Getting Your Money’s Worth at the Doctor

As we get older, it seems, at least for many of us, that our trips to the doctor become more and more frequent.  To make things worse, our trips are no longer one-stop shops.  There’s a different doctor to see for every medical ailment affecting our bodies.  This means, of course, that we go to the cardiologist on one day, the neurologist on another, the eye specialist on a different day—you get the picture—and in no time we find we are spending  most of our time lining up transportation and then sitting in waiting and exam rooms.  The doctor pops in, and before we even know what’s happened, he or she is running out, saying, “I’ll see you again in three months.”  And after he or she is gone, you realize you didn’t even get a chance to ask all of your questions!

Many adult children in the sandwich generation accompany their elderly parents on hospital visits.  Whether going for yourself or with your elderly parents, here are some ways to ensure that you make the most of both your and the physician’s time and energy:

  1. You will be more prepared if you write down your questions as you think of them before seeing the doctor. Keep a running list of them on your refrigerator or somewhere else that is handy for you.  When you go to the doctor, take the list with you.  All of your questions will be right there so you won’t have to rely on your memory, which is especially important if the doctor is in a hurry and wants to rush out the door.
  2. It’s a good idea to take someone with you. There are several reasons for this.  Maybe your hearing isn’t so good or your memory isn’t what it used to be.  Having another person with you lessens the chance that you may not hear or understand everything the physician is telling you.  Also, if you receive bad news of any kind, you’ll have someone with you to support you.  And, most importantly, you can go out for lunch together afterwards!
  3. Be honest and thorough with your doctor in reporting your symptoms, concerns, or problems. If you are not willing to tell your physician everything, he or she may not be able to treat you successfully.  Leaving out information alters the conclusions that a professional can make about your situation.  Some things, like incontinence issues, sexual issues, or loneliness, may be embarrassing to discuss.  Rest assured professionals have heard all of these things before and will better be able to address your issues if they know the whole story.
  4. A pen, a notebook, and sometimes even a tape recorder can be helpful and appropriate to bring with you when you know that a lot of new information is going to be communicated.
  5. Ask the doctor to slow down or repeat information if he or she is talking too fast. It may be necessary to ask the professional to use words that you understand if they are using medical terminology that is unfamiliar to you.  Once, when I got a new diagnosis, I had to do that.  The doctor was rattling on and on, and I was so upset that I was not hearing or understanding very well.  I finally said, “Look, this information may be routine to you.  I’m sure you say it 50 times a day to other patients, but this is the first time I’ve heard it.  I need you to slow down.”  It made a huge difference for the better in the relationship I have with this doctor now.  Sometimes doctors are just in a hurry and don’t realize how that affects the way they relate to you.
  6. When leaving, ask for written information if you feel you did not understand or are afraid you will forget what you were told. Some doctors will do this for you themselves.   If they are not able, ask a nurse to summarize and record the information for you.
  7. Do your own research about your particular conditions or disease processes prior to your appointment. You can learn a lot by discussing medical concerns with trusted friends or acquaintances, going to the library, or by going online.  You will be better prepared and your questions will be more specific.
  8. Know your body! Many times we defer to our physicians because we think they know more than we do.  It’s a good idea to remember that you are the expert on your body.  Recognize changes to your body and report to your physician new signs and symptoms, improvements, stress or emotional changes, drug side effects, etc.   Sometimes subtle body changes can be crucial in determining what is going on in the big picture and may make a difference in how your condition is treated.
  9. Lastly, if you are not satisfied with the way you are treated and if, after asking for what you need, your doctor is not able to provide that for you in a way that makes you feel respected and comfortable, you always have the choice to see a different doctor.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122

pblom@rah-tc.net

Rightathome.net/twincities/
CaregivingCompanion.com



Eldercare at Home: When Mom Refuses Help

“Lilly” wasn’t a Right at Home client, but she actually was a Right at Home client.  And she was to get a Right at Home caregiver who wasn’t really a Right at Home caregiver.

And if you think that sounds confusing, try explaining it to her potential caregivers.

Lilly was an intelligent woman in her seventies who was working very hard to mask her dementia.  In fact, she refused to acknowledge her Alzheimer’s diagnosis, and any discussion of the topic was strictly off limits.

The problem was that, although she denied her memory loss, Lilly needed help.  Like many people in her shoes, Lilly was losing her ability to take care of herself or to live safely on her own.  In addition to needing someone to tidy up her apartment, she needed an at-home caregiver to prepare meals so she wouldn’t forget to eat.  She also needed reminders to take her medications.  Her family wanted to have time to select the perfect memory care facility, but until then, they wanted to use an assisted home care company to ensure that Lilly was safe and healthy.

Lilly’s rejection of her diagnosis, however, wasn’t the only problem.  Not only did Lilly live in denial, but she had also always been very frugal with money.  Since that didn’t change with her diagnosis, her family knew Lilly would refuse any help if it cost money.

The solution was that Lilly would not be receiving paid in-home help from Right at Home.  Our social worker arrived at her home under the guise of a volunteer coordinator from a nearby church.  Instead of having a structured intake, Lilly believed that our social worker was there to coordinate volunteer services.  Any caregivers who arrived were then identified by her family as volunteers.

Senior care is a funny business.  When you enter someone’s home, you need to be respectful of the life they live and be sure to provide care with dignity.  For Lilly, that meant never acknowledging her memory loss or her need for senior home care services.

Lilly’s situation is not unique.  It’s not uncommon for families who are taking care of elderly parents to get creative to ensure that their parents are having their needs met.  Sometimes, all it takes is a little bit of thinking outside the box to keep Mom safe.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122

pblom@rah-tc.net

Rightathome.net/twincities/
CaregivingCompanion.com



Depression Is Not a Normal Part of Aging

“Lorraine’s” at-home caregiver always arrived on time and ready to perform her homemaking tasks, but Lorraine could never decide what she wanted her caregiver to do. Lorraine couldn’t make any decisions about what she needed help doing, so she’d go into the kitchen and make breakfast, leaving her caregiver alone in the living room to figure out what to do with her time. When Lorraine would finally give direction, she would then inevitably change her mind. Her caregivers, of which there were several, felt like they could never please Lorraine.

In addition to her indecisiveness, Lorraine had a flat affect and reported vague physical complaints which were not of concern to her medical doctor. Her physician had been telling her for many, many months that she was suffering from depression. Unfortunately, Lorraine refused to seek help for her depression. Because or her religious beliefs, she was waiting for “God to make it better,” even though her care management nurse, her physician, and her home care nurse each had recommended a trial of antidepressant medication. I also did my best to convince Lorraine to try an antidepressant but to no avail. After three years, Lorraine was still waiting for God to heal her depression. It was affecting her relationships and, unfortunately, she eventually lost her elderly home care service as well. It was just too frustrating for caregivers to work with Lorraine. They felt helpless.

What exactly is depression? According to the Mayo Clinic, it is a “medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.” People with depression tend to isolate themselves. They lose interest in life and usually have sleeping and/or eating problems, two of the most common symptoms of depression. Not having an appetite, weight loss, weight gain, and eating too much can all be symptoms. Not being able to get to sleep, awaking in the middle of the night, or not being able to sleep at all can also be symptoms, as well as wanting to sleep all of the time. It is estimated that 5-6 million people over the age of 65 have depression. One study indicated that as many as 25% of the elderly are depressed.

When we think of depression, we associate it with a dictionary definition characterizing it as “extreme gloom, feelings of inadequacy, and an inability to concentrate.” While depression may manifest itself in typical ways—having “the blues,” crying, or exhibiting a feeling of hopelessness—according to Kay King of NAMI Minnesota, depression sometimes comes out sideways. Other common symptoms of depression include (but are not limited to):

Anger/Irritability
Poor Concentration
Sleep Disturbances
Self Doubt
Pessimism
Forgetfulness
Mood Swings
Tearfulness
Vague Physical Complaints
Fear
Ruminations
Frustration
Feelings of Guilt
Fatigue
Feelings of Helplessness
Lethargy
Lack of Energy
Loneliness
Overeating
Weight Loss or Gain
Inactivity
Under eating
Indecisiveness
Helplessness
Isolation
Suicidal Thoughts
Confusion
Feeling Overwhelmed
Boredom
Apathy
Decreased Cognitive Function
Obsessive thoughts

If you are taking care of elderly parents and find they have been experiencing several of these symptoms for 2-3 weeks or more, you should definitely have them evaluated for clinical depression.  While most everyone experiences “down” periods at certain times in their lives, real depression is more than an occasional period of feeling blue.  It is an ongoing medical condition that people cannot choose to control, stop, or “snap out of.”

In addition to common physiological and environmental causes, depression in seniors can also be caused by side effects of prescription drugs, thyroid issues, and even some medical procedures.  It is not uncommon for a cerebral vascular accident, for example, to bring on depression after the stroke.  Additionally, chronic illnesses, such as diabetes, cancer, or heart disease, can also bring about depression.  While coping with a chronic illness is always difficult, it is not normal to become clinically depressed.  Treatment for depression, in some cases, may actually improve symptoms of other conditions.  Other contributors to depression in the elderly are grief, loss, loneliness, chronic pain, memory loss, alcoholism, boredom, and feeling that life no longer has purpose or meaning.

If you suspect the senior in your life is experiencing depression, it’s important to take your concern seriously and to intervene as quickly as possible.  Not only will depression affect quality of life, but white men over the age of 85 are at the greatest risk for suicide of all age-gender-race groups, 2.5 times higher than the rate for men of all ages.  Depression is not a normal part of aging, and fortunately, it is a treatable medical condition.

Unfortunately, those who are now seniors grew up in a time when there was much more stigma around mental illness.  They are terrified by any suggestions of mental illness, fearing they’ll be “locked up.”  They come from an era when people were ashamed to admit they had family members with mental illness for fear of being called “crazy.”  If someone had depression, it was kept hush-hush. We now know that depression is a treatable medical condition just like high blood pressure, diabetes, or asthma.

If you suspect the seniors in your life are suffering from depression, please take your concern seriously.  Encourage them to talk to their doctor or a licensed mental health professional.  The best treatment for depression is a combination of anti-depressant medications along with professional counseling (psychotherapy).  Nonmedical interventions, such as having regular family visits, regular exercise, senior companion care services, hobbies, as well as increasing social activity and having something meaningful to do, can also be helpful.  Most people who have depression, with the right treatment, can live much more meaningful and quality lives.  There is no need to suffer.

Paul R. Blom, Owner/CEO
Right at Home

P: 952-854-6122

pblom@rah-tc.net

Rightathome.net/twincities/
CaregivingCompanion.com



Maintenance Therapy – The Best Kept Secret in Senior Care!

By Above & Beyond Senior Services

Have you ever needed physical or occupational therapy (PT/OT)? Conditions that cause decreased strength, range of motion, balance deficits, difficulty with walking and memory issues are leading reasons seniors might need therapy. Most therapy is based on a model that requires patients to meet certain qualifying criteria. Typically, a person must demonstrate measurable, skilled progress or the therapy provider is required to discharge. Over the course of the last decade, a new option for wellness and exercise has become increasingly available to Minnesota seniors!

Maintenance therapy is the same PT/OT that you are familiar with, but with a few differences:

  • Starts after traditional therapy ends.
  • Has no requirements for frequency or duration of service.
  • Can continue on a long-term basis.Comes into the home, while allowing freedom to be active throughout the community.

Let’s meet Mary:

Mary had a massive stroke at 68. She was left with an inability to walk, difficulty with speaking, and decreased movement on the left side of her body. After completing rehabilitation in the hospital, then a care facility, she was able to return home with her husband, Ed. She also qualified for Medicare home therapy. When Mary was no longer considered homebound, she transitioned to an outpatient clinic. Mary was very motivated to get better, but this proved more difficult than imagined. It was hard to be disciplined in completing the home exercises her therapists assigned. Ed began to notice declines, despite Mary going for therapy twice a week. They were disappointed in her regression. It was time for a change. She wanted home therapy that focused on the tasks and activities that were important to her and allowed them to be in control of her rehab. Thanks to a recommendation from a trusted health care worker, Ed inquired about direct-pay, maintenance therapy.

The maintenance therapists helped discover Mary’s abilities and limitations. The couple’s therapy goals were set collaboratively. These weren’t goals for the purpose of insurance coverage, but the goals that were important to both of them. They were finding their “new normal”. Her desire to maximize her mobility, strength and balance was met by creative exercise instruction from her therapists. Over time, with PT/OT each week, Mary had many successes. Eventually she was able to walk throughout her home, enjoy her swimming pool and an adaptive horse-riding program! Her quality of life was significantly improved as she met her goals of participating in community activities and going out to dinner with Ed. She felt empowered, engaged and happy about her accomplishments.

While many people desire and achieve goals of improvement, maintenance therapy also understands that sometimes, true “maintenance of ability” IS the goal. Many seniors get caught in a cycle of decline which leads to hospitalization and rehab. Once home again, it’s difficult to maintain exercise programs independently. Lack of adequate maintenance leads to progressive decline and the cycle begins again. Introducing maintenance therapy can be a life changer for a senior.

When a client has ongoing, one-on-one therapy, they are able to maintain their physical abilities. This makes the difference between staying at home vs. moving to assisted living or nursing home. A benefit of maintenance therapy is the same therapist can continue with clients if they change the place they call home.

If you are a senior who wants to either regain or maintain your quality of life through wellness and exercise, maintenance therapy may be the missing link that you have been searching for.

Allison Bakke, OTR/L
Above & Beyond Senior Services

www.aboveservices.com
allison@aboveservices.com
612-965-5122

The Shred Party

What should you get rid of and hold on to? When and why?

If a shred party happens to spring up in your area, you may want to mark your calendar. For many years, shred parties, where a business or organization hosts clients or the public to the use of giant paper shredders, have presented a fun and easy way for folks to rid themselves of paper clutter. Sometimes, it’s more than just paper, as some industrial-sized shredders even have the ability to destroy hard drives and other electronic storage devices.

Protection from identity theft. Of course, this is not just about clutter: old bills and financial documents are just the sorts of things that scammers and identity thieves want to get their hands on. The only way to be totally certain that you are safe is the total destruction of those documents and devices once their practical use has come to an end.

A shred party can also be a nice day out. It’s not unusual for the big shredding trucks to be parked outside on a pleasant spring or summer day. Depending on the hosting organization, the shred party might be attached to some other activity, like a potluck, barbecue, or community celebration.

What do you bring?The better question may be: when is it wise to let go of the documents that you’ve been storing? It’s important to be sure because they certainly aren’t something you can get back from the shredder once they’re gone!

A recent article from CBS News suggests the following guidelines:1

  • For your tax returns, hold on to those for up to seven years.
  • Purchase and sale statements for your house, for your entire ownership of the house.
  • Utility bills, at least one year.
  • Statements from your investment or brokerage account, at least one year.
  • Purchase and sales confirmations related to your investment or brokerage account, at least one year.
  • Statements from your bank account, at least one year.
  • Statements from your credit card provider, at least one year.

It’s important to remember, also, that the above represents a general guideline; different sources offer different suggestions. CBS acknowledges that, in some cases, it’s okay to shred your tax returns after three years. Your financial professional may have a different prescription for you, however, based on their close understanding of your financial life.

Information provided by Candido Palomarez, Family CFO.  He may be reached at (763) 428-1000 or at Candido@Candidoinc.com

Securities and investment advisory services offered through Woodbury Financial Services, Inc., Member FINRA/SIPC. Insurance services offered through Candido, Inc., which is not affiliated with Woodbury Financial Services. Neither Candido, Inc., nor Woodbury Financial Services renders accounting, tax, or legal advice.

This material was prepared by MarketingPro, Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment.

Citations.
1 – cbsnews.com/news/heres-how-long-you-should-keep-tax-records/ [4/26/2019]

Winter Nutrition for Seniors

When the temperature drops, healthy eating can become less of a priority. Keeping a healthy diet in winter can be a challenge, especially if you are an older adult. With age, the body naturally starts to become less efficient in absorbing essential nutrients. Add in wintertime’s decreased activity, and many seniors opt for convenient, comfort foods laden with empty calories.

Recommendations for healthful chilly weather nutrition include the following:

  • Dark, leafy green vegetables. Choose antioxidant-rich dark greens such as spinach, broccoli, kale, and chard, and select yellow and orange vegetables including yams, carrots, and squash.
  • Citrus fruits. Oranges, lemons, grapefruit and limes are popular vitamin C-packed citrus fruits also rich in flavonoids that promote good HDL cholesterol.
  • Protein. Eating protein sources at meals and snacks throughout the day helps with blood sugar and energy levels. Beyond red meat, seniors can vary protein sources with eggs, fish, dairy, and nuts.
  • Soups and stews. Adding vegetables, beans and lentils to stews and soups is an easy, inexpensive way to increase fiber and nutrients. Cook a larger pot of a recipe and divide into smaller portions to freeze.
  • Vitamin D. With less sunshine in winter, the body needs other sources of vitamin D to help absorb calcium and strengthen muscles. Foods naturally higher in vitamin D include egg yolks, seafood, grains and fortified milk.

WebMD lists a number of nutrients that may be missing from the diet of seniors including vitamin B12, calcium, and magnesium. Encourage your older loved ones to talk with their doctor or dietician for a tailored nutrition plan that accounts for specific health needs and dietary likes and dislikes.

Many families also rely on Right at Home senior companion care providers to assist with grocery shopping, cooking well-balanced meals, and monitoring an elder’s eating habits. Sometimes a few simple dietary adjustments are all that is needed to keep older adults enjoying healthier foods in any season.

 

Paul Blom

Right at Home, Owner/CEO
2626 East 82nd Street, Suite 150  |  Bloomington, MN 55425
Direct:  952-767-6626
P: 952.854.6122  |  F: 952.854.6162

Website:  RAH-tc.net

Blog:  CaregivingCompanion.com