Originally posted @allaboutestates.ca

I don’t know about you- but I am struggling with our new normal and the mounting deaths in Long Term Care.  As you have been reading, for the last several years we have had major challenges in our Long Term Care system.  I previously wrote a 3 – part article on some of these challenges  ( Part 1: https://www.allaboutestates.ca/crisis-long-term-care/ Part 2:  https://www.allaboutestates.ca/crisis-ltc-homes-continued/ and   Part 3:  https://www.allaboutestates.ca/crisis-long-term-care-continued-3/

and they did not even touch upon some of  the major challenges being faced today with Covid- 19.  These current challenges ( and perhaps I need to write Part 4)  include a serious shortage of personal protective equipment, over crowding and lack of quarantine space, outdated policies and procedures and most critically at this time, the lack of testing protocols.  This is in addition to the pre pandemic challenges of the shortage of skilled personnel, older buildings and some of the other issues highlighted in the above blogs.

On May 23, 2020  there were over 1,262 deaths on Ontario Long Term Care residences.   This number is likely even greater this morning.

I have two questions/complaints today.  The first is not understanding why there has been such a delay in testing ALL patients and ALL staff  who work in Long Term Care residences. Yes many of us may be asymptomatic and we need to know this.  Why is this testing only starting now?

The second question/concern I have,  and I believe for the families with whom I work, is even more upsetting, is why have we kept all family members away from Long Term Care when the need is greater than ever?  Why bring in the army and why asks for volunteers when there are many many family members who want to be there to provide care, comfort and support. I have yet to hear any satisfactory answers.  Have you?  Our entire approach to aging, living and dying need to be re examined.

These are my questions this Monday morning and I welcome your thoughts and comments.

Originally posted @allaboutestates.ca

In this time of uncertainty when we don’t know what tomorrow will bring, there are a few things we know we can count on, such as the bond between mother and child.  For those of us today that cannot hold, hug or embrace our mothers, it is indeed a difficult time. We have to believe that they know they are loved and for those who have lost a mother, we have to believe that they knew they were loved.

“To the World

You are a Mother.

But to your Family

You are the World!”

I don’t know who wrote it, but I believe the sentiment. We all have had a mother and chances are this person shaped our lives more than any one else. For many of us, our mothers were our first loving and significant relationship. Our mothers influenced us, guided us, taught us, and loved us- unconditionally.

In my day to day work with families, I see many different mother- child relationships.  Most are  loving and caring and others that seem to be so complicated and challenging, I wonder what their history was together. When frailty and dementia are evident, sometimes we have to look a little deeper to remember the happy and healthier times.

This physical distancing is difficult and I share in the sadness of not being able to hug our mothers and similarly, it is difficult not being hugged by our children.

It is indeed a Mother’s Day like no other and I can only hope we will be able to hug each other soon.

Originally posted @allaboutestates.

It is hard to focus on anything outside of the current state of affairs and mounting challenges  as a result of Covid. Everyone’s lives are impacted at some level, so today’s blog discusses a few elder care concerns I am seeing.

Most recently I have read that the Ontario government is making changes to long term care homes through a temporary emergency order which is supposed to assist with staffing.  The order “removes training requirements for workers, allows homes to bring in volunteers and eliminates the need for administrators to report most complaints to the ministry”.    While in theory we can also support additional care being made available it does not necessarily mean the providers have the necessary education/training  or will be even paid appropriately to be safely delivering these services.  I don’t know what this is going to look like and my fingers are crossed.

I  am receiving many calls from families who want assistance dealing with increased caregiving challenges.  This ranges from not being able to visit family members who may be in a hospital, retirement or long term care facility to being alone with your care-partner and not having any breaks at all as community programs have temporarily closed their doors.

Ensuring we have copies of our parent’s powers of attorney documents handy- just in case we need to act in a hurry – is another key message I am speaking with my clients about. This is especially critical if you are not living with your aging relatives.

Staying in communication either by phone or internet is also really important now for families who can no longer visit one another. For those many individuals who are not able to communicate by telephone, this makes it even more difficult.

Keep talking together.  I have been so touched by watching family members sing and play music to their loved ones from afar.  I thought I would share this  video of one local residence. https://www.youtube.com/watch?v=pDamTmswNuU


Originally posted @allaboutestates.ca

Today’s blog is sent from my home office to yours, as you are likely  working from home- whether you are already in self quarantine or being socially distant and respectful. So much can change in one week and hard for us all to imagine what next week will bring.  However until then, I want to share some positive activities that can be initiated as we figure out how best to support our seniors who are undoubtedly struggling with this current state of  ‘stay home and welcome no visitors’. Thanks to Laura Tamblyn Watts, Policy Director from NICE for sharing these suggestions.

Virtual connectedness is a fantastic tool and I know teledining has been around for some time, thanks to my buddy, Ron Beleno, dementia advocate and caregiver. Until next week, stay well.

Originally posted @allaboutestates.ca
Recently I had the pleasure of taking a vacation with my mother and husband. As it turned out, it was a family oriented resort which put us in the middle of young parents and young children.
Now while several of our friends have grandchildren, my boys are not there yet.  So…..we spent several days enjoying inter generational families  (grandparents and grandchildren) enjoying each other’s company.
This ‘family time’ reminded me of the summers I spent with my own maternal grandparents and how I took for granted three generations living together under one roof.
Times have changed….think of how many families/friends  you know where the adult children have moved out of the province ( or out of country) for educational and then employment opportunities. Many never return ‘home’ and as a result, like my own nuclear family, parents /grandparents live many hours drive ( or flight) apart.
It is not just grandparents who find themselves not enjoying a daily, weekly or monthly visit.  Familial relationships become more complicated and definitely more distant when siblings and first  cousins don’t know each other.
So today I feel fortunate being able to spend quality time not only with my own mother  and husband but also witnessing the joy that these many families appear to be experiencing together.
Life is short.


by Audrey Miller on March 8, 2020

in Articles & Blogs by Audrey, Elder Care, Health Care

Originally posted @allaboutestates.ca

As I sat down to write today’s blog, it seems that the topic that is on many people’s mind is the coronavirus or Covid 19.

As some of you may know, I often write/present about being better prepared and understanding options in advance is my preferred message. So I thought today’s blog would discuss some things we can do to prepare ourselves and our aging relatives to avoid getting ill if at all possible and getting ourselves prepared should we get sick.

As of Feb 28, 2020, “public health officials say 14 confirmed cases of the novel coronavirus have been diagnosed in Canada so far, with seven cases reported in Ontario and seven in British Columbia. One presumptive positive case has been reported in Quebec.”

While our numbers are not as high as other countries, we are being proactive.

The U.S. Centers for Disease Control (CDC) is monitoring the situation closely and is the best source of information. The CDC is urging individuals to stay calm and Share Facts, Not Fear. Among the CDC’s advice are these common-sense tips:

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

It’s also important to remember that we are still in the middle of the seasonal flu season, which impacts older adults every year. According to the CDC, it’s estimated that 70-85% of seasonal flu-related deaths have occurred in people aged 65+.

While there is no vaccine for the coronavirus, it’s never too late for individuals to get their annual flu shot. Talk to your doctor or pharmacist about how you can protect yourself and those around you.


Dr. Vera Etches, the City of Ottawa’s top health office Shared that in terms of being prepared, we should think about being home for a period of time which would include stocking up on needed prescriptions ahead of time so there is no need to do so during a possible pandemic. She also recommended people stock up on non-perishable food.

If you are caring for someone and are not feeling well, stay home and see  who can provide coverage for you.

Stay well!

Originally posted @allaboutestates.ca

January  was Alzheimers’ Awareness Month and  on January 30th,  we also recognized and raised awareness for Young Caregivers.

Many young carers,  defined by Stats Canada as young people between the ages of 15-24,  are helping their family members who are living with dementia. There are many carers who are much younger who also provide support and care to the family but are not part of the larger Stats Canada data collection.

Previous research  highlights that on average, these young people are spending between 14-27 hours of care per week, the equivalent to a part- time job.

In 2012, in partnership with the Vanier Institute of the Family, we produced ‘Lucky, The Young Carer Rap’.  Today, eight years later, the numbers of young carers has increased. There are now organizations dedicated to supporting these young people including  Youngercaregivers.ca and St. Elizz   and documentaries and films, such as Much Too Young.

Today we have more seniors  aged 65 and other than children under 15 and tomorrow this number will continue to grow.  With more seniors and less children, we will see more family members taking on these caregiving roles.  While caregiving might be shared amongst family members, there are just fewer young people available.

I am not aware of many young people who choose to provide care to a parent or grandparent but there are many in this very situation.

January 30th was a day about bringing increased awareness of young caregivers. However, any day is a good  day to talk to your families and your children about  these young caregivers so they do not remain hidden and on their own.


-Audrey Miller


Interview by Jennifer Paterson January 10, 2020

In 2018, 25 per cent of Canadians, or 7.8 million people, aged 15 and older provided care to a family member or friend with a long-term health condition, a physical or mental disability or problems related to aging, according to data published this week by Statistics Canada.

This compares to 8.1 million people, or 28 per cent of Canadians, when the data was previously published in 2012.

While the numbers are decreasing, the issue is that fewer caregivers are having to do more, says Audrey Miller, managing director of Elder Caring Inc. While the data showed 64 per cent of caregivers said they spent less than 10 hours a week on these responsibilities, 15 per cent spent 10 to 19 hours and 21 per cent spent 20 hours or more.

Read: Elder care costs Canadians $27B annually in lost income, vacation

Also, while the 2012 data found 35 per cent of Canadian caregivers are juggling work with their responsibilities, the latest data didn’t delve into this area. “I don’t know if that number has changed,” says Miller. “That information isn’t here. . . . Having said that, the information is going to be the same as it was in terms of absenteeism, presenteeism, challenges that mainly women have who are looking after parents. That continues to be the bulk of the carers.”

Indeed, the latest data found half (47 per cent) of all caregivers reported caring primarily for their parents or parents-in-law in 2018, while about 13 per cent reported providing care to their spouse or partner and eight per cent said they provided care to their child with a long-term health condition, or a physical or mental disability.

“Providing care to children can be a challenge, given that children often require more intense care, but also because many caregiving parents are active in the labour market,” noted Statistics Canada. “Despite the often competing demands of care and working in a paid job, the parents who provided care for their child typically spent just over 14 hours on caregiving activities per week.”

Read: How to support working caregivers

In 2018, about 70 per cent of caregivers said they received some kind of support or assistance for their caregiving duties. The most common source of social support was when the caregiver’s spouse or partner modified their life or work arrangements to help (45 per cent).

However, many caregivers don’t receive the social or financial support and assistance they require. In 2018, about one-third of caregivers said that there was another kind of support that they would have liked to have received in the previous year. These included financial support, government assistance, and tax credits (68 per cent); home care or support (40 per cent); information or advice (39 per cent); and help from medical professionals (36 per cent).

Since December 2017, when the federal government made changes to employment insurance benefits aimed at helping caregivers, it has received an increasing number of claims for the benefits. In 2018, it said it expected to receive about 22,000 claims for caregiving benefits by fall 2019.

“There’s more financial support and there’s more talk [from the provinces] about caregiver benefits and allowances,” says Miller.

Read: More than 8,000 caregiving EI benefits claims since Dec. 2017: Feds

But employers also have a role to play in terms of the information and advice required by caregivers. “There’s a lot out there,” says Miller. “People don’t know how to access things. People don’t know how to navigate the system. . . . The insufficient supports lead to poor mental health, caregiver burnout and high, high stress. It’s very hard to function on the job when you’re worried about other things.”

So what can employers do? “I think being aware is No. 1 — not having your head buried in the sand,” says Miller. “Being able to offer some lunch and learn services that aren’t going to cost the employer big dollars. . . . We’re not going to resolve issues, but we’re going to be able to provide answers.”

In addition to services from human resources and an employee assistance program, many employers and employees may not be aware that their extended health benefits also offer an option. “Registered social workers visits are frequently covered,” says Miller. “The consultation . . . isn’t going to break the bank, but when people know they can submit [the claim] because, even though we’re talking about their parent, I’m consulting to you, adult employee, as you’re having the issue.”

Welcome to 2020!  Truly hard to believe that we are in a new decade. Time seems to have flown by.  As I sat down to write this blog, I wanted to start the new year with some good news.  I thought I would update readers about the long awaited spousal unification program.   In fact I blogged about this very topic in January 2017 with the following story:

‘After 70 years of marriage Norman and Mae are told by our government that in order to get the care they need, they need to live separately. Certainly there is something not right about this statement, yet as hard as it is to believe, that was the story reported in the National Post on Jan 6, 2017.  At age 94 and 91, Norman and Mae have enjoyed what can be considered a long life and an even longer marriage. The article indicates that they have always lived together- no easy feat at any time. I sincerely doubt they ever anticipated having to live separately in order for them both to receive publicly funded care in a Long Term Care facility.

As we age we may not always have the same health care needs as our partners. A couple’s different care needs may be able to be met in the community if finances permit either at home or in a retirement setting. However when care needs exceed what can be met in the community, many look to Long Term Care facilities, our publicly funded ‘nursing’ homes.

Norman and Mae had both applied for Long Term Care.  According to the story, Mae was offered a bed at her preferred setting. By the way, one typically has 24-48 hours to make a decision as to whether to accept the placement or not. If she accepted the bed, Norman would be on his own, which the family felt was not manageable. She passed on the placement bed so she could remain with her husband. Only a few short weeks later, Norman was offered a spot at the same facility where Mae had declined the bed offer. However due to Ministry policy her name had been removed from all of the waiting lists and she now has to wait 3 months before she can even reapply. There was no mention how long the initial waiting period had been. Many of the ‘preferred’ homes have wait lists of several years.’ This has not changed since this blog was first written.

I don’t know what happened to Norman and Mae but  I continue to read about many other couples who find themselves in similar situations.

In December, Waterloo MPP Catherine Fife and the ‘Till Death Do Us Part Act’ passed second reading. It must still pass a third and final reading before becoming law.

It’s a new year and a new decade and I am in an optimistic mood.  The government is reportedly investing $1.75 billion over the next five years to create 15,000 new LTC beds and will also redevelop 15,000 older.  Maybe this is the decade where we will have adequate beds available and couples will be able to  live together in a publicly funded facility and receive the care they need.


It is hard to believe that  Christmas and Hannukah start next week.  Truly, where does the time go?  Well, given that we are here I thought I would repost a holiday blog.

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)and 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.