Caregiver StressMeter

To help you determine what level of stress you may be experiencing in your role as a caregiver, a group of leading eldercare and caregiver stress experts have developed this brief survey.  Your answers are completely confidential and there are no right or wrong answers. Once completed, an assessment of your responses will give you the resources to help you make your personal caregiving experience more rewarding and maintain your own health and spirits!!


Follow this link
http://www.caregiverstress.com/stress-management/stress-symptoms/caregiver-stressmeter/

Alzheimer's or "Just" Old Age?

Q: My mother is 71, and she has been forgetful for years, but it seems she is getting worse and repeats herself all the time. Is there a way to distinguish between Alzheimer's and just old age? Is there a test or something? 


A: When memory loss and other problems of brain function occur, it is important to secure a comprehensive evaluation by an internist, geriatrician, neurologist, and/or psychiatrist. It is necessary to rule out various treatable brain conditions that can mimic Alzheimer's disease. Examples of disease that can be mistaken for Alzheimer's include Lyme disease, certain metabolic disorders, and even depression. There is specific testing for Lyme infection; if the test is positive and treatment allows for troublesome cognitive symptoms to disappear, one could rule out Alzheimer's. Tests can be performed for metabolic conditions such as thyroid dysfunction. Psychiatric evaluation includes the use of specific depression scales such as Beck Depression Inventory to further differentiate Alzheimer's disease from other mental conditions.

A final, unequivocal diagnosis of Alzheimer's, unfortunately, can only be made by the direct pathological study of the brain after death (on autopsy). There are no specific tests for Alzheimer's disease, so one should be wary of claims of any specific mental or physical test. For example, there is a high association between apolipoprotein E-4 and Alzheimer's, but this association only defines susceptibility. It is neither specific nor predictive of who will develop the disease.

You may soon hear about a new imaging test that can diagnose Alzheimer's disease at an early stage, but the test is not yet available in the clinic. It entails injecting radiochemicals, which are agents that bind to targeted abnormal tissues — in this case regions of the brain associated with Alzheimer's. The radiochemicals light up and can be seen on a magnetic resonance imaging (MRI). This new kind of imaging tool is very valuable for research purposes. It allows researchers to follow the disease course and to test proposed new drug therapies. I consider the testing potentially very advantageous, as it would allow us to diagnose and introduce treatment early. But we do not yet have effective treatments and the testing is very expensive, so it is not clinically useful at this time. It is hoped that in the not-too-distant future the diagnostic imaging test will move into the clinic and we'll have more effective therapies to offer patients

An expert in Alzheimer’s disease, Dr. Robert N. Butler was a gerontologist and a professor of Geriatrics and Adult Development at Mount Sinai Medical Center before passing away from acute leukemia at the age of 83

Senior Moment - Libby Deege

Seniors may be just as mentally agile as younger people. The reason their thinking appears sluggish is they mull things over longer, a new study shows.

Researchers have found that when people aged 60 and older are asked to make quick decisions, they respond as slowly as young children. And both groups react much more slowly than young adults, according to the study published in Child Development.

The slow response times in children are the sign of brains that are still maturing, said Roger Ratcliff, a study co-author and professor of behavioral and social sciences at Ohio State University. But the apparent sluggish thinking in the elderly may simply be the result of seniors emphasizing accuracy over speed when they deliberate.

The new research could have important repercussions for seniors worried that their thinking has become too slow to allow them to continue driving safely or performing other tasks that occasionally require quick reaction times. 

Ratcliff and his colleagues have been studying the impact of aging on mental agility for the last decade. In their new study, they looked at how seniors and other adults compare to children.

They ran several experiments designed to rate mental ability and agility across all ages. In one, for example, more than 300 study volunteers watched as a group of asterisks flashed up on a computer screen. The number of asterisks ranged anywhere from 31 to 70. The volunteers were told to quickly decide whether they’d been shown a small number (31 to 50) or a large number (51 to 70) of the star shaped marks.

When the researchers looked over the responses they found that response times and accuracy both improved with age, up to a point. Accuracy remained good even among older volunteers, but response times in general suffered as people got older. Of course, in some cases, early dementia or the effects of medication may be the cause of slowing mental agility, but in healthy seniors, slow reaction times among the elderly can often be improved, Ratcliff said. In another set of experiments, he and his colleagues coached older volunteers to obsess less about accuracy and to focus more on speed.  In the end, his seniors were able to react just as quickly as college students.

Ratcliff suspects that other age related deficits, such as declining memories, make seniors less sure of themselves and that makes them want to deliberate longer so they won’t make mistakes.

“Older people don’t want to make errors, so what they do is adopt a more conservative decision criteria and that slows them down,” he explained.

By Linda Carroll

What's the Difference Between Alzheimer's Disease & Dementia?

On a cold, snowy winter day, a bowl of soup sounds good.

"What’s the soup of the day?" you ask the waitress at your favorite restaurant. A few minutes later you are enjoying a steaming cup of clam chowder.

"Soup" is a general term for a category of food. Soup comes in dozens of flavors, like chicken noodle, tomato, clam chowder, or mushroom. Every can of mushroom or tomato soup is soup—but not every can of soup is mushroom or tomato.

This simple example, first used by Canadian dementia expert Carol Bowlby Sifton, is an elegant way to describe the differences between dementia and Alzheimer's disease.

Like "soup," the word "dementia" is an umbrella term for anything that can cause issues with brain functioning such as confusion, memory loss, or loss of problem solving ability. While Alzheimer’s disease is the most common form of dementia in older persons, there are many more varieties, including Lewy Body dementia, vascular dementia, or frontal lobe dementia.

Families often say that they struggle to understand what doctors mean by dementia. That's why it's important to ask the doctor what type of dementia is being diagnosed. David Troxel, a noted dementia expert who worked with Home Instead Senior Care to develop its Alzheimer's and Other Dementias Training Program, emphasizes that the doctor should be able to tell you the specific diagnosis and the reason for that diagnosis, just like the waitress should be able to tell you the soup of the day and how that is different from other soups.

"It's important to know the type of dementia being diagnosed," Troxel said, "because different dementias have different characteristics, and family members need to know what to expect." Persons with frontal lobe dementia, for example, often undergo profound personality changes and can get very disinhibited and outrageous. Persons with Lewy Body dementia may have profound visual hallucinations, including talking to little people in the room or seeing animals that are not really present. "It can be very helpful and reassuring for families to know that a particular behavior is part of the disease process, not just 'bad behavior'," Troxel noted.

In addition, different dementias may call for different medicines. Individuals with pure frontal lobe dementia often don't do well on the typical memory medications like Aricept, Exelon & Razadyne, but they may respond to an anti-depressant. Persons with Lewy Body dementia seem to be very sensitive to mood-altering medications like anti-psychotics. In fact, an old nursing phrase says, "start low and go slow" when giving psychotropic medications to a person with Lewy Body dementia.

Finally, when the physician gives you a specific diagnosis it's a sign that you’ve seen a medical provider who understands the contemporary best practices surrounding diagnosis. You can feel that you and your family member are in good hands.

Likewise, other professionals you may work with to care for your family member, such as professional in home caregivers, should be trained to understand the distinctions between various dementias. Paul Hogan, chairman of Home Instead Senior Care, says "Our CAREGivers are trained to understand the differences between Alzheimer's disease and other forms of dementia. We want our clients' families to know that we are here for them no matter which dementia diagnosis they face."

Family caregivers can form a care team with the senior's doctors, pharmacists, and other care providers focused on providing the best possible care and that focus needs to include an accurate understanding of the diagnosis, its symptoms, and its possible treatments. "Until we find a cure, the best approach to any of these dementias is engagement, activities, communication and loving care," says Hogan

Couple Married 72 Years Dies Holding Hands - Libby Deege

This has been going around online I thought I had to share! Who wouldn't want a love like this!!

An Iowa couple who was married for 72 years died one hour apart last week in the hospital as they held hands

On the day she graduated from high school, Norma Stock promised to spend forever with Gordon Yeager. The couple got married on May 26, 1939 in State Center.
"They're very old-fashioned. They believed in marriage til death do you part," said son Dennis Yeager.
Dennis Yeager was the youngest of four children born to the couple. His sister Donna was first born.
"Staying together for 72 years is good, I'd say that's exceptional," said daughter Donna Sheets.

The way the kids tell it, dad was the life of the party while mom kept everything together.

"Anybody come over -- she was the hostess with the mostest. She just seriously -- the more she did -- the more she smiled," said Dennis Yeager. "Dad would be the center of attention, like, 'Weee look at me,' and mom was like 'get him away from me!' You know we even got a picture like that."
Norma didn't really want the distance, and family said she hardly left Gordon's side for 72 years.
"They just loved being together. Everybody argues once in awhile, but they still, he said 'I have to stick around. I can't go until she does because I have to stay here for her and she would say the same thing,'" said Dennis Yeager. Dennis Yeager said the couple left home last Wednesday to go into town, but they didn't make it.

At the intersection of Highway 30 and Jessup Avenue just west of Marshalltown, state troopers said Gordon pulled in front of an oncoming car. The Iowa State Patrol crash report said the other driver attempted to avoid the crash but was unable to stop in time.

"I rushed from Des Moines where I was working and saw them in the hospital," said Dennis Yeager.
In the intensive care unit of Marshalltown's hospital, nurses knew not to separate Gordon and Norma.
"They brought them in the same room in intensive care and put them together -- and they were holding hands in ICU. They were not really responsive," said Dennis Yeager.

Gordon died at 3:38 p.m. holding hands with his wife as the family they built surrounded them.
"It was really strange, they were holding hands, and dad stopped breathing but I couldn't figure out what was going on because the heart monitor was still going," said Dennis Yeager. "But we were like, he isn't breathing. How does he still have a heart beat? The nurse checked and said that's because they were holding hands and it's going through them. Her heart was beating through him and picking it up."

They were still getting her heartbeat through him," said Donna Sheets.

At 4:38 p.m., exactly one hour after Gordon died, Norma passed too

"Neither one of them would've wanted to be without each other. I couldn't figure out how it was going to work," said Donna Sheets. "We were very blessed, honestly, that they went this way."
"They just loved being together," said Dennis Yeager.

At their funeral on Monday, Norma and Gordon held hands in their casket. Family said they will be cremated and their ashes mixed together.

Read the Full article at http://www.kcci.com/

Fall Foods!! - Libby Deege

Fall Flavors!!
Apple Crisp!

Ingredients
10 cups all-purpose apples, peeled, cored and sliced
1 cup white sugar
1 tablespoon all-purpose flour
1 teaspoon ground cinnamon
1/2 cup water
1 cup quick-cooking oats
1 cup all-purpose flour
1 cup packed brown sugar
1/4 teaspoon baking powder
1/4 teaspoon baking soda
1/2 cup butter, melted
 
Directions


1.Preheat oven to 350 degrees F (175 degree C).

2.Place the sliced apples in a 9x13 inch pan. Mix the white sugar, 1 tablespoon flour and ground cinnamon together, and sprinkle over apples. Pour water evenly over all.

3.Combine the oats, 1 cup flour, brown sugar, baking powder, baking soda and melted butter together. Crumble evenly over the apple mixture.

4.Bake at 350 degrees F (175 degrees C) for about 45 minutes

Sometimes favorite foods have a great story that makes the dish all the more delicious. It’s that way with Betty’s corn pudding, which she entered in the Homemade Memories Recipe Contest. The corn pudding is a favorite because her mother-in-law and father-in-law always had a garden in the country and would grow the corn, shuck it and deliver plenty to freeze.
Please share your story that will passed along to the next generation.  Be it a memory, or a favorite recipe.  I know for me personally it will be my Gram's molasses cookie recipe.  I was fortunate enough to snag the beat up old round tin that she used to bring them over in when we were helping her downsize.  Memories that will forever be rooted in my heart.  Share your stories here on on the Homemade Memories Facebook page.  You can also visit the Craving CompanionshipSM website at www.mealsandcompanionship.com for more ways to keep those memories alive. "Now this recipe is special to my grandchildren as they always request that I make it when they come over for special occasions such as Thanksgiving and Christmas. I always think of my father-in-law, how he used to work so hard to provide fresh vegetables for all his children. He is greatly missed." 

You are NEVER to old to learn something new!! - Libby Deege

For those of you who haven't seen this couple attempting to use their new Web Cam software take a few minutes and watch! Priceless...what can be learned from Bruce and Esther Huffman?

1. You're never too old to learn something new
2. You're never too old to be childish
4. You're never too old to be in love

Click here to watch video

What is Elder Abuse? - Libby Deege

Each year hundreds of thousands of older persons are abused, neglected, and exploited. Many victims are people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs. Abusers of older adults are both women and men, and may be family members, friends, or “trusted others.”

In general, elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but broadly defined, abuse may be:

•Physical Abuse - inflicting physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.

•Sexual Abuse - non-consensual sexual contact of any kind.

•Neglect - the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.

•Exploitation - the illegal taking, misuse, or concealment of funds, property, or assets of a senior for someone else's benefit.

•Emotional Abuse - inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening.

•Abandonment - desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

•Self-neglect – characterized as the failure of a person to perform essential, self-care tasks and that such failure threatens his/her own health or safety.

What are the warning signs of elder abuse?

While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:

•Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
•Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
•Bruises around the breasts or genital area can occur from sexual abuse.
•Sudden changes in financial situations may be the result of exploitation.
•Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
•Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.
•Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

Most importantly, be alert. The suffering is often in silence. If you notice changes in a senior’s personality or behavior, you should start to question what is going on.

Remember, it is not your role to verify that abuse is occurring, only to alert others of your suspicions.

Simple Blog- Libby Deege

I attended a funeral yesterday of a beloved Caregiver for Home Instead Senior Care. After hearing all she had done with her life and all the people she had touched through her 80 years, I found this picture and thought she did all these things and was so happy every day!!

Mediation: Resolving Elder Care Conflicts Without a Battle - Libby Deege

Jerrod and Morgan Williams have been at odds for several years about their mother's care. Now a decision must be made and they are no closer to agreement. Gregory Jakes' children and his doctors all agree that he must stop driving. Even though his son has twice disabled the car, Gregory has twice had it repaired and continues to drive. Both of these families were referred to mediation as a last resort before turning to the courts to resolve their conflicts.

Elder care can be difficult under the best of circumstances. Mix in old family history and sincere differences of opinion and things can easily become unmanageable. As an older woman once said to me, "This would all be so easy if it weren't for the people!"

As an alternative to either throwing up their hands and walking away or ending up in court, many families are turning to Elder Mediation as a way to find a workable resolution.

A mediator is a professional who will help families open up communication in order to find the best solution to their particular situation. The mediator is neutral - not aligned with any particular "side" - and is part of the process only as a facilitator of the discussion. The goal is to give everyone a voluntary and confidential place to be heard, to share their concerns, and to explore options.

At the end of the process all the participants sign a document summarizing their aggreement. This document is not legally binding, as it would be if issued by a court of law. Family members are always free to seek legal advice before agreeing to any compromises.

Some families say that meeting with a mediator greatly reduced their stress and helped them accomplish far more than they had hoped. Others, while not able to resolve all their differences, were able to reach interim agreements and identify milestones that would indicate the need to revisit their options.

Elder mediators can assist families with resolving differences over caregiving responsibilities, residential alternatives, financial arrangements, guardianship decisions, individual roles and responsibilities in decision-making, and end of life decisions.

Mediators will not make decisions for the family, nor are they therapists. However, many families have found that meeting with a mediator can be therapeutic because the process helps diffuse tensions while allowing everyone to express themselves honestly and focus on the ultimate best interest of their senior.

How to Find a Mediator

Like Geriatric Care Management, there are no licenses required to be a mediator. However, there are ways to find experienced mediators who are highly regarded by professionals:

Check with your local family or probate court. They often maintain a list of mediators.

Bank Account of Memories

Bank Account of Memories


The 92-year-old, petite, well-poised and proud mother-in-law of my best friend, who is

fully dressed each morning by eight o'clock, with her hair fashionably coiffed and

makeup perfectly applied, even though she is legally blind, moved to a nursing home

today. Her husband of 70 years recently passed away, making the move necessary.

Maurine Jones is the most lovely, gracious, dignified woman that I have ever had the

pleasure of meeting. While I have never aspired to attain her depth of wisdom, I do

pray that I will learn from her vast experience.

After many hours of waiting patiently in the lobby of the nursing home, she smiled

sweetly when told her room was ready. As she maneuvered her walker to the elevator,

I provided a visual description of her tiny room, including the eyelet sheets that had

been hung on her window. "I love it," she stated with the enthusiasm of an eight-yearold

having just been presented with a new puppy.

"Mrs. Jones, you haven't seen the room ... just wait."

That doesn't have anything to do with it," she replied. "Happiness is something you

decide on ahead of time. Whether I like my room or not doesn't depend on how the

furniture is arranged ... it's how I arrange my mind. I already decided to love it...

"It's a decision I make every morning when I wake up. I have a choice; I can spend the

day in bed recounting the difficulty I have with the parts of my body that no longer work,

or get out of bed and be thankful for the ones that do. Each day is a gift, and as long as

my eyes open I'll focus on the new day and all the happy memories I've stored away ...

just for this time in my life.

Old age is like a bank account ... you withdraw from it what you've put in ...So, my

advice to you would be to deposit a lot of happiness in the bank account of memories."

Helping Seniors beat the Heat - Libby Deege

Older citizens are more vulnerable than younger individuals because they do not adjust as well to the heat, they perspire less, and they are more likely to have health problems that require medicines that work against the body's natural thermometer. A sudden or prolonged increase in temperatures can place a strain on the heart and blood vessels before the body can acclimate itself
When the temperatures begin to creep up, take immediate action. The following tips from Dr. Robert Luchi, Professor of Medicine-Geriatrics, can help you beat the heat:

Keep cool. Air conditioning can be a lifesaver, especially if you have heart disease. If you don't have air conditioning, head to a cool shopping center, senior center, library, movie theater, or place of worship.

Cool baths or showers can provide relief. Ice bags and wet towels are also helpful.
Beware of dehydration; drink plenty of water even if you are not thirsty.

Curtail physical activity during extremely hot weather. Activity adds to heart strain.

 Avoid heavy meals and alcohol. Alcohol acts as a diuretic, causing your body to lose water.

 Limit salt use.

 Wear loose fitting, lightweight clothing. Don't forget to wear a hat or carry an umbrella to protect your head and neck when you are outdoors.

 Take the heat seriously. Dizziness, rapid heartbeat, diarrhea, nausea, headache, chest pain, mental changes or breathing problems are warning signs that you should seek immediate medical attention

CAREGiver of the Month Shares her favorite caregiving story...

Angie Sieren has been selected for the CAREGiver of the month for the month of June. Angie was chosen because she has been doing an excellent job picking up fill-ins and going above and beyond for her clients. She has a genuine heart that desires to get to know her clients well, which results in trust and friendship.


"When I first met Willie, he was very protective of his home and the responsibilities he wanted me to take care of. PROUD would be the word to best describe this man of a 5 foot stature. But when I met him it seemed as if he were more like 6 foot tall. He would shuffle behind me pushing his walker everywhere I went while I was doing the chores he had asked of me, making sure I was doing it the RIGHT way....as in HIS WAY. Keep in mind he lived in a tiny little one bedroom trailer. As time went on, Willie began to share more about himself, his time in World War II, and memories of his beloved wife. In turn, he also began to ask more about my life and me. As the days grew into weeks and the weeks turned into months, Willie and I chatted like we were old time friends. He began making me breakfast every morning and this was a huge feat for him as he was partially blind in both eyes. So the task was a major undertaking, but one he was so very proud of. My most fond memory of my time with Willie was when we spent an hour going through old albums. The ones he and his wife would listen and dance to for hours. I will never forget the day he played his favorite on his old record player. We were sitting at his kitchen table. I was listening and laughing to so many of his old stories. He got up from the kitchen table and shuffled into his living room. He was smiling and laughing. He then turned and asked if I would join him on the dance floor. It was a fast one so I wasn't sure if I could keep up. But he waved one hand in the air while holding tightly onto his walker with the other. I popped out of my chair and waved my hands wildly in the air just trying to keep up. When the song was over. I hugged him and thanked him not only for the dance but sharing so many specials memories of his with me. I told him how honored I was that he shared such special memories with me. Our relationship as client and caregiver developed into one of being friends. From that day on Willie no longer shuffled after me to make sure I was doing what I needed to do. He now would sit at the kitchen table and chat w me as I moved about his house cleaning and doing laundry. Always wanting me to take a break and sit to chat or to drink a soda of his or eat a snickers candy bar that he had purchased because he knew that they were
my favorite. I had done it. I had earned this man's trust and was able to bring many smiles and laughter into a house that once was so very quiet and lonely. I will always remember how nervous I was my very first shift. But now all I can remember is how fortunate I was to be a part of Willie's life....to have been trusted....to have been loved by such an amazing human being. I am grateful to HISC for the experiences I have been given. My words of widsom to others would be: Remember you are ALWAYS a guest in your clients home. That what our clients are asking of us to come and do is scary for them.....it's also very brave...and so very humbling. That each senior is unique and special so go out of your way each and every shift to make your client feel that way. Be compassionate and kind. I have been blessed with the relationships I have developed in the last 4 and 1/2 years."

Angie found Home Instead Senior Care through a search on the internet. She was a stay-at-home mom for 10 years and decided it was time to do something for her. She wanted a part-time job that would offer her flexible hours. Working with seniors appealed to her because while she was growing up she would volunteer at a nursing home with her mom. Angie says, “It was time to do something for me.” What she didn’t expect was how much she received in return, from her clients. CAREGiving has been an excellent match for her because it has allowed her to maintain flexibility to continue to raise and be active in her children’s lives.


Working with and helping people have always been an active part of Angie’s life. Prior to CAREGiving Angie worked with children with special needs, she was a substance abuse counselor for teens and their parents, and as stated earlier she would volunteer with her mom at the nursing home. When she went into the nursing home she would read to the residents, bring them kittens to pet/play with, and sometimes her mom made her ride the horse to the nursing home so the residents could feed them apples and carrots. It was all of this that molded Angie into the successful CAREGiver she is today.

She grew up in Keota, Iowa (south eastern part of the state). She received her bachelor’s degree in psychology and sociology from Simpson college. Angie married her high school sweetheart in 1993, they now have 2 daughters who are 14 and 12. Kurt, Angie’s husband was relocated, for his job, to Minnesota but they relocated back 5 years ago and they currently live in Johnston. Here their girls are very active in school/sports. This keeps Kurt and Angie busy, but they love watching their girls grow and do what they love. When Angie isn’t busy at one of her girls’ sporting events she enjoys being outside, boating, grilling, shopping, reading, and just spending some down time as a family.

Pet Estate Planning - Libby Deege

Great Article!! Enjoy!

You don't have to be Leona Helmsley to want the best for your pet after you die. She'd left her dog Trouble $12 million when she passed away in 2007. A judge cut the award to $2 million and awarded some of the money to her grandchildren, but the Maltese still lived a life of luxury until his death in December. The dog's passing was just announced this month by the Helmsley trust.

Pet estate planning has grown since Helmsley's will made headlines. Today there are retirement homes for pets all across the country, and at least 45 states allow for pet trusts. A pet trust is an agreement that specifies how an owner wants a pet to be cared for, including details on who will be responsible for the animal and how the care will be paid for.

There are also attorneys who specialize in pet trusts, along with how-to books like "Who Will Care When You're Not There?" by tax attorneys Robert E. Kass and Elizabeth A. Carrie, "Fat Cats and Lucky Dogs" by law professor Gerry W. Beyer and estate planner Barry Seltzer, and "Petriarch: The Complete Guide to Financial and Legal Planning for a Pet's Continued Care" by animal attorney Rachel Hirschfeld.

Hirschfeld wrote a pet protection agreement that is legally binding and can be found online for as little as $39. Companies like Trusted Pet Partners, founded by attorney Chris Jones of Santa Barbara, offer a simple online pet trust for $289. Other online resources include a free planning guide from the Humane Society of the United States called "Providing for Your Pet's Future Without You" at http://www.humanesociety.org/petsinwills.

Exactly how many pets are abandoned after their owners die is unknown, says Richard Avanzino, former president of the San Francisco Society for the Prevention of Cruelty to Animals, but his best guess is 2 percent of surrendered animals, or 150,000 dogs and cats a year. A study from the late 1990s published in the Journal of Applied Animal Welfare Science found 1 percent of dogs and 1.5 percent of cats coming into 12 animal shelters had been surrendered because of owner death.

In 1979, Avanzino went to court to prevent the euthanization of a dog whose owner, Mary Murphy, had committed suicide. Murphy left a will instructing that her 11-year-old dog Sido be euthanized.

"She didn't think anybody else could take care of her in the same pampered, loving way," said Avanzino.
A judge ruled disposal of personal property does not extend to killing a living creature.

"People from the grave cannot dictate the demise of their beloved pets just because they are not around to take care of them," Avanzino said.

Murphy's case prompted the San Francisco SPCA to set up one of the nation's first sanctuaries for pets who outlive their owners.
A few veterinary schools offer estate planning options like lifetime care for pets and placement in a home. The Stevenson Companion Animal Life-Care Center, established by the Texas A&M College of Veterinary Medicine, offers a place for pets to live in addition to veterinary care. The Stevenson Center in College Station, Texas, currently houses 20 cats, 15 dogs and a llama, said Ellie Greenbaum, assistant to the director. They also have 377 animals from 20 states registered as potential residents. The fee for lifetime care is between $50,000 and $100,000 per pet, with any leftover funds donated to the center or the college.

But lifetime pet care arrangements don't always cost that much. Blue Bell Foundation For Cats in Laguna Beach, Calif., charges $6,500 for lifetime care for cats. The organization was founded by Bertha Gray Yergat, who wanted to ensure care after her death for the 200 cats she'd rescued. Yergat left about $1 million in assets, said Susan Hamil, chairwoman (and original member) of the foundation's board of directors. The organization now houses 50 cats.

One big problem is making sure trusts are written so that the pets and funds can be turned over quickly to the designated caregiver or facility. "The need when you pass away is immediate," Hamil said.
 
Most people will choose a friend or relative to take their pets.
 
"Much like an adoption, the goal is to make sure it will be a good match," said Kim Saunders, vice president of shelter outreach for Petfinder.com, an online pet adoption database. "You may love your best friend or family member, but they may not be a dog person." So some people designate an agency to find a new home for the pet.

Some owners leave money to whomever they're entrusting their pet to as a way of making sure the animal does not become a financial burden. Unfortunately, sometimes when large sums are involved, Avanzino said, "greed gets in the way."

In one case, Avanzino said, a cat was to be cared for by a maid and butler who were to get free room and board as long as the cat was alive. "The first time we saw the cat, we estimated it was 8 years old. Four years later, the cat was about 4 and the next time, the cat they brought in and said was the same cat, was estimated to be about 1 year old," he said.

In another case, the owner of a German shepherd left relatives the use of an entire estate as long as the dog lived. "They kept it alive almost two years on life support. The dog was totally incapable of moving," Avanzino said.

USA Today: Most Baby Boomers lack a plan to care for parents

A majority of Baby Boomers say they are likely to become caregivers for their parents, but only half can name any medications their parents take, a new survey shows

The survey of 600 adults ages 45 to 65, conducted for the Home Instead Senior Care network, also found:
•31% don't know how many medications their parents take.
•34% don't know whether their parents have a safe deposit box or where the key is.
•36% don't know where their parents' financial information is located.

"The majority of caregivers we work with have done no advance planning,'' says Jeff Huber, president of Home Instead Senior Care, a company that provides non-medical care services. "It is not important until it's urgent. So much stress and uncertainty down the road can be prevented."

Lack of planning can lead to serious complications when decisions need to be made quickly, says palliative care nurse practitioner Mimi Mahon, an associate professor at George Mason University in Virginia. "It's vitally important to plan ahead and have these conversations with parents, or families can act out of fear and make mistakes when emergencies arise."

Prescription drugs are of particular concern. In the survey, 49% couldn't name a single drug their parents took. Ask parents about their medications and, if necessary, do research, experts say. Find out the dose, what it's for, who prescribed it and why. People 65 and older account for about a third of all medications prescribed in the U.S., according to the National Institutes of Health, and older patients are more likely to have long-term and multiple prescriptions, which could lead to unintentional misuse.

"It's kind of a never-ending process for caregivers," says Sandy Markwood, head of the National Association of Area Agencies on Aging, part of the Department of Health and Human Services. "It gets further complicated when there is more than the family practitioner. A parent might have several specialists. It's a lot for a caretaker to keep up."

Markwood says the Administration on Aging, also under HHS, has been encouraging better record-keeping by seniors and stronger communication between seniors and caretakers since Hurricane Katrina. "Then you had a situation when seniors were evacuated without their medications and no one knew what medications they were on," Markwood says. "Doctors had to start from scratch."

One must-have answer for caretakers: What drugs can parents go without and which ones must be taken on schedule. For instance, blood pressure and anti-depressant medications cannot be missed, Mahon says.

The bottom line, she says, is being a staunch advocate for your parents' health care starts with "having conversations and putting plans in place."

Alzheimer's - Sundowning: Libby Deege

Sleeping problems experienced by individuals with Alzheimer’s and caregiver exhaustion are two of the most common reasons people with Alzheimer’s are eventually placed in nursing homes. Some studies indicate that as many as 20 percent of persons with Alzheimer’s will, at some point, experience periods of increased confusion, anxiety, agitation and disorientation beginning at dusk and continuing throughout the night.

While experts are not certain how or why these behaviors occur, many attribute them to late-day confusion, or “sundowning,” caused by the following factors:
•end-of-day exhaustion (mental and physical)
•an upset in the “internal body clock,” causing a biological mix-up between day and night
•reduced lighting and increased shadows
•disorientation due to the inability to separate dreams from reality when sleeping
•less need for sleep, which is common among older adults

Tips for reducing evening agitation and nighttime sleeplessness
•Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
•Monitor diet. Restrict sweets and caffeine consumption to the morning hours. Serve dinner early, and offer only a light meal before bedtime.
•Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. Your doctor may also be able to prescribe medication to help the person relax at night.
•Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it’s most comfortable. Also, keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.

Nighttime restlessness doesn’t last forever. It typically peaks in the middle stages, then diminishes as the disease progresses. In the meantime, caregivers should make sure their home is safe and secure, especially if the person with Alzheimer’s wanders. Restrict access to certain rooms or levels by closing and locking doors, and install tall safety gates between rooms. Door sensors and motion detectors can be used to alert family members when a person is wandering.

Once the person is awake and upset, experts suggest that caregivers:
•approach their loved one in a calm manner
•find out if there is something he or she needs
•gently remind him or her of the time
•avoid arguing or asking for explanations
•offer reassurance that everything is all right and everyone is safe

Wedding Rings and Engagement Rings - Libby Deege

As we are slowly creeping into Spring and Summer, it always reminds me that wedding season is starting to fire up! I started thinking about some of my older realitives and even my own parents who just opted for the wedding ring VS the whole engagement ring and then the wedding ring. How long ago did all of this start? The man goes out and buys a diamond then goes out to buy even more diamonds to present the day of the wedding. I often think of the act of telling your friends "Hey I am engaged!" the first response "Let me see the ring!!" What happened to congratulations? Has it become of symbol of how much you are loved by the size of the diamond?

Not just a mere object to adorn a finger, the ring has been a powerful symbol throughout history. Its circular shape and its banding to the body have given it meaning - from the magical to the practical. Rings have represented the cycle of life, the sun and moon and in the case of engagement rings, eternal love.

Although we now mostly associate the diamond, with its nearly indestructible properties, as the symbol of eternal love, it was first the plain ring that represented the promise of companionship. Today we still honor the plain ring as wedding bands, although the diamond engagement ring is seen as a more important or more powerful symbol of a man's love for his bride.

There is some evidence to suggest that the first wedding rings used by ancient peoples were actually ropes that held a woman as property and that is why the symbolic ring remained a part of our tradition. Rings may also have been used to signify ownership to men or tribes, and the exchange of rings signified the passing of the daughter of one clan to another.

Today, the diamond engagement ring is regarded by most as an essential part of the act of getting married. There are many styles, shapes and types of rings to choose from and diamonds to fit almost any budget. The modern wedding ring has spawned a global business of retailers, crafters, miners and importers. And to think it all began with a simple little bit of rope.

What really Is Fibromyalgia? - Libby Deege

You hear a lot about Fibromyalgia. My mom was diagnosed with it several years back but I was never really sure what the disease really was.

Fibromyalgia is the most common arthritis-related illness after osteoarthritis. Still, it is often misdiagnosed and misunderstood. Its characteristics include widespread muscle and joint pain and fatigue as well as other symptoms. Fibromyalgia can lead to depression and social isolation. More than 12 million Americans have fibromyalgia. Most of them are women ranging in age from 25 to 60. Women are 10 times more likely to get this disease than men

Fibromyalgia causes you to ache all over. You may have symptoms of crippling fatigue -- even on arising. Specific tender points on the body may be painful to touch. You may experience swelling, disturbances in deep-level or restful sleep, and mood disturbances or depression. Your muscles may feel like they have been overworked or pulled. They'll feel that way even without exercise or another cause. Sometimes, your muscles twitch, burn, or have deep stabbing pain. Some patients with fibromyalgia have pain and achiness around the joints in the neck, shoulder, back, and hips. This makes it difficult for them to sleep or exercise. Other fibromyalgia symptoms include:

• abdominal pain
• anxiety and depression
• chronic headaches
• difficulty maintaining sleep or light sleep
• dryness in mouth, nose, and eyes
• fatigue upon arising
• hypersensitivity to cold and/or heat
• inability to concentrate (called "fibro fog")
• incontinence
• irritable bowel syndrome
• numbness or tingling in the fingers and feet
• painful menstrual cramps
• stiffness

Fibromyalgia can cause signs and feelings similar to osteoarthritis, bursitis, and tendinitis. Some experts include it in this group of arthritis and related disorders. But the pain of bursitis or tendinitis is localized to a specific area. The feelings of pain and stiffness with fibromyalgia are widespread.
 
Currently there is no cure for the pain of Fibromyalgia, but it can be managed with medication and regular check ups.

A Poem for CAREGivers

Blessed In Aging


~Esther Mary Walker

Blessed are they who understand

My faltering step and shaking hand

Blessed, who know my ears today

Must strain to hear the things they say.

Blessed are those who seem to know

My eyes are dim and my mind is slow

Blessed are those who look away

When I spilled tea that weary day.

Blessed are they who, with cheery smile

Stopped to chat for a little while

Blessed are they who know the way

To bring back memories of yesterday.

Blessed are those who never say

“You’ve told that story twice today”

Blessed are they who make it known

That I am loved, respected and not alone.

And blessed are they who will ease the days

Of my journey home, in loving ways.

This poem, as read by Mary Maxwell in the video

“A Reminder That Laughter is the Best Medicine.”

View the video online at CaregiverStress.com