates.ca

Many of us have questions/concerns about where we will live, when we are no longer able to remain in our homes and this seems to be a topic discussed regularly. I am sure over the holidays there were many similar sounding conversations had with friends either talking about their parent(s) or in planning for themselves.Most times the conversation is triggered following the death of a spouse or an admission into hospital with the realization that a return home, may not be possible.

But what about for those healthy seniors who want to remain living in their own homes but require something more. The ‘something more’ might include:
– Socialization and someone knowing if you are dead or alive
– Getting help changing a light bulb or challenges turning off the remote (yes I admit, having 3 remotes is confusing)
– Sharing a meal
– Remain in charge.

You may recall that I previously blogged on the UK having a Minister for Loneliness, so it comes as no surprise that the Public Health Agency of Canada reported that “people with adequate social relationships are at a 50% lower risk of death than those with poor or insufficient social relationships. As a risk factor for mortality, social isolation exceeds obesity and physical inactivity.” Welcome to the OASIS model that developed organically in a Kingston Ontario apartment building and is being started in a mid town Toronto apartment building.

Christine McMillan is the driving force and OASIS came to be because of her determination and hard work as well as support from community partnerships (the South East Local Health Integration Network or SELHIN) and Trillium Foundation grants. Oasis is also working with UHN OpenLab. OpenLab describes themselves as ‘a design and innovation shop dedicated to finding creative solutions that transform the way health care is delivered and experienced.’

Oasis is truly a supportive living program created for the seniors and designed by the seniors. Government monies provided for the hiring of 24/7 PSW support (which complemented what the LHIN was already providing) and other services, including exercise programs, organized social programs and entertainment. Of interest as well was that many Oasis members who were eligible for long term care chose to defer this move- which provided substantial financial savings to the LHIN and our health care system.

The apartment owners provided the party room- which became a lounge and a separate dining area so this provided space for subsidized meals to be brought in three times a week.
It seems that what was naturally occurring in Kingston is having more of a challenge in getting the required support in Toronto.

*reference: https://uhnopenlab.ca/project/oasis/

Originally posted @allaboutestates.ca

All of the writers (and presumably the readers as well) know the importance of having their ‘important paper’ work completed. For me, most importantly this means completing Powers of Attorney for both Property and Personal care as well as Advanced Care Directives. For you, perhaps the ‘most importantly’ may be the Will, but regardless we can all agree that these are all key documents for living (and for dying) well.

Many people (of all ages) don’t like to talk about these things as they feel either:
– Nothing will happen to them and/or
– If they do talk about it, something will happen.
So where does that leave them?

I had the opportunity recently to review my own documents and reviewed again, with both my husband and children, what my wishes are and where the documents are located. This conversation was easy enough.
The more challenging discussion is how to talk to your children about completing their own paperwork. What is the right age to do this, when is the right time?

For me, the incentivizing factor was a trip they were planning- which would take them out of the country on holiday. My sons are in their late 20’s, have jobs and live on their own. I felt it was time. I shared this article with my sons and found it helpful.

I am well aware of situations where there has been an accident or serious misfortune involving a young adult (over age 21) and as a result, they sustained significant brain damage. Sustaining significant brain damage and capacity are often linked so having had an attorney for both property and personal care allowed the parent to deal with financial matters (school and car loans, banking) as well as personal matters including accessing their son’s social media accounts.

I know that this is not a pleasant topic to think about, but an important one to consider AND act upon.

Glad To Be A Day Older…..

by Audrey Miller on January 11, 2019

in Articles & Blogs by Audrey

Originally posted @ allaboutestates.ca
As we wind down 2018 and look forward to 2019, I always ask myself ‘where did the time go?’

I don’t really know because I am sure like many of you, I don’t feel much older than I did last year or the year before. I think we notice that someone else looks older (or has ‘aged’) when we look at them- but certainly not when we look at ourselves in the mirror. Look and feel are two different things.

A friend shared the following sentiments with me and I thought I would repost them. I am unable to ascertain who the original author is; Ms. Google dates it from 2015 from a variety of sources, so credit goes to someone, other than myself for the following 12 points below:

1. I talk to myself, because sometimes I need expert advice.
2. Sometimes I roll my eyes out loud.
3. I don’t need anger management, I need people to stop pissing me off.
4. My people skills are just fine, it’s my tolerance of idiots that need work.
5. The biggest lie I tell myself is “I don’t need to write that down, I’ll remember it.”
6. When I was a child I thought nap time was punishment. Now it’s like a mini vacation.
7. The day the world runs out of wine is just too terrible to think about.
8. Even duct tape can’t fix stupid, but it can muffle the sound.
9. Wouldn’t it be great if we could put ourselves in the dryer for ten minutes; come out wrinkle-free and three sizes smaller.
10. If God wanted me to touch my toes, he would’ve put them on my knees.
11. When the kids text me, “PLZ” which is shorter than please, I text back, “NO” which is shorter than “YES”.
12. At my age “getting lucky” means walking into a room and remembering what I came in there for.

Now, my own sentiments about getting older are slightly different. I am trying to be more thankful and appreciative of having another year. More specifically I am grateful for having another day- because truly, nothing is promised to us. Getting older is a gift and while there may be a few more grey hairs, extra pounds and extra wrinkles, the experience gained has provided me with some well earned wisdom along the way. Thank you and happy New Year.

Originally posted @allaboutestates.ca

At this time of year many of us, regardless of age, can get the flu. Unfortunately for seniors, the flu can be particularly dangerous- for a number of reasons
– Pneumonia
– Dehydration
– Greater falls risk with weakness
– Body weakness and
– Delirium- the topic of today’s blog

I had previously written about hospital acquired delirium which I believe merits reposting.
“Delirium is one of the 3 big ‘D’s that we see with our older clients. The other ‘D’’s are dementia and depression but I suppose the biggest ‘D’ out there is death. I recently came across a Reader’s Digest article while waiting at a doctor’s office that had been reprinted from The Walrus. The original title is “Why Is No One Talking About Hospital-Acquired Delirium?’” Read more about Delirium

Over this holiday period I had a number of clients get sick, enter hospital and develop delirium. The Mayo clinic shares that the ‘signs and symptoms of delirium usually begin over a few hours or a few days. They fluctuate throughout the day, and there may be periods of no symptoms. Symptoms tend to be worse during the night when it’s dark and things look less familiar. Primary signs and symptoms include:

Reduced awareness of the environment, such as:
– An inability to stay focused on a topic
– Getting stuck on an idea rather than responding to questions or conversation
– Being easily distracted by unimportant things
– Being withdrawn, with little or no activity or little response to the environment
Poor thinking skills, such as:
– Poor memory
– Disorientation
– Difficulty speaking or recalling words
– Rambling or nonsense speech
– Trouble understanding speech
– Difficulty reading or writing
Behaviour Changes and may include:
– Seeing things (hallucinations)
– Restlessness, agitation and combative behaviour
– Calling out, moaning or being quiet and withdrawn
– Slowed movement or lethargy
– Disturbed sleep and reversal of night-day-wake cycle
Emotional Disturbance such as:
– Anxiety, fear or paranoia
– Depression
– Irritability or anger
– Apathy or euphoria
– Rapid mood shifts

The risk here is that the amount of recovery can be dependent on the health and mental status of the individual before the onset of delirium.
A healthy person is more likely to recover; those who already have MCI or some degree of dementia, may not.

Lesson Learnt: If you notice any of the above symptoms, have them checked out.

Glad To Be A Day Older…

by Audrey Miller on December 31, 2018

in Articles & Blogs by Audrey, Elder Care

Originally posted @allaboutestates.ca

As we wind down 2018 and look forward to 2019, I always ask myself ‘where did the time go?’

I don’t really know because I am sure like many of you, I don’t feel much older than I did last year or the year before. I think we notice that someone else looks older (or has ‘aged’) when we look at them- but certainly not when we look at ourselves in the mirror. Look and feel are two different things.

A friend shared the following sentiments with me and I thought I would repost them. I am unable to ascertain who the original author is; Ms. Google dates it from 2015 from a variety of sources, so credit goes to someone, other than myself for the following 12 points below:

1. I talk to myself, because sometimes I need expert advice.
2. Sometimes I roll my eyes out loud.
3. I don’t need anger management, I need people to stop pissing me off.
4. My people skills are just fine, it’s my tolerance of idiots that need work.
5. The biggest lie I tell myself is “I don’t need to write that down, I’ll remember it.”
6. When I was a child I thought nap time was punishment. Now it’s like a mini vacation.
7. The day the world runs out of wine is just too terrible to think about.
8. Even duct tape can’t fix stupid, but it can muffle the sound.
9. Wouldn’t it be great if we could put ourselves in the dryer for ten minutes; come out wrinkle-free and three sizes smaller.
10. If God wanted me to touch my toes, he would’ve put them on my knees.
11. When the kids text me, “PLZ” which is shorter than please, I text back, “NO” which is shorter than “YES”.
12. At my age “getting lucky” means walking into a room and remembering what I came in there for.

Now, my own sentiments about getting older are slightly different. I am trying to be more thankful and appreciative of having another year. More specifically I am grateful for having another day- because truly, nothing is promised to us. Getting older is a gift and while there may be a few more grey hairs, extra pounds and extra wrinkles, the experience gained has provided me with some well earned wisdom along the way. Thank you and happy New Year.

The happy season is now upon us and back by popular demand I am sharing my holiday jingle. It is written with the best of intent and I hope will make you smile.

T’was the fight before Christmas, when all families know,
It’s better to forgive than tell them to F. O.,
Mom probably liked you better, if memory serves,
So while I am a P.O.A., she will get what she deserves

Come on siblings and get off your butts,
I need alittle help, ‘cause I really am going nuts,
I am pulled in many directions, with no time for my own,
Let’s hire an expert who we can speak with by phone

This Plan will save time and money and help us agree,
We can all care for Mom, in addition to me!
A Plan of Care will outline Mom’s needs,
Working together, we all will succeed

All families are strange, of this I am sure,
Now where did we put Elder Caring’s brochure?
Some guidance is needed to keep mom from harm
‘Cause with caregiver burnout, I’ve nearly bought the farm

I won’t wait this time, I will call them right now
Professional counsellors will give me know- how
I found it along with various papers
Advanced directives, wills, now finally some answers!

Meeting a counsellor, has made it much easier
I now have perspective on how to proceed
Hiring a caregiver is just what I need!
Alittle respite will go a long way
Of keeping my sanity day after day

Why did I wait? I really don’t know
We are living to 100 and there’s a long way to go
Having knowledge and resources makes it much easier
And learning when to say Yes and how to say NO!

Our government tells us, we should be aware
For those less fortunate, it may not be fair
Our society is aging and we all will need care
Live with your children? A threat or a dare?

Dementia is scary, forgetting all we know
The best is to love but how can we let go?
I too am part of the boomers, still looking ahead
One needs to be positive, no point feeling dread

We’ve had the talk and filled out the Binder
Make sure your wishes are clear- just a reminder
What’s ahead for us all, we really don’t know
I hope to have the choice when it’s my time to go

Planning ahead – my message is clear
Keep talking to your family and loving them dear

Our very best for a healthy 2019.
Audrey and the Elder Caring team

The holidays can be a wonderful time to spend together with loved ones, remembering the meaning of the season and celebrating together. When visiting with and sharing time with a family member who has dementia, the challenge is with the expectation. The Alzheimer’s Society notes that often caregivers must deal with feelings and emotions that arise when remembering past holidays when their family member was well. They may also feel overwhelmed with trying to maintain holiday traditions while keeping up their care giving responsibilities. They may worry about visitors who don’t feel comfortable around a person with dementia or about meeting expectations of friends, family and themselves. They may even feel guilty for not being able to get into the holiday spirit.

The person with dementia may have an equally difficult time coping with the holiday season. They may find that they feel a particular sense of loss at not being able to participate the way they once did. They may find it difficult and anxiety inducing to deal with the influx of guests and the change to routines. If you find yourself in this position, there are things that you as a caregiver can do to reduce stress for both yourself AND those you are caring for.

For caregivers, it is important to recognize your limits and take time for yourself. Try to change the expectations you place on yourself and others. Keep other family members and friends informed of your loved ones’ medical and cognitive status and seek help from them when you need a break.

To help make the holiday season less stressful for your loved one, and thus more enjoyable all, MAREP, an Alzheimer’s research organization has provided some great suggestions:

Take your time – synchronize your pace to that of your family member with dementia. The holiday season is about enjoying quality time with family and excessive entertaining activities can be overwhelming
Plan one activity at a time – multitasking can lead to frustration for everyone. Understand if your family member doesn’t seem to appreciate the efforts of an elaborate dinner – they may be happy to be in your company and get anxious with all of the activity and fuss involved in meal preparation. Alternately, they may enjoy being included in the preparations for the holiday meal
Consider the noise level and multiple distractions that cause a person with dementia a great deal of stress when with large groups of family or friends. Do not be offended if they want to go home immediately after eating dinner. Be considerate of the words “do you remember” as this often places pressure a person to reminisce and remember specifics if they have memory difficulty. Sharing photo albums of previous holiday celebrations can assist with a relaxing form of reminiscence.

Provide a quiet place for a family member with dementia to relax – they may need some time to relax to continue with the activities of the season
Set priorities and a routine for the holidays in advance. Decide what is most important and focus on those priorities.

Include the person with dementia in decision making around the holiday plans and listen to their preferences and hopes for the holidays,
Go for a drive/walk to watch the lights,
Play games (your own Hannukah or Christmas traditions),
Sing holiday songs.

Gift ideas can include:

Talking and sharing stories Looking at photo albums together.
Listening to music and watching old movies together. Hand lotion and a hand massage can be very well received- gentle touching can be appreciated. For those in the later stages, picture books of animals and babies are often well received. For the caregiver, providing some respite time can be a wonderful gift and one that is priceless.

Stress and the holidays may seem to be inextricably linked but by planning outside the usual box, these tips will hopefully reduce stress for both you and your family member with dementia.

Originally posted @allaboutestates.ca

Does her name sound familiar? Audrey was 57 years old when she died last month, by her own choice and with medical assistance. She had been diagnosed 2 years earlier with incurable cancer and had chosen to die on her own terms- except she really didn’t.

In her own words: “people like me are dying earlier than necessary because of this poorly thought out law” which requires the ‘suffering person to be competent immediately before life-ending treatment is administered’.

Ms. Parker had previously been ‘Assessed and Approved’ for assisted dying but because of the advances of her cancer and the high risk that she would lose her capacity, she opted to end her days before she actually wanted to. In my view this is a tragic story. Last week I attended a Dying with Dignity webinar highlighting some of the advances and key challenges that Canadians continue to face around Medical Assistance in Dying (MAID) and Bill C-14, the federal law on medical assistance. One of the most pressing issues of concern is around advance planning for those with dementia. An earlier polls conducted by Ipsos Reid, reported that 8 in 10 Canadians agree that individuals with a ‘grievous and irremediable medical condition, including patients with dementia, should be permitted to consent to assisted death in advance. Specifically the question is whether a ‘still competent patient with a serious degenerative illness should be allowed to make an advance request for assisted death that could be carried out when he or she is no longer competent.’ Today this issue is more prevalent than ever. As we age, more and more of us will be likely living with dementia. The question is whether we can choose to die with dementia- on our own terms. Something to think about…

Originally published @allaboutestates.ca

My fellow bloggers and I write frequently about Powers of Attorney, however my concerns are often focused on the lack of planning when it comes to making Powers of Attorney for both Personal Care and Property.
More specifically, although I do not have any statistical data, my subject matter experience tells me that people are more likely to have an attorney named solely for property than having both or only having appointed an attorney for personal care. People seem to care more about their finances than they do about they own care needs. Many times a trust or financial organization has been named as attorney for property yet there is no one named for care. Why do we continue to fool ourselves by thinking that we are going to live well and cognitively intact until we die in our sleep?

Dr. Katherine Arnup highlighted the death experience in the Vanier Institute of the Family research paper called Death, Dying and Canadian Families. I summarized her findings in a previous blog and while it is from a few years ago, I don’t believe much has changed.

The top 3 Canadian desires are:
Desire 1: We want to live forever: We are living longer with more and more of us reaching our 100th birthday.
Desire 2: We want to be fully able and then to die suddenly in our sleep: Only 10% are lucky enough to experience ‘sudden death’. The rest of us will likely linger. For many seniors’ ‘old age’ is accompanied by a progressively increasing number of ailments and chronic conditions.
Desire 3: We want to die at home: Most Canadians die in hospital.

I recently shared the death of a long time client of mine. Her last days were spent in the hospital and it was a difficult journey for her.

Part of our lack of planning, even by those who work in the health and legal fields is that of planning for when we become ill and are no longer able to make sound decisions. We ignore the inevitable and bury our heads in the sand. The message is timeless. Think about tomorrow and how you want to live UNTIL you die and choose someone who can speak for you when you can no longer speak for yourself.

by Cathy Preston, VP, Individual Markets at RBC Insurance, November 19, 2018

Read: ‘It Was 24/7′: Coping With The Stress Of Being My Mother’s Caregiver

At some point or another, most of us will have to assume a caregiver role in life, whether for a child, spouse, parent or friend. In my house, that role was taken on by my father when my mom was diagnosed with rheumatoid arthritis. But when he passed away at the age of 63, my mother’s full-time care fell to me and my sister.

In 2012, 8 million Canadians, or 28 per cent of the population aged 15 and over, provided care to family members or friends with a long-term health condition, a disability or problems associated with aging. And according to a recent survey among working Canadians, two in 10 had to take time off work to provide care for a loved one — a number that’s likely to rise given the aging boomer generation.

Whether it’s an aging parent, a sick child, spouse or friend, the emotional, mental and financial burden of a being a caregiver can be challenging at best, and potentially catastrophic without the proper supports in place. Based on my personal experience, here are five tips I can share to help better manage caregiver stress.

Don’t forget self-care
It may sound trite, but it’s truly important you look after yourself, too. In the last year of my mom’s life, I moved back into our childhood home and lived in the same room as her, while my sister’s family occupied the other rooms. It was 24/7 and all-consuming.

You can’t help others if you’re down for the count.
Caregivers can quickly become drained and exhausted, yet carry a sense of guilt if they want to escape for a bit and have some fun. It’s critical you allow time for self-care; even an hour a day to go for coffee, work out or meet a friend can help change your mindset and ease stress that can easily lead to depression or anxiety. After all, you can’t help others if you’re down for the count.

Accept help from others
Oftentimes people may feel a responsibility to handle everything on their own or believe that accepting help from others makes them appear weak. But even the most resilient or capable among us can become strained under the pressures of caregiving.

It’s perfectly acceptable to let others help, whether that’s an offer from the boss to send dinner to your house, a friend picking up groceries or running errands, or a family member coming by to help clean. And don’t necessarily wait for an offer. Decide what you are realistically capable of handling on your own, then prepare a list of things that can be delegated and let others choose which items they would like to help with.

Learn to communicate
The stress of caregiving presents itself in many ways, including irritability, anxiety and depression. Often, this can lead to caregivers becoming isolated or not feeling understood, reluctant to “burden” others with their situation. Some may argue with family members or have trouble expressing how they feel.

Reach out to a good friend, find local support groups where you can connect with others who are going through a similar situation and take advantage of any counselling services available through employee assistance plans. Being able to talk about your emotions is necessary for coping and can help create stronger bonds with loved ones.

Find support
One of the most overwhelming aspects of being a caregiver is the sheer number of responsibilities, from navigating the health care system to making decisions in times of crisis. Not to mention everyday errands, shuttling to doctor’s appointments or finding competent assisted care.

Although it may feel like it at times, remember that you are not alone
Sites like Elder Caring provide guidance, education and care management services to support patients and their families, with links to helpful resources and blogs on topics ranging from dementia to resolving family disputes. …