Resistance and Seniors: A Care Manager’s Tale

Resistance and Seniors: A Care Manager’s Tale

Like in the childhood game, “telephone,” the first call came from the neighbor across the street, who called the son in Texas who, in turn, called his sister in New Mexico, who, in turn, called me, the eldercare consultant in New Rochelle.

It seems the neighbor across the street observed their eighty-two-year-old mother taking her garbage to the curb. How, she inquired of the son, could he and his sister be so neglectful, not her words exactly, it was more the tone of her voice. I imagine, the neighbor was trying to be helpful. Given the adult children’s geographic distance, perhaps she thought they were not aware of what was taking place during these thrice weekly jaunts to the curb. The truth be known, the son and daughter had been trying, unsuccessfully, for over a year to persuade their mother to just give a companion a try. Just a try.

Despite hints of early dementia, the mother was readily able to reiterate to her children all the reasons for not wanting anyone coming to her house. To start, she was not having difficulty managing on her own. Regarding her shopping needs, what she was not able to pick up in the supermarket, there was a COVID volunteer from her local church she could count on. A companion would interfere with her privacy. Hinging on that, she had her sentimental belongings throughout the house, and she was certain they would disappear within a week of the companion’s arrival. And so, it was with this background that a daughter, undaunted by her mother’s past refusals, called this eldercare consultant, confident that what she and her brother were unable to do, I could accomplish.

With the weight of the adult children and the neighbor accompanying me to her house, I met with the mother. She was welcoming and showed me around her home. I was slightly suspicious. Tours usually come after a client gets to know me. Perhaps the unsolicited tour was to make a point about her capabilities or maybe she was just being hospitable. With the sightseeing out of the way, we got down to the reason for my visit. Mom was well rehearsed. She conveyed to me all the same reasons she had shared with her children.

This type of resistance is not unusual, as an eldercare consultant I have come across it repeatedly. The mother recognized that accepting help brings with it relinquishing privacy and adjusting to a new routine. She saw it as a sign of weakness to acquiesce. What she was indifferent to, was a little bit of help could go a long way to ensuring her continued safety and longevity in her home.

While empathizing with each of the mother’s reasons for refusing help, I used one of my tried-and-true strategies. “Give it a try, just for a few weeks,” Not a budge. “How about if you think about it?” I asked. Affirmative. And with that I said I would give her a call in a few weeks.

“I’m happy you didn’t forget about me,” she said two weeks later. In the same breath, she said she would be in touch with me when the time was right. Will the time ever be right I thought to myself? Or will the next call be from the daughter, all her mother’s excuses banished, replaced with an urgent request for help.

Making Your Bed and Other Strategies for Lessening Caregiver Stress

Making Your Bed and Other Strategies for Lessening Caregiver Stress

Covid-19 has thrust many of us into new or expanding caregiving roles. Medication management, arranging doctors’ appointments virtual and otherwise, making sure a senior is eating more than tea and crackers, and doing our best to ensure our elders feel connected in a world where quarantine and isolation have been the keywords of these last nine months.

Alongside these caregiving responsibilities, we have family and work commitments and, yes, an obligation to keep ourselves healthy. While the initial reports are promising for vaccines, we are still awaiting that GPS to give us clear and consistent direction.  While waiting for those directions to appear, I would like to share five strategies to help you, the caregiver, lessen the stress that accompanies the increased role you may be assuming:

  • Accept the feelings that come with this time. Your anxiety doesn’t have to control you when everything around you feels so uncertain. Focus on what you can control: you, your thoughts, your actions. Speak with those friends who offer you reassurance and comfort and let the other incoming calls go to voice mail, especially when those unsolicited advice-givers are on the other end.
  • Have an emergency contingency plan. Try to organize what the National Alliance of Caregiving calls a “care squad” or simply a caring support team that can help in the care of a loved one in the event you become ill. Identify trusted people who can provide help such as bringing over groceries, picking up medications, offering technical guidance for virtual doctors’ appointments, and making those all-important outreach calls to a parent.
  • Practice self-talk. Remind yourself that you have coped with difficult situations before and think back to how you handled them. Re-discover that strength and confidence. Extend to yourself the empathy that you would impart to a friend in need.
  • Stay in the present, ask yourself: “What do I have to deal with right now?” “What can I control right now?” Think about all the times you worried about the future and the outcome was not as dismal as you imagined it would be.
  • Stick to a routine. As Gretchen Rubin speaks of in her book The Happiness Project, start your day by making your bed. You may say why do that, I’m just going to unmake it at night? Making your bed sets the tone for the day, it takes little effort and goes a long way in making order out of chaos. Holding on to a routine brings a sense of normalcy during very abnormal times.

Finally, some years ago at a tag sale, I picked up a small 4X4 framed piece of embroidered needlework, never knowing how relevant it would be for these times. It reads: “Long is Not Forever.”  I hope you will hold on to those words as I do.

Putting Pen to Paper in the Time of COVID-19

Putting Pen to Paper in the Time of COVID-19

To write a letter is human, to receive a letter, divine
—Susan Lendroth

Four years ago, I downsized. Living in an apartment house, I am now part of a community, not a formal one, but one with a passing hello in the lobby or weather conversation in the elevator. However, it was my relationship with our fifth-floor neighbor that went beyond the hello and the weather. Meg was of an earlier generation, there was no computer in her home and only the most basic of cell phones. In lieu of these items were plenty of paper and pen.

Given the generational gap, Meg was a woman of notes. Invariably, they would be slipped under our kitchen door. They varied in nature, telling us she would be visiting family, wishing us a happy Thanksgiving or my favorite, letting me know how much she enjoyed looking at my hanging geraniums that she could see from her living room window. In our three years as neighbors, I left my computer and iPhone behind. From my side of the hallway, it was a note thanking her for taking in our newspapers or a holiday card with an accompanying note. There was something so special about our across the hall communication. These notes were acts of thoughtfulness. Sometimes on a random piece of paper or other times on a real piece of stationery, especially when Meg’s birthday rolled around. The common characteristic that each of our exchanged notes shared was gratitude.

As much as I delighted in having Meg across the hall, I knew that a woman approaching her ninetieth birthday with an array of minor health problems, should not be living alone. Her children, also knew this. Meg would tell me in her soft voice, that while she understood the logic of a move to assisted living, she was saddened to leave her beloved New Rochelle where she was born and raised her family. Inevitably, acceptance trumped resistance. We had said our good-byes many times, voicing how fortunate we both were to have each other as neighbors. I returned home one day, the wreath that changed with the season was off Meg’s door and Meg was gone.

In the weeks following Meg’s move, I sent a note, bringing her up to date on what was going on with my family and inquiring about how she was doing. In return, I received a lovely card from Meg. A few brief sentences, with her ever-thoughtful sentiments.

Quoting Phyllis Theroux, a writer based in California: “to write a letter is a good way to go somewhere without moving anything but your heart.” In these times of COVID-19, where going anywhere is done with an abundance of caution or not at all, a note not only moves the heart but let’s those we care about know they are remembered.

Social Distancing-Social Engagement in the Age of Covid-19: What We Can Do

Social Distancing-Social Engagement in the Age of Covid-19: What We Can Do

I live in New Rochelle, New York, a city whose fame is rooted in the Petrie’s of The Dick Van Dyke show. That image of a suburban family living on a quiet tree-lined street changed dramatically on March 10. New Rochelle became the first COVID-19 containment area in the United States.

On that date, I was visiting a client. Twenty minutes into my visit, the governor made his announcement. Although I felt fine, after checking with the caregivers to make sure food and medications were in good supply I left. Not yet knowing what a containment area meant, I shamefully headed to the supermarket, one thirty minutes away from the city where I have lived and shopped for forty years.

For people over 60, of which I am one, the instructions, even before this declaration, was to stay home. I had not taken the directive seriously. But the time had come. So instead of home visits, the telephone has become my link to clients. My weekly tutoring sessions at a local elementary school stopped. The library where I volunteer closed. My world had narrowed. Like the icon I tap when I take that occasional selfie, I now had to reverse my focus, making sure that my social engagement trumped my social distancing.

So, what have I learned that we can all practice and share with adult seniors? First, is the heightened importance of staying in touch. Communication whether it be by phone, emails or the use of video conferencing is paramount. But sadly, the oldest of the old are the least technologically savvy. This is where letters, especially with a photo enclosed, and cards and drawings from grandchildren will go a long way. Also, contacting a senior’s house of worship can result in congregants phoning members to fill the void created by COVID-19. Local aging in place organizations have volunteers who are also calling community members.

Beyond communication, the significance of a daily routine is important. For older adults who were going to senior centers or adult day programs, their regular schedule has been disrupted. Taking a walk has both mental and physical benefits. Combining this with in-home activities such as watching The National Park Virtual Tours or The Georgia Aquarium Live Cams can lessen the isolation and provide mental stimulation.

Is there a “What not to do?” Definitely. Dr. Laurie Archbald-Panno a geriatrician at the University of Virginia suggests a “news diet.” One news viewing in the morning and one in the evening. That’s it.

Our seniors have seen much in their lifetimes. They have lived through wars, TB and Polio epidemics and some, the Great Depression. Our government has assured us that at some point the COVID-19 virus will pass. But who better to give us this reassurance than our true survivors, our seniors. Let’s help them as they help us.