Should Mom be living alone?

However healthy your Mom is, if she is living alone, she needs to care for herself and her well-being. When you and your Mom disagree about whether this is happening, a neutral third-party tool helps settle the question.

The Lawton Instrumental Activities of Daily Living Scale (ADL) is designed to rate Mom’s ability to:

  • Use the telephone
  • Shop
  • Prepare food
  • Do Housekeeping
  • Do Laundry
  • Obtain transportation
  • Be responsible for own medications
  • Handle finances

The Lawton Instrumental Activities of Daily Living Scale (ADL) gives you clarity around whether Mom needs additional support to get through a normal day.

If you are reading this before Mom experiences a serious health event (such as a stroke or a serious infection) commit to working through this assessment together every six months. This discipline gives you and your Mom the chance to track her changes over time. It also exercises your relationship muscles by starting regular conversations about life-changing and emotionally charged topics before an urgent decision needs to be made.

If you determine that Mom’s abilities are at the point where she needs support in order to live at home, the time has come to discuss next steps.

What considerations factor into Mom’s next living arrangement?

  • What does Mom want?

    Most older adults want to age in place by continuing to live at home. Is this what Mom wants? If so, what supports will Mom need to live a safe, healthy life? Will Mom welcome these resources into her home?

  • Care

    What level of care does Mom need now? How quickly is her condition accelerating?

  • Cost

    What financial resources are needed? Where will they come from?

  • Convenience to friends & family

    Does family intend to visit? If so, will Mom’s new living arrangement be convenient for family visits? Would being located near friends provide more emotional connection than locating near family?

Who gets a vote?

Who gets a vote on Mom’s next living arrangement? How will votes be weighed? Does Mom’s vote count? Do the votes of adult children / family members count? Does anyone else get a vote? If so, who?

Does the vote of the adult child footing the bills count the same as the vote of the adult child providing the most care? Do all adult children get a vote or only the adult children who have been involved in care?

Alternatives

Search engines give the impression that someone living with dementia either lives at home or in a skilled nursing home. In truth, there are a range of care alternatives that may be successful depending on the unique factors of each situation.

 
Contact your local Area Agency on Aging for resources near you.

What 24 hours in your parents’ home can teach you

THE ALZHEIMER’S GEMBA IS YOUR PARENTS’ HOME

“Go see, ask why, show respect”

— Fujio Cho

Can Alzheimer’s really be as big a deal as people say?

After all, my parents and I talk on the phone every week, and Mom seems fine.  Sure, the last few weeks she handed the phone to Dad and walked away. But Mom’s always had her moods.  And sure, Dad does interrupt our conversations to tell Mom to put down the banana.  But I probably should have called at a better time of day.

When a Loved One is diagnosed with Alzheimer’s life changes for every person in the family.

Acceptance comes in waves, with the hush of denial in between.

Let’s say you are a family member who wants to support your Loved One and Caregiver through Alzheimer’s.  There is a technique you can use to speed up your acceptance.  The same technique helps you clearly see the new lives that your Loved One and Caregiver now live.

Here it is: Spend twenty-four hours in your parent’s home.

 Photo by Henri Picot via Unsplash

While you’re there, pay attention to the items listed below. Can you see differences between your parents ten years ago, and your parents today?  Notice each of your parents in the morning, afternoon, and evening.  Remember: this is a fact-finding mission.  The temptation is to jump into immediate improvement mode. Do your best to simply observe. Only when the visit is complete, and you review what you learned, are you ready to identify possibilities that may improve each of your parent’s new realities.

The good news is that even though there is yet to be a cure for Alzheimer’s, there are many ways to improve life for your Loved Ones with Alzheimer’s and your Caregivers. What’s important is that improvement possibilities address what is needed today, and when possible anticipate what may be needed in the next six to twelve months. This requires effort.  Observe the following.

                   Household Safety Checklist by Professor Robyn Gerson, UCSF                   Household Safety Checklist by Professor Robyn Gerson, UCSF

Twenty-four hours at your parent’s home will give you a fresh perspective on how Alzheimer’s has already changed their lives.  It will speed up your acceptance of the new realities of their lives and yours. And, twenty-four hours will help you identify things in your parent’s lives that you can explore with them as things they may consider improving.

Given all that you learn, this exercise may be the best return you will ever get on an investment of twenty-four-hours.  Plan now for a return visit in six to twelve months to see what has changed and what that can teach you.

Your friend on the journey,

Barbara

RELATED ARTICLES FOR ALZHEIMER’S KIDS

WHO’S DOSING WHO? – Alzheimer’s, your parents and their medicine  Read

LUNCH WITH JACK & MRS. SPRATT –  Alzheimer’s, your parents and their diet Read

INDEPENDENT LIVING AND YOUR LOVED ONE – When is it time for a change?  Alzheimer’s, your parents and their safety  Read

Why Thanksgiving dinner was late

“Dinner will be in another hour or so,” my sister Diane greets us as we walk in the door.

“Oh! Are we early?” I ask, checking my watch.  I’m the drum major,  leading the parade into her kitchen.

Diane faces me, smiling.  Ginger Rogers-style, I take three steps backward, out of the conversation circle. Diane is Fred Astaire, stepping forward in time with me.

Diane whispers through her smile. “At some point today, Mom turned the oven off, with the turkey roasting in it.  We think it was around noon.” Diane smiles and shrugs lightheartedly.  “She was helping.”

I smile nervously and give Diane a hug.

“Our best guess is that an extra hour is enough to thoroughly roast the turkey,” she continues.  “We just need to be flexible on the actual dinnertime, OK?”  I marvel again at my sister’s calm.

I step into the living room to find Mom sulking, having been asked to excuse herself from the  dinner preparation. Dad is pacing back and forth, brow furrowed.  I take a deep breath.

“Looks like we have time for a game before dinner!” I say with enthusiasm. “What’s it going to be?”

Since our lives are simple compared to what each day as a Caregiver asks of our Dad, my sister and I were able to take a breath, chose a calm response, and flavor our response to this twist with humor.  What we found is that this approach opened up possibilities for us to love-each-other-through-it-all.  

Think about it.  You could give your Caregiver a precious gift by reminding them that a response like this is available for them to use too.   One good demonstration from you could be enough to show your Caregiver how they might approach some of the surprises that come their way each day.  

Happy Thanksgiving!

Your Friend on the Journey,

Barbara

Alzheimer’s at Lunch: Jack and Mrs. Spratt

ALZHEIMER’S, YOUR PARENTS AND THEIR DIET


“…And let thy gifts to us be blessed.  Amen.” 

The aroma of a big German hug of bratwurst and sauerkraut welcomes us to lunch.

Dad stands up and slips from the sun room to the kitchen. He has recently taken on host duties.  As he gains experience setting tables, he gets a lot of exercise during meals fetching missing things..

In Dad’s absence, a bowl of coleslaw is passed around the table.  Next, the sauerkraut. Then the salt and vinegar potato chips, Mom’s favorite.  I notice the first round of dishes pass by Dad’s empty plate. As he returns brandishing the brown mustard, I serve him a brat. 

Dad cuts and spears his first bite.  As he brings it to his lips, Mom says, “Please pass the brats, and the coleslaw.”

I lay down my fork and eye Mom’s plate. Yes indeed, it is already empty.  Randy passes the plate of brats to me, and I pass them to Mom.  Mom happily takes another.  Same thing for the coleslaw. I eat a few bites, and ask Dad about his neighbor’s health.

Dad barely gets to the neighbor’s diagnosis, when Mom interrupts his story, “Please pass the sauerkraut.”

I glance over.  Mom’s plate is spotless again.  I pass the sauerkraut.  This time when Mom accepts the bowl, she empties it directly onto her plate.  A quick glance at Dad’s full plate confirms that Mom is far ahead of all of us in lunching speed.

“Please pass the coleslaw,” Mom asks.

Dad passes the bowl and Mom accepts it.  To our surprise, Mom picks up her fork and begins to eat direct from the serving bowl.  When the bowl next meets the tablecloth, it is empty and sparkling clean. I blink my eyes in amazement.

Dad remembers something suddenly.  He jumps up and slips into the kitchen again. Quick as a flash Mom rises from her chair, reaches across the table, and stabs the brat on Dad’s plate.  With a swift and practiced hand, she drops it on her plate. In the time it takes Dad to grab a handful of napkins and return to the table, Mom has eaten every morsel of his entire brat.

Dad returns,  looks at his plate, and then at Mom.  Mom is busy searching the table for something else to eat.  Resigned, Dad picks up his fork and starts in on the remnants of coleslaw, kraut and chips that survive on his plate.

I catch Randy’s eye.  I think we’ve uncovered the secret behind Mom’s weight gain … and Dad’s weight loss.  

Alzheimer’s is a brain disease that is different in every person it touches.  What unusual behaviors has Alzheimer’s brought out in your loved one?   How are you doing in your acceptance that this behavior is simply part of the disease?   How are you handling the reality that behavior changes due to Alzheimer’s are beyond your control?

 

Can clothing choices can impact a Loved One’s health?

ALZHEIMER’S, YOUR PARENTS AND THEIR CLOTHES


Mom walks out of my guest room dressed for Christmas Eve service.  She’s wearing a big smile.  And her favorite red summer dress.  It’s 30 degrees outside.

“Who made this wardrobe choice?” I wonder.  Dad says that Mom chose the dress herself. 

During the service, the church heat kicks on, and the temperature rises to beach conditions. As I fan myself, the congregation stands for prayer.  Suddenly, Mom leans on me.  Heavily.  Then she crumples. Mom? Mom! What is happening?  My heart stops.

As I panic a young man from the congregation rushes over to help.  He’s a paramedic he tells me, and before I know it, he revives Mom.  Mom is perspiring heavily, so the paramedic and I each take an arm and walk her into the narthex.  Together we help Mom out of the linen jacket of her dress.  I search for something else that I can to remove to cool her off.  Then I see the insulated undershirt I gave her four years ago.  Mom is wearing it under her summer dress.  I guess this wardrobe choice was Mom’s, too.

It occurs to me that my Dad has yet to ever dress a woman for Christmas Eve church service.  Even if he had, he is impervious to weather –  cold, heat, rain, snow it is all the same to him..  I remember Dad getting in the car for church when I was a child.  Snow a foot high. Me shivering in the back seat, watching my breath.  Dad wearing just his Sunday suit.  I wonder, does Dad even know that women have different summer and winter wardrobes?  Can he tell the difference between a summer dress and a winter dress?  Has he ever heard of “layering”?

Before bed, I consider what I can do to help.  Maybe I just need to rotate Mom’s clothes twice a year like I do mine.  I can make sure that her closet only has clothes that fit, are in good condition and are the right weight for the season.  This way, whoever makes the wardrobe choices, chances are good Mom will be wearing something seasonally appropriate.

What wardrobe or fashion challenges has your Alzheimer’s Caregiver experienced with your Alzheimer’s Loved One?  What suggestions do you have for helping Alzheimer’s Caregivers make appropriate clothing choices?

We try to outsmart Alzheimer’s

ALZHEIMER’S, YOUR PARENTS AND THEIR NEW REALITIES


“You’re not going to believe this,” Dad tells me, with a half-smile. “This morning, your Mom hands me the ring and says, ‘I found this on my dresser.’”

Dad and I had hoped that, just once, Mom’s spotty memory would work in our favor. 

I have an idea as to where this is going. “What did you say?” I ask him.

 “I said, ‘That’s your ring, Chris.’”

“And?”

“And she looked me straight in the eye and said, ‘NO. No it’s not.’ Then she stuffed the ring into my hand and walked away.”

“You’re kidding.”

“Nope. Turns out your Mom really can tell the difference between her real wedding ring and the fake.”

I’m taking this all in with a strange blend of curiosity and amusement. “Are you going to give her real ring back?”

“Heck no,” he shoots back. “If Chris has it, it will no doubt end up behind the toilet or in the kitchen sink again. It needs to be safe – safer than that.”

Mom’s wedding ring holds a lot of memories for Dad.  The many times it has been found in unlikely places has moved him to consider ways to take special care with it.  That’s when the idea of a replacement ring came up.

“Anyway, thanks for buying it for me, Barbara.”

“Well, it was worth a try, Dad.”

Was this escapade Dad’s idea or mine?  It hardly matters. It’s like asking if the crazy bit came from Lucy or Ricky – it’s comedy all the same. And I’m Dad’s sidekick in our little slapstick hijinx show. 

What madcap capers have you and your Alzheimer’s Caregiver found yourselves caught up in, all in the name of doing something kind for your Alzheimer’s Loved One? 

Finding a good time to chat with your Caregiver

ALZHEIMER’S, YOUR PARENTS AND THEIR CLOTHING


“Your blue eyes look so pretty when you wear this blouse, Hon.” Dad sweet-talks Mom as I wait on the phone.

“These clothes are fine.” replies Mom

“Honey, it’s laundry day.  Time to give this outfit a bath,” Dad teases.

“I wore this to bed, so it’s already clean.  Just leave me alone,” says Mom.  I hear her footsteps, loud at first, then fading as she walks away.

“Dad? Are you there?,” I ask.

“Oh for goodness sake!,” Dad snaps. “The oatmeal is burning.” I hear the click of the stove dial and the clang of the pot. “Look, I’ve got to go,” Dad says.

“I love you Dad. Talk to you soon.”

“Bye.”

I glance at the notes on my computer screen.  Today I wanted to continue our conversation about visiting the local Adult Day Program with Mom. Three years of notes on just this subject stare back at me on the screen.  Three years of phone calls with the Director, three years of planning.

Clearly, I need to put even more effort into finding a good time to have this conversation with Dad.

Does it require a lot of effort to find the right time for the important discussions you need to have with your Caregiver?  When there are only so many opportunities to be with a Caregiver in person, the list of critical conversations grows. 

The process of elimination helps. During meal preparation, meal time, and meal cleanup remember that your Caregiver is juggling chores and Caregiving, so they are twice as busy.  Try to call afterward.  Perhaps they take walks or naps every day.  Respect that.  Show your support and love for your Caregiver by putting effort into finding a good time for them to have the conversations that need to happen. 

When can your Caregiver be present for a conversation?