Sunday, November 30, 2014

Facilitating a Good Death for Your Loved One

Dedicated to my friend, Amelia Pryor, who passed away October 17, 2014.

Who has not wondered, at least once in a while, what their last moments will be—fraught with agony, grief and remorse, or eased with peace, acceptance and joy. Concern about a loved one's passing can weigh especially heavily on a caregiver who feels such deep responsibility.

So, how can caregivers help to facilitate a “good death” for their loved one while taking care of themselves? Although never easy, preparing for the inevitable is the first step.

In our own time, death has been denied, rejected or treated as an abject failure.  Other cultures take an opposite view. Some have had an obsession with death, or death may be treated as an ordinary, everyday reality, or as the highest reward. Consider ancient Egypt and the cult of the dead: royal mummies placed in outsized pyramids rise out of the desert sand. Or regard contemporary Catholic Mexico with its All-Soul’s Day, children dangling skeletons and other remembrances of our human mortality. Even today, death haunts certain sectors of the Arab world, whose belief in jihad (death to non-believers) attracts young, displaced men, who do battle to die for their cause, and win a special place in Paradise.

When Americans do reflect on death (which for most of us is a special, even rare occasion), a good death may mean having one’s loved ones in attendance or at least having said a loving goodbye, and, above all, enjoying a painless passing. But the reality of our current snarl of medical, drug and insurance interests has confounded these simple goals. For many, dying has turned into a prolonged period of extreme medical interventions and a final, agonizing and only-too-often anonymous demise in a hospital or nursing home.

Caregivers can do better for their loved ones. Consider some of the following suggestions for easing the end of life.

1. Plan Ahead. The capstone of a life well lived requires talking about it beforehand. Even if that conversation never occurred, do the right thing by considering what your loved one would have preferred if they had had a voice.

2. Contact Hospice.  If your patient has a life-limiting disease, hospice treatment, with its focus on care, not cure, can address the full range of physical, emotional and spiritual needs of a dying person.

3. Make Your Wishes Clear. While you’re at it, why not also have a say in your own end-of-life care by completing an advance directive? Having that talk about your own mortality and how you choose to end your days can be a tremendous relief for both you and your family. Your fears and denial about your own ending will be profoundly lessened.

4. You Have the Power. As a caregiver, you can be an advocate for your loved one by having a Medical Power of Attorney. Strive to create the perfect setting for his or her final moments, whether in a care facility, hospice residence or your own home. Your dying loved one may enjoy special music or a religious ritual and the awareness that their nearest and dearest will continue to remember and honor his or her life.

5. Develop a No-Regrets Perspective. By providing the best care possible over the course of the illness, and by staying within your own physical, emotional and financial limits, you can free yourself from guilt and distress as you let go of your loved one. Being at peace with yourself will ultimately make for a more peaceful passing for your cherished person.

Tuesday, November 4, 2014

Plan of Action in the Event of a Crisis

It may be instructive for some readers to know that I landed in my local hospital (PeaceHealth St. Joseph Medical Center in Bellingham, Washington) over the summer with a compressed back fracture after a fall in my garage. I managed to avoid surgery, but the healing process has been excruciating, and ever so slow. I did manage to learn some important facts along the way, which I can pass along to you. 

1. Always be or have a strong advocate when you go through the emergency room—a typical route for accident, cardiac, burn or stroke victims.

2. Be prepared for different types of pain and discomfort. First is the pain of the original event or injury. Next, is the pain associated with medical intervention. Often that is surgery, but sometimes, other treatments cause ancillary pain. An important source of imbalance is pain medication, essential to endure the injury or medical situation.

However, over time, pain medication can produce constipation, anxiety, personality changes, agitation and other side effects, depending on the individual’s overall health and body chemistry. Another issue in the healing process is incapacitation: the inability to carry out your normal activities. In some cases, this can last for weeks at a time.

3. Be certain you or your advocate has a grasp of hospital organization, can be present for discharge and fully understands the physician’s instructions. This includes types of medicine, times to administer, dosages and warnings of potential interactions. Medical staff should also discuss the physical limitations of the patient, next doctor’s appointment, short-term home care and long-term prognosis. 

Preferably, have a second person on board who can verify the doctors’ orders—a close relative, friend or professional caregiver hired before you or your loved one come home.

If the patient has been formally admitted and spent at least three nights in the hospital, he or she may qualify for rehabilitation services. Ideally, the caregiver has already researched available facilities. If not, it’s wise to do so before release. 

Remember: Planning for a possible crisis before it happens can assist you, your loved one and your entire family to achieve a smooth transition into care—and back to wellness.

Friday, October 3, 2014

Guest Post: Understanding Age-Related Hearing Loss

By Joan McKechnie

According to the Hearing Loss Association of America, approximately 20% of adults in the U.S. report some level of hearing loss. Of these 48 million people, the vast majority are the over the age of 65 and hearing loss is specifically linked to changes in the body due to aging. The organization further reports that at the age of 65, one out of three people reported hearing loss. Understanding the cause(s) behind age-related hearing loss is the first step in maintaining quality of life.

 Why Is Age-Related Hearing Loss So Common?

 Many argue that advances in health care are helping people live longer and longer. However, certain organs in our body may not able to continue to function optimally for that long. In age-related hearing loss, the actual structures within the inner ear often cease to function.

 The inner ear contains a vast number of tiny receptor cells known as hair cells. (If viewed under a microscope, they have structures that look like hair poking out from their tops.) These hair cells help pick up relevant information within incoming sound waves, translate it into electrical pulses and, via the hearing nerve, the information is transmitted to the brain for decoding.

As we age, sometimes from as early as our mid to late 40s, hair cells may begin to deteriorate. The body is unable to regrow new hair cells at the moment, so when a critical mass of hair cells is affected, hearing loss will be experienced. In time, that gradual loss in hearing ability can start impacting quality of life.  Once this has occurred, the condition does not simply “go away.” Rather the negative effects tend to get worse the older one gets.

Other contributing factors may accelerate the progression of age-related hearing loss:

·         Damage to the inner ear hair cells from prolonged exposure to harmful noise levels
·         Family history
·         Certain medical conditions and medications
·         Smoking

What Does Hearing Loss Sound Like?
We use the phrase “sound like” because age-related hearing loss rarely leads to complete deafness. Typically, an individual will retain some hearing ability. Common symptoms include:

·         Difficulty hearing people around you, especially in noisy areas
·         Frequently asking people to repeat themselves
·         Frustration at not being able to hear others, TV, radio, etc.
·         Certain sounds seeming overly loud
·         Problems telling apart certain sounds such as “s” or “th”
·         More difficulty understanding people with higher-pitched voices
·         Ringing in the ears

 Why Is It Essential To Manage Age-Related Hearing Loss?

Beyond the obvious reduction in quality of life and risk of becoming socially isolated, growing evidence suggests that if left unmanaged, hearing loss can aid in the progression of dementia and Alzheimer's disease. Researchers believe that the strain put on the brain to decode sound when hearing loss is left unmanaged is simply too much and overwhelms the brain. Another idea voiced by several studies is that social isolation, which is commonly experienced by people with hearing loss, may also aid in the progression of these conditions.

 Can Age-Related Hearing Be Cured?

Sadly, no. Because the body is unable to regenerate hair cells, the damage is irreversible. However, using devices such as hearing aids, the condition can be managed. The first step is getting a hearing test at your doctor’s office or local hearing center. The test will show if you have any hearing loss and its severity. Many types of hearing aids are available, as are other helpful devices that amplify sound.

Hearing loss should not be ignored. It can and should be managed.

Joan McKechnie, who is HCPC Registered (Health Care Professions Council in the UK), works for Hampshire-based

Wednesday, May 21, 2014

Guest Post: A Few Ideas for Improving Your Elderly Parent's Quality Of Life

By Genevive Serrao

Once our parents get older, it’s only natural to want them to stay safe and happy, above all else. While it’s difficult watching a parent grow older, knowing their life will never be the same again, a few simple things could do wonders. 

Strength Training is Vital

Even if your elderly parent exercises regularly, they may not be focusing on the right muscle groups. Want if they’re going to the gym and only using a treadmill? Not that walking isn't important, mind you. However, strength training is much more effective for helping your aging loved one stay strong. It prevents bones from becoming weak and brittle, as well as increases flexibility and range of motion, which ultimately make for greater quality of life.
Encouraging Social Interaction

Everyone needs friends—even if the visits are brief or only once a week. Your local area should have a few places where your parent could meet other seniors. Maintaining social connections has a way of keeping spirits up. Family members can’t always be there to keep their loved one company, after all. And, current research suggests that when seniors spends too much time alone, they have an increased likelihood of feeling lonely or depressed.  

Spending Time with Grandchildren

Many elders love nothing more than spending time with their grandchildren. Moments together can make for lasting memories. And you don’t have to live down the block to stay close. You can keep your parents in the loop by sending family photos, and if they know how to use a computer, chat via Skype.

Looking for Potential Issues

As our loved ones “age in place,” we have to keep an eye out for potential safety hazards. Something as simply as reaching for a something in a high kitchen cupboard could lead to serious injury. Check that rooms have all necessary safety features (like grab bars in the bathroom) and take the time to keep the most frequently used items in the home easily accessible.  

Keeping it Clean

Your elderly parent may be used to cleaning up after everyone —just as they may have always done. Perhaps you could encourage them to let go of outdated expectations and devote more time to hobbies or new interests. Hiring a cleaning service frees them from worry about scrubbing floors or keeping the bathroom clean.

What could be more satisfying than seeing your parents making the most of their golden years?

About the Author

Genevive Serrao, the contributor of this article, is currently writing for New York Housekeeping, a company specializing in maid and house cleaning services. Genevive loves playing guitar and is a Jimi Hendrix fan. You can follow Genevive on Twitter (@SerraoGen).

Sunday, April 6, 2014

Guest Post: The Cultural Divide... How We Care for Our Elderly Around the Globe

By Genevive Serrao

Placing our elderly relatives in a care home is a common practice in the Western world. But this practice is all but unheard of in the East, where they prefer to look after their own family members. Neither of these cultural differences seems to be wrong, but why are they are so far apart in terms of emotional and family-related care? Let’s take a closer look at the way that elders are treated in different parts of the world.

The West

We’ll kick off with the care of the elderly that we are most familiar with—in the Western world. Impersonal care characterizes our healthcare system and has many negative connotations for the elderly. In the not-so-distant past, elderly and ill relatives were sometimes moved into large and remote facilities, where abusive behavior was tolerated. Thankfully, nursing and retirement homes conditions have improved in recent times. The fact does remains: Why do so many families choose institutional care for their elderly loved ones?

Developing Countries

In the majority of poorer countries, nursing homes for the elderly simply do not exist. This may be due to financial constraints, but is probably more a result of cultural differences. Families tend to look after one another and that includes  parents, once they grow old and can no longer manage their own care. As these countries become more influenced by the west, it seems that some governments are looking into the possibility of private health care for the elderly population.


Japan’s growing number of older adults are becoming something of an issue in their traditional culture. It continues to be common for parents to live with their grown children until they die. With Japan’s considerable economy and personal wealth not being an issue, we are now witnessing an increase in private health care and retirement homes. 


With more than 2 billion people, you would imagine that the Chinese would have some type of care already in place for the expanding number of elders. Decision-makers in this Eastern powerhouse do not seem to consider that a real priority, though. Families continue to follow the old ways of looking after aging relatives until their demise. Families rely on hospitals primarily for short-term care and even serious illnesses. With the average life expectancy increasing every year, one wonders about how this will affect the typical Chinese household in 20 years’ time?

East Meets West

BBC recently reported that some families in Europe are opting to “export” their loved ones to care facilities are far away as Thailand, which has a “strong culture of looking after its elderly.” Costs are significantly lower for dementia care than in countries such as Switzerland, Germany and England, while the reputation for quality care is “very high.” Families stay in touch via Skype and the occasional visit. While this practice is not yet common, the number of families forced to send their family members continents away may inevitably increase along with the elder population. 

The Future?

With the rising costs of private care homes and the faltering economy, perhaps the West could learn from their Eastern counterparts and keep their aging parents a little closer to home during their later years. The reality is that families in the U.S. and abroad may want to care for their loved ones in their own homes, but, despite their best efforts and intentions, cannot cope with the overwhelming demands of caregiving.

About the Author

Genevive Serrao, the contributor of this article, works with All State Cremation, providers of simple cremation services in Hamden, CT. Genevive loves playing guitar and is a Jimi Hendrix fan. You can follow Genevive on Twitter (@SerraoGen).

Saturday, January 18, 2014

Guest Post: 5 Places to Look When Seeking Dementia Care for a Loved One

By Ryan Hughes

It is absolutely heart-breaking to see someone you love suffering from dementia. When dementia strikes, everything changes. The one you love may not be able to perform simple tasks any longer or may lose the ability to solve day-to-day problems. Feeling like you’re on an emotional roller coaster is common, with all of the personality changea. Dementia is a disorder that cannot be handled alone. You need to get help. Here are five places to look when seeking dementia care for a loved one.

Begin with the Primary Care Physician
A proper diagnosis is key and it is important to eliminate any other possibilities. Dementia is often misdiagnosed as Alzheimer's disease and vice versa. Reactions to medication, thyroid conditions, and lack of certain vitamins can also cause similar symptoms. A visit to your loved one's physician is important to get a baseline status, health history, and a referral to a specialist. A battery of tests will be performed, including brain imaging and blood tests in order to gather comprehensive information.

Visit One or More Specialists
When dementia is suspected, a specialist will be the next step in order to get the specific care that is needed to deal with your loved one's disorder. Ask the primary care physician to point you in the right direction and do your own research as well. Expect to make the rounds as you visit psychiatrists, psychologists, neurologists, and doctors, who have made dementia their area of expertise.

Seek Online Sources of Assistance
You'll find a host of helpful resources online. The Alzheimer's Association ( has a great deal of information, including the Alzheimer's and Dementia Caregivers Center. There is a help line that is available at all times, as well.

Learn About Lifestyle Modifications
Many steps can be taken at home to assist your loved one who is dealing with dementia. Discover medications that are helpful in improving symptoms, providing your loved one with more clarity and peace of mind. You can also make changes in diet to promote cardiovascular health and brain functioning. Reduce the amount of red meat in the daily diet and include a great deal of fresh produce. Whole grains, fish, and foods that are rich in omega-3 fatty acids are beneficial for cognitive abilities. Your loved one also needs regular, physical activity to keep the blood circulating and maintain well-being.

Bring in Home Health Care Aides or Seek a Facility
If your loved one can no longer be independent, you can bring home health care aides into the home on a daily basis. However, you may find that moving your loved one to a facility is the best option for round-the-clock care. There are many facilities that specialize in providing care for dementia patients. You can ask the primary care physician and team of specialists for their top recommendations. The Alzheimer's Association and other online sources can assist you in narrowing your search in order to find the best in care for your loved one.

Dealing with dementia in a loved one is truly challenging. Fortunately, resources abound to help you in caring for a dementia patient. Don’t give up. There is always hope... and helping hands.

Methodist Homes ( is a Christian organization providing care, accommodation and support services for persons 70 and older throughout Britain.

Friday, January 10, 2014

Guest Post: Enhancing Senior Health with Yoga

By Shannon Lochwood

Yoga is often practiced by young people looking to maintain their health and improve their overall fitness level, and many older adults aren’t familiar with even the basics of yoga. However, that doesn’t mean that seniors can’t benefit from taking yoga classes or doing yoga on their own.

In fact, yoga has a wide variety of benefits for senior citizens – maybe even more than for younger participants. While certain types of yoga may not be ideal for seniors, there are forms that will be beneficial for seniors of all different levels of health.

Image courtesy of Shutterstock
Improved Flexibility
Decreased flexibility is often a common problem for older adults. While any type of regular exercise like walking, jogging or even playing a sport like tennis or golf can improve flexibility, yoga is one of the best activities to immediately improve flexibility over the entire body.

Increased flexibility will decrease the chance of experiencing a minor or major injury that could result in chronic pain, or worse, a broken or damaged bone.

Yoga may also be able to improve joint flexibility and decrease pain associated with arthritis and other inflammatory conditions like it.

Better Stability
Many injuries that affect seniors aren’t related to serious accidents – they’re related to minor incidents in the home, such as minor falls or simply tripping over something. Practicing yoga on a regular basis can help seniors improve overall stability to avoid those falls that can result in very problematic injuries on the wrong surface.

Sleep Quality
It’s commonly said that seniors need less sleep than their younger counterparts, but many seniors don’t really feel that way. A lot of seniors also feel that they have a particularly hard time falling asleep at night, especially if they’re taking any type of medication that may keep them awake or are experiencing chronic pain related to another condition.

Yoga may help all individuals that feel they have a hard time falling asleep, simply because the movements of gentle types of yoga are often relaxing. Yoga classes also focus on the relaxing aspects of the practice and may even incorporate meditation, which makes many seniors feel more grounded and comfortable after sessions.

If you do take up yoga partly to improve your sleep, consider scheduling classes in the afternoon or evening instead of in the morning or during the day so you’ll be ready for bed within a few hours of your class.
Image courtesy of Shutterstock

Mental Health
Yoga is known as a relaxing activity, especially if you take classes that incorporate meditation, and for many seniors that suffer from anxiety or depression, doing yoga regularly may help to alleviate or manage the problem.

While some seniors may be hesitant to try yoga with its “new-age” label, others jump at the chance. Seniors that often balk at trying yoga are sometimes the ones that benefit the most, as well.

If the benefits of yoga sound appealing but you’re just not sure about the activity, try to keep an open mind. You may find an activity that you really enjoy once you understand the basics, and. yoga classes can also be another way for seniors to socialize or discover new things in their city. Many major cities such as Los Angeles or Miami have yoga classes just for seniors.

Shannon Lochwood is a freelance writer and has contributed to several health blogs. She loves everything about health, mental and physical and loves to encourage people of all ages to try fun new ways to exercise into their daily routine.